PODCAST – The One Thing: Arthur Vera, Zuniga Health

This week, at The One Thing Podcast by The Horton Group, our hosts, Robin Bettenhausen and Tom Kallai, spoke with Arthur Vera, founder and CEO of Zuniga Health.

Zuniga Health’s mission is to empower individuals and communities to achieve optimal health and well-being.

Through their comprehensive healthcare services, they prioritize preventive care, disease management, and personalized solutions that cater to the unique needs of each patient. By reducing employer costs and ensuring employees have the care they deserve, they’re reshaping the landscape of healthcare solutions.

Zuniga Health was inspired by Arthur’s family’s experience and desire to provide affordable health insurance to working families – especially in the Hispanic community.

“I took all of my knowledge and insurance and said, ‘Why don’t I package that knowledge to give back to working individuals who are now the new generation building Chicago?” Arthur said.

Listen to the podcast for more information on Zuniga Health’s growth plan and commitment to serving small to medium-sized employers and the Hispanic population.

Transcription & Podcast Clips

Hello and welcome. Thanks for joining us for the Horton Group’s One Thing podcast. My name is Robin Bettenhausen and I’m here with my co-host Tom Kallai, and we are super excited about today’s best Art Vera. Art is the And CEO of Zuniga Health. And I think what makes the most sense today is to really dive in and talk about why Zuniga Health, what’s happening in the marketplace. And I think help to answer the question that I get all the time from clients about why are there only a few health insurance carriers out there? What’s new? Where else can we look? Why are there only a few. So, Art, welcome. Thanks so much for being here today.

Thank you. I look forward to our conversation.

Wonderful. So, I guess, tell us how was the idea of Zuniga born?

I know it has a little bit to do with your grandpa and so tell us how that was born and really how you’re trying to sort of Honor or hope to emulate and Zuniga as it comes to your grandfather.

Well, I spent about 25 years in the payer Market Commercial Medicare Medicaid. Government-sponsored health plans and just like a lot of families in and the u.s. that were affected bike. Ovid, my family was affected by covert through a loss of a family member so that required me to go back to Chicago and really, you know, be with the family and while I was there three things, sort of occurred.

The discussion around my nephews, who are, you know, in the Moolah Niall younger generation centered around the loss of, you know, our family member but also the topic of insurance came up. How does how do now, given this pandemic, individuals deal with the cost of taking care of one’s loved one? You know, and I was sort of surprising to me that insurance was a kind of a topic and in s being born and raised. Chicago, I went to the area that my family’s from, which is the Halsted Maxwell Street area, which is known as the Ellis Island of the Midwest, at the time when my grandfather immigrated from Mexico to Guanajuato, from Guanajuato Mexico to Chicago and opened. The market called Alfonso’s grocery in 1929 people, like, to claim Chicago is their city, but they’re talking about coming in the 80s. My grandfather was there. When the 29 and for 30 years, he provided the groceries and butcher shop, to all of the immigrants that built Chicago, the Irish that then, settled, in the back of the Yards, the Germans Italians, the Jewish Community, the Hispanic community that was entering through the Pilsen area 18th Street. And so that, that then really struck me that, my father grandfather’s Legacy was really giving back to working class. Families who were building Chicago and I took all of my knowledge and insurance and said, why don’t I package that knowledge to get back to working individuals who are now the new generation building Chicago, and part of that new generation were Hispanics and so Hispanics. In Illinois, are the largest minority employed group that outpaced every other group in the state? Eight. And they’re also the fastest homeowners both in Chicago and in the western suburbs. And so, I took my 25 years of healthcare Health, Plan experience and said, let’s address a model for working families, that are in small and mid-sized employers. And that was that, that was the impetus for Zuniga.

Art, you mentioned that you had spent years consulting in health insurance. Is there something that you saw in the space of void or an opportunity that really drew you or moved you to start Zuniga?

Yes. Yes. It really first became during the Obama years when the ACA came out to try to build affordable, you know, access to care through the Affordable Care Act. And one of the things that really sort of struck me in my years of health insurance was that every time somebody wanted to they had insurance but they wanted to access it. They had to pay money and I was like wow, that’s an interesting model, you have insurance. You want to access your services and now you have to pay money out of pocket. So I looked at plane designs that were really incentivizing and then data shows, data shows that people that are insured. Don’t actually access the insurance because of the cost factors and doing it. So, you have insurance unique care, you’re working, but you’re not accessing the service.

The second was that employers were being crushed by double-digit increases out there. And when you have a balance sheet and the balance sheet has a line item that says cash, Reserve, cash Reserve, small businesses, don’t have a line item that says cash Reserve. Right there, they’re building those businesses. Sometimes paycheck to paycheck and trying to get those companies off the ground. And so, the space that was neglected was the small and midsize employers, who are being really sort of crushed with premium increases. And then the most shocking thing that I read one thing about going to Harvard, you do a lot of research before you do anything. So maybe that was a good part of my training was that the research showed that one out of five working employees. Don’t pick up their meds because of the copay. Wow, these are people that have jobs, and I reflected that comment is somebody I need no here in Miami and they were like that know that that’s not true. That’s like maybe ten dollars. That’s like $20 I said well you know you may be able to drop you know, hundred dollars at dinner and not blink. You know, with your wife but you are working families kid to table economics. It’s important. That’s that’s that’s a big number when you have a ten dollar for the husband, a 20 dollar for the wife, maybe a five dollar for the child and now, you know, people are making decisions. Do I take my meds, do I even pick them up. It said, one out of five, don’t even go and get the medicine.

So, when you think about some of those major conditions, those medications are helping to keep in check, not having those meds makes a huge difference in the long run.

Exactly. And then, one of the things from my own family background, my mother had diabetes and when she was alive and they wanted to send her to a place where self-management to learn how to manage their diabetes. And I was speaking with her, and I said, I said, where do you have to go? Well, it was like a one-and-a-half-hour bus ride. She never had a license. She didn’t drive a car. Then I asked her. Well, is it in Spanish? And those classes are done in espanol. She’s like, no, it’s all in English. So, how would she benefit from any of that? Yeah, so many obstacles to get the care that you need. Exactly. So the other part that I was thinking through with Zuniga is, how do we actually speak to this Hispanic population? Speak to them. So that they know that this service is available, that they know that they can access care and then build a plan design that incentivizes that as well as in. It gives the employer there has to be something that would drive the employer to really make the decision. Because I spent a number of years. Also in the self-funded space, and how do we and self under was really a cost driver for employers shifting from fully insured to self-funded as a way of trying to control costs and but how do you actually get more money into the employers pockets? And so designed a level funded model where there is a potential for every employer to get 100% of the unused claim fund Surplus back. So, for the first time now employers can have money as a credit. So even if it’s a small credit, 30,000 50,000 100,000 that that’s money that they can use for inventory for staff for another truck, right? Yeah, back into programming all that. Yeah.

So I took all of the elements of the best model and put that together, I always. And all of us have heard that in this whole dynamic around health care that those in Washington. Have the Cadillac plan, right? The Cadillac plan, you are hearing the Cadillac plan. And so, I said, why can’t working people have a Cadillac plan? Why do you have to be a government? Why do you why do you have to be retired in Medicare to feel like you’re you have the Cadillac plan? Why don’t I get the Cadillac plan? Well, I’m working, right? The previous 40 years of life. Yeah. Well, no Monda the working track, right? And so that was the Impetus of Zuniga. And then taking the family name was important to me for the legacy of my grandfather. And I’m a member of the Texas Association is panic Chamber of Commerce. They advocate for about 60,000 hispanic-owned, businesses throughout Texas.

And one of the things that they were pleased on, is that the company name, wasn’t it?

Dark name, write a name that you couldn’t pronounce. And I said, well, I’m not quite sure, you know, Zuniga would be a name that people would perceive to be easy, and he said they said well the chamber was founded in 1975 by Henry Zuniga. So, they said, then he is not going to be, you know, an unknown name here in Texas, I could be a problem, is that a problem? It also sticks out which is great, right?

So, what you’ve shared so far, just being a new healthcare plan out there really focusing on certain areas of the community certain set of individuals. It seems like it really fits a gap that was out in the healthcare space. So how are you getting the word out about Xena guess?

Well, the there’s a couple of ways in which that brand is going out, and one specifically being associated with the Hispanic Chambers. So, I am in Illinois, a member of the owner, Hispanic chamber of commerce and met with the leadership there to really Explain to them the value of the company. What we’re doing. There’s also a little village Chamber of Commerce on 26th Street, that they are producing a more Revenue out of the 26th Street area than the West Loop right now, because of the growth of the businesses in the little village. And so, I’m a member of that, as well, as I indicated to mock the Texas, Mexican American Chamber of Commerce Ours and it’s really that venue and then second working through strong broker partners. And in Chicago I’m happy that the partner is the Horton Group. I think we share a lot of things in Synergy and kind of can talk about that. It what I feel is strong but and it’s really working through a broker channel that shares the same passion that shows the same mine. It’s set as it. Everyone says that they have the same DNA that we have, and they do right from the from the appointment of many Franco as your vice president, to these strategy and commitment to this Panic market. And so that’s, that’s a great Synergy.

Art, you mentioned, you know, a couple different things that were interesting. You’re targeting the Hispanic market, different structures.

We call ourselves The One Thing podcast, so if you had to boil, Sit down and tell us what’s the one thing that said, Zuniga apart from traditional insurance carriers?

First of all, the name and to, we speak to them. Everything that we have in the model is both in English. And in Spanish, one of the things that was quite striking. When I spoke to the Illinois, Hispanic chamber, they said a lot of their members and they advocate for a lot of the small businesses by Hispanic businesses in Chicago. Is that they those businesses don’t even know where to call. About insurance. And so we have, if you look at the back of your your ID card right now, there’s probably about three or four numbers back there. Like what what number do I call on Zuniga? There’s one number. There’s one number. And so that number is through a partnership with MedWatch their pathway could see are and that that number, when you call that number, they will adjust everything you need in English and in Spanish. Whether it be, how do I find a pediatrician 10 miles from my house that speak Spanish. How do I have an EOB? I don’t quite understand what. This is anything they will triage that through one number. Yeah, it Harkens back to what you were saying about your mother and her trying to get treatment for diabetes.

Just eliminating barriers to receiving care.

Correct. And fundamentally in my mind, and I’ve worked for a lot of wellness companies, and wellness programs have done a, you know, a good job trying to keep people healthy, but a lot of times, those models are kind of a carrot and a stick kind of approach, right? And I talked to one woman who said, yeah, there’s a running challenge in every just team signed up and they’re running five miles at lunch and we’re barely able to make it up the stairs to the office. So how are we going to compete in the running Challenge and so fundamentally to me, it was just three things if you’re working. Go see your primary care doctor, go, get a blood test and take your meds. And so, for that basic hair under the Zuniga model, we eliminated, all co-pays, there are no co-pays for Primary Care, generic drugs Imaging, and in labs and imaging co-pays, for Imaging can be up to 50 to 100 dollars on a copay. And so those three things are four things. Is that really what I would consider basic and preventive care.

You don’t open your wallet. You just go get the care and take a lap test. Take your meds. It’s so encouraging for people to know that what they pay out of their paycheck is going to cover them for when they go get those Services as you started at the top of the hour, just when people don’t get that care. It’s unfortunate, right? I mean their pain, the company’s paying for it. So, eliminating those barriers is important and that leads me.

I guess to my other question of, you know, you’re new and newer in the space, you’re able to access through a lot of different associations. And for So what have you seen is the results? What’s the feedback that you’re getting from groups that have signed on zooming up?

It’s critically positive. You know, one of the things that as we’re, you know, we’re launching and we’re quoting now and we’re saying, you know, our quotes are typically 15 to 20% lower in premium, and then when you eliminate all these out-of-pocket costs on the copay, And then the potential for the employer on the back end to have a savings through a level funded model and you have to kind of explain what that is, right. All of the premiums are calculated actuarially through some up to the risk pool as a population that sets the premium amount. And so once they paid 112 to the premium every month, if we adjudicate less than that projected amount in the premium. That that savings that excess Surplus. Compacted it to the employer. But what happens if we exceed? What happens if we actually in a scenario, we were projected to adjudicate a million dollars in claims and we adjudicate eighty-eight hundred thousand.

Well, there’s a 200,000-dollar Surplus but what happens if the opposite, what if we adjudicated a million to write? What if we went over, right? There’s a part of the premiums have a stop loss coverage. And so, the stop-loss carrier becomes a firewall that covers that excess amount when that those dollars hit the attachment point, then that goes to the stop, oh, scarier for payment. So, the premium for the employer is leveled, it never goes up and it never goes down. But hence the name level funded and what you see in other models is one that goes over. Then there’s you know based on the contract the premium goes up for the employer and so they don’t have any predictable budget, right. How do you how do you have a predictable budget? When the premium is variable right? You know? And so, those are all the good things and getting back to covet. One thing that we found out about COVID was that telemedicine became increasingly?

It was…you know some founders of telemedicine companies they exploded right through covet. And so, their health plans and Zuniga at thinks telemedicine is definitely incredibly valuable but the thing that was occurring in the data shows that when you have two or three free telemedicine visits and then the third or fourth is out, 30 40 dollars. Utilization drops. And so, under Zuniga telemedicine and telepsychiatry unlimited, that’s fantastic. Unlimited as a parent of three kids. Telemedicine visits have been fantastic for fantastic. Exactly. And so, if you’re working person don’t want to go to urgent care and you have a swollen, I get on a telemedicine council, they say oh okay we need put an antibiotic will prescribe that you click off didn’t pay anything. It was your trip to visit. You go to what green CVS, you pick up the generic drug antibiotic. Boom, you’re done, and easy peasy and I wanted unlimited telepsychiatry, because there still is this stigmatism among Hispanic populations to seek Mental Health, Services.

You know, you always have both male and female, if there’s you know some issue then I think we can really address depression anxiety, any of those conditions through telepsychiatry, our Behavioral Health councils, but to do that unlimited, if you really having depression and you think, wow, I’m going to hit my third one. And now I have to tell somebody I’m paying you Something out of our bank account to pay for the third one. I don’t think you need to be exposing that. Just have it unlimited and seek the care you need. So, it’s really keeping working families. Healthy. That was, that’s the whole, the whole goal and being able to do that virtually at all hours or when it’s convenient for a working family is fantastic. Exactly. Exactly. You mean. Nobody knows when they’re going to get sick but when you do get sick, you need to be able to get the care. You know.

Immediately one thing that I found, there’s a lot of things that are out there on wellness and and Healthcare, but nothing really happens.

We don’t go to parties and talk about hey what’s your condition and what’s your copay and what’s your, what’s your no? Nobody talks about that but but but when two things happen, all of a sudden, you want to know a lot about your insurance company when you’re diagnosed with the condition or your scheduled for a procedure. When those two events occur, you’re diagnosed with high blood pressure, Joseph hard, you know, or you’re scheduled for procedure, a ptca, a stent. You know, all of a sudden, you start googling health information. You start going back to your enrollment papers saying, what did I sign up for?

Yeah, exactly. Look at my enrollment. Do I have enough medical benefits to cover this? And then you go on the whole family, calling everybody will have, you know, I mean, they all mean. Well, they all have all the wrong information to tell you, right? Because they had a friend that had this and that happened. You like, wow. So yeah with Sunni got its if you’re scheduled for a procedure or diagnosed with the condition you just, you know, you can even just call the concierge service, get all the information and or if not then you know, everybody wants a walk around with their insurance benefits in their smartphone because that’s the Latest, you know, and one of the things I realized recently, I saw a couple of people and he said, well, you’re carrying your whole television. I mean the thing was pretty big like, well, I mean there’s got to be a limit to, but we have all of that on Google Play and apple on a mobile app for Zuniga and it has all of your Wellness information.

You know, your benefit and one of the things that I found with the mobile app tap, the number one thing people use off the mobile app is the temporary ID card. Mmm, Yeah, of all the things that it can do you’re at the doctor’s office and for some reason you’re looking, and you don’t have the ID card, right? Right. And now you got to call somebody, or they got to call the office. And they now it’s just, here’s a temporary ID. Card. Boom, and ready to go.

Yeah. Art, what would you say? What has been the biggest challenge?

Starting Zuniga, the think the biggest challenge is always, you know, getting the name out, you know, getting the brand out because there’s so much brand out there from the from the major, you know carriers. But, you know, the thing that is quite different for Zuniga is in. We’re not venture-backed. I’ve worked for been tracked, companies. I’ve raised 15 million of in, from some of the startup with the Silicon Valley, a premier of venture capitalists and I’m I am driven by my growth but but the right level of growth, right? So I don’t have a need for unrealistic expectation numbers, you know, if I told the board, my projected numbers that I want to achieve, I’d be first on the list to be fired, you know, because when you raise ten fifteen twenty million, the you know they have This expectation for growth that is that is hopefully it’s attainable but it’s a see a cash that you’re burning, right? And so I think could good growth in each market that were in. I’m license. Currently in Florida, Illinois, and Texas, and building building that growth model has been quite quite rewarding and exciting and and being able to Were to tell the story when somebody says right now.

If you had to call the CEO and founder of one of the major carriers, how would you even find them?

Well, I tell them, I’m it. I’m, I’m the founder and CEO of Zuniga health and and I have a team that is working with the same DNA that I have around. Great Value to, to Working Families. Speaking of growth. And this is a good segue for me but it are things like that.

What has resonated so well with small to medium-sized employers with Zuniga, what’s the thing that really really hits?

It hits them as the message?

Yes.

That that they’re going to get a cadillac service without paying it was orbited premiums.

It’s just and also that they can actually get their employees to seek care. That’s needed. What all these are, what I’ll do without these barriers, right? And you tell someone, there’s no copay. They’re like, well, why doesn’t other carriers do that? Well, because I have a different cost structure model, right? I’m operating at a different, you know, level, I guess.

Yes, if you look at and I’ve done this, look at salaries of the executives, and major health plans, and it’s 5 million, 6-million-dollar salary. I’m not going to be making 5-million-dollar salary. I could tell you that, you know, I’m going to have a very profitable company and a growth model, but it’s really putting all of the, all of the resources, you know, to enable a plan design that gets people incentivize their…there’s been a lot of discussion because of the need for care to go to a direct provider, direct doctor mono or contract doctor Moll, but you can still do this on the. If you create the plane design that enable all that access to doctors, right? I mean you don’t need to have to go to a direct, you know, model.

So, the peak biggest piece that people really want to know on the Employers side, as you know, what’s their Network? What kind of doctors are will might blow my will?

Yeah, that’s usually the first question. My wife asked me, what? Yeah, but what’s the doctor I mean, am I going to kind of You know, strip mall doctors. Or am I going to sort of wear? And so, we’ve contracted it Zuniga, the two largest Premiere networks in the country, but the hundreds of doctors and great facilities and so access is not going to be 2. X s is going to be to the best Jayco rated facilities in the country on the physician and, and the network side. And so, taking all of that. Those elements that I’ve learned and contracted and consulted with carriers for 25 years and took all the best pieces, right? Took all the best pieces and said, let me put the Zuniga puzzle together by putting all the best pieces. Because if you were going to launch a company today in 2023 is got to look different than a company in 2000, right? Because of. And so, I took all of the best pieces in 2023 and laid those later. All together and then said fantastic. You know, my model is a company. I could write down to a company of two employees up to 399, right? And so, no one wants to. No one wants to talk to a company of 10 people, but guess what if your startup with 10 people, you’re a pretty good-sized startup, right, right. You’re a pretty good size, you know, when I start when I when we Raise 6 million from Sequoia Capital. There were just four of us just for people in the company, humble hand, and I was a chief technology officer. So, I had to build all the, you know, it infrastructure. And I was a band of one, right? I told everybody I’m the Chief Information officer buddy, but I’m the chief bottle washer? Because every time I go in the lunchroom, there’s like dishes. So, you know, this clean this place up and most small and Is employers are running winging and doing all those roles to we’re multiple hands.

Yes. As our last question of the day. What’s next for Zuniga?

This just continued growth, you know, both in the markets that I’m in. But, you know, I want to expand the Colorado, Arizona, Nevada, right? All areas that have seen, you know, tremendous tremendous growth both in the Hispanic population but in Hispanic businesses expand Enoch entrepreneurs, right? And it’s just amazing, just by way of, you know, the numbers, when I went to my high school in Chicago, my brother and I were the only two, Hispanic students, and the whole school. And now the school is 90%, Hispanic, Right? And when I went to Boston and I was head of the Hispanic student council for all of Metro, should the Metro Boston?

There are only 300 Hispanic students in the whole Metro Boston area. Yeah. And I knew who they all were because we called every school Wellesley Boston, Boston University and we had everybody, everybody, under registers. So, I knew every student who is in every Boston University, and those numbers have changed right now. And just in Illinois, I went to the University of Illinois, Chicago. And when I was there, Hispanic students of Mexican and sent out of 18,000 students work, there were only 200 of us.

At the time, I think that’s what I’m most excited about pursuing guy is just the representation that you’re bringing to the marketplace that there was a void. Yes, it’s very exciting. And I think anyone listening is going to feel the same way. Yep. And then, you know, you know, the Synergy with Horton is great, right? From the fact that both companies are family names, the Horton is a family name soon. He has a family in need then And the commitment to the Horton has to small and mid-sized employers for services. Both on the health property casually side here, your full line of business that you have, as well as the full line of services that Zuniga has for small and mid-sized employers and then third just the commitment. Also, to the Hispanic Community, right? It’s just that was the Synergy that was just the perfect timing right of where the markets at. And so yeah. So, I took off, took off up to Consulting and said let’s let’s put all these pieces together. I know what they are and build the best, you know, trading partners to pull all the elements together, build a team that has the same DNA structure that That I have that has the passion every day, every day and then, you know, so I think there’s great things that are that are going to go in there.

All right, I think you’re doing great work. And I think your grandfather would be proud of you doing the name honor.

Yes. Thank you.

Thank you so much for your time today. We really appreciate it, and we’ll see you next time. Thank you.