What if the fastest way to grow your agency wasn’t hiring more people, but removing friction?

In this episode of The Rodney Mattos Show, Rodney Mattos Sr. sits down with Andy Neary to break down how artificial intelligence is quietly transforming independent insurance agencies and why those who embrace it early are building a massive competitive advantage.

This isn’t an AI hype episode. It’s a real-world, operator-to-operator conversation about how agencies are moving from 30% to 50%+ EBITDA by redesigning how work actually moves through their business.

Rodney shares how Apeironix was born inside Triforta as an internal solution to eliminate manual work, reduce errors, and restore momentum across renewals, policy verification, commissions, and submissions. What started as a fix for internal pain points has evolved into an automation layer helping agencies compress workflows that once took hours into minutes, without replacing people.

You’ll hear how independent agencies can:

• Reach 50% EBITDA without adding headcount
• Eliminate repetitive admin work that drains teams
• Create operational predictability buyers and private equity reward
• Turn automation into a valuation multiplier, not just a cost saver
• Use AI to amplify their best people, not replace them

Rodney also explains the Mirror Effect, the async automation breakthrough behind Apeironix, and why motion, not effort, is now the true measure of progress.

If you’re an agency owner thinking about scale, sustainability, or exit and you’re tired of grinding harder for thinner margins, this episode will change how you think about AI, operations, and enterprise value.

Episode Highlights

• Why automation is now existential for agencies
• The math behind EBITDA expansion with AI
• How efficiency directly drives valuation
• The Mirror Effect: AI that mirrors human judgment
• Why automating between systems matters more than tools

Learn More & Connect

Explore Apeironix and the automation layer built specifically for insurance agencies:👉 https://apeironix.com

If this episode resonated, share it with another agency owner and subscribe to The Rodney Mattos Show for more conversations about building smarter, more valuable insurance businesses.

Insurance won’t fix itself. We will.

If you’re an employer staring down another renewal and feeling that familiar knot in your stomach, this episode is for you.

In Episode 8 of Blueprints for Better Benefits, Rodney Mattos Jr. and Rodney Mattos Sr. go straight at the thing that stops most leaders from taking control of their health plan: fear. Not abstract fear. The real kind, felt by CFOs who need predictability, HR teams who are already stretched thin, and CEOs who want to protect their people without gambling the business.

This episode is a reset. A reframe. A reality check. Because fully insured may feel safe… but for many employers, it’s quietly draining budgets year after year, with less transparency, less control, and fewer options than you’ve been led to believe.

Together, we unpack the Top 10 fears employers have about self-funding, and we dismantle them with real-world experience, proven strategy, and a few stories from the frontlines that hit close to home.

Episode Highlights

• Why employer fear around self-funding is often learned helplessness from years on the fully insured treadmill
• The #1 concern: “What if claims blow up our budget?”, and how captives cap risk and define maximum exposure
• Catastrophic claims explained: stop-loss insurance and why those claims exist in fully insured plans too (you just don’t see them)
• “We don’t have claims expertise”, why you don’t need it when you have the right quarterback and infrastructure
• Predictability & cash flow: how captives' smooth volatility while keeping costs stable month-to-month
• HR workload: why the right self-funded model can mean less friction, not more
• Legal/ERISA fears: what employers already carry today, and how compliant vendors and oversight reduce liability
• The “career-risk” fear: how leadership teams gain confidence with actuarial modeling, board-ready education, and proof
• Myth-busting: why captives aren’t a trend or discount program, they’re a Fortune 100-level strategy made accessible to midsize employers
• Real savings story: how a mining employer uncovered and reclaimed $1.5M in waste and reinvested it back into their people

What You’ll Take Away

This isn’t a hype episode. It’s a field guide for leaders who want clarity.

Self-funding isn’t a silver bullet. But it is a smarter, more transparent, more human strategy, when designed correctly, protected correctly, and managed intentionally.

And the truth is simple: The only thing scarier than making a change… is staying put while costs keep rising and control keeps shrinking.

Learn More & Connect

📩 hello@triforta.com

🌐⁠⁠https://www.triforta.com/education⁠⁠

🔗LinkedIn: @Triforta-partners

We are Triforta.

And this is how employers take control, reduce volatility, and finally sleep at night.

What if there was a benefits strategy that wasn’t too rigid… and wasn’t too risky…but just right?

In Segment 7 of Blueprints for Better Benefits, we introduce GuidedEdge®, Triforta’s proprietary alternative funding methodology designed for employers who feel trapped between high-cost fully insured plans and the perceived risk of full self-funding.

GuidedEdge is the bridge, combining the predictability of fully insured, the flexibility of self-funding, and the upside participation of more advanced risk models, without the long runway or governance lift of a captive.

If you’ve ever said:

• “Fully insured is too expensive”
• “Self-funding feels like too big of a leap”
• “We want transparency without sleepless nights”

This episode was built for you.

Episode Highlights

• Why GuidedEdge is known as the “Goldilocks” option, not too hot, not too cold
• How GuidedEdge compresses implementation timelines to 3–4 weeks
• The role of advanced stop-loss and shared-risk layers in stabilizing cost
• Real-world results: 148+ GuidedEdge clients, $10M in claims paid, $4M+ in underwriting profit returned
• How fewer than 8% of U.S. employers are using strategies like this today
• Where GuidedEdge fits on the funding spectrum (fully insured → self-funded → captive)
• How utilization data reveals the “bell curve of opportunity” inside every plan
• Why monetizing low utilizers while protecting against high-cost claims changes everything
• Side-by-side plan comparisons showing real savings with no network disruption

Who GuidedEdge Is Built For

• Employers with 20+ enrolled employees
• Organizations facing abnormal or double-digit renewals
• CFOs and HR leaders seeking claims transparency and predictability
• Employers who want flexibility without catastrophic risk exposure
• Physician groups, school districts, construction, mining, and mid-market employers
• Leadership teams ready to rethink how healthcare dollars actually work

Key Takeaway

Most employers don’t need an all-or-nothing solution.

GuidedEdge proves there is a middle path, one that:

• Lowers costs
• Improves transparency
• Limits downside risk
• Shares upside savings
• Preserves employee experience

It’s not an insurance product. It’s a strategy, designed, governed, and supported by Triforta’s team of actuaries, analysts, and benefit strategists.

Learn More & Connect

📩 hello@triforta.com

🌐⁠https://www.triforta.com/education⁠

🔗LinkedIn: @Triforta-partners

We are Triforta.

And this is how employers take control, reduce volatility, and finally sleep at night.

GuidedEdge isn’t about taking a bigger risk. It’s about taking a smarter one.

In this episode of Blueprints for Better Benefits, we introduce the strategy that transforms self-funding from a smart decision into a stable, long-term solution: Captives.

Up to this point in the series, we’ve covered the core building blocks of better benefits, self-funding, stop-loss protection, transparent PBMs, GuidedEdge, and integrated cost containment. But even with a well-designed self-funded plan, many employers still worry about volatility, big claims, and unpredictable renewals.

That’s where captives come in.

In this segment, we explain why Triforta views captives as the ultimate form of “sleep-at-night risk control.” By pooling risk with thousands of like-minded employers, captives stabilize costs, smooth out claims volatility, and give employers predictability that simply doesn’t exist in the fully insured world.

We walk through:

• Why Triforta partners with captives and how they empower employers to regain control
• The scale behind the captive model, including 3,000+ employer members, over 1 million covered lives, and billions in healthcare spend under management
• How a 30% stop-loss renewal cap and no-new-lasers policy protect employers from disruptive rate spikes
• Why captives act as a shock absorber, smoothing the highs and lows of claims experience
• How stop-loss premiums flow through the captive, and why member-held capital reserves are an asset, not an expense
• The renewal methodology that replaces extreme volatility with predictable, manageable increases

We also review real-world outcomes, including:

• Average first-year savings of 7.5% for employers transitioning into the captive
• 82% of employers saving money in year one
• And for those who don’t save initially, why the captive model still prevents the kind of crushing premium hikes common in fully insured plans—and positions employers to recover and win long-term

This episode makes one thing clear: captives aren’t about chasing short-term wins. They’re about building stability, predictability, and resilience into your healthcare strategy, so employers can plan confidently, even in uncertain claims years.

Episode Highlights

• Why captives are the foundation of long-term self-funding success
• How Triforta uses captives as a built-in shock absorber
• What “no new lasers” and renewal caps really mean for your budget
• How collective scale unlocks leverage individual employers can’t achieve alone
• Real case study outcomes from employers who made the move

Learn More & Connect

Interested in adding stability to your benefits strategy?

📩 hello@triforta.com 🌐 https://www.triforta.com/education 🔗 LinkedIn: @Triforta-partners

We are Triforta, and this is how employers take control, reduce volatility, and finally sleep at night.

In Part 4 of Blueprints for Better Benefits, we move from “self-funding basics” to what employers actually want next: consistent savings and predictable stability.

So far in this series, we’ve covered how self-funding—paired with stop-loss and pass-through PBMs can reshape your benefits spend. Now we take it further.

This episode introduces Triforta’s Integrated Cost-Management Platform (ICM), our coordinated approach to cost containment that helps employers reduce the everyday claims spend that quietly consumes the majority of a health plan (often around 65% of total spend).

What is ICM?

ICM isn’t “one more vendor.” It’s a connected strategy built on three pillars:

1) Integrated Point Solutions Curated, pre-vetted programs that target high-cost areas like imaging, elective procedures, second opinions, neonatal/NICU management, and specialty care, negotiated at preferred pricing and designed to plug into your existing plan.

2) Real-Time Interventions This is where savings become proactive. With live pharmacy claims feeds, our clinical and pharmacy teams can intervene when high-cost specialty scripts appear, identifying clinically appropriate alternatives and working directly with providers to reduce spend without compromising care.

3) Annual Playbooks Instead of reacting at renewal, we build a customized plan strategy each year—based on your actual claims trends, so cost containment becomes a repeatable system, not a one-time project.

The Ocean Effect: Captives + Collective Leverage

Mid-sized employers don’t naturally have Fortune 50 leverage. But in a member-owned captive, you do.

We explain how pooling risk with like-minded employers creates the Ocean Effect—absorbing claims volatility more smoothly, improving renewal stability, and unlocking better pricing and contract terms across the vendor ecosystem.

In short: you stop navigating turbulent healthcare waters alone, and you gain the purchasing power, strategy, and stability typically reserved for the biggest companies in the country.

The Bottom Line

This episode is about turning benefits from a budget problem into a business advantage, through structured playbooks, real-time interventions, and collective leverage that drives down cost and reduces volatility year over year.

Episode Highlights

• Triforta’s ICM platform: a coordinated cost-containment system
• Three pillars: Point Solutions, Interventions, Playbooks
• Rx savings strategies like Tier-Zero copays, international sourcing, and manufacturer assistance
• Why mid-sized employers can now access big-company leverage
• The Ocean Effect: how captives stabilize renewals and reduce volatility
• A phased approach to cost containment (Year 1 → Year 3) that’s manageable and measurable
• Why cost containment and risk management must be engineered together

Connect with Triforta

Ready to build a cost-containment playbook that actually performs?

📩 hello@triforta.com 🌐 https://www.triforta.com/education 🔗 LinkedIn: @Triforta-partners

We are Triforta. And this is where better benefits become a better business.

In this episode of Blueprints for Better Benefits, we demystify one of the most important, and misunderstood, components of self-funded health plans: stop-loss insurance.

Self-funding gives employers control over plan design and healthcare spend. Stop-loss provides the protection that makes that control practical and predictable.

We explain how stop-loss works, why most Fortune 100 companies rely on self-insurance, and how mid-sized employers can use the same strategies without exposing themselves to catastrophic risk. This episode breaks down complex concepts into clear, real-world explanations so employers can evaluate self-funding with confidence.

You’ll learn how specific and aggregate stop-loss work together to cap financial exposure, why fully insured plans trap employers on a renewal treadmill, and how self-funded plans allow organizations to benefit from good claim years instead of being penalized for them.

In This Episode, We Cover

• Why self-funding typically costs less than fully insured plans
• The difference between specific and aggregate stop-loss
• How stop-loss protects against catastrophic and cumulative claims
• Why fully insured plans reward carriers—not employers
• What a transparent self-funded cost structure looks like
• How employers choose the right stop-loss deductible
• Why the “deconstructed” benefits model is the future

Who This Episode Is For

✔ Employers with 50–750 employees ✔ CFOs and financial leaders ✔ HR and benefits decision-makers ✔ Organizations evaluating self-funding for the first time

Connect with Triforta

Interested in building a smarter, safer benefits strategy?

📩 hello@triforta.com 🌐 https://www.triforta.com/education 🔗 LinkedIn @Triforta-partners

We are Triforta, and we help employers build predictable, transparent, and sustainable healthcare strategies.

In this episode of Blueprints for Better Benefits, we unpack one of the most misunderstood drivers of rising healthcare costs: pharmacy rebates.

Rebates are often positioned as savings, but in practice they frequently inflate drug prices, reduce transparency, and shift costs onto employers and employees. We explain how Pharmacy Benefit Managers (PBMs) negotiate rebates, why those dollars rarely reduce premiums or out-of-pocket costs, and how incentives favor higher-priced drugs over lower-cost alternatives.

You’ll learn how vertical integration across insurers, PBMs, specialty pharmacies, and providers allows carriers to capture revenue at multiple levels—while remaining compliant with ACA Medical Loss Ratio rules. The result is a system where employers pay more each year with little visibility into where their healthcare dollars actually go.

We also break down real-world examples, including why prices for drugs like Humira increased even after biosimilars entered the market, and why significantly cheaper options often remain off formularies.

If you’re responsible for benefits, budgeting, or financial strategy, this episode offers clarity, and a better way forward.

In This Episode, We Cover

• Why pharmacy rebates don’t work like consumer discounts
• How PBM incentives reward higher-priced drugs
• Why rebate dollars don’t lower premiums
• Vertical integration and its impact on employer costs
• The true flow of pharmacy dollars, from employer to manufacturer
• Why transparency is essential to cost control

Who This Episode Is For

✔ Employers with 50–750 employees ✔ CFOs and finance leaders ✔ HR and benefits decision-makers ✔ Organizations exploring self-funding or alternative models

Connect with Triforta

Ready to take control of your pharmacy spend?

📩 hello@triforta.com 🌐 https://www.triforta.com/education 🔗 LinkedIn @Triforta-partners

We are Triforta, and we exist to help employers build transparent, predictable, and sustainable healthcare strategies.