This episode features an interview with Serafina Miller, Senior Principal Consultant at Mercer. Serafina has been in the industry for over two decades, specializing in group account management for multiple industries like banking, biotechnology, transportation, engineering firms, and law firms. At Mercer, Serafina partners with employers to ensure their employee benefits programs integrate with compensation strategies and business objectives, as well as aligning with the organizations’ DEI strategies. In this episode, Sasha sits down with Serafina to discuss designing inclusive benefits plans, why self-funding is a win-win for finance and benefits teams, and the importance of provider alignment.
This episode features an interview with Serafina Miller, Senior Principal Consultant at Mercer. Serafina has been in the industry for over two decades, specializing in group account management for multiple industries like banking, biotechnology, transportation, engineering firms, and law firms. At Mercer, Serafina partners with employers to ensure their employee benefits programs integrate with compensation strategies and business objectives, as well as aligning with the organizations’ DEI strategies.
In this episode, Sasha sits down with Serafina to discuss designing inclusive benefits plans, why self-funding is a win-win for finance and benefits teams, and the importance of provider alignment.
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“A lot of conversations in these last handful of years about provider alignment to the communities in which they serve, and really pushing insurance carriers to work on their provider diversity. Hiring more Black, Latine physicians, transgender physicians, non-binary physicians, because there are certain conversations that are much easier to have because there's an alignment of life experience. There's a believability factor that's built into that dynamic. It encourages more people to get more engaged in their healthcare. We're so focused on preventive care, if we have more diverse physicians, people will get more engaged in their preventive care and ideally live, the goal is longer, healthier, and therefore, happier lives.” – Serafina Miller
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Episode Timestamps:
*(00:32): Serafina dives into Mercer
*(05:54): What size groups are moving to self-funded
*(08:47): Ancillary and PTO trends in the benefits space
*(12:09): What family-building, fertility, and reproductive health benefits look like
*(18:00): Components of an inclusive benefits program
*(26:46): The importance of virtual care
*(28:56): Serafina’s advice for those new to the industry
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Links:
Connect with Serafina on LinkedIn
Connect with Sasha on LinkedIn
Learn more about Collective Health
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 Serafina Miller. Serafina is a Senior Principal Consultant at Mercer. She partners with employers to ensure their employee benefits programs integrate with compensation strategies and business objectives, as well as aligning with the organization's DE& I strategies.
Sasha Yamaguchi: Thank you so much for being with us today, Serafina. I'm excited to have you.
Serafina Miller: Thank you so much. I'm really excited to be here.
Sasha Yamaguchi: You're with Mercer. Mercer is, of course, a very well known consulting company. For those listening in, I would love for you to share a little bit about what Mercer does, what is your role there and how do you work with different employers?
Serafina Miller: Absolutely. So Mercer, think of us as human resources consulting firm, or more the way I like to think about it is any benefits that touch your employees from a total rewards and people management standpoint, we're there to support you. So I'm here in our health practice. So I say my jurisdiction is the US so I work with my clients and their US benefits
Serafina Miller: and help benefit strategy. We have colleagues in our wealth practice, think of retirement plans, investment consulting for 3Bs as well. And then in our careers practice, like they're the biggest of us all. They're really on the human capital side. So people think of them oftentimes for communications, but it's job architecture and looking at salary tiers and making sure that, especially from like a DE& I perspective, that salary tiering all makes sense.
Serafina Miller: And it's equitable looking at. Mergers and acquisitions support. One of the things that actually a lot of our tech clients have benefited from is outplacement services that we can also provide. So we think about taking care of a company's biggest and most important asset, their people. That's what Mercer can support with.
Sasha Yamaguchi: That's great. Sounds like different parts of Mercer, but be able to support the employer as a whole, which is great in different areas. Absolutely. So, in your role as a consultant and as a principal, how do you personally work with employers, of course, on their US based benefits, but overall, their business strategy, you're working with them throughout the year, I assume?
Serafina Miller: That's correct. So, it's an ongoing partnership, and it really is, from our vantage point, a true partnership. Because while my focus is US benefit strategy, so thinking about where the employer, um, Currently sits in their peer marketplace, maybe where they want to sit. Are they at the 25th percentile? They want to get to 75th or even get back to market median, helping them understand the pros and cons of that.
Serafina Miller: Ensuring again, there's an employee benefit offering that supports their intended objectives, right? For most employers being competitive in the marketplace, but also driving value to their employees because you've seen over the last five years, especially in light of COVID, benefits are now a very top of mind.
Serafina Miller: Benefit to employees when they're considering jobs and even changing jobs, where it used to be salary was the foremost consideration, now benefits are very much neck and neck with salary. And so understanding how an employer wants to differentiate themselves in the marketplace with their benefit offering and support the diverse needs of their workforce brings a lot of joy to, to be able to have those conversations and think about how to support people more broadly.
Serafina Miller: And then recognizing that. Benefits sits within, I'm a visual processor, so benefits sits within the pie of the total rewards strategy and the total rewards offering. So understanding what's happening that year with their compensation strategy. Maybe they're having a great year and salary increases might be higher, sometimes it might be lower.
Serafina Miller: What's happening with their Resting schedule and equity that they're offering their people. What's happening with their 401k match as an example. So as we think about sometimes benefit considerations and more specifically employee contribution considerations, that if an employer is having a tough year and they want to raise employee contributions a bit more than they would normally.
Serafina Miller: What's happening on the compensation side. So understanding if they raise and play contributions higher than normal and the salary increase isn't as high as normal, are they effectively giving their people a net pay reduction? So while, again, my focus is US benefits and even partnering with my global consulting team members to think about how the offering might sit for an employer globally speaking, it's important for us to have context in terms of what's happening with the employers.
Serafina Miller: Company and what's happening with their next year's compensation strategy because we're really there to take care of, again, their most important asset, which is their people.
Sasha Yamaguchi: That's great. So our audience, we have everyone tuning in from small group employers to large to jumbo. Is there a size range out of curiosity that you work mostly with or are you working with all different size companies?
Serafina Miller: I have a pretty wide range myself of employers I have the privilege of working with. I work with a company that has about 350 employees. I'd say they're very risk tolerant, so they're already self-funded and prepared to take on that challenge. The largest employer that I happen to work with has about 10, 000 employees and then everybody in between.
Serafina Miller: But for Mercer, as an overall brokerage and consulting firm, we work with employers that have typically from 100 employees. Up to the jumbos. But I think what's important to reiterate, and I see this a lot with prospective clients that I meet with, they're only 500, Fortune 500 companies. And we can't be the world's largest HR and benefits consulting firm if we only work with the Fortune 500s, the jumbo employers.
Serafina Miller: So actually the majority of our, the employers that we work with are between a thousand and 5, 000 employees.
Sasha Yamaguchi: That's great. And one of the reasons I ask is I believe self funding, which we're going to get into in a minute, is growing among all employer sizes. And I know that you, again, work with different size groups, have thoughts around self funding.
Sasha Yamaguchi: So, I'd love to jump in a little bit on, are you seeing groups of all sizes look at self funding? And then, I know that within Mercer, you've done a lot of work around this and sharing internally how to show this as an option. What are you seeing in the self-funded arena and groups of different sizes looking at it?
Serafina Miller: There's a technical aspect to self funding your medical and pharmacy benefits in terms of being able to take on the claims risk. Does your employee demographics and actual claims utilization make sense for you to self fund, i. e. can the employer take on that claims cost or are they sometimes are getting a better deal by being fully insured?
Serafina Miller: One client I had the pleasure of working with for the past six years that we've been rather adept at negotiating the fully insured renewal. And so self funding actually isn't in their favor, which is fine, right? We want our employers to pay the best price possible, but when it comes to self funding.
Serafina Miller: Really the way I look at it, and so many of my colleagues look at it, it's a strategic transition for an employer to consider. It used to be the adage was, if you had a thousand employees, that's when you should be looking at self funding. We're seeing more and more employers, more at the 500 headcount, and begin to look at self funding as an option.
Serafina Miller: And we do feasibility studies with, with clients all the time to determine if this is the right year to make that transition. Why is self funding so important? What's important is it puts plan design decisions in the hands of the employer. And more often than not, the intention there is to be able to expand coverage, to add coverage that they're limited in doing so in the fully insured market.
Serafina Miller: And oftentimes if they're adding certain benefits that are intended to support a specific percentage of their population, the underwriters in the fully insured market are intended to. Kind of like a pit boss, right? Protect the house. So we're trying to make sure that clients overpay for their benefits.
Serafina Miller: That's where self funding becomes really critical because they pay for what's being used. And as far as cash flow goes, it becomes a very important value proposition for the finance team to understand, hey, you don't have to pay as much, right, in terms of hard dollars. And we recognize claims fluctuation, but they're willing to take on that risk.
Serafina Miller: It's a win-win oftentimes for both finance and for the benefits team.
Sasha Yamaguchi: That's great. I love the pit boss analogy. That's the first I've heard that one used, but it completely makes sense.
Serafina Miller: I'm just hoping underwriters won't come for me on LinkedIn when this is over.
Sasha Yamaguchi: They'll be fine. So I think one point you just made that I think is really valuable is when employers look to go self funding, they now get the chance to build in benefits or really build the plan that they want for their population.
Sasha Yamaguchi: I feel like this is such a big topic and we'll hit on it in a few different ways, but what are some of the trends that you're starting to see in the benefits space? And starting with ancillary PTO, to your point earlier about employers are attracting new hires based on the benefits programs. I'd love to start a little bit there of what are you seeing employers build in now to make it as attractive as possible?
Serafina Miller: The first thing I want to address is The headline that I think was Netflix was the first one that kicked this off was unlimited PTO. And this has been, I think, percolating and permeating within the total reward space. Who's doing it and does it work? And people think that this is really a true trend when it comes to paid time off.
Serafina Miller: And actually, at least the data that we have, that's not bearing fruit. We not only have our National Employer Survey, but we've been doing for the last six years, now going into our seventh year, our Tech Total Rewards Survey, and We're just not seeing a high uptick of unlimited PTO. And I think what's really important to understand there is if a company doesn't have the culture to support taking time off in the first place, and the importance of taking time to rejuvenate, to come back refreshed, expanding from, say, 20 days a year to unlimited PTO isn't going to actually encourage people to take that time to take care of themselves.
Serafina Miller: Because what we saw so much... Post COVID and with George Floyd's murder is the levels of burnout were so significant and employers were pushing and trying to figure out what solutions they could put in place to take care of that burnout. Sabbaticals had to rise for a moment. There's only 88 keys in a piano, so sometimes it's old, it's new again.
Serafina Miller: So we did have a few clients implement sabbaticals with, you know, say three years of service or four years of service, they get three or four weeks planned time off. But. Again, with economic pressures we've been seeing in the last 12 months, especially some of those programs actually have been rolled back.
Serafina Miller: So while we want to see more paid time off trends, I think the tried and true is really what's State the test of time, which is oftentimes an invested base years of service, 20 days on average. But in terms of inclusive benefits, I'd say more on the leave side is moving away from maternity leave and paternity leave and going into a parental leave program, because one, it encourages.
Serafina Miller: So, um, I think it's important for us as fathers of heterosexual couples to take that time off as equally as the mother to bond and to be with their new baby. But also, it moves away from, again, specifying benefits for heterosexual couples as compared to people who want parental leave benefits because they're single by choice.
Serafina Miller: Or they're a gay couple, lesbian couple, transgender, non binary. So, as we think about the importance of being inclusive, language and plan design gets very important. So, moving to a parental leave benefit has been a trend we've seen pretty consistently. And then with our clients, even globally speaking, trying to offer upgrade.
Serafina Miller: Some countries have a lot more parental leave than others because of statutory requirements. If only we could have it here in the US We'll get there at some point in time. But beginning to create those minimum standards has been really helpful for employees to have an expectation of what they can be offered regardless of what country they happen to sit in.
Sasha Yamaguchi: That's great. And interesting to see some of the trends of the unlimited PTO, but then what you're seeing the result of that and if it's attractive or not. And I think you made a really good point of Unlimited PTO, but not necessarily having things built in that align with that. And I think one thing that I would love to have you hit on is employers are really looking at expanding benefit packages around things like family building, fertility, reproductive health.
Sasha Yamaguchi: One, why are those benefits so important and what are you seeing being implemented the most as you're working with your employers?
Serafina Miller: Certainly. So prior to this wave of inclusive family forming, even before it became inclusive, just having infertility benefits, let's go back to the beginning, right? We knew that people who wanted to have a child who couldn't do so naturally were willing to cash pay on their own.
Serafina Miller: And what we were seeing, and I hate to raise this as an example because it's pretty extreme, but the optimum situation where you have a number of frozen embryos and There's multiple implanted. So we saw for years were high rates of twins and triplets, NICU claims, Neonatal Intensive Care, make it out of consulting speak and acronyms, but where a baby had to be in the hospital longer than normal, that the delivery itself was a more complicated delivery than a natural.
Serafina Miller: Delivery if it wasn't fertility assisted and so kind of twofold one to be attractive in the employee space employers began adding Infertility and fertility by the vets and then there was also recognition that if they could support the intending parents Clinically speaking on the front end when trying to conceive that ideally the pregnancy itself would be a very healthy low risk Uncomplicated pregnancy, really focusing on resulting in what they call a singleton birth.
Serafina Miller: So only having a single baby at one time as compared to ending up with twins or triplets. And so therefore the delivery itself and the recovery is more in line ideally with an unassisted pregnancy. We saw kind of a push and a pull of including some of these fertility benefits, but I want to clarify to the definition because I get very, language is very important to me, especially in the benefits space, because we know two people could be saying similar things, but they use different words.
Serafina Miller: We have no idea what they're saying. So infertility, Benefits is where if you're a woman under the age of 35, you have to be having unprotected sex for 12 months, be approved to have access to infertility benefits. You get a medical diagnosis of infertility. And if you're over age 35, you have Unprotected sex for six months because God forbid we're now considered geriatric pregnancy at 35 or older.
Serafina Miller: It's a whole different conversation. I know. It's terrible. It is pretty terrible. But moving away from that and moving into the fertility space was removing that medical diagnosis and why that was so important as again, with an infertility benefit, it's a very heteronormative benefit. It excludes women who are single by choice.
Serafina Miller: And it excludes anyone else who's not in a heterosexual couple. So having a fertility benefit where really the care and the direction, the decision is between the employee or their eligible partner and the fertility specialist. And that really opened up support and care and recognition that employers want to be able to offer this benefit to all of their people.
Serafina Miller: And so fertility benefits became really a big focus and then expanding that into supporting, some employers were already covering adoption services, doing some reimbursement, IRS is helpful in that regard too, but we're also seeing expansion into surrogacy benefits. But oftentimes, As we think about what's being offered, fertility benefits first, and then along with adoption, and then later on surrogacy.
Serafina Miller: There's some vendors out there that, if they're offering, say, a reimbursement benefit, that we're seeing those three benefits being offered all at the same time. And because it's kind of cost agnostic to the employer, whereas others, if they're cycle based benefits, The addition of adoption surrogacy may come at future states as far as what the budget will allow for employers, but we're seeing, I'd say again, fertility becoming table stakes with our national survey that the 2022 results, we saw the biggest uptake or adoption of in vitro fertilization benefits in employers from 21 to 22.
Serafina Miller: So while we thought that we could have met that initial wave, we're still seeing a greater increase in the addition of fertility benefits in the employer space.
Sasha Yamaguchi: That's interesting, and I love to hear that. I remember when I first joined the industry and moved into healthcare, infertility was such a big topic and benefit, right, of what can be covered and how much.
Sasha Yamaguchi: So to hear that it's still having an uptick, I am curious on the surrogacy benefit. What does that cover? What are you seeing employers cover, out of curiosity, when they add that as part of the package?
Serafina Miller: It's, again, it's going to be typically a cash reimbursement. And because this isn't recognized federally, it's still going to be a taxable benefit to the employee in question.
Serafina Miller: But it covers the care, again, for the surrogate, because the surrogate can't be covered by the health plan, as an example. So those, in terms of the implantation and the medical care. All of that.
Sasha Yamaguchi: I can imagine that's a valuable add to a plan for employees to have that as an option.
Serafina Miller: Yeah. I mean, at least some dollar benefits.
Serafina Miller: The challenge is, is that again, we think about what's equal versus equitable. Equal is an employer offers say a $50,000 lifetime maximum benefit, whether you're using fertility services, adoption, surrogacy. A truly equitable benefit, I don't think employers can afford because surrogacy is so expensive, on average at least 100,000.
Sasha Yamaguchi: Yes, agreed, and just to be able to provide some support. And I'm sure as part of that, there's a process of why is that employee looking at surrogacy, right? So, very interesting. So, along those lines, staying with benefits program, and I know you do a lot of work around DE& I strategies. What are some of the programs or things that you're helping your clients put in place to ensure that they do have an inclusive program?
Sasha Yamaguchi: I think this is a big topic, but I would love to hear a couple of thoughts on this and what you're seeing and suggesting to your clients.
Serafina Miller: It's a very big topic, and this is actually, again, it's It's, maybe it sounds silly that I find joy in my work, but I really truly do find so much joy in my work because I'm privileged to be able to work with employers, want to expand coverage for their people.
Serafina Miller: So most often it starts with that transition again, from being fully insured to self-funded and the gates really get opened in terms of what the employer wants to do. So We always look at ABA therapy, and with mental health parity that's done a lot of work to shore that up, but oftentimes what we'll see built in health plans is say, as an example, a 60 visit limitation for occupational, physical, and speech therapy.
Serafina Miller: And so we make sure that if the person has diagnosis of autism spectrum disorder, that those visit limitations are waived because we know that child, as an example, could go through those sessions in three months very easily. So in terms of accessibility, that becomes really important. What typically doesn't get a lot of play, but is actually very passionate for me as well, as we think about hearing aids.
Serafina Miller: Benefits. The hearing aid device allowance and the exam frequency. It's not going to break the claims bank, but so often coming from the fully insured side, the benefit is oftentimes 200 or so per pair of hearing aids, which is really quite nothing. So we work with the plan to look at And then we have a per hearing aid benefit because not everyone needs to hearing aids, and you know to increase that closure date to 2, 000 per hearing aid.
Serafina Miller: And then an exam frequency typically of ideally every 12 months, or at most the maximum outside 24 months. But one of the things we've been talking with clients too a lot is transgender healthcare benefits, and really understanding. What's covered and what's not covered, and I'm really, really proud of what our clinicians do here at Mercer in terms of being able to work with an employer's health plan and to, at a very clinical claims level, we're talking ICD 10 code level, what's currently covered relative to it.
Serafina Miller: The gold standard recommendation, which is the World Professional Association for Transgender Health, WPATH. They had their standard of care seven. They just released the standard of care eight that we're working with our clients to now align with, but we'll do a complete clinical assessment to understand.
Serafina Miller: What's currently covered relative to the gold standard and therefore it's the gap in terms of what's not covered from an actuarial standpoint, have those priced out for claims and coverage and then work with our clients to have those implemented. Oftentimes, the bigger bookends of those coverages are already taken care of.
Serafina Miller: Mental health parity took care of being able to have access to a mental health specialist. You have to have a clinical diagnosis of gender dysphoria to have access to transgender health care services. And oftentimes that diagnosis is required from, if one, sometimes two, mental health specialists that you've been working with for six months, sometimes 12 months.
Serafina Miller: So the front end is typically covered because of mental health parity. Healthcare reform took care of the more expensive surgeries, what we colloquially call bottom surgeries, because of non discrimination requirements that were put forward through healthcare reform. So even fully insured plans don't typically cover bottom surgery, but we typically see it's not covered with all the services in between that historically have been deemed to be cosmetic.
Serafina Miller: So we're talking about facial hair removal, feminization, masculinization, breast augmentation. And when we think about the mental health of people who are transgender, there's such a misalignment oftentimes of how they see themselves inside versus what they get to see in the mirror. And so while someone might deem these to be cosmetic, these are actually services, surgeries, and procedures that help them recognize themselves in the mirror.
Serafina Miller: And so we typically find that when the historically deemed to be cosmetic surgeries are covered, but only half of transgender people that we're aware of that go through surgeries end up having bottom surgery as well. The other half just have their masculinization or feminization, the top surgeries, and leave it at that.
Serafina Miller: I think it's a really important distinction because we get so caught up sometimes on thinking of a person's transgender, they just want bottom surgery. That's the farthest thing from it. And I'm so grateful for the internet and having access to a lot of reading and information to get myself educated to be not just an ally, but a co conspirator in this space.
Serafina Miller: But separately too, moving away from that, a lot of conversations in these last handful of years about provider alignment to the the communities in which they serve, and really pushing insurance carriers to work on their provider diversity. So hiring more Black, Latine physicians, transgender physicians, right, non binary physicians, because For me as a woman, I will say I have to see an OBGYN, I don't have to, but I do because I take care of my preventive health, and I'm sure a male OBGYN is perfectly qualified coming out of medical school, doing rotation and everything else, but for me personally, I will only ever see a female OBGYN, especially one who's also had children, because there are certain conversations that are much easier to have because there's an alignment of life experience, and there's a believability factor that's It's built into that dynamic, and so I think it would be very important for us to translate that to someone who is Black, who is Latine, who is from Southeast Asia, right?
Serafina Miller: Maybe they want to see an Indian doctor. And there's cultural alignment. I think it encourages more people to get more engaged in their health care. And again, we're so focused on preventive care. If we have more diverse physicians, people will get more engaged in their preventive care and ideally live, the goal is longer, healthier, and therefore happier lives.
Sasha Yamaguchi: You really bring up a good point, well throughout, but at the end of having providers that you're comfortable seeing, and I'm curious what the statistics are on that network of specialists or providers growing as things grow in the industry. I think that's really important to have that available for the population.
Serafina Miller: It would, and so what we're seeing now is, you know, with provider directories for a long time, it was just a provider's name. So now insurance carriers are trying to get at least pictures. of the physicians because they, with their contractual agreement, providers don't have to release their race or ethnic identity, which would be ideal to have.
Serafina Miller: But at least pictures help us get along the way, but it's, you know, but there's such a disconnect and I know that there's a fear that certain physicians won't be seen because of their background, but I think that's the chance that we have to take. There was a study done, In Oakland, I think this was back in 2018, with about 1, 300 black men, half of whom were given a black primary care physician, half of whom were given a white primary care physician.
Serafina Miller: And the study showed that those that were assigned a black primary care physician had a significantly higher adherence rate to their preventive screenings. even the more invasive ones. And we think about the fact that Black men die at unnecessarily higher rates of heart disease than white men. They were able to actually show with this engagement in their preventive care, they were able to stave off some of these heart conditions and again, extend Black men's lives.
Serafina Miller: So, as we think about the importance of supporting our people, we go back to the push and pull. We need to have more diverse physicians, so we need to encourage people to go into medical school and have access. We also need to encourage our insurance carriers to look for and recruit more diverse providers as well.
Sasha Yamaguchi: Yeah, agreed. And I think I would add to that the world of point solutions and a lot of these vendors, I do feel like they're playing a big part of supplementing what's out there as well. I think to all of the points you've made, that's where the point solution vendors can come in and help as well.
Serafina Miller: Yes, I would say on the mental health side, I'm not being paid by this company, but it just, I'm very familiar with them.
Serafina Miller: Disclaim that. I mean, it layers in a lot in this space, especially when we think about how they are supporting employees and family members access to short term mental health, bringing providers into a network that we're so accustomed to cash pay because people are willing to cash pay, right? And I think mental health, especially, that's so critical to have, and the technical term is provider concordance, me being a benefits nerd, but, you know, provider alignment to their patients and, and having access.
Serafina Miller: Greater access to diverse providers in mental health. It can't be overstated how important that is.
Sasha Yamaguchi: Agreed. And, and I think for employees, dependents who are in geographies and areas where there just may not be a robust network of physicians in town, I also think these LERAs, other vendors, are super important so that people have access, period, whether it's virtually or in person.
Serafina Miller: And that's, if we can call it a silver lining of COVID, I should like knock on wood when I say something like that, but virtual care really took off in a way that we were waiting for this to happen for years. And granted, state by state licensing stood in the way for a very long time. So we had to navigate that.
Serafina Miller: But one of the things that we got from COVID that was beneficial for our experience with their benefits program is recognizing virtual care works. And that it's a valuable place in various modalities of accessing care. I mean, again, just thinking about mental health benefits to get serious for a minute.
Serafina Miller: I've never done so many employee assistance program RFPs during 2020 than I had in the prior five years, because there was a recognized need for better, more impactful mental health benefits. And one of the things we wanted to make sure is when someone's reaching out to a provider, A video visit's great, telephonic is next best, but can they also chat with someone?
Serafina Miller: Because maybe, since we're all shelter in place, maybe someone's in a situation where they cannot talk on the phone, they can't get on a video visit. Can they at least get support from someone through tech space to get that kind of support? So it's, this has become kind of, I would say, table stakes in terms of a medical vendor and even other vendor offerings that virtual care is part of that, that offering.
Sasha Yamaguchi: And I agree with your point in that once everyone was more remote, work at home, shelter in place, these offerings, benefits, and the interest in virtual care just exploded, which is great. So you've mentioned a couple of times joy and enjoying your job. I think a lot of our audience are probably those that have just gotten into our industry or starting out in their careers, and I would love for you to share any advice that you would have, whether it be a...
Sasha Yamaguchi: Broker, a consultant, a sales representative, anyone listening in that's getting into our industry, what would be the advice that you would give them?
Serafina Miller: I mean, I think there's a couple different reasons why people can get involved in our business. I want to be paid a fair wage. Don't get me wrong. I'm not trying to work for free.
Serafina Miller: I've got mortgage and college tuitions to save for. But there are some people who get involved in this business where it's really, Salary based, right? It's compensation based. For me, I will say that while I've been in this business for goodness, 24 and a half years now, it's amazing how fast it's gone by.
Serafina Miller: It was truly at Mercer that I fell in love with my career, that I fell in love with my industry. The company I was at before was an exceptional Six years was a great training ground. Ironically, the two founders left Mercer, San Francisco to start their consulting firms like, Oh, I can see why they did X, Y, or Z.
Serafina Miller: But being able to work with clients at Mercer, again, being able to self fund and really think strategically more broadly about how benefits sit with, within their total reward strategy, within their business strategy. I began to truly understand the impact that I could have. And sometimes when we see the news and see what's going on, we can be left to feel a bit powerless.
Serafina Miller: And so what control do we have in our little corners of the world and knowing that I get to partner with an exceptionally talented benefit teams, the clients that I support and help take care of their people, that's what makes it exceptionally rewarding. But I never forget that I'm also a human being in this, that I'm a mother, I'm a Black person, I'm a woman, the daughter of a nurse for 40 years who worked here at a private hospital in San Francisco that was then purchased by Sutter and watched that whole transition to the CPMC model.
Serafina Miller: So I bring all of that experience and perspective into the consulting I do with clients. To think about what is the employee experience going to be when we put these benefits in place? When we put this employee contribution schedule in place, if I were on the receiving end, how would I feel? How would I want to be communicated to?
Serafina Miller: Because at the end of the day, we're all human beings. I think what's really important for people who are thinking about this career is that Don't forget to bring your whole self because that, I think, is what enriches the experience and enriches the story. It brings the best, I think, consulting work to our clients when we're not just regurgitating all the data we have and showing how smart we are, but recognizing that we're, again, equally human beings and that we understand what's important to our clients and their people and want to have that much more holistic conversation.
Sasha Yamaguchi: Well, that was wonderful, Serafina, and I appreciate so much your passion because I feel there are a lot of individuals that are trying to make healthcare a great experience for individuals, period. I know it's something we've been working on and we continue to work on. So, I think knowing The excitement, energy, and passion you have for working in this industry and sharing that with others helps us along that path of creating a great experience for people as they access their benefits.
Serafina Miller: If you don't mind, I'll share a quick story about a client I was working with in 2020. And it's a healthcare client and their nurses were really unhappy with their existing employee assistance program. And they're trying to bring providers on site to support them. We're still in the height of COVID and the providers are really falling short and they had a very traditional EAP program, employee assistance program.
Serafina Miller: And you're looking at the marketplace, looking at the non traditional vendors, they are significantly more expensive. And I will say. What that illustrates is the true cost of impactful short term mental health benefits, right? Where we're basically self funding mental health benefits as compared to paying a PEPM.
Serafina Miller: And while it did put, you know, a hit on their budget, I did take sort of my consulting hat off for a second and said, you know, there was a emergency room nurse who worked for the Kaiser hospital in Santa Clara and she walked into the ED, shot herself in the head. You've got pediatric nurses that their work life was very difficult before COVID.
Serafina Miller: And COVID put such an exceptional strain on their job and on their mental health. And so this is such a worthwhile investment into what they bring to. The hospital, what they bring to your patients, and you can't afford to not do this. And I am proud to say that the client did move forward with implementing this non traditional EAP program.
Serafina Miller: But I would say if some of my colleagues were in the room, like this is, maybe this is non consulting 101. But again, this is remembering there are people at the end of this decision. And so for the employer to have said, yeah, we looked at the marketplace and there are some great options out there, but they're too expensive.
Serafina Miller: We're not willing to invest in you. What does that say to their nurses?
Sasha Yamaguchi: Thank you for sharing that and what a nice way to end together because I think that's really important is, yes, there's the consulting aspect, there's the financial aspect, but you have to think about the employee and the person at the end of it.
Sasha Yamaguchi: So thank you for sharing that. Let people know listening how they can reach you. I would love for you to share a little bit of how people can get in touch with you.
Serafina Miller: LinkedIn would be the most perfect way to get a hold of me, Serafina Miller. I keep it simple. I look forward to it.
Sasha Yamaguchi: Thank you, Serafina. Thank you for joining us today.
Sasha Yamaguchi: I know everyone listening is going to pick up a lot of great information on the industry, healthcare, and a lot about benefits and what needs to be included going forward to make a great benefits program for employees. So I appreciate everything that you shared and your insight and for being with us today.
Serafina Miller: Thank you so much for having me. It's a true privilege. Thank you so much.
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.