Volume 31



HealthSure 20 years… and counting!


What’s Your Story? What’s Your Legacy?


Have you seen this person?


HealthSure 20 years… and counting!
I did it my “WHY?”*
By Barry Couch, CIC, ARM

I have always answered, “What do I want to do now?” and “What should I do next?” by first answering, “Why do I want to make this choice?”

20 years ago, I was asking “Why?” about a lot of things. Why do I want to own my own business? Why do I want to be in insurance? Why do I want to focus on healthcare? Why do I want to spend time serving on boards, committees and city councils? Why do I want to move my company from Belton, to Temple then to Austin? Why do I want to create a nation-wide version of our most successful program?

That’s a lot of “whys”. But for me, not knowing the purpose behind my plans and actions – my “whats” – puts me in a position of doubt which always leads to uncertainty and the risk of failure.

One of my favorite sayings is, “Failure will never overtake me if my determination to succeed is strong enough.” So, to protect and strengthen my determination, I have made a ritual of pursuing opportunities and making decisions by starting with “Why?”

Our foundational “Why?”

20 years ago, my answer to “Why?” was the same as it is today. My career was founded on the desire to build a company of individuals with the vision, passion and opportunity to help those who would not otherwise know how to, or be able to, manage the daunting depth of risk healthcare providers deal with every day. This answer has never diminished in meaning and power. In fact, as the world of risk and insurance becomes increasingly complex, our “Why?” becomes even more powerful with each passing year.

Every choice and every opportunity to invest in people or in the acquisition of knowledge, capability and resources, comes with a degree of risk. I have discovered that any amount of risk is easier to face and need not be feared when your actions are true to your “Why?” In essence, every choice I’ve made, and every choice we help our clients make, starts with a deep investigation and confirmation of their “Why?” And, I’m happy to say that the power of “Why?” has proven time and again to transform risk into an asset, not just a liability.

Over the last 20 years we have toiled relentlessly to become the leaders in this philosophy. By positioning risk as an asset, we are transforming traditional insurance purchasing decisions. Our clients embrace the concept that with the right approach, and a hard-nosed assessment of what is truly at stake, they can transform risk into an asset. For them, insurance buying decisions are no longer commodity based. Instead, they ask, “How can I get the best possible return from my investment in risk?”

Deep roots for modern times

With every twist, turn, opportunity and challenge, sticking to the pursuit of my purpose has given me the confidence to act when it was time to change course.

20 years ago, the tipping point decision of all decisions, was moving full-time into the healthcare space and away from general business. This vital decision was not made in a vacuum. It was preceded by my decision to volunteer for hospital board service. Thirty years of board service for two different hospitals and the chance to serve on nearly every committee, has added a perspective that has been priceless to my career. It has allowed me to learn the full spectrum of challenges a healthcare provider like a hospital is required to manage – all of which include risk. My hospital board service opened many doors and certainly my mind and heart to see that there was much more to my business than the products I sold.

Early on, circumstance presented a challenge to hospitals, and an opportunity for my team and I, to help hospitals during a time when insurance was basically unavailable and unaffordable. We had to help our clients learn how to assume and manage their own risk without being dependent on insurance. This, needless to say, was a huge turning point in our company’s history. Self-insurance is now one of our main advantages as we continue to find new and innovative ways to help our clients overcome the complexities, costs and short comings associated with the traditional strategy of just buying insurance.

Major collaborative milestones

Along the way, an invitation by the Texas Organization of Rural and Community Hospitals (TORCH) to help their members was a milestone that started slowly. But, over ten years, the TORCH Insurance Program has gathered a tremendous amount of momentum and we now provide services to over seventy member hospitals. Because we count each of them as friends as well as clients, I am certain our journey together has just begun.

With the launch last year of the Rural Hospital Insurance of America (RHIA) program, we have been given the opportunity to test our “Why?” at a national level. Coupled with our experience and success collaborating with TORCH, our “Why?” has given us the confidence and the wisdom to navigate the national scene in collaboration with National Rural Healthcare Association (NRHA).

Because our “Why?” is so deeply rooted in who we are, and more importantly, the needs of the people we help, we continue pressing forward and searching relentlessly to find new and better ways to manage the daunting depth of risk healthcare providers deal with every day. And, we are never alone. This fall, we are witnessing the birth of an entirely new collaborative program that is the very first of its kind in rural healthcare. To claim we “hatched” this program ourselves would be misleading because it too is the result of the relationships and shared “whys” of many of our clients and friends.

The Community Hospital Insurance Coalition (CHIC), is a powerful, collaborative response to the increasingly complex and challenging world of risk and insurance our clients find themselves in. And, importantly, it is absolutely true to HealthSure’s – and my own personal – “Why?”

Onward to more beginnings

Today, we continue our journey with gratitude for the trust, confidence and support of all the people who have been and will be, with us along the way. So many friends have been made from these relationships. Our friends include the TORCH members and staff, the legal and audit community supporting our members, the insurance companies that believe in our company, the folks at NRHA who have placed so much trust in us, and, of course, each and every client who allow us to help them answer their own “Why?”

And finally, and very importantly, our HealthSure team of coworkers remind me every day of how blessed Brant and I have been to serve our healthcare community.


*With apologies to Frank Sinatra!



What’s Your Story? What’s Your Legacy?

By Brant Couch, CIC, CPA

The Dickens classic, “A Tale of Two Cities”, begins with one of the most famous first lines ever; “It was the best of times, it was the worst of times…” Sound familiar? If we’re really honest with ourselves, this might very well be the first line in our own personal history book.

As HealthSure celebrates our milestone 20th anniversary, I find myself asking, “Is 20 years a long time?”

Well, I guess that depends on if you’re talking about 20 years of marriage or 20 years raising a child… or a 20-year career. All of these things could be looked back upon with feelings of accomplishment, joy, and growth as well as defeat. One thing I know for sure is, when I think about the past 20 years, I think of all the people that were a part of my history.

When I look back 20 years, it’s hard to remember all the moments that shaped my history. I struggle to remember all the characters along the way. When I bump into old friends those memories come flooding back and I relive that part of my story. But, give it a little time and those memories will fade again. While many fade, there are just some memories that stick; those that we never forget even if they seemed insignificant to everyone else. We carry them around with us forever.

A car ride and the beginning of my HealthSure story

One of those for me is a car ride with my father when I was in my early twenties. I honestly can’t remember where we were going, but I’m pretty sure it was on our way to the gulf coast for some bay fishing. This is somewhat of an obsession for my father. I was very early in my career as an auditor for Ernst & Young and conversations about his business and my job were common.
In this particular conversation, he was telling me about the trials and tribulations of a business partnership he was ending to start a specialty insurance brokerage just for the healthcare industry. Most people in business would lean into that conversation asking questions like what happened to the partnership? What’s the business plan for your new company? What’s the market look like? Who’s your competition?

Well, I can assure you I asked none of these questions. He might as well have been talking to the family dog because I was either too green or too dumb to recognize the significance of this situation. That is until he started talking about this thing called a legacy. Of course, I knew what the word meant, but I always associated it with U.S. Presidents or Hall of Famers. In this instance, he was talking about building something that the next generation could be proud of, be part of, and be successful in. He was talking about his own story. His own personal history book.

Twenty years ago, HealthSure Insurance Services was born. At that time, I would have said you were crazy if you asked me if I’d ever go work for my Dad in the insurance business. Are you kidding? I was in a much more glamorous profession… accounting!

The power of one person’s legacy

The truth is, my dad was my buddy and sparring partner for life’s challenges. Our family got along great, for the most part. We actually liked being around each other and sought out opportunities to spend time together. I had heard too many horror stories of fathers and sons going into business and how Thanksgiving dinner was ruined for life. Keep the carving knife away from the business partners!

If you laughed at that, it’s likely because you have a business partner now or you had one before. So, 14 years ago when dad came to me with the idea of working for him, it wasn’t an easy decision. Like good accountants (yes, he’s one too) we did our due diligence. For 6 months! It was comical to everyone who knew us. One friend told me, “You’re stupid if you don’t do this.” I took the job.

So now, here we are 20 years after that long car ride on our way to the gulf coast. A lot of that story has been written. It has been the best of times and the worst of times. I’m starting to understand what he meant by leaving a legacy. I have two children of my own now. I have no idea if they’ll ever have an interest in being a part of HealthSure, but I don’t think that’s the point my dad was making.

Who you help is your legacy

A legacy for the next generation can show up for anyone your story impacts. Who did you offer a job to and what did you teach them along the way? What client did you help solve a problem that could have caused a disaster in the board room? What community service project did a staff member think up and now the whole company is involved? Whatever it may be, we’re all going to leave a legacy. What you do to shape it and how you write your own personal history book is up to you.

Is 20 years a long time? Not to me, we’re just getting warmed up. I look around HealthSure and I see people who are poised to move us forward another 20 years. They are excited about our growth, our potential and our purpose. They’re not just knocking on doors, they are knocking down doors. They are writing their own personal history books and that will be our legacy.



Have You Seen This Person!
We’re Looking for A Players!
Our purpose is to help healthcare organizations succeed in the increasingly complex world of risk and insurance, and we need to add more “A players” to our team to support the growth of our organization.

Please be on the look out for the following positions:

HealthSure offers flexible work arrangements, a strong culture of empowerment, teamwork, and support to advance your career.




Small but important print
This communication is designed to provide a summary of significant developments to our clients. Information presented is based on known provisions. Additional facts and information or future developments may affect the subjects addressed. It is intended to be informational and does not constitute legal advice regarding any specific situation. Plan sponsors should consult and rely on their attorneys for legal advice.
What Happens Next? This ACA Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.

©2018 HealthSure. All Rights Reserved.

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Take the Community Hospital Insurance Coalition (CHIC) for example. With our expert support and management, more than 30 rural hospitals who have come together to own this medical stop-loss reinsurance company. They are paying less for their insurance, improving benefits program performance, and receiving their share of a significant annual surplus cash distribution (~$2.5 million since inception in 2018).