This episode is built entirely from your favorite moments. In this year-in-review special, hosts Chelsea Ryckis and Donovan Ryckis of Ethos Benefits count down the most-watched clips of the year, the conversations that changed how employers think about their self-funded health plan. Across seven conversations you'll hear from an HVAC owner who found a 97% price difference on the same medical claim, an HR leader who saved her company $24 million, a PBM insider who exposes who owns who in the drug supply chain, a stop loss expert who makes self-funded vs. fully insured make sense, a reference-based pricing specialist who busts the biggest myth about balance billing, a birth advocate making the case for doulas as a benefits strategy, and Mark Cuban on where healthcare pricing is headed next. If you only watch one episode of this podcast, make it this one. What You’ll Learn * What a PBM actually is, and who owns who in the "Big 3" * Why international drug sourcing can cut prescription costs by more than 75% * How an $80,000 medical claim became $2,000 for the identical treatment from the identical doctor * The real financial impact of reference-based pricing: one company's path to $24 million in savings * How to tell when your broker isn't actually on your side, and what fiduciary disclosure should look like * Why "balance billing" fears are mostly a scare tactic, and what the real numbers show * The simplest way to explain self-funded vs. fully insured health plans to any employer * Why doulas and maternal health support belong in a modern employee benefits strategy FROM OUR SPONSOR You're doing the work. Don't leave the proof behind. Managing a health or retirement plan takes time, oversight, and judgment. Fiduciary In A Box documents your governance, vendor oversight, and committee decisions in one secure platform, so your fiduciary process speaks for itself. Learn more at www.fiduciaryinabox.com. Time Stamps 00:00 - Welcome to The Business of Benefits 01:14 - Meet Your Host: A Highlight Reel Intro 02:08 - What Is a PBM, Really? (feat. Rachel Strauss) 05:20 - Who Actually Owns the PBMs (Vertical Integration) 07:33 - International Drug Sourcing and Real Savings Numbers 12:15 - The $80K Skin Graft That Became $2K (feat. Bryan Orr) 15:49 - The Big Lie of Healthcare Pricing (feat. Stephanie Porrino) 20:07 - The Problem-Solution Cycle and Choosing Your Hard 21:12 - Rolling Out a New Plan Before Open Enrollment (feat. Danielle Young) 22:52 - Balance Bills, Mythbusted 25:42 - A Word From Fiduciary in a Box 26:30 - Self-Funded vs. Fully Insured, Explained (feat. Spencer Smith) 31:00 - POSIWID: The Purpose of a System Is What It Does 32:37 - RFP Gatekeeping and the Trip to Aruba (feat. Mark Cuban) 34:04 - Get Rid of Insurance Completely: The Future of Healthcare Banking 37:13 - The Truth About Childbirth in America (feat. Brittany George) 40:47 - Why Doulas Are Like Direct Primary Care for Birth 42:43 - We Are Robbing Women of This Experience Connect with Rachel Strauss, "PBM Princess," VP of Strategic Development at EHIM LinkedIn: https://www.linkedin.com/in/rachelmstrauss/ Website: https://rachelmstrauss.com/ Company: https://www.ehimrx.com/ Bryan Orr, Co-Founder, Kalos Services LinkedIn: https://www.linkedin.com/in/bryanorrkalos/ Company: https://www.kalosflorida.com/ Stephanie Porrino, Founder and CEO, Empower Healthcare Insights LinkedIn: https://www.linkedin.com/in/stephanie-kochporrino/ Danielle Young, VP of Business Development, ClaimDOC LinkedIn: https://www.linkedin.com/in/rbpdanielleyoung/ Company: https://claim-doc.com/ Spencer Smith, ParetoHealth LinkedIn: https://www.linkedin.com/in/spencer-smith-self-funded/ Company: https://paretohealth.com/ Mark Cuban, Co-Founder, Mark Cuban Cost Plus Drug Company Website: https://www.costplusdrugs.com/ LinkedIn: https://www.linkedin.com/company/costplusdrugs Brittany George, HeR Consulting LinkedIn: https://www.linkedin.com/in/brittanyspaziano/ Company: https://herconsulting.net/ Patrick Williams, Co-Founder, Fiduciary in a Box LinkedIn: https://www.linkedin.com/in/corporatefiduciary/ Company: https://www.fiduciaryinabox.com/ Chelsea Ryckis, President, Ethos Benefits LinkedIn: https://www.linkedin.com/in/chelsea-ryckis-8508a192/ Donovan Ryckis, CEO, Ethos Benefits LinkedIn: https://www.linkedin.com/in/donovanryckis/ MORE FROM ETHOS BENEFITS Website: https://ethosbenefits.com/ Podcast site: https://businessofbenefitspodcast.com/ YouTube: https://www.youtube.com/@thebusinessofbenefitspodcast Finished with the content? Claim your CE credit here: https://ideas.ethosbenefits.com/continuing-education SHRM Ethos Benefits is recognized by SHRM to offer professional development credits (PDCs) for SHRM-CP® or SHRM-SCP® recertification activities. HRCI Ethos Benefits is approved to offer HRCI® recertification credits for this program. This program has been approved for 0.5 - 1 HR (General) recertification credit(s) toward aPHR®, PHR®, SPHR®, and GPHR® certification.