Expert in Benefits for Brokers, Self-Funded Groups & SIMRPs: Matthew Kohler
Expert in Benefits for Brokers, Self-Funded Groups & SIMRPs: Matthew Kohler
The employee benefits industry has spent the last several years adding more.
More virtual care. More wellness programs. More behavioral-health resources. More pharmacy solutions. More apps, platforms, portals and point solutions.
In many cases, those additions have created real value. They have also created a new problem: employees often have more benefits than they know how to use.
That is becoming one of the most important challenges in benefits strategy.
An employee may technically have access to virtual primary care, urgent care, counseling, an EAP, a health coach, nutrition support, prescription resources and multiple wellness programs. But when that employee actually needs help, the question is often much simpler:
Where do I go?
That question is increasingly shaping the work of Matthew Kohler, Founder of Remote Wellness Solutions.
Kohler works with insurance brokers, self-funded groups, SIMRP organizations, TPAs, MEWAs, Chambers of Commerce, associations and other organizations to help structure healthcare and non-insurance benefits around the people who ultimately have to use them.
The opportunity, as he sees it, is no longer just about adding another benefit.
It is about building a better way into the healthcare system.
The Problem Is No Longer Access Alone
For years, the benefits conversation focused heavily on access.
Could employees get to a doctor?
Could they see a behavioral-health provider?
Could they access care virtually?
Could employers offer more services without dramatically increasing cost?
Those questions still matter. But the market has matured.
In many cases, employers already have access to those services. The new problem is fragmentation.
One solution handles virtual primary care. Another handles urgent care. Another handles counseling. Another handles wellness. Another handles prescriptions. Another handles navigation.
The benefits may all be good individually.
The employee experience may still be terrible.
That is where care navigation becomes much more important.
A strong navigation layer gives the member a clear starting point and helps direct that person toward the appropriate level of care.
That could be primary care.
It could be urgent care.
It could be a counselor.
It could be a health coach.
It could be a nutrition professional.
It could be prescription support.
It could be a chronic-care resource.
And sometimes, the right answer is an in-person physician, specialist or facility.
The goal is not to force everyone into virtual care.
The goal is to make it easier for people to get to the right care.
Care Navigation as the Front Door
For large employers and organizations serving broad populations, that front door can become one of the most valuable parts of the benefits strategy.
Instead of asking employees to understand the architecture of the benefit package, the navigation experience can help organize it for them.
A member may begin with a health dashboard, a wellness interaction, a benefits question or a care need.
From there, the experience can use available information, personalized recommendations, health education, coaching, communications and benefit data to help guide the member toward the next appropriate action.
That matters because people do not experience healthcare as a list of products.
They experience it as a sequence of decisions.
Do I need a doctor?
Can this wait?
Should I use urgent care?
Do I need counseling?
Is this something I should discuss with a primary-care provider?
Would a coach or nutrition professional help?
Do I need to be seen in person?
A better benefits strategy helps answer those questions.
That is the larger vision behind the work Remote Wellness Solutions is pursuing.
Where Non-Insurance Benefits Fit
Non-insurance benefits remain an important part of the equation.
Virtual primary care, virtual urgent care, behavioral health, employee assistance, wellness, coaching, prescription programs and other services can create meaningful value for employers and members.
But their value increases when they are placed inside a broader care strategy.
For an insurance broker, that may mean helping a client fill a specific gap.
For a self-funded employer, it may mean creating a better pathway into care.
For a SIMRP organization, it may mean supporting a large participating population with healthcare, wellness and engagement resources.
For a TPA or MEWA, it may mean building something that can be deployed across multiple employer groups.
The important point is that the benefit itself should not dictate the strategy.
The population should.
A group with weak access to primary care may need one solution.
A group with plenty of benefits but low utilization may need a navigation and engagement strategy instead.
A large employer may already have excellent clinical resources and simply need a better way to connect employees to them.
That flexibility is central to how RWS approaches non-insurance benefits.
Building an Integrated Care Ecosystem
Virtual care still plays an important role, particularly because it can remove many of the barriers that keep people from engaging with healthcare in the first place.
But virtual care becomes more powerful when it is part of an integrated system.
Primary care can provide an ongoing relationship.
Urgent care can provide immediate access for episodic needs.
Behavioral health can expand access to counseling and mental-health support.
Health coaching and nutrition can support longer-term goals.
Wellness can help engage members before a problem becomes more serious.
Prescription programs can address another major point of friction.
Care navigation can connect those pieces.
That is what an integrated virtual care ecosystem should do.
It should not feel like six unrelated benefits.
It should feel like one healthcare experience.
And the member should not have to understand which vendor sits behind which service.
The member should simply know where to start.
Why This Matters More at Scale
The need for this kind of structure becomes even more apparent in large-group benefits.
A workforce of 500 people is complex.
A population of 20,000+ members is exponentially more so.
At 20,000, 50,000 or 100,000+ members, there is no single healthcare need, no single demographic profile and no single pathway that makes sense for everyone.
Some members will need primary care.
Some will need behavioral-health support.
Some will need preventive-care reminders.
Some will need a coach.
Some will need help navigating prescriptions.
Some will need in-person care.
Others may not need clinical care at all, but they may benefit from wellness engagement or education.
That is why scale changes the conversation.
It is not simply about negotiating a lower price.
Large populations can justify better integration, more sophisticated navigation, more personalized engagement and different program structures.
They can also create opportunities for custom economics, co-branded experiences and technology integration that may not make sense for smaller groups.
For RWS, those larger populations are especially compelling because the impact of getting the structure right can become significant.
Self-Funded Groups and the Value of Better Direction
Self-funded groups have a particularly strong reason to care about navigation.
For these organizations, the way employees interact with the healthcare system matters financially as well as operationally.
If a member can be directed toward the appropriate level of care earlier, that can improve the experience and potentially reduce unnecessary friction in the system.
But the bigger point is not simply cost avoidance.
It is access and decision-making.
A member who does not know where to go may delay care.
They may use a resource that is poorly suited to the need.
They may ignore a benefit that the employer is already paying for.
Or they may abandon the process entirely.
Better navigation creates a more direct path.
That is one reason care navigation and integrated virtual care are becoming increasingly relevant in self-funded benefits strategy.
SIMRPs, TPAs, MEWAs and ASO Arrangements
The same model can apply across other parts of the benefits ecosystem.
SIMRPs — Self-Insured Medical Reimbursement Plans — may require healthcare, wellness, preventive-care, engagement and non-insurance benefit components around a larger program.
TPAs and ASO arrangements may want to offer stronger healthcare capabilities across an entire book of business.
MEWAs may be looking for scalable solutions that can serve multiple participating employers through a common structure.
Each presents a different distribution opportunity.
What they have in common is scale.
When a solution can reach many employer groups rather than a single population, the strategy changes.
The clinical services still matter.
The economics still matter.
Implementation still matters.
But the navigation experience becomes increasingly important because the population is larger, more diverse and more difficult to engage through a one-size-fits-all approach.
Chambers of Commerce and Association Benefits
Chambers of Commerce and other membership organizations represent another area where this model can make sense.
A Chamber may serve hundreds or thousands of employers, many of which would have limited leverage if they approached healthcare and non-insurance benefits independently.
Collectively, that membership can represent a meaningful population.
That creates an opportunity for non-insurance benefits for Chambers of Commerce that go beyond a simple discount program or member perk.
A Chamber could potentially make virtual care, behavioral health, wellness, prescription resources, coaching or care navigation available across participating employers.
More importantly, it could provide a central entry point that helps those members understand how to access and use those services.
That same principle applies to trade associations, professional associations, cooperatives and other organizations built around aggregated membership.
The value is not just access.
It is organization.
It is giving members a clearer healthcare experience than they would likely be able to build independently.
The Role of Remote Wellness Solutions
Remote Wellness Solutions sits between the benefits organizations trying to solve these problems and the healthcare, wellness and technology capabilities that can help solve them.
RWS works with insurance brokers, self-funded groups, TPAs, SIMRPs, MEWAs, ASO structures, Chambers of Commerce, associations, cooperatives and other strategic partners to evaluate what already exists and determine what is missing.
Sometimes that means adding a new benefit.
Sometimes it means bringing several services together.
Sometimes it means improving navigation around programs that are already in place.
Sometimes it means helping a partner build an integrated virtual care strategy.
And sometimes the opportunity is much larger: developing a model that can be distributed across tens of thousands of members through a strategic partner.
That flexibility is intentional.
RWS is not built around the idea that every organization needs the same answer.
The strategy should match the population.
The Future of Benefits Is Not More Products
The benefits market will continue to add products.
There will be more virtual-care platforms.
More behavioral-health solutions.
More wellness technologies.
More AI.
More pharmacy programs.
More point solutions.
That part is inevitable.
The more important question is whether employers and members will be able to make sense of all of it.
That is where care navigation, integrated virtual care and non-insurance benefits begin to converge.
The next generation of benefits strategy will not simply ask:
What else can we offer?
It will ask:
How do we make the resources we offer easier to understand, easier to access and more useful?
That is the direction Matthew Kohler and Remote Wellness Solutions are pursuing.
For an insurance broker, that may mean giving a client a better healthcare strategy.
For a self-funded group, it may mean creating a smarter front door into care.
For a SIMRP, TPA, MEWA or ASO arrangement, it may mean developing a scalable model that can serve a much larger population.
For a Chamber of Commerce or association, it may mean turning aggregated membership into meaningful healthcare access.
And for organizations serving 20,000+ members, it may mean building an ecosystem capable of directing each person toward the resource that actually makes sense for them.
Because ultimately, the best benefits strategy is not the one with the longest list of products.
It is the one that helps people know what to do next.
