Episode Transcript
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Speaker 1 (00:04):
Happy Sunday Folks. Is Brian Thomas Hosi the fifty five
Care some morning shure during the week anyway, but on
Sundays I get to talk with John Rohlman and about
medical insurance cover since he is the name of the
company he owns and operates, so works with hundreds of
insurance companies, thousands of different policies, and learned a lot
over the years talking with John about medical insurance and
(00:25):
how John will take care of you as a client
walking through and explaining insurance. You know, he's got access
to all these insurance policies. He's going to make sure
that you don't have any pitfalls that a lot of
people will fall into, like ending up with a two
hundred and fifty thousand dollars medical bill that you can't
pay for because you bought a policy that doesn't cover
it even though you thought you had medical coverage. There's
(00:46):
so many different ways to get medical insurance coverage, including
saving money. Is what you're paying in premium now you
may think is a good value. When John looks at
you personally and analyzes what you have versus what's out there,
you may find out that you don't have the best
out there and you are exposed in many different ways.
(01:07):
John has another edition of Rethink Healthcare Together. Number to
get in touch with John, and you want to do
it or his team members. Don't forget you don't have
to work directly with John. He's got a well oiled
machine over at the outfit. It's five one three eight
hundred two two five five. That's five one three eight
hundred call or coversincy dot com as a form online
you can fill out to get the process started. And
(01:27):
it sounds like it's just the greater Cincinnati area, but
if you're listening in another state, he can handle you nationwide.
Uh and so no problems there, So take advantage of it.
There's no obligation to you. You don't have to pay
for him to do this analysis, and you may find
out you are in a far better place, not just
from coverage but also financially. John.
Speaker 2 (01:46):
It's always a pleasure talking with you, you see, Brian, good morning.
Speaker 1 (01:49):
Today we're going to be focusing on business owners and
we've got a new terminy to know about IKRA. What's
IKRA and how does this impact well, maybe your small
to medium sized businesses, say like folks with between five
and one hundred employees.
Speaker 2 (02:04):
Well there's there's when we'll talk about those each individually.
So ICRO of course stands for individual.
Speaker 1 (02:11):
Coverage do you mean, of course, I don't know what
it means.
Speaker 2 (02:14):
I will be talking about it, right but individual coverage
Health reimbursement arrangement so basically an HR health reimbursement account,
and these are starting to get a big.
Speaker 1 (02:28):
Popular, very popular.
Speaker 2 (02:30):
There's a lot of motivation behind these right now for
a lot of employers just because they're getting destroyed by
group health insurance. Right So, if you're listening today, even
if you're an employee of a larger group, it's it's
something that you know, if you know the HR director,
you're something that started looking at PROD.
Speaker 1 (02:51):
To them to get in touch with jobs.
Speaker 2 (02:53):
Yeah, I mean it's because listen, the the AICAR scenario
can really save a lot of these larger groups a
lot of money, you know, and on top of that,
it can really help the employee as well, because you know,
we see so many scenarios right now where a lot
of employers that offer group health insurance can't even afford
(03:17):
to provide any type of subsidy towards the spouses and children,
they can't do it. They just they're like, hey, we're
getting creamed that a thousand bucks a month for one employee.
I can't afford to pay for your wife or your
kids either, So if you want to be on this plan,
you've got to pay for it. If you're in that
kind of situation. It's a fantastic conversation that we can
start having because these are literally the groups that we're
(03:38):
helping out the most. If you're working for like Major
Fortune five hundred companies, you know, these aren't for them
their self insuring anyway exactly, you know, but you know
these are really for the harder working business owners, right.
You know, we're I'm a business owner. We're approaching close
to twenty employees, you know, and I'm always looking for
different scenarios and we help help so many small businesses
(04:02):
in the greater Cincinnati area. I've helped so many businesses nationally.
You know, we actually just helped a group of thirty
employees out in California.
Speaker 1 (04:10):
You know.
Speaker 2 (04:11):
I mean it's you know, we're we're doing this all
across the map through different scenarios. But you know, kras
are one of those really unique things that a lot
of people aren't aware of. There's some really good information
out there. We've partnered up with some really good, very
smarter than me people that can help on this side
to even set these type of accounts up. But basically,
(04:32):
what a NIKRA does it enables an employer to basically
set set aside a lumpsom amount of money per month
or per year for each of their employees. And typically
it's a lot less expensive than what they're paying for
the actual health insurance. That money is in that pool,
and then the employee can utilize that money for two things.
They can use it to buy their own health insurance
(04:55):
on their own right, get their own plan. You can
choose your plan through you, you can choose through me. Right,
We'll sit down with you individually and pick your plan.
Speaker 1 (05:02):
Right.
Speaker 2 (05:03):
The other thing too, the icker can do is if
there's money left over after you pick your plan, you
can utilize that money to help cover out of pocket expenses.
Speaker 1 (05:12):
Yeah.
Speaker 2 (05:13):
Yeah, So the nice thing for the employer you can
kind of set the stage with what he wants to pay.
You know, of course there's minimums and we would talk
about that that they have to provide. You just can't
go I want to do anichroat fifty bucks a month
for each employee, it's not gonna work. Well, fifty buck
go very far, not gonna go very far. You might
be able to cover the dental plan. But yeah, so
it's it's a unique situation. But there's two things that
(05:33):
really kind of happen here. It helps alleviate the huge
costs increases each year for employers, especially if you're an
employer that has seen significant increases in premiums due to
maybe claims of your group. That's a huge thing that
most people don't really understand with group health insurance, Like, hey,
I got a really good deal. I'm moving from X
(05:55):
insurance company to another insurance company. There I'm saving twenty percent.
Well I had two employees this year that just had
major claims. Well, now my rates are going up forty
five percent, right, So the AKRA and the nice thing
about that it can kind of keep us more at
a level playing field with the coverages that are out
there as a whole. Of course, it also lets me
(06:15):
help your employees that maybe be in that situation be
in groups of people that are hundreds of thousands of people,
so you're not going to see those huge swings in
premiums year to year.
Speaker 1 (06:28):
So the individual employee takes the money from akra goes
out into the world through you finds a plan that's appropriate,
and that person may be part of a giant risk
pool that direct keeps things flat, so they're personally not
going to experience these wide, you know, increases in premium
because they personally had a large health.
Speaker 2 (06:45):
Insurance Erectly, they're gonna see the same thing as the
rest of the market. Right, So that's that's a that's
a big, big, big benefit. You know where we see
EKRA is really working right now. Number one, I'm looking
at this for more of those fifty plus employees because
you know, they're they're have the mandate they have to
provide coverage, so that's going to be a big thing
for them.
Speaker 1 (07:06):
Uh you know, if.
Speaker 2 (07:07):
You're if you're under fifty, it's typically not going to
be a phenomenal scenario because the biggest problem with doing
an EKER is those employees can't qualify for tax credits.
So we have seen this kind of scenario played out.
Give you an example, like we've been helping a lot
of retire police and firefighters, So there's a there's a
there's a basically a thing when they're they're provided this
(07:29):
ekra hr a program. When they retire and they're not
yes sixty five, they basically don't want them on the
group plan anymore with the firefighters and policemen, so they
give them money and go, hey, you need to go
and find your own plan. The problem is a lot
of these individuals have lower incomes at that point because
they're retired, they can't qualify for tax credits, so we
actually it ends up costing them more money sometimes well.
Speaker 1 (07:53):
It would get a finer point on the middle qualify
for tax credits, because last week we talked about that
cap sixty four thousand dollars and if you made a
dollar more than that then you weren't eligible for the
tax credit. So by virtue of being in an incra
vehicle getting money from the employer or in the case
of police and fire, your prior employer, but you're entitled
(08:14):
to the moon, that takes you out of the realm.
So you couldn't go to the marketplace and get an
Obamacare plan and then be eligible for a tax credit.
Speaker 2 (08:21):
You can go get the plan, you wouldn't be able
to get the tax credit, right because the HDHRA actually
wipes away the tax credit. You can't double dip the
system how the federal government looks at it. So yeah,
so it is a unique situation. So again that's something
we would have to look at to make sure. You know,
that's why I say it doesn't always work the best
for employers over under fifty. But again, you're absolutely hit
(08:44):
the nail on the head. I mean, what if this
does go away, like I've talked about last week, right,
so we're going to see a lot more people that
probably aren't going to get tax credits. So even these
employees that you're doing in HRA, they might even even
get tax credits anyway because their income might be over
that threshold. So that's why the Chris might even be
people better at the end of this year or two.
(09:05):
So it does kind of give us a unique scenario
where this might be the best thing here at the
end of this year, regardless of where they're at. And
it just like I said, it opens up the door
to more options. I love when employees have options, right,
I mean, when if you have thirty employees that all
have different doctors, I mean, what the worst thing you
can do as an employer is going. I'm changing from
(09:25):
exit insurance coming to Z Well, twenty percent of my
employees just lost their primary care because they're not in
network with the new plan that I'm going in. So
it does give you a lot more flexibility in that
realm and it can help out, you know, tremendously.
Speaker 1 (09:38):
So what kind of money are you talking about per employee?
I mean, I'm not being an employer, and I don't
I have no idea how much you would have to
allocate you So you can't just throw fifty bucks ahead. Yeah.
Speaker 2 (09:50):
So basically it's based upon where where your company's at,
and it typically has to be the price of the
cheapest silver plan in your area based upon the age range.
So again that's there's a calculation that we do. But
typically what we're seeing is somewhere between thirty to forty
(10:11):
percent cheaper than what you see on the traditional group side.
Oh really, typically consistently. Yeah, So again it's it's huge savings.
Speaker 1 (10:18):
You know.
Speaker 2 (10:18):
I think maybe one or two times we ran into
it wasn't as much of a savings just because of
their health pool. But yeah, for the most part, I mean,
you can probably hang your hat on twenty to twenty
five percent across the board.
Speaker 1 (10:30):
All right, And even with that savings to the employer,
the IKRA, I'll say, contribution or allocation is sufficient for
that employee to go out like talk to you.
Speaker 2 (10:42):
Absolutely, absolutely, yeah, I mean especially if you know, like
I said, it has to be based upon the cheapest
silver plan. So you know, a lot of people don't
really need a silver bronz you know, gold plan or
Platinum plan. A lot of them pick the bronze plans,
you know, which are usually just as good, and I'm
maybe have a little bit higher reductible, but that money
(11:03):
can be really utilized to help offset that cost almost tremendously.
So we we do see a lot of times on
the employee side that their contributions of what they're paying
towards their health insurance drastically goes down. So it's saving
your employees money too, fair enough. So I'll give you
an example. I'll just give you one that I mean,
I think it makes numbers make the most sense, right,
So we just did a group and they were paying
(11:23):
almost I think the average price for each employee was
close to nine hundred bucks a month. I think they
were doing like a seventy thirty split, So I've been
quick math. I mean, I know they were paying over
six hundred bucks a month for each employee. We were
able to do an incro plan for them, and I
think it was like a little over four hundred bucks
a month. So when they saved you know, thirty three percent,
you know for each employee, which one thirty five and
(11:46):
oh they had forty eight, they were close to fifty.
So that's why they really wanted to do because everything
they were to go over the threshold. Yeah, I mean,
it's a tremendous savings for him, a two hundred bucks
ahead almost fifty employees.
Speaker 1 (11:57):
So wow. Yeah, and so would that four hundred there's.
Speaker 2 (12:01):
One hundred and twenty thousand dollars year of savings in premium.
Speaker 1 (12:04):
But that's still adequate enough for the employee to get. Yeah,
really good coverage. This is what I'm trying to get.
Speaker 2 (12:10):
Yeah, really really good coverage. Yeah, I mean, and they
were paying less, So I mean, the employee was probably
paying two or three hundred bucks a month and then
now they were paying like one hundred and fifty on
average what they're paying out of pocket on their premium.
Speaker 1 (12:23):
That fact alone is really rather excuse me, revealing that
you can get good coverage for that low premium.
Speaker 2 (12:30):
Yeah, I mean, because again you're going through the open market.
I mean I said, you're going on the open market.
So the best thing there is just there's just more options,
you know, and and insurance works better with more numbers, right,
Economies of scale comes into play, right if you think
about it on that end, So the more people in
those situations that the better the premiums are. And like
(12:52):
I said, I mean groups in general, unless I'm going
out and just recruiting and hiring everybody out of college,
and my entire risk pool is twenty somethings. I mean,
we're my companies across the board. You know, you get
a group of fifteen that we're at fifteen employees. I mean,
you know, if one of my employees, if I did
a group plan, which I'm not never going to look
(13:12):
at it like I do look at it just for giggles, right,
you know, And if I was to do a group plan,
if one of my employees went in and had a
major accident or god forbid, got diagnosed to the major illness,
I mean, I know, my rates would double. There's no
way I could do that. And then what are gonna
do next year? Turn around, go to my employees and go, sorry,
I can't afford this anymore, like good luck. You know,
(13:33):
we're going to cancel a group plan or go do
something that's less coverage, you know, I mean it just
it doesn't make sense.
Speaker 1 (13:39):
So in practice with your business, you are having your
employees do the same thing that you would do for
a business. Yeah. Absolutely, they're going out and they're getting
whatever plan they choose and whatever options they choose, and
they select themselves the same way you would do for
(14:00):
a group that came in to talk with you.
Speaker 2 (14:02):
Exactly with you, we do exactly the same thing. So
if you're a smaller group, you know, like under fifty employees,
and you know how we traditionally had done it with
a lot of these groups. Look at and see if
the employees qualify or tax credits, you know, look and
see what the employer can pay on their side, which
is typically the section one twenty five we talked about
the indemnity plans, the ancillary coverages. Sometimes letting your employees
(14:23):
buy their own major medical plans through us, you will
help them walk through. It's not like I'm making them
go out and figure it out on their own. Then
that we save them a lot of money that way too.
You know, give me an example, like we just did
a we did a group here of like twelve employees.
You know, most of their employees are making between thirty
and forty grand a year. Most of the employees had families.
(14:44):
Most of the employees' spouses didn't work, right, So I mean, like,
I mean, it was a big chunk. So it's like, wow,
like these guys, even if the tax credits go away,
they're still going to qualify because of their income thresholds
way below that cap, right, So, I mean most of
these employees were able to get health and insurance almost
under one hundred bucks a month for the major medical plan,
and we were gable. We came back in, we did
(15:05):
secondary coverage kind of fill the holes in like we
talk about every time we do this.
Speaker 1 (15:10):
You can afford those extra plans when you're only paying
one hundred bucks for the major Well.
Speaker 2 (15:14):
Yeah, so this is how we do it. This is
this is like literally how we do it. So the
major medical plan we get to pay by the employee,
right because they can't have the employer paid directly for
a tax credited health plan. There's a big fine for that.
So we just go to the employee, go, hey, you're
paying three hundred bucks, four hundred bucks, one thousand bucks
a month because you have a family plan. You're not
going to pay one hundred and fifty. I can't pay
(15:36):
roll to duct that. Can you do the one hundred
and fifty on your own? They're going absolutely.
Speaker 1 (15:41):
Right, they go that.
Speaker 2 (15:42):
So then we go back to the employer and go, okay, well,
now you're no longer providing group health insurance, right, but
you were paying four hundred bucks a month for each employee. Well,
let's take two hundred that or two hundred and fifty,
and let's do secondary coverages to Section one twenty five,
and you provide the voluntary coverages. You pay for it
as a employer. That helps cover all the holes and
(16:02):
the big gaps that the major medical has. So now
they have better coverage. And I'm gonna fix your price
because this price hasn't gone up in ten years, and
it's age band and when they get in so they
get older, it's not gonna go up. So I'm going
to keep your prices in your premiums pretty stable over
in the next hopefully decade and you're providing your employees
a better coverage and I just saved you one hundred
(16:23):
and fifty to two hundred bucks a month per employee.
Speaker 1 (16:25):
That's just amazing and they.
Speaker 2 (16:26):
Have better coverage. And that's what we do. So every
scenario is different. So the nice thing is like, I
feel like I have this huge toolbox of just options,
so it doesn't make a difference how you come to me.
I can do an inkra, I can do individual plans.
I can do plans that are Section one twenty five
for your employees and show you how to do a
better way. But the biggest thing in Brian, just have
(16:47):
that conversation, you know, and then most of the people
that talk to us we help.
Speaker 1 (16:52):
Yeah, and again, I have lots and lots of my
listeners who've taken the recommendation to give you a call
and they get back with me, tell me, I just
cannot believe what he was able to do for me
and the money that I'm saving now because I made
that phone call.
Speaker 2 (17:09):
Yeah, I mean, it's just the thing about it is
always kind of start the conversations with these employers. I'm like, listen,
I'm kind of like the anomaly because I'm not just
a group guy. I mean, most of your group guys
are gonna come in, they're gonna sell group because that's
all they know. I mean, I get guys all the
time to call me and go, hey, I just do
group health insurance and I can never do individual can
Can I work with you guys to do individual covers?
(17:30):
Like absolutely, I'll show you how to do it. I'm
teaching group guys how to do it because they're getting
whacked right now by what we're doing. And then you know,
a lot of the individual guys that are out there,
and I have a lot of agents that are just
one man shows right. They can't. They don't have the
infrastructure to handle groups, right. It's a lot of work.
(17:51):
I have employees that I have an employee, literally my
off of one employee that her entire job is just
making sure that all the groups are okay that we
work with. It's an entire job. We hired one one
that staffer that's her entire thing is she's the group girl.
And you know, anything comes in, she's the one handling
it just for the groups. Because that's I made her
a master of that and she knows exactly what's going on,
(18:13):
how the products work. She's the main person out. Everybody
in the office can kind of help her because we
do get a lot of calls sometimes, but you know,
that's her entire job because I've been able to grow
my business into to a realm where I can support
that because when you're dealing with a thirty five man group,
you know, if I was just a one man show
and I had to make an adjustment.
Speaker 1 (18:33):
Do you know his paperwork that is, No, I don't.
Speaker 2 (18:37):
It's a trumendous amount. It's a tremendous amount. I had
one of my agents, he's been around for like four years,
a very good agent, and he goes, he goes, and
he goes, I broke up a twenty five man group.
I'm like, that's great. How did you help him? Walk
me through the whole scenario?
Speaker 1 (18:51):
Goes.
Speaker 2 (18:51):
It took me a month and a half to do
everything because it was just so much work. I was like,
I understand that. I was like, you have to hire
assistance if you're going to keep doing this, because you
have to be able to support that group moving forward
if they have issues or questions or anything along that line.
And he goes, yeah, yeah, this is this is an
animal and that's why most individual agents don't do it.
So when I say I'm the anomaly, I'm like, I
(19:13):
don't know many people that can do what I do
because because I built the business that way to be
able to support that. So when I go in, I
can go, well, we can do the group side, we
can do the individual side, and you know, seventy percent
of the time, the individual side makes the most sense.
Speaker 1 (19:26):
And that's where you look at each employee. Each employee,
ever employee is different. Every employee is in a different
place in their world. They're different ages, they're different medical conditions,
and different budgets. Different budgets all the employees maybe make different
range in the salary, so you accommodate for each one. Yeah,
that individualized thing that I think that's one of the
coolest elements about what you do. It's you take the
time to actually work with each employee, putting them in
(19:50):
the best possible place. So you know, the guy in
the cube next to you may have a completely different
carrier and a completely different stack of policies because they
wanted extra or they didn't want as much, or whatever
they decided to do based upon the information you provided
them as opposed to we're all covered by company acts.
Choose the HMO or the PPO, right, And that's really
(20:10):
what it comes down to.
Speaker 2 (20:11):
They just say the Copey plan, you know. I mean
that's that's pretty much how most companies operate. And at
the end of the day, it's like it's not a
perfect scenario for every single employee. So it's almost like
they have to choose the lesser of two evils, right.
And you know who's the main person of contact, Well,
it's your HR person. I'm like, you know, nobody small
businesses have an HR person.
Speaker 1 (20:34):
I think they outsource that now.
Speaker 2 (20:36):
I guess they have it through like into it or
something like that.
Speaker 1 (20:39):
I know I hear commercials for like HR services you
can outsource ag.
Speaker 2 (20:44):
Yeah, you get to hope they can answer those questions.
They're not licensed insurance agents. I mean I always tell
people like list when it comes to health insurance, I
literally want you to think about this. I don't want
you to answer one more question about health insurance ever again,
ever again, mister employer, you just to have your employe
calls well.
Speaker 1 (20:59):
And you know it's a funny thing about that. I
got to follow up with most people, I would argue,
couldn't answer a question about health insurance anyway. No, I mean,
what small business owner has time to deal with the
level and depth of knowledge that you have in the
insurance business. You know, they're the ones that are subject
to the door knocker, the guy coming in and saying, hey,
I can ensure your employees for less premium dollars a month.
(21:21):
They end up globbing onto a policy that exposes their
employees in so many ways that we've talked about in
the past.
Speaker 2 (21:26):
It is I mean, and there's not really a huge
savings going from one group to another. You know, what
are you giving up? If you're going to cut cost ten, fifteen,
twenty percent, you're giving up coverage obviously, you know. I
mean they'll all do exactly the same thing. The actuaries
look at your claim history on your group, right, I mean,
they're You're not You can't be sitting here, John, you know,
every year I kind of make it there's something changing
in your plan and it's probably not for the better.
(21:49):
You know, if you're cutting costs, I mean, it's just
not happening from what I've seen.
Speaker 1 (21:53):
Also very confusing to the employees.
Speaker 2 (21:56):
Oh yeah, yeah, and you'd be surprised how many times
I'll talk to an employer and they give me the
information on their plan, and then once they actually send
it over to me, I'm like, that is nothing what
you told me. Yeah, like it doesn't even it's you're
not even the ballpark, but like this isn't exactly what
you had. You've been telling your employees this, because like
I'd be very upset if you walked around and told
all your employees you had twenty five hundred dollars adultable
(22:16):
and you're really signing about seven thousand. And it's just
like I get it, Like that's not your realm. I'm
not a you know, I could even tell you the
first thing about how to do an electric outlet. You know,
I'm not an electrician. It's not my hairy of forte.
So if you're an electrician, if you're a plumber, if
you're a contracting company, you got a demolition compound't care
(22:37):
what it is, that's your forte. That's what you know.
You don't need to no health insurance. You just need
to know you have a guy and you can just
give me a call.
Speaker 1 (22:43):
Yeah, five one three eight hundred two two five one
three eight hundred call absolutely or cover sincy dot com.
Just reach in through the website and fill out the
form there, and you have the other important component. I
cannot I cannot understate the value of this of working
with you in the sense that and I always bring
it up because I think it's so important getting insured
(23:05):
Through cover Sincy and John and his team, you get
to keep them and so you don't ever have to
get on a damn phone call with an insurance company
about some claim that got denied or some confusion you
have over the situation involving your claim, because, man, you
mentioned multiple times how things don't get filed, the doctor
doesn't follow through was sending the claim in the claim
(23:27):
gets mishandled by the insurance company, whatever happens, and then
you're left hold in the bag, at least you think
you are. You get a bit of a bill from
your doctor's office saying you owe seven hundred and fifty
bucks for something. You're like, wait, what happened here? I
thought this had been taken care of. So instead of
calling the insurance company and spending two hours on hold,
they're talking to some guy and punjab he just call
(23:48):
up John and one of his team members will iron
it out.
Speaker 2 (23:51):
I know you have all the.
Speaker 1 (23:53):
Right numbers at the insurance companies. I mean you figured
out who to call and who's going to get to
get the scenario taken care of or at least figured
out now.
Speaker 2 (23:59):
And I get it too. And you know, I do
want to preface this because I know you're You're very
big on our care department. I am too. We put
a lot of time, effort and money and building out
our customer service side so that we can help alleviate
a lot of this frustration. But I will say this too.
I mean, for as good as we are, we are
not Jesus. We're not miracle workers every single time. I
(24:21):
mean it's you know, because we had a client not
too long ago. It was kind of frustrated because you know,
he called in. He's like, I need I are not
a SAP. I'm like, do you have to understand? Like
I have to work with the insurance companies too, and
they are slow, right they are. There's hoops, there's paperwork
that has to get filed. We walk you through it,
(24:42):
but it is a process. There's very few things that
I can do in twenty four hours when it comes
to them. If like, if it's going to take you
a month, it's probably gonna take me at least a week, right,
because again it's we know what we can do. But
again it's like I hate it too, because I mean,
out of one hundred carriers, I get people all the
time going which one's the best one to work? I
(25:03):
was like, they kind of all suck they do? Do
they pay claims? Yes? Is there a process to go through? Absolutely,
they take a.
Speaker 1 (25:15):
Week, as opposed to me going out into the world,
it may take a month, But I don't understand the processes.
The value of you and your team is you understand
the process. You know exactly where to go to. You
know you're going to be dealing with people who suck
or companies get suck on some level or another. But
at least you know who to call. Oh yeah, I
(25:36):
mean I think I pick up the phone and call
some eight hundred number and be put on hold, and.
Speaker 2 (25:39):
Then I can't even tell you how many times I've
had to pick up a phone call and talk to
a vice president overclaim We probably do a weekly.
Speaker 1 (25:47):
You have access to the vice president. How long it
would take me to get in touch with someone like that, and.
Speaker 2 (25:51):
You'd be surprised, like just even how many times it's like,
oh my god, we just had one not too long ago.
It was like literally the claim was filed completely clean,
everything was done the right way, and it just came
back Brian It's like, nope, this this wasn't done. I'm like, no,
I know it's done right. So I literally have to
get on the phone with the vice president and going
(26:11):
like who is this person and claims you need to
go have a talk to them because this is not
your procedure. It goes, no, it's absolutely right. He goes
to me, He goes, you can't make this crap up.
I mean, it's just you hired him, you know, his
his fifth person below him hired that person. You know.
But it's like it happens right. It's you know, any
(26:34):
anytime you talk to and I don't care what company
you call with customer servers or something like that, it's
you know, it could be your TV. You know. It's
like there's always an experience that you're gonna have. We
just try to we just try to make it as
less cumbersome as possible and.
Speaker 1 (26:48):
Work with you.
Speaker 2 (26:49):
But we're there every step of the way. There's never
any point that we're going to be like here you go,
go figure it on your own. It's literally like, hey,
we can take you up to this point and going.
They won't talk to us anymoere because this is hippa.
You need to handle this part, but please keep us
in communication unless in case we need to be involved more,
you know, but we do. We do try to handhold
you as much as possible, and it's I'll tell you
(27:09):
it's it's gotten so much better working on that end.
I mean even in the point where my team is
so good. If I have an issue with Microsoft and
I have I literally just turn go down to my
office and like, hey, this is this show. I'm having
to take care of it.
Speaker 1 (27:23):
That's great because they're getting what are they gonna say, no, no,
it was acting, how to do this? Make the call yourself.
They've actually better. I mean they do it all.
Speaker 2 (27:32):
Day long, so they've gotten so much better than even I.
Speaker 1 (27:34):
Can do it anymore. Cover since dot Com. Let's say
you get in touch with John on the team or
call them up at five one three eight hundred two
two five five five one three eight hundred call It's
worth the time. Trust me on this, Hey, what could happen?
They say you, You're in the best possible place you
can be with your current insurance. That's at least going
to give you a peace of mind considering all the
options that are to John and his team's disposal. This
(27:56):
has been another edition of Rethink Healthcare together with John
Omen from Cover Sensi
Happy Sunday Folks. Is Brian Thomas Hosi the fifty five
Care some morning shure during the week anyway, but on
Sundays I get to talk with John Rohlman and about
medical insurance cover since he is the name of the
company he owns and operates, so works with hundreds of
insurance companies, thousands of different policies, and learned a lot
over the years talking with John about medical insurance and
(00:25):
how John will take care of you as a client
walking through and explaining insurance. You know, he's got access
to all these insurance policies. He's going to make sure
that you don't have any pitfalls that a lot of
people will fall into, like ending up with a two
hundred and fifty thousand dollars medical bill that you can't
pay for because you bought a policy that doesn't cover
it even though you thought you had medical coverage. There's
(00:46):
so many different ways to get medical insurance coverage, including
saving money. Is what you're paying in premium now you
may think is a good value. When John looks at
you personally and analyzes what you have versus what's out there,
you may find out that you don't have the best
out there and you are exposed in many different ways.
(01:07):
John has another edition of Rethink Healthcare Together. Number to
get in touch with John, and you want to do
it or his team members. Don't forget you don't have
to work directly with John. He's got a well oiled
machine over at the outfit. It's five one three eight
hundred two two five five. That's five one three eight
hundred call or coversincy dot com as a form online
you can fill out to get the process started. And
(01:27):
it sounds like it's just the greater Cincinnati area, but
if you're listening in another state, he can handle you nationwide.
Uh and so no problems there, So take advantage of it.
There's no obligation to you. You don't have to pay
for him to do this analysis, and you may find
out you are in a far better place, not just
from coverage but also financially. John.
Speaker 2 (01:46):
It's always a pleasure talking with you, you see, Brian, good morning.
Speaker 1 (01:49):
Today we're going to be focusing on business owners and
we've got a new terminy to know about IKRA. What's
IKRA and how does this impact well, maybe your small
to medium sized businesses, say like folks with between five
and one hundred employees.
Speaker 2 (02:04):
Well there's there's when we'll talk about those each individually.
So ICRO of course stands for individual.
Speaker 1 (02:11):
Coverage do you mean, of course, I don't know what
it means.
Speaker 2 (02:14):
I will be talking about it, right but individual coverage
Health reimbursement arrangement so basically an HR health reimbursement account,
and these are starting to get a big.
Speaker 1 (02:28):
Popular, very popular.
Speaker 2 (02:30):
There's a lot of motivation behind these right now for
a lot of employers just because they're getting destroyed by
group health insurance. Right So, if you're listening today, even
if you're an employee of a larger group, it's it's
something that you know, if you know the HR director,
you're something that started looking at PROD.
Speaker 1 (02:51):
To them to get in touch with jobs.
Speaker 2 (02:53):
Yeah, I mean it's because listen, the the AICAR scenario
can really save a lot of these larger groups a
lot of money, you know, and on top of that,
it can really help the employee as well, because you know,
we see so many scenarios right now where a lot
of employers that offer group health insurance can't even afford
(03:17):
to provide any type of subsidy towards the spouses and children,
they can't do it. They just they're like, hey, we're
getting creamed that a thousand bucks a month for one employee.
I can't afford to pay for your wife or your
kids either, So if you want to be on this plan,
you've got to pay for it. If you're in that
kind of situation. It's a fantastic conversation that we can
start having because these are literally the groups that we're
(03:38):
helping out the most. If you're working for like Major
Fortune five hundred companies, you know, these aren't for them
their self insuring anyway exactly, you know, but you know
these are really for the harder working business owners, right.
You know, we're I'm a business owner. We're approaching close
to twenty employees, you know, and I'm always looking for
different scenarios and we help help so many small businesses
(04:02):
in the greater Cincinnati area. I've helped so many businesses nationally.
You know, we actually just helped a group of thirty
employees out in California.
Speaker 1 (04:10):
You know.
Speaker 2 (04:11):
I mean it's you know, we're we're doing this all
across the map through different scenarios. But you know, kras
are one of those really unique things that a lot
of people aren't aware of. There's some really good information
out there. We've partnered up with some really good, very
smarter than me people that can help on this side
to even set these type of accounts up. But basically,
(04:32):
what a NIKRA does it enables an employer to basically
set set aside a lumpsom amount of money per month
or per year for each of their employees. And typically
it's a lot less expensive than what they're paying for
the actual health insurance. That money is in that pool,
and then the employee can utilize that money for two things.
They can use it to buy their own health insurance
(04:55):
on their own right, get their own plan. You can
choose your plan through you, you can choose through me. Right,
We'll sit down with you individually and pick your plan.
Speaker 1 (05:02):
Right.
Speaker 2 (05:03):
The other thing too, the icker can do is if
there's money left over after you pick your plan, you
can utilize that money to help cover out of pocket expenses.
Speaker 1 (05:12):
Yeah.
Speaker 2 (05:13):
Yeah, So the nice thing for the employer you can
kind of set the stage with what he wants to pay.
You know, of course there's minimums and we would talk
about that that they have to provide. You just can't
go I want to do anichroat fifty bucks a month
for each employee, it's not gonna work. Well, fifty buck
go very far, not gonna go very far. You might
be able to cover the dental plan. But yeah, so
it's it's a unique situation. But there's two things that
(05:33):
really kind of happen here. It helps alleviate the huge
costs increases each year for employers, especially if you're an
employer that has seen significant increases in premiums due to
maybe claims of your group. That's a huge thing that
most people don't really understand with group health insurance, Like, hey,
I got a really good deal. I'm moving from X
(05:55):
insurance company to another insurance company. There I'm saving twenty percent.
Well I had two employees this year that just had
major claims. Well, now my rates are going up forty
five percent, right, So the AKRA and the nice thing
about that it can kind of keep us more at
a level playing field with the coverages that are out
there as a whole. Of course, it also lets me
(06:15):
help your employees that maybe be in that situation be
in groups of people that are hundreds of thousands of people,
so you're not going to see those huge swings in
premiums year to year.
Speaker 1 (06:28):
So the individual employee takes the money from akra goes
out into the world through you finds a plan that's appropriate,
and that person may be part of a giant risk
pool that direct keeps things flat, so they're personally not
going to experience these wide, you know, increases in premium
because they personally had a large health.
Speaker 2 (06:45):
Insurance Erectly, they're gonna see the same thing as the
rest of the market. Right, So that's that's a that's
a big, big, big benefit. You know where we see
EKRA is really working right now. Number one, I'm looking
at this for more of those fifty plus employees because
you know, they're they're have the mandate they have to
provide coverage, so that's going to be a big thing
for them.
Speaker 1 (07:06):
Uh you know, if.
Speaker 2 (07:07):
You're if you're under fifty, it's typically not going to
be a phenomenal scenario because the biggest problem with doing
an EKER is those employees can't qualify for tax credits.
So we have seen this kind of scenario played out.
Give you an example, like we've been helping a lot
of retire police and firefighters, So there's a there's a
there's a basically a thing when they're they're provided this
(07:29):
ekra hr a program. When they retire and they're not
yes sixty five, they basically don't want them on the
group plan anymore with the firefighters and policemen, so they
give them money and go, hey, you need to go
and find your own plan. The problem is a lot
of these individuals have lower incomes at that point because
they're retired, they can't qualify for tax credits, so we
actually it ends up costing them more money sometimes well.
Speaker 1 (07:53):
It would get a finer point on the middle qualify
for tax credits, because last week we talked about that
cap sixty four thousand dollars and if you made a
dollar more than that then you weren't eligible for the
tax credit. So by virtue of being in an incra
vehicle getting money from the employer or in the case
of police and fire, your prior employer, but you're entitled
(08:14):
to the moon, that takes you out of the realm.
So you couldn't go to the marketplace and get an
Obamacare plan and then be eligible for a tax credit.
Speaker 2 (08:21):
You can go get the plan, you wouldn't be able
to get the tax credit, right because the HDHRA actually
wipes away the tax credit. You can't double dip the
system how the federal government looks at it. So yeah,
so it is a unique situation. So again that's something
we would have to look at to make sure. You know,
that's why I say it doesn't always work the best
for employers over under fifty. But again, you're absolutely hit
(08:44):
the nail on the head. I mean, what if this
does go away, like I've talked about last week, right,
so we're going to see a lot more people that
probably aren't going to get tax credits. So even these
employees that you're doing in HRA, they might even even
get tax credits anyway because their income might be over
that threshold. So that's why the Chris might even be
people better at the end of this year or two.
(09:05):
So it does kind of give us a unique scenario
where this might be the best thing here at the
end of this year, regardless of where they're at. And
it just like I said, it opens up the door
to more options. I love when employees have options, right,
I mean, when if you have thirty employees that all
have different doctors, I mean, what the worst thing you
can do as an employer is going. I'm changing from
(09:25):
exit insurance coming to Z Well, twenty percent of my
employees just lost their primary care because they're not in
network with the new plan that I'm going in. So
it does give you a lot more flexibility in that
realm and it can help out, you know, tremendously.
Speaker 1 (09:38):
So what kind of money are you talking about per employee?
I mean, I'm not being an employer, and I don't
I have no idea how much you would have to
allocate you So you can't just throw fifty bucks ahead. Yeah.
Speaker 2 (09:50):
So basically it's based upon where where your company's at,
and it typically has to be the price of the
cheapest silver plan in your area based upon the age range.
So again that's there's a calculation that we do. But
typically what we're seeing is somewhere between thirty to forty
(10:11):
percent cheaper than what you see on the traditional group side.
Oh really, typically consistently. Yeah, So again it's it's huge savings.
Speaker 1 (10:18):
You know.
Speaker 2 (10:18):
I think maybe one or two times we ran into
it wasn't as much of a savings just because of
their health pool. But yeah, for the most part, I mean,
you can probably hang your hat on twenty to twenty
five percent across the board.
Speaker 1 (10:30):
All right, And even with that savings to the employer,
the IKRA, I'll say, contribution or allocation is sufficient for
that employee to go out like talk to you.
Speaker 2 (10:42):
Absolutely, absolutely, yeah, I mean especially if you know, like
I said, it has to be based upon the cheapest
silver plan. So you know, a lot of people don't
really need a silver bronz you know, gold plan or
Platinum plan. A lot of them pick the bronze plans,
you know, which are usually just as good, and I'm
maybe have a little bit higher reductible, but that money
(11:03):
can be really utilized to help offset that cost almost tremendously.
So we we do see a lot of times on
the employee side that their contributions of what they're paying
towards their health insurance drastically goes down. So it's saving
your employees money too, fair enough. So I'll give you
an example. I'll just give you one that I mean,
I think it makes numbers make the most sense, right,
So we just did a group and they were paying
(11:23):
almost I think the average price for each employee was
close to nine hundred bucks a month. I think they
were doing like a seventy thirty split, So I've been
quick math. I mean, I know they were paying over
six hundred bucks a month for each employee. We were
able to do an incro plan for them, and I
think it was like a little over four hundred bucks
a month. So when they saved you know, thirty three percent,
you know for each employee, which one thirty five and
(11:46):
oh they had forty eight, they were close to fifty.
So that's why they really wanted to do because everything
they were to go over the threshold. Yeah, I mean,
it's a tremendous savings for him, a two hundred bucks
ahead almost fifty employees.
Speaker 1 (11:57):
So wow. Yeah, and so would that four hundred there's.
Speaker 2 (12:01):
One hundred and twenty thousand dollars year of savings in premium.
Speaker 1 (12:04):
But that's still adequate enough for the employee to get. Yeah,
really good coverage. This is what I'm trying to get.
Speaker 2 (12:10):
Yeah, really really good coverage. Yeah, I mean, and they
were paying less, So I mean, the employee was probably
paying two or three hundred bucks a month and then
now they were paying like one hundred and fifty on
average what they're paying out of pocket on their premium.
Speaker 1 (12:23):
That fact alone is really rather excuse me, revealing that
you can get good coverage for that low premium.
Speaker 2 (12:30):
Yeah, I mean, because again you're going through the open market.
I mean I said, you're going on the open market.
So the best thing there is just there's just more options,
you know, and and insurance works better with more numbers, right,
Economies of scale comes into play, right if you think
about it on that end, So the more people in
those situations that the better the premiums are. And like
(12:52):
I said, I mean groups in general, unless I'm going
out and just recruiting and hiring everybody out of college,
and my entire risk pool is twenty somethings. I mean,
we're my companies across the board. You know, you get
a group of fifteen that we're at fifteen employees. I mean,
you know, if one of my employees, if I did
a group plan, which I'm not never going to look
(13:12):
at it like I do look at it just for giggles, right,
you know, And if I was to do a group plan,
if one of my employees went in and had a
major accident or god forbid, got diagnosed to the major illness,
I mean, I know, my rates would double. There's no
way I could do that. And then what are gonna
do next year? Turn around, go to my employees and go, sorry,
I can't afford this anymore, like good luck. You know,
(13:33):
we're going to cancel a group plan or go do
something that's less coverage, you know, I mean it just
it doesn't make sense.
Speaker 1 (13:39):
So in practice with your business, you are having your
employees do the same thing that you would do for
a business. Yeah. Absolutely, they're going out and they're getting
whatever plan they choose and whatever options they choose, and
they select themselves the same way you would do for
(14:00):
a group that came in to talk with you.
Speaker 2 (14:02):
Exactly with you, we do exactly the same thing. So
if you're a smaller group, you know, like under fifty employees,
and you know how we traditionally had done it with
a lot of these groups. Look at and see if
the employees qualify or tax credits, you know, look and
see what the employer can pay on their side, which
is typically the section one twenty five we talked about
the indemnity plans, the ancillary coverages. Sometimes letting your employees
(14:23):
buy their own major medical plans through us, you will
help them walk through. It's not like I'm making them
go out and figure it out on their own. Then
that we save them a lot of money that way too.
You know, give me an example, like we just did
a we did a group here of like twelve employees.
You know, most of their employees are making between thirty
and forty grand a year. Most of the employees had families.
(14:44):
Most of the employees' spouses didn't work, right, So I mean, like,
I mean, it was a big chunk. So it's like, wow,
like these guys, even if the tax credits go away,
they're still going to qualify because of their income thresholds
way below that cap, right, So, I mean most of
these employees were able to get health and insurance almost
under one hundred bucks a month for the major medical plan,
and we were gable. We came back in, we did
(15:05):
secondary coverage kind of fill the holes in like we
talk about every time we do this.
Speaker 1 (15:10):
You can afford those extra plans when you're only paying
one hundred bucks for the major Well.
Speaker 2 (15:14):
Yeah, so this is how we do it. This is
this is like literally how we do it. So the
major medical plan we get to pay by the employee,
right because they can't have the employer paid directly for
a tax credited health plan. There's a big fine for that.
So we just go to the employee, go, hey, you're
paying three hundred bucks, four hundred bucks, one thousand bucks
a month because you have a family plan. You're not
going to pay one hundred and fifty. I can't pay
(15:36):
roll to duct that. Can you do the one hundred
and fifty on your own? They're going absolutely.
Speaker 1 (15:41):
Right, they go that.
Speaker 2 (15:42):
So then we go back to the employer and go, okay, well,
now you're no longer providing group health insurance, right, but
you were paying four hundred bucks a month for each employee. Well,
let's take two hundred that or two hundred and fifty,
and let's do secondary coverages to Section one twenty five,
and you provide the voluntary coverages. You pay for it
as a employer. That helps cover all the holes and
(16:02):
the big gaps that the major medical has. So now
they have better coverage. And I'm gonna fix your price
because this price hasn't gone up in ten years, and
it's age band and when they get in so they
get older, it's not gonna go up. So I'm going
to keep your prices in your premiums pretty stable over
in the next hopefully decade and you're providing your employees
a better coverage and I just saved you one hundred
(16:23):
and fifty to two hundred bucks a month per employee.
Speaker 1 (16:25):
That's just amazing and they.
Speaker 2 (16:26):
Have better coverage. And that's what we do. So every
scenario is different. So the nice thing is like, I
feel like I have this huge toolbox of just options,
so it doesn't make a difference how you come to me.
I can do an inkra, I can do individual plans.
I can do plans that are Section one twenty five
for your employees and show you how to do a
better way. But the biggest thing in Brian, just have
(16:47):
that conversation, you know, and then most of the people
that talk to us we help.
Speaker 1 (16:52):
Yeah, and again, I have lots and lots of my
listeners who've taken the recommendation to give you a call
and they get back with me, tell me, I just
cannot believe what he was able to do for me
and the money that I'm saving now because I made
that phone call.
Speaker 2 (17:09):
Yeah, I mean, it's just the thing about it is
always kind of start the conversations with these employers. I'm like, listen,
I'm kind of like the anomaly because I'm not just
a group guy. I mean, most of your group guys
are gonna come in, they're gonna sell group because that's
all they know. I mean, I get guys all the
time to call me and go, hey, I just do
group health insurance and I can never do individual can
Can I work with you guys to do individual covers?
(17:30):
Like absolutely, I'll show you how to do it. I'm
teaching group guys how to do it because they're getting
whacked right now by what we're doing. And then you know,
a lot of the individual guys that are out there,
and I have a lot of agents that are just
one man shows right. They can't. They don't have the
infrastructure to handle groups, right. It's a lot of work.
(17:51):
I have employees that I have an employee, literally my
off of one employee that her entire job is just
making sure that all the groups are okay that we
work with. It's an entire job. We hired one one
that staffer that's her entire thing is she's the group girl.
And you know, anything comes in, she's the one handling
it just for the groups. Because that's I made her
a master of that and she knows exactly what's going on,
(18:13):
how the products work. She's the main person out. Everybody
in the office can kind of help her because we
do get a lot of calls sometimes, but you know,
that's her entire job because I've been able to grow
my business into to a realm where I can support
that because when you're dealing with a thirty five man group,
you know, if I was just a one man show
and I had to make an adjustment.
Speaker 1 (18:33):
Do you know his paperwork that is, No, I don't.
Speaker 2 (18:37):
It's a trumendous amount. It's a tremendous amount. I had
one of my agents, he's been around for like four years,
a very good agent, and he goes, he goes, and
he goes, I broke up a twenty five man group.
I'm like, that's great. How did you help him? Walk
me through the whole scenario?
Speaker 1 (18:51):
Goes.
Speaker 2 (18:51):
It took me a month and a half to do
everything because it was just so much work. I was like,
I understand that. I was like, you have to hire
assistance if you're going to keep doing this, because you
have to be able to support that group moving forward
if they have issues or questions or anything along that line.
And he goes, yeah, yeah, this is this is an
animal and that's why most individual agents don't do it.
So when I say I'm the anomaly, I'm like, I
(19:13):
don't know many people that can do what I do
because because I built the business that way to be
able to support that. So when I go in, I
can go, well, we can do the group side, we
can do the individual side, and you know, seventy percent
of the time, the individual side makes the most sense.
Speaker 1 (19:26):
And that's where you look at each employee. Each employee,
ever employee is different. Every employee is in a different
place in their world. They're different ages, they're different medical conditions,
and different budgets. Different budgets all the employees maybe make different
range in the salary, so you accommodate for each one. Yeah,
that individualized thing that I think that's one of the
coolest elements about what you do. It's you take the
time to actually work with each employee, putting them in
(19:50):
the best possible place. So you know, the guy in
the cube next to you may have a completely different
carrier and a completely different stack of policies because they
wanted extra or they didn't want as much, or whatever
they decided to do based upon the information you provided
them as opposed to we're all covered by company acts.
Choose the HMO or the PPO, right, And that's really
(20:10):
what it comes down to.
Speaker 2 (20:11):
They just say the Copey plan, you know. I mean
that's that's pretty much how most companies operate. And at
the end of the day, it's like it's not a
perfect scenario for every single employee. So it's almost like
they have to choose the lesser of two evils, right.
And you know who's the main person of contact, Well,
it's your HR person. I'm like, you know, nobody small
businesses have an HR person.
Speaker 1 (20:34):
I think they outsource that now.
Speaker 2 (20:36):
I guess they have it through like into it or
something like that.
Speaker 1 (20:39):
I know I hear commercials for like HR services you
can outsource ag.
Speaker 2 (20:44):
Yeah, you get to hope they can answer those questions.
They're not licensed insurance agents. I mean I always tell
people like list when it comes to health insurance, I
literally want you to think about this. I don't want
you to answer one more question about health insurance ever again,
ever again, mister employer, you just to have your employe
calls well.
Speaker 1 (20:59):
And you know it's a funny thing about that. I
got to follow up with most people, I would argue,
couldn't answer a question about health insurance anyway. No, I mean,
what small business owner has time to deal with the
level and depth of knowledge that you have in the
insurance business. You know, they're the ones that are subject
to the door knocker, the guy coming in and saying, hey,
I can ensure your employees for less premium dollars a month.
(21:21):
They end up globbing onto a policy that exposes their
employees in so many ways that we've talked about in
the past.
Speaker 2 (21:26):
It is I mean, and there's not really a huge
savings going from one group to another. You know, what
are you giving up? If you're going to cut cost ten, fifteen,
twenty percent, you're giving up coverage obviously, you know. I
mean they'll all do exactly the same thing. The actuaries
look at your claim history on your group, right, I mean,
they're You're not You can't be sitting here, John, you know,
every year I kind of make it there's something changing
in your plan and it's probably not for the better.
(21:49):
You know, if you're cutting costs, I mean, it's just
not happening from what I've seen.
Speaker 1 (21:53):
Also very confusing to the employees.
Speaker 2 (21:56):
Oh yeah, yeah, and you'd be surprised how many times
I'll talk to an employer and they give me the
information on their plan, and then once they actually send
it over to me, I'm like, that is nothing what
you told me. Yeah, like it doesn't even it's you're
not even the ballpark, but like this isn't exactly what
you had. You've been telling your employees this, because like
I'd be very upset if you walked around and told
all your employees you had twenty five hundred dollars adultable
(22:16):
and you're really signing about seven thousand. And it's just
like I get it, Like that's not your realm. I'm
not a you know, I could even tell you the
first thing about how to do an electric outlet. You know,
I'm not an electrician. It's not my hairy of forte.
So if you're an electrician, if you're a plumber, if
you're a contracting company, you got a demolition compound't care
(22:37):
what it is, that's your forte. That's what you know.
You don't need to no health insurance. You just need
to know you have a guy and you can just
give me a call.
Speaker 1 (22:43):
Yeah, five one three eight hundred two two five one
three eight hundred call absolutely or cover sincy dot com.
Just reach in through the website and fill out the
form there, and you have the other important component. I
cannot I cannot understate the value of this of working
with you in the sense that and I always bring
it up because I think it's so important getting insured
(23:05):
Through cover Sincy and John and his team, you get
to keep them and so you don't ever have to
get on a damn phone call with an insurance company
about some claim that got denied or some confusion you
have over the situation involving your claim, because, man, you
mentioned multiple times how things don't get filed, the doctor
doesn't follow through was sending the claim in the claim
(23:27):
gets mishandled by the insurance company, whatever happens, and then
you're left hold in the bag, at least you think
you are. You get a bit of a bill from
your doctor's office saying you owe seven hundred and fifty
bucks for something. You're like, wait, what happened here? I
thought this had been taken care of. So instead of
calling the insurance company and spending two hours on hold,
they're talking to some guy and punjab he just call
(23:48):
up John and one of his team members will iron
it out.
Speaker 2 (23:51):
I know you have all the.
Speaker 1 (23:53):
Right numbers at the insurance companies. I mean you figured
out who to call and who's going to get to
get the scenario taken care of or at least figured
out now.
Speaker 2 (23:59):
And I get it too. And you know, I do
want to preface this because I know you're You're very
big on our care department. I am too. We put
a lot of time, effort and money and building out
our customer service side so that we can help alleviate
a lot of this frustration. But I will say this too.
I mean, for as good as we are, we are
not Jesus. We're not miracle workers every single time. I
(24:21):
mean it's you know, because we had a client not
too long ago. It was kind of frustrated because you know,
he called in. He's like, I need I are not
a SAP. I'm like, do you have to understand? Like
I have to work with the insurance companies too, and
they are slow, right they are. There's hoops, there's paperwork
that has to get filed. We walk you through it,
(24:42):
but it is a process. There's very few things that
I can do in twenty four hours when it comes
to them. If like, if it's going to take you
a month, it's probably gonna take me at least a week, right,
because again it's we know what we can do. But
again it's like I hate it too, because I mean,
out of one hundred carriers, I get people all the
time going which one's the best one to work? I
(25:03):
was like, they kind of all suck they do? Do
they pay claims? Yes? Is there a process to go through? Absolutely,
they take a.
Speaker 1 (25:15):
Week, as opposed to me going out into the world,
it may take a month, But I don't understand the processes.
The value of you and your team is you understand
the process. You know exactly where to go to. You
know you're going to be dealing with people who suck
or companies get suck on some level or another. But
at least you know who to call. Oh yeah, I
(25:36):
mean I think I pick up the phone and call
some eight hundred number and be put on hold, and.
Speaker 2 (25:39):
Then I can't even tell you how many times I've
had to pick up a phone call and talk to
a vice president overclaim We probably do a weekly.
Speaker 1 (25:47):
You have access to the vice president. How long it
would take me to get in touch with someone like that, and.
Speaker 2 (25:51):
You'd be surprised, like just even how many times it's like,
oh my god, we just had one not too long ago.
It was like literally the claim was filed completely clean,
everything was done the right way, and it just came
back Brian It's like, nope, this this wasn't done. I'm like, no,
I know it's done right. So I literally have to
get on the phone with the vice president and going
(26:11):
like who is this person and claims you need to
go have a talk to them because this is not
your procedure. It goes, no, it's absolutely right. He goes
to me, He goes, you can't make this crap up.
I mean, it's just you hired him, you know, his
his fifth person below him hired that person. You know.
But it's like it happens right. It's you know, any
(26:34):
anytime you talk to and I don't care what company
you call with customer servers or something like that, it's
you know, it could be your TV. You know. It's
like there's always an experience that you're gonna have. We
just try to we just try to make it as
less cumbersome as possible and.
Speaker 1 (26:48):
Work with you.
Speaker 2 (26:49):
But we're there every step of the way. There's never
any point that we're going to be like here you go,
go figure it on your own. It's literally like, hey,
we can take you up to this point and going.
They won't talk to us anymoere because this is hippa.
You need to handle this part, but please keep us
in communication unless in case we need to be involved more,
you know, but we do. We do try to handhold
you as much as possible, and it's I'll tell you
(27:09):
it's it's gotten so much better working on that end.
I mean even in the point where my team is
so good. If I have an issue with Microsoft and
I have I literally just turn go down to my
office and like, hey, this is this show. I'm having
to take care of it.
Speaker 1 (27:23):
That's great because they're getting what are they gonna say, no, no,
it was acting, how to do this? Make the call yourself.
They've actually better. I mean they do it all.
Speaker 2 (27:32):
Day long, so they've gotten so much better than even I.
Speaker 1 (27:34):
Can do it anymore. Cover since dot Com. Let's say
you get in touch with John on the team or
call them up at five one three eight hundred two
two five five five one three eight hundred call It's
worth the time. Trust me on this, Hey, what could happen?
They say you, You're in the best possible place you
can be with your current insurance. That's at least going
to give you a peace of mind considering all the
options that are to John and his team's disposal. This
(27:56):
has been another edition of Rethink Healthcare together with John
Omen from Cover Sensi
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