Hidden fees in employer health plans are about to come out

Many companies pay for their workers' health care directly, and the fees buried in those plans have been hard to see. Paul Pender, an ophthalmologist, explains why new transparency and fiduciary rules taking hold in January 2027 will force these self-insured employers to ask for that data. This episode is based on his article "Self-insured employer health plans face a new reckoning," published on KevinMD. You will hear why the executives who sign off on these plans can be held personally liable, and how class action lawsuits argue that hidden fees cost employees money. He describes how brokers may shift from retention bonuses paid by insurers to fees paid by the employers they serve, and why employees could see better benefits and fewer surprise bills. He also outlines Our Town Healthcare, a physician-centered plan model set to be tested in two Georgia cities by a company he advises and invests in. Press play to hear why he expects the big players to resist, and why he says employers should have a compliance plan ready.

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