Rethink Healthcare Together Ep 05

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Episode Transcript

(00:08):
His Brian Thomas, you with JohnRolman to cover since the way to save
a lot of money on your medicalinsurance. You don't have to pay that
kind of crazy Obamacare premium or evenwhat you're paying for your employer coverage.
And employers, as we've learned onthis program, rethink healthcare together with John
Rolman, employers can say a heapload of money themselves and save their employees

(00:28):
a lot of money on medical insurance. You just need John to look at
your policy and rethink it. John, Good to see you again, man.
Oh, Brian's great to see youtoo. Understand your phone was ringing
a little bit after our last conversation. Yeah. One of the interesting things
is we're starting to get a lotmore of the employer groups to give us
a call. We had just hadone I talked to yesterday. Forty five
man group already has group health insurance. They're getting I guess it got scared

(00:52):
with a forty percent increase because theyhad a couple of people in that group
start having some medical claims. Andwe're analyzing their group right now, and
I mean there's an opportunity there probablyto save them thirty to fifty percent on
what they're currently paying. You know, it's an ex just a mind blowing
figure. I saw the other daywas doing the morning show, and one
of the components of inflation generally speaking, here's groceries. It was this.

(01:15):
That was the other thing was healthinsurance employee health insurance. And the figure
that they had down is twenty fourthousand dollars a year. That's crazy that
I know. And I said,well, you gotta have to John Roulman,
because that's just mind blowing. Imean, you can buy a house
and that would cover the mortgage andand taxes, you know, in terms

(01:37):
of that kind of money a decenthouse. That's a decent house exactly.
And speaking of which, we'll givethem information out ahead of time. We'll
do it throughout so in case youget the itch to call John and you
will you fight out the kind ofmoney you can save you it's five one
three eight hundred c a LL callfive one three eight hundred two two five
five. You can learn more evenwhile we're talking together today by going to
cover Sinsey dot com. That's eitherwith the or eye on the end.

(02:00):
What you need, as we initiallystart out pointing out, is a and
is a representative on your side,someone who owes you the client and obligation
to do whatever he can. That'sJohn and his team at Cover Sinsey to
find the best insurance premium to fityour needs and in most cases save money
on it. So better coverage forless money is really what this all boils

(02:23):
down to. It's pretty amazing whenyou think about it that way. Most
people think, well, how doI get better coverage and pay less And
there's just different techniques that we specializein to restructure how you actually buy your
health insurance. And like we talkedabout on previous shows, it's about layering
your coverage and letting certain policies coverthe out of pocket expenses. But that's

(02:43):
really where the savings is at,and that's how we break it down and
really structure it so that you canactually see the savings and get better coverage.
You know, no insurance company wantsto pay one hundred percent of your
claims. Ever, that's not theirgame. I mean, that's why they
have deductibles. That's why they haveco insurance, which we call the second
deductible. Yeah, I know,And it's like I always say, it's

(03:04):
there's methods within their programs to kindof almost prevent you from doing healthcare.
Right if you know you're gonna paynine grand to go do something, you're
to start rethinking that, like,well, do I really need to do
this? So hit that test orrecommending because it's three grand, you know.
And that was the corollary point tothe insurance premium that people because of
the cost of medical going up generallyspeaking, just whether it's the insurance component

(03:28):
going up or the cost of theprocedures going up, both of which are
going up, that people just say, you know what, I'm not going
to do that. I'm just gonnaforget it now. And the first thing
you have to think about is whenyou buy insurance, the first thing you're
you're hit with is the premium.Right, So, I think the average
premium right now for a family,if you're looking at the open marketplace,
let's say two people their forties,couple kids, I mean you're looking at

(03:49):
fifteen hundred to seventeen hundred dollars amonth for insurance premium. That's full price
like in the marketplace, if you'renot getting a tax credit, and then
you get to look at what's theout of pocket Well, now, it's
over nineteen grand, so you're talkingabout close to thousand dollars is your financial
exposure. And that's if you doeverything perfect in network, line everything up.

(04:09):
I mean, most people do nothave forty grand laying around to go,
hey, this is a bad year, I'm gonna go spend forty grand
on that. I mean, mostpeople think about maybe they're hot water tango
and not. Yeah, I know, but even if you've got forty grand
to burn in the fireplace, whyin the hell would you want to spend
it on medical luxuries if you don'thave to. No, I mean that's
just wealthy people end up becoming wealthybecause they don't make mistakes like that.

(04:32):
I mean, it's just a knownfact. You mind the pennies of dollars,
mind themselves, and when you mindsomething like this kind of money,
the benefit is obvious. Large canlarge sums of cash. All right?
With that in mind, the otherthing that I've learned from you, and
something I like to emphasize, it'snot just the insurance policy and the analysis

(04:56):
we get when we work with you, it's everything else that go along with
it. So now that I'm insured, I can rely on you, John
and your team to handle and navigatethe problems that I might run into with
claims, payments, with finding physiciansand that kind of thing. You have
a special team. You're you're myguy. Your team is my team,
and you're working for me. Solet's talk about common issues with claims.

(05:23):
So one of the things we startedgetting a lot of feedback on a lot
of the questions we saw, youknow, come in from the show,
is I have a situation, thisis I've got a claim, I got
a bill. What's my next stepthat I call the insurance company? Like,
wait, hold on. The firstthing you have to do and really
realize is that, you know,from what I've seen doing this nineteen years
and running claims almost on a dailyat this point, is almost ninety percent

(05:47):
of the issues that we deal withthat we see come through is actually from
the provider. And it could beyou know, billing the wrong plan.
I mean, you'd be surprised howmany times you've may have changed an insurance
plan at last couple of years,and that person just gets your claim and
they submit it through their online systemand then oh it dings an insurance policy
you had three years ago. What'sthat insurance comping together, they're like,

(06:09):
well, rejecting to reject the claim, So what's going to happen. They're
not going to get an EOB.I'll at doctor's office or wherever you're getting
your treatment done, is going tosend you a bill exactly and their claim.
God and I and here's the billfor four nine hundred dollars or whatever.
And I would probably say a majorityof us turn around and pay the
bill. That's because explanation of benefitsebs are like the peace of God.

(06:30):
When you look at those the billingthat comes from the hospitals and into line
items and everything. I didn't evensee that doctor. Who in the hell
is this? It's very confusing.I mean, I consider myself, you
know, somewhat educated. I'm justglad I'm married to a woman who's in
you know, practices law in thehealthcare around because every time I get something
like that, I hand it overto her right. So it's like I
got my own you in my house. I have the advantage of that.

(06:51):
But most people don't, and theygloss eyed over it and like, I,
okay, I was there, soI guess I owe the bill and
they write to check for it.When in it just hasn't gone to the
right insurance carrier, or the doctor'swrong. Yeah, more often not,
it's exactly what happens. And thenyou'll see things even the step further.
You know, we've seen wrong CPTcodes, I see DA nine codes.

(07:12):
I mean, they'll they'll bill yourinsurance company wrong or just you know,
it could be a clerical error.We don't know, but a lot of
those things come back. And thenthe only thing you're gonna get is a
bill, right, Yeah, Andthe first thing I always tell clients is
if you get a bill, waitThe next step is wait for that explanation
of benefits because we have to linethem up. Right. We got to
figure out, hey, is theinsurance company declining to claim for some reason?

(07:35):
Is it? Did they ever evenget the bill? Yeah, I
was just thinking about that. Thephysicians offen may have forgotten to submit it.
Yeah, sometimes they don't mail themout. It gets lost because what's
gonna happen. They get a clock, and if they don't get anything back
from the insurance company, you're onthe hook. Because remember, insurance doesn't
cover your doctor, right, It'snot covering that, it's not covering the

(07:56):
hospital. You're the insured, right. The legal part of that, you're
the insured person. So all you'redoing when you go to the doctor is
you're assigning your benefits. Right.It's just for them to be able to
get paid quicker, right, sothey can build your insurance and they can
get paid. Right. That's afinancial you know, stipulation that you have
there. But most people that's that'sthat's the wrong thing. You are the

(08:16):
insurance. So you need to makesure that you're getting that EOB back and
then line that with that claim.And then look at the bottom because there's
usually an asterisk, right, andlook the little explanation at the bottom.
Decline because they didn't get medical records. Decline because in proper coding, don't
just pay that bill. That's whenyou start after start asking questions, well
is this process properly? Now?This is the next step, right,

(08:39):
So what are you gonna do?You're gonna call the insurance company. We
know it's a nightmare. I dealwith it at the time. That's like
literally we have back doors to getaround the first like five layers of people,
because we have to get to theperson that makes that decision. Now
we have that the average person doesn't. So you're gonna deal with a couple
hours getting through whoever you need toand that claims apartment gets we answered six

(09:00):
times, you know, and theneventually they're gonna get you might get that
information like, well we didn't getthe right codes right, we didn't get
the explanation specifically why this claim happened. And then once you find that out,
then you gotta go back to theprovider. So it's a huge game.
I mean, it takes days,weeks. I've dealt with claims for
certain clients months and that's what wedeal and that's how I trained my team

(09:22):
to extrapolate that, look for thesepitfalls and then kind of go through that
next step. But again, itsucks, I mean, and especially when
you have big claims. If you'rein a you're in a fifty thousand dollars
claimer, more prepared to get paperworkfrom twelve people. Yeah, everybody's gonna
bill you under the sun. Andlike I said, just the first thing

(09:43):
you do is take a deep breathand realize you have time. When you
get that notice and you know itsays you have thirty days to pay,
well, you have time. Thereare collections laws, collections laws. Yes,
I gotta run in the court againat default judgment. I always tell
people, get a big old folderout, start putting everything in there,
and start lining at it all.And I was like, you know,
of course we have them send itto us. But if you're in that

(10:03):
situation and you don't have access tosomeone like my team, you know,
you have to line that up andmake sure that all those things kind of
go through properly. And there's allkinds of crazy things. Now. Of
course, if you're on a marketplaceplan, maybe you don't have to worry
about pre existing conditions, but youknow there are certain things that come back.
You know, if you switch aninsurance plan, maybe go to private
plan, or if you're buying someother coverages like disability or critical illness.

(10:26):
I mean, they can come backand say, hey, we're we might
dispute this. We're pulling medical recordsbecause it could be pre existing. It
wasn't something that we were aware of, specially in things like life insurance.
Right, they're gonna be go,hey, maybe you lie on the app.
They're gonna they're gonna I mean,they're in the business of making money
like all of us, so they'regonna do. The easiest thing thing to
do is not pay claim. Indeed, I mean they might open themselves up
to a bad faith claim, andwe used to hear about that all the

(10:48):
time, but in most cases thelevel doesn't just quite rise to that.
So you're not gonna have any illegalrecourse down the road either way. So
you know, the other thing I'vethis has been my varientce over my life
in terms of dealing with providers andinsurance companies. The provider will send you
a bill before it's even been throughthe insurance process. I mean, I'll

(11:09):
get a bill, I'll look atit. This is two hundred and seventy
five bucks. And I thought Ihad insurance for this, or at least
that you know, would be reflectedby it. And no, no,
and you just you sit and wait, like you said before, give it
a week, give it maybe acouple of weeks, and then sure enough
that EOB will come in. Andas it turns out, I don't know,
two seventy five are really only liketwelve bucks. Yeah, And when
I would say go even beyond that, give it thirty days, give sometimes

(11:33):
sixty days, because you have noidea when they build the insurance company.
So I mean you could be ina situation where you've went in and had
a procedure done well, it doesn'tmean they build them right away. I
mean they could have waited fifteen thirtydays to even send that stuff over to
the insurance company. So by thetime they get it, they're going to
have three, four or five weeksa process that claim, and you know,

(11:54):
it could be two months before youactually see a NEOB, so you
have to you have to give itsome time to go through and then reach
out to the insurance company. Nowone of the nice things too, a
lot of the insurance companies now haveportals that you can go into and you
can log into and you can actuallysee claims one of the first places you
should look because there's no claim backthere. They probably haven't even processed yet,

(12:15):
or maybe even they didn't even receiveit well, and that's another moment
where you can just sit back,exhale and sort of let the process go
through, because if they haven't submittedthe claim, then you don't know any
money, right, I mean,isn't that what it comes down to?
This is John Roman have covered sinceJohn's explaining process, But the great thing
is we sort of let in withthis segment of rethink Healthcare together. This

(12:39):
is the kind of thing that ifyou're working with John, John will do
for you. So you call himup and if you forgot the advice he's
given out today, you're getting theinsurance through John and they'll take care of
all these things and remind you atthat moment in time when you call it.
No, no, just wait,just wait, We'll be okay.
Just keep the paperwork if they sendthat, and then we'll do it a
full analysis after it all comes in. Cover sincey with a Yori dot com

(13:01):
is where you find them, it'sfive one three eight hundred call. That's
five one three eight hundred two twofive five out of network charges plan covering
charges out of network. I knowthis is something we've talked about before a
lot of these plans, I know, with open enrollment just recently either closing
or currently going on, you knowyou got to do within network out of
network providers, and you really canget clubbed, if I may be so

(13:24):
bold, like a baby harp seal. If you're out of network, you
have better insurance when it comes toprovider selection as well. Well. Yeah,
so at a network. Charges isa thing that we've seen a lot
over the years. Now, thereare some laws that have been put in
place. There's a lull back inJanuary of twenty two that basically was called

(13:45):
the No Surprise Act, right,and most people aren't even aware of that.
Well, we started seeing a lotwhen people go in and have our
surgery done, and the hospitals andnetwork, the surgeons in network, and
that's how you're checking out. Butyeah, what happens is is they go,
well, I guess our anesthesiologies isout today. He's six, So
we're going to go bring in thisanesthesiologist from you know, thirty miles away.
He's going to come and do youryou know, put you to sleep

(14:05):
today. And then what happens,he's not a network. So the insurance
company goes, well, he's nota network. Wink. You know,
now you owe his entire bill.We're not even going to negotiate it.
So that was a big thing thathappens, and you know, it's it's
definitely been cleaned up because of that, but we still see him kind of
poke through once in a while.And again, if you're someone in that

(14:26):
situation, you're not aware of thatthere's a protection there for you. You
might end up paying that bill.So we do see that. We actually
had a few cases here this lastyear where we've actually had to go back
in and say no, no,no, you can't. This has to
be treated as a network. Thiswas a surgery, it's there. There's
no surprise in that. The otherpiece that there's most as far as the
no surprise is supposed to be foremergency situations, right, I remember we

(14:52):
kind of talked about this. Yeah, so if you're on an HMO even
a PPO, right, and you'reat a network, right, they're supposed
to cover you. The insurance supposedto pay as if in charge and negotiat
as if you were in network.So I'm not going to extrapulate and put
you to a high reductible. Theycan't turn around and discredit to claim.
Right. But who deems an emergencyright? Right? So I mean,

(15:13):
yeah, maybe a doctor. Youknow, I've gone to urgent care and
they go, well, we don'treally do that here. You have to
go to the emergency rooms like wellit's not life threatening, Like I mean,
I'm not going to go to theemergency room for this and pay five
grand to walk through the door like, this is not life threatening. I'll
I use things like teledoc and stufflike that. But you know, in
those certain situations you have to beaware. I was like, don't go

(15:33):
to the emergency room unless it's lifethreatening. You know, we had a
client here recently a few months ago. Daughter was in a situation she needed
an immediate psychiatrical like based from whathe told me, it was very severe.
Now, the problem was he wason a plan. He was on
a marketplace plan, and the localchildren's hospital was not on it, and

(15:56):
that's the only place that would treather for that sit situation, right,
So what happens He goes in.Everything ends up being fine, thankfully,
but you know, a couple monthslater, but you get set bill and
full charge twenty five thousand dollars inchange, and you know he only had
a seven thousand dollars deductible and basicallyright on the bottom says at a network.

(16:21):
Right, So of course he's like, well do I I guess I
owe this bill because I mean theywere in there was like, stop,
that's not the situation. You toldme that this was an emergency, life
threatening situation. Let's let's take thenext step, let's figure out how do
we provide proof to the insurance cumpanybecause again, that doctor's office probably just
builds a code. If they don'tput it down correctly, they're not going

(16:42):
to deem it as an emergency lifethreatening Situh okay, yeah, yeah,
why were you in there? Ijust you know, talk to somebody.
No, it's not like and ofcourse this situation was on an HMO,
so they paid zero at a network, and you know, we have to
go back in and find out whatthe insurance company needed, what kind of

(17:03):
documentation. Of course that wasn't providedby the provider or the referral physician or
the hospital even billing it, sowe had to have them, you know,
get some documentation saying that. Imean, this was probably a two
month process because you know, peopledon't return phone calls right away, so
we're hounting them. And then eventuallywe were able to get that claim resolved
and the insurance company reprocess it asif it was a network. But you

(17:26):
know, man hours, I mean, we probably spent forty fifty hours on
that case, you know, tohelp that claim get resolved because of how
much time we had to spend dealingwith both sides of both parties on that
well, and that's not something wecharged for Brian. That's once you're a
client, we absolutely do that foryou. Well, And I'm just going
to double down on that because Iknew that you don't charge extra for the
service. I mean, that's partof the nature of your businesses that you

(17:48):
get all these goodies plus you know, hopefully less price a lower cost of
medical insurance. But the type ofwork you do, I'll draw a parallel
to like specialized legal work. Yourknowledge and experience is is just unbelievably valuable.
Not only is it the number ofhours when I think of, you

(18:11):
know, the amount of time Imight have to spend on the phone,
blah blah blah. Can I manageit? Probably because they used to,
you know, work in litigation attorneyAnte Blue Crossing Blue Shoot. I do
know a lot about medical insurance.Could I handle it? Yeah? But
knowing that I don't have to mytime is worth money. But when you
are doing this and you know exactlywho to call and where to go and

(18:32):
what to ask for and what roadsyou need to go down and what cul
de saction need to visit to findall the information to help your client out.
That's like hiring a lawyer. Imean you're doing like legal level work
which could could cost somebody, youknow, like a couple hundred bucks an
hour. You got fifty hours inthis guy's one case. That's that is
an amazing benefit. That's why I'memphasizing it so strongly because you know,

(18:55):
as I'm saying this, I knowhow it works. As I've talked to
you as much, I just stillfind it hard to leave. It's I
told you I got into this business. I thought it was all about just
helping people get health insurance. Andthen you start seeing all the issues they're
dealing with, and then you realizethere's there's no money to the middle.
There's absolutely there's no companies out there. I've never seen one that mitigates that
that portion helps people go through that. There's no advocacy program that I've ever

(19:19):
seen that's out there, like,hey, we're going to help you get
through this claim process. It's it'son you. So when I say forty
fifty hours for my team, Imean, can you imagine how many hours
are they taking an individual? Actually, you know, under depending on the
circumstances, I can see, like, if I had it all in front
of me, Brian, you're gonnaspend fifty hours on the phone looking for
paperwork and you know, negotiating withyour insurance company, or you can just

(19:44):
write the check and pay the damnbill. I can see myself going with
option too, just to say hellwith it. I'm just I can't handle
with this. And that's what mostpeople fall into. I mean, they
just pay the bill, and that'sjust a terrible situation. It is because
you're paying so much money for theinsurance and you hope it mea and there's
so many speed bumps and pitfalls alongthe way that that's why people get infuriated

(20:04):
by it. They think it's ascam and they think these things are out
there, but it's having to makesure everything's lined up properly. So coverage
assistance for all the problems associated withgetting claims paid, erroneous claims, wrong
ICD nine codes, all that kindof things that can happen. But then
also on the front end, theother added benefit of working with you it

(20:27):
cover SINCY is that before you getthe procedure, you can help your clients
find the providers that are excellent,but also at the best price, because
there is a huge value depending uponwhich policy you put together for them or
the employer group. There's a hugebenefit for finding someone who charges less for

(20:47):
any given service and you call upyour group and you do that for folks
absolutely, So you know, Iwould basically say it's being smart shopper,
like we do for everything else,a big good consumer shop. What you're
going to do, get the pricingup front, especially if it's elective surgery
it's not an emergency. I mean, you have time make sure you're you're
doing the right things because you know, we'll get a lot of people that'll

(21:07):
come back and they'll well, we'regoing to get that pre certified by the
insurance company, right, and theygo, well, the insurance cups like,
yeah, well we'll cover this,you know, but it's not a
guarantee of claims, right. They'renot a guarantee that we're going to pay
the bill. And that happens alot of times too, So even even
getting that pre certification doesn't even meanthey're going to pay for it. If
something comes back differently on the backside. You'd be very careful on those situations

(21:30):
as well. The other thing too, is shopping for care. I mean
one of the things I've listened toyour show as well, and you guys
promote you know, local imaging.That's all. Yeah, much benefit of
affordable imaging services. I know everytimes I see clients go in, they
go, oh, I just wentand had a xyz cat skin. It's
twenty I've seen them over fourteen grandBrian. Oh, if somebody walks into

(21:52):
a regional hospital, there's nothing elsearound. I mean I've I've saw someone
going for elective colonoscophy turn around,have Apollo up and build them with sixteen
thousand dollars. Oh my god.So I mean they are astronomical. I
mean you have to protect yourself.You have to shop ahead of time.
You know, even our care teamwill will share with you wherever you're at.

(22:14):
I mean we have we have aproprietary software. We can literally shop
your zip code and go, hey, your doctor says you can need to
get an MRI. Your local hospitaljust told you it's thirty two hundred dollars.
You got a nine thousand dollars reductible. Well let's not do that.
There's a place down the road doesit for four fifty same imaging machine.
Go there, go get that done. I mean, that's what you have
to do. Support the sponsors AffordableMedimaging dot com if I can throw that

(22:36):
in there too. But no,that and let me just use that as
an illustration because I have you havementioned, and I have mentioned my son's
experience in getting insured through you.That actually established amount that the insurance company
will pay for any given service.So, for example, with a CT

(22:56):
scan, now you go to AffordableImaging and get your CTS, let's say
it's a four hundred and fifty bucksor six fifty or whatever it is.
With a contrast, you're going toget maybe something in the thousands perhaps from
the insurance company. You get thedifference back. Yeah, if like my
son would get the difference in thecheck. Yeah. So if you build
a plan, and we're gonna talkabout this next week. If you build
a plan the right way and youhave first dollar covers, let's say you

(23:18):
buy it a policy that says,hey, any time you get an image,
we're gonna pay one thousand dollars,right, And so if you go
to the hospital and it's thirty fivehundred, well you're out twenty five hundred
dollars, right, but if yougo and chop around, you can get
it for less than a thousand.The benefit of an indemnity plan is you're
getting a check for the difference.Yeah, you're being rewarded for being a
smart shopper and a good consumer ofhealthcare. Yeah, and that might be

(23:40):
five hundred dollars in your pocket ormore. Oh, that's just just doesn't
sound right every time. I mean, this is one of the mind blowing
things about you get paid to havehealth insurance. That's kind of crazy concept.
It is, it is, butit works, and you prove that
it works, and magically the insurancecompanies stay in business cover since he stays
in business. And you've got alot of very happy clients, you,
sir, who are getting it's amazingbenefited. Probably puzzling like I did,

(24:03):
and I struggle with it for along time until you adequately explain it to
me as you're doing right now onour program here rethink healthcare together. John
Roman could be reached at five onethree eight hundred call five one three eight
hundred two two five five final onlineit covers since you with Y or I
and uh, can you can peopleinitiate contact through the website absolutely, so
they can ground their form. Uh, you just fill out your information right

(24:25):
there. You can actually schedule apoint with myself or any of our team
members right through that website, andlike I said, put as much information
there as you feel comfortable with.It definitely helps us out ahead of time,
especially if you're like, hey,I got a certain doctor that I
need to have, or even ifyou're on a prescription I mean that stuff.
We will shop all the over onehundred insurance companies that we have so
when we come back to you witha game plan when we do that appointment,

(24:48):
we want to make sure we're recommendingthe right product for you fair enough.
So cover Since you dot com initiatethe conversation there, what's the turnaround
time in terms of, you know, start to finish. I don't know
if you can even come up withan average on that. I guess it
would be more complex with an employerplan, but simpler perhaps with an individual
who's currently looking at Obamacare policy,which if you are, don't do that

(25:08):
talk to John. Yeah, Imean turnaround time right now? I mean
if you're an individual, I meanwe can probably get you wrapped up in
an hour, hour and a half. Oh, as long as we have
your information. Of course, themarket play plans are guaranteed issue, so
that's not something you have to waitfor underwriting or approval from an insurance company.
So that's about as much time aswe would need to spend with you

(25:29):
analyzing your case and making a recommendation. But once you do an application,
if it's on a private plan,I mean, it can take a couple
of weeks to go through underwriting.So if you are looking at making a
change, especially for something like Januaryfirst, now is an imperative time.
That gives us enough time and ifsomething comes back, you know, if
an insurance company says we don't wantto cover you for this, we don't
want this product on you, we'redeclining for this, that gives us enough

(25:51):
time to pivot to a different company. So again, you know, we
do a really good job of makingsure we don't put you into a situation.
But you know, sometimes people don'tshare every detail in their history and
there's a little skeleton somewhere, andwe understand that. But like I said,
I mean a couple weeks usually gothrough a private plan ACA plan something
we can actually do right away nowgroup plans. I mean, I would
definitely say if you think about aJanuary one effective day, you should call

(26:15):
yesterday. Yeah, So I meanthat can take anywhere from forty five to
sixty days. But don't let thatdiscredit you. The one company I was
just talking to you about earlier inthe show, he was very aware that
he needs to just enroll back intohis current group plan, and I basically
said, listen, we can probablychange your plan, you know, February
first or March first, because eventhough you sign up on a group plan,

(26:37):
the best part about moving to likewhat we told you, breaking up
their groups and moving into individual plansis once you decide to break your group
up, it throws everybody to aspecial enrollment period. So everybody gets sixty
days from that point when the groupdissolves to go back in and open a
roll with another plan. So you'renot hurting your employees by being able to
do that. We do this allyear long. So I was like,

(26:59):
if you're offering a group plan,we can make that change at any time.
You do not have to wait toyour next open enrollment. Fair enough,
and in so far as you know, maybe someone's listening out there right
now that said, well, hell'sbells. I wish I had heard John
Roman talk about this before I signedup with my employer plan. And I'm
talking about larger employers like mine.You know, I heard media the thousands

(27:19):
of employees. You know, thewindows opened and closed, and I'm already
locked in? Am I stuck?Or can I get out of it?
And well, maybe in your situationyou might be that depends. It depends.
Sometimes there's clauses that basically will stateif you had got coverage elsewhere,
you can jump off. But tobe honest with you, most people on
employer group plans, most of youremployers are paying a huge chunk of your

(27:41):
insurance. You don't even realize that. I mean, I've I've talked to
people that go on to Cobra likemy current plans two thousand dollars a month,
I was paying two hundred. Iwas like, well, your employer's
paying ninety percent of your olve insurancebefore. But what you have to look
at is are you still really payinga lot for your spouse and your kids?
Because there is a proportion right nowthan the Affordable Care Actor, you
can actually take your kids and yourspouse off if you can find more affordable

(28:07):
options, and a lot of timesyou'll be surprised. During COVID they now
may are now eligible for tax creditseven though they weren't before, so we
can we can analyze that for youmight be able to save a lot of
money by pulling your wife and kidsoff. And you can do that at
any point in time. Well,and that's why you call John Rouelman that
cover since John has been a realpleasure talking to me on anythink health care

(28:27):
together. There's more than one waysto skinn Gott and John literally knows every
single possible way when it comes togetting you ensured medically. Five one three
eight hundred call that's five one threeeight hundred two two five five again online
where you can initiate the discussion ofthe conversation with John on the team cover
Sinsey WITHYRI dot com. John,always a pleasure talking with you. Keep

(28:48):
up the great work man, Thankyou very I appreciate my pleasure.