Over the course of 15 years of working on all sides of the benefits table - from HR specialist to administrator to carrier account manager - Sher Sparano observed the health care process enough to see the lack of resources that HR departments had in handling their employees' benefits.

"I was really able to see that there was a real need for the human resources staff of companies because they were all on overload - and they really didn't know benefits, they were not trained in benefits," says Sparano. "So I had a lot to offer them."

With that, Benefits Advisory Service, Inc., of Forest Hills, N.Y., was founded. In the 20 years since, Sparano has made a name for herself as president of BAS through exemplary customer service to her clients, more than 60% of which are in the nonprofit sector, largely substance abuse rehabilitation services for youth and adults, a variety of children's agencies, and community health care centers.

With generally lower base salaries, benefits have always been "a main part of the package" for nonprofits, Sparano says, who despite the state of the economy, continues to work tirelessly to help her clients keep those packages competitive. And it's not just the benefits part of the business she cares about; Sparano devotes hours of her time each week to help these nonprofits flourish through her community outreach efforts that often have her out late into the night at committee meetings or fundraising events.

Sparano knows health reform is bringing an unprecedented level of change to the benefits advisory field, but one thing that won't change is her dedication to client service both inside and outside the office. "First and foremost I really believe that I have to have a consultative approach with my clients, whether the money's coming from premiums or charging them directly," she says. "I try to understand their missions, their goals, the direction that the company's going in - and really their human capital management because their staff is what makes it or breaks it and I need their senior upper management to understand that if they don't grasp these critical issues they won't be able to attract new employees and retain the best ones they have."

As a client of Sparano's for about 20 years, Marguerite Gebhardt appreciates how accessible Sparano is, as well as David Capo, senior account executive at BAS, without whom Sparano says she could not do her job. Gebhardt enjoys the individualized attention she receives as executive director of the Damian Family Care Centers in formulating a strategic plan for her employees' benefits. When a national carrier dropped Damian from its health coverage it could have turned "into a crisis for us," says Gebhardt, "if I didn't have somebody like [Sparano] and her team taking the responsibility to go out there and shop the plans and learn enough about our business, enough about our budgeting, enough about how much money I allocate every year for employee benefits across the board, so that when she comes in to present alternatives they're alternatives that are affordable both for the organization and for the staff members."



When Gebhardt met Sparano she was facing a 38% increase on health premiums at the hospital where she worked at the time. Sparano took on the account and got it down to less than half that. Then she took over responsibility from the HR department for dealing with the vendor and settling claims. "I had never even thought of using a broker because we always did this internally ourselves, and in retrospect I should have used a broker because they're much better at doing this stuff than we were," Gebhardt says.

For her part, Sparano never thought of becoming an insurance broker when she majored in art at Lehman College, part of the City University of New York, but because she had always worked, Sparano was also interested in business and also earned a business degree at Pace University.

When her husband took a biochemistry job with the government in Lexington, Ky., right after college, Sparano had her choice of two jobs, work in the HR department at St. Joseph's Medical Center in Lexington or take a higher paying job in another industry. "You know there are some moments in your life when you know you make the right choice? I just knew somehow or another that benefits were going to take off and we wouldn't be in Kentucky forever, we'd probably be going back to New York or another metro area, and I just thought it was a really good step career-wise for me," Sparano recalls.

After a two-year stretch at St. Joseph's, Sparano returned to New York where she met "a great mentor," HR Director Maria Pego, at her next job in the HR department at Mount Sinai Medical Center. With Pego's encouragement, Sparano developed her ideas to improve benefits by self insuring the pharmacy program, fixing the delivery of nurses' benefits and even upping union employee enrollment levels.

Today, Sparano brings that experience, along with her time at several other industry jobs (see sidebar) to her work with BAS in finding solutions for clients who are struggling with budget cuts and meeting fundraising goals. One solution Sparano brings to the table is to inform clients about New York State's Child Health Plus program, a prorated health insurance plan for children. Sparano set up appointments for Child Health Plus representatives to visit her clients and enroll eligible children in the program. "When it became apparent that the employer could no longer pay everything for the employee and their family we wanted to make sure that their families got good coverage," says Sparano. ". . . I didn't make any commissions on that, but it was the right thing to do."

Like many advisers, Sparano also encourages most clients to enroll in consumer-driven plans, but not without "massive campaigns in educating the employees on every aspect of how to best use their plans," she says, citing mail-in prescription plans and curtailing emergency room visits as two ways she promotes cost savings.

Peter Grisafi, chief operating officer at The Institute for Family Health, appreciates how Sparano and her team are available to assist any of his 900 staff members. "She's always advocating for the organization, making sure our premiums are low as possible, shopping our insurance and always taking into consideration the pros and cons to switching," he says. "Not just based on dollars but the reality: What does a switch mean to staff? What does a switch mean to management? Does it create extra paperwork? Is that company as reliable as the one we're currently with? She just thinks about every aspect and you never have to worry."

Once a year, Grisafi and Sparano travel to each of the approximately 25 health care facilities run by the Institute in the New York area to visit with employees in person.

Both Grisafi and Gebhardt brought Sparano with them from their relationship at previous employers when they began working at their current respective nonprofits.

"Sher always goes above and beyond what people expect her to do and I have so much confidence in her ability and in her morality and in her ethics and in the things that she believes in and she expresses outwardly through the way that she does business that I have never had a problem recommending her to other nonprofits," Gebhardt says. "She serves the nonprofit community very admirably."


Community involvement

Sparano does little advertising, thanks in large part to clients like Gebhardt and Grisafi, who recommend her company to others. "I'm very proud to say that most of it's been recommendations," Sparano says. "It's really been leading from one to the next to the next. I have done little advertising. I do speak at seminars and do presentations and fight for employee rights."

She's also no stranger to the community at large. She's on multiple committees, and is also a board member of her local Lions Club, where she heads the health insurance committee, and the Queens Chamber of Commerce.

She was recently recognized by The Queens Courier as one of its Top Women in Business for 2011. "When you're involved with not-for-profits they have very many needs, so I became very involved with helping them," says Sparano.

She often finds the community service work takes up a lot of her free time: "Sometimes just when I tell myself, 'OK, you're maxed out - no more,' somebody will come up with some critical need for one more organization and I frequently find myself saying yes even though I intended to say no. However, in reality you do have to limit it because the one thing I never want to do is spread myself so thin that I don't do a good job for the ones that I'm doing."

Sparano has six staff members at Benefits Advisory Service, which she runs with her husband and partner, Joe. The whole BAS staff gets involved in the community through activities such as a summer festival for a foster care agency client.

"When we set the company up we really did believe that if we were successful we needed to make sure we gave back to the community," Sparano says.

Sparano, often accompanied by her husband, attends a minimum of one event or planning committee meeting a week for her community service activities. The couple has formed many friendships through such events, but even though they enjoy it, Sparano admits there must be a limit. "Like everything else, it's a balancing act in life. There has to be time for family and friends," she says. "There has to be time for self."

Sparano would like to find more time for her artwork - "a real escape" - particularly etching and watercolors, but she also enjoys spending time with their four grown nieces and nephews and their families, attending the theater, reading and listening to music.


Future outlook

Just as the benefits advisory service industry is in a time of change and self-evaluation, Sparano knows her nonprofit clients must make adjustments to survive as well. The obvious approach is to focus on funding, but Sparano finds that meeting with senior management and having a frank discussion about strategy and what type of people they want within the organization will yield a more effective plan design. "We're able to see: Should something be self insured? Should other things not be self insured and be fully insured? Should we look at the entire benefits package, which I think has been remiss - especially in a lot of nonprofits. How many vacation days are you giving? How many personal days? How many sick time days?" she says.

Focusing on wellness programs, evaluating the standard life, health and disability offerings, but also taking a look at voluntary benefits, introducing FSAs to help with copays. "We have done lengthy education on things of that nature," says Sparano. It's about educating employers and their employees on how to be a more intelligent consumer of health care services, she says. Sparano is frequently out of the office conducing year-long education campaigns for clients. "We do that for everybody, not just my not-for-profits," she adds, "but certainly with not-for-profits it really helps."

So how can other firms cultivate such a sense of service on their staffs? "It starts at the top," says Sparano. "There is nobody I've interviewed for this job that I don't explain to them what we're about. They will only fit in if they're able to really relate to what we're doing."

She recounts one recent example when a charity client that reads books to children had a flyer looking for decent books. That same day, three members of her staff brought in books to start a collection box for them. "I think it's important that everybody understands that we can't survive in this community unless we give back," says Sparano.



Benefits from every angle

Sher Sparano uses her background on all sides of the benefits table to bring the best possible service to her clients.





St. Joseph's Medical Center //

Benefits Specialist. Ran the start-up operation and administration of the self-insured employee health fund. Administered and negotiated all employee benefits.



Mount Sinai Medical Center //

HR Special Projects Administrator. Wrote key executive manual; ran self-insured prescription plan. Streamlined NYSNA benefits. Educated employees on benefits offerings and encouraged enrollment in retirement plan.




Administrator. Managed the benefits negotiations, enrollment, education and customer service for 55 hospitals.



Empire Blue Cross/ Blue Shield //

Director. Managed Mega Accounts Division and all its components including customer service, underwriting, claim processing, managed care, and marketing.



Green Spring Mental Health Services //

Vice President. Key role in formation of mental health managed care company and developed systems that made the programs more user-friendly (i.e., designing review and appeal processes).



Benefits Advisory Service, Inc. //

President. Founded BAS, an employee benefits consulting/brokerage firm known for its hands-on service, personal touch, creative solutions, and advocacy.

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