America's Healthcare Advocate Blog

Empowering Brokers with Better Healthcare Solutions from BrokersBloc

Sat, 28 Mar 2026 15:51:53 GMT

Episode 2208 notes

Today , Stephen Combs and Ryan Ross from BrokersBloc, and how their approach to this business is significantly different than anything I've seen out there. And if you're a broker and you're looking for a better way to do business, an innovative way to do business, this show is a must-listen!

Stephen: “We're just trying to show brokers that there are alternative solutions out there, and there's a million out there, some really good, some really bad. So we have carefully vetted all of our carrier partners, looked at the paper that they're on on the reinsurance, the networks, the PBMs, and make sure that the package is a cohesive tech stack that bundles together nicely, that has a good user experience.

We have built a suite of products that are, again, non-disruptive to the employee and the employers, but they can save them money on some of the low-hanging fruit things, such as the pharmacy benefit manager and some steerage as well around hospital claims…”

This is Season 22 Ep 8 of America’s Healthcare Advocate. I’m Cary Hall

Learn about BrokersBloc: https://brokersbloc.com/

As always, if you need help or have something to share, contact me using this form on my website and let me know what's on your mind, the issues you are dealing with, or any other health, healthcare, or health insurance questions or concerns. Visit: https://www.americashealthcareadvocate.com/contact-us

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Episode 2208 Transcript:

00;00;01;14 - 00;00;05;15

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;05;20 - 00;00;25;26

Cary Hall

Hello, America. Welcome to America's Healthcare Advocates show Broadcasting Coast to coast across the USA. Here on the HIA Radio Network, you can find out more about me and this show by going to the website AmericasHealthcareAdvocate.com. AmericasHealthcareAdvocate.com. You have questions? Send me an email. I get a whole bunch of them, but I answer each and every one of them.

00;00;25;26 - 00;00;45;23

Cary Hall

So we want to thank all of you out there in the audience for listening to this broadcast. As we broadcast across the country, we just added two new affiliates. I'll talk about that a little later in the show, but also 16 podcast platforms and 648,000. This continues to amaze me, 648,000 downloads and listens on our podcast and YouTube.

00;00;45;23 - 00;01;10;19

Cary Hall

So thank you to all of you out there that pay attention to this broadcast is greatly appreciated. If you are looking for help, if you're chronologically challenged, or you're looking for an ACA, Obamacare plan, you might want to give the lovely Carolee Steele a call over RPS Benefits by Design 877-385-2224. She helps people all over the country with Medicare, and with the ACA issues.

00;01;10;19 - 00;01;27;27

Cary Hall

So if you want to give her a call 877-385-2224 the happy to help you anywhere in the country find coverage. So we're going to do a show today. This a little different than what we usually do. The show is kind of centered on brokers, but it also is a show that I want employers to listen to because you're going to learn a lot today.

00;01;27;29 - 00;01;36;19

Cary Hall

In studio with me today is Stephen Combs, founder of BrokersBloc. Welcome, Stephen. Thank you. You've been here multiple times, but you've been off camera, so I got you this time. You did?

00;01;36;21 - 00;01;38;17

Stephen Combs

Yeah. You got me this time. Yeah. All right.

00;01;38;19 - 00;01;42;14

Cary Hall

And Ryan Ross, who's marketing and operations director. Welcome. Ryan.

00;01;42;14 - 00;01;42;22

Ryan Ross

Thank you.

00;01;42;25 - 00;02;15;11

Cary Hall

Glad to have both of you here. So these two young men, they're young by me. Okay. Because I'm 76 years old, as we all know. Okay. But their approach to this business is significantly different than anything I've seen out there. And if you're a broker and you're looking for a better way to do business, an innovative way to do business, I strongly suggest you pay attention to this broadcast, because, you know, I've been doing this for 27 years, so 22 on the radio, according to Dave Thiessen, my producer, and I read the book.

00;02;15;14 - 00;02;40;06

Cary Hall

So this young man, Ryan Ross wrote a book. It's called benefits with friends. It's a really good book. It's written as a novel. Okay. We'll talk more about it. But, my point in saying this to you is, you're never too old to learn. I learned things in reading that the way they do things, the things that they're doing to improve the broker experience, to improve what brokers do for their clients.

00;02;40;06 - 00;02;54;17

Cary Hall

They help brokers do a better job. And that's really what we're going to talk about today. So welcome again to both of you. So let's just start off with how did this all come about Stephen. You live in Atlanta. He lives in new Jersey. How did this all come about?

00;02;54;19 - 00;03;09;21

Stephen Combs

So I was a broker in the metro Atlanta market for about seven years. I was working with my father. Came in, and the book kind of highlights this. But, I always joke that my dream as a child was to be a benefits broker, and.

00;03;09;23 - 00;03;14;16

Cary Hall

Okay, that's an unusual dream, Stephen. I guess I don't think Ryan had that dream as a child. But anyway.

00;03;14;18 - 00;03;20;17

Stephen Combs

And my backup plan is to be a professional motocross racer. Okay, so glad that the first one worked out for me. You know?

00;03;20;20 - 00;03;21;24

Cary Hall

Yeah, it's a lot safer.

00;03;21;24 - 00;03;46;02

Stephen Combs

Okay? It's a lot safer. Yeah. So, anyways, was actually living out in Utah, after college, selling property and casualty insurance, and my dad had some health issues back in Georgia, and my mom had actually called me and said, hey, he needs your help. You know, he's, you know, having some health issues. So I flew back in and started working with this agency, and I actually did fall in love with the benefits industry, worked with him for quite some time.

00;03;46;02 - 00;04;06;18

Stephen Combs

So selling small group middle size benefits. And we had worked with several general agencies in that market and just saw lots of gaps between the carriers, the access, the coverage, the things that are innovative that a lot of GA just don't seem to have. And so I wanted to create a general agency that offered different solutions for brokers that I couldn't get from the ones in that market.

00;04;06;21 - 00;04;07;07

Cary Hall

And you did.

00;04;07;09 - 00;04;08;05

Stephen Combs

And I did. Correct?

00;04;08;05 - 00;04;21;23

Cary Hall

Yeah, right. Let's talk a little about you. What brought you into this sphere and how did you get involved? With Steven? And then the two of you come together and establish what I think is a pretty amazing company. BrokersBloc.

00;04;21;23 - 00;04;29;11

Ryan Ross

So I am not a benefits guy. I didn't know benefits was around or a thing until. Other than, like, experiencing.

00;04;29;11 - 00;04;30;22

Cary Hall

Minding you're own healthcare.

00;04;30;24 - 00;04;31;05

Ryan Ross

Yeah.

00;04;31;09 - 00;04;32;02

Cary Hall

Okay.

00;04;32;04 - 00;04;39;20

Ryan Ross

I didn't know about benefits, but I know a lot more about marketing. I came from the marketing world and marketing and ad sales. I worked for Dow Jones.

00;04;39;27 - 00;04;44;23

Cary Hall

Yeah, I saw that Dow Jones, you worked at Dow Jones and you also worked at Finance?

00;04;44;26 - 00;05;04;14

Ryan Ross

Yeah. And then a marketing technology company in London. So like my background, as you know, my role at BrokersBloc is marketing and operations. That's kind of what I've always focused on. I started my own marketing agency in 2021, and eventually I'm like, I need to find the niche and the niche. So I was like, okay, I know the world of financial advising.

00;05;04;14 - 00;05;26;13

Ryan Ross

So I said, I'm going to help financial advisors who sometimes help with benefits, right? As we all know John Kuhlmann, he does that to but I was speaking at an event. I was reached out to by a guy named Don Chemi. He told me about, oh, this is NABIP, right? I am a member of NAFA, which is for insurance and financial advisors.

00;05;26;15 - 00;05;42;28

Ryan Ross

But this guy reached out and he's like, hey, can you speak about marketing at this event in Atlanta? I'm like, I'm in New Jersey. You want me to just fly down. And he was like, yes. But I'm like, all right, stage time is money time. Yeah. So if you can get on stage, do that. And this is what I advise brokers do.

00;05;43;01 - 00;05;44;04

Cary Hall

I used to do a lot of it.

00;05;44;10 - 00;06;00;20

Ryan Ross

It's it's a really good way to just generate authority. So I said let's do that. And one of the people on the board of NABIP was Steven. And he reached out to me separately. Right. He reached out to me on a Monday. He's like, can we speak later today? And I'm like, I'm booked today, but let's meet tomorrow.

00;06;00;20 - 00;06;16;08

Ryan Ross

I didn't know where this guy was coming from, honestly. But I'm like, wait, I like looked in my email and I found like, oh, he's with NABIP. And I thought it was about that. But then he told me about something totally different, and I told him I'm like, I'm not aware of what benefits are how it works at all.

00;06;16;11 - 00;06;32;13

Ryan Ross

So that being said, I know a lot about marketing and he's like, all right, that's fine. You know, about the financial services industry. It's kind of like that. And so I just had to learn a lot about it. So we met what last March. And here we are. And we've been through a lot last year and will continue to grow.

00;06;32;15 - 00;06;54;05

Cary Hall

Well, you you what you've created Stephen and Ryan is unique. I don't know anybody else that's doing what you're doing. There's a lot of GAs out there. Okay. I was never a fan of GAs. And definitely not a fan of FMOs. In fact, all of my contracts with Benefits by Design over the 27 years I did it were direct with the carriers.

00;06;54;05 - 00;07;09;24

Cary Hall

I wouldn't work with an FMO, but if I had a GA out there, that could provide the kind of things that you guys are doing that would have been a different world. Okay, so let's talk a little bit about what you see as your mission with BrokersBloc. Before we go to the break here. We got about three minutes.

00;07;09;29 - 00;07;36;08

Stephen Combs

Yeah. So our mission is we we always said we're not anti-BUCA we're non BUCA. But if it's, agency by general agency. So we're not trying to disparage the BUCAs We're just trying to show brokers that there are there's alternative solutions out there, and there's a million out there, some really good, some really bad. So we have carefully vetted all of our carrier partners, looked at the paper that they're on the reinsurance, the networks, the PBMs, make sure that the package is cohesive.

00;07;36;08 - 00;07;55;03

Stephen Combs

It's a cohesive tech stack that bundles together nicely, that has a good user experience. So we just built a suite of products that are, again, non disruptive to the employee and the employers, but they can save the money on some of the low hanging fruit things such as the pharmacy benefit manager and some steerage as well around you know hospital claims.

00;07;55;03 - 00;08;10;13

Cary Hall

I'm going to talk a lot, but we're going to do a deep dive on some of those things as we go through the show. But I want to explain what that term BUCA means for you and the audience that are listening. Is that what are what are you talking about? That's Blue Cross, that’s United, that’s Cigna that's who we're talking about here.

00;08;10;13 - 00;08;33;26

Cary Hall

We're talking about the big major carriers across the country, that that, that basically control the markets right now. So when you talk about BUCA you know, what what happens there is there's not a lot of competition anymore between the carriers, primarily because especially when you're talking about small group, medium size group, because of ACA, who sets the regulations, this is what you can offer.

00;08;34;02 - 00;08;53;05

Cary Hall

You know, someone said that basically what Obamacare did that turned insurance carriers into utilities, which is pretty much correct when you think about it, because the rates are set by the different states, they have to get approval to set a rate, and they're only allowed to offer certain things, a certain amount of money they're allowed to make, or the rest of it has to go back if they exceed that profit.

00;08;53;05 - 00;09;10;21

Cary Hall

So it's a completely different world than it used to be before Obamacare. And that's why I think there's a need for what these two young men are doing out there. And especially if you're a broker, if you're a medium size broker, you're a small broker and you don't have the tools, you don't have the ability to do what they do.

00;09;10;26 - 00;09;29;02

Cary Hall

They can add a lot. We're going to talk a lot about that today, and you're going to give you information I think could make a difference to a lot of you out there. If you want to go to their website, it's brokersbloc.com. brokersbloc.com is spelled bloc by the way brokersbloc.com. We'll be right back after the break.

00;09;29;02 - 00;09;46;10

Cary Hall

You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast Cross, USA. Stay right there. We've got more.

00;09;46;13 - 00;10;22;02

Cary Hall

To do. Welcome back. You're listening to America's Healthcare Advocate Show broadcasting coast to coast across the USA here on the HIA Radio Network. My producers, Mr.. Dave Thiessen behind the cameras, the man who puts all these shows up on all the podcast platforms and the YouTube platform. And Garner Cowdrey, who does all the work behind the microphones, putting all the audio together as we broadcast Coast to Coast, by the way, two new affiliates, we have WFEA-AM in Manchester, New Hampshire, and another new affiliate in Charlotte, North Carolina WRHI-AM and FM.

00;10;22;04 - 00;10;41;08

Cary Hall

We're on for two hours every Saturday. I guess they really like us. We thank you all. Make you part of America's Healthcare Advocate broadcasting family. Welcome to the network. We're happy to have you in studio with me, Stephen Combs. And Ryan Roth. They are from BrokersBloc. The website for them, by the way is BrokersBloc.com. BrokersBloc.com.

00;10;41;08 - 00;11;02;14

Cary Hall

Let me tell you about these two young men. They're kind of amazing young men as far as I'm concerned. Stephen is the founder of BrokersBloc. Stephen helps insurance brokers cut through the noise confidentiality, identify high performing, trustworthy vendors in an industry where brokers are constantly bombarded with vendor pitches. Are they ever I should know, okay, what he's doing basically is creating an alternative here.

00;11;02;22 - 00;11;22;12

Cary Hall

Their mission is to empower brokers to move beyond the default of brokers with clients that are better, safer, smarter benefits solutions for their clients and their clients are brokers. So this is where this makes a big difference, which is why I wanted to read a little bit about his bio. Ryan has worked at the intersection of marketing and financial services to 2011.

00;11;22;14 - 00;11;46;23

Cary Hall

He founded an independent financial advisor marketing company in 2021. He spent ten years at Dow Jones. That must have been really interesting, Ryan. And then the Financial Times, which is another interesting newspaper. You ever see that pink newspaper in the airport? That's the Financial Times. It's a pretty interesting newspaper to read. And then, he went on, to produce and hosted over 1000 webinars and 250 podcasts.

00;11;47;00 - 00;12;06;22

Cary Hall

And he also wrote the book. And I think it's kind of amazing. The book benefits with friends, which I read. All right. I'll talk a bit more about that in this segment. So, pretty remarkable young man. He's run 16 triathlons and three Ironman triathlon. So, he's also a pretty good athlete. So let's talk about this book for me because I was fascinated by this.

00;12;06;22 - 00;12;19;11

Cary Hall

I told you when you came in here that, I get a lot of people on this show that write books. Most of them. Yeah. I try to read them out of courtesy. Most of them are boring as hell and dry. And they're how you're going to do this or how you're going to do that.

00;12;19;18 - 00;12;39;17

Cary Hall

So you wrote this is a novel, and I'm reading this and I'm going, That's Stephen in there. That's that Stephen did the book. Now I've got to get that part in a minute. And some of the characters in the book, Porterhouse, who has his meetings at the Texas Roadhouse, and it's colorfully written and it's written in a way, that you enjoy reading it.

00;12;39;17 - 00;13;01;01

Cary Hall

It's not a boring, dry read. Okay. So I urge you, if you're a book, this is online at Amazon. I bought it on Amazon. I forget what the hell it cost. And I read it on, online at Amazon, on my, on my Kindle. But it's really an interesting book. And here's what I'll say about this. It kind of encapsulates their philosophy of what they're doing and how they're doing it.

00;13;01;03 - 00;13;06;17

Cary Hall

And it does it in a colorful and interesting way. The interesting part is when you wrote this, you didn't even know him.

00;13;06;22 - 00;13;12;11

Ryan Ross

I didn't well, I knew him, but I didn't know the story about how he got involved in the business. He took over his.

00;13;12;11 - 00;13;14;19

Cary Hall

Father's agency just like he just told.

00;13;14;22 - 00;13;27;00

Ryan Ross

So weird, I didn't know this. The original plot was like this guy that was in benefits, and he he just needed to modernize. But I realized, like, okay, I, I wrote that to learn about the benefits industry.

00;13;27;00 - 00;13;28;00

Cary Hall

You did a pretty good job.

00;13;28;05 - 00;13;46;15

Ryan Ross

I appreciate that because it hopefully comes out in the book. But what like I wrote it thinking, okay, this guy just needs to modernize. But that assumes he's been in the industry and like, he should know some of these terms. So I had to change the plot and I had to be like, you need to create some stakes in the beginning and some drastic thing.

00;13;46;22 - 00;13;52;20

Ryan Ross

It's just a narrative tool. So I'm like, okay, guys, maybe his dad dies. And so he's thrust into his.

00;13;52;20 - 00;13;55;29

Cary Hall

Dad didn't die, by the way. So we all know Steven's dad is still alive,

00;13;55;29 - 00;14;17;09

Ryan Ross

but he this guy's thrust into the industry and I'm like, I like food. And so I'm gonna name it al dente, which you did, right? And he was like a pasta manufacturer. So I knew pasta manufacturing. And he had to learn benefits. He had to get a license, and then he needed to do marketing. So it's for like, yes, it's for benefits brokers to maybe brush up their skills on benefits.

00;14;17;09 - 00;14;21;23

Ryan Ross

They probably don't need to do that, but it's more of like a marketing instructional book.

00;14;21;23 - 00;14;43;20

Cary Hall

No, I would disagree with that. I think that what's in here? Yeah. Like I said, I'm 76 years old, and I was kind of amazed. Some of the things you put in here that I saw as pieces, of things I did not know about, things that I didn't understand. And I said to you guys off camera earlier, if I had known you before, when I had Benefits by Design, I would have been one of your first clients.

00;14;43;22 - 00;15;02;03

Cary Hall

Because your innovation and your thought process on what you're bringing to the table allows. I see your niche as medium and small brokers. I don't know if that's what you see it as, but that's where I see guys that don't have and gals that don't have those kinds of tools or resources that you bring to the parties. So talk a little bit about that.

00;15;02;07 - 00;15;21;22

Stephen Combs

Medium and small brokers are their bread and butter. We do work with some larger ones, but most of our brokers are definably the small or medium sized brokers who need help with technology, with quoting, with spreadsheets and all those sorts of things. The larger brokers are more so looking just for the carriers that they don't want to necessarily maybe take the time to vet.

00;15;21;24 - 00;15;22;20

Stephen Combs

I understand that.

00;15;22;20 - 00;15;38;19

Cary Hall

Like like our PSM Nebraska GigCare, which we're a new carrier market, four years old. We worked with you guys, etcetera, etcetera. John Kuhlmann, who, by the way, is in the book, which I think is kind of interesting. Yeah. I'll see him up here next week, but, Yeah. So keep going. This is interesting.

00;15;38;19 - 00;15;58;24

Stephen Combs

Yeah. So we work with carriers that are, I mean, well-funded, you know, strong networks. Well, well-capitalized, you know, good tech stacks that are seamless for the for the broker, the employer and the employee. And so we help the brokers identify kind of cut through the slop because there's hundreds of vendors that pop up every single year. They all promise the same things.

00;15;58;26 - 00;16;14;01

Stephen Combs

And then you go and rollover group and then it's a disaster. Right? We we we avoid those things because when I was a broker, I was always looking for the next shiny object. And so I've learned over the years of doing it how to avoid those disastrous situations.

00;16;14;03 - 00;16;32;24

Cary Hall

That's funny when you said the next new shiny object, because it makes me think, Ryan, of how many those next new shiny objects are out there. And they last a year or two years and they start to crash and burn. And then the broker that I, there's one particular group from a number of years ago that was selling group health insurance, and it was like the greatest things of sliced bread.

00;16;32;26 - 00;16;53;03

Cary Hall

And they went belly up. And one particular broker I know got stuck with $1 million worth of claims to pay. And another broker who's a friend of mine wound up with half $1 million claims to pay. So vetting these guys, these these companies that are coming out and and there are there's a lot of innovation going on right now because the BUCA plans, in my humble opinion, are crashing and burning.

00;16;53;08 - 00;17;16;25

Cary Hall

I don't see how this is sustainable in the long run, because that the heavy regulation, you look at some of the increases that came through last year, they're massive 23%, 30% in Florida, I think it was as high as 38% in some cases. I mean, the the the industry, it's boxed in and it can't seem to figure out how to get around that.

00;17;16;25 - 00;17;44;25

Cary Hall

And Congress is doing nothing. Okay. So as usual. All right. So you're not getting anything from the politicians to change it. So what you guys are doing is bringing alternatives to the table and then showing these alternatives to the brokers. But talk a little bit about what you're doing on the marketing side to help brokers gain visibility because you've got, you know, the the podcast, the the webinars, the things that you're doing it, you talk about in here, a lot of brokers would go, I don't know if I can do that.

00;17;44;28 - 00;18;02;17

Cary Hall

So we're coming up on the break, so let's hold that right there. When we come back from the break, I want you to get into that and talk about how that's not really that difficult to do. You illustrate that in the book, and we'll talk about that when we come back from the break. The website is BrokersBloc.com. BrokersBloc.com.

00;18;02;19 - 00;18;21;19

Cary Hall

There's a lot of information up there. Take time to reach out to these guys. And by the way they have a thing called the 300 Club. We're going to talk about that in the next segment. If you're an employer and you've got a broker who's lazy and not doing his job, reach out to these guys. They have a network of brokers that are vetted and they're first class, and they'll be happy to help you.

00;18;21;24 - 00;18;45;19

Cary Hall

BrokersBloc.com. Stay right there. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA. Here on the HIA Radio Network.

00;18;45;21 - 00;19;08;15

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network, in studio with me, Stephen Combs and Ryan Roth from BrokersBloc. Their website is BrokersBloc.com. BrokersBloc.com. A lot of great information up there. And I keep talking about this book because, Ryan wrote a book that I think is pretty cool.

00;19;08;18 - 00;19;32;20

Cary Hall

This is benefits with friends. We're going to talk a little bit more about it here. So one of the things that you spend a lot of time on that book is marketing. So let's talk about how you help the piece in there on podcasts, which I like, you know, here we do podcasting different than what you're talking about doing, but, you know, to suggest to a broker that they do a podcast, most of these guys and gals are going to go, what are you talking about?

00;19;32;20 - 00;19;40;26

Cary Hall

I can't do something like that. So describe you do it in the book, but describe how you actually do this and why you think this is beneficial to the brokers.

00;19;41;00 - 00;20;01;14

Ryan Ross

So I think podcasts are really important to do, because any broker that wants to create marketing material or just create more sales inflow for themselves, visibility, you need to create visibility. They need to create authority. A podcast is a great way to do that. And I would say it's the most low drag way to do that as well, because all you need is a phone.

00;20;01;16 - 00;20;21;24

Ryan Ross

And there's a scene in the book where one of the characters he lands a podcast or an interview with this guy that he's wanted to speak with for a long time, and his marketing assistant's like, record that. So he sits down, he asks some questions, he puts his phone down. That's all you need to do, right? You put your phone down and say, I'm going to record this conversation.

00;20;21;24 - 00;20;40;11

Ryan Ross

You take that audio file, you make a Spotify account, you upload it to the Spotify account, you press publish, which is a really hard thing to do because it there's an element of vulnerability when you put anything out. Oh yeah. Absolutely right. You're talking no guys from radio 22, you know, you know every time you're like, oh is it ready to go make it ready to go.

00;20;40;11 - 00;21;03;11

Ryan Ross

Just push the button. People might not listen to the beginning. You might need to push it out to people in the beginning. But having a conversation on something that you are an authority figure on or at least you know a little bit about it, right? Having a conversation with friends is even easier, because you can banter for a little while and then say, I want to talk about these five things in my podcast interview.

00;21;03;11 - 00;21;23;15

Ryan Ross

Or maybe it's a shorter version, right? Interviews can be half an hour, or they can be a five minute podcast talking about, I want to talk about PBM transparency and how to analyze an EOB explanation of benefits, things like that. You can have three points that you want to talk about any five minutes you put that on a podcast, but that's only the first step.

00;21;23;17 - 00;21;42;05

Ryan Ross

Then you need to send it to people, right? I recommend people define what's called a dream 100. This is the 100 list of 100 people that you would do perfect with. And in the book I talk about you do, I took a talk about a niche. Right. The guy's niche in the book is manufacturing I because he knows about manufacturers.

00;21;42;06 - 00;21;43;00

Cary Hall

He made pasta.

00;21;43;04 - 00;21;53;25

Ryan Ross

He made pasta. He was a pasta manufacturer. But so many brokers, if they say like I am the broker for associations, right. Our friend John Kuhlmann does that. That's what his thing is.

00;21;54;00 - 00;21;56;14

Cary Hall

He’s really good at it probably. And he's also in the book.

00;21;56;14 - 00;22;06;06

Ryan Ross

By the way. He probably has other types of clients. But if you focus on the niche, what you focus on expands, because then you say, this is who I am for, right? You probably.

00;22;06;12 - 00;22;23;26

Cary Hall

And you become the authority figure. And John has become an authority figure in the association, and you work with him, both of you. So let's segue to something because he threw it out there. But one of the most complicated, misunderstood things out there is the PBM. First of all, tell what a PBM Steve is.

00;22;23;28 - 00;22;32;20

Stephen Combs

It's a pharmacy benefit manager as part of the health plan that manages all the prescriptions and that can eat up a lot of the claims. I mean, sometimes over half.

00;22;32;27 - 00;22;34;27

Cary Hall

Okay. Explain that.

00;22;34;29 - 00;22;58;07

Stephen Combs

Yeah. So a pharmacy like generic drugs aren't a big deal. Even the brand name drugs are not a big deal. Where it comes into play is there's TV, commercial drugs, the specialty medications. Yep. The ones that, you know, they're paying millions of dollars for ads, work because they have a patent on it and they can charge whatever. There's some examples, such as Stelara, costs like $27,000 every fill, which can be every other month.

00;22;58;10 - 00;23;07;14

Stephen Combs

I mean, who can really afford that as an employee or an employer? One thing that people don't realize is there's also massive rebates.

00;23;07;17 - 00;23;29;00

Cary Hall

That's the hidden part of the industry, and people do not understand. Yeah. So let's talk about that because there's a lot of money there under the table that the employer doesn't see if they're not, if the broker is not smart enough to know how to get those rebates. Okay. Or there's a part in the book actually where I think Ryan talks about, the asking for the asking you.

00;23;29;00 - 00;23;41;12

Cary Hall

He shake his head, just asking for the printout from the carrier on the rebates. And what he gets is a cut and pasted spreadsheet that doesn't tell him anything. Okay, because that's not something they want to disclose. So talk about it.

00;23;41;18 - 00;23;56;28

Stephen Combs

So large groups have got rebates forever. I mean they get them for if you have 500 plus employees, maybe a thousand plus any PBM is going to give you rebates if they want the business. There's no volume for them to make sense. Small groups and middle sized groups historically have never seen them.

00;23;56;28 - 00;23;58;12

Cary Hall

No, and they don't know what they are.

00;23;58;12 - 00;24;09;14

Stephen Combs

They don’t know what they are, until now. So now there's PBMs that operate just on basically like an admin fee. They charge an administrative fee, but all the rebates are passed through back to the employer.

00;24;09;14 - 00;24;10;28

Cary Hall

and they're not for profit basically.

00;24;10;29 - 00;24;17;28

Stephen Combs

Pretty much exactly. And those, those like Stelara, 27 grand after rebates it’s only about four grand. It's a big swing.

00;24;17;28 - 00;24;39;01

Cary Hall

Yeah it is a big swing. So so at Detego with our Population Science Management program for GigCare, we have Script Aid which is our own PBM. And we so we do three things. We do a drug importation okay. So if for that particular drug, if we brought it in from Canada would probably be 3 or $4000.

00;24;39;02 - 00;25;03;23

Cary Hall

If that, maybe less. Okay. So we do it that way. We do it with drugs that are on the formulary. If they're expensive and even if they're not on the formulary, we don't tell you: “Well, that's your problem”. Now you contrast that with the BUCA ACA plan. The broker's got no solution for that. No. Okay. Well our plan has the solution because we go out and we bring that drug in and we don't make them pay the difference is what it is, and we bring it in.

00;25;03;28 - 00;25;30;17

Cary Hall

The other thing we do is foundational assistance. And that's a big deal, okay. Because what 90% of the people don't know and most of the brokers don't know or don't know how to do it, is to file for foundational assistance. That's all stuff that you guys do. So that foundational assistance means, just so you understand the audience out there and brokers, if you've never heard of it, okay, if you need a growth hormone drug and it's $100,000 a year, you're probably not able to afford that unless you're a multi-millionaire.

00;25;30;23 - 00;25;47;23

Cary Hall

But if you are working with the carrier, like in our case Detego and Population Science Management, GigCare. We actually have our own nurses at Script Aide to go out and do the paperwork, get the medication, have it drop shipped to your door. And that's exactly what you're talking about, is it not correct?

00;25;47;23 - 00;25;55;05

Stephen Combs

Yeah. They call them patient assistance programs. And so but most of our carriers offer them as well. And the member typically gives them for free.

00;25;55;05 - 00;25;56;10

Cary Hall

That's exactly right.

00;25;56;13 - 00;26;13;25

Stephen Combs

Yeah. More times than not it's free. Yeah. We have some carriers that do it very gently where, you know, hey, you can get the medication through your health plan, but it's going to be your deductible and coinsurance. Or we can source from Canada or New Zealand or do a PAP or patient assistance program. And this is $0 co-pay.

00;26;13;27 - 00;26;18;22

Stephen Combs

Some of our carriers use a hammer instead of a scalpel.

00;26;18;24 - 00;26;21;14

Cary Hall

I'm gonna, I'm afraid to ask you where we come in. But anyway, go ahead.

00;26;21;20 - 00;26;39;07

Stephen Combs

So, this is not you guys, but. But what they do is. So they'll cover the medication no matter what. On a 30 day to 60 day supply. So there's no disruption in care, right? But then after that, the member then is required to do the program right. They're required to go through the advocacy program to get the medication and they get it for free.

00;26;39;07 - 00;27;02;10

Stephen Combs

Right? Okay. Now, if they can't source internationally or they can't do an assistance program, then they do get it through the health plan or they do cover it, but they have to go through those avenues first. And I do like that for the the clients that are willing to have a little bit of disruption, because if you're a group that's being just destroyed by high cost medications, these carriers can be a great solution.

00;27;02;10 - 00;27;19;18

Stephen Combs

But I just have to know, what are your needs? What is your risk tolerance? Is it you know, that you have some medications you want to reduce, and you want the employees to have the choice? Or do you want to, you know, make the employees go through the program? Again, it's not disruptive. They give them a 30 day to 60 day supply with plenty of time.

00;27;19;21 - 00;27;40;08

Cary Hall

That's correct. Yeah. Yeah okay. And so when you talk about these carriers you're talking about people very similar to what Detego, we're a TPA but we have our own plans. Talk about some of the other carriers you work with that are not the BUCA plans that are look, BUCA plans fit for some people. They don't fit for a lot of people and a lot of people are struggling with cost.

00;27;40;15 - 00;27;50;29

Cary Hall

And unfortunately, this is work. Okay. If if your broker's not willing to do the work, you're probably not gonna know there are alternatives out there. So talk about some of these other alternatives.

00;27;51;00 - 00;28;08;04

Stephen Combs

Yeah. So we have are they really fall into two buckets. We have the tech, you know, stack companies that are very AI based tech based. And that's going to be Angle Health, Arlo Health, Level Health. And those are the three real tech heavy vendors, Health In Tech as well. I was very tech focused. All the underwriting is done AI.

00;28;08;04 - 00;28;27;07

Stephen Combs

No health apps are required. Angle Health goes down to five lives. The other three go down to the ten lives. They all have prescription management tools. They're all do it a little bit differently. Health In Tech is the one that I like for the groups that are have a lot of high cost drugs because they use the hammer approach.

00;28;27;09 - 00;28;39;07

Stephen Combs

The rest use, the rest use the scalpel approach where it’s, hey, you have the choice, it's up to you. But that's what they do. And we have some more legacy carriers that are a little bit more well known to the population out there. We got TrustMark.

00;28;39;10 - 00;28;40;19

Cary Hall

I know TrustMark and used to work with them.

00;28;40;22 - 00;28;53;15

Stephen Combs

They're very good. We work with them a lot. We have all formerly All State Benefits now Nationwide Benefits. Yeah. Then we carry your Optimal Benefits. Yep. And then here's one that's maybe not well known per se, but Great American Insurance.

00;28;53;17 - 00;28;55;05

Cary Hall

I've heard of it. I don't know much about it.

00;28;55;05 - 00;28;57;21

Stephen Combs

Their reinsurance company, they've been around since the 1800s.

00;28;57;21 - 00;28;58;10

Cary Hall

That’s how I know them.

00;28;58;10 - 00;29;01;28

Stephen Combs

$33 billion in assets. So they're no joke?

00;29;02;00 - 00;29;02;19

Cary Hall

No, they are not.

00;29;02;19 - 00;29;09;29

Stephen Combs

But they've released a Small Group Level Funded plan, 2 to 99, Ten plus A underwriting. And the rates have just been phenomenal.

00;29;10;04 - 00;29;24;26

Cary Hall

So that is exactly why we're doing this show. What do I always say about this show? We're here to educate and inform. We just informed you and educated you. If you're a broker and you heard some of these names and you want access, you want to know how do I get involved? What do I do? This makes sense.

00;29;24;26 - 00;29;51;27

Cary Hall

I've got clients I need help with. Maybe I've got clients that I want to bring on board, but I can't because I don't have anything innovative. Go to the website BrokersBloc com BrokersBloc.com. We'll be right back after the break. Stay there. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA. We'll be right back.

00;29;51;29 - 00;30;12;05

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. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. By the way, maybe you work in a medium to small size agency and you guys are struggling. You know, trying to add new clients or even trying to keep your book.

00;30;12;07 - 00;30;28;16

Cary Hall

This podcast is up on 16 podcast platforms. It's on YouTube. You can go to this whole show, you know, tell the owner of your agency, your brokerage. Hey, we need to connect with these guys. Well, why? Who are these guys? Well, go up and listen to the show. Go up and do the podcast. Go up and do the YouTube.

00;30;28;16 - 00;30;33;19

Cary Hall

We’ve got. What do we have, 643,000. Dave just said in our last count.

00;30;33;20 - 00;30;33;27

Dave

Nine.

00;30;33;29 - 00;30;52;10

Cary Hall

There we go. 649,000. See, I get it wrong every time. The point I'm making is you're never too old to learn. There's innovation out there. These two young men, they're young to me. Okay. Are really good at what they do. And I urge you, to take a moment.

00;30;52;11 - 00;31;05;05

Cary Hall

And if you're a broker out there, go to their website, BrokersBloc.com. All right. Let's talk a little bit about, Well, first let's talk about the Broker 300 Club because I think this is kind of cool. And what does that mean?

00;31;05;07 - 00;31;33;07

Stephen Combs

And what it is, it's an exclusive club for our brokers that are, you know, high level producers that are innovative. They know what they're doing in the industry using innovative carriers. And so what it is, is we're putting together a retreat. It's going to be in May of next year, and it's going to be for brokers to get together, congregate with the carriers, innovative carriers, and just have, you know, dedicated attention to learning the new products, processes, systems, networks, everything that's out there that they can offer to their clients.

00;31;33;10 - 00;31;39;07

Stephen Combs

And if you're a broker wanting to be innovative in 2026 and 2027, you definitely want to be a part of it.

00;31;39;09 - 00;32;06;15

Cary Hall

See? And what that reminds me of is back in the day, when Paredo, which is the largest captive in the country now, and Berkeley Hamilton captive when they would hold events, Paredo was probably the best at this. They would hold them, usually twice a year in Nashville. And the amount of information that got pumped out in those events, I mean, you know, when I first started with Paredo, I think there might have been 300 total clients and brokers combined by the time I left.

00;32;06;15 - 00;32;24;02

Cary Hall

I think it was up to I think it's 4000, now brokers. And I don't know how many clients have got involved. It's it's gotten enormous. Okay. Because Cavanaugh and Clayton, the guys that started was very much like you guys. They did something out of the box. Okay. Problem was you had to be 100 lives or more to qualify for it.

00;32;24;02 - 00;32;37;05

Cary Hall

Well, you know, for us, that was great. You know, we were in the self-funded market. But what you're offering now is a solution for brokers in the small group market. And one of you just mentioned one of your carriers goes down to five lives, correct?

00;32;37;05 - 00;32;38;29

Stephen Combs

Actually, several of them go down to two lives.

00;32;39;01 - 00;32;55;08

Cary Hall

Well that's it. And that's a big deal because there are a lot of mom pop shops out there that can't get health insurance, or they get it on the ACA plans. It's horrifically expensive. And this is an alternative for them. So you're you're educating the brokers on how to find those people, get them set up and help them do it.

00;32;55;08 - 00;32;55;24

Stephen Combs

Correct.

00;32;56;00 - 00;33;19;00

Cary Hall

Okay. Let's switch gears a little bit and then talk about the, the broker directory, because this is to the employer out there because unfortunately, you know, in this industry got a lot of lazy people just tell you how it is. Okay. You know, my philosophy was if you can't get in front of your client once a quarter just to tell them how things are going and see how they're doing, are they having problems?

00;33;19;00 - 00;33;36;11

Cary Hall

Are things going well for them? You know, there are there other employees happy? What's going on. Then I don't think you're doing your job. And unfortunately I think in this industry that doesn't happen a lot. And if you're an employer, I tell you, you're unhappy with a broker that shows up once a year with the spreadsheet and says, pick your poison.

00;33;36;13 - 00;33;47;01

Cary Hall

That's not the way this should work. Okay, so talk a little bit about your broker list and what what those are qualified brokers that are looking for alternatives to what's out there. Let's talk about that.

00;33;47;04 - 00;34;10;21

Stephen Combs

Absolutely. So not only have we vetted carriers we’re also vetting brokers as well. So if a client of a group is looking for a quality broker that can meet their needs, we have brokers in all shapes and shapes and sizes. We have brokers that work with small groups, large group, medium groups. So whatever your needs are, wherever you're located at geographically, we can actually source you a very highly vetted quality broker.

00;34;10;28 - 00;34;37;29

Cary Hall

And so, you know, maybe you'll give them a 2 or 3 and they can pick the one they like type of thing. Yeah. Yeah. So that again that website is BrokersBloc.com BrokersBloc.com. There needs to be change in this industry okay. And you know what. What you're doing Ryan. You and Stephen, the two of you together, you know, to help brokers improve the process at the end of the day is really going to help the employer, and the employee with that experience.

00;34;37;29 - 00;35;03;06

Ryan Ross

Yes. Yeah. I mean, if one of the things that we try to do ourselves is figure out how can we systematize operations, and use AI to do that, and I think there's a big opportunity to help brokers do things in a similar way to actually how we do it, whether that's making creating content for those brokers. And then the brokers can also do a very similar thing for their clients to find their niche.

00;35;03;06 - 00;35;23;20

Ryan Ross

Right? But also figure out, okay, we use AI in different ways in order to streamline our operations because we're we're a lean team, right. But there's brokers in the similar situations, right? So it kind of the processes and the systemization funnels down to how the brokers can operate as well. So that's one of the things we can advise on as well.

00;35;23;23 - 00;35;41;28

Cary Hall

Yeah. You know in John Kuhlmann’s in the book and which is interesting, John's done a number of different radio shows with me. He's going to be back here next week, to do some more. But he works very closely with you guys, and has a lot of regard for what you're doing and innovates and uses a lot of your processes.

00;35;41;28 - 00;36;02;26

Cary Hall

And, you know, we talked about associations. Yeah. And how and I see the emails, the back and forth where you're working with him, all the various associations. But he is an example, at least to me, of a broker that found a niche. There are a lot of brokers out there in this space, and I'm I it's amazed me how it's just blown up.

00;36;02;28 - 00;36;21;11

Cary Hall

I mean, you know, Toolbelt, 1099 employees that work at Home Depot and, and Menards to come out, you buy a refrigerator, they're gonna you need to have the icemaker put in these guys come out or gals and put it in. And there's a whole association full of these guys with a 250,000 people in this thing. Yeah.

00;36;21;14 - 00;36;36;17

Cary Hall

NHRA. I happen to be a car guy. National Hot Rod Association. That blew me away. I'm like, he brought that. He goes, do you know who these guys said? Yeah, I've been to more NHRA races and you can possibly imagine. Okay. So I mean, it's amazing how many these are out there and you guys are assisting him.

00;36;36;21 - 00;36;54;24

Ryan Ross

Yeah. Well, you know, I think a lot of other brokers can think the same way that he's thinking, right. Like figuring out, okay, his niece's like associations. But the thing is, there's associations for so many things, right? One of our brokers, they are they focus on credit unions and non profits

00;36;54;24 - 00;36;55;05

Cary Hall

Interesting.

00;36;55;05 - 00;37;01;20

Ryan Ross

because these are all groups. Yeah. We were at a Texas Roadhouse the other night because I love Texas Roadhouse.

00;37;01;22 - 00;37;02;08

Ryan Ross

And we

00;37;02;08 - 00;37;04;18

Cary Hall

he actually eats at Texas Roadhouse. Great.

00;37;04;20 - 00;37;07;09

Cary Hall

Stephen not so much. So I'm just going to tell you. But anyway.

00;37;07;14 - 00;37;08;17

Ryan Ross

Actually I do okay.

00;37;08;17 - 00;37;08;28

Cary Hall

Okay.

00;37;08;28 - 00;37;28;04

Ryan Ross

It’s where he charges his Tesla. Yeah. So if you were in a Texas Roadhouse somewhere like oh I bet there's a restaurant association, of course. Or you could be a broker if you're a broker that's worked with 1 or 3 restaurants just because you found the business that way, think like, okay, what are the commonalities between my clients? And maybe they're a restaurant.

00;37;28;04 - 00;37;34;25

Ryan Ross

They're there's a restaurant association out there. You can be the broker for that restaurant association. Do things like that.

00;37;35;02 - 00;37;57;21

Cary Hall

Is that's exactly what I'm talking about okay. And that's why I think having these two young men here doing this show that we're going to do more of this, they've got they've got some great programs and we're going to be talking about these throughout the year. But this is why I wanted to do this today, because if I was that medium broker, that small broker who became a bigger broker because of this radio show back in the day before we had all of this AI and everything else.

00;37;57;28 - 00;38;13;24

Cary Hall

But the beauty of it is it's a tool now that's available. You just heard Ryan describe it. You heard Stephen talk about their their 300 club, what they're doing. I urge you to take a minute to connect with these guys and just listen to what they've got. You might be surprised what you learn and you might be surprised how they can help you.

00;38;14;00 - 00;38;35;00

Cary Hall

The website is BrokersBloc.com, bloc. BrokersBloc.com. Thank you both for being here, it was a great show today. Thank you. Appreciate you both. And now I leave you with this thought from Albert Einstein, the one who follows the crowd, will usually get no further than the crowd. The one who walks alone is likely to find himself in places no one has ever been.

00;38;35;02 - 00;38;51;27

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 Advocates Show. Broadcasting coast to coast across USA. Goodbye America.

00;38;51;29 - 00;38;58;20

Unknown

Gig Workers, Associations, and Self-Employed can now find Affordable Healthcare!

Sat, 21 Mar 2026 14:35:34 GMT

Episode 2207 notes

My guest today is a true expert on the topic: RPS Benefits by Design President and CEO, Maria Ahlers.

Learn more: https://www.rpsbenefitsbydesigninc.com or call (913) 385-2224.

This is Season 22 Ep. 7 of America's Healthcare Advocate. I'm Cary Hall.

Listen to this episode

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

On Rumble:

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2207 Transcript:

00;00;14;24 - 00;00;34;27

Cary Hall

The studio with me today is Maria Ahlers. She is the president of RPS Benefits by Design. What we're going to talk about today will be of great interest to anybody out there that is a member of an association, a co-op. Maybe you're just a 1099 gig worker and you can't find health benefits. There is a solution for you and we think we've got it.

00;00;35;00 - 00;00;57;00

Cary Hall

And now America's Healthcare Advocate , Cary Hall. Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. My producers day, Mister Dave Thiessen behind the cameras and Mr. Garner Cowdery behind the microphones, putting all this together so we can put this show out there on the air across country.

00;00;57;04 - 00;01;17;20

Cary Hall

For all of you that listen to the broadcast, and for those of you that like to go to the podcast platform, there are 16 of them. And there's also the YouTube channel. I think we're up to about 633,000 of you now have viewed us or downloaded us. So we greatly appreciate that, and we greatly appreciate the fact this is our 22nd year of doing this show.

00;01;17;23 - 00;01;40;15

Cary Hall

Absolutely amazing. Frankly, it is, I always say each week, if you are chronologically challenged or you're looking for ACA, you need to call the lovely Carolee Steele over at RPS Benefits by Design anywhere in the country. She can help you. If you've got a relative. You know, I just had a situation where I had a relative go into a nursing home facility, and we moved her plan to a different plan.

00;01;40;15 - 00;02;02;07

Cary Hall

That was a special needs model, and she did it all. She's remarkable what she does. So if you want help. 8773, eight, five, 22, 24 anywhere in the country, she's happy to help you. And I always tell you that if you're looking for employer sponsored health care, you did talk to the lovely Maria haulers, but today you can actually talk to her right here because she's on the air with me.

00;02;02;07 - 00;02;02;24

Cary Hall

Welcome back.

00;02;02;27 - 00;02;04;29

Maria Ahlers

Hi, Carrie. Nice to be back.

00;02;05;01 - 00;02;26;24

Cary Hall

It's great to have you back. We're going to have a I think we're going to have a really good show today. You know, it's interesting because we're going to focus on, on two things today. We're going to talk about what happens to folks that are 1099. And I'm looking at the show notes, as you said, over to, and I'm looking at this and, you know, they're 85 million people in this country that are ten, 99 employees.

00;02;26;26 - 00;02;31;10

Maria Ahlers

I did not know that. I know the, the landscape has changed for.

00;02;31;12 - 00;02;54;17

Cary Hall

In the next five years, that number will go to 110 million. Wow. Yeah, it's it's interesting because what I see happening to some degree is a lot of employers are shedding their whole. We have a client that, you know, we do we do business with it has, I think 30,000 brokers that work underneath them. They move them all from W2 to 1099.

00;02;54;19 - 00;02;57;25

Cary Hall

The cost of health care, health insurance was killing them.

00;02;57;25 - 00;02;58;22

Maria Ahlers

That's right.

00;02;58;25 - 00;03;15;21

Cary Hall

And they, they, they found it more economical to go to the 1099 model and let people make their own decisions. So it seems to me that's a part of the market just gets missed. I don't see I don't see a lot of concentration on it in terms of trying to find solutions for it.

00;03;15;25 - 00;03;39;24

Maria Ahlers

That's right. I mean, there isn't I think most of the employers, you know, I think a lot of this started with Covid when we went to remote working. Right. Remote worker like. Yeah. So a lot of it went to remote workers. And then they became 1099 contractors. And even to attract and retain those employees, HR sales have shown the top 2 or 3 reasons why employees work for companies is for benefits.

00;03;39;26 - 00;03;51;17

Maria Ahlers

So to keep your 1099 workers, you need to also have benefits. And they're forgotten about because they're contractors. They're not W-2 employees, but they still have the same needs as W-2 employees.

00;03;51;18 - 00;04;16;22

Cary Hall

And they can't be on a group health insurance policy because they're $10 employee. So even so, you know, we have a trucking firm up in Omaha that had 4000 truckers of that 4000, about 400 1099. They had no benefits for these folks. And as a result of that, they had massive turnover. They went you went to the PSM Population Science Managment, but GigCare model.

00;04;16;24 - 00;04;27;19

Cary Hall

Yeah. It is part of the detangle plan. And they offered that to their, to their drivers. And it worked out to be really well for them. So there are solutions. But you got to find the solutions Maria.

00;04;27;22 - 00;04;54;07

Maria Ahlers

That's right. And I think, you know, employers they are working within the traditional the traditional realm w-2s get benefits. 1099 don't that doesn't mean they don't deserve benefits. It's just again, trying to find carriers that will cover 1099 carriers. Most carriers won't cover 1099 GigCare workers. You know, your GigCare workers are your Uber drivers. They need medical benefits.

00;04;54;07 - 00;05;19;01

Maria Ahlers

They have families to support, hair salon stylists, realtors. You know they need medical benefits. We help a lot of realtors with getting their own medical benefits. And the and the benefit for the client is that there's no requirement on an employer contribution so they can contribute as much or as little as they want. So then it's more affordable for them.

00;05;19;01 - 00;05;39;00

Cary Hall

I'll go back to the conversation about the trucking firm. Actually they're in Lincoln, Nebraska, not Omaha. What they did to to help offset the cost of the plan. And they used GigCare. That's the plan. They used, the, the Population Science Management GigCare plan was they added a bonus to their, to their monthly. That's right.

00;05;39;02 - 00;05;58;09

Cary Hall

And it was based on the number of miles they drove. Yeah. So there was a creative way to give these people money to say, okay, if you're signing up for this, for this health benefit plan, GigCare, then we're going to go ahead and we're going to contribute X number dollars to your plan every month based on your driving a minimum number of miles, whatever the case may be.

00;05;58;09 - 00;06;10;08

Cary Hall

But here's what happened with that, which is interesting. They they their turnover started dropping because unlike the other trucking firms, they had health benefits.

00;06;10;10 - 00;06;36;10

Maria Ahlers

Yeah, we are actually we work with a lot of co-ops and associations. And we've heard that a lot is that they're they're the retention has gone up because they're able to offer benefits. And GigCare is also more agile in the fact that you can enroll. There's no open enrollment, there's no minimum contribution. It's pretty easy plan to pick out.

00;06;36;10 - 00;06;52;11

Maria Ahlers

We have HSAs, we have PPO, we even have an EPO. And it's on three different major carriers network. The the prescription is there so it's more agile for everyone. The 29 1099 contractor and the employer.

00;06;52;13 - 00;07;11;04

Cary Hall

Up until this product came in the market. And and it's different because the rates are universal. Yeah. So our rates so very state by state. You brought up ACA. There is no open roll up. You can roll in GigCare any any time of year you want to enroll. And the rate in Kansas is the same rate as California.

00;07;11;06 - 00;07;21;00

Cary Hall

The rate the rate in Missouri is the same rate as Florida. So our rates don't variable state by state basis like ACA because he is governed by the State Department, that's for sure.

00;07;21;02 - 00;07;37;06

Maria Ahlers

That's right. Yeah. It's it's done by your age your your health history. Yeah. And what coverage level you on employee employee child employee spouse family. And it's on three large major carriers network.

00;07;37;12 - 00;07;54;01

Cary Hall

Yeah we're very fortunate to have that the Blue Cross and Cigna. As partners of ours depending on what plan you pick and where you are, that we're able to offer those plans and they make a big difference. And so you have national coverage this is another thing too. And we're going to go to a break here pretty quick.

00;07;54;01 - 00;07;57;09

Cary Hall

But I just want to bring this up. We don't have a narrow network plan.

00;07;57;09 - 00;07;58;07

Maria Ahlers

No.

00;07;58;10 - 00;08;00;07

Cary Hall

Every ACA play my right or wrong.

00;08;00;08 - 00;08;05;13

Maria Ahlers

That's right. It's as if you're on a group benefit. It feels and looks like it but it's your own individual.

00;08;05;17 - 00;08;22;25

Cary Hall

Yeah, yeah. So these are national networks. They are not narrow networks. So then the one of the ways that the carriers control costs, they have to because these plans they use high Aetna pull out of the market completely left a million people without health insurance on ACA because they were losing so much money they couldn't keep doing it.

00;08;22;28 - 00;08;42;03

Cary Hall

So they narrow the network because if you control access, you control costs. Our plants aren't set up like that. We're on their top tier PPO network. So across the country you have if you want to go to MD Anderson, you have cancer, you want to go to Sloan-Kettering or, you know, whatever, you know, specialty hospital you want to go to.

00;08;42;11 - 00;08;44;18

Cary Hall

It's not out of network. That's right. It's in.

00;08;44;18 - 00;09;02;27

Maria Ahlers

Network. That's right. It's one of the larger carrier networks. And the prescription cost is is the same. You know, we find that a lot of our, our clients are really concerned about prescription costs. And it looks and feels the same as a group benefit except it's an individual plan. You have your tiered, you know, your $10 copay, your $20 copay, your $25 copay.

00;09;03;02 - 00;09;18;19

Maria Ahlers

So it looks and feels the same way. And I think that's really why people are drawn to it, is it looks and feels the same way. It's their own benefits they have. They can keep the same providers and maintain their prescriptions. Yeah.

00;09;18;26 - 00;09;38;18

Cary Hall

So when we come back to the break, we'll talk a little bit more about that. Some of the innovative things that are happening on GigCare that you might find interesting, like drug importation and foundational assistance. We're talking about all about that. But I got back from the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Networkcoast to coast across USA.

00;09;38;18 - 00;09;58;04

Cary Hall

If you want to reach out to Maria. 877385 2224 I'm sure that Hannah who her executive assistant be happy to chat with you and get you in front of Maria. If you're looking for any of these kinds of coverage for an association, for realtors, whatever the case may be, they are more than happy to help you out. RPS Benefits by Design.

00;09;58;04 - 00;10;07;14

Cary Hall

Stay right there. We'll be right back after the break.

00;10;07;16 - 00;10;31;07

Cary Hall

You. Welcome back. You're listening to America's Healthcare Advocate s Show, broadcasting coast to coast across USA. I want to give a shout out to 14:42 a.m.. RJ, the big talker in Topeka, Kansas. Very happy to have them as part of our America's Healthcare Advocate family. A great station up there in Topeka that carries her show The Big Talker.

00;10;31;07 - 00;10;50;10

Cary Hall

1440 k MJ. All right, so let's switch gears a little bit now because, you know, this is another issue. The ACA plans are boxed in by CMS, the centers for Medicaid and Medicare Services that tell them what they can do and what they can't do. We're not a CMS plan. No, we're not. We're regulated by a Reso, which is the Department of Labor.

00;10;50;10 - 00;11;14;11

Cary Hall

It's a totally different model that we have in place. And that model, which was set up under Population Science Management, as you mentioned, a large group plan, but individual coverage underneath that plan, which is GigCare. So what we did, what what with PSM and and and with GigCare was we start a drug importation program. We have our own PBM.

00;11;14;13 - 00;11;22;05

Cary Hall

As you know, if somebody needs a medication that is outrageously expensive here, we'll bring it in from Canada, New Zealand, Australia.

00;11;22;11 - 00;11;24;26

Maria Ahlers

Which then helps to reduce the cost.

00;11;24;29 - 00;11;51;07

Cary Hall

That's right. So, so the the craze over the weight loss drugs okay. When all this first started $1,100 a month if you didn't qualify as a type two diabetic under ACA, we brought that drug in for $89 from Canada. Okay. Versus 1100. That's just an example. I mean, Humira is another one. You know, where our cost is significantly different than what you're going to see out there, on the ACA plans.

00;11;51;07 - 00;11;59;25

Cary Hall

Because first of all, we're not trying to make a profit off of the medications. And all the carriers that that's part of the formula.

00;11;59;27 - 00;12;20;14

Maria Ahlers

That's right. I mean, you're you're really coming down to the needs of the individuals that really need the prescription. And you're finding ways I mean, we're talking about it in the political climate that we're in right now to of reducing the drug, drug costs. That's one of the biggest pieces we see a certain.

00;12;20;19 - 00;12;21;24

Cary Hall

Set of, of of.

00;12;21;24 - 00;12;42;17

Maria Ahlers

Spend. That's right. And when we look at group group renewals where a company comes up for renewal and they get a renewal rate, we're able to, depending on what plan they're on, if they're on a self-insured or level funded plan, we can actually look under the hood. And what we see a lot inside carry is a lot of that renewal rate increase is because of prescription costs.

00;12;42;19 - 00;13;06;13

Cary Hall

You have 1 or 2 people taking two major expensive drugs. And what everybody gets to pay now the whole group is going to be penalized because you've got one person over here on Humera or one person on some other major medication, that it's covered, but it's going to be reflected back in the premium. Our situation is very different because, we're we'll do drug importation.

00;13;06;19 - 00;13;19;15

Maria Ahlers

And not to mention you also do prescription assistance. So if someone can't afford a prescription, you have the company has some client care specialists that will help find a way to get that funding.

00;13;19;17 - 00;13;39;14

Cary Hall

It's called script date. And what you're talking about is foundational assistance and what we do. I'm going to give you an example here. You have a child on a growth hormone. It's over $100,000 a year. Well, most people cannot afford that. Obviously you can apply to foundational services to get that drug for free and have it drop shipped to your door.

00;13;39;14 - 00;13;59;11

Cary Hall

So what do we do? We have nurses. This is their job. They do all paperwork. There's a lot of paperwork. Yeah, okay. And then that paperwork goes to the doctor who in turn submits it to the pharmaceutical manufacturer. They approve it and it. And then that medication is sent. You can't do that on ACA. And you know how I found out about this?

00;13;59;13 - 00;14;18;21

Cary Hall

We had a broker in Fort Worth, Texas, whose child needed the growth hormone. He was on an ACA plan. They didn't have any coverage for it. It's basically it's not on the formulary. Sorry. It's not covered. And he was trying to figure out how he was going to pay for this, because you got to do whatever you have to do for your child.

00;14;18;22 - 00;14;19;08

Maria Ahlers

That's right.

00;14;19;10 - 00;14;26;26

Cary Hall

Let's be real. Well, we turned around to drug importation and put him on one of our plans, and he got the medication for free.

00;14;26;29 - 00;15;01;07

Maria Ahlers

I think this GigCare really fills a gap in our community that has been by far, long needed. We have people who are gig workers that need these care, these these plans and the ACA plans don't meet everybody's needs. We had a client that's in Australia. They're standing up a couple of virtual offices here. One of them is a virtual radiology office.

00;15;01;09 - 00;15;17;20

Maria Ahlers

Well, radiologists there, they want medical plan coverage. And they so they reached out to us because they heard that we were doing GigCare, and we were able to sign them up on it. And not everybody has to pick the same plan. That's the beauty.

00;15;17;20 - 00;15;19;09

Cary Hall

That's the other thing. You're right.

00;15;19;10 - 00;15;43;28

Maria Ahlers

You know, everybody can pick what works for them. And it's easy to understand. And that makes it easy for everyone. You know, going back to to the growth hormones, I had a girlfriend. She was on one of the major carriers plan, and the the stairways were costing her several thousand dollars a month. And so she asked me, she's like, Maria, is are there other solutions?

00;15;44;00 - 00;15;46;04

Maria Ahlers

And at the time there wasn't and there are.

00;15;46;04 - 00;16;08;02

Cary Hall

So yeah, there are. So it's having to will you just do what needs to be done. So you brought some attention. You brought up radiology. So Cat scans, CT scans, MRI eyes, all of that on an ACA plan. You're going to hit the deductible. That's right. You're going to hit the co-insurance. So now let's say the hospital says, well, we want to do a CT scan and it's $1,600.

00;16;08;04 - 00;16;12;10

Cary Hall

You're probably going to eat the largest part of that. Under our plan. They get a.

00;16;12;10 - 00;16;22;19

Maria Ahlers

Voucher. They do. They can go to one of the locations that that GigCare works with. And they can go there, give him the voucher and get taken care of.

00;16;22;19 - 00;16;42;08

Cary Hall

No, no deductible donation copay. And the plan is called green imaging. And what they do is they contract with a. Just heard me to talk about virtual radiology. These people contract with independent radiology centers around the country. We have a contract with them. We can send our people there. We pay for it, okay. And they don't have a deductible, coinsurance or anything else.

00;16;42;10 - 00;16;45;13

Cary Hall

So that's another idea of what separates us.

00;16;45;16 - 00;17;10;17

Maria Ahlers

Well, there's lots of ideas that separate you. There's a telemedicine piece, EAP we know mental health is very important. There's and even even though it's not a group traditional plan, you still get the preventive care for free. They also have their diet thrive, which is their diabetic program that they help you with. So there's lots of other things underneath this product.

00;17;10;21 - 00;17;31;13

Cary Hall

Yeah, yeah. You mentioned the telemedicine piece of our telemedicine piece is called My Life Doc. And the beauty of that is especially people are rural communities, you know, where they have to drive 45 minutes, sometimes an hour to get to a primary care doc. You can go up 24 over seven if you like the doctor, you can keep the same doctor and just keep going back to the doctor.

00;17;31;16 - 00;17;48;01

Cary Hall

The same thing with urgent care. You know, I always use the example of mom comes home from work at 530, 6:00 at night. Johnny's got pinkeye. She's got to drive to urgent care. No you don't. You go up on my live, doc, get him in front of the computer. Doctor says you've got conjunctivitis. Johnny. I'm going to give you a prescription.

00;17;48;01 - 00;17;48;26

Cary Hall

That took 15.

00;17;48;26 - 00;17;52;07

Maria Ahlers

Minutes. And if you go to urgent care, there's also a copay.

00;17;52;07 - 00;17;54;00

Cary Hall

Oh, yeah. There's no copay.

00;17;54;00 - 00;17;54;07

Maria Ahlers

Here.

00;17;54;07 - 00;18;13;18

Cary Hall

That's right. There's no copay to go out of pocket. So basically, you could accomplish the same thing. And the other piece that is really interesting is that we do behavioral health. And that's four visits for every person on this plan. And in today's world, with the social media pressure on these kids, having to be able to talk to somebody could make a big difference.

00;18;13;22 - 00;18;15;19

Maria Ahlers

And you can do that also virtually. Yes.

00;18;15;22 - 00;18;16;02

Cary Hall

All time.

00;18;16;03 - 00;18;20;11

Maria Ahlers

Virtually. Again, it's correct. It's it's accessible to anywhere that you live.

00;18;20;13 - 00;18;42;10

Cary Hall

If you want information on this 877385 2224, maybe you're in an association or you're in a farmer's co-op, or you're in a realty group and you guys don't have coverage or gals. Okay. And maybe what you've got is ridiculously priced. You're on ACA, subsidies are gone. You're paying maybe 1000 $1,200 a month. We see a lot of people paying those kind of numbers.

00;18;42;15 - 00;19;18;14

Cary Hall

This plan is significantly different. Maria can help you. 877385 2224 anywhere in the country. Their website rpsbenefitsbydesigninc.com. Go on it, send them an email. They'll be happy to help you. I'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to Coast Cross, USA.

00;19;18;16 - 00;19;36;12

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA. Here on the Issue Radio Network, you can find out more about us by going to the website America's Healthcare Advocate .com. If you have a question. If you need help with something, feel free to reach out to me. We'll be happy to get back to you.

00;19;36;15 - 00;20;00;07

Cary Hall

So let's switch gears now. You know we're learning. This is shocking me, frankly, to be honest with you, I had no idea there were as many associations out there. Yes, as I mean, Maria, it is just unbelievable. There's an associate. There's actually an association for all of the 1099 workers. I didn't even know this who work at Home Depot, menards and all these big box stores.

00;20;00;13 - 00;20;08;25

Cary Hall

If you need an icemaker installed in your refrigerator and you buy it there, they these are the guys and gals that come out and do it. There's an association of these people.

00;20;08;26 - 00;20;10;02

Maria Ahlers

There's an association.

00;20;10;04 - 00;20;35;04

Cary Hall

They've got like 40,000 people. This association. Well, Intel, they connected with the US. They had no health benefits. Okay. You know, we've got a farm co-op, in, in in Nebraska with 40,000 members. And, they've never had benefits to offer. And now they do. So talk a little bit about how this benefits it. We're talking specifically to people out there involved in association.

00;20;35;10 - 00;20;44;10

Cary Hall

Your association has no benefits. How do you set this up and how does it work. So it's not complicated. Now they need to understand you're the one that's actually making all this happen.

00;20;44;10 - 00;21;09;17

Maria Ahlers

That's right. It's simple. You call our phone number that you can find on our website the Benefits by Sign Inc website. You call in one of our good care consultants, ask you some questions. If you pass the medical, the overriding, then we'll go through and see what your budget is and and ask you what kind of plans you're looking for.

00;21;09;19 - 00;21;14;18

Maria Ahlers

And then we help you enroll and then then you get your card in the mail.

00;21;14;20 - 00;21;38;10

Cary Hall

So the say the CEO of the association comes and says, you know what? We really we think this is a pretty good plan. Talk about how you implement that. How do you market that outbound marketing, messaging, email, text, talk about all the things that you do to help them get people on the planet. Oh, by the way, every association that does this gets a $10 marketing fee every month for helping promote the GigCare plan, right?

00;21;38;11 - 00;21;56;19

Maria Ahlers

That's right. What we do is we work with the association and we try to understand what works for them. As far as what that roadmap looks like. To roll this out, we will get them a dedicated phone line, which then we become their benefits team. So then their employees can call us or their 1099 contractors can call us.

00;21;56;22 - 00;22;18;03

Maria Ahlers

We will do the marketing for them. We will send out emails, we will do outbound calls. We will, meet with them in person. So then what? So then we will do the enrollment for them. We'll help them find a plan, make sure their providers are getting their their prescription, their prescriptions are covered. And then do the enrollment for them.

00;22;18;06 - 00;22;21;24

Maria Ahlers

And then if they have any questions, they just call us or they call the GigCare team.

00;22;21;24 - 00;22;23;00

Cary Hall

Same thing with farm co-ops.

00;22;23;01 - 00;22;51;02

Maria Ahlers

Yep. Everybody. Everybody's the same. We have a general line that if you are a 1099 and you just need medical coverage, you can just call our general line. If you're with a co-op, an association, a realtor group, a franchise group, an organization that has and we have a client that has about 410, 99 contractors that works in a warehouse, installing, widgets.

00;22;51;05 - 00;22;57;25

Maria Ahlers

And they need medical care. So we we become their benefits team for their 1099 contractors and their w-2s.

00;22;58;00 - 00;23;22;22

Cary Hall

And we've also got you've also got a client who has 400 franchises. They service. That's right. They are now on board gate care. So talk about how that's going to work. And for franchisees who you know, the the manager of that particular let's say you know, sub shop or pizza shop or, or whatever the facility is, if it's a franchise, you're able to offer plan.

00;23;22;22 - 00;23;24;13

Cary Hall

So how do you how does that all work?

00;23;24;14 - 00;23;47;10

Maria Ahlers

You know, I think you brought in a really good point, Kerry. We have employers that have W-2 employees, and through the renewal it may have increased, but they have one or 2 or 3 employees and they still want to provide those employees with benefits. They qualify for GigCare. So that's just like the franchise owners. The franchise owners have a small team.

00;23;47;14 - 00;23;57;25

Maria Ahlers

They call us, and we work with them to determine what works best for their their employees. And same thing. We become their, their benefits team.

00;23;57;27 - 00;24;10;27

Cary Hall

So that has to make a difference, Maria, in terms of retention and recruitment, because the second question that a potential employee always asks after what am I going to get paid is what are my benefits?

00;24;10;28 - 00;24;33;08

Maria Ahlers

That's right. What are my benefits? And we'll create the marketing tools for them, the benefits booklet for them so they can have it. We want our small employers to feel and look just like a big employer. They can offer benefits. They have growth opportunities. They have a great culture. Those are all the things small, small organizations have to.

00;24;33;10 - 00;24;41;22

Maria Ahlers

What they need is a solution for medical. Because of the because of the Department of Labor, of insurance.

00;24;41;24 - 00;25;03;11

Cary Hall

Yeah. Let's talk about realtors have it because we have found this is an area that, you know, I was somewhat surprised. I'm, I get I'm going to tell you a quick story here. Well, we have a broker in Nebraska who had a client in Florida, and that client was paying 2200. No, excuse me, $3,200 a month, for health insurance for himself and his wife.

00;25;03;11 - 00;25;28;04

Cary Hall

Now, he was 57, 58 years old. Whatever the case may be. Well, he paid he paid it. He was on. He was on a Blue Cross Blue shield plan in Florida. And then he got his ACA premium increase and it went to $5,000 a month. Wow. Can you imagine? That's a house payment and a half. Okay. So the the our broker in Nebraska knew him personally how he put him on get care.

00;25;28;04 - 00;25;31;26

Cary Hall

We put him on gig K for $1,200 a month.

00;25;31;28 - 00;25;33;10

Maria Ahlers

I have a better plan.

00;25;33;10 - 00;25;49;01

Cary Hall

That's a better plan. No. Now network national coverage, prescription drugs, the whole nine yards, 1200. I was blown away. Now, the rates in Florida are extremely high. They put through huge increases last year, but, that's just one example.

00;25;49;02 - 00;26;15;00

Maria Ahlers

We hear stories like that all the time. I had an attorney down in Texas. He has a couple of 1099 paralegals that work for him. His problem is retention because they need medical benefits. He heard about us. He called us. He was paying for his family. 20, 23, 2400. He came to us and we were able to reduce it to 1500, 15, 1600.

00;26;15;02 - 00;26;31;28

Maria Ahlers

He was able to offer benefits to his paralegals. Realtors are the same thing. They get offered a association wide plans, but they're so expensive. Their group plans. Yeah, their group plans. And they're so expensive. And sometimes they don't even fit their families well.

00;26;31;28 - 00;26;50;23

Cary Hall

And the other thing is, what happened with a lot of these realtor associations is a realtor groups is that they go into these things thinking it's going to be a solution. Then the rates just keep going up. And what happens? All the healthy people bail, right? And then you're left with this group of people that are not healthy at all.

00;26;50;26 - 00;27;10;18

Cary Hall

And the rates are double, triple what they were to start with. So for realtors, this is a great solution. If you're a broker running a realtor office, you know I don't care who you are. If you're Keller Williams or your Remax, or you're Better Homes and Gardens or South Bays or whatever the case may be. This is a hell of a solution for them, isn't it?

00;27;10;24 - 00;27;27;02

Maria Ahlers

It is. It's we've heard a lot from realtors that they have found this solution better than what they've been offered. I think the the the main point here, Kerry, is good care works for a large group of people that have been forgotten.

00;27;27;05 - 00;27;48;23

Cary Hall

Yeah, there is no solution out there for these folks. You know, when we first designed this plan that did go with Population Science Management, our company that actually owns the plan, good care. It the, the we were the folks of Blue Cross and Blue Shield. Nebraska came to us with a very large group. They were they were moving off the DB2 on the 1099 and that's why we did it.

00;27;48;26 - 00;28;00;10

Cary Hall

And then we realized, Holy cow, there are 85 million people out there. 88 million people that don't have that are 1099 that are struggling for coverage. And if they have to buy ACA plans, you just gave examples.

00;28;00;16 - 00;28;06;18

Maria Ahlers

Well, you also think about the the kids that are aging off of their parents plan too, right?

00;28;06;18 - 00;28;07;23

Cary Hall

I hadn't even thought of that. Yes.

00;28;07;25 - 00;28;28;05

Maria Ahlers

So you're hitting a lot of different demographics on on this product that can fill their need. Kids who are aging off of their their parents plan, 26 year olds, they need a plan. And this is again, we're on Aetna, Cigna and BlueCross BlueShield of Nebraska network. Yeah. Why not.

00;28;28;07 - 00;28;49;08

Cary Hall

Yeah. Can and by the way that that Blue and Braska network has what's called the blue card which then gives you access nationally to all the Blue Cross and blue shield plans. That's why we were able to offer Blue Cross and Blue Shield, as we do, across the country. When we come back from the break, we'll, we'll dive in a little more on some of the examples we've seen.

00;28;49;10 - 00;29;12;05

Cary Hall

And some of the differences. This is made for people, whether it's franchisees, franchisors, whether it's co-ops or whether it's associations. As Maria said, there's a solution here. You do have to pick up the phone and give them a call if you want some help. 877385 2224 pick up the phone. Call them. Ask for Maria. You'll probably get Hannah first.

00;29;12;07 - 00;29;29;13

Cary Hall

Her executive assistant. And she's wonderful. Okay. And then she can talk to you about putting is in play for your association, your co-op. Maybe you're not on the board of directors, but maybe you're just a member. Well, you might want to be the one that brings us to their attention and say, you know what? We could be doing this and it would make a big difference.

00;29;29;20 - 00;29;53;15

Cary Hall

Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across USA. The website is our rpsbenefitsbydesigninc.com. Stay right there. We'll be right back after the break.

00;29;53;17 - 00;30;16;18

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network in studio with me Maria Ahlers, she is the president of Benefits by Design. We are talking about 1099 workers out there. There are 88 million of you, I believe, now going to go up to over 110 million next five years.

00;30;16;20 - 00;30;33;29

Cary Hall

And you may not even be a GigCare worker. You may just be somebody that's part of an association. Or maybe you are a GigCare worker and you're part of an association that, as I talked about earlier, installs appliances for Menards or Home Depot, whatever the case may be. Or maybe you're in a farm co-op.

00;30;34;02 - 00;30;42;04

Cary Hall

Some of the other folks that that Maria that we're seeing have tremendous interest is playing some of the other groups that you've talked to.

00;30;42;06 - 00;31;01;05

Maria Ahlers

A manufacturing organization that has about 400 GigCare workers, that installs Wi-Fi in the in the, in the, in the warehouse. We have telemedicine. Radiologists that are needing GigCare are needing some sort of medical care attorneys office.

00;31;01;08 - 00;31;07;00

Cary Hall

That's what I had not thought of attorneys because I thought most attorneys offered a full blown benefits plan, but evidently not.

00;31;07;00 - 00;31;12;05

Maria Ahlers

No, no. I mean, if they have a small firm, they they have 2 or 3.

00;31;12;06 - 00;31;13;23

Cary Hall

They have the same problem anybody else has.

00;31;13;24 - 00;31;45;16

Maria Ahlers

They do CPA offices where they have 2 or 3 employees that need GigCare, some sort of medical care. We have associations, like you said, of all kinds. You know, whether it's CEO associations, water associations, just a plethora of, of different organizations. We have just a person who is a plumber, and he has his own LLC and needs GigCare for himself.

00;31;45;16 - 00;31;48;08

Maria Ahlers

I mean, it's just it just fits with everybody.

00;31;48;08 - 00;32;10;05

Cary Hall

Yeah. It's interesting. You made me think of a category of a story of a group. We did. This is a group of the independent anesthesiologists, and this company managed the anesthesiologists. Kind of like our friend that owns the franchise management firm Franchise Resource. Luke Torrey, same same thing. But they do anesthesiologists, they schedule them and get them in, and they get them paid and all the rest of it.

00;32;10;07 - 00;32;23;00

Cary Hall

Then you have any health benefits. And when they saw what we could do with great care, they immediately put in place a lot of these anesthesiologists, E.R. docs and E.R. nurses, their contract doctors.

00;32;23;00 - 00;32;23;16

Maria Ahlers

That's right.

00;32;23;16 - 00;32;29;07

Cary Hall

And contract employees, contract nurses, anesthesia. And they do not have coverage under the hospital.

00;32;29;08 - 00;32;58;24

Maria Ahlers

That's right. Yeah. They they. Right. They they're they're contractors. And so they need medical insurance. We have, a physical therapist office where they do physical therapy, and their therapists are 1099 contractors. And so they need they needed medical insurance. So it's nice for us as a broker to be able to pivot and provide a solution for everyone.

00;32;58;27 - 00;33;05;13

Maria Ahlers

You know, we can do group benefits, we can do Medicare, we can do ACA, but now we can also help the 1099.

00;33;05;16 - 00;33;21;25

Cary Hall

And by the way, you know, if you are broker and you're listening to this, all you gotta do is call Maria. They'll be happy to get you involved in GigCare. They'll set it up with you, the whole structure and make it work. And they'll walk you through it, get you trained. If you need to call center, they've got the call center.

00;33;21;25 - 00;33;40;08

Cary Hall

They can do the whole nine yards. So if you're a broker out there and maybe that you've been trying to knock on the door or some of these groups, you couldn't get in the door, but you've got a product now, okay. You can give Maria calls. She'll be happy to get you set up underneath her agency as a GA and you could move forward with these plans, but it is amazing to me what I've learned in the last three years.

00;33;40;08 - 00;33;52;07

Cary Hall

We've had this plan out now for four years is, the, the, the width and depth of this market of. I never knew associations. You know, this mini association.

00;33;52;07 - 00;33;52;20

Maria Ahlers

Co-Ops.

00;33;52;20 - 00;34;11;21

Cary Hall

Out there. Okay. Farm co-ops, kind of new, but not really. Yeah. Okay. And, and and now, you know, there's a model that fits their needs and they can each individual, you know, you can pick an HSA plan if you want a really low premium, you're 50 years old. You don't have a lot of medical issues that may work for you.

00;34;11;21 - 00;34;22;14

Cary Hall

But if you're not, if you're 30 years old and you've got 2 or 3 little tricycle motors running around the house, that's right. And you need to have, urgent care and E.R. there's a plan that fits your needs as well.

00;34;22;18 - 00;34;44;26

Maria Ahlers

This these plans are there's so many options, and you can pick the network you want to be on, whether you want to be the Cigna network, the net network, the Blue Cross Blue Shield of Nebraska network. You can pick the deductibles that you want. You know, in most group insurance, the, the organization picks the plans to offer their employee size 44 overcoat.

00;34;44;26 - 00;34;46;01

Cary Hall

Does it fit everything?

00;34;46;03 - 00;35;06;18

Maria Ahlers

That's right. That's exactly right. Yeah. The other piece to this is what I get asked a lot is what about compliance? Do I have to complete any forms? No, there's no forms for employers to worry about. There's no Cobra that the employee needs the employers need to worry about. This is a plan that is with the individual under a group umbrella.

00;35;06;24 - 00;35;36;21

Cary Hall

Yeah. And and if the employer chooses to make a contribution, it's. That's right. That goes into the paycheck. And that's, that's the way the trucking firm in Lincoln, Nebraska did it because I use that example. So there are ways to make this work. And, and and this is an opportunity. This is why we wanted to do this show today was so that you could hear this coast to coast and understand that if you are one of these groups and you are this intrigued, you, you're you're curious, you're interested, you want to know more about it.

00;35;36;24 - 00;35;38;20

Cary Hall

This thing can make a lot of sense for a lot of people.

00;35;38;20 - 00;35;48;00

Maria Ahlers

Maria. It really can. It. Again, like I said, it is a solution that has been a gap in our medical care.

00;35;48;05 - 00;36;05;11

Cary Hall

So I have to tell you a quick story. So we had a large co-op who came to us and I think it's like 40, 40 or 50,000 people. And we put the plan in place for them. They said, can we get an exclusive? And we're like, well, no, we don't really do that. But I was curious, why do you want inclusive?

00;36;05;16 - 00;36;14;00

Cary Hall

Oh, because we want to go see how many members we can take away from these other co-ops because they don't have any benefit plans. And I'm like, Holy cow, I never thought of that.

00;36;14;00 - 00;36;14;11

Maria Ahlers

I didn't.

00;36;14;14 - 00;36;34;01

Cary Hall

So I will say this if you're looking to attract new members, this is a great way to do it. I mean, we've got some pretty diverse groups out there. We have the National Hot Rod Association. That's right. The NRA, the guys you see on television, on ESPN every Saturday and Sunday, racing those drag cars at 300 miles an hour, those funny cars down that quarter mile.

00;36;34;05 - 00;36;39;05

Cary Hall

Those guys are actually part of GigCare now. So, I mean, it's amazing to me.

00;36;39;05 - 00;36;45;10

Maria Ahlers

And, you know, to your point, some carriers won't even cover. So no certain industries or certain jobs.

00;36;45;11 - 00;36;45;21

Cary Hall

No.

00;36;45;25 - 00;36;47;09

Maria Ahlers

This doesn't do.

00;36;47;09 - 00;36;56;00

Cary Hall

That. Yeah. If you're you so you know, if you're if you've got ten day night construction workers to work for you and you're a general contractor, this is a great solution for them.

00;36;56;02 - 00;37;03;24

Maria Ahlers

Yeah. We had a company that they have, stunt men and.

00;37;04;01 - 00;37;05;04

Cary Hall

These stunt movie.

00;37;05;04 - 00;37;08;02

Maria Ahlers

Stunt men, and they couldn't get insurance coverage for them.

00;37;08;03 - 00;37;08;25

Cary Hall

Right.

00;37;08;27 - 00;37;10;04

Maria Ahlers

And GigCare was the solution.

00;37;10;07 - 00;37;35;25

Cary Hall

That's remarkable. You know, the reason we do these shows is to educate and inform. And that's why I asked Maria to come in here today and talk about this. And again, if you're in any of these groups that we talked about, associations, co-ops, your realtors, maybe you're you're you belong to a group of, you know, independent E.R. docs or anesthesiologists or maybe you're one of those Fedex drivers that drives the Fedex ground delivery trucks.

00;37;35;27 - 00;37;59;26

Cary Hall

I found out all those guys and gals are 1099. If you want this product, you want to learn about it. 877-385-2224 ask for Maria. We'll probably get Hannah first hand. We'll get you set up. And then, you can have a conversation about how to do this. And the website is rpsbenefitsbydesigninc.com. rpsbenefitsbydesigninc.com.

00;38;00;04 - 00;38;01;23

Cary Hall

Thank you Maria for coming in today.

00;38;01;24 - 00;38;02;21

Maria Ahlers

Thank you for having me.

00;38;02;21 - 00;38;17;25

Cary Hall

Well it was great. I, I think we're going to help a lot of people with this. So I'm happy that we're able to do it. And now I leave you to start from Albert Einstein, the one who follows the crowd to usually get no further than the crowd. The one who walks alone will likely find himself in places no one has ever been.

00;38;17;27 - 00;38;35;28

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 s Show. Broadcasting coast to coast across the USA. Goodbye America.

00;38;36;00 - 00;38;42;20

Cary Hall

Cary and Lauren visit Mara-Lago for Lincoln Day Gala

Fri, 20 Mar 2026 19:18:26 GMT

This is a subtitle for your new post

We wanted to share our photos and video from our wonderful night in Palm Beach, Florida at the Mara-Lago Club.

The Pain Scrambler: What Does it Do? How it Works Without Pain Meds

Sat, 14 Mar 2026 10:39:09 GMT

Episode 2205 notes

Today, we discuss all things PAIN. But, in a good way!

Dr. Arden Andersen of Brand New Day Health and Brenden Lundberg, CEO of Radiant Pain Relief, explain everything PAIN and how Scrambler therapy takes the pain level down for their patients from a pain level of 7 or 8, to 4 or 5, and even to ZERO. It uses no pain medication and is non-invasive.

Hear these true stories of chronic pain relief and lives changed.

As Judy R says: "I had severe, life-altering hip pain for 5 years. Generally, my pain level was at an 8 or 9. I came into Brand New Day at a 7 or 8 pain level almost every day to work the Scrambler Therapy". Here is how she reached zero. How she feared the pain would return. But it didn't.

This is one of many fascinating stories we will explore today and find out why so few have even heard of the Scambler.

This is season 22, episode 5 of America's Healthcare Advocate. I'm Cary Hall.

Learn More: https://brandnewdayhealth.com/

Listen to this episode

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

On Rumble:

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2205 Transcript:

00;00;09;23 - 00;00;34;28

Dr Andersen

Because somebody pretty much in every family is being inhibited in their life by pain. And so we have an exciting opportunity for people to get out of that pain. Non-invasively, we have a number of technologies. And one of them that we want to talk about today particularly is called Scrambler.

00;00;35;01 - 00;01;05;17

Cary Hall

And now America's Healthcare Advocate Cary Hall. Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to our website. AmericasHealthcareAdvocate.com in my producers today, Mr. Dave Thiessen. He's our HIA Radio Producer and does all of the video work that you see up there in our 16 podcast channels and that YouTube channel with now 623,000 views.

00;01;05;17 - 00;01;36;29

Cary Hall

We really appreciate all of you out there downloading the show and listening to it or listening to those podcasts. And Garner Cowdry, he is our Cumulus producer behind the board here. That makes all of this sound the way it's supposed to sound. And we're happy to have them on board today. All right. If you are looking for Obamacare or you're looking for Medicare, your chronologically challenged or you're a 1099 employee, you might want to think about giving Carolee Steele a call over at RPS Benefits by Design 877-385-2224.

00;01;37;05 - 00;02;01;05

Cary Hall

Once again, if your 1099 employee and you're looking for decent health insurance health benefits, they're going to cost less than ACA. Give Carolee a call 877-385- 2224. And on the group side, there's some great benefits out there that Maria Ahlers, who is the president of Benefits by Design, be happy to chat with you about as well. Once again, that phone number 877-385-2224.

00;02;01;11 - 00;02;08;20

Cary Hall

Joining me in studio once again, doctor Arden Andersen. Doctor you're becoming quite a pro at this our 5th or 6th show we've done now?

00;02;08;20 - 00;02;09;11

Dr Andersen

It is.

00;02;09;11 - 00;02;20;11

Cary Hall

Yeah. So we're happy to have you back in studio with us. And the CEO of Radiant Pain Relief, Brendon Lundberg. Welcome to the show, Brendon. Glad to have you here. He’s from Colorado just to do the show today.

00;02;20;12 - 00;02;46;26

Cary Hall

I did, yeah. We greatly appreciate that. My pleasure. You know, we're going to talk about Brand New Day and their website is BrandNewDayHealth.com. This clinic has done more to help people that I've had on this show that are friends of mine, that are people that I know personally, that have gone to this clinic for care and the what they're offering the Neuro20 suit, the Scrambler you're going to hear about today, the red light blue light treatment, all the different things that they're doing there.

00;02;46;29 - 00;03;07;12

Cary Hall

No meds, no surgery, no invasive procedures whatsoever. It is remarkable. I've sent multiple people there. They're friends of mine, colleagues of mine. I've had people on this broadcast. So I urge you, if any of these issues we're going to talk about Parkinson's today. We're going to talk about pain relief today, neuropathy today. We're going to have a whole host of issues to cover.

00;03;07;18 - 00;03;27;24

Cary Hall

This is a great opportunity for you to listen and learn. So doctor, let's just start with you and a little bit about Brand New Day and what's going on now. You know, every time we do one of these, we've got some new technology device or, or some new treatment that we're doing. And, you know, I'm talking to people who are doing it and they're like, I can't believe this.

00;03;28;00 - 00;03;30;21

Cary Hall

It's changed my life. Take it away, doctor.

00;03;30;21 - 00;03;56;18

Dr Andersen

Yes, thank you very much, Carrie, for having us. It certainly is a brand new day. It's an exciting, brand new day. That's just not a play on terms. I mean, it really is. Pain is one of those things that affects most people in the world, really, at some point in time in their life. And unfortunately, it seems to be more and more of a problem as people get older just because of arthritis.

00;03;56;20 - 00;03;59;23

Cary Hall

You say that at age 76. I want to point that out.

00;03;59;23 - 00;04;26;16

Dr Andersen

Yeah, but it's, you know, I mean, it's part of life, really is we have accidents, we have athletic injuries, we have just osteoarthritis. We have diabetes, we have all of those things. And pain, is pretty much a part of every family's life because somebody pretty much in every family is being inhibited in their life by pain.

00;04;26;19 - 00;04;54;29

Dr Andersen

And so we have an exciting opportunity for people to get out of that pain non-invasively. We have a number of technologies, and one of them that we want to talk about today particularly is called Scrambler. And I'll let Brendon explain a little bit more about that when we get to him. But Scrambler is one of those things that really reprograms the brain, because if we're in chronic pain, it's one thing to be in acute pain.

00;04;54;29 - 00;05;17;03

Dr Andersen

You get in an accident, you break your arm or something of that nature, it heals and you're out of pain, right? It's a whole nother thing, though, that you break that arm, it heals. You go to physical therapy and you get your range of motion back, but the pain is still there. And five years later, that pain is still there.

00;05;17;03 - 00;05;42;29

Dr Andersen

Or maybe it's even worse now. So that is really negatively affecting a person's life. And they may have been back to the surgeon. They may have been to another physical therapist, they may have had all kinds of filming done on it, and nothing shows up that invasive technologies will do anything about, gee, go home, have a nice life.

00;05;43;00 - 00;05;44;08

Cary Hall

No. Go home. And here's your.

00;05;44;08 - 00;05;45;19

Dr Andersen

Meds. All right, here's your video.

00;05;45;19 - 00;05;50;12

Cary Hall

Leave that out. Absolutely correct. The solution we get in the medical communities, here's your meds.

00;05;50;13 - 00;06;20;08

Dr Andersen

Absolutely. That's correct. And, well, here's the latest, greatest med on top of the already 2 or 3. The trouble and the problem is, is that that basically makes the patient a zombie. Yep. And that's not acceptable either because that even inhibits their quality of life has been further. So what we found is that that pain chronically has created a pattern in the brain to expect that signal every single day, 24 over seven.

00;06;20;10 - 00;06;47;13

Dr Andersen

And so even if we were to do something locally in that arm for the pain to go away, it's been in the brain for so long, the brain thinks it's still there. And so it still registers as a pain. Perhaps the best analogy I can give is people who have lost a limb. They get what's called phantom pain.

00;06;47;16 - 00;06;53;28

Dr Andersen

Well, the limbs not there anymore. How can you possibly have pain in the hand and the hand's not even there.

00;06;53;29 - 00;06;55;21

Cary Hall

A lot of veterans go through, correct?

00;06;55;22 - 00;07;31;16

Dr Andersen

Yeah. It's because the pain is in the brain, right? That signal that there is a problem here is in the brain. What Scrambler does is help to reprogram, reset the brain to relax. Basically regarding that pain signal and think or understand, if you will, that signal is no longer there creating that pain pattern. And so people that have been in pain chronically, for example, we had a lady come in five years of chronic hip pain.

00;07;31;19 - 00;07;54;02

Dr Andersen

It wasn't an issue that required a hip replacement. She didn't need that. She'd already been released from her physical therapist. She's got all kinds of range of motion. Not a problem there. But she still has this pain, she says to the point of 8 to 9, we use a scale of 0 to 10. Yeah, she's at 8 to 9 every day, which means it completely occupies her life.

00;07;54;05 - 00;08;02;18

Dr Andersen

Three weeks of treatment with the Scrambler. She's a 0 to 3. Depending upon what activities she does. She is happy as a lark.

00;08;02;20 - 00;08;28;13

Cary Hall

It's amazing. It's absolutely amazing. And you know what? What I find even more amazing is that that this is not this is this is not new. This has been around since 2009. You have to ask yourself, where's the medical community been this whole time? And that's why, you know, when we come back in this segment, we're going to talk to Brendon and we're going to talk about the technology, what's gone into this and how they're pioneering across the country.

00;08;28;19 - 00;08;47;04

Cary Hall

But this is what I'm talking about when I talk about alternative methods that can change your life. And they do this at Brand New Day, and they do it every day. And I've got personal experience there, okay. I've got friends that I send there. If you know somebody that's dealing with what Doctor Andersen just talked about, I don't care where you are in the country.

00;08;47;04 - 00;09;03;14

Cary Hall

We have people coming here from all over the country to go to this clinic, go to their website, BrandNewDayHealth.com, BrandNewDayHealth.com. They'll be happy to chat with you. Set up a consultation. Doctor Andersen will talk to you and they'll tell you what they can do for you. And there's a lot more to it than Scrambler.

00;09;03;18 - 00;09;23;29

Cary Hall

There are other technologies we're going to talk about today that they use as well. So we'll get into all that as we've evolved with the show. Stay tuned. You're listening to America's Healthcare Advocate broadcasting here on the HD radio network, coast to coast across USA. Once again, that website, BrandNewDayHealth.com BrandNewDayHealth.com. Stay right there.

00;09;23;29 - 00;09;33;10

Cary Hall

Don't go anywhere. Doctors are in the house.

00;09;33;12 - 00;09;57;13

Cary Hall

You. Welcome back to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HD radio network. In studio with me, Doctor Arden Anderson and Brendan Lundberg. He is the CEO of Radiant Pain Relief. And now we're going to talk about this technology. You just heard doctor talk about in the last segment. So let's start with this friend.

00;09;57;13 - 00;10;13;27

Cary Hall

And how did this all come about. And and it it's remarkable what it's doing and the people that it's helping. So just talk about the genesis of this is is you shocked me on the break when you said it's been around since 2009. Yeah. And I'm like, why isn't anybody using this? So let's talk.

00;10;13;29 - 00;10;38;00

Speaker 3

Yeah. The Scrambler therapy was FDA cleared in 2009. It's been research at Mayo Clinic, at Johns Hopkins, at MD Anderson. Some very reputable institutions globally. So yeah, and yet it's been lost in obscurity, in part because of economics. I mean, economics drive, you know, like how how people how the providers make money, how the system makes money and scramble therapy falls out of that because of the way it was taken through.

00;10;38;00 - 00;10;56;12

Speaker 3

The FDA was predicated on a Tens unit, which is therapy that's been around since the late 1960s. Right. Doctor Andersen? Yes. And, and yet it's very different this the mechanism of action is quite different. And as outcome is very, very different as well, because it's creating rather than just temporary relief, it's creating more of a lasting or durable you just describe.

00;10;56;12 - 00;11;17;15

Speaker 3

Correct? Yeah. It really goes the fact that is based upon the most modern scientific understanding of pain and chronic pain in particular, which is that it's the brain. We pain is a protective mechanism. Every it's the single greatest human common denominator. Everybody, as you mentioned a minute ago, rich, poor. And every race creed, color experiences pain. Yep. Right.

00;11;17;17 - 00;11;35;21

Speaker 3

And it is actually a protective mechanism. When we have the hand on the hot stove, we've broken an ankle or God forbid, we have cancer growing in our tissue. We actually want to feel pain in those circumstances because it gets our attention. It cuts through the noise of life. It says, hey, something's not right. It encourages us to learn to not touch hot stoves, and it protects us, right.

00;11;35;21 - 00;11;55;20

Speaker 3

And we we seek we seek care because we feel something that's uncomfortable. However, when pain becomes chronic, the brain becomes wired or habituated to expect and petulant pain. As Doctor Andersen said, much like a phantom limb pain. It's not about the tissue anymore. It's about the nervous system becoming wired to expect pain. The tissue is then reacting to that.

00;11;55;22 - 00;12;14;23

Speaker 3

So rather than masking the pain with a drug, which is what, you know, most doctors are prescribing and doing or trying to, you know, inject something or surgically repair or put in a spinal cord stimulator, something that's much more invasive. This technology very calmly, very safely helps retrain the brain back to a more normal perception of pain.

00;12;14;25 - 00;12;41;10

Speaker 3

We're not making people superhuman. We're not taking away their ability to pay, to feel pain. You know, we're not going to have them be crashing through walls and not feeling that pain, but it's going to help them be a more normal pain experience in their body. The way that it does. That. And the reason it's called Scrambler therapy, is based upon a dynamic and changing, i.e scrambled set of artificial nerve impulses that are generated in the device and transmitted through the body via skin surface electrodes.

00;12;41;12 - 00;13;06;00

Speaker 3

We don't place the the electrodes typically on the pain area, but rather around the pain area. And we transmit this information through the nervous system, which the brain receives as kind of an endogenous or a self-generated nerve impulse. And then the second it receives it, it's it's changed scrambled in response to change. So over the course of an hour or so of of treatment session, the brain is flooded with a dynamic and changing set of information which it can't interpret.

00;13;06;00 - 00;13;29;02

Speaker 3

It can't understand it because it keeps changing, but because of that, it wants to know what is this message I'm receiving? Is it safe? Is it information that's important? Is it a threat? It doesn't know because it keeps changing. And so as it as it works in try to interpret that, it starts to reallocate focus or, you know, energy and you know, there's a there's a saying we've probably all heard what, what we fire, we wire.

00;13;29;02 - 00;13;46;25

Speaker 3

Right. It's like it's like it's a habit kind of. And the brain has been in the habit, created these grooves or these myelination that have perpetuated pain as it goes through this process, something called neuroplasticity. The brain can change. And so in the first session, typically we'll see some level of relief. But it's really through a series of sessions over time.

00;13;46;27 - 00;14;07;06

Speaker 3

And it could be 10 or 15. We recommend daily sessions for 2 or 3 weeks. And through that process and through neuroplasticity, the break and go through a restorative process. What also happens because this is a process, not just a one time procedure, but it's a process, is that, you know, the person immediately. Typically night one starts to sleep better, which is hugely restorative to the nervous system.

00;14;07;08 - 00;14;36;06

Speaker 3

Right? I mean, that's most people in chronic pain aren't sleeping well through the night or they're on medications that are you know, artificially helping them sleep. So sleeping improves. Then as that starts to happen, they start to feel better. They start to maybe need their medications that they're on less they can start. We need down titrating off of those, which probably helps them feel better and maybe even most importantly, hope starts to return as they can start to feel better, as they can start to move better, as they can start to have better mental clarity because are not on these medications that are complicating them.

00;14;36;12 - 00;14;46;10

Speaker 3

They can interact in their world with their loved ones, with their kids, with their job, with their hobbies. Hope starts to return, and that becomes a hugely powerful catalyst to helping them continue to improve as well.

00;14;46;10 - 00;15;11;14

Cary Hall

You know. And is that's that's fascinating because, my wife had a heart attack here about a month a half ago. She's been dealing with, heart failure for the last six, seven years. And we had some remarkable news when we went to see our our cardiologist about a week ago. And, and our surgeon, who was going to she was prepared to do their, the surgery.

00;15;11;14 - 00;15;31;18

Cary Hall

They were going to do surgery. They came back and said your ejection fraction rate is at 54. Now you're at the low end of normal. You don't need any of this when you talk about psychological difference. Yeah. She was like like a 16 year old girl. Yeah okay. Because mentally she had hope now that she was going to be able to live a normal life with her.

00;15;31;18 - 00;15;53;14

Cary Hall

Six grandchildren and move forward. So yeah, the psychological I don't think people recognize the psychological completely. The other part of the problem is, and you alluded to this, okay. The reason why I think a lot of this doesn't get adopted is because the pharmaceutical industry and look, I'm not anti pharmaceutical. But let's be clear. There's a hell of a lot of money being made, selling medications.

00;15;53;15 - 00;16;12;06

Cary Hall

That's okay. Yeah. And the doctors are getting paid the medication. The companies are getting paid. The insurance companies are getting paid. Believe it or not. Okay? There's a lot of money flowing here. Yeah. So, you know, eliminating the need for OxyContin and other pain relief medications by using a technology like this, it's a threat.

00;16;12;06 - 00;16;12;23

Speaker 3

To the system.

00;16;12;23 - 00;16;13;21

Cary Hall

Thank you very much.

00;16;13;22 - 00;16;14;02

Speaker 3

It is.

00;16;14;04 - 00;16;30;21

Cary Hall

Okay. And it's out of the box because it's out of the box. It's a threat to the system. Then you're not necessarily going to see it adopted. And that's why, you know what Doctor Andersen and Steve Sanborn have set up at Brand New Day is so very, very different. Yeah. How many other clinics do you have to sit around the country?

00;16;30;22 - 00;16;34;16

Speaker 3

Well, there's there's a handful. You know, I don't know the exact number. I was given the.

00;16;34;23 - 00;16;37;20

Cary Hall

Stock pervasive throughout the country because it's not being adopted.

00;16;37;20 - 00;16;46;26

Speaker 3

Yeah. Well the consumers haven't heard about it because nobody behind it has been able to market it to them in a very broad way. Physicians don't understand it in many cases because they're not trained on this.

00;16;46;27 - 00;16;48;16

Cary Hall

I know, I understand it.

00;16;48;23 - 00;17;08;04

Speaker 3

Maybe I think I think many physicians want to do the right thing, but they also have an economic reality. They have, you know, feed their families and keep the lights on and pay their staff. Of course, they're going to do the things that generate revenue for them, and that's insurance based prescriptive medicine in most cases. Or, you know, injections, even though the injections, the steroid injections, Doctor Andersen can clarify this as a physician.

00;17;08;04 - 00;17;14;08

Speaker 3

But I think the literature is now showing they accelerate the degeneration of the tissue. They're actually making the person worse, even if they're giving some analgesic.

00;17;14;08 - 00;17;20;28

Cary Hall

But you're getting you're getting instantaneous relief. That's going to last a very short period of time when you right back in the box.

00;17;21;00 - 00;17;28;02

Speaker 3

And that's why I think Scrambler therapy is so powerful, because it is a process, again, that becomes empowering to the individual to where they can reclaim their life.

00;17;28;02 - 00;17;50;00

Cary Hall

And that's remarkable. If you want to learn more about this, maybe you're a physician and you'd like to learn about it, go to the website BrandNewDayHealth.com BrandNewDayHealth.com. They'll be happy to reach out to you and chat to you about this. If you're someone that in pain or one of your family members is in pain, or a good friend of yours, please, I urge you to go to this website I've sent lots of people to this clinic.

00;17;50;05 - 00;18;07;27

Cary Hall

It had great results. When I come back from the break, we're going to talk about Parkinson's now, neuropathy and some of the other things that they're treating it. Brand new day. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HD radio network. Coast to coast, across the USA.

00;18;08;01 - 00;18;21;05

Cary Hall

Stay right there.

00;18;21;08 - 00;18;42;10

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the high radio network in studio with me today, Brendan Lundberg. He is the CEO of Radiant Pain Relief. And Doctor Arden Anderson from Brand New Day Clinic. And if you want to know more about that and what they do there, that website is BrandNewDayHealth.com.

00;18;42;12 - 00;19;07;10

Cary Hall

So doctor, you know, we've had some pretty remarkable people come on this radio show that you've treated. But I want to start with Parkinson's because this is a disease that, you know, that affects a lot of people. It's being treated with medications. You've got a totally different way of treating this. It's a Neuro20 suit. I happen to have one of these suits and I use it for conditioning and working out.

00;19;07;17 - 00;19;25;16

Cary Hall

But talk about the Neuro20 we had. We brought the suit in studio. We've talked about it. Talk about that. And how this, along with the other treatments that you've got, the light treatments, the scrambled treatment, the effect is having on park space because you've this some of this stuff is just remarkable to me to even hear about.

00;19;25;22 - 00;19;58;07

Dr Andersen

It is actually and it's very exciting. Parkinson's is extremely devastating. And the problem is, is the numbers just keep going up. And so the problem is, is that conventional medicine is only looking at either stem cell therapy a drug or surgery. To address the Parkinson's issue. So essentially really all they're doing is they're looking at how do I address the symptom.

00;19;58;09 - 00;20;28;11

Dr Andersen

And nobody is really looking at well what's the electromagnetic process that's gone awry. So what we find is that if we can wake up that nervous system again, and this is where the neuro soup comes in, because the Neuro20 suit, even though it's on the body, the long and the short of it is it's actually stimulating the central nervous system and back to the brain.

00;20;28;11 - 00;20;59;09

Dr Andersen

Right? Stimulating, brain derived neurotrophic factor, which 20 years ago, we did not believe that brain cells could be regenerated. We thought it was impossible. And, well, there was a few people, Robert Becker, for one, who discovered that it was possible to do that. But nonetheless, conventional medicine. And still today, there's a broad spectrum of opinion that, well, you can't really do too much about it.

00;20;59;12 - 00;21;45;03

Dr Andersen

But what we're finding and there is a clinic now in, Europe that is associated with Steve and us that is following this protocol. And we now have the longest Parkinson's patient on the Neuro20 suit protocol continuing to improve over time. And this clinic is exclusively treating Parkinson's patients successfully. Now, there's a number of things that go into that because Parkinson's is an expression of an overall issue going on in the body.

00;21;45;04 - 00;22;05;21

Dr Andersen

So there's why did they get it to begin with? Yeah. What else may be associated with this? Do they also have some dementia and long term most all Parkinson's patients? Yes, they do. Dementia, yes. Do they have also a cardiac issue going on? Do they have maybe diabetes? So what other chronic illnesses do they have with that?

00;22;05;21 - 00;22;41;25

Dr Andersen

Because we need to address all of those things. And one of the things that Doctor Palermo, who has really pioneered a lot of this as the, medical director regarding their natural 20, is that it's one thing with a disease like Parkinson's to treat it and get improvement. It's another thing to maintain that improvement. And that's where nutrition has to come in to supplementing, particularly brain nutrition in order.

00;22;41;25 - 00;23;22;14

Dr Andersen

So the Neuro20 sued. Stimulating the brain derived neurotrophic factor holds and continues to progress. But we're talking about improving their not only their, strength but their coordination, reducing or eliminating their tremors, getting their personality back. Because one thing that we see with Parkinson's patients as they decline is they get a very flat affect. They get very rattly in their gait, and, and then they.

00;23;22;14 - 00;23;23;11

Cary Hall

Lose the ability to walk.

00;23;23;12 - 00;23;43;22

Dr Andersen

And then they lose the ability to walk, right? Absolutely. They're there. You know, you can see them. They're there, but they're not really there, unfortunately, because the brain's not working like it's close to. So the Neuro20 is making progress in reversing that whole systemic illness.

00;23;43;23 - 00;23;48;06

Cary Hall

So describe the suit I want. People are saying this is like a wetsuit. It looks like a surfers wet.

00;23;48;13 - 00;24;14;07

Dr Andersen

It does. It looks like a wet diver's or a diver suit. And it has pads on the inside of it where it is lined with silver. And so there's also a little bit of an antibacterial component to it just because of silver. It is then by Wi-Fi hooked into a unit that through the computer generates the signals.

00;24;14;07 - 00;24;17;12

Cary Hall

And then the computer's like an Apple computer. I have one that.

00;24;17;12 - 00;24;48;25

Dr Andersen

Is correct on an iPad. Yeah, iPad. And it generates a pulsed signal. And the pulse is the key to getting this brain derived neurotrophic factor to be stimulated in the central nervous system. And so it is unique. It is, cleared through the FDA, correct, as a medical device. So it requires a prescription. It's not like going to body 20 and putting on a unit to gain strength.

00;24;48;25 - 00;25;05;21

Dr Andersen

Yeah. That all it is, is a muscle stimulant unit. This actually is a central nervous system. Stimulate. That's different than stimulating the muscles because it's the brain. It's the central nervous system that we have to change.

00;25;05;21 - 00;25;24;17

Cary Hall

And the computer that you get with the suit, which you set up the therapy after they go through a series of sessions like I did, they can buy the suit, the computer, and they can take it home and you can show them or program for them, correct progressive treatment so they can keep because as you said, with Parkinson's, it's a continual effort.

00;25;24;18 - 00;25;36;07

Cary Hall

Correct. So this is something where someone can actually take the suit I have one, my wife has one. We use it for different reasons. But the point is you can take it and program it to do whatever you needed to do. Can you talk about that a little bit?

00;25;36;12 - 00;26;06;02

Dr Andersen

Yes, that is correct. Well, it depends upon, where you're at and what we see with Parkinson's is that most of these people are exhausted. Oh, because constantly the, the shake right burns a lot of energy. Right. And so with a Parkinson's patient as compared to, say myself or yourself that doesn't have Parkinson's, you have to go much slower.

00;26;06;04 - 00;26;31;13

Dr Andersen

The signal has to be much weaker. We can't have the intensity to it because what happens is, is will blow through their ATP long before we get any therapeutic benefit on that. So that's also why it's vital that we supplement them in order for that therapeutic aspect to be beneficial. So we have to go real slow starting out very slow.

00;26;31;13 - 00;26;59;23

Dr Andersen

And the brain then starts responding positively. So we begin to get additive benefit with each therapy, as opposed to if we go too fast, we then go the opposite way because we, like I said, we just blow out their energy and it doesn't work that way. And so that's just something that has been learned over time. In treating Parkinson's patients, each one is going to be a little bit different as far as what can they tolerate.

00;26;59;25 - 00;27;17;28

Dr Andersen

Because how early are we getting them in the right disease process? For one thing, as well as what kind of diet do they have? What kind of body health do they have? As I said, what other chronic diseases do they have? Because those things also steal, of.

00;27;17;28 - 00;27;18;03

Cary Hall

Course.

00;27;18;04 - 00;27;24;08

Dr Andersen

Attrition from them. So each one really has to be customized and then change as they change as well.

00;27;24;08 - 00;27;43;21

Cary Hall

And that's the beauty of this suit and the beauty of what it can do. It is quite remarkable. And I have seen the results this on people have come into the show. We come back in the next segment. I'm going to ask Doctor Andersen, tell the story of a man who came in from Washington, DC, who had dropped foot, who could not walk without a walker.

00;27;43;24 - 00;28;01;13

Cary Hall

And he walked to the door of this studio and sat in the same chair. The doctor is sitting here right now, and I want him to tell that story about how that suit and his treatment changed his life. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network.

00;28;01;15 - 00;28;25;06

Cary Hall

I urge you, if you know anybody that's got Parkinson's in your family, in your church, at your place of work, and you want to help them, have them go to the website BrandNewDayHealth.com, BrandNewDayHealth.com. People are coming in here for these treatments from all over the country. This works. I wouldn't have it on the show, and I sure as hell wouldn't endorse if I didn't believe in it.

00;28;25;12 - 00;28;37;13

Cary Hall

So I'm urging you BrandNewDayHealth.com. Stay right there. We'll be right back after the break.

00;28;37;15 - 00;28;57;17

Cary Hall

Welcome back to America's Healthcare Advocates Show, broadcasting coast to coast across the USA here on the HIA Radio Network. I want to give a little shout out to our newest affiliate W, RH, I am and FM 100.1 in Charlotte, North Carolina. We're actually on for two hours every Saturday there. That's pretty remarkable. We thank you very much.

00;28;57;17 - 00;29;24;21

Cary Hall

Very happy to have you on board. Is part of the America's Healthcare Advocate family in studio with me today, Brendan Lundberg. He is the CEO of Radiant Pain Relief, the company that does the Scrambler. We're going to talk a little bit about that and ask him to recap that. And Doctor Arden Anderson from Brand New Day Health, the clinic here in Kansas City, actually in the next to that, provides the services that we're talking about that are very different than what you're seeing from a typical physician.

00;29;24;21 - 00;29;51;07

Cary Hall

So this is all these therapies, they're noninvasive. There are no drugs involved. There are no surgeries involved. It is remarkable what they can do. I know because I've sent many people there and they've had remarkable results. I want you just to recap a little bit about Scrambler again. And this whole pain management thing, because it is a huge issue and is Doctor Andersen said, everybody knows somebody in their family or friends is going through this brand.

00;29;51;08 - 00;30;14;08

Speaker 3

And you're listening and you're dealing with pain, or someone you care about is dealing with pain and is affecting their life. Come to Brand New Day. I mean, this therapy is safe. It's consistently effective. It creates lasting relief. It creates empowerment that individual back into their life. And I spent the last 15 years working with this technology on the clinical care side, as well as on the, you know, the physician education side.

00;30;14;10 - 00;30;26;12

Speaker 3

If you're interested in adopting this into a into a clinical practice, please reach out to us via the Brand New Day website. You know, I'm on it. I think Brand New Day is the only clinic in the Midwest between Chicago and Texas that has this therapy.

00;30;26;12 - 00;30;30;03

Cary Hall

That's amazing. Yeah. So that's what we've got people coming in here from all over the place.

00;30;30;07 - 00;30;41;25

Speaker 3

100%. They're doing amazing things are brand new day. You know, I'm really, really impressed. And, you know, while pain has been where I focus the last 15 years of my life and career and passion, my dad suffers from Parkinson's. So I've been keenly aware.

00;30;41;28 - 00;30;42;28

Cary Hall

Oh, let's say you know this.

00;30;42;28 - 00;30;46;19

Speaker 3

Today, Doctor Andersen's comments. And I can't wait to get my dad hooked up to this.

00;30;46;19 - 00;31;05;20

Cary Hall

I would urge you to do it because I will tell you, I've I've seen the people that have come in and gone to these therapies, and I want to I want to switch to a story now, Doctor Andersen, I'm sure you remember we had a gentleman come here from Washington, DC, and he walked in the studio. He had a little bit of a limp, didn't have a typical normal gait.

00;31;05;22 - 00;31;26;29

Cary Hall

And he sat down and he had had dropped foot. And he told me before the show started that he had been in a walker and could not move without being in that walker until he came to a brand new day. And he came in here and did this radio show. I want you to talk about that and and how you were able to basically eliminate the drop foot.

00;31;26;29 - 00;31;36;04

Cary Hall

He was 90% better when I saw him and he was going to another. We could treat with you. So I'm most curious to hear how he is now. But tell the story.

00;31;36;07 - 00;32;00;28

Dr Andersen

Yeah, that's a very nice story, really. He had a spinal cord injury, post-surgery. Left him with bilateral foot drop. And to the point that he had to wear. Excuse me? He had to wear braces on both ankles and feet to hold his feet from just dropping. And then he had to use either crutches or a walker, to walk.

00;32;00;28 - 00;32;13;17

Dr Andersen

So he was not real ambulatory and particularly for him because he was formerly a, semi-pro or pro soccer player, I.

00;32;13;17 - 00;32;15;11

Cary Hall

Remember that, yes. Yeah.

00;32;15;11 - 00;32;49;00

Dr Andersen

And so very active man. Yeah, extremely. And for him not even to be able to walk normally just devastated him. Well, there was nothing that anybody could do conventionally for him because he had an injury to the spinal cord. He came here, he heard about us and put him in a suit. And even after the second treatment, he had more control of his feet and ankles than he had had prior to surgery.

00;32;49;03 - 00;32;58;11

Dr Andersen

And so he was really excited about it. And it continued to progress to the point where he didn't need the crutches anymore. As you saw him.

00;32;58;15 - 00;32;59;12

Cary Hall

Walked in this.

00;32;59;12 - 00;33;39;06

Dr Andersen

That's correct. That's correct. And he was able to graduate away from having the braces as well. He couldn't run. But he now had some mobility, normal mobility back to of the Allied quality of life to get back to those kinds of things. And so, he continued to progress, through that. Next week and so and then went back, went back home and, so foot drop is one of those things that we are seeing more of actually, because people are getting that information out.

00;33;39;09 - 00;34;03;18

Dr Andersen

We recently had a woman out of state who came to us with several things. One, she had foot drop, but she had foot drop because she had such significant neuropathy and pain that she was losing muscle strength in the legs. And so she was having foot drop because of that loss. Completely disturbing her life. She couldn't sleep well anymore.

00;34;03;18 - 00;34;29;20

Dr Andersen

She was not able to do her, chores around the home. And it was affecting the whole family. As a result. The first thing that we focused on was pain, because we can get to the neuropathy and the foot drop and so on with the Neuro20, but pain was the most important thing that was affecting her life, her sleep and so on.

00;34;29;20 - 00;34;46;08

Dr Andersen

Correct. By the time she left, she was pain free and went back home. And so that helped convince her that, yep, we need to move forward and address, other things. With that.

00;34;46;10 - 00;34;49;07

Cary Hall

And you were using the 20 suit for a lot of this, correct?

00;34;49;07 - 00;34;53;16

Dr Andersen

Correct. But we also added the Scrambler and and.

00;34;53;16 - 00;34;54;12

Cary Hall

The light treatment.

00;34;54;13 - 00;35;22;05

Dr Andersen

The light treatment. There's another therapy as well. We use. But we decided that pain for her was the first thing we had to address in order to improve her quality of life. Correct. Because even if we got rid of the neuropathy, that was not the primary thing. That was a negative in her quality of life. It was the pain that was the issue.

00;35;22;06 - 00;35;26;26

Dr Andersen

Right. And so now she's excited about moving forward and addressing.

00;35;26;26 - 00;35;28;01

Cary Hall

She has a new career, a life.

00;35;28;08 - 00;35;55;05

Dr Andersen

Absolutely. And one thing that I wanted to mention about the Neuro20 as well is that we're stimulating brain derived neurotrophic factor. So it's also beneficial for athletes that have been injured because we can actually put a program in for their running, for their throwing, whatever it is that they're doing to help reprogram the brain to bring back a more coordinated response.

00;35;55;05 - 00;35;56;00

Dr Andersen

Post injury.

00;35;56;00 - 00;36;10;10

Cary Hall

I work, I work out three times a week. I wear that suit every time I workout. It has made a big difference. Made a big difference for my wife who had to drop at the end. Other issues. But thank you both for being here. Thank you for coming in from Colorado. Do the surgery, doctor, as always, is great to have you on.

00;36;10;10 - 00;36;31;07

Cary Hall

Thank you. You know, my closers show out I'm just going to tell you okay. You have to understand. You have to see this to believe it and understand what they can do. I don't care whether it's Parkinson's or it's pain management or it's drop foot or it's neuropathy or it's wound healing. I can go down the list of people I've had on this show and what they've been able to do, and it's remarkable.

00;36;31;09 - 00;36;52;16

Cary Hall

The clinic is BrandNewDayHealth.com BrandNewDayHealth.com. I'm urging you, if you know anybody that is having these kinds of issues, reach out to them. Let come into town. If you live here in the Kansas City Metro, it's easy. But if you're not, if you're from, you know, Mississippi or Alabama, you're from California. Whatever the case may be, reach out to Doctor Ayres and Steve.

00;36;52;19 - 00;37;08;10

Cary Hall

Go through a process where they can tell you what your issues are and what they can do to help you. It may change your life. Thank you for listening to America's Healthcare Advocate Broadcasting here on the HRA Radio Network. Goodbye, America.

00;37;08;13 - 00;37;15;24

Unknown

You can. You.

Blue KC and Metro Blue with Barron Roberts

Mon, 09 Mar 2026 14:51:04 GMT

Episode 2203 notes

Today, we discuss all things Blue Cross Blue Shield of Kansas City with Barron Roberts, Director of Individual Markets and Small Group. The things you need to know!

Topics include:

-Metro Blue Innovation

-Spira Care

Learn More about Blue Cross Blue Shield of Kansas City:

Call 816-467-22145 or visit https://www.bluekc.com/

Keywords

bcbs, bluekc, barron Roberts, Blue Cross Blue Shield of Kansas City

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Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Play full audio podcast (above) or find it by clicking from the list below:

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Is your franchise healthy? We’ll find out with the Franchise Resource team

Sat, 28 Feb 2026 22:20:37 GMT

Episode 2206 notes

From accounting and payroll to healthcare, Luke Towey and his team consult with clients to find the perfect franchise that fits their personal needs, interests, and resources! We will learn a lot today, and if you are a franchisee or a franchisor, we will discuss ways to make them thrive.

This is season 22 Ep 6 of America’s Healthcare Advocate. I’m Cary Hall.

Learn more about Luke’s company: https://franchiseresourcellc.com/

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Episode 2202 Transcript

How Associations like UASA are finding GigCare offers their employees’ health benefits at a better price

Sat, 21 Feb 2026 16:44:30 GMT

Episode 2202 notes

How Associations like UASA are finding GigCare offers their employees’ health benefits at a better price

Today we are talking about the United Appliance Servicers Association and how GigCare is working for their members 1099/contract employees.

Developed by Detego , the PSM Nebraska GigCare 1099 Worker Program is now helping associations in ways previously unavailable or cost prohibitive.

Debbie Klintworth talks about how the United Appliance Servicers Association (UASA) has found GigCare to be the solution.

John Kuhlmann explains the details that make the ACA/Obamacare overly expensive and difficult and why GigCare approaches health benefits in a way that is opposite of how the major carriers do it for health benefits and for drugs.

Learn for about Debbie's companies: https://sloanappliance.com/ and https://www.d3sservice.com/

Connect with John Kuhlmann: https://kuhlmannfin.com/

This is season 22 Episode 2 of America’s Healthcare Advocate. I’m Cary Hall.

As always, if you need help or have something to share contact me with this form on my website and let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns. Visit: https://www.americashealthcareadvocate.com/contact-us

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Episode 2202 Transcript

00;00;12;27 - 00;00;25;26

Cary Hall

We have two guests in studio today. Debbie Klintworth and John Kuhlmann. Why Debbie Klintworth is using the GigCare program. And why associations are adopting it. And John Kuhlmann is going to talk about that and all the associations he works with.

00;00;25;26 - 00;00;34;28

Cary Hall

If you're a small business, if you're an association member, maybe you're a director. You want to listen to this show. Stay tuned, listen and learn.

00;00;35;01 - 00;00;39;09

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;39;12 - 00;00;55;07

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show, broadcasting Coast to coast across USA. Here on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. You have a question or comment? Send it to me. I get a lot of emails.

00;00;55;07 - 00;01;15;26

Cary Hall

I answer each and every one of them. You can also find these shows on our 16 podcast platforms like iHeart, Spotify and Rumble. That's just three of the 16 and our YouTube channel, which is America's Healthcare Advocate, where we've got about 608,000 views right now between that and the podcast platform. And that's because of all of you out there in the listening audience.

00;01;15;26 - 00;01;36;17

Cary Hall

So we're very happy about that. Want to thank all you for that. All right. In studio today we are going to do something a little different. We have guests in here today, and we’re going to be talking about the United Appliance Servicers Association. And you may be asking what is that got to do with health care? Well, we’re going to be talking about GigCare and how GigCare works for 1099 employees.

00;01;36;17 - 00;01;49;20

Cary Hall

And in studio with me today, I have Debbie Klintworth, and she is the CEO of Sloan Appliance in Carolina, or D3S Appliance Services in Texas. The two companies welcome. Very happy to have you here today.

00;01;49;20 - 00;01;50;26

Debbie Klintworth

Thank you so much for having me.

00;01;50;26 - 00;02;10;05

Cary Hall

And we've got an old veteran in here with us today. John Kuhlmann's back for another show. So welcome back John. Thanks for joining the group. We're happy to have you on board. And by the way, speaking of radio affiliates, we have a brand new affiliate in Manchester, New Hampshire. WFEA am one of our brand new affiliates in Manchester, New Hampshire.

00;02;10;05 - 00;02;24;23

Cary Hall

We're on there from seven in the morning to eight in the morning. We want to welcome them to the family and we're very happy to have them on board. So thank you all so much. So, you know, let me just start out with appliance repair. This is really kind of interesting. So I live in a house is three years old.

00;02;24;23 - 00;02;41;01

Cary Hall

We just built it. I bet you I've had an appliance repairman out to that house no less than 10 or 11 times. So we had the wine refrigerator go. We had the ovens where the temperature wasn't right. We had the hood section that wasn't working. We had the heat lamp outside that kept going off that we couldn't get on.

00;02;41;03 - 00;02;56;09

Cary Hall

And luckily for us, every one of these people from these different companies that we called have sent out quality people. They did a great job. They're very polite and, and and they fixed it. So, you know, like I always tell my wife, you know, I can fix anything. All I need to do is get on the phone, okay?

00;02;56;16 - 00;03;18;16

Cary Hall

So having so having a group in here like these folks today, United Appliance Servicers Association and Debbie in here, who owns two companies that belong to this association. First of all, just talk about the association for a few minutes. And this is the last thing I would have ever thought of. There was actually an association of appliance repair people, but it makes perfect sense.

00;03;18;23 - 00;03;24;28

Cary Hall

So talk a little bit about that and why you are in that. And a lot of other people with companies like yours.

00;03;25;00 - 00;03;58;28

Debbie Klintworth

Absolutely. We have been around for about 36 or 37 years as an organization. Wow. It started to actually level up the playing field for all of the companies so that we could become more professional. A lot of the people that do appliance repair know how to fix appliances, but they don't know how to run a business. And so it was to bridge that gap so that you won't see that, that you see a professional image from the outside looking in.

00;03;59;00 - 00;04;21;24

Debbie Klintworth

And so this organization was started to bring each company up to teach them what they don't know. Because you don't know what you don't know until it's really bad. And so we we bring it all together. We talk, we network and we work with the manufacturers GE, Electrolux, you know, Bosch, LG, all of them come to the conference.

00;04;21;24 - 00;04;23;06

Debbie Klintworth

They give training. Really.

00;04;23;06 - 00;04;24;04

Cary Hall

Yes okay.

00;04;24;07 - 00;04;25;14

Debbie Klintworth

So we partner with them.

00;04;25;20 - 00;04;48;25

Cary Hall

So quick story. We had a mixer valve that our builder put in our shower and it happened to be a Delta valve. But it's made in Germany the most. I'm like okay for real. Yeah. Well when when the repair people came to change it out, they wouldn't send it to them because it had to come to us because we were the clients.

00;04;48;25 - 00;05;09;19

Cary Hall

So they gave us the information. I called Delta, they're very nice. They sent the thing out and we got it. But I was like, for real? And they're only certain people in that company is one guy that understands how to put that thing. Yeah. And so yeah. So I so the training piece to me sounds like that's a pretty big deal because these things are constantly changing in today's world.

00;05;09;19 - 00;05;28;22

Cary Hall

You know what what a television did ten years ago five years ago is not what the televisions I have in my house do now. It's just so so you're constantly updating them. And so the, the companies are actually working in conjunction with you. So they know the best technology and the best way to fix these things.

00;05;28;25 - 00;05;54;17

Debbie Klintworth

Absolutely. They come in, they bring refrigerators, they bring ranges to the hotel where we have the conferences, and we actually break them down, learn how to fix them, go over, you know, issues that every one of them is having and teaching. It's a wonderful time for them to connect with the engineers, the the trainers and the executives to show up.

00;05;54;18 - 00;05;55;04

Debbie Klintworth

Yes.

00;05;55;04 - 00;06;03;28

Cary Hall

Yeah, that really is amazing. So that's interesting here. So they actually physically get to go through and do these things. And you have 600 people at this thing.

00;06;03;28 - 00;06;29;24

Debbie Klintworth

We do. Yeah. And that's a small conference a lot of people don't know. There are I think from the numbers that I have heard, 40,000 appliance repair companies across the nation, and we haven't even touched the surface of all of them coming. And I'll tell you a funny story. My husband and I run the business together, and I didn't want to go to the conference the first time because I said, no one's going to teach me how to run my business.

00;06;29;24 - 00;06;33;04

Debbie Klintworth

I'm doing just fine. And

00;06;33;04 - 00;06;35;04

Cary Hall

I love the confidence. John.

00;06;35;06 - 00;06;36;06

John Kuhlmann

Debbie's very calm,

00;06;36;08 - 00;06;38;17

Cary Hall

I can tell. Yeah, and very successful.

00;06;38;21 - 00;07;01;25

Debbie Klintworth

Yeah. I did not need someone telling me how to run my company, but I learned so much. We all have the same problems. We're all running a business, and we all network together and give each other ideas. And one idea can change the future of my company tomorrow. And so we all need to get together. We support it, you know, it's a support network as well.

00;07;01;28 - 00;07;18;25

Debbie Klintworth

And now I have friends that I call when I see a problem. Are you seeing the same problem across the nation. And and so we, we use each other, for support for education and to grow our businesses.

00;07;18;27 - 00;07;40;23

Cary Hall

So do the manufacturers. And I ask this question for a reason. Do the manufacturers, when somebody calls, like, for instance, we have an outdoor fireplace. And the thing was giving me fits on our deck, and I'm trying to find appliance repair people to fix it. And and I'm not getting anywhere. So I called the company itself and they said, well, we have certain people, we train.

00;07;40;25 - 00;07;41;03

Debbie Klintworth

Right.

00;07;41;03 - 00;07;43;27

Cary Hall

So that's the kind of thing you're in. So the guy.

00;07;44;00 - 00;07;45;01

Debbie Klintworth

That’s absolutely what we do,

00;07;45;07 - 00;08;00;05

Cary Hall

the thing works like a charm. I could not be happier with that. And then he went and fixed the one in the living room to make it work better than it had worked. But they you know, you could call all kinds of fireplace people, and they didn't know beans from apple butter about this particular fireplace.

00;08;00;07 - 00;08;26;26

Cary Hall

But the manufacturers sends this one group out, and the guy did the whole thing and it did a beautiful job. So that's basically an illustration of what you're talking about, right? Thermador comes up with a brand new oven and a brand new range top, and it's got all these different opportunities. And how do you fix it? Okay. If you if you if you're the independent guy out there that doesn't belong to this association or doesn't do that kind of education, you don't know that.

00;08;26;29 - 00;08;40;04

Debbie Klintworth

That's correct. So we become an authorized service provider for all of the major manufacturers, and we actually get introduced at some of these conferences. So we work directly with them.

00;08;40;07 - 00;08;46;26

Cary Hall

So that's interesting. They have a designation that makes you an authorized service provider for these particular appliances.

00;08;46;26 - 00;09;19;21

Debbie Klintworth

We can. That's where when I became a Bosch authorized service provider, I met them the the regional service manager at the United Appliance Servicers Association. That's where that interaction happened. And then we started the training. Before that time, I was getting the training at, I was getting the training at this association. The people that I brought with me were getting the training through United Appliance Servicers Association.

00;09;19;23 - 00;09;31;01

Debbie Klintworth

Because Bosch was there training. They’ll train everyone, even the people that are not authorized. So that you can be better. You know, Bosch wants the best people working on their product.

00;09;31;04 - 00;09;35;07

Cary Hall

That's their name on that appliance. Right? So probably helps to have so he knows what they all they're doing.

00;09;35;07 - 00;09;35;29

Debbie Klintworth

Absolutely.

00;09;36;07 - 00;09;58;09

Cary Hall

If you want to reach out to Debbie either of her company's the one that Oklahoma and Texas is D3Sservice.com. In the southeastern United States that be in the Carolinas, etc. you can reach out to her at SloanAppliance.com. That's SloanAppliance.com. Like I said, if you're an independent repairman out there and you're looking for a home, this might be a good place to look.

00;09;58;09 - 00;10;24;20

Cary Hall

And if you're looking for repairs, I think these folks know what they're doing. Go to our website and check it out. Stay right there. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network coast to coast across USA. Don't go anywhere.

00;10;24;22 - 00;10;50;06

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA. Here on the HIA Radio Network. In fact, we have another new affiliate we want to announce today. This is WRHI AM and FM, 100.1FM in Charlotte, Gastonia, South Carolina. We're pretty happy to have those folks on board, and we really want to say thank you because we're on for two hours every Saturday.

00;10;50;06 - 00;11;08;20

Cary Hall

So, 1 to 3, our new affiliate WRHI. It looks like Dave is going to have a little extra work to do. So we're very happy to have them on board. We want to thank them in studio with me today is Debbie Klintworth and John Kuhlmann. We're here talking about United Appliance Servicers Association, Debbie's company, Sloan Appliance Services.

00;11;08;20 - 00;11;31;08

Cary Hall

We've talked about the past, by the way. And while we're on break, I just ask her question. I said, what is an average salary for these folks make? So they're making between 70 and $100,000 a year. You might want to think about that if you're looking for an opportunity. Her websites, by the way, are D3Sservice.com that happens to be in Texas and in in the South Carolina.

00;11;31;08 - 00;11;52;05

Cary Hall

It's SloanAppliance.com. So if you want to reach out to her and ask her a little bit about what their company does, it might be helpful. So let's talk to more now about your company okay. And then you know how long you've been doing this. And you know, you mentioned Bosch, how many different appliance groups to use service, all the rest of it.

00;11;52;08 - 00;12;07;00

Cary Hall

And then then we'll talk about why and why John's here, obviously talk about GigCare and how this fits in for you. As you know, as a company owner. So let's just start with the history of what you do and how you got where you are today.

00;12;07;02 - 00;12;29;23

Debbie Klintworth

Well, my husband had a company, and he did the appliance repair. He was the hardest working one man show until I joined him. Then once I did, we've expanded. We started with just him, and we grew to two, three, four. Next thing you know, we're at 30 techs, and we grew all over the state of Texas. And and.

00;12;29;23 - 00;12;30;24

Cary Hall

You were in the Houston area.

00;12;30;24 - 00;12;56;28

Debbie Klintworth

And we were in the Houston area. Our actual office is in Magnolia, which is the outskirts of The Woodlands there in Houston. And we've grown all over Texas, and then we've grown into Oklahoma. So we're in Oklahoma City as well. We have several guys throughout that, that area. And then we decided to buy Sloan Appliance, about three years ago or coming up on three years ago.

00;12;57;04 - 00;12;58;10

Cary Hall

And that's in Carolina.

00;12;58;10 - 00;13;11;04

Debbie Klintworth

And that's where the home base is in Columbia, South Carolina. Okay. And but we cover all the major cities, Charleston, we're in Augusta, we're in Rock Hill, as well as Greenville.

00;13;11;05 - 00;13;18;18

Cary Hall

So you started out and now you've got two companies working in these areas. What are the plans going forward.

00;13;18;25 - 00;13;27;29

Debbie Klintworth

We plan on expanding more and more. We we do all major manufacturing brands, all of them.

00;13;28;00 - 00;13;35;25

Cary Hall

So you mentioned LG, Bosch, General Electric. What's that high end version of GE, I can’t remember what it what it's called.

00;13;35;27 - 00;13;36;29

Debbie Klintworth

Well with monogram.

00;13;36;29 - 00;13;37;26

Cary Hall

Monogram that's the.

00;13;37;27 - 00;13;48;18

Debbie Klintworth

One. And Cafe. We work on that. We work on Sub-Zero. We work on some of the smaller brands. Les Baer we work on, you name it.

00;13;48;18 - 00;13;52;12

Cary Hall

So Thermador or you know, all of those Gaggenau. Okay.

00;13;52;12 - 00;14;03;11

Debbie Klintworth

All of those, Mila, we we cover that, we get training from all the major manufacturers for this to say “We're an authorized service provider”. So this is.

00;14;03;16 - 00;14;14;07

Cary Hall

A question people should be asking. Yes. They call up Joe Blow's appliance. Are you an authorized? Because if they're not, that means maybe they know what they're doing and maybe they don't know what they're doing.

00;14;14;09 - 00;14;27;00

Debbie Klintworth

Well, correct. And if you have any appliances that possibly have a part that is going to be under warranty, I'm an authorized service provider. So I will make sure that they cover that part, not you.

00;14;27;01 - 00;14;52;23

Cary Hall

That's funny because that our house is going on the fourth year that we built this brand new house, and that that, wine refrigerator that we were talking about that was out of warranty. But those guys got it got involved with the with the manufacturer, and they got them to replace that part without charging us for it. And it was a whole new board of some kind, looked like a computer board that they put in there.

00;14;52;23 - 00;15;10;12

Cary Hall

And now the thing works like a charm. So it was, you know, but they're the ones that were able to do that. I would not have been able to do that. Right. Yeah. It's pretty interesting. So a little bit about why you thought, you know, with John and Kulhmann Group that the GigCare 1099 program works for your folks.

00;15;10;14 - 00;15;30;26

Cary Hall

In terms of offering them coverage across the country, because we're the are the beauty of us of what we do it at, you know, with PSM Nebraska and with our with our GigCare program developed through Detego, is our rates are universal. So it's the rates in in South Carolina that you just got hit with by ACA or 40% higher.

00;15;30;28 - 00;15;43;00

Cary Hall

Or in Texas they're 28% higher. Our rates are flat across the country. Our rates raised 6% this year. Right John? The right. Yeah. So so talk a little bit about why were you attracted to that.

00;15;43;03 - 00;15;47;02

Debbie Klintworth

What I've found is people are afraid of insurance because they don't understand it.

00;15;47;03 - 00;15;54;13

Cary Hall

It's 100% correct. They jump into it. I'm a 30 year recovering broker and I can promise you that's an accurate statement.

00;15;54;15 - 00;16;17;15

Debbie Klintworth

Yeah. And it's very scary. And at the end of the year, at the end of the year, you have spent all of this money on insurance. And what did you truly get from that? If you were healthy, you didn't use it at all, but you feel like you've wasted a lot of money. And so, I was looking for an affordable health care option for some of the guys that are in the association.

00;16;17;21 - 00;16;28;00

Debbie Klintworth

You know, maybe they would have an opportunity if they don't have insurance. You know, once you get off of your parents insurance at 26, everyone thinks they're invincible and they don't need health insurance.

00;16;28;02 - 00;16;29;11

Cary Hall

Do they ever. Yeah.

00;16;29;17 - 00;16;30;20

John Kuhlmann

Until you need it.

00;16;30;22 - 00;16;37;08

Cary Hall

Yeah, absolutely. I tell you, you're in a car wreck or you're playing softball and break your arm. Okay. Yeah. Then that. Oh, Lord, I got a problem.

00;16;37;08 - 00;16;57;22

Debbie Klintworth

Right. So we need something that's affordable that people understand, so they will use it. And not just have it handed to them and they don't know what they're buying, and then they have buyer's remorse at the end of the year because they didn't use it. So I had talked to John about what can we do, what are the options and what can we bring into the association.

00;16;57;22 - 00;17;10;17

Debbie Klintworth

So everyone can have good health care and they understand what they're actually truly buying, because not everybody can afford as a small business to provide, you know, very expensive group health care.

00;17;10;22 - 00;17;20;29

Cary Hall

Oh, it's for for small companies like yourself, medium to small companies. The pricing is ridiculous because they're tied up in all the ACA regulations. And, John, we're not.

00;17;20;29 - 00;17;46;15

John Kuhlmann

Right. We don't have all the extra fees and taxes, too, that Obamacare built into everybody's health insurance premiums. So I've I've mentioned this before in other, other shows, but Obamacare, when it went into effect, added about 21 new fees and taxes. So all the different insurance programs across the board, be it from small group to large group, so they basically have the carriers and TPAs collect those taxes and turn around and give it to the government.

00;17;46;17 - 00;17;54;05

John Kuhlmann

They bill them as premiums. People think they’re premiums, but they're actually taxes inside their health insurance premiums. So it drives up the cost. And we don't have that in GigCare.

00;17;54;07 - 00;18;14;00

Cary Hall

That's one of the big differences between us and the ACA plans. You know, that plus the fact that we're not making you buy something you don't need, like maternity coverage if you're a 25 year old guy. Probably not going to use that. You know, there's a big difference in the way that works. We have plans that have those things, but we have plans that don't have those things.

00;18;14;03 - 00;18;29;24

Cary Hall

And that gives, you know, I like to say a size 44 overcoat doesn't fit everybody. Well, ACA is a 44 overcoat, right? Yeah. They're trying to make everybody fit. That's part of the problem. The other part is, and I'm guessing before we come up, we're actually coming up on the break. I'll hold this thought till I get back.

00;18;30;01 - 00;18;47;17

Cary Hall

We come back from the break. I want to talk about what's the age span typically of the people to go into her business, young versus old, etc. and then we'll talk about why this is a good fit for her association and why it's a good fit for associations across the country that might be thinking about what can we do to help our members.

00;18;47;17 - 00;19;08;11

Cary Hall

Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA. We'll be right back. Stay right there.

00;19;08;13 - 00;19;34;10

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate Show, broadcasting coast to coast across USA here on the HIA Radio Network. If you have something going on, you need help out there. Get on the go to the website AmericasHealthcareAdvocate.com. Send me an email. We are happy to help you in any way we can. We had a gentleman the other day who had a son who was paraplegic, could not get a wheelchair from United Health Care because it didn't meet their criteria.

00;19;34;10 - 00;19;55;14

Cary Hall

Well, we took care of that problem. So if we can help you with something like that, we're happy to do it. The website is AmericasHealthcareAdvocate.com. My emails up there. I answer each and every one of them. In studio with me today is Debbie Klintworth, and John Kuhlmann. Debbie is from Sloan Appliance Services. She has two different companies, one located in Texas and one located in the Carolinas.

00;19;55;16 - 00;20;16;29

Cary Hall

And services that whole area. If you want to know more about her, the website for those particular companies are D3Sservice.com. That's in Texas, by the way. They're down there in Tyler, Texas. For all you folks in Tyler that I come down and see a couple times a year when I go see Cowboy George. So, also Sloan Appliance Service at sloanappliance.com.

00;20;17;01 - 00;20;33;23

Cary Hall

That particular service, is in the Carolinas, so she's happy to help you. And you want to reach out to John Kuhlmann, if you're an association out there and you're looking for a solution for health care, this is the man that can help you. He can also help you with 401 K and a whole lot of other things.

00;20;33;23 - 00;20;52;16

Cary Hall

And his website is kuhlmannfin.com. kuhlmannfin.com. I'll spell it for you. kuhlmannfin.com. All right John, let's talk about why this is working. I mean what do we got like eight associations now you and I are working on.

00;20;52;16 - 00;20;53;27

John Kuhlmann

It's close to a million lives. Yeah.

00;20;53;27 - 00;21;02;20

Cary Hall

So talk about why this is working is this is like a. This is rolling. Okay. Talk about why.

00;21;02;22 - 00;21;22;18

John Kuhlmann

The biggest thing I think is the as everybody's heard about on the news, the ACA subsidies have been reduced by 40%. And then, you know, we've talked about how it's the perfect storm. Unfortunately, the carriers are raising their rates dramatically, and they also are some have pulled out of the market. Aetna lost $2 billion last year.

00;21;22;20 - 00;21;42;27

John Kuhlmann

And because of that, they decided to pull out of the ACA market and dropped 1.1 million people off their individual plans that they used to cover it. It's really because when the government took took over with the ACA, they basically wanted to take over health care, but they didn't do anything to make health care better. And, the the program's just not working.

00;21;42;27 - 00;22;02;08

John Kuhlmann

It's not about that the subsidies are going away so much, as much as it is the program didn't do anything to fix the problems with health care. GigCare does that. So GigCare does things on the PBM side. I'll let you talk about that more extensively about it, Cary, but, they do great things on that, that all the ACA, most of the ACA carriers don't do.

00;22;02;10 - 00;22;15;09

John Kuhlmann

And, it's really much better for the members. They can get specialty meds a lot of times the low cost or no cost. Whereas if you're on an ACA plan, you literally have to pay most or all of your out of pocket to cover your ACA med, and things like that.

00;22;15;11 - 00;22;29;24

Cary Hall

So, Debbie, what do you think this does for the association as far as their ability to attract new members and also their ability to retain the people that are there because they're offering a health benefits plan that nobody else is offering.

00;22;29;26 - 00;23;02;18

Debbie Klintworth

It is helping people have a peace of mind and offering something not only to their themselves, but also their employees or their 1099 employees, that they can't afford. And it is so worthwhile. I know that I have a personal, issue way back when, before Obamacare, where my son was so sick and they kept saying I had a preexisting condition and I couldn't get him insurance, and he ended up having a hole in his heart that wasn't diagnosed till he was eight, because they wouldn't run the tests.

00;23;02;20 - 00;23;14;28

Debbie Klintworth

So that's another reason why I have gotten involved in this, because people think they can just skate by and the government will take on their health benefits. But I can show.

00;23;15;01 - 00;23;17;01

Cary Hall

Yes. Oh, yeah.

00;23;17;04 - 00;23;40;03

Debbie Klintworth

They really do. Oh, they're going to treat me, but they only have treat emergencies, you know. And my son, to me, it was an emergency. It was. And but because I didn't have insurance, he didn't get the treatment that he deserved, no matter how much I they wouldn't do it because I had some money. But they the hospitals knew I didn't have enough money to cover it just in case.

00;23;40;05 - 00;24;03;11

Debbie Klintworth

And so everyone needs to be covered. You cannot rely on the emergency situation where the, you know, the emergency room is going to treat you. Yeah. And you're going to be okay. Yeah. It's not like that. And this is real. You just need to understand what it does for you and how it's going to help you. And as far as the money goes, it's affordable.

00;24;03;14 - 00;24;17;26

Cary Hall

It is affordable. We're a lot more affordable than ACA is. Okay. Question to you. How many people between the ages of, say, 21 and let's say 40 in your company? What what what percentage of that is the repair people in your company?

00;24;17;28 - 00;24;27;18

Debbie Klintworth

Most of the people. Well, most of the people that work for me are under 60 and above 26.

00;24;27;19 - 00;24;45;16

Cary Hall

Okay. So that's that's the demographic. And in those demographics, John, you know, for instance, if you get up into the 50, 50, 45, 50, we're less than half what ACA is. The other thing is, and I ask you this on break, you have guys that live in rural communities who come in to work in the cities to do appliance repair.

00;24;45;16 - 00;25;06;28

Cary Hall

Maybe they live out in the country. They got ten acres or something, and they don't want to live in the city, but they're there. Guys that are hands on guys are good. They're good repairmen that the problem with with the ACA and Obamacare plans is most of the major carriers, all of them use narrow networks. And by narrow networks, I mean they can find the number of providers you're going to get.

00;25;06;28 - 00;25;33;27

Cary Hall

And those providers are usually centered around large cities or communities like Columbia, South Carolina, like Tyler, Texas. But if you live in Jackson, Texas, you're not going to have coverage, which means you're going to drive 45 miles to get over to Tyler. Right? Okay. To go see your doctor. Okay. Or if you've got an urgent care, you get to drive 45 miles to the close to surgery care versus the way we do it, where you have the Aetna PPO network, right?

00;25;34;03 - 00;25;58;21

Cary Hall

You have the Blue Cross Blue Shield PPO network in Nebraska. Okay. And you have that. You also have the Aetna EPO network, which is lower cost. But it keeps you you're confined to the network, which the networks second largest in the country behind United. But the point is they've got access wherever they are. They don't have to drive 50 miles if they're in Jackson, Texas, because it has got a provider in that community.

00;25;58;21 - 00;26;11;03

Cary Hall

That's the way that it works. How important is that to you when you're looking to recruit or get people to come? Because the number two thing they ask, tell me if I'm wrong after what am I getting paid is what are the benefits?

00;26;11;05 - 00;26;11;26

Debbie Klintworth

Absolutely.

00;26;11;26 - 00;26;12;20

Cary Hall

Okay.

00;26;12;23 - 00;26;21;17

Debbie Klintworth

Well, and we want to provide a benefit where they're not going to be in a such a small network that they're going to have to wait eight months to see a doctor to. Yeah, that is a big problem.

00;26;21;17 - 00;26;36;27

Cary Hall

It's huge. Yeah. So John, talk a little bit about, you know, how you see the associations. You know, now we're seeing all this interest from the associations. Right. And why did why did why does this then why did they want to do this.

00;26;36;29 - 00;26;58;27

John Kuhlmann

Well I think the big thing is like with the UASA, a lot of their members are small companies and they they can't afford to provide group group benefits to their employees. Also, a lot of them have 1099 workers. They're not W-2. So the GigCare fills that fills that gap in need. And then they can tell them, yeah, we have a program, they share it with them.

00;26;58;29 - 00;27;14;07

John Kuhlmann

Then the member can call in to an enrollment center and talk to them about signing up, getting back to what you talked about, we had a member sign up in Florida. It was a husband and wife. They're there and they're like 62. Their rate was going to be $2,700 a month on the ACA. That's what it was going up to.

00;27;14;07 - 00;27;33;20

John Kuhlmann

That's a house payment, right? Yeah. And, GigCare was $1,390. And they were they they obtained better coverage too with the Aetna network. So really a a great program and a big win for them. So that's that's really it. The big thing is the association members companies a lot of them just can't afford to offer it. And this this gives them the need.

00;27;33;20 - 00;27;41;03

John Kuhlmann

In addition to that, when they call in to the enrollment center, they will also be offered dental and vision and life, if they would like and other and other ancillary coverages.

00;27;41;05 - 00;27;42;22

Cary Hall

Yeah. So they're getting they're getting the full.

00;27;42;22 - 00;27;43;29

John Kuhlmann

Complete benefits package.

00;27;43;29 - 00;27;49;02

Cary Hall

Yeah, yeah. And the experience your members have has been a good experience. So to this point.

00;27;49;05 - 00;28;11;28

Debbie Klintworth

Yes, we are working through that. It's education to try to teach them what the insurance is providing. There's a lot of people are just scared. It's different. Oh you don't know the acronyms that everyone's using. And it's just about education. And once we get through that I think it's going to be, taking off and more and more people are going to be buying in you.

00;28;12;01 - 00;28;26;21

Cary Hall

So you're listening out there. You're you belong to an association. Maybe you're an a director, an association. You're thinking maybe this is a fit for us. Well, you know, you're not going to know if you don't reach out and talk to somebody. The guy needs to talk to you sitting right here. You need to talk to John Kuhlmann.

00;28;26;23 - 00;28;50;01

Cary Hall

You can reach out to him at kuhlmannfin.com. I'm going to spell it out. kuhlmannfin.com. You'll be happy to talk to you. He's he's worked with a lot of associations. He's got a lot of success behind what he does. And it's a very professional group. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network.

00;28;50;04 - 00;29;01;00

Cary Hall

Coast to Coast Cross, USA. Stay right there. We'll be right back right after the break.

00;29;01;03 - 00;29;25;00

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. Now, look, you know, you're listening to this, and maybe you work for an appliance repair service, and you're like, we really need to get involved with this association, okay. But you can do that. All right. But you need to go listen, tell your your boss, your partner, whoever it is.

00;29;25;02 - 00;29;46;12

Cary Hall

Go listen to the podcast or go off and look at the YouTube broadcast. America's Healthcare Advocate. Okay. And then they'll understand everything we're talking about here today and why this might be a benefit. Why what Debbie is explaining might be really important to you. So again, you know, go up on any of the 16 podcast platforms or on our YouTube platform.

00;29;46;12 - 00;30;10;07

Cary Hall

And it's all up there. John, let's talk about a little bit about what separates GigCare. You know, Population Science Management, owns the program. It was developed as GigCare, right. Under the company Detego, which is our, our our primary, company. But when we did this intentionally, when we wrote this, we wrote this to be very, very different than ACA.

00;30;10;10 - 00;30;30;27

Cary Hall

We're not governed by the Department of Insurance in these states. We're governed by ERISA. We're governed by the Department of Labor. There are federal guidelines that we qualify for with this plan. So we don't have to comply with a lot of I'll just call it nonsense that ACA makes you comply with. So let's talk a little bit about what some of those things you see that make us different.

00;30;30;29 - 00;30;47;08

John Kuhlmann

The first thing I wanted to say too is a lot of people are, you know, they're used to what they're used to. So they just kind of want to continue on with the same thing with the ACA. But the ACA is crumbling off and it's falling apart. And, GigCare is definitely a great solution, an alternative to look at, to do.

00;30;47;10 - 00;30;50;25

John Kuhlmann

One of the things we do is on the PBM side, I believe it's the pharmacy side.

00;30;50;28 - 00;30;51;08

Cary Hall

Yeah.

00;30;51;09 - 00;30;52;28

John Kuhlmann

To keep it in plain English ScriptAid.

00;30;52;29 - 00;30;54;16

Cary Hall

Yeah.

00;30;54;19 - 00;31;11;10

John Kuhlmann

We basically go out and find those drugs at a very low cost or no cost for the members. If you're on an ACA plan, those are most of the the large insurance carriers are all publicly traded. They're doing all they can, basically to get as many rebates as much as they can on the drugs, not to lower the cost of the drug and the medication.

00;31;11;10 - 00;31;28;19

John Kuhlmann

So GigCare does the opposite. They get the drug at the lowest price that they can possibly get it, get it at and try to transfer that over to the member. They've also added Mark Cuban's Cost Plus drug program. It's a wonderful program. There's a I'm forgetting the name of the drug. It's I believe it's like $14,500 a month.

00;31;28;21 - 00;31;34;16

John Kuhlmann

And Mark provides the drug for $400 a month. Yeah. So it's a wonderful, wonderful program.

00;31;34;16 - 00;31;52;27

Cary Hall

So we we have a drug importation program. And so what that drug importation program does, if you take a medication, it's it ridiculously expensive. And we go back to the when when the weight loss drugs first came out. And if you wanted to buy it and you weren't a type two diabetic, it was $1,100. Well, we brought it in from Canada for $89.

00;31;52;27 - 00;32;11;22

Cary Hall

So this is the kind of thing we could do. The ACA plans are precluded. They cannot do that. We can. Okay. We also have a foundational assistance program, which is a little bit of what John was talking about, by the way, all the work to apply for that medication and get it from out of, out of, out of Canada, we do it.

00;32;11;22 - 00;32;35;29

Cary Hall

Our nurses do it at Detego, at GigCare. That's their job, okay. And for foundational assistance, you have a kid let's say that needs growth hormones. You come on the plan a year later, doctor says your child needs a growth hormone that's 100 grand a year. Okay. You know, we can get you foundational assistance where we do all the paperwork, we file it. We get the med, and we get it sent to you at no cost or at a very low cost.

00;32;35;29 - 00;32;56;03

Cary Hall

If you qualify. And almost 90% of the people qualify because not everybody can write a check for 100 grand. Exactly. So those are, those are some of the differences. And that rebate thing is just a quick. What you're telling them there is that the carriers are getting rebates from the drug companies. Right. That they're never seeing. Right.

00;32;56;03 - 00;33;03;12

Cary Hall

A we're a transparent PBM. We do not take rebates. Rebates go right back into the cost of the med, which is what you're talking about.

00;33;03;13 - 00;33;24;09

John Kuhlmann

Exactly. So you take the drug Humira. Everybody sees it advertised on TV. It's typically around 7 or 8 grand a month. There's different versions of it. But, a lot of the large insurance carriers that are publicly traded, they'll, they say they get the drug for around $4500 to $5000 a month. GigCare typically can get that drug for about $2500 bucks a month.

00;33;24;09 - 00;33;25;12

Cary Hall

That's right.

00;33;25;14 - 00;33;44;28

John Kuhlmann

Because they don't take the rebate. So what that tells you is, as the large insurance carriers are all keeping that rebate. Well, if it's a $2,500 difference per month, that's 30 grand a year that they're pocketing off of every person that takes that drug. That's just one medication. GigCare doesn't do that, and that's why they're able to drive the value they do and bring the cost down.

00;33;45;01 - 00;33;48;03

John Kuhlmann

I think another good thing to talk about would be the green imaging program if you.

00;33;48;05 - 00;34;08;13

Cary Hall

Yeah, you mentioned and that's really unique. There's all the ACA plans out there. Debbie. If you need an MRI, Cat scan or, you know, which is a major expense, you're looking 3 to 5 to $6,000, you get it done in a hospital, it's going to be six grand. You you pay the deductible, you pay the coinsurance, and you pay a co-pay.

00;34;08;16 - 00;34;29;01

Cary Hall

So you're walking out the door. Let's say you've got a 3000 deductible out of pocket next to the five. Basically, you're paying for the whole damn thing. All right. They give you a network discount. You're still paying for the whole thing under our program. John's referring to the Green Imaging program. We give you a voucher. And there are independent centers all over the country that these folks are contracted with.

00;34;29;01 - 00;34;47;20

Cary Hall

You go in and you pay nothing. There's no co-pay, there's no deductible, and there's no co-insurance. Well, the ACA plans don't. Now they could do that. They're not precluded from doing that. But they're making money off that. Right okay. So they're not you know they're making money off that. There's a reason that they're doing it.

00;34;47;20 - 00;35;08;08

Cary Hall

Okay. So those are some of the things I think that do make us very different. Yeah. In terms of what we do in the way we do it. And, and, and you know, if you've got a provider, this is interesting when you brought that up about your son, you know, if we had that situation and and we go to that and Aetna says, well no this doesn't meet the criteria to cover it.

00;35;08;09 - 00;35;26;22

Cary Hall

We're going to appeal that. You're not going to appeal it. We are okay. And we're going to appeal up the process until we get it approved or we do a direct contract with that hospital that says, okay, here's the deal. We're going to pay you 130% above Medicare to do this procedure. Boom. We want we want the the procedure done.

00;35;26;23 - 00;35;44;22

Cary Hall

Period. Okay. And 90% of the hospitals will agree to that. There are some that don't, but the majority of them will. But it all comes down to advocacy, John. Right. You know, we've got a whole team of people that that's what they do. Right. So it you know Tracy Krausse, he in our organization, she does a fabulous job.

00;35;44;22 - 00;35;52;12

Cary Hall

Brandi Bornstein does exactly the same thing. If the broker's got a problem, if the members got a problem, we're there to fix that problem.

00;35;52;12 - 00;36;07;15

John Kuhlmann

I think another thing to add to is that where with GigCare. There's over 100,000. Well over 100,000 members on the plan. 147,000. So when GigCare’s representing you to get these things done. It's not you. One little person going to going to Aetna, it's GigCare.

00;36;07;22 - 00;36;09;12

Cary Hall

We’re the advocate.

00;36;09;12 - 00;36;14;11

John Kuhlmann

Things get done. Yeah. And usually there's not problems anyway. But when things are needed, they get done.

00;36;14;13 - 00;36;33;01

Cary Hall

You know, things happen. People have claims issues. I think, you know, I, I had a claim kickback for $1,000 the other day, and I get a letter from some anonymous physician service first. I think it's a scam. It's not. And for some reason it got kicked out. Well, I have a Med Sup plan. I don't have any co-pays, so I don't have any deductible.

00;36;33;03 - 00;36;47;29

Cary Hall

And they didn't know that I knew that. Well, I made it very clear that I didn't. I said I'm appealing this now, so don't make an issue out of this. And I gave it to my broker, Carolee Steel, who I talk about every week on this show. And she went in and knocked it down. And I'm not going to pay a dime of that.

00;36;48;00 - 00;36;48;24

Cary Hall

But you've got to have.

00;36;48;24 - 00;36;50;06

John Kuhlmann

An advocate, right? Right.

00;36;50;07 - 00;36;53;06

Cary Hall

That's the way it works. Well, thank you both for doing this. Okay. Thank you.

00;36;53;12 - 00;36;54;03

John Kuhlmann

Thank you for having us.

00;36;54;03 - 00;36;54;17

Debbie Klintworth

Thank you for that.

00;36;54;17 - 00;37;04;22

Cary Hall

It was just great. It was it was wonderful to have you come out and tell your story. It's wonderful to hear somebody start a small business, be successful and obviously you're very successful. What you do. So congratulations.

00;37;04;22 - 00;37;06;03

John Kuhlmann

She's only getting started. So.

00;37;06;03 - 00;37;08;20

Cary Hall

Yeah. Yeah, you're probably right. If I had to guess.

00;37;08;20 - 00;37;09;15

John Kuhlmann

Debbie’s a ball of fire!

00;37;09;18 - 00;37;29;02

Cary Hall

Once again. You know, I do these shows that this is about education. It's about teaching you opportunities that are out there for health benefits. In this particular case, if you're an association, this is a way to find a solution for your members that might make a big difference for you. Get ahold of John Kuhlmann. You can get Ahold of him at kuhlmannfin.com.

00;37;29;02 - 00;37;34;15

Cary Hall

I'm going to spell it kuhlmannfin.com. He’ll be happy to help you.

00;37;34;15 - 00;37;47;22

Cary Hall

And now I leave you with this thought from Albert Einstein, the one who follows the crowd, they usually get no further than the crowd. The one who walks alone is likely to find himself in places no one has ever been. Remember, friends, it's the funny thing about life.

00;37;47;22 - 00;38;05;10

Cary Hall

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. Here on the HIA Radio Network. Goodbye America.

00;38;05;12 - 00;38;14;01

Unknown

What’s Wrong with Kansas?

Sat, 14 Feb 2026 14:50:33 GMT

Episode 2204 notes

What’s Wrong with Kansas? The Health of the Sunflower State.

Today on America’s Healthcare Advocate and part of my Health Of Our Communities series the topic is our flagship station’s home state of Kansas and the effect of having the 2 ^nd highest tax rate, being ranked 45 ^th out of 50 states with a growth of only 1.4% and getting an “F” from CNBC and how all of this affects our lives, or health and our families. Even our states 4 ^th graders are below 4 ^th grade level proficiency.

My friend Philip Sarnecki joins me, taking time off from his campaign to discuss what’s wrong and how we bring about a massive turnaround by building business, creating jobs and becoming the best place for business and for families.

Philip believes the state governor is like a CEO and that business sense will trump political ambition to bring us a healthy state. What’s wrong with Kansas? Find out as we discuss bringing Kansas from worst to first!

This is season 22, episode 4 or America’s Healthcare Advocate. I’m Cary Hall.

Learn more about Philip: https://philipsarnecki.org/

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Episode 2204 Transcript

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

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;06;04 - 00;00;21;22

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA. Here on the HIA Radio Network, you can find out more about us by going to the website AmericasHealthcareAdvocate.com. You know, I got an email from a doctor the other day asking for some help.

00;00;21;24 - 00;00;41;11

Cary Hall

We gave it to her. She was very happy with that. Referred her over to the lovely Carolee Steele at RPS Benefits by Design, and she was able to get her into a program for health benefits. She was very happy with. By the way, if you are looking for help with ACA, Obamacare or any other type of health insurance, you can reach out to the good folks over at

00;00;41;11 - 00;01;08;10

Cary Hall

RPS Benefits by Design 877-385-2224. Maria Ahlers is wonderful at working on employer sponsored health care. She can do some pretty amazing things. Give them a call 877-385-2224. Joining me in studio again, I am pleased to say the man who I hope is going to be the next governor of the state of Kansas Philip Sarnecki. Welcome back.

00;01;08;11 - 00;01;09;28

Philip Sarnecki

Thanks, Cary, Great to be here again.

00;01;09;29 - 00;01;11;10

Cary Hall

I hope to have you back a lot more.

00;01;11;10 - 00;01;13;14

Philip Sarnecki

I’d love to be back more, this is fun.

00;01;13;15 - 00;01;21;21

Cary Hall

Thank you. Appreciate it. Yeah. Well, you know, this is this is personal to me. You and I have had a relationship. For what? I don't know, 8 or 9 years now.

00;01;21;21 - 00;01;22;28

Philip Sarnecki

Since probably about decade.

00;01;23;02 - 00;01;42;18

Cary Hall

Yeah. Pretty close. I know you pretty well. You. You know me pretty well. So my purpose in doing this, you know, this is way out of my lane right? This is not about health care, etc., but there are exceptions to the rule. Kansas has had some problems. I think a lot of us live in a cocoon, especially here in Johnson County, where everything looks wonderful.

00;01;42;18 - 00;01;58;18

Cary Hall

And we are we we think everything is great in the state. In reality, when you travel around the state, that's not necessarily what you see. Now, I've spent a lot of time in Hays, Kansas. Believe it or not, I did a full work, a full radio week in Scott City, Kansas, a number of years ago for a farm convention.

00;01;58;23 - 00;02;21;04

Cary Hall

I have I'm on the air in Wichita. I'm on the air in Salina. I'm on the air in Great Bend across the state on 15 radio stations. So I think there's a message here that needs to get out. So here's some things you probably don't know. Kansas ranked overall 21st in sales tax. 26 and corporate tax. 26th in property tax.

00;02;21;07 - 00;02;44;13

Cary Hall

And 23rd in overall taxes compared to Missouri, Texas, Indiana, which are ranked seventh, 10th and 12th. I know this is an issue you're concerned about. We can't attract business. And we'll talk about Star Bonds here in a little while, and we can't seem to attract new business. You and I talked about this the first time. Why do you think that is, Philip?

00;02;44;15 - 00;03;10;15

Philip Sarnecki

Well, you just mentioned, the taxes. And it's actually worse than that because when you when you rank those were ranked against states like California and New York and Hawaii and Connecticut and Washington. But if you actually just take the states that, you know, our border states that we compete with, maybe throw in Iowa and Arkansas, we actually have the highest personal income tax rate of all those states.

00;03;10;21 - 00;03;32;29

Philip Sarnecki

We have the second highest corporate tax rate of all those states and property taxes, which are not a problem in every state. But there's certainly a problem here in Kansas because our career politicians have failed to do anything about it. We are about if you take those states and average them out, we're about 50% higher on average with our property taxes versus all those states around us.

00;03;33;02 - 00;03;59;29

Philip Sarnecki

So, you know, why are we not attracting enough business? Well, if you have the highest personal income tax rate, the second highest, corporate tax rate, and you're overtaxing your people to death, we are also overregulating our people to death. As I go around the state, as I talk to legislators, one of the one of the big issue with business owners that when you speak to them is how much regulation they have to deal with in the state of Kansas.

00;04;00;03 - 00;04;19;10

Philip Sarnecki

And so that's one of the things we would do. What we're going to do on day one is we're going to rip out a lot of those regulations. And allow get the obstacles out of the way to allow entrepreneurs and investors and business leaders to want to come to Kansas to build their businesses, across all across the state.

00;04;19;17 - 00;04;41;01

Cary Hall

Yeah. I have to believe that if you're able to do that, you're able to accomplish that. I'm going in there and doing similar things to what Glenn Youngkin did, what President Trump did with their executive orders, wiping out a lot of the bureaucracy, the nonsense that the ridiculous things that businesses have to go through. And we both know because we're both private businessmen.

00;04;41;03 - 00;04;59;13

Cary Hall

But on the other side of this long time. Right. That that message is going to resonate. We're going to get that. You you look at what's going on in some of these states where they're taking, what we're old, utility facilities or coal facilities, turning them into gas and putting up AI projects next to them. You look at some of the things that they're accomplishing.

00;04;59;15 - 00;05;21;06

Cary Hall

You look at what just happened with the Kansas City Star Building. That building got sold to a data center because they had the power there to run the AI that they're going to do, because they ran printing presses in there. Duh. I mean, where around this state are there factories, opportunities that are sitting there, empty, vacant, that could be converted if somebody were in the forefront of this?

00;05;21;10 - 00;05;23;17

Cary Hall

But it seems like nobody cares.

00;05;23;19 - 00;05;43;01

Philip Sarnecki

Well, I don't I don't know that nobody cares. But I think people don't understand. I mean, when you you're a politician, I mean, the people that I'm running against, for example, have over 100 years in office between them. Most of them have zero business experience. What to speak of whatsoever. And so it's just they don't understand it.

00;05;43;02 - 00;06;04;10

Philip Sarnecki

It's not the lens with which they look through. And so I think one of the things, you know, as you know, I've been doing for over 30 years is we've been building businesses, we've been creating jobs. We've done it all across the state of Kansas. And that's what we're going to do as governor. I mean, it is one of my top priorities, if not my top priority.

00;06;04;13 - 00;06;23;17

Philip Sarnecki

Kansas needs to be the best place for businesses. It needs to be the best place for families. And I believe we can do that. I really do. But we have to come alongside and partner with the people of Kansas, partner with the businesses of the state of Kansas to make this work for everybody, because it's not working for everybody right now.

00;06;23;22 - 00;06;35;26

Cary Hall

So that means that you're going to concentrate on getting the message out to the business owners. Yes. And to potential business owners that want to come into the state and investors. We're open for business. That's right. That's what you're saying.

00;06;36;01 - 00;07;02;01

Philip Sarnecki

Yeah. And, you know, those are conversations. Those are the conversations I've been having for over three decades. Those are the conversations I'm really comfortable with. But we also have to create an environment that attracts people here. And we're going to have to do that by cutting regulations and by reducing the tax burden, both on individuals, because we have to have the labor force and then also on businesses as well.

00;07;02;04 - 00;07;19;21

Cary Hall

When we come back from break. I'm going to talk about what does it take to attract people who want to stay here. So we have all these kids graduating from KU, K-State, go down the list. Emporia, Pittsburg State, go down the list. All these kids are great. Do they stay here or do they leave? We come back. We'll talk about that.

00;07;19;22 - 00;07;44;11

Cary Hall

We'll also talk about how much did Kansas actually grow last year. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across USA. If you want to learn more about Philip, go to the website. PhilipSarnecki.org. Great website you that's on WinRed. okay. And also on Facebook it's Philip Sarnecki Governor.

00;07;44;13 - 00;07;58;18

Cary Hall

A lot of information up there about the debates. He just did a lot of other information. If you want to donate WinRed is a great way to do that. That's one of the ways I do it. And it's certainly an easy way that you can do it. We'll be right back after the break. Listening to America's Healthcare Advocate.

00;07;58;24 - 00;08;11;18

Cary Hall

Stay right there.

00;08;11;21 - 00;08;37;19

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast to coast USA here on the HIA Radio Network. I want to welcome KIUL 1240-AM in Garden City, Kansas. One of our newest affiliates. Happy to have you all on board out in Garden City/ In studio with Philip Sarnecki. He is candidate for the Governor of Kansas and we are talking about all things Kansas if you're interested in learning about him.

00;08;37;19 - 00;08;58;01

Cary Hall

And there's a lot to learn. Believe me, if you go up and research him about who he is, the businesses he’s has, the successes he's had. What his vision is for this state. Go to the website. PhilipSarnecki.org. You can also donate rather on WinRed if you want to do that as well. But PhilipSarnecki.org is the website.

00;08;58;04 - 00;09;12;20

Cary Hall

So this was a little shocking to me. When I was doing research for the show, Kansas grew by a whopping 1.4% last year and ranked 45th out of 50 states. Philip. That's pathetic.

00;09;12;23 - 00;09;31;02

Philip Sarnecki

Yeah, it is pathetic. I think I might have mentioned this, the first time I was on your show a few months ago because it had just come out, you know, CNBC ranked, our economy as a state 48th in the country. They gave us an F. Moody's had come out just after that and said we were one of 20 states already in a recession.

00;09;31;05 - 00;09;48;08

Philip Sarnecki

And, you know, you talked about it. If you kind of live in South Johnson County, you feel a little insulated from that. But we've been all over the state. I mean, we've been from Goodland to Wamego to Kingman Pratt, you know, all points in between. Eldorado. We go to Fort Scott, where I own businesses, by the way, and Eldorado and Fort Scott.

00;09;48;08 - 00;10;10;09

Philip Sarnecki

But it it's, people are feeling it, and and people are hurting, and, we have got to help, as a state as state leadership and unfortunately, our career politicians who are the people that I'm running against, they're nice people, but they just don't understand what they're doing. And that's why our economy is growing the way it is.

00;10;10;13 - 00;10;40;28

Philip Sarnecki

When you are overtaxing overburdening overregulating people to death, that's what you get. You get a growth rate of 1.4% and we're overspending. We have a $26 billion total budget in the state of Kansas, and Cary, 10.5 billion of that's been added in the last seven years with no population growth. So the same amount of people are taking on an additional $10.5 billion of revenue.

00;10;41;00 - 00;10;44;07

Philip Sarnecki

Well, no wonder our taxes are the highest of every state around us.

00;10;44;07 - 00;10;56;22

Cary Hall

And did I hear, is this correct or incorrect that we have added the numbers 40 or 60,000 new state employees in the state of Kansas since this particular governor?

00;10;56;22 - 00;11;18;20

Philip Sarnecki

I haven't heard that number, but what I can say is we have the third most state employees per capita of every state in the country. So only Alaska and South Dakota, which those kind of make sense because they're smaller states have more state employees per capita than Kansas does. So we're inefficient at every single layer you look at.

00;11;18;20 - 00;11;24;13

Philip Sarnecki

You couldn't run a business that way. I couldn't run a business that way. And that's why the people of the state of Kansas are suffering.

00;11;24;13 - 00;11;25;24

Cary Hall

And we're a small state.

00;11;25;25 - 00;11;26;27

Philip Sarnecki

We're a small state.

00;11;27;00 - 00;11;43;19

Cary Hall

We're going to switch to Star Bonds here in a minute. But if the Chief’s, you know, this deal with the Chiefs is done, Kansas will be the smallest state in the Union population wise to have an NFL team. Yet what do we you know, I hear you again. You look around the bubble in Overland Park. You look at Olathe, you look at Lenexa.

00;11;43;19 - 00;12;04;23

Cary Hall

Sure looks wonderful. Get out there into these smaller communities and see what's happening on Main Street. Go out there and look at the stores that are boarded up. Look at the factories that have shut down. Look at the jobs that are not there anymore. And the only thing keeping a lot of those little towns alive is agriculture, because we still have a dynamic agriculture program in this country, everything that we do.

00;12;04;26 - 00;12;25;19

Cary Hall

But there just doesn't seem to be support to attract businesses in your, you know, you read stories every day of the of of companies going into rural communities, taking old manufacturing facilities, turning around, building brand new businesses in them. President Trump's got all these initiatives out there, all of these opportunities. We're at 1.4% growth, Philip.

00;12;25;26 - 00;12;51;27

Philip Sarnecki

Yeah. This isn't a lack of opportunity. It's a lack of vision. And it's a lack of execution. And we need leaders in our state that can go out and they can attract investors. They can have conversations with business leaders and CEOs, and they can create an environment, an infrastructure that's attracting business, that's attracting jobs to the state of Kansas.

00;12;51;29 - 00;12;56;17

Philip Sarnecki

I mean, again, that's what you know, that's what I've been doing for three decades. And that's the exact same thing I'm going to do as governor.

00;12;56;19 - 00;13;20;00

Cary Hall

But as I said, you know, going out of that last segment, how many of these bright kids from KU, K-State, Pittsburg State, Emporia go down, Hays College, how many of these kids coming out of these schools with degrees in engineering and and architecture? And and I know some of these kids. Okay. You know, Ron Rowe’s kid is coming out of K-State with a degree and in engineering.

00;13;20;00 - 00;13;27;06

Cary Hall

I mean, do you down the list, where are they going? They're leaving here and going because the opportunities not here Philip.

00;13;27;06 - 00;13;53;11

Philip Sarnecki

In 2023. We were the eighth most moved out of state in the country. And the number one reason and cited by far, far and away number one reason, 44% of the people said jobs couldn't find the job that I wanted. So we're because of the overregulation, because of the overtaxing, because of the overspending, we are not creating the type of new jobs and new businesses.

00;13;53;11 - 00;14;06;03

Philip Sarnecki

We're not attracting the investment that we need. We're not bringing enough companies to the state of Kansas. And because of that, our economy is growing at one, four, 1.4%. And, we are we're struggling.

00;14;06;07 - 00;14;06;16

Cary Hall

We are.

00;14;06;19 - 00;14;10;18

Philip Sarnecki

That's why we're ranked 48 by CNBC and and on our economy.

00;14;10;21 - 00;14;29;15

Cary Hall

So so let's switch gears. We've got about three minutes left in this segment. Star Bonds. I the Chiefs are here with a good deal. Bad deal. No deal. It's done. Yeah. What are your overall thoughts on Star Bonds? We're one of what I think four states that actually offer something like this. Yeah, they've been very successful in some cases.

00;14;29;18 - 00;14;32;00

Cary Hall

I don't know. Is it a mixed bag? What do you think?

00;14;32;02 - 00;15;01;18

Philip Sarnecki

Yeah, I, I think, I think here's the problem with star bonds in general. There's been some, situations where they've worked very well. There's been other situations where they haven't worked at all. I think the problem is being are career politicians because they have no business experience and no business background. What they're doing is they're over relying on star bonds, because when when you can't get enough new businesses started, then that's the only option they have left to go to.

00;15;01;20 - 00;15;10;20

Philip Sarnecki

And then they want to pat themselves on the back, you know, for the deal that they get. And, you know, it was interesting in the debate last Friday, which I encourage everybody to go out and watch.

00;15;10;27 - 00;15;11;17

Cary Hall

The one in Wichita.

00;15;11;17 - 00;15;14;06

Philip Sarnecki

Yeah, my my first political debate ever, but we thought.

00;15;14;07 - 00;15;14;21

Cary Hall

You did pretty.

00;15;14;21 - 00;15;33;15

Philip Sarnecki

Well. Well thank you. We thought it went extremely well, especially for my first, one ever. But one of the candidates mentioned that the bond holders, he said, you know, I would never have the state bail them out. The bond holders would be responsible for that on the star bonds. But but the here's the problem with that.

00;15;33;18 - 00;15;54;29

Philip Sarnecki

That's not reality. Because if you did that, your bond rating is going to tank and all future bond issues, the amount of interest that you're going to have to pay is going to skyrocket. Yeah. Which is going to now overburden the state with interest payments to the bondholders. So no state in reality could ever allow that to happen.

00;15;55;01 - 00;16;18;00

Philip Sarnecki

And so that was just kind of an ignorant comment, by the person on the, on the stage, again, not understanding the economics and the business of these star bonds. So I think if they're negotiated, well, they could be used from time to time. But the problem is our career politicians are way, way over relying on them.

00;16;18;00 - 00;16;19;21

Philip Sarnecki

And that's that's my big concern about it.

00;16;19;21 - 00;16;38;01

Cary Hall

And that's why we have 1.4% growth in the state. And it's not changing because that's not being recognized and that's not being dealt with. If you want information go to the website PhilipSarnecki.org also WinRed if you want to go up there a lot of information up there. You make a donation. We'll be right back.

00;16;38;01 - 00;17;05;11

Cary Hall

After the break we're going to ask Philip how's it going? He's been out on the campaign trail. How's it going? We'll know more when we come back from the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network coast to coast across USA. Don't go anywhere.

00;17;05;14 - 00;17;29;24

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast to coast USA here on the HIA Radio Network. My producers today, Mr.. David Thiessen behind the cameras, who puts all these shows together, our 16 podcast channels and our YouTube channel. By the way, 623,000 views. Thanks to all of you. Between podcast and YouTube. We're really appreciate all of that out there.

00;17;29;25 - 00;17;52;15

Cary Hall

In addition to all of you listening across the country on our 241 radio affiliates. So thank you all very much. In studio with me, Philip Sarnecki, candidate for Governor of Kansas. His website is PhilipSarnecki.org. So how's the campaign going? I know you're all over the place trying to catch up with you. It's like herding chickens.

00;17;52;15 - 00;18;05;02

Philip Sarnecki

Yeah. So? So it's, Yeah. Thanks for asking. It's going great. I mean, we're about five and a half months in, you know, to this at, you know, in some ways, I didn't know what to expect. Obviously, I've never run for office before.

00;18;05;04 - 00;18;06;08

Cary Hall

But you and Ronald Reagan.

00;18;06;08 - 00;18;25;05

Philip Sarnecki

Yeah. Yeah. Well, yeah, the funny story behind that, I know, but, it's, you know, we're winning the game financially. So one of the reasons Republicans lost in 2018, in a state that, you know, we haven't had a Democratic senator in almost 100 years, or the longest running state without a Democratic senator.

00;18;25;05 - 00;18;26;08

Cary Hall

I didn't know. That's interesting.

00;18;26;08 - 00;18;50;16

Philip Sarnecki

Yeah, we have supermajorities in both houses. I mean, Trump won the state three times by huge margins, but we've lost the governor's seat, the CEO job to a Democrat in 2018 and 2022. And one of the big reasons is because we got crushed financially. The Republicans, did not do a good job of raising money, and they weren't well capitalized, you know, a political campaign in some ways is like a new business startup.

00;18;50;16 - 00;19;16;00

Philip Sarnecki

You have to be well-financed. You have to be well capitalized. So what? December 31st was a big financial cut off in the state of Kansas. The way they do it, where all the candidates have to disclose their financial numbers. And, not only were we number one of Republican and Democratic candidates far and away number one at about $3 million, but that was the most ever raised in the history of Kansas gubernatorial races.

00;19;16;00 - 00;19;47;11

Philip Sarnecki

By that date, December 31st. So we have a huge cash advantage as we come into the new year. There's an amazing grassroots enthusiasm going on all over the the state, wherever we go. People are so tired of politics as usual. They're so tired of career politicians. And I think the energy for somebody from the outside and a business leader, you know, all, President Trump and you know what he's done coming in from the outside or I think you and I might have talked about this the first time I was on as well.

00;19;47;14 - 00;19;56;14

Philip Sarnecki

There's about a dozen governors, the who had never run for office, you know, because essentially the executive branch, it's a CEO job. You're the CEO of the state.

00;19;56;14 - 00;19;57;14

Cary Hall

It's really what it amounts to.

00;19;57;14 - 00;20;17;16

Philip Sarnecki

Yeah. And you need you know, I was at the RGA meeting a couple of, a couple of months ago, and I listened to, a session with, you mentioned Glenn Youngkin earlier who had never run for office, former governor of Virginia, Bill Lee, governor of Tennessee, very successful business leader and CEO. He had never run for office prior to running for governor of Tennessee.

00;20;17;22 - 00;20;20;24

Philip Sarnecki

And Tennessee's doing a fantastic job. Well, yeah, we're.

00;20;20;24 - 00;20;23;21

Cary Hall

Headquartered one Detego is headquartering one of our companies there.

00;20;23;21 - 00;20;47;10

Philip Sarnecki

No. That's right. And then Mike Kehoe, of course, you know, very successful car dealer for many, many years in Missouri. And I was listening to this conversation that they were having the three of them. It was like a roundtable discussion, and the whole entire conversation was about international trade trips and recruiting investment to their state, conversations with business, leaders and CEOs.

00;20;47;12 - 00;21;08;21

Philip Sarnecki

It was about their state economy. And I just as I was listening to that and I was sitting there, I thought to myself, how could anyone think that your governor doesn't need very high levels of business acumen to do that job well, because it is a massive part of the job. And so we're there's this enthusiasm across the state.

00;21;08;21 - 00;21;19;25

Philip Sarnecki

And I'll give you one example. You know, four months ago when I was on here, I think the first time, I wasn't on social media, you know, I didn't have, Facebook, Instagram, and X.

00;21;19;28 - 00;21;22;09

Cary Hall

We kind of kicked you off. I'm proud to say the. I think.

00;21;22;09 - 00;21;43;04

Philip Sarnecki

That's right. Yeah. And, I, you know, I just, I had no, I didn't want to be on those. And my, you know, my team said no, no, no, you got to, you got to be on social media if you're running now. Well, not only are we on now, we are up to I think it's we're getting close to 35,000 followers in just about four months since we went up on social media.

00;21;43;04 - 00;22;12;09

Philip Sarnecki

We are of far and away the most followed candidate on social media. So everybody go out and follow us if you're interested in the campaign. And again, to me that just speaks to the grassroots enthusiasm that's out there across the state to get something different. We can't, you know, the Republicans in the state, we can't go 12 years with a Democratic governor and the people that we're running against, that I'm running against, those are the same people that have lost the last two governor's races, and we just can't do that.

00;22;12;09 - 00;22;12;27

Philip Sarnecki

A third time.

00;22;12;28 - 00;22;14;13

Cary Hall

There's not a vision there, Philip.

00;22;14;13 - 00;22;15;02

Philip Sarnecki

No there isn’t a vision.

00;22;15;02 - 00;22;40;21

Cary Hall

I pay close attention to politics in this state. I moved out of Kansas City, Missouri, to get away from what I was dealing with in Brookside, in Kansas City, in the state of Missouri, and moved to Kansas because was a better environment for my family, my grandchildren, the whole nine yards. But when I look at the state and I travel around the state where I'm doing radio in different places, and I see these towns and these cities where, you know, Wichita's a vibrant town doing very well.

00;22;40;25 - 00;22;59;03

Cary Hall

Okay. Got 3 or 4 luxury car dealerships. So Laird's going to Hays, going to Scott City, going to some of these other places and see how well they're doing. And why aren't they ripe for companies to come in and do startups and opportunities? Well, because a lot of what you just talked about, all.

00;22;59;03 - 00;22;59;07

Philip Sarnecki

The.

00;22;59;12 - 00;23;01;10

Cary Hall

Taxes and bureaucracy.

00;23;01;12 - 00;23;20;20

Philip Sarnecki

Yeah. Overregulating overtaxing and overspending, I mean, are, you know, regardless of what you might think of the Chiefs deal, here's one example. You know, the leaders of our state decided that they needed a luxury suite, paid for by the taxpayers, in the new Chiefs Stadium.

00;23;20;26 - 00;23;29;13

Cary Hall

Run that by me one more time. This is this is not public knowledge, people. This is breaking news in case. No, it's actually out there. Okay, well, breaking news here. Okay.

00;23;29;16 - 00;23;38;27

Philip Sarnecki

Yeah, they they negotiated in the deal. A luxury suite for themselves, paid for by the taxpayers. And, you know.

00;23;39;03 - 00;23;39;10

Cary Hall

We'll.

00;23;39;14 - 00;23;57;07

Philip Sarnecki

We'll, we'll get extreme value out of that, but I'll make sure that the taxpayers are not paying for that when I'm governor, because it's just it's tone deaf. I mean, when you look at the amount of spending I mentioned earlier, $10.5 billion of new spending in the last seven years, and that's what our Democratic governor has brought us.

00;23;57;07 - 00;24;21;14

Philip Sarnecki

But quite frankly, it's also what our Republican leaders in the House and Senate have brought us to. We are overspending and therefore, over taxing, and we're overregulating. So we're not growing the economy. As you talked about, 1.4% is anemic. So, it just it really bothered me when I heard that, that the taxpayers are going to be paying for that luxury suite.

00;24;21;16 - 00;24;42;05

Philip Sarnecki

And it's just, again, is that a huge number in a $26 billion budget? Not. No, but that's not the problem. The problem is these are the taxpayer dollars. And, you know, I grew up, my father was a janitor. My mom was a secretary. I mean, every dollar is precious. And we have to protect the taxpayers of the state of Kansas.

00;24;42;08 - 00;24;59;08

Cary Hall

My father was a coal miner. Yeah. Okay. So you know, I know. Every dollar. Yeah. I said, you know, to me that's just arrogant. I'm sorry. That's the way I see it, that you think you that you think you should have that privilege because you're in political office, right? Really? Yeah.

00;24;59;09 - 00;25;01;04

Philip Sarnecki

Seriously, I totally agree.

00;25;01;04 - 00;25;13;20

Cary Hall

No, I don't, I don't to me, that just. Yes, you said it. It's tone deaf. Yeah. In a time where we're not growing and we're being taxed to death, now we're going to have this luxury. Yeah. Oh. Tucked away.

00;25;13;20 - 00;25;14;14

Philip Sarnecki

Tucked into the deal.

00;25;14;15 - 00;25;19;19

Cary Hall

You get to pay for it. So yeah. Yeah. There you go. Yeah. You probably won't get invited. You get to pay for it.

00;25;19;19 - 00;25;25;06

Philip Sarnecki

I don't know if when I'm governor, we'll figure out some creative ways on how to use it. Oh, real value out of it.

00;25;25;06 - 00;25;43;20

Cary Hall

But if Chiefs to start playing football again. Like to have the last three years. I'm sure there'll be a lot of high level executives. Wouldn't mind coming to one of those games and talk about putting a deal together, you know, to come into this state and do some work and, you know the other thing is, obviously we touched on it a minute ago before we go to break here is we have to be able to keep these young people.

00;25;43;25 - 00;25;54;12

Cary Hall

We've got some of the best schools in the country. K state that architecture program is one of the best schools in the country. You know, we've KU’s got some great. KU Med, business school.

00;25;54;12 - 00;25;54;17

Philip Sarnecki

Yeah.

00;25;54;23 - 00;26;04;10

Cary Hall

Business schools I mean law schools. Emporia Pittsburg State go down the list. But those kids aren't staying here. So we have to create these opportunities.

00;26;04;10 - 00;26;11;28

Philip Sarnecki

Yeah, we need jobs. We need businesses that are here. We need jobs that will attract them. And it's, it's something we'll get done as governor.

00;26;12;00 - 00;26;28;01

Cary Hall

Yeah, I think it is something you'll get done. And I think you and I think one of the reasons why you're having this success you're having with the campaign is it's a different message. And I think people are ready for a very different message. If you want to learn more, go to the website PhilipSarnecki.org.

00;26;28;01 - 00;26;48;01

Cary Hall

All his information is up there. You can also go to WinRed. Support Philip Sarnecki for governor. You can do a quick boom there and do a donation. If you want to do that. You can follow him on Facebook as well. And of course, this show is posted at all 16 of our podcast platforms. It will also be posted up our YouTube and then broadcast on our 15 affiliates around Kansas.

00;26;48;04 - 00;27;08;06

Cary Hall

We come back from the break. We're going to switch topics now, and I'm going to ask Philip to talk about the success of the school system in the state of Kansas. How well are kids reading? How well are they doing it at math. We'll get into that when I come back from the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network.

00;27;08;08 - 00;27;19;07

Cary Hall

Coast to coast across the USA. Stay right there. We got the future governor in the house.

00;27;19;09 - 00;27;36;12

Cary Hall

Welcome back. You're listening to America's Healthcare Advocates Show broadcasting coast to coast to coast USA here on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. You have a question, a problem. You need help. Reach out to me. I'm happy to help you in any way that I can.

00;27;36;20 - 00;27;54;03

Cary Hall

Philip Sarnecki, hopefully the future governor of the state of Kansas in studio with me for the second time today. I hope to have been back many more times before we get to November. If you want to learn about this guy I've known him for, I think almost 9 or 10 years now. This is somebody who you really do need to get to know if you want a new governor.

00;27;54;09 - 00;28;18;10

Cary Hall

That’s going to turn this state around, get us away from 1.4% growth and the highest taxes in the area. This is the man that can do that. His website. PhilipSarnecki.org. You can also follow him on Facebook and support Philip Sarnecki for governor. Also on WinRed. So Hunter your campaign manager dropped this on me as he came in the studio.

00;28;18;10 - 00;28;37;14

Cary Hall

And frankly, I was shocked because my grandchildren go to Blue Valley School District, and it's one of the I think it's the number four rated school district or 14th rated in the country or something. It's ridiculous. It's a fabulous program, great academic program, great athletic program. That's not the case with State of Kansas, is it? Philip?

00;28;37;17 - 00;28;59;28

Philip Sarnecki

No. The state of Kansas is, struggling from an education standpoint, and there's a number of reasons for that. But, just to give you a couple of examples, we are 15th in spending. We're 40th in Nape scores. We last year spent a little over $20,000 per child, per student in the state of Kansas on education.

00;29;00;02 - 00;29;21;27

Philip Sarnecki

And yet we had the worst test score outcomes that we've ever had for a state. The worst? The worst. So for the first time ever, our test scores were below the national average. So in fourth grade, 70%, it's actually a little over 70% of our fourth graders are not proficient in math or reading. At a fourth grade level.

00;29;21;28 - 00;29;42;08

Philip Sarnecki

A little over 70%. And so we are we are failing our children. You know, I mentioned this at the debate, too. I mean, it kind of goes without saying that your children are your future. But if we don't fix this, Kansas won't have much of a future. This has got to be a top priority to fix.

00;29;42;08 - 00;30;06;10

Philip Sarnecki

So I'll give you a couple of examples. So one of the things where you see education succeeding around the country in different states is charter schools. And we have less than a dozen in the state of Kansas. And one of the reasons for that is the charter schools are approved by the districts. And we need an independent authority, an independent body that is approving those charter schools.

00;30;06;12 - 00;30;21;12

Philip Sarnecki

And then the other thing that we need to do is we need to be able to scale the schools that are doing the charter schools that are doing well. So let's go replicate those that are doing well across the country or across the state. Why are they doing well? And then let's, you know, go and replicate that.

00;30;21;12 - 00;30;42;21

Philip Sarnecki

So that's one thing that we need to be doing. The second thing is so the center for Education Reform, you so I mentioned CNBC ranked as 48th on the economy as a state and gave us an F. Well, the center for Education Reform for School Choice ranked us 50th. They ranked US dead last in school choice and gave us an F as well.

00;30;42;27 - 00;30;51;27

Philip Sarnecki

So we're getting an F on the economy. We're getting an F on school choice. So we we don't have enough options. So some people are thrilled with their schools and that's wonderful I.

00;30;51;29 - 00;30;52;21

Cary Hall

Really is.

00;30;52;21 - 00;31;16;02

Philip Sarnecki

Sure. Yeah, I grew up in a public school. My wife grew up in a public school. I mean, public schools, can be wonderful, but they're not working for everyone. No. And some people need different options. They need different choices. And parents need to be in control of that, not state government bureaucracy. And we need to give our parents more choice for those.

00;31;16;02 - 00;31;26;29

Philip Sarnecki

They do need more options, whether it's a charter school, whether it's a private school, whether it's homeschooling. And we need to empower the parents to be able to make those choices for their children.

00;31;27;03 - 00;31;53;01

Cary Hall

But we don't see that happening. We don't yet. And and while communities like Johnson County with the highest property taxes, and I know you and I both pay them, okay, but I've got grandchildren go to school here. So I'm like, okay, but you you get further out and into the rural communities where they don't have the assets and they don't have the ability or the quality of education for those kids declines dramatically.

00;31;53;01 - 00;32;15;03

Cary Hall

Yet there are no alternatives. They don't have a choice. They don't have a choice. And a lot of in a lot of places, like in Wichita, Salina and other places that have a choice there either, because, as you said, and charters are interesting because I served on a charter school, Urban Children's Leadership Academy in Kansas City. And I remember this is on the east side of Kansas City, mostly African-American population.

00;32;15;05 - 00;32;35;27

Cary Hall

The parents that came to that school were so thankful that their kids were going to school where they were in uniforms, where there was discipline, where they learned it was a I remember one mother's child was going to be kicked out of school, and she came in and she begged us not kick him out of school. I don't want him to have to do what I do for a living.

00;32;36;02 - 00;32;46;03

Cary Hall

I don't want him to have to stick people. She was a lab tech. That's all she did. She wanted him to have a future. These kids aren't getting that future because we don't have that system.

00;32;46;05 - 00;33;05;18

Philip Sarnecki

Yeah, well, that goes back to my being able. So there's an example. I'm not familiar with that school, but that's an example of take those schools that are doing well that are exceptional, and let's go scale those around the state and create opportunities to do that so we can, you know, we can empower the parents, to have those kind of choices and options for their children.

00;33;05;20 - 00;33;11;26

Cary Hall

So how do you answer this issue when people say, well, you're taking money away from the rural school districts, they won't be able to survive?

00;33;11;28 - 00;33;24;24

Philip Sarnecki

Well, first of all, if you look at the data, it's not true. The school school spending is continues to increase. It continues to go up and up. And so we're not doing that again. We're spending over $20,000 per student. That's what the taxpayers are spending.

00;33;24;24 - 00;33;25;26

Cary Hall

That's a lot of money.

00;33;25;28 - 00;33;51;00

Philip Sarnecki

Per student per year. That's what we spent last year in the state of Kansas to, you know, to educate our children. Part of the problem is that where the money's going, it's an allocation of resources. It's not a money issue. It's an allocation issue. Way too much money going to bureaucracy. I could go through. We don't have time, but I could go through the whole, educational layers in the state as opposed to getting the money into the classroom.

00;33;51;00 - 00;33;55;02

Philip Sarnecki

Exactly. Getting the money to the teachers and getting the money to the students.

00;33;55;02 - 00;33;59;03

Cary Hall

And how much of that revolves around the teachers unions and their influence in the state?

00;33;59;10 - 00;34;02;29

Philip Sarnecki

A big part of it, and I don't quite. No question.

00;34;03;01 - 00;34;03;16

Cary Hall

No question.

00;34;03;18 - 00;34;31;19

Philip Sarnecki

That then. And when you get career politicians that are bought and paid for, you know, that's one of the nice things about, you know, me being an outsider is I'm not beholden to anybody. No you're not. I don't owe anything, anything, anyone, anything for a political career. Because I've never had a political career like you. And so I can truly come at this with a different lens and, with a different, at it from a different angle than what, all the folks that I'm running against and the way that they approach it.

00;34;31;22 - 00;34;36;21

Cary Hall

And I think you do. Well, thank you. And I think you’re probably going to win this race. Well thank you. Humble opinion.

00;34;36;21 - 00;34;37;12

Philip Sarnecki

It's going very well.

00;34;37;20 - 00;34;54;28

Cary Hall

It certainly is. Thank you for coming on to of course. Now I leave you with this thought from Albert Einstein, the one who follows the crowd, they usually get no further than the crowd. The one who walks alone is likely to find himself in places no one has ever been. I would have to say that probably applies to the man sitting across me in this studio today.

00;34;55;00 - 00;35;10;28

Cary Hall

Thank you for listening to America's Healthcare Advocate Show, broadcasting coast to coast across USA. Goodbye America.

00;35;11;01 - 00;35;15;03

Cary Hall

Save A Life – Respond in Critical Moments

Sat, 17 Jan 2026 17:02:08 GMT

Episode 2201 notes

Katie Radginski founded Ready Train Go in 2020 after seeing a need for a higher quality of training for situational awareness and emergency preparedness. She brings her 20 years of experience and her empathy and compassion to her classroom and now to our show.

Learn how to Save A Life and the truth about the AED you see in offices and public places... what it can do and what it won't do.

This is Episode 1 of Season 22 of America's Healthcare Advocate, I'm Cary Hall.

Learn about Ready Train Go, call 636-439-8761 or visit https://readytraingo.com/

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

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Episode 2201 Transcript

00;00;07;25 - 00;00;27;18

Cary Hall

Hello, I'm Cary Hall on today's show. Think about if you have ever seen someone go into cardiac arrest. What would you do? Would you know what to do? Would you know how to do it? Do you know how to do CPR? We have an expert in studio today. Her name is Katie Radginski. She is with ReadyTrainGo.com.

00;00;27;23 - 00;00;34;28

Cary Hall

And we're going to teach you why CPR is really important. Stay tuned. Listen and learn.

00;00;35;01 - 00;00;38;28

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;39;06 - 00;00;52;22

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the HIA Radio Network. My producers today, Mr. Garner Cowdry behind the boards making all of this work on the Cumulus stations across the country.

00;00;52;26 - 00;01;13;19

Cary Hall

Dave Thiessen, behind the cameras, the man who posts all these shows up on our YouTube and podcast channels. You know, we have 16 podcast channels now, just to give you some idea. Spotify, Rumble, SoundCloud, iHeart radio, the list goes on. And obviously our YouTube channel, 608,000 people watching the shows on YouTube from time to time. We're pretty proud of that.

00;01;13;21 - 00;01;36;10

Cary Hall

Also, if you want to know more about us, go to the website AmericasHealthcareAdvocate.com AmericasHealthcareAdvocate.com. Send me an email. You've got questions. All the shows are posted there as well. We're happy to help you with anything if we can. If you are chronologically challenged, are looking for Medicare or looking for an Obamacare policy, call the lovely Carolee Steele at RPS

00;01;36;10 - 00;01;57;13

Cary Hall

Benefits by Design 877-385-2224. Also, you know, if you're a 1099 worker and you're looking for something more affordable than ACA, you might want to ask her about GigCare. That's a plan that could make a lot of sense for you. So you might want to go back and give those folks a call over at RPS Benefits by Design 877-385-2224.

00;01;57;20 - 00;02;18;09

Cary Hall

And on the Group side, you might want to talk to Maria Ahlers because she is offering products and showing products to employers across the country that are something different than what they're seeing from some of the carriers. So once again. 877-385-2224 if you want help anywhere in the country, RPS Benefits by Design. Joining me in studio today, Katie Radginski.

00;02;18;12 - 00;02;35;09

Cary Hall

And we're going to be talking today about CPR and other things to do with, critical care in terms of how do you deal with some of these emergencies. Most specifically. We're going to talk about CPR. Why is that important? What does it mean? What do you need to know if you want to get certified why should you bother?

00;02;35;12 - 00;02;44;00

Cary Hall

Why is it important okay. And where do you see incidents like this where this becomes a very important issue. So I'm going to tell a little story here before we get started. Welcome, Katie.

00;02;44;01 - 00;02;44;14

Katie Radginski

Thank you.

00;02;44;15 - 00;02;51;17

Cary Hall

Happy to have you here today. Came in here from Saint Louis today to do the show. We're very happy to have her. So my daughter works at Morgan Stanley.

00;02;51;17 - 00;03;19;11

Cary Hall

She is a financial analyst there. They're in a meeting, with one of their clients one day. And the gentleman's an older gentleman, like, I'm 76. I don't know if he was that old or older, but regardless of that he goes in to heart failure, has a heart attack. She is trained in CPR and certified. She goes into CPR, literally saves the guy's life by the time the paramedics get there and they tell her that. That story to me, Katie illustrates why you never know, right?

00;03;19;18 - 00;03;35;11

Cary Hall

Okay, so talk a little bit about this. Why... It's very interesting. In the show notes, I was going to this morning at about 430 in the morning. You had in here. If you're untrained, just call 911. And that really stuck out to me. Like, don't do more harm than you were. Good. So talk a bit about that, right?

00;03;35;11 - 00;03;52;12

Katie Radginski

I always tell people like the little voice in your head, like, listen to it because it'll say, call 911 and you're like, well, should I, should I not? Well now you just wasted thirty seconds of that person's possibility of, of being saved because you chose not to do anything. So doing something is that first step. And then once you call 911, they'll walk you through it.

00;03;52;12 - 00;04;09;03

Katie Radginski

And you don't have to be afraid of actually knowing what to do, even though getting certified is helpful because it gives you the confidence. Like anything, if you don't use it, you're going to lose it. Like I use the example usually, like I don't want an airplane pilot not knowing what they're doing when we take off.

00;04;09;07 - 00;04;10;04

Cary Hall

Probably not.

00;04;10;06 - 00;04;27;25

Katie Radginski

No. Like they have to have continuing education units, just like you should go to a class and get certified in CPR and first aid so that you understand the skills, because you going through one time isn't going to make you knowledgeable of everything. And you don't have to feel that, intimidation when when you're taking the class, I'm like, oh no, now I have to save everybody.

00;04;27;26 - 00;04;37;20

Katie Radginski

No, do what you can. You know, if that means you're calling 911 and then the paramedics come and take over, then you've done what you can do. But like with your daughter, she jumped in and she started CPR and saved the life.

00;04;37;20 - 00;04;54;09

Cary Hall

And I had no idea she even knew how to do that. And so my dad, Morgan Stanley, put as a program in place. We get trained if we want to volunteer. And she she started out in California doing it. Now she's kind of like the person in their facility here in Leawood who, you know, trains other people and knows how to and does this.

00;04;54;14 - 00;04;55;18

Cary Hall

It's really kind of amazing.

00;04;55;24 - 00;05;05;14

Katie Radginski

Right. And you never know what companies do that. Like a lot of companies in the area, even though like you said, it's Morgan Stanley is not one that you think like, oh, they're not medical providers. Like, well, why would they have CPR?

00;05;05;15 - 00;05;06;19

Cary Hall

They're financial planners.

00;05;06;25 - 00;05;24;10

Katie Radginski

Right. But there are tons of organizations that will do that, like car rental places, manufacturing companies like different places that you're going like, oh, okay. And they have safety teams because it's the just in case if something were to happen, you never know when emergencies can happen that they're they can step up and actually help their coworkers.

00;05;24;12 - 00;05;45;28

Cary Hall

So what what is the difference between CPR. And then when you see the mouth to mouth thing, I never really quite understood the difference between the two. One looks like it's relatively easy do whether or not I want to put my mouth over somebody else's mouth. I'm not so sure about that. So talk a little bit about what's the difference between those two and why one versus the other.

00;05;45;28 - 00;06;02;25

Katie Radginski

Well so here let's break it down for us. So CPR is cardiopulmonary resuscitation. So cardio is heart pulmonary is lungs. Resuscitation is bring back to life. So we need our heart to pump. So it when our heart pumps it goes. Ba dmp, ba dmp, ba dmp. It needs to have this rhythm. And it has electrical impulses that there's still the body.

00;06;02;28 - 00;06;23;07

Katie Radginski

It's complicated in order. When you do CPR and you're doing the the compressions part, you're pumping the heart for the heart when it just stops. When we do the breaths, it gives us the oxygen that the blood needs to circulate to the brain and the other vital organs. Because if you don't have oxygen to your brain, you won't be able to function as a person.

00;06;23;09 - 00;06;39;24

Katie Radginski

And so you put the combination of the two together. And that's what CPR is compressions and breaths. Now people will debate back and forth. Well, you don't need to do the breaths anymore because like you said, I don't want to put my mouth on someone. Well, they have devices that that's a breathing barrier that has a one way valve that lets the air go in.

00;06;39;24 - 00;06;48;01

Katie Radginski

And it doesn't let their vomit, their saliva, their goobers come up into your mouth. If they were to happen to puke during this process, which is.

00;06;48;04 - 00;06;48;28

Cary Hall

It does happen.

00;06;49;01 - 00;07;08;26

Katie Radginski

Unfortunately, that's a thing that will happen. But the thing is that's, that's an okay thing. But on the flip side, is like, people still need the oxygen, but if you can't do anything, do compressions, because it gets the heart reminding itself to go, hey, I have to actually pump. We gotta work. Because if I don't pump again, my blood's not going to get to the brain in the other vital organs.

00;07;09;02 - 00;07;23;01

Katie Radginski

So it's it's a both. If you don't know what to do, you could just start compressions and then do it at a beat of 100 or 120 beats per minute. So, like, think, Another One Bites the Dust if you're in a morbid feeling or another or, Stayin Alive or like.

00;07;23;01 - 00;07;24;20

Cary Hall

Okay, I, I could do Stayin Alive.

00;07;24;21 - 00;07;25;06

Katie Radginski

Baby Shark.

00;07;25;08 - 00;07;31;10

Cary Hall

that means that I do think, not the dance. Okay, but I can certainly do this. All right.

00;07;31;14 - 00;07;34;11

Katie Radginski

But just to get that rhythm in your head, and you just go and.

00;07;34;13 - 00;07;38;14

Cary Hall

120 beats. So how many compressions is that per minute then?

00;07;38;19 - 00;07;43;12

Katie Radginski

So that's about, make me do math this morning.

00;07;43;14 - 00;07;43;29

Cary Hall

No. I'm sorry.

00;07;43;29 - 00;07;47;06

Katie Radginski

No, 101 hundred, 120 beats per minute.

00;07;47;07 - 00;07;47;20

Cary Hall

Right.

00;07;47;20 - 00;07;54;18

Katie Radginski

So 30 compressions would be about 18 to 20s per 30 compressions. Okay, there you go. The math part.

00;07;54;20 - 00;08;11;22

Cary Hall

I put her on the spot. I didn't intend to do that. How do you know whether to do just the compressions or to go to mouth to mouth? I mean, how do you know which one? I in fact, it's funny because I did not ask Andrea if she did mouth to mouth or just did compression, but how do you know which one to do?

00;08;11;22 - 00;08;16;02

Cary Hall

How how in that moment, how do you know, which one to do?

00;08;16;07 - 00;08;22;06

Katie Radginski

So if you're if your heart is not pumping, you won't get the oxygen to the brain. So you have to start with compressions.

00;08;22;06 - 00;08;24;22

Cary Hall

Okay. So so you start with compressions at.

00;08;24;22 - 00;08;45;05

Katie Radginski

The basic, most basic level of training I would say just start with compressions like higher levels of training. There's other reasons why you would start with other things. But just to keep it simple, start with compressions. Your body has about 5 to 7 minutes worth of oxygen in it anyways. So usually just compression only CPR is going to give that person a better chance of survival than not doing anything at all.

00;08;45;07 - 00;09;02;19

Katie Radginski

Because when the blood stops flowing after three minutes, you get brain damage to the brain and after ten minutes it's irreversible. Now there's always exceptions. There's always miracles that happen, you know? But statistically speaking, after three minutes of no oxygen to the brain, that person is going to start having cells die. So it's important that we start doing something.

00;09;02;19 - 00;09;07;22

Katie Radginski

So call 911, start the compressions and then just go hard and fast. Keep going.

00;09;07;24 - 00;09;18;05

Cary Hall

And but you said it so you're on the phone with 911, you go “but I don't know how to do CPR”. Can you walk me through this. And they will literally tell you start the compressions now, do ‘X’ number.

00;09;18;05 - 00;09;31;06

Katie Radginski

And so so they'll tell you put your hand in the center of their chest. I usually tell people, take your middle finger, find the armpit line, and then just place the center of your hand in the sternum, place it over top or hold your other hand. Put your arm straight and just push.

00;09;31;08 - 00;09;46;27

Cary Hall

And that's it. That's it. It's pretty simple. So you do you do this continuously or do you do you know, the prescribed number in that in that one minute or whatever it is, period. And then stop and then start again or you just keep going nonstop.

00;09;47;00 - 00;09;54;02

Katie Radginski

So it depends on your training, if you've had training and if you understand the rhythm there's 30 compressions and then two breaths okay.

00;09;54;02 - 00;09;56;17

Cary Hall

So 30 take two breast and start over again.

00;09;56;21 - 00;09;57;25

Katie Radginski

And when you're breathing it's.

00;09;57;27 - 00;10;09;05

Cary Hall

Pretty rigorous I'm setting here thinking about that. If I've got to do 30 those I got two breaths I go right back at it again. Yeah. And you're waiting 8 to 10, 15 minutes to get an ambulance there.

00;10;09;06 - 00;10;11;11

Katie Radginski

That's why it's important to have more than one person trained.

00;10;11;11 - 00;10;11;27

Cary Hall

Oh.

00;10;11;27 - 00;10;32;27

Katie Radginski

So every two minutes you switch. And then here's the extra bonus information. If you have an AED, use that because that's going to help someone who's in true cardiac arrest. The AED will reset the heart so that that person can have a best chance of survival. Statistically speaking, you will have 70 to 80% chance of survival if you throw that AED in the mix versus just CPR.

00;10;32;29 - 00;10;46;10

Cary Hall

Okay, when we come back from the break, I'm going to talk about that AED, because one of the things that I as I was going through the notes for the show this morning was thinking about was, wait a minute, you mean I got to grab those paddles and go shock somebody? I mean, you see it all the time on television.

00;10;46;10 - 00;11;05;14

Cary Hall

You're like, I'm not so sure I want to do that. So when we come back, I want you to talk about what is that like? What's the risk there if you don't do it right, how do you do it right? And there's obviously training for that. And it's really funny because, you'll see a lot of businesses now have those on the wall right in their business.

00;11;05;14 - 00;11;19;17

Cary Hall

So they're there. But you have to know what you're doing before you use it. All right. When we come back to the break. We're going to talk with Katie about the AED. How do you use those paddles? How do you know if it's right or wrong, whatever the case may be. But if you want information, her company is called Ready Train Go.

00;11;19;21 - 00;11;46;07

Cary Hall

They train people all over the country. This is what they do. They do a lot more, which we'll talk about in some of the upcoming segments. But you want to reach out to her 636-439-8761 or ReadyTrainGo.com ReadyTrainGo.com. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network.

00;11;46;14 - 00;12;00;05

Cary Hall

Coast to coast Cross, USA. Don't go anywhere.

00;12;00;07 - 00;12;20;21

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate broadcasting coast to coast across USA here on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. All the shows are on the podcast platforms and on our YouTube platform in the studio with me, Katie Radginski. She is the founder of Ready Train Go.

00;12;20;21 - 00;12;42;05

Cary Hall

What are we talking about? We're talking about CPR. And in this segment we're going to talk about AEDs. So those of you watching this, obviously you're going to be able to see this. Those of you listening to us on the radio, the podcast can't see it. Sitting in front of me is a lime green AED, automatic. Explain this thing will you, because it looks very sophisticated and complicated to me.

00;12;42;09 - 00;12;48;19

Katie Radginski

So it's like it's the shock machine. That's what people, they call it, and they're scared of it. But I don't want you to be scared of it because it's only going to.

00;12;48;19 - 00;12;50;18

Cary Hall

Long as you don't use it on me. Katie. I'm good.

00;12;50;18 - 00;13;12;25

Katie Radginski

I can't, so that's the beauty of it, I can't. So the AED is actually only going to read, two different types of, of rhythm. So ventricular fibrillation, ventricular tachycardia. So that's fancy for the heart spazzes out in two special rhythms. One is where the heart kind of goes into, I guess spastic mode, where it just kind of like that kind of a rhythm for those who are just listening.

00;13;12;25 - 00;13;28;02

Katie Radginski

And then the other one, it's just going from top to bottom, electrical impulses going up and down. It's not actually hitting where it needs to hit in the heart. Okay. So when you have the electrical impulses, it goes, but when it gets out of whack, it goes in those two weird rhythms where the blood can't circulate to the brain on the other vital organs.

00;13;28;03 - 00;13;39;03

Katie Radginski

The AED comes along and it shocks the heart. It stops it, and then the heart will, will spontaneously restart. It's not actually giving you a jump start like jumper cables, okay?

00;13;39;03 - 00;13;40;23

Cary Hall

Because that's what I always thought it did.

00;13;40;23 - 00;13;59;28

Katie Radginski

Nope. It's stopping the heart. Now, if we had a victim that we put the AED on and it said, okay, we have a shockable rhythm, then it will say, will administer the shock. Now if you touch the victim who had the pads on it while I press the shock button, then yes, you die too. But when you can't, you can't do that unless someone here is in cardiac arrest.

00;14;00;07 - 00;14;05;23

Katie Radginski

Now, if the person is in what's called asystole, we're going, like on the movies. You see them going, oh, quick, quickly.

00;14;05;23 - 00;14;06;18

Cary Hall

Flatline?

00;14;06;19 - 00;14;07;03

Katie Radginski

Flatline.

00;14;07;03 - 00;14;08;08

Cary Hall

Okay, that's not real.

00;14;08;10 - 00;14;26;25

Katie Radginski

Because this AED will not. Read. That's not a shockable rhythm. You can't stop something that's already stopped. Okay. And so that's why it's super important that you understand, you can't make things worse and excuse me, they're already dead, so I can't make them more dead by stopping the heart to make the heart not stop.

00;14;26;26 - 00;14;29;16

Cary Hall

And that won't bring them back.

00;14;29;19 - 00;14;31;27

Katie Radginski

Not if they're they're flatlined now. Correct. Right.

00;14;31;27 - 00;14;35;09

Cary Hall

So then now we're back to compressions and mouth to mouth.

00;14;35;10 - 00;14;37;29

Katie Radginski

Correct. So the heart now our CPR.

00;14;37;29 - 00;14;45;23

Cary Hall

That's a remarkable clarification because I always thought you watch television shows, guys. They show the flatline. That's the first thing they show. That's baloney.

00;14;45;23 - 00;15;06;12

Katie Radginski

It is. And so it's like a glorified stuff of like, now with medical intervention, with other methodologies. Yes. You can bring someone back from what they call asystole. Not always, but it's just sometimes just not with this machine. So this one, again, is foolproof. The person goes down, you're you're cutting the steps. Basically, you turn it on.

00;15;06;14 - 00;15;21;21

Katie Radginski

The hardest part of the whole thing is turn it on. It will start talking. It will like it will beep. It will say in a very commanding voice like, stand clear and it'll say, remove patients clothing. So you remove the clothes with scissors. So like this has scissors in it. These will cut through a penny. They're that strong.

00;15;21;21 - 00;15;34;08

Katie Radginski

It will cut through the shirt you cut through. If it's a woman you cut down their bra. Because yes, it has a underwire in it. You don't want to have electrical burns on that person. So. Okay, cut straight down. The person will get new clothes. It'll be okay.

00;15;34;08 - 00;15;36;29

Katie Radginski

Like, I don't want to ruin this expensive shirt.

00;15;37;01 - 00;15;49;25

Katie Radginski

No, no. Like cut it off. And then you're placing the pads, one on the top right between the collarbone and the, the nipple line. So top upper right and then lower part of the sternum below the armpit about two inches. Avoid the breast tissue

00;15;49;25 - 00;15;57;29

Cary Hall

So it's not like they show on television. You guys you watch they're putting a right here on the chest. That's not how you do it.

00;15;58;00 - 00;16;11;14

Katie Radginski

No not for this type of machine. Right. So it's top upper right lower left because it wants the electrical impulse to go through that heart. Now if you have a child and you'll see pictures on the AED they actually have pictures on the actual pads.

00;16;11;17 - 00;16;11;28

Cary Hall

Okay.

00;16;11;28 - 00;16;27;16

Katie Radginski

Where it's here and here. Now the Zoll brand, they have a, responsive feedback device. Some people call it a brick. It's just an extra pad that goes in the middle. This tells you where your hand goes, and then it also sometimes will speed you up or slow you down on your compressions. So you put the pads on.

00;16;27;16 - 00;16;43;11

Katie Radginski

It says stand clear analyzing. If it says shock advised, then you'll press the shock button and it will light up. You'll press the shock button, person will get shocked, and then either they'll come back to life or they won't. If they don't come back to life, then our job is to do the CPR.

00;16;43;11 - 00;16;44;10

Cary Hall

Back to CPR.

00;16;44;10 - 00;16;47;01

Katie Radginski

We’re going, okay heart, remember, you're supposed to beat. You're supposed to go.

00;16;47;03 - 00;16;51;10

Cary Hall

So this is a big green box. What's inside of there? The pads.

00;16;51;13 - 00;16;53;02

Katie Radginski

No, the pads are right here.

00;16;53;04 - 00;16;56;28

Cary Hall

Just. Okay. What do those pads look like? Because that's not what I'm. That's not what I envision.

00;16;57;04 - 00;17;21;13

Katie Radginski

So the pads. So think about when you go to the hospital and you get your heart read like the the EEG, the EKGs Yeah, yeah, yeah. They're giant sticker pads. Maybe like 2 or 3in. Right. And they're super sticky. So they'll go on top and then people will ask, well, what happens if they have chest hair? Well, if you cut down the clothes and you bare the chest and it looks like Chewbacca, then you probably need to take the razor that's in here because there's a razor inside.

00;17;21;18 - 00;17;28;09

Katie Radginski

And then you do a quick shave job. It's not going to be pretty. Don't worry about razor burn. Just kind of shave it, shave it real quick and then stick it on.

00;17;28;11 - 00;17;29;15

Cary Hall

Wow.

00;17;29;17 - 00;17;44;06

Katie Radginski

And you just go from there. So, like here and here, press the shock button. After you start the CPR, let's say that it doesn't work. They don't come back, start CPR. After two minutes, the AED will reanalyze it again because it'll say, okay, did the heart catch on to this rhythm it's supposed to be doing?

00;17;44;06 - 00;17;50;26

Cary Hall

How does it do that? Is that is that do you attach it? It reads what's actually going in the body to those pads.

00;17;50;27 - 00;18;01;02

Katie Radginski

It does. There's electrical wires inside the pads. Got it. So it's like stickiness pads. Wires goes into here. And then the magicalness happens I don't know the technical.

00;18;01;09 - 00;18;02;27

Katie Radginski

Electricity part of it.

00;18;02;27 - 00;18;11;25

Katie Radginski

But it happens. Also this button here that if the person needs, if it's, if it's a person who is 55 pounds and.

00;18;11;27 - 00;18;13;06

Cary Hall

Morbidly obese.

00;18;13;09 - 00;18;14;15

Katie Radginski

No, no, 55 pounds.

00;18;14;16 - 00;18;15;10

Cary Hall

Oh 55.

00;18;15;14 - 00;18;26;01

Katie Radginski

Not kilograms, but okay, 55 pounds. So like eight years or older then they would need to have pads. Adult size pads if they're less than 55 pounds, if they're eight years old or younger.

00;18;26;01 - 00;18;27;19

Cary Hall

So two year old, three year old.

00;18;27;19 - 00;18;32;02

Katie Radginski

Right. Then you would use pediatric pads. Now it will dial down the amount of energy that it gets.

00;18;32;02 - 00;18;34;03

Cary Hall

That there are pediatric pads in there, not.

00;18;34;03 - 00;18;34;19

Katie Radginski

In this one though.

00;18;34;20 - 00;18;35;25

Cary Hall

Okay. How interesting.

00;18;35;26 - 00;18;55;14

Katie Radginski

So this one looks like there's a button that you press that says whether it's a pediatric one or not. So this one will dial down the joules electrical impulses sent so that, it won't get as much energy. Now, let's say you forget to press the button. It's okay. You can still use the adults energy on the child, because the body knows what to do with the extra electricity.

00;18;55;16 - 00;19;16;07

Katie Radginski

It will just go out like. Yes, minor detail. You might have, internal burns on the heart, but the body will heal itself. That's, again, the great thing about, about how our bodies are made. So you place the pads. So if it's a child, let's say two year old, their body is probably going to be not, you're going to be too small to have the pads in the traditional placement.

00;19;16;11 - 00;19;19;18

Katie Radginski

So you'd put one on the front and then one on the back. And there are pictures.

00;19;19;22 - 00;19;21;29

Cary Hall

That there's a picture that shows because they.

00;19;21;29 - 00;19;39;21

Katie Radginski

Saw in the front one, back. Right. And that way it goes through the heart in that, that specific way. So same with an infant. You can use these on infants as well. If a child goes into cardiac arrest and you don't know, then you could place it on there. This is going to be what's going to save someone's life if they go into cardiac arrest.

00;19;39;24 - 00;19;45;26

Katie Radginski

And really, you can't mess it up. Like I said, the one thing is you turn it on and listen to the instructions and that.

00;19;45;29 - 00;19;47;10

Cary Hall

And it tells you what to do.

00;19;47;10 - 00;19;48;09

Katie Radginski

Absolutely.

00;19;48;12 - 00;20;02;17

Cary Hall

So that's that. That is absolutely so so it's not again, we're going back to what we see on television. It's not the two pads on the wall. And you grab them and you and you put the two pads on them because they're quote unquote flat lighting. If they flatline, you're not even using us. Right?

00;20;02;18 - 00;20;19;24

Katie Radginski

Well, and we're not in a hospital setting either. In a hospital setting. They have the paddles. So those paddles exist, but they look in different shapes and sizes, and they actually have a dial on them that tells you, what joules or what weight the person is. So the doctors and the nurses on the techs can actually figure out how much energy that person needs.

00;20;19;24 - 00;20;24;13

Katie Radginski

This is just general for anybody, to be able to use. And so it's like.

00;20;24;15 - 00;20;28;27

Cary Hall

So when you train people on CPR, do you automatically train them on how to use the AED?

00;20;29;03 - 00;20;31;06

Katie Radginski

I do, yes. Okay. Super important.

00;20;31;08 - 00;20;51;26

Cary Hall

Yeah. Obviously I mean that's intimidating to look at that thing and not now once you've explained it, that makes it sound like it's not all that difficult to do. And then your point, you push the button on the box and the box tells you what to do. Right. So it's going to tell you open the case, get the get the pads out, put the pads on, yada yada yada.

00;20;51;26 - 00;20;54;18

Cary Hall

Do all of that. Okay. How interesting.

00;20;54;18 - 00;21;10;26

Katie Radginski

So I challenge our listeners today that when when they go to the store, the next time, go look for the AED. Just look at it. It's not that scary. I mean, it's got two buttons on and shock and then it has the pads. So like look and you'll be surprised at how many you actually see in your area.

00;21;10;29 - 00;21;29;02

Cary Hall

It's remarkable. You know, you don't know what you don't know. All right. And this is great to have Katie here today. I had no idea about any of this. Right. So to me this is fascinating. It’s gets great education. It's a great opportunity. You've got a business or whatever the case may be, and you don't have this in place.

00;21;29;09 - 00;21;54;15

Cary Hall

This is probably something you should think about. You might want to give her a call. 636-439-8761. ReadyTrainGo.com is the website. ReadyTrainGo.com. She can help you anywhere in the country. Lady knows what she's talking about. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network.

00;21;54;21 - 00;22;10;29

Cary Hall

Once again, that website you want to learn more about what Katie does. ReadyTrainGo.com.

00;22;11;02 - 00;22;34;02

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across USA here on the HIA Radio Network. I want to say hello to all of our stations out in Cape Girardeau, Missouri, KAPE 1550-AM, 100.3-FM and 95.7-FM. That's why I said all. They've got three radio stations there. We're on there on Saturdays and Sundays.

00;22;34;08 - 00;22;52;12

Cary Hall

Here's a little piece of trivia. You don't know the most famous talk radio show host in the world actually started out on KAPE. That would be Rush Limbaugh. So I've had the privilege of broadcasting in that studio. Great people down there. We're very happy to be on in Cape Girardeau, Paducah, Kentucky, that's the broadcast area they broadcast in.

00;22;52;12 - 00;23;08;13

Cary Hall

And we want to thank them for keeping us on the air. In studio with me today. Katie Radginski. And we're talking about her company, Ready Train Go. We're learning a lot today. There's a lot here I didn't know. First question I want to ask before we introduce the audience to Manuel, we'll get to him in a minute.

00;23;08;15 - 00;23;22;16

Cary Hall

He's the silent guest, by the way, for those of you listening on radio, is how hard when people are when you're doing these compressions, Katie, how hard do you push and should be worried about, oh, I might break a rib or I might talk to me about how that works.

00;23;22;16 - 00;23;40;08

Katie Radginski

So you want to press down at least two inches. So people will debate, like how much body mass you have to have to actually press down on somebody that hard. And it all depends on the person. You know. Are they, are they physically fit? Are they not. Can they are they coordinated. Are they not. But two inches. Is that the maximum depth that you really want to push for an adult.

00;23;40;10 - 00;23;56;08

Katie Radginski

And so and to answer the question about like the, will I break a rib, you might and that's okay because think about it. You're doing the exact opposite thing that the body's made to do. The ribs are made to protect the heart and the other vital organs. And so if you're pushing on the ribs, of course something's going to give.

00;23;56;10 - 00;24;04;26

Katie Radginski

You're probably going to separate some cartilage. You might crack a rib. You might just, make a giant, nasty bruise on the person, and yet the body will heal.

00;24;04;27 - 00;24;06;10

Cary Hall

But they're alive. They're alive.

00;24;06;12 - 00;24;19;11

Katie Radginski

Right. Again, like I said earlier, you can't make it worse than it already is. Like, if they're dead, you helping them to have their heart pump the blood to the brain and the other vital organs. It can't do anything that's worse.

00;24;19;12 - 00;24;30;19

Cary Hall

So I'm going to guess that if you've got somebody that's a 250 pound, 300 pound male, and you're trying to do this, you're going to be pushing a lot harder than your 124 pound woman.

00;24;30;26 - 00;24;31;14

Katie Radginski

Absolutely.

00;24;31;14 - 00;24;32;00

Cary Hall

So, okay, the.

00;24;32;00 - 00;24;49;19

Katie Radginski

First couple of compressions are going to be the hardest. And once again, once it kind of gives a little that means it'll separate. Then you'll be able to, do more compressions. Now, if you are working with someone who is 300, 300 plus pounds, you’ve got to call 911, and you have to tell them, hey, this is someone who's larger.

00;24;49;23 - 00;25;00;03

Katie Radginski

You might need a bariatric gurney. You might need they have machines. I forget the name of the machine, but it looks like a spider. And it actually manually does the compressions around that person.

00;25;00;05 - 00;25;00;26

Cary Hall

Holy cow.

00;25;00;26 - 00;25;09;02

Katie Radginski

Right. It's it's kind of scary looking because it's intense. It's like they hook the person up. It looks like spider fingers that go around the the chest, and it just: domp, domp, domp.

00;25;09;03 - 00;25;25;03

Katie Radginski

And it just keeps going. So like that helps the paramedics whenever they come. Especially if it's someone of larger stature because they're not going to be able to sustain that. Like I said, every two minutes you should be switching out. Otherwise you're going to be basically doing sloppy CPR and not helping that person have a chance of survival.

00;25;25;06 - 00;25;38;08

Katie Radginski

I tend to think about like, if you're going to, have you ever exercised before, and you go on an elliptical, so like the elliptical. Has those things that go back and forth like the last 30s of your, your stint that you've done and you're like, I'll just do it for 30 more seconds. Well, you've already pushed past your limit.

00;25;38;08 - 00;25;55;18

Katie Radginski

Now you're just blop in your head back and forth and have on your arms, and you're letting the machine do the work for you. That's sloppy CPR at its finest. That's an example of that. You're not actually doing anything for your body by staying on an elliptical. The extra 30s just flopping and hanging on. So it's like change out before you get to that point of exhaustion.

00;25;55;20 - 00;26;06;24

Cary Hall

Interesting. All right. Let's introduce Manuel, he's sitting over here for those of you that are, listening on radio, you can't see Manuel, but he has a mustache. And what is man world's function? Katie.

00;26;06;26 - 00;26;27;22

Katie Radginski

So today he's my advertising director. He's coming here just to market with me. But in all seriousness, though, he's an example of one of the mannequins that we use. He is, a CPR mannequin. So he has, a chest. He has a torso. This mannequin today has a mustache on just for grins. But when we teach classes, we don't put mustaches on because you have to sanitize the faces.

00;26;27;22 - 00;26;29;02

Katie Radginski

And that would be gross to have to.

00;26;29;04 - 00;26;30;03

Cary Hall

Okay. All right.

00;26;30;05 - 00;26;48;09

Katie Radginski

But, with him, this is how we teach people how to do the compressions and the CPR. So he's got an anatomical sort of anatomically correct chest where he has a chest, a nipple line. Although everybody won’t look like this when you bare the the chest, the skin moves weird and everything will be everywhere else.

00;26;48;09 - 00;26;58;12

Katie Radginski

But most, people have armpits. When you find the armpit line, you take your middle finger and you find the center. So think about to the nose like your nose down, and then your armpit line kind of trace an “L”.

00;26;58;15 - 00;26;59;13

Cary Hall

Like a cross.

00;26;59;16 - 00;27;16;27

Katie Radginski

And your hand just goes right in the center and then you'll go straight down. Now Manuel has a feature where he clicks. When you hit two inches, he'll click and he'll tell you, hey, that's deep enough. And that way, you know, when we practice, we auditorial hear it. Some versions of mannequins will have lights that light up. I have a different version.

00;27;16;29 - 00;27;31;17

Katie Radginski

I call her Annie, so she's a cue CPR mannequin where she has a cord that comes out of her and tells you how fast you're going, what your depth is, and then if your breaths actually went in. So when we do the breaths on the mannequin, we pinch the nose. Depends on the breathing barrier I'm getting way into more stuff.

00;27;31;18 - 00;27;31;25

Cary Hall

Yeah.

00;27;31;25 - 00;27;45;04

Katie Radginski

You know, when you have a certain type of breathing barrier, you have to pinch the nose. Otherwise the air will come out the nose when you breathe into their mouth. But with him, you can pinch the nose and tilt the head back. His mouth opens up and the chest will actually expand. So you'll see the chest expanding on the mannequin.

00;27;45;04 - 00;28;05;18

Katie Radginski

And that's that's Manuel's function, you know, for that, with the other mannequins that I have, it'll tell you did the breaths were they efficient enough. Did it, did you exhale enough to make the the chest rise so that you get oxygen in the system or not? And then that way it gives the students real time feedback so that they when they're practicing, they know if they're doing CPR good or not.

00;28;05;20 - 00;28;22;25

Cary Hall

That's remarkable. So to me, when I'm looking at this and listening to you, it's one thing to hear how to do this. It's something else to actually be able to do it on this mannequin. And I'm assuming the mannequins you're going to know the mannequin’s going to tell you you're not doing this right, or you're doing it right, right.

00;28;22;26 - 00;28;39;14

Cary Hall

So you're going to so you're while you're doing it, you're learning how to do it properly. Do the compressions. Take the two breaths. Come back. If you're going to do the the the mouth to mouth and it's hold the nose, do the breathing, then go back and do the compressions. It this is a great way to train people.

00;28;39;16 - 00;28;48;05

Cary Hall

The other thing it seems fascinating to me is this gives you confidence. Hey, you know, I could really do this right now that I've trained on this thing, I feel like I could really do this.

00;28;48;08 - 00;28;51;26

Katie Radginski

And that's the thing of the joy of being an instructor that because what.

00;28;51;28 - 00;29;06;01

Cary Hall

It is scary to think about doing this to somebody. Right. You know, am I going to do it right. I'm going to cause more harm than good. But if you have this training and my daughter had this training and then you've got that level of confidence, you can go do this.

00;29;06;04 - 00;29;14;20

Katie Radginski

And that's our hope. After you attend the class. That's even one of the goals of it that you're confident to just respond and to try something, because again. Something's better than nothing.

00;29;14;23 - 00;29;30;22

Cary Hall

Yeah. So how long is a class like when you train somebody on this? You let's say you're in a company and they said, we've got five people here that we're going to train on this, we've got ten people. We're going to go train everybody, but we're going to train like ten people, one in each department. Whatever the case may be, how long does it take to go through that?

00;29;30;25 - 00;29;35;16

Cary Hall

You're going to teach them how to do this mouth to mouth. You’ll teach them compressions. How long does all that take?

00;29;35;20 - 00;29;43;10

Katie Radginski

So it depends on the course they actually want to take. So like that's it's more complicated than that. So it can range from 3 to 5 hours. It all just depends.

00;29;43;10 - 00;29;44;27

Cary Hall

On three hours.

00;29;44;29 - 00;30;00;27

Katie Radginski

So as little as three hours if they just want to learn the quick basics of things. So we teach through American Red cross certification so people walk away. That's important to me that like, I didn't make any of this up. Like, I'm following curriculum. I'm following what the scientific advisory board says, saying, hey, this is the standard.

00;30;00;27 - 00;30;17;16

Katie Radginski

This is a quality of care that we give. That way, again, not going rogue and just saying, yeah, we'll try this. Because I have no business doing that. Right. So, so 3 to 5 hours and that includes adult and child and infant CPR, first aid and AED.

00;30;17;18 - 00;30;27;20

Cary Hall

Wow. Okay. So but the basics, if somebody wants to bring you in to train folks in their company, you're looking at a three hour program basically for the basic program.

00;30;27;22 - 00;30;29;27

Katie Radginski

I would say closer to four just to say not.

00;30;29;27 - 00;30;33;22

Cary Hall

To cover, but so it's going to be it's going to take them four hours out of their workday to do this.

00;30;33;22 - 00;30;49;00

Katie Radginski

If they just show up and do it now, we offer it in different formats. So we have it in a blended learning where you do half of it online so they can do the head knowledge online and then they come in person. Now those would be, you know, two hours with me. So two hours they do the hands on portion because that's the other component.

00;30;49;00 - 00;31;06;29

Katie Radginski

Like you need to know like you need to physically do it. I can't just click a button on a screen and say, yeah, I'm trained because I don't want my neurosurgeon doing that, or not my cardiologist going like, yes, we'll do open heart surgery with a button of a mouse like that. That doesn't make sense. And so, we have to have that hands on, components to retain the information.

00;31;07;06 - 00;31;30;02

Cary Hall

And, and so it can be a two part process where they could get two hours of training alotted. And then you come in and bring in Manuel and do the actual training with the mannequin there in the facility. Wow. How interesting. You know, it seems to me that it makes a lot of sense for companies to think about this, because what you don't want to do is not think about it and not have anybody this ready to do it.

00;31;30;02 - 00;31;51;02

Cary Hall

And here we are in the studio, and you would right down the hall and, and and got the device right off the wall. Brought it in here. We just showed it to everybody. So the I guess the point I'm making is that you don't know when this is going to be necessary. And it's far better to have people trained in how to use it than to have somebody die on the floor in their office because nobody knew how to do CPR.

00;31;51;07 - 00;32;14;03

Cary Hall

And if you had, if you needed the AED device, you wouldn't know how to use or you didn't even have an AED device. So you lost what could be, you know, somebody's important to your company or your team mate, whatever the case may be, because you didn't bother doing the training. Right. And this this could make. How off once you do the initial training, do you come back every year and just make sure everybody's up to speed or how what you said necessary.

00;32;14;03 - 00;32;26;10

Katie Radginski

So it's every two years the certification ends every two years. Okay. But if you do the online portion, you can always, go back and redo the online portion or the American Red cross has apps that you can download to refine those skills.

00;32;26;13 - 00;32;52;21

Cary Hall

But there you have it. And I strongly suggest if you own a company or you have a company or whatever, you know, you work at a nonprofit, whatever it is, you probably should think about doing this. You want to talk to somebody who really knows what they're doing. Katie's that person. You can reach her at 636-439-8761 or the website ReadyTrainGo.com.

00;32;52;21 - 00;33;12;20

Cary Hall

They'll train you anywhere in the country. Happy to do it. She clearly knows what she's doing. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network coast to Coast Cross, USA. Don't go anywhere.

00;33;12;22 - 00;33;31;00

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. You know, I do these kind of shows because we talk about educating and informing. And Katie came in here today from Saint Louis to do this show with me. And I'm amazed at what I'm learning today.

00;33;31;03 - 00;33;47;22

Cary Hall

And I hope you're amazed by listening to this or watching it on our YouTube channel. You want some help with this? You really should think about having this. If you don't have this in your company or you haven't trained in a long time, you need to get a hold of this lady, okay? She's clearly professional, clearly knows what she's doing, and it could make a big difference.

00;33;47;22 - 00;34;12;25

Cary Hall

If somebody goes into a heart attack situation and or heart failure and you know what to do. Or somebody in your company knows what to do. You can reach her at 636-439-8761. Their website ReadyTrainGo.com. All right. We're going to change gears now. So we talked about this on the break. One of the things that stuck out to me today was when I was going through the notes for this show, was the first aid kits.

00;34;12;29 - 00;34;33;02

Cary Hall

Now it's funny, my wife, who thinks of almost everything, bought first aid kits for us. Each of our cars and our children have them in their cars. So this is something she did, and it made me think like, okay, well, people in this part of the country, they like to hunt deer season, turkey season, whatever the case may be.

00;34;33;05 - 00;34;51;24

Cary Hall

They like to go out on their boats on the lake. Unfortunately, that usually involves imbibing a lot of, adult beverages. And they also like to go hiking and camping. My my daughter and her family, they do a fair amount of camping. So do people even think about having a first aid kit? What should you have as a first aid kit?

00;34;51;24 - 00;34;58;14

Cary Hall

I mean my wife bought these things. They are in like a red box and I don't know what's in them. But let's just. Yeah, I haven’t opened one up to look at it.

00;34;58;14 - 00;34;59;03

Katie Radginski

Oh, no.

00;34;59;05 - 00;35;04;13

Cary Hall

why? Why is that important? Why should people have it? It should be obvious. But please, if you would. Right.

00;35;04;13 - 00;35;07;16

Katie Radginski

So, Cary, first of all, you should look in your first aid kit.

00;35;07;18 - 00;35;11;14

Cary Hall

I will see that now. I'm going to go back and open the thing up and look at it.

00;35;11;14 - 00;35;12;28

Katie Radginski

How long ago did she buy it for you?

00;35;12;28 - 00;35;14;09

Cary Hall

Oh, about a month. Two months ago.

00;35;14;10 - 00;35;15;07

Katie Radginski

Okay, good. I was gonna say

00;35;15;13 - 00;35;16;11

Cary Hall

They are brand new.

00;35;16;13 - 00;35;30;09

Katie Radginski

If it’s two years, I’d say, oh, you missed the boat. So you should first of all, check it. Every time the weather kind of changes, or does extreme temperatures. Because if you have super hot days and super cold days, your Band-Aids that you have in your first aid kit are going to peel themselves open.

00;35;30;10 - 00;35;31;14

Cary Hall

I never thought of that.

00;35;31;17 - 00;35;46;07

Katie Radginski

So making so making sure the integrity of your first aid kit is sound is the first thing. So about every time that you change your, batteries in your smoke alarms in your house, like, just take your first aid kit, make it a routine. Same with your fire extinguishers. Check them, give them a little shake back and forth.

00;35;46;07 - 00;35;49;10

Katie Radginski

Make sure the powder is different. That's a whole other topic though.

00;35;49;10 - 00;35;56;28

Cary Hall

But actually I have two very large fire extinguishers, one right outside of the kitchen and one downstairs. So I'm very, very big on fire extinguishers.

00;35;56;28 - 00;36;21;24

Katie Radginski

Yeah. So make sure those are checked too, inspected, in the green. But with first aid kits. My, my biggest advice is get a first aid kit for whatever you're doing. So, like you mentioned, someone's hunting or they're going, they're going fishing. Like you have all sorts of injuries that can happen that way. And so like have gauze have, you know, bleeding control kits of some sort, gauze, roller bandages, like, people bring tampons, like, that's fine.

00;36;21;24 - 00;36;45;27

Katie Radginski

Like those things that absorb blood is what you want. Or even you could even could bring a tourniquet like a commercially made tourniquet. And that would help. It would be better for you to have more than you need than not enough. And so with your first aid kits, you can buy a commercially made one or just go to like the Dollar Tree or go to your favorite big box store and go get the supplies and put it in a pretty little bag or a box and just take it with you.

00;36;45;28 - 00;36;49;12

Cary Hall

How do you know what to buy if you're going to do it yourself, Katie, do you have that on your website?

00;36;49;13 - 00;37;06;23

Katie Radginski

So on my website, no, but I have resources I can connect you to, to be able to have that. Okay. So like minimum like bandages, you know, Band-Aids, bandages, cold compress, or like the instant ice pack things. Yeah. But again, think about what what is outside? Like, what weather are you facing? Is it cold or is it hot?

00;37;06;23 - 00;37;28;24

Katie Radginski

If it's hot, maybe you need to have the cold packs. If it's cold, maybe you need to have some of those hot hands things with you. Yeah. Just in case. And so the American Red Cross’ website also has lists of all of the different equipment that you could have and you could potentially, need. But again, it's think about where are you going, what potential injuries could happen.

00;37;28;26 - 00;37;29;12

Katie Radginski

You know, so if.

00;37;29;12 - 00;37;44;29

Cary Hall

You're hunting trip is a lot different than just going out with the family to camp out, you know, you know, in, in a national park or something, a hunting trip. You're talking about firearms. You know, if you're going to kill an animal, you're going to have to dress the animal all that.

00;37;45;05 - 00;37;46;16

Cary Hall

I mean, there's a lot going on in.

00;37;46;24 - 00;37;48;14

Katie Radginski

There’s a knife and all of those things.

00;37;48;15 - 00;37;58;16

Cary Hall

Yeah, there's a there's a lot of things that could go wrong. I mean, you know, harken back to the days of Dick Cheney shooting a guy when they were bird hunting. So, I mean, people there are accidents when you hunt, right?

00;37;58;16 - 00;38;12;25

Katie Radginski

So you would consider having extra rolled gauze, maybe a chest vent, a tourniquet. It absolutely. Gloves, those different things. Just so that again. But but if I'm a soccer mom taking my kids to soccer practice or something like I might not have all of that.

00;38;12;25 - 00;38;14;03

Cary Hall

You will need all that.

00;38;14;06 - 00;38;32;01

Katie Radginski

Perhaps not. I mean, like, I carry like a three day survival pack in my car, but, like, that's not normal. I understand that, and that's completely fine, but it's what I do, you know? So if I'm going to the range or if I'm going hunting or doing something like I'm going to bring my my beefed up first aid kit that has the ambu bag, which is another type of breathing device.

00;38;32;01 - 00;38;45;15

Katie Radginski

Or if I, I'll take my, you know, the blood pressure cuff or I'll have the different types of bandages, the hemostatic dressing, the quick clot that stops the bleeding instantly like chemically cauterizes it. So like, I'll have those things with me, but the average person maybe doesn't need that.

00;38;45;18 - 00;39;06;14

Cary Hall

Do you suggest having those in a company? So let's say you run a machine or. Yeah, I think back to some of my days as a broker and some of the, the places that I went, like I had one particular facility was a meatpacking facility, in down in southern Missouri. Now, they had safety equipment everywhere. Absolutely. Because it was a very dangerous job.

00;39;06;14 - 00;39;20;11

Cary Hall

And there were some horrific injuries that happened at that facility. And I remember them well. But also like if you just have a simple machine shop and where there's an opportunity for somebody to get hurt on a machine, you should definitely have some type of first aid kit in that shop.

00;39;20;14 - 00;39;39;29

Katie Radginski

Yeah. So most most companies have they're regulated by OSHA. And so that's an organization that basically occupational health and safety organization as though that's not exactly what. Right, right. But they have these rules and these guidelines. You have to have so many first aid kits for however many people you have. And what kind of, place that, that you are.

00;39;39;29 - 00;39;51;21

Katie Radginski

So then they have different codes like ANSI is another acronym. That's a type of a first aid kit that says you have to have this packed in there. So they have these list of saying you have to have these things at a minimum when you're running a machine shop.

00;39;51;21 - 00;40;08;02

Cary Hall

But that's not every business. That's just business, like a machine shop or whatever the case may be. Other businesses like white collar businesses, etc. wouldn't necessarily think of that. But things happen, right? People get hurt, things happen. There are accidents, whatever the case may be. So having one of those kits is going to make a lot of sense

00;40;08;02 - 00;40;08;19

Katie Radginski

It is.

00;40;08;20 - 00;40;29;10

Cary Hall

Okay. Well thank you for doing this today. I really appreciate your coming in here. This was one of the most educational shows I think we've ever done. And I really appreciate you doing this. And again, you know, if you have a business, maybe your church, maybe it's a school you're involved in. You know, whatever the case may be, if they don't have classes on CPR, they haven't.

00;40;29;10 - 00;40;43;20

Cary Hall

You haven't you don't have anybody certified do this. You should reach out to Katie. The first aid kit, all of it. She she can talk to you about all of this and how they do it. Is clearly something that we should all be aware of. Clearly something that folks should learn how to do because it could save a life.

00;40;43;20 - 00;41;09;14

Cary Hall

You never know when that situation is going to occur. If you want help with this, please give Katie a call. 636-439-8761. ReadyTrainGo.com. Is the website ReadyTrainGo.com anywhere in the country. She's happy to help you. Thank you for listening to America's Healthcare Advocate. And now I leave you with this thought from Doctor Martin Luther King.

00;41;09;17 - 00;41;30;09

Cary Hall

Americans must learn to live together as brothers and sisters, or we will surely perish together as fools. Truer words never spoken. Thank you for listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across USA. Goodbye, America.

00;41;30;11 - 00;41;36;17

Unknown

Generosity, kindness and the Little Sisters of the Poor

Sat, 10 Jan 2026 11:01:33 GMT

Episode 2137 notes

To provide for the needs of the aged poor, Saint Jeanne Jugan walked the roads of France seeking alms. She was recognized by the begging basket she carried. She asked for money as well as food, clothing, wood, wool or whatever was needed for the Home. Jeanne thanked her benefactors by praying for them, and today’s Little Sisters happily continue this practice. My guests on today's show are Mother Mary Thomas and Sr. Agnes from Kansas City's Little Sisters of the Poor order, located on James A. Reed Rd.

Today we learn of their mission and the care they provide for the elderly, with reverence and respect for the elderly regardless of religion, serving people 65 years and older, of any race or religion (or no religion), who are low-income. Serve those who can’t afford to pay for care. "Old age has many gifts that are often overlooked in today’s society. They are our ancestors, built foundation of what we have today" Join me for this extraordinary discussion with these sisteres who are making each day count for our elderly's "last place they will live" with respect and grace.

This is episode 2137 of America's Healthcare Advocate, I'm Cary Hall.

Learn more: Carrie Rojas Director of Development, Little Sisters of the Poor 8745 James A. Reed Rd, Kansas City, MO 64138

816.761.4744

https://littlesistersofthepoorkansascity.org/ or, outside of the Kansas City area, https://littlesistersofthepoor.org/

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Listen to this episode.

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Watch on Rumble:

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2137 Transcript

00;00;12;13 - 00;00;31;08

Cary Hall

On today's show, I'm going to be joined by Little Sisters of the Poor. Mother Mary Thomas is going to be in studio with me and Sister Agnes Clare. We're going to talk about what they do. You know what they do. They do something nobody else does. They take care of poor people who are senior citizens and elders. I think it's going to be an interesting show.

00;00;31;14 - 00;00;33;22

Cary Hall

Stay tuned. Listen and learn.

00;00;33;24 - 00;00;39;14

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;39;16 - 00;00;56;26

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network. My producer, Mister Dave Thiessen, behind the camera, the man who puts all these shows together. Posts them up on our YouTube and podcast channel. By the way, 604,000 views.

00;00;56;26 - 00;01;15;17

Cary Hall

Thanks to all of you out there in the listening audience. Garner Cowdry. The man behind the board over here making sure everything is working in the Cumulus studio here in Overland Park, Kansas. By the way, if you happen to be chronologically challenged and you're looking for Medicare coverage or ACA, give the lovely Carolee Steele a call at RPS.

00;01;15;17 - 00;01;39;01

Cary Hall

Benefits by Design 877-385-2224. Anywhere in the country. She can help you. 877-385-2224. All right. Today's show is very unique. It's a show I've wanted to do for quite a while, actually, and I'm very fortunate to have in studio with me today, Mother Mary Thomas and Sister Agnes Clare of Little Sisters of the Poor. Welcome, sisters.

00;01;39;03 - 00;01;39;19

Sister Agnes

Thank you.

00;01;39;20 - 00;01;40;00

Mother Mary Thomas

Thank you

00;01;40;07 - 00;01;56;23

Cary Hall

Very happy to have you here. So the Little Sisters of the Poor was founded in 1839 by Saint Jeanne Jugan. We'll talk about that as we get into the history. But let me explain to you why I want to do this today and why I think this is important. You know, I do shows like this, I just did Zuzus Petaqls here.

00;01;56;25 - 00;02;22;07

Cary Hall

We were talking about helping people with Christmas, that kind of thing. This is a different message. You know, there are all kinds of charities out there that help children there. There are charities out there to help dogs and cats. Okay. There are charities out there that help veterans. They all do wonderful things. Think of one charity you know, it helps the elderly that are poor, that have no place to go and have nothing in terms of ability to fund or pay for private facility.

00;02;22;10 - 00;02;43;19

Cary Hall

That's what Little Sisters of the Poor do. They take care of the elderly that are indigent, poor and need help. They provide homes for them, whether it's in residential care or whether it is, skilled nursing facilities. They have all of that available right here in Kansas City. So they're all on the show today to talk about their mission, what they do and how we can help them.

00;02;43;19 - 00;02;59;13

Cary Hall

Welcome, sister. Thank you. Very happy to have you here Sister Thomas. So tell us a little bit about the history of Little Sisters of the Poor. All the way back to 1839, I was reading this this morning doing show notes. I'm like, I didn't realize that the order was that old. So talk a little bit about that history.

00;02;59;16 - 00;03;32;18

Mother Mary Thomas

So as you heard from Cary, our congregation is founded in 1839, in France, during the French Revolution, there were so many old people who were on the road and nobody was taking care of them. So St. Jeanne Jugan, who is our Foundress, took one old lady, who was blind, left near the road and took her to her house and put her in her own bed, and she went to sleep on the attic on her own.

00;03;32;20 - 00;03;58;08

Mother Mary Thomas

Soon other ladies came to. She found there were more ladies and then other young women who came to help her. And that's where the congregation began. So now we have like 153 homes in 30 countries. We are the international congregation, which is in all of the 30 countries and five continents.

00;03;58;11 - 00;04;16;24

Cary Hall

That is a lot of that. When I was reading this this morning, 30 countries. Yeah. Let's just talk a lot about this. So, it's really quite remarkable in all the places that you've served in a number of places you've been in Gallup, New Mexico, by the way. I've spent some time in Gallup, I know a little bit about Gallup, New Mexico and the Indian population there.

00;04;16;29 - 00;04;29;18

Cary Hall

You were in Denver for three years. You're in New Jersey. And so you've served in different places across the country here, in the United States. And Sister Agnes, where where have you served besides here in the United States?

00;04;29;20 - 00;05;10;25

Sister Agnes

Well, I have been a Little Sister for 52 years. So all through these years I've been to many countries. First of all, I overseas in my country in Hong Kong and then to France and England and Ireland. And then I come to America. 21 years ago, the first home was in San Francisco, where I stayed for 13 years, and I went to Denver and California, then Denver and California and finally ended in Kansas City, which is where I, I begin my fifth year here.

00;05;10;28 - 00;05;16;08

Cary Hall

Well we're glad to have you. Yeah. And you all do a lot of traveling.

00;05;16;11 - 00;05;16;24

Sister Agnes

That’s right.

00;05;16;27 - 00;05;34;24

Cary Hall

You move from a lot of different locations, which is kind of an interesting way for all of this to work. So let's talk a little bit about what you're doing here in Kansas City. This is, as I said, you have skilled nursing and then you have assisted living. You've got to you know, the building is what 30 years hold here about

00;05;34;24 - 00;05;35;25

Mother Mary Thomas

40.

00;05;35;25 - 00;05;45;19

Cary Hall

It's 40 years old. It's a it's a beautiful building. It's all brick. It's over off at James A. Reed road. You actually arrived here in Kansas City in 1882,

00;05;45;25 - 00;05;46;09

Sister Agnes

Correct.

00;05;46;11 - 00;05;49;25

Cary Hall

Yes. That's a long time ago. Let's talk about that, sister.

00;05;49;28 - 00;06;21;20

Sister Agnes

Well, 62 sisters from France have made their way to Kansas City in 1882, and they started to open their first home. it’s called a legacy for the aged home. So this home they have, they located it in a building which is built for the widow and the orphans of the Civil War soldiers.

00;06;21;20 - 00;06;27;27

Cary Hall

I saw that and it was they were treating widows and orphans of Civil War soldiers. And that's really quite remarkable.

00;06;27;27 - 00;07;07;04

Sister Agnes

Yeah. And the sisters converted as a home for the aged, where they stay until 1932. And then from 1932 with the expansion of the trafficway, which forced them to relocate somewhere else. So the sister looked for a place, on 53, between 53 and Highland. And and at that time, the bishop did a very, very huge procession of 3500 people to bless and to lay the foundation stone in that building.

00;07;07;07 - 00;07;38;13

Sister Agnes

And we stayed there until 19, 1982. And the sisters felt that they need a new building, the old building and more modern and also more functional home. So and in order to meet the changes of the federal and state regulations. So with the help of many generous benefactors, they they found a place of where we are now in James A Reed road.

00;07;38;15 - 00;07;39;24

Sister Agnes

In Raytown [Mo.].

00;07;39;24 - 00;07;45;14

Cary Hall

Mary, let's talk a little bit about what you're doing at that home today and who you're serving in that home.

00;07;45;17 - 00;08;15;21

Mother Mary Thomas

So in this home I arrived in December last year. So we have over 75 residents where we care for them apartment and also assisted living in the nursing. So we, we give them I am the mother superior of the home, which is taking care of the residents or older people who are poor. But we do not take people who have more.

00;08;15;26 - 00;08;16;19

Cary Hall

Financial means.

00;08;16;20 - 00;08;21;27

Mother Mary Thomas

Financial means. So we always take for the poorer, the better for us.

00;08;21;27 - 00;08;39;16

Cary Hall

Yes. Now this is interesting because it's you're all listening to this, Little Sisters of the Poor is obviously a Catholic order. But here's what I want everybody to understand. They take people. It doesn't matter what your religion is, it's non denominate. You can be a Baptist, you can be a Catholic. You can be Jewish. It really doesn't matter what your religion is.

00;08;39;16 - 00;08;56;13

Cary Hall

They will take you if you have a need. That's what they do with this home. That's one of the reasons why I wanted to do this day. I want to make sure everybody understands, as far as I know, they are the only folks here in Kansas City that actually take these people in to a facility, they provide them with private room that has a bathroom.

00;08;56;19 - 00;09;18;14

Cary Hall

Okay. And they have it's a beautiful facility. I've been at it. It's it's well-run, it's spotlessly clean. And what they do is very unusual in today's world because we don't have a lot of people out there taking care of the elderly. You know, in this country, the culture is not that of taking care of the elderly. We have a tendency here in this country to let's put them at home.

00;09;18;16 - 00;09;39;26

Cary Hall

Let's look, you know, in other countries around the world, the parents live typically with the children when they age. That's not what we do here. So their mission in terms of helping these people, they're kind of like the last resort for people who don't have money, can't get into another facility, don't want to be in a medicaid facility because those are absolutely horrific and maybe they don't have family can help take care of them.

00;09;39;26 - 00;09;59;10

Cary Hall

So that's why we're doing this today. And we think what they do is important. And that's why we're putting this show on today. We're going to come back from the break. We're going to continue this conversation with both sisters and Little Sisters of the Poor. We're going to talk more specifically about what they're doing in the community and what they need from us in order to be able to help them with their mission.

00;09;59;10 - 00;10;19;20

Cary Hall

Stay tuned. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network, Coast to Coast Cross, USA. We'll be right back.

00;10;19;22 - 00;10;41;19

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. You can find out more about us by going to the website. AmericasHealthcareAdvocate.com. All these shows are posted up there. They're also on 16 podcast platform and those YouTube platforms. If you want to tell somebody about this, maybe you know somebody thats got time.

00;10;41;19 - 00;11;01;28

Cary Hall

Maybe they're retired, semi-retired. They'd like to help out or know more about Little Sisters of the Poor. Go up there to the show, tell them about the show, let them listen or watch whatever they want to do. There is a website. Remember these sisters do homes all over the world. So Gallup, New Mexico, Denver.

00;11;02;01 - 00;11;19;14

Cary Hall

There are a host of places around the country. They still do these homes San Francisco, San Pedro, California, these are just some of the cities that they've been or are in. If you want to learn more, you're listing this somewhere else in the country. Maybe you're in Alaska, maybe you're, in Redlands, California, or wherever the case may be.

00;11;19;17 - 00;11;45;15

Cary Hall

Their website is littlesistersofthepoor.org, anywhere in the country. If you want to learn about. Is there a home in your area? Could you help? Could you volunteer? Little Sisters of the Poor dot org. Also, if you want to help out here in Kansas City, please give Carrie Rojas a call at 816-203-8015. 816-203-8015. We're going to talk about what they're looking for in the way of volunteers in the third segment.

00;11;45;15 - 00;12;07;26

Cary Hall

But they need drivers. They need people that can help do some landscaping. They need people in the kitchen. If you're a retired nurse and you want to come in and do counseling or help them out, they would love to have you. So once again, 816-203-8015. All right, sister, let's talk a little bit about quality of living. You know, Medicaid nursing homes are very difficult for people to live in.

00;12;07;28 - 00;12;30;20

Cary Hall

I always say the first thing you notice when you walk into Medicaid home is the smell. Usually it's Pine-Sol or or Clorox or something, and you've got two people to one room sharing one television. There's no privacy. It's just not a quality of living. When I walked into your home, I didn't know what to expect. When I walked into that building, that all brick building in the lobby.

00;12;30;22 - 00;12;51;00

Cary Hall

You've got a beautiful lobby. Yeah, some religious artifacts out there, some statues, some other things. And the place is absolutely spotless. I was amazed. I was like, this is, this is this is clean or cleaner than a hospital I've been in. But what the other the other part that I think is amazing is you. These people have their own room with their own bathroom.

00;12;51;04 - 00;13;07;28

Cary Hall

So they're not sharing a bathroom or a television or something. So talk about the quality, because to me, the quality of life that you're providing is not the norm unless you can pay to go into a private facility. So it's very different. So talk a little bit about that, Sister Mary.

00;13;08;01 - 00;13;34;13

Mother Mary Thomas

When they come to us, they come, they become part of our family, the residents, the employees, the sisters it’s one big family, we live together. So you want to give them respect, good care, gentle, our way of dealing with them, talking to them. We really become part of their life. They come, they are poor so they don't have much maybe to give us.

00;13;34;15 - 00;14;03;17

Mother Mary Thomas

But that's why we go out to the church collection. Different places to ask for money, because of what we receive from them, is not enough to run the home, to feed 75 people in the home, for three meals and good care and provide our medical care. They need laundry done. Rooms are clean, so we want to make we treat them as they really for us is like the Lord Jesus, Lord Jesus whom we are serving.

00;14;03;17 - 00;14;19;12

Mother Mary Thomas

So we want to give him the best we can, best care we can provide to them, and make their last days happy and enjoyable where they can really live with us peacefully. And when the Lord calls, they are ready to say.

00;14;19;12 - 00;14;20;24

Sister Agnes

Yes to the Lord.

00;14;20;26 - 00;14;40;29

Cary Hall

You know, it, it it it's amazing to me when I, when I was in there and I looked at you live with them. That's the part that I think is very interesting. You’re there every day interacting with them, whether it's meals or recreation or, or, you know, they're doing hobbies. Whatever the case may be, you're with them the whole time.

00;14;41;03 - 00;14;59;24

Cary Hall

Let's go back to this cost thing. So most of these people have Medicaid. Medicaid doesn't cover the cost of half of what it cost to run that home, okay. And that's one of the problems is you're taking these people in who are if it weren't for you, who knows where they would be? Probably in some Medicaid home if they could get in.

00;15;00;03 - 00;15;15;04

Cary Hall

But the point is they're getting a different quality of life you're providing for them. You're living with these folks in the home. Talk a little bit about some of the experiences. Sister Agnes, is some of these people that you're in the home and how you interact with them.

00;15;15;06 - 00;15;34;10

Sister Agnes

Well, we care to make the elderly happy is our, the goal or the call of our mission. So we try our best to make them happy, and we try to create a place where the residents call home, and they’re welcomed as Christ, and we serve them as family.

00;15;34;13 - 00;15;37;21

Cary Hall

And that's really a different way of doing what taking care of the eldery.

00;15;37;25 - 00;15;38;27

Sister Agnes

Exactly.

00;15;38;27 - 00;15;55;20

Cary Hall

A different level of compassion and care, Sister Mary, in the way you do this, for these folks, I mean, the people that I saw in there, when I was there, for our last meeting, it's clear that they're very fortunate to be there, and they're being very well taken care of.

00;15;55;22 - 00;16;24;02

Mother Mary Thomas

So in order to show them what we need, we depend on divine providence to God provide us when we need it. So people from Kansas City been very generous to us all these years, 143 years. We are serving the people of Kansas City and we never lack anything because people are very good to us and give us what we need financially or things, whatever we need.

00;16;24;02 - 00;16;51;02

Mother Mary Thomas

So we count on our patron saint, which is Saint Joseph. We call on him when we need something, we ask him to, we need something. And he always has, never has let us down. So our foundress, St. Jeanne Jugan, had great trust in Saint Joseph and we as a little sisters continued that to counting on Saint Joseph to provide what we need our residents, these guys for what funds we get from the residents.

00;16;51;02 - 00;17;02;14

Mother Mary Thomas

It's not enough to run the home, but because of the people's generosity we are able to do now. Till now, all this up to 143 years.

00;17;02;14 - 00;17;19;03

Cary Hall

It's quite remarkable when you think about you mentioned you've got 75 people in this home, you've got room for more, which you you need more staff, you need more help to be able to do that. But having said that, people don't necessarily think about this. You've got to feed 75 people three times a day.

00;17;19;05 - 00;17;41;05

Cary Hall

You've got to make sure their laundry is done. I didn't even think of that part tell you said it. Okay. You get their rooms are clean. I'm sure that, you know, they need other personal services, medical care, all the rest of it. So that's all part of what you do in running this home to provide as sister Agnes said, this family atmosphere for these people to let them know that.

00;17;41;07 - 00;18;04;27

Cary Hall

And that's interesting that you said to keep them happy. Sister Agnes said, because so many senior citizens, especially in situations like Medicaid homes, they become very withdrawn because they're not having interaction. They're not they're not in a place where they're comfortable or they’re happy. Your situation, what you're providing with is something completely different. It's a level of security.

00;18;05;01 - 00;18;25;02

Cary Hall

It's a level of care. It's all of those things that make a big difference for all of them. When we come back from the break, we're going to talk about how you can help out a little bit of that divine providence. Okay. What they need that you can help out with here in the Kansas City metro, or if you happen to be listening anywhere else in the country, you can certainly get involved with Little Sisters of the Poor. The website.

00;18;25;02 - 00;18;47;10

Cary Hall

For them nationally is Little Sisters of the Poor dot org. LittleSisterOfThePoor.org. If you want to help out here in Kansas City, maybe you've got some free time, maybe you're semi-retired, maybe you'd like to make a donation, or you've got some other way to help reach out to, Carrie Rojas. You can find her at 816-203-8015. 816-203-8015.

00;18;47;14 - 00;19;07;11

Cary Hall

We'll be right back after the break with more. Stay tuned. You're listening to America's Healthcare Advocate broadcasting coast to coast across USA.

00;19;07;13 - 00;19;29;21

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. I want to give a shout out to KMET, 1490-AM and 98.1-FM in Redlands, California. One of our great stations up there listening to America's Healthcare Advocate. Happy to have you on board with us a long time.

00;19;29;23 - 00;19;51;02

Cary Hall

I know the folks up in, California enjoy the show. We get a lot of feedback. So thank you all. All you folks over at Calumet. All right, let's switch gears here a little bit. Sister Agnes, your official title is ‘Beggar’, Okay. You. Yeah. So let's talk a little about what it means to be the chief beggar for Little Sisters of the Poor, Sister Agnes.

00;19;51;06 - 00;20;23;12

Sister Agnes

Well, I'm proud of this title you gave me. All through my religious life, my job is mostly on begging on, collecting. Or you can say begging. I, I go for every day. We go to different, markets, offices and, and all the bakery places to solicit monetary and, donations in-kind. And the people are very good enough to provide for us.

00;20;23;12 - 00;20;47;12

Sister Agnes

Enough for the whole week at the table. So, I'm proud of that. And I enjoy my begging because I can reach out to the people whom I solicit there charity and create a channel of grace for their souls for this seffless charity and that of selfless charity.

00;20;47;15 - 00;20;55;27

Sister Agnes

It was already, what the Foundress believe that sharing is a common gesture among the human family.

00;20;55;29 - 00;21;46;24

Sister Agnes

We're all, accorded to live in fidelity. It was in this, it was in this spirit that she ensure this subsistence of her work through the collecting. The collecting is a fundamental element of our charism. Is another way of serving the elderly. It affirms our fidelity to receiving the poorest elderly, and it bears witness of our trust in God without disrupting the human beings and creativity. We count on the intervention of the Providence through the collecting we associate the lay people to join our work, and we will work together for the good of our residents in view of God.

00;21;46;26 - 00;22;01;01

Cary Hall

And thank you. I think that pretty much says, what your mission is. As far as let's talk a little about specifics, Sister Mary. Okay. So you need you need you've got how many acres is that facility? It's a big facility.

00;22;01;03 - 00;22;02;23

Mother Mary Thomas

It's 23.

00;22;02;25 - 00;22;18;07

Cary Hall

23 acres. And you've got a pond on it. I mean, it's wonderful. It's beautiful because, you know, all the folks at home have a place they can go out. There's recreation, you know, they can walk. They can. They can fish in the little pond. They can do a lot of things, but that needs upkeep. That's that's work. Right?

00;22;18;09 - 00;22;50;17

Cary Hall

Okay. So you're in need of people if if folks want it, if you've got a church group, you got a men's group, if you've got, you know, maybe, maybe at work, you have people that get together and go out and do volunteer. BlueCross the Kansas does this. I know Blue Cross of Kansas City does it. If you've got a group that goes out and does work in various community projects, this is a project you might want to give Carrie Rojas a call and say, hey, we'd like to come down on a Saturday or we'd like, come down and help out and do some cleanup or be involved, with Little Sisters of the Poor

00;22;50;17 - 00;22;56;13

Cary Hall

over on James A Reed road. So that's one thing they need. Hygiene drives. What are hygiene drives?

00;22;56;15 - 00;23;16;12

Mother Mary Thomas

You know, to take care of 75 people. We need a lot of Kleenex, shampoo, mouthwash, body wash, all these things. Everything is now expensive. So if people can help us that way, will be very grateful because we need on that for them to take care of the daily basic. Yeah.

00;23;16;15 - 00;23;35;29

Cary Hall

And Sister Agnes, you mentioned, going to bakeries and different food facilities. So you, you know, if, if someone owns or runs a grocery store as a manager of a grocery store or a restaurant or a bakery, and they have goods that they can donate to you, you're more than happy to receive those.

00;23;35;29 - 00;23;37;00

Sister Agnes

Oh, sure.

00;23;37;02 - 00;23;38;02

Cary Hall

Okay.

00;23;38;05 - 00;23;48;05

Sister Agnes

We'll arrange a date and then go regularly to get the food to make sure they have this, pastry, which the residents love it.

00;23;48;05 - 00;24;10;09

Cary Hall

So the idea then obviously is if you have if you have, a bakery, if you have a restaurant, if you have a grocery store, maybe you're a manager for Price Chopper or, you know, Aldi's or one of the other stores that, you know, think about this, maybe this way, you know, when you have dented canned goods or, or goods that are a day old and you can't put them back on the shelf, they'd probably love to have them.

00;24;10;09 - 00;24;30;29

Cary Hall

If you want to do something like that, reach out to Carrie Rojas, 816-203-8015. 816.203-8015. She'd be happy to chat with you. Let's talk about something that you did here recently, that you had a few folks attend. When you throw a dinner, you throw a big dinner. You you talk about. So you had a spaghetti dinner last Sunday.

00;24;31;02 - 00;24;38;00

Cary Hall

I was cooking for grandchildren, so I didn't get to come. But let's talk a little about how many people you had or what did you serve, Sister Mary?

00;24;38;00 - 00;25;01;16

Mother Mary Thomas

So we had 600 people attended. It was first time for me. I went just like amazed to see all these people coming in and out. And most is like everything was donated. The meatball, the spaghetti, the bread, the cake, everything was donated. So whatever we made is like all our profit. That was enough. And we had the crafts sale.

00;25;01;18 - 00;25;08;02

Mother Mary Thomas

We had silent auction and we had so many volunteers to help us. It was so wonderful to see.

00;25;08;02 - 00;25;09;15

Cary Hall

How 600.

00;25;09;22 - 00;25;30;15

Mother Mary Thomas

People that and you mentioned how many meatballs they made it and how much pasta and two big bread, garlic bread. It was beautiful. And people just so happy. When they went home, they were just like thanking you when they have they paid for that. They were still happy about it. Yeah. Yes. It was a beautiful day for everybody.

00;25;30;18 - 00;25;37;17

Cary Hall

Yeah. And that that's a wonderful event. And so who had to make the 600 meatballs? That's what I want to know. Sister Agnes.

00;25;37;19 - 00;25;50;13

Sister Agnes

We have a catering. He was very kind and he offered his help for us for this fundraiser, Okay. And the catering themselves with all the staff they make, they prepare all this meatball and pasta.

00;25;50;16 - 00;25;59;18

Cary Hall

And so we have we have an event coming up on December 6th. It's a breakfast meat collection. Talked about what people can do if they want to bring food to that drive.

00;25;59;21 - 00;26;25;13

Sister Agnes

So every year has a night tradition. We have a meat drive around this time and this time this year we we decided to put it on the 9th of December from from 9 to 3. Right. And then, you can drive through and then could, first of all, go to the grocery and buy whatever we need.

00;26;25;13 - 00;26;32;03

Sister Agnes

We have a list still. So you put it and then you drive through and then the system, we receive your credit card donations.

00;26;32;06 - 00;26;50;25

Cary Hall

What they're looking forward to, everybody understands hears are looking for bacon, ham, sausage holiday breakfast. It is December 6th. That that that is the date if you just so they're over on James A Reed Road they're easy to find if you you know want to go over there and drop something off of feel free to do that. They'd be happy to have it.

00;26;50;27 - 00;27;08;27

Cary Hall

And you certainly it's certainly something they can use. As they said, they're feeding 75 people every day. Think about that. That's a lot. That's a lot of bacon and a lot of ham. Okay. So let's switch gears here and talk about something else. Now you have a van, Sister Mary is broken down okay. It's 16 passenger bus.

00;27;09;00 - 00;27;26;09

Cary Hall

And so therefore you need to have the ability to get people in your facility if they want to go to Walmart and go shopping or they need to do this or go to a doctor's appointment. You don't have a van right now. Now. So, you know, if you're out there, you're a car dealer, okay? Or you're used car dealer or whatever the case may be.

00;27;26;09 - 00;27;36;25

Cary Hall

Or maybe you're somebody that has a connection to Ford or GM or whoever it may be. We're looking for a van. They need to replace this van. You're looking for a 12 passenger van, right.

00;27;36;29 - 00;27;39;03

Mother Mary Thomas

With the two handicap access.

00;27;39;09 - 00;27;39;20

Cary Hall

Right.

00;27;39;20 - 00;27;49;06

Mother Mary Thomas

Also, because we have a few residents who are on the wheelchair, so they can also be able to go out. What we have is the the lift doesn't work.

00;27;49;08 - 00;27;50;00

Sister Agnes

And a battery.

00;27;50;02 - 00;28;00;26

Mother Mary Thomas

Battery doesn't work, so it's very hard to take them out. Like for example, the Christmas light. We want to take them to see the Christmas lights, but no access to take them out.

00;28;00;28 - 00;28;29;10

Cary Hall

So they're looking for a van. So if it is anyone out there that you know has access or or can start a conversation with Ford Motor Company or General Motors or anybody else, please feel free to reach out to Carrie Rojas once again. That phone number is 816-203-8015. By the way, if you would like to be a driver, if you can come and help take people to the doctor, if you can take people if they need to go to Walmart or pick up prescriptions, whatever the case may be, they'd love to have you.

00;28;29;10 - 00;28;47;15

Cary Hall

If you want to come as a volunteer, they'd love to have you come as volunteer and help out with this part with where they can get these folks outside of the home, when they when they need to go do something or just as Sister Mary just said, if they just want to go look at the lights on the plaza, if you've got the ability to help do that, please reach out to them.

00;28;47;23 - 00;29;15;06

Cary Hall

They could certainly use the help. Once again. Carrie Rojas is at 816-203-8015. 816-203-8015. They'd be happy to chat with you. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across USA. Stay right there. We've got more. When we come back.

00;29;15;08 - 00;29;31;20

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. You know you're listening to this. I don't care where you are in the country. They have a need. And like I said at the beginning of this show, give me a name of another charity that does it.

00;29;31;23 - 00;29;50;27

Cary Hall

There aren't very many. I don't know of any, frankly, especially where they actually take them into a home, give them a decent place to live. Their own private room, their own bathroom, provide three meals, a day for them, personal hygiene, laundry, cleaning, the whole nine yards. They do it all into the facility here in Kansas City is beautiful.

00;29;50;27 - 00;30;09;03

Cary Hall

Yes, it's older, but they maintain it. It's spotless. It's very well done. This is a quality of life you don't typically see for the elderly when they get stuck into a medicaid facility, two to a room, sharing a bathroom and one television. That's not a way to end your life or wind up in your old age where you want to be.

00;30;09;03 - 00;30;27;22

Cary Hall

What they're providing is a quality of life that's far above that. Okay, and if you've got the money to afford that kind of nursing care with a long term care policy, but that's great. But a lot of people don't, and that's what they do. So their website anywhere in the country, Little Sisters of the Poor.org. Little Sisters of the Poor dot org.

00;30;27;25 - 00;30;53;08

Cary Hall

If you have time, you want to volunteer. Maybe you have a business that can help out. Maybe you can write a check. Give Carrie Rojas a call 816-203-8015. Help them help those. They can't help themselves. All right, let's switch gears a little bit. Sister Mary, let's talk about we've talked about all the physical things you're doing to take care of people.

00;30;53;11 - 00;31;12;01

Cary Hall

You know, end of life going to happen for everybody. Nobody's getting out of here alive. Okay. So so let's talk about hospice care. Because you do hospice care. They don't have to leave if they're in hospice. You let's talk about how you do that. And in the spirituality piece that you bring to that, you're you know, this a Roman Catholic order.

00;31;12;01 - 00;31;17;28

Cary Hall

I'm Catholic, but you're providing this to people of all denominations. Talk about sister Mary.

00;31;18;00 - 00;31;42;05

Mother Mary Thomas

So as the as Carrie said, we are a Catholic congregation, Roman Catholic. We take care of the elderly. So we have mass for them every day in a chapel where they can participate, the mass, any race, color, anybody can come and pray to the Lord everyday mass there. They have everyday rosary there. So you a they have a anointing of the sick every three months.

00;31;42;05 - 00;32;03;28

Mother Mary Thomas

They have confession every week. So we do provide not only bodily things, but we provide also spiritual life for them. So when the time comes when the Lord is going to call them, we stay with them, even if you have to stay nights and days, we stay with them. We never leave them alone. We hold their hand, we pray with them.

00;32;03;28 - 00;32;26;03

Mother Mary Thomas

We sisters take a turn in the night because we know when they will close their eyes here. When they open next in the heaven, they will see Blessed Mother. Or Saint Joseph or Jesus come to them, but they will remember who I was holding their hand in the last the last minute. I was there with them, praying with them.

00;32;26;03 - 00;32;44;09

Mother Mary Thomas

The family, those who have family, they can come and stay with them. But there are many who don't have the family, so we are their family. So we provide that. We stay with them and we prepare their heart to go to heaven and prepare their soul to the you know.

00;32;44;12 - 00;33;00;15

Cary Hall

A lot of people, you wouldn't necessarily think of that. I mean, even when I was doing all this, getting ready to do this show day, I did not think of that. Okay. How important is that? You know, to contrast that with being in one of these Medicaid facilities where there is nobody there, okay? They're on their own.

00;33;00;16 - 00;33;20;28

Cary Hall

They're by themselves. There's nobody there when they pass, there's no family with them. There's nobody in that facility who has any kind of personal relationship. And here, I just heard you say it. If you're sitting there 24/7 with him in that room, they're not by themself. That has to mean a lot. It has to mean a lot to these folks, that they because as you said.

00;33;20;28 - 00;33;42;18

Cary Hall

And it's sad I talked about this at the beginning of the show. In this culture, in this country, we don't necessarily look at those of us. And I'm chronologically challenged at 76 years of age. We don't necessarily look at those of us that are seasoned citizens as an asset. We look at them as a liability. Okay. That's not how you folks do this, you know, out.

00;33;42;21 - 00;34;00;24

Cary Hall

Little sister says something completely different. You look at the whole person, you take care of them physically. You take care of them mentally. And you're helping them spiritually. And that's quite a message that you deliver in a way. You do this. I just think it's remarkable what you do and the fact that you devote your lives to this.

00;34;00;26 - 00;34;22;00

Cary Hall

And, and you've been doing this. How long have you been? How long is that? 132 years in Kansas City? What did you say? 143 I was I was off, okay. It's 143 years in Kansas City. Give dating all the way back to the Civil War. Now think about that. Okay. So you know, Carrie Rojas likes to say the best kept secret in Kansas City.

00;34;22;00 - 00;34;36;27

Cary Hall

I hope we're going to change that. Okay. I hope we're going to make a difference where there not the best kept secret in Kansas City because they have a mission. And they need your help. Your your closing thoughts, sister Mary, as we finish up the show today.

00;34;37;00 - 00;34;52;16

Mother Mary Thomas

My closing thoughts. I want to thank the people of Kansas City who has helped us all this year, 143 years, and we count on them to continue for maybe 100 more years, who knows we want to stay here. We want to take care of the people of Kansas City.

00;34;52;18 - 00;35;10;27

Cary Hall

And that's what they do. And so here's what I'm going to do. I'm asking you, if you're listening out there, you know, you're retired. Yeah. And, I'm going to use the example or somebody I know was sitting there with your Fox News turned on all day, okay. Doing absolutely nothing. How about doing something that might help somebody?

00;35;11;01 - 00;35;26;18

Cary Hall

Maybe you've got time to go be a volunteer. Maybe you can go down to the home and just help them in the kitchen. Maybe you can help them with the grounds. Maybe you can drive. Maybe you can take five people, take them to the doctor, or take them to Walmart. Whatever the case may be, they have a need for help here.

00;35;26;21 - 00;35;42;12

Cary Hall

If you've got the ability, it doesn't have to be money. If you don't have the money to do this. And if you do have, that's wonderful. But if you don't, you certainly can step up here, and take some time. Go down to spend a day, spend two hours, three hours. You know, it's rewarding to be able to do something to help others.

00;35;42;18 - 00;35;58;16

Cary Hall

As I said, you know, we elderly in this country are kind of left behind. They're not looked at like they are in a lot of other countries, in a lot of other cultures. And that's where these that's where the sisters of the poor make a huge difference in people's lives. And I think it's important for us to get this message out there.

00;35;58;16 - 00;36;17;19

Cary Hall

So if you want to get involved, I don't care where you are in the country. They've got homes all over. They've they've got homes outside of the country and other places. So it's Little Sisters of the Poor dot org. is the website nationally if you want to go look up a home. If you want to help out here over on James A Reed road.

00;36;17;21 - 00;36;35;16

Cary Hall

They certainly love to have you. If you've got a business, maybe you've got a group, maybe you've got a civic group. Whatever the case may be, and you'd like to take a Saturday, go on. My men's Bible study group does this. You know, we've done other homes before and helped out. We're certainly going to be at Little Sisters of the Poor this year in the spring to help out.

00;36;35;16 - 00;36;59;04

Cary Hall

My point is they need that help. They've got 23 acres out there. It's a big facility. All right, take the time. Get involved. Call Carrie Rojas. The number is 816-203-8015. You can make a difference if you want to. You pick up the phone and give them a call. Whether it's money, whether it's food, whether it's volunteer hours.

00;36;59;06 - 00;37;16;09

Cary Hall

I really appreciate both of you coming in here. Thank you so much for this. And thank you, Carrie for putting all this together and making all this happen. That it because I think it's an important message that needs to be delivered. And now I leave you with this thought from Doctor Martin Luther King. Americans must learn to live together as brothers and sisters.

00;37;16;15 - 00;37;38;15

Cary Hall

We are surely going to perish together as fools. Truer words never spoken. Thank you for listening to America's Healthcare Advocate broadcasting. Coast to coast across USA here on the HIA Radio Network. Goodbye, America.

00;37;38;17 - 00;37;41;02

Cary Hall

PSM's GigCare is the Alternative for many who can't afford the ACA increases including 1099 workers

Sat, 03 Jan 2026 02:08:29 GMT

Episode 2136 notes

The ACA/Obamacare Mega Tsunami is coming! Increases premiums, Reductions in subsidies and the impact this will have across the country, and it's here as we begin 2026.

My expert guests from Detego Health are John Stockton and Tracy Krause , who will discuss GigCare, provided by Population Science Management as the alternative to the ACA (Obamacare): Better benefits and lower costs.

Stockton tells us " If you become a consumer data respondent, you can have access to PSM’s GigCare Health Benefits plan".

Today we will separate fact from fiction on the topic of health benefits on America's Healthcare Advocate.

This is episode 2136

GigCare is not available in all states. Learn more at https://gigcare.net/

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Listen to this episode.

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Watch on Rumble:

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2136 Transcript

00;00;06;11 - 00;00;29;20

Cary Hall

Hi, I'm Cary Hall, America's Healthcare Advocate. On our show today, we're going to talk about the mega tsunami that's coming. That's right. The mega tsunami that's coming with all of the ACA Obamacare plans. We're going to talk about an alternative. You're a 1099 employee if you're self-employed out there, if you're a realtor, if you're a contractor doc, if you're an Uber driver, whatever the case may be, we've got something it is worth taking a look at.

00;00;29;26 - 00;00;34;28

Cary Hall

It's called GigCare. Stay tuned. You're going to learn a lot on this show today.

00;00;35;01 - 00;00;39;12

Announcer

And now America's Healthcare Advocate, Terry Hall.

00;00;39;15 - 00;00;54;08

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. My producers in studio today, Mr. Dave Thiessen, the man behind the cameras that posts all these shows up on our podcast YouTube platform.

00;00;54;10 - 00;01;15;24

Cary Hall

By the way, 604,000 of you have viewed our YouTube and podcast. We're pretty happy about that. We want to thank you, all of you out there in the audience that pay attention to this show and go up to our YouTube platform and our 16 podcast platforms. By the way, our website is AmericasHealthcareAdvocate.com. If you have a question or comment, please feel free to send me an email.

00;01;15;26 - 00;01;33;08

Cary Hall

I get a lot of them, but I answer each and every one of them. So if I can help you, I am more than happy to do that. If you are chronologically challenged and you're looking for Medicare coverage, or you're struggling with this Obamacare issue that's coming on board right now, you can always reach out to the lovely Carolee Steele over at RPS Benefits by Design.

00;01;33;10 - 00;01;59;02

Cary Hall

Wherever you are in the country, they're happy to help you, with Medicare or with ACA. Additionally, if you are an employer looking for an opportunity that might be something different you probably ought to call Maria Ahlers over at RPS Benefits by Design 877-385- 2224. Anywhere in the country 877-385-2224. In studio with me today, John Stockton and Tracy Krause from Detego.

00;01;59;09 - 00;02;16;15

Cary Hall

We are going to be doing a show today on GigCare. So this show today and I've wanted to do this for some time. We're going to talk about why GigCare was created. Detego is the parent company that created GigCare. Why did we create it? What does the product do? And it's a health benefits plan.

00;02;16;20 - 00;02;33;24

Cary Hall

And who is this product really For. So that's what we're going to talk about today. And here's here's the thing you want to keep in mind. There's a huge tsunami coming in ACA right now, with all the increases and the reductions in subsidies and all the rest of it, it's going to impact people across the country in a lot of different ways.

00;02;33;29 - 00;03;00;25

Cary Hall

In addition to that, okay, if you're a 1099 employee out there, if you're if you're an Uber driver, if you're a contract ER doc, if you're a contract ER nurse, if you're a contract anesthesiologist, if you're a realtor, if you're a truck driver and you're 1099, this might be a health benefit plan you want to take a look at. But we're going to start off by just talking about what's going on in the marketplace today and the disruption that we expect to see.

00;03;00;25 - 00;03;15;23

Cary Hall

So, John, let's talk about that a little bit there. You've got a table there that's talking about some of the increases we're going to see across the country. Let's talk about that and the disruption that we're going to see. You. And I kind of nicknamed it the ACA tsunami. So let's talk about that.

00;03;15;28 - 00;03;24;01

John Stockton

I think the only place I would disagree, Cary, I went into ChatGPT and I said, what's bigger than a tsunami? And the answer is a mega tsunami.

00;03;24;03 - 00;03;27;06

Cary Hall

Okay. I didn't even know that existed. Okay. So I'm impressed.

00;03;27;06 - 00;03;53;17

John Stockton

The the average increase for the ACA across the country is 23.43% projected at this point. There are a handful of states that I circled that just are eye popping. Texas is at 31, Tennessee's at 35, North Carolina is at 28. New Mexico's at 36. You see these Arkansas is at 36. Delaware is at 38. You just see the impact of the ACA.

00;03;53;17 - 00;04;02;26

John Stockton

You seen a large carrier pull out of the ACA. So the in and that impact is just the base rate increases, not even considering what's going on with the subsidies.

00;04;02;28 - 00;04;15;10

Cary Hall

Yeah. So when you put all that together, if you're not on an employer sponsored health plan and you're out there on your own trying to figure this out, it becomes much more challenging and much more difficult, does it not?

00;04;15;11 - 00;04;35;02

John Stockton

Oh, it absolutely does. You are stuck and you are relying upon the ACA to take care of your needs. And we know that with this magnitude of increase, the people that will leave the ACA are those that can leave the ACA. So in our opinion, the ACA is looking at a death spiral and it's only going to get worse.

00;04;35;04 - 00;04;58;25

Cary Hall

And the reason we say that is because the only people are going to stay on there are the people that have to stay on because they're too sick to get off. And we're already seeing that in the marketplace with a lot of people. I would say if you look at people below the age of 30, 35, even below the age of 35, and you ask them, do you know, it was funny, we were on a on a zoom meeting here a couple about a month or so ago, and there were a number of very young people on there who were IT people.

00;04;58;25 - 00;05;06;03

Cary Hall

And we asked how many of them had health insurance. They laughed. They said, Tracy. They said, no, we don't need health insurance.

00;05;06;06 - 00;05;07;03

John Stockton

I'm like.

00;05;07;05 - 00;05;21;15

Cary Hall

Okay, you don't need health insurance. And with that's the attitude. And the other part of the attitude is that Obamacare, ACA is too damned expensive and they just don't feel like it's worth what they're going to be forced to pay for it.

00;05;21;17 - 00;05;28;25

John Stockton

The underlying cost of health care is a whole separate conversation you and I have had before, Cary, but the financing model for the ACA is not working either.

00;05;29;02 - 00;05;50;05

Cary Hall

No. And we only think it's going to get worse. So let's talk a little bit about let's just talk about why this product, Detego is the parent company here, Population Science Management is the company that actually offers the GigCare product. We can talk about that a little later, but the GigCare product was actually designed to go into the 1099 marketplace.

00;05;50;05 - 00;05;58;26

Cary Hall

People that are 1099 folks out there that don't have group health insurance plans now, they're how many of them are there? 80 million now, John.

00;05;58;28 - 00;06;06;07

John Stockton

80 million. By the start of 2027, the gig economy will represent 100 million Americans which is astounding.

00;06;06;07 - 00;06;22;08

Cary Hall

So we think that this is an opportunity for people in those areas, people that are realtors, people are those Uber drivers, people that are contract drivers for Fedex or those Amazon drivers that are contract Amazon drivers or the truck drivers or such a broad.

00;06;22;08 - 00;06;27;28

John Stockton

It's hospitality. It's the beauty space. It's the tattoo artists, the musicians and.

00;06;28;00 - 00;06;29;19

Cary Hall

The tattoo artist. John, that was one.

00;06;29;19 - 00;06;34;16

John Stockton

It's a very broad message. When you start talking about 80 million today, it's again very broad.

00;06;34;16 - 00;07;01;06

Cary Hall

And those are the folks that don't have access to employer sponsored health care. So they're looking for an alternative. And the GigCare product was created specifically for that marketplace to give them an opportunity to find health benefits that were better than what's on ACA, that were less expensive than was on ACA, and actually offer a wider range of coverage in some areas than what we see on ACA.

00;07;01;13 - 00;07;16;25

John Stockton

I would just also add, Cary, it might be for W-2’s that are part time and not eligible. So GigCare is a great fit for those who aren't eligible. So we talked to a lot of large employers who have a number of part time employees, where this is a consideration.

00;07;16;27 - 00;07;35;29

Cary Hall

That brings to mind some of the other employers that we've talked to. Okay. You know, we have a trucking company out of Lincoln, Nebraska that has 4000 truck drivers. Well, it turns out 400 of them are 1099 people. And they didn't have any health benefits to offer them. We're seeing this in co-ops, agricultural co-ops across the country. Right, John?

00;07;35;29 - 00;07;41;09

John Stockton

Absolutely. A lot of large farmers co-ops, a lot of association opportunities that it's created for us.

00;07;41;10 - 00;07;56;03

Cary Hall

Where they're not where they don't have access to the kind of health care we're talking about unless they go on the ACA, Obamacare, which unfortunately, a lot of them just are not don't want to do or have had a bad experience with or it's cost prohibitive now.

00;07;56;03 - 00;08;09;18

John Stockton

It is cost prohibitive. And depending on what happens with the subsidies, it could get even worse. It's still the average increase going up 23.4% is is with the subsidy staying the same. So it could it could get significantly worse.

00;08;09;21 - 00;08;23;01

Cary Hall

Yeah. And that's a state by state thing. So so you're seeing that say this is another thing we'll talk about when we start talking about the plans here. But our plan pricing is universal across the country. It doesn't change on a state by state basis like ACA does. Correct?

00;08;23;01 - 00;08;29;25

John Stockton

Correct. We have the same rates across all of our state where we offer our coverage, and they're just by age band.

00;08;29;28 - 00;08;50;06

Cary Hall

So it is by age band. We offer it across the country and we come back from break what we're going to do is we're going to start talking about GigCare, how it works, who it serves, and how you gain access to it. If you want information on this, by the way, if you're a broker and you want to learn how to sell this product, I'll take it out in your marketplace.

00;08;50;13 - 00;09;18;09

Cary Hall

We are happy to have you. It's very simple. Here's what you do. You go to GigCare.net, GigCare.net. There's information up there. Fill out a card, send it into us. Okay. On the web, it's easy to do. Okay. Or you can call 866-886-2030. That's 866-886-2030. Be happy to chat with you. And if you're somebody looking for this kind of health benefit, we're more than happy to talk to you about what we're offering at GigCare, how it can serve you, and why.

00;09;18;09 - 00;09;36;23

Cary Hall

It could very well be something that would be better for you from a cost standpoint, and also a benefit standpoint, and what's in the marketplace today or what's actually coming to the marketplace. So we'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA.

00;09;36;23 - 00;09;51;14

Cary Hall

Once again, that website is GigCare.net that phone numbers 866-886-2030. Stay tuned. We'll be back with more.

00;09;51;17 - 00;10;10;25

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 up to the website America's Healthcare Advocate. By the way, you hear this show. You want to tell somebody about it. Maybe you've got a company that's got 1099 employees along with W-2 employees.

00;10;11;02 - 00;10;30;08

Cary Hall

You go up on the podcast platform, it's on SoundCloud, Spotify, 16 platforms across the country, and our own YouTube channel, America's Healthcare Advocate. All you gotta do is tell them to go listen to the show there. They'll understand exactly what we're talking about. Once again, it's AmericasHealthcareAdvocate.com. The YouTube channel is America's Healthcare Advocate.

00;10;30;13 - 00;10;52;26

Cary Hall

If you want information, maybe you want to find out more about this. 866-886-2030. 866-886-2030 or GigCare.net. All right. We're going to change up a little bit. Tracy. So let's talk a little about you know, I don't know who it was I was talking to not so long ago. We were talking about customer service. He said, you know the problem.

00;10;52;28 - 00;11;13;10

Cary Hall

The word service has gone out of customer service. And so especially when it comes to health benefits and when you when you're talking to people, they've got a claims issue or a provider issue. How critical is that. And I ask you to come in today to talk about this. Because that's really your area of expertise. And one of the things that you help us do and do so well.

00;11;13;10 - 00;11;15;09

Cary Hall

So let's talk a little bit about that, Tracy.

00;11;15;11 - 00;11;43;18

Tracy Krause

Great. Thanks, Cary, for having me. I 100% agree with you. I've been in the customer service area for different consulting firms, for different carriers now in this role with Detego, and it's really putting that service back into the customer service. There aren't many things as personal to somebody as their health care. And at that point in time, when they're at the doctor's office and they have that ID card, that's their insurance, that's their security, and they need to make sure it works.

00;11;43;21 - 00;12;09;17

Tracy Krause

So at Detangle Health, we have the customer service agents who are live. We're also leveraging artificial intelligence. Right. We're doing some of those voice IVR as you know hit a button go here. But at the end of the day it's being able to talk to a live person who can listen to you, understand. And then direct you through the right ways in order to get your questions answered, your problems resolved, your doctor's office answered.

00;12;09;21 - 00;12;19;18

Tracy Krause

That's really what it's about. It's that first point resolution, and that sets the tone for that relationship between the member and the coverage that they purchased.

00;12;19;19 - 00;12;38;12

Cary Hall

And I think one of the things that separates us from the national carriers, if you will, you know, when you call and there's four voice prompts you have to go through before you get to the fifth one. And if you're lucky, if you're lucky, you might be able to actually talk to somebody. Okay. Our program doesn't work that way.

00;12;38;14 - 00;12;40;29

Cary Hall

Customer service starts. What time does it start? In the morning? Seven.

00;12;41;02 - 00;12;41;23

Tracy Krause

Seven in the morning.

00;12;41;23 - 00;12;55;19

Cary Hall

And it goes till six at night. So obviously we've expanded the hours so people have more of a chance to call if they have an issue. And the idea is, as you said, to have a live person there to talk to them so that they, they know they can get their problem resolved.

00;12;55;20 - 00;13;19;06

Tracy Krause

We've even gone to that outbound proactive reach. So once a member has had the conversation with their agent, they've selected the plan. And then things kind of go into that quiet period, right? We've started that proactive outreach where we're calling the members and saying, do you have any questions? Did you have anything? Maybe now that you've had the plan in place for a week or so, what kind of questions do you have?

00;13;19;06 - 00;13;43;22

Tracy Krause

And we've really uncovered what those, employees, what those members are trying to buy and how we can help them. It's about finding the right information. It's also about, in this day and age, right. We've got five generations in the workforce. You've now got those same five generations seeking health care. And they all have different needs. And so it's just providing them the information they need for their health care journey to be successful.

00;13;43;25 - 00;13;47;22

Tracy Krause

That's really a lot about the customer service aspect.

00;13;47;24 - 00;14;07;27

Cary Hall

You know what I always used to say it, I've been I was broke for 27 years was. It's not if you're going to call, it's when you're going to call. You will have an issue. Somewhere along the line there will be a provider issue or there'll be a claims issue or something will happen. But the idea is that we've got somebody there to help you, and we're not just telling you, well, that's your problem.

00;14;07;27 - 00;14;09;01

Cary Hall

You need to get it solved

00;14;09;01 - 00;14;10;06

Tracy Krause

100%.

00;14;10;09 - 00;14;28;29

Cary Hall

And that's the whole purpose behind customer service. Switch a little bit to now how we communicate with brokers. Because we are 100% broker distribution. That's important for you to know all right. So we rely on our brokers all over the country, to take our product out in the marketplace. And we go to a lot of trouble to service our brokers.

00;14;29;05 - 00;14;37;24

Cary Hall

And give them the information they need in the tools they need. So let's talk a little bit about that and how if a broker has a problem, what we do to step in and help them.

00;14;37;24 - 00;15;00;15

Tracy Krause

So the level of service that we provide is equal to the education that we set it up in the beginning. Right. Let's let's all be on the same page. Right. Population Science Management, which is administered by Detego, is an opportunity for your clients to get access to a group health plan. Now within Population Science Management we have different segments.

00;15;00;15 - 00;15;34;11

Tracy Krause

We have the GigCare, which is what we're talking about today, right. Major medical comprehensive coverage with three different provider networks to choose from. Great. We also have Max Guard, which is a limited benefit plan that also now has a network. We then also have reference based pricing models, which might be what the agents and brokers clients once we are here to be that one, stop with three different solutions that may or may not be the best fit for your client.

00;15;34;11 - 00;15;36;28

Tracy Krause

But we are here and we do provide a solution.

00;15;37;02 - 00;15;52;17

Cary Hall

One of the things we do is who really goes to a lot of trouble to educate the brokers, talk about that and what that because you're not just going to walk in and get this product and take it back out on the street. So when you go to sell an ACA product or when you go to sell a Medicare product, you go through a whole training process.

00;15;52;19 - 00;16;00;22

Cary Hall

You go through a training process to sell GigCare. Any of the Population Science Management plans, you have to go through it. So talk about that.

00;16;00;24 - 00;16;29;00

Tracy Krause

This is a great opportunity. This is delivering a health care model in a different space. Right. And again we're not for everybody. Population Science Management isn't that ACA where you're going to drop those unhealthy people. People are unhealthy right. It happens. Things happen. What this is is it is that absolute health benefit option for you to choose from.

00;16;29;02 - 00;16;58;27

Tracy Krause

And each one of our tiers within Population Science Management serves a different purpose for the clientele that you're going after, right? That early retiree probably is going to want a GigCare plan, right? It's got three different national networks. It's got the comprehensive coverage that, rideshare driver, they're not going to want that comprehensive coverage. They probably got that Max Guard suite of plans for them to consider.

00;16;58;29 - 00;17;17;21

Tracy Krause

What we do up front, though, is have that education for those agents that want to take the time. Right. This is the GigCare. This is Population Science Management. This isn't Medicare and this isn't ACA. And this is unique to our space. And it's an absolute solution for your clients.

00;17;17;21 - 00;17;33;29

Cary Hall

And so what that means is if you're the broker and you're listening to this and you're interested, there is a training process. You actually have to take a test, okay. And you have to go through this training process. And the reason for that is because as Tracy just said, this isn't for everybody. There are different plans that fit different needs.

00;17;33;29 - 00;17;54;22

Cary Hall

And that's what we're doing here. We're talking specifically today about GigCare. That plan, which primarily services the 1099 market. But if you want information you're interested in, you've got an area out there that you cannot get those clients coverage. You can't find policies. They like narrow networks. Under ACA, prices are too high. They don't want to do it.

00;17;54;27 - 00;18;17;00

Cary Hall

Now you've got a product that probably makes some sense, but you're going to have to go through the training and education process so that you can present it the way it needs to be presented. If you want information, go to the website GigCare.net, that's gig hairnet or call 866-886-2030. 866-886-2030. Stay tuned. We'll be right back after the break.

00;18;17;00 - 00;18;34;16

Cary Hall

We're going to get into the plan designs now. And what are they actually look like and what do they cover? We'll be right back after the break. Stay right there.

00;18;34;19 - 00;18;53;08

Cary Hall

Welcome back. You're listening to America's Healthcare Advocates Show broadcasting coast to coast across USA here on the HIA Radio Network. My producer today, Mr. Dave Thiessen. Behind all the cameras, Garner Cowdrey, the man behind the microphones. Again, all these shows are posted on our podcast platforms. There are 16 of them. Okay. As well as our YouTube platform.

00;18;53;08 - 00;19;13;29

Cary Hall

So you hear about this, you tell somebody about it, you want to share it with somebody. That's a great place to go. And instead of you trying to explain all of it, then go up there and listen to the whole show and get all the information so they understand how it works. We're talking about the plan today, the health benefits plan called GigCare offered by Population Science Management, 866-886-2030.

00;19;13;29 - 00;19;29;19

Cary Hall

If you want information you want to call, learn more about it. That's what you can do. Or you can go to the website GigCare.net. All our information is up there. All right John, let's get in the weeds a little bit okay. And talk about these plans. So there are seperate plans Tracy just talked about offering on separate networks.

00;19;29;22 - 00;19;34;29

Cary Hall

So first we have the Blue Cross and Blue Shield plan which is offered in Nebraska. And that plan is called.

00;19;35;04 - 00;19;46;08

John Stockton

We call that plan Thrive Okay. So we have an important partnership in the state of Nebraska with Blue Cross. And we are, very excited about our opportunities in that great state, working with the local Blues there.

00;19;46;10 - 00;20;00;18

Cary Hall

And we've got a lot of, a lot of opportunities coming up in the state, in Nebraska, a lot more work we're doing in the state of Nebraska with some of those farm co-ops in the state of Nebraska. Yeah. So let's let's switch gears, because we now have Aetna National Network to offer our clients.

00;20;00;25 - 00;20;27;27

John Stockton

So the Aetna plans are branded Livelihood with the Aetna plans. They are EPO which means in-network only. Obviously anything out of network that's emergency is going to be covered as in-network deductibles range from 1800 up to 8300. We have HSA options. Probably the more popular question Cary we get from brokers is where is the intersection between where GigCare is more competitive than the ACA

00;20;27;27 - 00;20;28;24

Cary Hall

on a price point,

00;20;28;24 - 00;20;29;16

John Stockton

On a price point.

00;20;29;16 - 00;20;36;28

John Stockton

So I wanted to talk about that real quick, because we sell in four age bands that are the same rates across all of our states that we sell into.

00;20;36;29 - 00;20;42;23

Cary Hall

But that separates us from ACA. Our rates don't vary based on the state. They're the same across the country.

00;20;42;23 - 00;21;09;11

John Stockton

Right. And so those age bands are 18 to 29, 30 to 44, 45 to 54 and 55 to 65. So this year, our sweet spot for GigCare has been really in, 40 to 45. Plus, in the first segment, we talked about the rate increase on the ACA being in 23 and change the impact of subsidies could literally have some members paying double what they're paying this year in 2026.

00;21;09;13 - 00;21;25;06

John Stockton

So we feel like our sweet spot will be pushed down into the lower age bands. But again, then there's same rates across all the states we sell into, and we expect to be competitive, certainly in that 30 to 44 and possibly even into that 18 to 29, I suspect, depending on the state.

00;21;25;12 - 00;21;43;13

Cary Hall

Yeah. Because what's going to happen is as the subsidy is reduced and the prices go up, our prices have pretty much stayed the same. I think our increase this year was 7% if I’m not mistaken. So, I mean, when you compare that to what's going on in the marketplace, that's pretty significant. And by the way, that's the same increase that we had last year.

00;21;43;13 - 00;22;09;16

Cary Hall

So we're very proud of the fact that we were able to keep it in the single digits and down to 7%. So again, you know, let's talk about some of the plans. So you mentioned the HSAs and some of the high deductible plans. And this goes back to you know, what Tracy was saying earlier. What the 25 year old Uber driver needs is not what the 55 year olds, you know, looking at retirement now in five years or ten years, whatever it is, they don't have any children at home.

00;22;09;16 - 00;22;15;02

Cary Hall

If they're empty nesters, an HSA at $6,500 probably makes a lot of sense.

00;22;15;02 - 00;22;30;23

John Stockton

Yeah, no it does. And I think all of our call centers do a very good job with the needs analysis. So we can illustrate both the Aetna logo or Blue Cross if we're in Nebraska. And we can also show an EPO or PPO option. So we're trying to meet the members where we are at.

00;22;30;25 - 00;22;54;14

John Stockton

Tracy mentioned Max Guard. So Max Guard literally it's a limited benefit offering with a price point roughly half of GigCare. So we had some conversations with some of our rideshare drivers, etc. it's probably represents about 30% of what we're marketing today for Max Guard. And then, for somebody who wants a more comprehensive plan, we have our GigCare solutions.

00;22;54;16 - 00;23;17;00

Cary Hall

Yeah. And so the idea here is that we've got something that fits whatever category you happen to be in if you're a senior citizen, or we're approaching senior citizen or you're 25, 35 years old, maybe you've got, you know, 2 or 3 kids in the house. We've got different plans that offer better opportunity. So let's go back to EPO versus PPO because this is going to confuse people.

00;23;17;03 - 00;23;20;28

Cary Hall

So EPO, if you're on Aetna means you can go anywhere in the Aetna network, right?

00;23;21;00 - 00;23;40;03

John Stockton

Yeah. Aetna networks are broad networks. The EPO simply means if there are out of network providers, they're not covered. You have to go in network. So our guys will work with you guys along those just to make sure the members understand the network. PPOs cost more than EPOs everything else being equal. But if you want an out of network solution BlueCross in Nebraska.

00;23;40;06 - 00;23;58;18

Cary Hall

So the idea there is that they're looking at the EPO. You've got access to the whole national network, but that's a huge network. It's some of the best hospitals in the country. MD, Anderson Sloan-Kettering go down the list okay, Mayo, they're all in there. If you're a traveling cross country, you have an accident or something happens. You need medical care.

00;23;58;20 - 00;24;11;00

Cary Hall

You're covered anyway. It's not that we're not covering you, but we're saying if you stay in the network, A, it's going to benefit you price wise, okay? And and it's an opportunity. You still got this huge network.

00;24;11;02 - 00;24;13;01

John Stockton

Cary, I was with Aetna for 25 years.

00;24;13;02 - 00;24;13;25

Cary Hall

Yes you were.

00;24;13;25 - 00;24;26;17

John Stockton

We used to run disruption analysis on all these large prospects. And if it got to more than one and a half or 2%, it was. It caught my attention. So yeah, there's hardly any out of network utilization with these large networks sometimes. That in particular.

00;24;26;19 - 00;24;49;26

Cary Hall

Yeah. Because because they offer such broad numbers here. I'm going to make a distinction here that's really kind of important. When you look at ACA those are narrow networks. You know why? I'll tell you why. Because if you control access you control cost. So what the carriers are trying to do because they are struggling to control cost under ACA, because you've got government mandated health care, here.

00;24;49;26 - 00;25;12;17

Cary Hall

And when the government mandates something, it doesn't leave a lot of leeway for these carriers to make sense out of this or even be competitive. So they squeeze the networks down. Well, the problem is, if you happen to live in Nebraska and you're in Grand Island or you're in Scott City, Kansas, you may not have a provider. You may be in a situation where you have to drive an hour, 45 minutes, whatever it is to get to a primary care.

00;25;12;17 - 00;25;34;01

Cary Hall

And if you need a hospital, you're going to go to one of the metropolitan areas for a hospital, because rural hospitals are typically not in these networks. When you contrast that with the Aetna national network, where you've got coverage across the country, there's a significant difference here. So, you know, when we talk about these plans versus the ACA plans, those are some of the things that we think separate us.

00;25;34;06 - 00;25;53;16

Cary Hall

That particular piece on networks and access. If you're in a rural community, this can be really, really important to you. And again, you know, if you do want the PPO versus the EPO, the EPO cost less money. It's a great way to save some money and still have a great plan and great access. There's coverage there for you, so that makes a difference.

00;25;53;23 - 00;26;13;20

Cary Hall

Let's switch gears just a little bit and talk about some of the differences. So Tracy, let's talk a little about the telehealth program because I think our telehealth program this is really funny. I saw an analysis the other day for the carriers are now charging for telehealth, anywhere from $25 to $65 for a telehealth visit. We don't charge for any of that.

00;26;13;23 - 00;26;16;08

Tracy Krause

Right? When you're using our telemedicine.

00;26;16;11 - 00;26;17;05

Cary Hall

MyLiveDoc

00;26;17;08 - 00;26;35;06

Tracy Krause

Correct. And but that's all about preference to. Right. You're going back to that age where they're used to what they're used to that was on the back of their card. We've partnered to provide this free telehealth, right. It's free. But this is the avenue in which you get to seek that care.

00;26;35;07 - 00;26;37;19

Cary Hall

So it's very, very different in that respect.

00;26;37;22 - 00;26;38;17

Tracy Krause

Very different.

00;26;38;17 - 00;26;55;24

Cary Hall

And there's three things we offer here. So first of all there's 24/7 urgent care emergency care. So the analysis I always like to use is, mom comes home from work at 5:30 at night. Johnny's got pinkeye. She's got to put him in the car drive him to urgent care, wait 45 minutes to an hour to see a provider get a prescription.

00;26;55;24 - 00;27;12;07

Cary Hall

Go get the prescription. Drive back home. She's just took two hours out of her day now. It's 7:30 at night. She's dead tired, and she's had to do all of this. Or, if they’re on our plan they can go to mylivedoc, pull up 24/7 a doctor, a nurse practitioner. Johnny sits down in front of the computer.

00;27;12;10 - 00;27;34;18

Cary Hall

Doctor goes, you got conjunctivitis, young man. Here's the prescription, mom. It took 15 minutes. So we think, especially in the rural communities where they have to go a long way back and forth as you just said, Tracy, this can make a big difference. The other thing that we do here is, again, we go back to rural communities. If you find a primary care provider on there that you like, maybe you live in Scott City, Kansas, you don't want to drive.

00;27;34;19 - 00;27;54;10

Cary Hall

Whatever the case may be, you can stay with that primary care doctor in a third piece. And this is really kind of important. I just did a show on this is Ryan Lefebvre, 27 year broadcaster with the Kansas City Royals about mental health and behavioral health. There is a crisis in this country of mental health and behavioral health, especially in young people.

00;27;54;13 - 00;28;14;10

Cary Hall

You know, you see all this, John? You've got two boys now that are grown and out of the house, but I've got six grandchildren, okay. They're not there yet, but they're getting there. I've got one 17 year old and there's a lot of concern about the pressure that's on them with all of these issues on behavioral health, the beauty of this program, these are free.

00;28;14;13 - 00;28;28;02

Cary Hall

There's four free business for everybody in the family. Your son, your daughter's having problems. You know, they're having problems. You can bring up that behavioral health provider. They can sit in a room with the door closed on a computer, and they can go back and forth and talk to them. How important is that private.

00;28;28;02 - 00;28;33;27

John Stockton

The generations all access care differently? I want to be face to face with the doc, my 28 and 24 year olds don’t.

00;28;34;02 - 00;28;35;02

Cary Hall

That's our generation.

00;28;35;08 - 00;28;55;03

John Stockton

They don't want to be face to face. My two boys want to be virtual, so we have to meet members where they're at. The other thing I want to mention, Cary, Tracy mentioned this earlier. The proactive outbound nature of what we do is extremely important because we're engaging the disengaged. The disengaged will cost four times the engage. So our ability to proactively reach out to members is really important.

00;28;55;03 - 00;29;07;27

Tracy Krause

It goes back to that Population Science Management. Right. We're going to have different generations allowing them the ability to access care at different points where it intersects their life.

00;29;07;29 - 00;29;29;18

Cary Hall

Right where they are and what they want. If you want information on GigCare the website is GigCare.net. GigCare.net. The phone number 866-886-2030. 866-886-2030. Stay tuned. We'll be right back after the break with more.

00;29;29;21 - 00;29;33;28

Cary Hall

We're talking about what are you talking about, John? The upcoming what are we calling it?

00;29;34;00 - 00;29;34;28

John Stockton

the Mega Tsunami, Cary.

00;29;34;28 - 00;29;36;19

Cary Hall

The mega tsunami is coming.

00;29;36;24 - 00;29;59;14

John Stockton

Only, fewer than 20 states have finalized their ACA rates. The average projected increase for the ACA and independent of what happens with the subsidies is over 23%. A number of states are well into the 30s. For those losing subsidies, it could easily get into the 75 to 100% range. So some members losing subsidies will literally see their prices double within the ACA.

00;29;59;14 - 00;30;09;00

Cary Hall

So we think that PSM, the Population Science Management offer of the GigCare product, is an alternative that people and brokers really need to take a look at.

00;30;09;03 - 00;30;14;21

John Stockton

A variety of solutions. Aetna, Blue Cross, EPOs, PPOs that are going to meet members needs right where.

00;30;14;21 - 00;30;36;04

Cary Hall

They are 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 have a question or problem, please feel free to reach out to me. I'm happy to help you, in any way that I can. The websites AmericasHealthcareAdvocate.com. If you are interested in the GigCare product, you want to know more about it.

00;30;36;11 - 00;30;56;14

Cary Hall

You think it might be a fit for you, or maybe might be a fit for some people in your company? If you've got 1099 workers that you can't offer any coverage to, this is a great way to introduce them to GigCare. Great way to do it. The website is GigCare.net. The phone numbers 866-886-2030. 866-886-2030.

00;30;56;18 - 00;31;17;11

Cary Hall

Somebody like the lovely Tracy Krause will be happy to help you and talk to you about the plans. Different plans, different sets of plans. You heard Tracy talk about that from Unlimited Med to our Group Benefits side to our Individual side, which is, GigCare. All right. John, let's talk a little bit about this super tsunami a little bit and kind of educate people, I guess.

00;31;17;15 - 00;31;18;25

Cary Hall

Make it easy on me. I'm sorry.

00;31;18;25 - 00;31;45;15

John Stockton

So we've had a number of conversations and most recently a large farmers co-op used the term whiplash is coming. And here's why. So fewer than 20 states have finalized their 2026 ACA rates. We have this shutdown that's really due in large part to subsidies. So people haven't seen their their state's final ACA rates. Most often. They don't know what's going to happen to the subsidies.

00;31;45;17 - 00;32;09;01

John Stockton

So people generally are unaware of this tsunami or this mega tsunami that's on the way. So the term that was used as there's going to be some whiplash when people open their ACA statement. So the thing I want to make brokers aware of is there's a lot of unknown and, naivete, if I can use that word around where things are going with the ACA.

00;32;09;03 - 00;32;14;22

John Stockton

So the beautiful thing about, our offering is they can enroll in GigCare in any month out of the year.

00;32;14;24 - 00;32;17;02

Cary Hall

So there's no open enrollment to open enrollment.

00;32;17;05 - 00;32;35;13

John Stockton

So, ACA is the all around January 1st, right? So we are very busy enrolling people right now, but certainly with this whiplash that's going to kick into effect, people can jump off the ACA whenever they want. And and we're a solution any month of the year. That's that's an important consideration that I wanted to point out.

00;32;35;17 - 00;32;45;02

Cary Hall

Yeah it is. And when the dust settles and we see where we're at with subsidies and all the rest of it, yeah. I think your comment about whiplash is, is spot on.

00;32;45;05 - 00;32;47;10

John Stockton

Yeah. So brokers need to educate what's going on.

00;32;47;12 - 00;33;01;05

Cary Hall

And again, you know, you're a broker out there. This is something you really ought to take a look at. It's going to make a difference for you. It's going to make a difference for your client and maybe their clients out there. You can't you have not been able to get in the door to talk to them because you didn't have a product to offer.

00;33;01;10 - 00;33;17;07

Cary Hall

You do now, okay. It's called GigCare. The website is GigCare.net. There are a couple of things I want to touch on, though, that are a little different. What we do. We like to say that we offer some different benefits. Benefits that are not the same as what are on the ACA plan. So we have a program called Green Imaging.

00;33;17;10 - 00;33;33;17

Cary Hall

And if you need an MRI or a CT scan, you can get a voucher from us from Green Imaging. And you're going to go to an independent imaging center. And you're going to get that MRI and that CT scan done, and you're not going to pay anything for it. That's right. No deductible, no co-insurance and no co-pay.

00;33;33;21 - 00;33;54;15

Cary Hall

That's part of what we do. We're different than ACA because we can do things that the ACA plans can't do. Some of the other things we do we do drug importation. So we have three different programs we can help people with on drug importation, and foundational assistance, if they have a very expensive med like a growth hormone, that they that they can't afford.

00;33;54;22 - 00;34;10;20

Cary Hall

We have a foundational assistance program. You know, who does all that paperwork, all of our nurses at Script Aid. We don't put that back on the client as Tracy says, we're there to serve the member, and that's what we do. So those are a couple of things very different about us. We talked a little bit about mylivedoc.

00;34;10;20 - 00;34;30;15

Cary Hall

We think it's a great program. Again, there is no copay when you use mylivedoc, whether it's mental health, urgent care or just primary care, there is no co-pay. And then we have another program for diabetes. And if you're a diabetic, we're going to enroll you and Diet Thrive. That program is going to make sure you got your A1C.

00;34;30;15 - 00;34;51;06

Cary Hall

They're going to make sure if you're taking metformin is being drop shipped to your door, or you're getting it and you're taking your medication so that we're managing the disease. You know, John, how important is it to manage chronic disease in terms of, you know, giving people what they need, but being able to keep cost under control because you're being proactive, not reactive?

00;34;51;07 - 00;34;51;19

Cary Hall

Yeah.

00;34;51;22 - 00;35;16;14

John Stockton

No, that's, for us to help our clients and our members to be engaged, Cary, doing the things they know they're supposed to be doing. We’re the most obese country in the world. So coming alongside plan sponsors, employers, members to really help them engage in a path to a journey of wellness is extremely important. And what we do now is going to show when we get further down the path in our years.

00;35;16;16 - 00;35;43;21

Cary Hall

Yeah, it is, and it's critically important that we do this in a way that serves people, and gives them that opportunity for these plans that are going to make a difference for them because they are different. Yeah, we're we're serving different pieces in the marketplace. And we think that if you're one of those folks out there looking for this kind of coverage, and you, as John has said and as Tracy has said, you know, there is a maga tsunami on the coming. It's going to have a tremendous impact in this country on a lot of folks.

00;35;43;23 - 00;36;03;08

Cary Hall

Our plans, we think are more affordable. You'll see that when you actually look at the plans and different plan designs, they're more flexible. We have far more designs and opportunities than what are offered on ACA because we can because we're regulated differently than ACA is. We're regulated by the Department of Labor under the ERISA laws.

00;36;03;13 - 00;36;25;12

Cary Hall

So we're compliant with all of that. But it makes it different for us in terms of the product we offer. So if you're the broker out there and you're looking for something to serve a marketplace, and I'll give you a couple of examples we have, what do we have five different initiatives with major real estate firms going on right now, from Reese Nichols to, I mean, go down the list, Better Homes and Gardens.

00;36;25;12 - 00;36;42;26

Cary Hall

So we've got a whole series of, and we've got associations of realtors where they're the Missouri Association or the Kansas or the Iowa, whatever it is. Okay, that are happy to have this product because these realtors, you know, have been on ACA and I'll give you an example one, before we close out the show here, the gentleman was 52 years old.

00;36;42;26 - 00;37;04;13

Cary Hall

He worked at Reese Nichols. He has a wife and one child is paying $3,100 a month. He moved to the GigCare plan on an HSA with a $5,500 deductible, and he dropped his cost of $1,400 a month. Better plan, better price, better opportunities. That's what GigCare offers. If you want information on it, go to the website GigCare.net.

00;37;04;16 - 00;37;29;21

Cary Hall

That's GigCare net. The phone number 866-886-2030. 866-886-2030. If you're a broker, you owe it to yourself to take a look at this. If you're an employer out there and you've got those 1099 employees and you have nothing to offer them, this is an opportunity. If you're an association looking for a way to offer something to the members of your association, this is a great opportunity.

00;37;29;21 - 00;37;35;17

Cary Hall

And we've got a lot of associations now, John, that are that are engaging with us to offer this plan across the country.

00;37;35;24 - 00;37;39;12

John Stockton

Yeah. Again Mega Tsunmi, take the high ground and we’re the high ground Cary.

00;37;39;13 - 00;37;41;17

Cary Hall

Yeah, we do believe we are the high ground. Okay.

00;37;41;17 - 00;37;48;11

Tracy Krause

Population Science Management has those plans that we're going to fit each one of your individual client's needs.

00;37;48;17 - 00;38;07;01

Cary Hall

So again and I urge you, if you want information go to the website gigcare.net or call 866-886-2030. And now I leave you with this thought from Albert Einstein, the one who follows the crowd they usually get no further than the crowd, the one who walks alone is likely to find himself in places no one has ever been.

00;38;07;03 - 00;38;24;16

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;38;24;19 - 00;38;31;13

Unknown

A better way to handle your Association’s Health Insurance Benefits for both W2 and 1099 workers

Fri, 19 Dec 2025 22:01:05 GMT

Episode 2139 notes

Today we are talking with J ohn Kuhlmann, Lauren Broyles and Josh Bowman from the Kuhlmann Group.

If you've ever wondered how your Association can get health benefits and how would that work? Or maybe you've got a large group plan and you'd like to figure out a better way to handle your health insurance benefits, that is our topic on this episode. Most importantly, listen and learn today, as we talk about how an association can actually offer health benefits, especially if you've got 1099 employees.

This is Ep 2139 of America's Healthcare Advocate.

To learn more about GigCare , the Kuhlmann Group and health benefits for 1099 workers as well as W2 employees: 314-494-7860 and visit https://kuhlmannfin.com

We’re discussing a better way to handle your health insurance benefits

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Listen to this episode.

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Watch on Rumble:

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2139 Transcript

00;00;00;07 - 00;00;21;10

Cary Hall

Coming up in today's show, America's Healthcare Advocate, we're going to be talking with John Kuhlmann from Kuhlmann Group, as well as Lauren Broyles and Josh Banwart his associates that work at Kuhlmann Group, with them. If you've ever wondered how would my association get health benefits, how would that work? Or maybe you've got a large group plan and you'd like to figure out a better way to handle your health insurance benefits.

00;00;21;12 - 00;00;34;27

Cary Hall

You can do that by talking with these folks. But most importantly, listen and learn. Today, as we talk about how an association could actually offer health benefits, especially if you've got 1099 employees.

00;00;35;00 - 00;00;39;07

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;39;09 - 00;00;46;24

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network.

00;00;46;29 - 00;01;08;21

Cary Hall

My producers today, Mr. Garner Cowdery behind the microphones. And Mr. David Thiessen behind all the cameras. The man who post all these shows up on our podcast and YouTube channel, by the way, 608,000 views now, thanks to all of you out there in the listening audience. On the podcast channels, all 16 of them in our YouTube channel, and we have a new affiliate.

00;01;08;29 - 00;01;30;13

Cary Hall

We'll talk about that a little later on in the show if you have issues, if you have questions, if you need help with something, you can go to the website. AmericasHealthcareAdvocate.com. AmericasHealthcareAdvocate.com. Send me an email. Yes, I get a lot of them. But yes, I answer each and every one of them. So feel free to send me an email if you need any help with something. We're happy to help you.

00;01;30;16 - 00;01;46;28

Cary Hall

In studio with me again today. John Kuhlmann, CEO of Kuhlmann Group. And you brought a few associates today. All right. So we have Lauren Broyles, who is your vice president director of operations. And I have Josh Banwart, who is also a financial advisor with Kuhlmann Group. So welcome all three of you. Happy to have you here.

00;01;47;05 - 00;01;48;03

Cary Hall

You're an old pro at this

00;01;48;08 - 00;01;48;21

John Kuhlmann

Thanks, Cary.

00;01;48;23 - 00;01;52;29

John Kuhlmann

Yeah, I’ve been doing it since 1991. So a long time ago when I started my firm.

00;01;52;29 - 00;02;09;00

Cary Hall

Yeah. So so let's talk a little bit about that because what you do is a little different, than what I see out there with a lot of brokers. What you do, you, you, I think you kind of, you kind of specialize in this association management, association health benefits and all. The other thing is you go with association management.

00;02;09;00 - 00;02;28;04

Cary Hall

So it's a different corridor. We're working with you, with the GigCare program, some of the programs on that for 1099 and self-employed. But let's talk about how you got into that and what you do there that makes you so different than everybody else. Because I've been doing this for 23 years and the first person I ever ran across it does this like you do.

00;02;28;06 - 00;02;50;04

John Kuhlmann

Thanks, Gary. So in, 2019, we started working with one of our clients, and, we, basically saved them $1.4 million just on their health insurance and another $120,000 on their ancillary coverages. And at the time, they were the with the 13th largest consulting firm in the country. And, they had been with them for years.

00;02;50;06 - 00;03;06;07

John Kuhlmann

And, the line that they gave them on every renewal was, well, medical trends running around 8 or 9%. So it's a fair increase. You should just take it. And they don't even really show the group out when they do. They don't really do an adequate job. And that's pretty much what we see on most groups that we work on.

00;03;06;09 - 00;03;25;26

John Kuhlmann

So, we don't take that approach. We actually go to market on every line of coverage with every carrier. And there's a big reason for that. There's a lot of value in the TPA’s that we go to. TPA stands for third party administrators, whereas you hear about the BUCA’s. Those are all the big publicly traded insurance companies.

00;03;25;26 - 00;03;45;26

John Kuhlmann

So their motivations are different than the than the TPAs. The TPAs are privately owned, and because they're privately owned, their whole focus and goal is to drive the most affordable health care with the best benefits possible to the members. So for this client, not only did we save him the 1.4 million on their health, 120,000 on their ancillary, but we also improved all those benefits.

00;03;45;28 - 00;04;03;04

John Kuhlmann

The next thing is, is that we after we did that, the CEO shared with us that he has an association. And at the time they had over 3000 dues paying members. Before we were in the picture, they had over 3000 dues band members. When we came into the picture, they had shrunk down to 850 dues paying members.

00;04;03;07 - 00;04;19;26

John Kuhlmann

So there's they were like, do you think you could do this for our customers and help them? Because it would create a lot of goodwill for our customers and help us help our customers. And, absolutely said absolutely. So we did that in about two and a half years later, they're back up to about 3500 dues paying members, which is tremendous growth for the association.

00;04;20;03 - 00;04;36;12

John Kuhlmann

We're not the only reason why that happened. Their executive director, was a big part of why that happened, too. But, with our programs and our that are very comprehensive, we helped basically do that and we in turn have also saved a lot of their clients five figures, on their benefits. Also.

00;04;36;15 - 00;04;53;20

Cary Hall

You know, if you're listening to this and you're wondering maybe you're a member of an association. Maybe you're just a member of an association, maybe you're a director, maybe you're a CEO. Or maybe you're someone thinking about what you want to do, and we'd like to have an association, but we'd like to talk about maybe we can do health benefits.

00;04;53;23 - 00;05;15;03

Cary Hall

Well, there are a lot of hoops you have to go through, and there are certain ways it has to be done that what you need is a knowledgeable expert. And that's what Kuhlmann Group is and that's what I'm listening to you. That's what you're demonstrating to the audience. That's why I wanted to do this show today. There is a lot of need in the marketplace right now, especially when we talk about the 1099 self-employed space.

00;05;15;03 - 00;05;32;17

Cary Hall

We'll get into that a little later in the show. But the idea of innovation, that's what Kuhlmann Group brings to this. And if you are in an association and you don't have benefits for health care. These are the folks you want to talk to because that's what they do. So talk about you've got a pretty long list of everything you do here.

00;05;32;17 - 00;05;52;13

Cary Hall

I was just doing show prep about 4:30 this morning. Was ramping up and I worked on this yesterday as well. But the point is, you know, I'm seeing everything on here from critical illness to financial advisory to payroll to individual voluntary benefits. And it goes down the list. I'm guessing, Lauren, you probably have a lot to do with how all that happens.

00;05;52;18 - 00;05;55;21

Cary Hall

Yeah, it actually does the work. If I had to guess.

00;05;55;24 - 00;06;14;27

Lauren Broyles

Yeah. So I actually talk with a lot of the customers and to speak on the Association John was talking about. A lot of the members, they're little mom and pop shops. So this has brought a solution to those mom and pop shops where they don't know where to turn, where it might just be a husband-spouse group, and they need access to benefits.

00;06;14;27 - 00;06;24;26

Lauren Broyles

So this has been a huge, you know, basically solution to them to get needs met for their employees and put benefits in place.

00;06;24;29 - 00;06;32;05

Cary Hall

You know, so John, that's interesting. Lauren brings that up because the most underserved everybody wants to do the 500,000 life case.

00;06;32;08 - 00;06;33;00

John Kuhlmann

We want to do that too.

00;06;33;00 - 00;06;50;16

Cary Hall

Oh I know but it's the 1 to 50 that in this marketplace are getting killed with these huge increases. You've talked about this before that are coming across on the ACA type plans. All the rest of it. And as Lauren said, it's a mom and pop shop. Maybe they've got you know, I'm a 27 year recovering broker.

00;06;50;22 - 00;07;11;07

Cary Hall

Okay. Right. And I remember going into place that there be ten, 11, 12 employees and they're getting killed on cost. One of the things that you're doing with your association management is bringing them solutions like that. So talk a little bit about that. I know you're doing the GigCare program, consumer data respondents with the folks with our company of Population Science Management out of Nebraska.

00;07;11;14 - 00;07;18;07

Cary Hall

But talk about Lauren just mentioned that giving them access to something they can't find in the marketplace that you're doing. Right.

00;07;18;09 - 00;07;34;14

John Kuhlmann

So on all size groups, basically what we bring to the table is a full array of benefits. And on anything we do, we make sure that we check all of the options that any client could have for everything. So when you look at these smaller companies, many of them can't even afford to provide health insurance to their members.

00;07;34;19 - 00;07;51;17

John Kuhlmann

That's why we brought in the GigCare solution, the 1099. Right. You also get some employers will. What we found is a lot of employers are outsourcing their IT because the it doesn't want to be an employee. They want to work for other companies and help multiple companies. But some employers want to be able to cover those 1099 people.

00;07;51;17 - 00;08;13;08

John Kuhlmann

So we have two solutions for that. We have the GigCare, but we also have in particular one TPA that will literally allow you to cover 1099 people in addition to your regular W-2 people. It's really a wonderful program. It's probably the best health care program out there for groups. It's not probably it is. So we have a lot of groups that we've been able to put with them and literally not have the rates change in three years.

00;08;13;10 - 00;08;28;03

John Kuhlmann

And actually, we just had one of our larger groups with 600 employees and their third year of no increase. The rates actually went down in their third year and their benefits stayed the same. So it's really powerful stuff. In addition to that, they bring powerful solutions to the table for PBMs.

00;08;28;05 - 00;08;29;26

Cary Hall

Pharmacy Benefit Managers. Yes.

00;08;29;26 - 00;08;53;00

John Kuhlmann

Okay. So the prescription drug side of their plans basically they do some great innovative stuff on that, just like GigCare does on its pharmacy side for its individual members. They basically are able to get the drugs that are name brand drugs for individuals, high cost drugs, typically at no cost or low cost for the member. Whereas under if you're with one of the large insurance carriers, basically you're usually paying your out-of-pocket max for it.

00;08;53;03 - 00;09;12;26

Cary Hall

Yeah you are, that, you're coinsurance and maybe some the deductible depending on the plan. So when we come back from the break going to talk more about this. And then in the third segment we're going to talk about how Kuhlmann group actually offers financial planning help to a lot of members as well. And Josh will talk to you about that. If you want information, maybe you're curious about how did they do this?

00;09;12;26 - 00;09;35;08

Cary Hall

Or maybe you've got an association or co-op or whatever the case may be, and you're looking for a solution, or you'd like something that would help members like was just described by what John talked about. 314-494-7860, So anywhere in the country, they're happy to help you. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across USA.

00;09;35;09 - 00;09;47;22

Cary Hall

Don't go anywhere. We've got more.

00;09;47;24 - 00;10;13;25

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate Show broadcasting coast to coast across USA here on the HIA Radio Network. You can find out more about us by going to the website. All the information is up there. Shows are also posted there on all 16 podcast platforms, and our YouTube platform. I want to welcome our newest affiliate in the Ozark Mountains, KWPN, 1440AM and 105.1FM, in West Plains, Missouri.

00;10;13;28 - 00;10;33;01

Cary Hall

We want to thank Jim Lambert. He is the, station manager, putting us on the air and welcome them to the America's Healthcare Advocate family. We're happy to be on up in the mountains in the Ozarks. Thank you for joining America's Healthcare Advocate. John, let's talk a little bit more about what's interesting to me is that you guys look for solutions that other people just don't seem to take the time to look for.

00;10;33;06 - 00;10;48;12

Cary Hall

You made that comment about brokers. Brokers go in and show a spreadsheet and say pick the least evil on the spreadsheet, as opposed to, the way you're doing it, which is: Here are the problems. What are your needs and how do we find a solution?

00;10;48;12 - 00;11;10;07

John Kuhlmann

Right. So one of the things is, we have a true passion for what we do, and we outwork everybody. And we don't come back and tell any client ever. Hey, you just got a 10% increase in medical. Inflation's running around 9 to 10%. So you should just take it because it's fair. You'll never hear that from us. As a matter of fact even if our groups get a rate decrease on the renewal that that happens sometimes it's rare.

00;11;10;10 - 00;11;18;13

John Kuhlmann

You know, we still we still shop them out. And the reason for it, it's the second or third most expensive line item that any company has. And for a few companies, it might even be the most expensive.

00;11;18;13 - 00;11;19;23

Cary Hall

Yeah, absolutely.

00;11;19;25 - 00;11;37;28

John Kuhlmann

So we always make sure we do that. And we do that on every line of coverage. Because basically what we found is even on the ancillary, most brokers do what's best for them, not what's best for the client. Why I'm bringing that up is, as a consultant, we know that the health insurance drives the relationship between the client and the broker, the consultant.

00;11;38;01 - 00;12;01;05

John Kuhlmann

So unfortunately, for most folks, once they pick the health insurance, the broker just puts them with who usually is best for them. And we don't do that. We shop everybody on the ancillary like we do on the on the health insurance side. And then we also add in a Ben Admin system and, basically help the employees with an enrollment platform and we automate all that with the payroll so that there's less administrative work to do.

00;12;01;08 - 00;12;05;02

John Kuhlmann

Lauren. Lauren handles that for us with our clients on a regular basis.

00;12;05;05 - 00;12;18;27

Cary Hall

Talk about that, Lauren. How do you handle that? And I noticed when I was going to all the materials you're doing everything from payroll. We're going to talk about financial planning in the next segment. You know, all the other things that you do. Critical illness, Clever Rx. Tailored 1099 Contractors.

00;12;18;27 - 00;12;20;22

Cary Hall

Talk about how all that works.

00;12;20;24 - 00;12;52;14

Lauren Broyles

Yeah. So I handle the administration side. So I'm everywhere from the implementation to the service. So my job on customer service is to make your HR teams life easier. We service all size groups. So maybe your lack of an HR team. So I help make sure that everything streamlines from your payroll to the benefits to the carrier side. So, like John was speaking on, we still have some people that we come across that are still using paper enrollment forms to enroll their, employees at renewal time, which is just insane.

00;12;52;17 - 00;13;14;15

Lauren Broyles

There's so many solutions out there. We like to put in Ben Admin Systems. It makes the HR teams life easier because things are automatic. When you leave things up to paper or in a person's hands, there can be, you know, human error when that happens. So making it more streamlined. So it's on EDI connections eliminates errors that can occur.

00;13;14;16 - 00;13;33;20

Cary Hall

We had Kenny Delco on, a couple times and talked about what you're doing with NHRA, an association you're working with. National Hot Rod Association. Kenny has a saying that he does that’s part of the GigCare discussion. He said, “a company built for hard working Americans”. And you have a saying that “we're Main Street, we're not servicing Wall Street”.

00;13;33;24 - 00;13;34;16

Cary Hall

What does that mean?

00;13;34;16 - 00;13;46;20

John Kuhlmann

What? So we always, share with folks that we're all about Main Street, not about Wall Street. And what we mean by that is a lot of the bigger consulting firms, they literally are working with the big carriers

00;13;46;21 - 00;13;47;08

Cary Hall

The BUCA carriers.

00;13;47;08 - 00;13;57;24

John Kuhlmann

The BUCA carriers, most of them publicly traded. And like on prescription drugs, they, some of them even get cuts off all the prescription drugs that the member takes, when they're already overpaying.

00;13;57;24 - 00;14;15;23

John Kuhlmann

They're getting the rebates. So the a lot of the privately owned TPAs, third party administrators that we work with, they'll literally cut the, the rebates out of the plan and get the drug to the member, or either low cost or no cost helping the member also dramatically lowering the cost of the drug. You take a drug like Humera, it's about $8000 a month.

00;14;15;28 - 00;14;17;01

Cary Hall

Yep.

00;14;17;04 - 00;14;22;11

John Kuhlmann

A lot of the bigger carriers will tell you, though, that it'll only cost you 4500 to 5000 a month for the drug.

00;14;22;14 - 00;14;29;11

John Kuhlmann

And their right, if you go through them. Yeah. What they don't tell you is that they're getting a rebate of about $2,500 a month on that drug,

00;14;29;13 - 00;14;32;15

John Kuhlmann

Every month on every member on the drug.

00;14;32;18 - 00;14;45;29

John Kuhlmann

It's insane. So the TPAs we work with, they cut all that out, and they either get the rebate eliminated to lower the cost of the drug by the cost the rebate, or if the pharmaceutical company insists on paying the rebate, they put it back in the client's claim bucket typically.

00;14;46;02 - 00;15;04;19

Cary Hall

Or like Detego, when you work with our company, Detego Health, our TPA, we have our own program called Script Aid and we just import the stuff. Right. And if you're taking Humira and we're importing it, you're going to pay a lot less than what you're going to pay any of the major carriers, that's for sure. I don't think a lot of the public really understands this.

00;15;04;22 - 00;15;21;18

Cary Hall

And it's understandable. This is not. Look, health care is confusing as hell. Okay. Believe me. As I said, I've been doing this 27 years. It's not an easy topic for people to wrap their head around, but what you're hearing is when when you want to do something like this, you need an expert. And that's what these people are.

00;15;21;24 - 00;15;27;03

Cary Hall

And what you're talking about is solutions that are out of the box. Right. Okay. And they take work.

00;15;27;10 - 00;15;44;09

John Kuhlmann

Right. It's a lot of work. Yeah. But we put it in. Yeah. We just won a group of 100. And there was two other firms that we were up against and a new client for us. We picked them up. And their existing consultant had been with them for around 35 years.

00;15;44;11 - 00;15;45;20

Cary Hall

That's a long time.

00;15;45;20 - 00;16;02;28

John Kuhlmann

And we replaced them and, saved the group, basically well over six figures just on their medical. So we're going to be bringing other great solutions in to automate things and make them more efficient, improve things too. But we really do try to bring a whole package, approach to everything we do, but related to benefits.

00;16;02;28 - 00;16;25;22

John Kuhlmann

So another big area that we run into is people on their payroll. So we don't sell payroll, but we have some very good partners on that that are literally technology companies that do payroll. They dramatically lower the cost of the payroll, and they significantly improve and make it more automated. And then that ties back into the Ben Admin System that Lauren was talking about.

00;16;25;25 - 00;16;32;23

John Kuhlmann

To give you an idea, we have a group of 100, in the state of Washington just on their payroll. We saved them $480,000.

00;16;32;25 - 00;16;33;17

Cary Hall

That's insane.

00;16;33;17 - 00;16;42;29

John Kuhlmann

Yeah, we saved them close to another hundred thousand on their, medical. And then we saved them about 20 grand, maybe 25 grand on their 401K.

00;16;43;03 - 00;17;06;13

Cary Hall

Those are all the things that contribute to making a difference. And that and that is critically important. You know, unfortunately, in today's world, as you talked about, you know, the a lot of the big houses, the big the big brokers, the big insurance carriers, they don't look at things quite like that. Right. It's the medium small size broker in your case, you know, you're pretty large firm, but you're still taking to heart what needs to be done for the client.

00;17;06;13 - 00;17;13;18

John Kuhlmann

We're actually bringing to the table solutions that the big consulting firms can do, but typically don't do.

00;17;13;18 - 00;17;14;21

Cary Hall

They don't want to be bothered with it.

00;17;14;21 - 00;17;30;01

John Kuhlmann

I can't tell you how many groups of two and 3000 I know of that are with one of the big name box house consulting firms. They don't even shop the groups out. It's it's literally criminal that they're getting away with this. But people think they need them. They think they need an army. All they are doing is overpaying for all their benefits.

00;17;30;01 - 00;17;46;14

John Kuhlmann

They're harming their employees. They're not really meeting their fiduciary duty to protect them. With things like the prescription drugs, they're not shopping it out adequately, doing what they should do. So we bring all those solutions to the table. And I can just tell you that we normally get every group we quote on. Yeah. And I was saying I.

00;17;46;15 - 00;17;47;12

Cary Hall

Would imagine you do.

00;17;47;12 - 00;18;02;00

John Kuhlmann

And the thing I would say is it's all about the data. If you will give us the data we need. The other thing we don't do, we don't do what the big consulting firms do. We don't make you sign a contract saying that you'll go with us no matter what and pay us. We'll just do our work and you can choose to go with us or not.

00;18;02;00 - 00;18;05;16

John Kuhlmann

We live off the merits of our work, so. And we normally win every time.

00;18;05;18 - 00;18;26;07

Cary Hall

It's a great solution. If you want information, you're you're fascinated, you're intrigued. What you're hearing here, can they really make a difference. Well you’re not going to know if you don't reach out to them. So if you want to contact John 314-494-7860. 314-494-7860. So if you're on the podcast or looking on YouTube, the number, the website is across the bottom of the screen.

00;18;26;07 - 00;18;49;21

Cary Hall

You can look at that as well. We'll be right back after the break. We're going to get in the weeds a little bit now and talk about some of the other things that they do on the financial planning side and some of the others. Stay tuned. We'll be right back after the break here on America's Healthcare Advocate.

00;18;49;24 - 00;19;10;07

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate Show broadcasting coast to coast here across the USA. If you want help or information, go to the website AmericasHealthcareAdvocate.com. Send me an email. I am happy to help you. My producer today, Mr. Garner Cowdrey, Mr. Dave Thiessen, doing a wonderful job as they always do. Broadcasting here out of our studios in Overland Park, Kansas.

00;19;10;12 - 00;19;33;05

Cary Hall

My guests in studio today. John Kuhlmann, the founder and CEO of Kuhlmann Group, Lauren Broyles he's the senior VP that does all the real work behind the scenes that John doesn't do. And that's adviser John Banwart, who's going to talk today about the financial advisor services they offer through Kuhlmann Group. So you know, people are listening to this and they're going, well, we were told “Associations” couldn't offer health benefits.

00;19;33;08 - 00;20;00;01

Cary Hall

They were told associations couldn't have health benefits. And there's that. I'm not saying that's not true, but there are there are ways to make this work, especially like talk about some of the associations. I mean, you've got over 750,000 people who are working with us on the GigCare program on right now, offered through PSM Nebraska are standalone and if they're willing to be a consumer data respondent, they have access to this large group plan.

00;20;00;03 - 00;20;05;16

Cary Hall

Talk about how people access that if they if they're like, what can we do that.

00;20;05;19 - 00;20;26;13

John Kuhlmann

Yeah. So the big thing is, is if you... Even if you have an association plan now, a group plan for your groups and associations, the problem with it typically is after the first year or two, what you typically see happen is the groups that are in it that are sick stay, and then the healthy groups leave because they can find insurance cheaper on their own.

00;20;26;13 - 00;20;27;16

Cary Hall

It’s called the death spiral.

00;20;27;17 - 00;20;45;03

John Kuhlmann

Yeah. And that's just very typical of what associations have happened. So we do things differently. And basically what we do is we bring in a solution like GigCare for the individuals that want to go on to the GigCare program, wonderful program. And then we also bring to the table group plans, but we broker that out.

00;20;45;03 - 00;21;04;19

John Kuhlmann

We consult with each group depending upon their size, on the health insurance and on the on the groups. And we broker that out with the different companies. And we check every company that's available in the market for where that group is located and headquartered. We also do it on all the ancillary coverages. We also provide financial advisory, including 401Ks and pensions.

00;21;04;22 - 00;21;21;12

John Kuhlmann

And one of the innovative things we do is we, have a PEP program when it's appropriate. And, we can show that to members, but we typically evaluate everything, even on that and all their options on the 401K to look at. And then Josh, we have Josh to work with on individual financial advisory and other things.

00;21;21;14 - 00;21;41;27

Cary Hall

So Josh, talk about what you do in your role here. In terms of financial advisor, we talked before the show and you're actually helping members. Let's say you've got a member of an association, he's turning 65 or 66 or she's turning 65, 66. They've had a 401K. They've got money sitting there now they're going to retire. What do I do with it?

00;21;41;27 - 00;21;54;25

Cary Hall

How do I invest it? This market's all over the place. Up 400 points one day down a thousand another. I know because I'm in it. So how do you handle that in addition to the 401Ks? Josh.

00;21;54;25 - 00;21;57;15

Josh Banwart

Yeah, absolutely. How do we retire and stay retired?

00;21;57;15 - 00;21;58;16

Cary Hall

Right. I like that's.

00;21;58;17 - 00;22;22;04

Josh Banwart

Kind of the key out there. Yeah. And generally we'll just assess a few key risks of running out of money. And how can we, make sure that, you know, that doesn't occur in your, your spend down? Also, there's often questions around estate and hand off, legacy. It's all complimentary to the 401K and the qualified plans and at Kuhlmann Group are just really trying to bring a collaborative, service right in into the mix.

00;22;22;04 - 00;22;45;12

Josh Banwart

We don't want to just be pigeonholed into one area. So, a lot of times it's it's just kind of assessing those key risks. One being inflation. How do we keep up? Generally the answer is the market. Yeah. That's uncomfortable. Right. So we place sometimes market based solutions. But then we've got to have some level of cash or guaranteed position that isn't going to be fluctuating in bad markets.

00;22;45;15 - 00;23;02;10

Josh Banwart

Generally the third one is the risk of a long term health care event. We say it's a flip of a coin 50/50, right? You or your spouse. And generally you're going to have something if you don't have a plan. The state has a plan for you. So we we generally like to have control as well. And then the last one is, is the one that makes everything else worse.

00;23;02;10 - 00;23;03;13

Josh Banwart

It's just longevity.

00;23;03;15 - 00;23;14;14

Cary Hall

So go to that long term care thing for a second. Because I'm gonna throw an interesting statistic at you. How many people in this country, lets see if any of you can answer this, have long term care insurance, give me a percentage.

00;23;14;22 - 00;23;16;02

Josh Banwart

I would guess less than 10%.

00;23;16;03 - 00;23;38;10

Cary Hall

It is less than 10%. You got 100% correct. Now I'm one of the ones that has had long term care since he was 45 years old. Okay. And and I, like Laurie and I still have that same plan in place. But the point is, and you touched on that, that if you don't have a long term care plan, you're going on Medicaid or you're eating into your estate to pay for long term care.

00;23;38;10 - 00;23;54;28

Cary Hall

So that's interesting that you touched on that. So talk a little bit about what are they looking at cost wise if they don't have a long term care plan to be in a halfway decent facility, not a medicaid facility where there's two people to a room, one shared television and a bathroom, they both get to share. That's a lot of fun, I'm sure.

00;23;55;00 - 00;24;03;22

Cary Hall

Okay. And the first thing you notice when you walk in the door is the smell of Pine-Sol. You know, you're in a medicaid facility. Talk about what it means to get into a decent private facility.

00;24;03;23 - 00;24;15;12

Josh Banwart

Yeah. So, I did a lot of studying on this. I actually pursued a credential specifically in long term care. And the reason is, is because it's a huge issue. There used to be a lot of companies in the space.

00;24;15;12 - 00;24;16;12

Cary Hall

There's not now.

00;24;16;12 - 00;24;36;09

Josh Banwart

Now there's about 11. And there's I certainly wouldn't sell all 11. Right. You know, when we when we step into that space. So you've got to be careful in evaluating that, and not overpaying. But there's, there's generally not to get too specific here, but there's generally three ways to solve it. One is you just take cash and put it on the sidelines, invest it, but it's protected.

00;24;36;11 - 00;24;53;17

Josh Banwart

That's the most expensive way. Right? Two would be some, some level of kind of basic long term care. You use it or lose it, you know, you pay for it. It's kind of like car insurance. We don't hope that we get in an accident. Right. But if we do, we're sure glad we have it. And the third is some sort of hybrid where we'll use.

00;24;53;20 - 00;24;56;06

Cary Hall

Life insurance to buy long term care.

00;24;56;08 - 00;25;01;27

Josh Banwart

And so what what the best option is, is generally dependent upon the individual, and their circumstance.

00;25;01;27 - 00;25;08;25

Cary Hall

But so give me an average cost that, you see for a decent long term care facility. But I'll tell you what my benefit is after you do that.

00;25;08;25 - 00;25;24;24

Josh Banwart

Yeah. So, so the average cost and depends on your state. Yeah. In the state of Missouri around Saint Louis is about $4,500 a month. That's right. And that's the average. Right. So if you have a more skilled nursing type facility, it's going to be well in excess of that memory care is, I think, maybe the most expensive it is.

00;25;25;01 - 00;25;25;20

Cary Hall

Yeah.

00;25;25;23 - 00;25;28;25

Josh Banwart

And and generally we'll see that close to ten grand a month.

00;25;28;25 - 00;25;45;25

Cary Hall

So my benefit right now is $300 a day and Lori’s is $300 a day, which wouldn't cover the cost of what he's talking about, it's gone up every year. It did not. Policy's gone up, but not every year. But the the benefit has held and and we're very fortunate to have it. And luckily I'm you know I'm if we're in enough we're in decent shape to it.

00;25;45;25 - 00;26;03;19

Cary Hall

If there's a difference we pay for it. The problem is it's less than 10%. What's interesting is, John, you're doing this as an association manager. How many people are there, do you think even know this is going to be an issue. Or they think here, oh, Medicare is going to pay for this. I don't have to pay.

00;26;03;21 - 00;26;26;18

John Kuhlmann

Most people, from my experience, don't they don't even think about it, though. Yeah. A lot of people don't even have a will. You know, one of the first things we talk to people about is basically, you know, do you have your state set up properly and just making sure that everything's proper, it's everything we do is really individualized to each customer, whether it be an individual, their needs, it's their individual needs.

00;26;26;18 - 00;26;42;16

John Kuhlmann

We want to make sure those are all covered properly. It's not peddling products or pushing stuff. It's about helping people doing the right thing. We do the same thing with the groups. It doesn't matter if you're a group of two or if you're a group of 5000. Anything in between. We're going to do that on everything we do, on every line of coverage, every every product or service.

00;26;42;16 - 00;27;02;24

Cary Hall

But you're able to if again, people are listening to this all over the country, they're they're watching me on the on the YouTube channel or on the podcast and they're going, well, we have an association, but we don't do any of that. And you gave that story earlier about membership declining and how when you turned it back around the associations have to be able to offer a reason for somebody to be there.

00;27;02;24 - 00;27;06;03

Cary Hall

Right? Right. And is that what you're helping them do?

00;27;06;04 - 00;27;25;24

John Kuhlmann

We drive that value? We're basically bringing, fortune 500 type benefits solutions, complete benefit solutions to small group and medium sized groups. Doesn't matter the size of your group. We're going to do all we can to provide the best value for all your benefits. Unlike they've ever seen before with any other firm. It's just we do.

00;27;25;24 - 00;27;27;13

Cary Hall

You’ve got a commitment to excellence and customer service.

00;27;27;15 - 00;27;32;07

John Kuhlmann

We have a passion for it. We truly care about our customers. I guess you could say we're old school.

00;27;32;09 - 00;27;33;07

Cary Hall

Yeah.

00;27;33;09 - 00;27;34;10

John Kuhlmann

We do what we say we're going to do.

00;27;34;10 - 00;27;38;02

Cary Hall

At 76 years of age that’s something. There's nothing wrong with old school folks.

00;27;38;07 - 00;27;39;27

John Kuhlmann

Well I’m 60. So I'm with you.

00;27;39;28 - 00;27;44;00

Cary Hall

You got a long way to go, pal. You're very young. And then we have these two over here.

00;27;44;03 - 00;27;44;26

John Kuhlmann

The youngsters?

00;27;44;29 - 00;28;01;18

Cary Hall

Very youngsters. Absolutely. If you want information, you want to reach out to John. You maybe you'd like to explore some of this. The way to do it is to give him a call. 314-494-7860. 314-494-7860. So there's a reason he's on here today is to educate you.

00;28;01;18 - 00;28;21;21

Cary Hall

That's why we do these shows to educate you on what you can do to help yourself. If you're in an association, you want to start an association, whatever the case may be, these people are experts and they're happy to help you. And if you're an employer with a small group or a large group, they're right there, okay? And they're offering solutions you're not going to find on a lot of the large carriers.

00;28;21;21 - 00;28;51;06

Cary Hall

So it's significantly different the way they do it. Once again, the phone number 314-494-7860. So when we come back from the break I'm going to talk about what do you do if you've got W-2 employees, but you've also got 1099 employees. We'll talk about that. Stay tuned. We'll be right back after the break here on America's Healthcare Advocate, broadcasting coast to coast across the USA.

00;28;51;09 - 00;29;12;20

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. Got a question? Send me an email. AmericasHealthcareAdvocate.com. We're happy to answer all of them. And thanks to all of you in the listening audience. As I said in the opening monologue, 608,000 people viewing that podcast and on YouTube.

00;29;12;23 - 00;29;32;02

Cary Hall

It's kind of surprising. But we do thank all of you. In studio with me today John Kuhlmann of the Kuhlmann Group. Also Lauren Broyles, who is his vice president of operations, and Josh Banwart, who is a financial advisor. We're talking about how they deal with not only groups, but associations. Because they're uniquely positioned to help associations.

00;29;32;02 - 00;29;54;17

Cary Hall

He's got 750,000 people on the association plans right now. They're working with us over at Detego on the GigCare program through our Population Science Management platform. These are things they're doing that are innovative. You're not seeing it out there from other brokers. So let's just start with that. I've got a company. It's a trucking company. They’ve got 4000 drivers, 400 of those are 1099.

00;29;54;18 - 00;30;12;07

Cary Hall

They had no benefits for them because you can't put them on health insurance plans. Okay. Because they're 1099. They came to us, we put the GigCare plan in place. They put together a little bonus program to kind of offset the cost with their drivers based on the number of miles they drove. They were thrilled because all of a sudden the drivers had health benefits.

00;30;12;09 - 00;30;21;25

Cary Hall

Okay. Through the GigCare program. So talk about how you deal with companies that have a double sided payroll like 1099 W-2. John.

00;30;21;28 - 00;30;41;26

John Kuhlmann

So I would add that with the GigCare, not only do they have benefits, but they have quality benefits that are affordable. You know, we had our other podcast that we did about the NHRA and, Kenny Delco, our driver of the GigCare car. He, basically explained how one of his good friends, his ACA rates were going to go up to $2,700.

00;30;41;26 - 00;30;43;02

Cary Hall

I remember this, yeah.

00;30;43;02 - 00;31;07;28

John Kuhlmann

And, through GigCare, he can cover himself and his wife for $1,290 instead of $2,700 and really have quality, better program. So we have that available at the GigCare program. And we always look at that for every association to put it in place for them. Or if there's a company that has 1099 people that aren't covered, we look at adding that for them to drive that value to help their members out, because if they don't help them, some of them may have to leave to go elsewhere.

00;31;08;01 - 00;31;25;09

John Kuhlmann

I know from a lot of our clients, we have several trucking companies that they have trouble retaining their drivers because they're competing against Amazon and all the other big companies, so they have to offer those benefits. And that's where GigCare is a wonderful solution. If they do have W-2 and 1099 drivers, right. But that's any company that has that.

00;31;25;09 - 00;31;43;22

John Kuhlmann

We can do that for any company doesn't have to be trucking. But we also have a group carrier that well, it's a TPA. TPA stands for third party administrator and they will insure 1099 members. Now when you insure a 1099 member on a group plan, you cannot contribute towards the cost of their insurance to keep it separate.

00;31;43;22 - 00;32;02;09

John Kuhlmann

Right. Because you can't have that employee employer relationship. So the member will have to pay for the cost of their insurance, but they are just another class of employees within the group plan. It's very, very powerful, works really well. And typically that carrier, that TPA is really one of the best TPA's in the country. They offer great solutions.

00;32;02;09 - 00;32;13;03

John Kuhlmann

They do things to keep the cost of health care down. We have a lot of groups with them that are going on their third year, with no rate increase at all. And, one of the groups actually got a rate decrease in their third year.

00;32;13;04 - 00;32;14;10

Cary Hall

That's highly unusual.

00;32;14;12 - 00;32;24;11

John Kuhlmann

totally unusual, right? And we still shop them out. Right? Even though that they're getting that we still shop them out to make sure that they're getting the best value for the dollar, because health care is the second or third most expensive line item.

00;32;24;11 - 00;32;27;00

John Kuhlmann

Like I said, that any any company has.

00;32;27;05 - 00;32;38;05

Cary Hall

So Lauren, I was talking to somebody the other day and we were talking about customer service and he said, Cary, he said the word service has gone out of customer service. I know you guys, you get to handle all that.

00;32;38;05 - 00;32;39;16

Lauren Broyles

Yes.

00;32;39;19 - 00;32;51;19

Cary Hall

So talk about your approach to customer service, how it's different and how when some you know, it's not if it's when they have a claims problem because inevitably say a hospital codes a visit wrong.

00;32;51;19 - 00;32;57;27

Cary Hall

They do this, they do that. And then somebody gets a balance bill. So talk about how you deal with customer service issues Lauren.

00;32;58;01 - 00;33;17;07

Lauren Broyles

Absolutely. So we definitely pride ourselves in our customer service. If you're a business owner especially, you know, you're working 24/7 around the clock. When 5:00 hits, our phones don't stop ringing. So we're around the clock service. Because when you do have a problem and is an emergency, like you're saying with a claims problem, we answer, we don't.

00;33;17;07 - 00;33;19;01

Cary Hall

You're there to solve, help solve the problem.

00;33;19;01 - 00;33;30;12

Lauren Broyles

Yeah. When there is an emergency, we're here to help solve the problem. And we're here to help you get to the right person to solve your problem. So we're answering around the clock on the weekends. Believe it or not, that's amazing. Yes.

00;33;30;14 - 00;33;44;19

Cary Hall

Yeah. Try doing that at one of the major carriers, folks and see what you get, okay. Not going to happen. Not going to. That's one of the reasons why you are successful. What you do is because you've got people like Lauren. Exactly. For you there has to be personal care for these folks.

00;33;44;19 - 00;33;51;09

John Kuhlmann

Lauren is, she has the, work ethic of somebody who's 40 or 50 years old.

00;33;51;12 - 00;33;52;19

John Kuhlmann

She literally

00;33;52;19 - 00;33;53;19

Cary Hall

and she's only 19.

00;33;53;19 - 00;33;55;21

John Kuhlmann

She sure looks 19.

00;33;55;21 - 00;33;56;04

Lauren Broyles

00;33;56;04 - 00;33;57;00

Cary Hall

00;33;57;02 - 00;34;16;27

John Kuhlmann

She is absolutely amazing. And, one of the reasons why we just don't lose clients is because of our customer service. We have most of the clients that we've ever picked up from 36 years ago. And, keep them. And then the ones we add, we keep them to. The only time we really ever lose a client is when they get bought up by another company, typically, and the new owner comes in and just gives it to their guy.

00;34;17;03 - 00;34;21;22

John Kuhlmann

We just don't lose it normally on any type of issue. We've never had a customer service issue.

00;34;21;27 - 00;34;34;28

Cary Hall

So we're wrapping up here. We got another two minutes left on the show. What message you want to give to people that may be considering. Hey, I've got an association. We've got membership issues. We have no health benefits. What do you want to say to them?

00;34;35;01 - 00;34;58;17

John Kuhlmann

So we bring a complete, package of benefits to all the members, for everything that they, they may have from a need standpoint. And we literally look at everything tailored to their needs. Right? Unlike most associations, it'll just try to put it in like a group plan for groups. We literally look at group options, but they're the individual group options for each group, no matter the size, and same thing for individuals.

00;34;58;19 - 00;35;02;13

John Kuhlmann

And then we have Josh to help out with any type of advisory stuff too.

00;35;02;15 - 00;35;20;15

Josh Banwart

They're kind of one step above, the basic benefit would be the deferred compensation. Right. This is the conversation about attraction and retention. Those are both important pieces of key employees. And so how do we make sure somebody doesn't leave. And this is a whole thread to pull on. How do we make sure somebody doesn't leave.

00;35;20;15 - 00;35;28;15

Josh Banwart

But we also, don't give up equity or control in our company. What's what's that middle ground. And that's something that we're working a lot on, especially the Kuhlmann Group.

00;35;28;18 - 00;35;43;16

Cary Hall

That's how you keep good people. Yeah. You go through all the trouble to get somebody that’s really good. And the guy down the street says, hey, you know what? I'll give you 20% more if you come down here. When you lose those people. I mean, I just saw this morning the Berkshire Hathaway's losing one of the number one people.

00;35;43;23 - 00;35;48;18

Cary Hall

They're going over to Morgan Stanley. So even the big guys lose them.

00;35;48;19 - 00;36;07;29

John Kuhlmann

So what, we typically tell new groups when we start working with them is that, we usually can save them 20 to 35% off of their, health insurance premiums. So that's just that, the ancillary it's very common. It's about the same number. We can't guarantee it. Right. But that is typically the value that we drive.

00;36;08;02 - 00;36;21;17

John Kuhlmann

We do the same thing again on the ancillary. Usually we are driving better benefits at a substantial savings. Then we're easily able to keep those premiums level and flat. No matter what we're always going to do what we should do to keep your benefits as strong as we can for your group.

00;36;21;23 - 00;36;39;18

Cary Hall

You know, I don't put people on this show. I don't believe in, I don't put people and products on this show that I don't use or I don’t service. These people work with us at Detego. They are using our GigCare program through Population Science Management. They offer a host of other solutions. If you're in any way interested in what they can do.

00;36;39;18 - 00;36;54;23

Cary Hall

If you're an association, a small group, a large group, reach out to them and they would be happy to help. You can call John at 314-494-7860. 314-494-7860. Thank you all three of you for doing this. I have to do some more of these.

00;36;54;24 - 00;36;57;01

John Kuhlmann

sounds great Cary, thank you for having us.

00;36;57;04 - 00;37;14;01

Cary Hall

00;37;14;04 - 00;37;19;29

Cary Hall

Thank you for listening to America's Healthcare Advocate Show. Broadcasting coast to coast across USA.

00;37;20;02 - 00;37;21;13

Cary Hall

Goodbye America.

The BlueKC Mental Health Show

Sat, 15 Nov 2025 16:22:44 GMT

Episode 2133 notes

Sportscaster Ryan Lefebvre , the storied broadcaster of the Kansas City Royals baseball team, joins me on this special show along with Kristin Gernon, Blue KC Behavioral Health Program Manager.

Kirstin has over 25 years of experience in the behavioral health field, focusing on children and families. She has been involved in initiatives like the "Shut Out the Stigma" campaign and has spoken on mental health topics, including its importance in youth sports and the new documentary "Not Good Enough".

"Not Good Enough" is available at: https://www.shutoutthestigma.com/documentary

Learn more about Blue KC: https://www.bluekc.com/

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Episode 2133 Transcript

00;00;00;13 - 00;00;24;23

Cary Hall

We're going to be talking about behavioral health. We're going to have a special guest in studio storied broadcaster for the Kansas City Royals, Ryan Lefebvre. And he'll be joined by Kristen Gernon who is Blue KC's behavioral expert. And we're going to be talking about the program called Shut Out The Stigma. There's an enormous issue in this country that young people, children that are dealing with all kinds of mental health problems that are not being recognized and need treatment.

00;00;25;00 - 00;00;32;07

Cary Hall

This program is going to focus on that. If you have children or grandchildren, you want to listen to this show.

00;00;32;10 - 00;00;36;06

Announcer

And now America's Healthcare Advocate Cary Hall.

00;00;36;07 - 00;00;48;17

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com

00;00;48;17 - 00;01;11;04

Cary Hall

Also 16 podcast channels and our YouTube channel. 604,000 views. Combination of both. Because of all of you in our audience. Out there that go to the show every week and view it. Our producer today, Mister Dave Thiessen behind the cameras, Garner Cowdry on the boards right here at our home studio and Cumulus in Overland Park, Kansas. Well, this is a special show today.

00;01;11;06 - 00;01;30;00

Cary Hall

The show features Ryan Lefebvre, the storied broadcaster of the Kansas City Royals. 27 years, actually, with the Royals. Welcome back. It's great to have you to see you. And thank you for taking the time to do this anytime. It's great to have you here. And Kristen Gernon, Blue KC Behavioral Health Care Manager. What are we talking about today?

00;01;30;04 - 00;01;53;01

Cary Hall

A program that's been in existence for five years called Shut Out The Stigma. And why are we doing this show? Because this is about behavioral health. It's about mental health. It's about issues that parents, grandparents and adults are dealing with on a day to day basis. And so the idea is to get this out in the public eye, get people to understand it and understand you don't have to be ashamed of it or you don't have to hide it.

00;01;53;07 - 00;02;10;16

Cary Hall

And Ryan is going to talk a lot about that and a book that he wrote. It is about that very thing. So let's just start with Kristin. Can you talk a little bit about this program? It's been in effect for five years now. You've partnered with Ryan and the Kansas City Royals to give some great exposure to this issue.

00;02;10;16 - 00;02;28;08

Cary Hall

And you and I talked about this, you know, before we started the show. It seems to me I've got six grandkids. It seems to me the pressure on these kids today is very, very different. We talked about this Ryan before we started the show. Then it was back when I was a kid, nine, 76 years old. So that goes back away.

00;02;28;10 - 00;02;52;04

Cary Hall

But we you grab a baseball, you grab a basketball, you go ride your bicycle today, it's like, okay, we got soccer practice and we got Girl Scouts and we got choirs. And it's like very, very structured. On top of that is social media and all the pressure that puts on these kids. And then you get into, you know, kids having other issues, acting out, doing things that are completely out of the norm.

00;02;52;06 - 00;03;01;23

Cary Hall

And how does all that fit into this whole issue with behavioral health now? And why is it so critical that it be recognized and dealt with as soon as possible?

00;03;01;25 - 00;03;23;06

Kristin Gernon

Oh, so many important points you brought up. Yes, kids are under more pressure than they've ever been under. We know that on any given day, 1 in 5 U.S. children or adolescents is living with a mental health condition, a diagnosable mental health condition, and some estimates are as high as 80% of individuals will will have a diagnosable mental health condition in their life.

00;03;23;09 - 00;03;42;10

Kristin Gernon

So as we think about our young people and the pressure they're under, it's scheduling. They're they're they're scheduled at every moment of their day between school and homework and activities and activities can be such a great source of positive things. Right. Being a part of a team is such an important thing. There's so many benefits that come to being a part of a team.

00;03;42;12 - 00;04;04;21

Kristin Gernon

The physical side of of sports and exercise is so good for our minds and our bodies, but sometimes it's too much and sometimes there's pressure from the adults in their lives to to perform and to excel at certain things. And what we find is that 70% of kids are dropping out of any kind of organized sports activities by the age of 13.

00;04;04;28 - 00;04;24;27

Kristin Gernon

So at the age of 13, when they might really need to be a part of such a a group, a positive group, like being a part of a team, they're missing out on those opportunities because they've dropped out. And so there are a lot of reasons for that. Some of that is financial and cost, but some of it is the pressure they feel from the coaches and the teachers and the parents, to perform in those moments.

00;04;24;27 - 00;04;26;18

Kristin Gernon

And it feels overwhelming.

00;04;26;21 - 00;04;34;09

Cary Hall

So, Ryan, you've got four kids. Yes, I do. You say before we went on the air that you've got two they're teenagers. Is that.

00;04;34;09 - 00;04;34;16

Ryan Lefebvre

Right?

00;04;34;17 - 00;04;58;00

Cary Hall

I do. Okay. So I'm kind of guessing you're probably seeing a little bit of this yourself. Okay. And you know how these kids know the expectation of performance and all the rest of it is out there? Do you see a difference between when you grew up? Obviously a little later than when I did, but do you see a difference between that and where we're at today, and then how all that fits into what Kristin just said?

00;04;58;03 - 00;05;31;04

Ryan Lefebvre

I do. And at the same time, I heard someone refer to us as were immigrant parents, in that we are the first generation of parents who are trying to navigate our kids through something that we never experienced. This we don't week. I can't tell my kids how I handle social media. I can't tell my kids how I handled the pressures of playing competitive travel sports because I got on my bike after school, like you said, and I biked my way to practice and I biked my way home.

00;05;31;06 - 00;05;52;24

Ryan Lefebvre

And that was it. I practice one day a week when I was their age, and we had games on the weekend, and that was the extent of it. So in that, in that regard, I don't I really can't draw upon my own experience. I'm also the one that really gets me to. And we talk about sports, but also on the academic side and the number of kids that I'm seeing.

00;05;52;24 - 00;06;02;15

Ryan Lefebvre

I have a high school sophomore and I have an eighth grader. Those are my two oldest, and they're already talking about taking classes in high school that have college credits.

00;06;02;15 - 00;06;03;00

Cary Hall

Yeah.

00;06;03;02 - 00;06;34;12

Ryan Lefebvre

Now, I understand the financial side of it. If a family can save a couple of years of college, by getting some of those, you know, general education stuff out of the way in high school, they only need two years of college as opposed to for, like I, I understand that, but the pressure these kids are putting on themselves right now, I mean, three hours of homework and we're trying to tell adults, when your work day is over, you need to go home and just be present with your kids, be present with your families, have dinner together.

00;06;34;17 - 00;06;55;22

Ryan Lefebvre

And yet we are training our kids that after you go to school for 7 or 8 hours a day, that's not enough. You got to take your work home for 2 or 3 more hours, and then you got to weave in a very high pressure sport there. And then we wonder when these kids get into their 20s, in their 30s and they're in the workforce, that they can't turn the motor off because that's that's what we're training them to do.

00;06;55;23 - 00;07;09;25

Ryan Lefebvre

So it's a it's a very it's a very complicated situation. And that we recognize the problem. But nobody wants to step in and say, okay, look that's a we are we are raising our kids to fail mentally and emotionally.

00;07;10;00 - 00;07;12;13

Cary Hall

That's exactly what's going on, is it not? Kristin?

00;07;12;16 - 00;07;22;29

Kristin Gernon

Yes. I think that he brings up so many good points about the pressure that kids are under and how can we support them when we maybe haven't navigated the the new, strange new world that we're in?

00;07;23;04 - 00;07;40;20

Cary Hall

I say I'm the number two pencil in the.com world because I can't even get, you know, I get social media. If it wasn't for Dave Thiessen, there'd be no media or anything else because I don't touch it. Okay? And, you know, when I grew up, we had rotary phones, okay. And what were called party lines, there was none of this.

00;07;40;20 - 00;07;53;19

Cary Hall

So it's impossible to relate to a lot of this in some ways if you haven't done it. And and so you have to at some point, somebody has got to step in and say, whoa, am I right or wrong here?

00;07;53;19 - 00;08;14;05

Kristin Gernon

Yeah, I think you're right. And I think that it starts with, if we can't change all of the elements of this strange new world we're in, how are we checking in with our kids? What are we asking them? What are the questions we're asking them? And are we listening to to them? What are we saying? So, so to to Ryan's point about all the practices and all the activities, let's use that time in the car.

00;08;14;05 - 00;08;29;19

Kristin Gernon

Let's use that time in the car to check in and really have those deep conversations, make sure that they're not on devices in the car. In those short trips, and check in with what's going on. Tell me about tell me about school. Ask some of those open ended questions that get them talking instead of just yes no. How was today?

00;08;29;19 - 00;08;44;10

Kristin Gernon

How was school today? Good? Fine. How can we ask those opening questions? Tell me about it. Who did you play with at recess? What kind of activities did you do right? What do you have coming up? Did anything make you smile today? That anything will make you laugh today? Yeah.

00;08;44;11 - 00;09;08;00

Cary Hall

You know, it's funny you said. I'm thinking back. I'd like at six grandkids, I get a grandson who's 17 years old, and his. How was school day? Okay, good. That's it. So I'll take him out to lunch and sit down with him and start a conversation. Then once I get him rolling, he's talking his head off. But you have to take the time to get them because otherwise they're moving on to something else.

00;09;08;00 - 00;09;14;28

Cary Hall

And then we're almost up here on the break. But how many times do you walk into a restaurant, you see a family, and the kids are sitting here with this.

00;09;15;00 - 00;09;16;00

Ryan Lefebvre

And so are the parents.

00;09;16;00 - 00;09;34;26

Cary Hall

Yeah. Oh, that's the other problem, right. So having dinner together as a family, we always did that. You know, we had dinner every night together as a family. I know both my daughters do it now, but those kinds of interactions with the family are critically important. And unfortunately, I think a lot of that's gone by the wayside. Yeah, we'll be right back after the break.

00;09;34;26 - 00;10;03;22

Cary Hall

You're listening to America's Healthcare Advocate here on the HIV network. You know, if you want to learn more about this, there's a documentary out there that was done Ryan Lefebvre in the documentary Shut Out The Stigma.com/documentary. So you can go watch this. But I come back to the break going to ask Ryan to talk about that. I'm also going to ask him to talk about this book, and I'm going to read a passage out of here that talks about when he started to recognize he had a major problem here and how he went after it, solve it, and change his life.

00;10;03;22 - 00;10;17;29

Cary Hall

Stay tuned. We'll be right back after the break. Here on America's Healthcare Advocate.

00;10;18;02 - 00;10;43;28

Cary Hall

Welcome back. You're listening to America's Healthcare Advocates Show broadcasting coast to coast across the USA. All of these shows are posted. All 16 of our podcasts platform, SoundCloud, Spotify, Cumulus Odyssey. We're on, I think from all of them that are out there, I'm pretty sure. And also on the YouTube channel. And so if you want to tell somebody about this, maybe you're a grandparent, you're seeing this with your grandkids, maybe the parents aren't quite seeing or whatever the case may be.

00;10;44;04 - 00;11;05;12

Cary Hall

Great place to go up to listen to the show or watch the show and learn what we talked about and how it might help you in studio with me today, Ryan Lefebvre, as I said, storied broadcaster, 27 years with Kansas City Royals and Kristen Gernon. He is the behavioral health manager for Blue Cross and Blue Shield. Dealing with the behavioral issues and talking about the program Shut Out The Stigma.

00;11;05;16 - 00;11;24;13

Cary Hall

So Ryan wrote a book some time ago about his whole journey with regard to mental health, depression, all things he dealt with. And I'm going to read this one piece because I think it illustrates something I never would have thought of. And probably you don't think of it either, especially if you see this behavior in children or your children and you don't understand what's going on.

00;11;24;13 - 00;11;42;07

Cary Hall

Let me read you this little piece. So they're in New York City, all right. And he's there with Mike Sweeney. And they have they're going out to dinner and they're going to go see a play called The Producers. So they're gonna go out this really nice Asian restaurant. So here we go. I felt immediately uncomfortable. Five minutes after taking our seats, I was in big trouble.

00;11;42;07 - 00;12;06;24

Cary Hall

I tried to make conversation to distract my own thinking, but the world was slowly caving in on me. I began to sweat while others complained how cold it was. I had my hands folded in my lap between bites, squeezing as hard as I could. Both my legs were in constant twitch. I could feel my heart pounding. There was a warm, tingling sensation in the center of my chest, as if I'd been injected with some sort of burning fluid.

00;12;07;01 - 00;12;30;26

Cary Hall

I started this, it started to spread slowly to my shoulders, down toward my stomach. I thought I was going to pass out. I don't know how it feels to have a heart attack or a seizure, but I thought something horrible was going to happen. I read that the first time I read that, and I thought the physical reaction of being in it, that was a panic attack, said, it's one of your first ones.

00;12;30;29 - 00;12;50;15

Cary Hall

It was graphic. So talk a little bit about that. And then this whole journey as you what you found yourself, you know, where you were. You grew up, your father was a major league baseball player, very successful. Your mother was a flight attendant. You know, you had you had some unusual conditions, and you're in major league clubhouses.

00;12;50;15 - 00;12;55;11

Cary Hall

A lot of other things. And here you are a broadcaster with the Kansas City Royals. You got this perfect life.

00;12;55;13 - 00;12;56;01

Ryan Lefebvre

00;12;56;03 - 00;13;01;10

Cary Hall

And all of a sudden this is starting to happen. It's not so perfect anymore. Ryan.

00;13;01;12 - 00;13;27;18

Ryan Lefebvre

Well that was 20 years ago. And you're reading that and I'm thinking it this 2025 is 20 years since, the bulk of that book was written, which began as a reflection and, journaling, which my mom encouraged me to do. And I'm not a writer by nature. I don't do not usually how I express myself. But when things would happen to me, I would get on my laptop.

00;13;27;18 - 00;13;47;20

Ryan Lefebvre

And that's how I would take these feelings on the inside and and give them, the written word at least. And when I was with my counselor, it was the, you know, the verbal expressing these feelings that were trapped inside of me. And I'm really glad that I did that when I did, because if you were to ask me now, what do I remember about that panic attack?

00;13;47;20 - 00;14;08;07

Ryan Lefebvre

The first panic attack I had at the restaurant, I wouldn't have remembered, because that whole 2005 year was just like a blur for me. So that, I mean, that was that was a very frightening night. I got up from the table eventually, and I went into the bathroom and I thought, well, what do they do in the movies?

00;14;08;07 - 00;14;14;06

Ryan Lefebvre

In a situation like this where you splashed cold water on your face, right? And that that kind of unique bathroom?

00;14;14;06 - 00;14;17;15

Cary Hall

Two if I remember it was it was a waterfall and it was just.

00;14;17;15 - 00;14;31;13

Ryan Lefebvre

Yeah, it was and it just didn't help. And then we went to the movie or we went to the show on Broadway. The Producers, which at the time was the number one show on Broadway, and Mike Sweeney got his connections and we were like, in the third row or something. And I was miserable. And he knew it.

00;14;31;15 - 00;14;53;23

Ryan Lefebvre

And so we had a really good long talk after that. I couldn't sleep at all that night, but, the silver lining of all that was up until that night, the feelings that I had, I felt were just a matter of will or a lack of will, you know, like, you know, I'm a grown man. I mean, as you described, I, I basically had the life that I wanted.

00;14;53;23 - 00;15;11;01

Ryan Lefebvre

I mean, I checked off just about every box before I turned 30 years old in my career. So what is going on? Why am I why am I feeling this way? This is not making any sense. But when I started to have the panic attack and I'm sweating, is when I began to realize maybe there's something physically wrong with me.

00;15;11;01 - 00;15;37;04

Ryan Lefebvre

Maybe this isn't the result of how strong I am on the inside. Maybe there's an an uncontrollable. So when I got back from that trip to New York shortly after that is when I went to a doctor for the first time, and I was prescribed medication for the first time. And, so, like many things in life, the worst thing that happens to us can be a precursor to the best thing that happens to us.

00;15;37;04 - 00;15;59;13

Ryan Lefebvre

And so my recovery went to another level after that, before it was talking with my counselor, which was extremely helpful. The problem was prior to me taking the medication as I would have these great revelations with my counselor and in the 12 minute drive from her office to my house. By the time I walked in the front door, I was feeling miserable again.

00;15;59;13 - 00;16;21;17

Ryan Lefebvre

It just wasn't sticking. It wasn't. It wasn't absorbing into me as a new truth, or at least replacing a lie that I believed about myself. So with the medication did for me as it helped me with my anxiety. I was on Xanax for a while just to take the edge off the anxiety. And then I was on Lexapro, an antidepressant for three and a half years.

00;16;21;20 - 00;16;49;15

Ryan Lefebvre

And after a while, once that once that started to get into my system, my counseling sessions were much more meaningful. And the the revelations I had were, were longer lasting because I was getting through these episodes of of anxiety. And the book, to be honest, I mean, I'm, I'm grateful that I had the opportunity to write the book, but I've always said there's that's it's not a remarkable story.

00;16;49;16 - 00;17;08;09

Ryan Lefebvre

There's no walking on water moment in there. But I realized at the time that I had a unique platform and that if I thought I had the life that I always wanted to have, I'm sure just about every male sports fan would think that this is the life that they wish they could have. So how does this happen to Ryan Lefebvre?

00;17;09;20 - 00;17;33;12

Ryan Lefebvre

And I thought, a story was written about me in the Kansas City Star in the spring of 2006, which eventually led to the book. And I just realized that this was going on all around me. It may not have been manifesting itself like it was in my life, but this is going on all around me. So the the the big purpose of the book, Cary, for me was to just share my story that somebody might be able to read that book and it relates to their story.

00;17;33;14 - 00;17;51;04

Ryan Lefebvre

But the ultimate goal is if somebody reads that book and then they're willing to share their story so that if, Cary Hall reads my book and it means something to him, and then he has a friend who's going through depression now, Cary Hall can use his story to inspire his friend. That was the purpose of the book.

00;17;51;07 - 00;18;09;14

Cary Hall

That was the purpose of the book. And I'll tell you a quick little story. After we did one of these shows a number of years ago, we stood outside on the street talking about the show, and I thanked Ryan for doing the show, and he said do you know what, Cary? I wasn't put here to be a broadcaster. I was put here to help deal with this issue and tell people what they need to do to help themselves and help people in their family.

00;18;09;22 - 00;18;29;19

Cary Hall

I think you just heard that. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network, coast to coast across USA. By the way, the name of that documentary is “Not Good Enough”, and you can find it at ShutOutTheStigma.com/documentary. It's: “Not Good Enough”. Stay tuned. We've got more.

00;18;29;19 - 00;18;42;02

Cary Hall

We'll be right back after the break.

00;18;42;04 - 00;19;03;01

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. You can find out more about us on the website. AmericasHealthcareAdvocate.com If you have a question, a problem, an issue that I can help you with, please reach out to me. I had the gentleman the other day had a united health care plan, but couldn't get a wheelchair for his son.

00;19;03;03 - 00;19;24;14

Cary Hall

We kind of got in the middle of that and helped him get a wheelchair. So if we can help you, we're happy to do it. Send me an email. AmericasHealthcareAdvocate.com in studio with me, Ryan Lefevre, broadcaster, 27 years with Kansas City Royals and Kristin Gernon. And she is the behavioral health you would think I do radio Behavioral Health Manager for Blue Cross and Blue Shield’s program.

00;19;24;14 - 00;19;43;16

Cary Hall

And by the way, I want to talk briefly here about the Spira Care program and the fact that they incorporate behavioral health at all of these primary care clinics. And that's part of what you oversee and do. And this is a unique set up because most direct primary care clinics don't touch this. This is this is a big program.

00;19;43;16 - 00;20;03;20

Cary Hall

Erin Stuckey, Jenny Housley, Kim White, Christina Lively all the folks at Blue Cross have been behind this for a long, long time to put this program in place. A lot of times I talk about this hometown carrier and what they do well, this is this is exactly what I'm talking about. 5000 kids and teens get served each year in this program.

00;20;03;23 - 00;20;34;05

Cary Hall

And it's a great program throughout the city. They connect with the school systems and others. So that's a little bit about what I'm talking about when I call them the hometown carriers. So we just heard Ryan talk about that whole thing. Like I said, the first time I read that, I was like, I had no idea of the physical manifestation of this. Then I go to my granddaughter, who's eight years old, has significant ADHD that we've been battling for years, and watch this child have what we call the meltdowns, where she just goes completely off the rails.

00;20;34;07 - 00;20;54;24

Cary Hall

Her mother's tenacity is remarkable. And after all of what we've gone through, they finally got her on a series of meds that work, and she's a different child. She's excelling in school. She's a great soccer player. But so what I was seeing was exactly what Ryan was talking about in a different form, was the physical manifestation of what she's going through.

00;20;54;24 - 00;21;11;28

Cary Hall

And she had and, you know, I'm old school friend. When you did that, when you were in Catholic school, you know, if you act like that, the nun was coming down there with the pointer and it was going across your knuckles or your rear. And one of the two, it was none of this. Okay. So, you know, when I saw that, I'm kind of like, well, she needs to be disciplined.

00;21;12;03 - 00;21;30;13

Cary Hall

No, that's not what she needed. But I didn't know that. And now I see this completely different child because somebody, her mother and her father had the forethought and the tenacity to stick with it till they found the solution. So talk about how all that kind of comes together, including for adults, not just children. Like Ryan talked.

00;21;30;13 - 00;21;30;29

Ryan Lefebvre

About.

00;21;31;01 - 00;21;53;10

Kristin Gernon

It’s so important that we do talk about the physical manifestation because it does come out in physical symptoms. Well, you know, with young people especially, you're going to see kiddos who are struggling, maybe with depression or anxiety, having more stomach aches and headaches and being school avoidance. And and it may not come out or they may not be able to articulate I'm feeling anxious or I'm feeling depressed, but it's going to come out in some other way.

00;21;53;10 - 00;22;13;06

Kristin Gernon

So although our bodies tell the story about what's going on in our minds and what we're struggling with and, and I think the important thing to think about when we think about adults over the years, when we aren't talking about it, when we aren't getting the help we need over, over the course of time, that takes a toll on our bodies, takes a toll on our organs, and leads to significant chronic health conditions.

00;22;13;06 - 00;22;31;09

Kristin Gernon

So Spira Care, as you mentioned, is such an important partner. Because they look at us as not just our mind or our body, but both and the the interaction between the two, we know that if we're struggling with our mental health challenges, it's going to impact our physical health. If we're struggling with physical health, it can take a toll on our mental well-being as well.

00;22;31;12 - 00;22;51;02

Kristin Gernon

So you can't separate out the two. They they work closely, hand-in-hand. Ryan's message is so important because it makes it okay and normal for us to talk about this. And I think too many people go through lots of their lives trying to man up or, you know, you know, rub a little dirt in it and, you know, we're going to be a tough guy and we're not going to talk about it.

00;22;51;02 - 00;23;11;11

Kristin Gernon

I can handle we try to think our way through a problem when our brain is what's having a having a difficult time, right. We don't tell people who have asthma to just breathe harder. Right. But but somehow we think as as humans, as adults, we can just think our way through these problems. But there is a physical manifestation when we don't address it, and it takes a toll over time.

00;23;11;18 - 00;23;35;29

Kristin Gernon

And our young people don't have some of the words and the skills to articulate that. So it really comes out as tantrums, or it comes out as stomach aches and headaches and and that school avoidance I mentioned. So, so tuning in to all of that. But when we as adults are talking about it, when we normalize the conversation, when the Royals use their platform for this, it's such a powerful tool, to make it easier for the rest of us to say, yeah, actually that that resonates with me.

00;23;35;29 - 00;23;39;01

Kristin Gernon

I can connect with that message. I'm struggling to.

00;23;39;07 - 00;23;45;12

Cary Hall

Yeah. And I is the idea that you have to recognize the problem before you’re going to solve the problem. Right? Ryan.

00;23;45;14 - 00;24;13;10

Ryan Lefebvre

Yeah. And and you know, when I look back on my recovery, my initial recovery, and people say, you know, do you feel like you're cured from this? And I had never used the word cured. I, I manage it and I continue to manage it. I mean, 20 years later, after, you know, the bulk of what's in my book and when I was at my lowest, I mean, I am who I am today because I continue to manage it, but I, I realize I don't know if it was intuition or I just had the right people in my life at the time.

00;24;13;10 - 00;24;38;03

Ryan Lefebvre

But I had what I called my triangle of recovery. And first of all, I had a I had a counselor, Dale Williamson, who was really good about taking me back to where I began to believe these things about myself. The lies, as she put it, and or began to believe that I wasn't enough. Where did that start? And I was able to get in touch with that.

00;24;38;03 - 00;24;58;02

Ryan Lefebvre

So at least I knew that as a 34 year old at the time, if I feel this about myself, okay, here's where that comes from. When I was four, I went all the way back to when I was four years old. So I've been carrying this for 30 years. But just to be just to be willing to recognize that and replace, as she put it, lies with truth, you know, how do you feel right now?

00;24;58;02 - 00;25;16;08

Ryan Lefebvre

And I would tell her how I'd feel. And you okay, well, is that true? When you look around, what's going on in your life right now? Is that true? No. Okay, well, that's a lie. So let's just identify that. That that's a lie. Okay. In the previous segment, I covered how the medication just kind of helped control my emotions so I could take in this new information.

00;25;16;11 - 00;25;41;21

Ryan Lefebvre

And then I had a life coach, Gary Kuzmic. And the focus of my life coach was, okay, you have all this information on now, how are you going to begin to live your life? And, mental health awareness has been wonderful over the last ten years in particular. But in my opinion, and I'm not a professional in my opinion, I don't think there's enough attention on those three things.

00;25;41;23 - 00;26;05;16

Ryan Lefebvre

When did you begin to feel this way about yourself? What are you going to do about it, and how are you going to live the rest of your life based on the information that you have? And the word that comes with that is accountability? Yeah. And the accountability is okay. Somebody may have done something to me a long time ago, and I was victimized in some way, but I can and I wasn't able to control that.

00;26;05;19 - 00;26;16;25

Ryan Lefebvre

However, I do control whether I want to label myself as a victim or not. And right now, we're starting to get out of it but right now. I think there's an epidemic in our country of being a victim is a good thing.

00;26;16;28 - 00;26;17;20

Cary Hall

Victimology.

00;26;17;22 - 00;26;38;20

Ryan Lefebvre

And people love to say it's okay to not be okay, and that's fine as long as you say it's okay to not be okay for now, because it there is a there is a feeling that if you're not okay, then you can kind of camp there for a while. And there has to be a point where you have to decide, and this is on the person.

00;26;38;22 - 00;26;55;03

Ryan Lefebvre

And I just spoke somewhere and a counselor was just, you know, how do I deal? And I'm trying to get through to this person. And I said, listen, your effectiveness is going to be directly related to how willing the person you're talking to wants to get better, not just feel better. That's the medication problem we have right now.

00;26;55;03 - 00;27;11;10

Ryan Lefebvre

They just want to feel better right now. If you want to get better, and if you want to look at Ryan Lefebvre now, 20 years later, and first, for some reason I look like I've got it together is because I wanted to get better. I was done trying to feel better today or this week or this month. I wanted I wanted to get better.

00;27;11;17 - 00;27;32;05

Ryan Lefebvre

And that's the hard part because that's on us. And these are adult decisions that are on us. We can't blame mom or dad or whomever from 20 years ago anymore. Our adult decisions are ours. And so the moving forward, what am I going to do with this information? How am I going to live my life now? What am I going to watch on TV?

00;27;32;06 - 00;27;53;06

Ryan Lefebvre

How much time am I going to spend on social media? If I'm struggling with a breakup, why am I still listening to our song? Why am I still going out with the guys or the girls from high school and college that usually the the night ends up with the same result as it did, and I go home feeling terrible about my decision, my life decisions or whatever.

00;27;53;09 - 00;28;14;00

Ryan Lefebvre

That then is incumbent upon the adult. This is on you now. They're off the hook. And so for me, at the time, I was willing to go there. I was willing to let go of some things, but I understood that if I was going to get better, I was going to get better. People were going to help me.

00;28;14;00 - 00;28;29;19

Ryan Lefebvre

But that was a choice that I needed to make, and I didn't. Let me say one more thing. When you get on this path, unfortunately, you don't know how long the path is going to be. It might be a year, it might be five years, it might be ten years. But it's it was my choice to get on that path and stay on that path.

00;28;29;19 - 00;28;49;13

Cary Hall

The takeaway from that Kristin, is he made a decision that he had to be accountable to himself for what was going on. And when a lot of people do is what he just talked about. What Ryan just said victimology because it's a very it's what we do in this country now, as opposed to taking responsibility and starting down the road where it's going to make a difference.

00;28;49;13 - 00;28;52;16

Cary Hall

We've got about a minute left. Your thoughts on that? Yeah.

00;28;52;16 - 00;29;13;16

Kristin Gernon

Oh, he made so many important points and I think about this in the context of our kiddos. Right. How can we teach them that early on so they don't have to get to a crisis point later. Right. How do we help them to understand what's going on, connecting their feelings and their thoughts into something, and in and taking that ownership really early on when they don't necessarily understand, what's going on.

00;29;13;16 - 00;29;27;14

Kristin Gernon

Right. But how can we help them, find that accountability early on? Understand with that insight. Now, a lot of times it is adults telling our own stories about what, we've experienced and what we've gone through to hopefully help them to to have some of the tools.

00;29;27;17 - 00;29;43;14

Cary Hall

We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network, coast to coast across USA. We'll be right back with more. Stay tuned.

00;29;43;16 - 00;30;06;08

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. Again, you can always send me an email if you want to. Shows are posted on the YouTube platform. Podcast platform. 604,000 views. Thanks to all of you out there. It's really quite remarkable. In here you'll see Ryan Lefevre, broadcaster for the Kansas City Royals, and Kristin Gernon.

00;30;06;09 - 00;30;27;19

Cary Hall

She is the Behavioral Health Program Manager for Blue Cross and Blue Shield. Before we switch to baseball. And I promised that we would do a little discussion about baseball, the Royals, what's coming up this season, though? Let's talk about the course available and what what's out there for the public. That Blue Cross Blue Shield of Kansas City is doing to help people across the board deal with this issue?

00;30;27;19 - 00;30;28;11

Cary Hall

Kristin.

00;30;28;14 - 00;30;49;21

Kristin Gernon

So I would encourage all parents and it really just any caregiver interested grown up to go to shutoutthestigma.com. There's a lot of great information about youth sports and mental health and how those intersect and how we can better support our young people so they don't burn out of sports. And so that that we're protecting their mental well-being while they're so busy with all the activities.

00;30;49;21 - 00;31;03;00

Kristin Gernon

That gives you some solutions and talking points parents can use to better engage with their kiddos. But I also encourage you to take a course. We have a free course available to anyone, who goes to the website,

00;31;03;02 - 00;31;08;07

Cary Hall

And you don't have to be a Blue Cross Blue Shield policyholder. You know, this is what I mean by working in the community.

00;31;08;07 - 00;31;33;09

Kristin Gernon

Yeah, that's such a great point. So it's entirely free. Go and watch the documentary. Not good enough. It really highlights this important issue. And then take a course. There's a course that helps you to think more, more about this issue and how we can support our young people. The course is designed for young people to take, for coaches to take, for any caring adult to take, to really dive in deeper to the themes of that documentary, “Not Good Enough” and the pressure that kids are feeling.

00;31;33;11 - 00;31;49;29

Cary Hall

So if you're looking for help, okay, this this is a place you can go. And by the way, if you have a Blue Cross Blue Shield plan that includes Spira Care, you've got care available to you right there in all of the clinics across the city. There's 11 of them. And they have they all have behavioral health there.

00;31;49;29 - 00;32;05;00

Cary Hall

So once again, thank you both for talking about this whole topic today. Now we're going to switch gears. Let's talk a little bit about the Royals this season. What do you think's going to happen next season. Take it Ryan.

00;32;05;02 - 00;32;07;27

Ryan Lefebvre

Well I can tie this into our conversation.

00;32;07;27 - 00;32;10;26

Cary Hall

I can't wait to hear this. Okay.

00;32;10;28 - 00;32;17;09

Ryan Lefebvre

About 25 years ago, at least, Denny Matthews, the 57 year voice of the Royals.

00;32;17;09 - 00;32;17;29

Cary Hall

He’s still on.

00;32;17;29 - 00;32;43;26

Ryan Lefebvre

We've been together for 27 years. We were talking about a team that, had fallen below expectations after a great season the year before. And Denny said something profound, as he often does. But Denny said, you know, I'll bet when a team takes a monumental leap forward one year, I'll bet about 80% of the time, the next year is a year of regression.

00;32;43;28 - 00;32;59;10

Ryan Lefebvre

And then after that, then they really take off. And so, as we as we discuss it further, and the royals took a monumental leap forward in 2024, they won 30 more games than the year before they went to the playoffs. They advanced one round. Nobody was expecting that.

00;32;59;15 - 00;33;00;15

Cary Hall

It was wonderful.

00;33;00;15 - 00;33;19;16

Ryan Lefebvre

It was it was an historical achievement. No team had ever lost 106 games or more one year, and went to the playoffs in the history of the game. That would be a monumental leap forward. So it's only natural for everyone to expect another monumental leap forward. Well, that's not what happened. They took a step backward.

00;33;19;16 - 00;33;43;27

Ryan Lefebvre

They had a winning year, but they didn't go to the playoffs. And what happens? I think just observing what you know, Denny said, and then seeing it with my own eyes over the last 25 years or so. Sometimes, just like in life, things come easy and we don't appreciate what it takes to be successful. And then the next year comes and it's more challenging.

00;33;43;27 - 00;34;02;00

Ryan Lefebvre

And for the Royals, they had more injuries this year than they did the year before. They didn't hit in clutch situations in 2025 like they did in 2024, and suddenly the wins were a lot more difficult to come by than the year before. And so it was it was disappointing. It did not go according to plan.

00;34;02;02 - 00;34;21;00

Ryan Lefebvre

Okay. But just like in life, you have to make a decision. You know, things are not going the way we want. But what are you going to do now? I can tell you, I've seen a lot of Royals teams that went through what the what the 2025 Royals went through, and they are dead and buried. They're 10 or 15 games below 500 noncompetitive and things didn't work out.

00;34;21;02 - 00;34;49;09

Ryan Lefebvre

They pack up their tents and the season is over. They didn't do that. They still had a winning season. Yeah, they were in it until game 159 mathematically or so. So they continued to be competitive. But there were a lot of lessons learned about, you know what winning games is really difficult. And I think they're going to go into 2026 with a greater appreciation of the finer details that go in to winning a baseball game, and that there are many different ways to win a baseball game.

00;34;49;11 - 00;35;09;08

Ryan Lefebvre

So how does that relate to our conversation today? It's the exact same thing. Some years are good years. Some years are tough years. But if we're learning something every year for growing every year and if we’re reflective every year, and we can look at okay things didn't go the way we had planned, but what went wrong? And am I willing to change?

00;35;09;08 - 00;35;26;03

Ryan Lefebvre

Am I willing to do something different in the upcoming year and learn from my mistakes instead of camping in them, as we were talking about in the last segment? So I'm really looking forward to 2026. The question has come up, you know, what are the royals need to be better? They just need to be better. They could use a couple.

00;35;26;03 - 00;35;39;03

Ryan Lefebvre

They could use a couple of players like every other team could use a couple of players. But I think the lessons learned, if it's handled correctly, I think the lessons learned in falling short in 2025 are going to serve them well in 2026.

00;35;39;03 - 00;35;39;17

Cary Hall

Well, you know.

00;35;39;18 - 00;35;53;00

Cary Hall

And they're fun to watch. You've got a man child that I think really connects with these young guys. They got some great leaders on there and Salvi and some of the other guys and yeah, I gotta I'm up to of course, I'm optimistic about them every year.

00;35;53;00 - 00;35;53;19

Ryan Lefebvre

Right.

00;35;53;22 - 00;36;10;04

Cary Hall

But I'm optimistic that they will do well, next year and, and they'll continue to grow. It's, you know, it's not easy. We're small market team. You know, we don't have the payroll the Dodgers do. Right. So we don't have Shoni Otani. Right. And some of those. But, you know, again, for a small market team, I think we do pretty well.

00;36;10;04 - 00;36;12;25

Ryan Lefebvre

Well, if Denny's formula stays true this year.

00;36;12;27 - 00;36;13;14

Cary Hall

Yeah.

00;36;13;16 - 00;36;21;04

Ryan Lefebvre

Monumental leap forward regression. And then as he said and then look out. So hopefully 2026 is a look out year for the rest of the league.

00;36;21;05 - 00;36;38;20

Cary Hall

I really like that. We hope it is the lockout year this year. And we hope that, we enjoy watching them as much as we did last year and even more so, you know, back to the topic today. You know, oftentimes I talk about the hometown carrier, the difference between them and what I call the conglom-o national carriers.

00;36;38;20 - 00;36;53;20

Cary Hall

You heard about that today. The resources they put in. The 5000 kids a year they help. The various organizations, they help in the city. You don't have to be a Blue Cross, Blue shield, client. You don't have to be a member. But you can go up on the website that they've got set up and you can get help.

00;36;53;23 - 00;37;15;06

Cary Hall

You can about counseling and all the rest of it. Those are all things they offer. And if you happen to have one of those Blue Cross and Blue Shield plans with Spira Care, which, by the way, have zero co-pays, you have behavioral health available to you at no cost, additional cost to you. So that's a little bit of why I think it makes a difference to be the hometown carrier versus the not hometown carrier.

00;37;15;09 - 00;37;20;19

Cary Hall

So thank you all for listening today. We greatly appreciate it. Once again, that documentary is:

00;37;20;19 - 00;37;21;01

Kristin Gernon

Not Good Enough.

00;37;21;07 - 00;37;22;12

Cary Hall

And it can be found.

00;37;22;12 - 00;37;25;22

Kristin Gernon

At shutoutthesigma.com/documentary.

00;37;25;22 - 00;37;40;13

Cary Hall

Right. Okay. So there it is. It's available to you. And now I leave you with this thought from Albert Einstein, the one who follows the crowd. They usually to get no further than the crowd. The one who walks alone is likely to find himself in places no one has ever been. Remember, friends, it's a funny thing about life.

00;37;40;13 - 00;37;51;22

Cary Hall

If you refuse to accept anything but the very best. You most often get it. Thank you for listening to America's Healthcare Advocates Show, broadcasting coast to coast across the USA. Goodbye America.

Our Small Group Show with Blue Cross Blue Shield of Kansas

Sat, 15 Nov 2025 01:25:10 GMT

Episode 2134 notes

My guest Misty Snodgrass and I explore why only one carrier services 103 Kansas counties and even goes below five lives in small group coverage. They are Blue Cross Blue Shield of Kansas, and they are truly the hometown carrier.

Misty is their Director of ACA & Medicaid and is my expert guest.

At Blue Cross Blue Shield of Kansas, community involvement is a key component.
Discuss how an EPO (Exclusive Provider Organization) may be a great option and we’ll contrast PPO Designs, etc.
Other carriers pull out of the state when claims go up. Not Blue Cross of Kansas. They are here to stay and in all 103 counties. We’ve been here for 80 years and we aren’t going anywhere.

This is episode 2134 of America’s Healthcare Advocate. I’m Cary Hall.

Learn more about BCBSKS.com or call (866) 906-5253.

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Watch this episode on YouTube Podcas t:

Watch this episode on rumble:

Listen to this episode.

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2131 Transcript:

00;00;00;18 - 00;00;18;03

Cary Hall

Let me tell you a little bit about this upcoming show today. You know, I'm going to define the difference between the hometown carrier and the national carriers that you hear me use that phrase a lot. We're main Street, not Wall Street. Well, I'm going to tell you why. I'm going to tell you why. Blue Cross and Blue Shield of Kansas is the only carry that services 103 counties.

00;00;18;10 - 00;00;31;05

Cary Hall

I'm going to tell you why. Blue Cross and Blue Shield of Kansas is the only carry that goes below five lives on small group. I'm going to tell you that and a lot more. And my guest is Misty Snodgrass, and she's going to explain it all.

00;00;31;07 - 00;00;35;21

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;35;23 - 00;00;43;23

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network.

00;00;43;24 - 00;01;01;02

Cary Hall

You can find out more about us by going to the website AmericasHealthcareAdvocate.com. AmericasHealthcareAdvocate.com. You have a question or comment? Send me an email. I'm happy to help you. We had a young man the other day who needed a wheelchair. He couldn't get it. We were able to step in and help them make that happen.

00;01;01;07 - 00;01;22;22

Cary Hall

With the good folks over at United Health Care. So we're happy to help anytime we can. Also, we are on 16 podcast platforms and our YouTube channel, 604,000 views. Thanks to Mr. David Thiessen, my producer that handles all of our podcast, the YouTube channels and also films all of these shows and puts them up there for all of you to see and watch and listen to.

00;01;22;26 - 00;01;45;06

Cary Hall

We thank all of you and the listening audience and our audience in general for pushing those numbers up, because they are better than anything we've ever seen. So we're very happy with what's going on. Once again, the website is AmericasHealthcareAdvocate.com. If you have questions in studio with me, Misty Snodgrass, she is the director of ACA Obamacare, if you will, and Medicaid for Blue Cross and Blue Shield of Kansas.

00;01;45;06 - 00;01;49;16

Cary Hall

Back for another show. You like it so much the first time you came back to do another one, I.

00;01;49;16 - 00;01;51;21

Misty Snodgrass

I know it was a great show. Thank you so much for having me.

00;01;51;22 - 00;02;12;18

Cary Hall

It was a great show and we got a lot. We got a lot of response after that show. Great, because I think we explained to people, you know, information that they didn't know and didn't have. And that's the whole idea behind this. So today's show, you know, you hear me use this phrase a lot, okay. When it you know, I work with Blue Cross, the Kansas City Blue Cross of Kansas, that blue cross of Nebraska.

00;02;12;25 - 00;02;32;05

Cary Hall

So I work with three different Blue Cross plans on the radio and marketing, etc. and I use that term hometown carrier with all three of those plans. And there's a reason for that. You know, one of the things that I learned in the last show I did with Misty was this 103 counties in Kansas. You know how many carriers are in all 103 counties.

00;02;32;07 - 00;02;33;02

Cary Hall

How many Misty?

00;02;33;02 - 00;02;33;20

Misty Snodgrass

Just one.

00;02;33;20 - 00;02;35;01

Cary Hall

That's right, and who would that be?

00;02;35;02 - 00;02;35;17

Misty Snodgrass

That would be us.

00;02;35;19 - 00;02;55;12

Cary Hall

That would be Blue Cross of Kansas. So when I say hometown carrier, that's because I'm talking about the carrier that's going to service you wherever you are, whether you're in Hays, whether you're in Scott City, whether you’re in Emporia, it doesn't matter. Blue Cross of Kansas is going to have a plan, whether it's a individual plan or small group plan.

00;02;55;13 - 00;03;11;08

Cary Hall

Now we're going to talk a lot about those today or a group health insurance plan of some kind. They're going to have a plan in your area that they can offer you. Unlike a lot of the national carriers who kind of pick and choose where they want to be. And then you have carriers and pull out of the marketplace like Aetna did this year.

00;03;11;11 - 00;03;30;00

Cary Hall

1 million people on ACA lose their coverage as of December 31st. So the hometown carrier means they live here. They work here. They're in our community and they cover the entire state. And that's, you know, yeah, I was going to show notes this morning. I was looking at some of the things that you wrote, and I'm like, they're really dedicated to this.

00;03;30;00 - 00;03;32;03

Cary Hall

This is a big deal to you guys.

00;03;32;08 - 00;03;51;01

Misty Snodgrass

It’s part of our mission it’s to the core of who we are, we want to serve as many Kansans as we can. That is our pure mission. And so we are, you know, they we work here, we play here, we spend our time. We we grow our families here. And we want to help support the employers and our communities that are, you know, trying to make find their way in this world right now.

00;03;51;01 - 00;03;55;22

Misty Snodgrass

And so and also any individual members that are trying to find health care coverage.

00;03;55;24 - 00;03;56;25

Cary Hall

It's confusing.

00;03;57;01 - 00;03;58;06

Misty Snodgrass

Oh, yes.

00;03;58;08 - 00;04;19;22

Cary Hall

Yes. She says, oh yes. And this year it's really confusing. It is. And so, you know, when when we tell you that if you want to call and talk to somebody that's not calling to get a sales pitch, that's explained when they call and you have award winning customer service and great people out there that do a great job.

00;04;19;22 - 00;04;31;07

Cary Hall

So talk a little bit about that, because if you just want to call up and talk to somebody about, well, what should I do? You know, that to me is really important. So talk a little bit about this.

00;04;31;07 - 00;04;48;00

Misty Snodgrass

Yeah, absolutely. I mean, this health insurance is complex for even those of us that work in it. You know, it's not even just people that are trying to figure out in they're open enrollment, period, whether it be for individual or their small group plans. And so it really is challenging. What does co-insurance mean. What do all these terms mean?

00;04;48;00 - 00;05;04;03

Misty Snodgrass

How does it impact me? That's the bottom line is how does it impact me. And so we have great teams throughout the entire state of Kansas that are just focused to answer those questions for you. You're not going to get some, you know, you have to push one to talk to two people, you know, all of those things or talk to a robot.

00;05;04;10 - 00;05;27;04

Misty Snodgrass

You actually talk to real life people in Kansas that know your health system at Hays Medical Center. They know you know Wichita Via Christi. They know, what those providers are in your communities to make sure that they're covered and they'll stay on the phone call as long as they can. Their goal is not to get you off like a lot of places is like, what can I you know, answer right now and quickly get you off and move on to my next call.

00;05;27;06 - 00;05;53;08

Misty Snodgrass

Their actual focus is first call resolution, so they will stay on the call with you as long as they need to to answer your questions. And they're not pitching you, any sort of products they're asking you. You know, what is your concerns? What are you concerned about out-of-pocket costs? Are you concerned about prescription drug co-pays? And so they're happy to answer those questions and help walk through kind of the scenarios to look and see if your medications covered on your formulary, you know, is your doctor in network.

00;05;53;15 - 00;06;02;12

Misty Snodgrass

And it is a real person that answers. And we love our customer service team. They are award winning because they really are focused on doing the good work and very passionate about it as well.

00;06;02;13 - 00;06;16;26

Cary Hall

Yeah. And so those are some things that are really... let’s, kind of dissect that a little bit. Right. You see a lot of commercials on television this time of year on the Medicare side. And the rest of it, and most of those are for call centers, national call centers. And yeah, I used to make a joke.

00;06;16;26 - 00;06;33;11

Cary Hall

In fact, I still do, especially in Kansas City, that when you call one of those numbers, you asked about the hospital north of the river and they ask you what river? You know, you're not talking to somebody in your own community. Okay. So you know, when you call and you ask, well, tell me about Via Christi.

00;06;33;11 - 00;06;57;29

Cary Hall

They go, well, what is Via Christi? You probably know they don't know the hospitals in Wichita and Via Christi, being a large hospital system. Wichita. Absolutely. That's the point. Okay. When you're talking to people there and the people that work for Blue Cross of Kansas work all over the state of Kansas. So when you're talking to people that work at Blue Cross of Kansas, they know every one of those communities and they know they know the providers.

00;06;57;29 - 00;07;04;00

Cary Hall

They know what's available and all the rest of it. And you're talking to people that live and work in your community. And that's really the whole point of this thing, isn't it?

00;07;04;00 - 00;07;25;10

Misty Snodgrass

Absolutely. Well, and I think it's just not only, is it that we, you know, know those we live in those communities, right? So we know where Hoxie, Kansas is. And, you know, our kids are playing on the soccer fields and they may get injured and need to go to the local health system there. And so we really are knowing our communities that we are embedded in our communities and we give back to our communities.

00;07;25;10 - 00;07;43;22

Misty Snodgrass

I think that's really important as we are. You know, your tax dollars are staying here. Your, premium dollars are staying here. And so it's really important because it helps to reinvest in Kansas. It's just like every small business owner. My dad's a small business owner, and everybody wants to reinvest in their communities because they know it just helps everything.

00;07;43;22 - 00;08;03;27

Misty Snodgrass

And so it helps to uplift it. So we're there. We're volunteering. You should see how many volunteer hours we do in our communities. We're working at local zoos in Topeka. We're putting backpacks together for kids, for school or helping at trunk or treats all around the state. And so we really are wanting to give back every single day to our communities as well as serve them.

00;08;04;00 - 00;08;21;08

Cary Hall

See, and, again when I talk about hometown carrier, you hear me use the phrase a lot of times we’re Main Street, not Wall Street. But that's because they're not for profit. They're not looking at what the next quarterly earnings report is going to say. What they're doing is they're talking to you about what's going on in your community.

00;08;21;08 - 00;08;41;05

Cary Hall

They are putting back in your community? They're creating an opportunity to connect with the community and support people that live and work in Kansas. They're the same people you go to church with, the same people you go to PTA meetings with. I mean, they are the same folks. They're there every day to serve. And again, they live and work in your community.

00;08;41;05 - 00;08;56;06

Cary Hall

So that's the difference. And so that was the first thing I wanted to talk about today was this. What is this whole idea of hometown carrier? Why does it make a difference? When I come back from the break, I'm going to talk about some of those charities and the communities that they're involved in and what they're doing here.

00;08;56;09 - 00;09;21;00

Cary Hall

And let you hear what they're doing. And then you might want to ask yourself, you know, are any of the national carriers doing this? Good question. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. If you're looking for information and you want to talk to somebody at Blue Cross and Blue Shield, you can call them at (866) 906 5253.

00;09;21;02 - 00;09;39;01

Cary Hall

That's (866) 906-5253 or go up on the website bcbsks.com. That's the website go up. All these plans are up there. You can explore these. And then if you want to pick up the phone and call, they'll be happy to chat with you, walk you through it. So you know what? Maybe this one's a better fit than this one is.

00;09;39;08 - 00;09;57;04

Cary Hall

Or let's look at your formulary for your prescription drugs. They'll do all that for you. When we come back from the break. We're going to continue the show with Misty. I want to talk about what they're actually doing in some of the communities. Where they actually involved and what's happening in the communities that Blue Cross and Blue Shield of Kansas is supporting right here in the state of Kansas.

00;09;57;04 - 00;10;12;18

Cary Hall

We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA. Stay right there.

00;10;12;21 - 00;10;15;23

Cary Hall

00;10;15;25 - 00;10;39;01

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. Shout out to our affiliate up in Salina, Kansas KSAL NewsRadio 1150 a happy to have us as part of the family. They're broadcasting to all the folks in and around Salina, Kansas. In studio with me today, Misty Snodgrass from Blue Cross and Blue Shield of Kansas.

00;10;39;07 - 00;10;57;27

Cary Hall

We're talking about the theme of Hometown Carrier. What does it mean to be that hometown carrier? Why is that different than the national carriers? We're talking about what they do. We're also going to talk about the plans that they offer, where they service them. You know, this is the only carrier that services is all 103 counties in the state of Kansas.

00;10;57;29 - 00;11;24;20

Cary Hall

It's a big deal if you're out in Hays or Scott City. Emporia, you know where maybe the national carriers don't participate. So we're exploring all of that. If you want information on any of their plans, bcbsks.com is the website. Or you can call their customer service folks. They're happy to talk with you. Just explore options about what you've got or what maybe you think you might want to change to once again, (866) 906-5253.

00;11;24;25 - 00;11;52;24

Cary Hall

A lot of turmoil in the ACA Obamacare market, right now. Open enrollment is here on November 1st. Obviously, now's the time to call and do a consultation. This is not a hard sale or anything like that. You heard Misty describe it. They're there to help you. (866) 906 5253. All right. So let's talk a little bit about community involvement because this is something you do that national carriers just don't do, okay.

00;11;52;27 - 00;12;04;01

Cary Hall

They're not equipped to handle it frankly across the country. So you know to the you folks that's important. So talk a little bit about some of that what you do and how does all that work in the state.

00;12;04;05 - 00;12;25;15

Misty Snodgrass

Yeah I think it's really, really important because like I said, we're not only investing in and health care, but we're also investing in other initiatives that are important in our community. So one great example. We actually have a Blue Health Initiatives team that's dedicated to this. We have an entire team of folks that are dedicated to working in community, helping support community based organizations, local nonprofits,

00;12;25;18 - 00;12;47;00

Misty Snodgrass

Where can we plug in and not, you know, take over, but be a supplement to be able to assist them. Sometimes it's financially, sometimes it's just time and energy, sometimes is volunteer work. And so that work is really important to us as the core of who we are is fundamentally important to our board. They actually report all the information activity to our board of directors.

00;12;47;02 - 00;13;06;04

Misty Snodgrass

That's how important this is a strategic initiative for our company. And it's a high priority. And so some of the things that we're doing in community is we're building local fitness courts in areas where there may not be a local gym or a YMCA. They're able to, you know, go to a park. It's an outdoor facility, and they're able to go lift weights.

00;13;06;04 - 00;13;11;15

Misty Snodgrass

They're able to play on tennis courts. It's just to help encourage fitness and community and also to create community.

00;13;11;21 - 00;13;26;15

Cary Hall

And in some of these communities, they don't have a gym in a rural community. They've got a community park. If they can go in there and add to that and make that, you know, workout stations or walking stations, what ever it is. But it doesn't sound like it but you know what? It's really important to people who live in that community.

00;13;26;16 - 00;13;47;04

Misty Snodgrass

Absolutely. And it's focused on wellness. Overall physical wellness. You know, we know physical health and mental wellness are a key and and tied together. And some of the other things that we're doing is like I mentioned, we do some backpack events around back to school. We’re stuffing backpacks with school supplies. We're doing trunk or treats with, you know, candy and so forth.

00;13;47;04 - 00;14;12;04

Misty Snodgrass

And we're really focused on being in community. We support other initiatives. One great example in Wichita is called Baby Talk, and it's to help pregnant moms that need resources while they're pregnant, they may not have information. I've been a pregnant mom before and it's really nerve racking. And so we support that initiative in Wichita to help moms throughout the state.

00;14;12;04 - 00;14;29;20

Misty Snodgrass

So it's virtually and in person in Wichita. It also provides that people go through the classes and kind of learn some tricks of the trade. You also get a gift card for childcare or your car seat carrier. Or you could get a crib, you know, it's a it's a gift card that can go towards those kind of purchases.

00;14;29;20 - 00;14;52;16

Misty Snodgrass

And so it's really important that we invest in various initiatives that we're doing in local communities. And I could go on and on. I could spend days because I'm so proud of the work that our Blue Health Initiatives team is and how intentional they are. You know, they're very, very focused. One other thing we're working on is how can we make our language access better so individuals that may not have English as their first language

00;14;52;21 - 00;14;53;04

Cary Hall

Speaking Spanish.

00;14;53;05 - 00;15;14;20

Misty Snodgrass

Yes, absolutely. Absolutely. And so we're working to make sure that with our materials that they know the rights. Because whenever you go into a health care provider, you have rights to have access to language access. So we're working on that right now to improve language access. And we know that that's important because if it's not your your first language. I mean, we think health insurance is confusing.

00;15;14;20 - 00;15;28;24

Cary Hall

Well, you know I'll tell you a story. I was in Scott City, Kansas doing radio probably ten years ago. And I'm like, what are all these feedlots out here? Well, the biggest slaughterhouses in Kansas, JPL and the rest of them are just outside of there over toward Dodge.

00;15;28;25 - 00;15;29;17

Misty Snodgrass

Yeah.

00;15;29;20 - 00;15;42;28

Cary Hall

I heard there were more Mexican restaurants in that town, and I love to eat mexican, and I was like, this is like amazing. And I'm like, well, why are there so many Mexican restaurants? Because our entire population here, working population is 80% Hispanic.

00;15;43;05 - 00;15;44;02

Misty Snodgrass

So absolutely.

00;15;44;02 - 00;16;00;15

Cary Hall

You think in Kansas, you know, Dorothy's going to click her heels and she and Toto ride off? It's not quite like that. Yeah. We have we have a large community of people here that are non-English speaking community primarily, and that's a big difference. So you guys are moving to help those folks do what they do?

00;16;00;17 - 00;16;19;25

Misty Snodgrass

Absolutely. And we're partnering with organizations. And also, one of the things that we are hoping to do next year is go into those communities and help explain what their benefits are, because we know if people don't know what their benefits are, they don't use them. And so we want to make sure that they're aware that we have telehealth available in Spanish, that we do have resources available in Spanish.

00;16;19;28 - 00;16;36;26

Misty Snodgrass

And what does health insurance really mean? What does a coinsurance mean. That doesn't always translate very well, which is very complex for if it or isn't our first language? And so we want to be really intentional and thoughtful to serve all Kansans regardless of what language they choose.

00;16;36;26 - 00;16;55;13

Cary Hall

And when we go to break, I have to ask you on the baby talk plan that you've got those classes. You do not have to be a Blue Cross and Blue Shield policy holder? I want to make that point because BlueKC offers something similar to that on the behavioral side. So those classes are available for anybody in the state of Kansas.

00;16;55;13 - 00;17;00;25

Cary Hall

Any mom that wants to do those classes, where do they go? Do they go on your website for this?

00;17;00;27 - 00;17;18;00

Misty Snodgrass

We're going to have it on our website. We don't. But I will get you the website and you can put it up and share that out with your listeners, because it is a really important program to help educate on prenatal. It's really important to make sure you're getting going to your doctor's visits, make sure you know kick counts, all of those important things.

00;17;18;02 - 00;17;20;14

Misty Snodgrass

And when it comes to prenatal and pregnancy.

00;17;20;16 - 00;17;36;27

Cary Hall

I've got six grandchildren. Trust me, I know what my daughters went through. So I can assure you this is a welcome thing to have in the community. There are a lot of women out there that will be able to participate in this. So as soon as we get this information, we'll put it in the broadcast, we'll put it up on the podcast and on the YouTube so you all can see it.

00;17;37;00 - 00;17;54;29

Cary Hall

Anywhere in the state of Kansas enrolled. They don't cost anything. It's what they're doing to help folks in Kansas do what they need to do. If you want help, if you want to, if you want the policy explained, if you want to understand what your benefits are, if you're looking for a policy and you don't know what to do, especially during this turmoil with the ACA.

00;17;55;02 - 00;18;21;07

Cary Hall

(866) 906-5253. (866) 906-5253 or BCBSKS.com, bcbsks.com. If you want to just go up and explore but are open and then call them, do that, they'll be happy to chat with you and make it work for you. We'll be right back after a break. Welcome back to the break. I'm going to get into some plans now. I'm going to start talking about what are they offering on the small group side.

00;18;21;09 - 00;18;43;04

Cary Hall

You know it's interesting. And we'll get into this in a minute. How many carriers offer plans to small group below five? That's the question we're going to answer when we come back from the break. Stay tuned. I'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting. Coast to coast across the USA here on the HIA radio network.

00;18;43;07 - 00;18;58;11

Cary Hall

So the website for Baby talk is babytalkict.com. That's babytalkict.com.

00;18;58;13 - 00;19;23;25

Cary Hall

Welcome back. You're listening to America's Healthcare Advocates Show broadcasting coast to coast across the USA. My producers day Mister Dave Thiessen behind the cameras posting all these shows up on our podcast YouTube platform 604,000 views. Thanks to all of you. It's kind of amazing and Garner Cowdrey, he's on the board here working. All the audio here at Cumulus at our hometown flagship station here in Overland Park, Kansas, in studio with me,

00;19;23;25 - 00;19;43;09

Cary Hall

Misty Snodgrass once again here to talk about Blue Cross and Blue Shield of Kansas. We're talking about how unique they are to this state and what they do in the state that's very different than the national carriers. If you want help, call them. Just have a discussion. You know, ACA is upon us open enrollment. There are a lot of premium increases.

00;19;43;09 - 00;20;11;03

Cary Hall

People pulling out of the market like Aetna did, you know that kind of thing. (866) 906-5253. (866) 906-5253 no, high pressure sales tactics. This isn't some number on television that you're going to call some national call center. Okay. That's not how this works. These are folks right here in our community that live and work in Kansas. The website BCBSKS.com, BCBSKS.com.

00;20;11;09 - 00;20;35;10

Cary Hall

So what I'm going to the show notes this morning. I see this down to one life. And I remember when I was a broker, the major carriers, the national carriers would not go below five lives. So you there are more small businesses out there are one, two, three, four and five employees than you can shake a stick at it and they won't even offer them coverage

00;20;35;12 - 00;20;35;25

Misty Snodgrass

No.

00;20;35;28 - 00;20;38;22

Cary Hall

Well, so why is that first of all?

00;20;38;25 - 00;20;42;06

Misty Snodgrass

Well, I think is it's a lot of work, right. You know, it is a lot of work.

00;20;42;08 - 00;20;44;12

Cary Hall

It's as much work to enroll five as it is 50.

00;20;44;14 - 00;20;45;11

Misty Snodgrass

100%.

00;20;45;11 - 00;21;09;00

Misty Snodgrass

And so I think that you know, we're not focused on margins. So that's the difference. And we are focused on really helping all Kansans be covered. And so we believe small businesses, regardless of size, are the backbone of our economy and the backbone of Kansas. And so whether you're a small employer, a family owned business, or a company with 50 employees, we have plans that are designed for you.

00;21;09;00 - 00;21;25;06

Misty Snodgrass

And, you know, it's we believe every job matters. And we believe if you have one employee, two employees to 500, you're just as important and we'll treat you. And we have a team dedicated for those size. So it's not just like you're going to you know, we're going to give you preference to the ones that are 500 and.

00;21;25;08 - 00;21;35;02

Cary Hall

You’ve got a whole segment of your customer service people and your sales reps. They represent just ten and below. That's it. So they understand that space intimately.

00;21;35;03 - 00;21;55;12

Misty Snodgrass

They do. They do. And the complex needs around it. Right. Like it's whenever your employer is deciding what health coverage to select,it's a really nerve-Racking thing. They're wanting to keep their employees for retention. They know how important it is. And every time every employer, including us, you know, we went through our open enrollment, there's questions are related to it.

00;21;55;15 - 00;22;09;28

Misty Snodgrass

What does this mean for me? What does this out-of-pocket cost me? And for me. And it's unique based upon the needs of every employer. And so it's a lot of work trying to figure out, you know, do you have individuals in your plan that are going to be high utilizers folks that are going to have complex chronic conditions?

00;22;09;28 - 00;22;28;10

Misty Snodgrass

And so we work through that. We listen and then we try to reflect back and find the plan that actually works for them. So it's it's customized based upon and tailored, our suggestions and recommendations based upon the needs of you as an employer versus you call on a call center and they say, and here's our plans, here's what we have to offer here.

00;22;28;10 - 00;22;31;25

Misty Snodgrass

And we actually will go out and meet with you. We'll go into your offices.

00;22;31;26 - 00;22;33;15

Cary Hall

Five lives and they’ll go out to meet with you less than that.

00;22;33;15 - 00;22;52;01

Misty Snodgrass

Yeah, absolutely. And that is, you know, we love what we call them, our micro groups. We love our micro groups. There are the heart of Blue Cross, Blue Shield of Kansas because we also know those micro groups. Sometimes they grow to be 100 employees, and we were there for them when no one else was. And also sometimes they just want to be at five employees and four employees.

00;22;52;03 - 00;22;57;27

Misty Snodgrass

And we are okay with that. We want them to grow and thrive in the way that's best for them and support them for their health care needs.

00;22;57;27 - 00;23;17;07

Cary Hall

So when I'm going to show notes this morning and I see down to one life and it triggers in my mind, a question I used to see, but why would they offer a plan to one life? Well, the answer is you got a mom and pop shop, okay? And one of them is going to retire because they're turning 65. What happens to the other person?

00;23;17;09 - 00;23;21;07

Cary Hall

Well, they lose her coverage, right? No, they don't explain that.

00;23;21;13 - 00;23;45;05

Misty Snodgrass

Yeah. So they're they're able to stay on as a group. There are certain qualifying criteria, but they're able to stay on as part of our groups. And you know they're not going to go get priced astronomically because they're in the metallic plans. And so they're able to go get that coverage for them if they want to be a part of a group, because sometimes it's more affordable than for them being in the individual market, or the plans may be more advantageous to them.

00;23;45;11 - 00;23;52;13

Misty Snodgrass

And so we look at it is we want to cover every Kansan and every small employer matters regardless of size.

00;23;52;16 - 00;24;09;14

Cary Hall

So let's talk a little bit about EPO and PPO. So this is how we kind of get in the weeds a little bit here. So these are two separate group plans. I think most people out there know what a PPO is. That's the network the largest network. But let's talk about difference between that and EPO.

00;24;09;19 - 00;24;11;24

Cary Hall

And there is a difference. And there's a cost saving.

00;24;11;24 - 00;24;30;23

Misty Snodgrass

Absolutely. And I think it's really important. And I know when I first started learning about EPO because they came on kind of out of right after the ACA passed, it was kind of where they started to rise to prominence. And an EPO is called an Exclusive Provider Organization, you know, and it's typically a lower premium.

00;24;30;26 - 00;24;53;19

Misty Snodgrass

And it's a real simple network design. And so it's perfect for businesses that are centered primarily in Kansas, that they're not going to have a lot of people traveling or employees outside of the region. So in other states, because it is more affordable to not have a national wide network. Now, that doesn't mean if you're traveling and you have an emergency, that you’re not going to be In-Network, you're not going to get some out of network costs.

00;24;53;19 - 00;25;03;18

Misty Snodgrass

It's a lot of confusion around that. They think, oh, I can't leave the state. Oh my gosh, I'm in Oklahoma. I got to go drive back to Kansas and I have a medical emergency. No, we want you to go to the hospital.

00;25;03;21 - 00;25;04;28

Cary Hall

It’s Covered just like anything is.

00;25;04;28 - 00;25;21;04

Misty Snodgrass

It is. We have that focus. And so it's really advantageous for kind of your local regional employers that are in the state. We also have a PPO design. And you know, as a remote work kind of blew up during Covid in the pandemic.

00;25;21;06 - 00;25;37;19

Misty Snodgrass

We have employees that are in multiple states, right. There's employers that have people that are close to the Kansas border that are actually living in Missouri. We have people that are on the southern border of our state that live in Oklahoma, but they work in Kansas.

00;25;37;19 - 00;25;56;24

Misty Snodgrass

And so and vice versa around all of our surrounding states. And so we have what's called a PPO so that they're able to leverage what's called our blue card network. So you basically are a host member on a different, so you'd be on, you know, Blue Cross Blue shield in Nebraska's network when you're still a Blue Cross Blue Shield of Kansas member.

00;25;56;24 - 00;26;05;22

Misty Snodgrass

And so it gets a little bit complicated, but you're able to access all the local providers in your community. And so you're able to leverage that nationwide network as part of your In-Network.

00;26;05;23 - 00;26;27;17

Cary Hall

So I want to go back to the EPO thing for you and just kind of drill home something here. So let's say you're in Wichita and you're listening to this. You know what? I need to find out about that EPO, I'll bet you that 90% of your care would be at Via Christi hospital or Via Christi providers. Because that’s Wichita. I used to do a lot of work in Wichita. We’re on the radio down there on KNSS.

00;26;27;17 - 00;26;43;01

Cary Hall

I know it very, very well. Well, then, how much of a need are you going to have to go outside of network? Well, if you're going to go to KU for cancer treatment or heart or whatever it is. That's in-network, if you're going to go to Via Christie, that's in-network.I mean, what was the name of the hospital?

00;26;43;01 - 00;26;44;02

Cary Hall

Hayes, you mentioned.

00;26;44;04 - 00;26;44;24

Misty Snodgrass

Hayes Medical Center.

00;26;44;25 - 00;26;45;18

Cary Hall

Hayes Medical Center.

00;26;45;18 - 00;26;47;06

Cary Hall

They’re in-network.

00;26;47;11 - 00;27;08;27

Cary Hall

So when I'm when I ask you to look at this EPO thing, and if you look at the value that's being offered and the value is it, you're in the whole Blue Cross of Kansas network in all 103 counties and you can save money. It would make a lot of sense to take a look at that and go to your employees and say, here's what we're going to do.

00;27;09;00 - 00;27;25;10

Cary Hall

We're going to cut costs by X because we're going to go on this new plan with this EPO. You've got all the hospitals in Kansas, but you're not going to go to MD Anderson. Okay? I mean, there you go. Okay. You know, you're going to go to KU. Well, interestingly enough, KU has a partnership with MD Anderson.

00;27;25;12 - 00;27;41;13

Cary Hall

So you can get a lot of those treatments at KU that you can get it M.D. Anderson, because they're already there. My point in telling you that is it's worth exploring. That's okay. So that's why when she talks about that dedicated team of ten and below, give them a call.

00;27;41;15 - 00;27;55;11

Misty Snodgrass

Now we have 90 over 90% of the providers in Kansas in-network. So it's a broad network even for an EPO. So it's fantastic coverage. So if you're even traveling the state you're able to access that which is not like other EPO’s out there.

00;27;55;13 - 00;28;09;28

Cary Hall

It's not. And it's very, very different because they're offering coverage across the state near where we go. This is what I'm talking about when I say, you know, pick up the phone and call one of their folks at that team. It's dedicated. All they do is ten and below. They know what it means to have a three life.

00;28;09;28 - 00;28;32;27

Cary Hall

Four life, six life case. All right. And they're happy to talk with you and show you this is what the plan looks like. Here's what we can do. And, oh yeah, all you people have access. All hospitals and doctors throughout the state. They're inside that network. So do it. (866) 906-5253. (866) 906-5253 their website. You can go look at the plans on the website.

00;28;32;29 - 00;28;54;13

Cary Hall

bcbsks.com. bcbsks.com. When come back from the break. We're going to talk about what's going to happen in the marketplace this year. How many national carriers are coming in here with aggressive new plans? How does that compare with what Blue Cross and Blue Shield of Kansas is doing, and how does that compare for what you're looking for? What's the stability of that?

00;28;54;13 - 00;29;11;19

Cary Hall

We'll talk about all that when I come back from the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network coast to coast across USA. We've got more. Don't go anywhere.

00;29;11;21 - 00;29;32;14

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across the USA. The show today is focused on Blue Cross and Blue Shield of Kansas, the hometown carrier. And you know, I did that on purpose because I really wanted to get you to understand the difference between what they do in this state, where I live, where you all live.

00;29;32;14 - 00;29;53;25

Cary Hall

Okay. And what how that contrasts with the national carriers do. We're going to dive a little more into that. But once again we talked about that EPO, PPO. There are a lot of different plan designs out there they can help you with, if you want information. (866) 906-5253. You're not going to get high pressure sales tactics. You're going to get somebody who wants to talk to you, explain their options.

00;29;53;25 - 00;30;22;02

Cary Hall

They've got a whole team of people on ten and below. So employers with ten or fewer lives, national carriers don't even go below five lives. They do. Blue Cross and Blue Shield of Kansas goes down to one life. Okay. Also, the website BCBSKS.com, bcbsks.com. All right. So let's talk about this because this kind of this is what actually triggered me doing this show today was you and I were having a conversation after the last show, and I knew this was coming.

00;30;22;02 - 00;30;40;04

Cary Hall

I didn't know was already here that a certain national carriers are coming in here this year, and they do this from time to time. They'll come in with very aggressive pricing in the marketplace. And then two years later, when the claims numbers start going up and they're catching up with where they are, they pull out.

00;30;40;06 - 00;31;02;20

Cary Hall

Now as an example of that was what happened with Aetna. They lost $2 billion on ACA. And they finally said we've had enough. And they pulled, not, they didn’t just pull out of Kansas. They pulled out of every state that they were in okay. So it does happen. So the point there is you guys are always here. Yeah. It's steady okay. Let's talk about.

00;31;02;20 - 00;31;18;23

Misty Snodgrass

That. Yeah I think it's a great comment. And you know and Cary if you remember this a few years back, this happened again right? When things didn't get as profitable, when there was kind of the, the you know claims got a little bit tumultuous. Other carriers pulled out of the market and it just kind of happens over and over again.

00;31;18;23 - 00;31;39;00

Misty Snodgrass

If they're not hitting their margins, they have shareholders. We don't. And we have our members that we're focused on. And so I think that we're always here, we want to serve this market forever. It is a passion of ours, is our CEO. It's probably one of his favorite markets, actually. If he said he had a favorite child, he’d probably say

00;31;39;01 - 00;31;56;27

Misty Snodgrass

It was. I don't know that, you know, I'm just kidding. But he he really is passionate about serving small employers. And individuals as well and making sure they have access to care, because a lot of folks will go after the big, the national careers will go after the big employers, but a lot of them won't stick around for the smaller or the individuals and

00;31;56;27 - 00;31;58;05

Cary Hall

So they won't even offer coverage.

00;31;58;05 - 00;32;28;15

Misty Snodgrass

Absolutely, absolutely. And so we we want to be the stable carrier. We have been the stable carrier. We've never left. We've been around for 80 years. We've been here since the ACA began. We have no intention of leaving. We're actually a part of my role is what can we do to even enhance our ACA market? What can we do to actually serve our members and our employers more and better and provide, you know, help improve the total cost of care, and our affordability, but also help what other tools can we bring that are innovative to help, you know, both impact the individual from a quality of life perspective.

00;32;28;15 - 00;32;47;19

Misty Snodgrass

So we're having conversations about mindfulness tools for employers because we know behavioral health is a major concern. And so what can we do to help improve and reduce. Employee productivity help improve that. Missed days because of whether it be physical or mental illness. And so it is a high priority. We're here to stay.

00;32;47;21 - 00;32;51;09

Misty Snodgrass

And we're very passionate about the work and serving all 103 counties that we're in.

00;32;51;13 - 00;33;10;09

Cary Hall

Yeah. It's not a come and go situation. We're here this year and two years to now. And it's believe me, we've got multiple examples of this that happens okay. You know these folks at Blue Cross and Blue Shield of Kansas, there's no quarterly earnings report. No. It's all a little different. You know when I say main street, not Wall Street.

00;33;10;09 - 00;33;21;18

Cary Hall

That's what I'm talking about okay. And that's what's important. And when you talk about your CEO actually focusing and acknowledging that, that's pretty significant.

00;33;21;18 - 00;33;22;05

Misty Snodgrass

Absolutely.

00;33;22;08 - 00;33;31;12

Cary Hall

That means he understands as you said, how many small businesses out there have five employees or ten employees.

00;33;31;13 - 00;33;44;00

Misty Snodgrass

It's the cornerstone of our economy and our communities. Small businesses are donating to the local high school football teams and it just trickles down. And so we understand how important. And it's a cornerstone and we're here to stay.

00;33;44;03 - 00;33;50;15

Cary Hall

So talk a little bit about some of the product lines that are going to be offered this year on the group side both small group and the larger group side.

00;33;50;17 - 00;34;12;14

Misty Snodgrass

Yeah absolutely. So we have small group. We have EPOs and PPOs available. We have various metal tiers. So I think I talked about that in our last program. We have in small group a platinum, gold, silver and bronze. And we're the only one in market with a bronze plan. And I think there is going to be a new entrant on the platinum plan.

00;34;12;14 - 00;34;35;18

Misty Snodgrass

But we have most of our small groups are in gold because they want to have a richer benefit, lower predictable out-of-pocket costs from deductibles and maximum out-of-pocket. And we also offer a predictable co-pays. A lot of carriers will have co-insurance, and that's when it gets really messy, right? Like people are like, what is this going to cost me when I go to the pharmacy counter on this particular drug I'm on?

00;34;35;18 - 00;34;45;23

Misty Snodgrass

And so co-insurance is, I always say it's kind of fuzzy math. It's very it's very hard to predict. We have a predictable copay. You know, if this is your medication, you're going to go pay this amount.

00;34;45;23 - 00;34;48;18

Cary Hall

Tier 1, tier 2, tier 3 or whatever it is, that’s it.

00;34;48;23 - 00;34;49;07

Cary Hall

00;34;49;07 - 00;34;49;27

Misty Snodgrass

00;34;49;29 - 00;35;10;10

Cary Hall

So here's what she’s saying, it's not that plus 20%. Well, you take Jardiance, and my wife takes it. I've actually paid for it. It's $700. Okay. Now you got your copay. Let's say your co-pay is tier three or tier four, it’s $75 or a 100 bucks. Oh, and you owe 20% of the total cost of that med. That's a little different deal.

00;35;10;10 - 00;35;19;24

Misty Snodgrass

Yes. And we do have caps on our high costs specialty drugs as well because on what you have to pay out of pocket so that you'll know what you're paying. Because we do want people to take their medications. We know when people are on their medications...

00;35;19;24 - 00;35;20;13

Cary Hall

It kinda helps, doesn’t it?

00;35;20;13 - 00;35;39;21

Misty Snodgrass

They’re staying out of the hospital. Right. And in the emergency rooms, which are higher cost of care alternatives. And so we do have a priority on prescription drugs predictability, your co-pays for your doctor, we actually incentivize you to go to the doctor. So we have your first five visits are like basically in some of our plans free.

00;35;39;21 - 00;36;01;25

Misty Snodgrass

Or they may be a $35 copay, depending on what metal tier you're on. And so we want folks to go to the doctor. We're not wanting you not to get care because we know you're going to stay with us for a while. Usually, most of our employers have stayed with us for 40 plus years. And so we want to make sure we're taking care of folks, because those that national carriers will come in and have aggressive pricing and then two years, they'll they'll increase it.

00;36;01;25 - 00;36;11;14

Misty Snodgrass

And then all of a sudden they're gone. They're gone. And you're no longer in it. And you come back to us usually. And then you know that we want to focus on making sure you're well both physically and mentally.

00;36;11;18 - 00;36;17;02

Cary Hall

We got about 45 seconds left talking very quickly about virtual because all the rural counties. Yeah. The big deal.

00;36;17;02 - 00;36;32;06

Misty Snodgrass

Absolutely. And we think that's a big deal. So we have telehealth for physical and mental health. So instead of going to, you have an ear infection. You know it's an ear infection, right? You don't want to go sit in a waiting room at or I don't for sure an emergency department. You don't want to go pay for that copay.

00;36;32;08 - 00;36;49;27

Misty Snodgrass

We provide. Typically some of our plans there is some variability but usually free telehealth services. And so you're able to go in and access it's Amwell is our current vendor that we use. And you're able to go access that 24/7. Be able to go get that, get your prescription. You don't have to go sit in a waiting room.

00;36;49;27 - 00;36;54;02

Misty Snodgrass

And so you're able to have that. And so that helps especially in areas when there aren't providers.

00;36;54;05 - 00;37;09;06

Cary Hall

Or you're in a rural community, you have to drive 45 minutes to get to an urgent care center or something. This is great. It's the online. You go on, you're on the screen, you're talking to the doctor, nurse practitioner. You get what you need is one of the many things that they do. Thank you. This is a wealth of information.

00;37;09;06 - 00;37;21;12

Cary Hall

It's like drinking from a firehose. But I'm telling you, I think a lot of you learned a lot today about what Blue Cross and Blue Shield of Kansas does. Now, you know why I say the hometown carrier? Because that's really what they are.

00;37;21;19 - 00;37;42;16

Cary Hall

And now I leave you with this thought from Doctor Martin Luther King. Americans must learn to live together or they are surely going to perish together as fools. I don't think truer words were ever spoken. Thank you for listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the HIA Radio Network. Goodbye America.

Maria Ahlers on Group Health Insurance

Sat, 15 Nov 2025 01:00:34 GMT

Episode 2138 notes

Maria Ahlers is the action-oriented and results-focused professional who jois us today. Maria has over 20 years of experience in Business and Human Resources, strategic planning, developing project scope and customer relationships. She knows Group, and will let us know the latest from RPSBBDI!

This is episode 2138 of America’s Healthcare Advocate. I’m Cary Hall.

Learn more: https://www.rpsbenefitsbydesigninc.com or call (913) 385-2224

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Watch on YouTube

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Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

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Episode 2138 Transcript

The BlueKC FEP Show: Everything you need to know about the Blue Cross Blue Shield Federal Employee Program

Fri, 07 Nov 2025 14:40:10 GMT

Episode 2131 notes

JMy guest, Ron Miller is BlueKC’s FEP Senior Sales Consultant & Labor Liaison and Ron and I have all the things to know Right Now and why Federal Employees should consider Blue Cross Ble Shield for their health insurance needs!

The Blue Cross and Blue Shield Federal Employee Program is the number one health insurance choice for federal employees, retirees, and their families.
For nearly 60 years, we’ve been committed to offering federal employees the best healthcare coverage in the U.S.
More than 99% of our members stay with us year over year.
Our preferred provider network includes 95% of doctors, 96% of hospitals and 65,000 pharmacies nationwide. And you never need a referral to see a specialist.
24/7 care provided by Teladoc Health – treatment for minor injuries and illnesses, mental health support, dermatology care and more by phone or video.
Preventive care is always covered when you see a Preferred provider.
OPEN ENROLLMENT SEASON runs from Monday, Nov. 11th through Saturday, Dec. 8, 2025.

Virtual Fairs:

https://www.fepblue.org/events

To learn more about the Blue Cross Blue Shield Federal Employee Program, visit fepblue.org or call 800-411-BLUE.

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Watch this episode on YouTube Podcas t:

Watch this episode on rumble:

Listen to this episode.

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Play full audio podcast (above) or find it by clicking from the list below:

iHeart

Episode 2131 Transcript:

00;00;01;14 - 00;00;23;24

Cary Hall

And now America's Healthcare Advocate, Cary Hall. Hello, America. Welcome to America's Healthcare Advocates. Show Broadcasting Coast to coast across the USA. Here on the HIA Radio Network, you can find out more about us by going to the website AmericasHealthcareAdvocate.com. Also, all these shows are posted on our podcast platform and YouTube platform. New numbers.

00;00;24;01 - 00;00;46;28

Cary Hall

We are at 605,000 views. That's because. And listens on podcast. That's because of all of you in this audience. I want to thank you too. The show continues to grow. We continue to pick up affiliates and what's going on on our podcast. And YouTube is beyond anything I thought we'd ever accomplish. Hats off to Garner and to Dave Thiessen for putting all this together.

00;00;46;28 - 00;01;06;22

Cary Hall

And Dave, particularly for all the shows he videotapes and puts up there. If you're looking for ACA, Obamacare, maybe you're going to get one of those letters and you got one of those 17% increases. Of course you wouldn't if you were on Blue Cross and Blue Shield of Kansas City. But let's just say you're not. You might want to give Carolee Steele over at RPS Benefits by Design a call.

00;01;06;25 - 00;01;26;08

Cary Hall

And see if they can help you. That would be (913) 385 2224. That's (913) 385 2224. And if you're looking for employer sponsored coverage, call Maria Ahlers she'll show you everything in the marketplace and help you make the right decision. All right. In studio with me for what is this, like the 12th, the 13th year we've done?

00;01;26;15 - 00;01;27;16

Ron Miller

It's been a lot of years.

00;01;27;21 - 00;01;29;01

Cary Hall

Well, you've been there 30 years.

00;01;29;01 - 00;01;29;16

Ron Miller

30 years.

00;01;29;17 - 00;01;45;09

Cary Hall

Okay, I don't have that number, but I've been doing this since Ron Rowe brought us in. Yes. And that was seven, 18 years ago. Yes. As Blue Cross became our first sponsor. Yes. And so today we're going to do what we call the FEP Show. That's the Federal Employee Show. We do this every year.

00;01;45;11 - 00;02;07;12

Cary Hall

The purpose of it is to inform the federal employees about this open enrollment period they have, which is very narrow. It's November 10th to December 8th. It's not a large open enrollment period. So the idea here is to get this information out there. We'll put it up on our YouTube channel. Our podcast channel, and then we'll tell the federal employees, you know, where they can go to get more information.

00;02;07;12 - 00;02;16;26

Cary Hall

But the whole idea about this is to educate folks. So let's just start with how many federal and postal employees estimate do we have in the Kansas City metro?

00;02;17;02 - 00;02;31;18

Ron Miller

Kansas City Metro, we have over 39,000 members. That and their families have chosen us. And, you know, we appreciate that federal employees in the Kansas City area, over and over have shown we have a 99% retention, which is.

00;02;31;18 - 00;02;32;05

Cary Hall

Insane.

00;02;32;05 - 00;02;40;19

Ron Miller

Which is insane that, you know, members join us and they stay because we have and we'll touch on this later. Our customer service is oh, we'll.

00;02;40;20 - 00;02;41;05

Cary Hall

Talk about.

00;02;41;05 - 00;02;45;19

Ron Miller

That. And so we just have, we just really it's really a priority for us.

00;02;45;22 - 00;02;51;28

Cary Hall

Blue Cross and Blue Shield. Yeah. I the fact that you retain 99% of your members, that's, That's really hard to believe.

00;02;51;29 - 00;02;53;00

Ron Miller

It's hard. Yeah.

00;02;53;02 - 00;03;07;00

Cary Hall

But it's remarkable tribute to the folks at Blue Cross of Kansas City and all that you guys do. So let's talk a little bit about, doctors, hospitals and access, because this is another piece of this that makes it so different than anything else that's out there in the marketplace.

00;03;07;05 - 00;03;30;09

Ron Miller

Yeah. For all of our plans that we have there nationwide plan, some of them. May you have to stay in the network for both our basic and our blue focus. But as far as access, we have 99% of all doctors. That are in nationwide that are in the network. Okay. So if you go in for Thanksgiving, you're going to go see somebody out of town.

00;03;30;09 - 00;03;32;00

Ron Miller

You're going to have coverage wherever you are.

00;03;32;00 - 00;03;33;12

Cary Hall

Hundred percent, wherever you are.

00;03;33;14 - 00;03;43;21

Ron Miller

You’re going to have coverage. So that's one of the good things about Blue Cross Blue Shield. You're not going to go anywhere. Show your Blue Cross card. And they're going to say, what is it that you have.

00;03;43;24 - 00;03;47;16

Cary Hall

No they will not. So yeah they won't you know.

00;03;47;16 - 00;04;03;26

Ron Miller

And so the doctors, hospitals that we have, we also have a Teladoc program, you know, which during Covid really kind of picked up where people are able to do it, on their phone, for doctors and so we still have that Teladoc, available.

00;04;03;26 - 00;04;08;05

Cary Hall

Which is interesting because, you know, that that also has mental health support on it as well.

00;04;08;08 - 00;04;23;19

Ron Miller

That is, that is and that's really been a priority for us, as well as a lot of other people out there with just, you know, things. As things are going mental health is definitely, mental health parity that we have in the state. And so it's a very important thing. And we have that with our Teladoc as well.

00;04;23;20 - 00;04;40;16

Cary Hall

Yeah. And I know Erin Stucky, your CEO, has really kind of pioneered this along with, you know, you've got Ryan Lefebvre who's going to be in this radio studio in a couple of weeks to talk about mental health and all that. You know, there is an issue with this, especially, you know, amongst younger people. I've got, you know, six grandchildren.

00;04;40;23 - 00;04;58;26

Cary Hall

And thank God none of them had this issue. But there are a lot of young people out there on social media and these other places. You see these kids committing suicide. You see these kids harming themselves. And the fact that you've got this available in Teladoc, where the kid can go in a room, close the door and get on a computer and talk to a clinician.

00;04;58;29 - 00;04;59;29

Cary Hall

That's a big deal, Ron.

00;04;59;29 - 00;05;18;26

Ron Miller

Right. Yeah, it is a big deal. It gives people some privacy. It gives people some comfort, especially to be able to do it in their home. You know, I think that allows some people to have some comfort to do it in their own home. And so it's just one of the things that we try to do, you know, and we've been in Blue Cross is 60 years in the federal employee program.

00;05;18;29 - 00;05;20;25

Cary Hall

That's amazing. I didn't know it was that long. Yeah.

00;05;20;25 - 00;05;27;21

Ron Miller

60 years of continuous service to the federal employees of their family. Of the members and the families.

00;05;27;25 - 00;05;30;17

Cary Hall

And, that includes postal workers as well.

00;05;30;18 - 00;05;32;05

Ron Miller

Includes postal workers as well.

00;05;32;06 - 00;05;39;25

Cary Hall

So pretty remarkable. Let's talk a little bit about the FEP Medicare prescription drug program. And how that works and what that's like.

00;05;40;02 - 00;05;59;16

Ron Miller

For, Medicare prescription drug programs. So for postal employees, we'll talk about that real quick. Postal employees, it's an automatic add. You don't have an option for it. Okay. So when you retire, and turn 65 as a postal employee, you're automatically going to be enrolled in that Medicare prescription drug program.

00;05;59;16 - 00;06;01;05

Cary Hall

And you get to keep your benefits.

00;06;01;08 - 00;06;09;24

Ron Miller

And you get to keep your. Those are your those are your, prescription drug benefits, a medical drug. But as well that goes along with your medical benefits.

00;06;09;24 - 00;06;10;01

Cary Hall

Right.

00;06;10;03 - 00;06;18;04

Ron Miller

So but you have to enroll in that because if you do not as a postal employee, you will not have any, prescription drug program or prescription drug.

00;06;18;06 - 00;06;18;19

Cary Hall

Covered.

00;06;18;19 - 00;06;19;02

Ron Miller

Benefits.

00;06;19;02 - 00;06;36;11

Cary Hall

Yes. So that's really kind of important thing to know. Very important. So if they have questions about that, the phone number is (888) 338-7737. That's (888) 338-7737. If they want to call and try to have somebody say, well what is it and how does it work.

00;06;36;11 - 00;06;49;29

Ron Miller

Yeah, what is it? How does it work. They can call that number. They can also call, you know, your blue cross. If you turn around on your Blue Cross card, the back of it, on the back of there is your customer service number. We're always available to answer those questions.

00;06;49;29 - 00;06;59;26

Cary Hall

So talk a little bit about, you know, the approved prescription drugs and some of the tiers and how all that's going to work for these folks that are on these plans with the out-of-pocket costs, because that's always a big issue.

00;06;59;27 - 00;07;22;24

Ron Miller

Right? So, some of the out-of-pocket cost on those. The prescription drugs, so on the on the new Medicare MPDP, is what they like to call it. There are some savings. So there is a, deductible that is on there for the Medicare prescription drug program of $2,500.

00;07;22;24 - 00;07;27;00

Cary Hall

Okay. That's the typical one that's on the Medicare programs. The same thing that I have.

00;07;27;00 - 00;07;46;27

Ron Miller

So that is your stop loss. So that's the most that you're going to be out of pocket in the calendar year. That wasn't available before. There was no stop loss on the Medicare prescription drug program. Right. On your regular prescription drug plan. So that is a really big thing, because a lot of people as you age, as we all age, we take more prescription drugs.

00;07;46;29 - 00;07;47;14

Ron Miller

00;07;47;14 - 00;07;53;24

Cary Hall

He’s looking at me. You're seeing this, right? The guy with the white hair feature, right? Yeah. You're right pal.

00;07;53;27 - 00;08;08;08

Ron Miller

So you know, we take more stuff. It's more expensive. And so it really kind of gives you an idea of, hey, this is the most in a calendar year that I'll be out. So it kind of helps you prepare and kind of train for what, or just prepare for what you're going to have for the year.

00;08;08;08 - 00;08;32;15

Cary Hall

And here's the thing, okay. This is confusing to people, okay. And we don't expect you to understand this just by listening to the broadcast today or the podcast or whatever. But I urge you, you know, if you do have questions (888) 338-7737. The customer service. And we'll talk about this later in the show at Blue Cross. And Blue Shield of Kansas City is above and beyond, any competitor in the marketplace.

00;08;32;15 - 00;08;50;10

Cary Hall

And they get they've won award after award after award. J.D. power multiple years. There's other ones. We'll talk more about that later in the show. But the point I'm making is don't be concerned or confused. Get the facts, call that number. They'll be happy to help you. Right? That is correct because there's always somebody there to do whatever is needed.

00;08;50;11 - 00;09;03;14

Ron Miller

There's always somebody there to to help you out. And so and definitely use the resources. FEPBlue.org on our website, you can always go to FEPBlue.org. We have a lot of great information there as well.

00;09;03;15 - 00;09;20;15

Cary Hall

Yeah. We're gonna come back to the break. When we do, we'll start talking about the other benefits that are available, including the FEP dental and the FEP vision. These are some pretty robust benefits. So if you're a federal employee or one of the federal employees in your family, you definitely want to listen to this.

00;09;20;17 - 00;09;48;09

Cary Hall

Then we'll talk about the actual plan designs for this year. What changes there are and what they look like. So stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA here on the HIA Radio Network. We'll be right back after the break. Stay tuned.

00;09;48;12 - 00;10;13;23

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA. Here on the HIA Radio Network, you can find out more about us by going to the website AmericasHealthcareAdvocate.com. I want to give a shout out to one of our oldest affiliates, KGOZ, 101.7, in Trenton and Gallatin Missouri. I remember going up to that studio to do live radio up there.

00;10;13;25 - 00;10;30;01

Cary Hall

How long I've been on the air, Dave? 20 years. So I was up there, I think about 18 years ago when we first started, they were opening a LifeFlight base, and we also had a Saint Luke's had taken over the regional hospital there. So shout out to them, because we've been around a long time on KGOZ 101.7.

00;10;30;01 - 00;10;46;29

Cary Hall

We're on their Saturday mornings. I think it's about 8:00. So thank you all. And we're so happy to still be on the air there. All right. In studio with me, Ron Miller from Blue Cross and Blue Shield of Kansas City. This is our FEP show. This is the show we do to tell federal employees how they can enroll. And what that timeline is.

00;10;46;29 - 00;11;07;16

Cary Hall

And this is kind of important for you to know. I'm going to repeat this. Probably every segment. Open enrollment here starts on November 10th and it ends December 8th. What is that, 18 days? Yeah, it's about 18 days. That's the shortest open enrollment period. Of anybody out there, that the federal employees have. So it's really important that, you know what your options are.

00;11;07;21 - 00;11;26;18

Cary Hall

And if you don't understand this stuff, did you call 1-800 411 BLUE. 1-800 411 BLUE. That is dedicated to the federal employees to help you. FEPblue.org is the website, FEPblue.org is the website. So the options for the health plans for the postal workers, just go through those briefly. If you can, Ron.

00;11;26;20 - 00;11;47;25

Ron Miller

Yeah. So last year the postal workers, all the federal employees were in one big group. All right. We had postal workers, we had federal employees. And last year, the, postal employees separated from the federal employees. And now you have two buckets. You have the postal employees, and you have the federal employees. They're all they're all federal employees.

00;11;47;25 - 00;11;48;20

Ron Miller

But postal.

00;11;48;23 - 00;11;49;12

Cary Hall

Is separate.

00;11;49;12 - 00;12;10;19

Ron Miller

Yeah, they're separate from. So they all three still have the same options. So on the postal side, they still have the Standard Option, the Basic Option and the Blue Focus okay. So they have the exact same options for postal as they as they've always had before. So there's no change. So they don't have to go out there and look and say oh are these benefits different.

00;12;10;19 - 00;12;11;14

Cary Hall

They're just separate.

00;12;11;14 - 00;12;33;22

Ron Miller

They're just separated out as two different buckets. So for postal employees, you still have your standard option, which is for us, which is our it's our traditional, deductible plan. You can go in or out of network. All right. You have total flexibility. It also has on the prescription drug. You have a 90 day supply mail order on there.

00;12;33;26 - 00;12;51;06

Ron Miller

So if you're taking a lot of maintenance medicine, it's always a good plan to have because it's going to save you money over time. Yeah. So that's the standard option. The basic option that's been really been our growth engine over the years. The basic option is kind of a in-network copay based plan. So you kind of know what your co-pays are going to be.

00;12;51;06 - 00;13;07;09

Ron Miller

You know what your out of pocket expenses are going to be. And so the basic option has really been the driver. People really like the copays. They like to know what their out-of-pocket expenses are going to be. And the good thing about it is still, Cary, on both of these plans, they're nationwide plans.

00;13;07;11 - 00;13;08;12

Cary Hall

That's amazing.

00;13;08;15 - 00;13;09;02

Ron Miller

Yeah.

00;13;09;06 - 00;13;11;08

Cary Hall

Wherever they are. You don't have to think about it.

00;13;11;08 - 00;13;17;09

Ron Miller

And we use for all of our FEP, we use our Preferred Care Blue Network. That is the largest network that we have.

00;13;17;09 - 00;13;18;28

Cary Hall

And that's that's the best network, the.

00;13;18;28 - 00;13;41;11

Ron Miller

Best network period of period. And that is across the board. So in any state that you go to you're using the largest network that's available to the Blue Cross Blue Shield plan in that state. You don't have a little limited network. You're not limited. You know, if you go live in a rural area, we have hospitals and doctors that are in those areas, and.

00;13;41;18 - 00;13;49;18

Cary Hall

That's pretty amazing. Let's switch gears a little bit and talk about the Blue Cross Blue Shield FEP Dental features, and what those look like this year.

00;13;49;20 - 00;14;07;23

Ron Miller

Yeah. And before we get I'm sorry I skipped that. We're going to go back real quick. And so the Blue Focus. Blue Focus has been was new. So we brought up Blue Focus as kind of a low cost option. There's a lot of young federal employees that are coming into the federal employee, plans now or, government.

00;14;07;26 - 00;14;17;21

Ron Miller

And so we really, Blue Focus is really kind of helps people. It's a lower cost if you're not using your health insurance. You say, but I need it, but I don't spend a lot of money on it, so I'm not going to use it.

00;14;17;21 - 00;14;18;05

Cary Hall

00;14;18;05 - 00;14;38;00

Ron Miller

Blue Focus has really been a really good plan for those young federal employees just getting their career started. And we really kind of just kind of nailed that down. And it's really good plan. It has all of your it has ten free Teladoc's. It has your first five visits to your PCP or your Primary Care Physician are no co-pays.

00;14;38;08 - 00;14;42;20

Ron Miller

So they really kind of encourage you to use it without having any out of pocket expenses.

00;14;42;20 - 00;14;49;08

Cary Hall

You ask most 25 to 35 year old guys. That was last time I went to the doctor, when I broke my arm in softball.

00;14;49;15 - 00;14;50;20

Ron Miller

Yeah, that's exactly right.

00;14;50;20 - 00;14;57;23

Cary Hall

And the ladies will go to their OBGYN, but that's basically it. I mean, these folks do not go to doctors, period.

00;14;57;23 - 00;14;58;06

Ron Miller

They don't go to doctors.

00;14;58;06 - 00;15;05;11

Cary Hall

So it doesn't make sense for them to have a big, bloated benefits plan if they're not going to use it. So that's really great because it gives him an option to come in at a much lower cost.

00;15;05;12 - 00;15;17;14

Ron Miller

And it has that Teladoc feature. You know, with all the young kids. I have a 20 year old daughter. She doesn't know how to do anything that's not attached to her phone. Right. I mean, and so that is so great about that whole Teledoc thing.

00;15;17;14 - 00;15;27;11

Cary Hall

I don't know how to do anything that is attached to the phone, which is why my grandson at 17 fixes everything I need fixed. So so let's let's now let's switch gears and talk about the dental.

00;15;27;15 - 00;15;46;15

Ron Miller

Yeah. So the dental. So the dental plan is really good. So we started out initially when the dental came out for federal employees. We did not we did not have a plan. So we've been in the dental for the last ten years. We are now the number one dental option of federal employees nationwide.

00;15;46;16 - 00;15;47;09

Cary Hall

Are you serious?

00;15;47;09 - 00;16;04;15

Ron Miller

Yes. So we have the largest nationwide dental network. Again, we have preventive coverage. No waiting period. And I'm going to say this no waiting period on crowns, bridges, implants and dentures. That's insane. Insane. Day one coverage.

00;16;04;15 - 00;16;21;23

Cary Hall

That's that. I let me just tell you, there is no other dental plan out there. And I have the best dental plan you can buy. All right. And no other dental plan has no waiting period. I'm sorry. They just don't. So this is, pretty remarkable that you get this plan. You can immediately go in and get a crown or bridge, whatever you need.

00;16;21;25 - 00;16;23;00

Cary Hall

That's pretty strong. Yeah.

00;16;23;00 - 00;16;37;20

Ron Miller

And one thing I always remind people is that, you know, you have your medical benefits that you pay for, and then you have your two options on your supplemental dental and supplemental vision. So those are separate costs for you, but the costs are very minimal for the benefits that you get.

00;16;37;21 - 00;16;42;27

Cary Hall

If you have to get a crown or a bridge. And you know, I've had multiples, it's a lot of money.

00;16;42;27 - 00;16;43;22

Ron Miller

It's a lot of money, a.

00;16;43;22 - 00;16;50;27

Cary Hall

Lot of money. Yeah. If if you've got a plan that's going to cover it, you're making money. If you use that plan because you're not paying the cost of that dental.

00;16;51;04 - 00;16;53;25

Ron Miller

I have a crown. I have a crown this afternoon. So I know exactly.

00;16;53;25 - 00;17;01;10

Cary Hall

What I have to do tomorrow. So we'll see. All right. We got about two minutes left real quick. What are we doing here on the Vision plan?

00;17;01;10 - 00;17;28;10

Ron Miller

Let's talk about the vision plan. So the vision plan? A vision plan is definitely a great plan, right? If you're wearing glasses, you know how expensive, how expensive they are. So everybody, every year you get a zero copay, zero cost comprehensive eye exam. So you always want to get your eyes checked every year. We also have if you pick what we have a fully covered Blue Cross and Blue Shield FEP Vision Collection, frames.

00;17;28;12 - 00;17;44;05

Ron Miller

You're going to pay nothing for the frames. If you pick those frames out of our collection, you pay nothing for the frames. But if you would like to have some Oakley's or something fancy with the name on it, we do have a. We give you a $140 that goes towards the cost of those frames.

00;17;44;05 - 00;17;45;18

Cary Hall

Yeah, I use Costco pal.

00;17;45;21 - 00;18;05;20

Ron Miller

Yeah, or Costco. Yeah. And so and so. And then a lot of people say, well, Ron, I don't wear glasses, but I do wear, contact lenses. So we do have a contact lens allowance of $140 as well. So you can either do glasses for the year or you can do in lieu of the glasses. You can do the contacts.

00;18;05;22 - 00;18;24;22

Cary Hall

That's, that's a pretty decent benefit, I'll tell you right now. And you're very you're very fortunate if you're on one of these plans because, all of this is included. If you want more information, go to the website FEPblue.org. FEPblue.org or the phone number 1-800 411 BLUE. Stay tuned. We'll be right back after the break.

00;18;24;26 - 00;18;53;02

Cary Hall

Now we're going to go through the plans and talk about the plans and the upcoming virtual health fairs that they're offering on all this stuff. So we'll talk about all that in the next segment. Stay tuned. You're listening to America's Healthcare Advocate broadcasting coast to coast across USA. You're on the HIA radio network.

00;18;53;04 - 00;19;14;03

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. You can learn more about us by going up at our website. AmericasHealthcareAdvocate.com. All you federal employees out there, go to our YouTube channel. America's Healthcare Advocate. On that channel. This show is posted up there.

00;19;14;04 - 00;19;32;27

Cary Hall

You can watch the show with Ron in studio with me, or of the 16 podcast channels we've got. And I think that's all of them out there pretty close. We're up on all those podcast channels, from SoundCloud to Audacy to you name it, we're on it. Okay, so you can also go up on the podcast channel and listen to everything we're talking about.

00;19;33;02 - 00;19;50;03

Cary Hall

So if it's your spouse that's a federal employee, you want to tell her, hey, I heard this. Or if you're the federal employee and your spouse needs to know what the plans are offering, this is a great way to do that. And we're going to talk about what's coming up here with some virtual health fairs they're going to do.

00;19;50;03 - 00;20;08;27

Cary Hall

That will also give you an opportunity to learn more. So let's switch gears now and just get back to the actual plans themselves. The Standard, Basic and then the Blue Focus again and some of the cash benefits. I think this is the only health insurance plan in the country that offers people money, for doing things they should do anyway.

00;20;08;27 - 00;20;09;07

Cary Hall

Yeah.

00;20;09;07 - 00;20;30;18

Ron Miller

I mean, you know, definitely on all the plans that we have, we definitely want to promote healthy lifestyles, healthy, healthy living. And one of those ways for us is to incentivize our members to do some of the stuff. And so for the Standard in the Basic option, you have a $50, you can earn up to $50 for completing just your Blue Health Assessment.

00;20;30;21 - 00;20;49;18

Ron Miller

That's it. So your Blue Health Assessment, you go out there, you put in, your blood pressure, you put in your height, your weight, you put in any information. And it's a really a good spot to just keep track of your stuff from year over year. Right? So if you go out there, you log that stuff in. We do not share that information with anybody.

00;20;49;18 - 00;20;49;26

Ron Miller

Okay.

00;20;49;26 - 00;20;55;07

Cary Hall

So that's great. So your your your boss isn't going to see your information.

00;20;55;07 - 00;21;22;06

Ron Miller

Yeah. We don't share that information. We don't we don't give it to any of our vendors. Nobody. That is just information that is in there. So you get $50 for doing the Blue Health Assessment. We also have online coaching for your pregnancy, tobacco care, as well as hypertension and weight management. So all of these things that people struggle with, especially if you're new, if you're a new mother, we have a great new mother package that we mailed out to our new pregnant moms.

00;21;22;06 - 00;21;36;09

Ron Miller

That's cool. So yeah. So if you if you get into the program, we send you vitamins, we send you a nice little welcome, Blue Cross. Welcome Kit, for the for the boy or the girl that you're having. And it's and we're going to give you $50 for doing so.

00;21;36;09 - 00;21;39;17

Cary Hall

You get prenatal and postnatal care. Yes. As part of the plan.

00;21;39;17 - 00;22;03;15

Ron Miller

As part of the plan. That's part of the deal. Yeah. And then like I said, you know, a lot of people have are trying to stop smoking. Tobacco cessation. We have a great program for that as well. Hypertension, hypertension management. If you sign up, we can send you out a blood pressure monitor as well. So we have all of these great benefits, all of this stuff for our people that we really want them to incentivize them.

00;22;03;15 - 00;22;08;08

Ron Miller

We want to give them money for doing it, and we want to give them something to help keep track of it as well.

00;22;08;08 - 00;22;09;18

Cary Hall

You're also keeping them healthy.

00;22;09;18 - 00;22;10;22

Ron Miller

Yeah, yeah.

00;22;10;25 - 00;22;11;29

Cary Hall

One, it's a pretty good idea.

00;22;11;29 - 00;22;12;28

Ron Miller

Yeah, it's a great idea.

00;22;12;28 - 00;22;17;24

Cary Hall

I mean, yeah. And $150 for completing their annual physical. Yeah. So yeah,

00;22;17;25 - 00;22;40;09

Ron Miller

That is on the Blue Focus. Yeah. So if you, if you're on the Blue Focus as we said for our healthier younger members. Well I don't do anything but we want to at least incentivize them to go in once a year to get their physical. You get your physical, you have $150. And what we what we've done, we've partnered with our blue 365 partners, Reebok, Skechers, TRX products, Blue Apron.

00;22;40;16 - 00;22;57;25

Ron Miller

So we have all these different products that they can use that $150 for. So it's not anymore that I just can use it on health care expenses. You can also use it on Reebok TRX, if you’ve got a workout room and you want to put some new TRX. If you want to eat healthy Blue Apron, that’s a mail order.

00;22;58;01 - 00;23;04;28

Ron Miller

That's great. Yeah, yeah. So we have a lot of we have a lot of great partners in Blue 365 that you can use that $150 for.

00;23;05;01 - 00;23;24;01

Cary Hall

And you know that Blue 365, and I have the Blue 365 because of my Medicare supplement, I have access to Blue 365 and these hearing aids that you that I talk about on the show, I got those from Focus Hearing, but I was able to take advantage of Blue 365 and got a significantly strong discount on the cost of these things.

00;23;24;01 - 00;23;40;09

Cary Hall

So that Blue 365 is available on a lot of different plans that they offer. But I'm telling you, it's a great time to take advantage of it because there's all kinds of benefits out there. And they're there across the board on all the Blue Cross and Blue Shield plans. So, let's talk about the basic option.

00;23;40;09 - 00;23;51;16

Cary Hall

You know, on the Medicare side, enrolled in A and B, and then, you know, getting to this thing about getting $800 a year, again, you're paying people money that are on a health insurance plan.

00;23;51;16 - 00;24;10;29

Ron Miller

Yeah. And and so, you know, we have a lot of annuitants or retirees, on our plan. So they've had a great career with federal employee program. They're still on they're still on the plan. And so we want to incentivize them of taking, hey, if you have Medicare Part A and B, if you take B, we realize there's a cost to that.

00;24;11;00 - 00;24;26;21

Ron Miller

Okay. And to kind of offset that cost, we want to give you $800 reimbursed for you and your spouse. So not only just for you but your spouse as well. So it's basically $1,600 in the household toward your part B premiums that you could have, every year.

00;24;26;22 - 00;24;57;08

Cary Hall

That's, I don't get that, by the way, just so you know, that's a that's for federal employees. That's a really nice benefit. Seriously, to offset the cost of your of your, part B. And the thing about part B is, is so critical is that 20% that’s not covered by part A, part B. Signing up for part B is critical because if you're only on part A, you don't have any of that, the hospital or, you know, physician benefits, outpatient, all that's not covered.

00;24;57;11 - 00;25;05;00

Cary Hall

Party part A, part B together along with the Blue Cross plan. Now, you've got total coverage all the way around. And it's a pretty remarkable plan.

00;25;05;00 - 00;25;11;02

Ron Miller

Really, really, really. I mean, you'll have a little. But really, most of your out-of-pocket expense will only be your prescription drugs.

00;25;11;02 - 00;25;11;14

Cary Hall

Yeah.

00;25;11;14 - 00;25;13;20

Ron Miller

And then we waive the deductibles.

00;25;13;22 - 00;25;14;17

Cary Hall

Yeah.

00;25;14;19 - 00;25;22;11

Ron Miller

So, you know, your out-of-pocket expenses for having A and B and getting reimbursed for reimburse for B? Yeah. I mean, it's really.

00;25;22;17 - 00;25;23;24

Cary Hall

That's not a bad option. Yeah.

00;25;23;24 - 00;25;26;05

Ron Miller

It's not a bad option at all because then so yeah.

00;25;26;05 - 00;25;45;06

Cary Hall

So let's talk. This is important. So let's talk a little bit about these Benefit Virtual Health fairs that are coming up. And, and again, the USPS. So there's one set for the federal employees and a second set for postal workers. So let's kind of go through this. And by the way, Dave is going to post all these up, on the video.

00;25;45;06 - 00;26;00;23

Cary Hall

So you have them and it's going to be up on our website when we post the show. So you'll have these as well. But I want to run through them today so you can hear this because obviously we're explaining a lot here. But these these are actual seminars, virtual health fairs, whatever you want to call them.

00;26;00;23 - 00;26;05;19

Cary Hall

They go into the plans a great detail. And are they allowed to ask questions during these things, like get a chat bot?

00;26;05;21 - 00;26;14;23

Ron Miller

Yes, they are we. So we do have active chat bots and all of those. So as you see here. So as you see you cannot see this. But so we have.

00;26;14;23 - 00;26;18;02

Cary Hall

Yes they can watch watching on YouTube. So they can okay.

00;26;18;08 - 00;26;43;01

Ron Miller

So there'll be benefits. So benefits is going to be doing both not only the medical but they'll also be doing the dental and the vision okay. So during those virtual health fairs they'll be talking about medical. They'll also be talking about dental and vision okay. So a very so you get to cover everything. And then we will have Blue Cross and Blue Shield representatives there that will be able to answer questions in the chat box that you alluded to.

00;26;43;04 - 00;27;07;28

Ron Miller

And then for the USPS, as they are separated out, they have their own virtual health fairs as well. And so those are all they start. So benefits starts in November. The last one is on December 8th. And then on the version for the USPS, it's November 4th, the 20th, the 3rd and the 8th. So they have one about every week going through the open season.

00;27;07;28 - 00;27;29;11

Ron Miller

That allows you to try to fix it. And they're not all at the same time as well, because everybody's schedules are a little bit different. Some of them are 10 to 5. There's one from 3 to 7 p.m., one’s from noon to 5 p.m. There's a lot of different as well as for the, USPS, everybody. There's a lot of different schedules, especially for the post offices.

00;27;29;11 - 00;27;31;11

Ron Miller

The morning schedule is afternoon shift.

00;27;31;11 - 00;27;32;20

Cary Hall

But yeah, because you're out delivering mail.

00;27;32;20 - 00;27;42;21

Ron Miller

They’re out delivering mail. If they’re not delivering, they’re getting sorted for the next day. So there are those evening and there are those morning times for those post office, employees.

00;27;42;21 - 00;27;46;04

Cary Hall

And how long do these last typically.

00;27;46;06 - 00;27;51;07

Ron Miller

They, they could they they last for about three hours.

00;27;51;09 - 00;27;52;04

Cary Hall

That's a lot.

00;27;52;07 - 00;28;07;28

Ron Miller

But that covers. When you first start it, they kind of give you an outline of what, what it will look like. So if you're looking just there for the Blue Cross and Blue Shield, you can come back in oh 2:00.

00;28;07;28 - 00;28;27;15

Cary Hall

Okay, I get it. Okay. So this is for all okay. Yeah. So so then there's a specific time to come back in. Yes okay. All right. Well that's important to know. So once again here's what we're going to do. We're going to post all of these up on on the on the YouTube platform. And we're also going to post them up on our website when we, when we set the show up.

00;28;27;15 - 00;28;44;09

Cary Hall

So that'll be up there. And it's an opportunity. As I said, you don't have to sit there for five hours. They'll give you the breakdown. You can go out and come back in when they're going to talk about the Blue Cross plan, or maybe just talk about Dental and Vision or if you're a postal worker or whatever the case may be, all of that will be in there.

00;28;44;09 - 00;29;07;27

Cary Hall

Also, it's really important to understand there's a very tight window here, November 10th to December 8th. You don't want to miss the open enrollment period. It's critical. You can go to the website FEPblue.org if you need help, or you can call 1-800 411 BLUE. That's 1-800 411 BLUE. When I come back from the break, we're going to talk about Blue Cross and Blue Shield of Kansas City.

00;29;08;00 - 00;29;18;11

Cary Hall

Main Street, not Wall Street. Stay tuned. We'll be right back after the break.

00;29;18;13 - 00;29;39;19

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across USA. Here on the HIA Radio Network. You know, today, Dave Thiessen, my producer here behind the cameras. And Garner Cowdery, once again doing a great job. They're the ones that put all these shows together. They get them up on our YouTube platform, our podcast platform 605,000 views.

00;29;39;22 - 00;29;55;10

Cary Hall

It's because of all of you out there in the audience that listen to this show, follow the show, etc. we really appreciate you. When you're following us and you're paying attention to these shows, we know a lot of you do because I get a lot of comments. So this show today is with Ron Miller from Blue Cross Blue Shield of Kansas City.

00;29;55;10 - 00;30;12;23

Cary Hall

It is for the federal employees, both postal workers and federal employees for the open enrollment period, which starts November 10th and ends December 8th. It's really important to know that if you're one of the federal employees, maybe you've got a family member. Whatever the case may be, might want to remind somebody, we got a limited amount of time.

00;30;13;01 - 00;30;30;23

Cary Hall

There's a whole series of webinars they're offering. We're going to post all of those. You heard Ron go through them, on the website, and we're going to post them on the YouTube. So you'll be able to see those as well if you want help. 1-800 411 BLUE. 1-800 411 BLUE. And November 10th through December 8th is open enrollment.

00;30;31;00 - 00;30;56;19

Cary Hall

And, the phone number 1-800 411 BLUE, as I said, and the website FEPblue.org. All right. So this is interesting. So that line that I just did comes from Ron Rowe. Yes. We're Main Street not Wall Street. And what I mean by that when I say that is primarily focused on customer service, the 87 years you've been here in Kansas City, some of the other things you're doing, you're very unique, like you're the only plan on ACA, Obamacare this year.

00;30;56;23 - 00;31;19;01

Cary Hall

It is rolling out a single digit increase, 4% versus everything else. That’s 11, 12, 13, 23, 29% higher. It means something to be the hometown carrier. And that's really what you are. You're not doing an earnings report every quarter to Wall Street. That's why I say that. Okay, I'm trying to put in play. You're not UnitedHealthCare. You're not Aetna. You're not Centene.

00;31;19;03 - 00;31;30;02

Cary Hall

You know Ambetter. You're Blue Cross and Blue Shield of Kansas City. But what makes this most interesting to me is the customer service award. So I want you to go through these because I think this is actually quite remarkable.

00;31;30;08 - 00;31;36;27

Ron Miller

Yeah. In your line. Your line is fantastic. And the reason why, the line that Ron said and that, you know, Ron comes up with most of those things.

00;31;37;02 - 00;31;37;25

Cary Hall

Yes. Okay.

00;31;38;02 - 00;32;01;16

Ron Miller

But like you said, it really talks about that we. Customer service is here. We live amongst our members. Okay. And so it is important to us because we have family members, we have friends, we have neighbors that have Blue Cross and Blue Shield. So we're not just working for people we don't know. We're working for people that we live amongst.

00;32;01;19 - 00;32;24;10

Ron Miller

So we're in the community. We are the community. And so we have over 39,000 members, federal employee members here. And so this SQM World Class Certification is amazing. So we have, 100% of our eligible staff met in 2024, met the world class certification.

00;32;24;10 - 00;32;26;18

Cary Hall

Right. So explain SQM

00;32;26;20 - 00;32;51;25

Ron Miller

So it's a customer advocates that called survey. So member. Oh so they get surveyed customers get surveyed and 85% they have to meet 85% of their calls are at a very satisfied level. So they go back out. They survey the members who have called in and they say, well, how was your experience? Your experience? And they said, fantastic.

00;32;51;25 - 00;33;06;04

Ron Miller

So they say very satisfied. And 85% is very satisfied and 100% of our eligible, because those aren't our new people that were in there. There are new customers. 100% of our reps made that in 2024.

00;33;06;04 - 00;33;07;04

Cary Hall

That's remarkable.

00;33;07;07 - 00;33;08;07

Ron Miller

That is remarkable.

00;33;08;09 - 00;33;26;10

Cary Hall

In today's world, where the line: “customer service”. The word “service” is gone, I'm just going to tell you, you don't believe me. Call up AT&T, call up an airline, pick. Pick anything you want out there. Okay, and see what you get. How many voice prompts do you go through? How many people do you have to talk to before you to get something done?

00;33;26;14 - 00;33;44;23

Cary Hall

This is why this matters, okay? And here's why it matters to you. Because when you have an issue, maybe you have a claim issue. Maybe you have a provider issue. You're going to call. And I can tell you from personal experience, because I've been on Blue Cross and Blue Shield for 24 years. Okay. At least, it's one call resolution.

00;33;44;23 - 00;33;47;25

Cary Hall

And if that person can't fix it, they take you right to the one that can.

00;33;47;25 - 00;34;04;00

Ron Miller

Take you right to the one that can. And because health insurance, you don't know how good it is until you have to use it. Okay. And so when you use it and you have a problem, you want to be able to call somebody to fix it. And as you said, the first call resolution is what we strive for and what we do.

00;34;04;04 - 00;34;23;02

Ron Miller

Okay. And so not only are the reps but also the supervisors. So it’s the training. It's the strong focus on coaching from both the supervisor and both the supervisors are world class. So all of the customer service. So there's a standard that's being set in that in that call center there that's just over and over.

00;34;23;04 - 00;34;44;18

Cary Hall

FEP, World Class Call Center, fourth consecutive year. Four years. So this is not just something has happened. This has happened over the last four years. They also have won the J.D. Power Award at least three times that I know. So the point I'm making here, why use that line Main Street, not Wall Street? It's because these people really do care.

00;34;44;20 - 00;35;04;15

Cary Hall

They are your neighbor. They are in church with you. They're at the PTA with you. They're at the soccer field with you. They know who you are and you know who they are. And to me, I would always tell my clients, obviously not federal employees, but I would always tell my clients that, look, here's all the choices, here are the prices, etc..

00;35;04;17 - 00;35;23;18

Cary Hall

I'm going to tell you right now that if you have a problem with this carrier or this carrier, I'm warning you, you're buying price here. You're not buying benefit. And when you have an issue, please don't call me and be upset, because this isn't working, because I'm telling you right now their customer service is not good. And if you have a claims issue, it's going to be a nightmare.

00;35;23;21 - 00;35;42;06

Cary Hall

Lo and behold, you know that happened multiple times. The other thing I would say is, on the other hand, you come over here to Blue Cross. Blue shield. Might not be the cheapest plan available, but I can tell you this when there's an issue, there's somebody there's going to take care of it. Here's the other thing. When there's an issue like this and it can't get resolved, there's somebody like Ron Miller there.

00;35;42;14 - 00;35;48;22

Cary Hall

I had a guy who was our rep. Every time I had an issue. Tom Moppin, remember, Tom.

00;35;48;22 - 00;35;49;07

Ron Miller

Tom Moppin.

00;35;49;07 - 00;36;08;07

Cary Hall

He was my man, my man in Baghdad. When I had a problem, that couldn't get fixed. I'd call Tom. Tom would fix it. Or if it got completely out of hand, I'd call Jenny Housley. Who's the chief revenue officer? So the difference here is you have access to these people and they really do give a damn. So I think that's a big issue.

00;36;08;07 - 00;36;28;03

Ron Miller

Yeah. And and I'm in the agencies like I've, I've had, the federal employee program for 23 years. So when I go into agencies, I go in the health fairs. They've seen me year over year over year over year. So they know that when I tell them I'm not, I'm not telling them something that I don't believe in because I'm coming back next year.

00;36;28;05 - 00;36;31;06

Cary Hall

And and if they didn't write the name right.

00;36;31;09 - 00;36;32;26

Ron Miller

Then I will be back.

00;36;32;29 - 00;36;54;00

Cary Hall

So yeah, it absolutely makes all the difference. I remember during the AFL CIO car show with him, I'm the radio guy, right? I was supposed to be like the town celebrity guy. Everybody talks to Ron. Nobody wanted to see me. So they all know who he is, okay? And that's part of what this is all about visibility, accountability and giving you the service you need. Critical to know.

00;36;54;03 - 00;37;10;22

Cary Hall

The FEP starts November 10th ends December 8th. Short window. The website FEPblue.org, the phone number 1-800 411 BLUE. They do a great job. I urge you, to take the time to see what your benefits are going to look like this year. And I think you'll find that they're going to make a lot of sense.

00;37;10;22 - 00;37;38;03

Cary Hall

And now, ladies and gentlemen, I leave you with this thought from Doctor Martin Luther King. Americans must learn to live together as brothers and sisters, or we will surely perish together as fools. Truer words were never spoken, especially in this time in our country. Have a great day. Thank you for listening to America's Healthcare Advocate. Goodbye, America.

00;37;38;06 - 00;37;40;14

Cary Hall

Zuzu’s Petals Helps Local Families in Kansas City with Toys & Food for Christmas and much more

Thu, 06 Nov 2025 13:41:18 GMT

Episode 2132 notes

John Massey and a couple of his friends came together and created a program called Zuzu's Petals. Born out of a great love of Christmas and how each of them were impacted by Chrfistmas when they were young, this non-profit takes care of families that cannot afford to have a Christmas, and they do it in a very unique way.

John, Mak and Dan love Christmas so much, they created a way to share it and help local families. John joins us this year in a heartwarming show that you really need to hear.

To help them visit: https://zuzus-petals.org/ Or, call John at 816-977-1955

And if you need help or have something to share, contact me Cary Hall, America's Healthcare Advocate at https://www.americashealthcareadvocate.com/contact-us

And let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

Watch this episode on YouTube Podcas t:

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Listen to this episode.

Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

Play full audio podcast (above) or find it by clicking from the list below:

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Episode 2132 Transcript:

00;00;13;00 - 00;00;33;16

John Massey

Kind of awkwardly trying to pull away because, I mean, I don't know what to do with myself, and he just would not let go of my hand and eventually did. And we left. And I mean, man, the scene in that car afterwards was. I don't think people really realize, you know, what these things do for people that have nothing.

00;00;33;18 - 00;00;47;00

John Massey

And I mean, those kids probably in the foster care system now, but they they had one day, you know, just one day where they didn't have to worry about anything. And, oh.

00;00;47;02 - 00;00;51;28

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;52;00 - 00;01;13;12

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to our website, AmericasHealthcareAdvocate.com and all of our podcast platforms. There are 16 of them. Our YouTube channel, all of the all of our shows are posted up there for everybody to listen to.

00;01;13;12 - 00;01;35;20

Cary Hall

After we do them, they are posted up on those sites. Here's some news. We're at 605,000 views thanks to Mr. Dave Thiessen, our producer behind the cameras, and Mr. Garner Cowdrey who records all these shows here in the studio at Cumulus. And I couldn't believe it and didn't he told me, we're at 605,000. That's a tribute to all of you who listen to this show.

00;01;35;20 - 00;02;00;29

Cary Hall

Go to the website, go to the podcast, go to YouTube. Thank you. We appreciate all of you out there and really appreciate the opportunity to bring this show to you. Or we think we hope, we educate and inform. And that's the purpose of these shows. If you are chronologically challenged or looking for an ACA Obamacare plan, you need to give Carolee Steele over at RPS Benefits by Design, a call (877) 385-2224. (877) 385-2224.

00;02;01;04 - 00;02;21;27

Cary Hall

Anywhere in the country, she can help you. She is happy to do so. Also, if you are an employer facing one of these big premium increases coming through on your group plan need talk to Maria Ahlers at RPS Benefits by Design. She's got some pretty amazing plans she can offer you. And here's the thing about her she was a human resource director for 15 years, so she knows both sides of the equation.

00;02;22;00 - 00;02;40;19

Cary Hall

The side of the equation from the employer and employee standpoint as well as the broker. And she's got access someplace. Other people don't have her urge you to call her at (877) 385-2224. If you're getting one of those renewals. So in studio today with me, John Massey is the president and one of the founders of Zuzu's Petals.

00;02;40;25 - 00;02;58;25

Cary Hall

This is a charity, and we've been doing this show every year for, what, five years? Just about. Yeah, I think I think so. Fifth one now these are this is a group of young men that I just think are a tribute to what young men in this country should be kind of like Charlie Kirk, if you will, from the standpoint of who they are, what they do.

00;02;58;28 - 00;03;23;15

Cary Hall

You know, they're Christian men in the Catholic faith, and they created this whole thing by themselves because they saw a need out there for families at Christmas who didn't have the money or the wherewithal to provide Christmas for their children. So let's just go right to this. This is the fifth year we've been doing this. I always enjoy hearing how many kids got served last year and how this year.

00;03;23;15 - 00;03;28;23

Cary Hall

Let's just do that first, because I love hearing this every year because it just keeps growing exponentially.

00;03;28;23 - 00;03;31;22

John Massey

Yes, sir. Well, that was a heck of an introduction. I'm very grateful.

00;03;31;22 - 00;03;32;17

Cary Hall

It’s fact.

00;03;32;19 - 00;03;50;14

John Massey

Yeah. So last year we were able to help 208 kids, which came to 71 whole families service. So we try to approach our services as we're providing this to a family rather than an individual child, because we believe that family is the foundation of society.

00;03;50;15 - 00;04;13;03

John Massey

Right. And that's what we're trying to bring, bring joy and happiness to at that very important time of year, when want I think is most, most keenly felt. So that was a record for us. And then we're out there to break it again this year. We've already got, I believe it's 230 kids in the hopper at the moment, and it's October, so that number is just going to keep on climbing and climbing.

00;04;13;05 - 00;04;14;29

Cary Hall

Especially after this show airs.

00;04;15;02 - 00;04;30;07

John Massey

Yeah. Well yeah, absolutely. So well I mean we're excited. We're beyond grateful. We've been very blessed with how the community has gotten behind it so far, and we can't wait to see where it goes every year. Just gets a little more serious. And yeah, I mean, we're along for the ride for sure.

00;04;30;14 - 00;04;44;25

Cary Hall

So tell the audience what you do, because this is the part that I think is really quite amazing. What they do is very, very different. It's like turnkey Christmas. It's really quite remarkable. So describe what do you do for these families.

00;04;44;27 - 00;05;11;28

John Massey

Absolutely. So our broad goal is to enable families to create core memories that they get to take with them for the rest of their life. And for me, Christmas was always the happiest time of year for me. I mean, all of my happiest memories I have as a kid. I'm one of seven kids where all on Christmas Day, and what we want to do is use Christmas as a vehicle to help these families that are really struggling, really struggling.

00;05;11;28 - 00;05;36;08

John Massey

It's some, some really tough times of being in this experience out there. Use Christmas as a vehicle to create some memories that they can hold on to. And how we do that is through four major services. And every family receives all four. So the first service is almost like a Make-A-Wish for Christmas gifts. So what we do is when families approach us, they say, you know, I'm in need.

00;05;36;08 - 00;05;54;25

John Massey

I'm in such and such a financial situation. We will we'll ask them in the interviews that we have with all the families, you know, if this was your one opportunity to get your kids whatever you wanted to get them, what would that be? And then we'll step in, you know, within the realms of what's reasonable. And we'll we'll.

00;05;54;28 - 00;05;56;02

Cary Hall

They’re not going to get a new car. Right, right.

00;05;56;02 - 00;05;57;28

John Massey

Right, right. As much as we'd love to get the car.

00;05;57;29 - 00;05;59;09

Cary Hall

Yeah, yeah.

00;05;59;12 - 00;06;19;29

John Massey

But we’ll fulfill those requests. Next, because once again, we're about family. We we're trying to think of ways to bring the family together, you know, later on on Christmas Day. And so we're like, well, all of my memories with my family were all around Christmas dinner. And so we step in and we provide them a dinner that they can come, come together as a family and enjoy.

00;06;19;29 - 00;06;43;14

John Massey

So that is courtesy of Brancato’s. Brancato’s Catering here in Kansas City and wonderful, amazing company. Yeah, we couldn't be more grateful for their support. And so every family gets, you know, Christmas dinner with all the fixin's I get turkey, mashed potatoes, gravy, sweet potato pie, cranberry sauce. Like everything you ever had on Christmas Day as a family, these families are going to get.

00;06;43;14 - 00;07;06;24

Cary Hall

And that's brought to their door ready to eat. And by the way, Brancato’s are the folks that own the Brass Onion restaurant over on 135th. And I urge you, if you want to have a great meal, go in there. But these people do so much in this community nobody hears about. And they do this for Zuzu’s Petals and you know, having, beeing able to provide the entire meal and walk into the door is pretty special.

00;07;06;26 - 00;07;07;08

Cary Hall

Yeah.

00;07;07;08 - 00;07;33;13

John Massey

And so in addition to that, what we also do is provide decorations for the family. So I mean just little things that you don't you I mean I'm sure we all take for granted here. A lot of these families don't have a Christmas tree you know. And so we get an a Christmas tree, we get them decorations for the tree so that they can, you know, the mom and the kids and dad, you know, can hang around the tree decorated, you know, listen to some Christmas music while they're doing it.

00;07;33;15 - 00;07;59;02

John Massey

And then the fourth part of the service, which is personally my favorite, is Santa's Workshop. So we rent out a house every year and we decorate it to the nth degree. We hire well, we don't hire a Santa Claus, Santa actually comes down from the North Pole with us for a day. And then all of the families get to bring in their kids to spend 30 minutes with Santa Claus.

00;07;59;02 - 00;08;17;15

John Massey

And I mean, Mrs. Santa Claus is there as well, so she's the one that actually greets them. We have all sorts of activities for the families, like roasting marshmallows. They have hot chocolate. They have one on one meetings with Santa where Santa is like, now, you know, I know that you were sticking gum and Jane's hair last week.

00;08;17;15 - 00;08;35;08

John Massey

Like, why are we doing that? Come on, we got to get beyond this. If you want anything for Christmas and they just get to have one magical like experience where Santa is talking to them and he knows who they are and he knows, you know, if they’ve been good or bad this year and, it's just so much fun.

00;08;35;11 - 00;08;55;23

John Massey

It it is so much fun. And so that that's what we try to bring families is just one, one experience, you know, through these services where no matter how hard life gets for them, and a lot of the time it's heartbreaking what these families are going through that they just get to hold onto and say, there is good in the world that we got to experience.

00;08;55;23 - 00;09;20;09

Cary Hall

Yeah, it is. And you know, I the first time I heard about these guys, I was like, this is really quite remarkable. And every year I've done this show, they've added things, they've improved it. They've served more families. You know, they'll they'll they'll blow past 250 kids this year. I can almost guarantee it. For people would have, would have no Christmas if they didn't do what they're doing.

00;09;20;12 - 00;09;31;18

Cary Hall

So let's give out the website so that if folks want to get involved and they want to donate, they can donate money. There are other things they can donate. So let's give out the website and then the phone number.

00;09;31;18 - 00;09;58;23

John Massey

Absolutely. So our website is zuzus-petals.org. That's zuzus-petals.org. Some of the ways you can support us is one I mean donations are the obvious one. You know these services cost money. They're expensive, but you know that we're trying to create very unique experiences for these families. So please donate. We also take hard donations like gifts, decorations.

00;09;58;23 - 00;10;13;04

John Massey

So please send those to us. You can attend our annual gala and then also support us by buying some of our merch. Our Christmas sweater has officially been released for the year and any of our additional merch’s

00;10;13;04 - 00;10;15;02

John Massey

So is their hat.

00;10;15;04 - 00;10;42;22

Cary Hall

So these are all things you can do. I will going to be right back after break with you. We'll talk about this gala. What's involved. Why you might want to go and get involved. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network coast to coast across the USA. Stay there. We're going to be right back with more.

00;10;42;24 - 00;11;05;13

Cary Hall

Welcome back. You're listening to America's Health Care Big show Broadcasting coast to coast across the USA here on the HIA Radio Network. I want to give a little shout out today to KGOZ 101.7, in Trenton and Gallatin, Missouri. I think it's our oldest affiliate in the system. They have been with us since we started this show, Dave tells me 20 years ago.

00;11;05;13 - 00;11;23;28

Cary Hall

So I've kind of lost track, but we want to thank those folks up there. They do a wonderful job for having us on the air. All the years that were up there. We were on the air Saturday. I think it's around 8 or 9:00 there on KGOZ 101.7. All right. So let's let's talk a little bit about this Gala story.

00;11;24;00 - 00;11;30;29

Cary Hall

Because this happens every year. Country club Christian, it's on December 12th this year. Talk about the time and what's going to happen.

00;11;31;07 - 00;11;55;07

John Massey

Absolutely. So this is by far with all of the calendar events that I have every year. This is my favorite. So Country Club Christian church, you know that beautiful gothic gorgeous home church on Ward Parkway. We rent that out. And then starting at 5:30pm we have a Christmas party. There's a silent auction with all of this awesome Chiefs memorabilia.

00;11;55;07 - 00;11;57;25

John Massey

You graciously donated some last year, which.

00;11;57;29 - 00;11;59;14

Cary Hall

We’ll donate more this year.

00;11;59;16 - 00;12;14;21

John Massey

And thank you. Thank you raised us some really great money. There's live music during the party, and it's just a really wonderful sort of festive environment where a bunch of people that don't know each other are hanging out, you know, which I think is something that we probably need nowadays, you know, and, and.

00;12;14;22 - 00;12;19;23

Cary Hall

Doing something that everybody can enjoy and get their arms around and it's something good.

00;12;19;27 - 00;12;46;08

John Massey

Absolutely, absolutely. So people that have never met before are talking, making connections. And then at 7:00pm everyone adjourns into the main hall where you will I mean, if you are even remotely into Christmas music at all, it is the best thing you will ever experience. We have a choir of almost 50 members. There's a a full orchestra and we just we play music.

00;12;46;08 - 00;12;54;28

John Massey

We tell stories. Christmas stories that you would have heard growing up that we, you know, dramatize a little bit. But to some music it is everything you could want to do.

00;12;55;03 - 00;12;56;13

Cary Hall

It’s a theater production is what it really is.

00;12;56;20 - 00;13;09;19

John Massey

Yeah. Yeah. Basically. Yeah. So I mean, bring your family. It's a, it's a wonderful family event and you know, as, as to give the expression but as warm and fuzzy as you could ever hope a Christmas event to be.

00;13;09;21 - 00;13;12;12

Cary Hall

How do they sign up for that. How do they find out about that.

00;13;12;14 - 00;13;33;05

John Massey

So you can go to our website at zeus-pedals.org like we said before, and you can purchase tickets through our website. There are family packages because I know when you try and bring your whole family to something, things can get a little expensive. But please, you know, come and just help us get the word out there for what we're trying to do.

00;13;33;07 - 00;13;34;12

John Massey

In the Kansas City community.

00;13;34;14 - 00;13;58;11

Cary Hall

Yeah, it's they really make a difference. It's really quite remarkable what they do. And so let's talk a little bit about if you would like to donate at Christmas time to help these young men put these packages together that include, you know, the gifts the kids get to pick, the food, the trees, all of the decorations, and then the different events they put on for the kids and the family.

00;13;58;11 - 00;14;02;25

Cary Hall

So let's just talk about that. Donate. Well, how do they do that when they go to the website.

00;14;02;28 - 00;14;14;07

John Massey

So there is a donate page on the website. We are a 501C3. So we are completely tax deductible. And then what I'll also say is we don't have any paid employees.

00;14;14;09 - 00;14;17;05

Cary Hall

So all of the all volunteers correct.

00;14;17;11 - 00;14;43;24

John Massey

Correct. There may be a time in the future when we get so big that we have to hire paid employees, but for right now, all of the money that you donate will go directly to the families. And we can guarantee that. And then as far as like hard donations. So if you've got a Christmas tree that you don't use anymore, or you've got some gifts that you'd like to donate, we have a contact us page on our website as well where you can shoot us an email, you know, give me a text.

00;14;43;27 - 00;15;06;15

John Massey

We'll be giving out my phone number here, so please. I mean, I know that sounds a little bit crazy, but my my cell phone number out there. But that's how passionate we are about this reach out to us and we would be grateful for anything that you're able to donate. I mean, I was working a pop up event just the other week, and this lady writes children's books, and she asked if we'd like to take some of their children's books that she's written.

00;15;06;17 - 00;15;11;23

John Massey

And we said, heck yes, you know, send them on over. So anything that anyone's able to give.

00;15;11;26 - 00;15;30;29

Cary Hall

Maybe you'd be thinking, well, I've got this or I've got that, or I got access to this or that, but they're probably not going to want that. Don't do that. Okay. Go up on the on the website if you want to do it that way. zeus-pedals.org. Or you can call John. Very simply he's going to give his phone out here.

00;15;31;06 - 00;15;58;23

Cary Hall

(816) 977-1955. (816) 977-1955. If you've got something that you want to donate, I'm sure they'd love to have it. Give them a call or go online. If you want to donate, you can certainly do that. And you know that this gala is is for the family. And if you want, obviously, if you're an empty nester or whatever, and you just want to enjoy the memories or Christmas or what it's all about.

00;15;58;25 - 00;16;15;16

Cary Hall

Country Club Christian is an absolutely gorgeous church. It's a big church, holds a lot of people. So that's December 12th. What a great way to start the Christmas holiday. You know, maybe you go to this church or that church and they have a Christmas concert. Whatever. It's not going to be quite like this is going to be, hey, yeah, this.

00;16;15;16 - 00;16;44;29

Cary Hall

They've got a full symphony, a huge choir. It's like it's a theater production. It really is what it is. And it's well worth, you know, taking your family to and just enjoying and really kind of set the tone for the season. So I absolutely urge you if, if you have an opportunity to go to that gala, enjoy it and really get in the spirit of Christmas once again, that website is zeus-pedals.org, zeus-pedals.org or (816) 977-1955.

00;16;45;01 - 00;17;03;26

Cary Hall

You know, when we come back to the break, I'm going to ask John. We do this every year. To tell a couple of stories about because you you listen to this and you, you know, you're yeah, you know people when you actually hear what happens to people in this situation, you know what it means to them, what it's like when they open the door.

00;17;04;03 - 00;17;23;12

Cary Hall

And there's John and his people standing there with the meal. You know how they get the how they get the gifts. We'll talk about that in a minute. How they do the gifts. So the kids don't know that they're getting the gifts from Zuzu’s Petals. They think they're coming from the parents. This thing is so well done and so well organized, it’s just very, very different in the way they do.

00;17;23;12 - 00;17;39;01

Cary Hall

It's all, as John, to tell some of those stories when we come back and we can personalize this a little bit and let you actually understand, you know what they do. They definitely need donations. They're going to do, they think 70 families this year. I have a funny feeling they're going to do over 90 this year the way things are looking.

00;17;39;01 - 00;18;02;24

Cary Hall

So they're gonna need money, they're going to need money and they're going to need gifts and all of that. So if you want to get involved once again, 816 is if you want to call John (816) 977-1955 or zeus-pedals.org. Go up on the website. There's a contact them page they'll be happy to reach out to you. If you've got something you want to talk about, maybe you've got something you want to donate and you don't know whether they're going to want or not.

00;18;02;24 - 00;18;22;14

Cary Hall

What column okay. Or go up on the website and send them a quick email. They'll get right back to you. They're very good about this. They know exactly what they're doing and be happy to do it. So when we come back from the break, we're going to get into some of these personal stories. I think you're going to enjoy this, and it'll give you some insight into what you know, what they do and what a difference they can make and why.

00;18;22;14 - 00;18;39;20

Cary Hall

This is really in my mind, a tribute to these young men and what they've created out of whole cloth, because literally they created this thing. I remember the first year I did this, I think they did, what, 20 or 30 families first year? okay, there you go. 21 families, first year. And now we are at 70 last year.

00;18;39;20 - 00;18;57;00

Cary Hall

And as I said, I'm sure they're going to break 90 this year. So once again the website zuzus-petals.org if you want to learn more. And by the way, you know you want to tell somebody about this show or have them listen to, hey, maybe we should get involved. Maybe your company should get involved. Maybe our church should get involved up to the website Americas HealthcareAdvocate.com.

00;18;57;03 - 00;19;27;04

Cary Hall

Or to our YouTube page. Same thing. America's Healthcare Advocate, the show's up there. Listen to it. Or one of the 16 podcast platforms. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HD radio network Coast to Coast Cross, USA. We'll be right back after the break.

00;19;27;06 - 00;19;50;08

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. Do you want to find out more about us? Go to the website AmericasHealthcareAdvocate.com in studio with me today. John Massey. He's the president and one of the founders of Zuzu's Petals. This group of amazing young men who is the oldest, the oldest guy in your group, 35.

00;19;50;10 - 00;19;53;24

John Massey

31 actually.. He’s about to marry my sister, FYI.

00;19;53;24 - 00;20;16;04

Cary Hall

Lord. Okay, but 31 years old. Okay. And they started this thing from scratch on their own. It's grown every year. It's remarkable what they've done. And every year we do this show for them, because it's the least we can do for the people that they help. And there are a lot of people out there need help, and the family's fortunate enough to be able to get help from Zuzu’s Petals and make the full Christmas.

00;20;16;04 - 00;20;36;21

Cary Hall

They don't have to do anything. It's all done. From food to gifts to a Christmas tree to ornaments. It's all there. Okay? Along with, you know, a Santa's house for them go and meet Santa. I mean, this thing is remarkable, what they've done and how they've put it together. And I urge you to get involved if you really want to do something, you know, you see these large charities and that's great.

00;20;36;21 - 00;20;59;28

Cary Hall

But if you want to reach out, and as they say, touch someone. Here's a chance, okay, to reach out and touch someone instead of 70 families this year it will probably be like 90. And I'm predicting they're going to have 250, 260 kids by the time they get done with this thing. So the website, zuzus-petals.org. You can get Ahold of John if you want to get involved.

00;20;59;28 - 00;21;28;23

Cary Hall

Maybe your church, your civic organization, maybe you personally, I don't know. Maybe you're maybe your workplace. Maybe. Maybe you guys would like to do something for Christmas Day think, What could we do? Well, this is something you could do that would make a big difference. Give John a call (816) 977-1955. (816) 977-1955. So every year I ask you to do this, there's one particular one that I want you to do this year where you showed up at this woman's house.

00;21;28;26 - 00;21;40;06

Cary Hall

She didn't have anything. She was the single mom had nothing for these kids. And you showed up at the house for Christmas. You just tell that story because that story from start to finish is one of my favorite stories.

00;21;40;07 - 00;22;02;21

John Massey

Yeah, I think it's interesting because when we started, I don't think we quite realized, you know, the depth of need and just how how rough it is out there for some families. I mean, the story that you're talking about. It was actually it was one of our first deliveries. It was on our first day of deliveries.

00;22;02;22 - 00;22;23;12

John Massey

Yeah. And I'd been in communication with this lady for a few weeks. You know, we like ran the interview with her in very, very nice and very up beat. Very, very grateful for what we were going to do for her. And we, called her when we were on our way to her house, letting her know that we'll be there in ten, 15 minutes, whatever it was.

00;22;23;14 - 00;22;39;13

John Massey

And she said, awesome. I just knock on the door when you get here and we'll let you in. So we pull up in what's, you know, obviously a pretty rough neighborhood. Most of these places that we go, you know, more difficult neighborhood.

00;22;39;15 - 00;22;43;06

Cary Hall

Yeah. They're they're not living in the suburbs and in million dollar homes.

00;22;43;06 - 00;22;58;29

John Massey

No, no, exactly. And so we go up, we knock on the door, we make sure the address is correct, we knock on the door, and I know we're probably waiting 20 or 30 seconds or so, and a young guy comes up to, the door, and it's one of her kids.

00;22;59;01 - 00;23;03;15

John Massey

And right off the bat, what kind of thinking will this defeats a lot of the purpose.

00;23;03;17 - 00;23;29;28

John Massey

You're not supposed to be here. Yeah, but then, what we found out shortly after is we walked in, and the lady that I'd been communicating with was actually lying in a bed in the living room, and she was in hospice, so she did not. Unfortunately, she's no longer with us, and she didn't have very long to live at that point.

00;23;30;00 - 00;23;49;23

John Massey

And it was like all she wanted was to just give her boys, her two boys that were there just one Christmas before she left. And that, I mean, that was a lot to take in when we this was my first day. We had no idea what to expect when we're going into these houses and we go in, you know, we try and bring some cheer in there as well.

00;23;49;23 - 00;24;11;24

John Massey

So, you know, we're all, yeah, we're really happy. Give her a hug and her two boys sitting over on the couch, which once again is not ideal, but in this scenario, it is what it is. And so we we make the delivery, we say Merry Christmas, give her a hug. And I go over and I say, wish her boys Merry Christmas as well.

00;24;11;29 - 00;24;24;23

John Massey

From memory their ages were 14 and nine. Okay. And I shake the hand of the 14 year old and he was very gracious. And then I go and I shake the hand of the 19 year old and I say, hey bud, Merry Christmas.

00;24;24;23 - 00;24;26;29

Cary Hall

9 or 19?

00;24;26;29 - 00;24;58;00

John Massey

Nine, I'm sorry. Yeah. Nine. And I go shake his hand. I say, hey, like Merry Christmas. Hope you guys, I hope we're able to step in there for you and he he's staring right into my eyes and he will not let go of my hand. And there was this very kind of awkward, uncomfortable 10 to 15 seconds there where I'm kind of awkwardly trying to pull away because, I mean, I don't know what to do with myself, and he just would not let go of my hand and eventually did.

00;24;58;00 - 00;25;23;03

John Massey

And we left. And I mean, man, the scene in that car afterwards was, is I don't think people really realize, you know, what these things do for people that have nothing. And I mean, those kids probably in the foster care system now, but they they had one day, you know, just one day where they didn't have to worry about anything.

00;25;23;03 - 00;25;23;24

John Massey

And, you know, that.

00;25;23;24 - 00;25;42;23

Cary Hall

Was the memory with their mom that you created that they'll never lose. Yeah. And that that's what I mean by illustrating what they do and why it's so very, very different. You so but that particular you provided food, the tree. Yes. And the whole thing. The whole thing.

00;25;42;25 - 00;26;01;10

John Massey

The whole thing. The whole thing. And it was. Yeah. I mean that anyway, I think it was kind of fitting and obviously like divine intervention that that was the first one that we did or one of the first ones, because then you when you when you realize, I think the wants, that's out there, I mean, it makes everything else easy.

00;26;01;11 - 00;26;13;07

John Massey

You know, there was another one last year where the, the parents came to Santas workshop with the kids with the kids so the kids were with Santa. And we were.

00;26;13;07 - 00;26;20;24

Cary Hall

Like, that's where you get the. So when the parents, you separate kids from the parents and then you give the gift, right? Right. So they got put them in the car. The kids never see them.

00;26;20;26 - 00;26;41;21

John Massey

Correct. Which is for the audience that doesn't know it. That's part of the point is to let the parents be the heroes in this. Right now, we're not riding in on a on a white horse saying like, you know, yeah. Exactly. Right. Well, I mean, metaphorically not, yeah. But yeah, we want the parents to participate in this, like we want them to share in the joy.

00;26;41;21 - 00;26;46;00

John Massey

We want them to be the ones that wake up on Christmas morning and see the joy in their their kids eyes.

00;26;46;04 - 00;26;47;12

Cary Hall

So what happened?

00;26;47;14 - 00;27;13;23

John Massey

So where, we’re were working with the parents, the kids are with Santa, we’re, taking the gifts to the car. And this dad, really, really nice guy. He's telling me how, you know, he lost his job, and, you know, he's he's never had to use a service like this before. And after we, you know, we take him through, we show him all of the items, make sure that that is what that he wanted.

00;27;13;25 - 00;27;39;21

John Massey

He starts crying. You know, this is a grown man, you know? Then it just starts getting very emotional. And where there are more like, hey, like, no worries. You know, we’re, we all get down on our luck sometimes. I mean, that's one of the reasons I wanted to do this is my family went through tough times when when I was a kid and he just said, I promise you, he looked at me and he said, I promise you, you know, when things improve for me, I'm going to do this for somebody else.

00;27;39;23 - 00;27;48;27

John Massey

And I was like, well then, man, I mean, God bless you. You know, like what? What else do you say to that? But, you know, you tip your cap to him wish him a merry Christmas.

00;27;48;29 - 00;28;09;25

Cary Hall

You know, that's the thing. It's I think a lot of people don't realize a lot of folks out there living paycheck to paycheck. They miss a couple of paychecks. They're on the street. Okay. I mean, it's rough and that for folks in that particular situation. So now you multiply that by Christmas. Well, if they've got enough money for rent wherever they're living, okay.

00;28;09;25 - 00;28;31;07

Cary Hall

And groceries, they probably don't have the money for gifts. And, and, and a really nice Christmas dinner and all the things that come with it. But that's what these folks do. That's why I asked John every year to tell a couple of these stories, because, again, there's lots of Christmas charities out there in this town, you know, all over the place.

00;28;31;10 - 00;28;49;12

Cary Hall

But if you really want to just reach out is, you know, there was an old commercial, I forget who it was and touch someone. This is a way to do it, okay? This is a way where you can walk in, make a donation, get involved. Go to the gala on December 12th. The Country Club Christian, great opportunity.

00;28;49;15 - 00;29;13;12

Cary Hall

Have a great time. You bring your whole family, bring your, if your a grandparent, bring grandkids. Have a great time and get in the mood for Christmas. But at the same time realize what you're doing here. You're really helping some people that need help. The website, zuzus-petals.org. zuzus-petals.org. The phone number (816) 977-1955. (816) 977-1955.

00;29;13;20 - 00;29;37;29

Cary Hall

Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Once again, that website is zuzus-pedals.org. You want to call John directly and get involved? (816) 977-1955. We'll be right back. Stay there.

00;29;38;01 - 00;29;56;29

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. You can find out more about us, go on to the website or up on the podcast channels, or 16 of them, or once again on the YouTube channel. So this particular show. We're here talking to the folks and Zuzu's Petals.

00;29;56;29 - 00;30;18;27

Cary Hall

John Massey, president and founder of Zuzu’s Petals, along with the other gentleman that work with him. If your company wants to do something this year, it will make a difference where you literally are going to make a difference to a family. This might be the place to do it. It's zuzus-petals.org, zuzus-petals.org or (816) 977-1955.

00;30;19;00 - 00;30;29;20

Cary Hall

If you want to call John, he’ll come out and talk to you. Maybe you want to have come and talk to the HR director, the CEO, whatever the case may be, he’d be happy to have a chat with you, so feel free to get Ahold of him.

00;30;29;20 - 00;30;49;25

Cary Hall

They've got a huge gala coming up on December 12th at Country Club Christian. It’s a theater Production is what it really is. Okay, you've got a full orchestra, a 50 member choir. It's just a wonderful time, food, a great time for people to get together. And that church is beautiful up on Ward Parkway. So that's December 12th. What time is that?

00;30;49;27 - 00;30;53;19

John Massey

Party starts at 530PM and then the concert starts at 730PM.

00;30;53;19 - 00;31;09;24

Cary Hall

Okay, so 530PM it starts and then and the concert is at 730PM. So it's going to be a great time. All right. So what is it. So this is Dave's idea and we've done this before. How did all this just start. You know were there are five of you when you originally started or four?

00;31;09;26 - 00;31;11;23

John Massey

It was actually just three of us.

00;31;11;28 - 00;31;23;23

Cary Hall

One of the three of you. And you belong to Saint Vincent's Catholic Church. That's how you all know each other? Yep. Okay. And then one day. What? This just like you sit around drinking beer and trying to figure. Yeah, it does.

00;31;23;25 - 00;31;30;13

John Massey

It started a long time ago, actually. So Christmas has always been. I've just had.

00;31;30;13 - 00;31;31;16

Cary Hall

Your favorite holiday.

00;31;31;16 - 00;31;58;00

John Massey

Well or it my parents always put such an intense amount of effort into making that day just the most magical experience any of my, my siblings could ever wish for. And as I got older, you know, I think I saw that not everyone had that. And I also saw that you know, like I mentioned earlier in the show that my family went through some tough times.

00;31;58;00 - 00;32;23;13

John Massey

Yeah. And I remember very specifically my parents being so stressed out about bringing Christmas. Right? Because times were tough, finances were tight. And at the time I'm kind of thinking, you know, like what? Like I I'm I'm fine, you know, like, I don't need a bike or I don't need that, but I think as I got older, what I realized was, is whether or not I needed it.

00;32;23;16 - 00;32;42;20

John Massey

It's kind of irrelevant. The point was, is that my parents wanted me to have something that they were worried they weren't going to be able to give to me. So anyway, later on, I'm obviously from Australia. I'm not I'm not from Kansas City, but my mom's from Kansas City, which is how I ended up here. And she's got she's got a massive, massive family.

00;32;42;20 - 00;32;58;14

John Massey

I've got a lot of cousins in the Kansas City area. I got very close with my cousin Danny from out here who you've met. He's been on the show on previous year, and we were both kind of at a point in our careers where we were trying to figure out, you know, what it was we wanted to do long term.

00;32;58;16 - 00;33;18;19

John Massey

And I'd bounced around, tried a couple of different things. And I remember being in a career interview with, with a mentor of mine who asked me very specifically, you know, like what? Yeah. What are you passionate about? Which I always hated that question, if I'm being honest, because I'm like, well, I don't know. I mean, football like.

00;33;18;22 - 00;33;19;29

Cary Hall

I'm drinking beer.

00;33;19;29 - 00;33;22;03

John Massey

Yeah, exactly. I'm very passionate about drinking beer.

00;33;22;09 - 00;33;27;15

Cary Hall

What's that you're drinking? So, I'm really good at drinking beer. Yeah.

00;33;27;17 - 00;34;00;11

John Massey

Exactly, exactly. And what my answer at the time, and this was, like, supposed to be a serious interview so I couldn't say this, but my answer was Christmas. I mean, it's the one thing that I could think about work on 365 days a year and never, ever get sick of it. I didn't say that in the interview that later that night I was over Danny's house and we were just having a glass of scotch, and I was telling him about this, and we had a good laugh over, you know, what I wanted to say, but I couldn't stay.

00;34;00;14 - 00;34;28;02

John Massey

And that was followed by probably a 30 second silence. And then there was this what if, you know, like we both he grew up very similar to me. So he's one of 11 kids. And Christmas was always like a huge part of his life as well. And so we were like, well, if you were to take the concept of, say, Santa Claus and you were going to try and make that real, how would you do that?

00;34;28;05 - 00;34;48;25

John Massey

And this is what we came up with. So that's where that's why we started. That is how it all started. And I remember I had started working on this website on Wix.com, which I am the furthest thing from a developer that you will ever meet. I know nothing about it, but I built something that I was kind of proud of.

00;34;48;25 - 00;35;10;05

John Massey

Honestly. I worked on it for about six months and I was in my office at my day job. And then Mak who you've also met. That's the guy that's marrying my little sister in a couple of months. He was walking past my office and I didn't really know him at the time. I just knew he built websites for the company that I worked for, and I pull him in and I was like, so we're about to launch this, you know, could you take a look at it?

00;35;10;05 - 00;35;27;25

John Massey

And he's like, oh, yeah, sure. And I show it to him and he's just kind of looking at it. And within seconds he goes, I mean, what if I just built you one, which Mak’s this super nice guy? I later found out that that's Mak’s way of saying this stinks, and you should not do this ever again. Just let me do it for you.

00;35;27;25 - 00;35;54;05

John Massey

And I was like, hey, okay. And that's how he then became involved. And so he built us a website. And then it was Chiefs preseason football. This is five years ago now. 4 or 5 years ago we were watching a really crappy game and we launched it. And then that year we ended up servicing 21 families, 52 kids.

00;35;54;05 - 00;36;16;23

John Massey

I remember then the next year it was 127 kids or 45 families. Then last year it was 208 kids, 72 families. And then this year, I mean, we've already got 80 families in the hopper, you know, and it's October, so like, that number is going to grow and grow and grow. And, you know, that's why we're here, trying to let people know what we're trying to do.

00;36;16;29 - 00;36;36;18

Cary Hall

And, you know, I do this show every year for a reason. Obviously, I've helped these guys every year. I've made donations to them to help them get this thing off the ground and do what it needs to do. Their remarkable in what they do, they're passionate about it. I think you can tell that if, again, as I said, if you want to help somebody a specific.

00;36;36;20 - 00;37;01;16

Cary Hall

So this is an opportunity where you can get involved with these folks and know that there is a single family out there going to benefit from what you're doing, from the way you're helping them. People that wouldn't have a Christmas without what they're doing. Okay. Their remarkable young men. The website is zuzus-petals.org. If you want to call John once again, if your company wants to do something or your church or your civic group, you want to do something.

00;37;01;20 - 00;37;32;12

Cary Hall

(816) 977 1955 the big gala is December 12th at Country Club Christian. Starts at 5 or 530, but at 530 okay, at Country Club Christian goes music in the theater start at seven. Bring the whole family. Kick your Christmas off with real music and people that really are going to enjoy Christmas. This is your opportunity, so I urge you to take the time to look into this to see if you can help these folks and make a difference out there for people that really need a difference.

00;37;32;15 - 00;37;34;28

Cary Hall

John Massey. Thank you once again for coming in here.

00;37;34;29 - 00;37;35;12

John Massey

Thank you, Cary.

00;37;35;18 - 00;37;39;08

Cary Hall

You can tell me other guys playing hooky, they better be here next year

00;37;39;11 - 00;37;40;27

John Massey

I will I'll give them a good ribbing.

00;37;40;29 - 00;37;49;05

Cary Hall

Yeah. You should okay. And now, ladies and gentlemen, I leave you with this thought from Albert Einstein. The one who follows the crowd they usually get no further than the crowd.

00;37;49;12 - 00;38;11;03

Cary Hall

The one who walks alone is likely to find himself in places no one has ever been. Remember, friends is 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;38;11;05 - 00;38;17;22

Cary Hall

You. You.

My Blue Cross of Kansas ACA Show-The cost of insurance premiums in the ACA are Going UP-What to Know

Sat, 11 Oct 2025 15:18:23 GMT

Episode 2130 notes

Misty Snodgrass is Director, ACA & Medicaid at Blue Cross Blue Shield of Kansas and she'll let us know what you Must Know if you have an ACA insurance plan .

MISTY: This is unprecedented. At BCBSKS we're doing our best to hold the rates down and even taking a hit financially. But we want to make sure that people in Kansas have access to coverage.

CARY: Like Misty said, they're more than happy to talk to you and just explain what's happening because there are a massive number of changes coming in the marketplace and ACA.

Misty leads the strategic and operational direction for the ACA line of business and oversees the Healthy Blue Medicaid partnership. She is responsible for ensuring regulatory compliance, financial performance, product and market strategy, and operational excellence. She is known for her compassionate, results-oriented approach as syays she prioritizes access, quality care, and member satisfaction—delivering sustainable success in a complex, highly regulated healthcare environment.

This is episode 2130 of America's Healthcare Advocate

Learn more about anything discussed on this program. Visit https://www.bcbsks.com/ or call 866-906-5253

Episode Producers: Audio: Garner Cowdry Camera: David Thiessen

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Below are audio podcast players to stream from here on our website. or search for "America's Healthcare Advocate" on your favorite podcast platform.

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Episode 2130 Transcript:

00;00;01;14 - 00;00;06;04

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;06;07 - 00;00;28;06

Cary Hall

Hello America, welcome to America's Healthcare Advocate. Show. Broadcasting coast to coast across USA here on the HIA Radio Network. My producers today Mr. Garner Cowdrey behind the microphones and Dave Thiessen behind the cameras as always. I'm Cary Hall, the host of America's Healthcare Advocate. Thank you for joining us today and making us one of the most listened to talk shows across the country.

00;00;28;08 - 00;00;47;09

Cary Hall

And you know that you can always go up on our website or on our YouTube channel and 16 podcast channels to listen to these shows. If you miss one or you want to listen to it during the week. So they're up there. So joining me in studio today, this is a show that I've wanted to do for a couple of months now because of what we see coming.

00;00;47;12 - 00;01;05;29

Cary Hall

And the show today is going to focus on ACA. We're going to talk a little bit about small Group too, but primarily what's going to happen with the ACA plans as we get close to open enrollment. So I'm going to share a little something with everybody. These are some predicted increase numbers in states in and around the Midwest.

00;01;06;02 - 00;01;41;23

Cary Hall

I've got the whole list of all 50 states. But let me give an example here. Kentucky's looking at a 29% increase. Indiana's looking at a 26% increase. Illinois 29%. Kansas on average is 30%. Joining me in studio now, Misty Snodgrass. It's going to be a big disruptive year for ACA. And by the way, Misty Is the director of ACA and, Medicaid for Blue Cross Blue Shield of Kansas, and she's here today to talk to us about that and what they are doing to try to help people.

00;01;41;26 - 00;01;51;11

Cary Hall

In terms of containing costs and get them across the board so it's shocking. I haven't seen numbers like this. I can't remember the last time I saw numbers like this.

00;01;51;12 - 00;02;08;01

Misty Snodgrass

No, this is unprecedented. Thanks so much for having me. And to your listeners, I'm really appreciative to be here to help educate on what's going on. But, yeah, these numbers are unprecedented. We're doing our best to hold that the rates down we are going to be taking, you know, a hit financially. But we want to make sure that people have access to coverage.

00;02;08;01 - 00;02;16;24

Misty Snodgrass

And so we are working really hard to help improve health outcomes here at Blue Cross Blue Shield of Kansas. But yeah these rates are unprecedented. And we've not seen anything like it.

00;02;16;26 - 00;02;37;08

Cary Hall

Yeah. Now I will say this. That level of increase does not apply to the Blue Cross Blue Shield plan, but it certainly applies to a whole host of other carriers I've seen out there. And on top of that, top cause more confusion and disruption in the marketplace: Aetna is leaving and 1 million people across the country are losing their coverage.

00;02;37;10 - 00;02;49;07

Cary Hall

So it's going to be a very disruptive year. And I think what I'm trying to do with these kinds of shows. And thank you for being here because you're truly an expert at this, is tell people what they need to do to get ready.

00;02;49;09 - 00;02;49;26

Misty Snodgrass

Yeah.

00;02;49;29 - 00;02;51;20

Cary Hall

Don't wait until

00;02;51;22 - 00;02;52;22

Misty Snodgrass

No.

00;02;52;24 - 00;03;15;00

Cary Hall

Because you know, as I told you, I’m a 27 year recovering broker from when I had Benefits by Design. We even talked, starting now, throughout up until we get to the Open Enrollment Period and it never failed. People procrastinated and waited, and then they're all trying to get in at the same time.

00;03;15;02 - 00;03;27;15

Cary Hall

And it's very, very difficult and can cause a lot of frustration and all the rest of it. So it's far better to be proactive right now. So what what are you telling people if they want to call you and consult? What are you telling people.

00;03;27;15 - 00;03;46;25

Misty Snodgrass

Yeah, no, I think I think that's a great question. I think this year is different than even the last few years, which have been a lot of a lot of changes. And so, you know, first of all, open enrollment for this year is going to go until January 15th of next year. That's changing. So just be prepared. But you know, get in early, start looking at the plans.

00;03;46;26 - 00;04;04;18

Misty Snodgrass

Start looking at the prices. Go to healthcare.gov. Go to our website bcbsks.com and start to look and see what the prices are going to be in the impact to you because you're able to plug in what prescription drugs you're using, what providers you're using, and start to see what the price of impact is going to be to you.

00;04;04;18 - 00;04;08;09

Misty Snodgrass

Because it is going to be felt by the majority of Americans.

00;04;08;11 - 00;04;11;23

Cary Hall

But if they call you guys and they just want to talk to somebody, this.

00;04;11;25 - 00;04;13;03

Misty Snodgrass

That's where yeah.

00;04;13;05 - 00;04;35;08

Cary Hall

This is where you're different than what I call the conglomo carriers, okay? Because your customer service is right there in Topeka. Yep. It's Kansans Helping in Kansans. You've won multiple awards for customer service because people can actually call and talk to somebody. Yes. Okay. And you can also do that with your local broker. Obviously if you've got a broker you've used and he's helped you or she's helped you, that's what you should do.

00;04;35;14 - 00;04;55;09

Cary Hall

As long as you can get in touch with them, do it. But otherwise they can call you, just talk to you and get get an understanding of, okay, what do I need to be concerned about? What's my plan going to look like? Like, I'm one of those people that had the Aetna plan. I'm losing my coverage, you know, or I'm one of those people who just found out I got my renewal letter and I have a 27% increase.

00;04;55;09 - 00;04;57;07

Cary Hall

Yes. All right, So talk a little bit about that.

00;04;57;07 - 00;05;20;24

Misty Snodgrass

Happy to do it. We love our customer service team. They're actually part of the team I'm on. So we're able to work with them and they're they're fantastic. They want to talk to our members. They're not trying to get you off the phone. They are locally based in Kansas. You're able to answer, they're able to answer any questions, even about your claims, or your billing or what you may have and what the different kind of products that are being offered.

00;05;20;24 - 00;05;35;00

Misty Snodgrass

So they're able to help you, call the one 800 number and they're able to, you know, answer any questions that you maybe have. We also have a great sales team, that is able to actually help answer questions. And they're not trying to sell you a product. They're just trying to find the product that works best for you.

00;05;35;02 - 00;05;53;05

Misty Snodgrass

And so you're able to call either our customer service or our sales team in-house and have those questions, Or also go to brokers and be able to answer the questions you may have. Yeah. Our customer service team is second to none. They have a very quick metric related to answering. You know, a lot of people don't want to sit on a call and wait and hold, be on hold.

00;05;53;05 - 00;06;01;25

Misty Snodgrass

They answer very quickly. They answer your questions concisely, and their goal is to answer your questions on your first call. So you're not having to call back repeatedly. So they're they're wonderful.

00;06;01;27 - 00;06;27;26

Cary Hall

You've won multiple awards for this. You continue to win multiple awards for it. And you know, I always this is the example I use when you a lot of times people will call one of these national carriers or one of these call centers that’s advertising in which we see all the time on television. You get: “licensed brokers, call and they'll help you”. You call and you ask a question like, what hospitals are in Kansas City north of the river?

00;06;27;26 - 00;06;41;04

Cary Hall

And they're going, what river? Yes, yes, I'm talking to somebody that really understands the market here. Okay. So, you know, the same thing applies here if you're out in Salina. Yeah. Or you're in Topeka or you're in Wichita.

00;06;41;05 - 00;06;43;23

Misty Snodgrass

Western Kansas, very, very rural area. Yeah.

00;06;43;27 - 00;07;05;02

Cary Hall

Yeah. That that's critical. So it's important to know the state and know what's available there. And also how you marry up the providers to the program and all the rest of it. So that that's critical. I think. So before we go to break. We’ve got about two minutes left. You are in all counties in Kansas, all 103.

00;07;05;05 - 00;07;08;17

Cary Hall

A lot of the carriers arn’t. So address that right before we go to break here.

00;07;08;18 - 00;07;28;15

Misty Snodgrass

Yeah. Just to clarify, we don't have Wyandotte and Johnson because BlueKC has it. Yes, but 103 of 105 most of our competitors or the other carriers are not. They’re only in certain areas. They tend to cherry pick areas. We’re in the far you know, we touch the Colorado border. We go all the way to the frontier side of the Kansas, frontier part of our state.

00;07;28;15 - 00;07;47;15

Misty Snodgrass

And so, yeah, it is a priority for us to serve all counties, regardless of whether or not it's a profit or not for profit, mutually owned company. And so our focus is on serving Kansas, making sure we're improving health outcomes, reinvesting in our communities. And so it is a priority to be in all counties regardless of what the, you know, margin is in that in that area.

00;07;47;21 - 00;08;07;22

Cary Hall

That's one of the reasons why they're different. You know what I like to say about these local BlueCross plans? They’re main street, they're not Wall Street. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast. If you want information, you can go to the website. BCBSKS.com.

00;08;07;28 - 00;08;41;25

Cary Hall

That's BCBSKS.com. The phone number. Once again, if you want to call one of those lovely people at their customer service center and they're happy to help you. 866-906-5253. 866-906-5253. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate here on the HIA Radio Network. Coast to coast across USA.

00;08;41;27 - 00;09;04;14

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. I want to do a shout out to KSAL 1150. Our great affiliate up in Salina, Kansas is very happy to be on the air there, and they're part of our family for America's Healthcare Advocate broadcast me shows out throughout Kansas in the area around Salina.

00;09;04;15 - 00;09;20;18

Cary Hall

I want to welcome them again. Little shout out to all the folks up there in studio with me, Misty Snodgrass. She is the director of ACA and Medicaid at Blue Cross and Blue Shield of Kansas, and we're talking all things ACA. We're going to do a little discussion about group here as well. But you heard in that last segment.

00;09;20;18 - 00;09;41;00

Cary Hall

Now you're going to hear me repeat this. Don't wait until the last minute. Open enrollment is going to start here. We're going to talk about that in a minute. But what you need to know is this is going to be a different year. It's going to be tsunami. There's going to be massive displacement and other issues going on. Now's the time to get ahead of this if you're on an ACA.

00;09;41;00 - 00;09;48;12

Cary Hall

So let's just go through the dates. Yeah. Because it gets a little confusing for folks. So it opens up on November 1st. Then what happens.

00;09;48;12 - 00;10;06;11

Misty Snodgrass

Yeah. So you're able to start selecting your plans or even comparison shop. But as you said start early. Don't wait until the end of December thinking that, oh, I'm going to be able to be covered January 1st. You need to be enrolled by December 15th, to be covered by January 1st, or enroll by January 15th to be covered by February 1st.

00;10;06;11 - 00;10;21;24

Misty Snodgrass

There are some special enrollment periods, but they're not the big special enrollment period that used to be there. So there are fewer events such as life events, moving, pregnancy, having a child. And so you really got to act now and things are changing by the minute. And so stay up to date as to what's happening.

00;10;22;01 - 00;10;42;17

Misty Snodgrass

We're doing our best to educate our members about what's coming down and what the changes are occurring. We're putting that in our renewal letters. We're also putting information out via social media, and our website to make sure people understand what's happening. Because, you know, there's been a lot of confusion, a lot of changes. And so make sure you stay on top of it because you can't wait because you're going to be, you know, delayed in your coverage.

00;10;42;17 - 00;10;45;03

Misty Snodgrass

And it is a major disruption in the ACA market.

00;10;45;07 - 00;10;56;04

Cary Hall

Yeah, I cannot recall and I can't how many years ago when I was doing this, writing it from the day they started, you know, ACA, Obamacare, I've never seen anything quite like this.

00;10;56;10 - 00;10;59;00

Misty Snodgrass

And Blue Cross Blue Shield Kansas has been in market.

00;10;59;03 - 00;11;07;07

Cary Hall

You were one of the pioneers. Yeah. It was you guys. Blue cross of Kansas City I think were the first carriers. We were Actually in the market. Approved and up and running.

00;11;07;07 - 00;11;21;21

Misty Snodgrass

That's right. Yeah. And a lot of people left in 2017 and 2018, but not to the degree that is happening now or the rate increases that are happening. And we've stayed. We’ve stayed the journey. Our focus is on serving Kansans. And so we're going to be here to stay even through all the turmoil we’ll do our best to educate our members.

00;11;21;21 - 00;11;38;01

Cary Hall

Yeah. You know, when you're 80 years plus, I think people can realize the Blue Cross of Kansas isn't going anywhere. Just so you understand. All right. So let's talk about four and five Kansans in the past found plans for $10 a month or less. Yeah. It and then that's going to change.

00;11;38;01 - 00;11;38;27

Misty Snodgrass

That is going to change okay.

00;11;38;28 - 00;11;43;15

Cary Hall

So let's just start with that one. And what's going to happen to the subsidy levels and all the rest of it.

00;11;43;21 - 00;11;49;29

Misty Snodgrass

Yeah. So you may or may not be aware there were increased subsidies that passed with the American Rescue Act.

00;11;49;29 - 00;11;50;26

Cary Hall

Up to 400%.

00;11;50;26 - 00;12;09;28

Misty Snodgrass

Exactly. That exactly. And so there wasn't really a big cliff. You know, the last few years post-Covid, however, those are set to expire at the end of this year. And if they are not renewed by Congress, then that's when more and more Kansas are going to be paying more and more. Like you said, you know, $10 per month, it could jump to hundreds of dollars per month.

00;12;09;28 - 00;12;27;22

Misty Snodgrass

Some estimates are it's going to increase by like approximately 70% nationwide. So it's just going to be depending on what your income is and also what subsidies you're eligible for. And so it's going to go back, if Congress doesn't act, to the original subsidies which are between is, you know, 100 and 250% of federal poverty level.

00;12;27;24 - 00;12;35;11

Misty Snodgrass

And so make sure you're checking to see if you're still eligible for subsidies, because you may get a surprise bill if you if you're not aware of it.

00;12;35;14 - 00;12;41;17

Cary Hall

So the other thing is self-affirmation. People being able to self affirm. And that was allowed.

00;12;41;17 - 00;12;42;04

Misty Snodgrass

Yep.

00;12;42;07 - 00;12;43;00

Cary Hall

It’s not allowed now.

00;12;43;07 - 00;12;45;01

Misty Snodgrass

There's a lot of changes coming. You're going to.

00;12;45;01 - 00;12;45;26

Cary Hall

Talk about some of that.

00;12;46;08 - 00;12;50;07

Misty Snodgrass

And there's court cases actually on a lot of this stuff. So it's changing by the day you know.

00;12;50;07 - 00;12;52;03

Cary Hall

We talked about that off camera before the show.

00;12;52;03 - 00;13;00;29

Misty Snodgrass

Absolutely. And so some of the things that you have to affirm that you are making a certain amount, you're new going to have to provide additional documentation. And so

00;13;00;29 - 00;13;01;11

Cary Hall

Tax returns.

00;13;01;16 - 00;13;08;13

Misty Snodgrass

Exactly. You're going to provide concrete documents as to what your income is versus saying I do make this amount. And so there's a lot of changes coming.

00;13;08;13 - 00;13;16;26

Misty Snodgrass

Make sure you're up to date with them. We're going to keep our members informed because there's court cases now pending out there. There's decisions being made. So stay abreast of all the changes that are coming.

00;13;16;26 - 00;13;40;11

Cary Hall

And once again, if this concerns you, you can give them a call. You can have a conversation just to understand what's happening or where you're going to go. All right. And then you'll understand what your choices are. If you're educated about what's going on, you can make a better decision. You know, you can always call them at 866-906-5253.

00;13;40;16 - 00;14;01;19

Cary Hall

Like Misty said, they're more than happy to talk to you and just explain what's happening because there are a massive number of changes coming in the marketplace. So what do you think's going to happen now when we see that coming in terms of the reduced subsidies, the increased costs, all the rest of it, it looks to me like a lot of people are going to start losing coverage.

00;14;01;19 - 00;14;24;29

Misty Snodgrass

I think that's a good possibility. We've estimated about 30% of Kansans, based upon the data, are going to lose their health insurance coverage because of the increased cost as well as potentially subsidies going away. And so we are doing our best to keep our rates low, and we're working on affordability. That is a top pillar of our company to make sure that we can have, you know, whether or not you're eligible for subsidies or the cost sharing reductions.

00;14;25;06 - 00;14;36;14

Misty Snodgrass

We're actually prioritizing affordability. We're working on various programs to make sure that we are, trying to keep our costs and our rates low so that we can serve more and more Kansans. That's our ultimate goal, is to serve more and more Kansans.

00;14;36;15 - 00;14;59;01

Cary Hall

And that's what you guys do really well because you're focused on Kansas. You're not in and serving all 103 counties that you serve. And that's a significantly different, task or goal rather than what we see from some of the national carriers. You know, in the marketplace. So talk a little bit about as far as, SEPs are concerned and qualifying events.

00;14;59;01 - 00;15;04;11

Cary Hall

So we're going to go to break here in a few in about two minutes. But let's do that first.

00;15;04;14 - 00;15;31;23

Misty Snodgrass

So you know it used to be you could be able to sign up for, you know, a special enrollment period year round. And that has changed. And so we're now only going to be available to have special enrollment periods for “qualifying life events”. So an example of a qualifying life event would be a job loss. We know a lot of people, especially in certain communities there's layoffs occurring and they're going to the marketplace, ACA going to healthcare.gov or going to their local carrier's website and selecting a plan.

00;15;31;25 - 00;15;47;08

Misty Snodgrass

And they are now only going to be able to do that for a job loss or for, the birth of a child or if they're moving into a different state. And so that's going to be, a different thing. You know, when ever you are able to do it much more broadly. It's only going to be during those certain types of events.

00;15;47;10 - 00;16;02;11

Cary Hall

And they're narrowing it. And I'm going to guess, based on the fact that, you know, the whole self-affirmation income thing and all the rest of its changed, that you're going to have to be able to present documentation or show 100%.

00;16;02;14 - 00;16;12;01

Misty Snodgrass

Yeah. And so it's more important than ever to explore what your options are and to get ahead of this before, you know, there's a lot of confusion or you're trying to figure this out the week of Christmas to get covered

00;16;12;03 - 00;16;13;23

Cary Hall

It's probably not a good time to be doing this.

00;16;13;25 - 00;16;15;13

Misty Snodgrass

No, no.

00;16;15;16 - 00;16;26;14

Cary Hall

Yeah. It's probably no, not when you're trying to figure out how am I going to pay for all the Christmas presents I bought. Okay. And everything else is going on now I got to figure this out probably a good idea to get in front of this a little bit.

00;16;26;14 - 00;16;39;11

Misty Snodgrass

Yes. You need to start looking ahead now, having conversations with, you know, salesmen and your brokers, your customer service teams to figure out what's happening because it is really important for getting a handle on what this is going to cost.

00;16;39;12 - 00;17;02;15

Cary Hall

Yeah. And this is going to this is going to hit a lot of Kansans. And you just heard Misty say they're anticipating 30% of the people being displaced in Kansas. I've heard that over. I've heard that from CEO of Blue Cross of Nebraska, Blue Cross of Kansas City. And now you're sitting here listening to Misty, who's the director for ACA and Medicaid, say exactly the same thing regarding Blue Cross Blue Shield of Kansas.

00;17;02;15 - 00;17;17;06

Cary Hall

So there's a lot coming and a lot of changes coming. We'll be right back after the break. We're going to talk a little bit more about how some of this is going to work, and we'll get in the weeds a little bit on some of the things that you need to understand moving forward about cost benefits and all the rest of it.

00;17;17;12 - 00;17;39;24

Cary Hall

And what are they offering at Blue Cross and Blue Shield of Kansas? We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network coast to coast across USA.

00;17;39;27 - 00;17;59;13

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA. My producers today, Mr. Dave Thiessen, Gardner Cowdrey in studio with me, Misty Snodgrass. She is the director of ACA and Medicaid. You can obviously tell this lady knows what she's talking about. All right. And this is kind of like drinking from a firehose for a lot of

00;17;59;13 - 00;18;18;04

Cary Hall

you out there today. But the idea here is to bring information to you so you are prepared for what is about to happen. Because I've said this, you know, on a couple of shows I've done up to now, and I'm saying it again today, these changes are going to be massive, and there's going to be a lot of panic in people about what do.

00;18;18;07 - 00;18;42;26

Cary Hall

So the last thing you want to do as we've talked about is wait. Which is why if you call that customer service number at 866-906- 5253, that's not a sales number. Those people are there to help you try to understand what's in the marketplace. They're not there to try to sell you something like some of these high pressure sales outfits you see on television once again 866-906-5253 or BCBSKS.com.

00;18;43;02 - 00;18;53;20

Cary Hall

All right. So let's talk a little bit about some of the plan differences plan designs. And then specifically zero in on these silver plans. And what we're going to see with these CSRs.

00;18;53;24 - 00;19;10;28

Misty Snodgrass

Yeah. So I think that's a great question because everybody's going to be shopping and it can be really overwhelming. I know whenever I've helped a lot of friends that have what is what is the metal tier, what is what is this MOOP, what is this deductible? What are all these things meaning. And so I think it's really important to educate everyone on the benefits they're choosing.

00;19;10;28 - 00;19;23;14

Misty Snodgrass

Because you may go to the lowest price, but is it giving you the most value? Is it going to be there when you need it? Is it going to be there when you're sick? Is it going to be there if you get a diagnosis? And so I think it's really important. One of the plans that we have is a high deductible plan.

00;19;23;14 - 00;19;42;14

Misty Snodgrass

We are the only one that we know of in market that has a high deductible plan. So that gives members options for what to choose for them. And these costs, CSRs, those cost savings reduction plans are able to help, offset some of the costs associated with copays, co-insurance that might be able to, be there, there in the market, in the silver plans.

00;19;42;16 - 00;19;50;02

Misty Snodgrass

And so they're able to help, individuals that have higher specialist visits, be able to help offset those costs.

00;19;50;09 - 00;19;52;16

Cary Hall

What do they have to do to get enrolled in a CSR type program?

00;19;52;26 - 00;20;02;16

Misty Snodgrass

So they're able to see if they're eligible. So there is some income eligibility for a CSR. So it's not available to everybody. But they are able to see if they're at a certain income level whether or not they're eligible for those CSRs.

00;20;02;16 - 00;20;11;12

Cary Hall

That between the 100 and 250% income. Yep. So basically if you're in that category this can make a big difference. But if you're not in that category then you can't enroll in it.

00;20;11;13 - 00;20;24;28

Misty Snodgrass

That's right. That's right. And about 93% of Kansans are in a 100 or 250% in the ACA market. That's what it was last year. So we're hoping that a lot of individuals be able to take advantage of them. They just not may not be aware that they're available for them.

00;20;25;01 - 00;20;51;27

Cary Hall

Those are not necessarily available form a lot of these other carriers, including that high deductable plan that we're going to talk about here in a second. So again, that's another reason to reach out and get some information. So let's talk about those high deductible plans. Because as I said while we're on the break there, you know, if you've got a house with four tricycle motors running around and, you know, like my daughter, up in Washington State, and she's at the E.R. or she's at the urgent care or at the primary care every week.

00;20;52;01 - 00;20;55;21

Cary Hall

Yeah, it's a weekly class. They're all under the age of eight. Yes. Okay.

00;20;55;21 - 00;20;56;28

Misty Snodgrass

They’re on a scooter probably.

00;20;57;01 - 00;21;17;29

Cary Hall

Thank you. And so? So what she needs is very different to when somebody who's 55 or 6o needs. So talk about, where do those plans. You said that earlier the plan that's going to basically fit your need and fit your budgets. Talk about where do you see those plans. And how do they work and how does that help people in the marketplace?

00;21;17;29 - 00;21;36;19

Misty Snodgrass

Yeah, no, that's a great question, everybody. That's the important part about shopping is what does it mean to you and your family? You know, we can talk about what every one of these metal tiers are. So gold is great for individuals with chronic conditions or families with ongoing needs, or those that just want that comfort of I want to have a consistent premium.

00;21;36;19 - 00;21;54;05

Misty Snodgrass

I'm not going to have a lot of co-pays and co-insurance when I go to the doctor. So it's just kind of a peace of mind. Decision. The silver plans are really available for those individuals that are doing cost saving and, reductions or those individuals that are on those subsidies. And so they're able to be kind of a more balanced between the gold and the bronze.

00;21;54;07 - 00;22;05;29

Misty Snodgrass

They're able to give you a little bit of more peace of mind, but they're going to have a higher deductible or they're going to have a higher maximum out-of-pocket. And I think it's really important. A lot of folks are like, what's the difference between a deductible and what's the difference between a maximum out-of-pocket.

00;22;06;02 - 00;22;11;21

Misty Snodgrass

Deductible is whenever what you pay until the insurance kicks in, and then the maximum out-of-pocket is what you would pay.

00;22;11;21 - 00;22;31;05

Misty Snodgrass

So if you have a $2,000 deductible, you're going to pay until that, $2,000 amount. If you have a $10,000 maximum out-of-pocket, you're only going to pay $10,000 for the entire year for your coverage. And so it's really important to see how frequent of a user you are. So if you're going to be a higher utilizar of health care, you're going to have a chronic condition.

00;22;31;05 - 00;22;48;19

Misty Snodgrass

You might have cancer, you may have HIV. Whatever your condition may be, you might be selecting a gold plan. It’s going to provide you peace of mind and some consistency that lower maximum out-of-pocket, that lower deductible. Those silver plans are kind of those balance. People that are healthy but may have some income restrictions.

00;22;48;19 - 00;22;58;00

Misty Snodgrass

And so those are really great to be a balanced option. And then the bronze plans are available to be able to serve, those that are kind of the healthy, those that are really,

00;22;58;02 - 00;22;59;00

Cary Hall

I don't need a lot of anything.

00;22;59;01 - 00;22;59;17

Misty Snodgrass

Exactly.

00;22;59;17 - 00;23;03;02

Cary Hall

But I need to know if I wind up in the hospital. I'm not going to have $150,000 bill.

00;23;03;04 - 00;23;27;12

Misty Snodgrass

Exactly. You're kind of buying a piece of mind, essentially with a bronze plan. So it's really great for healthy individuals. And so our high deductibles, we have them in multiple metal tiers. It's called our simple silver plan. And individuals are able to see if they want to, select that high deductible plan, you know, so that they're able to have those services covered at a certain level, but they want to have a lower, price point in their premiums.

00;23;27;15 - 00;23;45;03

Cary Hall

So let's switch gears a little bit. Let's talk about formulary because this gets missed. I remember who we had Benefits by Design. When people come in for those appointments. “Please bring a list of your prescription drugs”. And they'd be like, why? Because we want to make sure they're covered. Yes, well, I have.

00;23;45;06 - 00;24;05;12

Cary Hall

I have prescription coverage. You think you have prescription coverage. You may if you're on Jardiance and your formulary doesn't cover Jardiance you're paying for it. Well, you know what that copay is? I do because my wife's on it. And before Medicare kicks in with the big deductible that's out there. Now, I was paying $400 a pop.

00;24;05;14 - 00;24;12;22

Cary Hall

Okay, that's what it costs. So talk. Why is that important for people? And they need to ask those questions.

00;24;12;22 - 00;24;29;00

Misty Snodgrass

Your formulary is like one of those devil in the details, but no one goes to look at it. So you can actually go on healthcare.gov, or you can go on our website and find out, what our formularies are and what's covered. And so we're very transparent with that. But there are different co-pays for different types of metal tiers and different types of plans.

00;24;29;07 - 00;24;44;13

Misty Snodgrass

So if you're a chronic condition, you may have a 0 to $10 copay, depending on or even $20 depending on it. But the different tier levels are going to do that. But just because it says the amount and the tier level doesn't mean that it's going to be covered, or there's not going to be a ton of steps to get there.

00;24;44;13 - 00;25;04;24

Misty Snodgrass

And so we really focus on trying to be, more, probably more liberal with our formularies. That's a typical, Blues way. We usually cover more things in our competitors, just because we also want to keep people healthy. We know that, you know, prescription drugs are by far the highest cost of our benefit. But they are what also keep some people healthy.

00;25;04;24 - 00;25;18;18

Misty Snodgrass

And so we want people to take their medications whether they have diabetes or hypertension, because that ultimately keeps people out of the emergency room and the hospital. So, our goal is to help improve outcomes, but also help reduce the total cost of care. But you need to check and see if your medications are covered.

00;25;18;21 - 00;25;31;15

Misty Snodgrass

You need to see if your PCP has covered your primary care because there are. You know, you may think, oh, I'm going to go select this plan because it's the most affordable, but your primary care or the hospital of your choice may or may not be covered. And so it's really important to look into that.

00;25;31;17 - 00;25;58;06

Cary Hall

Well, and here's the thing okay. We talked about some of the other carriers. You're the only one that's offering 103 counties. One of the biggest complaints that I hear, especially in Nebraska and Kansas, some other places, is people go on these other plans and they don't realize there's okay, I live out in Hays. Yep. I've got to drive 45 minutes to get to the primary care doc because it's not in Hays. He’s someplace else or she's someplace else.

00;25;58;08 - 00;26;04;14

Cary Hall

So you know that. And because Kansas has so many rural markets. Yes, this is.

00;26;04;14 - 00;26;20;20

Misty Snodgrass

Critical. It's absolutely vital, especially in the far parts of the southwest and northwest part of our state. But, you know, there is limited access to care. You want to make sure you have the provider of your choice that you want to go to make sure that your plan is covering that provider. And so it's really important to see who your primary care doctor is.

00;26;20;20 - 00;26;40;25

Misty Snodgrass

And another thing that we're different is we want you to go to your primary care. We're not wanting you not to use your care. We know how important primary care is in managing health conditions and, you know, doing preventative screenings, referring you to mammograms, colonoscopy. And so it's really important we encourage people to go get their annual wellness visits, which not everybody does.

00;26;40;26 - 00;26;41;15

Cary Hall

You know, they don't.

00;26;41;15 - 00;26;58;10

Misty Snodgrass

Want you to not use their care. We're looking I'm actually looking daily to see who's not using our care, because we are trying to find ways to go get them engaged, because we know ultimately our folks stay with us for a while. Like you said, they'll go try out a new plan, maybe a little more cheaper, but they're going to realize there's going to be a lot more headaches and a lot more pain with it.

00;26;58;10 - 00;27;12;25

Misty Snodgrass

And so they decided to come back to us and they're like, you're kind of worry free for us, but you're a little bit more. You might be a little bit more expensive, but we're working to do that affordability. We're hoping in the next couple years that we're going to not only be the health care plan of choice, but we're the most affordable choice as well.

00;27;12;28 - 00;27;17;22

Cary Hall

That's more of what you're mission is about. It's not about the quarterly earnings report. No.

00;27;17;24 - 00;27;19;00

Misty Snodgrass

We have no shareholders.

00;27;19;02 - 00;27;37;01

Cary Hall

Yeah. Yeah. It's a little different approach. It's a little different way of doing things. If you want help. And you know we keep urging you to keep this in mind. You know, write the phone number down or, you know, look up at their website BCBSKS.com or give them a call at 866-906-5253.

00;27;37;01 - 00;27;38;29

Cary Hall

866-906-5253.

00;27;38;29 - 00;27;49;29

Cary Hall

When I come back from the break, we're going to switch gears now and talk to all you small employers out there about what you're going to expect to see on ACA and what those plans are going to look like.

00;27;49;29 - 00;28;08;02

Cary Hall

Stay right there. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. Stay there. We'll be right back.

00;28;08;04 - 00;28;28;10

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. All our shows are posted on 16 podcast platforms and on our YouTube channel. Got about half a million visits up there on that YouTube channel. We're getting a lot of play. And an awful lot of you are going to those podcasts.

00;28;28;10 - 00;28;44;13

Cary Hall

So thank you so much for all of you that listen on all 240 stations around the country, we appreciate all that too. So let's change topics a little bit. So the people that have been hit the hardest, are the small employers. Let's talk about what's in store for them this year.

00;28;44;15 - 00;28;50;06

Misty Snodgrass

Yeah. So we were actually able to hold our rates lower than our individuals. So that's exciting for us.

00;28;50;08 - 00;28;51;04

Cary Hall

That's amazing, frankly.

00;28;51;07 - 00;29;10;20

Misty Snodgrass

So that's a big, so it's, you know, around a 7 to 9% depending on kind of the plan that's a significant improvement with our small group. That's been a priority for us. We're working hard to make it even more affordable. And I'll tell you a little story, Cary, my dad, has been a Blue cross Blue Shield of Kansas policyholder.

00;29;10;20 - 00;29;28;24

Misty Snodgrass

He's had a small business his entire life. And has been with Blue Cross Blue Shield of Kansas for over 40 years. And so it's a priority. I know how hard it is for small business owners to me to make that real expensive decision every month. So everything that we're doing and every decision we're making is how can we make it more affordable?

00;29;28;24 - 00;29;32;16

Misty Snodgrass

Because we want to be serving more and more small, small groups in our area.

00;29;32;19 - 00;29;50;03

Cary Hall

And here's the thing. In addition to the fact that it's difficult for small employers, they have to deal with this. And by the way, 7 to 9%, that's the lowest increase I've heard in the country right now. And I've my ears pretty close to the ground that a lot of the stuff, the other carriers are nowhere around there.

00;29;50;03 - 00;30;14;28

Cary Hall

So that's a big deal. But the other thing is, in addition to the cost, there's the issue of being able to hire good employees and the issue being able to keep good employees. If you can't give people the, you know, the second question they ask is after what's my salary? What are the benefits? Yep. Okay. Well, if you if you're going to hit people with 20 and 30% increases or cost shifting, let's raise deductible.

00;30;15;04 - 00;30;24;28

Cary Hall

Raise the co-pays. Oh, and you're going to have to pay more than what you were paying as an employee, because my contribution can't be as big. That disrupts the whole workforce.

00;30;24;28 - 00;30;42;08

Misty Snodgrass

Absolutely. It's just an important benefit. We all, are passionate about, having health insurance, being able to cover it for our individuals, our employees and our families. And so we're really, really focused on that. It is a big, big bite out of every, employer's budget.

00;30;42;08 - 00;30;43;08

Cary Hall

The number two cost.

00;30;43;08 - 00;30;46;22

Misty Snodgrass

Yep. Absolutely. Sometimes even number one, you know.

00;30;46;25 - 00;30;48;09

Cary Hall

A hundred percent. Yes.

00;30;48;12 - 00;31;04;00

Misty Snodgrass

And so I every time we're making decisions, I think of my dad and you know, every decision he had to make. On whether or not, you know, can give your employees raises because of whether or not costs are going up. So we're doing our best to make sure that we are, preventing those, you know, significant rate increases.

00;31;04;00 - 00;31;22;01

Misty Snodgrass

We also have other options for our members. A lot of the products are very similar to our individual market. So we have metal tiers. We have a lot of our employers are in gold, as you can imagine. They want to provide the most robust benefits, but that may not be what your your employees may need. Depending on the age of your workforce, there's a lot of things that can factor in, so feel free to give us a call.

00;31;22;01 - 00;31;40;18

Misty Snodgrass

We're happy to help walk you through that and find the plans that work best for you and your employees. Or use a broker if you're using a broker. And a lot of small groups don't use brokers all the time. But sometimes they do. And if they're able to just call, you know, my dad has known, his individual person that he's called to go get his quotes for 20, 30 years.

00;31;40;18 - 00;31;49;26

Misty Snodgrass

I mean, our individual that our employees stay forever, you know, so they're very knowledgeable. They have relationships, which is a big thing. And they're working to fight hard to get hard to keep the lowest rates possible.

00;31;49;26 - 00;32;06;23

Cary Hall

Yeah. And something you guys do is that if you are a small group employer, you can call and get direct help and directly enroll if you need to do that. So that's great. Talk a little bit about the level premium plans. And then you know, how important is that moving forward for next year?

00;32;06;26 - 00;32;26;17

Misty Snodgrass

Yeah, we view our levels on it as an opportunity for employers that want to manage their cost based upon their population that they, their employees that they have, you know, and so we, we have a lot of level funded plans. They are very specific to the employer. So it's hard to give a lot of details just because of the complexity.

00;32;26;17 - 00;32;43;08

Misty Snodgrass

We'll walk through what kind of history you guys have with your employees. So it's different than choosing an ACA small group plan where you're kind of a group rated. That's kind of what a small group's your group if you have, you know, kind of a younger workforce, it might work better for you.

00;32;43;10 - 00;32;59;20

Misty Snodgrass

But it may not depending on the health care costs associated. So it's really important to reach out and find out if that's the best for you as an employer or your employees, and we'll be able to help you, walk you through it, guide you. And it's not you know, our folks don't get paid more because they put you in one sort of plan.

00;32;59;25 - 00;33;03;23

Misty Snodgrass

It's really the entire goal is to help you get covered and your members to be covered.

00;33;03;29 - 00;33;12;20

Cary Hall

And if they need somebody to come out and literally help them explain to you, I know you guys do it. Yeah. You're not going to get a lot of they're not in a lot of the carriers to do that.

00;33;12;20 - 00;33;13;23

Misty Snodgrass

No, no ones going to your office.

00;33;13;26 - 00;33;29;06

Cary Hall

I don't think there are any to be really honest with you. No. So let's talk a little bit about that because here's the employer trying to deal with what's going to happen next year with increases and changes. And then typically in a small business, what I always found when we were doing this was the husband didn't do that.

00;33;29;06 - 00;33;32;25

Cary Hall

If the wife worked in the business, she was the one that handled it. So yeah.

00;33;32;25 - 00;33;46;27

Misty Snodgrass

My mom is that my mom is. But she was there. She helped with the accounting and stuff, so she was always looking at that. And she's helping to look at what's best for the employees. And so absolutely you can we will come to your office gladly. And we will walk you through it.

00;33;46;27 - 00;34;08;23

Misty Snodgrass

We will also after we don't just sit there and sell the product to you or try to get you on a certain product, we actually come back and have conversations. What's working? Here's what's going on. Here's some things we want your folks to be going to make sure they're getting their annual wellness visits. Go, go encourage them to go get their annual wellness visits, because that helps you as an employer keep costs down well and also keeps your workforce healthy.

00;34;08;26 - 00;34;24;26

Misty Snodgrass

We want to help with productivity, keeping your workforce healthy. And so it's really important, to ask those questions. We will send people to your office, no matter if you have five employees or 500 employees. We really want to make sure that we're able to provide personalized, service as well as details to help you answer your question.

00;34;24;29 - 00;34;43;05

Cary Hall

They're very different approach. Yes, extremely different approach typically, than what people see out there. And a great way of doing business with what you guys do. Thank you very much for joining us today. I think we like I said, I'm sure everybody listening was like trying to drink from a firehose on this thing, but it's critical that people understand.

00;34;43;08 - 00;34;44;13

Cary Hall

So you're going to come back?

00;34;44;13 - 00;34;44;25

Misty Snodgrass

I will

00;34;44;26 - 00;34;59;06

Cary Hall

when we're going to go through the actual plans on the next show, we're going to tell people, and here's why we're not doing it today. This is changing week by week. Not because of them, but because of what's going on on the regulatory side. The legislative side, and all the rest of it.

00;34;59;06 - 00;35;04;20

Cary Hall

So the great news here is, we'll have all that information. You'll be back to do another show with me.

00;35;04;20 - 00;35;05;13

Misty Snodgrass

I'd be happy to.

00;35;05;14 - 00;35;21;01

Cary Hall

Yeah. Thank you so much for coming up today. She is Misty Snodgrass, over at Blue Cross and Blue Shield of Kansas. You know, they have a very different way of doing business. If you’re with one of those national carriers out there. You might want to ask them when the last time was they sent a rep out to your shop to talk to your folks.

00;35;21;01 - 00;35;42;14

Cary Hall

Okay. Probably didn't happen. If I had to guess. Their focus is on the people in this state, you heard them say that you know they're doing everything they can to hold cost down 7 to 9% on small group. I, I haven't seen that number anywhere else period across the country. So it's a very different way of doing business. that is they like to say it's Kansans helping Kansans.

00;35;42;14 - 00;35;58;24

Cary Hall

As I like to say they’re main street, they're not Wall Street. So they're very different at what they do. And now, ladies and gentlemen, I leave you with this thought from Albert Einstein, the one who follows the crowd, they usually get no further than the crowd, the one who walks alone is likely to find himself in places no one has ever been.

00;35;58;26 - 00;36;13;16

Cary Hall

Remember, friends, is 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, here on the HIA Radio Network.

00;36;13;18 - 00;36;14;29

Cary Hall

Goodbye America.

The Big 4 Weight Loss Drugs Ozempic, Wegovy, Zepbound, Mounjaro. What are there long term effects?

Mon, 06 Oct 2025 18:19:47 GMT

Episode 2129 notes

I've wanted to do this show for a long time. It's personal to me. This is on what I call the big four weight loss drugs. Ozempic, Wegovy, Zepbound and Mountjaro. And the reason I wanted to do this show was because I was struggling with some weight issues and went to see my primary care doc, and she goes, well, let's just go ahead and give you Wegovy. And I thought, you know, I think I'm going to go find a weight loss clinic. I'm going to get into a program and see what I can do. And I did. So I’ll let you know how that went, but also that it made me think about these products and I started doing a little research, started looking around, and I'm like, you know what?

We don't know what we don't know. And it gave me, some significant hesitation about using these, so this show today is about that. It's about what do we know? What don't we know? What do we know that are side effects, potential problems down the road for other kinds of diseases and comorbidities because most studies go back only 3.5 years or less. Some additional questions are: What are the long-term effects and what happens if you’re on them on them for a lifetime?

I’ll also review the manufacturer country Green List, so if you are getting one of these from another country to save cost, which are considered safest.

We have the research, and I'll lay it out in detail in this episode and I’ll let you know what I think. The studies we've referenced are listed below.

This is episode 2129 of America's Healthcare Advocate. I'm Cary Hall.

Episode Producers:

Audio: Garner Cowdry

Camera: David Thiessen

Research - Nathan Haldeman

Research for this episode:

Semaglutide and tirzepatide basic info: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf

Timing of risks involving weight loss drugs : https://pubmed.ncbi.nlm.nih.gov/37952131/

Info related to weight regain with weight loss drugs: https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/

Info about suicidal signals with weight loss drugs (no signals found): https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type/

Gastrointestinal complications with weight loss drugs :

https://gi.org/journals-publications/ebgi/phil_paul_nov2023/

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf

Thyroid risks with weight loss drugs: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf

Pancreatitis, gastroparesis/obstruction caution: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf

Human relevance with thyroid issues: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf

Success stories with meaningful weight loss using the drugs: https://www.nature.com/articles/s41591-022-02026-4/

Findings regarding weight loss drugs helping heart health:

https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or/

Findings regarding weight loss drugs ability to help prevent diabetes:

https://www.reuters.com/business/healthcare-pharmaceuticals/eli-lilly-says-weight-loss-drug-cut-diabetes-risk-by-94-trial-2024-08-20/

Basic side effects of weight loss drugs: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf

Warnings regarding who should and shouldn’t take these drugs:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf

Specifics with body composition during weight loss drug use - how to maintain the loss and what you're actually losing:

https://www.nejm.org/doi/full/10.1056/NEJMoa2032183/

Cost and healthcare surrounding weight loss drugs: https://aspe.hhs.gov/sites/default/files/documents/127bd5b3347b34be31ac5c6b5ed30e6a/medicare-coverage-anti-obesity-meds.pdf

More regarding prices and utilization pressure:

https://kffhealthnews.org/news/article/glp-1-weight-loss-diabetes-drugs-cost-deprescription-medicaid-north-carolina/

Real- world persistence about weight loss drugs: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823644

How to take the drugs and dose them properly: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf

Lifestyle tips to help the drug’s effectiveness:

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.16275

Planning timelines for weight loss with and without the weight loss drugs: https://pubmed.ncbi.nlm.nih.gov/35441470/

Necessary things to do prior to taking the drugs that can improve your safety with them:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf

How do these drugs actually work: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf

Warnings about lack of long term data for these drugs:

https://www.nejm.org/doi/full/10.1056/NEJMoa2307563

Stopping often leads to weight regain:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252

Drug warnings about pulmonary aspiration:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf

Signals about serious GI events:

https://jamanetwork.com/journals/jama/fullarticle/2810542

Suicide relations to these drugs, how it’s a misconception:

https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type

Patients with diabetes may have retinopathy complications:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf

Pregnancy cautions:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf

These drugs can affect your ability to digest other medications:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/217806Orig1s020lbl.pdf

We need more data about the effects of body composition:

https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

Warnings about unapproved versions of these medications:

https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss

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Episode 2129 Transcript:

00;00;01;14 - 00;00;06;08

Cary Hall

And now America's Healthcare Advocate, Cary Hall.

00;00;06;10 - 00;00;26;19

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate. Show broadcasting coast to coast across the USA. Here on the HIA Radio Network, you can find out more about us by going to the website AmericasHealthcareAdvocate.com. Also our YouTube channel. Almost half a million views up there now. So we appreciate all of you out there who go up on YouTube and follow our show.

00;00;26;21 - 00;00;49;05

Cary Hall

And in addition to that, your your favorite podcast channel, whatever it might be. SoundCloud, Rumble, Spotify, we're on system. All the shows are up there as well. Also, if you are chronologically challenged or if you are looking for ACA, there's going to be major changes in this market this year on the ACA. In the Medicare plans, you need to talk to somebody.

00;00;49;05 - 00;01;11;13

Cary Hall

I'm going to suggest you call Carolee Steele that 877-385-2224. She's over at RPS Benefits by Design. She is a certified expert in Medicare and ACA, and she can help you anywhere in the country. There going to be some big increases, some plan changes. All the rest of it. If you need help, give her a call at 877-385-2224.

00;01;11;19 - 00;01;33;28

Cary Hall

And if you're an employer. We were just talking about this with Dave before we went on the air. And you're one of these small, employers under 50 lives, and you're getting hit with big premium increases, and there are going to be big premium increases this year. Maria Ahlers can help you see some of these alternative plans that are out there that can get these costs in line 877-385-2224.

00;01;34;00 - 00;01;59;11

Cary Hall

All right. This show. I've wanted to do this show for a long time. It's personal to me. This is on what I call the big four weight loss drugs. Ozempic, Wegovy, Zepbound and Mountjaro. Okay. And the reason I wanted to do this show was because I was struggling with some weight issues. And, went to a first of all, I would see my primary care doc, and she goes, well, let's just go ahead and give you Wegovy.

00;01;59;14 - 00;02;15;25

Cary Hall

Oh, okay. And then, of course, I went and found out that cost $1,100 a month. That kind of chilled me a little bit. And I thought, you know, I think I'm going to go find a weight loss clinic. I'm going to I'm going to go get into a program and see what I could do. And I did, and I think I've talked about this before.

00;02;15;25 - 00;02;38;07

Cary Hall

I went on metformin for about six months and changed my diet around, went from 250 to 235 and I'm holding about 235. I probably should get down another 10 pounds, but that's going to be the hardest one to do. I was very tempted, okay, to use one of these drugs because it's instantaneous. You start using it, you start shedding pounds.

00;02;38;10 - 00;03;03;17

Cary Hall

Well, I started doing a little research, started looking around, and I'm like, you know what? We don't know what. We don't know. And it gave me, some significant hesitation about doing this. So this show today is about that. It's about what do we know? What don't we know? What do we know that are side effects, potential problems down the road for other kinds of diseases, comorbidities.

00;03;03;17 - 00;03;22;15

Cary Hall

And I'm going to talk about that. Okay. What do we know in the short term are the issues that you're going to have to deal with if you take all of these drugs? Here's the other thing. I can't even count on two hands. The number of friends I have who are taking these medications. Look, I'm not saying that you shouldn't take them or they're bad for you.

00;03;22;16 - 00;03;44;02

Cary Hall

What I am saying is people need to understand what they're doing, and you're not necessarily. I didn't hear it from my primary care doc. She didn't say anything to me about possible issues going down the road. What could the comorbidities be? None of that. So I decided to do it. Do this show. And bring some of this to your attention.

00;03;44;04 - 00;04;10;06

Cary Hall

So these blockbuster weight loss drugs work by slowing stomach emptying. That's what they work. They they alter the gut hormone signaling. It's time to empty your stomach. Okay? That's what they do. So it's really as simple as that. They're slowing down the digestive process. They deliver large short-term weight loss. But the problem is the safety warnings and the knowledge gaps are significant.

00;04;10;07 - 00;04;32;00

Cary Hall

So that's what we're going to talk about. So what happens when you take these drugs long term. Well here's part of the problem. The studies that have been done on Wegovy, which is about 3.3 years, they lack the decade long studies that we typically use when we're grading how a drug works. So we're talking about how does it affect the organs.

00;04;32;00 - 00;04;50;22

Cary Hall

What kind of cancers could it possibly cause? What are the neuropsychiatric side effects? Now that was something I never even thought of. Well guess what? There are some neuropsychiatric side effects from this medication. There can be for certain people, and these are outcomes in non-diabetic users. The New England Journal of Medicine is saying.

00;04;50;28 - 00;05;12;07

Cary Hall

We typically do this for ten years. Well, we've only had these for 2 or 3 years. So again, you know, the unknown risks. What are they. And then we how do we balance that with the need for this medication. You know, it's funny in this country, that I'm sure you all will understand this. We like instantaneous gratification.

00;05;12;09 - 00;05;34;10

Cary Hall

All these three, these four drugs, they will give you instantaneous gratification. The question becomes, now what does long term use look like? How effective are they in the long term. And then what are the side effects. What are the issues that you're going to deal with. So long term is, you know, randomized data for patients 1 to 2 years.

00;05;34;16 - 00;05;56;17

Cary Hall

The largest cardiovascular outcome trials with Wegovy, followed patients a medium of 3.3 years, far from the 10 to 20 years, on the horizon that people typically care about. So right there, they did a study 3.3 years. This was limited to how it was going to affect cardiovascular issues, but it only went for 3.3 years.

00;05;56;24 - 00;06;22;00

Cary Hall

Well, typical studies would come out for these things, are ten years, to give you a clear understanding of what the effects of that particular medication are going forward and how they're going to affect you. So what I'm showing here is we have a very short window of data to deal with. And that window of data doesn't tell us enough to know in some cases, what are the long term effects of these medications.

00;06;22;02 - 00;06;45;25

Cary Hall

The other problem is typically after you stop these drugs like, Wegovy, two thirds of the people that had weight loss gained it back. All right. So now we're into what I call the Yo-Yo effect. This is the problem that many, many of the weight loss programs, weight loss drugs. You know, before these drugs came out, there were a host of other programs.

00;06;46;02 - 00;07;03;23

Cary Hall

Weight Watchers, go down the list, and you have people go on these diets and they go on these programs, and they work. And then they yo yo back up. Well, the problem with this medication is right, that if you go off of it, two thirds of the people after they went off, it started gaining the weight back.

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

Cary Hall

So what happens then with weight loss versus continued use? What happens if you continue to use this drug for not one year, but two years, three years, four years, five years? How long can you do this without incurring significant risk down the road? For some of the things we're going to talk about today. Damage to your organs? Cancer?

00;07;27;15 - 00;07;51;26

Cary Hall

These psychiatric issues. There are a host of things like this. Thyroid issues. We're going to talk about all that and try to get information out to you so that you understand. Once again, I'm not saying that these drugs aren't safe. The FDA has approved them. But I am saying that there's not enough information out there. And the reason I chose not to use the medication was just that.

00;07;51;29 - 00;07;56;19

Cary Hall

I didn't need to open up an opportunity for other long term problems for me.

00;07;56;19 - 00;08;14;16

Cary Hall

I'm already in the Agent Orange program. I've talked about this before. I certainly didn't want to do anything to compound that issue. So what we're trying to do today basically, is go through this and talk about how these medications affect people, what are the side effects, what do they do for people that have other comorbidity issues?

00;08;14;22 - 00;08;41;01

Cary Hall

When we come back from the break we’re going to talk about that. We'll talk about IBS, we'll talk about Crohn's and we'll talk about colitis. And do they impact those things? Remember you're dealing with your gut health here. When you take this medication. That has a lot to do with how you feel, how you function and your overall health. So when you start playing around with your gut health, by slowing down this digestive process, what happens and what are the side effects, what occurs after you do all that?

00;08;41;01 - 00;09;00;28

Cary Hall

So, when we come back from the break. We'll get into some of that. We'll talk about very specific things, that these four medications can cause and do cause in people to use them. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across the USA.

00;09;01;02 - 00;09;14;21

Cary Hall

We'll be back with more. Stay right there.

00;09;14;24 - 00;09;43;19

Cary Hall

Welcome back to America's Healthcare Advocate show broadcasting coast to coast across the USA. Here on the HIA Radio Network. You can find out more about us by going to the website America's Healthcare Advocate.com. All these shows are posted up on the YouTube, on the website, and all the podcast platforms. So maybe you're considering this. Somebody in your family is. You might want to have a list of this and kind of learn what the problems are, what the exposure is for taking these four medications.

00;09;43;21 - 00;10;06;05

Cary Hall

So let's keep going. Switching from Wegovy to a placebo. Weight gain versus continued loss if the treatment continued. This suggests many patients are going to need ongoing therapy to maintain the benefits. Meaning when they went to the placebo, they started gaining weight again. All right. So short term they work. Long term? We're going to talk about that.

00;10;06;05 - 00;10;11;24

Cary Hall

Can you keep taking these things forever. Do you have to stop, regroup or change meds.

00;10;11;24 - 00;10;33;14

Cary Hall

Suicidal thoughts. This is under review right now. There is no casual link to date. However, the FDA's 2024 review reports did not find evidence that the drugs cause suicidal thought. But the monitoring continues in a large 2025 study. They also found that no increased risk versus the medication.

00;10;33;14 - 00;10;53;19

Cary Hall

So right now the issues regarding your mental health, they're saying this is not having any long term effects. They haven't seen it. But remember what I said. They only got two years three years worth of data here to study. So they don't know. All right. They're monitoring. That's a good deal. Here's where I think it really gets to be significant:

00;10;53;22 - 00;10;56;16

Cary Hall

Gastrointestinal complications.

00;10;56;18 - 00;11;22;12

Cary Hall

So this is an issue. A study: “higher risks” of listen to this pancreatitis, bowel obstruction and gastroparesis. And what that is that's IBS. That's Crohn's and colitis. That's what that is. Okay. That's a large word for those three things. So you know if you've got Crohn's or you've got IBS. I have friends that have it. My wife has ongoing issues with it from time to time.

00;11;22;14 - 00;11;44;08

Cary Hall

What they're saying here is you've got a significant risk here. Higher risk that you're going to irritate that and make it worse. So that's one of the side effects. Here's another one. What they've noticed in thyroids with Wegovy and Zebound is that there's a warning with the medication that says they are producing thyroid C-cell tumors in rodents.

00;11;44;10 - 00;12;06;29

Cary Hall

Well, okay. It's in rodents, right. But typically, where do they test these kind of things? Well, they test them short-term, obviously in rats, in mice and all the rest of it. And what they're finding is that it's impacting in the thyroid. So now, you know, you add to the gastrointestinal this piece of the thyroid. And now we're talking about some significant risk.

00;12;06;29 - 00;12;27;20

Cary Hall

In my mind that would be a deterrent for me wanting to take these meds because that's a problem you don't need to have. So decade long safety data are lacking. And so the problem is weight often returns after you stop using it. That then becomes, you're going to have chronic use.

00;12;27;20 - 00;12;57;13

Cary Hall

Are you going to have to use it continually. And then where does that fall when we're talking about these other issues that could be a result of this medication long term. Once again the suicide issue has not been found to be significant. But they are observing signals, that caution. And they're advising doctors, specialists to be careful with these medications because they do cause issues for people that have, IBS, Crohn's, colitis, and they can affect it.

00;12;57;16 - 00;13;22;23

Cary Hall

Another issue, obviously, on this cancer thing. So the cancer warning, it reflects cancer. They're finding cancer in these animals when they give them these medications over a period of time. So what does that mean to you if your thyroid, you have cancer in your thyroid? I've had many people that were clients of mine over the years on the insurance side that had these issues.

00;13;22;23 - 00;13;42;16

Cary Hall

And it can be very difficult. There’s surgeries involved. There's radiation, there's chemo, there's all these things that, literally change how someone lives because your thyroid has been significantly damaged. So, you know, again, what I find interesting about this, I love my doctor, my primary care doc. She's amazing. Okay. But we didn't talk about any of this. Not okay.

00;13;42;20 - 00;14;04;14

Cary Hall

There was no mention of it. It was like, okay, here you know, you want to try this medication? It'll certainly help you lose the weight. So you know that's the issue now. All right. What we don't again, as I’ve been saying earlier, we don’t know what we don't know, and the FDA doesn't know, all right?

00;14;04;14 - 00;14;24;10

Cary Hall

And doctors are not necessarily putting an emphasis on this. But if you're the person that goes in and you get the med. And you've got IBS or you've got Crohn's, you got ulcerative colitis and you start taking this and all of a sudden you start getting very, very sick. That means that this medication is what's causing that issue.

00;14;24;16 - 00;14;44;01

Cary Hall

Again, you know, you go in and you get your thyroid checked. When you get a physical, they check your thyroid. Well, all of a sudden your thyroid is out of whack. And they want to put you on a medication for thyroid. Is somebody going to make a link between, oh, I'm taking Wegovy or I'm taking Zepbound or, you know, whatever it is.

00;14;44;04 - 00;15;05;21

Cary Hall

And, and perhaps that's causing this problem. So that's where you kind of have to be your own advocate, which is what I kind of did whenever I was looking at doing this. I didn't want to take these meds until I knew what I was getting into. And this is what I discovered after I did the research and looked around and all of these sources.

00;15;05;21 - 00;15;31;14

Cary Hall

By the way, when we post these podcasts, we put all the sources where we're getting this stuff from. So whether it's New England Journal, medicine or the FDA or US Food and Drug Administration, we put all that information up there. So what I'm giving you here is actual data and information, from these the government, entities that are tracking this and entities like the New England Journal of Medicine, etc., etc., who've actually looked into this.

00;15;31;14 - 00;15;47;11

Cary Hall

And so we're kind of like what I said. We don't know. We don't know. We know that there are issues surrounding this. We know what some of those issues are. When I come back from the break now we're going to talk about so where do we go from here? What does this mean. All right. Can you should you keep doing this.

00;15;47;13 - 00;16;07;10

Cary Hall

Or maybe you need to start looking at is this a smart way to move? I mean, you look at Oprah Winfrey. She swears by this now. She's finally lost weight. She's able to keep it off. She's not doing it on Weight Watchers. You know what is? That's great. But what's she gonna look like in five years? Six years, seven years, eight years, nine years, ten years?

00;16;07;16 - 00;16;24;09

Cary Hall

And is she going to get sick long term from using these medications? Is she going to have a thyroid cancer issue? You know, is she going to have another gastrointestinal issue? They haven't said anything about cancer links to this as far as gastrointestinal. That's going to be another question down the road. It has to be. All right.

00;16;24;13 - 00;16;51;15

Cary Hall

So when we come back from the break. We'll talk about where do we go from here, and what's safe and what's not safe to do. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate, broadcasting on the HIA Radio Network. Coast to coast across the USA. We'll be right back with more.

00;16;51;17 - 00;17;14;15

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. You can find out more about us by going to our website. AmericasHealthcareAdvocate.com. A little shout out to our affiliate in Topeka, Kansas, KMAJ 1440 The Big Talker. We are on Saturday mornings at 10:30am.

00;17;14;15 - 00;17;35;00

Cary Hall

Very happy to be on in Topeka, Kansas, the capital of the state of Kansas. All right, so let's continue talking. So, here we see that stopping these drugs often time leads to weight regain. So with Wegovy, two thirds of the weight that was lost was regained after they stopped using Wegovy. For one year.

00;17;35;07 - 00;17;56;23

Cary Hall

All right. So with Zepbound, they gained substantial weight. In fact, they gained more than they had lost when they stopped using it. So this is to the what I call the Yo-Yo effect. Short term? Yes. Long term. How do you treat that? Then it becomes a chronic issue, meaning you're going to repeat using that over and over again.

00;17;56;27 - 00;18;18;05

Cary Hall

Look, if you're morbidly obese and you've got all these other comorbidity issues, you're a type one diabetic, you're a type two diabetic, and you've got heart issues. You've got joint issues because you're carrying all this extra weight around. This is a great short term solution. The question is then where do you go from there.

00;18;18;08 - 00;18;39;10

Cary Hall

It seems to me that if you're going to do this, what you need to do is you go on the med and then you get into a program somewhere like, you know, the old, weight loss programs that are out there. You go to a client that specializes in this stuff, and then how, how do I start changing my habits so that taking this made a difference and now I can maintain it?

00;18;39;13 - 00;19;05;14

Cary Hall

That seems to me to be the logical approach. But again, if you're somebody that's morbidly obese and you're suffering with co-morbidity issues, with heart attack, heart, high blood pressure, cholesterol, you've got joint problems. Knee replacements, hip replacements, all of that. Yes, you definitely will find benefit in this. And does that offset the risk? More than likely for someone in that situation it does.

00;19;05;15 - 00;19;24;14

Cary Hall

If you're taking this to lose 10 pounds or 15 pounds, that's vanity. I mean that's really what it amounts to. All right. That can be done through diet and exercise. But for people that seriously need this medication. It certainly does make a difference in their lives. It could certainly help. But, let's keep going.

00;19;24;17 - 00;19;51;29

Cary Hall

So one of the other things they found out is a delay in gastric emptying now causes issues with pulmonary aspiration. So they don't basically want you having surgery where you're going to go under a general anesthetic if you haven't stopped taking this for at least 24 hours and gone on a liquid diet. So there's another issue. And that's really kind of funny, because, Laurie just had a procedure here not very long ago, and now she's thin and she's tall.

00;19;52;05 - 00;20;22;00

Cary Hall

But nobody asked about whether you had when the anesthesiologist came in. I just remember this. Nobody asked if you were taking these meds. Which could cause, an aspiration risk, while you were under the general anesthetic. So I thought that was kind of interesting. The GI events. So once again, they're talking about obstruction, gastroparesis, which is Crohn's, you know, IBS, ulcerative colitis, that that comes from the Journal of American Medicine.

00;20;22;02 - 00;20;46;16

Cary Hall

And they are they say they are debating this issue, but it's definitely out there. They're definitely saying that it's there. It's one of those things that has to be evaluated. The warning again, you know, on the C-cell for the thyroid that is actually in the material you get when you take the medication. So there is a warning, on the issue of taking the medication and the risk it does to your thyroid.

00;20;46;16 - 00;20;49;20

Cary Hall

On the gallbladder disease and pancreatitis.

00;20;49;22 - 00;21;05;27

Cary Hall

That's also now an actual warning that comes with the medication. So while they're debating it, they're making you aware that there's definitely an issue there. And it's something that you need to think about and something you need to look into if you're going to take these medications.

00;21;05;27 - 00;21;10;17

Cary Hall

So here's some other issues that and this surprised me because I didn't know it.

00;21;10;18 - 00;21;30;12

Cary Hall

There's a green list of sources that these medications can come from. There's a couple here that I don't have a problem with Belgium and Canada, but they're also China and India on here. And I will tell you this straight up, if I were going to take one of these medications, I would make damn sure it wasn't coming from China or India.

00;21;30;14 - 00;21;49;05

Cary Hall

All right. You know, we know for a fact that the Chinese cut corners. They play games. They don't do things the way they're supposed to do them. There's no way on God's green earth that I know I'm going to hear it. Well, we get a lot of the generic medications from China. I know we do. Okay. And it's a deep concern.

00;21;49;05 - 00;22;09;21

Cary Hall

I don't know why. I know that there's a move now in the Trump administration to get away from that. But it's been like that for years. And it's definitely a problem. But I certainly would be concerned about taking any one of these four medications if they came from China. You know, they're also talking about compound pharmacies here.

00;22;09;23 - 00;22;33;20

Cary Hall

And what kind of an issue that presents, because we have these pharmacies out there, they put different medications together and put together compound pharmaceutical products. Well, these are unapproved versions of any of these medications. So they're saying basically, you don't go to a compound pharmacy and get a mix of a, Wegovy and a Mounjaro or a Wegovy and some other medication.

00;22;33;22 - 00;22;58;10

Cary Hall

That's 100% wrong. And they are not approved, and they're telling you to stick to only approved products. So I know there are a lot of people out there like these compound pharmacies. A lot of women use them for issues around, menopause and other kinds of issues that they help with, and that's great. But in this case, the FDA is saying absolutely do not use these medications in a compounded format.

00;22;58;12 - 00;23;18;16

Cary Hall

And they said stick only to the approved models. That's the way they're supposed to work. So here's, so what do these do when it comes to weight loss. So mostly they cause fat to disappear. But here's another piece. And you need to understand this, especially if you don't exercise and you're not getting enough protein.

00;23;18;18 - 00;23;44;03

Cary Hall

They also delete lean mass. What does that mean. That means muscle mass. All right. So in addition to getting rid of the fat, long term functional outcomes and bone effects need more data. This is what we don't know. All right. Need more data. So there's an issue. All right. So it shows the majority of the loss is fat loss.

00;23;44;05 - 00;24;05;20

Cary Hall

But once again now they're talking about bone effects. So let's say you have osteoporosis and you're going to take this medication. Hopefully your doctor is going to say, well, hang on a minute, I need to make you aware that if you've got osteoporosis and you take this, you're going to further damage your bone health. Possibility.

00;24;05;20 - 00;24;27;29

Cary Hall

Or long term functional outcomes. In other words losing muscle mass. If you're taking these meds, you're on a diet. I remember when I went into this weight loss program, getting enough protein was a really big deal. Every day. It was get off of the carbs, you know? And the other things you don't need to be doing, sugar all the rest of it.

00;24;28;05 - 00;24;48;10

Cary Hall

But the key was to getting enough protein, making sure you're getting x number of grams of protein. I think it's like 90 a day. I can't remember specifically. But the idea is that you have to have enough protein. In order to, your body mass, especially your muscle mass, to be able to continue like it's supposed to.

00;24;48;12 - 00;25;08;02

Cary Hall

So they're telling you right here, the FDA is telling you there's a trade off. This is the verbiage from the FDA. There's a trade off. It's mostly fat. But you're also going to have muscle loss and you're going to have mass loss. And then this side effect on issues with regard to bone.

00;25;08;04 - 00;25;29;14

Cary Hall

So if you have osteoporosis this is definitely something you need to look into and ask questions about before you go on this medication. Again understand why I'm doing this. This is like a rage in this country right now. You know, they're dropping the prices down. I've seen a couple of them now they're coming for 120, $90 a month, etc..

00;25;29;18 - 00;25;47;05

Cary Hall

So that you can buy the medications, but do understand that there is a risk involved. And I'm going to repeat what I said. If you're somebody that's morbidly obese, I would tell you to do this in a New York minute, at least get the weight off and then see if you can get into a program where you can keep it off.

00;25;47;05 - 00;26;06;19

Cary Hall

But what I'm saying, basically, is this. If you use this, it's not a long term solution. It's not. You're going to have to make some lifestyle adjustments once you get rid of the weight in order to keep the weight off. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting on the HIA Radio Network.

00;26;06;25 - 00;26;26;14

Cary Hall

Coast to coast, across the USA. When I come back from the break, we'll talk about the green list. That's the list of foreign manufacturers that the FDA says you can rely on. And we'll talk about some of the other issues in terms of how these medications are being used, who's manufacturing them, and what do they mean to you when you go out and start using them.

00;26;26;19 - 00;26;43;12

Cary Hall

Stay right there. We'll be right back after the break. You're listening to America's Healthcare Advocate, broadcasting on the HD radio network. Coast to coast across the USA. We'll be right back with more.

00;26;43;14 - 00;27;02;28

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across USA here on the HIA Radio Network. All these shows posted on the podcast platforms and YouTube. If you want to go up and tell somebody about and have them listen to it. This is one I’m probaly going get a lot of listeners. There are a lot of people interested in these medications.

00;27;03;01 - 00;27;24;09

Cary Hall

So let's talk about some of the other issues that are out there. So there is a retinopathy issue here with regard to your your vision and your eye health. So basically what they're saying is that if you have any of these issues with regard to your vision and your vision health, this can exacerbate that problem.

00;27;24;10 - 00;27;45;29

Cary Hall

These medications can. So that's another one that we that we haven't talked about. The green list from the FDA does include Belgium and Canada. I told you China and India on here. But here's what’s interesting. In a compliance snapshot they reviewed 48 overseas manufacturing facilities. This is what I find interesting. This is totally the opposite of what they just said in the other in the other piece.

00;27;46;01 - 00;28;08;18

Cary Hall

21 of those facilities of the 48 were in noncompliance. So what were they doing? What were they adding? Were the adding baby powder to the medication? I don't know. I mean, we know some of the things that go on in China, right? You know, you tell me I don't know. Well, but this is funny because they're saying that Belgium, Canada, China and India are Green listed.

00;28;08;18 - 00;28;29;22

Cary Hall

And then they're saying when they checked 48 of these overseas facilities, 21% of them were non-compliant. Let me make a, take a guess here of the 21 that were in noncompliance. 20 of them were in India and China. There might have been one in Canada or Belgium that didn't comply. But I'd be willing to bet that the majority of those were in either one of those places.

00;28;29;23 - 00;28;45;05

Cary Hall

Once again, I'm going to say what I said earlier. If it's coming from China or India, I'm probably not going to be taking it. All right. I mean, that's definitely as far as I'm concerned. That's an issue. Those people do not. Especially the Chinese, do not have our best interests at heart.

00;28;45;07 - 00;29;02;11

Cary Hall

If they did, they wouldn't be shipping millions, millions of pounds of fentanyl materials over here for the cartels to make drugs to run into this country for methamphetamine and fentanyl. So you're never going to convince me that the Chinese have anything good in terms of their intentions towards this country?

00;29;02;18 - 00;29;13;01

Cary Hall

Let's keep going. Birth control and pregnancy. All right. If this is really an issue, it is unapproved for folks that, women that are pregnant.

00;29;13;01 - 00;29;37;21

Cary Hall

And there is an issue with if you're on birth control, you're taking these medications that it affects the birth control medications. So meaning that they may not work. All right. So once again you know you're a young woman and you've got weight issues. And you you know, want to make yourself more attractive. You take these meds but you're also on a birth control, medication.

00;29;37;22 - 00;30;10;06

Cary Hall

You need to really check and see if this makes sense. All right. And can you take this medication and not have issues? That's from the FDA. I'm going to go back to this issue with eye health. Diabetic retinopathy complications. So again these meds are typically they were originally designed for diabetics. And if you're on an ACA plan-Obamacare plan, or they've just been approved for part D Medicare, you can get these medications if you're diabetic.

00;30;10;08 - 00;30;21;03

Cary Hall

Now they're saying that this is the New England Journal of Medicine saying this can very serious this can cause very serious problems with vision. So here's another side effect you need to be aware of.

00;30;21;10 - 00;30;39;09

Cary Hall

Pregnancy and fertility. Once again, if you're taking this medication when you’re pregnant, you're going to have issues with it and an oral contraceptive effect of this can be reduced. This is part of the study from the FDA. You're taking those birth control pills, which means you can get pregnant while you're taking it.

00;30;39;11 - 00;30;55;01

Cary Hall

Drug interactions. Delayed gastro emptying. We've talked about that. And the absorption of other medications. So now you're taking this is not unusual for people that are overweight. And I take blood pressure and cholesterol meds.

00;30;55;07 - 00;31;17;13

Cary Hall

You're taking blood pressure and cholesterol. And what we're hearing here is that this impacts the absorption rate of those meds. Well, how about those daily vitamins you're taking and those supplements you're taking to try to keep yourself healthy? Is it going to impact those as well? So somehow this impacts your absorption rate of these medications. All right.

00;31;17;19 - 00;31;41;19

Cary Hall

So you know to recap some of this pregnancy and birth control issues. Definitely an issue here in terms. And you should not take this while you're pregnant. Lean mass loss does happen. All right. It's mostly body fat. But there are going to be lean mass losses. The co-morbidities with gastrointestinal issues. Anytime you start playing with gut health you've got a significant issue there okay.

00;31;41;24 - 00;32;04;12

Cary Hall

And if you've got Crohn's, if you've got IBS, if you’ve got any of these other issues, you're probably going to exacerbate it. The FDA is cracking down on ingredient imports. They are concerned about this because of physical contamination. They've detained shipments on this. Again, I'm going to go back to this. Get something that's made in this country or made in Canada.

00;32;04;26 - 00;32;23;13

Cary Hall

Or made in Belgium. They're certainly available. I know a lot of people are using methods to import this stuff. If you're going to import it, bring it out of Canada, New Zealand, Australia. I did a broadcast on this years ago. It's important to understand those formularies in those countries are identical to the formulary in this country.

00;32;23;17 - 00;32;47;13

Cary Hall

The only difference is the government regulates the price of the medication. So as an example, if you want to take Wegovy, and through, let's say one of them a plan like GigCare which is our product for 1099 folks out of Detego. We can bring that... It's $1,100 a month to buy it. If you don't have, if you're not a diabetic and you're not getting it for medical use, right?

00;32;47;20 - 00;33;13;04

Cary Hall

We can bring it in from Canada for $88. Okay. Yeah. Now, if you can get it from China for $40, I'm going to suggest you probably not do that right. That's probably not going to be a good idea. But you can bring it in from Canada for $88. So if you do want to take this and you make a decision to do it, and you, you're using one of these methodologies where you can call up, get your prescription and you hear me advertised on the radio and you can get your prescriptions.

00;33;13;04 - 00;33;35;10

Cary Hall

You can turn around, and have it shipped into you, make sure you're getting it from someplace like Canada, New Zealand or Australia. And they've said Belgium as well. Okay. Not from China. All right. All right. Thank you all for listening today. The whole purpose of this show, once again, was to educate and inform that there is, an enormous popularity of these medications out there.

00;33;35;13 - 00;33;56;16

Cary Hall

They certainly have a place. They certainly help people that are morbidly obese, people that are significantly overweight, that have other comorbidity issues. You know, if you've got, a heart attack, stroke, those kinds of issues from weight, weight issues, this is a way to overcome that. And it's a way to lose the weight. The question is, what do you do long term?

00;33;56;16 - 00;34;17;21

Cary Hall

What I'm suggesting is if you take these meds for a year and you get yourself on track where you want to be, you need to go into a program where you can keep the weight off and that doesn't mean... you can’t keep taking this stuff forever. That's part of the problem with it. Okay. Because it increases the opportunities for other comorbidities to take place.

00;34;17;24 - 00;34;34;14

Cary Hall

Thank you for listening today. And now I leave you with this thought from Albert Einstein, the one who follows the crowd. You usually get no further than the crowd. The one who walks alone is likely to find himself in places no one's ever been. Remember, friends, is the funny thing about life. You refused to accept anything but the very best.

00;34;34;14 - 00;34;45;28

Cary Hall

You most often get it. Thank you for listening to America's Healthcare Advocate show. Broadcasting coast to coast across the USA here on the HIA Radio Network. Goodbye, America.

Philip Sarnecki – Kansas Businessman, Family Man and Job Creator on Kansas, Health Ins & Benefits and what we can learn from Florida

Tue, 23 Sep 2025 21:54:07 GMT

Episode 2128 notes

Today my friend and guest is Philip Sarnecki a Kansas businessman, a job creator, a husband, and father who rose from humble beginnings (the son of a janitor and a secretary) who then built one of the nation’s largest financial services companies and has led businesses that today employ nearly 1,000 people across multiple industries.

This is Ep2128 of America's Healthcare Advocate.

Learn more about Philip and his plans for the state of Kansas: https://philipsarnecki.org

Learn about me, Cary Hall: America’s Healthcare Advocate: I have a strong desire to empower my fellow Americans and cancel the noise and confusion surrounding the US healthcare system. My goal is to enable you to become the expert for your own healthcare management, saving you time, money, and effort.

Learn even more: https://www.americashealthcareadvocate.com As always, if you need help or have something to share? Contact me with this form on my website and let me know what's on your mind, the issues you are dealing with, or other health, healthcare, and health insurance questions and concerns.

https://www.americashealthcareadvocate.com/contact-us

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Episode 2128 Transcript:

00;00;01;14 - 00;00;06;02

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;06;05 - 00;00;26;11

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA. Here on the ABC Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. AmericasHealthcareAdvocate.com. If you have a question, if you have a comment or an email, feel free to send me an email.

00;00;26;11 - 00;00;55;26

Cary Hall

I get a lot of them, but I answer each and every one of them, so I'm happy to do so. Once again. AmericasHealthcareAdvocate.com is the website. All the shows are posted up on YouTube and our 16 podcast platforms. So your favorite podcast platform, we're on it. I'm quite sure that if you are chronologically challenged and looking for Medicare or individual health insurance, you want to give the lovely Carolee Steele a call over at RPS Benefits by Design 877-385-2224.

00;00;56;00 - 00;01;13;04

Cary Hall

Anywhere in the country, they're happy to help you. If you're an employer looking for group health insurance, employer sponsored health care, Maria Ahlers can help you anywhere in the country. She does a great job. Just helped a small group out of Columbia, Missouri that was struggling with their premiums, what they were paying, and she did a great job.

00;01;13;04 - 00;01;24;01

Cary Hall

We got about a new policy. So once again 877-385-2224. All right. So I think I've been doing this radio show 18 or 19 years. What is it, Dave 18 or 19?

00;01;24;01 - 00;01;24;08

Dave

19.

00;01;24;09 - 00;01;32;29

Cary Hall

19 years? Okay. And this is the first time I've ever had a show like this. So in studio with me today Philip Sarnecki, very happy to have you here.

00;01;33;04 - 00;01;59;05

Cary Hall

He is a gubernatorial candidate for the state of Kansas. Like I said, we've never done this before. I've known this man for quite a while. I'm happy to have him on here. He is the kind of man that we need in politics. I'm going to have to question why he's doing this in a minute. But having said that, I think you're going to learn about a guy today who really understands what this state needs and can make changes that are going to affect everybody in the state of Kansas.

00;01;59;05 - 00;02;00;28

Cary Hall

So welcome to the show, Philip.

00;02;01;00 - 00;02;02;08

Philip Sarnacki

Thank you Cary. Great to be here.

00;02;02;08 - 00;02;16;21

Cary Hall

So first thing I have to ask is why you're if you're a reasonably sane man. Reasonably. Yeah. You’ve had very successful businesses. You've built from scratch. And now you're entering into this political arena at a time when it's a little hot.

00;02;16;22 - 00;02;36;26

Philip Sarnacki

Yes, yes. Well, I will tell you that that is a great question. And I've spent, really a couple of years, pondering that, talking to people, praying about it. And where we've landed is, quite frankly, I'm tired of losing, as a Republican, I know not all of your audience out there are going to be, Republicans.

00;02;36;26 - 00;03;01;08

Philip Sarnacki

But, you know, we have lost we being the Republicans, the gubernatorial seat, the last two elections in Kansas. And that's a state where Donald Trump won 58% of the vote. We have not elected a Democratic senator in almost a hundred years. And we have supermajorities in both houses. But somehow we keep losing the gubernatorial seat and it's really the CEO job.

00;03;01;08 - 00;03;26;04

Philip Sarnacki

It's it's, you know, it's a different political job. I've talked to a number of governors about this, Glenn Youngkin in Virginia being one of them. And, you know, he mentioned to me, he said Philip, people have a tendency to throw all these political jobs in the same bucket. Senate, Congress, Governor. He said., but the reality is the governor's job is a totally different job that needs a totally different skill set, he said.

00;03;26;04 - 00;03;50;09

Philip Sarnacki

It is a CEO job. It is the job of a business leader. And he said all those skills that you've developed and built and acquired over the last 30 years, like that fits perfectly in the gubernatorial seat and I think what's happened is these people that have run for the last two gubernatorial elections, they're wonderful people. They're very nice people.

00;03;50;09 - 00;03;51;26

Philip Sarnacki

I've written some of them checks.

00;03;51;28 - 00;03;53;15

Cary Hall

I'm sure you have,

00;03;53;18 - 00;04;03;24

Philip Sarnacki

But they don't have the skill set to really lead from that place. And that's what I believe that we've been called to do and what we're bringing into this role.

00;04;03;24 - 00;04;30;04

Cary Hall

You know, when you first told me as we were having lunch and I remember having a conversation, I was a little surprised, that I was like, you're really going to do this? You were like, yes, I really am. And we had that conversation about why this is a different way to do this. And I think the fact that you're calling yourself the CEO, which is essentially what you are, and you're looking at it from that model that speaks lives about where you think this should go.

00;04;30;07 - 00;04;54;20

Philip Sarnacki

Yeah, absolutely. I think when again, when you look at it, you know, Senators and Congress people which are very important obviously, but they basically debate and they vote. It's called the legislative branch. Well, this is called the executive branch for a reason. And you're running multibillion dollar budgets. You're appointing leadership positions. You're building leadership teams, you're holding people accountable, or at least theoretically, that would be a.

00;04;54;20 - 00;04;56;00

Cary Hall

concept in government, right.

00;04;56;04 - 00;04;56;13

Cary Hall

You’re hoping you can do.

00;04;56;17 - 00;05;15;02

Philip Sarnacki

That's right. You can hold people accountable. And, you know, those are the skills that I've applied to my businesses for the last 30 years. And I think if we bring those in to the government sector, very similar to what Donald Trump is doing on a national scale, that we can do a lot of that right here in Kansas.

00;05;15;02 - 00;05;30;01

Philip Sarnacki

And by the way, there are a lot of governors around the country right now, who hadn’t ever run for office. Well, Glenn Youngkin, Youngkin, Kevin Stitt, Bill Lee in Tennessee, there was Doug Burgum. You've got Cohen in Nebraska. So there's a lot even the Democrats have a few. So yeah.

00;05;30;02 - 00;05;53;22

Cary Hall

That's interesting, you’ve mentioned that Democrats have few because they do. And those typically that are not politicians that are Democrat governors seem to have a different tact than the ones that are purely politicians, which is exactly what you're pointing out here on the Republican side of the equation. Right? You're looking at people coming into politics that have a very different perspective about what should happen and how it should happen.

00;05;53;24 - 00;06;23;04

Philip Sarnacki

Yeah, I think that's exactly right. I think we're not bound by, you know, the, the, the ways of the past. If you will. Not bound by kind of the political, what what's the expected thing to do in politics, really bringing in outside perspective and an outsider's lens to what we're doing. And I think that's what we can do to be bold and really shake some things up in a positive way.

00;06;23;04 - 00;06;29;08

Cary Hall

Yeah, I agree with that. I think the other thing I would have to point is you're not carrying a lot of baggage. That's right. Exactly. You don't.

00;06;29;22 - 00;06;30;26

Philip Sarnacki

I've never voted.

00;06;30;28 - 00;06;39;15

Cary Hall

You have you vote in every election but you as well, right? Yeah. But you haven't been in politics and you're not pulling a sled behind you.

00;06;39;16 - 00;06;39;22

Philip Sarnacki

Correct.

00;06;39;25 - 00;06;44;19

Cary Hall

With a lot of political decisions. So this is a totally different model. That's the way you're approaching this.

00;06;44;19 - 00;06;52;12

Philip Sarnacki

Yes. I have voted consistently. I have no voting record, in Congress or the Senate, or what have you. That's that's correct.

00;06;52;12 - 00;06;53;27

Cary Hall

Yes. And that's that's to your benefit.

00;06;53;27 - 00;07;11;26

Philip Sarnacki

And we're also not here's the other thing. When you're an outsider like President Trump, we're not beholden to the interests of, you know, a lot of the people that I'm running against, again, many of which I know and some I know well, some of them have done nothing but politics for 25 and 30 years.

00;07;11;29 - 00;07;14;09

Cary Hall

That’s part of the problem.

00;07;14;12 - 00;07;38;14

Philip Sarnacki

Some of them have been running for 20 years and haven't won anything, and I just got tired of writing checks to people who weren't winning and were were really caught up in the establishment, the political establishment. And I just felt we needed somebody from the outside. And originally I was looking at backing somebody like that. And the more and more I talked to people, they said, you're the person.

00;07;38;14 - 00;07;39;13

Cary Hall

You need to be, the guy you.

00;07;39;13 - 00;07;40;09

Philip Sarnacki

You need to be the guy to do it.

00;07;40;12 - 00;07;57;25

Cary Hall

You're the man in the arena now. Well, when we come back for the break, I'm going give you a little bio on Philip and how he got where he is. You're going to find this interesting. In the third segment, I'm going to ask and do something very unusual. I'm going to ask him to tell a story that I saw him do in front of a group of young people about who he is and where he came from.

00;07;57;25 - 00;08;27;22

Cary Hall

His name is Philip Sarnecki. He is running for governor. The website is philipsarnecki.org. philipsarnecki.org. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on The HIA Radio Network. Coast to coast across the USA. Stay right there. We'll be back with more.

00;08;27;25 - 00;08;52;00

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. Want to give a shout out to KNSS AM and FM 98.7 FM and 1330 AM, Wichita, Kansas. One of our great broadcast partners in Wichita. Happy to be on the air up there and have them as part of the America's Healthcare Advocate family.

00;08;52;04 - 00;09;09;25

Cary Hall

Let me tell you a little bit about Philip Sarnecki. You know, this is a guy. He's not a trust baby. Nobody put a silver spoon in his mouth. He bootstrapped his way up. Started out well, we'll get him to tell a story here in the third segment. Let me tell you a little bit about this guy, because he's truly what I would call a self-made man.

00;09;09;27 - 00;09;36;27

Cary Hall

Philip Sarnecki is a Kansas businessman, family, man, job creator who has built companies that today employ 1000 people across multiple industries. He founded and led RPS Financial Group Services. He also his leadership firm expanded to over 18 offices across the country, including 12 throughout Kansas with 100,000 Kansans underneath that group for Wealth Management, Life Insurance and other things at Northwestern Mutual.

00;09;37;02 - 00;09;59;18

Cary Hall

Through that program offered. Included in some of his other businesses. He's the largest national franchise owner of Strickland Brothers Quick Lubes, establishing locations across Kansas: Derby, Pittsburg, Fort Scott, Independence. And he is part owner of 513 Films who have had actors like Mel Gibson in their films. I've actually seen some of those films and they do a pretty good job.

00;09;59;22 - 00;10;11;11

Cary Hall

Those are family centered films that are a little different than some of the stuff you see rolling out of Hollywood, so to say that you have multiple interest would be an understatement, I think.

00;10;11;13 - 00;10;13;16

Philip Sarnacki

Yeah, I'm kind of a business mutt.

00;10;13;19 - 00;10;13;29

Cary Hall

Yeah, you.

00;10;13;29 - 00;10;39;10

Philip Sarnacki

Are. Yeah, but I've spent I really spent, 30 plus years, you know, in the insurance and investment business, wealth management business. And, we were able to, you know, grow our firm across multiple states Arizona, New Mexico, Texas, Missouri, Kansas. But just in Kansas, we had clients in all 50 states, but just in Kansas, we had, almost 100,000 clients.

00;10;39;13 - 00;10;46;18

Philip Sarnacki

We actually paid out almost $135 million in dividends last year. Just to residents in Kansas.

00;10;46;19 - 00;10;48;08

Cary Hall

And you had 10 billion under.

00;10;48;10 - 00;11;02;19

Philip Sarnacki

And just in Kansas, we have about, we had about $10 billion of assets under management. Those companies were sold as of August 31st. So this is my second day of retirement, quote unquote. And,

00;11;02;22 - 00;11;06;14

Cary Hall

He's going to retire like I do at 76. Okay. Not.

00;11;06;18 - 00;11;24;04

Philip Sarnacki

Yeah. So we are, we're all in on this. I mean, we we really feel like, you know, you can't do this part time. We have a couple of our other businesses where we'll actually be selling as well. So it'll just leave us with a few. But I have great people running those, and I honestly, I don't spend a ton of time on them right now.

00;11;24;07 - 00;11;38;19

Cary Hall

Yeah, because you'll be you'll be spending all your time doing this. That's right. So so talk a little bit about some of the things that, you know, we talked a little bit about this off air before you went on. One of the problems we have in the market in Kansas specifically is we don't allow association plans in here.

00;11;38;23 - 00;11;59;12

Cary Hall

We're not doing anything creative. That's not just in insurance. By the way. We'll have that conversation later. But there's very little innovation. It's kind of like we're stuck in this rut. And this is why we we have to sell the ACA plans, Obamacare plans. Well that's great, but why don't you open the market up to allow other plans to come in that are not part of that ACA model?

00;11;59;16 - 00;12;09;20

Cary Hall

And you mentioned some things are going on in places like Florida. How do you see your vision affecting the way we provide health insurance, health benefits to people in Kansas? Philip.

00;12;09;22 - 00;12;29;09

Philip Sarnacki

Well, I think at a high level, we have two major issues. One, we don't have enough competition, as you just stated. We need to open it up to association plans. I mean, I see what you've done as an entrepreneur with Gig Care, which I think is fantastic, and we need more of that in Kansas because that will lower prices.

00;12;29;11 - 00;13;02;21

Philip Sarnacki

For people that'll help distribute the products better get them out to western Kansas, for example. But being able to band together and provide for association plans, and make it make it easier for smaller businesses to buy health insurance and to get started. One of the things, as I've spent a couple of years really evaluating, you know, whether or not I was going to run, I talked to a lot of people, including some Kansas legislators, for example.

00;13;02;24 - 00;13;23;04

Philip Sarnacki

And as a business owner who owns numerous businesses, I know the challenges and the red tape and the bureaucracy that's here in the state of Kansas to get businesses started. And we've got to do away with that. I was having a conversation with a state senator, and she looked at me and said, Philip, you don't even you don't even know how bad it is.

00;13;23;06 - 00;13;28;12

Philip Sarnacki

She said, it's even worse. I went through this long list and she looked at me and said, it's even worse than what you think.

00;13;28;19 - 00;13;50;07

Cary Hall

And people don't think that the oh, I'm in a Republican state, right? We've got Republican senators, Republican congressman, we've got a super majority. But the bureaucrats underneath all of this, right, are controlling it. You know, it's interesting because they are the they're not elected in these offices, but they exert so much control and pressure that I think it gets away from the politicians.

00;13;50;07 - 00;13;57;17

Cary Hall

I think it gets away from the state senators, the governor, the. Yeah, it it's it's almost like it's impenetrable.

00;13;57;19 - 00;14;18;28

Philip Sarnacki

Well, I had a friend of mine who said, you know, what's so attractive about you running as an outsider and somebody that's never been in politics is he said, it's the perspective that you bring. And his analogy was he said, these people that have been in politics all of these years, two and three decades have done nothing else.

00;14;19;00 - 00;14;41;12

Philip Sarnacki

He said it's a little bit like a fish in water. He said, you have no concept what it's like to be outside of the water. If you've spent your entire life in the water and you know, maybe it sounds like a children's analogy, but the reality is, I think there's a lot of truth in that. And so I think people don't look at things in a creative way.

00;14;41;12 - 00;14;53;02

Philip Sarnacki

They don't, they're just kind of caught up in, in all of that bureaucracy. Because the reality is, you know, there's a swamp in Washington DC, but there's a swamp in Topeka, too.

00;14;53;02 - 00;14;53;14

Cary Hall

Yes, there is.

00;14;53;14 - 00;15;03;22

Philip Sarnacki

There's a little mini swamp out there. And, but it's a swamp nonetheless, and we need to get out there. And I think without question, I'm the best person to get in there and shake that up.

00;15;03;28 - 00;15;16;06

Cary Hall

Yeah, I think you definitely will be the best person to get in there and shake it up, because you're not a typical politician. So before we go to break a little bit about an example that plan that’s in Florida that you brought to my attention. Yeah. Talk about what they're doing in Florida.

00;15;16;10 - 00;15;37;19

Philip Sarnacki

Yeah. So Florida's doing a section 804 import program is what they're doing, the importation program, SIP. And it's very unique. They're the only state in the country that's doing it right now. We're doing a lot of research on it, but it really looks like Florida, now, they're starting it at the at the public sector. So it's not going out private yet.

00;15;37;22 - 00;15;56;08

Philip Sarnacki

So I think it's a little bit of a pilot program right now. But they're expecting to save about $183 million for the state through that program. And what they're going to be doing is importing drugs from Canada. And you know, whether sure, the drama is in the details. And, you know, we would need to put something together to obviously take a look at that.

00;15;56;13 - 00;16;08;06

Philip Sarnacki

But that's the kind of innovation that Kansas needs to be leading on. And that's what I want to bring to the table as governor, as the CEO of the state, is to be leading the other states with that type of innovation.

00;16;08;12 - 00;16;27;14

Cary Hall

So let me give you an example. Wegovey, the weight loss drug. If you can't get it as by virtue of the fact that you're a diabetic and you want to buy it, just because you want to lose weight, it's $1,100 a month. You know what it costs if it comes in from Canada, New Zealand or Australia, $88. $88 versus $1100.

00;16;27;16 - 00;16;44;27

Cary Hall

So what's the commonsense alternative? You just heard it right. This is what I mean when I talk about thinking outside the box and having somebody run for this office, it's going to make a difference because they're not going to be stuck doing the same things that we've always done. When you ask the question, why do we do it that way?

00;16;44;28 - 00;17;02;05

Cary Hall

Well, that's the way we've always done it. I think it's time to get rid of. It's the way we've always done it. Yeah. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on The HIA Radio Network. Coast to coast across the USA. If you want to get involved, the website is philipsarnecki.org.

00;17;02;09 - 00;17;23;04

Cary Hall

philipsarnecki.org. You can go up on the website, you can become a volunteer. You want to donate? I’m sure they’d be happy to have you do that. We'll be right back after the break. Stay tuned.

00;17;23;07 - 00;17;44;20

Cary Hall

Welcome back. You're listening to America's Healthcare Advocates Show, broadcasting coast to coast across USA. He is Philip Sarnecki, he is running for governor in the state of Kansas. And I asked him to come on this broadcast and talk about what his vision is. The website is philipsarnecki.org. philipsarnecki.org. If you want to get involved.

00;17;44;24 - 00;18;01;01

Cary Hall

If you want somebody in the state of Kansas who's not a politician, if you want somebody in the state of Kansas who is a CEO and understands how to run a business and you want to see what that looks like. Take a look at what's happening in Virginia right now and what governor Youngkin has been able to accomplish.

00;18;01;07 - 00;18;21;18

Cary Hall

And then ask yourself what that would look like in the state of Kansas. Years ago, I don't that was probably. Had to be at least six years or more. I attended one of your one of your training sessions as an observer. And, all these young people from college who were being recruited come to work at Northwestern Mutual.

00;18;21;20 - 00;18;44;21

Cary Hall

And I’d watch you get up in front of them. And I'm thinking to myself, before you started, they're going to see this guy who is very wealthy, has, very successful businesses, runs his whole show here, also runs, you know, Northwestern Mutual in New Mexico and Arizona. And they're going to see a very successful businessman. And then you got up there and you told the story.

00;18;44;23 - 00;19;03;11

Cary Hall

And I was thinking about that over the weekend before we came to the show. And I was, I would say, moved, okay. Because I grew up in a situation very similar to yours. My father was a coal miner, okay. Who then became a finish carpenter. Self-taught. Your father was a janitor. So, Philip, nobody put a silver spoon in your mouth.

00;19;03;13 - 00;19;07;25

Cary Hall

Let's talk about your story and how you started your family and the whole nine yards.

00;19;07;27 - 00;19;31;18

Philip Sarnacki

Yeah. I grew up in a in a small town, a little farming community, about a thousand people. You know, one of those places with, no stoplights and one gas station. One grocery store. You know, a lot more churches than grocery stores and gas stations. And it was just it was a great place to grow up. And, you know, we didn't farm, but a lot of my friends, either they did or their grandparents did.

00;19;31;21 - 00;19;51;14

Philip Sarnacki

And, I grew up, you know, I had to earn any money that I wanted to spend, and it was delivering newspapers. My brother and I would mow lawns. We walked, I walked beans, which is a horrid, horribly miserable job for a 13 or 14 year old. Most people don't even know what that is.

00;19;51;21 - 00;19;52;13

Cary Hall

What is walking beans?

00;19;52;20 - 00;20;13;15

Philip Sarnacki

Well, yeah, walking beans you get up at, you know, 6:00 in the morning. And keep in mind, you're 13, 14 years old. 15 years old. You have long sleeves, long pants in the summer. It's blazing hot. And you basically literally spend 7 or 8 hours walking up and down, bean rows, and you've got a hook and you're pulling out the button weeds, etc..

00;20;13;18 - 00;20;38;03

Philip Sarnacki

Now they kill all of that with, you know, Roundup. Yeah, right. Herbicide, pesticides, etc.. The technology's a lot better than having a 14 year old do it, but, it will make you want to go to college, I can tell you that. But it also, you know, it's one of those things. I hated it at the time, but looking back, the values that that teaches around hard work and discipline, they're invaluable.

00;20;38;05 - 00;21;03;00

Philip Sarnacki

They became invaluable to me later in life. So my father, my mom and dad met very young and, got married and, you know, then had me, my dad prior to that had been in Vietnam. And, he went there. He had, I believe 20, 20 vision, if I'm not mistaken. And when he came back because of Agent Orange, you know, he was legally blind at night.

00;21;03;02 - 00;21;20;13

Philip Sarnacki

And so even though he was trained to be a paramedic, he could do that part time, but because he couldn't drive at night, he couldn't do it full time. And so, you know, he didn't have a lot of options for work. So he was a janitor, for, 35 years. And, but, you know, I saw both my parents.

00;21;20;13 - 00;21;46;06

Philip Sarnacki

My mom worked numerous jobs. She worked as a secretary, at the university. She, would wake up at, you know, four, 4:30 in the morning and go, go downtown. Now downtown was, you know, extremely small. Right? It was like Gary's Pizza, the bank, the bowling alley. And that was about it. And then the donut shop, and she'd go down and make donuts, and then she'd come home and help the kids get ready and get us off to school.

00;21;46;06 - 00;22;02;16

Philip Sarnacki

And then she'd go to her regular job. And then I'd oftentimes see my father as he worked all day long as a janitor. And then in the evening, he would come home and he would go off to work. You know, doing, work as a paramedic, as a part time paramedic. So, you know, I just watched my parents work really hard.

00;22;02;16 - 00;22;09;19

Philip Sarnacki

I mean, we didn't have a lot of money. You know, I grew up in about a 950 square foot home with five of us and one really, really small bathroom.

00;22;09;20 - 00;22;10;08

Cary Hall

That's small.

00;22;10;08 - 00;22;35;23

Philip Sarnacki

That small? Yeah, it's it is small. And, I didn't even realize how small it was at the time. We had a neighbor a couple doors down that had two bathrooms, and I thought they were loaded, you know, because they had two bathrooms, and, And you know, again, you look back and, I didn't love, not having some of the financial resources, that I saw other kids have, but I wouldn't change it for the world.

00;22;35;23 - 00;23;06;04

Philip Sarnacki

Looking back now, because my parents taught me, I think what's truly important. My father passed away last year, but they were married for 58 years. And I saw that dedication to each other. I saw incredibly hard work. Faith was always important in our family and just the importance of family as well. And, so, you know, looking back now, I couldn't be more thankful and appreciative for my parents and really, the whole environment in which I grew up, which was not a lot of money.

00;23;06;04 - 00;23;28;19

Philip Sarnacki

And I, you know, I have some stories, when we were, kids, we had a white station wagon, and it had a hole in the floorboard behind the driver's seat. So my brother and I called it the Flintstones car. This was before the days of that. Seatbelts were really, you know, really important. And, are really valued.

00;23;28;21 - 00;23;49;11

Philip Sarnacki

And my dad would put a, a wood board and a blanket over it, and but we would, you know, we'd love to, to pick that up and kind of look at the, the road flying by us underneath. And if you remember those little rubber balls, we would kind of like dropping those out of there and then racing to the back of the station wagon, watching them go bouncing down the road.

00;23;49;14 - 00;24;06;25

Philip Sarnacki

And then when I, when we got older, when I was in high school, we, we moved up to a yellow station wagon. Things were a little better by then, but it didn't go in reverse. So this was the car that I drove in high school, was a yellow station wagon that didn't go in reverse. And, you know, you got to be really careful how you park.

00;24;06;27 - 00;24;28;08

Philip Sarnacki

You have a car that doesn't go in reverse. But, you know, I remember I was really young. I remember, you know, maybe being seven years old. I'm kind of guessing, you know, walk out into the kitchen and, you know, my mom is sitting at the kitchen table and she's got, bills spread out all over the table, and she she's in tears because she doesn't know what bills to pay.

00;24;28;11 - 00;24;50;12

Philip Sarnacki

And, you know, I think why that's important is because I think that drives a lot of the way that I look at the working class people in the state of Kansas and what we would do to try to help. I mean, those memories are seared into my brain, and all of that is the lens with which I look through.

00;24;50;14 - 00;24;55;01

Philip Sarnacki

You know, if I were to become governor and to lead this state.

00;24;55;04 - 00;25;14;09

Cary Hall

And that's a very different approach. Okay. Your your story mirrors mine in a lot of ways. But, you know, like, I my we never owned a car even with a hole in the floor. Yeah. Right. But but but I get that. And your point about looking back on that and not regretting it, you know, I my father used to he'd get up in the morning, come in the room.

00;25;14;17 - 00;25;32;25

Cary Hall

Get up babe, you're going to hit a lick. And that meant we're going to go to work. And we’d be in it for 12 hours a day. That's the way he worked. So you learn the value of that and that carried over. You started out Northwestern Mutual at the bottom of the rung where you wind up by the time you wound up leaving Northwestern Mutual.

00;25;32;25 - 00;26;00;03

Philip Sarnacki

Well, you know, it's such a unique company because you're really running your own business. You're just kind of doing it under their umbrella. So as a 19 year old, I had a really good friend and they lived a very, very, very different lifestyle. Although their, their estate, their 86 acre estate was very close to our home in a it was only about two miles away, but it seemed worlds away of course, tennis court, basketball court at 10,000 square foot, home, a lake that we would waterski on.

00;26;00;03 - 00;26;21;13

Philip Sarnacki

And I got to spend time out there and, his my buddy's dad owned an agency office and, you know, was very successful, not just financially, but, also how he controlled his time as well. And the, the importance of family. And, you know, how he was able to coach his kids and and just be there and be present.

00;26;21;15 - 00;26;40;21

Philip Sarnacki

And so I got to watch that. But I started as a 19 year old, really was my first business where I was selling insurance. So I kind of grew up in sales. But I had a lot of success with it early on, and I needed the money. I had, you know, I, I played football for one year in college, but after that, I didn't even really play.

00;26;40;21 - 00;27;03;25

Philip Sarnacki

I practiced for one year. I redshirted and practiced for one year. But I would, you know, I needed money. I needed to pay for school, I needed spending money. And so as a 19 year old, I was out working really 40 plus hours a week in addition to going to school as well. And, then was able just to leverage that into eventually owning an agency office myself.

00;27;03;27 - 00;27;28;19

Cary Hall

So if you wonder how that story resonates, you should have seen the people after he did this, whenever he was briefing young people who were tempted to come to work at Northwestern Mutual. In other words, nobody handed him anything. Okay? What he has created, what he has done with the multiple businesses he’s owned and the success he’s had is the same vision he wants to bring to the state of Kansas.

00;27;28;21 - 00;27;50;13

Cary Hall

If you want more information, it's philipsarnecki.org. philipsarnecki.org. That's the website. Lots of information up there. You want to volunteer. You want to get behind this man. That's your opportunity to do it. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on The HIA Radio Network. Coast to coast Cross, USA.

00;27;50;14 - 00;27;57;18

Cary Hall

Stay right there.

00;27;57;20 - 00;28;17;06

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the USA. My producers: Behind the camera Mr. Dave Thiessen, doing what he always does, recording all these shows and getting them up on our YouTube channel. Half a million views. Thanks to all of you out there in the listening audience and those 16 podcast channels.

00;28;17;10 - 00;28;36;28

Cary Hall

A lot of folks going up there and listening to these shows behind the microphones. Mr. Gardner Cowdrey here with Cumulus folks, we're very happy to be here in studio today and doing this show with Philip Sarnecki. He is a gubernatorial candidate for the state of Kansas. And we're happy that he took time to come in and talk to us about what his vision for the state of Kansas is.

00;28;37;01 - 00;28;40;05

Cary Hall

I heard a rumor you're producing a book. Writing a book?

00;28;40;08 - 00;28;56;00

Philip Sarnacki

Well, I'm. Yes. You know, I'm working with some people that are helping me write a book. Okay. Given the story that you just talked about, a little bit about my upbringing and some of the things we we've been able to do, I've had people for, years, kind of mentioned. Well, you should write a book. You should write a book.

00;28;56;02 - 00;28;59;08

Philip Sarnacki

And I always just. I'm like, when in the world would I have time?

00;28;59;10 - 00;29;01;23

Cary Hall

I heard that a couple of times, like, yeah, nevermind.

00;29;01;25 - 00;29;20;24

Philip Sarnacki

And but as we started exploring this and, and it came up or I threw it out, people, you know, would say, boy, that'd be a great way for people to hear your story and learn your story. So we went ahead and started it. And yeah, it should hopefully be wrapped up in the next couple of months, and we'll have a book out and we'll be able to take it out across the state of Kansas.

00;29;20;24 - 00;29;31;09

Philip Sarnacki

And they can, you know, in a deeper way, share, you know, learn a little bit more about my story. We share a lot of leadership lessons in there throughout my career. And I think just life lessons as well.

00;29;31;09 - 00;29;33;20

Cary Hall

When you get it ready to go, you have to come back on and we’ll talk about it.

00;29;33;20 - 00;29;34;00

Philip Sarnacki

I’d love to, that’s great.

00;29;34;03 - 00;29;50;15

Cary Hall

So what do you see as the you know, here we are in Johnson County, Kansas, number four, wealthiest county in the country. That shocks a lot of people when I say that because we're in flyover country. Okay. But that is fact, okay. And you're in the number three most livable city in the country.

00;29;50;15 - 00;30;10;08

Cary Hall

Voted number three this year after being number four, number five last couple years. But our taxes are pretty damn high. Philip, I mean what I pay in property taxes, we've got great school districts. But I mean those numbers are pretty high. How do you envision this whole tax question across the state of Kansas? And, and how do you see that impacting this election?

00;30;10;11 - 00;30;31;14

Philip Sarnacki

Well, there's a lot of, you know, there's 105 counties in Kansas, so there's a lot more counties than just Johnson County. Correct. And, you know, part of the problem that I think and one of the reasons I decided to run is I believe that Kansas has been mired in mediocrity for a long, long time. We have not been able to grow our population base to speak of.

00;30;31;16 - 00;30;50;10

Philip Sarnacki

We have the highest income tax rate of all of our border states. Plus, you can throw in Iowa and Arkansas, and those are really the states that we compete with. We also have the second highest corporate tax rate of all of those states as well. And then you mentioned property taxes, which in some areas are just completely out of control.

00;30;50;13 - 00;31;08;25

Philip Sarnacki

Now, a lot of that is obviously, the decisions and is administered locally at the city. And, and state, city and local level. But but I think there are some things that we can do from a state standpoint, as well, I think, you know, you can use it as a little bit of a bully pulpit as well.

00;31;08;28 - 00;31;31;02

Philip Sarnacki

And, to be able to, to get those down. I just think the whole concept of paying off your home after living in it for 25, 30 years or whatever it may be, and then your home is paid off, but you have to continue to pay taxes to the government. Is really it's like you really never own your home.

00;31;31;05 - 00;31;38;22

Philip Sarnacki

And so it's something we need to dig into. And and again, we need to be bold and taking action and seeing what we can make happen there.

00;31;38;24 - 00;31;58;15

Cary Hall

So a couple things that number one, you that resonates really well with those of us that are chronologically challenged because there there are a lot of seniors that this is a struggle for. Oh, so that that's definitely an issue. But let's talk about this. Why can't we attract young talent to Kansas? Why don't we attract, technology to Kansas?

00;31;58;15 - 00;32;12;09

Cary Hall

You you've got a skilled workforce. You've got a great it's a wonderful place to live, all these opportunities. But for some reason, we don't seem to be doing any of that. Yet I see there's other states doing that all the time.

00;32;12;11 - 00;32;29;07

Philip Sarnacki

Yeah. So I think there's a couple of things that are happening there. I mean, you mentioned Glenn Youngkin earlier, I'm connected with Glenn Youngkin on LinkedIn, and I see, I mean, a couple of times a week, he's talking about a new business that's coming to Virginia or a new business startup in Virginia. Company expands in Virginia.

00;32;29;09 - 00;32;56;02

Philip Sarnacki

He is doing a phenomenal job as the chief cheerleader of that state for business. And, you know, when you're attracting business, you're attracting jobs. We also and we talked about this earlier. We have to make it simpler, get rid of the red tape and the bureaucracy for new business startups. Because if you do that then you you don't have to go out and give these tax abatements to big companies to get them to come to Kansas.

00;32;56;05 - 00;33;14;10

Philip Sarnacki

You can get, you know, the Garmin’s of the world that start here. You can get the companies that get the get started here and grow here. And so by by eliminating a lot of that red tape and bureaucracy, making it easier for business startups, that's going to help with that as well. So it's kind of a cyclical thing, right?

00;33;14;10 - 00;33;36;08

Philip Sarnacki

Or not a cyclical thing, but it's kind of a, you know, chicken and chicken and egg because what happens is, you know, companies say, well, we need the talent. And then, you know, the, the, the students or the people that are graduating and they want to stay here and work here. Now, we do attract a lot of businesses or a lot of, students, but we also lose a lot of people.

00;33;36;08 - 00;33;57;12

Philip Sarnacki

Once they graduate as well. And so we have all kinds of ideas on how we can, get, get folks to stay here and help them build businesses here. You know, one of the things about this generation that's really interesting is they're pretty entrepreneurial. And I think if you if you take the obstacles out of the way, I think we can get a lot of business startups here in the state.

00;33;57;13 - 00;34;06;08

Cary Hall

And encourage them to do it and not try to make it more difficult for them to do it instead of having to jump to 15 hoops, maybe only three hoops. And you're.

00;34;06;08 - 00;34;22;09

Philip Sarnacki

There. Yeah, absolutely. It's, it's businesses are succeeding in spite of the state of Kansas right now. The state of Kansas is not helping, new businesses succeed. And that's what we need to do. Yeah.

00;34;22;11 - 00;34;41;25

Cary Hall

He's Philip Sarnecki. He's running for governor in the state of Kansas. The website is philipsarnecki.org. philipsarnecki.org. I think you can see why I think he's going to be a good fit for the state. I've never done this before. I don't do politics. You know that other than it applies to health issues like ACA and some of the other things.

00;34;42;02 - 00;35;05;09

Cary Hall

But in this particular case, I thought it was appropriate. I think this is somebody that thinks outside the box, and I think he's somebody can make an enormous difference in this state and move us down the path a lot further than we are today, and put aside some of the political nonsense that goes on. And let's focus on what it would be like to have an actual CEO as governor, somebody that looks at this as a business.

00;35;05;12 - 00;35;12;21

Cary Hall

You've got a model for that. He's sitting at 1600 Pennsylvania Avenue. This could be a model very similar to that. Thank you for coming on the show.

00;35;12;24 - 00;35;14;17

Philip Sarnacki

Thank you, Cary. Thanks so much for having me here,

00;35;15;25 - 00;35;22;26

Cary Hall

And now, ladies and gentlemen, I leave you with this thought from Albert Einstein, the one who follows the crowd usually get no further than the crowd.

00;35;22;28 - 00;35;48;07

Cary Hall

The one who walks alone is likely to find himself in places no one has ever been. 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 broadcasting coast to coast across USA here on the HIA Radio network. Goodbye America.

00;35;48;09 - 00;35;54;29

Unknown

The ACA Tsunami Is Coming - 2026 Update - Where we're at on the Individual Health Insurance Marketplace

Sat, 20 Sep 2025 18:51:36 GMT

Episode 2126 notes

There’s a lot of chatter out there. That's about the best way I can put it about what's going to happen with ACA . And, you know, I'm seeing pieces in the media that are portraying what's going to occur and the changes that are going to happen and how they're going to impact people, and unfortunately, there's a lot of false narrative out there. So I'm going to I'm going to explain where we're at on the individual health insurance market on Obamacare and ACA . Then I'm going to talk with two experts about what can you do to prepare yourself so that you're not caught up in a trap and you can't make a decision to solve the problem?

Then we’ll discuss give you the kind of coverage you need and how to find it.

That's what we're talking about in this episode, and that's the message we're trying to get out to everyone to is be prepared. This is coming. It's going to be like a tsunami. There going to be a lot of people displaced off of these plans are going to be looking for alternatives and so how do you deal with it, what are the best solutions and show you how you can do that and make sense of it for you and your family.

If you're an employer, what do you need to be looking at? Because the ACA plans for small group are going to get hit hard, hit just as hard as the individual plans are, if not harder in some cases.

Learn more from our guests Carolee Steele and Maria Ahlers from RPS Benefits by Design by visiting https://www.rpsbenefitsbydesigninc.com or call 877-385-2224

https://www.americashealthcareadvocate.com/contact-us

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Episode 2126 Transcript:

00;00;01;14 - 00;00;05;15

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;05;19 - 00;00;24;25

Cary Hall

Hello, America. Welcome to America's Healthcare Advocates, broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to our website, AmericasHealthcareAdvocate.com. All these shows are posted on your favorite podcast platforms Spotify, SoundCloud, Rumble, you name it, we're on there.

00;00;24;25 - 00;00;43;22

Cary Hall

And the YouTube platform America's Healthcare Advocate. My producers in studio. Mr. Dave Thiessen behind all the cameras today. The man who puts all this together gets it up on all the podcast and YouTube platforms. And Garner Cowdrey here from Cumulus, a recording today's show and doing all the audio work so we can bring this out to all of our affiliates across the country.

00;00;43;28 - 00;00;52;17

Cary Hall

So in studio with me today, Carolee Steele and Maria Ahlers, from RPS Benefits by Design. Welcome back for the. I don't know what this the 50th show.

00;00;52;17 - 00;00;54;29

Carolee Steele

We feel like an old married couple.

00;00;55;06 - 00;01;17;21

Cary Hall

We've been doing this for a while. So what are we doing today? Well, there's a lot of chatter out there. Okay. That's about the best way I can put it about what's going to happen with ACA. And, you know, I'm seeing pieces in the media that are portraying, you know, what's going to occur and the changes that are going to happen and how they're going to impact people.

00;01;17;27 - 00;01;35;04

Cary Hall

And unfortunately, there's a lot of false narrative out there. So I'm going to I'm going to step in here for a minute and kind of explain where we're at on the individual health insurance market on Obamacare and ACA, how we got here. Okay. And then what does that look like? So let's just start off with some facts, okay?

00;01;35;06 - 00;02;02;21

Cary Hall

Between 2014 and 2019, benchmark premiums for ACA plans increased as much as 90%, 90%. Okay. And we'll talk about why here in a little while. Rural counties have been hit especially hard. 52% of the counties participating in Obamacare only had one plan, because the carriers either don't have the ability to do a network or they can't get access to care in those rural markets.

00;02;02;21 - 00;02;47;09

Cary Hall

So there's another problem. All right. So federal subsidies and this is where it starts to become an issue. Federal subsidies are now at a $100 billion a year, 100 billion, which in ten years is $1.2 trillion. So what we've got here, all right, is we've got an unsustainable situation that cannot continue. And what prompted all this, what caused us to move from where this thing was originally designed, was the changes made in 2021 and on out, where we moved the poverty level up to 400% of the of the annual poverty level, which means we increased, increased the subsidies significantly.

00;02;47;09 - 00;03;11;17

Cary Hall

And that's where we had a huge number of people enrolled in these plans, because at that point, the subsidies' were up to as we as I just talked about, okay, billions of dollars that weren't planned for this was as a result of Covid. It was supposed to be temporary. But you know as well as I do, anytime you introduce a government program where you're handing people money, it's not going to be temporary.

00;03;11;19 - 00;03;31;27

Cary Hall

Well, actually, it is this time because it's being pulled back. Okay. And what's happening is the Trump administration is bringing it back to what it was originally designed to do. Now, that's not what you're seeing in the press. That's not what you're hearing. You're hearing that the Trump administration is going to throw 8 million people off of the Medicaid and ACA plans.

00;03;31;27 - 00;03;51;06

Cary Hall

Okay, I broke that down on another show. I'll very quickly just make sense out of this. Over 1.4 million of those people are illegal aliens, okay, that are on the plans like in California other places. And the remainder of those people that are going to be displaced on these plans are people that are going to lose those subsidies up to 400%.

00;03;51;08 - 00;04;13;17

Cary Hall

The plan was when President Obama, qnd this passed. Okay. And John McCain was the passing vote in the Senate, pushed it through. The idea was to give people subsidies up to 150 to 200% of the poverty level, people that actually needed subsidies to get health insurance. It was never designed to go to 400% of the poverty level. That's where it's at, and that's what's going to change.

00;04;13;19 - 00;04;17;00

Cary Hall

So Carolee, there going to be some big disruptions in the marketplace.

00;04;17;00 - 00;04;39;07

Carolee Steele

Huge, huge, huge. And just to reiterate, American Rescue Plan was enacted in 2021. So they had basically, like you said, enhanced subsidies. So they really weren't like true to what they were prior to. So with that, now if anybody doesn't know what subsidies are, that's monies that the government gives to the carrier on your behalf for part of that premium.

00;04;39;12 - 00;05;02;09

Carolee Steele

So your premium then is decreased because of the subsidy that you that they're giving to the carrier. Okay. So currently enhanced subsidies are scheduled to expire at the end of 2025. So what does that mean? That means starting in 2026, millions could see just a huge jump, an increase in the marketplace plans because their subsidy will go down.

00;05;02;12 - 00;05;27;15

Carolee Steele

And so, so from there you have a decreased financial assistance. So and then from there what do you do from there? You've got to come to one of us so that we can figure out how to pivot or be able to look at other companies. You may end up having to not have the exact doctor you want if you're going, if you can afford something that has a more narrow network, you're going to have to probably do that.

00;05;27;19 - 00;05;30;21

Carolee Steele

Aetna is also dropping out of that market.

00;05;30;23 - 00;05;32;01

Cary Hall

1 million people.

00;05;32;03 - 00;05;50;01

Carolee Steele

Well, yeah, 10,000 members in the metro here. So Aetna has 10,000. So and they were kind of really Saint Luke's driven. So you know going back we're going to have to look at other carriers that might contract with Saint Luke's. And so that's where that's where it comes for us.

00;05;50;04 - 00;06;19;12

Cary Hall

So what you and we're referring here to the Kansas City market, the show broadcast nationwide. This is happening in every market across the country. Correct. We're just using this as an example. But just moving from 400% of the poverty level back to 150 or 200%. That's where the big change is going to come, is I said, when President Obama passed this bill, it was never designed for that piece of the marketplace, but it was enhanced by the Biden administration when they moved this up to 400% of the poverty level.

00;06;19;12 - 00;06;46;13

Cary Hall

And with the huge influx of people, you have 24 million people on these plans now that's going to change. And what's happening is so let me give you some examples of a couple things to kind of put this in perspective. If you're a 52 year old male, but I'll use an example of a realtor here in Leawood, Kansas, 52 year old male wife, the same age, one child made way too much money to get a subsidy, make him a significant salary, is a very successful realtor.

00;06;46;15 - 00;07;13;23

Cary Hall

His premium is $3,100 a month, $3,100 a month. He moved to a GigCare plan. Okay, which is the plan offered by Detego. Okay, a GigCare plan for $1,300 a month. Why? Because we're competing in the marketplace in a different way. What's happening is that people that aren't getting subsidies are going off these plans because they become unaffordable.

00;07;13;25 - 00;07;31;21

Cary Hall

Right. And then what's going to happen? What's starting to happen now is what we call a death spiral. You're going to and this is being referred to in the media in a lot of places, the healthy people are coming off the plans. Yes they are. They're going to look for alternatives like GigCare. They're going to look for alternatives on the group side like ICHRA.

00;07;31;26 - 00;07;50;02

Cary Hall

And we'll talk with Maria about that a little later on. Okay. But there are marketplace solutions out there that are going to come into play. They're going to start to change the dynamic here. But this all centers around the fact that this was never designed, okay, to be a completely government run system. Oh, are there are people that wanted that?

00;07;50;02 - 00;08;04;28

Cary Hall

You bet there are. The, you know, the group people in this country that want Medicare for all. And they think that solution, that's where they were hoping this is going to go. What they didn't count on was that the Trump administration was going to come in and they were going to change this back to what it was originally meant to be.

00;08;05;02 - 00;08;26;27

Cary Hall

So that's where we're at. Okay. And then when I come back from the break, I'm going to talk with two experts now, and we're going to start talking about what can you do to prepare yourself. I don't care where you're at in the country. This is happening. Okay. So what can you do to prepare yourself so that you're not caught up in a trap and you can't make a decision to solve the problem?

00;08;26;27 - 00;08;44;00

Cary Hall

That's going to make sense for you economically, and going to give you the kind of coverage you need. That's what we're talking about here today, and that's the message we're trying to get out to. Everyone is be prepared. This is coming. It's going to be like a tsunami. There going to be a lot of people displaced off of these plans are going to be looking for alternatives.

00;08;44;03 - 00;09;02;12

Cary Hall

And so how do you deal with that? What's the best solution for that? That's what we're here to talk about today and show you how you can do that and make sense of it for you, your family. If you're an employer, what do you need to be looking at? Because the ACA plans for small group are going to get hit hard, it just as hard as the individual plans are.

00;09;02;12 - 00;09;25;00

Cary Hall

It's not harder in some cases. So how are you going to prepare for that? Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. Stay right there. We've got more.

00;09;25;02 - 00;09;51;05

Cary Hall

To. Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the USA here on the HIA Radio Network. Want to say hello to our affiliate in Pensacola, Florida, WNRP, AM 1260 and 95.3FM. We're on 8:00 in the morning there on Saturday mornings in the Pensacola area. Happy to be part of that family in Pensacola, Florida.

00;09;51;08 - 00;10;13;05

Cary Hall

Welcome on board. Glad to have you. In studio with me today. Carolee Steele and Maria Ahlers from RPS Benefits by Design. We're here to talk about all the changes that are coming and they are coming, which is why we're doing this show today well ahead of what we're going to anticipate in the open enrollment period. The changes that are coming to ACA, we've got changes coming in Medicare.

00;10;13;11 - 00;10;30;08

Cary Hall

That's going to be a different show, but we really want to focus on ACA today, Obamacare, ACA. Whatever you know it as. Both on the small, on the small group market and on the individual market. How is it going to impact what's it going to look like? So I'm going to roll through some of the numbers here just to give you some idea.

00;10;30;10 - 00;10;53;08

Cary Hall

So these are the carriers. We're just going to use the KC metro. But again I'm doing this. So it's a you know, it's a microcosm of what's going on. But this is going on around the country. I'm just using this example. So Celtic Insurance is going to have a 24.4% increase. Medica insurance 29.2% increase Oscar 11.7% increase.

00;10;53;15 - 00;11;16;24

Cary Hall

United Health Care 10.7. Guess what? Blue Cross and Blue Shield of Kansas City -4.4 I'm going to repeat that blue Cross and Blue shield of Kansas City -4.4. So Blue Cross Blue Shield of Kansas City is coming in with a different plan in the marketplace. We're going to talk about that is the solution. But to give you an idea there's a lot of disruption coming up.

00;11;16;25 - 00;11;40;17

Cary Hall

And when people lose these subsidies you know, how are they going to respond to that? How is that going to work? Well, when you're looking at these kinds of increases which have nothing to do with the subsidies, these are just the increases based on the fact that these carriers are having claims, they're outstripping what they're bringing in, which is why Aetna pulled out of the market after losing over $2 billion last year.

00;11;40;19 - 00;12;01;17

Cary Hall

On the individual health insurance side. They just couldn't do it anymore. Okay. So you have two dynamics here. One is reduced subsidies, the other is increasing costs, that are associated with ACA and that's impacting the marketplace. So let's talk about this. So it looks like you're going to see significant increases across the board.

00;12;01;18 - 00;12;15;23

Carolee Steele

And that to your point it's going to stack. So you've got increased premiums. And then you have lowered subsidy. So that's going to stack on there to where their premiums are going to be significantly higher because of that.

00;12;15;23 - 00;12;38;08

Cary Hall

So blue cross and blue Shield of Kansas City not unusual that they would be innovative and figure out a way to do this. The, the, you know, the individually, operated not for profit Blue Cross plans seem to have an ability to do things like this, right? Do innovative pieces. And so as a result of that, you know, here we're looking at the only one in the marketplace.

00;12;38;11 - 00;12;49;20

Cary Hall

It's going to have a -4.4. So talk about this new plan that they're going to offer. And yes, people are going to have to make some adjustments. But you're going to have a Blue Cross plan. Let's talk about that.

00;12;49;20 - 00;13;08;09

Carolee Steele

And there is something to say about that with local customer service and things. That is a huge plus. So as far as like some of their plans currently have like a Blue Select Plus that may pivot to a Blue Select. So the market mean that the network is going to be a little bit less, but the premium is also going to be less.

00;13;08;09 - 00;13;16;29

Carolee Steele

So you have to kind of look to see who are your non-negotiable doctors and who do you want what where can you kind of sacrifice as far as going elsewhere.

00;13;16;29 - 00;13;29;21

Cary Hall

So you're going to see access narrowed. So you're going to have a narrow network okay. But you're still going to have a great benefits program, but you're going to have to it, you know, you may have to make a change in doctors to stay in that network.

00;13;29;24 - 00;13;55;16

Carolee Steele

The Blue Select and Blue Select Plus are still pretty robust, except for but the new new one that they're coming out with has a very narrow network, but a very low premium. And so that is kind of they're innovative, you know, to be able to add something to the market because they know this is coming. They know that people, you know, are going to be kind of with those enhanced subsidies going away, they're going to have sticker shock for sure.

00;13;55;16 - 00;14;01;22

Carolee Steele

And so that's why they've developed this new plan, you know, and so they're going to be able to offer other options.

00;14;01;24 - 00;14;20;19

Cary Hall

So that's one solution that's going to be in the marketplace. Let's talk about another one. GigCare which is offered by Detego. I gave the example in the opening monologue about the real estate broker here. So if you're making 150, 200 and $300,000 a year, I know there are a lot of you out there to do.

00;14;20;22 - 00;14;33;05

Cary Hall

And you can afford to do something different. Maybe you don't want to pay $3,100 a month for three people on plan, and you come to a plan like GigCare. This is designed specifically for 1099 people or.

00;14;33;05 - 00;14;39;12

Carolee Steele

W2 people that do not have coverage offered, you know, from their company. So they do not or their wife. Yes. Right.

00;14;39;17 - 00;14;43;15

Cary Hall

So there there is a solution, that is significantly different.

00;14;43;16 - 00;15;08;12

Carolee Steele

Correct. And the all of the marketplace plans, well, at least in the KC Metro, but very much, across the nation as well, are EPO's. That's exclusive provider organizations. So there is no network outside of, you know, you don't have to have like an HMO, you don't have to have referrals, but there's no out of network coverage except for emergency.

00;15;08;19 - 00;15;36;07

Carolee Steele

And so that's where GigCare, you know, they have those, but they've got Blue Card. So anywhere you go in the United States that offers like Preferred Care Blue, etc., you can go to those doctors. I have people that travel to Florida. They're doctors are in there. Here, their doctors are in there and that's huge because, those EPO's, especially with restricted networks, are going to make a difference, that you're going to have to pivot and look elsewhere to see how you can get covered.

00;15;36;08 - 00;15;51;09

Cary Hall

So the GigCare plans have an EPO model and they have a straight PPO model. And you're referring to the PPO model is the Blue Card model, which is anywhere in the country by the way, you may not know this yet, so I'll announce that here on this show, we are now going to have the Aetna network.

00;15;51;09 - 00;16;00;20

Cary Hall

And the Cigna network is options under GigCare. So it'll be an option for Aetna, Cigna and Blue Cross and Blue Shield which is going to make a big difference right.

00;16;00;20 - 00;16;18;06

Carolee Steele

Even if you have an EPO though like if you're like we're in the Kansas City metro, it's Blue Cross and Nebraska network. So Blue Card will go anywhere here. So even though it's a PPO and EPO, there's a little more flexibility as far as a network is designed when you're outside with that Blue Card.

00;16;18;13 - 00;16;35;08

Cary Hall

So again you know you're seeing some differences here. There are solutions out there. You're looking at the solution here from Blue Cross Blue Shield to Kansas City. We're talking about this GigCare solution. When we come back from the break I'm going to talk to Maria Ahlers about a small group solution called ICHRA. What does that mean. How does that work?

00;16;35;08 - 00;16;55;18

Cary Hall

How can that benefit employers? So we'll talk about that and some of the other plans that are out there that are a little different in their model, but still offer good coverage for people so they can get these cost controls in line and make sense out of it. So I think there are solutions, but they're just not going to be the solutions that have been out there for the last five years.

00;16;55;18 - 00;17;13;07

Cary Hall

And if you're a lazy broker and you don't want to get off your rear end and look at some of the other options, you can't just put this spreadsheet down and say, here's, here's all, here's the deal. Cross United, Cigna, Aetna (no longer) but plans and pick your poison. You have to you have to be innovative enough to look at opportunities.

00;17;13;12 - 00;17;17;19

Carolee Steele

You just have to look outside the box and see what there is out there. And that's where we come into play.

00;17;17;19 - 00;17;36;17

Cary Hall

And that's what these folks do. I don't care where you're at in the country if you need help. 877-385-2224 ask for the lovely Carolee Steele if it’s on the ACA side or the Medicare side. If it's on the group side, Maria Ahlers can certainly help you, or are one of the other folks there will be happy to help you on the group side.

00;17;36;20 - 00;17;59;20

Cary Hall

But they can make a difference because they're willing to step out of the box and look at things that are different . 877-385-2224 or the website rpsbenefitsbydesigninc.com. Go to the website, send them an email if you want help. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting coast to coast across the USA.

00;17;59;21 - 00;18;11;22

Cary Hall

Stay right there.

00;18;11;24 - 00;18;29;23

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the USA. All these shows are on our podcast platform. So Spotify, SoundCloud, TuneIn, you name it we’re on there. Rumble, all of them. And the YouTube channel. Dave Thiessen pulls all this together, gets it up there for you and does a great job with this.

00;18;29;23 - 00;18;55;24

Cary Hall

So you can tell somebody about this. Hey, maybe it's your employer and you guys are not aware a lot of people are not aware of what's coming. Have them go listen to the podcast, have them go look at the YouTube video so they understand what's going to happen on the employer side. And if it's, you know, we're talking about the individual health insurance, you know, if this is your husband, your wife, whatever the case may be, your family, you might want to have a conversation with them, have them take a listen to this and look for some alternatives.

00;18;55;24 - 00;19;19;11

Cary Hall

If you just want some help and a consultation. 877-385-2224 ask for Carolee. If it's on the individual side. If it's on the group side to ask for Maria, callers 877-385-2224 anywhere in the country okay, doesn't matter where you are, they're happy to help you. The website is rpsBenefitsByDesignInc.com if you want to go up on the website.

00;19;19;17 - 00;19;24;22

Cary Hall

All right. So the the changes on verification. Let's get that first. And we're going to go right to group.

00;19;24;23 - 00;19;51;27

Carolee Steele

Give it on okay. Consumers are required to verify their eligibility for a subsidized plan each year now. Or they have an additional $5 monthly premium. And that's new versus previous years. And also they have to verify prior to their, plan starting that they have a proof of a qualified life event. Like if you're losing employer coverage, you have to provide proof first before the plan will start, not after.

00;19;51;29 - 00;20;12;12

Cary Hall

Okay. So this is this has been coming for some time because we had people. I did a piece on this when I was, when I did the Medicare show. You've got people on the ACA plan that are getting big subsidies. And they're also over here on the Medicaid plan, two plans, same person. Okay. So there's a lot of fraud and waste going on here because they weren't verifying anything that's changing.

00;20;12;12 - 00;20;30;21

Cary Hall

Correct? Okay. They're going back to the way it was originally set up, which when you originally went on to an ACA plan, you had to present your tax return to get a subsidy. Well, when they opened this up in 2021, the all the rules went away and it flooded this place. That's why you got 24 million people on here now.

00;20;30;26 - 00;20;51;19

Cary Hall

And there's going to be some shock and awe as a result of the changes. All right. Let's switch gears. So the small employer is the one that gets punished the most, Maria. In this marketplace, you know, the big employers 100 lives and above, we were talking about on break. You can go to the Pareto Captive, you can go to Berkeley, you can, you know, go to one of our plans on Detego that are in the captive model.

00;20;51;19 - 00;21;03;00

Cary Hall

And you can lower your costs and make a lot of sense. The small employer, those 50 and below they’re other ones are getting clobbered. What are the solutions to them like ICHRA and you talk about some of those.

00;21;03;00 - 00;21;33;04

Maria Ahlers

Absolutely correct. Yes. There are creative solutions outside of what we call the BUCAs, right. The Blue Cross, Blue Shield, United, Cigna and Humana. ICHRA, as you mentioned, Cary. ICHRA stands for Individual Coverage Health Reimbursement Arrangement. And what that provides is instead, when you're on a when you're on one of the big BUCA plans, your employer contributes, at least 50% to the premium.

00;21;33;06 - 00;21;57;06

Maria Ahlers

What small business employers are doing is sometimes that's a huge cost for them. When they have to pay at least 50%, most of them will pay more because they want to be competitive in the market. So now what they're doing is we're looking at ICHRA where the employer sets a percentage or a flat rate of what they want to contribute to an employee for their premium health care.

00;21;57;09 - 00;22;23;18

Maria Ahlers

Now, what that employee does is that employee then takes that amount. So say your employer wanted to contribute $300 a month to your premium. You now have $300 a month to go on your own and find your own plan. We can help do that. We have partnerships where we will set it up on a platform, with the amount that the employer wants to to contribute.

00;22;23;18 - 00;22;47;09

Maria Ahlers

Then the employee goes on to the platform, they know they have the $300. They can shop with different carriers with different plans. They can pick the amount of their deductible. They can do the PPO, they can do a high deductible health plan, and then they can enroll and they can see what their coverage is. And then that $300 is contributed to their monthly rate, and then the rest is taken care of by the employee.

00;22;47;09 - 00;23;06;28

Cary Hall

So the beauty of this is instead of painting everybody with one brush, right. So you got employees that are 25 years old and you got employees that are 60 years old and they're all on the same plan. Well, now they don't all need the same plan. No 60 year old doesn't need maternity benefits, and they don't need access to children's mercy.

00;23;07;01 - 00;23;25;00

Cary Hall

So for them to go to this new narrow network Blue Cross plan maybe would make a lot of sense. Okay. But in order to navigate that, they have to understand what it is. And that's where you all come in and say to the employer, hey, you, you put the subsidy together. We'll handle getting your people on the plans they need to be on.

00;23;25;01 - 00;23;25;12

Cary Hall

Right?

00;23;25;12 - 00;23;40;07

Maria Ahlers

That's right. You tell us how much you can afford within your budget. We set it up and then your employees go on there, and the plans are on there for them to see, from different carriers, different amounts, the network, and they pick what works for them.

00;23;40;10 - 00;23;59;10

Cary Hall

See you. I, I've said this is the thing I've used on this show for years, size 44 overcoat doesn't fit everybody. Okay, so this is exactly what I'm talking about. That gives the employer a fixed cost. That's the whole idea. And it gives the employee the freedom to go pick what they want.

00;23;59;17 - 00;24;00;23

Maria Ahlers

That's right. That's exactly.

00;24;00;23 - 00;24;01;21

Cary Hall

It makes a lot of sense.

00;24;01;22 - 00;24;27;04

Maria Ahlers

It does. And then the employees, if they need help deciding what plan works for them, that's where my team comes in and provides that individual consulting. Now, with RPS we also work with Carolee, where if we feel that an ACA plan may be more beneficial for them, then we'll refer them over to that to our Solutions team to do that.

00;24;27;07 - 00;24;32;24

Maria Ahlers

But it's a one stop shop, Cary. We'll figure out what the best plan is for your employees.

00;24;32;24 - 00;24;52;10

Cary Hall

Yeah. Don't you know, don't try to negotiate this yourself, okay? It's complicated. Believe me. I've been doing this for 30 years, and it's getting more complicated, not less complicated, because you got government right in the middle of this now, and trying to sort through all this to make sense out of it in the marketplace is difficult. Here's some other solutions that people are doing.

00;24;52;13 - 00;25;17;02

Cary Hall

We've got we've got some new direct primary care clinics here in Kansas City. Exemplar Care is part of Hy-Vee. They're opening up new clinics here. So what we're seeing is employers saying, you know what, I'm going to buy that direct primary care, unlimited access for my employee and their family. It's $91 a month, let's say, and then I'll go buy a high deductible plan.

00;25;17;05 - 00;25;24;10

Cary Hall

Let's talk about how would you marry those two up, like, because I know you're doing this, the HRA and the HSA talk about that, Maria.

00;25;24;10 - 00;25;58;17

Maria Ahlers

Yes, we can we can pick pieces from different, plans to make it work for our clients. So you can do a, as you mentioned, care. You can do a direct provider membership for, for every day to day, you know, the ear infections, the preventative, the annual wellness that could be for that. There are also providers that are there's also programs where you can do that virtually now and you just pay a monthly fee, and it covers all their day to day stuff as well as well as prescription.

00;25;58;19 - 00;26;21;05

Maria Ahlers

But then we can also offer what we call catastrophic plans, where if somebody gets diagnosed with a major medical condition, then you have the catastrophic coverage that can also help cover that. There's HRA where, employers can pay for first dollar coverage, or they can pay for the back end coverage. There's a HSA account we've heard, actually.

00;26;21;05 - 00;26;48;29

Maria Ahlers

Now people are very much a proponent of HSA where they're saving 20 to $30,000 already to cover their medical expenses. There is GigCare to help with the solutions? There's level funded. Most companies now are trying to get away from the ACA because they are they are age rated.

00;26;49;02 - 00;26;51;20

Maria Ahlers

Are they are set

00;26;51;23 - 00;27;10;11

Cary Hall

And you're going to see your employers that when you've got reasonably healthy groups are going to start looking for a way out. That's right. They want to get off. They want they've got to find something that works. This thing is not sustainable the way it is now. But as a broker you have to be willing to step outside the box.

00;27;10;14 - 00;27;17;24

Cary Hall

Yet be willing to listen to what somebody is dealing with. How do I solve the problem. And here's the set of solutions.

00;27;17;27 - 00;27;40;16

Maria Ahlers

There's so many solutions we can implement. You know, we've done a gap plan to help with the larger, high deductible health plans where we add that as a plan for our clients. And that helps cover the gap between the deductible between the two plans. There's just a lot of creative solutions.

00;27;40;21 - 00;27;47;28

Maria Ahlers

We just need to know what your needs are, what your pain points are, and let's get together and figure out the different options.

00;27;48;04 - 00;28;09;27

Cary Hall

Here's the thing, okay? You have to be, you've got to be proactive here. Don't wait until you know renewal hits you with a 25% increase. Or a 29% increase from Medica or Celtic or one of the other ones. Okay, now's the time to act. Start a consultation, give them a call, get ahold of Maria.

00;28;09;27 - 00;28;29;02

Cary Hall

Get Ahold of Carolee. 877-385-2224. It doesn't cost you anything to talk to these folks, okay? And they can help you get a solution. That's going to make sense, but you have to get in front of it, not do it. At the end of the situation where now you've got to renewal and you don't have any time to make a decent decision.

00;28;29;09 - 00;28;53;06

Cary Hall

So once again, 877-385-2224 or their website RPSBenefitsbyDesignInc.com. rpsbenefitsbydesigninc.com. When I come back we're going to explain HSAs so you understand how they work and these HRAs and how you can incorporate those and keep benefits for a major network, but have that benefit if you have a catastrophic illness.

00;28;53;11 - 00;29;09;22

Cary Hall

Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA.

00;29;09;24 - 00;29;29;25

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. My producer, Mr. Garner Cowdery, behind the microphone. Dave Thiessen behind all the cameras. Putting all this together. For all of you out there in our audience, on our podcast channels, YouTube channels, and across the air on all of our terrestrial radio stations.

00;29;30;00 - 00;29;55;06

Cary Hall

In studio with me, Carolee Steele and Maria Ahlers from RPS Benefits by Design. We're telling you, get prepared. It's coming. It's going to be a tsunami. It's coming. Don't wait until you're caught up in it, okay? These people can help you navigate through. The sky is not falling. It's not the end of the world, okay? But you've got to prepare yourself and if you're the employer, for God's sake, pick up the phone and give these folks a call.

00;29;55;11 - 00;30;16;26

Cary Hall

If you're an individual and you're concerned and maybe you're one of those Aetna people, you're losing coverage altogether. Okay, well, give them a call. They're happy to help. 877-385-2224 they are experts. They do this nationally. Okay? 877-385-2224 or the website rpsbenefitsbydesigninc.com.

00;30;16;28 - 00;30;21;00

Cary Hall

You know, HSAs were introduced I don't know was it 15 years ago?

00;30;21;00 - 00;30;39;23

Cary Hall

Something like that. And it was a hard concept for people to grasp. Correct. But when you look at how they function versus how what I call the American Express Plan, where you have your American Express card, you don't have to you walk in and make a $10 co-pay and you're done. Well, those days are gone. Yeah, that's why the premiums are going through the roof.

00;30;39;29 - 00;30;46;19

Cary Hall

Let's talk about how the HSA works, why is it beneficial and why are a lot of people moving to those plans?

00;30;46;19 - 00;30;59;18

Carolee Steele

Well, I think it’s wonderful. I have an HSA. So what HSA is, is that you can put monies away every year toward, it's a certain amount depending on if you are single.

00;30;59;18 - 00;31;00;20

Cary Hall

It’s up to $6,300 a year.

00;31;00;20 - 00;31;24;16

Carolee Steele

Or a family, you can put that away. It's typically you've got to, everything comes out of pocket until you meet that deductible. And then there's a percentage for insurance. Typically the employer offers an HSA that is a reduced premium compared to the other standard traditional plans. So that was one good. It also, you can use that money.

00;31;24;16 - 00;31;26;03

Carolee Steele

It rolls over to the following year.

00;31;26;03 - 00;31;28;17

Cary Hall

So it's not a use it or lose it at the end of the year.

00;31;28;17 - 00;31;50;10

Carolee Steele

Correct, it's not a flex spending account. It is an HSA account. Yes. And this is really wonderful because if you have a family, your daughter needs to have her teeth pulled to get something for wisdom teeth pulled. You can use that as long as they're tax dependents in the family. You can use those HSA funds toward that as well.

00;31;50;10 - 00;32;00;04

Cary Hall

And here's the thing. When you put the money in there, it's a tax deduction. Right. So if you put $6,300 in there you just took $6,300 off of your tax liability.

00;32;00;04 - 00;32;00;18

Carolee Steele

Correct.

00;32;00;21 - 00;32;01;17

Cary Hall

It's a tax deduction.

00;32;01;18 - 00;32;02;09

Carolee Steele

That's huge.

00;32;02;09 - 00;32;04;06

Cary Hall

And Maria, once you hit a.

00;32;04;06 - 00;32;09;29

Maria Ahlers

Certain amount you can invest that money in the money market.

00;32;10;04 - 00;32;11;02

Cary Hall

I didn't know that.

00;32;11;02 - 00;32;11;13

Maria Ahlers

You can.

00;32;12;09 - 00;32;30;06

Cary Hall

So there's another option. Yeah. So the money stacks up. You get past your first year, you've got enough to cover the deductible coinsurance typically down the road. Okay. As you continue to add to it, you're building an account. And as you said you can invest that money Maria. So this is an opportunity individual side.

00;32;30;06 - 00;32;45;29

Cary Hall

So tax deductible going in tax free coming out. You can use it for more than health care. You can use it for dental. You can use it to buy glasses. You can use it for a host of different things right. You get a debit card. You have an HSA account. That's how it works. How does this work for employers?

00;32;45;29 - 00;33;03;15

Cary Hall

Now, Maria, in terms of you talked in the last segment, if you drop premiums 30%, the employer can afford to say, you know what, if you got an HSA, I'm going to go ahead and add another $100 a month to this for your HSA account to encourage people do it. Does that make sense?

00;33;03;17 - 00;33;20;00

Maria Ahlers

There's a lot of different strategies, Cary, that we work with our clients. We have clients where they do, a high deductible health plan, offer an HSA, and then they contribute 100% to the employee's HSA to help with their costs up to their deductible.

00;33;20;03 - 00;33;37;17

Maria Ahlers

We have clients that will, embed an HRA, which where they'll cover again, if your deductible is $3,000, that employer will cover, will decide they'll cover the first, maybe the first 1500 of your deductible, or they'll cover the back 1500 of your deductible.

00;33;37;21 - 00;33;58;09

Maria Ahlers

But these are creative strategies that we work with our clients to make it work for them, but yet provide them with comprehensive coverage for their employees. So yeah, there's there's it's it's all about strategy. And I think the point that you made earlier is we need to start on it proactively.

00;33;58;15 - 00;34;21;24

Maria Ahlers

Most employers will wait until they get their renewal. Well then we only got 60 days. And with that 60 days we have to strategize, look at different options, go to market, look at the financial analysis. The other piece to this that some of our clients don't, recognize that we've, put into play a lot is critical illness and accident and hospital indemnity.

00;34;21;27 - 00;34;26;17

Maria Ahlers

Those lines of coverage help with the medical costs as well.

00;34;26;20 - 00;34;30;23

Cary Hall

So there are ways to blend those in. And there those are relatively inexpensive.

00;34;30;23 - 00;34;31;18

Maria Ahlers

Relatively inexpensive.

00;34;31;20 - 00;34;53;17

Cary Hall

I had a cancer plan for I don't know how many years it was. I had a bulk cancer plan of $50,000, and the way it worked was, I hate Aflac, just so we all know I like ducks. I prefer it with orange sauce. Yes, but you know, I don't like the Aflac model because what they do is you have to send in your claims and then they reimburse you.

00;34;53;23 - 00;35;02;01

Cary Hall

The model that I had was once I was diagnosed with cancer, and the actual diagnosis went into the carrier. I got a check three days later, period.

00;35;02;01 - 00;35;06;11

Maria Ahlers

And you can spend it on whatever you like.

00;35;06;11 - 00;35;06;19

Cary Hall

Whatever I wanted.

00;35;06;26 - 00;35;20;06

Cary Hall

If wanted to go sit on a beach in Mexico and decide, okay, this is where I'm going to finish it up. That's right. I've got terminal cancer. That was my money to do what I want with. But that was a very inexpensive policy. But it gave me peace of mind.

00;35;20;08 - 00;35;23;12

Maria Ahlers

Because we know bills don't stop just because you're in the hospital. No.

00;35;23;13 - 00;35;40;17

Carolee Steele

And to piggyback on that, as far as having your, like a critical, like, cancer, stroke and heart, you may have you may have a Medicare supplement. So you don't have a lot of medical out-of-pocket, but you may have to go to Mayo Clinic, and you're going to have to stay in a hotel, and you're going to have to fly there, and you're going to have to do all that.

00;35;40;21 - 00;35;44;14

Carolee Steele

So that is also used. That money can be used for that as well.

00;35;44;14 - 00;36;01;28

Cary Hall

Yeah. So I think what we're trying to say here is we're wrapping this up today. And thank you both to me and Maria and Carolee. You know, it's great to have experts in studio that can really walk you through this stuff. It's complicated, but this is why I do these broadcasts. And I bring people on here that can explain this to make sense out of it.

00;36;02;00 - 00;36;24;00

Cary Hall

So you're looking for a solution? You heard Maria just say this. Here's what happens. Everybody waits until those renewal notices hit or ACA open enrollment starts and then they start calling. Well, you're not the only one okay. You know. Yeah. The phones are melting down. I remember doing this back when I ran Benefits by Design.

00;36;24;07 - 00;36;45;24

Cary Hall

And literally the phones would be melting down with people in a panic trying to get this done. This year's going to be worse. That's why I'm doing this show way ahead of time. Okay. So you know that it's coming. And prepare yourself. If you're an individual, you need help. Get ahold of Carolee, 877-385-2224. If you're an employer, you just heard Maria walk through how they do this.

00;36;45;29 - 00;37;06;23

Cary Hall

They do a full blown analysis. This is a come in and lay a spreadsheet down. They come in, they do a full blown analysis, come back to you with a series of solutions, and then you pick the one you think makes the most sense. That's what I'm suggesting you do. 877-385-2224 is their phone number. Their website is rpsbenefitsbydesigninc.com.

00;37;07;00 - 00;37;24;02

Cary Hall

If you are one of the folks that are facing these kinds of renewals and what's happening, now's the time to reach out to them. And now I leave you with this thought from Albert Einstein, the one who follows the crowd they usually get no further than the crowd. The one who walks alone will likely find himself in places no one has ever been.

00;37;24;05 - 00;37;40;01

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 here on the HIA Radio Network. Goodbye America.

2026 ACA Update from BlueKC - Premium Reductions while other carriers premiums will go up!

Fri, 12 Sep 2025 14:32:27 GMT

Episode 2127 notes

Barron Roberts is my expert today on this Blue Cross Blue Shield Kansas City update show. How will it play out for all of you out there in the audience for your coverage in '26? We will cover the individual side and what Blue Cross is doing to lead the way. They're actually going to have premium reductions on the individual side, and we'll talk about what are the answers to the employers out there, the small group employer, the employer under the 100 lives.

Get all the details and find the best way to go now, because come January 1st, all the Aetna plans are pulling the pin on ACA. They're going to be gone. And I will cover what's going to happen with the other plans. They're going to be significant increases across the board. BlueKC continues to lead the way as the local hometown carrier.

This is Ep2127 of America's Healthcare Advocate.

Learn more at https://www.bluekc.com/ or 833-467-2145

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Episode 2127 Transcript:

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

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;06;03 - 00;00;29;02

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate. Show broadcasting coast to coast across USA. Here on the HIA Radio Network, you can learn more about us going to our website. AmericasHealthcareAdvocate.com. Also your favorite podcast platform, SoundCloud, whatever it may be. Spotify, Rumble, all of them. We're on 16 of them and our YouTube channel, America's Healthcare Advocate.

00;00;29;02 - 00;00;54;29

Cary Hall

My producer today, Mr. Dave Thiessen, behind the cameras, doing what he always does, bringing all these shows together. They go up on our podcast platforms and our YouTube platform. And Garner Cowdrey, who is behind the microphones here in our beautiful Cumulus Studios. If you need help, if you are, chronologically challenged or you are looking for individual ACA, the lovely Carolee Steele at RPS Benefits by Design, will be happy to help you.

00;00;55;01 - 00;01;16;17

Cary Hall

You can reach her at 877-385-2224. And if you're looking for employer sponsored health insurance, Maria Ahlers is also happy to help you. They have access to all the great plans out there, including those brand new Blue Cross and Blue Shield plans are going to roll out this year. And so in studio with me, Mr. Barron Roberts from Blue Cross and Blue Shield of Kansas City.

00;01;16;17 - 00;01;17;01

Cary Hall

Welcome.

00;01;17;04 - 00;01;18;08

Barron Roberts

Thanks, Cary.

00;01;18;10 - 00;01;41;03

Cary Hall

I haven't done a show like this, I think in probably six years. And now I'm going to tell you why I just said that. So here's what's going on in the ACA marketplace that I warned you this was going to happen some months ago. This is this is what we're looking at with carriers. Celtic Insurance increased this year 24.4%, Medica 29.2%.

00;01;41;05 - 00;01;47;29

Cary Hall

UnitedHealth Insurance 10.7%. You want to tell us what the Blue Cross and Blue Shield increase is going to be this year?

00;01;48;00 - 00;01;54;14

Barron Roberts

Yeah. So in in Kansas we're looking at a -4.1%. And in Missouri a negative six.

00;01;54;16 - 00;01;55;23

Cary Hall

Did you hear what I just said.

00;01;55;25 - 00;01;57;17

Barron Roberts

I reversed that Cary.

00;01;57;20 - 00;02;16;05

Cary Hall

That's all right. Yeah that's all right. The point is they’re actually going to be a premium reduction. Now the last time I did a radio broadcast where there was a decrease in premiums was Ron Rowe, about eight years ago, if I remember correctly. So it's been a while. All right. And this is a great piece of news for everybody in the Kansas City metro.

00;02;16;05 - 00;02;40;06

Cary Hall

So I'm going to repeat that. So they're looking at Missouri at a -4.4%. And in Kansas a -6.1%. So there must have been a lot of work went into this. If you're bucking the whole marketplace, okay, all the national carriers, etc., and you're coming in at numbers that are good, and then we're going to talk about some of the specific plans you're going to offer.

00;02;40;13 - 00;02;43;06

Cary Hall

They're going to be very different. But how did you guys get to this.

00;02;43;12 - 00;02;59;21

Barron Roberts

Yeah we put a lot of work designing these new plans. We gathered member feedback from across the community. We gathered our broker partner feedback, months and months ago to put together plans that would fit, the members of our community.

00;02;59;24 - 00;03;21;20

Cary Hall

You know, it, when we talk about the independent Blue Cross plans, like Blue Cross of Kansas, Blue Cross of Nebraska, Blue Cross of Kansas City. You know, there's the tagline that always comes to mind for me when I look at that versus the big carriers. The big Aetna’s, the big UnitedHealthcare's. the Cygnus, and that is we're Main Street, not Wall Street.

00;03;21;23 - 00;03;27;01

Cary Hall

And you're right down here on Main Street. You know, you serve this market. You've been here for how many years?

00;03;27;01 - 00;03;27;25

Barron Roberts

Over 85 Years.

00;03;27;25 - 00;03;39;01

Cary Hall

85 years in Kansas City. And you're able to come to the people in this city and say, we're going to cut premiums this year by 4.4% Missouri and 6% in Kansas. That's pretty significant.

00;03;39;08 - 00;03;59;15

Barron Roberts

Absolutely. There's a lot going on in the ACA this year. You know, there's enhanced subsidies that are going away or expected to go away at the end of the year unless there's something that changes about that. You'll have a $5, additional premium applied to your bill if you don't go in and update your income. It's a very active open enrollment this year.

00;03;59;15 - 00;04;16;20

Barron Roberts

And we would encourage everyone to go out and review their details within their marketplace account to ensure that they are getting, assessed the right premium for one, but also evaluate their options. And as you mentioned, we're giving decreases this year. We're going to be much more competitive.

00;04;16;22 - 00;04;44;07

Cary Hall

Well, you’re going to be much more competitive. And there's a tsunami coming. I've been telling people this for the last four months. Okay. I've done multiple shows on this. There's a tsunami coming that, no longer are you going to be able to self affirm. You're actually going to have to, you know, have documentation that says you made ‘X’. The automatically renewing subsidies are going from 400% of the poverty level back to 150 to 200, which is where they were before we had the expansion in 2021.

00;04;44;14 - 00;04;49;28

Cary Hall

Well, that's going away now. So there's going to be massive market disruption in the marketplace.

00;04;50;00 - 00;05;00;04

Barron Roberts

Between 90 and 93% of Americans today on the ACA, have the enhanced subsidies. So 90 to 93% are going to be affected by these changes.

00;05;00;07 - 00;05;25;11

Cary Hall

That's huge. All right. And so what BlueCross has done is they've stepped up to the plate and said, we're going to buck the market trend. You guys are taking a risk here. There's no guarantee. You know this is going to work out for you guys in a year from now. You're not going to be going, oh, Lord, you know, but the fact that you're willing to make that commitment to this community after 80 years of serving this community says a lot about Blue Cross and Blue Shield of Kansas City.

00;05;25;13 - 00;05;40;04

Barron Roberts

You know, most certainly. And we've done a lot of things to to get there. What we're looking at different care management programs. In addition to that, we're rolling out a brand new network in 2026. Will help us get to the pricing point that, members are looking for.

00;05;40;11 - 00;06;03;02

Cary Hall

Yeah. And that new network you’re going to have, we'll talk about that when we get into the next segment of the show. And then obviously, Spira Care and how that's going to fit into the equation is really interesting because we're seeing a lot of initiatives now for, primary care, direct primary care, getting away from the hospital models, the other models, which is kind of funny because how long Spira Care have been in existence.

00;06;03;05 - 00;06;04;11

Barron Roberts

Yeah, since 2018.

00;06;04;12 - 00;06;24;14

Cary Hall

Okay. So I mean you the compliment Danette Wilson. Okay. For having, you know, the vision to say we're going to do something really different. I remember when everybody was like, this is never going to work. Well here we are in 2026. And guess what. Not only is it working, it's working phenomenally well.

00;06;24;16 - 00;06;41;05

Barron Roberts

Yeah. Very well. Our members are reporting, 96% customer effort score at Spira Care, which is a true testament to the experience that they get there, the accessibility, and and being able to get to a provider that, keeps costs low.

00;06;41;07 - 00;06;45;07

Cary Hall

Let's give folks the dates when they can when this is all going to start with OEPs.

00;06;45;07 - 00;07;09;04

Barron Roberts

For ACA, you'll have a shopping period or shopping window towards the tail end of October, so you can go out and see what the different prices and plans that are available. And then open enrollment starts November 1st up until December 15th for a 1/1 effective date. And then if you're enrolling for a 2/1 effective date, that enrollment can come in after December 15th up to January 15th.

00;07;09;06 - 00;07;30;21

Cary Hall

And that's it. That's it. Okay. So here's my admonition to all of you out there in the audience. All you folks like to procrastinate. This is one year where you better not procrastinate. Okay. You know, I'm going to give you the phone number, and I'm going to suggest you that you probably you ought to start making some calls and start talking to people and get ahead of this thing.

00;07;30;23 - 00;07;45;24

Cary Hall

So you can call the folks down at Blue Cross. They can they can chat with you. They can set up a time to talk to you after OEP, whatever you want to do. But you need to get ahead of this because once this tsunami hits, you guys are going to get buried. You're the only plan in town

00;07;45;24 - 00;07;48;11

Cary Hall

that’s offering decrease, you're going to get hammered.

00;07;48;12 - 00;07;49;18

Barron Roberts

We're going to get a lot of calls. For sure.

00;07;49;20 - 00;08;14;10

Cary Hall

Yes, you are. And there's going to be a lot that has to happen here. So the phone number is 833-467-2145. 833-467-2145. And the website is bluekc.com. Yes. Yep. All right. So if you want information you can go up to the website. But I would strongly suggest you start making arrangements to have these conversations now. So you're not caught at the last minute.

00;08;14;13 - 00;08;37;18

Cary Hall

Because as I said it's going to be a tsunami. There are a lot of changes coming. A lot of folks are going to be affected by these changes. We come back to the break. We'll talk some more about this and how and the new plans and the new network and all that they’re doing, and then we'll switch gears when we get to the third segment, and we'll start talking about what's going to happen to the small employer, because small employers on ACA type plans are also going to get hit with very significant increases.

00;08;37;20 - 00;08;57;03

Cary Hall

What is Blue Cross doing to address that, and how are they addressing that so they can help the small employer in the marketplace? Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across USA. We've got more. Stay right there. That phone number once again.

00;08;57;06 - 00;09;12;10

Cary Hall

833-467-2145. Stay right there. We'll be right back after the break.

00;09;12;13 - 00;09;30;00

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. Once again, you can find out more about us by going to the website AmericasHealthcareAdvocate.com. You have an email. You want to send me a note? Please do so. Go to the website. I'm happy to help you.

00;09;30;01 - 00;09;50;27

Cary Hall

Any way I can. I want a shout out to WNRP, AM 1620 and FM 95.3 Pensacola, Florida. Happy to have those folks on board as part of America's Healthcare Advocate family broadcasting down there every Saturday at 8:00 in the morning. And we love Pensacola, Florida, by the way. So, all right, let's switch gears now.

00;09;51;00 - 00;10;11;29

Cary Hall

And we kind of gave people a little tease there. This new plan, which I'm hearing a lot. In fact, we just had the folks from RPS Benefits by Design up here, and they were talking about it. And you guys have had a big broker meeting the other day, and there's some pretty excited brokers out there to learn about this new plan that's coming in play, and what a difference it's going to make people.

00;10;11;29 - 00;10;12;25

Cary Hall

So let's talk about it.

00;10;12;25 - 00;10;13;20

Barron Roberts

Yeah.

00;10;13;22 - 00;10;14;25

Cary Hall

What's it going to be called. Yep.

00;10;14;25 - 00;10;16;27

Barron Roberts

It is going to be called the Simply Blue Plan.

00;10;16;27 - 00;10;19;19

Cary Hall

Simply Blue. All right.

00;10;19;21 - 00;10;32;26

Barron Roberts

And we'll actually have three one in each metallic category. So gold, silver and bronze. We're pretty excited about it. At the smaller rollouts that we've done so far, brokers are getting excited about it.

00;10;32;28 - 00;10;35;12

Cary Hall

We had a group up here this morning. It's pretty excited about it.

00;10;35;14 - 00;10;49;17

Barron Roberts

Yeah. So, the price point on that, that will be our lowest price plan that we have available. It'll be offered in the Johnson County, Wyandotte County and Jackson County metro area. Okay. And it'll be a part of what we call the Blue Metro Network.

00;10;49;18 - 00;10;50;01

Cary Hall

Okay.

00;10;50;04 - 00;10;59;24

Barron Roberts

That'll consist of Saint Joseph, Saint Mary's University Health and Providence. And it also includes University Health Lakewood as well.

00;11;00;03 - 00;11;06;05

Cary Hall

Lakewood and then downtown. Yep. Okay. Then Providence Hospital over in Kansas City, Kansas. That was the other one.

00;11;06;05 - 00;11;08;11

Barron Roberts

Saint Mary's down south.

00;11;08;13 - 00;11;09;00

Cary Hall

In Blue Spring.

00;11;09;02 - 00;11;11;04

Barron Roberts

and Saint Joseph.

00;11;11;07 - 00;11;27;23

Cary Hall

So it’s a narrow network. But the price point is going to be. Much better. You know what people are going to have to do is be willing to accept a narrower network in order to get that price point. The good news is you're giving them an option.

00;11;27;26 - 00;11;28;15

Barron Roberts

Absolutely.

00;11;28;18 - 00;11;44;08

Cary Hall

They're not going to see with the other carriers so you're addressing the issue by getting creative and giving them an option so that somebody, you know, if they do lose their subsidy and they need coverage, at least they can keep they can still stay in Blue Cross.

00;11;44;11 - 00;11;44;22

Barron Roberts

The.

00;11;44;25 - 00;11;48;24

Cary Hall

Whole nine yards. Okay. Now is Spira Care accessible on those plans.

00;11;48;24 - 00;11;53;01

Barron Roberts

So each one of those plans will have access to all nine Spira Care centers.

00;11;53;01 - 00;12;12;22

Cary Hall

That's huge. Yeah. All right. So now you just took primary care out of the equation from the standpoint did they have to drive to a facility. They've got one of the nine Spira Care centers. So you're connecting the two now. So all of their primary care, behavioral health, all the other things that go with that will be in Spira Care.

00;12;12;25 - 00;12;19;04

Barron Roberts

Yeah, they'll have access to that. And, access to Spira Care is much faster than a traditional primary care.

00;12;19;08 - 00;12;30;23

Cary Hall

23 days to a typical wait to get in to see a primary care doctor. Then you get 7.5 minutes. That's the average time you get with your primary care. Little different. In Spira Care. Talk about.

00;12;30;23 - 00;12;48;27

Barron Roberts

That. Yeah, yeah. So in Spira Care. You can get in and get your original orientation visit set up much earlier than traditional PCP office visits. And then on top of that for sick care or a little bit more urgent type care. You can get in to see Spira within a few days, if not the same day, depending on the circumstance.

00;12;48;29 - 00;13;10;29

Cary Hall

To me, when you're balancing that narrow network piece for cost effectiveness and but you're not saying to them, well, you're going to go find a new primary care provider. No, you can come to Spira Care and we'll take care of you here. We've got nine clinics around the Kansas City metro, so you're giving them an option where they've got primary care, taken care of.

00;13;11;02 - 00;13;16;26

Cary Hall

Whatever they need is right there. If they need major medical, they can go to one of the hospitals and get major medical.

00;13;16;28 - 00;13;30;02

Barron Roberts

Absolutely. And hit on one more thing there Cary. Care at Spira Care is at no cost to members. So they've got easy access, affordable access. They'll have a great experience there and care is at no cost for Spira Care members.

00;13;30;02 - 00;13;46;24

Cary Hall

Yeah. So there's your there's your key takeaways right there. And you heard him say in the last segment, 96% of the people coming away from Spira Care are telling them they're doing a good job. All right. So if you're not going to make co-pays. You're not going to have to pay out-of-pocket costs for this.

00;13;46;26 - 00;13;53;29

Cary Hall

When you think about marrying that up with the plan, it's going to save you a significant amount of money. That sounds like a pretty win win deal to me.

00;13;54;01 - 00;13;59;23

Barron Roberts

Yeah, absolutely. That is, taking total cost of care down for members and families for sure.

00;13;59;23 - 00;14;00;19

Cary Hall

So rolls out.

00;14;00;19 - 00;14;09;14

Barron Roberts

Win. This will roll out, January 1st is a new product. Open enrollment starts 11/1. Great. Start looking for that plan starting 11/1.

00;14;09;14 - 00;14;23;27

Cary Hall

And if they want to call and just have a consultation with somebody and talk about that plan, they don't have to wait to open enrollment to make a phone call to say this isn't Medicare. Right? Okay. Right. Yeah. Where we got the thought police out there going, you can't call it. You can't talk to anybody.

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

Barron Roberts

Yep. They can.

00;14;24;14 - 00;14;41;29

Cary Hall

So this is a different deal. This is ACA. So they can call anytime they want. If they've heard about this plan it's called Simply Blue. That's pretty easy right. Simply Blue. And there are three plans. There's there's the there's the gold. There's the silver and there's the bronze. So you've got three separate plans to offer.

00;14;42;02 - 00;14;44;07

Cary Hall

I assume there's going to have different deductibles.

00;14;44;07 - 00;14;49;16

Barron Roberts

Correct. 2000, 4000 and 6000. And the premiums all vary depending on the plan. Okay.

00;14;49;16 - 00;15;09;23

Cary Hall

So if you know, if you're if you're one of those folks that's chronologically challenged, you're in your 50s, you probably don't need a $2,000 deductible because you’re not running to the E.R., the urgent care and all the other things you're going to have to do with the household children. So you could go to a $5,000 deductible. Can that be tied to an HSA?

00;15;09;25 - 00;15;18;25

Barron Roberts

So actually new for 2026, bronze and catastrophic plans will be eligible for HSA, compatibility.

00;15;19;00 - 00;15;37;09

Cary Hall

Okay. So that's huge. Yeah. And the thing about the HSA is that I always try to get people's heads is it money going in is tax deductible. So you made 100 grand. You're going to pay taxes on 100 grand. No you're not. You're going to take 6300 off that. It’s your money you're putting into your account. Oh and by the way, when you take it out it's tax free.

00;15;37;12 - 00;15;45;13

Cary Hall

So if you went to the higher deductible plan and you had to go have a surgical procedure, you've already got your deductible there to pay to get it done.

00;15;45;15 - 00;15;45;28

Barron Roberts

Correct.

00;15;46;04 - 00;15;50;01

Cary Hall

And if you don't use it, you don't lose it. Unlike,

00;15;50;04 - 00;15;51;22

Barron Roberts

Like an HRA or something like that.

00;15;51;22 - 00;16;02;03

Cary Hall

All right. This plan is not a flex. It's not an HRA. This money rolls over every year. So you can continue to add to it So if you put all those pieces together you got some answers here.

00;16;02;04 - 00;16;03;24

Barron Roberts

Absolutely.

00;16;03;27 - 00;16;18;28

Cary Hall

And that's that's really kind of what BlueCross Kansas City has always been known for is that you have the answers and you're serving this community. And this is a great opportunity. You know, once again, they're called Simply Blue. I strongly suggest that you are the up on the website, yet.

00;16;19;01 - 00;16;21;24

Barron Roberts

No. They won't be up on the website until late October.

00;16;21;24 - 00;16;22;11

Cary Hall

Okay, so.

00;16;22;11 - 00;16;23;12

Barron Roberts

During the shopping season in.

00;16;23;12 - 00;16;45;01

Cary Hall

October, you can go up there. They'll be up there if you just want to call and have a conversation with him about this, you can do that. 833-467-2145. 833-467-2145. By the way, there are 1 million people out there across the country that are losing their coverage because Aetna’s pulling out of the market. You folks probably ought to be the ones on the phones first.

00;16;45;04 - 00;17;04;01

Cary Hall

Okay. And looking for these plans and to see what they can do because, come January 1st, all the Aetna plans are pulling the pin on ACA. They're going to be gone. And I and I read to you earlier what's going to happen with the other plans. They're going to be significant increases across the board. BlueKC continues to lead the way as the local hometown carrier.

00;17;04;07 - 00;17;25;17

Cary Hall

We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network coast to coast across USA. Stay right there. We've got more in the next segment.

00;17;25;20 - 00;17;51;26

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. My producer behind the microphones, Mr. Garner Cowdery behind the cameras, putting all these shows together as he does every week. Dave Thiessen in studio with me, Barron Roberts, BlueKC we're talking about the coming tsunami That's what's going to happen, both on the individual side and on the group side with anything associated with ACA.

00;17;51;28 - 00;18;12;28

Cary Hall

And how is that going to play out for all of you out there in the audience? So we've talked about on the individual side and what Blue Cross is doing to lead the way. They're actually going to have premium reductions on the individual side. Right now we're going to switch gears here, and talk about what are the answers to the employers out there, the small group employer, the employer under the 100 lives.

00;18;13;00 - 00;18;30;23

Cary Hall

What are the answers to them? What is Blue Cross doing to address the issues that they're going to deal with? Because that's going to happen. All right. And if you're you know, you need to talk to your broker. If you don't talk to your broker, call the folks at Blue Cross and Blue Shield at 833-467-2145.

00;18;30;25 - 00;18;43;07

Cary Hall

If you want to have a conversation before you get to the point where you've got the renewal, now you're looking at a 20% increase that came from another carrier. you might want to give them a call and have a chat. All right. Let's talk about what you're going to do.

00;18;43;09 - 00;18;53;00

Cary Hall

Alright, how are you addressing this market and what are you doing to help employers deal with these issues and the brokers out there that are the ones representing your products?

00;18;53;03 - 00;19;18;00

Barron Roberts

Yeah, absolutely. Gary. So we put a lot of work into the 2026 plan designs for small group. Number one. We went out and surveyed our broker community and asked them, what are employers asking for? We took those notes. We took, feedback from our team, and we developed new plan designs for 2026, to help reduce the overall, premiums on the baseline for employers.

00;19;18;03 - 00;19;22;12

Cary Hall

And you're confident this year's new rollouts, what are they going to look like?

00;19;22;15 - 00;19;42;19

Barron Roberts

You know, we've already had a couple of smaller rollouts, our broker community and our brokers that we've presented in front of our pretty excited about these changes. We've got updates to Blue Select Plus eligibility, more members, will become eligible to enroll in Blue Select Plus, Blue Select Plus has Spira Care. We have brand new plan options.

00;19;42;22 - 00;19;53;13

Barron Roberts

Some of them have higher deductibles, new plan designs. Some of them have no deductible on medical, whatsoever with fixed co-pays. So that's going to open up a lot of opportunity there.

00;19;53;14 - 00;19;54;24

Cary Hall

Run that by me one more time.

00;19;54;25 - 00;20;04;16

Barron Roberts

No deductible on medical. And so we’ll have just co-pays on primary care office visits, specialist visits. And some of those plans have just co-pays on inpatient as well.

00;20;04;21 - 00;20;14;19

Cary Hall

That's going to be remarkable. Yeah. That's going to be that going to be a game changer for people. Let's go back to Blue Select Plus you talked about some things. So what are some of the things going to happen there.

00;20;14;23 - 00;20;21;29

Barron Roberts

Yeah. So for Blue Select Plus, for many years now we've been getting questions and really requests to expand our Blue Select Plus eligibility.

00;20;21;29 - 00;20;22;09

Cary Hall

Right.

00;20;22;15 - 00;20;38;00

Barron Roberts

So you know members that live in Miami County or right outside Johnson County, right outside Wyandotte County, we have employer groups that are within those counties today that have members that live just across the county.

00;20;38;00 - 00;20;38;10

Barron Roberts

Line,

00;20;38;11 - 00;20;39;10

Cary Hall

right.

00;20;39;13 - 00;20;44;01

Barron Roberts

That have not previously been eligible for Blue Select Plus or Blue Select Plus with Spira Care.

00;20;44;05 - 00;20;44;20

Cary Hall

Right.

00;20;44;23 - 00;21;09;19

Barron Roberts

And so starting in 2026, we're actually opening up some eligibility there and allowing those members to enroll in Blue Select Plus and Spira. Wow. Yeah. So I think they're going to be excited. Those members that live in those counties will have, new plan options. The Spira Care experience if they enroll in the Spira Care plan. And those employers may be a little bit more open to offering, that plan option as well.

00;21;09;26 - 00;21;27;23

Cary Hall

Yeah. And the beauty of that is we talked about Spira Care in the last segment. We’ll touch on it again a little bit because the beauty of that is that the employer can say here we're going to go to a higher deductible, but all of your primary care, behavioral health, X-rays, labs, all that is going to be handled by Spira Care.

00;21;27;25 - 00;21;45;00

Cary Hall

All right. And if you need to be referred out, they'll take care of doing that. So you're taking away the biggest obstacle to care that people have. That is I can't afford a $50 copay, okay. Or a $75 copay to go to a specialist. Okay. But I can go to Spira Care and I don't have to pay anything.

00;21;45;03 - 00;22;01;26

Cary Hall

So now you're marrying that to this plan, which keeps affordability in line and also says to the employee, my employer really does care because they put this plan in place so that I can go to Spira Care, not just the employee, but the employees family as well up there on the plan, right?

00;22;01;26 - 00;22;13;00

Barron Roberts

Right. and when you think about total cost of care savings, if you got a family of four of going to the provider every year on top of reduced premium, you're going to save a significant amount of money.

00;22;13;02 - 00;22;36;15

Cary Hall

Yeah. And you know, I've got six grandchildren. And I can assure you that my two daughters with those six children, there is not a week goes by that there is not a visit at the urgent care, the E.R. or some specialist doctor that they've got to go to because there's a new issue we've got to deal with. Okay. So for families, to me, this just seems to make an awful lot of sense.

00;22;36;18 - 00;22;46;24

Barron Roberts

Yep. And those care centers also offer, services that support pediatric care as well. So if there's younger children there, they can help them as well.

00;22;46;26 - 00;22;49;26

Cary Hall

Yeah. So we've got nine locations around the metro. Where are.

00;22;49;26 - 00;23;00;17

Barron Roberts

They? Yeah, absolutely. Cary. So, Tiffany, Liberty, Legends, Shawnee, Olathe, Overland Park, Independence, Lee's Summit and Crossroads.

00;23;00;19 - 00;23;02;11

Cary Hall

Well, you've got one almost everywhere in the city.

00;23;02;14 - 00;23;03;12

Barron Roberts

All over the city.

00;23;03;15 - 00;23;14;22

Cary Hall

Nine locations for Spira Care. Anywhere in the city you have access to Spira Care. So in other words, there's some places close to you. Yeah. Okay. You're not going to have to drive 45 minutes to an hour to get to a facility.

00;23;14;25 - 00;23;30;27

Barron Roberts

Right. And the whole the whole concept of putting the Spira Care’s all around the Kansas City community, if you look there, really circled all within the 435 interstate. So any member within the Kansas City community should be able to get to a Spira Care within 10 to 15 minutes.

00;23;30;29 - 00;23;51;20

Cary Hall

And this is the solution. That as an employer, you really need to take a look at. If you want to keep your employees happy, give them a benefit that’s going to mean something to them and, give them access to the kind of care they need. This is an opportunity to do that. Talk a little bit before we go to break about level funded, fully insured in the ACA.

00;23;51;20 - 00;24;19;13

Barron Roberts

Our Level Funded, option for 5 to 99 size employers, 5 to 9 enrolled employees. That option is available for the small groups. A lot of groups are finding those options to be you know, a great product, an affordable product. It is a very attractive and growing market in that space. For ACA, that's 2 to 50. 2 to 50 enrolled employees.

00;24;19;16 - 00;24;24;26

Barron Roberts

And then for fully insured, underwritten, it's 51 to 99 enrolled employees.

00;24;24;26 - 00;24;41;21

Cary Hall

So explain that because that that. I'm an employer now I've got 75 employees. So if I want to move to it and I and my workforce is trending below 45. So now I know that you know that if they're trending below 45, they're going to be a healthier bunch, right?

00;24;41;24 - 00;24;42;11

Barron Roberts

They ought to be.

00;24;42;11 - 00;25;10;17

Cary Hall

We'll make an assumption that they're reasonably healthy. Okay. So having said that, when they go to that model, they're going to be judged on that group as a group, not being judged on this giant pool of people over here with ACA, a lot of sick people and other people on it. It gives them an opportunity if they've got a pretty healthy group or group that doesn't have a lot of major issues where they can actually put a program together, that really is kind of tailored to what they need, correct?

00;25;10;17 - 00;25;18;07

Barron Roberts

Yep. And in addition to all the planned changes, the new plans we have coming out, we've also opened up our underwriting guidelines Cary.

00;25;18;10 - 00;25;19;01

Cary Hall

Oh really?

00;25;19;01 - 00;25;19;24

Barron Roberts

In addition to.

00;25;19;24 - 00;25;21;04

Cary Hall

That. Well, that's a big deal.

00;25;21;04 - 00;25;22;09

Barron Roberts

It is a huge deal.

00;25;22;15 - 00;25;28;01

Cary Hall

Yeah okay. So explain what that means because I'm sure the audience out there what does that mean. They opened up their underwriting.

00;25;28;01 - 00;25;53;09

Barron Roberts

Yeah. So, we're making it easier for employer groups to apply for coverage. Those that have at least ten or more enrolled employees on the plan. And so what I mean by that is we need a we need a group census with at least ten or more enrolled on the plan. We need that group app. And we need a couple of other pieces of information and we can turn around and quote that group on, level funded or fully insured?

00;25;53;12 - 00;25;54;17

Barron Roberts

51 and 99.

00;25;54;20 - 00;26;20;16

Cary Hall

You know, that's pretty amazing. You've got a suite of products here. Yeah. I'm kind of talking to the broker audience now a little bit. You've got a suite of products here that are addressing concerns in the marketplace, and I'm not seeing this anywhere else. I'm not seeing it from the other carriers out there. I'm seeing carriers pull out of the marketplace, and I'm seeing articles in the Wall Street Journal, other places talking about how difficult it's going to be for them to continue this year.

00;26;20;19 - 00;26;42;11

Cary Hall

But you're seeing something completely different here by the hometown carrier. And if you're the broker out there, you really need to engage in this. If you haven't gotten to one of their seminars, the webinars to learn about these products, you need to because you're going to be getting calls from your clients, who are going to hear this show and the commercials run during the week where we talk about these kind of things.

00;26;42;11 - 00;26;58;26

Cary Hall

They're going to ask you, why haven’t you been telling me about that new Blue Cross plan? Okay. Because they're going to be a host of new Blue Cross plans. They're going to address, what's going to happen in this marketplace. And I'll repeat what I said earlier. We're going to see a tsunami in changes this year on the ACA.

00;26;58;26 - 00;27;23;10

Cary Hall

Small group side across the board. Impacted by all the changes that are happening. And it's important for you to get ahead of that. 833-467-2145 if you're an employer, okay? And you just want to have a conversation, they're happy to do it. 833-467-2145 or the website bluekc.com, bluekc.com. We'll be right back after the break to wrap it up, stay tuned.

00;27;23;10 - 00;27;37;24

Cary Hall

You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across the USA. Don't go anywhere.

00;27;37;27 - 00;28;02;27

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. You know, I do these shows to get information out to all of you about what's going to happen in the marketplace. I got I have BlueKC up here today to tell us what they're doing to address the concerns that people are going to have as we get closer to renewal on the individual side and on the employer sponsored health care side.

00;28;02;29 - 00;28;31;23

Cary Hall

They've got answers. They've been here for 83 years, okay? They've got answers. They're the hometown carrier. They're the only carrier in this market that's actually reducing premiums on the individual side. So again, if you're a broker or if you're an employer or an individual and you want information 833-467-2145 is the phone number. They're happy to talk to you and get you set up for what's going to come down the pike this year 833-467-2145.

00;28;31;23 - 00;28;50;16

Cary Hall

And the website bluekc.com. All right, let's go back to Spira Care a little bit because this is such a unique value proposition. Now, and, you know, it's funny, you don't have to wait 23 days to get in to see a doctor. Yeah. And the visit is probably going to last longer than 7.5 minutes. Right. I know the average visit

00;28;50;18 - 00;28;59;27

Cary Hall

with Spira Care is about 30 minutes. Okay. But it's it's a very different care model. So talk a little bit about that and why that is really something both employers individuals should consider.

00;28;59;27 - 00;29;23;19

Barron Roberts

So you know starting off with just the Spira Care story, we rolled it out in 2018. Over time, we've added more care centers across the Kansas City community. We're up to nine so far. With that, the idea was to ensure that every member within Kansas City could have access to Spira Care easily and relatively close. So each member can get to a Spira Care center

00;29;23;24 - 00;29;28;01

Barron Roberts

within 10 to 15 minutes at least, that was the design that we had in mind.

00;29;28;03 - 00;29;28;25

Cary Hall

And it worked.

00;29;28;28 - 00;29;54;11

Barron Roberts

Yeah, yeah. Members are you know, reporting a great experience there. We grade ourselves on the customer effort score of our members not only the Blue Cross members, but also our Spira Care members. And for the those Spira Care members, the customer effort score is 96%. And just to put it in perspective, you know, gold plans, industry best is right around 72%.

00;29;54;11 - 00;29;56;22

Cary Hall

So holy cow. Are you serious?

00;29;56;22 - 00;30;00;18

Barron Roberts

We're getting great. Great feedback from members on the experience that they have

00;30;00;18 - 00;30;07;27

Cary Hall

at Spira Care. And have you got the capacity to handle what's going to be coming down the pike? Because I got a funny feeling, pal. Your phones are going to be ringing.

00;30;07;27 - 00;30;24;13

Barron Roberts

Yeah, yeah. We do. Each of our care centers have capacity to continue to grow and grow membership. Some of the newer ones have even additional capacity to have additional rooms in there that they can add on. So, we're pretty confident our, the growth opportunities we have ahead for 2026.

00;30;24;18 - 00;30;46;07

Cary Hall

So there is one component about Spira Care that I always thought was unique because nobody else does this. I mean, there are there are other models out there for direct primary care. But your behavioral health, I mean, this is a big deal to Erin it's a big deal to Jenny, you know, Christina Lively, all the C-suite people at Blue Cross. Talk a little bit about that and the fact that, you know, it's right there in the center.

00;30;46;07 - 00;31;07;01

Cary Hall

You don't get referred out to go see somebody outside. You can start right there in behavioral health. And to me, this is important, especially for people with kids these days that are dealing with issues, whether it's, you know, cyber bullying or what's going on at school or just some of the talk a little bit about that whole behavioral health piece and how that fits.

00;31;07;01 - 00;31;10;04

Cary Hall

Because I think that separates Spira Care from everything else out there.

00;31;10;08 - 00;31;35;21

Barron Roberts

Yeah, yeah. So, as you mentioned, it's very important at BlueKC you know, our leadership team, all of our all of our team members, to provide access to behavioral health services, not only at Spira Care, but also through all of our apps and all of our resources and mindful, we've got a ton of resources available. But at Spira Care, we did integrate behavioral health care, to ensure that members had access to that service.

00;31;35;21 - 00;31;44;08

Barron Roberts

And there is screenings that occur within the Spira Care centers to help understand if members need that type of care and we help get them there.

00;31;44;10 - 00;32;01;22

Cary Hall

Yeah. And, you know, for the mother, you know, that’s got 2 or 3 children and she's got one that's having a problem. She doesn't have to worry about going someplace else. She can go to Spira Care and that child can be privately counseled, whatever they need to do. And the whole thing works like it's supposed to.

00;32;01;24 - 00;32;05;06

Barron Roberts

Yeah. So, in addition to that, there's no cost at Spira Care.

00;32;05;10 - 00;32;20;23

Cary Hall

Well, that's that's a big piece, right? Yeah, yeah, it's the, you know, all the co-pays are gone. So, you know, that's critical to talk about some of the other services that Spira Care offers. You I know labs and X-rays are available in certain facilities. How are you handling prescription drugs. The rest of it.

00;32;20;26 - 00;32;46;18

Barron Roberts

Yeah. So, each of our Spira Care plans have, prescription drug, model plans that enable, low cost for prescriptions. So tier one and tier two are co-pays, and then tier three, typically have a level of coinsurance. But, the Spira Care centers will refer out those prescription drug needs to, local pharmacies that are in network so members can get access to those prescriptions.

00;32;46;21 - 00;32;53;17

Cary Hall

So that's all part of the plan. They don't have to go deal with another plan or some other issue. That's all going to be handled through the Spira Care facility.

00;32;53;17 - 00;32;55;00

Barron Roberts

It's all built in. Okay.

00;32;55;04 - 00;33;01;15

Cary Hall

That that that's pretty significant in terms of how that works. Are you doing anything with urgent care after hours visits?

00;33;01;18 - 00;33;07;23

Barron Roberts

Yeah. So some of the care centers have not only they have after hours visits, but some of them are open on the weekends as well in case.

00;33;07;26 - 00;33;10;13

Cary Hall

That's new because that. Yeah. Okay. That's that's. Yeah.

00;33;10;13 - 00;33;24;26

Barron Roberts

So it's, you know, you have to call and make sure, you find out which care center is open on the weekends because they are rotating. So we always advise members to call and schedule appointments. You know, if they, if they need to get in at that point in time that they can do that.

00;33;24;28 - 00;33;30;13

Cary Hall

And can they make appointment just a regular appointment. They go online and make that appointment a line.

00;33;30;19 - 00;33;43;13

Barron Roberts

Definitely. So what we always recommend is that for that very first appointment, the consultation appointment to go ahead and make that call, once you're in the system, then you can make all of your regularly scheduled appointments on online.

00;33;43;16 - 00;33;59;23

Cary Hall

So you go and you have that initial visit usually takes about 45 minutes to an hour. Where they actually sit down right and listen to what it's not 7.5 minutes, right? Okay. It's a real opportunity to sit down and talk to the provider and let them hear about your health history and what you do.

00;33;59;26 - 00;34;13;06

Barron Roberts

Yeah. And the Spira Care experience is a lot different than a traditional, experience or the PCP office. They have consultative rooms with comfortable seating in there. With a table. You can you can talk eye to eye with the provider that's there.

00;34;13;07 - 00;34;25;16

Cary Hall

I mean, you're not doing this. Yeah. The doctor's over here on the computer and you're here. The doctor's over here filling in the computer screen. Oh, you're 7.5 minutes is up next, right? Yeah, it's a little different.

00;34;25;21 - 00;34;29;00

Barron Roberts

Most of the time. You spend less than 7.5 minutes sitting in the waiting room.

00;34;29;00 - 00;34;29;24

Cary Hall

Yeah, I know.

00;34;29;26 - 00;34;39;06

Barron Roberts

You take it back. So, the design, the features, the view, the experience is, wonderfully different.

00;34;39;07 - 00;34;55;01

Cary Hall

It is. Thank you for doing this today. Yeah. We're going to get you back. Okay. When the brand new group plans are released. So we can tell the audience what's going on there. Yeah. So if you're a broker, if you're an individual, if you're an employer, there are changes coming, and these folks can help you through that.

00;34;55;01 - 00;35;20;26

Cary Hall

They've got a product that can fit your budget and fit your needs. I don't care what it is. And you marry this up with the Spira Care model and you've got a value proposition. It's hard to beat if you want information, if you want help. 877-467-2145. 877-467-2145. You know, I've been a, my wife and I've been Blue Cross and Blue Shield members for, I think, the last 35 years.

00;35;21;04 - 00;35;40;11

Cary Hall

It's been a long time. Okay. Local customer service. They're good people and they do what they do really well. So thanks again for coming up here again today. And now I leave you with this thought from Doctor Martin Luther King. Americans must learn to live together as brothers and sisters, or we will surely perish together as fools. Truer words are never spoken.

00;35;40;13 - 00;35;49;17

Cary Hall

Thank you for listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network. Coast to coast across the USA. Goodbye, America.

Employers are offering New, Accurate & Pain-Free Breast Exams: Our Dr Explains: BEXA

Sat, 06 Sep 2025 16:32:25 GMT

Episode 2124 notes

Today we learn about Bexa: A Revolutionary Early Detection Option that Dr. Monique Gary tells me is closing the gap and delivering peace of mind. Dr Gary says women have been in need of another early detection option and reminds us that to many women delay routine exams or avoid them all together. But unlike the common experience, Bexa is accurate and pain free and companies should include this benefit to their employees.

This is a "Must Hear" episode.

Please listen and share, because breast cancer is the most common cancer among women—yet over 60% of those eligible aren’t getting mammograms. And for women who are under 40, pregnant, or avoiding mammograms, no real alternative has existed until now with this Doctor-led and developed Bexa Solution.

Also joining us is Elizabeth Vire, Bexa Chief Revenue Officer, who works with HR directors to bring this option to their workers.

Learn how you could do it as a broker, as a TPA, or a human resource director.: 1-888-469-2392

or visit https://www.mybexa.com/

This is Ep: 2124 of America's Healthcare Advocate.

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Episode 2124 Transcript:

00;00;01;14 - 00;00;05;28

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;06;00 - 00;00;24;26

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate. Show broadcasting coast to coast across USA. Here on the HIA Radio Network, you can learn more about us by going to the website AmericasHealthcareAdvocate.com. AmericasHealthcareAdvocate.com. Send me an email if you’ve got a question or comment I'll be happy to respond to.

00;00;24;27 - 00;00;44;08

Cary Hall

Oh, and by the way, thank you all of you who liked the shirt. Okay, the psycho bunny shirt. So I'm wearing it again. Just want to let everybody know that I listened to what you said. Additionally, if you want to follow the show or tell somebody about the show, we have the YouTube channel America's Healthcare Advocate, 16 podcast channels, including Rumble, which we just added.

00;00;44;08 - 00;01;02;17

Cary Hall

So the show is out there. We've got about a half a million views on YouTube, and I don't know what Dave, where we're at on the podcast? That's a couple hundred thousand, I think. So it continues to grow. This show today is probably one you might want to go up and listen to. I think you're going to find it pretty interesting in studio with me today, Doctor Monique Gary.

00;01;02;18 - 00;01;20;08

Cary Hall

She is the chief medical officer of Bexa and Elizabeth Vire. She is the chief revenue officer of Bexa. Welcome to both of you. Thank you. Flying in here from Philadelphia to be with us today. I really appreciate that. And you canceled a trip to get back here and try to be on the show. So thank you both for doing this.

00;01;20;10 - 00;01;43;22

Cary Hall

So this is a show that we've talked about. I've talked with Elizabeth about for some time when I met her and we talked about this program, what they do, the technology. I was floored by what it is. You know, we try very hard on this broadcast to bring you things that are leading edge medical technology, leading edge, cures that are being explored, things that are being done.

00;01;43;22 - 00;02;08;22

Cary Hall

They're sometimes out of the box, like the WAVi brain scan, like the Neuro20. Well, this device is very much like that. It's all about breast cancer. And it's all about why this device can do a better job than the conventional way we're treating breast cancer, and the conventional way we're looking to find out whether women have the beginnings of breast cancer, late stage breast cancer, whatever it is, we're going to explore all that today.

00;02;08;29 - 00;02;26;17

Cary Hall

You're going to learn a lot. So, you know, obviously this show is, directed toward women who have issues or may have an issue or have concerns. But if you're the husband, you're the father. You know, whatever the case may be, you've got a woman in your family who may be at risk. You want to listen to this show.

00;02;26;17 - 00;02;41;15

Cary Hall

So let's just start, Elizabeth. So let's talk about Bexa. It's an international company. You're here in the United States, you're in Columbia, South America, Saudi Arabia, Indonesia. That's pretty significant. Let's talk about what Bexa is and how it works.

00;02;41;15 - 00;02;57;01

Elizabeth Vire

Absolutely. Well, I always like to first start off with what Bexa is not. Just to make sure we're very clear from the very beginning. So Bexa is not a competitor to mammography. For those women above the age of 40 who are currently getting their annual breast screening, it's amazing. Keep doing what you're doing. Bexa is also not a mammogram solution.

00;02;57;01 - 00;03;19;21

Elizabeth Vire

So Bexa is an alternative to mammography. We are here to help close the annual screening gap in two ways. One, for those above the age of 40 who are not getting their annual breast screenings today due to pain, radiation inconvenience, delayed results, and dense breast tissue. And then two for those who do not currently meet the age guidelines of mammography unless they have some type of family history in most cases.

00;03;19;24 - 00;03;41;00

Elizabeth Vire

So Bexa is a painless, radiation free breast exam. We have our examiners who are certified breast sonographer come on site to an employer's location or to an on site clinic to provide those exams that last no longer than 30 minutes. So very in and out again, convenient and we have accurate and immediate results. We're also density fiber cystic and breast implant independent.

00;03;41;03 - 00;03;58;02

Elizabeth Vire

And we service our men and women above the age of 18. And again, you can be pregnant, breastfeeding because we are radiation free. So we really try to close that gap again of annual breast screenings. But then we remove all the barriers as to why women do not receive their annual breast screenings or can't today.

00;03;58;04 - 00;04;15;06

Cary Hall

So doctor, how did this come to be? Hey, I mean, we spent 2.5 hours last night over dinner. We had a wonderful time and I learned an enormous amount. And I've done a lot of research, a lot of work to get these shows ready. So what was the who was the brainchild behind all of this to bring all this together?

00;04;15;09 - 00;04;18;24

Cary Hall

And because it's completely different than what we're doing now.

00;04;19;00 - 00;04;39;07

Monique Gary

Oh, it's it's completely out of the box, but it's not entirely new. So the concept, the way Bexa works is a process called elastography. So it's looking at the stiffness of the breast tissue. An easy way to think about that. It's like a sponge, right? If your fingers are gliding along the sponge. It’s spongy, it‘s spongy, it’s spongy. If it hits an olive pit, all of a sudden there's something stiffer in the tissues.

00;04;39;09 - 00;05;03;13

Monique Gary

So that concept has been around since the 80s, really 1986, where we used to use that for finding cancers in the liver. Now where it gets really interesting. And this is the storytelling part of this conversation, where we're telling stories a little early, is that it was developed and innovated by a gentleman from the Harvard Robotics Laboratory named Jaeyong, whose mother had some breast issues, and she was very reluctant to get her mammogram.

00;05;03;16 - 00;05;18;07

Monique Gary

And he was working on the robotic haptics, like the fingers, you know, how hard you press on the phone and what happens as a result of that. And so why can't I take this type of technology and put it into something that's not radiation or something handheld to find masses in the breast, like that's what we should be doing.

00;05;18;10 - 00;05;34;13

Monique Gary

And that's how Bexa was born. It was initially called SureTouch. And so back in the late 90s, early 2000s. If you look up some things, you'll see a little bit on on SureTouch. But the email address when you get an email from SureTouch with SureTouch dot me.SureTouch.me. Well okay.

00;05;34;14 - 00;05;36;25

Cary Hall

Hold on a minute. There could be a problem with that.

00;05;36;26 - 00;05;51;16

Monique Gary

Our our CEO is he evaluated this technology cause we didn't invent it, right? We acquired it. And as he looked to acquire it, he said, well, that's gotta go. So what should we call it? And he began to do tremendous amounts of market research with women. And they said, we need a better breast exam.

00;05;51;19 - 00;05;53;07

Cary Hall

Better breast exam.

00;05;53;07 - 00;05;55;02

Monique Gary

Hence ‘Bexa’ was born.

00;05;55;04 - 00;05;56;11

Cary Hall

And that's how it all came to be.

00;05;56;11 - 00;05;56;28

Monique Gary

Indeed.

00;05;57;01 - 00;06;17;27

Cary Hall

So you know, Elizabeth said a couple things that are interesting. Age guidelines. So one of the things that I thought was interesting, when we looked at statistics was the number of women not getting exams. How much of that falls to women that are below the age where they qualify to go in for the mammogram? And older women I had this conversation with my wife.

00;06;17;27 - 00;06;34;23

Cary Hall

I was talking about all of this was doing show prep over the last 3 or 4 days. She said, gosh, I haven't had a breast exam. I don't even remember when. She's 76. So let's talk about that. Why is that piece important? Why is it being overlooked? There's a huge gap there. Let's talk about that doctor.

00;06;34;23 - 00;06;38;08

Monique Gary

Oh, boy. So you've opened the can of worms here, right? With the preventive test.

00;06;38;08 - 00;06;43;07

Cary Hall

I'm good at that. But you are. Not good at getting them back into the can, but I’m really good at opening it.

00;06;43;14 - 00;07;00;21

Monique Gary

This this one's not going back in the can. So, you know, there are clinical guidelines, meaning what doctors think women should do to check every year to make sure they're okay and that they don't have breast cancer. And then there are other guidelines. There are guidelines developed by folks who maybe don't do anything in the breast cancer space who are not oncologists.

00;07;00;21 - 00;07;21;05

Monique Gary

They're not breast surgeons like myself. And that's where the preventive task force sort of falls in. So the task force gives us some recommendations on when women, at average risk should start screening. And every society, every major medical society does the same thing. And they say women who have average risk, no family history. Right. They, don't have any radiation exposures, any of the other things.

00;07;21;05 - 00;07;30;24

Monique Gary

No mutations in the genes... start at 40. And we say go every year until you are... until your life expectancy is less than ten years. Right? Now.

00;07;30;27 - 00;07;39;20

Cary Hall

Well, okay. So how the hell do you know when your life expectancy is less than ten years? That's the part where I'm like, whoa.

00;07;39;21 - 00;07;41;17

Monique Gary

So that's not the I'm.

00;07;41;20 - 00;07;48;15

Cary Hall

76 years old. I thoroughly believe she's going to make it well past 86. Why, I'm lost.

00;07;48;18 - 00;08;05;00

Monique Gary

We'll get this. You're not the only one. So we're all the doctors because the task force says stop at 74. Once you hit 74 you don't have to go anymore. So there are women who are 75 who are vibrant, who play golf with pickleball every day. My Nana was 99 and driving. And she's wearing her lipstick. Right. I got a long life ahead of me.

00;08;05;00 - 00;08;15;05

Monique Gary

Why should I stop at 74? So there's a lot of confusion in what we're recommending to women, and it trickles down. The docs are confused, the women are confused, and you know what it means. Things are getting missed.

00;08;15;08 - 00;08;35;04

Cary Hall

Yeah, things are getting mixed and things are being missed. Okay. And that's one of the reasons why we're doing this show today is we're going to talk about those gaps. What needs to be done. Why is this technology different? Why do women prefer this technology when they are exposed to it versus getting the mammogram? Is it easier? Is it more convenient?

00;08;35;04 - 00;08;49;19

Cary Hall

What does that mean. And we'll talk about some other things. But when we come back from the break we're going to talk about what we call the Bexa solution. So we'll come back to the break. We'll talk about the Bexa solution, and we'll start getting into the weeds on how all of this works and what you can expect.

00;08;49;22 - 00;09;15;29

Cary Hall

If you want to connect with these folks and learn more about their product and their services. So the website is mybexa.com, mybexa.com. You want to call them, you can actually do that. 1 888 469 2392, 1 888 469 2392. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate. Broadcasting coast to coast across the USA.

00;09;16;00 - 00;09;28;20

Cary Hall

Don't go anywhere. The doctors in the house. We'll be right back.

00;09;28;23 - 00;09;51;01

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. I want to say hello to our newest affiliate, WZGM, AM and FM 96.1, Asheville, North Carolina. I want to thank Brian Siebold there. He is the program director for putting us on the air. Very happy to be in Asheville, North Carolina.

00;09;51;07 - 00;10;11;16

Cary Hall

Hope you all are doing well down there and recovering from that horrible flood and all the difficult times you had. But, welcome to the family. We're glad to have you on board in studio with me, doctor Monique. Gary, she is the chief medical officer for Bexa and Elizabeth Vire. She's the chief revenue officer. Doctor Gary completed her medical degree at Philadelphia College of Osteopathic Medicine.

00;10;11;18 - 00;10;39;04

Cary Hall

Her general surgery training at UMass, followed by breast surgical oncology fellowship at Georgetown University Hospital. She holds multiple faculty appointments. Associate Professor of Surgery, PCOM Temple, University. Associate Professor of Health Equity within Dartmouth University, and a fellow of the American College of Surgeons, Society of Surgical Oncology, and a master's degree in Molecular biology. Probably knows a little bit about the topic.

00;10;39;05 - 00;10;59;12

Cary Hall

Right. Elizabeth Vire is the chief revenue officer. She has 15 years experience with revenue growth, leading high performance sales teams, optimizing and market strategies. And what Elizabeth brings to the table here. And we're going to talk about this later on. We're going to do another show. But we're going to talk a lot about what this means. And this is this is Elizabeth’s forte.

00;10;59;18 - 00;11;20;03

Cary Hall

What does this mean to self-insured employers? What does it mean to TPAs? What does it mean to groups that want to reduce their overall cost? That's where Elizabeth's going to really shine in terms of discussing that this is where her expertise is. So two experts in here today very happy to have them. All right. You said something when we went on break.

00;11;20;06 - 00;11;24;12

Cary Hall

Why do we need more solutions? Why do we need them?

00;11;24;14 - 00;11;41;19

Monique Gary

Well, it's not because the current one doesn't work, right. We all know mammograms save lives. Colonoscopies save lives. Yes. Right. PAP smears, all of these things. So in the breast space, mammograms have been around since the 60s. But have the numbers of early detections gone up?

00;11;41;21 - 00;11;42;04

Cary Hall

No,

00;11;42;05 - 00;11;42;29

Monique Gary

to a point.

00;11;43;05 - 00;11;59;00

Monique Gary

And then they dropped back down. And the reason has a lot to do with why women aren't getting this one test that they know saves lives. If 1 in 8 of us would get it, if we would get this, we might find something early. Right. No woman ever said, hey, if you add contrast to that. I'll do that. Right. Give me an IV now.

00;11;59;00 - 00;12;12;27

Monique Gary

Right? Or if you had 3D, sign me up for it. Oh, AI? Now I'm going to stand in line for it. There's something wrong with the process of mammography that's offputting to women. And so when those numbers are stagnant, no matter how many Super Bowl commercials we all sponsor and how many Pink-Outs.

00;12;12;29 - 00;12;14;02

Cary Hall

And they wear the pink shoes.

00;12;14;05 - 00;12;26;08

Monique Gary

Where are the pink shoes? I got my pink shoes on. I love my pink. It's not moving the needle. And so what that means is there's an opportunity for innovation to fill those gaps. Not only that, the cancer yesterday is not the cancer tomorrow.

00;12;26;08 - 00;12;26;29

Cary Hall

But what does that mean?

00;12;27;00 - 00;12;36;10

Monique Gary

Meaning, in my practice, I'm seeing women who are younger and younger schoolteachers in their 30s. I'm seeing folks in their 20s get cancer, and all the statistics are showing 29 and 39.

00;12;36;12 - 00;12;37;26

Cary Hall

And the guideline is 40 and above.

00;12;37;26 - 00;12;39;18

Monique Gary

The guidelines 40 and above.

00;12;39;20 - 00;12;42;26

Cary Hall

So we're missing that whole class of women.

00;12;42;26 - 00;12;50;15

Monique Gary

And so what we say, oh, we'll get through risk scoring and know your family history. 80% of those young women have no family history of breast cancer.

00;12;50;18 - 00;12;53;17

Cary Hall

Wow. So 80% have none.

00;12;53;19 - 00;13;02;28

Monique Gary

Those young women are the one, the 29 to 39 year olds who are getting breast cancer faster than everybody else. No family history. A risk assessment might not have helped them.

00;13;03;00 - 00;13;13;24

Cary Hall

So you just said something. The 29 to 39 years old are getting breast cancer faster than in the. Yeah, what what do we do? Any idea why that's happening?

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

Monique Gary

It's a separate show. But there are things, environmental things. There are things called endocrine disruptors. Right. What's messing with our hormones? What's in our food that we're eating? What's messing with the inflammation in our bodies. Right. Our hair products. Right. Dyes. There's so many things that are contributing that we think are contributing smoking, vaping, alcohol, sedentary lifestyle. Covid really showed us that the health of this nation is very poor.

00;13;36;02 - 00;13;38;29

Cary Hall

Oh, we're we're absolutely the worst. Yeah.

00;13;38;29 - 00;13;55;07

Monique Gary

And so then we see these people and we're like, oh, you're too young for breast cancer. You don't fit the mold. But they do. And so there's two problems. There's the guideline problem right where people are okay, you're 40 and above. But what if you're a black woman like me, right. We're getting breast cancer ten years younger, more aggressive later stage.

00;13;55;10 - 00;14;12;25

Monique Gary

The guidelines say, well, maybe it's not enough evidence to say you should get, you know, additional screening. What about the women with dense breast? 48% of women. Every second person has something called dense breast. And the FDA says you should get supplemental imaging. We should do more stuff to look. It’s like looking at a cloudy sky looking for cloud.

00;14;12;28 - 00;14;29;25

Monique Gary

That's the density, right? Okay. FDA says you should get more imaging U.S. preventive task force those guidelines. And now there's not enough evidence to suggest that. So there's all this confusion. Meanwhile women don't know what to do and they're not getting their imaging every year. And so it's not a problem with the technology. But there is a problem with the process.

00;14;29;28 - 00;14;34;23

Monique Gary

And that's where Bexa comes in as a really smart solution for adoption that works.

00;14;34;25 - 00;14;41;09

Cary Hall

But there's a problem with acceptance. Yeah. Because the women are saying, not so much.

00;14;41;11 - 00;14;41;29

Monique Gary

I don't want that.

00;14;42;03 - 00;15;02;12

Cary Hall

Yeah I don't yeah, I'm busy. I don't have time to mess with that, yada yada yada, yada, yada. So we're missing this whole class where he was switched to the, you know, those of us that are chronologically challenged and where that's at. Okay. And and as a result of that, you're having the numbers are starting to creep up now.

00;15;02;13 - 00;15;15;11

Monique Gary

Yeah. Just think about it. Every year you go and they call you back and say, oh, you got to get another test because you've got dense breast, but it may not be covered by your insurance. So now you got to take another day from work. You got to find something to do with the kids, with the elders, something to do with the dinner that you were going to stop and pick up.

00;15;15;11 - 00;15;30;18

Monique Gary

You got to move your plans and get another test. It could be two weeks, it could be two months. And then they say, oh, you going to come back for a little bit more? Let's check it again in six months. So this process is expensive right. The process of we call that false positive meaning your mama was inconclusive.

00;15;30;18 - 00;15;37;17

Monique Gary

We kind of see something and it might be might not be. That process is so off putting to women that they say, you know what, I'm not doing that again this year.

00;15;37;20 - 00;15;57;18

Cary Hall

And then if I heard you correctly, and this is interesting because I've been in this industry for 30 plus years, it may not be covered by insurance. So there are policies that don't cover these follow ups. So then the woman, well, I can't afford to get a 1700 or 2000 or $3,000 MRI, Cat scan, whatever it's going to be.

00;15;57;20 - 00;15;59;13

Cary Hall

So I'm just not going to do it precisely.

00;15;59;16 - 00;16;18;06

Monique Gary

And have you if you've ever had an MRI, you go on that machine. Once you get that dye that makes your mouth water and you're like, okay, I'm not doing this again. And so all of these reasons are compounding why we're finding cancers at a later stage. So we got to do something different. We cannot continue to do the same things and expect different results.

00;16;18;08 - 00;16;19;24

Cary Hall

Yeah, that's the definition of failure.

00;16;19;25 - 00;16;20;11

Monique Gary

Precisely.

00;16;20;11 - 00;16;39;16

Cary Hall

And we're certainly failing. Yeah. This you know, you said something last night. We've only have about two minutes left. Back to that MRI thing. So I've had multiple MRIs. Had a brain tumor in 85. You know I, I've done this. Well you're on your back going in. How do the women do it when they go in for the breast MRI?

00;16;39;17 - 00;16;50;23

Monique Gary

Oh, so you're on your stomach in this Superman pose. Right face turned to the side, staring at the side of that machine. All that noise, all that whirring. Even if they play a little bit of music. But it's a completely uncomfotable...

00;16;50;23 - 00;16;51;10

Cary Hall

You can't hear any music in that thing.

00;16;51;10 - 00;16;52;29

Cary Hall

Superman, Superman pose.

00;16;52;29 - 00;17;07;12

Monique Gary

Yeah. Now it's better than that. It's better than the smash-a-graham, right? It's better than squeezing it between the two metal plates with 28 pounds of pressure, because that's what a mammogram is. So they're like, well, let's give every woman MRIs, but the MRI find everything and then you need ultrasounds after that and then you need biopsies after that.

00;17;07;15 - 00;17;17;25

Monique Gary

This whole process. And in the process the women aren't informed of what's been seen. They get a message in the portal, hey, we saw something. Call this number. And what are you supposed to do? You have no idea what's wrong with your breasts.

00;17;17;27 - 00;17;38;00

Cary Hall

and what's the anxiety level? My wife suffers from heart failure. The first thing she does when she gets her labs is goes right to the website. She did this yesterday. A couple of things were down. She's like, I hold the phone. You don't start interpreting your own information here. Let's go from there. But the level of anxiety is huge, right?

00;17;38;01 - 00;17;41;11

Monique Gary

You could have a cancer. You may not know what to do for weeks to months.

00;17;41;11 - 00;18;04;18

Cary Hall

And that's the problem. All right. So now you know when we come back from the break we're going to talk about the Bexa solution. Now we've framed the problem. We've talked about what's going on. Now we're going to come back and talk about how do we fix it. All right. If you want to learn more, the website is mybexa.com, mybexa.com, the phone number 1-800-469-2392 1-800-469-2392.

00;18;04;23 - 00;18;19;16

Cary Hall

You want to learn more about this? Go to the website or give them a call. You certainly might want to think about this if you've got a self-funded plan in a large employer group. If you're a TPA, even if you're a broker or human resource director, might want to take a look at it. We'll be right back after the break.

00;18;19;16 - 00;18;38;07

Cary Hall

You're listening to America's Healthcare Advocate broadcasting coast to coast across USA. Stay tuned. We've got more.

00;18;38;10 - 00;18;56;19

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. All the shows are posted on 16 podcast channels and the YouTube channel. So maybe you're that broker. Okay, that's got three clients in the Pareto Contrarian Re or

00;18;56;21 - 00;18;58;02

Cary Hall

the Berkeley Captive.

00;18;58;04 - 00;19;00;20

Cary Hall

400, 200, 300 employees.

00;19;00;22 - 00;19;19;24

Cary Hall

And you know what that bottom line number is going to look like when the reinsurance bill comes next year, because they had three major cancer claims, two of which were breast cancer. You could do a lot to eliminate that if you understood the Bexa model and how it works. So if you're a TPA, this is something you might want to think about.

00;19;19;24 - 00;19;37;05

Cary Hall

If you're a broker, you definitely should be thinking about it. All right. And if you're a human resource director, imagine what this would mean to the women in your company if they were told they could get this exam and do it in 30 minutes, in the convenience of the office. If they wanted to do that. We'll talk about all of that in this segment.

00;19;37;13 - 00;20;04;29

Cary Hall

To learn more about it, go to the website myBexa.com. myBexa.com. Do you want to talk to somebody? Call them ask for Elizabeth. She'll be happy to chat with you. 1-888-469-2392. 1-888-469-2392. Over dinner last night, we talked about a lot of different things, but she told some stories last night. You've probably I think you've done about 4 or 5 conferences here this year so far, if I remember correctly.

00;20;05;01 - 00;20;19;01

Cary Hall

Talk about some of it because we just talked about the inconvenience that having to lay on your belly and do this thing, 28 pounds of pressure. Talk about what you're hearing when you go to these conferences and women come up to you. Elizabeth.

00;20;19;01 - 00;20;38;10

Elizabeth Vire

Absolutely. So there's actually a few different things that I feel like we hear constantly. And it's so sad, really. It's interesting to be on this side of things. I knew breast cancer was a big deal. I just didn't realize how big of a deal it was. And, and yesterday at this conference that I was at, there were at least half a dozen women who were all breast cancer survivors.

00;20;38;18 - 00;20;56;02

Elizabeth Vire

That's a lot of women. Yes. Exactly. But the interesting thing is that you have these women who do have dense breast tissue. And the moment that doctor Monique starts to describe what the actual process or journey could be for a woman with dense breast tissue, you start to see this kind of light bulb go off, right?

00;20;56;02 - 00;21;14;01

Elizabeth Vire

And they're like, wait, there's something different that's out there. There's something different. That's an alternative to what I'm doing today that fits the needs that I have. The other thing is, you have these women who don't meet the age guidelines. And then and I'll tell you, I, I tell this story on a, on a pretty regular basis.

00;21;14;03 - 00;21;30;22

Elizabeth Vire

But there is there's a family member who is 24 and no family history, and she was diagnosed with what they thought was stage one and ultimately ended up being stage four. And that happened about two weeks before I took this job at Bexa. And that to me, like you just you never really quite think.

00;21;30;24 - 00;21;31;11

Cary Hall

00;21;31;11 - 00;21;31;25

Elizabeth Vire

00;21;31;25 - 00;21;32;13

Cary Hall

Years old.

00;21;32;13 - 00;21;50;27

Elizabeth Vire

24. Yeah. Stage four and no family history. So what happens whenever you feel that lump? And to doctor Moe’s point earlier you go in to see your provider and they say you're too young, you're fine, everything's normal. Come back again. Well we all know it's not easy to get into your PCP, right? You've got to wait. Typically, I know I have to wait 3 to 4 months if I were to go see mine.

00;21;50;29 - 00;22;06;21

Elizabeth Vire

And then on top of that, now you've got to have a script to even go in for a mammogram. If you have a concern, you should be able to go in and have that done. The other thing that I just heard a story yesterday. We had an examiner that was on site. She was providing demos and I went and asked this lady how it went.

00;22;06;23 - 00;22;25;21

Elizabeth Vire

And she said, in the past she's had two mammograms. She's 50. Her first one was okay. Her second one was so painful that she literally blacked out and they had ruptured a cyst. And it was because she had smaller breasts, but it was just it was this awful story that I was hearing. And then she said, I will never again get a mammogram.

00;22;25;29 - 00;22;45;17

Elizabeth Vire

And again, we're not anti mammography, but it's just to say there has to be an alternative solution that's out there. I fit one of the 62% of women above the age of 40 who do not have an annual breast screening, and that's kind of alarming based on the position that I'm in. But it's it's 100% true. I don't want the pain, I don't want I don't want any of that uncomfortable like... so it's just.

00;22;45;17 - 00;22;45;26

Elizabeth Vire

Yeah.

00;22;46;02 - 00;22;59;22

Cary Hall

So doctor, show the device. Why - how this is different. What it does. This is it. I mean, this this little machine that you're looking at right here is the whole device. So explain how this works.

00;22;59;23 - 00;23;05;04

Monique Gary

This is it. And you know, the first thing I'll say is this. If you told me 20 years ago that you could poop in a box and mail it.

00;23;05;07 - 00;23;08;01

Cary Hall

Right, well, there you go. Now, that's something I hadn't thought about, folks.

00;23;08;04 - 00;23;21;16

Monique Gary

Right. 20 years ago when I started practicing medicine, that you could do that I would have laughed out of the out of this booth and said, yeah, whatever. Okay. Yeah. And it's the same thing for every new innovation. So when we talk to doctors, they're like, okay, so if this is so good, then how come I didn't learn about it?

00;23;21;16 - 00;23;31;19

Monique Gary

How come I don't know about it? Because innovation is happening and we have to keep up with it. But how this works is my ten fingers, right? As magical as I think they are, I'm a surgeon. I think they do wonders.

00;23;31;20 - 00;23;32;11

Cary Hall

I'm sure you do.

00;23;32;11 - 00;23;48;21

Monique Gary

It right. The effectiveness of these ten fingers to find a cancer, to find a mass in the breast is like 50/50 flip a coin. It's called a clinical breast exam. And so what Bexa has done is that on the bottom of this device, there are not ten fingers, but 192 sensors.

00;23;48;26 - 00;23;49;11

Cary Hall

On that.

00;23;49;11 - 00;24;08;03

Monique Gary

Little this little device, 192 sensors that are arranged like a lattice. And everywhere where those two filaments overlap, it sends a signal up. And so as it glides along the breast, right. This is the clinical breast exam. As it glides along the surface of the breast, it looks for changes in the stiffness of the tissue below where it's gliding.

00;24;08;05 - 00;24;27;00

Monique Gary

Right. So think about it like fingers on a piano key or like, like hands gliding along something. And you're feeling for the changes in the stiffness. And where there's a cancer, the breast tissue is going to be stiffer. So it's looking for changes in that elasticity. It's stretchy. It's stretchy. It’s stretchy. Hmm. Something's pushing back on the sensor.

00;24;27;02 - 00;24;43;09

Monique Gary

And it can detect down to five millimeters. And that matters at six millimeters. Right a cancer that's aggressive triple negative the Her2 positive. They need aggressive chemotherapy that cost all of a sudden you talk about claims cost. The cost for some of those drugs through the roof.

00;24;43;14 - 00;24;58;15

Cary Hall

Well yeah. But what the other problem is you're talking about early detection using the standard methods where they're not even going in until they're 40. We're back to the 24 year old with stage four cancer and no history in her family. This changes that.

00;24;58;15 - 00;25;23;14

Monique Gary

This changes everything. But what this does what it does not do is it doesn't tell you if it's a cancer. It glides along. It finds the mass. Ultrasound defines the mass. So this is a handheld ultrasound right. And so you get two modalities in one. And this is important I'm going to come back to this because the cost in the time from a woman having a lump to getting a diagnosis can be weeks to months.

00;25;23;16 - 00;25;46;01

Monique Gary

I have a friend. She's a physician in Maryland. She's a primary care. It took her six months to get a diagnosis of DCIS stage zero. By the time she actually got the surgery, it was stage two, right? And so when you find a lump and you find it small and we got to talk about this, the reason we search for the lump is because the most common presentation of a cancer that's going to spread the way it starts is a lump.

00;25;46;03 - 00;26;02;22

Monique Gary

It starts as a mass 97% of cancers that go anywhere and that become stage four start like this as a lump. And so if you're going to save lives. If early detection is going to save life. Find the lump, find it fast, find it cheap. Tell her what it is and then tell her what to do about it.

00;26;02;24 - 00;26;08;01

Monique Gary

And do it in a sensitive and humane and compassionate way, person to person. That's the difference.

00;26;08;08 - 00;26;28;12

Cary Hall

They're not. They're not waiting 30 days to get through. So this is so you're the let's just say the employer sets this up in-house, decides we're going to start doing this. We've had four cancer claims. You got 300 women here in our company or whatever the case may be. We had four major claims last year. Of those four, three were not detected when they should have been.

00;26;28;12 - 00;26;33;18

Cary Hall

Two were below the age of 40. We're going to bring this in. How long to do that exam?

00;26;33;22 - 00;26;50;19

Monique Gary

This exam with the encounter with our examiners that we trained. Talk to the woman, ask her what she feels, go over the breast exam with her. You get the device. Any masses that are found, you get the secondary study 20 to 30 minutes, 20 minutes. 20 minutes you're putting your clothes on. 30 minutes you’re signing the survey.

00;26;50;19 - 00;26;51;27

Monique Gary

You're walking back to your desk.

00;26;52;00 - 00;26;53;05

Cary Hall

And they have the results.

00;26;53;05 - 00;27;13;19

Monique Gary

And they have the results. Now if a mass is found, it gets sent immediately to a fellowship trained breast radiologist. And you know, they're kind of like unicorns in this country right now. Finding a doctor, a radiologist who just does breast imaging they are in very high demand. But we have them and they will read that ultrasound. They'll look at the picture, the measurements, they'll get all the features that our ultra sonographer will send.

00;27;13;26 - 00;27;35;14

Monique Gary

And they'll say, you know what this looks like. You should check it again in six months. This this looks like a cyst. This looks like nothing. This looks like you need a biopsy. And so how many women are being referred for that? That's called the referral rate. Right. So when you compare how many women after a mammogram need more pictures, 13 to 21%. Bexa? 2 to 5% of women are going to need something after the Bexa exam.

00;27;35;20 - 00;27;53;01

Monique Gary

Because we find the mass, we tell you how suspicious it is and then those 2 to 5%, because that number is so small, they get a call from me or a member, my clinical team that says, hey, you had a breast exam with us. We saw something. Who's your PCP? Who's your gynecologist? Let's get you in to get some more imaging.

00;27;53;03 - 00;28;17;08

Cary Hall

And now let's go back to the insurance hurdle. You have the actual diagnostic information from the radiologist who knows how to read breast exams. So now the pre cert to get the rest of the testing done is a walk in the park because it's medically necessary. The magic two words. It's medically necessary because you just showed them. There it is.

00;28;17;11 - 00;28;21;24

Cary Hall

Here's the pictures. Here's the analysis. Yep it's all done. Get them in.

00;28;21;27 - 00;28;22;19

Monique Gary

Exactly.

00;28;22;22 - 00;28;23;18

Cary Hall

It's remarkable.

00;28;23;18 - 00;28;37;10

Monique Gary

And if they have problems, they call us and we find somebody in that market. Every new market we enter, I find doctors who are on standby waiting to receive these women. If they've got a breast issue, they know if I'm calling, they're going to see these women, they're going to get them in.

00;28;37;12 - 00;28;59;05

Cary Hall

It's remarkable. It can make a huge difference. You know, once again, I do these kinds of shows for a reason. This is technology that is not... most folks don't know anything about this. I certainly didn't before I met Elizabeth. It's remarkable what they're doing. They can change the way we're treating breast cancer in this country in terms of getting it done earlier, smarter and better.

00;28;59;08 - 00;29;21;13

Cary Hall

You want to learn more? mybexa.com is the website, mybexa.com. Phone number 1-888-469-2392. 1-888-469-2392. We'll be right back after the break. The doctors still in the house. Stay tuned. We've got more.

00;29;21;15 - 00;29;43;05

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate Show, broadcasting coast to coast across USA. You know, you've got women in your family, or your a guy listening to this, this is audience tilts a little bit toward men. And our women in audience capacity climbing every day. But nonetheless, I'm talking to you guys out there. You got a wife?

00;29;43;11 - 00;30;05;05

Cary Hall

She's under the age of 40. She's never done this. You need to talk to her, okay? You don't want to be the one with the 24 year old wife that's got stage four breast cancer. Because she didn't detect it wasn't detected early. Let her listen to this podcast. Let her listen to the broadcast, go up on the YouTube and tell them that it's there because it can make a big difference for them. The website is mybexa.com.

00;30;05;05 - 00;30;23;29

Cary Hall

It's a great website. Videos are up there. I spent a lot of time on it. Easy to understand. They've got a lot of initiatives up there. You'll want to take a look at mybexa.com. You want to call them? Learn about this. Learn how you can incorporate it into your company's health plan. Learn how you could do it as a broker, as a TPA, or a human resource director.

00;30;24;02 - 00;30;47;02

Cary Hall

1-888-469-2392. 1-888-469-2392. It's a great program, can make a big difference and can make a huge difference in terms of claims cost as you move forward. All right. So let's talk a little bit about this. Net Promoter Score I saw this I'm like okay what is the Net promoter score? So explain that Elizabeth and talk about what it is.

00;30;47;03 - 00;30;47;16

Monique Gary

Absolutely.

00;30;47;16 - 00;31;10;04

Elizabeth Vire

So it's important that we have a 98 NPS score okay. 98%. That's incredibly important, especially in the industry that we serve today. Because if we look at this with I mean, you're talking about carriers, or other vendor solutions that have, you know, teens or even like in the 30%. Right? So to have a 98 means that if we were to come back on site, people would opt in to doing a Bexa breast exam again.

00;31;10;11 - 00;31;27;08

Elizabeth Vire

So they truly love us. And I think the very unique part about what we do is one, we service self-funded employers. You can be fully insured as well, but the billing is a little different. So self-funded employers is very important. But when we come on site after an exam is performed, we ask that patient then or that member then.

00;31;27;13 - 00;31;39;29

Elizabeth Vire

Would you mind filling out a quick survey? The vast majority of women will fill out that survey. I think it's 97% of those women. And then that's where we get our NPS score of 98%. Remarkable. So, yes, women love us.

00;31;40;05 - 00;31;56;01

Cary Hall

The other thing is, from the employer's standpoint, I told you this dinner last night, if I'm the employer and I got 200 employees, and of that, 40% are women, and I bring this program in place and put it in and say, oh, by the way, you know, you guys, out there you, want to bring your wife's in here because they're covered.

00;31;56;04 - 00;32;23;00

Cary Hall

We'll do it for them. Okay? Whatever the case may be, the concern, the level of concern and care that shows by the employer, doctor, is like, they really do give a damn, don't they? You know, I had the folks up here, for Exemplar Care and Doctor John said, you know, the best thing that I ever heard, when I was actually in the clinic or working was an employee came in from a company and said, “you know, this is the only damn thing my employer does for me that’s any good”.

00;32;23;02 - 00;32;33;21

Cary Hall

And it was like, okay, well, but so the point is, it's engagement. And it shows in addition to the ROI, at the end of the day, it shows something.

00;32;33;23 - 00;32;52;00

Monique Gary

And what it really speaks to is the experience, right? A Bexa breast exam feels like wellness, and your typical breast exams kind of don't have that same sense. And that speaks to the quality of our examiners. They're the lifeblood of what we do. When I train these examiners, I train them to be compassionate, to ask questions, to engage with these women.

00;32;52;07 - 00;33;07;11

Monique Gary

And no woman ever walks out of the typical of breast experience and says, oh, I feel more educated about my breast now. I understand what I've got going on. They're like, crap. I hope they didn't find something this year. I guess I'll find out on my phone in you know, one week, two weeks whenever I get the results. But when women leave they say, “are you're going to be here tomorrow?”

00;33;07;13 - 00;33;28;04

Monique Gary

“Can I call my sister? Can I call my. You know, my coworker is on vacation. She says she'll come back early for this”. We have gotten those types of phone calls and those types of referrals because you go in, it's a ten by 12 room. It's a heated massage table, it's warm gel. It's a friendly face asking you questions, showing you what your breast exam is and encouraging you to do your own breast exam at home.

00;33;28;04 - 00;33;39;02

Monique Gary

And it's something found. She's looking at it right then and there and she said, we get this over to the radiologist and we're going to get your result right away, right. That process feels like wellness. That's what women want.

00;33;39;04 - 00;33;52;10

Cary Hall

Yeah. It not only does it feel like wellness, it is wellness. Okay. Because you're detecting this early and you're getting them into the protocol where if there's an issue, it's not going to be stage four.

00;33;52;15 - 00;34;01;00

Cary Hall

So what is so let's talk about that for just a second. You know in this country unfortunately we treat things after the fact.

00;34;01;00 - 00;34;20;04

Cary Hall

I like I said, at dinner last night, we put the Band-Aid on. Meanwhile you're bleeding out of your femoral artery. Okay. How much of a difference does this make? Will this make? You know, when you talk about overall the difference between reducing these stage four stage three cancers versus where we are now?

00;34;20;06 - 00;34;42;09

Monique Gary

Those are good questions. And the number one, the cost of breast cancer care in this country is totaling over $29 billion. Right. And stage four stage, when you go up in a stage, you're going up by 80,000 to $100,000 per stage that that insurer, that employer is paying right for that later stage diagnosis. So when you find it early, it saves money for the company for sure.

00;34;42;09 - 00;35;02;23

Monique Gary

But think about your employee, right? She now has a longer health span. She's more invested in that company. She has reduced absenteeism because she doesn't need chemotherapy. Right. She's going to stay with that company. Right? The GDP of an entire nation goes up when we invest in women's health solutions. And that's been shown. McKinsey did a great report on that last year where we talked about at the World Economic Forum last year.

00;35;02;29 - 00;35;12;10

Monique Gary

So investing in breast cancer care and early detection is dividends, right? Not just the direct cost but the indirect out of, you know, downstream cost for sure.

00;35;12;13 - 00;35;28;01

Cary Hall

So in the numbers number one high cost claim $528,000 okay. Number two $419,000 okay. So you're looking at you know, $1 million in claims here for each and every one that we're talking about.

00;35;28;03 - 00;35;42;24

Monique Gary

I’ll do you one better. The cost of a false positive. Right. That cost of the secondary imaging, the possible biopsy that may ensue the six month later follow up imaging that you need, that cost is totaling 2 billion to the health system for false positives.

00;35;42;24 - 00;35;45;26

Cary Hall

And that could be basically eliminated.

00;35;45;28 - 00;36;06;19

Monique Gary

Reduced significantly, significantly, dramatically. And this is where we've got to get smart about what we're doing. Because on the surgical side of things, I'm doing less and less surgery, right. They're doing shorter courses of radiation. Everything's getting smaller and de-escalated on the treatment side of things, as we find things early, but we're ramping up on the looking for things side of things, right.

00;36;06;19 - 00;36;18;24

Monique Gary

We're ramping up on early detection. So now you need a mammogram, ultrasound, MRI, follow it up in six months. You need a biopsy. You need pathology. All those costs are starting to snowball. There's a real problem in this country.

00;36;18;26 - 00;36;22;04

Cary Hall

And the way to solve that is with this kind of technology.

00;36;22;04 - 00;36;22;24

Monique Gary

Absolutely.

00;36;22;27 - 00;36;36;24

Cary Hall

It can make a huge difference, right? Yeah. You know, thank you guys, both of you, for coming in here. I'd love for you flying in here like you did. You changing your plans to be here? When we do these kinds of shows, that makes a difference. And I think this one is going to make a lot of difference.

00;36;36;24 - 00;36;56;07

Cary Hall

So I appreciate both very much. You know, I'll say it again. You know, I do these for a reason, and you're the reason out there in that audience listening to this. There's somebody out there listening this right now that knows there's an issue. There's somebody out there that’s a human resource director that knows she had 3 or 4 women last year that had major cancer claims.

00;36;56;09 - 00;37;14;23

Cary Hall

I've got a good friend, who just finished a she had stage four cancer. She's still going through radiology. She's still going through chemo. Okay. She has gotten her hair back. We had lunch the other day. This is a very difficult situation for for women. And it's something you can change if you want to change it. You want to learn.

00;37;14;25 - 00;37;32;10

Cary Hall

You have to take the first step or nothing's going to happen. It's just that simple, right? The way to do that is go to the website, mybexa.com. Look at it for yourself, all right. Or pick up the phone, go to the website and call them. Ask for Elizabeth. Have a conversation. They'll come out. They'll talk to you.

00;37;32;12 - 00;38;04;01

Cary Hall

Phone number 1-888-469-2392. 1-888-469-2392. And now I leave you with this thought from Doctor Martin Luther King. Americans must learn to live together as brothers and sisters, or we will surely perish together as fools. Truer words were never spoken. Thank you for listening to America's Healthcare Advocate broadcasting coast to coast across the USA here on the HIA Radio Network. Goodbye America.

00;38;04;03 - 00;38;11;08

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