Financial Wellness Today: Smarter Employee Benefits: Adam Zebian on the Power of Self-Funded Health Plans

This is all over the country. This is an issue. And then, Rising Healthcare Costs are Straining Texas Businesses as the Legislature Seeks Solutions. So before we get into it, because I know you’re like a chainsaw when you start talking about this. We hear you really get involved because you’re very passionate about what you do and providing solutions for people.

So before we get into it, tell us a little about yourself and your history in the healthcare industry. Sure. And thank you. So I started in the industry early on in 2000s. My father was in the business for 45 years.

And so I somewhat followed in his footsteps. So I became a financial advisor in the beginning and really learned what it meant to be a fiduciary to my clients. And so learning that process and understanding how to run a business, how to build a business, learn the insurance business inside and out, just become a student of the business. And my father’s influence was certainly a big help in getting me started. And my business has naturally evolved into the employee benefit space.

I got into the employee benefit space probably in 2005. But really when I started focusing on the industry, it was in 2009 when healthcare reform started and happened and under the Obama administration. And I knew that there was going to be systemic change. So I was already neck deep in it. And I figured that was going to be a great opportunity for me to find my niche in the space.

And so I spent some time working for a fairly large third party administrator. I learned the ins and outs of how to build plans, how to design them, the underwriting aspects of it, the risk that’s involved with employer controlled healthcare, and spent some time in large brokerage. And then finally, here I am now today, I’m working for myself, started Helix Insurance Advisors three years ago, and really wanted to become an independent fee based advisor that is focused on one thing, which is purely about healthcare. That’s not so much the health insurance, but really focusing on working on helping employers and employees find better ways of consuming healthcare and being more healthcare literate. Well, that’s the reason the show is Financial Wellness Today, because we’re talking, this is an impact on employees.

It’s an impact on employers. It’s an impact on people that are unemployed. So this is a major, major topic and a major important piece about quality of life. Before we go further, I have some questions for you, but can you explain what a fiduciary is and what the difference is in the market of someone that’s not a fiduciary? I’m acting as a fiduciary, right?

So the idea is to be aligned with the employer and the employee’s interests, right? We are governed by ERISA, just like the 401k market is. So employers have the ability to control their healthcare spend. If they’re a larger employer in that 50 plus employee space, they are held to the same guidelines as the Affordable Care Act and the ACA laws. They need to be doing the best interest for their employees, and I have to be doing what’s in their best interest as well.

So I try to align myself in how my fee structure is built rather than commission based. That’s a big part of it. That’s something that I think the regular person doesn’t really understand. Sure. So most insurance agents and most brokers, they’re paid based on the commissions that are earned from the amount of premium that they write.

So if I write a piece of business with Blue Cross or Health New England or whoever the carrier is, the insurance carrier is the one compensating us and that fee needs to be disclosed. In some way, shape or form, you have to disclose your fee disclosure through a contract. That’s how I do it. And so any dollar that’s taken in by Helix is recorded and we have to disclose any earned and unearned revenue. And so the only revenue that I take in is revenue that is directly paid by the employer to Helix insurance advisors.

So I don’t take, typically, compensation from insurance carriers. But just about everybody in the business is commissioned one way or the other, right? Yeah. 99% of most brokers, most insurance agents, most agencies are paid on commission. Correct.

All right. So why has healthcare become one of the biggest financial threats to American businesses and what can an employer do to take back control? It’s a very loaded question, but to be blunt, I believe there’s a lot of different reasons. But to be fair, I think there’s some very misaligned incentives and I think healthcare is broken systemically. It’s not just one thing.

It’s not just a silver bullet where, you know, it’s one thing. It’s not government. It’s not just the insurance companies. It’s not the pharmacy benefit management companies or the pharmacies themselves. It’s everything.

And it’s compounded. It’s compiled. I believe the catalyst was in 2009 when the healthcare law changed and then since then you’ve seen how the volume of care is predominant over the value of care, right? Everything is volume based. Insurance companies only make money as premiums go ups and as costs go up.

Employers and employers are one foot in the bill for that. And I think there’s a huge discrepancy of healthcare literacy. I think that’s one of the biggest culprits is people don’t understand where the problems are, what the problems are, and then how to fix it. And just changing insurance carriers does not solve the problem. And that’s what most employers do is they look at their rate, they look at their premium, they look at their balance sheet every single year, they see those costs going up and up and up every year, not to their benefit, but to the insurance company’s benefit.

And so the only way you can control that is you have to, as an employer, take control back. And you do that by self-insuring your health plan. And that is the only fundamental way that you can do that. You know, I’m an optimist, I’m not a pessimist, and in working with Cambridge Credit Counseling for over 20 years, obviously our goal is to help people to really narrow things down and make some decisions if they’re having some difficulty financially. In healthcare, the employees don’t really have much of a say in this process.

So it really comes down to the leadership of any company making that decision that they have to do something to try to make sure that the employees have good choices to make. But even in that, even in my own experience, just reading through benefit guides and whatnot, a lot of it’s confusing. And again, they don’t really have a say in it. It really becomes the company trying to do the best they can to cover their employees with the plan that they choose and have it not be putting them out of business. That’s correct.

This is what we’ve been doing systemically for 30, 40 years, right? Employers have a benefit. They mostly will stay status quo. A lot of them don’t like to change because change is hard. And changing just insurance carriers can be difficult, even if the benefits were almost identical.

Right? There’s always difficulty in change. And that, to me, is the biggest competitor I have, is just getting employers to make those changes. But yes, employees, they might have a couple of choices between a high plan, a low plan, if they even know what that means, basically a higher deductible or a lower deductible. These are plans that are not built by the employer.

These are plans that are built by insurance companies, managed by the state and federal government. So the rates are set by them, the plans are designed and prepackaged, and basically you’re picking it off the shelf. And that is not my version of what a high performance health plan should look like or what the employer should be making decisions on. That way, when we look at building a health plan, custom building a health plan, it’s built around the employer and the employee’s needs, not something that’s cookie cutter off the shelf that the state and federal guidelines mandate. And I think that’s the challenge, is that they’ve only seen it one way.

A lot of them haven’t experienced any kind of alternative strategies. And there’s a lot of different techniques and strategies that employers have options to, but most don’t take that option. Most will somehow bite the bullet or cost shift the expense back to the employees. And that’s how these high deductible health plans have come so prevalent and become so prevalent to employees. Because now, instead of the employer being the one absorbing those costs, they’ve shifted those costs to the employees and high deductible health savings accounts and HRA accounts and flex spending and whatnot.

You brought it up. I remember just as an employee, when we made the shift in 2009, and I’m only remembering it because I remember just saying to myself, this is just going to mean that I have to raise my deductibles on everything in order to have a premium that’s affordable. And the other part is, I talk about company and morale when a manager has to make a tough decision. It doesn’t always help the cohesiveness of employees and the employer because they have to make tough decisions. It seems to be that healthcare is becoming this continuous difficult decision because obviously with everything costing more in the economy as it has since we’ve gotten out of COVID, it’s been four plus years now of everything kind of going the wrong way, it seems.

Obviously, we just recently had the gas issue and it’s starting to come down now, but that greatly impacts people. Then when it’s time to renew your healthcare, almost every employee, it seems, or people that you talk to think it’s going to increase, just like energy, right? So when you go into an employer as a prospect, what’s the first discussion that you’re having? So the first thing is, I try to, as a financial advisor, I used to do this all the time where you do some fact finding, right? You have to understand, well, why am I there in the first place?

Where’s the pain? Is it really just cost? Is it employee access to healthcare? Is it, maybe it’s a prescription drug problem where they have employees that are taking high cost medications that they may know about. Some know, some don’t, but they, again, they see those rising costs and they don’t understand why.

And they’re looking for somebody to tell them why. And a lot of times their broker can’t tell them because the insurance companies don’t disclose that. If you’re a smaller employer, less than a hundred employees, typically, you’re not getting any information. You might get a couple of, you know, you might get some background noise. Maybe some employees are talking about things or maybe somebody’s approached HR and they find out things, right?

But that’s typically it. But the insurance company is not giving you data or claims experience to make an informed decision. And that’s part of the biggest problem. You don’t know if you’re spending a million dollars, how much is actually being used for healthcare consumption. Like where’s the utilization, the claims?

And the government says, well, 80 to 85% of every dollar has to go towards claims. The other 15% or so has to go towards fixed administrative costs, state fees and taxes and all of that stuff, profits, et cetera. But that 85% of the dollar is undisclosed information. We don’t know where it is, who’s getting care, where, what happened. So pricing is a big problem.

And so these conversations that I have with a CFO or especially the business owner is, do you really want to know where your money is going? And if the answer is yes, then great. We can do a lot to solve that problem. But if they really don’t care, if they’re just trying to find a easy quick fix solution, I’m really probably not the guy because I’m not just going to go out and shop insurance. Any broker can do that.

It’s important for them to understand the root cause of what’s happening. And it’s sometimes one person. It could be one employee. It could be a couple of employees. But typically the insurance company keeps that information very closed and hush hush because they don’t want to disclose that information.

And the amount of money that I’m typically saving employers is between 20 to 30%. That may seem like an astronomical far-fetched amount of money, but the case studies prove that. And so these conversations that I have is you have to change. You have to create some kind of disruption or else you’re just going to keep renewing your contract and keep getting those increases. And if that’s all you want to do, it is what it is.

But for the employers that are really looking for the right answers, they’re looking for a better way to give their employees better access to care, even free health care. And this is something that we promote a lot of. The employer can provide free health care to their members by finding good quality, high quality care at lower cost. And usually the better quality care, the better providers out there charge less. And that’s very easily done.

So it sounds like you’re not the mainstream solution that people are used to hearing. It sounds like you are having some way to be creative with building a plan for an employer that’s not your typical plug and play. That is correct. We customize almost every plan that we build. A lot of it will have a lot of the same similarities that the state and federal plans have.

But for example, when we’re doing a self-funded design, we’re only following federal mandates. The state mandates go away. The biggest, biggest culprit about creating savings is avoiding medical loss ratio rules in the ACA guidelines, which basically says for every dollar that’s taken in, remember I was telling you 85% of every dollar that’s taken in has to go towards claims. Well, if the insurance company deteriorated those factors, that ratio, and if they kept claims down, they would have to give the money back to its policyholders. That does not happen.

So when we save money for an employer, when an employer has any kind of surplus, 100% of any of that surplus goes back to the employer. It’s not going to the insurance company. It’s just money that hasn’t been spent on premium. So there’s huge advantages of that and understanding what the risk is. All right, I want to back you up for a second.

So you said self-funded. That sounds frightening. So what is the difference between self-funded and the alternative? All we’re talking about is typically a funding mechanism, right? So if you’re fully insured, which is what most people have or see, is a plan that’s Blue Cross, Cigna, Aetna, United, a plan that is fully insured by the carrier.

So that means you’re giving 100% of the risk to the insurance company to manage your health plan, which in my opinion, they do a very terrible job of that. When you self-insure or partially self-insure, you’re partially taking on some of the risk. We still have a component of insurance. We call it stop-loss to protect the employer from catastrophic risk. That takes that fear away.

There is a mechanism of protection that employers will have and that’s what we call stop-loss. That has to be in place. You have a third-party administrator that administers the claims and does the same functionality as an insurance company, just cheaper, right? And then we hire a third-party PBM or pharmacy benefit manager that manages the RX side of things rather than the insurance company managing all of it and you giving the house away and they manage all the risk. You take on some of the risk, but you also reap the rewards of that as well.

So if you’re spending a million dollars, doesn’t matter which bucket, if you’re self-insured, it’s a funding mechanism. That means the employer is funding those claims using their own dollars rather than paying premium. And by eliminating some of the fat, the waste, the abuse in these health plans, the taxes, the fees that are involved in fully insured plans, the employer can save a minimum 10% to 15% just off of that. And we talked a little bit about broker fees. So my fee structure is based on employee count.

It’s not based on commission, based off a premium, right? So I was talking about this before, employer premiums, the broker could typically make anywhere between 3% to sometimes 6% of that number, right? A lot of times even my fee is about 10% to 20% less than that. So there’s going to be savings, not only in broker fees, there’s going to be savings in taxes and fee structure that’s eliminated from a fully insured plan. And then we are going to try and attack the claims.

The claims bucket is where the most of the money is going. And so how do you do that? You got to find high quality care and you have to pay less for healthcare. Now the problem is most employers don’t realize this or most employers don’t realize this until they’ve had experience. You don’t find out what the cost of healthcare is until after you’ve used the service.

And that happens two to three months later, you get an EOB, you get a bill. Most of the time it’s wrong and people don’t understand it. It’s very- EOB is? Explanation of benefits. That’s coming from your insurance company, whoever that is.

And then the medical bill will come from the hospital or facility or provider’s office, right? And those two things have to match. And a lot of times they don’t. And a lot of times they’re using codes that are very complex and confusing to understand. And whether or not those prices are actually accurate is a whole other conversation.

But a lot of times they’re not. All right, Adam, so you’ve worked with employers for more than 20 years and have that experience from your father handing down a lot of information. I’m sure you’ve seen a ton of changes over time. You mentioned 2009 was a very significant time where everything shifted. What’s the biggest mistake you see companies make when managing their health plan?

I think for most, a lot of employers don’t look at it as like a business unit, right? Especially now, health care has become the second or third line item on their balance sheet. And I don’t think they take it serious enough. They shop it around. They’ve probably been with their broker for many years, maybe decades.

And every year it’s the same. The same status quo, kind of just roll over those benefits, they might make some changes to try and save some money, but I don’t think a lot of employers realize that they have all the leverage. They have the ability to take more control. Unfortunately, there’s a lot of brokers out there that don’t do what I do. They sell a product, they sell a program, they might sell, you know, the same kinds of programs and products that they’ve been doing for 10, 15, 20 years.

And unfortunately, in today’s world, that doesn’t work anymore. I think complacency, and I think that because they have not evolved, they’re not taking health care as serious as they should, right? And if they have a business line item that is costing them sometimes millions of dollars, let’s focus on that. I don’t know how that’s possible that they’re not paying attention to it. Sometimes it’s mind-blowing to me.

And we see the data. Sometimes if you’re a larger employer, there’s data, there’s 5,500 filings that they have to file with the IRS every year. And we see their costs going up and up and up and up and every year. And the brokers don’t want to do anything about it because the last thing they’re going to want to do is take money out of their pocket or the agency and reduce spending because the minute they reduce premium, they are taking money and compensation out of their pocket. So most don’t want to do that, right?

And negotiating with an insurance carrier or two or three insurance carriers to get to a certain number threshold that they’re willing to accept is ludicrous to me. Because even if you get it from, let’s say they start at 18% and they end up at, let’s say a single digit 8% when it’s all said and done. That’s their negotiating power that they’ve used. Most of them don’t realize that’s not even justified. How do we know that that 8% is even a real number or a good number?

They don’t. 8% of what? 8% of what? Yeah. Exactly.

So a discount or, and it’s just how insurance carriers operate, just because they’re willing to accept 8% as an employer, you’re willing to accept an 8% increase. You don’t really know if that’s justifiable. You could have deserved a minus 10 for all we know. Maybe you deserved a 30% increase or 40% increase. But how do you know that?

You don’t know which is up or down, but they think they get a better deal because they started at a higher number and somehow negotiated it down. But with what? I have never, like one of the reasons I love this, the premise of our show is to bring on trusted experts that can uncover some of the things, especially in the commission-based world. And I’m not disparaging people that are paid by commission at all, but we’ve all heard horror stories of people that are paid by commissions that are leading by the amount of money that they’re going to make instead of really what’s best for the individual or the client or the employer. That’s the dilemma.

Health insurance, and I’m very careful with my words. Health insurance is a very expensive business. It’s complex, it’s confusing, and it’s built that way. Talk about the system being built specifically that way. Just wasn’t built for the right entities, right?

It wasn’t built for employers or employees. It’s built for big corporate, big pharma. And they’ve profited astronomically from this, and brokers as well. And there’s a few of us that have decided to take a different path, right? A more transparent path.

And the more you unbundle and you unpack and you peel that onion back, the more money is to be saved. The money-saving problem is not the issue. And the HR manager probably doesn’t know that. They don’t. The employee, when they look at their plan, unless it’s really relevant, it’s not the main stuff.

The things that they probably look at are, what’s my co-pay, what happens if I get this? Most employers are choosing the lowest-cost option. Let’s be honest. And if it’s an HSA option, or health savings account option, most of them are not funding that account properly. Sometimes the employer helps and they will contribute, but that’s their money.

That’s the employee’s money. But health savings account’s not the answer. If anything, it’s been a detriment. And we’ve seen it in how people end up in debt, and why people end up in debt, especially medical debt. It’s because they can’t afford, not just the, it’s not the contributions that’s coming out of their paycheck every week, because that’s automatic, right?

It’s the back-end exposure of their deductible, their co-pays, their co-insurance, their out-of-pockets. It’s unaffordable. It’s unsustainable. But that’s what happens, and it’s this crazy cycle. There’s a lot more components to that.

But there is several competing interests that has caused this problem, and it’s mostly because of insurance, right? And so employers need to be able to understand that they can take control. They can provide better healthcare, better outcomes, for lower costs. If they focus on healthcare, the actual healthcare that their employees are consuming, it can be negotiated, right? The cost of care can be negotiated and treated differently.

If they’re focusing on the healthcare that they’re consuming and paying less for that healthcare, they can save money very easily. But it’s not that. It’s about the patient experience, right? You can save all the money in the world, but if the employees aren’t happy, it doesn’t matter. I’m glad you said that.

I wrote an article about the cost to employers when an employee is struggling in the workplace with debt problems, bringing it home, measuring all their key performance indicators. This is the problem for employers today. The cost to lose an employee, you have to hire a new one and retrain them, get them up to speed, hopefully retain them past the first year. You know those statistics aren’t great. And when you add a big component like this, you have to know that some people, because it continues to increase, they’re starting to look for something else.

And when you bring an alternative into an employer, because the employee also is used to the ease of use. The cost after a while goes away, so once you get the new premium, oh my, they’re taking this much more out of my paycheck, then it just goes back to normal life. That’s what it is. You get past it, move on, right? So when you come in with an alternative for the employer, how does that look differently to the employee where they might react, because it’s unorthodox, maybe they might react poorly to something that’s not as easy or what they’ve been used to?

Yeah, so you said it. So anytime an employer comes to the table with a renewal increase, you have literally taken money out of every single employee’s pocket, right? Wages have not even come close to keeping up with the rising inflationary costs of healthcare. Not even close. In the last 60 years, right?

The cost of wages has highly, not even, I just can’t even explain the astronomical. You know where that’s showing up, right? That’s showing up in all the kids, the young kids coming out of college, living with their parents. You asked me before, when I’m sitting down with an employer, instead of giving your employees a pay cut, let’s give them a pay raise, right? Let’s come back to the table with something meaningful that’s beneficial to employees.

It’s an employee benefit again, where we provide high quality primary care, telemedicine, inpatient outpatient care, urgent care for no cost. So imagine going back to the 70s and where healthcare was pretty much free to employees. Now employers can pay for that healthcare, but they’re paying a lot less for that healthcare because a lot of times we eliminate the middlemen. We eliminate networks, we eliminate bogus providers that we don’t want employees going to see that have very low quality metrics. So when we go to find high quality care, miraculously cost comes down, right?

But we can offer free healthcare and better quality healthcare, even lower cost healthcare, bundled surgical arrangements. We can do those things in a self-insured environment that you cannot do with a fully insured carrier. They don’t allow it. Listen, I’m the host and I’m considering asking the producer to like put cuckoo clock like noises in here because it doesn’t sound like that’s possible. It’s very possible.

And it’s possible to provide better quality primary care, which is probably one of the biggest sectors of the healthcare industry that’s been decimated by the system because there are no independent doctors anymore. They’re all owned by hospitals, they’re all owned by big carriers, Optum being the biggest. These physicians get terrible reimbursements, right? We don’t talk about this a lot. We talk about the employees and the employer, but how about the doctors?

The providers themselves are getting absolutely hammered by these insurance companies and how they’re being reimbursed and when they get reimbursed for the services that they provide. Primary care was one of the biggest parts of the industry that got crushed. And that’s why there’s very few family owned practices. And now we’re going back to more of these are, there’s doctors now that are branching out of the system. We have now thousands of providers that run these, what we call direct primary care practices.

There’s a lot of local ones now, but there are few and far between. But these are practices that are membership driven. So you’re no longer paying premiums and going to see a doctor that’s based on a volume based production system, right? Where a doctor sees 20, 30, 40 patients a day in order to get paid. These are doctors that have much less patient care systems where they have maybe two to 300 patients now, but their revenue and their livelihood is based on a membership.

So you pay 50, 60, maybe a hundred dollars a month to see a doctor 24 seven. You have all their attention. It’s a completely different model, but that’s value based care versus volume based care. That’s just one example. And so we certainly promote that type of advocacy for patients to get good quality primary care because that’s the cornerstone of every health plan, right?

During COVID, telemedicine skyrocketed, right? Why? Because telemedicine was a way to reach a doctor, get access to care very quickly. Telemedicine has been around for a long time though, hasn’t it? It has.

It’s been around for 15 years, right? But it got very, very prevalent during COVID because nobody wanted to go to the hospital. Nobody wanted to go to the doctor. And even if you did want to go to the doctor, you got to wait two to three weeks. That’s insanity.

That’s not healthcare. I hear it’s even worse in some areas still. If you try to find a doctor in the state of Massachusetts right now, a primary care doctor, if you can even find a doctor that’s taking on new patients, you are going to wait six months to a year to see that doctor. So at the beginning of the show, I brought up, right? In Georgia, it’s crippling school systems.

In Texas, it’s ruining businesses, right? So let’s get to the employer and the employee right now. Obviously, the employees would like to have more coverage and pay less. And you said that that’s possible. Very possible.

So for an employer, because I have learned this over time in the work that I do working with HR, working with CFOs in some instances, or even leadership CEOs, and sometimes it just seems like it’s a painful process to go through this audit, to go and figure out what the alternative is. So what’s your message to employers that understand that this is going to be an issue next year too? It’s an issue this year. It was an issue last year. It’s only getting worse?

I think it’s a long-term play at the end of the day, right? I think if you’re an employer that is looking for a more sustainable, more cost-effective way to run a healthcare practice, because I don’t care who the business owner is, they run a healthcare business, right? When you have a line item that’s that expensive, every business is in the business of healthcare and health insurance. Sure. So how do you want to manage that?

Do you want to take more control over it, or do you want somebody else to manage it? Now, if somebody else is managing it and doing a poor job, wouldn’t you fire them, right? Why wouldn’t you make that kind of change? If you see that something’s just not right, and when I talk to a lot of employers, getting an increase of 20, 30, 40% or more is almost impossible for them to even imagine, but it’s happening. It’s happening.

This is one of the craziest times I’ve ever seen in the insurance industry. And so my question is, what do they want to do about it? Because if they want to fix it, it can be fixed. I’m part of an organization that does exactly that. And when I joined the Health Rosetta Association, and when I looked at becoming a different advisor for employers, we do things differently.

We unbundle, we work transparently, and miraculously, when you start doing things that are aligned with them, meaning if I’m working with a vendor, unless their interests are not aligned with the employer and the employee’s best interests, we don’t work with them, right? So how they’re compensated, how they function has to be aligned with the employer. So in other words, if they’re doing a service for advocacy, as an example, and we’re trying to steer a patient for something simple like x-rays or imaging or an MRI or something of that nature because they need to have surgery, where that patient gets care, the cost of that care can vary from practice to practice, right? So if you’re getting an MRI in a hospital facility compared to a freestanding independent facility, the price variation could be six, 700%, right? So we reward employees that get good quality health care, being willing to accept going to a certain facility because we are going to get it for a much cheaper price, same quality if not higher quality, and the employer will pay 100% of that cost because it’s a much lower cost of paying for health care.

So if I go to a hospital and it’s $3,000, that’s a $3,000 claim that we got to deal with. If we can go to a facility for 600 bucks and it’s the same exact procedure, why would we spend more money? So when employers have that kind of control in a health plan to help, I would say, re-engage with the employee and be able to steer them to high quality, low cost providers, everybody wins. You brought this up earlier. This is a health care literacy problem.

So I would think that in your work by acquiring a client, it’s going to take a little bit of communication with the employees to really teach them what the shift is. Correct. And without that, again, it would be hard for them to really understand what the benefit is because they’re not going to be involved in this decision. They just want to know that they’re getting quality health care and if for some reason they didn’t have to pay for it, that would be, I’m sure, a humongous bonus and you’ve mentioned that you could potentially create a path for that. We build health plans to function in two paths.

Path A is go where you’ve always gone. Go to the same providers, primary care specialists, dermatologists, whatever. You have a deductible, co-pay, co-insurance structure, whatever that structure is traditionally what they’ve seen. Option B is the high performance path. We have advocates to help steer patients to zero cost care and that could be anything that really requires prior authorization.

So that could be a high cost surgery, that could be cancer treatment, that could be a number of things. But when they go down option B and they go down that path and they’re being handheld by one of our advocates, one of our nurses, our nurse practitioner, our skilled clinician, they’re going to be paying nothing out of pocket and the employer is going to basically reap the rewards of paying less for that health care because we’re steering to high quality. And high quality means lower cost. It’s a complex issue, man. It is.

It is. It’s very complex. But that’s why they would hire someone like me. Most brokers don’t do this kind of work. They’ll place the business.

Most are saying, make sure you stay in network. Well, how good is that in network provider? And let’s say you go in and get that care and somehow, some way the anesthesiologist or the facility may be out of network. But you are down this path, down the path of thinking, oh, this is all in network. I already checked everything out.

And then you start getting the bills and you start noticing things and the bills keep coming and coming and they’re more complex and you don’t understand them. That’s the problem with health care. It’s meant to be confusing. And they’re going to steer a patient down this network path where networks don’t hold a lot of value. They give you this presumed value of having access.

You can only see a doctor if you have a network. That is not correct. Most doctors, they hate insurance. I know that. And hospitals hate insurance.

Of course they do. So that’s not the only way you can get access to health care. We can actually work directly from employer to provider in a seamless transaction and a seamless access to care by paying differently, which is unheard of, right? It’s not very common. Not very common at all.

But that’s very, very possible. All right. So we’re running out of time. Before we get out of here, I try to end the show with fun. So what’s your favorite hobby?

So I have this weird hobby. I call it knitting for men. So I restring baseball gloves. I recondition and relace and recondition baseball gloves. I work at a local facility and a lot of times people come to me and they have a glove that they’ve had for 30 years, 40 years.

Or maybe they have bought a brand new glove and they need me to break it in. Or if they have a kid that, you know, maybe they broke their glove. I can do all of that. I relace gloves. I fix them.

I clean them. I condition them and bring them back. It’s a good hobby. If I remember correctly, you were a pretty nasty catcher. I am.

I am. I still catch. I still play a little bit in the Tri-County Leagues. I’ve been coaching and doing strength and conditioning and player development for probably 25 years. Awesome.

Outside of college. Yeah. Well, look, this is important information. Obviously, this isn’t going away anytime soon. No.

I’d love to have you on again in the near future to continue this conversation. Tell our listeners and our HR directors and CFOs where they can find you. Yeah. So you can find me at www.helixins.com. That’s our website.

You can find me at azebianathelixins.com or you can call me at 413-454-5021. All right, Adam, thanks for coming, man. Thank you. Appreciate you. And that’s going to wrap up the show.

Again, Financial Wellness Today is your trusted source for expert insights, honest answers and confident financial decisions to be made in the future for whatever it is that you’re trying to enhance your goals to be financially well. Whether it’s a company trying to give more to their employees and try to do better as a company or if it’s an individual trying to help themselves or a family member or a loved one that might be struggling financially, that’s what the purpose of the show is. Until next time, this is Gordon Oliver with Financial Wellness Today.