The EOB Podcast

Justin Leader and Julie Selesnick
  • 5.0 (14)
  • MEDICINE
  • UPDATED BIWEEKLY

Healthcare benefits are broken. Confusing by design. Buried in fine print. Protected by jargon. The EOB Podcast (Explanation of Benefits) exists to rip the curtain back. Hosted by Justin Leader, founder of BenefitsDNA — a known disruptor in the healthcare benefits industry, alongside Julie Selesnick, Director, Legal & Compliance at Judi Group and Founder & Principal Attorney at Health Plan Legal Counsel, a non-conflicted resource for fiduciaries sound benefit choices. This podcast breaks down what’s really happening inside health plans, contracts, and EOBs… in plain English. This isn’t theory. This isn’t recycled talking points. And this definitely isn’t fluff. Each episode dives into topics like: What your EOB actually says (and what it doesn’t) Fiduciary responsibility & plan sponsor accountability Contract language, negotiations, and hidden incentives Why benefits cost what they cost — and how to fix it Real-world wins, failures, and lessons learned from the front lines The goal is simple: make healthcare benefits understandable, actionable, and harder to hide behind complexity. Along the way, Justin and Julie bring in “Friends with Benefits” — industry insiders, legal experts, and operators who are actively challenging the status quo and building smarter, more cost-effective benefit plans. If you’re tired of lip service… If you believe benefits don’t have to be this complicated… If you want real education you can actually use… Welcome to The EOB Podcast — where we keep it real, challenge the system, and explain benefits the way they should be explained.

Episodes

  1. 6D AGO

    Gag Clauses Are “Banned”… So Why Can’t You Access Your Data? | What Employers Need to Know

    Gag clauses were officially banned under the Consolidated Appropriations Act (CAA)… so why are employers still struggling to access their own healthcare data? In this episode of The EOB Podcast, Justin Leader and Julie Selesnick break down the real story behind gag clauses — what they are, why they were prohibited, and how they’re still impacting employers today. While plan sponsors are now required to submit annual gag clause attestations confirming they have access to their data, many are finding that access is still limited, delayed, or controlled through internal “company policies” rather than explicit contract language. This episode covers: What gag clauses actually are in healthcare contracts Why they were banned under the CAA How carriers and PBMs have adapted post-ban The challenges employers face when requesting claims and pricing data What the gag clause attestation requires (and why it matters) How to think about fiduciary responsibility and data access Practical steps employers can take to improve transparency If you’re an employer, HR leader, CFO, broker, consultant, or plan fiduciary, this episode will help you better understand your responsibilities — and why simply signing an attestation isn’t enough. Because when it comes to healthcare benefits, you can’t manage what you can’t see. Follow for more conversations breaking down healthcare benefits, ERISA compliance, PBM transparency, and the real financial mechanics behind employer-sponsored health plans. This episode was shot on Dec 18th, 2025

    31 min

  2. MAR 17

    Friends with Benefits 1: Mike Miele on PBMs, GLP-1s, and Drug Pricing

    Welcome to the first episode of our new “Friends With Benefits” series on The EOB Podcast.   Julie Selesnick and Justin Leader bring in one of the smartest people they know in the healthcare benefits industry — Mike Miele, FSA, MAAA, Senior Vice President of Insured Services at Capital Rx — to talk about the topic everyone in benefits is arguing about right now: pharmacy benefit managers (PBMs).   Mike pulls back the curtain on how PBMs actually work, how rebates shape the entire drug pricing ecosystem, and why employers often have far less visibility into their pharmacy spend than they think. Along the way the group dives into GLP-1 drugs like Ozempic and Wegovy, exploding pharmacy trends, rebate economics, and the uncomfortable truth about who really controls drug formularies.    Topics include: The real story behind PBMs and pharmacy rebates Why GLP-1 drugs are driving pharmacy trend The economics behind drug formularies and rebate deals Why employers struggle to get transparent pharmacy data How plan sponsors can better manage pharmacy spend If you’re an employer, HR leader, benefits advisor, or healthcare industry insider, this episode will help you understand the forces driving prescription drug costs — and what questions you should actually be asking. And yes… this episode also launches our new segment: Friends With Benefits.   More industry insiders are coming. Follow for more straight talk on healthcare benefits, pharmacy, and employer health plans.

    42 min

  3. MAR 3

    The Biggest PBM Transparency Rule in Decades? DOL Crackdown on Rebates, Spread Pricing & Hidden Fees

    In Episode 2 of The EOB Podcast, Justin Leader and Julie Selesnick break down the proposed U.S. Department of Labor rule that could become the most consequential PBM transparency regulation in decades. The proposed rule would require Pharmacy Benefit Managers (PBMs) to provide detailed disclosure of: • Manufacturer rebates • Spread pricing practices • Pharmacy clawbacks • Indirect compensation • Affiliate & GPO relationships • Audit rights and verification standards But here’s the key: PBMs are already subject to compensation disclosure requirements under ERISA Section 408(b)(2) and the Consolidated Appropriations Act (CAA) of 2021. So what makes this new rule different? Justin and Julie explain: Why employers cannot delegate fiduciary responsibility How rebate retention clauses can cost millions The impact of pharmacy clawbacks on independent pharmacies Why spread pricing is still a major issue What plan sponsors should be asking for in their RFPs right now Why you don’t need to wait for the rule to pass to demand transparency If you are an employer, HR leader, CFO, broker, consultant, fiduciary, or compliance professional, this episode gives you a practical roadmap for reducing PBM risk and protecting your health plan. You don’t need a new law to start being proactive. Follow for more episodes breaking down healthcare benefits, ERISA compliance, fiduciary risk, PBM reform, and employer health plan strategy.

    37 min

  4. FEB 12

    The Voluntary Benefits Reckoning: Lawsuits, Hidden Commissions & the Fiduciary Wake-Up Call

    In this episode of The EOB Podcast, Justin Leader and Julie Selesnick pull back the curtain on the explosive Schlichter voluntary benefits lawsuits—and why they could permanently reshape how employers, brokers, and carriers operate.   This isn’t legal theory. It’s a real-world warning shot.   Justin and Julie unpack how “voluntary” benefits quietly became a multi-billion-dollar profit machine, why hidden commissions and weak loss ratios are now under a microscope, and how many employers may already be sitting on ERISA exposure without realizing it.   You’ll learn why the old “employees pay for it, so it’s not our problem” mindset is officially dead—and what a defensible, fiduciary-first approach to benefits actually looks like moving forward.   If you’re responsible for employee benefits—or advising those who are—this episode is your early advantage.

    55 min
  • 4 Episodes

5
out of 5
14 Ratings

About

Healthcare benefits are broken. Confusing by design. Buried in fine print. Protected by jargon. The EOB Podcast (Explanation of Benefits) exists to rip the curtain back. Hosted by Justin Leader, founder of BenefitsDNA — a known disruptor in the healthcare benefits industry, alongside Julie Selesnick, Director, Legal & Compliance at Judi Group and Founder & Principal Attorney at Health Plan Legal Counsel, a non-conflicted resource for fiduciaries sound benefit choices. This podcast breaks down what’s really happening inside health plans, contracts, and EOBs… in plain English. This isn’t theory. This isn’t recycled talking points. And this definitely isn’t fluff. Each episode dives into topics like: What your EOB actually says (and what it doesn’t) Fiduciary responsibility & plan sponsor accountability Contract language, negotiations, and hidden incentives Why benefits cost what they cost — and how to fix it Real-world wins, failures, and lessons learned from the front lines The goal is simple: make healthcare benefits understandable, actionable, and harder to hide behind complexity. Along the way, Justin and Julie bring in “Friends with Benefits” — industry insiders, legal experts, and operators who are actively challenging the status quo and building smarter, more cost-effective benefit plans. If you’re tired of lip service… If you believe benefits don’t have to be this complicated… If you want real education you can actually use… Welcome to The EOB Podcast — where we keep it real, challenge the system, and explain benefits the way they should be explained.

Information

  • Creator
    Justin Leader and Julie Selesnick
  • Years Active
    2K
  • Episodes
    4
  • Rating
    Clean
  • Copyright
    © Copyright 2026 All rights reserved.
  • Show Website
    The EOB Podcast

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