Healthcare Rebel Alliance: Q&A with Marshall Darr, StretchDollar

Marshall Darr is a former Decent employee (he's back!) who has since spun out with some of the early team to launch StretchDollar. StretchDollar is the perfect place for small businesses to start when it comes to their health benefits. Through the platform, business owners can offer employees tax-free funding that they can use to offset the cost of individual market policies that they select and they own. There's no minimum participation, contribution, and absolutely no cost to use it.

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Nick Soman, Decent: Why did you decide to start a company in healthcare? And why this one?

Marshall Darr, StretchDollar: Healthcare is a big problem for pretty much everyone in the US, but the pinch is extra tight for a small business owner. I've always loved small businesses, and one thing I've noticed is that there's no good place to start when it comes to your health benefit. With StretchDollar, small business owners can make tax-free funding available to help employees cover the cost of individual market plans they select and they own. We don't charge anything for the service, and we're hoping it makes getting more people more access to better care possible.

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Nick Soman, Decent: You were known at Gusto and then at Decent as a great teammate AND a great seller. Some people think it's hard to be both. What are they missing?

Marshall Darr, StretchDollar: Selling is mainly about listening, so is being a great teammate. Lots of life tends to take care of itself if you can be present and attentive with someone and work together to solve their problems (odds are you'll solve some of your own on the way too).

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Nick Soman, Decent: What are the best and worst things about your job?

Marshall Darr, StretchDollar: Best thing - helping people. Early on, when onboarding a new company to StretchDollar, I matched an employee with a policy that saved her $1,370 per week on her insulin. Nothing is better than seeing your work have a tangible, positive effect on the people you're doing it for.

Worst thing - nothing makes time move faster than starting a company. There's more to do than there are hours in the day, and it takes particular attention and focus to not burn yourself out running 24/7.

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Nick Soman, Decent: Your company, StretchDollar, offers free ICHRAs so employers can contribute pre-tax dollars and let employees pick their own health plans. What misconceptions about ICHRA would you like to clear up?

Marshall Darr, StretchDollar: There are a few:

• ICHRAs are too complicated - this can be true if you'd like it to be. It's a very flexible funding tool that can solve a lot of different problems, or just the one we're focused on, which is "how can you make health insurance premiums as affordable as possible."
• Individual market plans are worse than small group plans - This used to be true everywhere but we've seen a large deterioration in the fully insured small group space while the individual market has largely stabilized. That means that most employers can save money by making the switch.
• Employees hate having to front their premium expense for months on end before getting reimbursed - as they should, but most ICHRA providers are automatically reimbursing employees and sometimes, like with StretchDollar for example, even preempting the premium pull from the carriers to eliminate the employee float entirely.

Nick Soman, Decent: Who else in healthcare inspires you, and why?

Marshall Darr, StretchDollar: You come to mind. I worked at Decent with the team for 5 years and learned an absolute boatload about the industry. Other names that, in my opinion, everyone in the space should know are Molly Moore - she does many amazing things but we met back at Decent when she was initially designing our DPC focused health plans. Shannon Goggin and the whole Noyo team are another one doing some amazing work in the space.