Rezilient Summit 2025 CEO Panel

At our 2025 Inaugural Healthcare Summit in St. Louis in early August, Danish Nagda, Rezilient CEO and Co-Founder was joined by Justin Woodard, CEO of Woodard Cleaning and Restoration, Davis Karandish, CEO ofCapacity, and Landon Hobson, CEO of Cosmos Corp to discuss the challenges of leading three very different types of businesses in turbulent times.

In case you missed our Summit, catch the whole discussion on the video below and in the transcript.

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Danish Nagda

We have a diverse group of leaders on the panel today: We've got family business, we've got an AI startup, and we've got someone who's running a manufacturing business in the middle of a tariff war. I want to talk about what it's like to be in all your shoes.

I'm going to start with Justin. How does being a leader for a family-owned business uniquely affect your healthcare decision-making? Obviously, you are past the point where it's cousins working in a shop together, but still, family-owned businesses have a relationship with their employees that's very unique. How do you balance that with year-over-year renewal increases, healthcare costs, tough healthcare decisions?

Justin Woodard

I think sometimes I take it too personally. When your name's on the building, sometimes that sits with you in a different way. I want to do the best that I can to have these folks that have built this business before me to continue to have it do well, and then also have a great place for people to work. And often when you're dealing with healthcare decisions, you're dealing with incomplete information, you're dealing with a lack of transparency, and frankly, we're dealing with a couple of hundred people and their families, and we're in a boardroom trying to make a decision that ultimately we're in this place where we're torn between just the raw financial part of the decision and people's lives, where 200 different families could have 200 different healthcare needs.

The plan that we put together, frankly, can't be that robust to take care of all of their needs. I just get really irritated and agitated and handle it pretty poorly because I take it so personally. But that's the sort of thing that I'm thinking about, is that I've got these people that need to trust in my care, trying to make a good decision, and sometimes it feels like my hands are tied behind my back.

Danish

You can already see that he's a great leader because his first thing is to say that he's not doing a good job, which is interesting because from my vantage point from the outside, his people trust him. You can see why.

Family-owned businesses have this really tough challenge: the reason why people join those businesses is because of these types of things. “I'm not good at this” is actually what they love.

I'm going to go to Landon next. Cosmos Corporation is doing everything they can on the healthcare side, then we had a change in leadership on the country level, and one of their biggest initiatives is that they are adding tariffs on other countries. But really if you're importing from another country, your business is paying the tariff. How have recent tariffs affected your overall business operations and also your healthcare decisions?

Landon Hobson

We're getting hit in three ways.

I'll actually start with this: Nobody's going to call their baby ugly, right? So this is kind of a bold statement, but I think we are the kind of ideal American company, and I'll tell you why. We manufacture $4 a bottle pet shampoo in suburban America, St. Charles County.

We purchase 90% of our raw materials within 200 square miles of our plant, and we net export huge sums out of the U.S. We sell to 70 countries. So we are a net exporter by far, not even close. The reason I'm saying that is I think the tariffs are supposed to help those ideal American companies, right? My training is in economics, so I'm not naive enough to say that the President should take just Cosmos into consideration.

I understand there's a whole country economics situation, but it's hit us in three ways. Number one is the part we do import — we have to import sprayers and wipes, because you can't be competitive if you don't. They have gone up dramatically.

Our export business has dropped in the 30 to 40% a year range. Countries are putting reciprocal tariffs back on us for our exports, which is an issue because our customers don't want to invest in us because they don't know what's coming next. And so they're not going to give us that extra space in their store this year. We're actually going to slim you down because we're not sure what that product will cost, and we know that we can't raise your price any further. We already sit at a super premium: dog shampoo that's $15 a bottle. Most of you don't pay that much for your own shampoo.

The third piece is we buy local and those local companies are now having a rush of people coming to them and saying, “I can't buy it from China because it's not competitive.” It's COVID all over again, right? So then those local companies decide to raise their prices because China used to be 10 cents and they were 13 cents and you were willing to pay that 3 cents or 30% difference. Therefore, they’re going to sit 30% above the tariffs because they’re an American manufacturer, they offer an advantage of speed and smaller minimum order quantities.

So we get hit from increased direct material costs, decreased revenue, and from some of the manufacturers locally that we purchase from, it's given them a ticket to raise their prices because people are coming to them, it’s supply and demand. In today's world, it's hurting what I would say is an ideal American company: one that’s employing people, manufacturing, exporting, and buying locally.

I'm hoping when it's all said and done that it's a net positive to us. There could be some really good trade deals come out of this. We do face tariffs in these countries that make us not competitive in other countries. If those tariffs can come down long term, then it could be a net positive, which is good.

How does that affect health care? It affects health care a lot. The US is still the largest pet space, but our business is 15 to 20 percent international. So if you cut that by 30 to 40 percent, our revenue is unstable at that point in time.

Then [Cosmos HR Director] Stacey brings to us this is the healthcare package that we're going to go to the employees with. We have to be careful in case the tariff war, the trade war accelerates. What happens then? Our revenue drops. We've got a lot of fixed costs.

We're not able to change our cost structure because we're a manufacturer. We have building electricity, equipment, manufacturing employees. So it makes for uncertainty in all of our decisions, but in the healthcare decisions specifically, we have to consider that – if our revenue is not there – are we going to cut corners? Are we going to contribute less to the employees? So it really does impact that.

Danish

Rezilient is in a very interesting place because – unlike a traditional point solution – I'm having a consultative relationship with the CEOs because we're the quarterback on the care side for their health plan.

No offense to point solutions, but you don't just get to go and say: hey, I do this thing and you spend this much on this thing. And this is how much it’s going to save you.

They can’t have the conversation we're having. I'm asking him about tariffs. I'm asking him about running a family owned business. We're having like real conversations. It is a consultative relationship. And part of that is if he has to deal with tariffs, he can't spend on healthcare.

It's hard. CEOs are making these decisions every day.

David is also an investor in Rezilient and he has believed in what we're doing. But at the same time, you're building your own company around customer success.

So my big question is, if benefits is so hard and AI is allowing us to 10x people, how do you think AI is going to impact how people build companies and scale their staff?

David Karandish

It used to be that if you wanted to build a piece of software, you need some kind of expensive dev team to go build it out and show what it can look like. Now we have high school kids doing summer internships, building fully workable prototypes, POCs that are in some cases even going into production. And so I think the cost of taking your idea and bringing it to life, it's not at zero, but it is going towards zero with this technology.

When I think about where this intersects with healthcare, we are a country where people are getting older, the labor participation rate continues to go down, even as unemployment fluctuates. We are going to need solutions that scale when there is an aging population and when there becomes a dearth of workers, whether it's due to immigration policies or population expansion, etc. So I think this technology is going to not be just a job augmenter or even job replacer, but it's going to be necessary for what happens to us from a population standpoint over the next few years.

We've seen it, our dev team can tell you how much it's augmenting them on a daily basis, but it's also on the healthcare delivery side. I'm sure our team will tell you that there's never enough people or time or effort that we can put in and the business continues to grow. So if the right approach is, how do we use it to help in this really difficult time where we don't have enough workers? We have all these businesses that are relying on us.

Danish

I think AI does augment that. But one question I have for you, Justin, is despite that, for your business, it's really hard to imagine how AI can be used for cleaning. And one bigger question is, how are you all thinking about your strategies in terms of healthcare? Obviously AI is an augmenter and we have to deal with tariffs, but I don't think tariffs affect your business that much.

How are you all thinking about the rising cost of care and sort of your benefit strategy? Because you did make some changes this year. And I'd love for you to share that.

Justin

If you look at the entire cost structure of the business, we're in a pretty stable business – whether we're cleaning carpet or clean up after water damage or fire damage – that market doesn't necessarily increase much each year.

Even if we're increasing our revenue eight or 10 percent, we have to deliver that service with our people. If we're really good at what we do, we can maintain our margin. So as we get another dollar of revenue, we can deliver that service at about the same margin.

We still have marketing and our technology team and our HR team that we need to support the rest of the company. So from top to bottom, we have pretty stable percentages. We generally know what to expect.

If we're growing at 10 percent and health care costs go up 10 percent, we can make all of those equations work. But if healthcare increases by 15 or 20 percent – as that balloons, it pushes other things out and we have to make other decisions. Frankly, property insurances can have some pretty weird fluctuations as well. So as we're looking at our benefits, we look across the whole package and try to encourage our marketing team to make sure that we can get more leads so we can grow so we can spend the same percentage on our benefits each year.

So that's just straight math equation. The other part of it is we we do want to make an effort to provide things that our people want. That's where it gets a little challenging, because when you have a couple hundred families and they're all in different times of their life, some folks don't want to spend as much on healthcare.

They don't frankly need to if they're younger. And if somebody is having a child, they're going to be spending more on health care. At different times in people's careers, they actually want different things from the benefits.

So that's another part of the equation. What do our people want now? What parts of the benefits offering should we spend a bit more on? Disability versus life insurance or they want different things from health insurance. So we look at the equation and we look at our people and ask them what they need and want. Then we try to do the best we can to make all of those things work. Part of that is having Rezilient, of course.

Danish

Landon is one of our earliest customers. Can you talk a little bit about it? This is the one time I'm going to ask someone to say something nice about Rezilient directly.

Can you share a little bit about some of the benefits that partnering with Rezilient has brought to your company and to your employees?

Landon

I'll share a company example and then I'll share a personal one just for free. In the last two months, it was renewal time and healthcare costs are obviously rising and we are trying to decide which plans are we going to offer. At the time, we had Rezilient and we had a zero deductible plan that went through BJC. That plan cost was just going up and up and up, mainly because people were going to urgent care and the emergency room for things that they don't need to be going for. There were some, I guess you could say, perverse incentives there that we were subsidizing that at a higher rate.

As we went to redo our benefits, we were able to offer a $500 deductible, but we tried to structure it to where we could move people up to a high deductible plan with an HSA and then pair that more with Rezilient: you can have a lower premium, you can save the dollars for a high cost event on a high deductible plan.

But all of your everyday needs, you can go for free as many times as you want in person or telehealth with Rezilient. The only way that we were able to do that is because our high utilization rate of Rezilient is saving us money – and saving employees money. We’re migrating people on to the high deductible plan, putting in an FSA or HSA and matching some dollars to it, and really pushing them to Rezilient. Hopefully that means our healthcare costs go down.

We're utilizing the fixed cost of Rezilient, and we're saving the employees money through premiums and ideally putting some money tax free into a situation where they can be prepared for a high cost event. Rezilient has allowed us to do that.

30 to 40% of our employees now are on high deductible plans where two years ago it was zero. That does save us money and it saves employees money, and our utilization of Rezilient because of that has gone up.

A personal story: my wife and I use Rezilient. [Rezilient provider] Maggie has helped us many times. We were in North Carolina visiting my family and my wife was having some stomach issues. I just told her it was acid reflux. So I'm buying her Nexium and Milanta and telling her “just chug this stuff, babe.”

Suddenly, she has more pain. So we get on the phone with Maggie to figure out what this is. I'm in the room and she's FaceTiming with Maggie and she's describing the pain, and Maggie says: “I think you have gallstones”. And in my head, I'm certain it’s acid reflux. Then I Google gallstones and suddenly, I realize this is gallstones.

Before we set up an appointment with Maggie, we were going to the ER, and my wife called her primary care, but couldn’t get through to anybody.

Maggies asked when we were coming home, which was in two days. I'm not sure how she did it or what she did, but we got my wife in for surgery in a matter of 48 hours from when we arrived home, and she got the gallstones taken out. We didn't have to do it in North Carolina, which was going to have to happen if we went to the emergency room there.

Imagine what could have happened if we couldn't have solved the acid reflux knowing there were gallstones there. So I'm glad she took the next step, because there was no acid reflux, but I made her like chug Milanta. I appreciate Maggie getting on a call and solving it.

It is a real example of: “I have an issue. It's free. Let me get on a phone call”. It took 15 minutes. We were able to pack up the car and drive home. Maggie introduced us to the surgeon at BJC. We were in within 48 hours, problem solved. That saved a lot of money for Cosmos.

We have 15 stories every quarter of things like that happening with Rezilient.

It helps us make smarter decisions, for sure. I will do a quick PSA to say, do not see Dr. Hobson, he's not very good at being a doctor, but we're so happy that Maggie did an incredible job to take care of my wife.

Danish

Some of the brokers in the room will realize Landon only has a narrow network plan. So had she gone to the ER in North Carolina, it would have broken the health plan. It would have been a really big deal.

So, you know, the fact that this is a good example of where our clinicians provide great healthcare, but they're also part and parcel with the health plan. Your regular primary physician has no idea how your health insurance works, but we think about that all the time, because for us, it's not really about how much money can we save the health plan. It's usually that they have incentives for the patient. So it's $0 out of pocket. And that's something that's really important to our people. And so that's a really big part of the story.

The last question I have is for you, David. You kind of touched on AI in healthcare. What are you most excited about right now? Obviously, you don't have an healthcare AI company, but you are building one of the fastest growing companies in St. Louis right now.

Where does AI actually add value? What are the things in healthcare where you think AI adds up?

David

There are a few areas in healthcare where AI really starts to shine. First of all, who likes to fill out that long set of paperwork when you go to the doctor? No one. Or scheduling an appointment? The basics, like getting you into the person that you want to go see. That's a very good use case for AI.

We are working with an organization that does care plans for folks with autism. For those who are familiar with autism, you can have someone who is lightly autistic and on the spectrum to someone who has a pretty severe impact of autism.

This particular organization has 80 different care plans, depending on which doctor and provider you're working with. We're using AI to transcribe that information, extract it, and feed it into their system. We compared it against human transcriptions and we actually found out that the humans were transcribing it at a lower rate than the AI was in terms of medical error.

You also get just simple use cases around answering things like “what are my benefits?” Being able to ask an AI that question and come back to you with an answer, then you start to see folks starting to chip away at things like “I'm having these symptoms. What should I consider?” It doesn't mean that it's going to be a replacement for a doctor, but it means that you can start to be a more informed consumer as you make some of those decisions.

Danish

So I hope you all really enjoyed this panel. We are incredibly grateful for all of you touching our company and being a part of this. I know that sometimes when it comes to healthcare, people don't think of CEOs. We think of HR, we think of health plans, but the folks that are up here are making the hard decision of adding things like Rezilient to help reduce the total cost of care, which ultimately affects their employees. And as you can see from Justin earlier, they take it very personally. It is important. And so can you, can we get a round of applause for the CEOs?

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