Take the Red Pill: Kelly Fristoe on Breaking the Healthcare Status Quo

Kelly Fristoe didn’t plan on building a career in health insurance.

He started out trying to become a pharmacist, struggled through school, sold supplemental insurance door-to-door, failed forward through several early career moves, and eventually built a successful benefits agency. Along the way, he became deeply involved in NAHU—now NABIP—and ultimately served as the final president of NAHU and the first president of NABIP.

In this episode of The Noble Agents, Kelly joins Tom Stein for a wide-ranging conversation about what happens when a broker stops simply selling insurance and starts questioning how healthcare is actually financed.

They discuss the extraordinary difference between healthcare prices and costs, including Kelly's example of a procedure priced around $6,800 at the Surgery Center of Oklahoma versus roughly $46,000 through a traditional hospital/network arrangement.

Kelly also explains why Direct Primary Care, transparent pricing, alternative plan design, and better incentives can fundamentally change the economics of an employer health plan.

One of the central ideas of the conversation is simple:

Healthcare and health insurance are not the same thing.

Healthcare is the care delivered by physicians and medical professionals. Insurance is one of the financing mechanisms used to pay for that care. Confusing the two makes it much harder for employers and employees to understand where their healthcare dollars are actually going.

Tom and Kelly also dig into broker compensation and incentives. Kelly describes moving away from relying solely on traditional commissions and toward arrangements where his firm can participate financially when it creates measurable savings for the employer—making it much clearer whose side of the table the advisor is sitting on.

The conversation ultimately becomes a challenge to brokers, especially those early in their careers: learn the industry deeply enough to uncover its secrets rather than simply becoming programmed by the existing system.

• How Kelly went from aspiring pharmacist to health benefits advisor
• Why persistence matters more than a perfect start
• How NAHU/NABIP helped Kelly develop as a broker and industry leader
• Why competitors can—and should—learn from one another
• The difference between healthcare delivery and healthcare financing
• Why hospital chargemaster prices can distort the conversation around healthcare costs
• What the Surgery Center of Oklahoma teaches us about transparent pricing
• Why Direct Primary Care can improve both access and incentives
• How rising healthcare costs can consume money that otherwise could become employee wages
• Why broker compensation structures influence behavior
• Moving from commission-based compensation toward value-based advisory relationships
• Why small employers still need sophisticated benefits advice
• The books Kelly recommends to brokers who want to understand the healthcare system
• Why the next generation of brokers should be willing to “take the red pill”
• How industry relationships and collaboration can make brokers dramatically better at solving client problems

Never Pay the First Bill — Marshall Allen

The Price We Pay — Marty Makary

Kelly recommends both as starting points for brokers who want to understand healthcare pricing and begin questioning assumptions built into the traditional system.

The best benefits advisors aren't merely shopping insurance policies.

They're learning how healthcare is priced, how it is financed, where incentives are misaligned, and how to build plans that leave more money with employers and employees.

As Kelly puts it through the Matrix analogy, brokers have a choice: accept the system as it is—or take the red pill, pull back the curtain, and learn how it actually works.

Get out there. Fight for Main Street. And go help somebody.

This episode of The Noble Agents features a wide-ranging conversation with Garrick from The Phia Group about what separates great consultants, brokers, and benefit professionals from everyone else.

Garrick shares his unconventional path into the healthcare benefits industry, beginning as a claims analyst working on subrogation and eventually moving into business development. His story becomes a broader discussion about curiosity, initiative, incentives, consultative selling, and the willingness to admit what you don’t know.

A central theme is that great selling is not about pushing a product. It starts with understanding the client’s actual problem, defining what a successful outcome looks like, and then determining whether your solution can realistically get them there. Sometimes the most credible thing an advisor can say is, “We’re not the right solution for you.”

The conversation also explores why organizations need cultures where people can ask “dumb questions,” challenge assumptions, and contribute ideas from every level. That same mindset applies to brokers working with employers: clients often don’t know what they don’t know, so the advisor’s job is to create an environment where uncomfortable questions can be asked and real problems can be uncovered.

Tom and Garrick dig into one of the biggest mistakes in healthcare consulting: starting with a solution—or a conclusion—before proving there is actually a problem. They discuss claims audits, plan documents, stop-loss contracts, vendor arrangements, and the danger of chasing sophisticated cost-containment strategies while ignoring the basic infrastructure of a self-funded health plan.

The episode ultimately identifies the trait Garrick sees in the best benefits consultants: high agency combined with curiosity. The strongest advisors aren’t married to a carrier, vendor, program, or ideology. They continually investigate new ideas, understand the technical details, remain skeptical when appropriate, and choose the solution that best serves the client.

The conversation closes with a deceptively simple question: What is insurance? Traditional insurance protects against catastrophic risk, yet modern health insurance has evolved into something much broader—often functioning as a mechanism for paying nearly every healthcare expense rather than simply protecting against catastrophe. That distinction raises important questions about what employers are actually buying and what risks they should be managing themselves.

The takeaway: Great advisors stay curious, define the problem before prescribing the solution, master the fundamentals, retain control where they carry the risk, and keep iterating until they find a better answer.

What happens when a small business wants to offer health benefits—but simply can't afford traditional major medical coverage?

In this episode of The Noble Agent Podcast, Tom Stein, CEO of American Trust Administrators (ATA), sits down with Scott Martin of Coterie Advisors to discuss Fundamental Care, an innovative limited-benefit health plan designed for employers who need an affordable first step into offering employee benefits.

Scott explains how Fundamental Care fills an important gap in the marketplace by helping employers who have been priced out of traditional health insurance while also serving companies that want to offer different benefit options to different classes of employees. When appropriate, Cody Advisors also serves as a general agency for ATA's level-funded health plans, helping brokers transition clients into comprehensive self-funded solutions as their businesses grow.

In this episode you'll learn:

• Why many small employers never offer benefits—and how affordable alternatives can change that.
• The two types of employer groups that benefit most from Fundamental Care.
• How limited-benefit plans can serve as a bridge to traditional level-funded health plans.
• Why employee retention is often the driving force behind first-time benefit offerings.
• How employers can structure benefits for different employee classes.
• What reference-based pricing is and why education is so important when introducing innovative health plans.
• Why more brokers are moving away from traditional fully insured products and toward level-funded solutions.
• The characteristics Scott sees in brokers who successfully embrace innovation and better serve their clients.

Whether you're working with startup companies, first-time benefit buyers, or employers looking for a more affordable way to provide coverage, this conversation offers practical strategies for expanding your solutions and helping more businesses offer meaningful employee benefits.

If you're a broker looking to better serve employers at every stage of growth, this is an episode you won't want to miss.

Subscribe for weekly conversations on level funding, self-funded health plans, broker growth, healthcare innovation, and the future of employer-sponsored benefits.

Fight the good fight.

The Best Level-Funded Brokers Think Differently | With Victoria Armstrong

What separates the brokers who consistently win level-funded business from those who struggle?

In this episode, Tom Stein, CEO of American Trust Administrators (ATA), sits down with Victoria "Torri" Armstrong, one of ATA's most experienced broker support specialists. Every day, Torri works directly with brokers, underwriters, and employer groups, giving her a unique perspective on what actually leads to successful level-funded cases.

Together, Tom and Torri discuss the habits, systems, and mindset that separate great brokers from average ones—and why the best producers focus on education, preparation, and long-term relationships rather than simply chasing the lowest premium.

In this episode you'll learn:

• Why level-funded cases require just a little more information upfront—and why that pays dividends later.

• The underwriting documents that dramatically speed up quoting and improve accuracy.

• Why employer education is often the deciding factor in whether a case closes.

• The biggest misconceptions employers have about self-funded health plans and stop-loss insurance.

• Why the best brokers act as trusted advisors instead of insurance salespeople.

• The difference between maximum-funded and minimum-funded plans—and why most new groups should avoid minimum funding.

• How claims reporting helps brokers improve renewals and lower long-term healthcare costs.

• The common characteristics Torri sees in the brokers who consistently build successful level-funded practices.

Whether you're writing your first level-funded case or looking to grow your self-funded business, this conversation is filled with practical advice from someone who helps brokers navigate these challenges every day.

If you're committed to becoming a better advisor and helping America's small businesses take control of healthcare costs, this episode is for you.

Subscribe for weekly conversations on self-funding, level-funded health plans, broker growth, and the future of employer-sponsored healthcare.

Fight the good fight.

In this episode of The Noble Agent’s Guide, we sit down with Brian from Local Edge to explore why some of the best future level-funded brokers may already be sitting inside the P&C world.

Brian brings a unique perspective coming from the personal lines and commercial P&C insurance space into self-funded and level-funded health plans. The conversation uncovers the crossover skills most brokers completely overlook — especially around underwriting, relationship-building, expectation-setting, and long-term client trust.

Key topics include:

• Why level-funded plans shocked Brian coming from traditional insurance
• The “aha moment” of surplus checks and money returning to employers
• How incentives change behavior in healthcare spending
• Why underwriting discipline matters in both P&C and health insurance
• The massive opportunity P&C brokers are missing in group health
• Why relationship-driven brokers outperform transactional agents
• How top producers educate instead of simply quoting
• Why trust and curiosity matter more than spreadsheets
• The similarities between high-value P&C underwriting and self-funded health plans
• How level-funded plans become a financial tool for business owners

One of the strongest themes throughout the episode:

The best brokers are not chasing transactions. They are building long-term relationships around trust, education, and service.

Brian also shares:

• Lessons from handling inbound insurance sales at scale
• Why door-to-door and boiler-room salespeople often become elite producers
• How great brokers set underwriting expectations upfront
• The importance of referrals and relationship flywheels
• Why business owners want one trusted advisor across all insurance needs
• The crossover opportunity between commercial P&C and employee benefits

Memorable takeaway:

“Insurance is the many paying for the unlucky few.”

If you’re a broker trying to understand where the industry is headed — and why relationship-first advisory work matters more than ever — this episode delivers practical insight from both the P&C and employee benefits worlds.

Guest:

Brian — Local Edge

Topics Covered:

• Level funding
• Self-funding
• P&C insurance
• Underwriting
• Group health
• Broker relationships
• Client trust
• Referral systems
• Commercial insurance
• Employee benefits
• Surplus checks
• Sales psychology

Episode 8 | Season 1

#LevelFunding #SelfFunding #InsuranceBroker #EmployeeBenefits #PNCInsurance #GroupHealth #BrokerStrategy #Underwriting #HealthcareCosts #NobleAgentsGuide

In this episode of The Noble Agent’s Guide, we sit down with Indiana-based broker Brian Dusenberry to unpack what separates transactional insurance agents from long-term trusted advisors in the level-funded and self-funded world.

Brian has spent decades in partially self-funded and self-funded health plans, and this conversation dives deep into how transparency, service, and long-term relationship building completely change the insurance business.

Key topics include:

• Why self-funding changes how employers think about healthcare spending
• The moment business owners finally “see where the money goes”
• Why level funding continues accelerating in small group markets
• How brokers provide value even when they don’t win the case
• The importance of underwriting transparency and employer education
• Why the best brokers think in decades instead of commissions
• The difference between a “job mentality” and a “career mentality”
• Why retention is built through service, not pricing spreadsheets
• How elite brokers use communication without overwhelming clients
• Why AI won’t replace relationship-driven insurance advisors

One of the most powerful moments in the episode:

Brian explains that he never truly loses a case:

“Either I win, or I learn.”

That mindset becomes the foundation for long-term success in employee benefits.

The conversation also explores:

• Why service-heavy brokers create lifetime clients
• The residual nature of insurance and building recurring income
• The crossover between military discipline and long-term brokerage success
• Why small-group health insurance creates unusually stable recurring revenue
• The importance of becoming a trusted resource rather than a quote machine
• How referrals are built through honest advisory work

Memorable takeaway:

“The groups that leave usually don’t leave because of service. Life changes around them. If you serve deeply enough, they often come back.”

Brian also shares his perspective on:

• The future of AI in insurance
• Why brokers must commit to insurance as a career
• What characteristics signal future top producers
• Why “people people” often win long-term
• How self-funded plans create visibility that fully insured plans never provide

If you’re a broker trying to build a real long-term career in employee benefits, level funding, and self-funded health plans — this episode is packed with practical wisdom from someone who has already lived it.

Guest:

Brian of BD Insurance

Topics Covered:

• Level funding
• Self-funding
• Small group health plans
• Broker retention
• Client service
• Underwriting
• Insurance careers
• Residual income
• Healthcare transparency
• Broker mindset
• Referral systems
• Employee benefits

Episode 9 | Season 1

#LevelFunding #SelfFunding #InsuranceBroker #EmployeeBenefits #BrokerStrategy #HealthcareCosts #ResidualIncome #SmallBusiness #Underwriting #NobleAgentsGuide

In this episode of The Noble Agent’s Guide, we sit down with Jason Powers of Legacy Brokers to unpack one of the most misunderstood topics in employee benefits: level funding.

Jason has spent decades in the self-funded and level-funded space helping brokers and employers navigate the real mechanics behind these plans — beyond the marketing language.

This conversation goes deep into:

• Why “level funded” is mostly a marketing term
• The dangerous differences between carrier-model and true self-funded plans
• Why many brokers are selling self-funded plans without even realizing it
• The importance of guardrails, accommodation, advance funding, and surplus ownership
• How incentives change when carriers control surplus dollars
• Why underwriting still matters in a post-ACA world
• The difference between transactional brokers and consultative advisors
• How great brokers think about risk, curiosity, and long-term client relationships
• Why self-funding isn’t the answer — but the conduit to finding the answer

One of the biggest takeaways:

Self-funding doesn’t lower costs by itself. It creates visibility. And visibility is what allows employers to finally manage healthcare spend intelligently.

Jason also shares:

• How the industry has changed from “self-funding is dangerous” to mainstream adoption
• Why the best brokers ask better questions
• How AI and instant quoting can create shallow advisory work
• The “company credit card” analogy for self-funded health plans
• Why curious brokers consistently outperform transactional ones

If you’re a broker trying to understand the future of level funding, stop-loss, and self-funded strategy — this is a foundational conversation.

Guest:

Jason Powers

Legacy Brokers

Topics Covered:

• Level funded vs self-funded
• Stop loss and accommodation
• Surplus ownership
• Fixed costs vs claims liability
• Broker incentives
• Underwriting
• Cost containment
• Consultative selling
• Small group self-funding
• Carrier-model plans

Episode 7 | Season 1

#LevelFunding #SelfFunding #HealthInsurance #EmployeeBenefits #StopLoss #BrokerStrategy #HealthcareCosts #InsuranceBroker #NobleAgentsGuide

In this episode of The Noble Agent, Tom sits down with Byron Gilroy, a veteran of the small group health market with nearly three decades of experience serving independent brokers in Texas.

This is a practical conversation for brokers who want to get better at serving Main Street employers, especially those crossing over from Medicare, ACA, or fully insured group health into the level-funded space.

Byron breaks down the real-world habits that separate strong brokers from average ones: setting the table correctly in the first meeting, getting the census right the first time, explaining the process clearly, and building trust through honest conversations instead of hype.

If you are a broker trying to understand how to position level funding the right way, avoid messy quoting situations, and create longer-term retention with clients, this episode is full of hard-earned wisdom.

1. The biggest mindset shift brokers face when moving from Medicare or ACA into group health
2. Why the first business-owner meeting matters so much
3. How to identify the employer’s real pain point before you quote anything
4. Why census accuracy can make or break the quoting process
5. How participation and employer contribution work together in small group
6. Why many young brokers lose the sale during the process instead of at the close
7. How to properly explain timelines, underwriting, renewals, and expectations
8. Why level funding is about more than just monthly premium
9. How claims funds, deductibles, and stop-loss structure affect long-term renewal strategy
10. Why honest brokers win more trust, more retention, and more business over time
11. The difference between speed, technology, AI, and real human judgment in underwriting
12. Byron’s simple definition of what insurance actually is

Too many brokers try to rush to a quote before they have done the discovery work. Byron explains why that mistake creates confusion, weakens trust, and causes deals to fall apart later in the process. He also shares how disciplined brokers can slow down, ask better questions, and build better cases from the start.

This episode is especially valuable for:

1. independent brokers
2. employee benefits advisors
3. general agents
4. brokers new to level-funded health plans
5. producers moving from Medicare into the small group market

If you want to become the kind of broker who serves deeply, explains clearly, and builds long-term relationships in the level-funded space, this conversation will help.

Level funding is not just about getting a lower premium. Done correctly, it is about transparency, claims discipline, better renewal strategy, and building a plan that gives business owners a real chance to win over time.

If this episode helped you, share it with another broker who is trying to better serve Main Street employers through transparent health plans.

Like, subscribe, and follow The Noble Agent for more conversations on level funding, broker development, underwriting, and how independent brokers can build lasting value in the small group market.