Jul 27, 2026 · 1 hr 14 min · 12 segments
Todd Martin, Chief Sales Officer at NOVA Healthcare Administrators, joins Ray in-studio to break down what's really happening inside your health plan and why the arrangement most employers are in was…
Forget about 100, you know, 100, 200 life groups, but we have 1,000-plus groups that are still fully insured having an insurance carrier administer claims to It seems ludicrous to me, and especially in this advent of the passage of the CAA, it seems to me, although on the one hand you say, well, if they're fully insured, they're really avoiding the risk associated with being self-funded.
But couldn't you make an argument that there's an inherent risk if you're fully insured and that you're not? There's no way you're spending plan dollars wisely because the arrangement that you're in is conflicted.
So it's a little bit of an awkward segue from what you just said, but it just comes to mind that The value that you bring in this environment more than ever as an independent TPA is you're essentially protecting an employer.
against the lack of fiduciary oversight or you're kind of reinforcing the fact that they are being a fiduciary, a steward of plan dollars.
You don't get anything that really helps tell the story or what's driving the cost within that spend.
It was when I first started working at Nova and they're like, go meet some brokers.
And I said, where can I go meet the most brokers? And I was like, New York City.
And the majority of the employers or the consultants that I talked to, they didn't care about cost.
If you're getting a 20% fully insured renewal, you're like, ooh, that's a good year.
But whose bottom line is really growing at 20%? So employers, I feel when you have conversations with them.
Forget about 100, you know, 100, 200 life groups, but we have 1,000-plus groups that are still fully insured having an insurance carrier administer claims to It seems ludicrous to me, and especially in this advent of the passage of the CAA, it seems to me, although on the one hand you say, well, if they're fully insured, they're really avoiding the risk associated with being self-funded.
But couldn't you make an argument that there's an inherent risk if you're fully insured and that you're not? There's no way you're spending plan dollars wisely because the arrangement that you're in is conflicted.
So it's a little bit of an awkward segue from what you just said, but it just comes to mind that The value that you bring in this environment more than ever as an independent TPA is you're essentially protecting an employer.
against the lack of fiduciary oversight or you're kind of reinforcing the fact that they are being a fiduciary, a steward of plan dollars.
You don't get anything that really helps tell the story or what's driving the cost within that spend.
It was when I first started working at Nova and they're like, go meet some brokers.
And I said, where can I go meet the most brokers? And I was like, New York City.
And the majority of the employers or the consultants that I talked to, they didn't care about cost.
If you're getting a 20% fully insured renewal, you're like, ooh, that's a good year.
But whose bottom line is really growing at 20%? So employers, I feel when you have conversations with them.
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