Category: Education
Julie Selesnick on the Lawsuit that Should Terrify Every Employer and Why You Could Be Next (Ep. 10)

Julie Selesnick on the Lawsuit that Should Terrify Every Employer and Why You Could Be Next (Ep. 10)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

In this must-watch episode of The Benefit Whisperer, Ralph Weber sits down with ERISA attorney Julie Selesnick to unpack one of the biggest legal stories in employee benefits: the JP Morgan healthcare lawsuit—and why it should matter to every employer and plan sponsor.

Julie brings 25+ years of legal experience and explains:
✅ What the JP Morgan case is really about
✅ Why PBMs (Pharmacy Benefit Managers) are under bipartisan fire
✅ How employers unknowingly violate fiduciary duties
✅ Why your broker might be working against your best interests
✅ What you must do now to protect your business and employees

This episode is essential for:

  • CFOs, HR Leaders, and Benefit Managers

  • Business owners with self-funded health plans

  • Anyone responsible for healthcare plan compliance

🎯 Learn how to safeguard your company from costly lawsuits and build a benefits plan that actually works.

🔔 Subscribe now for insider insights, unfiltered truths, and actionable strategies to reduce healthcare costs and improve employee benefits.

👉 Contact Ralph Weber:
📧 Ralph@TheBenefitWhisperer.com
📞 832-924-3330
🌐 www.thebenefitwhisperer.com

00:00 Introduction to Healthcare Law and ERISA

03:01 The Impact of the CAA on Healthcare Plans

05:58 Legal Trends in Pharmacy Benefit Managers (PBMs)

08:53 Understanding the JP Morgan Lawsuit

12:04 Fiduciary Duties in ERISA and Non-ERISA Plans

14:56 Potential Ripple Effects of the JP Morgan Case

17:59 Lessons for Employers from Recent Lawsuits

23:55 Understanding Controlled Groups and ERISA

26:28 Best Practices for Health Plans

31:15 The Future of Healthcare Litigation

37:48 Advice for HR Leaders and CFOs

39:54 The Importance of Benchmarking in Healthcare

#JPmorgan #HealthcareLawsuit #ERISA #PBMs #HealthPlanCompliance #EmployeeBenefits #JulieSelesnick #TheBenefitWhisperer #RalphWeber #TransparencyInHealthcare

Podcast title card featuring Adam Russo and Ralph Weber. Text reads: “Why ‘Good Discounts’ Are Costing You a Fortune – Inside a Smarter Healthcare Model: Reference-Based Pricing with Guest Adam Russo, Esq.” Episode 09 of The Benefit Whisperer. Logos and portraits of both speakers included.
Why “Good Discounts” Are Costing You a Fortune. Inside a Smarter Healthcare Model: Reference-Based Pricing with Adam Russo, Esq. (Ep. 09)

Why “Good Discounts” Are Costing You a Fortune. Inside a Smarter Healthcare Model: Reference-Based Pricing with Adam Russo, Esq. (Ep. 09)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

Is your PPO network actually saving you money—or just selling you a myth?

In this eye-opening episode of The Benefit Whisperer, host Ralph Weber sits down with Adam Russo, co-founder and CEO of The Phia Group, to expose the broken economics of traditional healthcare pricing. They dive deep into the real story behind Reference-Based Pricing (RBP), why most brokers avoid it, and how smart employers are slashing costs without cutting care.

✅ The truth about PPO “discounts”
✅ Why laziness—not logic—drives plan design
✅ How RBP protects patients from surprise billing
✅ What AI and price transparency mean for the future of healthcare

🎧 Whether you’re a CEO, benefits advisor, or just tired of rising deductibles and shrinking benefits, this episode will change how you think about cost, quality, and control in healthcare.

🔗 Learn more about Adam Russo and The Phia Group: https://phiagroup.com
📩 Contact Ralph: Ralph@thebenefitwhisperer.com
📞 Call: 832-924-3330

Chapters

00:00 Introduction to Healthcare Challenges

02:36 Understanding Reference-Based Pricing

06:40 The Necessity of Reference-Based Pricing

12:47 Consumerism in Healthcare

18:41 Addressing Balance Billing Concerns

22:22 The Power of Representation in Healthcare Billing

24:18 Understanding Healthcare Pricing Variance

26:40 The Importance of Patient Education

28:15 Challenges in Educating Employers and Employees

32:24 Implementing Reference-Based Pricing

34:54 Analyzing Healthcare Data for Cost Reduction

36:33 The Role of AI in Healthcare Transparency

👇 Drop a comment, share with a friend, and hit subscribe to never miss an episode of The Benefit Whisperer.

#healthcarecosts #RBP #benefitsstrategy #healthcaretransparency #thebenefitwhisperer #AdamRusso #employeebenefits #healthcarepodcast

Podcast title graphic for The Benefit Whisperer featuring Benjamin Jolley, discussing prescription drug pricing, PBM corruption, and spread pricing.
The Billion Dollar Drug Scam (ep. 8)

The Billion Dollar Drug Scam (ep. 8)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

Why Are Prescription Drugs So Expensive? The Truth About PBMs, Spread Pricing & What Employers Can Do

In this eye-opening episode of The Benefit Whisperer, host Ralph Weber sits down with pharmacist and reform advocate Benjamin Jolley to expose the hidden forces behind America’s skyrocketing prescription drug costs. 💊

From shocking stories of $1,800 bills for $140 drugs to the disturbing influence of pharmacy benefit managers (PBMs) and their spread pricing schemes, this conversation breaks down complex systems with clarity—and urgency.

🔥 Highlights include:

  • Why the U.S. pays more for drugs than almost any other nation
  • How a New Jersey benefits plan saved $1 BILLION just by rewriting its contract
  • The dangerous power of vertically integrated PBMs like CVS Caremark
  • The recent bipartisan push by 39 state Attorneys General to break up monopolies
  • How employers and CFOs can protect themselves from being held personally liable

If you’re an employer, benefits administrator, policymaker—or just someone wondering why your prescriptions are so expensive—this is a must-watch.

📌 Chapters:
 0:00 – Welcome + Prescription Drug Teaser
 0:41 – Meet Benjamin Jolley
 1:00 – Why Prescription Costs Are So High
 4:00 – What Is Spread Pricing? (Shocking Example)
 8:00 – Silencing Critics: Non-Disparagement and Audits
 13:00 – What Should Employers Be Paying Per Member?
 17:40 – 39 Attorneys General Demand PBM Reform
 21:00 – New Jersey’s $1B Savings by Rewriting a PBM Contract
 25:00 – Closing Thoughts + How to Reach Benjamin
What Every Business Owner Needs To Know About Level-Funded Plans (Ep. 7)

What Every Business Owner Needs To Know About Level-Funded Plans (Ep. 7)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

Are you overpaying for employee benefits without leveraging their full potential? Discover how to make your benefits strategy work smarter, not harder with level-funded plans!

Ralph Weber dives into why group benefits shouldn’t just be numbers on a spreadsheet but powerful tools that can attract talent and secure your business’s future. Ralph unravels the advantages of level-funded plans, particularly for small businesses with fewer than 100 employees, which make up roughly 98% of all US businesses. 

Ralph explores how level funding offers a blend of flexibility and cost-effectiveness unseen in fully insured plans, cutting through the confusion of healthcare regulations like the ACA. 

Key conversation points include:

  • (00:57) The difference between fully insured and level-funded plans
  • (02:19) The financial impact of the ACA on small businesses
  • (08:45) How level funding can offer significant refunds
  • (12:23) Strategies for maintaining affordable healthcare coverage
  • (25:23) Options beyond level funding for diverse employer needs
  • And more!

Connect with Ralph Weber:
Medical Debt Is Bankrupting Americans (Ep. 6)

Medical Debt Is Bankrupting Americans (Ep. 6)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

What if the greatest threat to your financial security isn’t a market crash, but a medical bill?

In this eye-opening episode, Ralph Weber uncovers the hidden costs of America’s broken healthcare system. Every minute, a family files for bankruptcy due to medical expenses, and employers are spending over $16,000 per employee each year, often more than they invest in their own core business.

Ralph breaks down why this system is unsustainable and what you can do about it. He shares practical, forward-thinking solutions — from customized level-funded health plans to smarter prescription drug formularies, that could dramatically cut costs and protect your bottom line.

If you’re a business owner, HR leader, or simply someone trying to make sense of rising healthcare costs, this conversation is a must-listen.

Key discussion points include:

  • The alarming rise of medical bankruptcies [00:01:04]
  • How medical debt impacts both employees and employers [00:03:00]
  • Innovative healthcare solutions to manage and reduce costs [00:10:11]
  • The role of self-insured plans and level funding [00:10:48]
  • Real-world examples of healthcare financial struggles [00:06:42]
  • Legal implications for employers not managing health costs effectively [00:17:07]
  • And more!

Resources:

Connect with Ralph Weber:
How the Affordable Care Act Changed Health Insurance Forever (Ep. 5)

How the Affordable Care Act Changed Health Insurance Forever (Ep. 5)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

What does optimizing your group benefits really mean for your business?

This week, Ralph Weber discusses the intricacies of healthcare benefits, focusing on the Affordable Care Act’s impact on health insurance and the workplace. Ralph aims to demystify complex regulations and unveil strategies to help you cut healthcare costs. 

Key discussion points in this week’s episode include:

  • The intent and outcomes of the Affordable Care Act [01:12]
  • Understanding employer and individual mandates [02:37]
  • Navigating participation requirements and minimum contribution [08:14]
  • Differences between self-insured and fully insured plans [22:33]
  • Innovative strategies like health reimbursement arrangements (HRA) [24:43]
  • And more!

Connect with Ralph Weber:
Unlocking the Potential of Your Employee Benefits (Ep. 3)

Unlocking the Potential of Your Employee Benefits (Ep. 3)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

How can understanding your employee benefits transform your business’s future? Welcome to The Benefit Whisperer!

In this episode, Ralph Weber explores the hidden potential of employee benefits. He explores how you can rethink your approach to healthcare to attract top talent and cut costs. Ralph shares his journey from air traffic control to the world of group benefits, revealing insider secrets and strategies to help you design the perfect plan for your business and employees.

Key conversations include:

  • Ralph’s Background: From air traffic control to group benefits expertise
  • The Evolution of Employer Health Benefits: Why it matters for businesses today
  • Understanding Healthcare Costs: Uncover astonishing price differences
  • Real Solutions for Real Savings: Proven strategies that saved a company millions

Connect with Ralph Weber:

About Ralph Weber:

With over three decades of experience in the healthcare and insurance industries, Founder Ralph Weber holds his CFP designation both in the US and in Canada, and focuses on cross border planning issues. Advanced planning designations include CLU, ChFC, ChSNC and AEP, which give him extensive background in planning issues and estate planning as well as for special needs dependents.
Medical Debt is Bankrupting Families and Crushing Businesses: How CFOs Can Help (Ep. 2)

Medical Debt is Bankrupting Families and Crushing Businesses: How CFOs Can Help (Ep. 2)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

What can be done to tackle skyrocketing medical costs that often lead to personal bankruptcies?

In this episode, Ralph Weber dives into the complexities of the healthcare system. He shares his insights on reducing costs for employers while providing substantial employee benefits. With personal stories and industry expertise, Ralph discusses how deciphering and managing health plans can significantly impact reducing waste and saving costs.

Key conversation points include:

  • (01:45) The rewarding aspect of helping employers provide affordable healthcare for their employees
  • (04:15) Addressing medical debt and bankruptcy issues
  • (06:04) Disparities in medical billing and the real cost of procedures
  • (13:37) The importance of transparency and incentive-based healthcare
  • (14:04) How Ralph’s background as an air traffic controller helps him manage complex financial planning
  • (15:59) Practical solutions for businesses to become ‘the CFO of their health plan’
  • (19:24) Imagining the future of workplace healthcare and medical costs
  • And more

Keep your costs grounded and healthcare soaring by understanding the profound complexities of this industry with Ralph’s guidance. Tune in!

Resources:

Connect with Ralph Weber: