Rodney Mattos Show

GLP-1s and specialty drugs are driving a major surge in employer healthcare costs, and many CFOs, CEOs, and HR leaders feel stuck between absorbing higher pharmacy spend or cutting benefits. In this episode of Blueprints for Better Benefits, Rodney Mattos breaks down why GLP-1 medications, specialty pharmacy costs, and rising prescription drug spend are becoming some of the biggest drivers of health plan inflation in 2026.

You’ll learn how a properly structured self-funded plan can give employers better pharmacy cost visibility, more control over specialty drug spending, and practical tools like prior authorization, step therapy, and biosimilars to manage costs without harming employee care. The conversation also explores how captive health plans and smarter health plan strategy can help businesses control rising healthcare costs while still protecting benefits, improving retention, and supporting long-term financial stability.

If you are looking for insights on GLP-1 costs, specialty drugs, self-funded health plans, employee benefits strategy, and how to manage healthcare costs without cutting benefits, this episode is for you.

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In this episode of Blueprints for Better Benefits, Rodney Mattos breaks down what the latest FTC settlements involving major pharmacy benefit managers mean for employers, CFOs, HR leaders, and plan fiduciaries. If your pharmacy costs feel like a black box, this conversation explains why PBM transparency is becoming one of the most important issues in employee benefits strategy.

We unpack how PBM contracts, rebate structures, and spread pricing can quietly inflate pharmacy spend, and why regulators are pushing for greater oversight. More importantly, we show what these changes mean for employers evaluating a self-funded health plan, stronger vendor alignment, and better control over rising healthcare costs.

Rodney and the team walk through real-world examples of employers who improved visibility, negotiated better terms, and reduced pharmacy spend by demanding more accountability from their PBM arrangements. This episode is especially relevant for organizations that want to move from reactive renewals to a more intentional, data-informed health benefits strategy.

If you are asking whether your current plan gives you enough visibility into pharmacy costs, rebates, and contract terms, this episode will help you understand the opportunity in front of you.

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Email: [email protected]

In this episode of Blueprints for Better Benefits, Rodney Matos Jr. and Rodney Sr. break down what happens when a catastrophic claim hits a self-funded health plan. From premature births and specialty drugs to serious workplace injuries, they explain how a properly structured self-funded plan, stop-loss insurance, aggregate stop-loss, and a captive health plan can help employers contain risk, protect cash flow, and avoid devastating renewal increases.

If you are a CFO, CEO, HR leader, general counsel, or plan fiduciary evaluating self-funded health insurance, this conversation offers a practical look at catastrophic claims, health plan risk management, and how employers can create more predictable outcomes through better structure, stronger plan documents, and aligned vendor contracts.

You will hear real-world examples of how employers responded to high-cost claims, why self-funded plans do not mean unlimited exposure, and how the right stop-loss coverage can turn uncertainty into clarity. The episode also explores how employee benefits strategy, plan governance, and cost containment can help mid-market employers strengthen both financial control and employee retention.

If your organization is exploring alternative funding strategies, self-funded plans, or captive insurance for employee benefits, this episode will help you understand why structure matters more than fear when the worst happens.

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Email: [email protected]

In this episode of Blueprints for Better Benefits, Rodney Mattos Jr. and Rodney Sr. break down how CFOs can move from simply absorbing rising health insurance premiums to actively managing cash flow in self-funded plans. If you are a CFO, controller, HR leader, or employer responsible for your organization’s P and L, this conversation will help you understand why self-funded health plans can offer greater visibility, better forecasting, and more strategic control than traditional fully insured plans.

You’ll learn how self-funded plans help employers replace unpredictable renewals with clearer financial planning, how stop-loss insurance creates guardrails around risk, and why access to claims data can turn employee benefits into a true business lever. The episode also explores real employer examples from Nevada industries like construction, mining, manufacturing, and hospitality, showing how companies can use health plan data, benefits strategy, and cash flow planning to lower costs, improve transparency, and strengthen retention.

Whether you are evaluating self-funded employee benefits, comparing fully insured vs self-funded plans, or looking for ways to control rising healthcare costs, this episode offers practical insights and a framework to start asking better questions at your next renewal.

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Are you a small business owner with 20 to 50 employees wondering why your health insurance costs keep rising every year? In this episode of Blueprints for Better Benefits, Rodney Mattos breaks down why many small employers are paying too much for health insurance and what they can do about it.

If you’ve been told your company is too small to explore better options, this conversation challenges that thinking. Rodney explains how traditional fully insured health plans often leave employers with rising premiums, limited transparency, and very little control over where their healthcare dollars go. He also introduces a smarter alternative for small business health insurance called Guided Edge, a model designed to help employers gain more visibility, improve cost control, and reduce unnecessary spending without the complexity many people associate with self-funded health plans.

This episode is especially relevant for business owners, CFOs, HR leaders, and operations teams at companies with 20 to 50 employees, and even growing employers up to 250 employees, who want a better approach to employee benefits, health benefits strategy, and healthcare cost containment.

In this episode, you’ll learn:

If your company is tired of runaway renewals and wants more clarity around small business health insurance, employee benefits, and cost control, this episode will give you a practical starting point.

Learn more about Triforta and discover smarter strategies for health insurance cost savings and employer-sponsored health plans at triforta.com.

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Explore our insurance agency, Triforta: https://www.triforta.com/

Learn more about our software for insurance agencies, Apeironix: https://apeironix.com

Visit the full podcast website, The Rodney Mattos Show: https://rodneymattos.com/

Connect with Rodney

Email: [email protected]

LinkedIn: https://www.linkedin.com/in/rodneymattos

What is the real cost of being fully insured? In this episode of Blueprints for Better Benefits, Rodney Mattos breaks down why fully insured health plans often create rising healthcare costs, limited transparency, and reduced employer control. For many organizations, what looks like stability on the surface can actually hide misaligned incentives, renewal increases, and missed opportunities to improve both financial outcomes and employee benefits.

This conversation explores the hidden challenges behind fully insured vs self-funded health plans, including why employers, CFOs, CEOs, and HR leaders are rethinking traditional insurance structures. Rodney walks through how self-funded health plans, level-funded plans, and stop-loss insurance can give businesses better visibility into claims data, stronger cost management, and a more strategic approach to employee health benefits.

If your business is dealing with rising premiums, unpredictable renewals, or limited insight into what is driving plan costs, this episode offers a practical look at how health plan transparency, smarter benefits strategy, and alternative funding can help employers take greater ownership of outcomes.

In this episode, you’ll learn:

• Why fully insured health insurance may cost more than employers realize

• The key differences between fully insured and self-funded health plans

• How self-funding can improve cost control, transparency, and flexibility

• Why stop-loss coverage matters in managing risk

• How employers can turn employee benefits strategy into a financial and talent advantage

Whether you're a CFO, CEO, HR leader, or business owner evaluating your next renewal, this episode will help you better understand the real financial impact of staying fully insured and what a more strategic path forward can look like.

If you want to explore better ways to manage employee benefits costs, improve healthcare cost containment, and build a more transparent plan, Triforta is here to help.

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• Explore our insurance agency, Triforta: https://www.triforta.com/

• Learn more about our software for insurance agencies, Apeironix: https://apeironix.com

• Visit the full podcast website, The Rodney Mattos Show: https://rodneymattos.com/

Connect with Rodney

Email: [email protected]

LinkedIn: https://www.linkedin.com/in/rodneymattos

In this episode of Blueprints for Better Benefits, Rodney Mattos Jr. and Rodney Mattos Sr. challenge one of the most persistent myths in employee benefits, that small and mid-sized employers are too small to self-fund.

For employers who have been told they need hundreds or thousands of employees before self-funding becomes viable, this episode explains why that belief is outdated, what has changed in today’s market, and how smaller groups can use tools like shared risk pools, stop-loss protection, transparent pharmacy strategies, and care navigation to build a smarter, more controlled health plan.

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In this episode of Blueprints for Better Benefits, Rodney Mattos Jr. and Rodney Mattos Sr. unpack one of the biggest reasons employers stay stuck in fully insured health plans: broker incentives that reward rising premiums and discourage better options.

For employers frustrated by repeat renewals, limited transparency, and the same carrier-driven recommendations year after year, this episode explains why self-funded and captive strategies often never make it to the table, how compensation structures shape advice, and what leaders can do to evaluate whether their broker is truly aligned with their interests.

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Key Takeaway

If your broker earns more when your health plan costs more, that is not alignment. Employers need advisors whose incentives support lower waste, better strategy, and stronger long-term plan performance.

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In this episode of Blueprints for Better Benefits, Rodney Mattos Jr. and Rodney Mattos Sr. break down what actually happens when an employer moves from a fully insured plan to a self-funded or captive model.

For employers considering a change but worried about confusion, disruption, or employee backlash, this episode offers a practical walkthrough of what stays the same, what changes behind the scenes, and how a well-designed transition can improve control without creating chaos.

Topics We Cover

• What employers and employees can keep the same during a transition, including networks, doctors, plan design, and enrollment systems

• How self-funding changes the financial structure behind the plan

• Why claims funding, stop-loss protection, and reserve strategy matter

• How transparent pharmacy management and pass-through PBMs improve visibility and reduce waste

• What real-time claims data allows employers to measure, manage, and improve

• What a responsible 90 to 120 day transition timeline looks like

• How HR teams can manage communication, education, and employee support during the rollout

• Why a well-structured self-funded plan is designed for resilience, not volatility

• How employers know when it is time to stop renting their health plan and start owning it

Key Takeaway

The best self-funded transitions do not feel like a revolution. They feel like an evolution. Most of what employees experience stays the same on the surface, while the real changes happen behind the scenes, where employers gain visibility, control, flexibility, and the ability to improve their plan over time.

Explore More

• Explore our insurance agency, Triforta: https://www.triforta.com/

• Learn more about our software for insurance agencies, Apeironix: https://apeironix.com

• Visit the full podcast website, The Rodney Mattos Show: https://rodneymattos.com/

Connect with Rodney

• Email: [email protected]

• LinkedIn: https://www.linkedin.com/in/rodneymattos/

In this episode of Blueprints for Better Benefits, Rodney Mattos Jr. and Rodney Mattos Sr. break down what actually happens when an employer moves from a fully insured plan to a self-funded or captive model.

For employers considering a change but worried about confusion, disruption, or employee backlash, this episode offers a practical walkthrough of what stays the same, what changes behind the scenes, and how a well-designed transition can improve control without creating chaos.

Topics We Cover

Key Takeaway

Explore More

Connect with Rodney