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Cutting-Edge Benefits Podcast
Claimlinx
74 episodes
6 days ago
Are you a business owner or HR leader tired of skyrocketing health insurance premiums and confusing benefits packages? Welcome to the Cutting-Edge Benefits Podcast, where we break down the smartest, most cost-effective ways to offer high-quality employee healthcare — without breaking the bank. Each episode, our experts at ClaimLinx reveal insider strategies to help you: ✅ Cut hidden costs in your current health plan ✅ Understand the difference between self-funded and fully insured models ✅ Build competitive benefits packages that attract and retain top talent ✅ Stay ahead of healthcare trends
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Health & Fitness
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All content for Cutting-Edge Benefits Podcast is the property of Claimlinx and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
Are you a business owner or HR leader tired of skyrocketing health insurance premiums and confusing benefits packages? Welcome to the Cutting-Edge Benefits Podcast, where we break down the smartest, most cost-effective ways to offer high-quality employee healthcare — without breaking the bank. Each episode, our experts at ClaimLinx reveal insider strategies to help you: ✅ Cut hidden costs in your current health plan ✅ Understand the difference between self-funded and fully insured models ✅ Build competitive benefits packages that attract and retain top talent ✅ Stay ahead of healthcare trends
Show more...
Health & Fitness
Episodes (20/74)
Cutting-Edge Benefits Podcast
HSA Explained: The Most Misunderstood — and Most Powerful — Tool in Healthcare

In this episode, Tom Quigley breaks down one of the most misunderstood acronyms in healthcare — the HSA (Health Savings Account) — and explains why it may be the single smartest way for individuals and certain business owners to fund healthcare in 2026 and beyond.

Most people think HSAs are confusing, restrictive, or not worth the effort. Tom flips that narrative completely, walking listeners through what an HSA actually is, how it works, who should use it, who shouldn’t, and why it’s one of the most tax-advantaged tools the government has ever created.

This is an educational episode — but make no mistake — it’s also strategic. If you don’t understand HSAs, you’re likely overpaying for healthcare and missing major tax advantages.

Tom starts at square one:

  • An HSA is a personal health savings account

  • It can only be used if you have a qualified high-deductible health plan

  • Money goes in pre-tax

  • Money comes out tax-free for eligible medical expenses

  • The account is owned by the individual

  • Funds roll over every year

  • The account can earn interest or investment returns

If funds are used later for non-medical purposes, they’re taxed — effectively turning the HSA into an IRA-like account in retirement.

Setting up an HSA is surprisingly simple:

  • Open an account online (ex: HSA Bank or similar providers)

  • Receive a debit card

  • Use the card for eligible medical expenses

  • Contributions can be made:

    • All at once

    • Gradually throughout the year

Tom:

“You can literally do it in two minutes.”

Tom draws a critical distinction here:

  • Individuals:
    HSAs make a lot of sense.

  • Employers funding HSAs:
    Usually a mistake.

Why?

  • Once employers put money into an employee’s HSA, the money is gone forever

  • Employers lose all control

  • This is why ClaimLinx prefers Medical Expense Reimbursement Plans (MERPs) for employers

Tom:

“Once the money goes into the HSA, it’s their money. No control. No clawback.”

Approximate 2026 limits discussed:

  • Single: ~$4,400

  • Family: ~$8,750

  • Catch-up (age 55+): +$1,000

(Exact limits can be confirmed by searching “2026 HSA contribution limits.”)

HSAs only work with high-deductible health plans, which means:

  • No copays

  • No coverage until deductible is met (except preventive care)

  • Everything applies toward the deductible

Tom explains:

“Copays don’t exist in these plans — and that’s actually the advantage.”

HSAs are designed to replace copays, not supplement them.

A major misconception cleared up:

  • HSA funds can be used to pay deductibles

  • You just can’t “double dip”

  • You use HSA money to cover expenses before insurance kicks in

Even better:

  • If you don’t have money in the HSA yet, you can deposit funds before paying the bill and still get the tax advantage

Tom shares how savvy users treat HSAs:

  • Max out contributions every year

  • Pay medical expenses out of pocket

  • Save receipts

  • Let the HSA grow

  • Withdraw tax-free later in retirement

There is no time limit on reimbursement.

Tom:

“You could pull out $20,000 tax-free ten years later if you saved the receipts.”

Tom clarifies confusion with FSAs (Flexible Spending Accounts):

  • FSAs = “use it or lose it”

  • HSAs = your money forever

If you were thinking you needed to predict expenses precisely — that’s an FSA mindset, not an HSA one.

Tom strongly recommends HSAs for:

  • Owners of:

    • S-Corps

    • LLCs

  • Anyone with 2%+ ownership

  • People not eligible for Section 125 plans

  • Individuals comfortable with higher deductibles

  • People focused on tax efficiency

HSAs are also a great option for employees who understand them — alongside a Medical Expense Reimbursement Plan.

Tom explains why copays persist:

  • They condition people psychologically

  • They increase premiums

  • They increase agent commissions

  • They make insurance more expensive overall

Tom:

“Copays make zero sense — they exist to raise premiums.”

HSA dollars can be used for many non-traditional medical expenses, as long as they’re eligible under IRS Publication 502.

Examples:


  • Show more...
    6 days ago
    10 minutes 17 seconds

    Cutting-Edge Benefits Podcast
    Enhanced Subsidies Are Gone: Why Healthcare Costs Exploded Overnight

    In this end-of-year episode, Tom Quigley delivers a blunt post-mortem on what many Americans feared — and hoped wouldn’t happen.


    The enhanced ACA subsidies have officially sunset, and the fallout is immediate and brutal. Premiums that were once manageable have exploded overnight, forcing families, couples, and small business owners into impossible choices:

    pay unaffordable premiums, go uninsured, or gamble with their financial future.


    Tom doesn’t just react — he explains why this happened, who benefits from the chaos, and why the system is failing exactly as designed. This episode connects the dots between uneducated consumers, corrupt incentives, and a healthcare structure that punishes logic while rewarding greed.


    🔍 Key Topics & Insights

    1. The Enhanced Subsidies Are Gone — and the Damage Is Real


    Tom confirms what many listeners are now experiencing firsthand:


    Enhanced subsidies are fully sunset


    Premiums jumped immediately


    Some people chose to drop insurance entirely — even catastrophic coverage


    Tom:


    “They’re saying, ‘Why would I waste money on it?’ And that’s terrifying.”


    2. Real Numbers: From $200 to $2,800 a Month


    Tom shares a shocking real-world example:


    Couple paying ~$200/month


    New premium: $2,800/month


    That’s not inflation — that’s a de facto tax increase of over $24,000 per year.


    Neil:


    “That’s a 3,000–4,000% increase.”


    Tom:


    “Unreal — and totally avoidable.”


    3. Why People Are Going Uninsured


    With costs this high, some individuals are:


    Skipping insurance altogether


    Rolling the dice for a year


    Waiting for Medicare eligibility


    Using only virtual care and DPC


    Tom is clear:


    “That’s not smart — but it’s understandable.”


    Without catastrophic coverage, one event can mean:


    Bankruptcy


    Lifetime payment plans


    Financial ruin


    4. Medicare vs. the Rest of the System


    Tom draws a sharp contrast:


    Traditional Medicare remains the best insurance in the world


    Yes, Part B and supplements increase — but nothing like ACA plans


    Medicare Advantage may fluctuate, but Medicare itself is stable


    For everyone else?


    “They’re paying more for health insurance than a mortgage.”


    5. Direct Primary Care: The One Thing That Still Makes Sense


    Tom reinforces what he’s said all year:


    Direct Primary Care (DPC) is a no-brainer


    Flat monthly fee


    Unlimited visits


    Massively discounted labs and diagnostics


    Longer doctor visits


    Real preventive care


    Tom’s own example:


    “I had $2,000 worth of labs done for $100.”


    One or two lab visits alone often cover the entire annual DPC cost.


    6. Will Enhanced Subsidies Ever Come Back?


    Tom is pessimistic — but practical.


    He outlines the only two logical paths forward:


    Option 1: Government Fully Involved


    $50,000 deductible for every American


    Government buys reinsurance


    Savings fund the system


    Catastrophic protection guaranteed


    Option 2: Private Market + High-Risk Pool


    Allow medical underwriting again


    Government funds high-risk individuals


    Insurance companies cover healthy pools


    Costs drop dramatically


    Either option:


    Saves trillions


    Restores logic


    Requires political courage


    7. Who’s Really Blocking Reform


    Tom pulls no punches:


    Corrupt Departments of Insurance collecting premium tax


    Commission-based agents protecting income


    Hospitals inflating costs unchecked


    Pharma posturing while avoiding real reform


    Lobbyists controlling policy


    Tom:


    “It’s a big dupe — and the American public doesn’t know enough to fight back.”


    8. The Education Crisis Nobody Wants to Talk About


    Tom identifies the core issue:


    Americans understand mortgages and car loans


    They do not understand health insurance


    No education in:


    Grade school


    High school


    College


    Result:


    “People pay more for healthcare than housing — and don’t question it.”


    9. The ACA Isn’t the Villain — Ignorance Is


    Tom makes a critical distinction:


    What the ACA did right:


    No preexisting exclusions


    No lifetime limits


    Preventive care


    What went wrong:


    No flexibility






    Show more...
    1 week ago
    9 minutes 32 seconds

    Cutting-Edge Benefits Podcast
    Healthcare Without Insurance? Why 2026 Is the Year Employers Finally Say “Enough”

    This is the episode title that makes employers uncomfortable — and for good reason.

    In this candid, forward-looking conversation, Tom Quigley explains why 2026 is the year many employers stop asking “how do we renew?” and start asking “why are we doing this at all?” Traditional health insurance has reached a financial breaking point, and companies are being forced to choose between paying carriers or paying employees.

    This episode is not about ditching responsibility — it’s about rebuilding healthcare around logic, math, and control, using tools like Direct Primary Care, catastrophic-only coverage, and Medical Expense Reimbursement Plans to regain sustainability.

    Tom lays out exactly who this approach is for, who it is NOT for, and why fear-based messaging from commission-driven agents is keeping businesses stuck.

    Tom doesn’t dance around it:

    • Health insurance costs are destroying margins

    • Company valuations are declining

    • Employees want raises, but benefits eat payroll

    • Employers are forced into impossible choices:

      • No wage increases

      • Higher employee contributions

      • Or “go buy your own coverage”

    Tom:

    “They’re throwing their hands up and saying: good luck.”

    Tom explains why Direct Primary Care is gaining traction:

    • Monthly flat fee paid directly to the doctor

    • Unlimited visits

    • Deeply discounted labs and tests

    • Longer appointments (30 minutes, not 7)

    • Focus on prevention, not billing codes

    Doctors love it because:

    • No insurance paperwork

    • No carrier interference

    Employees love it because:

    • Better care

    • Faster access

    • Lower real costs

    ClaimLinx doesn’t sell DPC — but enables it:

    • Employers use a Medical Expense Reimbursement Plan (MERP)

    • Monthly DPC fees reimbursed tax-free

    • Employees keep access without payroll penalties

    Tom:

    “It’s not insurance. It’s doctors saying, ‘Pay us directly — it’s cheaper for everyone.’”

    Tom is clear — this is not about going uninsured:

    • Catastrophic coverage protects against:

      • Hospitalizations

      • Surgeries

      • Major events

    • Without it, bankruptcy is a real risk

    The strategy:

    • Use DPC for everyday care

    • Use catastrophic insurance for true risk

    • Reduce claims by improving prevention

    Tom:

    “You still need catastrophic coverage. That’s non-negotiable.”

    The secret isn’t cutting care — it’s cutting waste:

    • Buy the lowest-cost catastrophic plan

    • Stop paying carriers for:

      • Office visits

      • Drug copays

      • Urgent care

    • Employers design benefits themselves using MERPs

    Result:

    • Lower employer spend

    • Better employee experience

    • Predictable costs

    Tom addresses the fear tactics head-on:

    • “It’s illegal” → False (IRS publishes eligible expense lists)

    • “It’s unethical” → Opinion, not law

    • “There’s gray area” → Only if agents don’t understand the rules

    Tom:

    “Your attorney isn’t practicing law without a license — but some agents sure act like it.”

    This is where Tom draws a hard line:

    ❌ Companies on the brink of bankruptcy
    ❌ Businesses that cannot meet plan obligations
    ❌ Employers unwilling to manage compliance

    Why?

    • MERPs are regulated by:

      • Department of Labor

      • IRS

    Tom:

    “If you’re barely staying afloat, don’t promise benefits you can’t honor.”

    Tom doesn’t say carriers are useless — just misused:

    • They’re good at:

      • Large claims

      • Network discounts

    • They’re terrible at:

      • Everyday care

      • Cost control

    The future:

    • Carriers = catastrophic protection

    • Employers = benefit designers

    • 2026 is the tipping point for employer health insurance

    • Direct Primary Care restores real doctor–patient relationships

    • Catastrophic-only coverage is essential — not optional

    • Employers can save 30–60% by redesigning benefits logically

    • Fear, not law, keeps companies stuck

    • This strategy is powerful — but not for unstable businesses

    “It’s either pay the carrier or pay your employees. You can’t do both anymore.” — Tom Quigley

    “Direct Primary Care is doctors opting out of a broken system.” — Tom Quigley

    “You’re still using carriers — just for what they’re actually good at.” — Tom Quigley

    “This isn’t healthcare without responsibility. It’s healthcare with logic.” — Tom Quigley

    👉 Visit: https://www.ClaimLinx.com



    Show more...
    1 week ago
    5 minutes 15 seconds

    Cutting-Edge Benefits Podcast
    The 2026 Employer Health Plan Reset: What Smart Companies Are Changing Now

    As 2026 approaches fast, Tom Quigley lays it out plainly:
    traditional employer health plans are officially broken — and pretending otherwise is no longer an option.

    In this episode, Tom explains why 2026 has become the breaking point for employers, what finally snapped inside the legacy health insurance model, and why the smartest companies are resetting their entire benefits strategy before renewal instead of waiting to be ambushed by 30–40% increases.

    This conversation is about logic over fear, math over emotion, and why employers who don’t change now are guaranteed to lose.

    Tom gets straight to it:

    • Routine 20–40% annual increases

    • Employers absorbing costs they never planned for

    • Employees paying more while benefits get worse

    • Deductibles rising, coverage shrinking

    Tom’s blunt assessment:

    “They’re not set up to win. They’re set up to lose every time.”

    The breaking point isn’t just cost — it’s sustainability.

    Tom calls out the real blocker to change:

    • Employers rely on commission-based insurance agents

    • Agents protect their revenue stream

    • Options that lower premiums = lower commissions

    • So those options never get shown

    Tom:

    “They’re being shown traditional solutions that make zero sense — because the salespeople are afraid.”

    Employers are finally questioning:

    • Sky-high deductibles

    • $10,000 out-of-pocket maximums

    • “Benefits” that don’t feel like benefits

    Why were these kept so long?

    • Fear of change

    • Lack of education

    • Blind trust in carriers and agents

    Tom:

    “What do you expect? These are desperate people selling desperate products.”

    Tom explains why many employers are moving in the wrong direction:

    • ICHRAs are being pushed aggressively

    • One-size-fits-all design

    • Poor fit for most workforces

    • Far inferior to properly structured Medical Expense Reimbursement Plans

    Tom’s verdict:

    “It makes zero sense compared to what we do.”

    Tom identifies the critical failure:

    • Employers did not take advantage of the Affordable Care Act correctly

    • They stayed locked into traditional group health

    • Insurance companies (for-profit) guided decisions

    • Employers followed — and now they’re paying for it

    Tom:

    “When you keep going down the wrong road, you don’t end up anywhere better.”

    Instead of reacting, smart companies are:

    • Looking at the entire financial picture

    • Letting math guide decisions

    • Designing benefits proactively

    • Balancing employee experience with employer sustainability

    Tom:

    “They’re solving the puzzle logically — not emotionally.”

    Tom contrasts old vs. new:

    Legacy Plan

    • $5,000–$6,000 deductibles

    • $10,000 out-of-pocket exposure

    • High payroll deductions

    • Low employee satisfaction

    Modern ClaimLinx Plan

    • Zero deductible mindset

    • Copay-driven experience

    • Lower payroll impact

    • Better employee engagement

    • Employer costs cut dramatically

    Tom:

    “How is a $10,000 out-of-pocket a benefit for working at a company?”

    Tom explains the core ClaimLinx approach:

    • Employees get simple, predictable copays

    • Employers buy lower-cost backend coverage

    • Same major carriers — half the cost

    • Logic replaces fear

    Tom:

    “That’s the funniest part — it’s the same carriers. Just done right.”

    Tom closes with a hard truth:

    • Healthcare decisions are emotional

    • Fear drives bad buying behavior

    • Employers stop thinking logically

    • That’s when they get exploited

    Tom:

    “Common people’s problem is they let emotion override logic.”

    • 2026 is the breaking point for traditional health plans

    • Commission-based sales models keep employers stuck

    • High deductibles are not benefits

    • ICHRAs are often a step backward

    • Smart employers redesign before renewal

    • ClaimLinx replaces fear with math and logic

    “They’re not set up to win. They’re set up to lose every time.” — Tom Quigley

    “Commission salespeople don’t want to be carved out — so they don’t show better options.” — Tom Quigley

    “How is a $10,000 out-of-pocket a benefit for working at a company?” — Tom Quigley

    “Logic fixes healthcare. Emotion destroys it.” — Tom Quigley

    👉 Visit: https://www.ClaimLinx.com
    📞 Schedule a Call: Redesign your 2026 health plan before renewal hits


    Show more...
    2 weeks ago
    3 minutes 54 seconds

    Cutting-Edge Benefits Podcast
    nside ClaimLinx: How Elite Service Turns Confusing Benefits into Real Savings

    This episode pulls back the curtain on what actually makes ClaimLinx work—not just the strategy, but the people.

    For the first time, listeners meet Chelsea and Emily, two of the field service managers who travel across the country educating employers and employees on how to use the ClaimLinx solution in real life. This conversation makes one thing crystal clear:

    ClaimLinx isn’t just a cost-saving model — it’s an advocacy system.

    Tom explains why service is the backbone of the company, while Chelsea and Emily walk through what happens after a business signs on: the calls, the questions, the pharmacy issues, the doctor confusion, the claims problems — and how ClaimLinx solves what traditional insurance never does.

    This episode is all about education, advocacy, and real human support in a healthcare system that is anything but human.

    Chelsea and Emily explain their role clearly:

    • They are field service managers, not call-center reps

    • They travel across the U.S. (primarily east of the Mississippi)

    • They train:

      • Employers

      • HR teams

      • Employees

    • They explain how to use the ClaimLinx system, not just what it is

    Chelsea sums it up:

    “Insurance isn’t easy. It’s always changing. We’re the experts so our clients don’t have to be.”

    One of the biggest problems ClaimLinx solves is fear and confusion.

    Employees often think:

    • “This sounds too good to be true.”

    • “There’s no way we save this much and still have good benefits.”

    Chelsea explains:

    • Education removes fear

    • Understanding builds confidence

    • Confidence leads to adoption

    And once employees use the system:

    “They say, ‘You guys are top tier.’”

    Emily draws a sharp contrast between ClaimLinx and traditional insurance:

    • No phone trees

    • No automated systems

    • No endless transfers

    • No unanswered voicemails

    Instead:

    • You call → you get a real person

    • If you leave a voicemail → you get a call back

    • If there’s an issue → someone owns it

    Emily:

    “We pride ourselves on that personalized approach. It’s not just a mission statement — it’s how we work.”

    Chelsea breaks down the most common service calls:

    • Doctors saying: “We don’t accept that insurance.”

    • Pharmacies rejecting prescriptions

    • Confusion over secondary cards

    • Life events:

      • Marriage

      • New baby

      • New hires

      • Terminations

    Key difference:
    👉 ClaimLinx steps in and talks directly to doctors, pharmacies, and offices to fix billing and processing issues.

    They don’t say “call this number.”
    They make the call.

    Chelsea explains the resolution process:

    • Every call is logged and tracked

    • Full visibility into:

      • Plan design

      • Dependents

      • Claims history

      • Prior interactions

    • Errors are often caught immediately

    • The team is already planning next steps while listening

    Chelsea:

    “We’re usually ten steps ahead while we’re on the call.”

    Emily highlights something critical:

    People don’t just want answers — they want to be heard.

    • Even when there’s no immediate answer, ClaimLinx communicates

    • Simple updates build trust:

      “I don’t have the answer yet, but I’m working on it.”

    That alone separates ClaimLinx from nearly every insurance experience people have ever had.

    Tom makes it clear:

    • ClaimLinx without service doesn’t work

    • Employees already don’t understand their current insurance

    • Employers worry employees won’t understand the new solution

    Chelsea and Emily are the bridge:

    “They’re the conduit from our solution to the employees.”

    More interaction = fewer bad decisions.

    Tom reinforces the core identity of ClaimLinx:

    “We’re not an insurance company. We’re advocates.”

    That means:

    • Helping employees access manufacturer drug rebates

    • Negotiating claims

    • Pushing back on outrageous hospital bills

    • Teaching people they don’t have to blindly pay everything

    Tom shares a real example:

    • $1,500 ER bill for an hour visit and saline

    • His response: “I’m not paying that.”

    Chelsea previously worked for Humana, and the contrast was stark:

    At a carrier:

    • “No, you can’t.”

    • “It’s denied.”

    • “Go somewhere else.”

    • No one-call resolution

    At ClaimLinx:

    • Real problem-solving

    • Real escalation

    • Real outcomes



    Show more...
    2 weeks ago
    15 minutes 52 seconds

    Cutting-Edge Benefits Podcast
    The Subsidy Cliff Is Back: What the End of Enhanced ACA Subsidies Means for 2026

    With just 21 days left on the clock, Tom Quigley dives headfirst into the reality many Americans are now waking up to: enhanced ACA subsidies are gone, the income cliff is back, and 2026 is shaping up to be a brutal year for anyone relying on the Affordable Care Act.

    In this raw, unscripted conversation, Tom and Neil break down what’s actually happening (and what isn’t), why people are shocked by 300–400% premium increases, and why millions of Americans are suddenly forced to choose between overpriced insurance or rolling the dice uninsured.

    Tom doesn’t sugarcoat it. This episode is about risk, reality, and consequences—and why the government’s failure to act now will ripple through the economy, healthcare system, and middle class in 2026.

    Tom clarifies the biggest misunderstanding:

    • Subsidies were not eliminated

    • Enhanced subsidies were

    • The old income cliff is back

    Example:

    • Household threshold: $81,000

    • Income at $81,000.01
      👉 Entire subsidy must be repaid

    Tom:

    “There are no layers anymore. It’s a cliff.”

    This puts enormous pressure on:

    • Self-employed individuals

    • Commission-based earners

    • Families with bonuses or fluctuating income

    Tom shares a real client story:

    • Couple paying ~$670/month

    • New premium: $2,800/month

    The options?

    • Keep income artificially under the threshold

    • Pay nearly $34,000 a year for coverage

    • Or… go uninsured and gamble

    One client’s decision:

    “I’ll take my chances at 64. I’ll gamble for a year.”

    Tom makes it clear:

    • Insurance exists to transfer risk

    • Without catastrophic coverage:

      • Bankruptcy

      • Lifetime payment plans

      • Financial ruin

    While virtual care and third-party services can help, they are not a replacement for catastrophic protection.

    Tom:

    “Being uninsured is a quick way to go bankrupt.”

    Tom reiterates his long-standing position:

    • Buy catastrophic coverage

    • Use:

      • HSAs

      • Medical Expense Reimbursement Plans

    • Pay out-of-pocket tax-free

    • Stop paying for “kitchen sink” coverage you don’t need

    The problem?
    Most people have never been educated on how insurance actually works.

    Neil asks the big question: How much damage does this do in 2026?

    Tom’s answer:

    • It absolutely hurts the economy

    • Healthcare inflation eats disposable income

    • Middle-class spending slows

    • Hospitals take on unpaid care

    • Employers face more pressure

    Tom:

    “They need to extend the subsidies for two years and actually fix the system.”

    Tom tears apart proposals to simply fund HSAs or give people cash:

    • People already don’t understand deductibles

    • They won’t spend it on healthcare

    • They’ll spend it on:

      • Christmas

      • Cars

      • Living expenses

    Tom:

    “Trusting people with money for something they’ve never been educated on is laughable.”

    Tom makes an important distinction:

    What the ACA got right:

    • No pre-existing condition exclusions

    • No lifetime limits

    What broke the system:

    • Forced coverage of all 10 essential benefits

    • No ability to carve out unnecessary coverage

    • Exploding premiums due to overregulation

    Tom:

    “Why is a 57-year-old man paying for maternity coverage?”

    Tom pulls no punches:

    • Group health agents are commission-driven

    • They actively fight solutions that reduce premiums

    • National insurance associations lobby to protect commissions

    • Employers listen to them—and lose millions

    Example:

    “A company in St. Louis is throwing away a million dollars because their agent told them our solution was wrong.”

    Tom predicts:

    • Democrats benefit politically if subsidies expire

    • Upper-middle-class voters feel the pain first

    • Republicans in tight races are exposed

    • Another government shutdown is likely in January

    But by then?

    “The train has already left the station.”

    There is no healthcare crisis.

    There is:

    • An education crisis

    • A lobbying crisis

    • A political courage crisis

    Tom:

    “I’ve been saying for 25 years the system doesn’t work. Now people are finally listening.”

    • Enhanced subsidies are gone — the income cliff is real

    • Premium shocks of 300–400% are happening now

    • Going uninsured is a dangerous but increasingly common choice

    Show more...
    3 weeks ago
    8 minutes 9 seconds

    Cutting-Edge Benefits Podcast
    Stop Buying Insurance Like It’s 1998: Modernizing Your Health Plan in 2026

    In this episode, Tom Quigley of ClaimLinx delivers a wake-up call to employers still buying health insurance with outdated strategies. If your company is stuck in the 1990s mindset—high premiums, minimal customization, and cookie-cutter plans—then you're bleeding cash. Tom explains how modern 2026 health plan design leverages Section 105 tax law, medical expense reimbursement plans (MERPs), and a fully customized approach to cut costs while improving employee benefits.

    He breaks down what today’s smartest employers are doing instead—and why relying on commission-based brokers is one of the costliest mistakes businesses continue to make.

    • 🧠 Most businesses still buy health insurance like it’s 1998—despite decades of regulatory and technology shifts.

    • 📉 You can save 30–60% by buying the lowest-cost group option and using MERPs to fill in the gaps.

    • 🤯 Brokers are incentivized to keep your premiums high because they earn a percentage of what you pay.

    • 🧾 Section 105 allows you to self-fund benefits tax-free and offer better plans to employees without overpaying insurers.

    • 🔥 Employers should stop handing off benefits decisions to HR—this is a finance-level strategic decision that affects EBITDA.

    • 🕒 There’s still time to implement smarter 2026 benefits before December 31st, but most companies wait too long.

    “We’re not solving world peace—we’re solving a health insurance crisis that doesn’t actually exist. You’re just being ripped off.”
    — Tom Quigley

    “If you're working harder and making less, it’s because your business is paying 1998 prices in a 2026 market.”
    — Tom Quigley

    • Small and mid-sized business owners

    • CFOs and controllers

    • HR directors ready to rethink open enrollment

    • Entrepreneurs tired of skyrocketing healthcare costs

    • Self-employed individuals shopping for better options

    Visit ClaimLinx.com to schedule a strategy call with Tom and his team.

    Spotify | Apple Podcasts | Google Podcasts | Amazon | iHeartRadio

    💥 Key Takeaways:💡 Notable Quotes:👥 Who This Episode Is For:📞 Ready to Modernize Your Health Plan?🎧 Available On:

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    1 month ago
    7 minutes 23 seconds

    Cutting-Edge Benefits Podcast
    Sunsetting Subsidies: What It Really Means for Healthcare in 2026

    In this urgent episode, Tom Quigley of ClaimLinx breaks down the confusion and panic surrounding the sunsetting of enhanced ACA subsidies at the end of 2025. Many individuals and small business owners are seeing massive spikes in healthcare premiums—but much of the fear is based on misinformation.

    Tom clarifies what’s actually happening, who’s impacted, and why the enhanced subsidies were so critical for middle and upper-middle-class Americans. He also dives into the politics behind the delay in action, and how smarter plan design using Section 105 and Medical Expense Reimbursement Plans (MERPs) can offer financial relief—even if the subsidies expire.

    • ✅ Enhanced ACA subsidies were introduced during COVID and extended via the Inflation Reduction Act through 2025.

    • ❗ They’re set to expire on December 31, 2025, unless Congress intervenes.

    • 🔍 The sunset of these subsidies mostly affects the middle and upper-middle class, not lower-income earners.

    • 💰 Families could see their premiums jump from $200 to over $1,800–$5,500 per month in some states like New York.

    • 🔧 Traditional brokers are pushing ICHRAs (Individual Coverage HRAs), but Tom explains why MERPs are more flexible, tax-advantaged, and cost-effective.

    • 📉 Insurance brokers and carriers don’t want consumers to understand how this system works—because it threatens their commissions.

    • ⚠️ The threat of a government shutdown in January 2026 looms if Congress fails to act.

    “People are paying more for health insurance than their mortgage—and they’re being told that’s normal.” – Tom Quigley

    “The insurance industry thrives on your confusion. The more you don’t know, the more they make.” – Tom Quigley

    • Small business owners struggling with rising healthcare premiums

    • Self-employed professionals facing premium shock

    • HR teams and CFOs evaluating 2026 benefit plans

    • Anyone confused about ACA subsidies and what's next

    Visit ClaimLinx.com
    Schedule a strategy call with Tom and his team to find out how to lower costs, even without subsidies.

    Spotify | Apple Podcasts | Google Podcasts | Amazon | iHeartRadio


    💥 Key Takeaways:📢 Notable Quotes:👥 Who Should Listen:📞 Take Action:🎧 Listen On:

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    1 month ago
    10 minutes 51 seconds

    Cutting-Edge Benefits Podcast
    How to Save 30–60% on Health Insurance with Smarter Plan Design

    Health insurance costs are rising fast—and small businesses are feeling the heat. In this episode, Tom Quigley explains how smarter plan design can slash health insurance costs by 30–60% while improving employee benefits.

    Tom outlines why traditional insurance plans are loaded with unnecessary costs, how pharmaceutical rebates are being hidden, and why most employers are unknowingly overpaying by tens of thousands each year.

    The truth? You're paying for features your employees barely use—and getting crushed by deductibles and rate hikes in return.

    • Why traditional insurance carriers overcharge for basic coverage like copays and office visits

    • How to restructure your plan using a high-deductible option + a Medical Expense Reimbursement Plan (MERP)

    • What hidden cost drivers (like PBM rebates) are doing to your premiums

    • Why “lowering costs” by raising deductibles hurts your employees

    • The real math behind how ClaimLinx saves companies thousands per employee

    • Simple first steps every small business owner can take today to stop the bleeding

    Tom shares how companies using the ClaimLinx method have saved tens of thousands—even hundreds of thousands—per year by simply purchasing their insurance differently.

    “You think you're lucky with a 6% rate hike? Try raising your prices 6% and see how your customers react.” – Tom Quigley

    Visit ClaimLinx.com
    Schedule a free consultation with Tom and his team today.

    Spotify | Apple Podcasts | Amazon Music | iHeartRadio | Google Podcasts

    💡 Key Topics Covered:🔧 Real-World Results:🧠 Smart Quote:📞 Want to Save 30–60% on Health Insurance?🎧 Available On:

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    1 month ago
    7 minutes 2 seconds

    Cutting-Edge Benefits Podcast
    Why Every Small Business Needs a Benefits Consultant

    In this powerful episode, Tom Quigley breaks down the real role of a benefits consultant—and why small businesses can’t afford to rely on traditional health insurance brokers anymore.

    Tom outlines how most brokers are incentivized by insurance carriers, not employers, and how this creates a massive blind spot for business owners trying to contain healthcare costs. He explains the difference between selling a product and building a cost-saving strategy.

    If your premiums keep rising and your employees keep getting hit with higher deductibles and less coverage, it’s time to rethink who’s advising you.

    • What a true benefits consultant does (hint: not just pushing a spreadsheet)

    • The conflict of interest in traditional broker models

    • How ClaimLinx finds grants, rebates, and hidden savings for employees with major medical conditions

    • Why your business is likely bleeding money on health insurance without realizing it

    • Examples of businesses saving 30–60% annually using smarter plan designs

    • The power of a Medical Expense Reimbursement Plan (MERP) for covering gaps cost-effectively

    • Why owner involvement is critical—and why relying on HR alone is a mistake

    “Convincing people they’re being ripped off is easy. Convincing them to change? That’s the hard part.” – Tom Quigley

    Visit ClaimLinx.com
    Schedule a call with Tom and his team today.

    Spotify | Apple Podcasts | Google Podcasts | Amazon Music | iHeartRadio

    💡 Key Topics Covered:🔥 Quote of the Episode:📞 Ready to Cut Costs?👂 Listen Now On:

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    1 month ago
    7 minutes 3 seconds

    Cutting-Edge Benefits Podcast
    The 2026 Healthcare Panic Button: New Alternatives for Individuals & Employers (Feat. Amber Krauza)

    In this packed episode, Tom Quigley invites Amber Krauza of CEHAS to help tackle one of the biggest questions hanging over the country right now: “What the hell are people supposed to do when health insurance jumps 40%, 50%, even 60% overnight?”

    The entire marketplace is in upheaval — open enrollment is a disaster, premiums are skyrocketing, networks are shrinking, and millions of people suddenly can’t afford coverage. Tom and Amber break down real alternatives for both individuals and employers, especially people who are healthy, priced out of the ACA marketplace, and sick of fighting with insurance companies and corrupt state departments of insurance.

    Amber brings solutions for 40 out of 50 states, while Tom exposes why the system is collapsing — and why employers absolutely must pivot or face financial ruin in 2026.

    This episode blends hard truth, practical solutions, and Tom’s classic “tell it straight” commentary — plus a few jokes about monkeys, Chicago, Wheaton, and why no one under 30 wants to leave their house anymore.

    • ACA premiums in many areas have risen 40–60%.

    • In some states, networks have collapsed to the point where there’s only one hospital available.

    • Brokers who ignored Amber 6 months ago are now calling her back begging for solutions.

    Amber breaks down three types of plans for individuals and employer groups:

    • Available in 40 states

    • Nationwide access

    • 5–6 strong network choices including:

      • Blue Cross Blue Shield

      • Aetna

      • Cigna

      • FirstHealth/PHCS

      • HealthSmart

    • Rates barely moved this year — one plan increased only 3.5%, compared to the marketplace’s 40–50%.

    • Similar to “major medical lite”

    • Lower premiums

    • For employers who still want solid coverage but cannot afford traditional plans.

    • Designed to avoid employer mandate penalties

    • A workable option for:

      • Restaurants

      • Hospitality

      • Retail

      • High-turnover industries

    • Ensures employees have basic coverage to keep them compliant.

    • For healthy people willing to roll the dice

    • 10 doctor visits per year

    • $1M annual / $5M lifetime max

    • Telemedicine included

    • Great for:

      • Gap months

      • New hires

      • People waiting for Medicare

      • People priced out of ACA

    Amber explains pre-existing condition rules:

    • Only major conditions in the last 5 years trigger a decline.

    • Type 2 diabetes? Accepted.

    • High blood pressure? Accepted.

    • CPAP use? Accepted.

    • Pregnant? Still accepted if enrolled before diagnosis.

    • No SSN required — ITIN / Tax ID is fine.

    Huge advantage: “Applications submitted by the 18th start the 1st of the next month.”
    You don’t have to wait for open enrollment.

    Tom explains why business owners can’t ignore this:

    • Staying with traditional insurance could bankrupt them.

    • MEC or MVP plans can save businesses, especially in industries with:

      • Small margins

      • High employee turnover

      • Low subsidy qualification

    • These plans allow employers to offer something instead of nothing, helping retention.

    • Brokers told clients “Don’t worry, I’ll get you a great deal” — now they’re eating their words.

    • Many are calling Amber for help because their networks disappeared or premiums doubled.

    • Tom:

      “I could train a chimp to do what most brokers do. Press a few keys, print a spreadsheet, and call it a day.”

    Amber and Tom both warn:

    • If people can’t afford insurance, hospitals will get crushed.

    • Marketplace access is shrinking.

    • Many states with corrupt insurance departments block competition altogether.

    • Solutions must come from outside the traditional industry.

    Amber highlights a fascinating shift:

    • Younger people (20s & early 30s) avoid doctors, offices, or anything requiring in-person visits.

    • They love:

      • Telemedicine

      • Links

      • Online enrollment

      • Zero paperwork

    Meanwhile older generations still want paper forms and face-to-face meetings.

    • If you’re healthy but can’t afford ACA premiums:
      Amber’s plans are a strong alternative.

    • If you’re an employer getting crushed by 2026 renewals:
      Consider MVP or MEC options to keep your business afloat.

    • If you’re between jobs or waiting for Medicare:
      Limited medical plans can provide safe temporary coverage.




    Show more...
    1 month ago
    19 minutes 15 seconds

    Cutting-Edge Benefits Podcast
    Will the Subsidies Sunset? The Political Tug-of-War That Could Reshape 2026 Healthcare

    In this direct, no-filter conversation, Tom Quigley tackles the question dominating American households, employers, and policymakers right now:

    Will the enhanced ACA subsidies sunset — or will politicians cave and extend them?

    Tom breaks down the math, the politics, the corruption, and the sheer incompetence swirling in Washington as lawmakers try to figure out what the hell to do with a healthcare system on the brink of collapse. He doesn’t hold back, calling out both parties, the lobbyists, the insurance companies, and the total lack of understanding lawmakers have about how insurance actually works.

    This episode is Tom at full force: blunt, sharp, and brutally honest — dropping insight after insight on how subsidies interact with employer insurance, why the math is being ignored, and how the entire debate is based on false assumptions about what consumers understand (spoiler: they don’t).

    • Politically, Democrats want subsidies extended.

    • Some Republicans can’t afford to vote against them or they risk losing tight races.

    • Tom predicts:

      • Maybe a one-year extension

      • Maybe another compromise

      • Definitely more confusion

    • The real issue: Both parties are missing the mathematical reality.

    Tom explains the hidden truth:

    • A 25-person group paying $500,000 annually in premiums → NOT taxable

    • If 20 employees move to subsidies and only 5 remain on the plan → employer pays $100,000

    • The remaining $400,000 becomes taxable income

    • That taxable income more than offsets the cost of extending subsidies

    Yet politicians never include this in their budget debates.

    Tom:

    “They have NO clue what they’re talking about when they go on TV. Not one.”

    • Middle-class families get crushed — especially two-income households.

    • One $2,000 raise could push a family over the subsidy threshold → they owe the full subsidy back.

    • Without subsidies, millions can’t afford premiums and hospitals get slammed with unpaid care.

    • Politically, Republicans know this could cost them elections.

    Tom’s take:

    “If I’m the Democratic candidate, I’m hiring someone like me to explain exactly how the Republicans are screwing people.”

    • There’s talk of giving people subsidy money directly.

    • Tom laughs:

      “They’ll use the money for Thanksgiving or Christmas — not deductibles.”

    • Neil adds:

      “Or put it down on a car.”

    • Tom says the only way cash transfers could work is with a locked medical card and someone advising them — otherwise it’s a disaster waiting to happen.

    Tom outlines a reality no politician will touch:

    • The ACA would’ve been fine if networks were left alone.

    • The 10 essential benefits requirement blew up premiums.

    • Insurance companies and hospitals have been fleecing America ever since.

    • Lobbyists have blocked nearly every reform that could lower costs.

    • Tom’s national fix would solve everything overnight:

      • $50,000 deductible on every American

      • Government reinsures everything above it

      • Employers allowed to self-fund below that amount

      • No employer mandate

      • Real competition underneath

    Tom:

    “But they don’t want solutions. They get elected by scaring everyone.”

    Tom doesn’t hold back:

    “Nancy Pelosi was 85 years old. What is she still doing in Congress?”

    “Our forefathers wanted one or two terms and you're out — now you need a billion dollars to run.”

    • Businesses must prepare now — subsidies may or may not be extended, and chaos is guaranteed.

    • ClaimLinx can reduce exposure, lower costs, and help employers navigate either outcome.

    • Move employees to subsidies when appropriate — the taxable income created offsets tax burdens.

    • Stop trusting politicians — trust the math.

    • Have a 2026 strategy ready before the government announces anything.

    “They don’t understand deductibles, co-insurance, or copays — and you want to hand them $6,000 and expect them to be wise consumers?” — Tom Quigley

    “This isn’t health insurance. It’s a tax break with rules. Learn the rules.” — Tom Quigley

    “Insurance companies, hospitals, pharmaceuticals — they’re all fleecing America.” — Tom Quigley


    👉 Website: www.ClaimLinx.com


    Show more...
    1 month ago
    11 minutes 33 seconds

    Cutting-Edge Benefits Podcast
    From Confusion to Clarity: How ClaimLinx Simplifies Employee Benefits

    After breaking news about skyrocketing 2026 health insurance premiums, this follow-up episode dives into the solution—how ClaimLinx simplifies the chaos of employee healthcare for small and mid-sized businesses.

    Host Tom Quigley pulls back the curtain on an industry designed to confuse, where most employers think “the more you pay, the better the plan.” In reality, the opposite is true. Tom explains that health benefits are a math problem—and ClaimLinx knows how to solve it every time.

    By combining transparency, logic, and math-based planning, ClaimLinx helps business owners move from frustration and confusion to complete clarity—saving hundreds of thousands in premiums while giving employees better coverage.

    1. Why Employee Healthcare Is So Confusing

      • The insurance industry thrives on complexity—deductibles, copays, and coinsurance are intentionally designed to confuse.

      • “You’ve got a $3,000 deductible, but the hospital bills you $6,000. No one understands why,” Tom says.

      • Agents and carriers benefit from the confusion—it keeps employers dependent on them.

    2. The Biggest Misconception in Benefits

      • Most companies believe higher premiums mean better coverage.

      • Tom flips that on its head: “The less you pay, the better the benefits—because you can do it smarter yourself.”

      • By restructuring plans and leveraging tax law, ClaimLinx regularly reduces premiums by 40–70%.

    3. The ClaimLinx Approach: Simple Math, Proven Results

      • “We’re under the premise that two plus two really does equal four,” Tom says.

      • ClaimLinx treats benefits as a math equation, not a guessing game.

      • Example: converting a $5,000 deductible plan into a zero-deductible, copay-based plan that saves employers money and boosts employee satisfaction.

      • “If you write down the numbers, I win every time,” Tom jokes.

    4. How ClaimLinx Consulting Simplifies Everything

      • The process is straightforward: analyze, restructure, and educate.

      • ClaimLinx handles all plan setup and ongoing support, while showing employers exactly how and whythey’re saving money.

      • Every client receives access to a claims portal and is paired with a dedicated service rep and licensed agent for year-round support.

      • “If they use us as their advocate, they’ll be very happy,” Tom explains.

    5. Proven Success in Action

      • On the day of recording, Tom reports four new companies signing with ClaimLinx—representing over $1.8 million in savings.

      • Clients find him through TV appearances, email outreach, and referrals.

      • “They’re starting to realize I’m not just talking about saving money—I’m proving it,” Tom says.

    6. Media and Awareness

      • Neil points out that Tom’s expertise deserves a national stage: “You should be on Fox, CNN, MSNBC—everywhere.”

      • Tom laughs it off: “They don’t want answers. They want everyone mad at everyone.”

      • Neil adds: “Then we’ll take it to Newsmax—my media giant’s got you covered.”

    • Stop overpaying for confusion. Simpler plans = smarter savings.

    • Rethink “value.” Premium cost does not equal quality of care.

    • Treat benefits like a math problem. With the right formula, your company can win every time.

    • Leverage expert advocacy. Let ClaimLinx handle the complexity so you can focus on running your business.

    “The more you pay, the worse your benefits are. The less you pay, the better they get—if you do it right.” — Tom Quigley

    “We’re under the premise that two plus two really does equal four. It’s math, not magic.” — Tom Quigley

    “If you write down the numbers, I win every time. I never lose.” — Tom Quigley

    “Confusion is profitable for them. Clarity is profitable for you.” — Tom Quigley

    “They don’t want answers—they want outrage. I want solutions.” — Tom Quigley

    👉 Website: www.ClaimLinx.com
    📞 Schedule a Call: Talk to Tom Quigley and his team today to simplify your company’s health benefits and start saving immediately.

    The Cutting Edge Benefits Podcast delivers straight talk, real math, and zero fluff about fixing America’s broken employee benefits system.
    Simulcast weekly on The Neil Haley Show, reaching over 150 stations and 5 million listeners nationwide.


    Show more...
    1 month ago
    5 minutes 5 seconds

    Cutting-Edge Benefits Podcast
    The 2026 Health Insurance Meltdown: Why Businesses Are About to Get Crushed by Rate Hikes

    In this explosive Cutting Edge Benefits Podcast episode, Tom Quigley delivers his most powerful reality check yet on the 2026 healthcare crisis. With UnitedHealthcare and other major carriers raising premiums by 40–52%, Tom exposes how employers are being ripped off in broad daylight—and how ClaimLinx’s simple, proven system could slash costs by hundreds of thousands of dollars.

    Tom reveals an actual client example: their premiums skyrocketed from $62,000 to $95,000, yet with ClaimLinx, those same benefits could cost just $25,000—a savings of over $800,000. He calls out insurance companies, agents, and Congress alike for being part of a corrupt, profit-driven machine that’s pushing small businesses and the middle class to the brink.

    This episode is classic Tom: unfiltered, data-driven, and fiercely protective of the American business owner.

    1. The Breaking News: Out-of-Control Premium Increases

      • A real business example shows a 52% rate hike from UnitedHealthcare.

      • ClaimLinx’s solution would cut those costs by nearly 75%.

      • Tom: “Help me help you. I’ll save you $800,000—but you have to listen.”

    2. Why Premiums Are Exploding

      • The sunset of government subsidies opened the floodgates for carriers to gouge businesses.

      • “These companies—United, Aetna, all of them—they’re stock companies. Their job is to increase stock value, not protect you.”

    3. The Math No One Talks About

      • Tom breaks down the numbers:

        • Middle plan: $180,000 premium reduction potential.

        • Out-of-pocket lowered for employees.

        • Employer net savings: $150,000–$250,000 on a 25-person team.

      • “It’s math, not emotion. The agents don’t even understand the spreadsheets they’re selling.”

    4. How the Current System Hurts Employees

      • HR departments are cornered, employees pay more for less, and agents collect bigger commissions.

      • “Everyone wins but you: agents get a raise, carriers please their shareholders, and states collect premium taxes.”

    5. The ICHRA Illusion vs. the ClaimLinx Solution

      • Tom exposes individual coverage HRAs (ICHRAs) as a costly trap.

      • “Premiums and out-of-pocket hit $10,500—what a joke.
        A Medical Expense Reimbursement Plan does it all better and cheaper.”

    6. How to Survive the 2026 Crisis

      • Rethink insurance: buy catastrophic coverage only and self-fund benefits through tax-advantaged plans.

      • “Pay for direct primary care—$99/month, unlimited visits, cheaper labs—and save the rest for real emergencies.”

      • Stop giving away $50,000 a year to insurance companies. “Invest it in your people or your business.”

    7. Tom’s Message to Congress

      • “They’re all corrupt. They live in la-la land.”

      • He proposes a national fix:

        • A $50,000 deductible for every American, funded by tax-free savings and competitive markets underneath.

        • “Let the free market and logic win—this system is designed for failure.”

    8. The Middle Class Is Getting Crushed

      • Wages can’t keep up with inflation and healthcare inflation.

      • “They’re paying $4,600 a month for health insurance—that’s their mortgage, their car, and their cottage combined!”

      • Tom warns that small business owners who accept these hikes are dooming their future.

    • Stop buying insurance the traditional way. You’re financing corporate greed.

    • Switch to a Medical Expense Reimbursement model. It’s flexible, legal, and proven to save 50% or more.

    • Use Direct Primary Care to eliminate waste and give employees real healthcare access.

    • Contact ClaimLinx now before your 2026 renewals hit—every day you wait, you lose money.

    “They’re stock companies. Their job is to make shareholders richer—not to protect you.” — Tom Quigley

    “Help me help you. I’ll save you $800,000 if you just listen.” — Tom Quigley

    “It’s math, not emotion. The agents can’t even read their own spreadsheets.” — Tom Quigley

    “They all win—insurance agents, carriers, the state—and you lose.” — Tom Quigley

    “You’re buying health insurance like you’re buying gas from a station that just doubled its price—and thanking them for it.” — Tom Quigley

    👉 Website: www.ClaimLinx.com

    Show more...
    1 month ago
    11 minutes 20 seconds

    Cutting-Edge Benefits Podcast
    CVS Health’s Exit from the ACA Marketplace: What It Signals for Employee Benefit Strategy in 2026

    In this special Halloween edition of the Cutting Edge Benefits Podcast, Tom Quigley and Neil Haley dissect breaking news from the healthcare industry: CVS Health’s shocking decision to exit the ACA individual marketplace in 17 states for 2026. While some may see this as an isolated corporate move, Tom argues it’s a clear reflection of a profit-obsessed system collapsing under its own weight.

    With his trademark candor, Tom calls out the real motives behind CVS’s exit—profit margins and shareholder demands—not consumer care or innovation. He breaks down how the ACA individual market became an unprofitable “loss leader” for major corporations, likening CVS’s health plans to the cheap gas at a convenience store—a hook to get people in the door to buy other stuff.

    Throughout the conversation, Tom and Neil use sharp analogies, humor, and blunt truth to expose the dysfunction in the current system and guide business owners on how to protect their teams from market chaos in 2026 and beyond.

    1. Why CVS Really Exited the ACA Market

      • CVS Health, through Aetna, wasn’t earning enough profit to satisfy shareholders.

      • Tom: “They’re stock companies. If they’re not making enough for their shareholders, they’re gone—goodbye, see you next.”

      • Their ACA product featured limited networks and underperforming teams—“probably former failed insurance agents,” Tom jokes.

    2. The Corporate Game: It’s All About the Store Traffic

      • CVS’s goal wasn’t to revolutionize health insurance—it was to get more people into the store.

      • Tom compares their strategy to gas stations offering cheap gas to sell snacks and drinks.

      • “Drugs were their loss leader,” Tom says. “They wanted you to come in for prescriptions, then leave with almonds, ice cream, and a passport photo.”

    3. Impact on Employees and Consumers

      • Those with CVS/Aetna ACA plans will have to switch to other carriers in their state.

      • Some states, like Kentucky, have only two carriers left, making this exit more significant.

      • Still, Tom emphasizes: “It’s just one more carrier playing the profit game—it’s not about care, it’s about stock price.”

    4. Deeper Instability or Business as Usual?

      • CVS’s move doesn’t signal a total collapse but highlights systemic instability where insurers chase higher-profit markets.

      • “They might make 10% profit, but they want 20%. It’s never enough,” Tom explains.

    5. How Small Businesses Can Protect Their Teams

      • Tom urges business owners to change their mindset: buy catastrophic insurance only, then fund the rest of the benefits directly.

      • “Stop chasing headlines. You’re not buying insurance—you’re building benefits,” he says.

      • ClaimLinx’s approach helps businesses control their own benefits, avoiding disruptions caused by insurer shifts or government subsidies.

    6. Lessons from the Corporate Health Shuffle

      • Large insurers view health coverage like CVS views snacks—it’s about upselling.

      • Insurance companies want you to add dental, vision, and extras that bring pure profit.

      • “They want impulse buyers,” Tom says. “If everyone only bought what they needed, the whole agent system would collapse.”

    7. The November Crunch: Renewals and Subsidy Changes

      • With subsidies set to sunset, fearmongering headlines will explode—but Tom insists it’s just political theater.

      • “They’ll adjust the premiums, move a few numbers, and make it sound like the world’s ending,” he quips.

      • His advice? “Ignore the noise. Focus on your business’s balance sheet.”

    “If you’re smart, you buy catastrophic insurance and fund benefits yourself. Everyone else is just impulse-buying health care.” — Tom Quigley

    “It’s all buzzwords and headlines—CNN, MSNBC, they love scaring people. I love saving them instead.” — Tom Quigley

    👉 Website: www.ClaimLinx.com
    📞 Schedule a Call: Talk to Tom Quigley and his team to find out how your company can cut costs and improve benefits for 2026 and beyond.

    Stay ahead of healthcare disruption with the Cutting Edge Benefits Podcast, where Tom Quigley and Neil Haley deliver straight talk on how to beat the system, save money, and empower your employees.

    Show more...
    2 months ago
    9 minutes 25 seconds

    Cutting-Edge Benefits Podcast
    Health Insurance Costs Surge in 2026: Why Employers Can’t Afford the Status Quo

    In this Halloween edition of Cutting Edge Benefits, host Tom Quigley and co-host Neil Haley tackle the chilling reality of what 2026 holds for U.S. employers facing skyrocketing healthcare costs. With projections showing nearly a 9% rise in employee healthcare costs, Tom delivers a candid and fiery take on what’s truly driving this crisis—greed, corruption, and complacency at every level of the healthcare system.

    Tom calls out the insurance carriers, pharmaceutical giants, hospital administrators, and even government agencies for perpetuating an unsustainable model that punishes small and mid-sized businesses. He argues that the traditional way of buying health insurance is broken—a “round peg in a square hole” that no longer fits the modern economic landscape.

    But this episode isn’t just a rant—it’s a roadmap. Tom outlines ClaimLinx’s proven strategy to help businesses fight back, lower costs, and enhance employee benefits by leveraging tax laws and innovative plan design. Through ClaimLinx’s Simple Option Solution, employers can transform health insurance from a crippling liability into a competitive business asset.

    1. The 2026 Health Insurance Cost Explosion

      • Premiums expected to rise nearly 9%, with some companies already seeing 30–40% increases.

      • Tom bluntly states: “It’s all about greed. It’s all about the Benjamins.”

    2. Corruption in the System

      • A raw look at how profit-driven motives—from insurance carriers to big pharma—keep driving costs higher.

      • “Corrupt people allow corrupt things to happen,” Tom says, emphasizing the need for employers to outsmart the system.

    3. The Myth of “Lower Rates”

      • Many brokers claim to secure lower rates, but they quietly strip away benefits—raising deductibles and removing copays.

      • Example: A supposed “6% decrease” that actually hid a 20% rate increase and a shift from a $500 to a $3,000 deductible.

    4. Impact on Small and Mid-Sized Businesses

      • The rising costs threaten business survival and employee satisfaction.

      • Passing the burden to employees is a short-term fix that destroys morale, retention, and recruiting power.

    5. The ClaimLinx Advantage

      • ClaimLinx teaches companies to buy insurance smarter and use tax laws to their advantage.

      • Employers can save up to 50% while offering better benefits than competitors.

      • Tom likens it to turning “a liability into an asset” on the company balance sheet.

    6. Timing is Everything

      • November is renewal season, and HR teams are bracing for bad news.

      • Tom urges business owners: “Don’t be another sucker who takes the rate increase—change the game.”

    • Stop accepting rate hikes as inevitable—there’s always a smarter way to buy insurance.

    • Use tax codes strategically to reduce employer and employee costs.

    • Evaluate benefit designs that give employees more coverage at less cost.

    • Schedule a call with ClaimLinx before renewal deadlines to explore custom savings opportunities.

    👉 Website: www.ClaimLinx.com
    📞 Schedule a Call: Book a consultation with Tom Quigley and his team to find out how to save up to 50% on your 2026 healthcare costs.

    “Corrupt people allow corrupt things to happen.” — Tom Quigley

    “It’s like Christmas every day for me—I get to show people how to win the healthcare game.” — Tom Quigley

    “They think they’re heroes for stripping benefits. They’re not saving you money—they’re robbing your employees.” — Tom Quigley

    Catch every episode of the Cutting Edge Benefits Podcast—your insider’s guide to smarter healthcare strategies for 2026 and beyond.
    Simulcast weekly on The Neil Haley Show across 150+ stations and all major podcast platforms.

    💡 Key Discussion Points⚙️ Actionable Takeaways🔗 Connect with ClaimLinx🗣️ Memorable Quotes🎧 Listen & Subscribe

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    2 months ago
    9 minutes 13 seconds

    Cutting-Edge Benefits Podcast
    How to Buy Health Insurance for Your Business in 2026

    In this powerhouse episode, Tom Quigley breaks down how small businesses should approach buying health insurance for 2026. With inflation, subsidy uncertainty, and insurance carrier greed on the rise, most businesses are wasting tens—sometimes hundreds—of thousands of dollars every year.

    Tom lays out a step-by-step framework for saving money while providing better employee benefits, and exposes the shocking truth about brokers, HR decision-makers, and even departments of insurance.

    1. Get the Lowest-Cost Option

      • Ask your current carrier for the cheapest available plan with the same network—no matter the deductible.

    2. Run the Math with ClaimLinx

      • Tom’s team will show you how much you’re overpaying and what you can recover by managing benefits yourself.

    3. Design a Strategic Plan

      • Let employees voluntarily go on spouse plans, Medicare, TRICARE, or ACA subsidies if applicable. Structure your plan to allow this and capture more savings.

    4. Optimize & Layer Benefits

      • Use a Medical Expense Reimbursement Plan (MERP) to improve benefits tax-free, stack group plans if needed, and add disease grants, hospital discounts, and prescription savings to reduce costs even further.

    • 💰 “Your broker works for the insurance company—not for you.”

    • 🚫 “Insurance agents make more money the more you spend. Of course they’re not showing you how to cut costs.”

    • 🧮 “If I can save you $100K, why didn’t your broker already do that?”

    • 😤 “HR and office managers shouldn’t be in charge of buying health insurance. They’re protecting their turf, not your company.”

    • 🐒 “A chimpanzee could do what most brokers do.”

    • “My job is to win. I’m incentivized by what I save you. I don’t sell policies—I fix broken systems.”

    • “You’re not just saving money—you’re increasing your business’s valuation and EBITDA overnight.”

    • “Egos and laziness are costing companies millions. Do the math, and do better.”

    Tom shares how he tried to help a private equity-backed company save $10 million/year—only to be dismissed by the CEO who said he was “too busy.” The same company’s agent admitted they had the best benefits at the lowest cost—all thanks to ClaimLinx.

    • Small to mid-sized business owners under 50 employees

    • CFOs and CEOs looking to reduce their 2026 healthcare spend

    • Any employer tired of brokers pushing rate hikes without strategy

    • Private equity groups managing portfolio companies' expenses

    • HR directors open to real solutions (not clinging to control)

    Don’t throw money away on bad benefits. Get the truth.
    👉 Visit ClaimLinx.com
    📅 Schedule a free discovery call with Tom and his team.

    #CuttingEdgeBenefits #ClaimLinx #HealthInsuranceStrategy #SmallBusinessSavings #MedicalExpensePlan #TomQuigley #BusinessHealth #EmployerBenefits #2026Planning

    💡 Key Takeaways:✅ Tom’s 4-Step Process for Buying Smarter in 2026:💣 Hard Truths Tom Drops:🧠 Tom's Business Philosophy:🔥 Real Talk:📈 Who This Episode Is For:🎯 Call to Action:📲 Shareable Hashtags:

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    2 months ago
    8 minutes 3 seconds

    Cutting-Edge Benefits Podcast
    Subsidy Showdown: Will Congress Renew Health Insurance Aid Before 2026?

    In this no-holds-barred episode, Tom Quigley takes aim at Washington’s latest political standoff—the looming expiration of health insurance subsidies under the Affordable Care Act. With the government shutdown still unresolved, Tom explains why cutting subsidies could devastate small business owners, self-employed individuals, and middle-class families across America.

    As always, Tom delivers real talk with no sugar-coating. He breaks down how enhanced ACA subsidies lowered premiums to manageable levels for many working Americans—and why eliminating them would cause premiums to skyrocket 400–600%, leaving people either uninsured or broke.

    • ⚖️ Subsidy Extensions Are on the Chopping Block: Republican lawmakers signal willingness to negotiate—but do they even understand what’s at stake?

    • 📈 What Happens If They Expire?: Many people paying $300/month could see premiums balloon to $2,000–$3,000/month.

    • 🏛️ Who’s to Blame?: Tom names names—hospital administrators, health insurance companies, agents, even state departments of insurance.

    • 💸 Why Congress Should Support Subsidies: Cutting subsidies reduces government tax revenue in the long run. Tom explains why the math doesn’t add up.

    • 🤔 The Bigger Problem: Lawmakers on both sides of the aisle “don’t understand health insurance.” It’s time to stop making healthcare a political weapon.

    • 🛑 The Real Victim: The middle class—those who don’t qualify for Medicaid, but also don’t make enough to absorb $24K+/year in premiums.

    • 🗳️ 2026 Elections Are Coming: If these subsidies disappear, expect outrage from voting Americans—especially the middle class.

    • ✅ Why ClaimLinx Clients Are Protected: Tom designs plans so that subsidies are a bonus—not a requirement—for affordability.

    “These clowns don’t understand anything about health insurance… if they did, they’d be promoting subsidies—not fighting them.” — Tom Quigley

    “You’re running with thieves: the insurance companies, hospitals, agents, departments of insurance. You don’t have to be a thief—but you better think like one.” — Tom Quigley

    “When rates go from $300 to $3,000, people will be screaming. And guess who votes? The middle class.” — Tom Quigley

    “My job is to win. I’m incentivized based on what I save my clients. I win. We don’t lose.” — Tom Quigley

    If Congress lets these subsidies expire, small businesses and entrepreneurs will take the biggest hit. But you don’t have to wait for Capitol Hill to decide your financial future. ClaimLinx has a proven, tax-advantaged approach that helps businesses save thousands—with or without subsidies.

    Don't wait for Congress. Take control now.
    👉 Visit ClaimLinx.com
    📅 Schedule a free strategy session with Tom and his team.

    #CuttingEdgeBenefits #ClaimLinx #HealthInsuranceSubsidies #ACA2026 #GovernmentShutdown #SmallBusinessHealthCare #TomQuigley #MiddleClassCrisis #HealthcareReform #HealthcareInflation


    💡 Key Discussion Points:🔍 Notable Quotes:📌 What This Means for Business Owners:🎯 Call to Action:📲 Hashtags for Sharing:

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    2 months ago
    6 minutes 48 seconds

    Cutting-Edge Benefits Podcast
    The Disability Coverage Gap: How Small Businesses Can Protect Key Employees

    In this episode of Cutting Edge Benefits, Tom Quigley welcomes longtime friend and benefits expert Aaron McDonaldfrom Medfinity Financial for a deep dive into one of the most overlooked benefits in the small business world—disability insurance.

    Aaron shares how reverse discrimination in traditional group benefits plans leaves high-income earners significantly underinsured—and what business owners can do to fix it. You’ll learn how guaranteed standard issue disability planscan provide custom protection for executives and key employees, regardless of health status. Plus, they explore how these solutions perfectly complement ClaimLinx’s cost-saving healthcare model.

    • ⚙️ What “reverse discrimination” means in disability benefits for high earners

    • 🧩 Why most small business benefit packages are incomplete without key person disability

    • 💼 How ClaimLinx clients are layering disability coverage into their savings strategy

    • 🚫 Why traditional group disability coverage usually falls short

    • ✅ What is “guaranteed issue disability insurance”—and why it’s a game changer

    • 👩‍💼 How 3 high-income employees are enough to start a disability coverage plan

    • 💡 Using benefits to increase business valuation before an exit

    • 📈 Why adding disability + retirement protection helps retain and reward top talent

    • 🧠 Real-life examples of business owners upgrading limited coverage to full protection—even when previously deemed uninsurable

    • Disability insurance is the most important benefit a business owner can have—it protects your income when you can’t work.

    • Most small businesses undercover their highest-paid employees, exposing them to serious financial risk.

    • Medfinity Financial’s partnership with Guardian allows guaranteed issue disability plans starting with as few as 3 employees—no medical questions required.

    • ClaimLinx and Medfinity are working hand-in-hand to provide a holistic benefits approach: healthcare savings + disability + retirement protection.

    • Better benefits = better retention, better recruiting, and higher business valuation.

    “If you can’t work, where’s your money coming from?” — Tom Quigley

    “We help protect high-income earners from reverse discrimination in traditional group disability plans.” — Aaron McDonald

    “You could be completely uninsurable... and still qualify for this guaranteed coverage.” — Aaron McDonald

    “Disability insurance removes the need for GoFundMe pages.” — Tom Quigley

    ➡️ Aaron McDonald, Medfinity Financial

    • 📞 Phone: (248) 633-1394

    • 🌐 Website: medfinityfinancial.com

    • 📧 Email: AMcDonald@medfinityfinancial.com

    ➡️ Tom Quigley, ClaimLinx

    • 🌐 Website: www.claimlinx.com

    • 📅 Schedule a Consultation: Schedule a call

    #CuttingEdgeBenefits #ClaimLinx #DisabilityInsurance #SmallBusinessBenefits #ExecutiveBenefits #KeyEmployeeProtection #MedfinityFinancial #ExitPlanning #BusinessValuation #EmployeeRetention #GroupInsurance #ReverseDiscrimination #TomQuigley #AaronMcDonald #TheNeilHaleyShow

    🔥 Topics Covered:📌 Key Takeaways:💬 Quotes to Remember:🔗 Resources & Contact Info:📲 Hashtags for Social Media:

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    2 months ago
    11 minutes 14 seconds

    Cutting-Edge Benefits Podcast
    Healthcare Inflation vs. Your Business: How to Beat the 2026 Cost Curve

    In this no-holds-barred episode of the Cutting Edge Benefits Podcast, Tom Quigley breaks down the hard truth about why healthcare inflation is outpacing wages and profits—and what small businesses must do in 2026 to stay alive. From corporate greed and rigged state insurance laws to hospital billing scams and bloated broker commissions, Tom doesn’t hold back.

    You'll hear how ClaimLinx’s Simple Option Solution uses alternative funding models, tax laws, and smart plan design to save companies up to 50% on healthcare—without cutting employee benefits. It’s a complete mindset shift from the old, broken system—and one every CFO, CEO, and business owner needs to hear.

    • 💣 The truth about healthcare inflation: Why costs keep rising no matter what

    • 💊 How hospital administrators and stock-driven insurance companies are driving costs

    • 🧾 Why maternity costs have jumped from $5,000 to over $20,000

    • 🧠 Why HR managers should NOT be making insurance decisions

    • 💸 How to measure your insurance costs like a profit-driving business expense

    • 📉 The secret behind “alternative funding models” and how ClaimLinx uses them to save money

    • 💼 How brokers are incentivized NOT to save you money—and what to do about it

    • 📈 Using a tax-efficient strategy to reduce premiums and improve employee coverage

    • 🧪 Why Tom calls himself the “mad scientist” of healthcare benefits (and why it works)

    • 🔁 Why large companies are often more wasteful than small ones—and how to beat both

    • Stop outsourcing critical benefit decisions to HR and office managers who don’t understand the math.

    • Evaluate your healthcare spend the way you’d evaluate a million-dollar sale.

    • Ask: “If my business saved $500K on insurance, what would that mean for profit or valuation?”

    • Take advantage of 1954 tax code Section 105—it’s legal, powerful, and underutilized.

    • Don’t settle for 10–20% rate increases—fight back with data, design, and better partners.

    “It’s not an HR decision—it’s a corporate profitability decision.” — Tom Quigley

    “Every tax law has tax breaks—you just need to know how to use them.” — Tom Quigley

    “They float a 10% rate hike like they’re doing you a favor. That’s not savings. That’s theft.” — Tom Quigley

    “If you’re paying more and getting less, you’re the sucker at the poker table.” — Tom Quigley

    • ✅ Schedule a call with Tom: www.claimlinx.com

    • 🎧 Listen to past episodes: Cutting Edge Benefits Podcast

    • 📊 Learn about the Simple Option Solution: How It Works

    #CuttingEdgeBenefits #ClaimLinx #HealthcareInflation #2026Benefits #TomQuigley #AlternativeFunding #SmallBusinessHealthcare #InsuranceScam #HealthPlanSavings #HRvsCFO #HealthcareTransparency #StopOverpaying #EmployeeBenefits #NeilHaleyShow

    🔥 Topics Covered:🛠️ Key Takeaways for Employers:💬 Quotes to Remember:🔗 Resources:📌 Hashtags:

    Show more...
    2 months ago
    8 minutes 20 seconds

    Cutting-Edge Benefits Podcast
    Are you a business owner or HR leader tired of skyrocketing health insurance premiums and confusing benefits packages? Welcome to the Cutting-Edge Benefits Podcast, where we break down the smartest, most cost-effective ways to offer high-quality employee healthcare — without breaking the bank. Each episode, our experts at ClaimLinx reveal insider strategies to help you: ✅ Cut hidden costs in your current health plan ✅ Understand the difference between self-funded and fully insured models ✅ Build competitive benefits packages that attract and retain top talent ✅ Stay ahead of healthcare trends