With the inquirer. Your benefits plans are coming up here, people with Medicare and stuff, and I don't know what I should do about that because I'm sixty eight years old. You know what, Let's let's get our guests on this is cool to have. I can actually get a free consultant here. But what we're talking about here when you go in it is that time of year when you you know, have to go back in and do your
insurance work. Insurance YEP, and medicare as a matter of fact, that we're talking about pretty healthy jump in price here to discuss daniel leboard lebroad from Healthcare Benefits. He's our healthcare benefits expert. And daniel what are we looking at here?
You know, I think we're in for a shot this year. We were kind of in our industry were.
Kind of warned about it earlier in the year that we're see big increases. But I'll tell you, you know, we position.
Clients typically to say, hey, you're gonna have to look at an eight to ten percent each year. You kind of budget for that, and our goal is to always, you know, hopefully get that down further.
I'll bringing an option that lower.
That, but right now across the US, we're seeing I mean ten is on the low side. We're seeing twenty and thirty percent increases, which is unheard of.
Wow.
And the youse don't even have to do with, you know, any particular reason. It's just it's across the board, particularly the small employers, those with under fifty employees who are the hardest hit. They're gonna get destroyed this year. And that hurts employees as well because they got to pick up a portion or all of that increase as well.
So, Daniel, let me ask, and I think everybody's asking the same question in their brain right now, is how come on both sides of the aisle. Every year, every politician, it seems like, running on we're going to get healthcare prices under control, We're going to lower them this, that and the other, and now stuff like this happens, and it looks like, as you just said, you're we're telling people to build in that cost for basically the rest.
Of your life.
Why can't this be controlled.
The only it can be controlled? And that's the problem, The issue, the biggest issue we have right now is the system is controlled by really two parties. You're controlling it's controlled by the larger healthcare systems. You're you know, in Dallas we've got big Textans Health and Presbyterian and Baylor, Scott and White. Across the nation, you've got very large healthcare systems and they work. You know, their primary payer are the insurance companies. In my opinion, the two of
them are in collusion. You know, they're they're battling and working on contracts to get paid by the insurance companies.
Thescurance companies are trying to pay them. But overall the two of them are.
All they worry about is profit, and they have to answer their boarder directors, and so there's a misaligned incentive when it comes to the employers and the and the public because we just want good healthcare and a reasonable rate. But they're trying to but they're having an answer. They're having answer shareholders, and they have to make profit. And you know, it just doesn't work. And that's why rates cup every year because they everyone has to give themselves
a ten percent raise every year. They have to go to the board and say, hey, how do we make more money? Well, we got to raise rates, how do you that's it?
You raise race.
You have to do that, you have to pay providers. It's just this back and forth between the two of them. Meanwhile, we're sitting back here going we're footing the bill. So there are ways, there are ways, however, to stop that, and we're doing it at our company and a lot of broken around the country.
But I'll let you kind of ask the next question. I'll get into that.
Well, that was going to be my next question was how do you break up? How do you break up that party in exactly? How do you get more competition in there?
And yeah, so it's not even competition. So it's comes down to contract. So the largest payer of healthcare in the United States and Medicare, they could everything is based off of them.
So here's a good example and a way to understand.
How healthcare works with the health insurance company, the health care, the health systems. If I get a h you said you're sixty eight, I think ed right, you know, on a day over forty, just so you know, So if you go and get a procedure done and Medicare pays that health system one thousand dollars for it, right, that's the basis of all of all negotiation of all contracts. Medicare is a basis. So Medicare pays that provider one thousand dollars. Done, the health system says, hey, signa, we're
going to bill you six hundred percent Medicare. So they bill signa six thousand dollars for that procedure, right, six times. Now Sigma though says, hey, wait a minute, we have a contract with you. We're going to go ahead and we're going to We're gonna give you a fifty percent discount. What happens then it goes down to three thousand. That is still three hundred percent Medicare. We are paying three times what that true rate of the procedure is. And
that's the problem with the system. The two of them are overpaying. We're overpaying for care that we shouldn't be We should be doing the same, and the public should be paying the same amount of Medicare, or what we call reference face pricing.
We pay a little bit more.
We say, okay, Medicare doesn't make it really profitable for healthcare systems. I mean there might be a couple of percentage points with a profit. We say, hey, we're going to pay your fair. Reason about let's call it one hundred and twenty five one hundred and fifty percent of medicare. The healthcare systems make money. We pay a lot less for the healthcare we're getting. And that's how you keep control.
That's how you controlled the cost of health care by reducing the amount we're paying for claims.
And in that case, everyone wins.
The healthcare systems get paid, the employees get their health coverage, and our rates stay down.
The only one not happy about it is the insurance company.
Daniel Lebrod is our guest. He is the CEO of Ovation Health and Life Services. And so daniel who who needs to make this change? Can we as people? I mean, obviously we're the ones that are taking it up the you know, and what can we do about it? Politicians aren't doing anything about it? How can we change this?
So we're changing this. What we say is and I have a mastermind group. We talk about this a lot. We're changing one employer at a time. In my opinion, honestly, it starts with the employers. The employers have to be fed up and they are getting set up because they can't afford it.
They can't afford to offer benefits.
The employers need to first of all, know there are options and ways to do things, and these are things. Number one, you need to go self funded, and we can do self funding down to the smallest employer of two people all the way up to thousand thousand. The biggest companies in the nation use self funding as a mechanism to control costs. You need to be working with a consultant or a broker that embraces level funded self funding,
captives alternative funding situations. And some people think, well, that's new, I've never heard of it. Well, first of all, it's been around forever, and the ACA actually made it more viable to do it for smaller groups. But actually, now sixty four percent I believe the number is about sixty four percent of all US employers are doing some sort of self funding health plan. But that's still a lot
of those are the big employers. But still everyone is starting to embrace that because of realizing it's the only way to make change.
So my open enrollment's coming up in my company, whatever they offer me, that's that's what I got. Or is there a way to even is there an even little tricks of the trade to kind of, you know, nibble around and save yourself a few bucks.
You know, if you're getting through your employer, it really has to go into the employees complaining to the employer, like, we can't afford this, we need we need to look at I heard about these alternative strategies which are becoming the mainstream now. So you just say, hey, why are we why are we fully insured? Why aren't we looking at these other things, these other options? Have you talked
to our consultant ever broker about that. Unfortunately, the employees don't know what they don't know, and they're just taking what the employer gives them, and they don't have the power to make necessarily make that change. I know in Texas, if you're out in the you say, well, maybe I can go to the individual market under you know, healthcare dot gov and get a policy. Well, Texas, all that's available is HMO with and nobody likes it, you know,
and so everyone is kind of stuck in. And even those rates are terrible for the most part, they're going up every year.
It does start, in my.
Opinion, it does start with the employer, but the employer is not going to be making changes until either it hurts their pocketbook or the employees complain enough that I just can't do this. I can't afford this, And so it is it's got to be there's got to be that pain to make that move.
And I think this year is gonna be the year of pain.
Daniel Lebron is our guest from Ovation Health and Life and Daniel talk about that as I As I said, I'm not on medicare yet, but definitely thinking about it. What should I get a consultant? Because I hear so many people say, hey, talk to consultant, They'll tell you what to do in the plans, blah blah blah. Where should I just go home with these government websites and look it over. What's the best option?
So as you come about Medicare, Medicare is really confusing. We have we actually, you know, I have an in house specialists for that. We help people get a Medicare because it has so many options, you know, and you see people we have someone on our on our staff that turned sixty five last year.
Or in March, and you know they helped with it.
She's like, oh my god, I turned sixty four and a half. I started getting My mailbox is full of stuff on medicare, and I'm so confused, So I think you need There's a lot of options out. There's Medicare supplements, there's Medicare advantage plans. I personally like Medicare advantage plans.
I think they're they.
Give you the best coverage at the lowest cost. And basically your your Medicare is paying a health insurance company to pull you off of the Medicare books. Basically you get better coverage through a private through a private insurer, and it helps Medicare because now that the claims go to the insured, not to Medicare, which helps to help the Medicare system.
Fine.
Everything the financial decisions though, you have to look at it and say, what's the coverage of those, what's the cost going to be, and what is my best what's best for me financially, And that's everything.
We have to be asked what HSA's earlier, and I'm like, I'm not a big fan.
Of HSA's any longer, but they have their purpose for some people. You have to wait it out financially for yourself, your family and what is best for you. And that's where you definitely need whether it's a medicure consultant or your employee benefits consultant, at your at your employer.
Somebody needs to be able to guide you.
Along that pathway, and you should be getting that kind of service from your broker, consultant partner.
Anyways, you know, it's says she said about the HSA. I just started doing one a couple of years ago, and I like it a lot. It's maybe it's just a mind thing where I'm like, Okay, there's a bill that comes in as my kid went to the doctor, and it's seventy five bucks. I'm like, okay, well I didn't I didn't budget for that this month. Well okay, no worries because I had enough in my HSA to cover it. And you know, so it obviously still comes out of your paycheck. But I don't know, I've kind
of come to like that. Why don't Why aren't you a big fan?
It's in very So let's go back to an HCA's came out originally, when they came out years ago, it was it was the whole idea was that there was a big cost difference between an HSA plan and say a copay plan, So.
I could have my fifteen hundred dollars double copay plan.
It's five hundred dollars and my HSA plan is three hundred dollars. Awesome, I say two hundred dollars a month, I put it in an HSA account. Now it's twenty four hundred dollars a year in that HSA account. I'm saving money and I still own the cash, and I only use it if I really need to. Makes total financial sense. I've had h ANDSA plans. The problem nowadays is the HSA premiums have caught up to the copay plans, and so now employers put that in and the employee says, well.
I can't afford it. He said, I can't afford.
A doctor business this month, I have nothing, And employees are not putting money into an HSA account any longer. And so what ends up happening is the employee says, well, basically, I have no coverage on my health plan, so I'm just not going.
To go to the doctor.
And they're so they're getting crappy your coverage for the same price you go. Now I have other other clients that say, hey, I don't use it. If I do, I can afford a doctor visit, and I want to use that agency to funnel, you know, eight thousand dollars a year for my family tax free. That's where we see most people doing it, is they're using it as a tax free you know, put money away tax free, and that makes financial sense.
All right, Well, daniel Lebroad we could talk about this forever, and I'm sure we want to talk to you again.
Good stuff.
People want to find out more about what it is you do there at ovation Life. Where can they go?
Uh? You dan Lebroad on LinkedIn great way to connect with me, and then you can go to ovationlife dot com and connect with us.
There as well.
Daniel thanks so much, man, Hey, thank you. Take care, take care. And uh, it's also confusing. That's the reason I brought it up because obviously all my friends are about my age and everybody's is always talked about medicare and trying to get on that, but even healthcare. I'm oh, I'm I've had a healthcare system, you know, a plan working at every job I've had, and every one of those things, I was like, uh, just do what I did last year.
That's what I do a lot.
I mean, frankly, you know what everybody does.
Frankly, take right, Frankly, you take it for granted, Oh, absolutely, Like yeah, it's I mean, I'm saying we shouldn't should certainly I shouldn't.
You know, the order are pretty important. It is yes. With that, we check in with traffic and weather. What is going on?
Do you see Health Traffic Center Mammograms Save Lives called five one three five feet four pink. Schedule your annual mammogram with do you see Health Sexpert team five one three five eight four pink. Seventy five southbound Goldberths to Paddic a little heavy and southbound seventy five is songing through the work on Reggan Highway down to Norwood lad So planning a bit of a delay. Now went and wrote a Dutch comedy. We have police activity report a
good idea if you can just avoid that area. Went to northbound approaching Dutch Colony as an accident and cruiser there also breakdown on seventy five northbound the on ramp from Donaldson as a breakdown on the entrance ramp and clean up is underway. We're seeing two seventy five northbound something between two seventy five and twelfth Street. It's about a five minute drive.
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