The Benefits Playbook

The Basics of Healthcare with Michael Caussin, Licensed Health Advisor

Episode Summary

This episode features an interview with Michael Caussin, former NFL tight end and New York Times bestselling author. Mike became a licensed health advisor in 2023 and helps individuals and families find the health coverage they need. In this episode, Sasha and Mike get back to the basics of healthcare. They discuss why healthcare education is so important, how to navigate life events, and what people don’t know about coverage options.

Episode Notes

This episode features an interview with Michael Caussin, former NFL tight end and New York Times bestselling author. Mike became a licensed health advisor in 2023 and helps individuals and families find the health coverage they need.

In this episode, Sasha and Mike get back to the basics of healthcare. They discuss why healthcare education is so important, how to navigate life events, and what people don’t know about coverage options.

-------

“I want to be an asset to people in whatever I'm doing in my life. Let me teach everyone that's watching or following the simple basics of your day-to-day coverage. I've gotten much more positive feedback than I ever imagined of people commenting or messaging me on how helpful it's been. Which obviously for anyone, it's validating to get that reassurance that you're actually helping somebody.” – Michael Caussin

-------

Episode Timestamps:

*(01:15): Mike’s career background 

*(07:27): How Mike uses his Instagram to educate people

*(11:45): Mike’s advising process

*(18:49): How Mike helps people navigate life events

*(27:24): How Mike improves member experience

*(32:48): Mike’s advice for those new to the industry

-------

Links:

Follow Mike on Instagram

Connect with Mike on LinkedIn

Connect with Sasha on LinkedIn

Learn more about Collective Health

Episode Transcription

Sasha Yamaguchi: Let's face it, healthcare is confusing and costs are continuing to rise. Employers are looking for ways to improve the health of their people and their bottom lines. The good news? Many leading companies are leveraging self funded health plans and innovative benefit solutions to do just that. Learn from some of the best minds in employee health.

Sasha Yamaguchi: Welcome to the Benefits Playbook, Strategies for Self-Funded Health Plans. I'm your host, Sasha Yamaguchi, Commercial Leader at Collective Health. On today's episode, we are joined by Mike Caussin. You might recognize him from his five year NFL career as a tight end for the Jaguars, Bills, and Washington.

Sasha Yamaguchi: Today, Mike is a Licensed Health Advisor helping individuals and families find the healthcare that they need. Thanks for being with us today, Mike. Can't wait to talk about this transition of yours. 

Michael Caussin: Thanks, Sasha. Thanks for having me. I appreciate it.

Sasha Yamaguchi: Great. So, I think it's really interesting to have somebody that went from the NFL into healthcare.

Sasha Yamaguchi: So I think everyone listening is going to be very interested of how you made that change and what led you to that. So I'd love to start with your career journey. As I mentioned, you played in the NFL for five years. You've also co hosted a podcast and wrote a book with your ex wife, Jana. Now, you've chosen to help individuals with navigating this industry that we're in.

Sasha Yamaguchi: We would all love to hear, why did you get into healthcare? Like, what led you to that? 

Michael Caussin: For sure, I appreciate it. Yeah, so as you said, you know, spent five years, fortunate to, to spend those years in the NFL and At the end of that, met Jana, my ex wife, and did a few things after that. And then once we started, we did a podcast together and wrote the book and everything.

Michael Caussin: And that kind of started the trend of post football careers, where kind of the similarities through whether it's podcasting or writing the book was helping people in some kind of facet. Like our podcast was relationship based. We were very open, very vulnerable about highs and lows in our marriage. And everything like that.

Michael Caussin: And now that we're divorced, we co parent very well. We're great friends and just better friends than we were spouses. And so that kind of was ingrained in my mindset to be like, okay, I need to find something to help somebody in some capacity. I can't just, I did medical sales years ago, like before I did the podcast with Jana and everything.

Michael Caussin: And that was good. I enjoyed parts of it. And even in that you're an asset in some kind of capacity. So that's part of why I enjoyed it. So that was the trend that I was trying to find. So that's kind of, I mean, falling into healthcare wasn't something where I was like, Oh yeah, healthcare is going to be the thing, you know, I, if you had told me that at 36 years old, I'll be doing this and enjoy it, I'd be like, there's no way, you know, who enjoys healthcare?

Michael Caussin: But I found my home here and I love it. 

Sasha Yamaguchi: I love that you say that because you fit right in with those of us that have been doing it for a while. I've been in healthcare for about 25 years and then the joke that we all say when we're sitting around the dinner table or in meetings is, you know, how many of us chose healthcare?

Sasha Yamaguchi: But it is, it's a great industry and helping people, helping clients, helping our broker partners, whatever it is, you know, it's such. A need for people to understand what they have available and how to access it. So that's really interesting to hear how, you know, you didn't know that you would be doing it, but now you love it.

Sasha Yamaguchi: So I think that's great. For sure. Thank you. So I am curious, being new to the industry a little over a year, what's your impression? What have you learned? And then, of course, I want to talk in a little bit about how you're helping people through social media. But what's just your first impression your first year in? 

Michael Caussin: It's funny because it's one of those careers and you can probably attest to this, Sasha, where it's like, even after a few months in, you feel like you've been in for years, just from your, the amount of knowledge that you obtain and learn in those early months in that first year is significant.

Michael Caussin: And so, I mean, the first couple of months, obviously just like any new career, it's training and learning, but it's again. We all hear the terminologies of healthcare deductibles and co-insurance and copays and PPOs and HMOs, but no one really knows what it means. And I was one of those, I mean, I came from the NFL and it's, it's one of those things, you get spoiled because things are just taken care of for you when it comes to the health and our insurance is incredible.

Michael Caussin: So I never really paid attention to any of that. Until I got into this business. So a lot of it at the beginning was learning what all of those terms meant and how they're implied and everything. So that was the first part, but then just learning the whole system in its entirety from, you know, employer plans to government, to private.

Michael Caussin: And just kind of how the wheel works has been fascinating. 

Sasha Yamaguchi: Interesting. Yeah. And I think that's a great point because a lot of people have really good healthcare plans through the NFL, through wherever, and you know, you have people helping you with it, but it is good to eventually learn exactly how it works, how to access your benefits, you know, where you can take.

Sasha Yamaguchi: Advantage of your plan and get the most out of it. So I think that's a really interesting insight. Is there anything that surprised you the most that as you've been learning or helping people or, you know, talking about benefits, is there anything that you were like, wow, I had no idea it worked that way or people should know more about this?

Sasha Yamaguchi: Was there one or two things that really stuck out over the last year? 

Michael Caussin: That's a really good question. I would have to say just how it all works and. How much control, you know, we feel helpless where we feel like we're in this box of like, we just have to have our employer coverage or we have to have the government coverage.

Michael Caussin: You know, it used to be called Obamacare. Now it's ACA, where people just kind of go with what the man, the government tells them to do when you can take a lot more control and be a smart consumer when it comes to making those decisions and learning how your plan works. And so that's been the biggest thing that probably I've learned is that, Hey, you can be a smart consumer, you can ask the right questions.

Michael Caussin: And we'll get into it with like my social media and stuff. I'm like, Hey, even if you have an employer plan and you're trying to pick which tier of your employer plan to pick, contact me, let's go. Let me dissect it for you. Translate it, ask you the right questions. What are you looking for out of your coverage?

Michael Caussin: What do you need, you know, your necessities, your wants, all of those things, and I'll help you figure out which one to pick.

Sasha Yamaguchi: I think that's great because there can be multiple plan options. There can be tools to help you plug in what you might need, but I love that. What you're doing is you can sit down with, sometimes you just need to sit down with a person, go through the plans with someone that understands it and help make those decisions.

Sasha Yamaguchi: So as I've told you, I always joke to my friends and family and say, you know, I work in healthcare. So the most I can offer you is to help you understand your plans or your EOB. It's not very interesting or exciting, but it is really important. So I think that's great because there's tons of tools out there, but sometimes you just need to.

Sasha Yamaguchi: Talk to somebody that can really break it down, right, in layman's terms, so. You mentioned social media. I think what's really great and what struck us, and why I'm so excited for you to join, is on your Instagram, you legitimately bring it back to basics. So I would love for you to share with everyone, what do you do on Instagram?

Sasha Yamaguchi: I obviously have watched, and I think it's really educational and informational, but tell everyone what you've been doing and how you've kind of brought it back to basics and made it very easy for people to understand. 

Michael Caussin: For sure. So first, like, I've never been a big social media person. This Instagram I just created six to eight months ago, and because after doing this job for a while, I realized how many just simple questions people had, where I would like, maybe fast forward into all the complexities and those things are like, Yeah, okay, you said deductible.

Michael Caussin: But what does that mean? I'm like, Oh, okay, I gotta, I gotta bring it back a notch and not just jump to all of these other things. So. I was like, well, again, I want to be an asset to people and whatever I'm doing in my life. And so I was like, I just need to bring it back to the basics. Like you said, Sasha and

Michael Caussin: I mean, keep it vanilla as I can right now. It's like, let me teach everyone that's watching or following the simple basics of your day to day coverage. And then, as it progresses, I'll get more detailed into choices you have and everything. But, you know, again, that's, I've gotten much more positive feedback than I ever imagined.

Michael Caussin: People commenting or messaging me on how helpful it's been, which obviously for anyone it's validating to get that, that your reassurance that you're actually helping somebody. 

Sasha Yamaguchi: No, I think it's great and for everyone listening, I mean, Mike literally gets on a whiteboard and writes out deductible and what that means.

Sasha Yamaguchi: And I think, again, I've been doing it a long time, sometimes some of us forget. People don't even know what a deductible is. Like you do have to start from like square one and there's so much, especially nowadays being offered and available. I think it's extremely helpful for people. So I think it's a great way to educate.

Michael Caussin: I appreciate it. It's one of those things where even to this day, I'll talk to maybe clients on the phone and I'll start going through things and. I'll even pause when I mention, okay, this plan has a 5, 000 deductible, co insurance, whatever. I was like, do you understand, like, what that means? And I can feel the hesitation in people because it's one of those, we just want to be like, oh, yeah, yeah, yeah, I got it, I got it.

Michael Caussin: 80 percent of people don't really. I'm like, it's okay if you don't. I want to make sure that you understand. And then a lot of them be like, Okay, yeah, I don't really know what that means. I'm like, okay, let me break it down. So it's just like, we're just, we naturally just kind of want to say that to, I don't know, you know, to fit in or not feel stupid or dumb.

Michael Caussin: Like we, you know, we're grown adults, but we don't know what a deductible is. Most people don't, and it's okay. But it's having that person, having someone to ask those questions to is just It can be extremely beneficial. 

Sasha Yamaguchi: Now, I think that's great. I think, as I was listening, it's true. People are not going to willingly, even, so think about a big open enrollment meeting, nobody is going to raise their hand and go, can you explain a deductible?

Sasha Yamaguchi: Especially, right, young people coming off their parents plan, and it's the first time they're accessing healthcare. So, yeah. As you're saying all of this, I'm thinking, and for employers listening sometimes, and maybe it's important to build in like basics 101 and just educate from square one, because I can't remember last time I was at a meeting where someone admitted, Hey, I don't really know how that works.

Michael Caussin: Well, and that's the problem with it, right? Because these bigger companies and not a knock on them, because bigger companies. More or less have historically better coverage, superior, the best coverage that you can get. But that's what they do. They do a big meeting like that. They'll have however many employees in there.

Michael Caussin: All right. This is what your options are. The A, B, and C. Any questions? No. Okay. We're good. And then people get, they're like, I don't even know how to use this. They're shy. Yay. I got benefits, but I don't know what it means. 

Sasha Yamaguchi: Yeah, no, I think that's a great point. Again, back to basics sometimes is the best thing we can all do.

Sasha Yamaguchi: So you touched on this for a sec, but I would love for you to spend more time. What is your advising process like? So you have someone new reaching out after this podcast airs, you get a phone call and someone's like, help me, Mike, what does that look like? And maybe just share a little bit about how you've been helping people and give a couple of examples.

Michael Caussin: I start every phone call or meeting the same, whether it's a referral from a friend or current client, whether it's someone on Instagram, or whether it's a lead that I purchase and get into my system. I say, you know, Hey, how you doing? I'm Mike. Tell me a little bit about your situation. Right? And some people look at it as sales.

Michael Caussin: I don't consider myself an insurance salesman. And even the people on the other end think I'm trying to sell them something like I'm not selling you anything. I want to know about your situation. I'm going to ask the right questions, learn more about what your needs are. Why are you looking for coverage?

Michael Caussin: Did you lose coverage? Did you get laid off? Are you self employed and you're looking for something? You don't like your current coverage? What is it? So then I can find the thing that can grant some remedy in whatever those issues are. So I'm truly an advisor. And sometimes I can't help people in terms of maybe the specific private marketplace plans that I offer that, yes, if you sign up with those particular plans, do I get commission?

Michael Caussin: Absolutely. That's my job. But again, if there's something else that fits your needs better, then I'm going to, I'm going to steer you in the right direction. So that's a big part of it is just asking the right questions, understanding what they're needing. And I get a wide variety of reasons on why people are looking.

Michael Caussin: It's not just. Uh, aged out of my parents plan. Uh, just got laid off. You know, those are the pretty, pretty easy, simple ones. A lot, I'm getting more and more. I think we can all agree that the days are kind of gone of like. The boomer Gen X generation where it's like, Hey, you get a job for 30 years, you get a job with benefits and get a 30 year fixed rate mortgage and you'd live in, retire, and then you die.

Sasha Yamaguchi: Start a 401k from day one.

Michael Caussin: Right. Like my parents, like that was their mentality. It always kind of said to me and I'm the middle child, so I've always kind of done everything backwards, but it's, it's become such a more entrepreneurial society, right? And a lot more ways for people to earn a living and everything on their own.

Michael Caussin: So whether it's people just becoming self-employed, leaving their employer because they want to work for themselves, or even people who are on current employer plans, I need something better. 

Sasha Yamaguchi: Well I think that's great and one thing you hit on that we've talked about is entrepreneurial. I think a lot of people want to go out and start their own business or you know do something on their own and be creative and I feel like and I would love for you to kind of expand on this learning what's available because I think a lot of people are, I want to get out of corporate America, I want to start my own business but oh my gosh I won't have insurance or I won't have benefits.

Sasha Yamaguchi: I feel like helping and educating people gives them confidence in maybe taking that leap. I, I'm just curious your thoughts on that and if you feel that that helps just having those options. 

Michael Caussin: It definitely does. And for those people that I talk to that, yes, I left my employer, but I need to find coverage.

Michael Caussin: I'm like, okay, great. Outside of your traditional employer coverage. There's two directions that you can go. You have the public marketplace and the private marketplace. And this is everything I say when I'm sitting here talking to people. I say the public marketplace, those are your government and state based plans.

Michael Caussin: They're income based. They're, what I like to say is that they're available to everyone, but they're not for everyone. The reason I say that is because there's two groups of people that those plans really benefit the most. Those who may have pre existing conditions, are generally more unhealthy, take a lot of Just more health complications or those who may be living below the poverty line and qualify for tax subsidies.

Michael Caussin: If you're in one of those two groups, then great. Government plans are fantastic for you because they accept all pre existing conditions. You can qualify for tax subsidies, get very, very cheap, maybe even free healthcare. So that's great. But for the rest of those people that are in the middle make a comfortable living, decent living or great living or generally healthier, the people that are like, I never go to the doctor.

Michael Caussin: That's where I would steer towards the private marketplace. Those plans are health based, so they're medically underwritten and the analogy I use is kind of like a car insurance, right? You get car insurance, they look at your driving record, you have a better driving record, less accidents, less tickets.

Michael Caussin: That's where They're like, okay, Sasha, you're less of a liability to insure, so we're going to give you lower rates. It's the same kind of model, but from a health standpoint, like, oh, Sasha, we see your medical history here. We're looking at the last five to seven years. There's not much going on. So because of that reason, we're going to give you lower rates, better benefits and more upfront benefits before having to satisfy a deductible.

Sasha Yamaguchi: So on that point, it made me think of something. Have you worked or had people come to you? Because I feel like this is very common. Oh my gosh, I had to pay 100 for a prescription, right? Have you had those situations yet where you're like, well, hold on. Yes, a hundred dollars seems like a lot, but let me tell you how much it actually is.

Sasha Yamaguchi: Have you kind of dove into that with any of your clients? Because I feel like that's the biggest thing I hear is, you know, trying to help people understand that. Yes, it feels like it's a lot, but educating them on the back end of how much is actually going on. And I am curious, like, have you had those situations?

Sasha Yamaguchi: How have you handled them?

Michael Caussin: Yes, and I know you've handled them even more significantly than I have, but it's in trying to explain to people, I'm like, Hey, let's play the numbers game here. And I'll sit there and just do the math with them. I'm like, all right, so say on the plan that you were on, what this would have been, do the math over the course of.

Michael Caussin: Even one month or a couple of months of the whole year versus this plan and what it would have been, all this stuff. And so when I break it down the numbers and for those people who are patient enough to actually think in that way, it's black and white, it's complete sense. It makes total sense. But as you know, probably better than I do is that people think of right now, like, yeah, but right now I'm paying this.

Michael Caussin: I'm like, okay, if you're worried about right now, that's fine. But guess what? If you want that, you're going to be paying five times as much at the end of the year. So, what do you want to do? You can't, you know, people come in and I talk to them, they're like, yeah, well, I want, you know, free healthcare. Well, you don't qualify for free healthcare.

Michael Caussin: We all want free healthcare. It'd be great, but that's not how it works. 

Sasha Yamaguchi: Now, those are always the complex, I will say, conversations. So I think a big thing I would love to hear, because I'm guessing you've helped people with this and you went through it personally, is life events, right? So maybe there's a couple that's separated, or like you've mentioned a few times, you've lost your job.

Sasha Yamaguchi: How have you helped people and what are your thoughts on just helping them navigate? What was your own experience? Because I, I mean, I feel like that's a big part of a life event is. How does the healthcare part of it work? 

Michael Caussin: Yeah, I mean, that's a great point because when I was married, I was vested from the NFL, so we were able to have up my NFL insurance for the five years after I retired.

Michael Caussin: So we had both the kids on it and it was great and all that. And then once that lapsed, then we got onto Jana's coverage through SAG. And so I never really had to deal with that because even like, you know, I got into the NFL insurance before I ever aged out of my parents. So it was just, there's always something there I transitioned into and never had to pay.

Michael Caussin: Any mind to it. So then we get divorced and it kind of came up while I was going through things with my chair. I'm like, oh wait, I could, yeah. And so that was one of those things that I had to go through. And so when I do your point, when I, or your question, when I talk to people now, I just talked to a client this past week.

Michael Caussin: He's like, hey, I'm going through a divorce. Things will be final probably in the next month or so. I just want to see what my options are. I was like, dude, I get it. And he was around my age. I was like. I did this three years ago. Let me ask some questions about, you know, kind of what you need, what you're looking for and all that stuff.

Michael Caussin: But just let me put, give you peace of mind that we have options, affordable options, you're going to be good. You're gonna be taken care of. So I want you to be able to take that off your plate. Do you sense the relief of people like, okay, because a lot of people, again, they don't know, like he was getting an insurance through her employer.

Michael Caussin: Right. And so. They never really pay attention because they just took it out of her paycheck. So a lot of people just don't know what it's going to cost. So it is nice to be able to help those people transition from those things. And young kids that I get transitioning out of their parents plan, whether it's them calling themselves or their parents calling for them.

Michael Caussin: I have an appointment tomorrow with a mother and a son because he's aging out next month of his plan. But those are the moments I really, really enjoy because they just, they don't know what to do. And I'm like. I do have answers for you. 

Sasha Yamaguchi: That is so great. And as you're saying that, so I work at Collective and the reason we founded our company was member experience, so members that are on their employer's plan.

Sasha Yamaguchi: And as you're saying that, I immediately thought our industry has done so much to try to allow anybody accessing healthcare a good, a great experience, right? Like, we want you to be able to have access. Easy to access, easy to understand, and as you're saying this with the mother and the son, it's like we, for employers, want to give the best member experience we can for our clients, for their employees, and I just feel like what you just said completely ties to like, we're doing this at an employer level, and you are literally doing it at an individual level, like a mother and a son going through something Yes, she may have an employer plan or he, but you're literally helping people have a great experience, even when they're on their own.

Sasha Yamaguchi: And I just, I don't know, that just hit me. And I think it's. Just fantastic what you're doing, really. 

Michael Caussin: I appreciate it. And that's as much of a pain as any job or career can be. It's those moments when I'm able to help somebody or people that I helped. They're like, we didn't even know this private market existed because they were suffering from all the pain points I was talking about earlier, where it's like, they're healthy, they make a good living, but we're paying so much every month, but we never use our insurance, we're never going to satisfy our deductible.

Michael Caussin: Like, oh my gosh, thank you so much. I never knew someone could get so excited about insurance, but I mean, you know, but they do because they value what they have and how they live their life and everything. And they just didn't see a point in it, but they have three young kids and want to be able to make sure they're taken care of.

Michael Caussin: And so it's just, it is, it's the little gifts like that in this industry.

Sasha Yamaguchi: I feel like we have a theme of this podcast. Insurance can be exciting. 

Michael Caussin: Said no one ever except for us. 

Sasha Yamaguchi: No, I mean, it's a big part of every day for everyone. I also, I want to go back to another point you made that I think is super important.

Sasha Yamaguchi: You're helping people through life events with the actual plan and the benefits, but you made a comment about the financial part, right? So your friend coming off his wife's plan. It's like, what plan do I get? But then there's this financial piece to it, which I think we all know, but I want to go back and hit on that for a minute.

Sasha Yamaguchi: Cause I thought that was really important of like, you're helping people find the options and the plans. Now he has to pay for it on his own potentially. And so I think that's obviously a big part of it and financial, you know, everyone needs help there to make sure they're making the right choices. 

Michael Caussin: For sure.

Michael Caussin: And even I'll get clients that I'll text them or contact them and they'll say, send me, you know, 10 best plans you have to my email. I don't want to jump on the phone. And I'm experienced enough kind of in my career now where people like that, no offense to them, I get it because they're getting blown up from agents and everyone's trying to help them and trying to filter out the scam from the genuine.

Michael Caussin: But people like that I typically choose not to work with because what I'll do is I'll send them a text back. Like, Hey, any Joe Schmo off the street can just send you some numbers. I'm actually in this to help you. I can't do that without asking the right questions and figuring out what your needs are and what you're looking for.

Michael Caussin: If you would like to do that I would love to set up the time to talk because I'm here to help you find what fits your needs, health and budget needs to the best of my ability. I'm not going to sit here and just send random things to you because I don't know what you need. 

Sasha Yamaguchi: I think that's great. And it made me think of something.

Sasha Yamaguchi: I don't know if you've gotten into the world of this yet, Point Solutions, but there's a lot of vendors that have been created in a good way, in a positive way. Lyra, Hinge, Carrot, and so, I'm curious, and if not, I think it'll come, and we can talk more about it on the next podcast, but have you talked to any of your clients about, okay, they have the base network option of whoever, Aetna, Cigna, Anthem, but you also have these supplemental networks of providers that if you're going through infertility, you can use Carrot, for example.

Sasha Yamaguchi: Has that come up at all yet? I'm just curious. 

Michael Caussin: Yeah, it definitely has. And that's something that, that comes more with time and experience as you know, too, right? Where, you know, early on, I didn't know about all the little things that can also help or whatever. And it's all about, again, being a smart consumer.

Michael Caussin: And so that's, I feel like that's part of my responsibility too now as an agent, be like, Hey. Anytime you have something else come up, like talk to me, like, okay, for example, the private market plans, they're not the most ideal when it comes to maternity. Okay, so I, if I have clients, like younger clients, a young couple, maybe, you know, they're not pregnant, but they're planning on having kids in the future, I say, Hey guys, you know, I come, I remind them, I was like, I come with anyone that gets a private policy, they have my personal cell phone number, I'm like, Hey, as long as I'm not with my kids.

Michael Caussin: Text me, call me, I'll answer within the next few minutes. But I was like, anytime something comes up, a question, a billing issue, a claim to make, that's when you contact me. I'm like your health insurance concierge. But that's one of those things where I'm like, Hey, I know these clients are, you know, planning on getting pregnant in the future.

Michael Caussin: I'm like, when you find out, give me a call because there's other options. I was like, we can get her off the private plan, get her on something that's going to be much more cost efficient for you guys as a family. While she's pregnant, once the baby's two healthy checkups or two months old, we can get them both back on the private plan.

Michael Caussin: So I'm like, there's strategy behind all of this. And like, to your point, when you know about those other, you know, supplementary services or products or. You know, benefits, it can really help a family out a lot. 

Sasha Yamaguchi: Yeah, I agree. And I think there's so many coming out that are very helpful and vendors where, you know, you may not have the best access because you live in a rural area.

Sasha Yamaguchi: So you can do virtual, right? So I think that's, it is great in that we're having more options than ever to support people. So again, member experience to me is super important, so you're helping individuals, we help people as they call in and need to navigate. Is there any trend or, like, as you've been meeting with people where it comes to member experience, so they're calling into their carrier, right, and they're like, Mike, I keep calling in and I can't get help, you know, is that coming up at all for you?

Sasha Yamaguchi: Because again, our company, we founded it to make it very easy to access and just help, help them with whatever they need. So does that come up a lot with your clients? 

Michael Caussin: It does. You know, customer service is a part of what I do because again, like I was just saying, like I'm attached to their policy for the life of their policy.

Michael Caussin: So as long as they have it, like I'm their agent. And I'm here to help them through those things. So whether it's billing and all those things, I have days or I have weeks where there's just a lot of customer service things. And because private market plans specifically are built different billing departments, urgent cares that, you know, doctor offices at hospitals, they're nothing against them, but they're kind of set in their ways on how they do things.

Michael Caussin: What's your co-pay? We're going to take that. Then we'll send you your EOB, right? They're just routine like that. And so I've had to have a lot of conversations with billing departments. It's like, Hey guys, this is how it works. There's no co-pay on these plans. Everything is built through insurance. You guys are in network.

Michael Caussin: I confirmed that before I signed my client up. You're in network with UnitedHealthcare or whatever it may be. This is how you need to do it. And so that's kind of the headache at times because again, it's nothing against them, but they, it's just, you Maybe they haven't come across that in their career at the billing department for that facility.

Michael Caussin: So there definitely are weeks where I have a lot of customer service. 

Sasha Yamaguchi: You are calling and helping on bills. Yes, I am. Okay. That's a great way to learn. That is what my first big job was. I was a service rep, so I would call and help. You know, call the billing, call the provider, call the member, call the employer.

Sasha Yamaguchi: So, very interesting. Well, I think that's a great service that you provide.

Michael Caussin: I appreciate it. I know my clients appreciate it because that's part of my kind of, you know, pitch, I guess you could say too. I'm like, look, you're not going to have to call some 1 800 number on the back of your insurance card and wait for an hour.

Michael Caussin: I was like, you call me, you text me, I basically do that for you. I have ways to get in quicker, to talk to people faster, and two, I know the lingo, right? To talk to them about when Yeah. I don't want to sit there and play the game of telephone where I'm telling the client what to say and then they try to say the same thing back to the billing department.

Michael Caussin: It doesn't make sense. And yeah, so I just try to streamline it for them. 

Sasha Yamaguchi: No, that's great. And that's super important because again, members need help with that. So any trends you're hearing about or seeing as people come to you like. Different plan options, different types of benefits, you know, just anything that comes to mind as people are coming to you and maybe they're on a plan and there's like a new trend that you're seeing as you talk to your clients.

Michael Caussin: For sure. I would say mental health. So that is definitely a big thing right where obviously you've been doing this longer than I have, where I'm sure when you started your career, probably wasn't even talked about, right? No one ever mentioned it.

Sasha Yamaguchi: It wasn't one of the main things that we talked about a lot.

Sasha Yamaguchi: Yeah, right. 

Michael Caussin: And let alone for actual getting insurance coverage for that stuff. Right. And so that's been a big thing to navigate. And there are plans out there, private and public, that are still kind of behind the default now. Public plans, they are ACA compliant. One of those 10 things that have to be ACA compliant is mental health coverage.

Michael Caussin: But when you read the fine print of these plans, which most people don't, it's not what you think it is. Right. So that's one where I really, you know, there's more and more clients I've talked to that need mental health coverage, but at the same time, I'm like, Hey, it's not just up to the insurance company.

Michael Caussin: It's up to your therapist or psychiatrist. They accept insurance, probably less than half do. There's a low, there's a lower percentage that don't then do. And so that's probably the biggest trend I see on trying to help clients find what's feasible. But also that's a tough conversation because. A lot more people need help when it comes to that stuff, which I'm an advocate for.

Michael Caussin: But we can't always have our cake and eat it too. Right? As you know, it's like, you can't have everything. So I'm like, here's plan A, here's plan B, and here's plan C. What do you want better coverage for? Right? Do you want, to your point about prescriptions earlier, it's like, okay, do you want to pay 50 instead of 100 for this prescription?

Michael Caussin: Or do you want to save and have a, you know, deductible that's 5, 000 less than what it could be? Right, so that's when we play the numbers game.

Sasha Yamaguchi: Front end or back end, basically. Right. And I would say access back to your mental health, it's the coverage, but also the access. So again, that's why I think it's important to have these supplemental vendors and networks so that people can access and get the treatment they need.

Sasha Yamaguchi: Which is the most important thing. I always love to ask if someone's coming into our industry new, they're coming out of college and they're choosing to get into our industry from the get go, which now, luckily, people are. But what would, just what advice would you give them? Or tricks and tips? 

Michael Caussin: It's easy when you deal with a high volume of clients, of people.

Michael Caussin: Right? Again, as you know better than I do. It's not a one size fits all, right? Just like when we talk about prescription drugs themselves. FDA approved all this stuff, but then people might still get backlash because there's side effects and everything. It's like they, they list those because it's not a one size fits all.

Michael Caussin: And so it's the same thing when you are a broker, an agent, HR, or anything dealing with people when talking about their healthcare, where. You know, the wants needs of one person might be different than the other. So you can't treat them like every call I do treat people the same, but differently because I'm not going to give them the same spiel.

Michael Caussin: I'm not going to talk about the same things. And that's why I ask questions. I front load it with questions. Because I need to know what they, what need. And so for my advice, for anyone coming into this industry is just like, learn how to ask questions and listen, right? Like that's it. That's all you need to do.

Michael Caussin: You don't need to worry about all the information that you need to know yet. You don't need to worry about selling and be better at that because if you ask the right questions and listen. Everything else can be easy. It really can. 

Sasha Yamaguchi: I love that. And I run a sales team, and I think that's important in all aspects of, you want to listen because then you want to bring the solution for them, not start with, here's what I think you should do, right?

Sasha Yamaguchi: Here's what you need, and it may not be the right thing. So I think that's great advice. 

Michael Caussin: The card will give you the answers to the test if you just shut up.

Sasha Yamaguchi: Yeah, I like that. So kind of a funny question. I used to, I still travel, but when I would travel, you know, in the old days on a plane, someone you sat by would be like, what do you do?

Sasha Yamaguchi: Now nobody talks to each other. But some days I would tell them and then some days I wouldn't because the next question is like, so tell me about Obamacare. How does it actually work? So I am curious because you were NFL football player. Now you're in healthcare when you're at a party. Have you had any of those moments where you tell them what you do and then you just start getting peppered with questions?

Michael Caussin: Yes, for sure. It's almost more of the other way around where I'll have to stop myself because I'll geek out about it. Oh, interesting. We're all getting excited because maybe they'll ask like one question, right? And I'll kind of get on my soapbox and start getting into it and I get, I'm like, all right, sorry, guys, I'm good.

Michael Caussin: I'm drinking the Kool-Aid a little bit too much right here because you just, again, over the last year, I've just learned so much information and I've so much to share with people. On how to just understand all this better, but yeah, I've definitely had a lot of people ask me questions or again, like I said earlier, it's like, you know, I haven't this employer plan, but I don't really know.

Michael Caussin: You know, how to make sense of it. I'm like, all right, send me your summary benefits. Let me go through it.

Sasha Yamaguchi: That's great. Yeah. I'll check in with you a year from now, but no, that I think that's a great answer because it just shows clearly back to what you first said, how much you're enjoying it, how much you like helping people.

Sasha Yamaguchi: I always joke that the content isn't sexy, right? It's insurance, it's healthcare, but the same reason I've done it for so long is just helping my clients, you know, my brokers is what makes it really satisfying. So, okay. Final thought, question, I actually want to tie back to the NFL for a second. One, I freaking love football.

Sasha Yamaguchi: I grew up in Southeast Texas, but what was your best memory of playing in the NFL? 

Michael Caussin: Man, that's a good question. I mean, my first start, which came in 2011 against like the San Diego Chargers in San Diego, it's like, those are moments I'll never forget. Cause you know, there's certain things you want to accomplish in your career.

Michael Caussin: They check off, unfortunately mine ended sooner. Than I wanted to because of injury. So that stuff, but it's not even those things like my, I have a brother that's 14 years younger than me, and knowing that he got to like come to games or come to practice or come to training, you know, those kind of things are kind of what mattered to me the most, which also goes into something that I wanted to accomplish that I never did, which was.

Michael Caussin: I always envied the players who had already had like wives and kids and like after practice and training camp the kids would come onto the field and they'd play with them and I'm like, I can't wait to have that. That was something more important than maybe on field goals. I wanted that and I just didn't play long enough to have that.

Michael Caussin: So that's one thing that just kind of correlates with just my brother being able to watch, but my kids not being able to.

Sasha Yamaguchi: Yeah, no, that's, I actually got goosebumps because I, I love seeing that too. Yeah, watching the kids go down and like you get to see them after the game has got to be a great thing, so.

Sasha Yamaguchi: For sure. Yeah, well, thanks for sharing that. I think today's been so great and having someone that's fresh into our industry with a fresh perspective has been really cool. So please let people know where to reach out to you, how to connect with you, LinkedIn, social media. I definitely want to make sure everyone checks out your Instagram because I truly believe the way you break it down so basic is going to help so many people, whether they've had a plan for years or they're brand new.

Sasha Yamaguchi: But just share with everyone a little bit of how to reach out to you.

Michael Caussin: Yeah, the best way would probably be my Instagram, which is at M_CAUSSIN, C A U S S I N, DM me on there. You know, I'll find it. I go through all of them on a daily basis and we get in contact and we schedule a call and everything.

Michael Caussin: And then I can figure out how I can help you. And again, even if it's, you don't need a new plan, but you just want to understand what you have or your choices. Again, why I enjoy doing this is because I love educating and being an asset to people. And so, reach me on Instagram, you know, like you said, I try to be helpful with my videos and kind of break everything down.

Michael Caussin: But yeah, reach out, DM me, we'll figure out a time to talk. 

Sasha Yamaguchi: Great. Well, thank you, Mike, for being with us. I think this was great. I learned a lot. I think everyone listening is going to go ask more questions about their plans, to be honest, so. As they should. As they should. Right? So we are here to help people.

Sasha Yamaguchi: So thank you for being with us today. 

Michael Caussin: Awesome. Thank you, Sasha. 

Producer: This podcast is brought to you by Collective Health, a health benefits solution that guides employees toward healthier lives and companies toward healthier bottom lines. Check us out at collectivehealth.com.