All right, actually, before we get started, or maybe I guess we are, do you mind sharing with me what you just or I should say, share with everybody what you just shared with me about something that you and your team started doing before meetings?
Absolutely. So we recently started within our people ops team, starting our group meetings with a one minute meditation, really quick doesn't eat into your meeting time. But it's a really amazing way to quickly reset, get yourself out of what you were doing, and really make yourself ready to be present in the coming meeting. It's been huge, we've had some other leaders already asked to borrow it, to the extent where we're actually going to start recommending it. When we talk to people managers about performance reviews, we're going to kind of sneak in there that we recommend that they use this method to really kind of start all of their internal meetings that way, and help them kind of reset and be more present.
I love that. So that mean that everyone's gonna have to be on time too.
It does make it more difficult people who are late in this kind of half a meditation, the good and the bad of a one minute. But the nice thing is that it doesn't take up time. People don't feel like they're looking at their watch waiting for it to end because they have things to talk about. It's just 60 seconds. headspace has a ton of these available. And you can just kind of take a deep breath, let it out. And for most people, it's the first real deep breath they've taken all day.
Yeah. Do you know what email apnea is?
Oh, gosh, no, but it doesn't sound good.
No. And it's I forgot the percent of people. But I had a gentleman on my other shows name's James Nester, and he's the author of Breath. That's arguably one of the best books I've ever read. And I it was so powerful to me, I read it back to back to back. And one of the things that he talks about is that forget what percentage of people have this. But it's, it's a real thing. It's email apnea. And what happens is, you start your day. And the first thing that you do, like 99% of the other people do is you get right to your email, and you start responding and responding and responding. And you don't realize that you haven't taken a breath. And you're starting your day, you're setting yourself back so much, that you're not getting oxygen to the blood, and you're not setting yourself up for success. So it typically happens in the morning. But it obviously as you can think about probably happens multiple times during the day where you're just multitasking, and you're not focused on that breath. And then you need oxygen.
Absolutely, I'm just as guilty. The first thing I do in the morning is check my slack messages. And it's my job all day to think about health and wellness. And even for myself, I have to stop myself in the middle of working and say, Take a few deep breaths, or get up and walk around the room because otherwise I might be chained to my laptop, eight hours straight without having moved. And then you look at your Fitbit, and or whatever your Apple Watch your wearable device, and you've only taken 20 steps today. It's a scary thought when you have that tracking you to really see how little you've moved from your single spot.
Please don't remind me. I was like, while we're talking, I'm tempted to check mine. And I'm like, that's not going to be good.
Well, I walked less than a mile today. We'll see how it goes.
I'm with you on that. So let's talk about I've been really looking forward to this conversation for a variety of reasons. And I'm going to try to change it up a little bit. If you don't mind. Just give a quick synopsis of who you are, and what you do. Because we'll start there, and then I'll go into some of my questions.
Absolutely. My name is Alyssa Perlman. I do benefits. I've done benefits. Basically my whole career, I started at an ad agency, I moved to a CPG company. I'm in a tech startup now. So I've seen a lot of different ways of making it work and a lot of different employee groups that have really specific needs different from each other. And it's been really interesting today, I work at UIPath, which does robotics process automation. And I work on global benefits,
and why is working in benefits so important to you. And something that you are just so incredibly passionate about
working in benefits. For the first thing, it's so rewarding. So those opportunities that you have to help people plan for a new baby or to help them navigate their way through a medical emergency or, on the saddest of times help them through a loss. And in those moments, you really get to see how big of a difference you've made in such a pivotal moment of a person's life. And that's an amazing feeling.
That is That's powerful. But what about you personally, you and I have talked a number of times and unfortunately share some things in common from a health standpoint aren't Great, would you mind opening up a little bit about what you can share about your personal situation?
Oh, yeah, absolutely. So I have multiple chronic conditions, several of them. In fact, I'm on a whole bunch of medications at the same time, I see multiple different specialists on a regular basis, it's a lot to deal with, even for me who's an expert in this field, it's still just so much to deal with and really difficult to navigate. And so for me, I understand what these employees are going through when they're trying to use their plans when they're trying to access their care. And seeing how difficult it is for me, you can only imagine how difficult it is for the average person who doesn't have that level of expertise. And so I think it's really helpful having that understanding, to be able to kind of look at these plans and look at these suggestions and say, if I was doing this, and in a lot of cases, there are things that I do regularly, if I was in this situation with this makes sense to me, what I know how to approach it, would this be what I need? And so it really makes it even more meaningful to me to be able to do that for people because I understand what they're going through.
Yeah, that's powerful. I really, I can't say enough about that. Not that I wish everyone else at any other organization, go through the same situation, I've got to assume that really, it's nice to have a true advocate, a true Ambassador that's sitting at the helm of whatever it is that they're doing, but especially benefits.
Yeah, absolutely. And of course, it's not a prerequisite to be able to do this job. But I think, for me, it just gives me an extra level of insight that's sometimes really hard for us to get right. So employees only come to us when they really need something most of the time, you're not going to go through the trouble of going to your benefits person or going to your HR person, for a lot of reasons, sometimes it's not worth your trouble. And in a lot of cases, people don't want to have to tell someone, what they're going through these things a lot of time are very deeply personal for them. And so I don't necessarily know until something has gone very wrong for someone and they come to complain to me, I don't necessarily know what the process is like for someone going through this. If I'm just a regular benefits person, you only hear that, that feedback that's so egregious that someone need to come to you. And for me, I get to see the full spectrum of what's going on, because I'm in it all the time.
Yeah. And then are you is open typically, as you are today that with people and does that, you know, how does that bode Are you able to because you I mean, you can truly empathize with someone, whether it's their individual struggle, or just also having to go through the process of whatever it is that they're having to go through in order to obtain or ascertain the right kinds of prescriptions, or doctors or whatever it is that they're dealing with.
Depends, I'm really open with people when I think it will be helpful to the conversation for me to be open. But for the most part, I'm very fortunate that all of my conditions are a nuisance, but not a real problem for me, I, they don't require me to take time off of work, I figured out how to kind of walk down this very precarious, narrow path that keeps me in a place where I can do everything that I need to do. And so I only tell people when I think it will be meaningful, but the truth is, I understand the people who don't want to share it, I have several of my conditions, I don't know that any of my co workers know about until maybe they listen to this podcast. But it does certainly inform my decision making when we talk about strategy. And I understand where people are, even myself, I have all of these access, I have direct relationships to all of our account managers with my carriers. But if one of my prescriptions get denied, I don't want to tell them, they know me, goodness gracious. And so that sensation that I have, I completely understand why the employees have it to.
Yeah, that's powerful. I mean, the benefits is so important. And I don't think people realize that until it's either an afterthought or maybe it's when it comes down to them accepting a job and you guys are in a tech field, and it's extremely competitive. As a tech firm, how are you competing, you know, with the likes of Google or some of these other larger quote unquote, more established giants that are out there?
It's certainly challenging. I think for a lot of people benefits either mean very little or mean everything to them. And there's not a ton in the middle of that spectrum there. But it's becoming a much bigger piece of what people are considering when they're moving jobs and even when they're at the same job. They consider that I think employees are becoming more savvy about how much of their total compensation is really their benefits package, and in a itself. And for I work at a smaller at a tech startup, it's certainly it's not tiny, but we're nowhere near the size of the scope of what Google has, or any of those other giants. And you're talking about these companies that are regularly on those lists that are posted all the time, top 10 companies to work at for benefits, top 10 benefits packages. And so it's not just the employees that come from those organizations that expect that it's a lot of these employees that expect that because you can, you know, a lot of these wellness programs that are going on, because they do a great job of publicizing how good they are at benefits at wellness. And for us. Benefits is hugely reliant on economies of scale, and a company of our size, just cannot do the things that a Google can. So what we have to do is figure out how to do the most meaningful things, we can, with what we have the same program, if I implemented in my organization, and Google implements it in their organization, they're probably paying less for the exact same thing. And that's because of that economies of scale. So their cost per head is just lower than mine.
So what do you do?
Basically, what we do is we, we have to choose, right, we choose what we think are the most meaningful things and we invest in those. So instead of having this huge suite, we have a few things, we invest heavily in them. And we spend a lot of time and energy making sure that the employees know what they have and appreciate what they have. Even coming from larger companies where they had more benefit options, things that compete at that scale. Most of the time, the employees couldn't name What half of them are. Yeah. And so instead of trying to go big, we try to go specialize, we find a few things that are the most meaningful, and we just go all in on them.
speaking of specialized, what about specialty drugs, they're increasing it like exponential rates are, you know, you've seen this and being that your firm, by nature, being tech is younger, does this affect you? And if so, what can you do? Or what are you doing to offset these costs, I just throw a lot at you.
I mean, of course, it affects all of us, I don't know that there's a company out there that's not seeing their specialty spend increase enormously over time every year. And part of that is because there are more and more specialty drugs on the market. And part of it is that they're more expensive. I think for us, the best thing that we can do is just be thoughtful about the formularies. And there are two sides to that. There are a lot of cost control measures you can put in but every cost control measure you put in makes it a little bit harder for the employees to use it. And so you have to find the right balance that works for you that works for your budget to go in here. And an organization like ours, they are very concerned about employees being comfortable and everything being easy for them to use. And so for us, we put control measures in, but we focus those measures on things that will be the least disruptive for the employees. So when you're talking about your formulary is, every company right now is doing things like mandatory generics, that if you prescribe, your doctor prescribes you a brand name, they will switch you to a generic, they won't even ask you first, if you specifically need that brand name, you have to do extra steps to get it. And then of course, things like step therapy, where if there's a cheaper option on the market, instead of starting, first off with the most expensive version, they'll have you start with the cheaper version. And if it doesn't work for you, then you can go move on to a more expensive version, especially when there are multiple drugs that are biosimilar to each other. Having that nudge to push people to choose the cheapest option is super helpful. One of the things that's really difficult with our system is that when the doctors are prescribing your medication, they don't know how much it's going to cost you when they're doing it. And so it's not necessarily that they're not thinking about what it's going to cost. It's that it's hard for them to even determine that in a lot of cases upfront when they're doing it. So on the insurance side to control costs, they come back and say thank you for this but did you consider this is actually really expensive for us? Did you consider something else? These formularies By the way, change multiple times a year. I think a lot of us have these ideas in our head that our medical plans are static throughout the year but they're really not.
How does that work?
insurance companies so whatever you have, if you have it carved into your medical plan or if you have it carved out to a PBM to a pharmacy benefit manager they have formularies Usually you opt into kind of a specific formula. So they have option A or Option B, option C, whatever it is, for them, but they have these preset lists. If you're a larger self insured companies, you have a lot more control over specific things in that list. But if you're fully insured, or if you're smaller, generally, you're going to pick from column A, column B, or column C, that your company that the insurer is offering you. And if you're choosing that they're automatically evaluating, and every few months, we're releasing updates to that. So if new drugs have come out in the meantime, that are cheaper and biosimilar, that drug that you already taking, and that the insurance company had already approved for you can all of a sudden no longer be approved, in some cases.
So you're choosing this, under your under one, you're thinking it's one thing, but that can change. And that can change multiple times in the course of the year, I hear you properly.
Yeah, it's common for them to change every several months, they usually change at least once, sometimes twice in the middle of the year. And a typical year. And so if you're choosing an insurance plan, if you're making an FSA election or an HSA election, based on how much you think you're going to spend on a specific drug, the insurance company might change their mind in the middle of the year. And that's not us as a company changing your plan. That's the insurance company reacting to the landscape of drugs coming out drugs becoming generic, new things in the system that they hadn't considered. So they don't wait until the next year to make those changes. They make them in the middle of the year.
I mean, so this is a job in and of itself, just to stay on top of all these formularies. That mean, just that alone. It's just sounds like a lot.
It's definitely difficult. And certainly most employees don't understand it. It's one of the things that's more difficult for us to explain to folks that, hey, it's the middle of the year and your insurance company updated the formulary. So they'll give us the new list and also a list of which things moved. So some things actually get cheaper, some things get more expensive. And the reason for that is based on what the cost of the drugs is and also what other drugs are around it that may or may not have been last time we had this conversation.
Yeah, that's so interesting. And I'll move topics in a second. But I mean, I was affected by something like this with a migraine medication that I was taking where I guess that now I'm understanding exactly what must have transpired behind the scenes, because I was on you know imitrex, which is a specialty drug for migraines, and then they bumped me to the generic, if you will. So yes.
So imitrex is, actually, in most step therapies, it's the first one that they'll have you try, but as a generic version, but there are a lot of particularly if we're on the topic of migraine medications. This is one that we get all the time. migraines are pretty common in the population. That so for someone like me, I actually I started on imitrex. I had side effects from it, I couldn't take it. So they switched me to something else. And now when I get new insurances, I get these letters in the mail saying, Hey, have you tried imitrex? It's cheaper? But then you have to, in those cases, submit and say, Yes, I've tried and failed this, I've tried and failed that. And then they say, Okay, great, you're good. But you have to kind of go through this process with your doctors, and make sure that they're submitting all of that information to make sure you get get the information they need, and that they're not going to try to switch you to something else. And for a lot of people, when they do try to switch to something else, that's fine it for the whole point of them doing that is for a lot of people, it doesn't make a difference to them. If it's biosimilar, if you're switching from a brand name to a generic, for the most part, they're almost identical. And so if they can nudge you a little bit to do something that will feel the same for you, but is much cheaper for the insurance company. Overall, it's going to be better because when you talk about the renewal next year, if we spend less money with the plan, they're gonna come back with a cheaper renewal, or if you're self insured, every dollar that the insurance pays the company is actually paying.
Yeah, yeah, surely, if we could transition for a second is something most of the other heads of benefits that I speak with tell me that mental health is one of the biggest challenges that their employees are facing something that you're seeing is that and do you have any experience with that? And what do you suggest firms that are facing this challenge? What do they do with this? You know, this is a dilemma.
Oh, absolutely. 100% this was a trend even before COVID-19 hit, but certainly after everything really came to a head everything, particularly with mental health. It really exploded. People, all of a sudden, who had all of these resources and all of these coping mechanisms, those are gone and all of a sudden, for the first time people are isolated in their homes, whether it's with their family, which is difficult for them to be enclosed in that space or Whether people are by themselves and isolated, no matter which way you shake it out, it's been a lot more difficult for people. And as an employer, you're kind of expected to help people through that and help them get there. And for most of us, it's a huge dilemma. How do you get people? How do you get people there? Right? There's no magic answer to that. The best thing that we can do is have empathy to really care about everyone to have a culture of people understanding that they can ask for help. And then the other piece of it is just having the right resources in place that match what your population needs,
It's interesting, one of the people, I will not say their name, because what I'm about to tell you, they wouldn't want public, but one of them I was talking to they represent a very large financial institution and run the benefits. And she was telling me is that as crazy as this may sound, COVID has actually done wonders, even though mental health is gotten a lot worse. And in a way, it's done wonders for mental health and the benefits world in general, because it has really highlighted this issue that has actually been going on before. But obviously, it's magnified 10 times now. But at least it's brought it to the attention, because there are a lot of other people that might not have had some of these issues that they are, or maybe they had family members that really were dealing with this, but they were kind of keeping it to themselves and no longer can do that. Do you have an opinion on this?
Absolutely. I mean, it's certainly made people more likely to come forward. And in terms of in benefits, we're always making decisions about where to allocate budget to make the most impact. And the situation has really made it so that all of the business leaders truly understand the value and the importance of mental health care. I haven't even had to have that conversation to justify putting in some new programs we have during COVID. Because they already knew why we were doing it. And they supported it. 100%.
That's great. So speaking of mental health, it's my understanding that wellness is now in the top three of benefits expenses. Is that something that you're seeing? And if so, what are some of these? What are the other two biggest expenses that you're having to deal with?
Oh, yeah, absolutely. So for most companies, where I've been medical, followed by retirement, and especially in recent years, I would put wellness at number three.
Yeah. And it falls into, you're just saying it's three, it's in the top three, or it's like, third, most expensive,
it's third most expensive. medical plans are exorbitantly expensive. retirement, it depends on your match. But also, especially in tech, we all have to give generous matches, they expect that the match that we have at our company is 50% of contributions.
Wow.
Which is huge. I was amazed when I first came here, but yeah, wellness becomes number three, especially because of a few things. So number one with wellness, a lot of the times that you're doing different spot programs that are targeting something specific. So we have globally, headspace, which is a mindfulness app, and is targeted towards helping people on their mental health journeys. We also have active globally, which is a workout app. And we have in some countries, you know, including the US. So we add on top of that allowances in a work different ways in different companies based on different countries based on what the regulations are. But basically you're giving people a certain amount of money they can specifically spend on wellbeing expenses, pre COVID, those things were mostly things like gym memberships and massages, but we really had to rethink how we do things after COVID-19 hit. And now it's more often used for things like home fitness equipment, and apps and wearables and things like that, that people have really switched to
these wearables thing is tracking my less than while walking to the right oh my gosh,
But that's one of those things I know during the day, because it'll pulse a little bit and say, hey, you've not taken 250 steps this hour. And it reminds me that I haven't gotten up. But the biggest thing is that, you know, when you have a whole bunch of programs, they might each be a few dollars. But they add up together. And especially when you're doing a global program, and they have global pricing. If something's let's say $3 in the US, per head $3 in some other countries per head is a lot more of a share of their total rewards than it is in the US, especially when you start stacking these multiple programs on top of each other. And when you're talking about allowances, then you're giving people a lot more money than it costs to provide an app to them.
I personally am a fan that the wellness space is getting you know more attention these days. What about I mean, are you happy about that? Are you kind of upset that it needs to get there
I mean, I think everything's a process. I think it's always positive when you move forward. And I think it's really wonderful for employees to be able to have these things and for them to know that their company really cares about their mental health. I think a lot of times in the past people had this thought process. We've heard some from some employees, if they're struggling, can we have a mental health webinar? And you can't fix that with a mental health webinar? Can we do that? Absolutely. We're happy to do it. It's a piece of the puzzle. But I think now people are really understanding that it is only one piece of the puzzle to do that you have to really be supporting people's mental health all the time in a bunch of different ways. And not just once in a while calling in the employee assistance program when something's you know, come up.
Yeah, that's a good point. I got Do we have time for one more question?
Absolutely.
Okay. I think that for someone who is let's get back to the the person that's considering joining working for you versus a Google when they're looking to evaluate their benefits from an employee perspective, what advice would you give someone who is new to a company and is just completely overwhelmed when they're reading their benefits, maybe it's to your advantage that there's less because it's condensed, and there's less choices, there's psychological evidence that people like less choices than more.
That's actually true. That's something we always think about, because it's easy to want to give people more options. But in a lot of cases, giving them fewer options that are more tailored is more helpful to them. But yeah, if someone's coming in, and they're trying to evaluate their benefits, the best thing that they can do is show up be present. Most of these companies, certainly ours does a benefits presentation for new hires, when they come in, whether that's live like we do, a lot of companies have things pre recorded or available through a third party. Use those resources. I see a lot of the time people kind of trying to multitask through them. And I understand 100% why people have the urge to do that. Even recording this podcast, I had to put a pause on my slack notifications to make sure they didn't distract me while we're having this conversation. But benefits are complicated. And if you don't already understand them, a lot of people feel like we're speaking a completely different language. Sit down, give it the time, and 100% of your concentration at the moment. And that really helps. They'll walk you through exactly what all those things need. And also take advantage of the resources. So if your company has an advocate, team, a service center, whatever services for you to be able to call and have a dedicated person explained your benefits to you. Use them don't guess, where if you have an internal benefits team, you can talk to you when you're confused about something. Always ask the question, because the thing about benefits is that once you pick your plans, we're locked into them for a long time is great advice.
If you're looking for a year, right, I mean, there's until your annual renewal comes up.
Yes. And what most people don't realize is that receiving a new diagnosis or finding out that you're pregnant, these things are not qualifying life events. Oh, so even though it can completely change how you need to interact with your medical plan, you don't get to switch it for those reasons.
That's crazy. All right. Well, one more question if it's okay. What do you do? To stay in the know, in your field? I mean, you you just mentioned a lot of things that are going on in the in the benefits world? How the heck are you staying on top of everything? is great difficulty? Yeah, I mean, I don't know if there are resources that you recommend. Are there books out there? Are there other podcasts that you listen to? Like, how do you stay outstanding? Oh,
absolutely. It's actually, it's tricky, because a lot of anyone who works in benefits probably gets dozens of email solicitations a day. And a lot of outside vendors will have these webinars to teach you about a subject. But actually, most of that webinars, I'm explaining why their product is helpful and why you should buy it. So you just have to be really careful about what things you sit through, we all have a limited amount of time. The best advice I could give people is to ask your brokers, your consultant, whoever it is that you work with, they have a ton of resources available to them, they might not always think that you want to see them. So you might not even be sent everything that they have. interest, ask for those. Make sure also that if you're consultants, or if one of your vendors does a survey that you can participate in for free and get the results back. Always do them.
Oh, that's a good one. That's a good one. So it sounds to me like it's really important for you to have good relationships with the vendors and the consultants that have their expertise. So you can focus on your lane, have the relationship with them that are good, so that you can trust that you're getting good information?
Absolutely. And make sure that those people as well are expecting and understanding that anytime the law changes that affects that realm you expect them to tell you.
Great, that's good advice. Alyssa, this is excellent. I selfishly learned a lot. And I have a I have a inclination to believe that everyone else listening learned a lot as well. So again, I really yeah, I want to thank you for making today happen.
Oh, thank you. I'm so glad to be here.
It's a beautiful thing. You make it a great day. Thanks, you too.