The Single Most Powerful Health Plan Cost Containment Tool Just Got a Lot Easier!

News of this began about a year ago, and it is now a reality: Employers have a massive new tool to control healthcare costs.

Just Keep Fighting - Hard Work Eventually Wins

 

How to Become an HR Superhero

With over 15 years of teaching benefits and human resources at the university level, coupled with exclusive experience in working alongside C-Suite executives to implement and manage highly efficient benefit plans, I have a crucial piece of advice for any HR professional looking to be seen, appreciated, and impactful in their career.

 

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!

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?

  

Surround Yourself with Your Weakness

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

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?

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.

 

5 Reasons You've Never Heard of Reference-Based Pricing

 

What is Reference-Based Pricing and What Can It Do for Employers?

 

PODCAST - Healthcare Pricing on Trial: The Case for Reference-Based Pricing

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

How Big Pharma and Insurance Work, From Insider Brigham Buhler