and the great class of students that work behind the scenes of with the cameras and all the electronical quitman without you guys the show would be possible and i appreciate it i also believe this is our fourteenth year of doing the show so i thank you for that as well insurance and it to me it's very critical because it hit me personally when all these changes occurred and i will tell you that tom is is my personal health insurance advisor and i'm a client of his and it works out really well for me and i'm sure that he can do the same thing for me for many of you out there in the audience so tom what brought you into health insurance you know i i started actually in one nine hundred eighty five in the life insurance business and did ok but i don't think i believed in it as much as as helping people with health care or health insurance you know simply because it's just it's such a it's such an in your face need i mean you know it's a major topic of discussion today you can scarcely turn on the television read a news headline or whatever without hearing how health insurance or health care is impacting people's lives and i don't know nine hundred eighty eight i got into the business and really began to learn and enjoy it could you give us a little background on the start of health insurance because there was a time when there wasn't such a thing as sure so absolutely i mean many many years ago in fact i remember my father and mother who were older my dad died in two thousand and nine at age ninety but they used to call it hospitalization you  w many of your listening audience can probably remember those days where if you look at the structure of medicare part a was really only hospital protection because frankly back in the day you know if you needed a doctor office visit or a lab or a test or whatever it was relatively affordable it was you paid cash you didn't insure the small stuff you know and there were more many tests back in those days actually no they weren't running as many tests you know but nevertheless hospitalisation back in the day was a fail safe that was there for that unforseen catastrophic illness or injury which would be something like heart attack stroke fall yeah absolutely those types of things and so that's where it began other than that direct were primary care was paid directly you know in fact you probably remember many doctors made office calls even back in the day that have canned your home i don't remember that for me but i do remember my grandmother's physician coming to this house and then he paid cash for that position again and he left and that started to change about one well i got into the business in eighty eight so i would say that we were on the tail end of those days in eighty eight you know but still back in eighty eight one thousand nine hundred eighty through the early ninety's health insurance was a financial product that people could purchase relatively afford and what it did was indemnified the consumer meaning that you bought a bucket of money you know maybe a million dollar major medical plan and it had a deductible eighty twenty co insurance or whatever but there were no networks there was no  not none of that basically people were insured for things that they could not afford to pay cash for and that was hospital surgical and things began to change in the ninety's you know you saw the you know the landscape welcomed the health maintenance organization the h m o and then you began to see p p o as preferred provider organization so what is the difference  elf care and you have care you have care inside of their network and you have no care outside of their network so it's basically being a membership in a club similar to that i mean i don't know that th member agreement would say you're joining a club but it's a health in the purest sense of the word it's a health maintenance organization an h m o a p p o is a vehicle where you have an insurance company like let's say hospitals so that if an insured member stays in that network the insurance company has the peace of mind that they're not being gouged with reasonable prices you know so they kind of pr she ate and set the rates inside of this p p o network and it gives the consumer the choice of you know if you seek treatment in this preferred provider organization this network your plan will work you know that's in such deductible co pays everything is is fairly well mapped out but the consumer also has the freedom with a p p o to go outside of network although there is a penalty that they must pay but they do have the freedom to choose any doc any hospital so that's you know that's the difference perhaps between an h m o and a p p o and then they've come out with some new it's like the alphabet soup of health insurance they've come up with a new product called an e p which is an exclusive provider arrangement very similar to n h s so it's all becoming quite confusing the interesting thing that i see doc is this this relationship that i'm not so sure is healthy for the consumer between the insurance company ok and them kind of buying or owning their own providers slash hospitals etc in order you know they're shepherding consumers through their maze of preferred providers or exclusive providers but you know the interesting thing that never was there before is that there's the relationship between the people cutting the checks insuring the consumer and the fact that they also have a relationship with the providers and the hospitals themselves interesting development well you know from personal experience and  because they're being slapped on the hands in a number of ways one way they're being stepped in and most of these physicians now work for can vomits hospitals and like you say insurance companies which are probably behind a lot of the hospitals and so they're there they have a mandate to see so many patients within an hour so they're not giving a dedicated service in my opinion secondly they'll say well the insurance company won't pay for that or they might not pay for that or they don't like to pay for that i've heard those terms being applied to to blood work or x rays or whatever so you you technically end up having this financial institution dictating your health care and you know  there's a difference between health care and health insurance thank you so much and somehow we think that health care is health insurance and it's not that it's not that i was blogging with some people last night in a somewhat heated discussion over that very thing it's a shame that we have to have that discussion in america today but you know they do say that the first rule or law in communication is the definition of terms and it's important and i am so grateful that you say you stress that health care you know we hear about a health care crisis in america and yet everybody's focus then shifts to health insurance and health care is not health insurance and health insurance is not health care it's interesting you know that this exact dynamic that we were discussing and you see it today in pittsburgh with the you know the two major insurance companies downtown cata you know there's a turf war going on this group of doctors versus this one and these hospitals in i think you know if you look closely at that i think consumers need to ask the question is this a good trend that the insuring company is buying and controlling doctors and hospitals because i think that they miniscule late the providers with the carrot and the stick ok which brings me to a good point in the good point is health care there is a growing movement of doctors and surgeons in surgery centers in the united states that are done with the big box insurance ok and this frustrated as many working middle class americans are about health insurance trust me there's a lot of doctors that are just as frustrated because they're being corralled in controlled and manipulated by you know the big insurance companies to where many of them are no longer accepting insurance and they're going the whole other direction which is fantastic and it's a direct primary care movement where for example my physician in cannon's burg dr rebecca pollute of paragon personal health care i just pay her cash every month hundred bucks a month unlimited doctor visits no co pays no deductibles no rush rush interview i mean when you have a visit with dr pollute it's it's an hour visit you know it's like it used to be where she is caring for people no insurance no big brother no corporate you know manipulation and i see that all across the united states as my company is affiliated with a group called the free market medical association where indorsed vender of them and they are doing a lot of groundbreaking things in their members are in terms of caring for americans no insurance necessary or you know what i say is the biggest problem and you know i've been asked you can say i've been an alternative health care for twenty years but i've got to tell you i don't consider that alternative health care i see allopathy care what we term traditional health care as being the alternative of supporting your body and feeding your body on a nutritional basis and stopping the insults you know things like is you don't care what you do you wait to get sick and then you you try to it's treat it you try to surgically remove it put it back together by sewing it or or you suppress the symptoms which was i always call that frankenstein medicine it's kind of what i was taught those those three things and so we need to reverse that support your body i mean these are the young people today if they pay attention to what they're doing to themselves and how they're supporting their bodies they don't they don't have to worry about developing diseases matter but that's not the model that health care in this country goes by it's violate the rules get sick and then we'll throw money that way right have you use your magic insurance card right you're exactly correct health care begins in the kitchen it is very personal i mean people need to understand that their health in large degree now obviously there are exceptions with genetics and accidents and things of this nature but health care begins with with your  exercise your habits things of that nature and then i do believe that a good relationship the patient provider relationship with a good physician and again my particular physician is very well rounded in her approach meaning we have this discussion like tom you know remember it's two glasses of wine a dinner not to bottle ok you know and i mean and she gets it you know and if at all  possible again i see these direct primary care physicians doing everything they can to mitigate the risk of you know unforseen illness an accident by teaching the patient the consumer that hey you know your body you get one of the ok bill gates or i'm sorry the who was the guy with apple fiddlesticks you know steve jobs jobs with all the money that jobs had and all of his wisdom and and brilliance when is is is increase i believe failed you no money couldn't buy him out of that you know and i only bring that up simply because your body is like this is a valuable asset like it's amazing you know and yet sometimes we treat it like nothing so health care begins in the kitchen health insurance is designed to pay for the big stuff that you can't afford to pay so so you pick up a box of food that's what everybody tends to eat anymore and you look at the ingredients and most of those are toxic a lot of them have g m o genetically modified organisms you know why do i want that in my body if you have to you have to pay attention to what you're putting in and you put in the right stuff you get the right stuff out as you know and computer junk out of the computer right so so and that's mystically the purpose of healthy pets healthy owners we try to educate everybody on trying to do the right things for themselves and for their animals you know i doing a thing on i should mention that now i know i have a radio show and i am twelve fifty it's same station that it's called the answer is the station it's the same station that rosie unplugged is on and we do a show called healthy pets healthy people and just a couple shows ago we were talking about dog food and this grain get away from grain now there is an insurance for dogs and that's not what our topic is today but i just got in the jack this for a moment if you don't mind grain free wonderful you should shouldn't be eating grains but you look at all this kibble they have to do something to make the kibble when they remove the grain so they put in high sugar content and they don't put in sugar like white sugar they put in lentils and explanation of terms definitions for what is a co pay a co pay a co pay is is basically the patient has a contract with an insurance company the insurance company says if you go see these providers on this list when you go in for your office visit or your specialist visit or maybe a lab or a test you are responsible for x number of dollars twenty dollars fifty dollars cetera you know typically the  complex and expensive the procedure the higher the co pay so it's based on a procedure not a flat rate correct i did know that the most plans today you're going to see a twenty dollars co pay for an office visit if you see a specialist you're to see a fifty dollars co pay if you have a cat scan and it will be a two hundred dollars co pay now these very you understand it varies by the plan the company in the premium that you're paying but the interesting thing about co pays ok which is again i understand how they've structured these plans but the co pays are going up and up and up and up to where they are to the point where some of the co pays that people paying big monthly premiums ok visualize this people are paying high premiums today that look like mortgage payments in some cases big premiums and they're required to pay a co pay when they go see or when they have a test done and what i'm challenging consumers to think about and to even do is call that particular vendor or that surgery center or that c t scanning center and ask what is the cash price for this procedure and docs in some cases what is happening is these co interesting development and it's and sometimes it is more difficult to educate consumers to believe this like pick up the phone and call for example you know a chiropractic visit for example you know people often ask this insurance cover chiropractic what will it pay blah blah blah my co payment is x or y or z and i often say will have you ever just picked up the phone and asked your chiropractor in the absence of insurance what would it cost for me to just come here in a which by the way what is the cheapest way to buy any product or service cash cash pay cut out the middleman ok what are the challenges to insurance and i mean i've been in this business thirty two years so i'm not dissing health insurance but i'm saying that in some respects today's health insurance plan is part of the problem what do i mean by that only in health care doc do consumers first receive a product or service and then find out what it costs think about that well it even gets worse you can have a surgical procedure that's a failure and you still pay and you still pay so what is happening is behind the veil of this insurance product because what consumers are focusing on is their co pay what do i have to pay fifty dollars is a two hundred dollars is it five hundred dollars but but what they're not asking is what does this procedure cost what do you billing me or my insurance company for this procedure and it is behind that mechanism that you're going to find a lot of huge markups what i would call phony baloney right meaning what meaning in some cases you might find that people that for example a friend of mine dr vance lassy a direct primary care provider in houlton kansas if you are a subscriber to his facility and you need a cat scan for example you might pay cash two hundred dollars for that cat scan a local hospital for that same can scan using the same machine in the same town might bill six thousand dollars for that that same cat scan why because a third party is paying for it and nobody's asking the question why interesting right so this is part of the problem and i know you ask me more for what is insurance but insurance was designed as an affordable commonsense mechanism to protect people from unforseen catastrophic loss today it is so radically different today it's actually a major blight in my opinion in the fabric of society obviously if we have to see change the good news is change is happening another  term out of pocket yeah so what's the difference between co pay and out of certainly great question so out of pocket means this with a traditional major medical contract the consumer is given a monthly premium they have co pays they typically have a deductible which means that that is what is your responsibility for hospital or surgical typically maybe testing and therapy but you have a deductible which is part of out of pocket  out of pocket meaning what the consumer should be able to look at a major medical product and say ok if i have a horrible year if the worst case scenario occurs what is my maximum out of pocket meaning when does the bleeding stop financially for me you know if joe blotz the consumer has a five hundred thousand dollar major medical claim he or she should be able to look at their insurance contract and say you know providing that i'm using you know i'm using the right docs the right hospitals it's a covered expense what is the most i am going to pay out of pocket for the year and that's what out of pocket means no is it easy to d what that is no are there a lot of shenanigans even inside the insurance contract yes should consumers know absolutely what's that doing what well most brokers don't know is you know i kate in training a lot of insurance agents and you know not only is the consumer be fuddled by some of this but a lot of brokers can't even answer the question what's the consumer's maximum out of pocket i like to ask in that work what's your maximum out of pocket net because there is a difference there's a difference and usually there are two deductibles in a plan maybe three you know because now they have several networks embedded in these plans but i look at health plan when looking at the health of your health policy i look at three things what's your best case scenario what's your worst case scenario and what's your most probable when when analyzing what you're paying in return for what you're getting in looking at a health insurance policy you need to ask those three questions what's my best case scenario with this health insurance what's my worst case scenario and what's my most probable so the doctor who would be your insurance covers thousand dollars and you have to pay the first one hundred that's a deductible yeah yeah and one hundred dollars deductible today is almost unheard of today there are five and six thousand you know oh yeah and that's why i'm not coming to you running yeah will your planned ok and one of the you know one of the big pushes under the affordable care act is we want unlimited lifetime maximums unlimited you know out of that was my next question what's the difference between a maximum and a lifetime back the lifetime maximum would be how much money a policy pays during your lifetime and then you might have annual maximums on certain plans for example you're in a no lifetime which in my world ok but you know i i i'm not a numbers guy but there are a lot of numbers guys in the business and really an unlimited lifetime in my opinion is a phantom benefit meaning you know in the grand scheme of things it's not necessary to be frank with you but you know again a lot of people have been led to believe that that is ultimately it's very important course these are the same people whose who are paying sixteen hundred a month with a six thousand dollars deductible and very unhappy and that was my scenario and you sit and think i don't even i don't want to use my health insurance and you know i want to stay healthy and live the lifestyle as best i can to be healthy i want that health insurance if something goes awry if something happens with me it's actually like roller blading and falling or falling off a mountain bike or something like that that's what i'm worried about you know i'm not worried about this sniffle or or or the  i'm getting out of bed today you know and that's i believe the direction that we need to go i agree and but that's not the direction that so called affordable health care is taking us well it isn't you know going back to a great strategy a great strategy for anybody anywhere at any time has been in use today to you know to take control of your own health through have a good relationship with a direct primary care thyroid so forth and there are particular blood test that i suggest that are ordered most visions actually don't even know about these blood tests but the ones i do know about a moan order them because they say the health insurance payers won't pay for these tests because the actually i agree well you've often said and we believe it is the same my role is the same the number one thing i believe we can be doing to help the consumer is to educate the consumer about health care and educate the consumer about health insurance which means asking better questions that claim time if the doc says you need to test five why why am i going here or there they should begin shopping the sleeze should begin asking bold question even to the point where if i'm going in for surgery i should ask what will that cost why not why not why shouldn't what our association is willing to do that our hospitals are willing to do that somebody is willing to do it any of their not you need to press through and ask you know if you're dealing with somebody in at the front desk that can't answer the question then you need to say will find me somebody that can answer the question it be like going to an automobile dealer you know in looking at a car and saying what's this shortly but i want to come back and kind of focus on if you would on what this affordable health care is and isn't and where we can get around the deficits that it's bringing us thank you play stay tuned a healthy pets healthy owners will be back in a few moments to protect yourself basically that's what health insurance is what it is here before the break we were talking a little bit about definitions and another definition i had just said it will come back in the me so let's my background here with health insurance i try not to use of course have used it extensively in the past when i had a medical issue thank god it was there for me or i may be living under a bridge right now but my i had  shield my premium had gone up it was maybe about four hundred five hundred each year would go up sixty bucks or whatever and all of a sudden it jumped up that almost thirteen hundred dollars just out of nowhere and then my out of pocket went up and my co pays went up and it was to the point where that's at an affordable yes all right so i ended up then going to a p p o because that brought it back down again and then i saw that doing the same thing starting to go up and up and up and so i had a plan that i was comfortable with because it was great coverage it was a pricey but it wasn't that thirteen hundred dollar thing that was in that p p o and all of a sudden we had obamacare or the policies canceled and you have to sign up for obamacare interesting it was like boom and i just thought of the term i just wanted to ask let me ask if i forget again what's open enrollment open enrollment is a period of time under the affordable care act or as you called it the on affordable care act open enrollment is a period of time starting november first where consumers can go to the health care exchange either the federal exchange health care dot gov or an exchange in their state and they can purchase health insurance plans that are compliant under the affordable care act with open enrollment meaning regardless of your health situation you can be accepted into the plan regardless of any ongoing conditions there are no preexisting conditions etc so that's open enrollment and that was the other part of the question what is  a preexisting condition is like obviously a condition that preexisted the contract with you and your insurance company i like to refer to a preexisting condition in a commonsense way is let's say that you are going to buy car insurance at your local state farm agent and on your way to go see your state farm agent you unfortunately he had a deer and you've wrecked your fender and you've cracked your windshield ok that occurred before you bought the insurance so it's pre existing so if i have asthma but it's controlled is that considered preexisting yeah yeah anything like with a carrier that uses preexisting condition now again just for clarity's sake because you know we want to educate consumers under the affordable care act plans there are no preexisting conditions so they will buy existing conditions part of the reason that premiums are going up and up and up and up deductibles are going ok because it's tough to price a plan when you're buying these existing conditions some companies such as the one you are with which is a non obamacare plan that company number one under rights which means that they don't have to take everybody number two they do have a preexisting condition clause which means that if you have been treated for something in the twelve months prior to being accepted by the insurance company they can deny that claim for the twelve months following ok which is very reasonable and very common sense in fact it's no different than your homeowner's insurance your car insurance and your health insurance the way that it was for decades and decades and i had it years ago i had multiple knee surgery companies in the process of that and they excluded me and i was six months to your they wouldn't cover anything more and then until after that point you know that's a direct that's what a preexisting but it's not that you'll never get coverage it's just there's the reverse terrible months that that's it for a period of time and i appreciate you clearing that up because i think that that's important so getting back to the story i was telling about saw so i was on this and right in the middle of it it was just cut it was not under the gun yeah and i'm like even though that the government narrative you know just to remind your listening audience if we remember the government narrative right was you know the is going to people's premiums are going to go down how did that work for you if you like your plan you're going to be able to keep your plan how did that work for you not if you know you're like your doctor you're going to be able to keep your doctor how did that work for none of that apply for me so here's something that i've learned about media politicians big big corporations they lie a lie ok and it's amazing that they can say these things to get a bill passed or to get something done and i'm with you i believe that the affordable care act was not done for the american people but on the contrary i think the affordable care act was done to the american people and at the end of the day ok i'm sorry but numbers don't lie and i can i have the stats and i have the numbers across the united states of america rates are going up thirty four point five percent those are official government numbers and in some states rates are doubling you know i mean it's a it's a mess occurring well you know what what happened with me was i had this plan that say i don't remember the exact monthly payment was five hundred dollars a month so when i signed it was like four hundred dollars a month where i was on all of a sudden i was bounced  on that it was cut and then i was told you can sign up this is what we're offering in place of that and it was i didn't even have a choice you know this is what was offering in place of it i remember that that's the doubled monthly premium doubled my co pay tripled my out of pocket tripled and my coverage went down we saw i'm telling you that again you know i'm not here to bash a chevy to sell a ford or whatever but highmark to their credit  the first year of open enrollment under obamacare highmark had plans on on the marketplace right now you may have had one of their more robust plans and they priced them very affordably but they lost thousands and thousands of dollars some estimate as high as seven hundred million i don't know i can't remember the exact numbers but they lost a lot of money and as a result they took those plans off the market at the end of the first year and i know this firsthand because a lot of my friends had very robust bold plans with highmark and they just got a letter in the mail stating you can't have this anymore instead if you do nothing your plan is now that that's exactly what i go to and those people were rolled to a very high deductible blah blah blah so this is what's happening ok it's no longer look i'm not pushing democrat or republican as far as i'm concerned they both live all right salute they're both two wings of the same bird i'm fifty six i've been lied to by both sides of the political aisle and i and my message to anybody that will listen is listen we need to wake up and realize what's going on what the affordable care act did is shift the misery from one group of people to another and unfortunately as seems to be so often the case the working middle class the producer the taxpayer seems to be yet again shouldering the burden of the vast majority of the affordable care act which it's interesting a fair question should be why is income tied to health insurance whose idea was this and is it not clear to people that this is nothing more then you know an economic method redistribution of wealth socialism whatever you want to call it but it's a method again where the working middle class is funding you know the the poor and there are some legitimate poor ok in the united states but there are a lot of people that gaming the system and you know it and i know absolutely and that's that's a travesty for people such as yourself well in  circumstance i actually for the first time in my life thought i'm not going to have health insurance and you know and then of course now i'm breaking the law right and i could be penalize and all of that come after me because because i don't i'm not buying into your program to begin with right all right fortunately i heard about you called up and made an appointment and you were able to said you know probably toast and a half or something like that and you went through all the options and i  i have a nice plan to do so would you please start as well yeah it's not that plan is a hat absolutely so what happened with me right is when obamacare went down i'm no different than everybody else i you know i have insurance my premiums went up i became unhappy with the situation i didn't like how it went down politically or otherwise i didn't like what i saw going on in the insurance industry is far as the plan designs etc etc and i and i also after thirty years you know have developed some very good relationships with people in the business who are forward thinking maybe a little edgy ok and outside of the box that's a big one with me outside the box you know in innovation that's really what we're talking about you know a mentor and friend of mine often said tom in the midst of every adversity is the seed of equal or greater opportunity so when i saw obamacare go down obviously i was looking for solutions because i didn't think it was going to work the way the government was saying what because there's only one hundred pennies in the dollar ok and if you start insuring all of these sniffles and pick ups and wellness and pediatric dental and maternity and guaranteed issue and no preexisting conditions and then limited lifetime there is no way that that is sustainable ok there's no way rates are going to go down and i may not be the sharpest knife in the drawer but i can count furthermore you know i have a friend who is also an actuarial scientist from taiwan who i have had the privilege of meeting with and he said tommy this is not go ok and he also happens to be in the business and designed a suite of products that are outside the affordable care act now he's just one one mentor and one gentleman that i've seen do this but we  agency west penn life and health contracted with his company philadelphia american insurance company and they said look we're we're we're going to do something a little different this is legal they're filing the product in each state with the state department of insurance but they gambled that obamacare was not going to work for everybody and their products are non obamacare plans meaning what it doesn't mean they're illegal doesn't mean they're all moral  as i said they're they're fully insured they're licensed with state department assurance but they don't meet the affordable care act guidelines they don't have the ten essential benefits so in your case you're not paying for maternity with your we began to look for you know alternatives which there's all by the way there's always a choice you know we believe in america that this is the land of the free in the home of the brave right we believe in liberty and freedom and so when i hear  when i hear a narrative that says hey this is it this is all you've got health insurance now is affordable care act bronze silver gold platinum it's like yeah who says ok that's that's just your narrative but there's always we always have a choice as human beings right and by the way not to correct you ok but but it is it's not true that people who say forget it i don't want insurance you're not breaking any law you're which is a funding mechanism for their monstrosity called the affordable care act ok but you are on a non obamacare plan which here's our philosophy with that our philosophy with  catastrophic hospital surgical insurance just like the old stuff covers hospital room and board intensive care facility fee surgeon assistant surgeon radiologist path ologist attending physician blah blah blah test lab tests that you know exactly if any to keep you out of the weeds for an extensive hospital stay or outpatient surgery and in fact in some cases better than traditional major medical today but but and it significantly more affordable i will attest to that significantly more for it and then we have bolt ons that you can add to it like enhanced accident critical illness which pays cash on diagnosis of a serious ailment god forbid you know has cancer cancer heart stroke you know and in some cases ok i believe that this approach to health insurance not health care but health insurance gives the consumer more protection where they need it most for less money each month now can you know on the other side of the coin you know this plan is not going to cover every sniffle hiccup a nosebleed which in your case we discussed is not a worr you because you know you're not running back into the doctor for every sniffle take up a nosebleed you're caring for yourself with good choices diet exercise it's etter alternative to trying is trying to do the right things and you don't you don't always need for sniffle to go see a physician thank you now you know in fact sometimes i think it's best avoided because they end up giving you medications the screw your body up unnecessarily and we can attest that there's there's resistance there's addictions there's all of these things happen because of these over prescriptions prescribing these drugs that are affecting our bodies negatively so so i don't even want to run to the physician i go annually for a check up i don't want to do that but i do that you know and under my insurance policy i covered for that an exam well are you covered two things number one in network if you go to one of our p p o physicians you will be you will you will receive a discount for being in network in other words you will pay wholesale rather than retail and then once a year my plan will pay up to but not to exceed one hundred twenty five dollars for a wellness visit and that's a physical exam a physical exam blood draw whatever so how did we cover me not being fined by this great question and that's that's a fear and it boy again i look at it as a travesty among people because you know it is a motivating factor for many they're living in fear you know they're paying insurance in some cases for the wrong reason not to pay a penalty which is not why you have insurance but there are a couple of mechanisms for the faith based community for people who can identify let's say in the christian community under the obamacare law under the affordable care act there were exemptions granted to faith based organizations called christian sharing ministries ok christian sharing ministries and and so what we do in some cases for people that can qualify in that arena we will educate the consumer about the faith based membership which in your case is forty five dollars a month and it provides catastrophic hospital surgical reimbursement should something major occur so you have that on one hand yes and by by belonging to that christian sharing ministry you receive an exemption under the affordable care act to where you are not penalize for not owning and obamacare compliant health plan and then what we do over here with the  is we we supplement the christian sharing ministry with a suite of fully insured products up to five million life time up to one million per person per year and you will leave that covers hospital surgical office visits accident critical illness etc in the end it and there's no coordination of benefits between the two so this is paying in addition to that and by the way you have complete freedom of choice meaning what meaning god forbid if a client of mine became ill or is injured he or she can go to any doc any hospital from maine to california today fantastic choices and options now that's one way but of course not everybody is going to be able to identify in the the faith based community and for some that's just not an option well just recently we developed a plan in in coordination or conjunction with the group out of chicago who partner with us now and it is called a mac plan and max stands for minimum essential coverage and e c and what this policy is and again this is why i love innovation so much these these people came out and they they they have a self funded group where basically they are insuring the necessary requirements for preventative care right under the affordable care act to where if you buy into this met plan and it's like i don't know ninety six bucks a month for an individual it covers with no deductible the mammograms the pap smears the cola rectal screening etc etc and that's a nice little gimme for the small stuff but it brings that person into compliance with the affordable care act so they are given a ledger each year you know that they participate in a mac plan therefore they are exempt from any penalty under the affordable care act and then what we you on that met plan that minimum essential coverage which is essentially just taking care of preventative and wellness right then we layer on top of that the same suite of benefits that you have layered on top of your christian sharing ministry where they have for hospital surgical office visits testing labs critical illness enhanced accident dental yada yada we can build a suite of products on that plan to protect them from the big stuff so basic that anybody walking in your door and  tailor you can tailor a plan specific for them so that they're paying for what they need rather than a one size fits all approach from washington d c as we all know one side is one size never if it's oh yeah in this is the thing now now let me just interject this ok the truth is i cannot help everybody all right that's the truth and a big reason why is while our mech plan is guaranteed issue will take anybody no preexisting zone that and while the christian sharing ministry is guaranteed issue my fully insured suite of products that is an underwritten plan so there are some individuals who might call my radio ads or might walk in my office that unfortunately i'm not able to help ok and that would be individuals who currently have significant health history you know maybe they had a heart attack six months ago or a year ago or they're dealing with some ongoing cancer so there are there is a group of people that we are not able to help and that's sad that's where of a certainty no matter where we go with health insurance in the united states of america we need to have a catch net a safety net a failsafe for people that are currently dealing with significant health history but for healthy self employed individuals family you know whatever for people that don't have a lot of morbidity factors going on or anomalies going on we are able to take them out of this mess called obamacare right now  and custom designed an alternative that is legal that is affordable and provides adequate coverage freedom of choice low rates save people we're saving people thousands of dollars that's exactly what you did for me yeah you know and that's not what it's there for it's not there for that and that's you know that's an unintended consequence i might add you bring up a very good point of these ever increasing premiums i mean my goodness if i were forced to pay a thousand dollars a month for something i would want to use it right in so what that does is that actually drives over utilization which then just feeds the beast more and the rates tend to inch up more absolutely ok so it's a system some people consider the system right now in what is called a death spiral and a death spiral is where the healthy people who are in obamacare who are learning about companies like mine they're checking out trust me i mean people are leaving in droves we can barely keep up with it i got to tell you it's a great problem to have but absolutely but what's happening is the only people that are going to be left in that system are the over utilizers or the unfortunately the real sick and so the only way that they can continue to sustain those losses is do what with the premiums drive them up or seek additional government funding on the back side which doesn't seem to be happening under the current administration thank goodness for that so so i there are number of people that are in medicare and i and i from prior conversations with you i know medicare and obamacare don't interact right different but there are supplements from medicare that you have to purchase so you offer we we do and we're in the middle right now of medicare open enrollment for the advantage plans that started october fifth and runs the december seventh so you know here's the truth about medicare medicare is actually federal insurance right medicare  and be original medicare and the truth is is that if a consumer has original medicare a and b they don't have to have a supplement they don't the insurance industry wants them to believe you have to have a supplement but you don't you have relatively good coverage for hospital and out patient and if you want you can add a part d drug card to that and you're ok honestly you're ok it's a multibillion dollar industry to supplement medicare because there are some out of pocket concerns etc and theoretically the senior citizen or the medicare eligible individual is typically on a fixed income so they don't want any financial surprises i understand that but it would be immoral or wrong for me or any of my agents to say you have to have a medicare supplement you do not it's completely optional had medicare part b is optional again i would recommend people buy it but it's part it is optional so yes we do help people that are medicare eligible it's confusing it's like alphabet soup to medicare a b c d and then the plan designs a through j and then you have all this so we sit down with with medicare eligible people and we do we do a heck of a good job you know rather than a cattle call in a seminar you know my agents are trained to sit down just like a doctor and assess needs what hurts you where are you at what your budget what your prescriptions what are you taking you know and we tend to make very good recommendations based upon that consumers needs wants budget things of that nature again you're basically tailoring that that's correct so your your information your phone number and so forth will be propped up  it's all people have to do is pick up and give you a call yeah pick up give us a call to kelly at the front desk in all probability seven to forty two eight seven one eight seven west bend life and health were conveniently located on route nineteen between you know m is so there we are we have off street parking people can sit down we talk with them we will give them the best information that we have but even better than that can i tell you the other day i had a client in the same plan design as yours called me on a saturday and i was tired i would mitt you know i actually didn't get the call i got the voicemail and it was like i don't know ten am and i still get my act together drinking coffee and i thought man but i called the guy back in don't you know he was literally in the hospital having had a heart attack that thursday and i will tell you that one of the things that we pride ourselves in doing it and i say this to my clients at claim time use me use my staff what do you mean let us walk you through the maze of claim you know finally and this gentleman when he was released was in my shop and i was helping them file the claims and walk through on the back side so that's the other thing personal to my radio show i am twelve fifty every saturday morning from nine am to ten am it's a live call in show called how the pets healthy people back life and health are sponsors of ours