For decades, employers have been fed a lie: “There’s nothing you can do to control healthcare costs.” This couldn’t be further from the truth. The system is doing exactly what it was designed to do—profit off of HR, CFOs, and CEOs who believe that lie year after year.With 180 million Americans relying on employer-sponsored healthcare, it’s time to challenge the status quo. The Business of Benefits is your No BS, No Sales guide to the real solutions. No gimmicks—just the truth about how to take control, transform your benefits, and care for your most valuable asset: your people.Each episode dives deep into the data, exposing industry misalignments and inefficiencies that inflate costs while offering actionable strategies for designing financially sustainable, high-value benefits.Through eye-opening interviews with industry insiders, expert analysis, and real-world success stories, hosts Donovan and Chelsea pull back the curtain on the hidden flaws in the healthcare system. The result? An empowering roadmap for employers ready to break free from outdated models and unlock smarter, more sustainable benefits.If you’re tired of the same old sales pitch and ready to rethink benefits, reduce costs, and improve care—this podcast is for you. The truth is out there—are you ready to hear it?
87. Health & Welfare Plan Practices Part 1: Tactics or Tricks - Dirty or Dumb?
Every year the IRS puts out a memo called the "Dirty Dozen": a list of legal tax structures and processes that people are abusing. They're legitimate tools used the wrong way, and the memo flags them so people can get their house in order and know where the IRS plans to focus enforcement.
Donovan Ryckis applied the same concept to benefits. Twelve tactics Ethos is seeing in the market that are legitimate on paper but get abused in practice. This isn't happening everywhere, but almost any plan sponsor could probably find one or two of these in their plan, if not a lot more.
This is Part 1, tactics 12 through 7, with Donovan Ryckis (Co-Founder & CEO), Chelsea Ryckis (Founder & President) and Patrick Ansara (Director of Client Operations). Every tactic gets the same treatment: the tell, the damage in dollars, an honest look at whether there's a fair explanation, the fix, and then the verdict. Is it dirty, or is it just dumb?
What's covered: PMPM instead of PEPM, one letter that multiplies your fees 2.4 times. Contracts that quietly stop matching the proposal. Undisclosed equity between advisors and the carriers they recommend, and the 408 disclosure you're entitled to. PBM collectives, including a reprice study that came back $1.4 million better on a $9 million claim spend. Captives used as a broker's easy button. And the controlled market check, where you go to market and somehow land on the incumbent every year.
Built for mid-market and large-market plan sponsors. Part 2 counts down tactics 6 through 1.
Time Stamps
00:00 – Cold open
00:38 – Welcome to The Business of Benefits
01:01 – Where the benefits Dirty Dozen came from
02:31 – Meet Patrick Ansara
03:31 – How we grade each tactic: dirty or dumb?
04:25 – Tactic 12: PMPM instead of PEPM
11:54 – Tactic 11: The contract doesn't match the proposal
22:56 – Tactic 10: Undisclosed equity and ownership interests
30:36 – Tactic 9: PBM purchasing collectives and coalitions
37:42 – A word from Fiduciary in a Box
38:30 – Tactic 8: Captives as the broker's easy button
48:21 – Tactic 7: The controlled market check
1:03:09 – What's coming in Part 2
1:03:51 – This isn't broker bashing
1:05:43 – An industry that pays well for mediocrity
1:06:58 – Final thoughts
Ethos Benefits: https://ethosbenefits.com (https://ethosbenefits.com)
Podcast: https://businessofbenefitspodcast.com (https://businessofbenefitspodcast.com)
Apple Podcasts: https://podcasts.apple.com/us/podcast/the-business-of-benefits-podcast/id1724134305 (https://podcasts.apple.com/us/podcast/the-business-of-benefits-podcast/id1724134305)
LinkedIn: https://www.linkedin.com/company/ethosbenefits (https://www.linkedin.com/company/ethosbenefits)
Donovan Ryckis: https://www.linkedin.com/in/donovanryckis/ (https://www.linkedin.com/in/donovanryckis/)
Chelsea Ryckis: https://www.linkedin.com/in/chelsea-ryckis-8508a192/ (https://www.linkedin.com/in/chelsea-ryckis-8508a192/)
Patrick Ansara: https://www.linkedin.com/in/patrickansara/ (https://www.linkedin.com/in/patrickansara/)
FROM OUR SPONSOR
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Managing a health or retirement plan takes time, oversight, and judgment. Fiduciary In A Box documents your governance, vendor oversight, and committee decisions in one secure platform, so your...
10 Sept 2026
86. Movements, Not Memberships: Rethinking Employer Health Coalitions
Host Chelsea Ryckis interviews Karen van Caulil, Ph.D., President and CEO of the Florida Alliance for Healthcare Value, about how employers build healthcare purchasing power through coalitions.
27 Aug 2026
85. Charity Dollars, Real Savings: Rethinking Your Highest-Dollar Claimants w/ Brett Morris
Host Chelsea Ryckis interviews Brett Morris, Founder and CEO of the Samaritan Fund Program, about how charitable funding can offset high-cost claimants and reduce employer renewal increases.
Who has been a guest on Ethos Effect
Names identified in recent episode analyses. Showing up to five guests.
Karen van Caulil
Brett Morris
Rachel Strauss
Bryan Orr
Stephanie Porrino
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YouTube views
109,901
Score snapshot 15 Sept 2025
Apple Podcasts (US)
5.0 / 5
13 ratings
Spotify
5.0 / 5
5 ratings
Podcast Authority Score: 67 / 100
A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.
Quality
71
Social presence
0
YouTube
82
Engagement
77
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