In this episode of The Business of Benefits, Donovan Ryckis sits down with attorney and national thought leader Alden J. Bianchi to expose one of the most costly and overlooked failures in employer-sponsored healthcare: the illusion of broker transparency. The Consolidated Appropriations Act (CAA) was supposed to fix hidden compensation. It didn’t. Instead, it created a fiduciary requirement to ask, without ever creating a requirement for brokers to actually tell. Employers are expected to manage fiduciary risk without pricing transparency, claims clarity, or conflict-free advice. Alden brings decades of experience advising Fortune 500 employers, consulting firms, and government agencies on ERISA, fiduciary duty, ACA compliance, transparency regulation, machine-readable files, and emerging litigation.In this conversation, he explains why:CAA compensation disclosures are “an absolute joke”Brokers and ASOs avoid disclosure by redefining themselves Employers are left negotiating blindfoldedCurrent PBM and ASO lawsuits are stalled by standing issuesFiduciary governance needs to mirror 401(k) standardsMachine-readable files and AI will change everythingHidden compensation lives in places most employers never lookTransparency is worthless without someone who knows how to use the dataIf you're a CFO, CHRO, HR Director, consultant, or fiduciary of a health plan, this conversation will change how you see the entire benefits ecosystem.What You’ll Learn:Why CAA broker transparency rules failedHow hidden compensation still influences broker recommendations Why employers must build fiduciary governance like their 401(k) plans The difference between named vs. functional fiduciaries How data, machine-readable files, and AI tools will reshape oversight Why market concentration and hospital power keep prices high How reference-based pricing and captives fit into employer strategy What upcoming congressional reforms might change Time Stamps:00:00 – Preview00:53 – Show Opener01:18 – Donovan’s Introduction02:04 – Meet Alden Bianchi02:49 – Alden’s Background (ACA, ERISA, Romney Reform)03:39 – Why Employer Healthcare Costs Exploded05:10 – Fiduciary Exposure and 401(k) Lessons07:17 – Donovan on Lack of Data in Healthcare08:49 – ACA vs. CAA: What Transparency Actually Changed10:12 – Machine-Readable Files: Why They Matter10:59 – Broker Compensation Rules Are “A Joke”12:14 – Why Disclosures Don’t Work (Undisclosed Incentives)14:02 – Donovan on Conflicts in Broker Comp15:30 – The True Fiduciary Standard for Employers16:14 – Alden’s B.O.L.O.s: Override Commissions, Referral Fees17:48 – Fiduciaries Must Become Quant Analysts18:54 – Who Is a Fiduciary? Alden’s Simple Definition20:36 – Why Fiduciary Exposure Is Personal21:13 – SHRM, CAA Compliance, and Employer Pushback21:56 – Challenges With Gag Clauses, RxDC, and Disclosures23:33 – Why Naming a Fiduciary Protects the Board25:40 – PBM Lawsuits: Standing Problems Explained27:35 – Why ERISA Remedies Are So Hard to Win29:20 – How PBM Practices Impact Premiums & Wages30:31 – Employers Subsidizing Medicare Rates31:13 – The $35,000 Family Plan Problem31:44 – Extreme Cases of 16x–21x Medicare Pricing32:29 – Alden on Reference-Based Pricing’s Role33:29 – Why Obamacare Didn’t Lower Costs34:27 – Hospital Profits, Medicare Rates & Misconceptions35:08 – Are Hospitals Really Underpaid?36:18 – Where Employers Should Actually Start37:43 – Incentive Problems in Broker/Consultant Models38:29 – Group Captives, AHPs, and Small Employer Solutions39:47 – Why Transparent Products Matter40:20 – Claims Reporting Problems (Body-Part Categories)41:18 – The Real Issue: Market Concentration, Not Just Benefits41:43 – PBM Regulation vs. Antitrust Problems42:26 – Broker Compensation Should Be on Page 1 of Renewals44:05 – Hidden Comp in MECs, Indemnity & Non-ERISA Lines45:48 – Excess Compensation, Double-Dipping & Fiduciary Risk46:03 – Alden’s Final Advice to Employers46:55 – Follow Alden on LinkedIn (B.O.L.O. Posts)47:28 – Closing Thoughts & Episode Wrap-UpConnect With Alden BianchiLinkedIn: https://www.linkedin.com/in/ajbianchi/Firm Bio: https://www.mintz.com/people/alden-j-bianchiConnect with Chelsea and Donovan:Website: https://businessofbenefitspodcast.com/Instagram: https://www.instagram.com/ethoseffectpodcast/Chelsea: https://www.linkedin.com/in/chelsea-ryckis-8508a192/Donovan: https://www.linkedin.com/in/donovanryckis/Subscribe for Weekly Employer Insights!Finished with the content? Claim your CE credit here: https://ideas.ethosbenefits.com/continuing-educationSHRM: Ethos Benefits is recognized by SHRM to offer professional development credits (PDCs) for SHRM-CP® or SHRM-SCP® recertification activities.HRCI: Ethos Benefits is approved to offer HRCI® recertification credits for this program. This program has been approved for 0.5 - 1 HR (General) recertification credit(s) toward...
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