1 00:00:02,240 --> 00:00:05,059 This is where health insurance leadership comes together. 2 00:00:05,279 --> 00:00:08,960 Becker's fourth annual spring payer issues roundtable brings 3 00:00:08,960 --> 00:00:12,259 together over 400 payer and health plan executives 4 00:00:12,400 --> 00:00:16,524 and more than 100 speakers to Chicago April. 5 00:00:16,904 --> 00:00:19,785 This year's event includes keynote conversations with the 6 00:00:19,785 --> 00:00:23,064 industry's top leaders and former president George W. 7 00:00:23,064 --> 00:00:25,704 Bush. For the full agenda and event details, 8 00:00:25,704 --> 00:00:27,785 visit beckershospitalreview.com 9 00:00:27,785 --> 00:00:29,224 and click on the events tab in the 10 00:00:29,224 --> 00:00:31,519 upper right. We're looking forward to hosting you 11 00:00:31,519 --> 00:00:32,659 here in Chicago. 12 00:00:34,000 --> 00:00:36,079 Hello, everyone. This is Jacob Emerson with the 13 00:00:36,079 --> 00:00:38,960 Becker's Pay Your Issues podcast. Thrilled today to 14 00:00:38,960 --> 00:00:40,960 be joined by Jack Hooper, who is the 15 00:00:40,960 --> 00:00:44,204 CEO and cofounder of Take Command. Jack, thanks 16 00:00:44,204 --> 00:00:45,644 so much for taking the time to be 17 00:00:45,644 --> 00:00:46,945 with me on the podcast today. 18 00:00:47,405 --> 00:00:49,964 Jacob, thank you so much for for having 19 00:00:49,964 --> 00:00:50,524 me on. 20 00:00:51,085 --> 00:00:53,184 Excited to talk with you today. 21 00:00:53,644 --> 00:00:55,964 Likewise, Jack. Appreciate you taking the time to 22 00:00:55,964 --> 00:00:58,560 chat with us. Before we get started, can 23 00:00:58,560 --> 00:01:00,079 you first tell the audience a little bit 24 00:01:00,079 --> 00:01:02,479 about yourself, your background in terms of your 25 00:01:02,479 --> 00:01:05,439 career, anything involving health care, and then give 26 00:01:05,439 --> 00:01:06,959 us an overview of your your current role 27 00:01:06,959 --> 00:01:08,719 at Take Command and exactly what you all 28 00:01:08,719 --> 00:01:09,219 do. 29 00:01:09,644 --> 00:01:10,144 Sure. 30 00:01:10,844 --> 00:01:13,325 So I'm I'm Jack Hooper. I'm the CEO 31 00:01:13,325 --> 00:01:14,944 and founder of Take Command. 32 00:01:15,484 --> 00:01:18,384 So Take Command, we are a software platform 33 00:01:18,444 --> 00:01:19,665 that helps employers 34 00:01:20,444 --> 00:01:24,144 administer the new individual coverage HRA or ICRA. 35 00:01:25,319 --> 00:01:27,319 You might ask, alright. How does one get 36 00:01:27,319 --> 00:01:29,979 into being a, ICRA software 37 00:01:30,759 --> 00:01:31,259 administrator? 38 00:01:32,119 --> 00:01:34,359 For me, my my career actually started not 39 00:01:34,359 --> 00:01:35,319 in health care. 40 00:01:35,920 --> 00:01:36,420 I, 41 00:01:37,000 --> 00:01:38,679 I joke. I I used to work for 42 00:01:38,679 --> 00:01:39,659 the federal government. 43 00:01:40,200 --> 00:01:42,625 I was in intelligence and worked for the 44 00:01:42,625 --> 00:01:43,125 FBI. 45 00:01:43,984 --> 00:01:45,825 But now I say, you know, I'm I'm 46 00:01:45,825 --> 00:01:47,905 even cooler. I work in health insurance now. 47 00:01:47,905 --> 00:01:48,405 So 48 00:01:48,784 --> 00:01:51,105 grateful for that background, but but really what 49 00:01:51,105 --> 00:01:53,105 moved me into health care was was a 50 00:01:53,105 --> 00:01:54,085 personal experience. 51 00:01:54,625 --> 00:01:55,025 I have, 52 00:01:56,100 --> 00:01:58,659 two twin boys that are turning 13 next 53 00:01:58,659 --> 00:01:59,159 month. 54 00:01:59,780 --> 00:02:00,280 So 55 00:02:00,579 --> 00:02:02,439 that's kinda how I mark my milestones. 56 00:02:03,620 --> 00:02:05,780 And as much of a blessing as they've 57 00:02:05,780 --> 00:02:08,659 been, they were an enormous surprise for for 58 00:02:08,659 --> 00:02:10,275 me and my wife. We had just, 59 00:02:11,155 --> 00:02:13,634 left our jobs and families in Texas and 60 00:02:13,634 --> 00:02:16,215 moved to Philadelphia for graduate school 61 00:02:16,754 --> 00:02:19,634 and live living in a nice efficiency apartment 62 00:02:19,634 --> 00:02:21,814 and found out we were pregnant with twins. 63 00:02:22,610 --> 00:02:25,090 And, you can imagine the the shock and 64 00:02:25,090 --> 00:02:26,150 surprise and, 65 00:02:26,769 --> 00:02:29,009 really my personal journey of trying to figure 66 00:02:29,009 --> 00:02:31,189 out, okay, how much do twins cost? 67 00:02:31,569 --> 00:02:33,489 How much in student loans do I need 68 00:02:33,489 --> 00:02:34,389 to take out, 69 00:02:35,409 --> 00:02:36,789 to pay for these twins 70 00:02:37,395 --> 00:02:40,055 is, what got me into health care. So, 71 00:02:40,514 --> 00:02:42,055 Take Command was initially 72 00:02:42,514 --> 00:02:44,675 an early player in in kind of the 73 00:02:44,675 --> 00:02:45,175 ACA 74 00:02:46,115 --> 00:02:46,615 advising, 75 00:02:47,314 --> 00:02:48,935 movement of helping people, 76 00:02:49,395 --> 00:02:50,834 pick and choose a health plan in the 77 00:02:50,834 --> 00:02:51,334 ACA. 78 00:02:53,030 --> 00:02:55,610 We stepped into the predecessor to ICRA, 79 00:02:55,990 --> 00:02:57,450 the QSC HRA, 80 00:02:57,990 --> 00:02:59,930 and started working with small employers, 81 00:03:00,389 --> 00:03:02,090 and then actually had a chance to, 82 00:03:03,030 --> 00:03:03,830 work with, 83 00:03:04,150 --> 00:03:04,650 regulators, 84 00:03:05,525 --> 00:03:07,925 during the first Trump administration to help create 85 00:03:07,925 --> 00:03:10,164 some of the ICRA rules after after broader 86 00:03:10,164 --> 00:03:12,185 health care reform had failed. So, 87 00:03:12,884 --> 00:03:15,925 excited to, you know, it's kinda evolution going 88 00:03:15,925 --> 00:03:18,644 from individual to small business to now with 89 00:03:18,644 --> 00:03:19,144 ICRA 90 00:03:19,569 --> 00:03:20,770 working more and more with, 91 00:03:21,330 --> 00:03:22,230 large employers. 92 00:03:23,090 --> 00:03:25,090 Sure. Quite an evolution of a career you've 93 00:03:25,090 --> 00:03:27,169 had then, it sounds like, Jack, from from 94 00:03:27,169 --> 00:03:27,990 federal government, 95 00:03:28,449 --> 00:03:29,590 intelligence to 96 00:03:29,889 --> 00:03:31,969 health insurance. Day it all makes sense. You 97 00:03:31,969 --> 00:03:34,050 know, maybe there's a bigger plan out there, 98 00:03:34,050 --> 00:03:36,905 but I'm super grateful. Yeah. Sure. Well, so 99 00:03:36,905 --> 00:03:38,905 it's clearly it's a personal journey for you 100 00:03:38,905 --> 00:03:40,504 as well as much as it is professional 101 00:03:40,504 --> 00:03:42,664 in terms of the background of Take Command. 102 00:03:42,664 --> 00:03:44,125 And, you know, you mentioned, 103 00:03:45,224 --> 00:03:47,144 health insurance. It kinda sounded like or at 104 00:03:47,144 --> 00:03:48,424 least what I've heard from leaders in the 105 00:03:48,424 --> 00:03:50,200 industry before, when they talk to people who 106 00:03:50,200 --> 00:03:52,200 aren't in this industry, that it it almost 107 00:03:52,200 --> 00:03:53,640 seems like it would be very dry. But 108 00:03:53,640 --> 00:03:55,400 I think you and I both know it 109 00:03:55,400 --> 00:03:57,180 is it is anything but that. And, 110 00:03:58,280 --> 00:03:59,960 and it's also going through a a lot 111 00:03:59,960 --> 00:04:01,719 of change right now. It always has been. 112 00:04:01,719 --> 00:04:03,574 But right now, as as you know, given 113 00:04:03,634 --> 00:04:05,634 given the company that you help start and 114 00:04:05,634 --> 00:04:08,034 oversee, it's it's a it's an incredible time 115 00:04:08,034 --> 00:04:10,115 for for how this industry and how health 116 00:04:10,115 --> 00:04:11,735 benefits are changing. And 117 00:04:12,034 --> 00:04:13,715 that's that's what I wanted to get us 118 00:04:13,715 --> 00:04:15,335 started about talking today. 119 00:04:15,875 --> 00:04:16,615 An interesting 120 00:04:16,915 --> 00:04:18,214 move out of West Virginia. 121 00:04:18,560 --> 00:04:20,400 There's a county there that recently became one 122 00:04:20,400 --> 00:04:22,020 of the first public entities 123 00:04:22,639 --> 00:04:24,960 to drop the traditional group coverage that everybody 124 00:04:24,960 --> 00:04:28,000 knows in favor of an ICRA through Take 125 00:04:28,000 --> 00:04:28,500 Command. 126 00:04:29,439 --> 00:04:31,460 So maybe for our audience who isn't familiar, 127 00:04:31,520 --> 00:04:33,460 first, Jack, just give us a quick 128 00:04:33,845 --> 00:04:36,725 overview what is ICRA, and then what's kind 129 00:04:36,725 --> 00:04:38,964 of the what's kind of the significance here 130 00:04:38,964 --> 00:04:40,985 of seeing a public entity, 131 00:04:41,685 --> 00:04:42,985 go go in this direction? 132 00:04:43,764 --> 00:04:44,904 Yeah. Great question. 133 00:04:45,685 --> 00:04:47,365 You know, ICRA is a term 134 00:04:47,970 --> 00:04:50,370 you know, it's it's, six years old now, 135 00:04:50,370 --> 00:04:53,379 so it became a thing in in January 136 00:04:53,379 --> 00:04:54,149 2020. 137 00:04:54,529 --> 00:04:57,670 It stands for the individual coverage health reimbursement 138 00:04:57,730 --> 00:04:59,910 arrangement or individual coverage HRA. 139 00:05:00,685 --> 00:05:03,004 I think a lot of health executives, you 140 00:05:03,004 --> 00:05:04,225 know, early on 141 00:05:04,604 --> 00:05:05,504 kind of mistakenly 142 00:05:06,125 --> 00:05:09,985 threw it into the HRA, FSA, HSA category 143 00:05:10,604 --> 00:05:12,524 of, like, oh, okay. Here's another thing or 144 00:05:12,524 --> 00:05:13,664 or another twist. 145 00:05:14,169 --> 00:05:16,729 But but, fundamentally, although it shares the the 146 00:05:16,729 --> 00:05:19,550 three letter acronym with with, HRA, 147 00:05:20,250 --> 00:05:21,789 it really is a fundamentally 148 00:05:22,250 --> 00:05:24,810 new way for employers to think about, 149 00:05:25,209 --> 00:05:28,115 insurance benefits. So it, you know, I know 150 00:05:28,115 --> 00:05:29,794 many of your listeners have been around for 151 00:05:29,794 --> 00:05:31,714 a while, and this this idea of defined 152 00:05:31,714 --> 00:05:32,214 contribution, 153 00:05:33,074 --> 00:05:35,794 always seems to have, fits and starts in 154 00:05:35,794 --> 00:05:36,535 our industry. 155 00:05:37,394 --> 00:05:41,394 Well, ICRA actually now provides the the rules 156 00:05:41,394 --> 00:05:42,134 and regulations, 157 00:05:43,290 --> 00:05:45,610 for defined contribution to be a real thing 158 00:05:45,610 --> 00:05:47,449 in health care. You know, so what that 159 00:05:47,449 --> 00:05:48,990 looks like now is employers, 160 00:05:49,930 --> 00:05:51,470 small, medium, large, 161 00:05:52,250 --> 00:05:55,470 instead of purchasing a traditional group health plan 162 00:05:55,875 --> 00:05:57,095 for for their employees, 163 00:05:57,955 --> 00:06:00,595 now they can offer a defined contribution. So 164 00:06:00,595 --> 00:06:02,535 kind of this four zero one k style. 165 00:06:02,915 --> 00:06:05,154 There's a lot of flexibility with, hey. I 166 00:06:05,154 --> 00:06:07,395 wanna give maybe $300 167 00:06:07,395 --> 00:06:09,314 a month to my part time employees and 168 00:06:09,314 --> 00:06:12,120 600 to my full time or different amounts 169 00:06:12,120 --> 00:06:13,100 based on location, 170 00:06:13,720 --> 00:06:15,740 or other approved employee classes. 171 00:06:16,439 --> 00:06:18,379 It creates this really flexible 172 00:06:18,759 --> 00:06:21,639 opportunities for for employers. It solves a lot 173 00:06:21,639 --> 00:06:23,100 of the problems that, 174 00:06:23,660 --> 00:06:26,100 you know, group health plans have dealt with 175 00:06:26,100 --> 00:06:28,540 in terms of adverse selection or or not 176 00:06:28,540 --> 00:06:31,285 being able to anything more about remote work 177 00:06:31,285 --> 00:06:33,725 and being able to cover people coast to 178 00:06:33,725 --> 00:06:36,470 coast. But it creates this really cool opportunity 179 00:06:36,470 --> 00:06:39,639 for, individual employees now where, okay, they can 180 00:06:39,639 --> 00:06:40,139 go, 181 00:06:40,839 --> 00:06:42,860 purchase a plan in their local market. 182 00:06:43,240 --> 00:06:45,479 Administrators like Take Command and and others have 183 00:06:45,479 --> 00:06:48,279 gotten good at helping advise employees on, hey. 184 00:06:48,279 --> 00:06:49,959 You should pick this plan because it's got 185 00:06:49,959 --> 00:06:51,845 your doctor in it, or this one's gonna 186 00:06:51,845 --> 00:06:53,625 cover your prescriptions the best. 187 00:06:54,165 --> 00:06:55,225 And it creates this 188 00:06:55,525 --> 00:06:57,145 real real kind of flexible, 189 00:06:58,085 --> 00:07:00,404 layer of coverage at at two different levels, 190 00:07:00,404 --> 00:07:01,225 at the employer, 191 00:07:01,685 --> 00:07:03,785 and then at the the employee level. 192 00:07:04,680 --> 00:07:06,439 And the the other great thing about it, 193 00:07:06,439 --> 00:07:08,860 you know, we're super excited to see, 194 00:07:09,720 --> 00:07:10,220 Monongahela 195 00:07:10,600 --> 00:07:12,220 County in in West Virginia, 196 00:07:13,080 --> 00:07:14,279 you know, really be the first 197 00:07:14,840 --> 00:07:17,454 I know some other, like, municipalities have explored 198 00:07:17,454 --> 00:07:19,294 ICRA, but this was a a big public 199 00:07:19,294 --> 00:07:20,354 win for ICRA. 200 00:07:21,214 --> 00:07:24,175 And, you know, they Mongolia faces the the 201 00:07:24,175 --> 00:07:26,574 same challenges that a lot of employers do 202 00:07:26,574 --> 00:07:28,834 of of, hey. We've got rising, 203 00:07:29,535 --> 00:07:30,035 premiums. 204 00:07:30,894 --> 00:07:32,579 In this case, we've got a fixed 205 00:07:33,060 --> 00:07:35,879 tax base or tip or fixed revenue base, 206 00:07:36,099 --> 00:07:36,919 and absorbing, 207 00:07:37,220 --> 00:07:39,720 you know, these twenty, thirty, 40% 208 00:07:39,779 --> 00:07:40,279 increases, 209 00:07:41,219 --> 00:07:43,240 actually gets really hard. And, 210 00:07:44,180 --> 00:07:46,259 you know, so ICRA, because it's a fine 211 00:07:46,259 --> 00:07:46,759 contribution, 212 00:07:47,060 --> 00:07:49,144 it it does provide more cost control to 213 00:07:49,144 --> 00:07:49,805 the employers. 214 00:07:50,425 --> 00:07:52,125 There actually was a an interesting, 215 00:07:53,384 --> 00:07:56,285 their meeting minutes from from their council meeting, 216 00:07:57,064 --> 00:07:59,144 came out yesterday, and there's an item in 217 00:07:59,144 --> 00:08:00,845 it in in the commissioner report. 218 00:08:01,225 --> 00:08:02,745 Let me find it here real quick. 219 00:08:03,670 --> 00:08:06,650 Talking about saving $700,000, 220 00:08:07,750 --> 00:08:09,930 this last year by shifting to ICRA, 221 00:08:10,870 --> 00:08:13,750 and the the cost that their employees were 222 00:08:13,750 --> 00:08:14,970 paying, their premiums, 223 00:08:15,589 --> 00:08:17,770 dropped between about 7%. 224 00:08:18,854 --> 00:08:21,495 So a huge win just by being able 225 00:08:21,495 --> 00:08:23,435 to to control the cost 226 00:08:23,894 --> 00:08:26,474 and and kinda reset the the insurance game. 227 00:08:26,615 --> 00:08:29,175 And it's really interesting. Those those, figures you 228 00:08:29,175 --> 00:08:30,694 you stated there, Jack, in terms of some 229 00:08:30,694 --> 00:08:33,100 of the savings this county will see. And 230 00:08:33,100 --> 00:08:35,500 and I wonder, you know, you said there's 231 00:08:35,500 --> 00:08:38,220 other government entities that have been interested in 232 00:08:38,220 --> 00:08:40,540 ICRA, but this was really one of the 233 00:08:40,540 --> 00:08:42,379 more the the first or the more most 234 00:08:42,379 --> 00:08:42,879 public, 235 00:08:43,740 --> 00:08:46,264 situation that we've seen. So are you seeing 236 00:08:46,264 --> 00:08:48,524 more interest from from government employers? 237 00:08:49,384 --> 00:08:51,305 And could we see you know, I think 238 00:08:51,305 --> 00:08:52,504 fair to say, this is a pretty small 239 00:08:52,504 --> 00:08:54,745 county in a in a smaller state. So 240 00:08:54,745 --> 00:08:56,504 where do we are you gonna see at 241 00:08:56,504 --> 00:08:59,325 some point entire states or or larger, 242 00:09:00,105 --> 00:09:00,605 counties 243 00:09:00,909 --> 00:09:02,370 look into something like this? 244 00:09:03,309 --> 00:09:04,909 You know, I think so. And and I 245 00:09:04,909 --> 00:09:05,409 think, 246 00:09:06,190 --> 00:09:08,750 so so, yes, it's still early days in 247 00:09:08,750 --> 00:09:11,149 ICRA. As mentioned, it's it's six years old, 248 00:09:11,149 --> 00:09:13,009 which and and our, 249 00:09:13,464 --> 00:09:15,945 in our industry, it's it's, you know, the 250 00:09:15,945 --> 00:09:16,764 first inning, 251 00:09:17,384 --> 00:09:18,764 of of a longer game. 252 00:09:19,625 --> 00:09:21,384 But but I think, you know, for for 253 00:09:21,384 --> 00:09:22,524 health plan executives 254 00:09:22,825 --> 00:09:25,144 thinking about how this could evolve. Right? You 255 00:09:25,144 --> 00:09:26,264 know, you've got your, 256 00:09:27,370 --> 00:09:30,509 kinda early mover, early adopters right now. 257 00:09:30,889 --> 00:09:31,949 Now this county, 258 00:09:32,329 --> 00:09:33,149 you know, they, 259 00:09:34,250 --> 00:09:35,470 working with their team, 260 00:09:35,850 --> 00:09:37,389 they were really forward leaning. 261 00:09:37,929 --> 00:09:40,269 They were actively looking for solutions, 262 00:09:41,004 --> 00:09:41,504 and, 263 00:09:42,845 --> 00:09:44,924 ICRO was a great fit, and and now 264 00:09:44,924 --> 00:09:46,865 they're gonna recognize those savings. 265 00:09:47,324 --> 00:09:49,485 You know? And it's it's stories and case 266 00:09:49,485 --> 00:09:51,564 studies like that that kinda move you from 267 00:09:51,564 --> 00:09:54,100 the early adopter phase, you know, into the 268 00:09:54,100 --> 00:09:57,539 more kinda, you know, medium adopter or, a 269 00:09:57,539 --> 00:10:00,339 little bit more mainstream. So I I don't 270 00:10:00,339 --> 00:10:02,120 think it's gonna happen overnight, 271 00:10:02,659 --> 00:10:03,799 but I do think, 272 00:10:04,579 --> 00:10:06,600 you know, steady over time, 273 00:10:07,285 --> 00:10:09,445 ICRO is being is gonna become more and 274 00:10:09,445 --> 00:10:11,304 more mainstream and and commonplace. 275 00:10:11,684 --> 00:10:13,304 And and as a health plan executive, 276 00:10:13,924 --> 00:10:15,764 you know, really thinking about, alright, what is 277 00:10:15,764 --> 00:10:17,785 our ICRO strategy? How do we, 278 00:10:18,245 --> 00:10:19,065 play offense, 279 00:10:19,445 --> 00:10:21,205 if we've got opportunities to that? Or how 280 00:10:21,205 --> 00:10:22,184 do we play defense? 281 00:10:23,240 --> 00:10:26,440 I you know, ICRA, it's it's sub 1% 282 00:10:26,440 --> 00:10:28,360 right now, but if you're not thinking about 283 00:10:28,360 --> 00:10:29,879 it, I think you're you're gonna be a 284 00:10:29,879 --> 00:10:31,559 little bit behind in the next few years 285 00:10:31,879 --> 00:10:33,399 Sure. Or getting caught up in the heart. 286 00:10:33,399 --> 00:10:34,759 Yeah. No. It makes a lot of sense. 287 00:10:34,759 --> 00:10:36,839 And I think just given some of the 288 00:10:36,839 --> 00:10:37,335 group 289 00:10:37,654 --> 00:10:40,134 rates we've seen this year alone compared to 290 00:10:40,134 --> 00:10:41,894 some of those savings you you mentioned, Jack, 291 00:10:41,894 --> 00:10:43,894 I think for a lot of entities, a 292 00:10:43,894 --> 00:10:45,654 lot of employers, it's gonna be hard to 293 00:10:45,654 --> 00:10:46,154 ignore, 294 00:10:46,695 --> 00:10:48,855 moving forward. But I also wanted to talk 295 00:10:48,855 --> 00:10:50,535 wanted to talk about some of the bigger 296 00:10:50,535 --> 00:10:50,940 context 297 00:10:51,340 --> 00:10:53,679 here around ICRA and, of course, the ACA, 298 00:10:54,220 --> 00:10:55,740 and everything that's been going on at the 299 00:10:55,740 --> 00:10:58,379 federal level. Mhmm. With the expiration of the 300 00:10:58,379 --> 00:11:00,320 the enhanced subsidies last year, 301 00:11:00,700 --> 00:11:04,154 no real congressional solution in sight, even if 302 00:11:04,154 --> 00:11:05,915 that is in the form of going down 303 00:11:05,915 --> 00:11:07,774 the HSA path, which we've seen. 304 00:11:08,315 --> 00:11:12,174 Some Republicans really been pushing recently. So preliminary 305 00:11:12,315 --> 00:11:14,475 enrollment data for the ACA, and I know 306 00:11:14,475 --> 00:11:16,154 enrollment just ended yesterday, so we don't have 307 00:11:16,154 --> 00:11:18,789 the final numbers. But it has declined around 308 00:11:18,789 --> 00:11:20,789 the country. Some states, a lot more than 309 00:11:20,789 --> 00:11:21,289 others. 310 00:11:21,830 --> 00:11:23,669 But it looks like as of the start 311 00:11:23,669 --> 00:11:25,830 of this month in January, about three and 312 00:11:25,830 --> 00:11:27,990 a half percent decline around the country. So 313 00:11:27,990 --> 00:11:30,309 I wonder overall how you're thinking about this 314 00:11:30,309 --> 00:11:32,169 as you look through this data, 315 00:11:32,884 --> 00:11:35,205 and as as you see, you know, around 316 00:11:35,205 --> 00:11:36,825 the country, different state marketplaces. 317 00:11:37,605 --> 00:11:40,325 How is this instability affecting employer interest in 318 00:11:40,325 --> 00:11:42,404 ECHO right now? Does it change the value 319 00:11:42,404 --> 00:11:43,705 proposition for workers? 320 00:11:44,085 --> 00:11:45,625 How are you thinking about all this? 321 00:11:46,460 --> 00:11:48,480 It's a good good question, Jacob. 322 00:11:49,180 --> 00:11:51,340 And, you know, we did see a lot 323 00:11:51,340 --> 00:11:52,080 of employers 324 00:11:52,940 --> 00:11:54,000 this year were, 325 00:11:54,700 --> 00:11:55,759 exploring ICRA. 326 00:11:56,300 --> 00:11:58,220 I'd say they got close to the finish 327 00:11:58,220 --> 00:11:58,660 line, 328 00:11:59,100 --> 00:12:01,279 but, you know, some of the political uncertainty 329 00:12:01,875 --> 00:12:04,355 or market uncertainty is like, well, let's wait 330 00:12:04,355 --> 00:12:06,434 one more year. Let's let's kinda see how 331 00:12:06,434 --> 00:12:07,894 things shake out. So, 332 00:12:08,595 --> 00:12:10,514 you know, we we we've all learned in 333 00:12:10,514 --> 00:12:12,615 this industry not not to bet on Congress, 334 00:12:13,634 --> 00:12:14,615 and, you know, 335 00:12:15,839 --> 00:12:18,740 health care reform gets recast as insurance reform, 336 00:12:20,480 --> 00:12:21,620 over and over again. 337 00:12:23,200 --> 00:12:25,519 I I I do think, you know, what's 338 00:12:25,519 --> 00:12:28,259 encouraging, though, is is the long term, 339 00:12:29,154 --> 00:12:31,394 and seeing in in a strange way. I 340 00:12:31,394 --> 00:12:32,995 I I think, you know, we're all hoping 341 00:12:32,995 --> 00:12:34,774 for some reforms or for, 342 00:12:35,554 --> 00:12:37,715 the subsidies to be to come back or 343 00:12:37,715 --> 00:12:39,174 at least tapered down, 344 00:12:40,115 --> 00:12:42,590 over a period. You know, the the sudden 345 00:12:42,590 --> 00:12:44,929 shocks to the system are are what kinda 346 00:12:45,789 --> 00:12:47,809 hurt or or can be be frustrating. 347 00:12:48,990 --> 00:12:50,590 But we are encouraged, though, and now we're 348 00:12:50,590 --> 00:12:53,570 hearing Republicans talk about funding CSR payments, 349 00:12:54,190 --> 00:12:54,690 which, 350 00:12:55,115 --> 00:12:56,875 you know, would be great because that gets 351 00:12:56,875 --> 00:12:59,194 money where it's it needs to be for 352 00:12:59,194 --> 00:13:01,754 lower income Americans and helps bring the you 353 00:13:01,754 --> 00:13:03,855 know, removes the silver loading problem 354 00:13:04,235 --> 00:13:06,815 and helps bring premiums down for everyone else. 355 00:13:07,274 --> 00:13:10,014 You know, ICRA is interesting because it 356 00:13:10,639 --> 00:13:14,080 it doesn't rely on premium credits. Most ICRA 357 00:13:14,080 --> 00:13:14,580 recipients, 358 00:13:15,039 --> 00:13:17,440 because they're getting an ICRA allowance, they're not 359 00:13:17,440 --> 00:13:20,240 eligible for tax credits. So they're that small 360 00:13:20,240 --> 00:13:22,240 percentage of the market that's gonna pay full 361 00:13:22,240 --> 00:13:24,019 freight for for the premium. 362 00:13:24,695 --> 00:13:27,674 And so anything like CSR payments or, 363 00:13:28,134 --> 00:13:30,375 other reforms that can bring down that top 364 00:13:30,375 --> 00:13:32,714 line number are are desirable, 365 00:13:33,575 --> 00:13:34,394 for ICRA. 366 00:13:35,334 --> 00:13:36,955 I I was encouraged, though, 367 00:13:37,259 --> 00:13:39,420 again, as you mentioned, still early days with 368 00:13:39,420 --> 00:13:41,420 getting numbers in, and and there is a 369 00:13:41,420 --> 00:13:41,920 decline. 370 00:13:43,179 --> 00:13:45,420 A big fear I had was, oh, is 371 00:13:45,420 --> 00:13:46,800 this gonna be the, 372 00:13:47,740 --> 00:13:48,720 kinda unwinding 373 00:13:49,340 --> 00:13:49,820 or, 374 00:13:50,144 --> 00:13:52,884 you know, really damaging to the ACA marketplace. 375 00:13:53,504 --> 00:13:55,504 I have a feeling that 3% will drop 376 00:13:55,504 --> 00:13:57,845 a little bit further as as people, 377 00:13:58,545 --> 00:14:01,184 maybe they don't effectuate their policies fully in 378 00:14:01,184 --> 00:14:03,504 in January. But we're but we're past the, 379 00:14:03,504 --> 00:14:05,285 oh my gosh, the ACA is 380 00:14:05,589 --> 00:14:07,909 falling twenty, thirty percent, and we're gonna see 381 00:14:07,909 --> 00:14:09,850 big pullbacks and and kinda 382 00:14:10,389 --> 00:14:11,690 death spiral start, 383 00:14:12,070 --> 00:14:13,529 activity like we saw, 384 00:14:13,909 --> 00:14:15,509 you know, a couple years ago in in 385 00:14:15,509 --> 00:14:16,649 the individual market. 386 00:14:16,950 --> 00:14:18,490 It does feel like it's stabilized. 387 00:14:18,950 --> 00:14:19,450 And, 388 00:14:20,384 --> 00:14:24,004 the encouraging thing talking to some insurance carriers, 389 00:14:24,945 --> 00:14:28,305 okay. While while individual enrollment may be pulling 390 00:14:28,305 --> 00:14:28,805 back, 391 00:14:29,504 --> 00:14:31,125 is ICRA an alternative, 392 00:14:31,904 --> 00:14:34,085 for them to replace some of those losses? 393 00:14:34,144 --> 00:14:36,490 So that's where I talk about, you know, 394 00:14:36,490 --> 00:14:39,129 executives needing that kind of thinking and and 395 00:14:39,129 --> 00:14:40,889 strategy of, hey. How do we lean in 396 00:14:40,889 --> 00:14:43,290 here? And if we're if we're a big 397 00:14:43,290 --> 00:14:43,790 ACA, 398 00:14:44,889 --> 00:14:47,149 carrier and we're gonna lose some enrollments, 399 00:14:47,644 --> 00:14:49,725 let's go make it up in the small, 400 00:14:49,725 --> 00:14:52,924 medium, large business segment with ICRA, to replace 401 00:14:52,924 --> 00:14:54,225 those individual enrollments. 402 00:14:55,164 --> 00:14:56,924 Mhmm. And that's an interesting point. I think 403 00:14:56,924 --> 00:14:57,424 definitely, 404 00:14:57,884 --> 00:14:59,485 is would is catching the ear of a 405 00:14:59,485 --> 00:15:01,105 lot of our listeners, 406 00:15:01,565 --> 00:15:03,679 hearing hearing from you right now, Jack. I 407 00:15:03,679 --> 00:15:05,839 also you know, to your point, three and 408 00:15:05,839 --> 00:15:07,940 a half percent seems to be the worst 409 00:15:08,159 --> 00:15:09,759 number in terms of an enrollment drop, and 410 00:15:09,759 --> 00:15:12,320 it'll probably come down from there, which really 411 00:15:12,320 --> 00:15:13,360 goes in the face of a lot of 412 00:15:13,360 --> 00:15:15,360 some of the projections we were seeing of 413 00:15:15,440 --> 00:15:16,879 that it was, you know, doomsday for the 414 00:15:16,879 --> 00:15:19,084 ACA to your point. So I think that's 415 00:15:19,084 --> 00:15:20,764 also, you know, at least on our end, 416 00:15:20,764 --> 00:15:22,704 worth some follow-up coverage of 417 00:15:23,084 --> 00:15:24,944 where did these projections go wrong. 418 00:15:25,485 --> 00:15:26,845 That's a that's another story. 419 00:15:27,725 --> 00:15:30,444 But like like you've mentioned, it it's early 420 00:15:30,444 --> 00:15:32,764 days still for ICRA, and it's only been 421 00:15:32,764 --> 00:15:34,144 around for six years now. 422 00:15:34,500 --> 00:15:36,660 That all being said, adoption has grown a 423 00:15:36,660 --> 00:15:39,320 thousand percent since 2020 around the country. 424 00:15:39,700 --> 00:15:42,120 I I know the data can be difficult 425 00:15:42,179 --> 00:15:44,440 to to collect. Small denominators 426 00:15:44,820 --> 00:15:47,779 for that growth, but, yeah, it's, it's it's 427 00:15:47,779 --> 00:15:50,684 picking up. And and the the highest end 428 00:15:50,684 --> 00:15:53,504 I've seen in terms of, enrollment is is, 429 00:15:53,725 --> 00:15:55,745 upwards towards a million people enrolled 430 00:15:56,045 --> 00:15:58,384 around the country in these types of arrangements. 431 00:15:58,684 --> 00:16:00,225 And that's on the upper end of projections. 432 00:16:00,285 --> 00:16:02,365 It it, you know, it I've seen in 433 00:16:02,365 --> 00:16:04,205 half, in terms of on the lower end. 434 00:16:04,205 --> 00:16:05,600 But I think overall, 435 00:16:05,899 --> 00:16:08,139 what do you think it's gonna take at 436 00:16:08,139 --> 00:16:10,700 this point moving forward to to move this 437 00:16:10,700 --> 00:16:12,620 from a niche product to to really a 438 00:16:12,620 --> 00:16:16,059 mainstream option that ensures the traditional insurers are 439 00:16:16,059 --> 00:16:17,120 are all in on? 440 00:16:17,544 --> 00:16:18,285 Good question. 441 00:16:18,665 --> 00:16:20,825 Yeah. I think, you know, the projections and 442 00:16:20,825 --> 00:16:22,825 data are are hard to get here. It's 443 00:16:22,825 --> 00:16:25,625 it's getting better. There's some, entities like the 444 00:16:25,625 --> 00:16:26,605 HRA Council. 445 00:16:27,384 --> 00:16:29,865 Kaiser Family Foundation put it on their survey 446 00:16:29,865 --> 00:16:31,544 this year, so we'll start to get a 447 00:16:31,544 --> 00:16:32,524 lot more data. 448 00:16:33,340 --> 00:16:35,980 I I think it's probably in the 400,000 449 00:16:35,980 --> 00:16:37,200 to 600,000, 450 00:16:37,899 --> 00:16:41,259 enrolled range. So it's very small in terms 451 00:16:41,259 --> 00:16:42,559 of the overall market. 452 00:16:43,659 --> 00:16:44,940 You know, but when you look at the 453 00:16:44,940 --> 00:16:47,419 ACA, it was at 24,000,000. 454 00:16:47,419 --> 00:16:49,245 Now it's gonna be, let's say, it shakes 455 00:16:49,245 --> 00:16:51,184 out at 20 to 21,000,000. 456 00:16:51,725 --> 00:16:54,605 You know, what's gonna grow it to 25, 457 00:16:54,605 --> 00:16:57,485 thirty, fifty million is is going going to 458 00:16:57,485 --> 00:16:58,225 be ICRA. 459 00:16:59,004 --> 00:17:00,705 And I think what is gonna, 460 00:17:01,089 --> 00:17:02,870 you know, move that forward, 461 00:17:03,649 --> 00:17:05,829 as the ACA shows more resiliency, 462 00:17:06,929 --> 00:17:08,789 as health plans get better, 463 00:17:09,170 --> 00:17:12,130 you start to see these positive snowball effects. 464 00:17:12,130 --> 00:17:13,410 And and one of the things I like 465 00:17:13,410 --> 00:17:15,654 to talk about is who is the ACA 466 00:17:15,654 --> 00:17:17,414 designed for, and then who is it working 467 00:17:17,414 --> 00:17:18,315 with for ICRA? 468 00:17:18,934 --> 00:17:20,855 So most of the policies, you know, rightly 469 00:17:20,855 --> 00:17:22,475 so, are designed for 470 00:17:22,934 --> 00:17:25,674 subsidized individuals that are are truly independent. 471 00:17:26,549 --> 00:17:29,049 So it's all about narrow networks and and 472 00:17:29,190 --> 00:17:30,090 thin formularies 473 00:17:30,630 --> 00:17:33,509 to try to get that low premium, $0 474 00:17:33,509 --> 00:17:35,190 premium plan and and show up at the 475 00:17:35,190 --> 00:17:36,570 top of the state marketplace. 476 00:17:37,430 --> 00:17:39,289 What's been fascinating with ICRA 477 00:17:39,964 --> 00:17:42,525 is it's attracting a new type of buyer 478 00:17:42,525 --> 00:17:44,765 to the individual market. These are medium and 479 00:17:44,765 --> 00:17:45,984 large employers 480 00:17:46,525 --> 00:17:47,904 employees at at employers. 481 00:17:49,244 --> 00:17:50,545 They want HSAs. 482 00:17:51,164 --> 00:17:51,984 They want, 483 00:17:52,445 --> 00:17:54,950 broader networks. They're less price sensitive. Like I 484 00:17:54,950 --> 00:17:56,630 said, they're not getting a tax credit or 485 00:17:56,630 --> 00:17:57,130 subsidy. 486 00:17:58,230 --> 00:17:58,730 And 487 00:17:59,190 --> 00:18:01,830 what's been interesting, Jacob, is starting to talk 488 00:18:01,830 --> 00:18:03,990 to some insurance carriers that are looking at 489 00:18:03,990 --> 00:18:05,450 this opportunity and saying, 490 00:18:06,070 --> 00:18:08,410 Hey. I can design an off exchange 491 00:18:08,710 --> 00:18:09,210 plan. 492 00:18:09,615 --> 00:18:12,095 Still ACA qualified. Right? But we're not gonna 493 00:18:12,095 --> 00:18:13,694 sell it through the exchange, which means we 494 00:18:13,694 --> 00:18:15,134 don't have to pay exchange fees. We don't 495 00:18:15,134 --> 00:18:17,134 have to do the silver loading thing, and 496 00:18:17,134 --> 00:18:19,315 we can design it, you know, with with, 497 00:18:20,255 --> 00:18:21,474 features that, 498 00:18:21,929 --> 00:18:24,730 these employees are interested in. And and I 499 00:18:24,730 --> 00:18:26,490 share that because I think it creates a 500 00:18:26,490 --> 00:18:30,009 positive snowball where, okay, if the ICRA market 501 00:18:30,009 --> 00:18:32,889 is at, you know, 400 to 600,000 502 00:18:32,889 --> 00:18:33,629 right now, 503 00:18:34,355 --> 00:18:36,295 and we see counties like Mongolia 504 00:18:36,994 --> 00:18:38,835 who are having to move to ICRA because 505 00:18:38,835 --> 00:18:39,575 of cost. 506 00:18:40,275 --> 00:18:42,215 Okay. Well, now there's more in the market. 507 00:18:42,994 --> 00:18:45,174 We see the ACA market stabilize. 508 00:18:45,555 --> 00:18:48,375 We see plans get introduced for this audience 509 00:18:48,789 --> 00:18:51,029 that attracts the next level of county, right, 510 00:18:51,029 --> 00:18:52,809 or the next employer that, 511 00:18:53,509 --> 00:18:55,109 says, well, hey. You know, we don't have 512 00:18:55,109 --> 00:18:56,950 to save as much. It's worth it, or 513 00:18:56,950 --> 00:18:59,289 these options are better or as good as. 514 00:18:59,430 --> 00:19:00,950 And I think you start to see that 515 00:19:00,950 --> 00:19:02,890 that positive snowball effect. 516 00:19:04,025 --> 00:19:07,065 One one ancillary we've studied closely, Jacob, is, 517 00:19:07,384 --> 00:19:10,044 the transition in corporate America from 518 00:19:10,505 --> 00:19:12,044 primarily pension plans, 519 00:19:12,585 --> 00:19:14,044 in the seventies and eighties 520 00:19:14,505 --> 00:19:16,125 to four zero one k style, 521 00:19:16,994 --> 00:19:17,494 plans 522 00:19:18,329 --> 00:19:19,769 in the late eighties and and in the 523 00:19:19,849 --> 00:19:21,450 into the nineties and and, of course, where 524 00:19:21,450 --> 00:19:22,269 we are today. 525 00:19:22,650 --> 00:19:24,190 And it wasn't a sudden 526 00:19:24,650 --> 00:19:26,970 shift. It wasn't like every year or one 527 00:19:26,970 --> 00:19:29,549 year, everyone moved, but it was very, 528 00:19:30,304 --> 00:19:32,544 steady and meticulous. And over a twenty year 529 00:19:32,544 --> 00:19:33,924 period, right, you 530 00:19:34,304 --> 00:19:36,804 see pension plans really start to fade, 531 00:19:37,105 --> 00:19:39,345 and you see four zero one k really 532 00:19:39,345 --> 00:19:40,644 start to to become, 533 00:19:41,025 --> 00:19:41,765 you know, 534 00:19:42,319 --> 00:19:44,640 early adopters and then mainstream, and then it 535 00:19:44,640 --> 00:19:46,799 becomes the primary vehicle for a lot of 536 00:19:46,799 --> 00:19:49,039 employers. I I think we'll see similar movement 537 00:19:49,039 --> 00:19:49,779 with ICRA. 538 00:19:50,720 --> 00:19:53,039 And that's a really good point, Jack. And 539 00:19:53,039 --> 00:19:54,559 and I think even if you were talking 540 00:19:54,559 --> 00:19:54,944 about, 541 00:19:55,505 --> 00:19:56,944 you just talk about pensions to four zero 542 00:19:56,944 --> 00:19:58,865 one k's. If we're talking about, you know, 543 00:19:58,865 --> 00:20:01,524 a comparable of traditional health insurance to ICRA, 544 00:20:01,664 --> 00:20:03,184 you know, that this is something that's been 545 00:20:03,184 --> 00:20:05,444 in place since you could say the forties. 546 00:20:05,904 --> 00:20:08,464 You know, it's gonna take time, to to 547 00:20:08,464 --> 00:20:10,244 un unroll this kind of system. 548 00:20:10,579 --> 00:20:12,099 And and something you'd said earlier in terms 549 00:20:12,099 --> 00:20:13,720 of the traditional insurers 550 00:20:14,099 --> 00:20:15,539 because we're we're hearing that too that it 551 00:20:15,940 --> 00:20:17,380 I think for a while we were hearing 552 00:20:17,380 --> 00:20:19,079 that they were worried it was gonna cannibalize 553 00:20:19,539 --> 00:20:21,380 some of their product lines. But now to 554 00:20:21,380 --> 00:20:22,980 your point, it's a lot of them are 555 00:20:22,980 --> 00:20:24,599 looking at this as as an opportunity, 556 00:20:25,445 --> 00:20:27,785 to pick up more business or or investing 557 00:20:27,845 --> 00:20:31,065 in some of these ICRA administration companies directly, 558 00:20:31,765 --> 00:20:33,785 is what we're what we're certainly seeing. 559 00:20:34,325 --> 00:20:36,484 Yeah. One one stat we love to throw 560 00:20:36,484 --> 00:20:38,509 out, and it's true. We've 561 00:20:38,809 --> 00:20:41,369 validated the HRA council and and with other 562 00:20:41,369 --> 00:20:42,090 ICRA administrators, but, 563 00:20:43,769 --> 00:20:45,710 85 to 90% 564 00:20:45,769 --> 00:20:46,910 of small employers 565 00:20:47,609 --> 00:20:48,430 under 50, 566 00:20:49,450 --> 00:20:51,609 are using ICRA to offer coverage for the 567 00:20:51,609 --> 00:20:52,349 first time. 568 00:20:52,724 --> 00:20:54,724 So we hear a lot of you know, 569 00:20:54,724 --> 00:20:56,265 there's concern about cannibalization. 570 00:20:56,964 --> 00:20:58,724 And, yes, in the in the upper market, 571 00:20:58,724 --> 00:21:00,904 you know, if you're a group carrier and, 572 00:21:01,525 --> 00:21:03,125 it gets busted up and it goes to 573 00:21:03,125 --> 00:21:05,525 ICRA, you you want an individual plan. They 574 00:21:05,525 --> 00:21:07,285 are ready to catch as many lives and 575 00:21:07,285 --> 00:21:08,460 members as you can. 576 00:21:09,019 --> 00:21:11,659 But on the small market, there is an 577 00:21:11,659 --> 00:21:12,880 enormous opportunity, 578 00:21:13,740 --> 00:21:16,319 to get new lives, new people covered, 579 00:21:16,859 --> 00:21:19,099 that have never had coverage before. So that's 580 00:21:19,099 --> 00:21:21,875 that's something that's been really exciting. Yeah. Definitely. 581 00:21:21,934 --> 00:21:24,575 Entirely untapped market. It's it's really interesting to 582 00:21:24,575 --> 00:21:26,494 think about. Well, Jack, you've got the ears 583 00:21:26,494 --> 00:21:27,474 of a lot of those 584 00:21:27,934 --> 00:21:29,795 traditional health plan leaders, 585 00:21:30,174 --> 00:21:32,115 from all over the country right now. 586 00:21:32,575 --> 00:21:34,509 So what else are we missing? Any final 587 00:21:34,509 --> 00:21:36,349 thoughts you wanna share with them, final bits 588 00:21:36,349 --> 00:21:38,349 of advice as we as we look into 589 00:21:38,349 --> 00:21:39,329 this new year? 590 00:21:40,910 --> 00:21:42,849 New year, you know, obviously, we're 591 00:21:43,390 --> 00:21:44,929 not not used to uncertainty, 592 00:21:45,789 --> 00:21:46,929 in in the space. 593 00:21:47,545 --> 00:21:49,325 But, I would really encourage, 594 00:21:49,785 --> 00:21:52,265 executives to to look at ICRA and think 595 00:21:52,265 --> 00:21:54,125 about the strategy there. And, 596 00:21:54,904 --> 00:21:56,765 it's picking up steam despite, 597 00:21:57,224 --> 00:21:57,805 you know, 598 00:21:58,184 --> 00:22:00,664 uncertainty in the ACA, and and, ultimately, I 599 00:22:00,664 --> 00:22:03,509 think it's gonna be a huge component and 600 00:22:03,509 --> 00:22:06,009 and proponent of the of the individual market. 601 00:22:06,549 --> 00:22:08,389 And we're starting to see more and more 602 00:22:08,389 --> 00:22:10,649 stories like this county in West Virginia, 603 00:22:11,669 --> 00:22:13,289 have a huge success, 604 00:22:13,829 --> 00:22:14,490 in moving 605 00:22:15,234 --> 00:22:17,014 moving to the to ICR arrangement. 606 00:22:17,714 --> 00:22:19,875 Now the county is happy and employees are 607 00:22:19,875 --> 00:22:22,294 happy. So that's that's something that I think 608 00:22:22,514 --> 00:22:24,274 you know, and it's it's not just cost 609 00:22:24,274 --> 00:22:26,434 arbitrage or or something like that. 610 00:22:26,755 --> 00:22:28,454 It's it it really is. 611 00:22:28,809 --> 00:22:30,250 Hey. There's there's a way that this can 612 00:22:30,250 --> 00:22:31,630 be a better model. 613 00:22:32,170 --> 00:22:33,390 So I I would encourage, 614 00:22:34,089 --> 00:22:36,170 executives to think about this, you know, reach 615 00:22:36,170 --> 00:22:38,589 out, to us at at Take Command. 616 00:22:39,369 --> 00:22:40,410 We have a whole, 617 00:22:40,804 --> 00:22:43,684 strategy primer on on ICRA. We're happy to 618 00:22:43,684 --> 00:22:46,005 share, and can look at trends in your 619 00:22:46,005 --> 00:22:46,904 local market. 620 00:22:47,285 --> 00:22:49,544 There's resources from the HRA council, 621 00:22:50,325 --> 00:22:52,184 and others as well. And and, 622 00:22:53,044 --> 00:22:55,220 you know, it's it's very small now, but 623 00:22:55,220 --> 00:22:56,759 but I think we're gonna see, 624 00:22:57,299 --> 00:22:59,940 steady and and significant growth. And and and 625 00:22:59,940 --> 00:23:00,599 I truly, 626 00:23:01,539 --> 00:23:02,839 to be a little bit provocative, 627 00:23:03,940 --> 00:23:05,539 I don't know if it's three years, five 628 00:23:05,539 --> 00:23:08,019 years, ten years, but but we will look 629 00:23:08,019 --> 00:23:08,519 back 630 00:23:08,825 --> 00:23:10,424 and say, oh my gosh. What happened to 631 00:23:10,424 --> 00:23:13,144 group insurance? It's all gone away or it's 632 00:23:13,144 --> 00:23:15,404 all changed over. And that sounds crazy. 633 00:23:15,785 --> 00:23:17,224 But, again, if I was talking to a 634 00:23:17,224 --> 00:23:18,204 pension exec, 635 00:23:18,825 --> 00:23:20,585 in the mid eighties, they would have said, 636 00:23:20,585 --> 00:23:21,325 oh, no way. 637 00:23:21,785 --> 00:23:23,644 But but look where they are now. And 638 00:23:24,109 --> 00:23:26,849 we're seeing the pull through demand from employers, 639 00:23:26,990 --> 00:23:28,830 and I think that's what's gonna really start 640 00:23:28,830 --> 00:23:29,330 getting, 641 00:23:30,029 --> 00:23:31,090 the attention of, 642 00:23:31,630 --> 00:23:32,769 health plan executives, 643 00:23:33,390 --> 00:23:33,890 brokers, 644 00:23:34,509 --> 00:23:35,250 and consultants. 645 00:23:35,950 --> 00:23:38,029 You know, employers look at this and say, 646 00:23:38,029 --> 00:23:40,565 heck, yeah. Why why wouldn't I do this? 647 00:23:40,944 --> 00:23:43,585 And, that should be either a red flag 648 00:23:43,585 --> 00:23:44,484 or a giant 649 00:23:44,785 --> 00:23:46,625 beacon of opportunity if if you're a health 650 00:23:46,625 --> 00:23:47,444 plan executive. 651 00:23:48,224 --> 00:23:50,065 It's fun to think about exciting stuff on 652 00:23:50,065 --> 00:23:52,144 the horizon for the industry. So, Jack, I 653 00:23:52,144 --> 00:23:53,984 I wanna thank you for taking the time 654 00:23:53,984 --> 00:23:56,220 to chat with us about what you're seeing 655 00:23:56,279 --> 00:23:58,440 recently across the country and for sharing your 656 00:23:58,440 --> 00:24:00,859 insights with our listeners. We really appreciate it. 657 00:24:00,919 --> 00:24:03,079 Absolutely. Hey. Thank you, Jacob, and and, 658 00:24:03,640 --> 00:24:05,399 thank you for having us on. Real pleasure 659 00:24:05,399 --> 00:24:07,844 and real honor. Absolutely. And to our listeners, 660 00:24:07,844 --> 00:24:09,924 if you'd like to listen to more podcasts 661 00:24:09,924 --> 00:24:13,784 from Becker's Healthcare, you can visit beckershospitalreview.com.