What Is Sana? Tell Us About What You Do And How It Works.

Sana is a full-stack health insurance solution for small businesses. Sana customers save an average of 20% on healthcare costs while offering their employees rich benefits and access to premium virtual-first care options. There’s a lot under the hood we do to make it work, but it starts with an obsession with patients getting great care at low cost, and it turns out there are a lot of ways to make our health system work better.

What Is Your Background? What Led You To Starting Your Own Company, And How Did You End Up In This Space.

I always knew I wanted to be an entrepreneur. I have a lot of entrepreneurs in my family, and I looked up to them. I loved the idea of creating something new that could benefit society and building a company that people loved to work at. My Co-Founder Nathan Hackley and I came up with the idea for Sana while we were at Justworks, the payroll and benefits company we were at previously. We saw how broken and expensive health insurance was for businesses. It felt like a big opportunity. 

Neither Nathan nor I come from healthcare backgrounds. Across my career, I’ve worked in Hollywood, in big tech, and in startups. Nathan is a software engineer and designer. Being new to the industry was actually a big advantage for us. When a system is as broken as US healthcare, it can be really helpful to start with a blank slate and work on solutions from first principles. That’s how we started Sana and continue to think about problem-solving today.

What Have Been Both Your Favorite And Least-liked Parts Of Your Entrepreneurial Journey? What Have Been Your Most Challenging And Most Exciting Moments For You And The Company?

The best part of starting a business is the people—getting to work with a small group of talented, mission-driven people to build something new. I’m so proud of the team we have, and I enjoy working with them immensely. It’s energizing. The flipside of that is that at times we’ve hired people who aren’t a fit, and we’ve had to let them go. Managing the cases that don’t work out is the worst part of being an entrepreneur. We invest a lot in our interviewing process to mitigate that risk.

It was so challenging to get our first customer. I understood why prospects were reluctant to try Sana: Who wants to be the guinea pig for a new health insurance product? It took us a year and a half of grinding and selling before we got someone to say yes. We only had so much cash in the bank, and every month the funds depleted a little more. I had so much anxiety about it. If we didn’t land a customer, the business could have died before it even had a chance. That was the hardest phase for Sana. Landing that first customer was the most exciting moment because it marked our transition into having actual operations and things started to snowball from there.

What Was The Fundraising Process Like For You? Tell Us About Your Investors And How You Use The Funds You’ve Raised.

Fundraising was very hard at the beginning. We raised angel capital fairly quickly, but institutions balked initially. We have a complicated product that spans insurance, healthcare and small business sales and most VCs were overwhelmed with the complexity of it. Nearly everyone we talked with said we were “too early” for them—even some pre-seed firms, which is hilarious. I quickly learned that “too early” was code for “I’m never going to invest.” After kissing a lot of frogs, we got lucky and found a strategic partner from the world of insurance who understood our vision (Greenlight Re) and then found a couple of VCs who didn’t mind taking bets on complicated models (Gigafund and Trust Ventures). They gave us the capital we needed to prove out the business.

Now, fundraising is easier. We have fast growth and happy customers, and it’s more about optimizing for partners and terms instead of an existential concern like it was in the early days. 

Who Are Your Co-Founders Or People Who You Work Very Closely With? How Do Their Skills Supplement Yours?

Nathan Hackley is my Co-Founder. He is excellent at many things that I am not—engineering, design, product management. More generally, he has a rare ability to understand what customers need and translate that into a technical system that delivers the solution. I am much stronger at the business stuff - finance, partnerships, growth, etc. Our skills are different, but we are very aligned on how we want to build Sana. We see eye to eye on mission and values. I trust his judgment implicitly. We both enjoy being non-conformist, which makes working together fun and probably makes us better founders. We were really lucky to join forces at the inception of Sana. We built a lot of great foundational stuff very quickly with just the two of us because we had a very clear understanding of where we were going, divided work into our separate lanes and just sprinted in parallel. 

How Has COVID-19 Impacted Your Growth And Operation Over The Last Year?

Sana operates health plans for our customers, so COVID was top of mind for us more than typical firms. Our member advocates and website are the front doors to care for many of our members, so we tried to help people in need as much as possible. We promoted telemedicine when people were scared to do in-person visits, promoted vaccine availability where possible and made free mental health visits available to members as the pandemic dragged on. 

Inside of Sana, we have always been a remote-first company. In that way, switching to “work from home” wasn’t much of a challenge. In fact, Nathan and I feel like many of our views on distributed work have been validated as companies test it out and find it can be really great for a lot of people.

How Do You Think Your Industry Will Change Post-COVID?

The silver lining of COVID is that it has laid bare so many issues with our healthcare delivery system and has prompted healthy responses from regulators. Coming out of COVID, I hope we see more sustained adoption of telemedicine, a relaxation of licensing restrictions for practicing medicine cross-borders, more regulations to promote hospital price transparency, and increased support for marginalized groups that are typically underinsured. 

How Does Sana Stand Out From The Other Modernized Insurance Companies Out There? What Would You Say Is Your Core Competency?

Our core competency is a cultural one. We actually care about your experience with healthcare, and we are trying to make it cheaper and better. The incumbent carriers really don’t care about that stuff. They are too stuck in their ways, and their incentives are perverse in a myriad of ways.

Tell Us About Your Typical Workday Schedule.

I have a year-old daughter who is my alarm clock at 6:30 in the morning. I get to start every day playing with a little baby in pajamas, which I love, even though I am not a morning person. After that, I get ready for work and try to keep the first hour or two of my workday free to think and prioritize. I have a note-taking app, and I keep a daily journal where I lay out my priorities and log what I’m thinking about and whether I’m doing a good job of taking care of myself mentally and physically. That way, I start each day intentionally. The rest of my day is mostly meetings and replying to emails, sadly. It’s not very glamorous. Part of me misses the early days at Sana of focused, quiet work, where I was helping to build the products directly. My job now is mostly coordination between internal stakeholders and talking with investors or strategic partners, so meetings are the name of the game. I don’t work too late most days, maybe to 5 or 6. After work, I try to make time to work out, but I could be better about that. Most nights, I’m good at unplugging for a quiet dinner with my wife and daughter before doing our baby’s bedtime routine. 

What Are The Top Qualities or Skills You Believe Entrepreneurs Need In Order To Be Successful? Also, What Advice Do You Have For Entrepreneurs Who Are Just Starting Out?

You really only need one: extreme drive. If you have that, you can figure everything else out. Being a great entrepreneur isn’t rocket science. It is, however, extremely hard. Firing people is hard. Hearing “no” a thousand times from investors and customers is hard. Losing early customers is hard. Entrepreneurship is “Eating glass while staring into the abyss,” as Elon Musk says. You need to have something abnormal under the hood pushing you to persevere. 

My advice for early entrepreneurs, if you’re serious, is to start. Now. Quit your job. Pitch the idea to investors. Start hearing “no.” Stop making excuses. You’ll likely fail, and that’s fine. It’s not for everyone, but the only way to know for sure whether it’s for you is to try it.

Tell Us A Story Of Something That Happened To You, Something You Heard, Or Something You Saw, That Either Made You Laugh Or Taught You An Important Lesson.

In the early days of Sana, I pitched our business idea to a number of “important” people in the industry. In one week, I pitched the CEO of a prominent insurance carrier, and later I pitched the president of an industry association we were joining. Both of those people told me Sana was a terrible idea and I shouldn’t pursue it. I felt so deflated after each call. These were people who had worked in the industry for decades and knew the business inside and out. It was hard for me as a small beans startup founder with no customers to get a meeting with them. I finally got the call set, gave them my best pitch, and they were so dismissive of all these innovative approaches I thought would work. Those conversations shook me and had me revisit all of my assumptions for the business to make sure I wasn’t wasting my time and our angel investors’ money. Ultimately I disagreed with their assessments and continued to pursue the idea.

It’s pretty clear to me now that those guys were full of it. Dead wrong. Didn’t know what they were talking about.

I take a few lessons away from those calls:

First, is that you need to build conviction in your idea from first principles, not from what conventional wisdom says. Trust your own perspective and logic.

Second, is that people who have been in an industry for decades are going to be resistant to change, even if that change makes sense. So don’t sweat it if they don’t see the world as you do.

Third, is that if your business makes sense, but industry veterans think it’s a bad idea, that’s actually something that should make you really excited.

Being contrarian and right is the only way to really outperform as an entrepreneur, and important people telling you your baby is ugly is a symptom of being onto something exciting.

If You Can Have A One-Hour Meeting With Someone Famous Who Is Alive, Who Would It Be?

I’m really interested in biotech and the science behind increasing healthspan. I think the next several decades will bring some really exciting changes to our ability to program our bodies and conquer diseases. We already are seeing that in a small way with the mRNA COVID vaccines that were synthesized days after sequencing the virus’ genome. So I might meet with a scientist like Jennifer Doudna or Shinya Yamanaka, though I’d probably make a fool of myself because I’m such a novice in that domain. 

What Do You Do In Your Free Time?

Mostly I hang out with my wife and daughter. I used to read a lot and road bike, but being a Dad really sucks up a lot of free time. 

What Does Success Mean To You?

My favorite business school professor was a guy named Clay Christensen, who sadly passed away last year. He’s famous for coining the term “disruptive innovation,” and his books and class were hugely influential on how I approach company-building. In addition to his books on business, he wrote a book called “How Will You Measure Your Life” that contemplates what it means to live a meaningful life. My main takeaway from it is that success in life is ultimately about how well you cultivate relationships. When I’m at the end of my life, I hope the people around me feel like I’ve made their lives better. To accomplish that, I prioritize spending meaningful, focused time with my family above everything else. With Sana, I care about creating a work environment that people find empowering and inspiring. Ultimately I hope we build a business that makes the world a better place.

Will Young’s Favorites Stack:

Books:

1. The Innovators Dilemma (business)

2. Foundation Trilogy (Sci-Fi)

3. The Three Body Problem (More Sci-Fi. I like Sci-Fi, obviously)

Health & Fitness:

1. Garage gym. Lifting heavy weights is the best.

2. Zero - intermittent fasting app

3. Peloton (basic, I know)

Brands:

1. Chubbies (proud Sana customer!)

2. State Bags backpack for work stuff. It’s awesome.

Products:

1. Standing desk from Uplift

2. Cold brew coffee every morning

Upcoming Vacation Spots:

Bali. My wife and I were supposed to go for our honeymoon in 2020 but had to cancel. Someday we will actually do it.