Goodroot

Change is imminent. The real question is: is your plan ready to lead through it? ICHRA adoption is up 30%. Transparency mandates are gaining momentum. Employers are walking away from traditional insurance. And members? They’re frustrated, confused, and losing trust. In Healthcare Business Today, Empara CXO Ben Callaghan explores what this disruption means for health plans—and how AI-enabled platforms can reduce administrative strain, scale member support and help restore trust before it’s too late. If you’re rethinking your technology, operations or engagement model, this one’s for you. ?? Read the full article: https://lnkd.in/e2xnv9py #HealthPlans #HealthInsurance #AIinHealthcare #BenefitsTech

SB 11 threatens to dismantle one of the only healthcare cost-control tools small and mid-sized businesses have left. Self-funded health plans have given Connecticut businesses the power to build better benefits, control costs and break free from the opaque, high-cost traditional insurance market. Now, SB 11 would force many of them back into that system—stripping away control, transparency and affordability. Instead of supporting what works, this bill burdens employers with a blanket aggregate attachment point of $250,000 for all businesses offering self-funded health plans. That means every self-funded employer, regardless of size, would be forced to cover the first $250,000 in medical claims out-of-pocket before their stop-loss insurance starts paying. This isn’t reform. It’s a massive step backward. Goodroot CEO Michael Waterbury breaks down exactly what’s at stake—and who really stands to benefit from this reckless legislation—today in the?Hartford Business Journal: https://lnkd.in/eamgKZPP #SelfFunding #Healthcare #EmployeeBenefits #CTBiz

A hospital bill shouldn’t be a life sentence. But when members face limited coverage and overwhelming costs, it often feels like one. For benefits professionals, the challenge isn't just offering coverage—it's ensuring members can navigate the costs that remain. That’s where BillAssist comes in. We help lower high-cost medical bills by navigating?everything from hospital financial assistance programs to bill review and negotiation. Swipe through to see how one member’s $43,868 bill was reduced to $0. #EmployeeBenefits #BenefitsStrategy #HealthPlanManagement #HealthcareSavings #TPA

What do fiduciary oversight and new FDA drug approvals have in common? They’re both reshaping how pharmacy benefits are being managed—and how decisions are being scrutinized. In this month’s Navion Insights, we’re helping leaders make sense of what’s changing and where to focus next. Get the scoop below! ?? #PharmacyBenefits #EmployeeBenefits #BenefitsManagement #FDA

Yesterday’s American Heart Association Go Red for Women Luncheon was nothing short of inspiring. As a member of the Executive Leadership Team, I’m incredibly grateful to the hard-working, talented women who brought this event to life. A special thank you to Goodroot for sponsoring this vital cause and supporting the amazing work the AHA does for women’s heart health. The event was filled with powerful stories from speakers who shared their personal journeys – some that brought us to tears and others that reminded us of the strength and resilience of women. I walked away with key takeaways that resonate deeply: women need to say "yes" when help is offered (thank you, Caroline Wilke), and we must trust our gut, advocating for ourselves and our health (thank you Andi Campbell). Congratulations to the AHA team, who worked tirelessly behind the scenes to make this event a success. And thank you to my wonderful friends, colleagues and fellow Connecticut Women's Council members who joined me in supporting this cause: Tracy Hains, Jen Rose, Lindsay Loomis, MBA, Carrianne Polo, Judy Casperson, Danielle Tata, Kelly Chapman, Lauren Becker, and Cindy Maurer, SHRM-SCP, MBA. Let’s keep moving forward, supporting each other, and making a difference – together. #GoRedForWomen #AHA #WomensHealth #HeartHealth

A medication shortage. A major move. A moment where expert support mattered. For one client, securing essential medications became a challenge—just as they were relocating to another state. Managing refills, physician coordination, and coverage transitions alone would have been overwhelming. With Emry Concierge’s support, they didn’t have to. Swipe through to see how we ensured seamless medication access despite nationwide supply issues. #LifestyleDesign #LuxuryWellness?#HealthcareConcierge?#WealthPlanning

Pharmacy rebates are evolving—are you prepared? ?? With the removal of the?AMP cap, manufacturers are adjusting their pricing strategies, impacting how rebates factor into overall drug costs. Some are lowering WAC prices, while others are reworking their market strategies or pulling products entirely. We sat down with?Beckie Fenrick, Pharm D, Chief Pharmacy Officer at Navion, to break down what these changes mean, how manufacturers are responding, and what organizations should do to stay ahead. ?? Swipe through for expert insights on navigating the rebate shift. #PharmacyBenefits #RebateManagement #BenefitsStrategy #EmployeeBenefits

For years, issuers have managed their own justification forms alongside the Plan & Benefit Template submission process. But that’s changing. CMS is shifting the justification form into the MPMS portal, limiting access to just two users per organization. That means issuers need to be proactive—ensuring the right people have access and staying ahead of new workflow challenges. This shift will impact compliance, communication, and submission timelines. Is your team ready? Watch the latest episode of #RegulatoryJoe to learn how to prepare: https://hubs.li/Q03c3zVC0 #RegulatoryCompliance #HealthPlans #CMS #MPMS #PlanAndBenefitTemplate Joe Boyle

Your team's next payment integrity idea could be a game-changer—or a dead end. The best concepts don’t just sound good in theory; they need to solve real problems, create measurable impact, and align with broader strategic goals. Without a structured evaluation process, teams risk investing time and resources in concepts that won’t deliver results. Nichole Russ, VP of Payment Integrity at Penstock, shares four critical questions every team should be asking before moving forward. Swipe through to see how you can identify concepts that will drive real impact! #PaymentIntegrity #ClaimsManagement #HealthcareFinance

The biosimilar shift is here. Are you ready???? With?#Humira biosimilars gaining traction?and?#Stelara biosimilars launching for the first time, 2025 marks a major turning point in specialty pharmacy. More options mean greater opportunities for cost savings—but only with the right strategy. Swipe through to see what’s changing and what plan sponsors should do next. #Biosimilars #PharmacyBenefits #SpecialtyPharmacy #BenefitsManagement