Your Health Coverage Ends With Your Job. His Doesn’t.

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Excellent. Well, uh, today on the Insure
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Techch Leadership podcast, I'm pleased
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to be joined by Felix Ortiz. He is the
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founder and CEO of Smirk Health. Smirk
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builds portable health benefits for the
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more than 90 million Americans who work
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outside a traditional employer plan with
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coverage underwritten by CHUB.
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This conversation matters right now
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because the benefit system was designed
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in 1929 for full-time employees and the
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way people work has moved on without it.
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Felix is a repeat founder and an army
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veteran who learned insurance from the
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outside. So, we'll get into what the
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legacy system gets wrong, how you get a
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global carrier to underwrite a brand new
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model, and where AI actually helps a
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person manage their own care. Welcome,
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Felix. Thank you for having me, Joshua.
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Good morning.
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>> Yeah. Uh good morning. And uh
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anything else you'd like to just add at
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the beginning on the heels of that?
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>> No, I mean I I I think uh as as the
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evolution of AI is taking shape within
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the workforce, you're having a shift
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into a micro shift economy of workers.
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uh therefore uh resulting in the system
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uh getting um uh basically outpaced on
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what is actually needed in today's
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workforce. Uh so I think that uh it's
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exciting times to be within the world of
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of health, insurance and financial
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services and that entire intersection
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because you could truly transform the
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lives of many uh many employees but also
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many Americans that today are uninsured
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or uninsured.
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>> So
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before we get into the meat of it, uh
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one quick question. And so you've
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finished five of the seven world
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marathon majors.
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Uh guessing in order to do that, unless
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you're superhuman, that requires a lot
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of uh discipline and training, etc. Any
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lessons learned from that that uh you
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know, you've brought into building the
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company?
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>> You know, it's it's a great question.
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the uh I remember I uh my first uh major
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was the Boston Marathon and uh three
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months before that or four months before
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that my grandfather passed away. Uh so
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it kind of uh threw me off a little bit
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as part of my training but I remember
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everybody telling me that I'm going to
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hit the wall around mile 20 or 22 and I
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was like yeah it's not going to happen
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because I'm in like great shape and I
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can run but it's very accurate. And so,
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uh, so at that point, I just looked up
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into the sky and I think I had my
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grandpa pushing me all the way. Uh, but
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look, the discipline of running a
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marathon,
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uh, aligns to business very well because
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it's a marathon. Business is a marathon.
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You're going to have a good mile, a bad
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mile. You may have an ache here or
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there, but it's really the mental
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fortitude that pushes you through. uh
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the wanting to cross the finish line uh
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and and achieve the um you know in the
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case of a marathon achieve the success
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of receiving a medal and that meta goal,
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right? Not think 1% of uh the world
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actually runs a marathon. Uh it's no
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easy feat, but when you put your mind to
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it, uh there's nothing that you cannot
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accomplish.
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>> Yeah, that's great. So,
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um, Smirk is not your kind of first
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rodeo, and I know you're in Austin, so
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hope the metaphor is okay. Uh, but, um,
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you've had prior exits in HR, tech,
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fintech, insurance, but, you know, what
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did you see here that convinced you it
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was worth,
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uh, you know, starting something new
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again?
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>> You know, it goes back to when I was in
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the military. Um I I saw a pattern where
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as a soldier you have your military
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occupation skills uh and how that does
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not correlate to industry skills at that
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time. Now they've done a little bit
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better job at that. But if you think of
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of of health and access to care, uh even
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when you transition from the military as
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a young veteran, uh you know, unless you
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had some uh disability, uh you're given
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the option to maybe continue veterans uh
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uh healthc care, you know, usage, but
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really if you don't, you're you're left
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on your own, right? and navigating that
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was interesting for me uh in a sense
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that you know understanding why should I
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do an you know what's the difference
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between HMO or until I get employed and
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realizing at that point in time that I
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really couldn't get insurance unless I
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was uh within a company and that you
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know struck a chord with me and
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something that always kept in the back
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of my mind and then also the experience
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with my own little brother having to
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navigate um his heart condition from the
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age of five with my parents where he had
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to get a pacemaker and how the insurance
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company was deciding what doctor or not
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or what surgery can have for a
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5-year-old kid uh that was one of the
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youngest recipients of a pacemaker. So
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that uh led me to start creating these
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companies that really were a building
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block off each other whether it was the
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education technology company where where
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I consider it more of an MBA you know to
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total failure I learned what to do not
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to do uh but took those learnings and
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applied it to the second company um
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where we really unlocked the category of
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talent intelligence and we got very
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lucky to work with uh you know Fortune
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10 companies and Fortune 500 companies
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uh and that scaled very quickly and
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there I got the insight understanding to
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to un the psychology of HR you know how
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these CHRO leaders and uh you know
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talent acquisition leaders are viewing
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um their competitive advantage which is
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ultimately retention uh and being able
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to hire the best-in-class and then
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moving into the third company I started
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to see it from the other lens which is
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the employee lens and how they really
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just couldn't navigate an understanding
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of what is going to be covered at the
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doctor's 's office, what it costs, how
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they can get an appointment. You know,
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there are people even today that
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literally their doctor is going to a lab
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core or Quest Diagnostic and getting
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annual blood work and that's it. But
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there's no doctor, you know, checking,
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uh, other things, right? And so uh so so
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that blended together led me to the
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creation of Smirk where we see a world
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that um really uh if you think about the
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workforce today group plans have been
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focused on the eligible workers but
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those that are not eligible uh don't
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have access uh or that do not meet the
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criteria set. And so that's where you
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know Smirk was born and and and you know
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the evolution of smirk started.
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Got it. And
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so
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are there certain things that you've
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learned in terms of what the industry
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keeps getting wrong about
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non-traditional workers? Um,
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you know, they can't afford coverage or
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is it more that just nobody has really
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built coverage for how they work?
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>> I think it's a combination of all. you
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know, to really understand this
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consumer, you would have had to
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experience what it's like to be that
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consumer, right? I mean, you think about
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Silicon Valley, they keep funding these
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apps and, you know, uh that that are
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more like uh for social or or or other
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things that really do not go downward
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into the mid-range and and and lower
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income sphere. And that's because one,
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you know, they may believe that they may
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not make money in that arena or that
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people aren't uh there's persistency
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gaps or whatever it might be or higher
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risk, but the fact is until you provide
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a product that actually is intuitive and
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designed for this segment, you actually
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don't know. And so, uh, you know, the
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the industry, uh, I think number one, it
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it's it's a mindset shift, uh, that that
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that needs to be taking place. you know
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actual models were built on a group
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structure and uh within that you know
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they have their typical ratios and they
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just haven't designed product for this
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segment. Uh the second is that you know
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there is a uh a view that this segment
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uh you know if you're thinking about it
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from the capitalist side that they may
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not be able to make money uh because uh
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you know can they afford it right and
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and my view is that look you have credit
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card products you have cars uh that have
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different you know ranges um uh and they
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can service different uh segments and
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and not every car will be aligned to,
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you know, somebody will have a a Toyota,
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somebody else will have a Mercedes-Benz,
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you know, so on so forth, but ultimately
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they still have access to a car and when
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it comes to health, they don't. Uh, and
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that's the big pain point. Got
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>> it. And so, is this solution
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specifically designed for gig workers or
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what people would traditionally think of
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as 1099 workers or who are you
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targeting? Yeah, our our our target
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audience is really focused on those that
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are outside the traditional employment
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uh uh plan. So, think of your 1099. That
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could be from a, you know, contractor
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all the way, you know, at a at a
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boutique firm all the way through a a
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gig worker. Uh in addition to that, a
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part-time, hourly, and seasonal worker.
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essentially, you know, folks that are um
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not meeting the eligibility criteria or
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may be priced out of the existing
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offerings.
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>> Got it. And so what exactly does the
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product offer?
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So, so what what we've done is we've
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reinvented um a a product chassis uh
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that essentially allows it to be
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modular, meaning that uh a user can you
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have multiple foundational models of the
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these plan designs that is then tailored
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and personalized to each user. So within
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that uh what that basically means in
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short is that a user can start anywhere
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as little as $19 and go up to as high as
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$350 as an example, right? But the
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modularity and the ability to
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essentially have our AI infrastructure
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design that for you and you have the
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power to choose or add or or extract
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what you do not want really gives a lot
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of power while also providing visibility
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in a transparent way of what's covered
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and what's not because even today most
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uh a lot of folks uh that are fairly
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astute unless they're actuaries do not
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even know what's covered uh within their
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plan and how much it's going to cost to
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get to the doctor. Um, so so this plan
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design that we did is pretty bespoke uh
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in enabling that modularity,
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personalization, transparency and
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leveraging AI to benefit uh the user in
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a very efficient manner. So is it
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fundamentally a different plan
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construction or is it sort of the same
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types of plans that everyone gets but
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you're you're kind of repackaging it and
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making it easy to understand and make
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choices through a different user
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interface.
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>> No. Um, so we've taken what may you may
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know as a supplemental health equivalent
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type product that unfortunately has had
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a bad reputation in the past because of
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bad actors. Um, and we've gutted the
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whole thing and re-engineered it to be a
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fully insured medical plan, resulting in
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us being able to actually provide true
00:11:58.399 --> 00:12:01.670
insurance um that is modular and
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designed to the consumer in a way that
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they fully understand what they're
00:12:05.519 --> 00:12:07.430
getting and what's covered and what's
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not, what their out, you know, payout
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will be and so on so forth. So uh and
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it's all intersected with our AI agent
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and she enables in a very simplistic way
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uh the entire navigation for the user.
00:12:21.600 --> 00:12:23.430
Uh so that's that's that's how that's
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the big um you know uh evolution is that
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we've gutted it, we've re-engineered it
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and then we stack it on our agentic
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layer.
00:12:32.079 --> 00:12:35.670
>> Got it. And so how does distribution
00:12:35.680 --> 00:12:37.750
work in this model? Is it going through
00:12:37.760 --> 00:12:39.430
employers? Is it going through direct?
00:12:39.440 --> 00:12:41.990
Is it going through some other channel?
00:12:42.000 --> 00:12:44.389
>> I mean, we um we we we work with
00:12:44.399 --> 00:12:47.590
employers uh uh we're we're focused on,
00:12:47.600 --> 00:12:50.069
you know, large uh Fortune 500
00:12:50.079 --> 00:12:53.829
organizations as well as um unions too.
00:12:53.839 --> 00:12:57.110
Um you know, we we we have tested as
00:12:57.120 --> 00:12:58.949
part of enhancing our funnel
00:12:58.959 --> 00:13:01.750
optimization and AI on the direct to
00:13:01.760 --> 00:13:04.310
consumer just to optimize and enhance,
00:13:04.320 --> 00:13:06.550
but you know, our distribution model is
00:13:06.560 --> 00:13:09.590
a B2B TOC approach.
00:13:09.600 --> 00:13:13.110
Got it. And on the other end of it, like
00:13:13.120 --> 00:13:15.509
how does the, you know, portability
00:13:15.519 --> 00:13:17.269
work? I mean, at the end of the day,
00:13:17.279 --> 00:13:19.670
it's the individual's plan and wherever
00:13:19.680 --> 00:13:21.829
they move around, they get to keep it
00:13:21.839 --> 00:13:22.870
with them.
00:13:22.880 --> 00:13:25.509
>> Yeah. So, so, uh, as part of this
00:13:25.519 --> 00:13:27.430
bespoke solution that we created, you
00:13:27.440 --> 00:13:30.150
know, Jackie can work at company A and
00:13:30.160 --> 00:13:32.230
let's say that she leaves company A and
00:13:32.240 --> 00:13:34.389
no longer wants to work there. Uh, and
00:13:34.399 --> 00:13:36.470
she goes to company B, she maintains the
00:13:36.480 --> 00:13:37.990
entire product suite. It does not
00:13:38.000 --> 00:13:40.389
change. It doesn't get reduced. Um
00:13:40.399 --> 00:13:42.629
there's no price increase. It's it's all
00:13:42.639 --> 00:13:44.470
the same. Now, if the company was
00:13:44.480 --> 00:13:46.150
providing a subsidy, of course, the
00:13:46.160 --> 00:13:48.470
variance will now be covered by Jackie.
00:13:48.480 --> 00:13:51.350
Uh but she maintains access to the plan
00:13:51.360 --> 00:13:53.430
without issue.
00:13:53.440 --> 00:13:57.030
>> Got it. So, so some employers are are
00:13:57.040 --> 00:14:00.069
providing subsidies um to their gig
00:14:00.079 --> 00:14:02.550
workers or their 1099 workers
00:14:02.560 --> 00:14:05.430
>> to to their uh you know for the 1099s
00:14:05.440 --> 00:14:07.670
and uh and and well more the gig workers
00:14:07.680 --> 00:14:09.350
around mclassification you know there
00:14:09.360 --> 00:14:11.030
there's a certain way to do that that
00:14:11.040 --> 00:14:13.829
does not trigger that but in terms of
00:14:13.839 --> 00:14:16.310
the W2s that are part-time hourly and
00:14:16.320 --> 00:14:18.790
seasonal yes those folks would would
00:14:18.800 --> 00:14:19.030
sort of
00:14:19.040 --> 00:14:24.550
>> subs okay and what percentage of your
00:14:24.560 --> 00:14:27.350
um I guess plan members fall into those
00:14:27.360 --> 00:14:29.590
different buckets.
00:14:29.600 --> 00:14:31.829
>> You know, it's a hybrid. I mean, uh
00:14:31.839 --> 00:14:33.189
we're we're still early. We're we're
00:14:33.199 --> 00:14:34.790
growing pretty quickly, but I would say
00:14:34.800 --> 00:14:39.350
that, you know, it's probably around uh
00:14:39.360 --> 00:14:41.269
uh 55%
00:14:41.279 --> 00:14:45.269
on the part-time hourly seasonal uh
00:14:45.279 --> 00:14:51.189
worker uh and 45 on the gig1099 worker.
00:14:51.199 --> 00:14:53.990
>> Got it. And so how do you measure
00:14:54.000 --> 00:14:58.470
success uh with Smirk?
00:14:58.480 --> 00:15:01.030
>> You know, success to us is making sure
00:15:01.040 --> 00:15:05.189
that everybody uh that becomes aware of
00:15:05.199 --> 00:15:07.430
Smirk and utilize Smirk now has access
00:15:07.440 --> 00:15:09.670
to care that sticks with them throughout
00:15:09.680 --> 00:15:13.350
uh their journey of life, right? Uh I
00:15:13.360 --> 00:15:16.949
think of Smirk as the uh as sticking
00:15:16.959 --> 00:15:18.790
with the user throughout their life
00:15:18.800 --> 00:15:21.670
experience and and journey and adapting
00:15:21.680 --> 00:15:24.150
and personalizing uh to what your needs
00:15:24.160 --> 00:15:26.389
are at that point. Maybe when I started
00:15:26.399 --> 00:15:29.030
I didn't have you know a family now I do
00:15:29.040 --> 00:15:31.350
and you know I want to add my family or
00:15:31.360 --> 00:15:33.030
different things you know associated
00:15:33.040 --> 00:15:36.389
with it. So, uh, it it's it's really,
00:15:36.399 --> 00:15:39.670
um, uh, an evolution, uh, throughout the
00:15:39.680 --> 00:15:41.590
journey, uh, that we're looking at as it
00:15:41.600 --> 00:15:43.670
relates to Smirk, um, and and not just
00:15:43.680 --> 00:15:46.550
be a one-off type of situation. Uh, and
00:15:46.560 --> 00:15:48.949
so that's that's how we think of it.
00:15:48.959 --> 00:15:51.829
>> Are there specific metrics though, like,
00:15:51.839 --> 00:15:53.509
you know, retention, use of the
00:15:53.519 --> 00:15:55.829
coverage, claims paid, other things like
00:15:55.839 --> 00:15:57.829
that that you're tracking or that?
00:15:57.839 --> 00:15:59.990
>> Yeah. Yeah. Um yeah look I mean we track
00:16:00.000 --> 00:16:01.749
retention
00:16:01.759 --> 00:16:04.949
uh uh of course you know uh as well as
00:16:04.959 --> 00:16:10.629
churn uh as well as um uh utilization
00:16:10.639 --> 00:16:12.790
uh and claims. So we we those are our
00:16:12.800 --> 00:16:15.269
core four uh KPIs that we track. Of
00:16:15.279 --> 00:16:16.629
course if when we work with the
00:16:16.639 --> 00:16:18.790
companies uh there may be additional
00:16:18.800 --> 00:16:22.310
KPIs uh that we'll be measuring as well
00:16:22.320 --> 00:16:23.910
uh on their behalf from an ROI
00:16:23.920 --> 00:16:26.310
standpoint. uh but but at the baseline
00:16:26.320 --> 00:16:28.310
those are the four pillars uh that we
00:16:28.320 --> 00:16:31.509
you know use from a KPI measurement.
00:16:31.519 --> 00:16:34.230
>> And how did you get an organization with
00:16:34.240 --> 00:16:36.230
kind of the you know scale and
00:16:36.240 --> 00:16:39.269
credibility of a chub to
00:16:39.279 --> 00:16:42.310
um provide the coverage for this?
00:16:42.320 --> 00:16:44.629
>> Yeah, I I've been lucky enough to uh to
00:16:44.639 --> 00:16:46.629
know Chub for a bit uh and their
00:16:46.639 --> 00:16:49.350
executive team. Uh they're great uh very
00:16:49.360 --> 00:16:52.629
innovative uh carrier. It comes down to
00:16:52.639 --> 00:16:55.030
the leader of the division uh that that
00:16:55.040 --> 00:16:57.350
you work with within any organization
00:16:57.360 --> 00:17:00.790
and they're wanting to be innovative,
00:17:00.800 --> 00:17:02.470
create value and also grow their
00:17:02.480 --> 00:17:05.510
organization. And so it it happened to
00:17:05.520 --> 00:17:10.150
be um uh a mixture of you know having
00:17:10.160 --> 00:17:12.710
keen interests in this market uh the
00:17:12.720 --> 00:17:14.949
ability to grow it but also having an
00:17:14.959 --> 00:17:18.150
innovative um partner uh that as a
00:17:18.160 --> 00:17:20.789
underwriter and reinsurance partner that
00:17:20.799 --> 00:17:22.630
uh understands you know where we want to
00:17:22.640 --> 00:17:25.510
go and also see the vision and so uh you
00:17:25.520 --> 00:17:27.350
know we're lucky to be partnered uh with
00:17:27.360 --> 00:17:28.470
with Chuck
00:17:28.480 --> 00:17:31.190
>> and what was that sort of
00:17:31.200 --> 00:17:35.510
co-development process like? um any any
00:17:35.520 --> 00:17:37.510
lessons learned or insights you can
00:17:37.520 --> 00:17:39.029
share for others who may be looking to
00:17:39.039 --> 00:17:41.110
do something similar?
00:17:41.120 --> 00:17:45.110
>> You know, I I I would say that um we we
00:17:45.120 --> 00:17:47.750
we work very we view them as partners.
00:17:47.760 --> 00:17:50.310
Uh right, we we we work very closely and
00:17:50.320 --> 00:17:53.669
understand their position on how they
00:17:53.679 --> 00:17:56.630
view uh underwriting.
00:17:56.640 --> 00:17:58.950
uh what success looks like for them in
00:17:58.960 --> 00:18:01.190
terms of their metrics and KPIs, what
00:18:01.200 --> 00:18:02.549
are they trying to achieve over the
00:18:02.559 --> 00:18:05.669
coming quarters and always ensuring that
00:18:05.679 --> 00:18:08.390
it's a fully transparent u you know
00:18:08.400 --> 00:18:10.070
relationship right because there may be
00:18:10.080 --> 00:18:12.150
days that that you have you know good
00:18:12.160 --> 00:18:14.549
days bad days and you there's nothing
00:18:14.559 --> 00:18:15.990
wrong with you know sharing that
00:18:16.000 --> 00:18:19.590
information um and so uh I would say for
00:18:19.600 --> 00:18:21.430
any founder that's trying to approach a
00:18:21.440 --> 00:18:24.150
large carrier it's it's number one
00:18:24.160 --> 00:18:25.750
making sure you're going in through the
00:18:25.760 --> 00:18:28.630
right executive uh that and then making
00:18:28.640 --> 00:18:30.549
sure that executive is very innovative
00:18:30.559 --> 00:18:32.230
and understand and wants to solve that
00:18:32.240 --> 00:18:34.230
problem or or is looking to solve that
00:18:34.240 --> 00:18:36.150
problem because then that gives you you
00:18:36.160 --> 00:18:38.870
know uh problem uh alignment uh to
00:18:38.880 --> 00:18:41.270
solution. Uh and then once you're in
00:18:41.280 --> 00:18:44.230
there it's continuously developing that
00:18:44.240 --> 00:18:46.710
relationship and and building that
00:18:46.720 --> 00:18:49.270
trust. uh because sometime most times
00:18:49.280 --> 00:18:51.830
they'll start small uh in a sense that
00:18:51.840 --> 00:18:54.390
you know they'll want to use uh
00:18:54.400 --> 00:18:56.310
off-the-shelf products and then
00:18:56.320 --> 00:18:57.909
eventually they may want to design
00:18:57.919 --> 00:19:01.430
something um and then also understanding
00:19:01.440 --> 00:19:04.470
uh that you can build uh a big business
00:19:04.480 --> 00:19:06.630
uh around this right uh that that they
00:19:06.640 --> 00:19:07.990
understand that there's a positive
00:19:08.000 --> 00:19:10.070
outcome. So those are those are some of
00:19:10.080 --> 00:19:12.630
the areas that I would focus on if I
00:19:12.640 --> 00:19:14.549
were starting from scratch again.
00:19:14.559 --> 00:19:18.710
>> Yeah. And specific to the the Smirk
00:19:18.720 --> 00:19:21.430
wallet and the AI concierge that you
00:19:21.440 --> 00:19:25.190
spoke to, like does that sort of create
00:19:25.200 --> 00:19:27.590
a different
00:19:27.600 --> 00:19:30.150
you know user experience and are there
00:19:30.160 --> 00:19:31.990
certain things that you're trying to get
00:19:32.000 --> 00:19:35.110
people through in terms of
00:19:35.120 --> 00:19:36.789
um
00:19:36.799 --> 00:19:39.830
you know registration and and and and
00:19:39.840 --> 00:19:41.830
you know really getting themselves set
00:19:41.840 --> 00:19:44.710
up properly in the first you know couple
00:19:44.720 --> 00:19:47.270
of weeks or first month.
00:19:47.280 --> 00:19:49.750
>> You know, uh I it's interesting when we
00:19:49.760 --> 00:19:52.070
first started, we started pilot testing
00:19:52.080 --> 00:19:53.909
on dental because we wanted to
00:19:53.919 --> 00:19:55.909
understand the psychology and behavior
00:19:55.919 --> 00:19:58.710
of the consumer uh with the bespoke
00:19:58.720 --> 00:20:03.510
product uh and and so on. And uh what we
00:20:03.520 --> 00:20:07.590
learned was that uh we we our AI agent
00:20:07.600 --> 00:20:10.310
her name is Ailen um we had her on the
00:20:10.320 --> 00:20:13.190
back end so post enrollment but really
00:20:13.200 --> 00:20:16.230
users wanted to fully understand uh more
00:20:16.240 --> 00:20:18.950
and so we brought her forward and since
00:20:18.960 --> 00:20:21.669
then everything's been moving fairly
00:20:21.679 --> 00:20:25.270
quickly. So Ailen plays a critical role
00:20:25.280 --> 00:20:28.950
in guiding that user not only around
00:20:28.960 --> 00:20:30.950
what plan design structure looks like
00:20:30.960 --> 00:20:33.750
but also really giving them that comfort
00:20:33.760 --> 00:20:35.830
uh that they're going to get that doctor
00:20:35.840 --> 00:20:38.950
visit because she books appointments to
00:20:38.960 --> 00:20:41.110
uh provides the pricing you know and
00:20:41.120 --> 00:20:43.510
continues followup and so on so forth.
00:20:43.520 --> 00:20:46.390
So they remove that stress from the from
00:20:46.400 --> 00:20:49.190
the from the individual that that is
00:20:49.200 --> 00:20:51.430
unfortunate but causes a lot of pain uh
00:20:51.440 --> 00:20:53.590
within an individual in a daily life and
00:20:53.600 --> 00:20:56.310
you know when you're busy uh it creates
00:20:56.320 --> 00:20:58.710
more impact. So it's good to have that
00:20:58.720 --> 00:21:01.029
automated while also knowing what you're
00:21:01.039 --> 00:21:03.190
going to be getting at the same time
00:21:03.200 --> 00:21:04.870
what you're going to be paying and what
00:21:04.880 --> 00:21:06.950
the outcome uh will be associated to
00:21:06.960 --> 00:21:10.470
that. So that that that experience um
00:21:10.480 --> 00:21:12.789
has allowed users to enroll fairly
00:21:12.799 --> 00:21:15.430
quickly. We then uh focus on getting
00:21:15.440 --> 00:21:17.350
them activated to get their first
00:21:17.360 --> 00:21:21.029
appointment within the first 30 days uh
00:21:21.039 --> 00:21:23.350
and then continue their ongoing care
00:21:23.360 --> 00:21:26.070
management throughout.
00:21:26.080 --> 00:21:29.510
>> Got it. Um, so I think a lot of people
00:21:29.520 --> 00:21:33.270
have rolled out different types of,
00:21:33.280 --> 00:21:35.270
you know, chat bots or other types of
00:21:35.280 --> 00:21:36.870
user interfaces where you can have a
00:21:36.880 --> 00:21:40.310
dialogue with someone like a an EENE.
00:21:40.320 --> 00:21:44.149
But, you know, you talk about an AI
00:21:44.159 --> 00:21:47.430
infrastructure layer. So, you know, are
00:21:47.440 --> 00:21:49.190
those two things connected? Are they two
00:21:49.200 --> 00:21:51.350
different things? Like, what's the the
00:21:51.360 --> 00:21:52.710
distinction?
00:21:52.720 --> 00:21:54.549
Yeah, you know, most people will have a
00:21:54.559 --> 00:21:57.590
chatbot or or or an agent, but the
00:21:57.600 --> 00:21:59.430
agent's getting an input and output and
00:21:59.440 --> 00:22:01.029
they're probably using some LLM model
00:22:01.039 --> 00:22:03.029
associated to that. You know, with
00:22:03.039 --> 00:22:04.789
Smirk,
00:22:04.799 --> 00:22:07.510
as we have designed the plan, that plan
00:22:07.520 --> 00:22:10.310
is tied into our entire infrastructure.
00:22:10.320 --> 00:22:14.549
There is no input or output that uh the
00:22:14.559 --> 00:22:16.950
infrastructure would not know which then
00:22:16.960 --> 00:22:19.190
you know obviously Ailen now knows. So,
00:22:19.200 --> 00:22:21.990
we've trained it so that she knows
00:22:22.000 --> 00:22:23.909
everything. And so as a result of that,
00:22:23.919 --> 00:22:27.029
it isn't like I'm walking into um a
00:22:27.039 --> 00:22:30.230
chatbot and I say my back hurts and she
00:22:30.240 --> 00:22:31.909
may say, "Okay, you know, it could be
00:22:31.919 --> 00:22:34.310
this, that, or the other." And it stops
00:22:34.320 --> 00:22:37.190
there, right? Uh you know, I mean, in
00:22:37.200 --> 00:22:39.029
our case, it goes all the way through
00:22:39.039 --> 00:22:41.669
end to end to service user to eventually
00:22:41.679 --> 00:22:44.950
getting them uh the appointment and also
00:22:44.960 --> 00:22:47.190
understanding what they're uh what's
00:22:47.200 --> 00:22:49.110
covered, what's not, and and making sure
00:22:49.120 --> 00:22:51.350
that they're okay. And so it's the real
00:22:51.360 --> 00:22:55.270
personalization uh layer uh that ties in
00:22:55.280 --> 00:22:59.590
that is not just a one-off uh input.
00:22:59.600 --> 00:23:01.430
And
00:23:01.440 --> 00:23:04.230
you know I'm sure there's
00:23:04.240 --> 00:23:06.549
a trust issue
00:23:06.559 --> 00:23:09.510
that you know you've trying to navigate
00:23:09.520 --> 00:23:11.669
and you have to make sure that the
00:23:11.679 --> 00:23:14.549
answers people are getting are correct.
00:23:14.559 --> 00:23:17.270
So which is the bigger challenge kind of
00:23:17.280 --> 00:23:19.110
making sure the answers are correct or
00:23:19.120 --> 00:23:22.310
making sure that people are comfortable
00:23:22.320 --> 00:23:26.149
you know communicating with an an AI
00:23:26.159 --> 00:23:29.990
interface
00:23:30.000 --> 00:23:32.789
>> one one is make number one priority is
00:23:32.799 --> 00:23:34.470
making sure that the answers are always
00:23:34.480 --> 00:23:36.549
as correct as possible. We we we don't
00:23:36.559 --> 00:23:38.470
want to create an issue or a situation
00:23:38.480 --> 00:23:42.070
where uh the agent may misinform
00:23:42.080 --> 00:23:44.310
somebody because that that would not be
00:23:44.320 --> 00:23:49.430
good. Um uh the trust piece because
00:23:49.440 --> 00:23:52.549
there's so much AI going on where
00:23:52.559 --> 00:23:54.870
individuals are interacting with Gemini
00:23:54.880 --> 00:23:58.310
Grock uh you know Claude and you know
00:23:58.320 --> 00:24:02.149
Chad GBT and so on. What most people I
00:24:02.159 --> 00:24:03.350
view it a little bit differently. What
00:24:03.360 --> 00:24:05.110
most people aren't realizing is that you
00:24:05.120 --> 00:24:08.070
actually are starting to get a divide in
00:24:08.080 --> 00:24:09.830
AI infrastructure. And what does that
00:24:09.840 --> 00:24:12.470
mean? If you start to ask the the modern
00:24:12.480 --> 00:24:15.269
American or the modest American, are you
00:24:15.279 --> 00:24:18.470
using Grock or are you using uh Chacht
00:24:18.480 --> 00:24:20.230
or are you using you know Claude or
00:24:20.240 --> 00:24:22.390
whatever? What we've learned is that
00:24:22.400 --> 00:24:25.190
there's a split. Some major most of them
00:24:25.200 --> 00:24:28.470
may be using Grock and Gemini versus uh
00:24:28.480 --> 00:24:30.149
the ones that you would have to pay for
00:24:30.159 --> 00:24:31.909
similar to like a broadband divide,
00:24:31.919 --> 00:24:36.710
right? And so to me it's more around uh
00:24:36.720 --> 00:24:38.149
yes we want to make sure people can
00:24:38.159 --> 00:24:40.710
trust alien and we'll work very hard at
00:24:40.720 --> 00:24:44.070
that but also is ensuring that there is
00:24:44.080 --> 00:24:48.870
no divide uh in value uh to the end user
00:24:48.880 --> 00:24:51.430
and and that's how we think uh of alien
00:24:51.440 --> 00:24:53.269
and by the way that's a topic that no
00:24:53.279 --> 00:24:56.870
one talks about it's this like AI uh
00:24:56.880 --> 00:25:01.269
divide uh that is occurring um on tech
00:25:01.279 --> 00:25:03.029
uh infrastructure ructure value to the
00:25:03.039 --> 00:25:05.190
end user
00:25:05.200 --> 00:25:07.110
>> and so is that something you're trying
00:25:07.120 --> 00:25:09.269
to you know you view yourself at a
00:25:09.279 --> 00:25:11.350
leading edge of bridging.
00:25:11.360 --> 00:25:12.630
>> Yeah, I mean we view ourselves as
00:25:12.640 --> 00:25:15.350
leading edge bridging that you're going
00:25:15.360 --> 00:25:18.549
to get the same high level quality value
00:25:18.559 --> 00:25:20.710
with our infrastructure
00:25:20.720 --> 00:25:22.950
uh utilizing smart that you would get
00:25:22.960 --> 00:25:26.470
you utilizing a AI infrastructure that
00:25:26.480 --> 00:25:29.350
you would be paying for uh at a premium
00:25:29.360 --> 00:25:30.950
level. So, so that's that's how we think
00:25:30.960 --> 00:25:32.870
about it. It's it's about making sure
00:25:32.880 --> 00:25:35.029
everybody's treated equal and that they
00:25:35.039 --> 00:25:37.029
have the same value. Uh because that
00:25:37.039 --> 00:25:38.630
builds trust and you start to build
00:25:38.640 --> 00:25:40.789
community and and when it comes to
00:25:40.799 --> 00:25:43.430
people's health, there's no reason to
00:25:43.440 --> 00:25:47.269
devalue or or or or tear that around.
00:25:47.279 --> 00:25:49.029
>> Does it need to be a mobile first
00:25:49.039 --> 00:25:50.789
experience
00:25:50.799 --> 00:25:52.950
either for this population or just in
00:25:52.960 --> 00:25:54.549
general?
00:25:54.559 --> 00:25:57.350
>> Uh uh obviously we're mobile first, but
00:25:57.360 --> 00:26:00.630
no, it's also web. uh users can utilize
00:26:00.640 --> 00:26:03.750
it on the web. Uh we have found that
00:26:03.760 --> 00:26:07.350
consumers like to use the web as well uh
00:26:07.360 --> 00:26:08.630
not just have everything not have
00:26:08.640 --> 00:26:10.630
another app on their phone. Um
00:26:10.640 --> 00:26:12.149
especially when it comes to health, it's
00:26:12.159 --> 00:26:14.470
it's something that's very delicate. And
00:26:14.480 --> 00:26:18.070
so they, you know, they basically view
00:26:18.080 --> 00:26:19.669
the web as well. So I I would say
00:26:19.679 --> 00:26:22.310
probably on the percentage basis, you're
00:26:22.320 --> 00:26:25.430
looking at like 60 40 60 that would be,
00:26:25.440 --> 00:26:27.590
you know, uh mobile, 40 that would be
00:26:27.600 --> 00:26:29.430
web. So you want to make sure that it
00:26:29.440 --> 00:26:32.070
has that web consistency.
00:26:32.080 --> 00:26:34.549
>> Has your leadership approach evolved at
00:26:34.559 --> 00:26:36.390
all across the different companies you
00:26:36.400 --> 00:26:37.669
founded?
00:26:37.679 --> 00:26:39.430
>> Uh yeah, I mean I would say if you were
00:26:39.440 --> 00:26:41.110
to tell me when I first started my first
00:26:41.120 --> 00:26:42.789
company, I thought I knew everything. So
00:26:42.799 --> 00:26:46.549
I was like hard-headed young founder. Uh
00:26:46.559 --> 00:26:49.110
I think as most of you know ego got in
00:26:49.120 --> 00:26:54.230
the way. Uh but you quickly learn that
00:26:54.240 --> 00:26:57.430
uh it's hard. you can't do everything on
00:26:57.440 --> 00:27:00.950
your own. And so I'm very grateful uh
00:27:00.960 --> 00:27:02.710
for the learnings that I got through the
00:27:02.720 --> 00:27:05.510
various companies and because it really
00:27:05.520 --> 00:27:08.549
shaped uh my leadership skills uh to
00:27:08.559 --> 00:27:09.909
grow a company that we want to
00:27:09.919 --> 00:27:11.830
eventually take all the way, right? Uh
00:27:11.840 --> 00:27:13.830
and and so that's that's really
00:27:13.840 --> 00:27:15.350
surrounding yourself with the best of
00:27:15.360 --> 00:27:16.789
the best people and getting out of their
00:27:16.799 --> 00:27:20.390
way and really focusing uh on the core
00:27:20.400 --> 00:27:22.549
decisions that are critical to the
00:27:22.559 --> 00:27:25.669
business uh but not uh micromanaging
00:27:25.679 --> 00:27:28.950
them or or or telling them how they
00:27:28.960 --> 00:27:30.710
should do it because ultimately the
00:27:30.720 --> 00:27:32.549
reason that they're with you is because
00:27:32.559 --> 00:27:33.830
they're going to tell you what their
00:27:33.840 --> 00:27:35.590
recommendation is and then it's you know
00:27:35.600 --> 00:27:37.190
and if it's a decision they made then
00:27:37.200 --> 00:27:38.390
obviously you would be responsible for
00:27:38.400 --> 00:27:40.549
that but but yeah I mean it's it's it's
00:27:40.559 --> 00:27:42.710
a lot of lessons lesons um that I took
00:27:42.720 --> 00:27:45.990
in from various companies.
00:27:46.000 --> 00:27:50.149
>> Do you think there's a particular
00:27:50.159 --> 00:27:53.110
leadership skill or leadership dynamic
00:27:53.120 --> 00:27:56.149
that is needed today that either always
00:27:56.159 --> 00:27:58.630
was needed or or or maybe has evolved
00:27:58.640 --> 00:28:00.870
just given the rapid pace of change and
00:28:00.880 --> 00:28:03.990
the evolution of AI into every aspect of
00:28:04.000 --> 00:28:06.310
life and business?
00:28:06.320 --> 00:28:10.789
you know, I I I I think one is um
00:28:10.799 --> 00:28:14.070
understanding and managing pressure
00:28:14.080 --> 00:28:16.950
uh and and being able to distill that so
00:28:16.960 --> 00:28:19.669
that you control that so that doesn't
00:28:19.679 --> 00:28:22.470
feed back into your team because if if
00:28:22.480 --> 00:28:26.710
you come into your team um pressurized
00:28:26.720 --> 00:28:29.909
and uh and they sense that energy, it's
00:28:29.919 --> 00:28:31.669
going to have a downstream effect. And
00:28:31.679 --> 00:28:35.830
so, uh, to me, that's the biggest, uh,
00:28:35.840 --> 00:28:38.070
leadership value that you can have is a
00:28:38.080 --> 00:28:39.669
sense of calmness for the team because
00:28:39.679 --> 00:28:41.110
there's going to be things that will be,
00:28:41.120 --> 00:28:43.590
you know, rockets flying in, everything
00:28:43.600 --> 00:28:45.830
that that can happen. But if you don't
00:28:45.840 --> 00:28:49.350
have that calming presence, taking a
00:28:49.360 --> 00:28:51.669
step back, you know, a breath and then
00:28:51.679 --> 00:28:54.070
moving forward so that you can celebrate
00:28:54.080 --> 00:28:56.149
the small wins, but also understand that
00:28:56.159 --> 00:28:57.590
there will be big wins because every
00:28:57.600 --> 00:29:00.630
small win creates a a step towards the
00:29:00.640 --> 00:29:02.710
top where you want to end up at. And
00:29:02.720 --> 00:29:04.950
that's that that's that's really the the
00:29:04.960 --> 00:29:06.149
main
00:29:06.159 --> 00:29:09.590
>> uh you know area that I've zeroed in uh
00:29:09.600 --> 00:29:11.590
to to learning and also making sure that
00:29:11.600 --> 00:29:13.350
I continue to excel at.
00:29:13.360 --> 00:29:16.310
>> Got it. So, one last question and I
00:29:16.320 --> 00:29:18.310
really appreciate you coming on uh the
00:29:18.320 --> 00:29:19.830
podcast.
00:29:19.840 --> 00:29:22.549
Three years out,
00:29:22.559 --> 00:29:24.950
you know, is Smirk a coverage company,
00:29:24.960 --> 00:29:27.269
an infrastructure layer others build on
00:29:27.279 --> 00:29:29.830
or something else?
00:29:29.840 --> 00:29:32.389
>> Yeah, it's interesting. uh three years
00:29:32.399 --> 00:29:36.310
out we want uh smirk to be uh you know
00:29:36.320 --> 00:29:38.710
and it will be the infrastructure
00:29:38.720 --> 00:29:43.590
uh stack uh for uh AI uh within the
00:29:43.600 --> 00:29:46.070
health and financial intersection right
00:29:46.080 --> 00:29:47.590
because it's like knowing what's covered
00:29:47.600 --> 00:29:50.549
and you adjudicate and so on so forth a
00:29:50.559 --> 00:29:53.510
a as well as continuously designing
00:29:53.520 --> 00:29:56.149
plans now does that mean that we'll
00:29:56.159 --> 00:29:58.470
continuously want to we'll continuously
00:29:58.480 --> 00:30:00.389
design ongoing plans
00:30:00.399 --> 00:30:02.230
I see a world where we can partner with
00:30:02.240 --> 00:30:04.630
carriers uh to design so that they can
00:30:04.640 --> 00:30:07.750
embed their plans as part of that uh and
00:30:07.760 --> 00:30:10.789
use our tech stack. Uh so so so we we
00:30:10.799 --> 00:30:14.070
view ourselves as the end to end uh
00:30:14.080 --> 00:30:16.230
infrastructure layer. Of course we
00:30:16.240 --> 00:30:17.669
started with our own plan and we'll
00:30:17.679 --> 00:30:19.350
continue to design but we do see a world
00:30:19.360 --> 00:30:21.750
where carriers can utilize the
00:30:21.760 --> 00:30:23.909
infrastructure as well.
00:30:23.919 --> 00:30:27.350
>> Got it. Well, Felix, anything that we
00:30:27.360 --> 00:30:29.190
haven't covered that you'd like to touch
00:30:29.200 --> 00:30:31.269
on before we wrap up today?
00:30:31.279 --> 00:30:33.190
>> No, no. I think it's been uh an honor to
00:30:33.200 --> 00:30:34.789
be on the show with you and I appreciate
00:30:34.799 --> 00:30:36.389
your time.
00:30:36.399 --> 00:30:39.029
>> All right, great. Well, Felix Ortiz,
00:30:39.039 --> 00:30:42.149
founder and CEO of Smirk Health, thanks
00:30:42.159 --> 00:30:44.389
so much for joining me on the Insure
00:30:44.399 --> 00:30:45.990
Techch Leadership Podcast.
00:30:46.000 --> 00:30:49.120
>> All right, thanks Joshua. All right.