Daron and I started in the industry within a year of each other, more than two decades ago. He’s about as guru-ee as gurus get when it comes to stop-loss insurance, underwriting, and self-funding. I had a fantastic time exploring all that and then some with him in this episode of Gott’s Gulch.
2:10 - MGUs, stop-loss, and reinsurance
9:00 - What is stop-loss insurance?
13:20 - Size of employers self-funding today
16:15 - Why self-funding is harder in Sacramento, California
16:55 - AI in underwriting. Does it help or hurt? Article on AI in claim underwriting, “HIPAA Is Dead. Long Live the Data Brokers.”
25:40 - How a disgruntled employee could sabotage an employer’s self-funded health plan.
31:00 - How large should an employer be to self-fund?
31:25 - How captives work; pros and cons
42:25 - Three biggest problems in healthcare today?
49:45 - If hospitals don’t get in line, they’ll end up with Medicare for all.
52:50 - Fasting. Carnivore Diet. How long can you go without water or food? “A 27-year-old male patient fasted under supervision for 382 days and has subsequently maintained his normal weight.” He went from 456 pounds (207 kg) to 180 pounds.
Episode 252 of their DarkHorse podcast series, titled Think Fast, the two biologists recount completing a seven‑day dry fast—meaning no food and no liquids for the entire duration.
1:07:30 - the mythical, double secret TPA and BUCA carrier paying claims at 100% of Medicare?
1:19:50 - PEPM vs. % of billed charge in RBP?
1:34:30 - TPA reporting
1:38:00 - What’s coming in stop-loss?
1:44:50 - Ending with a case study.
