Category: Press / News

As a Regional Sales Director at ProAct, Inc. Mike delivers a fresh perspective on pharmacy benefits. With his diverse experience in all areas of employee benefits, he understands the major roll pharmacy management plays in not only cost containment but also employee satisfaction. ProAct focuses on flexible solutions with high touch service. Working with Brokers and TPAs, they customize a PBM plan that fits an employer’s budget, and their employee’s needs.

What is your background and how did you get into the EB business?
I started in the insurance business in 1989. After college graduation, I joined Metropolitan Life as a sales representative selling individual life insurance policies at the kitchen table. It taught me the “Rule of 50” in prospecting. From there, I moved to an independent agency for 7.5 years selling employee benefits to small business employers. For the next 10 years, I moved to the health carrier side of the business working for Kaiser, Emblem Health, and United Healthcare. In the health carrier sector, I learned about large group underwriting and the complexity of provider networks and contracting.

I then chose to move back to the agency side for 14.5 years with responsibilities focused on sales and management. I managed an EB department for 5 years and doubled the revenue in the department by adding great sales talent.

Another opportunity appeared with the introduction of ACA. We built a team to help employers complete their 1095s and file their 1094s with the IRS.

Most recently, I had the opportunity to join ProAct, Inc., a 100% employee-owned Pharmacy Benefit Manager. With the complexity of employee benefits and specialty pharmacy in today’s healthcare landscape, I have the important task of helping brokers and consultants help their clients manage pharmacy cost of their employee benefit programs.

What are your leadership principals?
My core leadership principals are to lead by example; challenge the process; enable others to act; and develop future leaders.

What are you looking forward to as a BAN Partner?
I am looking forward to ProAct’s collaboration with BAN membership to provide PBM education and value.

How are you advising your clients regarding inflation, higher interest rates and a shaky economy?
All employers are feeling the pressure of inflation, higher interest rates, a shaky economy, and employee retention concerns.

Complex conditions represent significant costs within employer health plans. In 2022, specialty spend throughout the industry continued to outpace non-specialty and grew approximately 11.6% compared to non-specialty growth of 6.9%. These challenges in specialty spend are changing how brokers and consultants are helping employers manage their total spend for pharmacy benefits.

ProAct offers various solutions to assist employers (plan sponsors) in managing specialty drug spend; including percentage-based copay programs, utilization management edits, as well as funding assistance partnerships.

The introduction of biosimilars can also offer some relief. By monitoring upcoming biosimilar and generic launches, ProAct can strategize appropriately, and implement formulary changes to transition utilization toward the agent losing exclusivity or by evolving our clinical programs to increase utilization.

ProAct’s Clinical Optimization Program offers an opportunity to discuss alternative medication therapies aimed at lowering prescription drug expenditures for plan sponsors, while improving health outcomes for members.

Around the corner in 2025, there will be an introduction of many new medications for gene therapy. We work with our brokers and consultants on planning in advance for these innovations to help provide solutions in mitigating substantial increases in pharmacy spend.

Are you concerned about a recession?
A recession will greatly impact employers in operating their businesses. We will work with brokers and consultants to help mitigate excess pharmacy spend through education.

What is your outlook in 2024?
Over the past few years, we’ve seen an unprecedented level of legislation around health plans and pharmacy benefit managers, leading to over 2,800 new pieces of legislation introduced around pharmacy benefits. We look forward to being a resource for Benefit Advisors Network Partners on the changing marketplace to ensure compliance with both federal and state reporting requirements.

What is the industry’s largest challenge?
The industry’s largest challenge is innovation and the rising cost of pharmacy benefits. We look forward to developing and executing solutions to help BAN’s brokers and consultants find innovative ways to manage their employers’ total pharmacy spend.

What are two lessons that you learned during your career that you can pass along to future leaders in the insurance industry?
In sales, it took me about 20 years in my career to learn that joint team selling can generate substantially better results. As a leader, I learned the importance of taking care of my team members and showing them how important they are to the company and our goals.

Mike can be reached at mikegrinnell@proactrx.com.

Follow Mike on LinkedIn.

Ashley Inman, a skilled business development and marketing professional, brings over a decade of experience in the tech and healthcare industries. As VP of Market Development at Truveris, she connects partner networks, benefits brokers, and self-funded employers with the right solutions to improve prescription drug pricing and contract transparency while driving vendor accountability.

Before Truveris, Ashley drove business growth in healthcare analytics, enterprise system consulting, competitive strategy spaces, and leading marketing and strategic client initiatives. With an MBA and undergraduate degree from Babson College, her academic background is rooted in entrepreneurship, management, and strategy. Ashley is based in New York City.

What is your background, and how did you get into this line of work?
As I’ve navigated my career across various roles in marketing, consulting, and business development, I’ve gravitated toward industries and teams where I can maximize contribution and impact both personally and vocationally. With so much inefficiency and costs in the healthcare space, it’s a natural fit for someone who loves to take a mission-driven approach to solving important issues while creating winning growth strategies. I also care a lot about people, so it’s important to me to be in a collaborative role working with like-minded people who are equally as passionate about using our unique skills and contributions to improve the lives of others by driving value and innovation in the space.

What are your leadership principles?
My leadership principles center on competition, teamwork, and a collective purpose. I thrive on data and results, channeling that energy to mobilize teams towards shared objectives. I care about authenticity and believe emotional intelligence is fundamental to building high-performing teams. Ultimately, my focus is on driving value for communities and utilizing my skills to make a meaningful impact. I try to lead by example, inspiring others to learn, grow, and challenge themselves, and the industry to build something great and make a difference.

Why are you passionate about BAN? What value has it brought you/your business?
We’ve long admired BAN and its member organizations, so to have the opportunity to join as an exclusive industry partner is a true honor. BAN and Truveris share a common purpose of using innovation to solve the most challenging issues facing the benefits community. We’re a recent member of the BAN network, yet we’re already busy meeting many agency members and forging new relationships. We’re excited to collaborate and partner with their clients’ pharmacy contracting needs.

Where do you see the industry headed for the balance of 2023 and 2024?
Truveris is exclusively focused on pharmacy, specifically PBM management and cost containment. We expect the trends in pharmacy that have received a lot of attention in 2023 will carry into 2024 with even greater significance. The role of specialty medications will continue to rise, fueled by the likes of biosimilars, gene therapies, and GLP-1s (diabetes drugs used for weight management). With a consistent rise in employer and member costs, the calls for transparency, regulation, and disruption in the supply chain will grow louder, especially entering an election year. PBM oversight and reform are key legislative agenda items receiving bipartisan support in Congress. Beginning January 1, 2024, the Medicaid AMP (average manufacturer price) cap will be removed as outlined in the American Rescue Plan Act of 2021. This will have sweeping impacts on drug manufacturers and PBMs seeking to preserve their profitability and will ultimately affect plan sponsors and their pharmacy contracts.

What are the industry’s biggest challenges?
We think of challenges through the eyes of our clients – i.e. the benefits agencies and the plan sponsors. The most obvious challenge facing the industry is rapidly rising pharmacy costs for plan sponsors, driven by the trends we mentioned before. Almost every employer sees this as a major issue, but they feel helpless to do anything about it. The root cause stems from a pervasive lack of transparency in pharmacy. The complexity and opacity of pharmacy contracts leave employers in the dark and lacking control over their own programs. The best thing that agencies and employers can do is not be complacent about it. There are things that can be done, and pharmacy is one of the only benefits that can be proactively negotiated to reduce costs.

How can you help BAN members address these challenges?
Partnering with agencies to support their clients is a real source of pride for us. As an objective third party, we can empower BAN members and their employer clients by giving them visibility and control of their pharmacy programs. We’ve built a tech platform for PBM procurement and oversight that creates pricing transparency and drives competition to reduce costs for employers. The technology replaces the traditional models of using spreadsheets or waiting to get renewal offers. On average, we can generate deal improvements of 20% against their current spend. We also readjudicate 100% of the claims against the contract terms throughout the life of the contract, so that both the employee benefits producer and the employer know if they’re getting everything that’s been outlined in the contract. Very often, we find errors or variances that result in a shortfall for the employer. Having that information gives them full visibility and allows them to reclaim those dollars and put them to use someplace else. It also helps them sleep at night, knowing that they’re holding their PBM accountable to all the terms in their contract.

Ashley can be reached at ainman@truveris.com.

Follow Ashley on LinkedIn.

CLEVELAND, OH and EAST SYRACUSE, NY (10/24/23) – Benefit Advisors Network (BAN), an international network of progressive and visionary employee benefit brokers and consulting firms from across the United States and Canada – announces it is partnering with ProAct, a fully integrated, employee-owned Pharmacy Benefit Management (PBM) company.

Under the terms of the new partnership, ProAct will offer BAN member firms affordable and flexible prescription drug benefit solutions for self-funded clients. They combine industry-leading client service with the latest in PBM technology.

“The ProAct team is a great addition to our bank of reputable partners. With overall prescription drug spending rising nearly 10% in 2023, our members will benefit from their expertise and custom-built plans as well as solutions to manage high-cost medications,” says Perry Braun, President & CEO of the Benefit Advisors Network.

Braun continues, “In addition, ProAct focuses on the mid-market sized employer group, making them a much better PBM partner for our members versus a mega-PBM vendor.”

“We recognize so many people can’t afford prescription medication and at times are forced to choose between necessities,” says Mike Grinnell, Sales Director at ProAct. “This is why we are excited to partner with BAN to support their member firms as they seek to provide employer clients with the most cost-effective pharmacy benefit needs.”

About Benefit Advisors Network
Founded in 2002, BAN is an exclusive, premier, international network of independent, employee benefit brokerage and consulting companies. BAN delivers industry leading tools, technology, and expertise to member firms so that they can deliver optimum results to their employee benefit customers. BAN intentionally limits membership because of the highly collaborative interactions. For more information, visit: www.benefitadvisorsnetwork.com or follow them on LinkedIn.

About ProAct

ProAct is a 100% employee-owned, fully integrated Pharmacy Benefit Management company providing benefits since 1999. Aiming to serve midmarket sized employers that are often underserved, ProAct offers flexible solutions for cost-effective prescription drug benefits. ProAct services a diversified client base consisting of manufacturers, unions, universities, municipalities, hospitals, corporations, not-for-profit organizations, long-term care facilities, financial institutions, and more. Through an organic growth strategy, ProAct has been able to provide clients with an offering that couples competitive pricing with a high-touch service model that only an employee-owned PBM could provide.

ProAct manages the dispensing of prescription drugs through its mail-order pharmacy, ProAct Pharmacy Services, as well as through its national retail pharmacy network consisting of over 64,000 pharmacies in the United States, Puerto Rico, Guam, and the Virgin Islands. For more information visit: https://proactrx.com.

Michele is Vice President & Director of Employee Benefits at CoyleKiley, BAN’s most recent member agency. Michele graduated from Creighton University in Omaha, Nebraska with a degree in Journalism/Marketing. She began her insurance career in 1995 at Rockford Health Plans. Michele holds her Accident/Health, Life and Long Term Care licenses. She joined CoyleKiley in 2010.

What is your background, and how did you get into the EB business?
Shortly after graduating from college, I started working as an Operations Manager for a medical billing office in Rockford, IL. I became friends with a few of the Account Executives that worked for the local HMO plan, who had offices in our same building. They asked if I would be interested in working with them and that was the beginning of my insurance career in 1996. That HMO plan was then purchased by a larger regional plan and shortly after that in early 2003, I left the carrier side to become a consultant with a small, locally owned and operated Employee Benefit agency in Rockford. Then, in 2010, I joined CoyleKiley agency to develop the Employee Benefits Division, which has grown from 1 employee to 9 employees in 13 years.

What are your leadership principles?
I have these two sayings hanging up in my office:
Leadership is about inspiring people to do things they never thought they could.
Leadership is not about being the best, but it is about making everyone else better.

What are you looking forward to achieving as a BAN member?
I am looking forward to collaborating with other insurance professionals on best practices to help me grow personally and professionally within my career.

How are you advising your clients regarding ongoing inflation, higher interest rates, and a shaky economy? Are you concerned about a recession?
We pride ourselves on our relationships with our customers which keeps us involved in their business throughout the year. We share industry trends as well as future outlooks with them on an ongoing basis so that price increases and economic setbacks are not a surprise. We have not spoken too much with our customers about a “recession” at this time.

What is your outlook for your agency in 2024?
To continue our 97% retention rate as being the “agency of choice” for our current customers as well as continue to grow locally, regionally, and nationally.

What is this industry’s largest challenge?
The cost of group medical insurance.

What are two lessons that you learned during your career that you can pass along to future leaders in the insurance industry?
I have learned that Transparency is always the best policy and to Treat others as you would like to be treated.

Michele can be reached at mkimes@coylekiley.com.

Follow Michele on LinkedIn.