Latest / Bill of Health / What If Your Employer Let YOU Choose Your Health Insurance? With Mike Markland (Bill of Health Ep.9)

Transcript

What If Your Employer Let YOU Choose Your Health Insurance? With Mike Markland (Bill of Health Ep.9) · Bill of Health

• 0:00
  It's an old saying, but it is appropriate.
• 0:02
  The definition of insanity is doing the exact same thing over and over,
• 0:08
  but expecting a different result.
• 0:09
  That absolutely holds true when it comes to health insurance benefits as well.
• 0:13
  Employers and employees, we all seem to lather, rinse, and repeat every year.
• 0:19
  Annual double-digit increases in costs, the same recycled HMO, PPO,
• 0:24
  and high-deductible plans, employers continuing to lose ground in the battle
• 0:28
  between affordability and attracting and retaining quality staff, right?
• 0:32
  Employees struggle every year between keeping their coverage or making
• 0:35
  very real budget decisions on rent, car payments, or health insurance.
• 0:41
  And every once in a while, something comes along to break that
• 0:44
  insanity cycle, a change, an idea.
• 0:48
  We call them disruptors.
• 0:49
  I want you to think about Netflix, how it changed how we consume media.
• 0:52
  Think about Amazon and how it changed how you shop.
• 0:55
  Disruptors exist in the benefits space, in the health insurance space as well.
• 1:01
  It's not a new idea per se, but one that is quickly gaining traction
• 1:05
  and more and more in favor.
• 1:06
  It's changing how employers and employees shop and how employers consume healthcare.
• 1:21
  Welcome back to the Bill of Health, everyone.
• 1:22
  I'm your host, Bill Feigh, the health insurance guy, and today I wanna
• 1:26
  spend just a little time talking about ICHRA, individual coverage health
• 1:32
  reimbursement arrangements, and how they are breaking the cycle of the same
• 1:36
  thing over and over and over again.
• 1:40
  Now, by the time that this episode drops, we will have done some
• 1:44
  episodes on other disruptors.
• 1:46
  For example, direct primary care, a couple of episodes on health shares,
• 1:51
  and then this episode on ICHRAs.
• 1:54
  I'd like to bundle those together and talk about how they are absolutely changing the
• 1:58
  game when it comes to employee benefits.
• 2:00
  If you are an employee of a company that has health insurance or if you're
• 2:04
  self-employed, you may think that this episode is mostly for employers.
• 2:07
  I want you to hold on, because it's very possible that you're gonna be
• 2:11
  introduced to an ICHRA sometime, and you're already gonna have a leg up, and
• 2:15
  you're gonna have some inside skinny and knowledge on what an ICHRA is and how it's
• 2:19
  going to help you make some decisions.
• 2:20
  So listen in, stay with us until the end.
• 2:22
  If you're an employer, I would love for you to sit and listen with an open mind.
• 2:27
  You know the kind of struggle that you've had regarding employee benefits.
• 2:31
  Give this a listen.
• 2:32
  If you haven't considered it in the past, maybe it's time to
• 2:36
  think about it in the future.
• 2:38
  Right now, ladies and gentlemen, it is time to get started.
• 2:41
  Let's get into it.
• 2:43
  I've said this before and I will keep saying it, I've said it on every
• 2:45
  episode, I love speaking to smart people.
• 2:49
  They help me make sure that I'm doing my very best for my consumers.
• 2:52
  I'm trying to build a platform here of smarter healthcare consumerism.
• 2:56
  It is critically important that I visit with, talk to, get information
• 3:00
  from smart, smart people, and we certainly have that with us today.
• 3:05
  Ladies and gentlemen, I have Mike Marklin from Atma, and I'm gonna give Mike just
• 3:09
  a few moments to introduce himself and tell us a little bit about what he does.
• 3:13
  Mike, welcome to the podcast.
• 3:15
  Thanks a lot, Bill.
• 3:15
  Appreciate you having me.
• 3:16
  Yeah, so I've been doing employee benefits for about the past six years, and the last
• 3:22
  four of those doing exclusively ICHRAs.
• 3:24
  Before that, I came up through the payroll space.
• 3:27
  I started at ADP, kind of moved from there into PEOs.
• 3:30
  So that's kind of the combination of co-employment, HR, benefits all
• 3:34
  packaged together in one solution, and then kinda from there, separated
• 3:38
  from the payroll HR side, moved just into the traditional employee benefit
• 3:41
  space, and now full-time ICHRA choice actually as of about five days ago.
• 3:45
  As some of the points that you were touching on earlier, we do a lot
• 3:48
  more than just the ICHRA choice.
• 3:50
  We do like to bundle in those other types of solutions that are the health
• 3:53
  shares, the direct primary cares, and bring a lot more of a all-encompassing
• 3:57
  solution to people by utilizing the ICHRA as that core structure.
• 4:02
  But it is definitely more than just that
• 4:05
  Mike, tell us a little bit, I understand that you're in Colorado Springs right
• 4:07
  now, but you're not originally from there.
• 4:09
  Tell us where you're from.
• 4:10
  Grew up in the Boston area, about 45 minutes outside of Boston, if
• 4:14
  you've ever been to the Gillette Stadium where the Patriots play.
• 4:16
  There's a town right by that.
• 4:18
  But I grew up there, went to UMass Amherst for college, and
• 4:21
  then four years ago I moved out here to the Springs with my wife.
• 4:24
  And, you know, since then we had two kids, and all of our family's back east,
• 4:28
  so you know, it's just, it's time to go back home, and we're moving back to Boston
• 4:32
  next week actually, so I'm sitting in a very empty house with boxes everywhere.
• 4:37
  The kids are going back to school in Boston, right?
• 4:39
  Boston area.
• 4:39
  Uh- That's great
• 4:40
  … not old enough for school yet.
• 4:41
  Actually a four-month-old and a two-year-old as of two weeks
• 4:44
  from now, so not quite there yet.
• 4:46
  Goodness, you're not getting any sleep anyway.
• 4:48
  You don't have time to work.
• 4:49
  I will say, wouldn't have pegged you for Boston.
• 4:51
  I'm not hearing the forget about it or park the car kinda thing.
• 4:54
  I wouldn't have pegged Boston, my friend.
• 4:56
  Yeah, man, you know, it's not as pervasive as you would think.
• 4:59
  If the parents, the grandparents didn't grow up with that accent, chances
• 5:02
  are you don't have it either, so.
• 5:03
  A lot of people like to play it up when they leave that part of the country.
• 5:07
  Yeah.
• 5:07
  Well, I'm happy to have you.
• 5:08
  You touched on something I wanna visit with.
• 5:10
  Just give us, anyone listening, employees, employers, give us a 60-second primer
• 5:15
  on what the heck is ICHRA, and now, by regulators choice, what's a choice?
• 5:19
  What does that mean?
• 5:20
  Choice and ICHRA, in all intents and purposes they are the same
• 5:23
  exact thing, they just renamed it.
• 5:24
  ICHRA was a tax law change that came out in 2020.
• 5:29
  So essentially what it did was it expanded HRAs, health reimbursement
• 5:32
  accounts, which have been around forever, to include individual
• 5:35
  market health insurance premiums.
• 5:37
  And what that in practice meant was that employers, instead of buying a group
• 5:42
  health insurance plan and then offering it to their employees as a take it or leave
• 5:45
  it basis, they could just buy whatever they wanted from the individual market,
• 5:49
  and it would be pre-tax for the employer.
• 5:51
  Anything the employee spends would be pre-tax on their end as well.
• 5:55
  It introduced the first ever true choice, true consumerism into the health insurance
• 6:00
  marketplace, and that was back in 2020.
• 6:02
  And since then there's been a couple of expansions and different
• 6:06
  components like health savings account.
• 6:08
  We're seeing some continuous expansion, and I think it's gonna continue to
• 6:11
  go down this route where there's just gonna be more and more opportunities
• 6:15
  for individuals to make their own health insurance or health related purchases.
• 6:19
  Mike, we're gonna get into the mechanics of it here shortly, but I just wanted
• 6:22
  to say that when you start looking at the current landscape and environment
• 6:26
  that we're in, I started looking around and, you know, ICHRA is not necessarily
• 6:30
  brand new, but it is not necessarily front of mind when it comes to benefit
• 6:35
  brokers, but that is changing rapidly.
• 6:37
  We're starting to hear the name mentioned more and more and more.
• 6:40
  It is absolutely something that is picking up momentum.
• 6:43
  Yeah, I think we're at a point in this country where it's clearly unsustainable
• 6:47
  the way that it's been going.
• 6:49
  We're seeing double digit increases year after year after year.
• 6:52
  You know, brokers, they're trying to do what's best for their clients,
• 6:54
  but they also are limited by what they know and the resources they
• 6:58
  have at the firm that they work at.
• 6:59
  There's also the commission side of it, which plays a very, very big role.
• 7:03
  And the ICHRA, it's a big question mark for brokers in all of those categories.
• 7:08
  At least it was a few years ago.
• 7:09
  It's starting to shape up and there's becoming some market normalities
• 7:12
  around some of those things.
• 7:13
  But, you know, back when it first came out, brokers weren't set
• 7:16
  up to write individual policies.
• 7:18
  There was no real way to compare individual plans to group plans
• 7:21
  pricing wise, coverage wise.
• 7:23
  The commissions were not there.
• 7:24
  The infrastructure was not there.
• 7:26
  So it was purely a defensive tactic for the first few years.
• 7:30
  If the client asked about it, they were forced to address it and learn about it,
• 7:35
  but if they didn't get asked about it, they were not the ones bringing it up.
• 7:38
  Why would they?
• 7:39
  It's something so new.
• 7:40
  It hasn't been proven to work.
• 7:41
  It's a big risk to introduce something like that to a client.
• 7:44
  But, you know, six years later, it seems to be the way that this is going,
• 7:47
  and I think more and more brokers are realizing that because it's just come
• 7:50
  up enough times and they're starting to lose clients to other brokers that have
• 7:53
  walked in the door talking about an ICHRA.
• 7:56
  So it's, it's getting to the point now where, you know, if you're not
• 7:59
  proactive with it, you're actually running a risk of getting your client
• 8:03
  taken from you by someone else who is proactive with this message.
• 8:06
  And there's only one percentage of companies that have one right now.
• 8:09
  So there's still a vast majority of companies have not even heard of this
• 8:14
  Yeah.
• 8:15
  Tell me a little bit about Atma.
• 8:17
  You've mentioned that you are obviously horizontally and
• 8:21
  vertically sort of integrated.
• 8:22
  It's not just ICHRA solutions that you offer, but health shares and direct
• 8:25
  primary care solutions and those things.
• 8:26
  But it's also a fair bit of record keeping and enrollment assistance.
• 8:29
  So tell us a little bit about the stack there at Atma.
• 8:32
  I mean, there's a lot of different components that go into it 'cause
• 8:34
  you gotta think of it from a, a standpoint of writing one group, right?
• 8:37
  You're not writing a group policy with one application.
• 8:39
  You're writing- Right … hundreds of potential individual applications.
• 8:43
  And if those employees- Yep … are staggered in states across the country,
• 8:46
  well, you're not just required to be licensed in the site estate, you now
• 8:50
  have to have your license in every state that there's an employee, and
• 8:54
  be appointed with whatever carrier that individual happens to choose.
• 8:57
  So it's the capacity to do enrollments across the country is not something
• 9:01
  that many people just had unless they were individual enrollment specialists.
• 9:05
  So first, we have to have those expansive licenses and appointments with every
• 9:08
  carrier across the country that you can possibly get one, and then you also have
• 9:12
  to be able to facilitate the premium payments, because most people don't
• 9:15
  want their employees to be responsible for either paying for that type of
• 9:19
  a thing upfront or for paying for it with just money loaded onto a card.
• 9:23
  They're worried about them just spending the money on other things, or
• 9:25
  just lack of the ability to track it.
• 9:27
  So what we do is we have the employer pay into our third-party bank
• 9:31
  account, and we facilitate all of the individual payments to the carrier.
• 9:34
  So it actually mimics a group plan the way it's administered.
• 9:37
  The employer guests just pay one bill, and then they deduct the employee's
• 9:40
  portion right out of their paycheck.
• 9:42
  We do everything else.
• 9:43
  So it's a one-stop shop, if you will.
• 9:45
  The employer does both their portion of the ICHRA and the employees, then
• 9:49
  you divvy out the money from there.
• 9:51
  Yep, exactly.
• 9:52
  I like that.
• 9:53
  That's great.
• 9:54
  There's a lot of moving parts here.
• 9:55
  And Mike, just a little background here for this platform.
• 9:57
  We're trying very hard to be a platform where people can come to
• 10:00
  be smarter healthcare consumers.
• 10:03
  And one of the things that Envisions, and the reason why I wanted to talk
• 10:05
  about ICHRA so badly, is because the notion or the option of choice
• 10:09
  here about how employees choose which program, what's best for them.
• 10:13
  Let's just talk about the mechanics of an ICHRA.
• 10:15
  You're coming into my company, I have 35 employees, we're gonna implement an ICHRA.
• 10:20
  Tell me, what does that mean for the employer?
• 10:22
  And then let's break it down and tell me, what does that mean for the employee?
• 10:26
  Well, for the employer, it's actually very, very simple.
• 10:29
  Beyond deciding what their contribution is going to be, they
• 10:33
  really don't have to do all that much.
• 10:35
  My team will go and we'll do all of the education, we'll
• 10:37
  do the enrollment meetings.
• 10:39
  We have a technology platform that employees will be able to access
• 10:42
  to have comparison tools and help them shop around in the marketplace.
• 10:45
  But really, we try to address a lot of the major concerns upfront in an
• 10:49
  enrollment type of meeting where all the g- employees are gathered together
• 10:52
  and we can just go through everything from start to finish and answer their
• 10:56
  questions, because it is a big change.
• 10:59
  You know, and I understand that people haven't done this ever before.
• 11:02
  Most of them have never bought their own health insurance or shopped around
• 11:04
  outside of just one or two options given to them by their employer So
• 11:08
  we're very heavy on the education.
• 11:10
  We have handouts.
• 11:10
  We really walk through… And honestly, it's not that hard at the end of the day.
• 11:15
  People do make major financial decisions in all sorts of areas around their life
• 11:20
  with incomplete information every day.
• 11:22
  This is now just another one of those things, and it's new, but
• 11:25
  people get used to it very quickly.
• 11:27
  And really for most people, you're just checking a few things.
• 11:30
  You're checking to make sure your doctor, a hospital that
• 11:33
  you like is in the network.
• 11:34
  If you have any prescription drugs, you're checking the
• 11:36
  formularies, the co-pays on those.
• 11:38
  But beyond that, it's really just a personal risk assessment.
• 11:41
  It's like how much do you anticipate using it this year?
• 11:43
  Like do you tend to get sick often?
• 11:45
  Do you have any chronic conditions?
• 11:46
  If yes, probably wanna buy a lower deductible, lower co-pays.
• 11:50
  If no, save money on premium.
• 11:52
  Mm. And that's where most people end up falling into actually.
• 11:55
  At the end of the day, you have a few small things you're concerned about.
• 11:57
  When you're only buying for yourself, you can buy such a narrower set of
• 12:01
  goods and services, narrower networks.
• 12:03
  Yes.
• 12:03
  That just inherently drives savings
• 12:06
  Yeah, the plan can be yours versus a one-size-fits-all sweatshirt.
• 12:10
  You're actually having something that's a little more
• 12:11
  tailored, a little more bespoke.
• 12:13
  That's really important.
• 12:14
  That's kind of the platform, the whole shebang here at The Bill of
• 12:17
  Health is what we're trying to build, that community of people who are
• 12:19
  making choices based on their usage, based on their health, based on the
• 12:22
  criteria that are important to them.
• 12:24
  Just real quickly to back up, the mechanics of an ICHRA for those folks
• 12:28
  that are listening, employees and employers, the employer contributes
• 12:31
  a little bit, their budget.
• 12:32
  They determine how much they wanna contribute.
• 12:34
  The employees can then use those dollars to go out and shop and buy the healthcare
• 12:38
  coverage that makes sense for them.
• 12:40
  As Mike mentioned at the top, tax deduction for their business,
• 12:43
  tax-free for the employee, and so the employee is given a lot of autonomy.
• 12:49
  The employee has the ability to go out there and use the tools and the enrollment
• 12:53
  assistance that's being offered to make sure that they're getting the right plan.
• 12:58
  Now, for the employee, Mike, what we've just talked about, that
• 13:01
  choice, that is the first thing that I hear, that it gets brought up to
• 13:05
  me all the time, is employers, HR teams, are very concerned that their
• 13:11
  employees are gonna feel a little overwhelmed with this responsibility
• 13:14
  of having to pick their plan.
• 13:16
  How would you address that concern if you were sitting in the office and listening
• 13:18
  to that sort of concern from an HR team?
• 13:21
  Honestly, I say just kind of a reworked version of what I just said.
• 13:24
  It's like, "Listen, your employees are adults." Yeah.
• 13:26
  "You trust them with all different components of your business.
• 13:29
  They run their day-to-day life every day.
• 13:31
  They are responsible adults.
• 13:33
  They can handle this, and we are there to help them through the decision, and
• 13:37
  we'll help them every step of the way.
• 13:39
  They can have an one-on-one meeting with someone on my team if they
• 13:42
  want to throughout this process." We make sure that they understand
• 13:45
  every possible resource is provided to them, but I do also kind of just
• 13:49
  push back on that fundamentally.
• 13:51
  I just kind of disagree, really.
• 13:52
  It's like these people are adults.
• 13:53
  You're hiring them to do jobs.
• 13:55
  You trust them to do those things.
• 13:56
  They buy their houses, they buy their cars, they invest for retirement, they buy
• 13:59
  car insurance, they buy life insurance.
• 14:01
  You don't think they can buy health insurance?
• 14:03
  I also, sometimes will even take it a step further and say, "What makes you think,
• 14:08
  as the employer, that you could make someone else's health decision for them
• 14:12
  better than they could for themselves?"
• 14:14
  Mm-hmm
• 14:15
  You know, it's- Yeah … that's, that's just backwards to me.
• 14:18
  And it's- Like, nothing else is
• 14:19
  boxed in … that's an interesting take, yeah.
• 14:20
  Right.
• 14:21
  And my platform and the song that I've been singing quite a bit is we need to
• 14:24
  be better… Well, you referenced it.
• 14:26
  We don't buy a car or a TV or anything without doing consumer reviews
• 14:30
  and some shopping around and those kind of things, and it's very easy
• 14:33
  to do that with health insurance.
• 14:35
  It's very easy to do that even on the marketplace.
• 14:37
  They just don't believe it, 'cause they've never done it.
• 14:39
  They've never had that autonomy or the freedom to do it.
• 14:41
  Right.
• 14:41
  Right?
• 14:42
  It's just new.
• 14:42
  That's all.
• 14:42
  They just haven't had the opportunity.
• 14:43
  Yeah.
• 14:43
  Yeah.
• 14:44
  It's just new.
• 14:44
  But think of what happened- I love it
• 14:45
  you know, when, like, pensions switched to 401s.
• 14:48
  I wasn't around when that happened, but, you know, I'm sure there was a
• 14:50
  similar type of hesitancy, like, "Oh, people are just gonna invest their own
• 14:53
  money, thousands of dollars with no…" It's like, well, 401s are outperforming
• 14:58
  pensions drastically, and that's why they took over the entire market.
• 15:01
  Because it turns out when people are given their own autonomy over their
• 15:04
  own money, there's gain to be had.
• 15:06
  There's something on the line.
• 15:08
  Right.
• 15:08
  They make a good decision.
• 15:09
  They smarten up.
• 15:09
  Also, the market reacts, right?
• 15:11
  Now there's just target date funds.
• 15:12
  You go and you pick.
• 15:13
  You say, "I'm gonna retire between 2060 and 2065," and it
• 15:16
  puts you in an aggressive fund.
• 15:18
  If you say- Right … "I'm gonna be retiring in 2030," it puts
• 15:20
  you in a very conservative fund.
• 15:21
  So the market does react to these problems and give solutions.
• 15:27
  That's what the market does.
• 15:28
  Right.
• 15:28
  That's what capitalism does.
• 15:29
  It's like, okay, this is a new change.
• 15:30
  It's gonna help society as whole, but yeah, it's not complete.
• 15:32
  All right, then companies start to pop up, and they fill in those gaps.
• 15:35
  And the next thing you know, it feels complete, and it feels like the new
• 15:38
  normal, and everyone's doing it, and we're all in a better situation.
• 15:42
  Yeah.
• 15:43
  Okay.
• 15:43
  I love that.
• 15:44
  I love it.
• 15:45
  Compliance.
• 15:46
  The next thing I hear is, what kind of burden am I adding?
• 15:51
  Is it complex?
• 15:52
  Is this ecosystem that you offer us to use, is it gonna be just another
• 15:57
  terrible chore for my business manager, my HR team, the payable person?
• 16:01
  Tell us a little bit about, from a compliance standpoint, how it
• 16:04
  differs from maybe a traditional group plan, and basically how
• 16:07
  it's integrated to a company.
• 16:09
  The class structures are a little bit more rigid, so some of the
• 16:13
  things that you can do very easily and cleanly in the group side can't
• 16:16
  necessarily be replicated on the ICHRA.
• 16:19
  Um, you know- Mm-hmm … traditionally things like paying people based on
• 16:22
  longevity, their tenure, that's not a strict ICHRA class, so you can't
• 16:26
  really do that in a compliant way.
• 16:28
  So there are a few things that you wanna just be making sure
• 16:31
  that you're doing the right way.
• 16:32
  And there's a few other pieces that you wanna look out for if you're a large
• 16:36
  employer, or it has to be an affordable contribution, but they have to have
• 16:39
  affordable coverage on a group plan too.
• 16:40
  So a lot of the other things are the same, just kind of reapplied
• 16:44
  towards the individual market.
• 16:45
  But we provide all of the reporting, the documentation
• 16:49
  that's required to set up an ICHRA.
• 16:51
  You have to do the 1095 reporting at the end of the year, you have to pay a
• 16:53
  PCORI fee, but if you're on a self-funded plan, you're used to those things anyway.
• 16:56
  So really there isn't much that's new.
• 16:59
  There's an ICHRA model notice, but that's very simple.
• 17:01
  It's posted on the enrollment portal.
• 17:03
  All the employees just have to check that box.
• 17:05
  And a lot of the technology takes care of these things, right?
• 17:08
  If you're doing it manually, like a traditional HRA, that's when it would
• 17:13
  be tricky because the employees are handling the funds, they're collecting
• 17:15
  receipts, they're submitting things for reimbursement, and that's a tedious
• 17:19
  and not great way to do it, and the technology gets around all of that.
• 17:24
  So the employees see all the legal notices.
• 17:26
  They check all the attestation boxes.
• 17:29
  We handle all of the money, so there's never any even opportunity for an
• 17:33
  employee to do something with that money other than spend it on health insurance.
• 17:36
  A lot of the compliance concerns are just mitigated by technology.
• 17:40
  Well, we're gonna talk a little bit about that reimbursement, 'cause
• 17:42
  that was another question I have.
• 17:43
  We'll talk about that here just in a few moments, 'cause you've answered
• 17:46
  that question, which is fantastic.
• 17:48
  The ICHRA, the broader ecosystem, including wellness and voluntary
• 17:52
  supplemental benefits, tell me just a little bit about that.
• 17:55
  Yes, we've got the ICHRA.
• 17:56
  Yes, that means that that employee's gonna get a stipend or some sort
• 17:59
  of contribution to them that they can go out and buy healthcare.
• 18:01
  But what's available to that employee on a broader basis?
• 18:05
  Yeah, the broader offering is actually where I think most of the value comes in.
• 18:08
  And I think I mentioned at the beginning, we view ICHRA or Choice- Yeah
• 18:11
  as really just the catalyst.
• 18:13
  You know, it's the centerpiece of the program.
• 18:15
  Because it is that compliant piece, it checks the box for large employers, you
• 18:19
  kinda have to have it, and it allows people to access the individual market
• 18:23
  on a pre-tax basis, which is great, but really, a lot of people don't even need
• 18:27
  ACA insurance plans, if you ask me.
• 18:29
  And that's why we bring in some of these alternative solutions like
• 18:32
  medical cost shares and direct primary cares, because if you're a
• 18:36
  healthy person, at any age really, you shouldn't be buying an ACA health plan.
• 18:40
  The main things that those are good for is guaranteed issue, right?
• 18:43
  So that was the big thing with the ACA- Yeah
• 18:44
  is they can't say no if you're sick.
• 18:46
  It has to cover whatever condition you have, which is great, and it's necessary.
• 18:50
  But if you don't have a preexisting condition, you don't need a
• 18:53
  plan that, that works like that.
• 18:54
  You can go buy a medical care cost-sharing option that is a fraction of the
• 18:58
  price of even the cheapest bronze or catastrophic plan on the marketplace.
• 19:01
  I'm talking like 33%, a third or a quarter of the cost.
• 19:05
  You know, you just bundle that with something like direct primary care
• 19:08
  so you have access to doctors, the access to care, urgent care, talk
• 19:12
  therapy, you know, anything that you could want, and there's your access.
• 19:16
  You got your healthcare, health share that has the catastrophic coverage
• 19:19
  piece, and now all of a sudden you have a kind of rebuilt health plan
• 19:22
  with catastrophic coverage and access to care at a concierge level for an
• 19:27
  extraordinarily low dollar amount.
• 19:28
  And that, through education, and obviously the choice, you have to first of all be
• 19:33
  giving the employees the access to these plans, but you give access to them, and
• 19:37
  you educate them about how they work.
• 19:39
  You make sure that no one that's sick with a big preexisting
• 19:42
  condition takes something like this.
• 19:43
  You always drive them to an ACA plan.
• 19:45
  But, you know, that's not most people.
• 19:49
  It's like half the country.
• 19:50
  Right.
• 19:50
  Half of the people in any given h- group health plan don't use it.
• 19:52
  They're just shilling money out year after year after year for something they
• 19:55
  don't use Put that never touch in people's
• 19:58
  pockets.
• 19:59
  Never
• 19:59
  touch objectives.
• 19:59
  Yeah.
• 20:00
  Yep.
• 20:00
  They don't touch it.
• 20:01
  Yep.
• 20:01
  Does it include dental and vision opportunities?
• 20:03
  I mean, we can do individual dental and vision, but the group
• 20:06
  versions of those policies are still just much more competitive.
• 20:09
  The plan designs are better- Yeah … the rates are better.
• 20:11
  So I don't generally recommend buying an individual dental or vision plan.
• 20:15
  Okay.
• 20:15
  There are some individual work site type of products that do fit, and those also
• 20:19
  pair very well with the health shares and the direct primary cares because one of
• 20:23
  the things that the healthcare doesn't do is cover the small stuff, right?
• 20:26
  So if you do have something- That's right … you go to a doctor, you're
• 20:29
  paying cash if you don't have a direct primary care, or if you have to go
• 20:31
  to a specialist that sits outside of the direct primary care, you're just
• 20:33
  paying cash for that appointment.
• 20:35
  So some people may want to have a payout if something actually
• 20:38
  happens like in an accident or they do get admitted to the hospital.
• 20:41
  We have one in particular that I like.
• 20:43
  It's a supplemental health plan called RenSecure Health.
• 20:45
  It covers 13,000 CPT codes, so it's just an incredibly broad plan.
• 20:49
  Basically, if you go into the doctor and get diagnosed with
• 20:51
  anything, it's gonna trigger this and pay out a minimum of 200 bucks.
• 20:55
  So these are just other little things that you can add there and
• 20:57
  sweeten the deal for employees.
• 20:59
  And really with the savings coming off of a group health plan, like employees
• 21:02
  are able to buy a number of these things at little to no cost oftentimes.
• 21:06
  So it's really just down to what does that person need?
• 21:08
  Do they need middle ground protection for the first $2,500, $5,000 or not?
• 21:14
  To me, I think ideally you just finance that yourself.
• 21:17
  You kind of self-fund the first $2,500, first $5,000 if you can.
• 21:20
  What's great if you can do that, but you also gotta realize that
• 21:23
  60% of Americans don't have $1,000 in their bank account, so- Right
• 21:26
  that's not for everybody, and which is actually why another benefit that
• 21:30
  we're bringing to the table for this upcoming January 1 renewals is an
• 21:34
  employer loan program for specifically that type of a gap that you can pay
• 21:39
  back via payroll deduction as 0% interest, and we can facilitate that.
• 21:43
  And employers, instead of trying to find some type of insurance product to jam
• 21:47
  in there and fit that gap, really at the end of the day, what they need access
• 21:51
  to is just money if they get into a jam.
• 21:54
  And if the employer can provide that, and we can service that through payroll
• 21:58
  deduction, that's another great benefit to have, and that also fills that gap.
• 22:02
  So there's all sorts of things that employers can do to provide benefits
• 22:05
  to their employees that are just never talked about Because the health insurance
• 22:09
  sucks up all of the funds, and that's really what employee benefits brokers
• 22:13
  have become at the end of the day, is just health risk analysis people.
• 22:16
  Yeah.
• 22:17
  It's interesting to me, this is something that's very near and dear to my heart.
• 22:19
  It's something that we're trying to do here on this podcast, on this
• 22:22
  platform, something that my business, personal business is about, is
• 22:26
  helping people find alternatives.
• 22:27
  I just didn't wanna be someone coming back with the same Anthem
• 22:30
  plan, the same United plan.
• 22:31
  Not that there's anything wrong with that, I'm not commenting on that.
• 22:33
  I'm just saying I wanted to be someone that brought alternatives to the table,
• 22:36
  something that could empower employees or people to make better, smarter healthcare
• 22:40
  decisions, and this model certainly fits.
• 22:43
  Just to review, ICHRA or choice, your employer provides a bit
• 22:47
  of money to you every month.
• 22:49
  You in then turn spend those dollars for healthcare solutions, health insurance
• 22:53
  solutions, either through the marketplace or through alternative models, health
• 22:56
  shares, direct primary care, supplemental coverage, all of those things.
• 23:00
  You're in charge.
• 23:01
  You're finding a plan that fits your personal needs, your personal
• 23:04
  spending, your personal health, and that way you're not having to deal
• 23:07
  with a one-size-fits-all solution.
• 23:09
  And companies like Atma are gonna be there to help you do administration work, help
• 23:14
  you with the enrollment, provide you with the technology stack to help everything
• 23:17
  run smoothly, and also make sure that they're facilitating the payments.
• 23:21
  So this is a model, if you're an employer, that I would absolutely
• 23:24
  encourage you to look at if you haven't already, or at least ask about.
• 23:28
  And if you need help with that, fine, I can certainly do that for you.
• 23:31
  I would love to.
• 23:32
  This is not an extended sales pitch.
• 23:33
  I don't want you to think that at all, but that is certainly within the confines
• 23:37
  or the scope of what I do, and I'd be glad to help bring it to life for you.
• 23:40
  If you're an employee, I would think it's probably something you're gonna see
• 23:45
  before too long, as we've listened to Mike talk about how it's something that's
• 23:49
  becoming more mainstream and something being talked about more and more.
• 23:54
  All right, Mike, hold tight for me here.
• 23:55
  You brought something up that I wanna talk about, and it's gonna
• 23:58
  be talked about in a little segment we like to call the Jargon Jar.
• 24:03
  It's time for the Jargon Jar, ladies and gentlemen.
• 24:05
  This is where we take the confusing, intentionally muddy language of
• 24:08
  the insurance industry, and we translate it into plain English.
• 24:13
  And today on the Jargon Jar, we're gonna talk about the topic of reimbursement, the
• 24:17
  HRA, the health reimbursement arrangement.
• 24:21
  Mike mentioned it before.
• 24:22
  When we think of that, we think of the old days where if you went to
• 24:25
  the doctor, you had to get a receipt.
• 24:27
  If you got a procedure done, you had to get a receipt.
• 24:29
  You turn those in, they look at them to make sure that they're okay, blah,
• 24:33
  blah, blah, and then you get reimbursed.
• 24:34
  It was a headache.
• 24:35
  It was an administrative chore.
• 24:36
  People didn't like it.
• 24:38
  Well, just so that we're clear, with the ICHRA arrangement and the advent
• 24:41
  of companies like Atma, that is not something that you're going to be doing.
• 24:45
  They're going to handle that side of it for you so that your compliance,
• 24:49
  if you will, you may have to provide your HR team or your billing team
• 24:54
  proof that you have insurance coverage.
• 24:57
  Maybe that's all you have to do.
• 24:59
  But every time you go to the doctor, you're not having to
• 25:01
  provide them with the reimbursement.
• 25:03
  They don't care how those dollars are being spent.
• 25:05
  They do need to make sure that you've got a plan.
• 25:07
  They do need to make sure that you can't spend that money on something
• 25:11
  other than medically related things.
• 25:12
  But it is not an administrative chore, N-O-T an administrative chore that
• 25:17
  needs to be worried about at the employer level or the employee level.
• 25:22
  The administrator of your ICHRA plan is going to do the heavy lifting
• 25:26
  when it comes to the record keeping, making the employer's job easy,
• 25:30
  and making sure there isn't too much burden placed on the employee.
• 25:34
  All right, my friends, that's the Jargon Jar for today.
• 25:36
  Mike, I've now part of the program here where we surprise you.
• 25:40
  Are you ready for a surprise?
• 25:42
  Sure.
• 25:42
  Let's do it.
• 25:43
  We're gonna go into Five for Fighting Mike, it's time.
• 25:48
  I'm gonna ask you five rapid-fire questions.
• 25:51
  Don't think, just answer.
• 25:52
  We'd love your take on these, and sometimes they can be a tad controversial.
• 25:56
  So number one, Detroit-style, Chicago deep-dish, New York/Brooklyn thin, St.
• 26:02
  Louis square cut with Provel cheese.
• 26:05
  Mike, who has the best kind of pizza?
• 26:07
  Gotta go New York-style, for sure.
• 26:10
  You like the foldable.
• 26:10
  Okay.
• 26:11
  Yeah.
• 26:11
  Get a slice there.
• 26:12
  Okay, I like it.
• 26:12
  I like it.
• 26:13
  Kansas City, North Carolina, Memphis, or Texas.
• 26:18
  Mike, who has the best barbecue and why?
• 26:21
  Is the correct answer Kansas City?
• 26:23
  Oh, man, whichever one is the heavily sauced one.
• 26:26
  I actually can't remember.
• 26:27
  I'm from the Northeast, so we don't differentiate very well,
• 26:29
  but whatever the saucy one is.
• 26:31
  That's
• 26:31
  … We're thinking Kansas City.
• 26:32
  Kansas
• 26:33
  City, yeah.
• 26:33
  So- Okay, so there you go.
• 26:34
  There you go
• 26:35
  … well done.
• 26:36
  I don't like to say this, but that is the correct answer.
• 26:38
  Well done.
• 26:39
  Mike, if you were speaking to employers struggling with the annual benefit
• 26:43
  enrollment decision, real quickly, just a couple quick bullet points, how could they
• 26:48
  benefit from looking at an ICHRA model?
• 26:50
  Oh, you maximize employee choice, you define your budget, and you
• 26:55
  get out of the health risk game, which is what you're doing right
• 26:58
  now in any regular insurance model.
• 27:00
  All of those things go away with the ICHRA.
• 27:02
  Thank you.
• 27:04
  This one's gonna be tough for you, okay?
• 27:06
  Hang in there.
• 27:06
  Patriots, Cowboys, 49ers, Texans, or Chiefs.
• 27:14
  Mike, who's your favorite NFL team?
• 27:16
  Be careful here.
• 27:17
  Oh, man, Patriots.
• 27:18
  City of Champs, man.
• 27:19
  You
• 27:19
  know that.
• 27:20
  Ah, come on.
• 27:21
  Oh, I don't know.
• 27:23
  I don't know what we do now.
• 27:25
  Drake Mayes, the new Tom Brady.
• 27:27
  All right.
• 27:27
  Get ready for another 20 years.
• 27:28
  Oh, my gosh.
• 27:30
  Okay.
• 27:31
  All right.
• 27:31
  I knew that was coming.
• 27:33
  Last one.
• 27:33
  If you're sitting across the table from an employee whose employer is
• 27:36
  implementing an ICHRA, what would you tell them in regards to why or how this
• 27:40
  is a great opportunity for them and how it promotes smarter healthcare consumerism?
• 27:45
  Well, you definitely have to ask employees a few questions based on their personal
• 27:48
  needs, but that's really the main benefit, right, is that it's personalized to them.
• 27:51
  It's exactly what they need, nothing more.
• 27:54
  They control that purchase.
• 27:55
  They control their spend.
• 27:57
  They've never had that before, and we're here to make sure that
• 28:00
  they are getting exactly what they need at the most affordable rate
• 28:04
  I love it.
• 28:05
  I love it.
• 28:05
  Now I'm gonna ask you a sixth question, an unprecedented sixth question in the
• 28:09
  Five for Fighting scenario here, okay?
• 28:11
  And I'm not trying to put you on the spot, but healthcare consumerism,
• 28:15
  employees, employers are all sort of concerned about saving money.
• 28:20
  Is there overall savings available to an employer, to an employee on
• 28:24
  average by adopting this ICHRA model?
• 28:26
  When you embrace the model of ICHRA plus the other things, like the health
• 28:31
  shares and the direct primary cares, I guarantee savings every single time.
• 28:36
  Because it doesn't matter- Yeah … if even a quarter of the people buy a, a
• 28:39
  health share instead of a ACA policy, that will drive the cost below whatever
• 28:44
  the group plan is sitting at today.
• 28:46
  So really it is, if you embrace this model, you will save money, your
• 28:49
  employees will save money, I guarantee it.
• 28:51
  I love it.
• 28:52
  I love it.
• 28:52
  We are way over our normal allotted time, but this was an important
• 28:56
  topic, so I wanted everyone to have a chance to hear this.
• 28:58
  I think it's important.
• 29:00
  It's a great discussion.
• 29:01
  There's a lot more to discuss, obviously, but we want to attack this in as
• 29:05
  much of a digestible chunk as we can.
• 29:07
  Special thanks to our guest today, Mike Marklin from Atma.
• 29:11
  I love, love, love talking to smart people, and you clearly have
• 29:15
  expertise that is worth sharing.
• 29:17
  Mike's contact information is gonna be in the show notes, so if you have
• 29:20
  questions and you wanna reach out directly to Mike, I'll volunteer him for that.
• 29:23
  Or if you certainly are welcome to get in contact with me.
• 29:25
  If you're an employer, you're a benefits coordinator, you're an HR person, or
• 29:29
  you're an employee and you've ever thought about shopping insurance plans or
• 29:32
  coverage or becoming a smarter healthcare consumer, be sure to follow along.
• 29:37
  TikTok and YouTube and Instas, Bill Phi, the health insurance guy, subscribe
• 29:41
  to the pod on Apple or Spotify.
• 29:43
  Give us a review.
• 29:44
  Those reviews help push us out to a broader audience.
• 29:47
  We'd love to have your thoughts on the program and any topics that you'd
• 29:49
  like for us to cover in the future.
• 29:51
  And if I could personally help you explore your options, head on over to
• 29:54
  my website at Core 360 Benefits Group and schedule a 30-minute consultation.
• 29:58
  We can do a lot of damage in 30 minutes and make sure that we've given
• 30:01
  you the information that you need.
• 30:03
  Ladies and gentlemen, thank you, thank you, thank you from the bottom of my
• 30:06
  heart for listening to The Bill of Health.
• 30:08
  Be smart, shop smart, and protect your wealth, and we'll see you next time
• 30:21
  This podcast is provided for educational purposes only and should not be
• 30:23
  considered legal, tax, investment, or
• 30:24
  insurance advice.
• 30:25
  Individual circumstances vary, and the listener should consult qualified
• 30:27
  professionals regarding their specific healthcare and financial situation.
• 30:29
  Opinions expressed are those of the host and guests and do not necessarily
• 30:31
  reflect the views of any insurance carrier or affiliated organization