My 2026 New Year’s Resolution

Run My Health Plan Like a Product

(And make it easy for you to steal our playbook)

Most CEOs make personal New Year’s resolutions.

I’m making an operational one.

In 2026, I’m running my health plan like we run every other product at our company.

And I’m making it ridiculously easy for other CEOs to do the same — whether you’re ready to go self-funded or not.

What “Running It Like a Product” Actually Means

On January 1st, ZERO Health goes self-funded. But self-funded vs. fully insured isn’t really the point.

The point is treating a big ongoing expense with the same operational discipline you apply everywhere else in your business.

Here’s what that looks like for us in 2026:

Weekly claims visibility Not annual renewal surprises. Not quarterly reports that arrive 6 weeks late. Weekly pipeline visibility showing what’s submitted, what’s paid, what’s pending, what’s trending.

CFOs don’t run P&Ls once a year. We don’t run our health plan that way either.

Real-time routing metrics Every time a member needs care, we track: Where did they go? What did it cost? Did someone help them navigate their options? Did they have support when they were confused or scared?

Routing isn’t about controlling costs. It’s about being there when members need guidance most — when they’re holding a referral with no idea where to go, or when a doctor says “you need surgery” and they’re terrified.

Routing is the operating system of healthcare spend. We’re measuring it like we measure every other operational metric.

Employee Experience after every claim

After every provider interaction, we trigger a PulseCheck:

• Operational: “How easy was it to schedule, check in, and handle billing?”
• Clinical: “Did this provider solve your problem?”
• NPS: “How likely are you to recommend this provider to a coworker?”

We’re building a Yelp for our own plan. Real-time sentiment. Real feedback. Real visibility into whether our plan is creating value or friction.

Mid-year adjustments

Traditional benefits wait 12 months to change anything.

We are going to optimize in real-time. If something isn’t working in March, we fix it in March. Not in January of 2027.

Benefits need to move at the speed of business, not annual renewals.

But Here’s the Thing

You don’t need to go self-funded to start managing your plan better. You just need data.

And that’s my second resolution: make it easy for other CEOs to get the data they need.

Most employers don’t have a benefits problem. They have a visibility problem.

So before you blow up your plan or fire your broker or commit to a massive change…

Just get the data.

4 Things to Ask For Now

If you’re fully insured:

1. “What was our loss ratio in 2025?”
   • The percentage of premiums that went to actual claims (vs. premium)
   • Month by month for a rolling 24 months
   • The rolling 24-month loss ratio shows you how your plan has actually been performing over time and where you’re likely leaving money on the table
2. “Can I get de-identified reporting for 2024?”
   • All claims over $10,000 (don’t let the carrier pick an arbitrary threshold)
   • You want to see: Date of service, diagnosis code, procedure code, amount paid, rendering provider(s)
   • Without this, you’re managing blind
   • Someone has this data – make them send it
3. “What’s our per-employee-per-year (PEPY) spend for the last 3 years?”
   • This is your total annual cost (premiums + fees) divided by covered employees
   • You want it broken out by year: 2023, 2024, 2025
   • This tells you your real trend and lets you benchmark against similar employers
   • Example: If you’re spending $12,000 PEPY and similar companies are at $8,500, you have a $3,500/employee opportunity
   • Industry benchmarks exist — your TPA or broker can show you where you sit
4. “What’s our employee NPS on the health plan?”
   • One question: “On a scale of 0-10, how likely are you to recommend our health plan to friends or family?”
   • Do it anonymously through a simple survey
   • If you’re below +70, your plan is creating employee friction you don’t see
   • And the don’t beat yourself up – this probably won’t be great (we started at -5)

If you’re self-funded:

1. “Can I get weekly claims data?”
   • You want: claims submitted, claims paid, claims pending, top claimants (de-identified)
   • Your TPA has this – most just don’t send it unless you ask.
   • Stop waiting for quarterly reports that arrive 6 weeks late
   • Weekly visibility = weekly decisions = real-time management
2. “How many high-cost procedures happened without navigation or support?”
   • Track: MRIs, CTs, surgeries, and even day-to-day stuff like labs and physical therapy
   • If that number is >25%, you’re leaving massive savings on the table
   • Routing determines whether you spend $400 or $4,000, $8,000 or $80,000
3. “What’s our per-employee-per-year (PEPY) spend for the last 3 years?”
   • This is your total annual cost (claims + fees + stop-loss) divided by covered employees
   • You want it broken out by year: 2023, 2024, 2025
   • This tells you your real trend and lets you benchmark against similar employers
   • Example: If you’re spending $12,000 PEPY and similar companies are at $8,500, you have a $3,500/employee opportunity
   • Industry benchmarks exist — your TPA or broker can show you where you sit
4. “What’s our employee NPS on the health plan?”
   • One question: “On a scale of 0-10, how likely are you to recommend our health plan to friends or family?”
   • Do it anonymously through a simple survey
   • If you’re below +70, your plan is creating employee friction you don’t see
   • And the don’t beat yourself up – this probably won’t be great (we started at -5)

Why This Matters

You’re running a business…

You track revenue daily. You forecast expenses weekly. You measure customer satisfaction obsessively. You hold every vendor accountable.

But somehow, one of your largest expenses operates in a black box?

The idea that you wait 9-12 months to know if your benefits strategy worked is like running your company on annual financial statements.

No CFO would tolerate it. No CEO should either.

My 2026 Commitment

Starting in January, I’m posting:

• Real numbers monthly (claims, trend, surplus, employee NPS)
• Every dashboard we build (you can steal the templates)
• Every decision, mistake, and win (the vulnerability is the value)

We’re not doing this because we have it figured out.

We’re doing this because it doesn’t make sense to navigate this alone, or in the dark.

We’re turning the lights on. Publicly.

Your January Resolution

Ask for the data.

You don’t need to change carriers, fire your broker, or commit to self-funded on January 1st.

Just ask for the 4 things above.

See what you get back.

Because here’s what I’ve learned in the last 6 months:

The folks who respond with clean data and helpful answers? Those are the good ones.

The ones who deflect, delay, or respond with vague explanations? They are not Liberals or Conservatives – they are Preservatives. People who just want to protect the status quo.

Which is why your renewal looks like a random number generator with a big fat commission attached.