Are You Guilty of Health Plan Spreadshitting?
You have five health plan options, all with double-digit premium increases, high deductibles, and exorbitant out-of-pocket costs for members. You need to figure out which one sucks the least. So what do you do? You create a fancy spreadsheet that details a side-by-side comparison. There’s nothing wrong with a careful analysis of your options. In […]
Why It’s Good to Be the Payer: The Importance of Holding the Keys to Your Health Plan
In health insurance, the payer is the organization responsible for paying claims. In a fully funded plan, the health insurance carrier is the payer. In a self-funded plan, the employer is the payer. While being the payer may seem like a bad thing, it’s actually a position of power. Whoever pays the claims is in […]
The Hidden Cost of Bad Benefits
What Would $500,000 Mean for Your Company? Many employers don’t realize how much bad benefits quietly drain from their business. When Wada Farms switched to a direct health plan, the company saved nearly $500,000 over four years. For a family-owned business, this savings was huge. It represented meaningful capital that could be reinvested into operations, […]
Ditch the Carrier. Own the Benefit Plan.
How Community Health Models Put Employers In Control If you want to provide health insurance for your employees, you need to work with an insurance carrier, or a broker who is appointed through an insurance carrier, right? Wrong! There’s actually an alternative. A community health plan connects employers and their teams with hospitals and providers […]
Direct Contracting Done Right: How Employers & Hospitals Win Together
What if employers and hospitals stopped negotiating against each other? In this episode of the Dysrupt Healthcare Podcast, Lester J. Morales sits down with Doug Hetherington, founder of Health to Business, to talk about a different approach to healthcare purchasing one rooted in transparency, partnership, and long-term alignment. This isn’t about fighting the system. It’s […]
2026 Outlook: Why Employers Settle for the Health Plan that Sucks the Least
If your company’s last employee benefits renewal involved choosing the option that sucks the least, you’re not alone. While the Peterson-KFF Health System Tracker reports that small group insurers proposed an average premium increase of 11% for the 2026 plan year, many employers experienced increases that were much steeper than that. Even if you were […]
Level-Funding vs. Self-Funding vs. Fully Insured Health Plans: What’s the Difference?
Do you know your health plan options? In addition to fully insured health plans, businesses can consider level-funding or self-funding for their health coverage needs. Before you settle on an option, take a moment to understand the differences between these three approaches. Level-Funding vs. Self-Funding vs. Fully Insured at a Glance In a fully insured […]
Healthcare Market Dynamics: Why Care Costs More in the U.S. and A Solution That’s Finally Working
Everyone knows that sky-high healthcare costs are a problem in the U.S. According to the Peter G. Peterson Foundation, U.S. healthcare spending per capita is $14,885 as of 2024. That’s more than double the average per capita healthcare spending of just $7,371. In comparison, Canada’s per capita healthcare spending is $7,301 and Korea’s is just […]
Rising Healthcare Costs Hurt – How A Direct Employee Benefit Model Is Changing the Paradigm
What happens when employers can’t afford to provide adequate family coverage, and workers can’t afford to get the care they need? Our country is already seeing the results – delayed care, medical debt, hurting families and stressed workplaces. The problems facing our healthcare system are substantial, and the solutions need to be bold. How Many […]