Thursday, June 6, 2024

Employers & Employees: Stop Buying So Much Insurance!

The insurance industry is massive, powerful, and 100% designed to win every single time. Commissions on some items you buy are more than 50%. YOU DON'T NEED ALL OF THAT!

Tuesday, June 4, 2024

Bad Drugs - Pharmacy Prices Are Killing Employers

Rx Costs have increased 500% since 2000; kickbacks now account for one-third of all spending on pharmaceuticals. What is an employer to do?


Monday, June 3, 2024

Surround Yourself with Your Weakness

 To give yourself the best opportunity for career success, surround yourself with your weakness.

Sunday, May 12, 2024

How Do You Pay Your Reference-Based Repricer?

When engaging in Reference-Based Pricing on your employer health plan, there are several different ways you can pay that repricer: per employee per month, a percentage of billed charges, a percentage of savings, or a flat fee. Which one or ones are best, and why?

Wednesday, May 8, 2024

Fleecing Employers - Health Insurer Overrides

What are health insurer overrides?  What do they mean for employers and employees?  How do you know where they are most likely to lurk?  

I've uncovered a new nugget of insider intel on this one - insurance brokerages are turning the volume up to 11 on their insatiable longing for these hidden payments.


Friday, March 22, 2024

I’m Coming Home

Today, with the greatest sense of professional pride I’ve ever had, I announce that I’ve come home to where I belong and where I will finish my career.  I’ve been in benefits full-time for 22 years (32 years if you add part-time work after high school, during college, and in law school).  Since 2002, I forged unimaginably rewarding and life-changing bonds with clients, teammates, and vendor partners.

Unfortunately, also during that time, the underlying businesses housing my team’s efforts were sold.  Each time, this corporate shuffling resulted in a larger, more bureaucratic, and an entity less aligned with our values.  Liberty Benefit sold to BB&T, which then merged with Sun Trust to form Truist and rebrand and reshape their hundreds of insurance agencies as McGriff. 

Culturally, philosophically, and at the deepest levels of intrinsic motivation, these entities became further and further removed from my mission and purpose:

To provide businesses with the most cost-effective, innovative, and high-quality employee benefit plans while simultaneously helping them manage their risk and compliance and treating every dollar as though it is the last an employee can afford to pay for care.

I wrote that in 2004, and it has been my North Star ever since.  Regrettably, often the larger an organization grows, the further it removes itself from such a mission.  Stock prices, shareholder demands, quarterly growth, EBITA, and a pursuit of new sales at all costs are not conducive to making sure each client continues to receive exactly what it needs – even if they were last year’s sale. 

So, after watching changes that did not align with my business values take over and then seeing private equity swoop in, 2023 became a year of endless introspection, prayer, and discussion with my wife. Something had to change. 

With a heart full of pride, energy, and vigor, I announce today that I am the newest member of the Mahoney Group, a privately held and employee-owned organization with no interest in Wall Street’s stock prices or private equity.  As I restart my career at 50 years old, I am now brimming with joy. 

I used to think I wanted to retire between 50 and 55.  Now, I chuckle at that assessment. The kids are grown and on their own.  My youthful exuberance to hunt, fish, bike, and backpack is still there, but only as a hobby—not an all-consuming addiction.

No. I know where I can make the biggest impact, and that is by providing businesses with the most cost-effective, innovative, and high-quality employee benefit plans while simultaneously helping them manage their risk and compliance and treating every dollar as though it is the last one an employee can afford to pay for care. 

In so doing, my new teammates at the Mahoney Group and I will fight doggedly to ensure you are not being taken advantage of by a deeply flawed healthcare delivery system. 

On we march! 

Craig Gottwals

Wednesday, December 20, 2023

On Armstrong and Getty for a Couple Hours This Morning

7 AM Hour - Just a Wee Bit Less Dynamic: features our guest, Craig, the Obamacare Guru, who joins Jack to discuss...

  • The escalation of Christmas...
  • The Trump/Colorado ruling...
  • Jack's confrontation conundrum...
  • Immigration...
  • Those magical family moments! 

8 AM Hour - Just Eat Your Cotton Candy! features Craig, the Obamacare Expert, who joins Jack to discuss...

  • The Trump/Colorado decision...
  • Weight Loss Drugs...
  • The Ukraine/Russia War.
  • Expert military analyst Mike Lyons joins the show to talk about the Israel/Hamas war.


Friday, September 15, 2023

Healthcare's Final Frontier: Navigating the Wild West of RBP with Industry Renegades

Omar Arif of ClaimDOC & Scott Schnaidt of HST on All Things RBP

Ever imagine healthcare could feel like the Wild West? Welcome to the untamed lands of Reference-Based Pricing (RBP), the sizzling frontier where a select few employers unleash radical savings while giving the traditional PPO system a stiff arm.

Unveil a world where only 3-4% of employers dare to tread, but where jaw-dropping 30-40% savings rain like gold and concierge-level service is the sheriff in town.

Curious about RBP's magic? This isn't just healthcare. It's "Health-FAIR!" Here, employers "price-match" medical costs against benchmark prices, slicing their claims in half compared to big insurers.

Projections say employer healthcare costs will shoot up another 7-9% in 2024. Yet Medicare Part D Premiums are projected to decrease by 1.8%. All major insurers participate in both markets. The lesson? Employers with private insurance are subsidizing Medicare. But hold your horses. With RBP, brace yourself for a 0-2% trend that turns the tables on traditional care.

Jump into this roller-coaster ride of a podcast with your guide through this maze, joined by two titans of the trade—Omar Arif of ClaimDOC & Scott Schnaidt of HST. They've both cracked the code, each in their unique ways, and the results? Nothing short of spellbinding.

🎯 What's on Tap:
  • The gears and levers behind RBP
  • Navigating the legal minefields
  • Secrets from Third-Party Administrators (TPAs)
  • RBP's performance across the geographical board
  • The art of handling balance bill claims
  • Litigation: When & How Often
  • Co-fiduciaries: The real deal or just smoke and mirrors?
  • Show Me the Money: Their pay structure dissected
  • Year-end Report Cards: The Good, the Bad, and the Profitable
And just when you think it couldn’t get any cooler—did one of these guys actually play pro baseball in a global tourney, while the other rocked the stage with NIRVANA? 🎸⚾

Lock in your earbuds. Prepare for a mind-bending journey. You’re entering "The Repricers"—Healthcare’s Final Frontier! 🌌🛸