Not many group benefits brokers can trace their career back to a nursing home laundry room. Brandon Scarborough (pictured), VP of Employee Benefits at Apollo Insurance Group in Kansas City, Missouri, can. It tells you everything about how he approaches this industry.
His first job out of college was with a company that managed housekeeping, laundry, and food service in nursing homes. Minimum-wage staff, maximum invisibility. As he moved from account to account, one thing kept nagging at him: the people changing the sheets and serving the meals were being offered nothing in the way of health insurance. The nurses and certified nursing assistants got coverage. The people scrubbing floors did not.
"I came up with this idea when I was 23 years old to start a company and just offer benefits to those employees in nursing homes," he says. "I quit that job and started a company just doing employee benefits to nursing homes."
That company grew quickly and expanded into full group coverage. By 2007, Scarborough had sold it to a financial firm that merged it with another employee benefits company. He stayed with the combined entity for 10 years, long enough to be named the 2012 Benefits Selling Broker of the Year at the Benefits Selling Expo in San Antonio.
From there, he opened a brokerage in the Kansas City area. Cobbs Allen, as it became, is now the Baldwin Group's Kansas City office. When that firm was acquired in 2019, Scarborough stepped away from the industry to start a nonprofit, thinking at the time that he was done with benefits for good.
"In 2019, I thought I was going to be out of the benefits industry for good," he says.
He returned in 2022, spending four years at a third-party administrator (TPA) while working through a non-solicitation agreement, before joining Apollo, where he now serves as VP of Employee Benefits. His career splits roughly 90 percent broker and 10 percent carrier and TPA. It is a vantage point, he says, that lets you see the whole system from both sides and understand where it quietly fails people.
The Individual Coverage Health Reimbursement Arrangement (ICHRA) is something Apollo has gone further on than almost any firm Scarborough knows of. Eight full-time staff focus exclusively on ICHRA enrollments across multiple platforms. Two in-house ICHRA specialists work with employers directly. That level of commitment is deliberate, and the market data backs up why.
According to the HRA Council's 2026 Growth Trends for ICHRA and QSEHRA report, more than 20,000 US businesses now offer an ICHRA as their primary employee health benefit, a 53 percent jump from 2025, as rising premiums push employers to look beyond traditional group coverage for alternatives.
"The popularity of ICHRA is picking up, and you can just tell from how much money is going into the ICHRA business, how much funding these platforms are getting," Scarborough says. "Most people see it as the wave of the future, including my business."
He stops short of declaring it a wholesale market takeover. Fully insured plans from the large national carriers are not dying, he says. They are slowing. ICHRA and self-funding are the two vehicles he sees employers gravitating toward as the traditional, fully insured model becomes harder to justify year after year.
That shift is happening against the backdrop of significant consolidation on both sides of the business. On the carrier side, deals like CVS acquiring Aetna, and carriers absorbing pharmacy benefit managers, have reduced competition and pushed costs upward. On the brokerage side, large firms are swallowing up smaller independent agencies at pace. For Apollo, sitting deliberately outside that wave, the moment looks more like an opening than a threat.
Ask Scarborough what actually separates good brokers from those going through the motions, and the answer is data. Specifically, who has access to it and what they do with it.
"Transparency is the big buzzword in our industry," he says. "Transparent PBMs, transparent health insurance carriers. The more access to data we're allowed, the better. When you don't have access to the information and the data, it's hard to affect the spend."
The Kaiser Family Foundation's 2025 Employer Health Benefits Survey found that 80 percent of covered workers at large US companies are now enrolled in self-funded health plans, reflecting how much of the market has already moved in the direction Scarborough describes. Nearly all Apollo's accounts sit on some form of alternative funding. Level-funded or self-funded plans with carriers like Angle Health, Arlo, and Level Health operate with transparent, pass-through pharmacy benefit managers and give brokers real-time claims access. That changes the nature of the entire broker-client relationship.
"You walk in with a 20 percent renewal, you call your buddy at Blue Cross Blue Shield and say, 'Hey, I think if you get it down to 15, they'll sign,'" Scarborough says. "And they sign at 15 percent. You got it down 5 percent. You look great. And they just move on about their day, and you do the same thing next year. Gone. That's archaic."
Apollo has also built its own proprietary AI tool to surface patterns in claims data, though Scarborough is careful not to overstate its role. "I don't think anything compares to getting your own eyes on it," he says. "The people you hire have to be able to look at a claims report and decipher what's happening in that group."
The technology also helps with one of the industry's starkest inefficiencies: the wild variation in what different facilities charge for the same procedure. To illustrate the point, Scarborough reaches for a hypothetical. "A hip replacement can cost, I'm just throwing out numbers, $70,000 at one facility, but $35,000 at the next," he says. "And those two facilities can literally be side by side in an office park." There is no logic underpinning the difference. Every facility sets its own chargemaster rates, and price bears no reliable relationship to quality of care.
Steering employees toward high-value providers is part of the job. So is being the first call when something serious comes up. "I always say, what do you do when they need to reach the escalations department?" he says. "You have to be that first call and you have to be able to solve their problems or at least lead them in the right direction to be able to solve their problems."
He describes a recent case that brought this into focus. A first-year Apollo client was running $300,000 above projected claims spend. The culprit was a dependent of a low-wage employee receiving infusion treatments costing the plan approximately $30,000 every month. Scarborough called the employer personally with the news.
"I felt like I'm delivering this bad news to this guy, and he ended up saying thank you," he recalls. The employer's response stopped him: "I've never had somebody tell us where we are actually at or where we are trending, even though it's bad news. At least I know."
Apollo enrolled the family in a manufacturer's assistance program. The monthly cost to the plan dropped to little or nothing. Those avenues, which also include international drug sourcing and biosimilar alternatives, only open up when a broker has the data in hand and is willing to look.
He is clear about what that level of service means for the relationship. "We are business partners," he says. "When you choose Apollo to be your broker, we are really an extension of your company." The annual renewal call as the primary point of contact, he adds, is simply no longer viable. "I think the days of handing people renewals and moving on about your day is just not possible to compete anymore. You have to go that extra mile."
Scarborough identifies Apollo's biggest growth opportunity as something that sounds straightforward but is genuinely difficult: convincing employers that a health plan without Blue Cross Blue Shield or UnitedHealthcare on the card still delivers full, accepted, high-quality care.
"It's really hard to convince somebody that has had that card and that comfort level of Blue Cross Blue Shield, not knowing how it works, but just knowing the name," he says. "It's all about making people understand that healthcare is changing and evolving and there are different ways to deliver healthcare to your employees."
Once that conversation is won, the next one is just as tricky. Level-funded and self-funded plans are widely assumed to be tools only for large employers. Apollo runs them for groups as small as 15. "Without the data, you're really just blind to what is going on in these certain accounts," he says.
New ideas consistently land better at the CEO and CFO level than with HR departments, and Scarborough is candid about why. "People don't like change," he says. "The CEO, CFO level is where a lot of the conversations take place, especially when you're talking about the second biggest line item they have, after payroll." HR professionals, he adds, are not resistant so much as realistic. What looks like a long-term win for the company tends to mean more short-term work for them.
At Apollo, every new client receives a one-page disclosure at onboarding showing exactly what the firm is being paid and from where. The Department of Labor's Employee Benefits Security Administration now requires brokers to disclose compensation on covered service provider agreements; a regulatory shift Scarborough views as overdue. He thinks the industry needs to go further still and has a specific model in mind.
"What I would like to see is you lay out expectations at the beginning, and if we're not meeting those expectations, we don't get paid," he says. Right now, he argues, the incentive structure is fundamentally broken. "You can do a really, really poor job and still get paid from the carrier. Where else can you just not do your job well and still get paid?" The current commission model also means brokers receive an automatic raise with every renewal increase. "All you have to do is renew and you get a raise."
As IBB's analysis of disclosed broker compensation across the US benefits market shows, the scale of what top firms earn from carrier arrangements is significant. Stripping that commission out of the premium, as Apollo has done with several larger clients, reduces the employer's rate directly, with a separate negotiated fee charged in its place.
On enrollment, Apollo does something else most agencies do not. They go in person, one-on-one, with every employee. Twenty-five to 30 minutes per person, reviewing prescriptions, checking for generics or biosimilars, confirming in-network providers, and matching each person to the right plan.
"Nobody wants to raise their hand in a group setting and say, 'Hey, I'm having GI issues,'" he says. "But if you're sitting with them one-on-one, you can have that conversation."
It is labor-intensive and requires more headcount than a typical agency. For a smaller firm competing against consolidators, Apollo serves groups from two employees to 5,000 with an average size of around 100, it is precisely the kind of differentiation that requires real commitment. "We want to be the solution for the people that other people are turning away," he says.
Despite the consolidation, the litigation, and the relentless cost trajectory, he is not pessimistic about where the industry is heading. "The world is not ending and everything is going to work itself out," he says. "I think that we are trending in the right direction, and there's a lot of really good brokers out there doing the right thing and trying to affect the healthcare spend. We need more of them." Direct contracts with hospitals, reference-based pricing, there are tools brokers are still too cautious to reach for. "There's just all sorts of different things that people are scared to try. And it just goes back to the education and the transparency and being able to have those conversations with people."
When the day ends, Scarborough's world shifts considerably.
He has been sober for 15 years, and the nonprofit he co-founded, Be Free KC, reflects that. The organization provides sober living homes for men and women in recovery from drugs and alcohol across the Kansas City area. This year it launched a recovery high school, a place for young people whose addiction has caused them to fall behind on credits to earn their diploma while keeping sobriety at the center of their lives.
An ex-college athlete, he still works out regularly when he gets the chance. But ask him what he genuinely does to unwind and the answer is immediate.
"I'm a single dad and my hobbies are my three daughters, to be honest with you," he says. "That's where I spend all of my time, being with my daughters and being part of their events."
One preparing for college and collegiate volleyball, and two younger girls with busy dance schedules. Family life keeps the pace high long after the workday ends.
