『The EOB Podcast』のカバーアート

The EOB Podcast

The EOB Podcast

著者: Justin Leader and Julie Selesnick
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今ならプレミアムプランが3カ月 月額99円

2026年5月12日まで。4か月目以降は月額1,500円で自動更新します。

概要

Healthcare benefits are broken. Confusing by design. Buried in fine print. Protected by jargon.

The EOB Podcast (Explanation of Benefits) exists to rip the curtain back.

Hosted by Justin Leader, founder of BenefitsDNA — a known disruptor in the healthcare benefits industry, alongside Julie Selesnick, Director, Legal & Compliance at Judi Group and Founder & Principal Attorney at Health Plan Legal Counsel, a non-conflicted resource for fiduciaries sound benefit choices. This podcast breaks down what’s really happening inside health plans, contracts, and EOBs… in plain English.

This isn’t theory.
This isn’t recycled talking points.
And this definitely isn’t fluff.

Each episode dives into topics like:

  • What your EOB actually says (and what it doesn’t)

  • Fiduciary responsibility & plan sponsor accountability

  • Contract language, negotiations, and hidden incentives

  • Why benefits cost what they cost — and how to fix it

  • Real-world wins, failures, and lessons learned from the front lines

The goal is simple: make healthcare benefits understandable, actionable, and harder to hide behind complexity.

Along the way, Justin and Julie bring in “Friends with Benefits” — industry insiders, legal experts, and operators who are actively challenging the status quo and building smarter, more cost-effective benefit plans.

If you’re tired of lip service…
If you believe benefits don’t have to be this complicated…
If you want real education you can actually use…

Welcome to The EOB Podcast — where we keep it real, challenge the system, and explain benefits the way they should be explained.

Copyright 2026 All rights reserved.
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エピソード
  • PBM Transparency Rule Sparks Chaos | Inside the DOL Comment Storm
    2026/04/20

    This one couldn’t wait.

    In this episode of The EOB Podcast, Justin and Julie break down the proposed Department of Labor rule on PBM transparency — and the flood of industry responses submitted before the comment deadline.

    With over 500+ submissions from carriers, PBMs, employers, and other stakeholders, the conversation reveals a clear divide:

    👉 Those pushing for more transparency 👉 And those… pushing back hard

    For the first time, the proposed rule would require PBMs to disclose all compensation — including rebates, spread pricing, administrative fees, and more — before a contract is signed.

    So why the resistance?

    Justin and Julie dig into real comment letters from major players in the industry, breaking down:

    • Common arguments against the rule (and what they really mean)
    • Why “this is too complex” keeps coming up
    • What employers are being told vs. what they actually need
    • How transparency impacts fiduciary responsibility
    • And where this could go next

    Along the way, they call out contradictions, questionable logic, and a few moments that are… unintentionally hilarious.

    Because when it comes to healthcare benefits: understanding how money flows isn’t optional — it’s the whole game.

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    1 時間 15 分
  • What If Hospitals Were Treated Like Utilities? | Fixing Healthcare Pricing & more | Friends with Benefits 2: David Balinski of Wire Health
    2026/04/14

    What if the solution to rising healthcare costs isn’t more complexity… but more structure? In this episode of The EOB Podcast, Friends with Benefits Episode 2, Justin and Julie sit down with David Balinski, Founder & CEO of Wire Health, to challenge one of the biggest assumptions in healthcare:

    👉 Should hospitals be treated like utilities?

    From unpredictable pricing to lack of transparency and inefficient administrative systems, this conversation breaks down why the current healthcare model isn’t working — and what it might take to fix it.

    David shares a bold perspective on how regulating hospital pricing could:

    • Reduce extreme cost variation Improve access to care
    • Shift competition toward quality and outcomes
    • Eliminate billions in administrative waste
    • Create a more sustainable system for employers and patients

    The episode also dives into:

    • Why healthcare lacks a true free market
    • The illusion of price transparency
    • How networks impact pricing and access
    • The inefficiencies in claims processing and repricing
    • Why employers and employees are both feeling the financial strain

    If you’re an employer, HR leader, CFO, benefits advisor, or simply someone trying to understand why healthcare feels so broken… this episode connects the dots. Because when pricing doesn’t make sense… the system doesn’t either.

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    1 時間 7 分
  • Gag Clauses Are “Banned”… So Why Can’t You Access Your Data? | What Employers Need to Know
    2026/03/31

    Gag clauses were officially banned under the Consolidated Appropriations Act (CAA)… so why are employers still struggling to access their own healthcare data?

    In this episode of The EOB Podcast, Justin Leader and Julie Selesnick break down the real story behind gag clauses — what they are, why they were prohibited, and how they’re still impacting employers today.

    While plan sponsors are now required to submit annual gag clause attestations confirming they have access to their data, many are finding that access is still limited, delayed, or controlled through internal “company policies” rather than explicit contract language.

    This episode covers:

    • What gag clauses actually are in healthcare contracts
    • Why they were banned under the CAA
    • How carriers and PBMs have adapted post-ban
    • The challenges employers face when requesting claims and pricing data
    • What the gag clause attestation requires (and why it matters)
    • How to think about fiduciary responsibility and data access
    • Practical steps employers can take to improve transparency

    If you’re an employer, HR leader, CFO, broker, consultant, or plan fiduciary, this episode will help you better understand your responsibilities — and why simply signing an attestation isn’t enough.

    Because when it comes to healthcare benefits, you can’t manage what you can’t see.

    Follow for more conversations breaking down healthcare benefits, ERISA compliance, PBM transparency, and the real financial mechanics behind employer-sponsored health plans.

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    31 分
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