# 66. Self-Funding Explained in 60 MINUTES with Spencer Smith

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Text version: https://stenobird.com/podcast/the-business-of-benefits-podcast-6744252/66-self-funding-explained-in-60-minutes-with-spencer-smith.md
Podcast: [The Business of Benefits Podcast](https://stenobird.com/podcast/the-business-of-benefits-podcast-6744252)
Published: 2025-12-04T15:48:00+00:00
Episode link: https://www.spreaker.com/episode/66-self-funding-explained-in-60-minutes-with-spencer-smith--68549292
Audio file: https://api.spreaker.com/download/episode/68549292/episode_66_spencer_smith_full_episode.mp3
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Duration seconds: 2721

## Resource

In this episode, Donovan Ryckis, CEO of Ethos Benefits, sits down with Spencer Smith (SVP of Sales at Pareto Health and host of Self-Funded with Spencer) to unpack captives, stop-loss, PBMs, and the steps plan sponsors can take to finally regain control of healthcare spend. Spencer shares how short, educational content helped bring self-funding concepts downstream, why captives act like “bumpers” against catastrophic renewals, and where employers should start: data access, pharmacy, and a long-term strategy. They cover real-world examples—NICU and oncology claims, lasers, biosimilars, international sourcing—and discuss why employee contributions keep rising when nothing seems to change. You’ll walk away with a framework to move from guaranteed cost to variable cost with discipline, reduce claims costs without cutting benefits, and ask your broker the questions that matter. What You’ll Learn: Self-funded fundamentals and the role of stop-loss How group captives improve predictability across renewals The first lever to pull: pharmacy strategy and data access Why “reduce claims” means smarter pricing and site-of-care, not less care Three questions every plan sponsor should ask at renewal: Why these solutions, specifically? How are you paid, where, and how often? What’s the long-term strategy beyond this 12-month cycle? POSIWID: the outcomes your system delivers define its true purpose Time Stamps: 00:00 – Welcome & Guest Introduction 02:10 – Spencer’s Journey into Self-Funding 06:20 – Breaking Down Stop-Loss & Captives 10:45 – Fully Insured vs Self-Funded Explained 15:12 – The 401(k) Analogy for Health Plans 19:20 – Why Short-Form Education Works in Benefits 24:05 – Pharmacy Costs & Where to Start Saving 28:48 – Broker Incentives and Transparency 34:32 – Data…

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