Paul Cella is the Managing Principal of the KeyArx group. Paul has spent 30 years providing insurance and financial advice to physicians.

James: [00:00:06] You are listening to the Broker Advisor podcast, where we explore the disability insurance market specifically as it pertains to protecting highly compensated healthcare professionals. The goal of this podcast is to arm you with interesting tidbits and anecdotes you can share with your clients and prospects. We have found that the two best ways to do that are to speak to healthcare professionals who have suffered from a disability or pick the brain of industry experts who excel in their field. My name is James Crook. I am a marketer and have a Disability Income Fellow designation. I am your host. If you like what you hear, please remember to rate and subscribe. Thank you. As always, this podcast is sponsored by MGIS, Insurance Health Care Professionals Expect. Welcome back to the Broker Advisor Podcast. Today we have got Paul Cella. He is the managing principal for the KeyArx Group. He has got a lot of great experience in the physician space, and we are super excited to have him on the show. Paul, welcome. 


Paul: [00:01:11] Hey, James, how are you, my friend? 


James: [00:01:12] I am doing great, and we are excited to have you. We nabbed you on short notice, so we really appreciate that too. 


Paul: [00:01:18] No worries. I can help anytime. 


James: [00:01:20] All right. So, Paul, just to get started, tell us a little bit about who you are and what you do. 


Paul: [00:01:26] So I’m the managing principal of the KeyArx group. I’ve been a chartered financial consultant. I’ve been in the business for 30 years. And primarily, probably 90-plus percent of my clientele is physicians. And we serve them in three main areas. And we do, I believe, in best in class at KeyArx, meaning if I don’t do it well, I farm it out to somebody else. Sure. We serve them in group. The ancillary benefits, the group short-term, long-term, life market space. We handle very sophisticated retirement planning. I acquired a company called Retirement Architecture last year. And last, we help doctors through life insurance reviews. So those are the three main areas that we focus in. 


James: [00:02:12] So you’re really. You’re very specialized. 


Paul: [00:02:15] Yeah, that’s it. And you know, with the doctors, our focal point is those three areas. But we also focus on mitigating risk, uncovering opportunities for them, and trying to save them money. And that’s where we continually focus our practice. 


James: [00:02:31] Okay. Awesome. So, tell me how you got into this niche position space. How did that happen? What’s the story? 


Paul: [00:02:42] The story is by happenstance. I fell into it. 


James: [00:02:45] That’s what everyone who have asked that has told me. So, I’m interested to hear how that happened to you. 


Paul: [00:02:51] So I have a friend and longtime client, one of my first disability clients. His name is Dr. Michael Nussbaum. And I got to tell you, James, probably the smartest individual I’ve ever met. So, he was in his residency. He’s a bariatric surgeon in his residency. He was bored, invented a retractable syringe, and wrote a novel in his residency. So, I don’t know too many guys. And I know, you know, hundreds and hundreds of doctors and he just blew me away. But anyway, he asked me one day; I’ll never forget, he asked me and, hey, Paul, do you do that disability stuff? And I’m like, Yeah, yeah, sure, of course, I do. And I had no idea. 


James: [00:03:29] Yeah, of course. Yeah. 


Paul: [00:03:30] And then I said, Hell, I’ll, you know, let me see what you can get, and I’ll get back to you and give,me a couple of days. I’ll put some stuff together for you. And then, I took a couple of days to learn about disability. So that’s how I got into the market. He referred me to some guys, and everybody said, well, Mike’s doing it; I’ll do it. And then from there, I just started doing lunch and learns, bringing in lunch, you know, talk to the director of a program and just say, hey, can I educate you guys on financial 101? And disability is the cornerstone, so ever since then, it just progressed from there. 


James: [00:04:03] So you got a good ROI on the lunches you brought in? 


Paul: [00:04:07] Absolutely. For the young producers, that’s it’s a great way to go. You build your farm team. 


James: [00:04:13] Right. Right. Okay, great. So that’s how we got into the space. So, the rest of this conversation, I’d love to know what some of the best strategies you have for kind of maneuvering in this space. What are some of the, you know, you talk about disability is the cornerstone. Right. I’m interested in. I’m just interested in how you how you’re getting into these doctor groups and how you’re using disability. You know, you brought this up. We were talking before you. You have this Trojan horse speech that you give. So, you know, just educate me. 


Paul: [00:04:58] Well, you know, you know, a couple things. You know, sharing ideas for the producer. If you’re in the market space, I don’t have to tell you how to get in, but if you want to get in, I what I did a lot is I went to my good networks, you know, like an accountant, who do you know in your life that’s dealing with doctors? And that’s what I did. I went to CPAs and said, hey, you know, either do rev shares if they were licensed, if sometimes they just, you know, they didn’t want to receive any compensation attorneys, um, people in pharma, people in people that are attracted or have some kind of connection to health care. And, you know, start if you have a spouse who’s your spouse used for an OB/GYN, who does your spouse use that? So, you got to look within yourself. But once you get if you have them, great. I work the referrals from them. Doctors are the number one purchasers of disability of any industry, any occupation in the United States. So, they typically want it. They want more. So, it’s you’re serving a market that it’s not like you’re going to a bricklayer. These guys want they want disability. You know, I like to show them ways that they can get it more how to get it more efficiently, you know, because a lot of doctors, they’ve been buying their policies since fellowship and residency, and they’ve cobbled together all these policies individual over time. And then the practice group disability is kind of like the final piece. 


Paul: [00:06:22] And that’s the piece that really, I think most times it’s not set up to max it out, and you know that that’s where we focus on. And that’s what I would tell the producer, focus on the group. And this leads into the, you know, the Trojan horse concept. Is that if you sell an individual policy to a doctor who belongs to a practice, let’s say you have an orthopedic group of ten, ten people, and you have one doctor, well, that doctor or the other nine have. They have their own insurance person. They’ll have their Northwestern or Guardian or whatever person. They’ll have their Schwab or LPL advisor or, and then they each have different CPAs and all. But it’s the group is the one item that they share together, and it’s the one item that you, you know, if you go in for individual, you have to sell all ten people with the group. You may only have to sell one, but you can get to the other people after you’ve got the group. And if you do a really good design and spend some time on the group for us, it earns you the right to ask for other business. And that’s the Trojan horse. You get in with the group disability, just like if you were doing their health or just like if you were doing their med mal. So, it’s a really a powerful place to start. I’ll talk to you what I’ve seen post-COVID, but that’s, that’s kind of the Trojan horse concept from my perspective. 


James: [00:07:42] Okay. Interesting. Yeah. 


Paul: [00:07:44] The other there’s another what I also was going to say is you were asking for other things the best way, and you know, it works. So, we usually stop doing it right when it works. But the second-best thing that I always do is ask for referrals. I go into my good guys that like me with I’ll go to, I’ll have my team go to their LinkedIn the doctor and look at their LinkedIn contacts and just, you know, Hey Jim, you know, I noticed, you know this one, this one, this one, this one. And guys fly together; orthopedics fly with other orthopedics and, or I say, orthopedics. I like the higher-income specialties because those have the biggest needs. But when you go to their LinkedIn, you can create a feeder system for yourself and, you go back to the doctor, and you say, I notice, you know, Doctor Smith and Brown and whatever. Would you mind if I drop your name and tell them I know you? And create referrals for yourself.  


James: [00:08:42] So what’s your. What’s your success rate on that? Are your contacts pretty open to doing that for you? 


Paul: [00:08:46] When I do it, it works 100% of the time, but it works so well I forget to do it. But usually, that’s we all get busy, and you know, but it’s something that I would strongly recommend doing that. That’s, that’s a nice feeder system for yourself.  


James: [00:09:02] Awesome. So, you talked about what you’re seeing post-COVID. Like tell me, tell me, get into that. You started talking about… 


Paul: [00:09:11] Post-COVID. What I’m seeing across multiple carriers, whether it’s MGIS or the Lincolns or the Hartfords of the world, I see rates going on, the rise, rates are on the rise. And when rates are on the rise, there’s an opportunity, for there’s always opportunity when things are shaken up. And I know, you know long haul claims disability, there’s a little bit of uncertainty, you know, what used to maybe be a 2 or 3 year claim may be longer because on the disability side. I see rate locks coming down, you know, so I think post-COVID, the doctors are angry. You know, there’s less nurses in the hospitals, so they’re hating medicine. They want to get out. Um, and, and I think disability, it’s still on their minds. And you know, I said earlier they want more coverage, but a lot of doctors get premium fatigue, and premium fatigue is if you’re spending, you know, ten, 15, $20,000 a year on disability insurance, you know, the spouse is usually saying, hey, I want to go on a nicer trip this year, the heck with more disability. So I think in looking at the disability, the group, it lends itself to an opportunity. And obviously, you know, especially when you have female doctors, they pay so much more than guys’ individual coverage. So when you have a group of female doctors or a large percent, a larger percentage of females in a practice, those are awesome to go after because if you can show them what an individual plan would cost versus the average group rate, and then you can get them more coverage and bring the cost way down. 


James: [00:10:52] It’s interesting. So you talk about premium fatigue. There’s a couple of things you brought up that I want to follow up on. So first, let’s start before premium fatigue; you mentioned that there’s less nurses around, and that’s making the doctors frustrated. So how is that impacting the benefits landscape for you? 


Paul: [00:11:12] What I think. I think they’re just getting more burnt out because they’re doing more things because of the lack of nurses, you know, around. So, I don’t have an exact answer for this one, but just in the last two years, I have seen some of my best clients just want to get out of medicine. They’re tired of it. They’re angry. And so, you know, at the same time, you know, a lot of them, when you just bring up the disability and the costs going up, and you can design something a little bit better, they’re interested. They want it. And I’m also going back to the practice and treating the disability to these doctors. You don’t have enough where it intertwines with the premium fatigue is, they want more. They just don’t want to pay for it. Well, if you can take the CFO or the leader of a practice and create a better mousetrap, you’re creating an executive benefit. So, giving them something, you know, for giving them more coverage for, you know, for the same dollar. I always try to go in and save the practice 15 or 20% on the premium. That’s my goal. Apples to apples. And they don’t need the savings. Then you redeploy the savings to get bigger, better benefits, you know, and if you can find savings and redeploy it or maybe have a small increase on the cost per head, per doctor, that really should be your goal. And if you treat it like an executive benefit, I think that mindset will bode you well. 


James: [00:12:44] Interesting. Yeah. So treat it like an executive benefit, not a commodity. Yeah. Yeah, for sure. Interesting. So, do you have so with the clients that you kind of deploy this approach with, do you find that the doctors, like ah do you feel like that’s counteracting that burnout that you’re talking about at all? Like, does it help with that?  


Paul: [00:13:08] It does, because they’re now they’re, you’re showing them appreciation. Yeah. Remember when COVID was here? You know, let’s, let’s serve our doctors. Let’s welcome our heroes. And. No, but nobody’s doing anything for them. Right, Right. So show. Hey, let’s do something for our heroes here. Yeah, that’s the way I see it. I feel like I’m on a mission for these guys. 


James: [00:13:29] Yeah. Awesome. So, premium fatigue. Any thoughts, generally, that we’ve talked about how that’s kind of related to the burnout, but just generally with premium fatigue, how do you counteract that when you have a client who might come to you and say, Hey, I’m tired of paying all this money for something I don’t use? 


Paul: [00:13:48] Right? Right. Well. 


Paul: [00:13:50] I mean, the easiest way I could say it is to take the female example. So, you have a 45, 48-year-old female, whatever, specialty, OB, whatever. And she may have, you know, 10 or 15,000 of an individual policy. And when you run the rates, your head will spin. I mean, you could see somebody with 15,000 a month with a $800, $850 a month tab. Wow. You know, for a female. So, if you take that and now you bring it back into the group policy, the group policy, I’m not saying it’s going to be a giveaway, but it may be $480. You know, it’s going to be literally that kind of spread between those two. So that’s the opportunity. So now the female that has 15,000, you can have a good solid contract. Now the MGIS contract is, in my opinion, the strongest group contract in the marketplace for doctors. It’s not an individual plan, but it’s pretty darn close. So you don’t have I don’t feel guilty, the producer. I don’t. I never tell somebody to get rid of disability. But now you can have someone that’s maybe in that last 8 to 10 years of practice, and you can say, Hey, they’re getting crushed with individual rates. You want to you want to take off ten here, let’s put ten more on the group side to have a more efficient design and help you with that premium fatigue. That’s kind of what I mean by that.  


James: [00:15:15] Gotcha. What I’m really getting from you is you’re treating you’re using the MGIS contract in specific. You’re using it as an executive benefit. You’re using it so you can take a consultative approach with the doctors, and that’s getting you more business through, you know, through other benefits that they’re trusting you with. 


Paul: [00:15:37] Right, exactly. And once you’re in the door to that producer who listens to this, you know what I was saying before, you’re in front of all ten of those, you might be in a partner’s meeting, but when you share that business, and you do a real good job, and you think through it, and you try to get more benefit, more, more benefit for that doctor and a better design, then you’re earning the right to say, Hey, can I show you what I really do? Well, what do you really do? Well, well, I do life insurance. I do retirement planning, or I or whatever that producer else, they do investments or whatever they do. So, I like to feel if you do a really good job with the group people, I’ll round this out round up on this one is that. I see; I very rarely come across really good design plans, very seldom. And on the disability side and most disability plans, my practices are bought by their health insurance professionals, and the health insurance professionals are usually wonderful at what they do. I hate health insurance. I stay away from it, but at the end of the day, they’re usually very good at what they do, but they’re not specialists with disability, and it’s more of an afterthought, right? And that there’s the opportunity. 


James: [00:16:47] That’s the commodity approach. Yeah, right. 


Paul: [00:16:50] Oh, no. You know, spreadsheeting stuff and. 


James: [00:16:52] Exactly. 


Paul: [00:16:53] I’ll show cheaper carriers and say this is why you don’t want to, you know, and typically I don’t, I don’t even show other carriers. I just, I make a recommendation. Right. Unless, unless they’re the shopping type. But I get them away from that with contract. 


James: [00:17:09] That’s great. Right. You’re taking the you’re like in fact, you know, in the research interviews I’ve done with some, you know, random brokers off the street who do the full suite of benefits. I do hear a lot of well, we spreadsheet everything. And the problem is that when you show the spreadsheet you’re price anchoring people to the lowest option. Right. And so you’re, but you’re price anchoring people using the IDI and saying, well. 


Paul: [00:17:39] You know, the game set match, James. You just say to the to that producer, tell your client we have a group contract that’s that the definition of occupation is down to the CPT codes. What’s that? Those are the procedures you’re performing. The producer may not know that, but the doctor knows what a CPT code is. So, if you have a definition down to the CPT codes, that’s the strongest possible definition you can have. So, there are contracts out there. I don’t want to beat up any companies, but there are contracts that say if you can’t perform in the national economy of medicine, what the hell does that mean? That means the company can control what you can be doing or not. So that’s horrible. So, you know, I would, I would uncover that piece. And I don’t like a lot of too many points. You know, when you’re comparing things, pick 3 or 4 of the biggies. The definition of earnings, is it taxable? And, you know, is all the sources included. The definition of occupation, transition, return to work. Don’t, in my opinion, I hate those charts where you have 87 points. They all get lost in it. It means nothing to them. Right? Give them two, three points, four at the most, and hit it home. 


James: [00:18:55] Okay. 


James: [00:18:55] Well, Paul, we really appreciate you coming on the show. Those were some really awesome insights. Paul’s the managing principal at the KeyArx Group. They specialize in helping physicians, which is an incredible value proposition. So, Paul, thank you very much. 


Paul: [00:19:09] James, I appreciate it. Have a great day. And if you ever need me for another talk, you let me know. 


James: [00:19:14] Oh, absolutely. 


James: [00:19:22] Thanks for listening to the Broker Advisor podcast. If you like what you heard, please remember to rate and subscribe. Have feedback. Please send it our way. 


James: [00:19:31] Thanks again. 



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