In The News
The GLP-1 Market Has Changed, Now Plans Need a Strategy
By Jake Velie, CPT, Founder, Chairman & CEO, National Integrative Health The GLP-1 market has already changed. The real question now is not whether these therapies will keep growing. They will. The question is whether plan sponsors have a real strategy for managing them.¹ ² Too much of the conversation is still framed the wrong […]
The Era of Passive Health Plan Oversight Is Ending
By Jake Velie, CPT, Founder, Chairman & CEO, National Integrative Health Employers are getting squeezed from every direction on healthcare costs. That part is not new. What is changing is how they are starting to respond.¹ ² For years, many plan sponsors treated high-cost healthcare as something to review after the fact. They got the […]
Why Brokers Are Asking for Infusion Carve-Outs Now?
By Jake Velie, Chairman & CEO, National Integrative Health When brokers start raising infusion carve-outs in renewal conversations, it is a sign that the old approach to medical-benefit drug spend is under pressure. This is not a labeling exercise. It is about cost, accountability, and control. In one recent NIH case, a broker managing over […]
PBM PUGILISM – With the Big Three Pharmacy Benefit Managers Facing greater scrutiny, more independent players are jockeying for position
Written by Bruce Shutan David vs. Goliath battle continues to intensify across the pharmacy benefit management landscape as self-insured employers struggle with reining in their Rx spend. In one corner lie the so-called Big Three PBMs, which are vertically integrated with the nation’s largest health insurance companies and control about 80% of U.S. prescription drug […]
The 2027 Cost Challenge Employers Can Act On: Site of Care, Stop-Loss, and Specialty Drug Sourcing
By Jake Velie, Chairman & CEO, National Integrative Health The 2027 Segal Health Plan Cost Trend Survey should change the conversation for every self-funded employer. The issue is not simply whether costs will rise. It is whether the same high-cost claim will become more expensive because of its site of care, its sourcing pathway, and its lack […]
The Data You Cannot See Is Costing You More Than the Data You Can
By Jake Velie, Chairman & CEO, National Integrative Health The National Alliance of Healthcare Purchaser Coalitions just released its 2026 Pulse of the Purchaser survey, and if you run a self-funded health plan, you should read it carefully.¹ Not because it says anything surprising about costs. Costs are up. Everyone knows that. The average employer expects a 7.7% […]
HVBA Innovation Summit Tampa Brings Industry Leaders Together for Education, Connection and an Unforgettable Casino Night
The Health & Voluntary Benefits Association® (HVBA) brought together brokers, consultants, industry leaders, innovators and strategic partners in Tampa for the 2026 HVBA Innovation Summit, delivering two days filled with meaningful conversations, timely education, relationship-building and plenty of fun. The experience began Wednesday evening with an exclusive VIP Dinner for HVBA Board Members and invited guests, […]
HVBA Innovation Summit Returns to Tampa August 20 with Cutting-Edge Healthcare Sessions and Upscale Casino-Themed Networking Reception
TAMPA, FL — August 19, 2026 — The Health & Voluntary Benefits Association® (HVBA) will bring benefits professionals, brokers, consultants, healthcare innovators and industry leaders together at the 2026 HVBA Innovation Summit – Tampa on Thursday, August 20, 2026, at Hotel Alba Tampa. Designed to be more than a traditional industry conference, the HVBA Innovation Summit combines timely education […]
Two Sleeping Giants Keep Missing Each Other, and Patients Pay the Price
By Jake Velie, Chairman & CEO, National Integrative Health The New England Journal of Medicine just published an article calling self-insured employers “A Sleeping Giant of Health Care Affordability.”¹ The authors, Dr. Suhas Gondi and Dr. Zirui Song, wrote it because most physicians do not know that a self-insured employer sits behind that carrier card their patient […]
PBMs Keep Putting It in Writing: They Are Not the Fiduciary
By Jake Velie, Chairman & CEO, National Integrative Health The most important sentence in some PBM paperwork is not buried in the pricing exhibit. It is not in the rebate schedule. It is not in the reporting package. It is the disclaimer. In one PBM pharmacy service agreement reviewed by our team, the language is direct: […]
PBM Transparency Is Coming, and It’s About Time
By Jake Velie, Chairman & CEO, National Integrative Health The momentum toward pharmacy benefit manager transparency just got a significant boost. As reported by Allison Bell in BenefitsPro on July 17, 2026, DOL Secretary nominee Keith Sonderling told the Senate Health, Education, Labor and Pensions (HELP) Committee that drafting new PBM transparency regulations is a priority for […]
Caribou Systems Is Asking the Right Question, and Plan Sponsors Should Listen
By Jake Velie, CEO & President, National Integrative Health Caribou Systems recently published a piece that every self-funded plan sponsor should read: “You’re the Fiduciary. Can You Prove It?” It’s a direct, uncomfortable question, and that’s exactly why it matters.¹ Their argument is simple and correct: ERISA fiduciary compliance isn’t about outcomes. It’s about process. Specifically, can […]
Case Study: Seamlessly Reducing High-Cost Pharmacy Spend Without Disrupting Member Care
Client Snapshot: The Illinois Plan Sponsor Top 25 Reprice An Illinois Plan Sponsor was facing a growing challenge with high-cost pharmacy claims. A small group of prescriptions was driving significant plan spend, and the company needed a clearer way to identify savings without disrupting employees who depended on these medications. NIH analyzed 1,677 claims of […]
Innovation Summit in San Antonio with Strategic Board Meeting, Industry Collaboration, and Business-Driving Partnerships
San Antonio, TX — May 2026 — The Health & Voluntary Benefits Association (HVBA) officially kicked off its 2026 Innovation Summit in San Antonio with a full strategic board meeting, setting the tone for a high-impact event focused on leadership, innovation, meaningful networking, and partnership development across the health and voluntary benefits industry. The San Antonio […]
Allied National Launches a New Approach to Traditional Group Health Coverage
Overland Park, KS – May 6, 2026: Allied National, one of the original pioneers in level-funded and reference-based pricing (RBP) healthcare plans, proudly announces the launch of Freedom Open Access, an end-to-end network alternative solution and bold reimagining of its decades-long commitment to affordable, transparent, and member-centric healthcare. Background Controlling ever-rising healthcare costs remains a challenge for […]
National Integrative Health (“NIH”) Announces the Addition of Joshua Ridgeway as Chief Operating Officer and the promotion of Robert S. Shestack to Chief Enterprise Actuary
New COO brings senior and benefits industry expertise to NIH’s leadership team April 6th, 2026 – DES MOINES, IOWA. NIH is a fast‑growing consulting firm specializing in healthcare design, data, pharmacy, and analytics, helping employers better manage healthcare costs while improving care quality and access to personalized services for their employees. NIH has named Joshua Ridgeway […]
HVBA Announces 2026 Innovation Summit in San Antonio: A Curated Leadership Experience for the Benefits Industry
San Antonio, Texas – HVBA today announced the upcoming HVBA Innovation Summit, taking place Thursday, May 21, at the renowned Hilton Palacio del Rio in San Antonio. Designed as a highly curated gathering of industry leaders, the Summit is redefining how the benefits community connects, collaborates, and drives innovation. Unlike traditional conferences filled with massive expo halls and […]
Health & Voluntary Benefits Association® Appoints Robert Lashley to Advisory Board
Mount Laurel, NJ — Tuesday, February 9, 2026 — The Health & Voluntary Benefits Association® (HVBA) today announced the appointment of Robert Lashley, President and Chief Executive Officer of ClickEnroll, to its Advisory Board. Lashley brings more than 30 years of leadership experience across insurance, benefits technology, artificial intelligence, and enterprise software development, further strengthening HVBA’s mission […]
PBM Reform Legislation Passed
Last Week the DOL, Today Congress: PBM Transparency and Compensation Disclosure Requirements As we told you on Friday, the DOL released proposed regulations requiring PBMs to disclose up to 8 “types” of compensation streams to a self-insured group health plan in accordance with ERISA’s section 408(b)(2)(B) Compensation Disclosure requirements (which you can read here, along with a […]
PBM Compensation Disclosure Regulations Released
DOL Regulations Confirm That PBMs Are Subject to ERISA’s Compensation Disclosure Requirements On Thursday, Jan. 29th, the Department of Labor (DOL) finally released long-awaited proposed regulations implementing – and clarifying – important aspects of the 408(b)(2)(B) Compensation Disclosure requirements. In short, these proposed rules clarify – and confirm – that Pharmacy Benefit Managers (PBMs) and any other service provider […]