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Episode 2012 Transcript:

00;00;01;14 - 00;00;06;03

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;06;06 - 00;00;34;13

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show Broadcasting Coast to coast across the USA here on the HIA Radio Network. We're on we think now about 238 affiliates because we just added another one KSYL AM and FM 104.9 in Alexandria, Louisiana. Very happy to have them all welcome them to America's Healthcare Advocate family and David Graichen,

 who was the manager there, brought us on the air.

00;00;34;13 - 00;00;56;16

Cary Hall

We're very happy part of their broadcast and happy to have them in the America's Healthcare Advocate family KSYL AM and FM 104.9 on Saturday mornings. Very happy to be there. My producer behind the microphone, Mr. Darren Wilhite behind the camera is Dave Thiessen. All these shows are located on 15 podcast platform and we have our own YouTube channel.

00;00;56;16 - 00;01;16;26

Cary Hall

America's Healthcare Advocate is the YouTube channel, so all the shows are videotaped and posted up there. So if you want to tell somebody about a show, you can certainly do that. Now, I normally lead these shows off by telling you if you're looking for Medicare and you're chronologically challenged like I am, you can reach out and just talk to the lovely Carolee Steele.

00;01;16;29 - 00;01;35;10

Cary Hall

Well, she happens to be here in studio today, so today you can actually watch her. And if you are looking for group health insurance, and if you're an employer or, human resource director, you can reach out to the lovely Maria Ahlers who's sitting here in studio today as well. So we're glad to have them back in again.

00;01;35;12 - 00;01;55;27

Cary Hall

We got a lot to talk about today. So again, if you want to reach out to them. By the way, the phone number, there is 877-385-2224 anywhere in the country. They are happy to help you. 877-385-2224 today we're going to talk about Medicare. We're going to talk some changes in the marketplace here in the Kansas City metro.

00;01;56;01 - 00;02;15;26

Cary Hall

And you may be experiencing these in other parts of the country as well. So that's why we're making this a topic today, because people are getting notifications that in some markets carriers are shifting out of Medicare Advantage. We're going to talk about that. We're also going to talk about what's new in Medicare. And then we're going to talk about, you know, a group health insurance plans.

00;02;15;28 - 00;02;40;27

Cary Hall

And how RPSBBDI approaches this, their customer service, program, how that works and how it services your employees. If you happen to be on one of the plans that they are the broker for because they are, broker excuse me, they are insurance carrier agnostic. They do all the carriers all over the country. So they're licensed with all of them appointed by them, and they can certainly bring you whatever product you may be interested in.

00;02;40;27 - 00;02;46;14

Cary Hall

And so let's just start with what's going on in the marketplace. Carolee, there are some changes afoot.

00;02;46;14 - 00;03;17;16

Carolee Steele

Yes, there are in the KC metro, Blue KC, which a lot of their, clients have already and members have already received communication from them. They are actually pulling out of the Medicare Advantage market for 2025. Now, this does not affect any type of Medicare supplement plan. They are still in place, intact, etc. however, and these plans they will be on will have full rich benefits all the way until December 31st.

00;03;17;16 - 00;03;42;26

Carolee Steele

So they'll have those until then. However, during the annual election period, which is October 15th to December 7th, they will want to either, look at Medicare supplements. And now people would say, well, I can't get on to that. I'd have to go through medical underwriting. But they do not have to do that because they're actually losing their plan.

00;03;42;29 - 00;04;07;07

Carolee Steele

They have what's called guaranteed issued. That means they do not look at your medical history and all what's going on. They accept you guaranteed issue, which means that, you know, you would be accepted. That's an option for them to do. Obviously, Medicare supplements were completely different that Medicare Advantage plans, Medicare supplements. You're on one. You know that.

00;04;07;10 - 00;04;13;27

Cary Hall

The Blue Cross Blue Shield plan have been for the last. Let's see, 75. What is that, 13 years? Something like that a lot.

00;04;13;27 - 00;04;32;23

Carolee Steele

Yes. So the Medicare supplement, you know, does cost per month, very rich benefits, etc.. As long as they take Medicare etc., so we can go over those options if they decide to pivot to do something on the Medicare supplement space.

00;04;32;26 - 00;04;48;02

Cary Hall

All right. So let's go back because you there's a lot in there. Let's unpack some of this stuff. So first of all the first thing they need to understand is if you are on one of the Blue Cross and Blue Shield Medicare Advantage plans, you've received notification saying that the plan is not going to be renewed for the year 2025, correct.

00;04;48;03 - 00;04;54;03

Cary Hall

However, all of the plans are in place through December 31st of this year, am I correct?

00;04;54;03 - 00;04;55;00

Carolee Steele

Yes, sir. Yes.

00;04;55;06 - 00;05;17;03

Cary Hall

So nothing changes there. Your providers don't change. Your out-of-pocket doesn't change. Costs don't change. Nothing changes. So rest easy. You know, we're only a month of June. July here, so we've got plenty of time, as we move forward to deal with the issue. But the most important thing out of that piece, that I think people need to hear, is there's no there's no need for panic.

00;05;17;03 - 00;05;19;17

Cary Hall

Don't panic because you've got coverage.

00;05;19;19 - 00;05;33;07

Carolee Steele

Everything will remain the same. It's going to be uninterrupted coverage on medical, your dental, your flex benefits. Everything that is in your plan right now will stay in tact until December 31st.

00;05;33;09 - 00;05;57;22

Cary Hall

And all the providers are the same. No, no. Change your provider anything. So you're good to December 31st. Here's another part that I think is key. They need if people I don't care whether you know you're on a blue plan now and you're working with RPSBBDI or you're working somewhere else, you need to reach out, and, and reach out to you and to the staff at RPSBBDI and get a time set up just to understand what's going to happen.

00;05;57;22 - 00;06;00;04

Cary Hall

Maria is shaking your head. Yes. Would you agree with that?

00;06;00;11 - 00;06;20;06

Maria Ahlers

Absolutely. I think, now's the time to reach out. Schedule an appointment. So that way it's done. It's taken care of. You will have to reenroll. So, now it's time to get on. Carolee and the team schedule, to even start just that preliminary, scope of what you're looking for. Yeah.

00;06;20;06 - 00;06;46;08

Cary Hall

And so here's what they've done at RPSBBDI. They've set up a separate email address for you to reach out to. So rpsmedicare@RPSBBDI.com rpsmedicare@RPSBBDI.com. Or you can always call them 913-385-2224 you know, if you don't get them, if you call on a Saturday or whatever the case may be, there's a prompt on their leave it and they'll get right back to you.

00;06;46;08 - 00;06;46;17

Cary Hall

Right?

00;06;46;18 - 00;07;10;18

Carolee Steele

Absolutely. And we I've had some calls to where people go, well, I want to switch now. And you can't switch now because there is no special enrollment period. They're like, well, I want to move now. I don't want to wait until. But we they have to actually wait until October. So we are booking appointments. I said I know it's in October, but it's going to be a little bit of a frenzy, at that time, because it's going to be a feeding frenzy.

00;07;10;18 - 00;07;25;05

Carolee Steele

And so I said, it's better to get on the books. We will get together. I will take you, you know, we'll take good care of you, make sure that you get into the right plan. Whether you want to flip, to supplement or, you know, do something else. We can pivot and do it then, but we can't do anything.

00;07;25;07 - 00;07;33;12

Carolee Steele

October 1st is when we can first have access to the benefits that are going to be offered for 2025 on an advantage plan. Yeah.

00;07;33;12 - 00;07;45;10

Cary Hall

So let's kind of clarify that a little bit. So we won't know. RPSBBDI will not know, what the new plans are going to look like. Who's going to offer what until October 1st. Right.

00;07;45;10 - 00;07;51;10

Carolee Steele

Correct. And that's when we have, access to that information and that we can share it with the general public.

00;07;51;10 - 00;07;54;12

Cary Hall

But, Maria, you're saying for folks, get on the phone that.

00;07;54;12 - 00;07;54;27

Carolee Steele

Oh, yeah.

00;07;54;29 - 00;08;09;00

Maria Ahlers

And get on the calendar. In previous years, when you're on the, Medicare Advantage program, if you wanted to stay on it, it would just rollover. This year. You have to call to re enroll and find a plan that works for you.

00;08;09;00 - 00;08;24;06

Cary Hall

So if you're one of those folks on the Blue Cross plan, that that is exactly what it has to happen. And by the way, just so you know, you don't have to do an in-person appointment. They can do it over the phone. You can do it on a zoom everything. Yeah. So you can do it. You can do a zoom conference and they'll be happy to set it up for you.

00;08;24;06 - 00;08;42;23

Cary Hall

You don't have to do anything. Just click the button and go on, and have a face to face meeting using the zoom. It works really well. I do about 5 or 6 of those a day. Trust me, I know how they work, so that's a great way to interact if you don't want to. But if you want to come to their offices in College Boulevard, 6800 College Boulevard.

00;08;42;25 - 00;09;02;21

Cary Hall

Okay, see, I got it almost right. Almost almost 6800 College Boulevard. They're happy to have you come down and meet with him in person. Once again, the website, if you want to call them or reach out and schedule is rpsmedicare@RPSBBDI.com. We'll be right back after the break. Continue this conversation about Medicare and other topics.

00;09;02;21 - 00;09;16;04

Cary Hall

Stay tuned. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. We've got more. Hang in there.

00;09;16;06 - 00;09;46;06

Steve Kuker

The golden rule treat others as you want to be treated. I'm Steve Kuker and this is one of the founding principles of my firm. Senior Care Consulting. Since 2002, our value statement has included. Honor our mother and father. Respect our elders. Care for those in need. And treat your family as our own. We've been honored to help hundreds of families make one of the most difficult decisions they could ever make.

00;09;46;11 - 00;10;21;19

Steve Kuker

Serving them in their greatest time of need. If you're looking for someone who can provide you experienced and objective guidance when searching for a senior care community, reach out today and discover the services of Senior Care consulting at 913-945-2800. Know your options and choose with care at SeniorCareConsulting.com.

00;10;21;21 - 00;10;43;20

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show Broadcasting coast to coast here across the USA on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. AmericasHealthcareAdvocate.com. So again, the purpose of doing these kinds of shows is to educate you. That's why these are put up on the YouTube channel.

00;10;43;20 - 00;11;01;05

Cary Hall

And they're on all the podcast channels to educate you as to what is going on in the marketplace. With the Medicare Advantage plans. Here in the Kansas City Metro, we have Blue Cross and Blue Shield pulling out of the Medicare Advantage market. You may be listening this in Paducah, Kentucky. You may be listening to it in San Luis Obispo, California, where we're on the air.

00;11;01;07 - 00;11;26;27

Cary Hall

Or you may be in Alexandria, Louisiana. This may be happening in your neck of the woods as well. You would have received a letter from the carrier advising you that it's happening. If it is, you can reach out to the folks at RPSBBDI. You can call them at 877-385-2224. That's 877-385-2224. They're happy to chat with you about other offers, other plan designs that are in the marketplace.

00;11;26;29 - 00;11;48;14

Cary Hall

Now's the time to get on the calendar. You heard Maria said. Because let me tell you what's going to happen. Everybody's going to wait. They're going to procrastinate until, you know, October, November, and then all hell is going to break loose with people. Tried this. I've been through this before. And when, you know, carriers move out of the marketplace under ACA and other products, this is what happens.

00;11;48;14 - 00;12;14;21

Cary Hall

And if you wait, then trying to get through to somebody and get help is going to become that much more difficult. Also, you can go to the website rpsmedicare@RPSBBDI.com. Send them an email, they'll get on the get you on the calendar and they can start talking to you about, hey, let's set something up. We'll start talking in August, September, and then you'll feel like, you know what you're going to go.

00;12;14;26 - 00;12;20;23

Cary Hall

So let's talk a little bit about that. And the fact that you get the carrier information about the 1st of October.

00;12;20;23 - 00;12;40;19

Carolee Steele

1st of October is when we can actually disclose benefits, etc., from each of the carriers that have a Medicare advantage plan for 2025. So that's when we are able to actually have a great discussion with them. Right now, we are just putting them on the calendar so that we there is no surprises for them. And they're not, you know, lost said.

00;12;40;19 - 00;13;02;16

Carolee Steele

They're on the calendar. We will have a phone call. We can have a teams invite. We can see face to face. We can go through or in person. We can do whichever one that they feel most comfortable about. The the move from the Blue Cross Medicare Advantage plan has to be consumer initiated. As far as like we as a broker, we can reach out to our people.

00;13;02;18 - 00;13;13;28

Carolee Steele

But as far as like them, nobody's going to flip you over to another carrier. That has to be done with a broker listing, and they have to go to, a lot of the carriers.

00;13;14;03 - 00;13;37;24

Cary Hall

And here's something I'm going to just this is we see this happen often. Don't go do this yourself. I'm just going to tell you flat out it's it's a mistake. Okay. You know, we did a show with the young lady here who did this on an ACA plan, got pregnant, and went back in to report the fact that she, she, she had she had filed it under her maiden, under her married name.

00;13;37;24 - 00;13;57;05

Cary Hall

They wanted it under maiden name. She went back to do that and she wound up losing your coverage. This is through the government website and through the the government care guides that were handling this. And it was a we did a whole radio show on her. She also did some television here, and she lost her coverage and it was a nightmare getting it back.

00;13;57;05 - 00;14;04;09

Cary Hall

I'm just telling you, don't go up there and try to figure this out on your own because it's complicated and it's difficult.

00;14;04;12 - 00;14;27;16

Carolee Steele

It is. And there's so many moving parts to Medicare and everyone's situation is completely different. They go, you know, well, what's the best of the thing? It depends on what is your non-negotiables, your doctors, are they in the network, the medications. ET cetera. You know, do you need more dental than you need something else. So we take a look at these situation, the life situation that they're in.

00;14;27;18 - 00;14;36;21

Carolee Steele

And then we can look to see what's across. The you know, horizon for all of 2025 Medicare space and figure out what's best for them.

00;14;36;25 - 00;14;52;10

Cary Hall

You know, Maria, what I've found in the past is when people went out and did this on their own on Medicare Advantage, where they signed up, and then they call you a month later and go, oh my God, I got in this thing, and I need I didn't realize they don't cover my prescription drug.

00;14;52;12 - 00;15;29;04

Maria Ahlers

That's right. Cary, I it I work for and my parents see Carolee, I don't try to diagnose or figure out which plan works best for them because they are the experts. There's so many moving parts to determining what is the right coverage for you and what, you know, medical benefits. It it affects your pocketbook. And so we really want to make sure that we're helping you out, not just about the plan, but also on the financial side to make sure that you can afford the coverage or if we can find you some subsidies, we'll do that too.

00;15;29;06 - 00;15;38;23

Cary Hall

And just because this is and that's a great point you bring up on the financial side, just because that premium is zero premium for another carrier, that doesn't mean it's an identical plan, right?

00;15;38;24 - 00;16;14;12

Carolee Steele

Absolutely. Because everything is going to be changing next year. That's why October 1st, we will go over all of the Medicare Advantage plan options that are available to them, figure out which is best. It's not a one size fits all. Absolutely not. It's not because everyone has different needs and different, as far as like like I said, providers, drugs, all the flex benefits, you know, so we look to see what the other carriers are going to be bringing to the table on Medicare Advantage, or if a better fit for them is to pivot off that Blue Cross Medicare Advantage plan and go to a Medicare supplement.

00;16;14;16 - 00;16;27;10

Cary Hall

And so the other side of that is that you don't know what you don't know, right? You you're the consumer. You think, well, it looks just like the one I had before. You may not know that your doctor or hospital, they all have different networks.

00;16;27;10 - 00;16;41;29

Carolee Steele

And they don't know the questions to ask. And so that's where we are. So that we actually do kind of a discovery process with them. And we ask the questions, you know, over time and figure out their situation and which plan works best for them.

00;16;42;03 - 00;17;11;05

Cary Hall

And I will tell you, do not call one of these phone numbers because you're going to get you're going to see hundreds of these ads done by various celebrities. Whether it's William Devane or the former governor of Arkansas telling you to call this number for a Medicare, you know, for Medicare evaluation, I if I had a nickel for every call that I get, marketing call from a senior care consultant, quote unquote, from one of these call centers, you know, I'd have enough money to fill a piggy bank.

00;17;11;07 - 00;17;28;07

Cary Hall

Okay. So I'm telling you, do those people do not understand your network in your town? Here's a little you want to do a quiz, ask them to tell you, hey, are the hospitals north of the river in the plan? And then ask them which hospital. They're not going to know what you're talking there. Go. What river? What river?

00;17;28;07 - 00;17;42;22

Cary Hall

Yeah. So always say. Yeah. So you know, that's just an example of what goes on you. That's why you talk to somebody here that understands what's going on and can help you with that and walk you through it so that you're getting what you need in a timely manner.

00;17;42;22 - 00;18;01;24

Carolee Steele

Right. And it could be another Medicare Advantage plan. It could be a Medicare supplement plan. Suppliments only cover medical. And so you would have to then go to get some type of drug plan. So that's where we come into play, is that we will make sure that you have everything you need to cover your health care needs.

00;18;01;24 - 00;18;09;14

Cary Hall

Yeah. And that also includes, if there's vision and dental on this plan, that may not be on the next time you go to enroll. Correct?

00;18;09;14 - 00;18;20;10

Carolee Steele

Correct. And that's where we come into play, is that we will look to see and we will fit your life situation with the certain Medicare Advantage Med supplement plan, you know, going forward.

00;18;20;10 - 00;18;29;12

Cary Hall

And again, you know, maybe they'll be offered, but they could be you could be a different amount of money for dental and a different amount of money. You're not going to know that stuff unless you send it on.

00;18;29;12 - 00;18;39;13

Carolee Steele

But not until October 1st. That's why we have to set up, you know, meetings for October, because we cannot really disclose anything now because we don't have that information. So that's we wait.

00;18;39;15 - 00;18;58;21

Cary Hall

And if anybody tells you that, that that's incorrect. Okay. Just to be really clear and be really honest about this. And if they try to move you now, they can't move you because you're still in the lockdown period until we get to open enrollment, which begins on October 15th. So once again, if you need help, you can call 877-385-2224.

00;18;58;23 - 00;19;23;26

Cary Hall

I don't care where you're at in the country, and if you're here in Kansas City, Metro obviously RPS Benefits by Design. Or you can go to their website, rpsmedicare@RPSBBDI.com. We'll be right back after the break. Stay tuned. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network.

00;19;24;01 - 00;19;36;13

Cary Hall

Coast to coast across the USA. We'll be right back.

00;19;36;16 - 00;19;55;22

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the HIA Radio Network. If you want to find out more about us, go to the website AmericasHealthcareAdvocate.com. That's AmericasHealthcareAdvocate.com shows are posted up there. If you want to send me an email free, feel free to do that.

00;19;55;25 - 00;20;12;13

Cary Hall

If there's a question, something I can help you with, I get people from all over the country oftentimes will send me an email, need help with some type of an issue regarding insurance or otherwise? We are happy to do so. If you've got a topic you would like us to discuss or talk about, or maybe you want to be a guest on the show.

00;20;12;15 - 00;20;39;18

Cary Hall

If you're a medical professional or someone associated with health care, we'd be happy to chat with you once again. The website AmericasHealthcareAdvocate.com in studio with me today is Carolee Steele from RPS Benefits by Design and Chief Operating Officer Maria Ahlers here talking about what's going on in the marketplace for Medicare. And now we're going to switch gears and talk about what's going on in the marketplace with group health insurance benefits, how those are changing and what we're going to see and changes coming up.

00;20;39;20 - 00;20;59;22

Cary Hall

Also, quick note, by the way, RPSBBDI is licensed throughout the country nationally, so I don't care where you're at. I said if you're in Paducah, Kentucky, or you're in Tupelo, Mississippi, or you happen to be right here in Kansas somewhere, feel free to reach out. Give them a call. The number is 877-385-2224. They can help you.

00;20;59;22 - 00;21;27;21

Cary Hall

Just about any insurance needs you have. 877-385-2224. That email, if you are interested in help with Medicare, is rpsmedicare@RPSBBDI.com. All right. Let's switch gears a little bit. Let's talk about what's going on in the marketplace with regard to, group health insurance. And and, you know, especially for small employers. Maria, this is a real challenge today.

00;21;27;23 - 00;21;41;02

Maria Ahlers

It is, they meet a lot of challenges in getting that premium to where it's affordable. So we're helping our clients to navigate through the challenge that the market is just bringing on.

00;21;41;04 - 00;22;01;23

Cary Hall

Yeah. And it's particularly challenge for small employers when they're trying to pay a portion of that for the employee. But we're really falls off a cliff typically is when it comes to that employee trying to put their family on a plan. How do you all deal with that and help them if the employer's got a plan? But the family rate is just more than they can afford?

00;22;01;28 - 00;22;26;10

Maria Ahlers

Well, we're fortunate enough to work with different carriers, and different carve out carve out option plans, to help with that cost. A lot of it is employee education. Cary is, sitting down with the employees and figuring out if they really need a certain plan. Sometimes moving up in a higher deductible because they're a healthy family helps reduce that cost as well.

00;22;26;16 - 00;22;33;15

Maria Ahlers

So really, just getting to know the employee and knowing what they need for their coverage is where everything starts.

00;22;33;15 - 00;22;49;17

Cary Hall

So that's interesting. So, you know, a lot of brokers in that situation can say, well, you know, this is what they're offering and we're really not going to be we're not really equipped to to deal with you on that. Let's say they want to go to an individual plan for the family, for the wife or for the husband and kids, whatever.

00;22;49;19 - 00;23;11;24

Cary Hall

The oftentimes one of the illustrations that I think it's really good is school district plans, their great benefit plans for the teachers. They're not so great when it comes to they're a great for the employees families if they can afford it. But I remember back, you know, when teachers would come to us from Olathe school district, from different school districts, and the plans were just the cost was beyond their ability to pay.

00;23;11;26 - 00;23;24;20

Cary Hall

You're talking 14, 15, $1,600, sometimes $2,000 a month. But if they move to an individual plan, then they then they can drop that cost significantly. Might even qualify for a decent subsidy.

00;23;24;22 - 00;23;58;06

Maria Ahlers

That's right. We we look at their family, their, their family, structure. Sometimes it is, more affordable to have, one spouse on an individual plan and the other spouse takes the kids, or it's more affordable for each of them to have their own plans with their own employers. So really, we're looking at what the whole picture to determine what's their best, options are, we don't just look at what their employer offers, but let's talk about your spouse or your significant other.

00;23;58;11 - 00;24;21;14

Maria Ahlers

And what are they offering? Are they covering what your, your plus one, your spouse, your significant other needs? And what makes sense on who should cover the kids, or does it make sense for both you to be on your husband's plan or the wife's plan? And then we have other carve out options, too. You know, one of the things we always hear from our clients is I get emails all the time.

00;24;21;14 - 00;24;37;13

Maria Ahlers

Maria. I need my premiums to be lower for my employees. And I agree, I would love to do that. But as we all know, our insurance costs is just continuing to grow up. And with that, we need to do a lot of employee education.

00;24;37;15 - 00;25;05;00

Cary Hall

And so, you know, that's an example that I just gave the broker that writes those large group plans is typically not going to be a broker that does individual health insurance. Now, RPSBBDI has always been a broker that services the large group, small group and the individual market. And so if you're faced with that, I don't care where you're at in the country, you know, like I, I keep referencing Paducah, Kentucky, for some reason today.

00;25;05;02 - 00;25;20;19

Cary Hall

Maybe it's because we're on the radio down there, but, or, you know, whether it's Cape Girardeau, Missouri, or whether it's San Luis Obispo, California, if you're up against that, you're not going to be able to talk to that that broker at that agency, because they only deal with large group plans. They're not going to deal with individual health insurance.

00;25;20;22 - 00;25;24;23

Cary Hall

That's where RPS Benefits by Design can make a difference, right?

00;25;24;29 - 00;25;53;03

Maria Ahlers

Absolutely. Where I hate to use a cliche, but we are a one stop shop. If we realize that your spouse is aging into Medicare, we have specialists for that. If you have a child that's aging off of your plan, we have specialists for that. We really can help in any situations we can. If you're a 1099, which a lot of carriers don't cover, we have an option for that.

00;25;53;08 - 00;26;02;27

Maria Ahlers

We really try to be creative in our approach to make sure that we have something that, is, is a fit for everyone.

00;26;03;00 - 00;26;18;24

Cary Hall

Yeah. So an example that would be, let's say that, you know, and your employer, your, your coverage is paid for by the employer. He's paying 50% of it, 75% of it. And the rest of it, you can afford to pay for that. But let's say your husband is an Uber driver, okay? Or your wife is an Uber driver.

00;26;18;27 - 00;26;43;28

Cary Hall

There are 1099 employee. Yeah. The carriers aren't offering coverage for that. We have RPS Benefits by Design has a plan for that. It's specifically for people that are 1099. Most brokers around the country don't even know those plans exist. And certainly aren't able to get people enrolled in them. So again, it's being able to serve all segments of the marketplace and do it in a way that really makes a difference.

00;26;44;02 - 00;27;14;20

Maria Ahlers

It really does in having everything housed in one place makes it easy. If you know you need your aging into Medicare, well, I'm going to call RPS. My son just graduated, you know, is turning 26. I'm going to call RPS. They are able to help us. We have specialists in, you know, different market groups, the small market, the large market, even on the group side, because each of it requires different regulations, different compliance, different plans, different carriers.

00;27;14;25 - 00;27;24;23

Maria Ahlers

And so our goal is to find one that works for, the employees. There's no point in offering plans if the employees can't afford it.

00;27;24;25 - 00;27;45;27

Cary Hall

Yeah. And unfortunately, in today's world, we're seeing a lot of that. We are. Yeah. And so again, you know, I reiterate, you know, if you've got, if you've got a situation like that, you maybe you're not getting any help or maybe, you know, there's not something that your particular broker in your case does. Of the folks at RPSBBDI will help you, they're happy to help you any place in the country.

00;27;45;27 - 00;27;55;03

Cary Hall

They do, in fact, all the way up here to do the show. You're talking about a client who had called you? Yes. And so, you know, people call in off this radio show all the time. All the.

00;27;55;03 - 00;27;58;25

Maria Ahlers

Time. We love it and we love it. Well, and.

00;27;58;25 - 00;28;16;13

Carolee Steele

I'm going to piggyback really quick on what you said about the employee is very affordable. But the spouse was not one person. She's like, well, he doesn't need to go to Medicare because he's on my plan. I said, well, find out how much of that premium is his and how much is yours. And she's like, all of it's his.

00;28;16;13 - 00;28;23;09

Carolee Steele

So she, you know, so he ended up moving to Medicare because the employer, the employee was covered very well.

00;28;23;11 - 00;28;43;27

Cary Hall

Yeah. And see, a lot of people don't realize that okay, that's a classic example of paying for something and not knowing what you're paying for. Well, that might be a good time to pick up the phone and give them a call. And just ask those questions, because if the employer in this case was paying for all of her premium, but none of the husbands that she moved to let a Medicare advantage.

00;28;44;03 - 00;29;04;05

Carolee Steele

Move to a Medicare plan, and it was a Zero Premium, Yeah. And and it really saved you. They didn't know that. She didn't know that most of the cost for her premium that was coming out of her check was for her spouse. So when her spouse turned Medicare eligible, then, you know, she made a first. She was like, oh, I'll just keep them on my plan.

00;29;04;07 - 00;29;09;13

Carolee Steele

But she knew that it was much more financial and their health care needs were covered well.

00;29;09;15 - 00;29;32;11

Maria Ahlers

And on the employer side, you know, that's why we worked so well together with the Medicare team, is we can look and see who has a spouse that's aging off of Medicare, that we can maybe put on a Medicare program versus being on the employer plan. The benefits may be more rich on a Medicare plan than on the employer plan.

00;29;32;13 - 00;29;50;18

Cary Hall

Yeah, because it the Medicare Advantage plan, you don't have, you don't have a premium right on most of these plans. Is there a premium plan? So so right out of the gate, you don't have a premium. You know, if this sounds complicated, that's because it is. Which is why I say to you, don't try to do these things on your own.

00;29;50;18 - 00;30;06;24

Cary Hall

I talked about this in the opening segment here, talked about in the last segment. Don't make the mistake of trying to go up online. And, and do this yourself and figure that you got to figure it out, because nine times out of ten, you're going to find out that there's some piece of that that's not going to work the way you think it does.

00;30;06;28 - 00;30;27;24

Cary Hall

Also, please stay away from these call centers that you get on that are calling every day. If you're over 65 or these advertisements you're seeing on YouTube and on the television, they are not the best source for you to go to to get the kind of coverage you need. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network.

00;30;27;28 - 00;30;34;26

Cary Hall

Coast to coast Cross, USA. Stay right there. We'll be back.

00;30;34;28 - 00;31;00;29

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA. My producers, Mr. Darren Wilhite behind the microphones on the Audacy Studios here and behind the camera, Mr. Dave Thiessen, who records all these edits, all these and puts them up on the YouTube channels. They are up there. So, you know, if you want to share this with a group of friends about what's going on in the marketplace right now with Blue Cross or some of the other issues that are out there, the YouTube channel is up there.

00;31;01;04 - 00;31;20;17

Cary Hall

You can certainly do that by telling folks to go there or even one of the podcast channels, iHeart Radio Audacy Radio, on Spotify, SoundCloud. We're on 15 of them, so you can certainly find us up on your favorite podcast channel. And obviously listening to us across the country, as we said earlier, we just have a new station. We just keep adding stations.

00;31;20;17 - 00;31;42;01

Cary Hall

We added the newest one, in Alexandra, Louisiana. Very happy to have those folks on. So let's change gears a little bit. We're talking about group here. One of the things that happens every year, Maria, is, employers have a tendency to wait. Also, some brokers aren't real proactive about getting those new rates out to the client.

00;31;42;01 - 00;32;02;19

Cary Hall

And, you know, I, I hesitate to paint this brush on all the brokers. But there are certain brokers that do this that they'll delay those rates on purpose. So it becomes more difficult for people to change. I'm suggesting it, you know, if you know there are going to be increases next year period. Yeah, okay. They might be 6% if you're really lucky.

00;32;02;22 - 00;32;21;20

Cary Hall

More like ten, 12, 15. And if you're not lucky, they could be as high as 23%. It depends on what you're on. Okay. And what if you're on an ACA plan? You know, or you know or you're on a level premium plan. You know, I remember getting level premium renewals that were 120% simply because, the carrier wanted to push them off the plan.

00;32;21;23 - 00;32;23;12

Cary Hall

So it happens all the time.

00;32;23;16 - 00;32;50;04

Maria Ahlers

It does. It happens all the time. What we do to be proactive is we work on renewals 120 days out. So we're looking at October right now, getting with our clients to discuss pain points. Are the plans working looking at utilization and claims. So then we can forecast what the renewals may come in at. Most carriers really don't release renewal rates until 60 days out.

00;32;50;06 - 00;33;09;10

Maria Ahlers

Sometimes we get lucky at 90 days out, which then we're really in a tight, in a tight timeframe to get everything done, because you're talking about going to get quotes which all the carriers are working on it. So anything that usually takes 5 to 7 days is now taking 7 to 14 days. And then we got to get employees enrolled.

00;33;09;10 - 00;33;38;04

Maria Ahlers

And if we're going to go to different carriers, complete all the paperwork, and then we have a benefits platform where all our, all your, all our clients employees can enroll on this benefits platform. Makes it really nice and smooth. You know, I, had a client, their renewal is August 1st, and, historically, their renewals have been in the in the teens, like you mentioned, you know, 15 to 20%.

00;33;38;10 - 00;33;47;21

Maria Ahlers

And this year we actually, went to market and found them, a plan that is 7% less than the renewal.

00;33;47;23 - 00;33;51;06

Cary Hall

And that they were thrilled. That's that's not a story. You hear every day.

00;33;51;06 - 00;34;12;18

Maria Ahlers

Yeah. Yeah. You usually don't get a decrease, but we, in this client, was with another broker for many, many years, and that broker just did the same thing. Renewed with the same carrier. And, they had reached out to me through a mutual, networking professional. And we went out and went to market and, got a 7% decrease for them.

00;34;12;24 - 00;34;36;08

Cary Hall

You know, that's funny. That brings to mind a story that, happened to me in Carterville, Illinois, where, this city was paying for a policy, this help that we had, their health insurance, they're paying for a life insurance policy. And we asked them where who was handling the life insurance policy because they were paying a ridiculous price for this policy, which happened, by the way, includes the city council.

00;34;36;10 - 00;34;55;24

Cary Hall

And they said, well, the broker three doors down, we think it's him. We're not sure. I said, well, who's getting who's getting the premium check? Who's getting who's getting the commission check? And it turned out it was a completely different broker. They had no idea who was covering them. So this happens okay. People get complacent, you know.

00;34;55;26 - 00;35;21;07

Cary Hall

And what you're hearing is you shouldn't okay. Because here because Maria they reached out to Maria. They were able to effect a 7% decrease. Not all brokers are, you know, Johnny on the spot and proactive about these things. And that's one of the that's one of the things that's different along with customer service. And as we wrap this up today at three, I talked briefly about your customer service because they're never going to tell you to call the carrier.

00;35;21;12 - 00;35;44;27

Maria Ahlers

No, no, we'll never tell you to call the carrier. You have a direct line. And as Cary famously says, it's not a 1-800 I don't give a damn. It's a direct line to a account manager. And that account manager takes care of everything for you. The beauty of it is, each account manager specializes in the market of the size of the employer.

00;35;45;04 - 00;36;01;13

Maria Ahlers

Again, each employer requires, depending on your size. You can only offer certain plans. And there's a lot of compliance issues. But we pride ourselves. We know that insurance makes an impact on employees.

00;36;01;16 - 00;36;03;22

Cary Hall

Makes the impact on the employers being able to keep.

00;36;03;22 - 00;36;04;07

Maria Ahlers

That's right.

00;36;04;14 - 00;36;04;17

Cary Hall

And.

00;36;04;24 - 00;36;25;08

Maria Ahlers

That's right. Recruit and retention. It's one of the biggest cost. Besides payroll is benefits. So we want to do everything we can to help people out. You know, we we love hearing the stories of. I couldn't get this covered before. And someone made a call, and we got it covered. You're at the prescription. The pharmacy place.

00;36;25;11 - 00;36;39;26

Maria Ahlers

Well, they can't find my ID card. Give us a call. We'll pull it up, text it to you, email it to you, talk to your pharmacist. Whatever we need to do to help you to navigate through this thing, call health care life, okay?

00;36;39;28 - 00;36;46;03

Cary Hall

I mean, I like that term. I haven't heard that before. That's pretty good health care life. That's. Yeah. Or for the life of the health care.

00;36;46;03 - 00;36;47;13

Maria Ahlers

Yeah. That's very healthy.

00;36;47;17 - 00;37;01;23

Cary Hall

Yeah. It's just, you know, I, I'm sure I could ask Carolee to sit here and recite story after story about customers that have called you where you're, you know, especially on the Medicare side where people get nervous and concerned and.

00;37;01;25 - 00;37;17;08

Carolee Steele

And it's so wonderful to have an agent of record because we can go to bat for you. We can figure out if we don't know, we can figure out who it is instead of just being, you know, you've got a Medicare advantage plan written. You don't remember who the broker was, and you have no idea if there's an issue that comes up.

00;37;17;08 - 00;37;29;12

Carolee Steele

You need a pre authorization for a surgery. You need something. We are able to navigate that as the agent of record. We can go and do that on their behalf with their assistance obviously and get those things done.

00;37;29;13 - 00;37;51;12

Cary Hall

Yeah. And it makes a big difference for folks. So again the purpose of the show is educational to it. You know, bring you up to speed on what's going on in the marketplace. On the Medicare side, the same thing on the group side. I don't care how big your group is, if it's five lives or 500 lives, if you reach out and call Maria at eight seven, seven three, eight five, 22, 24, they will connect with you and they will add value.

00;37;51;13 - 00;38;05;10

Cary Hall

Maybe they're going to tell you what you've got is great. There's no need for you to think about changing. On the other hand, you may find out like this. Like like the employer who reached out to them, on a plan they've been on for a lot of years because the broker chose not to move them or give them anything.

00;38;05;10 - 00;38;23;09

Cary Hall

It was innovative. They save 7% of their premium. They were probably pretty happy about that. That takes work. That takes effort. You've got to be willing to do it. They're willing to do it. They will not tell you to call the carrier one 800. I don't give a damn number. You're absolutely correct about that. But you can call 877-385-2224.

00;38;23;12 - 00;38;49;06

Cary Hall

They're happy to chat with you anywhere in the country. 877-385-2224 if you are chronologically challenged and you do have issues with Medicare, rpsmedicare@RPSBBDI.com, thank you for listening today. And now I leave you with this thought from Albert Einstein, the one who follows the crowd to usually get no further than the crowd. The one who walks alone is likely find himself in places no one has ever been.

00;38;49;13 - 00;39;11;10

Cary Hall

Remember, friends, it's a funny thing about life. If you refuse to accept anything but the very best. You most often get it. Thank you for listening to America's Healthcare Advocate show. Broadcasting coast to coast across the USA. Goodbye, America.

00;39;11;13 - 00;39;13;17

Cary Hall