Scott T. Kowalski, JD

Mike Schroeder, Founder & President of Roundstone, reveals the exact methods their clients use to save millions on health plan costs. Speaking at the Smart Business Dealmakers Conference, he breaks down his 'secret sauce' into 3 practical steps - starting with pharmacy spend data most companies never track. Watch the full clip to learn more. #HealthcareCosts #BusinessStrategy #SmartBusinessDealmakers

9

1 Comment

Join us today as Jason Dutra shares how long term care specialists and financial advisors are a match made in heaven. 📅 Date: Tuesday, October 22, 2024 ⏰ Time: 1:00 p.m. PT | 3:00 p.m. CT | 4:00 p.m. ET 🔗 Link in comments Here's what you can expect to learn: 💡 Why are LTC specialists and financial advisors a good match? 💡 How to meet more financial advisors and create meaningful partnerships. 💡 How a specialist can start to think like an advisor and open up more opportunities for them. 💡 How the self-funding conversation is key to this topic. 💡 I'll take any questions that you have at the end! See you on the call!

11

4 Comments

EOY healthcare premium increases got you down....again? A captive can be a great solution to manage costs, create a healthier workforce and possibly profit from a favorable claims history. Out of the chute, there may be a cost DECLINE in your premiums along with minimal increases per year (depending on a few factors). Controlling the INCREASES in costs alone year over year is worth exploring a captive option for your health insurance. We can help. Captives are all we do all day, every day. Stay safe out there! #CPA #CFO #riskmanagement #insurance #business #finance #financialmanagement #advisor #financialadvisor #interimCFO #insuranceagent #broker #businessowner #consulting #consultant #accounting

5

💡 Did You Know? Medicare Part A is often FREE! 🏥 If you've worked at least 10 years (40 quarters) in the U.S., you likely won’t pay premiums for hospital coverage. 🎉 Take advantage of the benefits you've earned! #MedicareFacts #HealthInsuranceTips #MedicareMadeSimple #RetirementPlanning #HealthcareSavings

4

1 Comment

If you are in healthcare, this is a must-listen podcast. Regardless of your opinion on Tucker Carlson, listen to the message of his guests Casey Means, MD and Calley Means They highlight the scope of the healthcare crisis, which is summarized in the stats below: - 74% of adults are overweight - 50% of children are overweight - 50% of adults have diabetes or pre-diabetes - 30% of teens have diabetes or pre-diabetes - 40% of 18 and under have a mental health diagnosis - Young adults cancers are up 70% - 1 in 36 children have a diagnosis of autism When we discuss ad nauseam how to fix healthcare, rarely does the topic of American’s collective poor health enter the convo. I believe nothing gets solved in healthcare (price, cost, transparency, fairness, etc) without massive improvements in our baseline health. Every decision we make must also involve a focus on diet, exercise, food quality and a goal to avoid unnecessary medications. According to Casey & Calley, physicians receive almost zero education on nutrition in medical school, and instead are to taught to simply identify medications to prescribe. Our food is sprayed with countless chemicals, many of which are illegal in Europe, and then processed to the extent that most of it is devoid of basic nutrients, yet made massively addictive at the same time. Once sick, Americans become lifetime patients of the medicinal industrial complex. So instead of solely relying on doctors to guide us through a Sickcare journey, we must start to look within. We have to educate ourselves. We have to vote with our wallets. And we have to be the guardians of our own bodies. You want to “fix” healthcare? Then start with your family’s dinner plates. It’s not just our lives at stake, but also the health of our kids, and quite frankly, our Nation itself. I have faith that we can turn things around very quickly, but it is up to each of us to help turn this ship around. Good Luck & Godspeed. #health #healthcare #food #foodquality #bigpharma #diet #exercise #tuckercarlson

279

79 Comments

What if I'm next? A self-serving PBM discretely deploys tactics that further their own interests at the expense of their employee-plan clients and plan members.  PBMs use their service agreements with benefit plans to impose their self-scheming schemes through often overlooked contractual provisions.  Inevitably, these self-service provisions increase the plan's total drug spend and the out-of-pocket costs borne by plan beneficiaries, but allow the PBM to increase its own compensation through hidden channels.  When faced with these increasing costs, JNJ's employees took action against their employer due to JNJ's alleged inability to adhere to their fiduciary duties and protect the plan from these common PBM schemes.  It’s not just PBM’s. Pharmacy costs make up a quarter of your health plan. The medical side is equally problematic, and the issues are starting to be revealed. Don’t be next. A third party independent review company is crucial to protect your plan and ensure ethical and fair billing. https://lnkd.in/gd7djY3N

23

5 Comments

Is your PBM really delivering on member service, or just making promises? When pharmacy benefits issues hit, your members (and their families) need real support - not endless hold times and unresolved problems. The City of Grand Rapids learned this the hard way before partnering with us as The Fiduciary and The Fully Disclosed PBM®. We've outlined the 5 questions you need to ask your PBM about member service. These aren't just checkboxes - they're the difference between frustrated members and satisfied ones. Let's be honest - if your members are struggling to get their medications, nothing else matters. Save this post for your next PBM evaluation. Your members will thank you. #EmployeeBenefits #PBM #MemberService #HealthcareBenefits #HRLeadership

1

Sami Inkinen makes some great points about an insurance company making unliateral coverage decisions instead of taking a more nuanced, patient/member-centric approach. To which I'd add: "The middle way" already exists for any number of physician-prescribed treatments - to wit, "Is this particular patient, with their particular situation, amenable to this proposed prescribed treatment, and 'is the juice worth the squeeze?'" i.e. Are the clinical, the risk, the quality of life, and the cost benefits worth what this treatment will cost the plan? It would be one thing is only fully-insured plans are going to be impacted by this unilateral "decision." It would be (will be?) quite another if a self-funded employer will be unilaterally barred from choosing to cover GLP-1s for their "suitable" employees. #healthcaretransformation #GLP-1s #virtahealth #employee engagement

2

THIS. 👇 Hearing the #feedback from the attendees of our #documentary screening has been my favorite part of this whole process. The emotional responses have ranged from anger and sadness to shock and #empowerment. The momentum for #transparency and better healthcare is strong. #Employers, don't be left behind. Watch "It's Not Personal, It's Just Healthcare" today to learn how you can offer the highest quality benefits at a fair price. #employeebenefits #ethosbenefits #healthinsurance #hr #cfo #ceo

10

🚨 California Mandates IVF Coverage for Group Health Plans Starting July 2025 ➡ California’s Senate Bill 729 will soon require group health plans to cover specific fertility treatments, including IVF, for policies written or renewed on or after July 1, 2025. ➡ Large group plans will need to cover up to three IVF cycles, while small group plans must offer infertility service options. Stay informed on this important update in Gallaghr's latest edition of Compliance Directions https://lnkd.in/g6Vsp2JK #ComplianceConsulting #EmployeeBenefits #ComplianceDirections

6

Understanding Medicare Parts A and B is key to navigating your healthcare options. 🏥🔍 Learn what each part covers and how they can benefit you. Let's connect and discuss your Medicare needs. 📈 #MedicareEducation #HealthcarePlanning #guidinglightbenefits

1

🚑 **Understanding Health Insurance: Deductibles vs. Out-of-Pocket Maximums** 💼 Navigating health insurance can be confusing, especially when it comes to terms like deductibles and out-of-pocket maximums. Here’s a breakdown: 🔍 **Deductible**: The amount you pay for covered healthcare services before your insurance starts to pay. For example, if your deductible is $1,000, you'll need to pay that amount out-of-pocket before your insurer contributes. 💰 **Out-of-Pocket Maximum**: This is the most you’ll pay for covered services in a policy period (usually a year). Once you reach this limit, your insurance covers 100% of eligible expenses. This provides a safety net, ensuring you’re not overwhelmed by medical costs. 📊 **The Difference**: - **Deductibles** are what you pay first, before insurance kicks in. - **Out-of-Pocket Maximums** cap your total spending on healthcare, offering financial protection. Understanding these terms is crucial for making informed health choices and managing costs effectively. Have questions about your health plan? Let’s discuss! #HealthInsurance #Finance #Healthcare #Deductibles #outofpocketmaximum #insurancetips #education

2

🤯🤯 Yes…that is my mind being blown by the information contained below!!! A must listen to!! If you wonder why the cost for your business’s healthcare is out of control. Look no further than the stats contained on this post! ✅✅✅ The question is what are you doing today to help you and your family become healthier? 😃😃

18

6 Comments

Understanding Medical Plan Funding Options 🔍 📅 Wednesday, September 18th 🕛 12:00 PM CST Are rising healthcare costs making your head spin? 🤯 Join us for a webinar that will demystify the world of health insurance and empower you to make smart decisions for your business! Key Takeaways: Clarity on Funding Options: Fully insured? Self-funded? Level-funded? We’ll break down the pros and cons of each, helping you choose the best fit for your company’s size, budget, and risk tolerance. 💡 Cost Control Strategies: Learn how to manage healthcare costs effectively, avoid budget surprises, and discover potential savings. 💸 Risk Management Insights: Understand the risks associated with different funding options and how to protect your business. 🛡️ Presented by Geniece C. Brunson, RHU, GBA, Principal at EPIC. Join Zoom Meeting https://zurl.co/zszv #HealthcareCosts #BusinessOwners #SmallBusinessTips #HealthInsurance #InsuranceWebinar #BusinessGrowth #FinancialPlanning #RiskManagement #CostControl #EmployeeBenefits #InsuranceKnowledge #InsuranceEducation #BusinessStrategy #GroupHealthInsurance

2

1 Comment

Observations to Aware When a Caregiver Needs Help https://lnkd.in/gYNqAsBg Meet Raymond Lavine (LTC Benefits): View the Videos: https://vid.us/xr5lso Why LTC Benefits: https://lnkd.in/ghdbbThc

2

1 Comment

Is your PBM really delivering on member service, or just making promises? When pharmacy benefits issues hit, your members (and their families) need real support - not endless hold times and unresolved problems. The City of Grand Rapids learned this the hard way before partnering with us as The Fiduciary and The Fully Disclosed PBM®. We've outlined the 5 questions you need to ask your PBM about member service. These aren't just checkboxes - they're the difference between frustrated members and satisfied ones. Let's be honest - if your members are struggling to get their medications, nothing else matters. Save this post for your next PBM evaluation. Your members will thank you. #EmployeeBenefits #PBM #MemberService #HealthcareBenefits #HRLeadership

3

If you're on Medicare, than you've likely received your "Annual Notice of Change" regarding changes to either your Medicare Advantage Plan, or your Plan D prescription drug plan. Medicare is going to experience some of the most significant changes it's ever seen as of January 1. We can help you to navigate these changes and help you to find great alternatives, always at no cost at all to you. You can reach us at 856-396-5054 or 888-417-1999 Licensed in NJ, PA, DE, NC, SC and FL. #MedicareBroker #MedicarePartD #MedAdvantagePlan #MedicareSupplementalPlan #MedicareNewJersey #MedicarePA

2