At an age when many of his peers are either preparing for or thoroughly enjoying retirement, John Kahle is just beginning what looks like his third, final and most audacious act.

Kahle is an active guy. A recent inductee to his alma mater's athletic hall of fame for his years as a power forward, he's also an avid tennis player. He's big on health, on fitness, on wellness.

He knows the value of it personally and he's committed to make sure his clients understand the value of it professionally. While his current to-do list may be short, it's also bold. Kahle is confident that with the help of his colleagues at Intercare Insurance Solutions they can transform group health insurance which, he concedes, is a mature and slow-moving industry.

That is just one of the many reasons why Kahle, chief wellness officer for Intercare, was selected from the hundreds of nominations submitted to be EBA's 2008 Employee Benefit Adviser of the Year.

Kahle's a key member of the Intercare team that has propelled the firm from its spot as the 19th largest broker in the San Diego region to the third position in just two years. Fifty percent-plus annual revenue growth is what's behind that leap.

He's been around and around the insurance business and at this point in his career he's settled himself at the foot of one of the industry's toughest obstacles - transforming the way employers look at health care. Kahle's trying to get his clients to understand that the cost of good health benefits is less like keeping the lights on at work and more like R&D. Sure the lights have to be on, but R&D is where the next iPod comes from. Investing in workers is how you go Google.

Yes, Kahle's out on the philosophical promontory, but he's also an expert on more traditional terrain. For him it's all connected.

Helping self-insured clients become data-minded often means inching them towards self-funding. Better data opens up a world of opportunities for focused health improvement efforts and targeted value-based benefits offerings.

He helps employers understand the importance of good data by also surveying employees, using health risk appraisals to separate fact from fiction for employer and employee alike.

An HRA program with one client revealed that while 94% of participants self-reported their overall health as "good" or "excellent." The assessment showed just 28% actually were. On the flipside, 1% self-reported an overall health status as "poor" or "needing improvement." The HRA showed that 56% of respondents met the criteria for poor health. Three percent self-reported a serious health problem while the HRA showed 16% had one.

Data's derivative

"The issue, really, is how do we leverage the relationship from the employer to the employee to lower health care costs and have better health care consumers," according to Kahle. Data is a means to an end. "To the extent that we can gather information, we can help the employer to make an informed decision of what they should be doing. That's what the employers want. They want a strategy. They don't want another rate: 'Here it is. So I'm good for another year.'"

Kahle's one of a growing number of advisers trading up the value chain - for themselves and their clients. Neither satisfied nor suited to traditional transactional brokering, Kahle says it's Intercare's goal to gather as much data as possible, transform it into information and then knead it into knowledge. From knowledge will come action, he says.

With a clearer picture of workforce health, employers can go about the business of improving the aggregate health status and reap the rewards that come with such effort. That requires communication and lots of it. Kahle and Intercare are among the very best, most progressive and most diligent in the industry when it comes to education - podcasts, Web seminars, newsletters, employee sites, surveys, e-mail blasts, snail mailings and focus groups are all employed.

If an employee, a spouse or HR still has a question then the company's dedicated million-dollar call center fields it.

A valuable quest

Considering value is central to Kahle at the moment.

"We understand the cost, but the cost and the value are two different things. And we don't do a very good job of informing both the employer as well as the employee on what the value of a benefit is," Kahle says.

This perspective has Kahle zigging when many of his peers are zagging on an issue like HSAs.

"My gut feeling is that if, in fact, an employee has a $2000 deductible and that applies also to the prescription drug side - which always is a shock to them - that the value that is being delivered by that product is not as high as the value that is being delivered by a much lower deductible," he says.

Instead of employers pricing sensitive populations out of drugs they need by raising co-pays, he says they should move in the other direction. Don't take the $20 co-pay to $30, take it to $10. The last thing an employer wants is a patient skipping needed meds to save a few sawbucks, he says.

"What happens is they become claims waiting to happen," according to Kahle. He says most, not all, of his clients get it. It's the other side of the industry that's doesn't.

"Most employers that we talk to understand that if we're going to take away some of the barriers to access, that is we're going to lower some of the co-pays ... for certain disease states, that's going to cost more initially. They all get that," he says. "The point is will it save us more in the long run? The problem we have is not the client. The problem we have is finding the product within the insurance industry."

The carrier community's reliance on an annual renewal cycle also contributes to the problem, according to Kahle.

"If we wanted to change the industry significantly all we'd have to do is go to two-year rates or three-year rates. Why we can't figure that out in our business is beyond me. I understand about actuarial and trends and all that kind of stuff that we all know, but why can't we be smart enough to figure out a two- or three-year rate?"

The rate carousel is doubly debilitating for the industry because it drives employers to focus on costs more than value and it pushes the universe of advisers to do the same.

"We treat our business as a commodity because the insurance industry gives us commodity pricing. We go to the employer and say, 'Okay, you can move from carrier A to carrier B for 8% less.' Then carrier B who has it for two years is upset when carrier C comes in."

Business churns from one broker to the next and insurance carriers pay as much attention to the novice adviser as they do to the masters. The latter aspect of the industry is what drove Kahle to merge his own firm - SFG Benefit Insurance Services - with Intercare in October 2006. To really have a shot at totally transforming the business he knew size was as important as skill.

"The thing that speaks to carriers is volume. You have to have volume. You can be a high quality agent and you and do a great job but if you don't have volume you don't get their ear," Kahle says.

PODCAST

Listen to the rest of our conversation with Intercare's John Kahle online at EBA's Raw Bar. Visit eba.podhoster.com.