About Decent

Several years ago, a big insurance company raised the level-funded plan rates at Nick's startup by 27% in January, because an employee had started an expensive treatment the February before. Nick asked the insurance company why they hadn't said anything sooner, and they said it was his data, so it was his fault for not looking.

Later, the employee told Nick she drove over an hour for each treatment. She would have preferred to be treated at home, which would have cut the cost by about 30%. An equally effective treatment cost 25% less and could have been made free to her. Adjusting her dose might have cut another 20%, with no negative impact on her health, and eased her side effects. Together, those changes would have cut the cost by more than half. Industry experts, including clinicians, worked out these savings, but by then it was too late to make any of the changes. Most of what she and the plan paid was waste, and Nick didn't catch it. He's building Decent to fix this problem for everyone.

Andrew wanted to build a company that applies AI to a problem that matters. At Meta, he led the internal AI assistant and agent platform, helping it move from answering questions to carrying out work. Decent brings that experience to health insurance, where better use of data can make a difference to what people pay and the care they receive.

Why now? Most insured employees at companies with 10 to 199 employees are on level-funded or self-funded plans: 51% in 2025, up from 19% in 2018.^¹ Those plans are priced on the group's own claims, and the employer can get claims reports during the year. And with the rise of AI, we can read and act on that data as it comes in, not once a year at renewal. The conditions finally exist to fix what's broken, and deliver affordable healthcare for all.

1. Price every option you can get. Fully insured, PEO, level funded and ICHRA, plus the ones you can't get and why. Our quote tool prices standard plans and ICHRA right away. PEOs and level-funded plans review your group first, so their prices take a week or two. Or book 15 minutes with Nick.
2. Recommend one. We tell you which option we'd pick and why, and what you give up with each of the others. If your current plan offers a renewal, it's always one of the options.
3. Keep working on it. When your plan shares claims data, we review it during the year and tell you what's driving costs. On a level-funded or self-funded plan, we also make the case to your insurance company before your renewal is set.

If you already have a broker you like, keep them. We're glad to be a second set of eyes during your plan year. If not, now you have us.

We put business associate agreements in place any time we access or share health information. We never tell you which employee a claim belongs to. Our privacy policy has the details.

We're free to you. The insurance company, PEO or plan administrator you choose pays us a commission out of what you pay them. The amount varies by company and by plan, and sometimes includes bonuses. A standard small-group plan is the same price whether you buy it through us or directly.

Before each renewal, we can tell you in writing what we'll be paid, and by who.

In 1944, FDR's Second Bill of Rights promised Americans "a decent living," "a decent home," and "the opportunity to achieve and enjoy good health." We still believe in that promise.

Some people think decent just means good enough. To us, that's kind of the point. Healthcare in America should be good enough to keep you healthy and safe: physically, mentally and financially. Good enough to trust with the people you love.

This is Nick's second company called Decent, because healthcare still isn't Decent yet. That's what we're working on.

Read the full story: Run It Back

Email hello@decent.com or book 15 minutes with Nick.