Group Health Insurance Options for Small Businesses | Are You Wasting Money?

Uh, well, we talked about not putting our foot in our mouth, so we won't start there. But, but I do want to start with something a little bit controversial, and that's what is wrong with the way that companies and people from companies are buying health insurance for their employees today? And is it something that can be fixed in your opinion?

Yeah, I think it can be.

And a lot of what's wrong is just the knee-jerk reaction of renewals and starting work way too late and employers not really taking that proactive approach. You know, with everything else, Matt, they control their costs, right? Like, you buy a good, you sell it, you have a margin. You know, with healthcare and the health insurance premiums people pay, it's really reactionary, the entire approach. And that's a lot of what's wrong, right? Because someone will be a broker and they'll, you know, amass some business and they'll kind of do things status quo. And then what happens a few years in is you wait till you get the renewal and that's your go, right? That's when you go off to the races. Then you shop the market with all the usual suspects, and then you kind of go back to the client, and then it's too late to really do anything different, right?

Right?

So like a lot of the problem is the process and then not doing anything different year over year because people get fat and happy. I mean, for lack of a better way of putting it, and there's no impetus to change. And if their clients don't perceive there's a problem, but there typically is a cost problem, then it's kind of business as usual, status quo is normal and kind of stinks, you know?

Yeah, it's interesting you say that because we've got, you know, sort of some delineation there, right, of your group size depending on how they purchase benefits. And how strategic they are about the process. But let's talk about those under 50 groups first here and just, and just discuss how can they be a little bit more strategic with how they purchase benefits? What can they do to get off the cycle? Like you said, it is very frustrating from both sides of the table. You know, we're a licensed benefits agency. We certainly have plans with our clients and, you know, we get the renewals back from Blue Cross, Blue Choice, whoever it is, and say, yep, it went up 8% or it went down 1% or it went up 4%. And there's almost no opportunity for us to step in and do a whole lot of changes there and plan design or whatever until, like you said, we take a step outside of the traditional routes and look at some unique ways of trying to help them get off the cycle. What are some of those unique ways? What can small businesses do?

Yeah.

So, I mean, it can be, it can be a blessing and a curse, right? The small market, like you may have a $20,000 a year premium for your small company, like all in, and someone might be taking $80,000 worth of drugs. Right. So, I mean, you're winning in that situation, right? But a lot, a lot of times, you know, given that example, the same, same thing, someone's taking a really expensive drug. One thing you could do to manage the claims risk of that group is to actually carve the drug off the plan and have the member source it a different way. And that's where working with a consultant who knows how to do that is really valuable, because maybe the group is spending $20,000, and this is like a low, low-end example, right? Like, like small group, I mean, 5-employee only or something. If you can carve off that drug and no one else has anything else going on, maybe you can take the premium down to $18,000 a year, right? So we're dealing with micro, micro numbers, but I mean, most companies spend several hundred thousand dollars a year even under that $50,000 mark, right? So, you know, carving up the drugs off the plan if you can, you know, that's one thing to do. Taking a look at other areas of risk, you know, maybe the plan design can be a little bit different. Maybe you actually take a look at self-funding a group where you're not just taking a census to market and getting the same results over and over again. Maybe you take that, you find out who the self-funded players are, and then you say, hey, this is your best-case scenario rate over here, right? Here's your worst-case scenario rate, which is your renewal, same benefits, let's just say. And then the delta there is how much money you could potentially save. And doing underwriting is how you— it's, it's an exploratory part of the process where you say what is going on, you know, with the risk of the group. Maybe it's paper and pen, maybe it's an online health application like an eHealth app or a FormFire or what-have-you solution. Sometimes, Matt, what you can actually do is just get underwriting done using a member-dependent level census, and there are some specific underwriting entities with whom I work personally that'll actually firm up a rate based on just the census, the benefit summary, and the renewal.

So there's a lot of different ways to approach it, but yeah, you're right.

I mean, you get a renewal increase, you can't negotiate it because guaranteed issue rate, and if you're healthier than the normal group in your population, you're kind of stuck just paying that unless your consultant knows where else to look and what of the process to change, right?

Yeah, throughout my career I've seen lots of folks come to small businesses, mid-sized businesses with different options than what exists on the once again, the traditional go-to-market, right? I go to my agent who goes to their general agent who shops it with the big national carriers. I guess I broke our pre-written rule that we weren't going to use names, but I think I used Blue and a good name, right? We're in South Carolina, so it's all Blue all the time here. And one of the challenges though is getting people to think differently about it. And I tend to sometimes agree with them depending on the situation of just like a, hey, All right, well, look, we took a flat renewal. It is what it is. Everybody's on a good plan, quote unquote, for those of you that can't see me with the air quotes. The people are, you know, the premiums have stayed flat. We're comfortable. We know the network's solid. But then obviously you get, then the year comes where it's a 15%, a 20%, or whatever. And we start, then we start scurrying around looking at other options. What else is out there? How do you break that mindset with folks when you've seen people get off that treadmill? Like what was the, before the 15%, 20% increase comes? Like, when do you start looking at those alternative options?

Yeah, I mean, and I've seen, you know, to your point there, I mean, certain agents, you know, will have the talk track of saying like, it's a B-list carrier. And again, there's my air quotes, finger quotes, if you will, you know, by saying it's not one of the nationals that they know, it's maybe like a lesser known one, but they rent a national network. So it's in and of the same in terms of market access. So there's a few things to unpack, right? I mean, On the network side, I typically say find a doctor that's not in this other nationally rentable network like Aetna or Cigna. They're the two, you know, largest ones that are nationally rentable by independent health plans, right? And typically, you know, people look up their doctor and they find out that they're in this network and they can, you know, divorce the big bad carrier sometimes, um, and, and there's no issue there. But in terms of breaking the, the thought process, uh, if someone's paying $400,000 a year in premium and they got a 0% increase, that means the carrier made money. Right? Um, it probably means their loss ratio is really, really low, and the carrier's not going to tell them what it is because they say, we don't have to do this below 100 lives enrolled, we don't have to give you this data, so we're just not going to. And it's, it's, it's like you're buying a car. I mean, it's kind of crazy, the back and forth sometimes. It's just, you think that you can get a straight answer, but to that person, the business owner, Mr. and Mrs., I would say, of the $400,000 you spent, if you were under this other arrangement over here you know, literally half that money most of the time, between 50% and 60% depending on the size of the group, sometimes less, is earmarked to paying for claims. And if that money is literally none of it spent, and that's not a realistic projection, but if none of it is spent, then only $200,000 of your money is going out the window and paying for admin and insurance costs. And then literally you have $200,000 still sitting in the plan. So I mean, the flat renewal, I mean, I've seen some of my small self-funded groups, Matt, have like a couple hundred dollars in claims charges, and then they get a flat renewal, and then they have a reserve of claims just sitting in the plan to help stabilize long term. So I mean, it's just having that shift from just seeing it as a liability to a company asset. And then when you start to have them think in that manner of, oh, half my money, like, how are you going to protect half my money, Mr. and Mrs.

Agent?

Like, how are you going to do that? Like, well, some people know how to do it, and others are less well-versed in it. They would just sell people on other things. Like, here's all the stuff I do technology-wise, or here's what I do compliance-wise, or, you know, here's my support staff. And a lot of that's important, don't get me wrong, but that's kind of like— that's your ticket to the dance, right? It's like, I answer the phone, I answer emails. Like, I'm not going to abandon you, client. I mean, like, that's, you know— but where it matters, like, do you want to pay $400 a month or do you want to pay $500 a month? Like, I have all the goodies at $400, you know, or do you want to overpay by not taking a diligent look? So it's, it can be contentious certainly at times, but it requires a mindset shift. At least I've found.

So those, those are some great points. And I think that's one of the things I'd like for you to clarify for us today in the sort of explain it to me like I'm 5 version of like, what are some of the other options if I get out of the traditional model, if you will, you know, you mentioned self-funded, you mentioned some of these other things, uh, some of these other ways folks can can get insurance and purchase insurance for their, their companies and their, their employees. And, you know, I just got off a session where we were talking about ERG stands for engage, retain, grow. And I always say, listen, we're trying to help you engage, retain, and grow your number one asset. And one of the most important benefits to your number one asset are these things, the health insurance, the supplemental insurance, all these other pieces that help them to take care of themselves and their families. So, so what are some of the other options that you look at? And you've always been really good at finding alternatives outside of the mainstream, which I think is something I've always been really impressed by with you. You. What are those options when you say, okay, hey, if I'm looking to take somebody off of the traditional track, here are the things I look at.

Sure.

Yeah.

A lot of times it's who you know, and you have to just look, right? Because if my entire career— me for my entire career, rather— I just looked to the national carriers for the solutions, then all I would know is basically what they put on the table. Really where my education started was, you know, reading a lot of industry-specific books, which I know that's kind of a blanket statement. But I mean, a lot of it came from there, right? And then talking to general agents that didn't work with those national carriers only, right? They had other solutions that they brought to the fray. And then working more with those independent health plans and kind of having in-depth conversations with them. And then kind of your social network ecosystem. A lot of times you talk to other people, you talk to people that have interests like you and say, hey, what health plans do you use? You know, everybody knows kind of the national players when it comes to like the level-funded space. And again, I'm not big on using names, but there are several that are— they're just national, right? Like, you know, like, they have level-funded solutions out there. Once you get to a point where you kind of can see through a lot of the marketing components of those sales pitches, if you will, to just really kind of delicately walk that line, right? You start to know what really matters. Like, okay, well, over here, 35% of the money is being spent towards claims. Over here, half of it is being spent towards claims. Like, total same cost, but like, once you dissect a health plan and you can say, all right, they're both $400 a month, but again, over here $200 is being spent towards claims, and over here it's only $150. Like, what's going to be more stable over time? Like, the plan that's better funded on the claim side. And then like, you break up the insurance costs. You're like, what is the money that's again going out the window that we're not even going to have, you know, a cent back on. And those are the fixed costs that are just, that are just gone. So I mean, a lot of it comes down to looking at the proposals. I mean, it sounds basic, basic, but like not just looking at the benefits network and 4-tier rates, um, taking a look beyond the numbers, you know, to the factors like what are the insurance costs, what are the claims funding costs, uh, what are the commissions. I mean, a lot of companies don't know that on these, uh, products, the brokers can set the commission level. A lot of times it can be justifiably higher because doing a self-funded plan is more work, right?

I mean, it's—

you're doing underwriting, you're hopefully monitoring the plan to see how it's performing. You're starting your renewal negotiations hopefully earlier because a more complex process, it's still pretty easy to just pay the bill and renew with the same benefits, even if they stay self-funded. But if you want to move them to a different self-funded plan, a lot of times you're pulling reporting, you know, you may be doing underwriting with the staff again. So in any event, it's a much more consultative sort of an approach beyond the financial reason why you want to self-fund and, you know, build up a claims reserve and have that stabilize your premiums over time.

So what are the key differences? We've talked about 3 different types of insurance now for small businesses: self-funded, level-funded, and fully insured. So, so what are the key differences between those 3?

Sure.

Yeah.

So, so fully insured is, you know, pay your premium, your claims are going to be paid. Right? It's a fixed 4-tier rate. Self-funded is the other side of the house. So it's fully insured and self-funded, right? There's two, there's two parts. I mean, every self-funded employer is partially self-funded unless they're like a jumbo jumbo employer and they don't buy any insurance for any reason, right? So that said, the self-funded side of the house, typically what ends up happening for smaller groups is they have what's called a level-funded plan, which means you have a 4-tier fixed rate system over here. It's $400, $800, you know, $780, and then $1,200 for family, like the 4-tier rates, right? Level-funded is structured the same way, right? You're fully funding your claims liability. You're in fact overfunding your claims liability. So you should have a little bit of a reserve over there. Typically it's 25%, but it can be as small as, you know, 5 or 10% in terms of overfunding your claims. But for an employer, it's just the same. Like the rates might look exactly the same, like $400, $800, $780, $1,200. Like those are the 4-tier rates. So that is a way to get into the self-funded space without worrying about the fluctuation. You know, a lot of employers from years past, Matt, have been kind of, again, taught that like you have your fixed costs and then your claims fluctuate on a month-to-month. Not a lot of small groups are ready for something like that, to pay a weekly or a biweekly check register in claims and have that be a fluctuating expense for the business. They're just not ready. Like, they're used to easy, easy pay the bill, have everything be covered. With, you know, traditional self-funded models, it's fluctuating, right? But for most of the groups I work with, they prefer just to have a stable bill, stable rate set. Again, sometimes it's just as easy as getting a proposal from a health plan and just showing them the 4-tier rates and then explaining how it works. Other times it's more nuanced, right? Like someone like me will go out and fish the stop-loss, the best stop-loss, right? And then I'll tie in the best independent administrator, and then I'll tie in the best pharmacy administrator and care management. Mobile app and legal and kind of all those things that need to be there for health plan to be fully built. Um, but it can be as complex or as easy as someone wants to make it, but no one wants to learn the complex, right? They just want easy a lot of the times, which is why it's, it's a, you know, smaller, it's a smaller subset of people that like really want to geek out on all the details and say, yeah, I want to do this. I want to do this and, you know, build it a certain way. So, but I like it.

Yeah. Well, and I think on the consumer side, it's the same way, right? And that's why so many people press the easy button. They likely overpay in the respect to just be able to go, hey, no network, known carrier. Okay, listen, we know we're going to pay more, but I don't understand anything Nico's talking about. And I just want to make sure that my people have insurance that they trust and that they can feel comfortable with. At the end of the day, there's, you know, we all pay a lot for security and simplicity. Like you talked about, which is something else that's a big element of this that we named the show HR Simplified because that's our goal is always to try to do the explain it to me like I'm 5 version of things because the TL;DR, if you will, for my millennial folks out there, the too long didn't read, we want to give you the headline and then fill you up with all the facts later. So let me get your thoughts on the other pieces that are starting to flow into the market, right? Like the ICHRAs and some of these other options for just blowing up the plans altogether. That I know this definitely, like, no good agent or broker wants to hear me talking about, like, hey, listen, I recommend folks blowing up plans at this point. But— and that's not— I don't recommend that to everybody, carte blanche. Obviously, it's highly situational. But talk to us a little bit about some of these other things that are coming into the market and putting yet another wrinkle into how we provide group benefits for our employees.

Yeah, absolutely. So, I mean, ICHRA, the genesis of it started, you know, with just HRAs funding premiums, you know, and companies kind of coming up from the ground and just saying, just give an allowance, you know. And then it became more, more systematic. And then, you know, the law changed. And then now you have this thing called the ICHRA, which for the first time, at least to my knowledge, it was approved as of, you know, January 2020. So I mean, it's a relatively new structure. You know, I've been charged with the task of kind of researching it. And there's several different vendors, right? And it's just, if you talk about simplicity, a lot of times the ICHRA is more complicated than even buying a level-funded plan because you have layers, right? But it could have a place, right? I mean, if you have a subsidy-eligible population, right, and they're able to kind of make use of those marketplace subsidies, then that's a good, good thing to look at and research, right? If it's, again, a population that's more or less young and healthy, no pre-ex, and they're okay with cost sharing, I mean, that could be a way to, again, stabilize premiums for a small group that otherwise doesn't have options. You know, so it comes down to the client. I mean, a lot of times, like me personally, I'm just able to do such a good job of controlling costs on the self-funded side. That's not to pat myself on the back, it's just knowing where to look and knowing how to do the process that the premiums are, you know, the same or lower than doing the ICHRA. Once you stack in the minimum central coverage and then maybe the buy-up and then maybe the cost-sharing or ACA plan in the end, it ends up costing about the same. It's just kind of turnkey, like one thing to talk about instead of several. So I don't know, I should do a deeper study on that, but that's I've only been charged to look at it once. And since it's so new, it's like, again, you talk about like the trusted old easy button solution. Like, we don't have to talk about this, we're just buying a national carrier plan. Like, but if you want to look at the ICHRA, it's certainly, you know, for some population it makes a lot of sense, and for others it's— they would rather just want easy, you know, to your point.

Yeah. And here's my fear with the ICHRA, and this will probably put me on some blacklist, I'm not sure, but, but my My fear is that there's not enough money in it for the agents. So therefore, the people that need it will not get exposed to it properly. And that is a very common problem in this industry is that there's just like, wherever my commission is, is where I'm going to make suggestions. Right? And so, and that's not a reflection on you. I know your situation is very different. That's a reflection on the industry. And it's certainly, you know, we watch it from the highest levels of folks on through until then it's like, okay, wait, "Oh, Blue started assigning more commission to the ICHRA? Oh, well then the ICHRA is the greatest product that we've got for these smog." And it's been funny to watch that shift since January 2020. And once again, I apologize to any of my friends who are listening to this that may take offense to that statement. But, you know, we're in a very unique situation in that I mentioned earlier. I mean, we're a licensed agency, but I don't perpetuate to anyone that I'm a benefits strategist. If you come to us and you want benefits through us, it's typically like, "Hey, you've got existing plans. We're trying to make the plans look as much like those plans as possible because those are where you want to stay." or it's an agent of record because administratively you want better support, you want better software, you want a better experience for your employees, one throat to choke, all that good stuff. So I would never come to anyone and say, I'm the Nico of Columbia, South Carolina, and I'm going to help you to design this crazy strategic level-funded plan that's going to, you know, blow up your old model, but I will make your life easier. And, but my concern as a small business owner myself is when I see plans like this and I go, Dang. And to your point, there are a lot of things wrong with the ICHRA plan, and it is, it is definitely a situational play. But, and they certainly are starting to see more traction there. But I always worry about things like that until there's enough commission assigned to them, do they get the exposure they need with the right audiences?

And it's kind of, I mean, it's like, it's crazy because it exists at the highest levels. It's like you hear about like crazy things like, you know, doctors doing surgeries that weren't recommended just because they get paid. And it's like, that's like the ultimately extreme, like, you know, industry-relevant example that I just throw out there. But I mean, it happens and you see like people are defrauding Medicare, you know, they're prescribing things to seniors that they don't need or they're doing things and it's just like it, you know, money does, it shapes decisions and decision-making and it's sad, but it does. I mean, it's just a fact of life. Like it's been going on forever. Right. But yeah, it's, it's one of those things where it does play into the conversation. And, you know, again, like some people just want the easy, some people want innovative and it's It's about the client, right? I mean, it just depends like where they want to fall. Like you might have someone that wants to say, again, we have a ton of money. Like we just got a VC funding round. Like we're totally good. Like we just got $15 million and we're 10 people. Like we'll just continue to overpay for health insurance because our time is better spent not thinking about it. And you find that especially in, you know, Charleston area where I lived for a number of years and where we met, you know, it's the Silicon Harbor, right? Like a lot of times there's not the impetus to look. Right? But then over here, you have a manufacturer who's like, we really need to control costs.

Like, we want to ditch the network altogether.

Like, we want to carve specialty drugs off the plan. You know, we want to have advocacy so people know how to use this thing because it's really complicated. You know, and so you get both ends of the spectrum, and you just have to meet the client where they are and say, what's your long-term plan? At least have a plan, not let's just shop it every 12 months, because that's, you know, to what other degree— I mean, what other area of your business do you do that? It's like just health insurance. It's like, let's just see where we are in a year.

Yeah, it's, uh, it's quite an interesting industry. I often joke about like, you know, how did we end up here? How am I working in, you know, part of that big nasty machine that is the healthcare industry? To your point, I mean, we were just on a call last week about KPIs, wonderful educational session. There was a, uh, a former doctor on the call who was talking about, you know, Hey, look, I'm really skittish around KPIs because I've watched too many people get prescribed medications based on KPIs of how much we needed to prescribe of this particular medication to reach our quota. And not necessarily so. So think about that, people, when you're sitting there and they're recommending a drug to you, is trying to understand, is this the right drug for me? Is this my real problem? Do I really need drugs anyways? I know that's— I'm going to go off into so many rabbit holes, man. Like the— yeah, this, this was the episode the Burning Bridges episode of HR Simplified. We're going to notice a steep fall-off in listenership after today. But, um, so, so yeah, I'll get it back on the rails here. So tell us a little bit about— so you've talked about, we talked about earlier, like, one of the things I've always been really impressed with you about is like, hey, it's cool, there's a million agents doing the normal, but Nico is trying to find some unique and innovative ways and alternatives and trying to educate people on what these other alternatives are. So why don't you explain to us a little bit about what you do and how you do that?

Sure. Yeah. So I mean, obviously I have a retail side of the house. I mean, that's kind of my 13 years of experience. Like, I looked at more than 1,000 benefits renewals, like really well-versed in underwriting and vendor selection, building plans, the rest. So I have that kind of retail book where just, just like you, I have a book of business that I service directly, right? I kind of realized that that was a limited, limited availability skill set, if you will. You know, not that many people spend the time going down all those rabbit holes, and each one is so, so deep. Like, how do you control healthcare costs? Like, you could talk to 15 different people and get 15 different answers, right? So I just realized that I like building plans. I like helping employers. It's hard to get an employer to divorce or fire their broker because, like me, I mean, like you, like, we're all friendly people, right? It's like we're not doing anything wrong or bad inherently. So I thought that it would be good to work with brokers. Right? So I actually started a general agency model where I help people, you know, like us, self-fund. Like, to answer your questions earlier, like, where do you start to look? It's like, well, talk to someone like me, you know? And I'm not gonna, you know, make this commercial, but it's like, talk to someone who's done it, right? Who's done it ad nauseam, year and year over for the same clients, and they've seen that this strategy works, right? So I build plans with brokers for their end-user clients. And I do so as a GA. And that's been really fun, you know, because it's rewarding. I'm helping people. There's no hard feelings for someone getting fired because the broker just didn't know how to do this process. And so that's— it's something I'm really interested in because it's collaborative. And again, it's not as contentious as saying like, hey, you're having problems, or convince someone that they have problems, which sometimes you have to do. It's like, hey, you're getting 15% a year increase. Like, that's not good.. And they're like, oh, I thought that was normal. And it's like, well, let's start from square one. Like, paying more for something every year is not good. Um, but anyway, I mean, you have to have those conversations. It's crazy. But, uh, you know, if that client had a broker that, you know, knew to contact someone like me or someone that wanted to help, or an outside, you know, party that could do something like this with them to help their company, then, you know, we can all play in the sandbox together. And that's, that's what gets me excited, right? Because it's like anything that you can scale idea-wise to help more people than you can on your own is a good idea. Right? So trying to be bigger than myself over here, obviously. That's awesome.

And we'll talk more about intermittent fasting later, but the, um, all right. So, so this one might be tricky to think about because anytime we've got these social constructs and anchors in our mind and all the norms and the experience that we have, it makes it hard to think in this respect, but blow you blow up the whole system and you've got the opportunity to start from scratch and, and help create the healthcare system for businesses and how they go about purchasing and acquiring the right— I don't even want to say plans because then I'm creating an additional construct there— the right way for their people to stay well and stay healthy and get treatment when they're not well and they're not healthy. How— where would you start with that? What would that look like for you if you could just wave your magic wand over the whole thing and start it over?

It'd probably be more of like a David Goldhill magic wand. Cause I read a book. I mean, like I've done so many times, the people that have done it better or thought about it critically before that I really respect and admire. So essentially what, you know, the model in his book, but I think it's called Catastrophic Care, but I could be wrong. Um, but people can look it up, you know, basically to decouple, you know, the employers from the equation. I'm not saying that I'm advocating, you know, that to happen, But, you know, just, just presumably speaking, everybody has a $50,000 deductible and it's a lifetime deductible, and once they meet $50K, then they're done, right, in terms of out-of-pocket costs. So what that would end up doing is everybody would pay way, way less for insurance, right? And then to open up the HSA laws where people can fund more money, right? So like me and you, like, maybe we have nothing go on until we're 23 and then we finally have a medical event, right? Because we're just super cautious with ourselves. We play sports, but we're careful. Like, whatever. That's actually my story. But still, you know, if I was able to amass, you know, $50-some-odd thousand of pre-tax, you know, tax-advantaged dollars into an HSA, then I become a consumer, right? Like, I'm not gonna go get a surgery that's overly expensive if I can get one in another place that's the same thing or higher quality result even for less money. So like, a construct like that would improve the way people seek out care. And because the cost of care is what drives premiums, and, you know, it really kind of serves a lot of different purposes, right? So there could be a strategy in which, you know, you can take your policy with you, or the employer can pay some of that premium for you. There'd still have to be social programs where someone's born with an illness, or someone has a chronic condition that's kind of not lifestyle related. Let's just say it's genetic, and they're going to need more, more care. You know, there have to be some sort of, you know, level of government intervention or, you know, state intervention to kind of give them Medicaid, Medicare-like options, or like a VA-type clinic situation. But what that would look like, I'm not sure. But I know that having a super high lifetime deductible would do a lot of things, right? Like reduce insurance premiums tremendously, like encourage consumerism because it's your money, like you'd have to save for your own healthcare. And you wouldn't have the problems of, you know, $2,000 a month family premium, just like your auto insurance, probably like $100 or $200 a car, like a month. And it's like, it's because it doesn't pay for oil changes and gas, you know, and all these miscellaneous things that you just know, like, all right, have a cracked windshield, like probably not covered. Like, I need to pay for that. It stinks, but my insurance is not going to be $300 a year or $300 a month, excuse me, next year because they paid for my windshield, right, or my tires. So anyway, that would— it would kill a lot of birds with one stone. Like, logistically, what it would look like, you'd still need administrators, you'd still need some sort of policy definitions, you'd still need someone to take on some of the risk on the stop-loss side. You'd still have to have consumer advocate programs, you know, to tell people where to go. Like, hey, how do you find the best place to go for XYZ surgery or XYZ drug that you need to get? And those solutions exist now. Um, so I feel like there'd be a change, right? Changing of the guard. It's like you'd have more people in that consumerism, you know, creating value by increasing people's level of knowledge with how to spend their own healthcare dollars. And then you'd have a decrease in a lot of the administrative costs. Like a lot of the carriers would just go bye, right? Um, but everybody would be presumably saving money because they're buying way, way less insurance.

It's interesting because as you're speaking, I'm just thinking about like how anchored the existing constructs are into our brains in that it immediately creates this sort of like, whoa, like everybody agrees that healthcare needs to be changed and fixed, but every unique solution proposed, first of all, elicits some political response, right? Like, oh, hey, what, you know, does that, oh, is that socialism? Ooh, is that this? Oh, is that that? Oh, like My political party disagrees with that, or my political party is aligned with that, whatever. So put that stuff aside, y'all, everybody listening in, and think about what is best for me, my health, what is best for my employees and their health and their families, and what can we do to actually better serve them and put the best plans in place. And when I say plans, I'm referring more to actual strategies in place to help them be a better person and a more healthy person, because more healthy people are going to produce for you at higher levels. They're going to be more engaged. You're going to keep them longer. They're going to have a higher level of faith and just be with your organization longer. And so all these things pay dividends. And I just think that too often people don't, and obviously we don't have the option to go into your fantasy world here, but there are options out there that are not the traditional. And I think that too often people kind of, you know, wave them aside and say, oh well, that's just not the way it's done, so I'm not going to do that.

Yeah, I mean, we say that, but at the same time, like, just think about the model, the $50,000 deductible. It's like, appreciably, how is it that much different to just say, like, let's just do an HSA? Like, let's find, like, the lowest cost HSA option out there, fully insured or self-funded. Like, I'm not picking on either side of the house at this point, but, like, self-funded has the more strategic benefit long-term financially if you can control your claims, because you get a dividend back and and, you know, all the rest, but just have an HSA, you know, fund it for your staff, buy the tools that allow them to be a healthcare consumer. And then like you just shrunk that model down to each employer. Like that could be a 2-life employer, you know, that could be any number of employee size employer, like just buy the HSA, fund it, give them the tools to use it. And you are going to pay less, you know, for healthcare costs.

Yeah. I promised we would come back to intermittent fasting because it came up once with, you said some dude who you talked to the other day who you haven't talked to in forever was like, aren't you the guy who's into intermittent fasting? And then as I was preparing, I was looking at your LinkedIn profile. You make reference to your unique dietary habits. So here's your opportunity to pitch all of us on why IF might be a good solution for us, Nico.

Okay. So I thought it was insane when I first heard about it.

I was like, don't eat for 16 hours?

Like who, what? Like I grab a peanut, you know, every time I'm in the kitchen or whatever, like I'll eat something. I don't know. I love it. I mean, I've been doing it for close to 3 years. I started with a 16:8, which is, to tie in pop culture, that's what some movie stars do to control their weight, right? Like The Rock, like Hugh Jackman, several actors to get in shape for roles have used intermittent fasting as part of their regimen, right? Along with diet and exercise. But simply just not eating. I mean, where's your calorie— where are your calories going to come from? Like, from your fat stores? Do you have them? Right, to get energy to your body. So I mean, I'm not going to get too scientific about it, but like, if you're trying to lose weight and you're always eating, your body's going to use that first, right? If you're trying to maintain weight, like, same deal. Like, if you're eating all the time, then, you know, you're fighting an uphill battle. Where if you don't eat, like what I do now, is, um, I was at like a 23, 22-hour fast where I literally would just have water and coffee. I'd exercise in the morning when I woke up. I'd have my meal like dinner time with the family, like 5:30, right? So I just wouldn't eat lunch or breakfast and it wasn't that big of a deal. Now I'm more to like a 20-hour window where, you know, the kids get home, like I'll have dinner and then I'll have like a little bit of a snack. I'm watching Netflix with the wife on the couch, you know, so I'm not as maniacal as I used to be, but I'll tell you, man, by the end of the fasting period, like mentally I'm sharper, you know, like I'm physically hungry and like that elicits a physiological response to go find food. But if you know, in modern society, I can just go to the kitchen and like, I can just find food. Like, I just drive that energy elsewhere, right? Like into my work and into conversations I'm having, into maybe critical thought, like into just doing whatever I'm doing at the time. So you get that, like you're in like a starvation mode to a certain sense, and you just have to harness that energy. So like, it's not just that I like to not eat. Like, I do think it's like kind of cool, right? It's like Yeah, I cannot eat for like 20 hours. Like, can you do that? So they get a little bit of like slap, you know, humor involved. But mostly it's just the way I feel. And like, I'm super productive. I don't do it on the weekends anymore. I was doing it like 7 days a week. And I was like, I like a lox bagel every once in a while. It's like, I like having lunch, you know, with my family, going to a place, having a picnic. And, you know, so anyway, I'm not a maniac anymore about it, but I still do it like every, every weekday. It's definitely different, I'll give you that.

I love it, I love it. I like anything different. And I think too many people just need to also hear it's okay to be hungry every now and then, y'all. All right, well, I'm gonna leave on that. Once again, probably be the episode, maybe the last episode. I don't know, it might get canceled after this one. The audience entirely, all, all our talk They're like, yo, so this guy's telling us we need to get off these plans, get on these, forget about that, stop eating. Like, what is happening here?

Yeah, miserable.

Come on, what just happened? Well, I mean, listen, both of our listeners will enjoy this conversation either way. Um, Nico, where can people find you?

So best place is, uh, you know, LinkedIn. Let me spell the last name, probably gonna put it somewhere and show it.

I'll put it in the show notes.

So on LinkedIn, find me. And then depending upon who you are, you know, I'm a I'm a retail broker, but I'm also a GA. So if you're a broker, reach out to me, you know, on LinkedIn. I'll triage you into the right way of contacting me. Um, if you're a client interested in learning more about some of these strategies, obviously you can reach me directly as well. So I'm all over that LinkedIn thing.

Awesome, man. Well, I appreciate your time so much.

Thank you for spending some of it with us today. Thanks for having me on.