Tag: Self-Insured Plans
Insurance FAQs: Your Employees’ Most Asked Questions (Ep. 23)

Insurance FAQs: Your Employees’ Most Asked Questions (Ep. 23)

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What if your company could save millions on healthcare without cutting employee benefits? 

Ralph Weber pulls back the curtain and shares real-life case studies from companies that did exactly that. From nonprofits to manufacturers to hospitals, Ralph reveals how they cut costs by up to 50% without sacrificing care.

You’ll hear how one nonprofit saved $5.9 million over three years, how a hospital stopped enriching its competitors, and how self-insured strategies gave a service company total control of its spend. He also walks through the tools that made it possible: reference-based pricing, domestic tier plans, drug advocacy, MediPay, and more.

What to expect:

  • Why “one-size-fits-all” plans are failing your people
  • How reference-based pricing drives transparency and savings
  • What a hernia repair should actually cost
  • Real numbers. Real results. No fluff.
  • And more!

Resources: 

Connect with Ralph Weber:
The Truth About PBMs and Rising Costs + What You Can Do About It (Ep. 19)

The Truth About PBMs and Rising Costs + What You Can Do About It (Ep. 19)

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Healthcare costs are spiraling out of control, but most employers don’t realize they have the power to change the game.

In this episode of The Benefit Whisperer, Ralph Weber explains why CFOs and CEOs must step into the role of health plan architects because fiduciary responsibility doesn’t stop at payroll.

Ralph and co-host Bill Tucker dig into the truth about PBMs (pharmacy benefit managers) and how these companies profit from a system that drives up premiums and hides real costs. 

Ralph breaks down the critical differences between fully insured and self-insured plans, why transparency is key, and how tools like MediPay.ai give companies leverage to save money while improving care for employees.

Here’s what discussions you can expect in the episode:

  • Why fiduciary lawsuits are changing employer responsibilities
  • How self-insured plans offer control and cost savings
  • Why PBM pricing remains a hidden threat
  • Practical steps to start designing smarter benefits
  • And more!

Resources:

Connect with Ralph Weber:

Are Your MEC & ICHRA Plans ACA-Proof? Don’t Bet $2,900 an Employee (Ep. 16)

Are Your MEC & ICHRA Plans ACA-Proof? Don’t Bet $2,900 an Employee (Ep. 16)

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In this episode, Ralph Weber, known as the Benefit Whisperer, discusses the Affordable Care Act (ACA) and its implications for employers. He explains the responsibilities of applicable large employers (ALEs) under the ACA, including the requirements for minimum essential coverage and the penalties for non-compliance. The conversation also covers the differences between self-insured plans and fully insured plans, as well as innovative health reimbursement arrangements (HRAs) like ICHRA and QSEHRA, which provide flexibility for employers in offering health benefits to their employees.

00:00 Understanding the Affordable Care Act (ACA)

07:35 Minimum Essential Coverage Explained

15:43 Self-Insured Plans and Their Flexibility

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

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

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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: