UPS
Prepared by
Joe Nalley
show your work.

Governance-backed healthcare for a workforce
that carries America's packages.

Substance use treatment. Behavioral health navigation. Claims verification. Maternity steering. Performance-guaranteed. Warranty-backed. 90-day pilot. Walk away if the numbers don't move.
joe.nalley@showyourwork.health · joe-nalley.com
Confidential · Prepared exclusively for UPS · Not for distribution · June 2026joe.nalley@showyourwork.health
Joe Nalley
02
Your Workforce

460,000 employees. Physical labor.
The largest sorting facility on earth.

5.2
OSHA recordable injury rate per 100 workers at UPS — double the private industry average of 2.8
BLS SOII 2023 / UPS 10-K
48K
Employees cut in 2024–2025. The remaining workforce carries the same volume with fewer people.
UPS Q4 2024 Earnings / Reuters
70 lbs
Maximum package weight, lifted and loaded manually by package handlers across all shifts
UPS Package Handler Job Description
Teamsters
340,000+ union members under a negotiated benefits agreement. Healthcare commitments are contractual, not discretionary.
Teamsters National Master Agreement 2023
Louisville
Worldport: 5.2M sq ft, 70+ aircraft gates, the largest automated package handling facility in the world. Your biggest employee concentration.
UPS Corporate / Louisville Business First
$14.8B
Total compensation and benefits spend. Post-layoff, every dollar is under scrutiny.
UPS 2024 10-K
Your package handlers lift up to 70 pounds, thousands of times per shift, in Louisville and 1,800 other facilities. The injury-to-opioid pipeline is not hypothetical — it's the most predictable clinical pathway in your workforce.
All figures sourced from public filings, BLS data, and union agreements. We verify against your claims data during pilot.02 / 12
Joe Nalley
03
The Gap

You cut 48,000 jobs to protect margins.
The benefits stack wasn't rebuilt.

SUD risk in the package handler population

Repetitive lifting injuries lead to opioid prescriptions. At scale — 460,000 employees, physical labor, rotating shifts — the injury-to-dependency pathway is a population health problem, not an individual one. Your EAP offers referral. The pipeline after referral has no owner.

Post-layoff behavioral health demand

48,000 layoffs put stress on the 460,000 who stayed. Survivor syndrome, increased workload, job insecurity — all documented drivers of anxiety, depression, and substance use. Your behavioral health coverage addresses presenting conditions. It doesn't navigate the episodes that follow.

Union benefit obligations need audit discipline

The Teamsters contract specifies healthcare commitments. Self-insured plans at this scale generate thousands of high-cost claims monthly. Your TPA processes them. Nobody independent verifies them before payment. Union trustees have fiduciary exposure. Independent verification is the remedy.

Postretirement medical obligations

UPS carries $4.6B in postretirement medical obligations (2024 10-K). Long-tail cost exposure on a population that ages into higher-cost episodes — behavioral health, chronic pain management, substance use. Programs that reduce cost per episode today compound over decades of retiree coverage.

You restructured the headcount. You restructured the operating model. The benefits infrastructure still runs the same programs at a higher per-employee cost. That's the gap.
03 / 12
Joe Nalley
04
The Portfolio

Four programs. Each independent.
Each designed to prove itself in 90 days.

Lead Program

Continuum

Virtual-first OUD/SUD treatment with buprenorphine and navigator continuity
Delivery-anchored virtual MAT program. Buprenorphine via permanent DEA telehealth pathway. Named navigator manages full episode — intake through stabilization through step-down. Built for the injury-to-opioid pipeline your package handlers face. 42 CFR Part 2 compliant. Kentucky operations, where Worldport is.
9/week IOP standard · 42 CFR Part 2 compliant · Fee-first, earning into risk · continuumhealth.care
Lead Program

Curated

Independent behavioral health navigation with readmission warranty
One named navigator per member across every BH episode — acute psych, IOP, PHP, residential SUD, eating disorders, PTSD. 13 clinical areas. Quality-scored provider database across 13 clinical areas. 30-day readmission warranty on SUD residential and acute psych. Post-layoff stress, injury-related depression, survivor anxiety — these don't resolve in six EAP sessions.
200K+ patients managed · 80%+ residential completion · Single-digit readmission · curatedhealth.care
Supporting Program

Caliber

Pre-payment billing verification — advisory-only claims governance
Verifies high-cost claims (>$25K) before payment using seven-check Billing Governance Standard. Issues Billing Governance Certificate. Advisory-only — never denies claims, routes findings to your team. Independent of your TPA. Union plan fiduciary obligations make independent verification a governance requirement, not an option.
4–6% expected discrepancy rate · 10 business day turnaround · verifythebill.com
Supporting Program

Waybright

Warranty-backed maternity navigation for self-funded employers
Claims-integrated early risk identification at weeks 16–20. Facility-level quality data in the consumer's hands. Delivery site steering. 30-day readmission warranty held by credentialed delivery providers. Our platform fee is at risk against maternity outcomes across your population. At 460K employees plus dependents, maternity is a material cost category.
$1,677 modeled savings per navigated pregnancy · 4-tier steerability · waybright.health
Supporting Program

Cadence

Specialty therapy continuation governance — published clinical framework
Evaluates whether specialty therapies should still be running. 65,234 patients across 3 locked cohorts including NIH federal validation. 29.1% flag rate. Published in Pharmacy Times (April 2026). CGS v1.1 — 8-section clinical framework, 7 reassessment triggers, 4 drug classes.
29.1% flag rate · $14.3M first-cycle savings · $3–6 PEPM · showyourwork.health
Each program operates independently. Adopt one, two, or all five. No bundling requirement. No platform lock-in.
04 / 12
Joe Nalley
05
Continuum · Substance Use

The injury happened on the belt.
The dependency happened after.

Your package handlers lift up to 70 pounds per package, thousands of times per shift. When they get hurt — and the OSHA data confirms they do at twice the national rate — the clinical pathway is predictable: musculoskeletal injury, opioid prescription, dependency risk, SUD. Continuum intercepts that pipeline with medication-assisted treatment, virtual-first delivery, and a named navigator who stays through the entire episode.
The Model
01
Buprenorphine via permanent DEA telehealth pathway. No in-person prescribing barrier. Accessible from Louisville, Atlanta, or any UPS facility.
02
Named navigator from intake through stabilization through step-down. Same person. Not a call center rotation.
03
42 CFR Part 2 compliant. SDOH and health equity fields built in. Confidentiality protections that match what Teamsters members expect.
04
Fee-first model, earning into risk-sharing in year two. You pay for results before we share in them.
Why UPS

Worldport in Louisville, KY is the largest automated package handling facility in the world. Continuum operates in Kentucky. Your single largest employee concentration is in our operating geography.

The Teamsters contract guarantees healthcare coverage. That coverage includes SUD treatment. But coverage and treatment are different things. A benefits card doesn't navigate someone through buprenorphine titration, weekly IOP, and 90-day step-down. A navigator does.

$9,000+
Average employer cost per SUD episode without early intervention
SAMHSA / Milliman 2024
67%
Of opioid-dependent workers cite workplace injury as origin
NSDUH 2023 / NIOSH
05 / 12
Joe Nalley
06
Curated · Behavioral Health

You laid off 48,000 people.
The 460,000 who stayed need more than an EAP.

Episode-chain continuity

One named navigator stays with your employee across every behavioral health episode for the life of their enrollment. Not a call center. Not a new intake every time. The same person who knows their history, their medications, their family situation after a coworker was let go.

Readmission warranty

30-day readmission warranty on SUD residential and acute psych episodes. If a navigated member is readmitted for a preventable delivery complication, the delivering provider covers it under their warranty terms. Our fee is at risk against population-level outcomes. Active after 100 measured episodes — actuarial discipline, not a marketing claim.

Independence

We don't deliver care. We don't own facilities. We don't have downstream economic interest in where your employee goes. The navigator's only incentive is the right placement at the right time.

13 Clinical Areas Navigated
Acute psychiatric
Residential SUD
IOP / PHP
MAT programs
Eating disorders
PTSD / trauma
Adolescent BH
Dual diagnosis
Detox
Crisis stabilization
Outpatient therapy
Neuropsych
Co-occurring medical
200K+
Patients managed across BH episodes
80%+
Residential completion rate
$3–7
PEPM tiered by population
+ episode spread + gain-share year 2+
For UPS: Curated fills the gap between what the EAP starts and what your employees actually need — especially now, when the post-layoff stress load is highest.06 / 12
Joe Nalley
07
Supporting Programs

Two more programs. Same pilot structure.
Same 90-day proof window.

Caliber · Claims Verification

Union plans need independent audit.

Teamsters trustees have fiduciary obligations over the health fund. At 460,000 employees, high-cost claims above $25K flow through your TPA daily. Caliber verifies them before payment using a seven-check Billing Governance Standard — CODEVAL, DUPCHECK, RATEVAL, DURVAL, CREDVAL, SVCVAL, BUNDLEVAL. Advisory-only. Never denies claims. Issues a Billing Governance Certificate that serves as a fiduciary compliance artifact.

4–6%
Expected discrepancy rate on high-cost claims
OIG / AHLA / MGMA
10 days
Standard turnaround. 5 days for short-hold TPAs.
Advisory-only · $3–5 PEPM · verifythebill.com
Waybright · Maternity

The most expensive predictable episode.

460,000 employees plus dependents generates significant maternity volume. Claims-integrated risk identification catches complications 4 weeks earlier than standard screening. Facility-level quality data — C-section rates, NICU admissions, readmissions by hospital — in her hands. The Teamsters agreement guarantees maternity coverage. Waybright makes that coverage produce better outcomes.

$20,416
Average commercial maternity episode
Peterson-KFF 2024
$71,158
Average NICU admission. 1 in 10 pregnancies.
HCCI 2021
30-day readmission warranty · $4.50–8.50 PEPM · waybright.health
Caliber and Waybright are independent of Continuum and Curated. Adopt any combination. Each proves itself on your data.
07 / 12
Joe Nalley
08
The Pilot

You cut 48,000 jobs to protect the bottom line.
You need proof, not promises.

We don't pitch outcomes we can't verify. We don't ask you to commit before you've seen proof. The pilot is the product — your claims data, your baseline, your measurement. Performance guarantees and warranties are active from day one. If we don't move the numbers, you walk away with the data and owe us nothing beyond the pilot fee.

Scope

Defined population. Minimum 1,000 lives for BH/SUD programs. Louisville/Worldport is a natural pilot cohort — concentrated geography, high physical demand, claims data already segmented by facility.

Timeline

90-day measurement window. Claims-verified outcomes, not self-reported surveys. Baseline established from your prior 12 months. Outcomes measured against your own history, not an industry average.

Guarantees

Performance guarantees are active from pilot day one. Our platform fee is at risk from the first navigated member. If population outcomes miss the baseline, we forfeit the at-risk portion.

Exit

If it doesn't work, you walk. No termination fee. No penalty. No lock-in. You keep the data, the baseline analysis, and the scorecard. The 90 days were free intelligence either way.

The Scorecard
Every pilot produces a claims-verified scorecard at day 30, 60, and 90. Metrics are agreed before launch — not after we see the results. You define success. We measure against it. The scorecard is the decision document for full deployment.

Continuum: treatment retention, MAT adherence, ED utilization, return-to-work
Curated: readmission rate, completion rate, cost per episode, navigation engagement
Caliber: discrepancy rate, prevented overpayment, turnaround time
Cadence: flag rate, review influence rate, continuation appropriateness, savings per cycle
Waybright: C-section rate, NICU rate, readmission rate, steering acceptance
Why This Works for UPS
You just restructured an entire company. Every dollar of benefits spend is under scrutiny. The Teamsters agreement guarantees coverage, but it doesn't specify how that coverage is managed. A 90-day pilot with a scorecard gives you evidence — for the board, for the union, for the benefits committee.

Three things you learn in 90 days that you can't learn any other way:
1. Whether your claims baseline matches what you think it is
2. Whether navigation changes employee behavior, or just generates reports
3. Whether a vendor will put their own fee at risk against their own performance
The pilot isn't the beginning of a sales cycle. It's the end of one. Either the numbers move or they don't. That's the whole conversation.
Pilot pricing: PEPM at standard rates. No setup fees. No implementation charges. Warranties and guarantees active from day one.08 / 12
Joe Nalley
09
Unit Economics

What the 90 days cost.
What we expect them to return.

ProgramPEPMAnnual (est.)Primary Lever
ContinuumPer patientVariableED diversion + retention
Curated$3–7$1.1–3.9MReadmission + completion
Caliber$3–5$1.1–2.8MPrevented overpayment
Waybright$4.50–8.50$2.2–4.7MNICU reduction + steering
Cadence$3–6$1.7–3.3MContinuation appropriateness
Illustrative: ~460K employees + dependents
Pilot: start with one program, one population segment
PEPM tiers by volume — 460K employees = deepest tier pricing
We publish the economics honestly. If the modeled savings don't exceed the program cost in the expected case, we say so. The remainder buys governance, guarantees, and risk transfer.
Continuum ROI Signal
Average employer SUD episode costs $9,000+ without early intervention. Workers' comp claims with opioid involvement average $52,000+ vs. $13,000 without. At UPS's injury rate, even modest early interception of the injury-to-opioid pipeline moves material dollars.
NCCI 2023 / SAMHSA / Milliman 2024
Caliber ROI Signal
At a 4% discrepancy rate on claims >$25K, a self-insured plan of this size typically sees $3–8M in preventable overpayments annually. Independent verification is a rounding error against the recovery — and a fiduciary compliance artifact for union trustees.
OIG / AHLA / MGMA
Portfolio Discount
Two or more programs: 15–20% combined PEPM discount. Three or more: 20–25%. Single scorecard, single data feed, one vendor relationship across all programs.
All economics verified against your claims data during pilot. We don't model in a vacuum.09 / 12
Joe Nalley
10
Competitive Position

What we do that your current
vendors structurally can't.

Dimension
EAP
Standard Nav
Telehealth SUD
Show Your Work
SUD treatment
Rehab referral
None
Prescribing only
Virtual MAT. Buprenorphine. Named navigator. Full episode.
BH depth
6–8 sessions. Referral.
Triage only
Not BH-specific
13 clinical areas. Episode-chain continuity.
Claims audit
None
None
None
Pre-payment. 7-check BGS. Advisory-only.
Maternity
Not maternity-specific
Education only
None
Claims-integrated. Facility steering. Warranty.
Cost guarantee
None
Engagement metrics
None
Provider-held delivery warranty. Platform fee at risk. The only vendor in the category that warrants outcomes.
Pilot terms
Multi-year
Annual contract
Annual contract
90 days. Walk-away. No penalty.
Union compatibility
Standard benefit
No fiduciary artifact
No fiduciary artifact
BGS Certificate. Fiduciary compliance layer.

We don't replace your current vendors. We fill the gaps they weren't designed to fill — with programs that prove themselves on your claims data before you commit.

10 / 12
Joe Nalley
11
The Team

Built from the payer seat.
Designed for the employer buyer.

Joe Nalley
Joe Nalley
Founder & CEO

15 years building healthcare organizations and governance structures. Specialty risk products at a Fortune 25 payer — maternity, MSK, oncology, CHF — across millions of commercial members. Direct visibility into how payers price, manage, and lose money on the exact episodes these programs address.

Built and scaled a 13-location health system (BH, SUD, MAT, primary care, surgical center, community hospital). 30,000+ patients. Exited. Founded ClearBill — $9.2M returned to payers in the first six months. Exited. The programs in this deck aren't concepts — they're built on the same architecture, sold to the same buyer, governed by the same standards.

Cadence: 65,234 patients · 3 independent cohorts · NIH federal validation · Published in Pharmacy Times
M.S. Applied Behavioral Analysis, Northeastern · joe-nalley.com
Platform
7 Products Built and Published
Curated, Continuum, Waybright, Caliber, Cadence, Compass, Covenant — each with its own site, canon, and governance standard. Same infrastructure. Same employer buyer.
Payer Fluency
Speaks Your TPA's Language
Claims integration, risk stratification, actuarial reserving, and stop-loss coordination are built in — not outsourced to a consultant after the sale.
Track Record
Two Companies Built and Exited
Not a first-time founder. Not a consultant with a slide deck. Every program here was built on operating experience with real patients, real claims, and real exits.
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Joe Nalley
12
Next Steps

One conversation. One pilot.
90 days of your own data.

Your largest facility is in Louisville. Continuum operates in Kentucky.
The geography writes the pilot.

Week 1–2

Introductory call. Identify which programs fit. Agree on pilot population and scorecard metrics. Worldport Louisville as natural pilot cohort.

Week 3–4

Claims data review. Baseline analysis. Pilot agreement signed. No setup fees.

Day 1–90

Programs live. Scorecards at day 30, 60, 90. Warranties and guarantees active throughout.

Day 91

Decision. Scorecard in hand. Continue, expand, or walk away. No penalty either way.

Timing
Pilot can launch within 30 days of agreement. No implementation timeline. No technology integration required for initial deployment. Claims data feed is the only prerequisite. A one-page pilot term sheet is available on request.
The Moment
UPS cut 48,000 jobs. Consolidated regions. Rebuilt the operating model around automation and efficiency. Every function is being asked to do more with less — including benefits. The Teamsters agreement guarantees healthcare coverage levels. The question isn't whether you spend. It's whether what you spend produces measurable outcomes. A 90-day pilot answers that question with your own data.
Start Here
We recommend starting with Continuum (SUD treatment — Louisville, KY geography match) and Caliber (claims verification — union fiduciary compliance). Add Curated and Waybright in wave two once the scorecard proves the model.
joe.nalley@showyourwork.health · joe-nalley.com · showyourwork.health
Confidential · Prepared exclusively for UPS · Not for distribution · June 202612 / 12