Episodes

  • Friends with Benefits 1: Mike Miele on PBMs, GLP-1s, and Drug Pricing

    Friends with Benefits 1: Mike Miele on PBMs, GLP-1s, and Drug Pricing
    Mar 17 2026
    Welcome to the first episode of our new “Friends With Benefits” series on The EOB Podcast. Julie Selesnick and Justin Leader bring in one of the smartest people they know in the healthcare benefits industry — Mike Miele, FSA, MAAA, Senior Vice President of Insured Services at Capital Rx — to talk about the topic everyone in benefits is arguing about right now: pharmacy benefit managers (PBMs). Mike pulls back the curtain on how PBMs actually work, how rebates shape the entire drug pricing ecosystem, and why employers often have far less visibility into their pharmacy spend than they think. Along the way the group dives into GLP-1 drugs like Ozempic and Wegovy, exploding pharmacy trends, rebate economics, and the uncomfortable truth about who really controls drug formularies. Topics include:
    • The real story behind PBMs and pharmacy rebates
    • Why GLP-1 drugs are driving pharmacy trend
    • The economics behind drug formularies and rebate deals
    • Why employers struggle to get transparent pharmacy data
    • How plan sponsors can better manage pharmacy spend
    If you’re an employer, HR leader, benefits advisor, or healthcare industry insider, this episode will help you understand the forces driving prescription drug costs — and what questions you should actually be asking. And yes… this episode also launches our new segment: Friends With Benefits. More industry insiders are coming. Follow for more straight talk on healthcare benefits, pharmacy, and employer health plans.
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    42 mins
  • The Biggest PBM Transparency Rule in Decades? DOL Crackdown on Rebates, Spread Pricing & Hidden Fees

    The Biggest PBM Transparency Rule in Decades? DOL Crackdown on Rebates, Spread Pricing & Hidden Fees
    Mar 3 2026

    In Episode 2 of The EOB Podcast, Justin Leader and Julie Selesnick break down the proposed U.S. Department of Labor rule that could become the most consequential PBM transparency regulation in decades. The proposed rule would require Pharmacy Benefit Managers (PBMs) to provide detailed disclosure of:

    • Manufacturer rebates

    • Spread pricing practices

    • Pharmacy clawbacks

    • Indirect compensation

    • Affiliate & GPO relationships

    • Audit rights and verification standards

    But here’s the key: PBMs are already subject to compensation disclosure requirements under ERISA Section 408(b)(2) and the Consolidated Appropriations Act (CAA) of 2021.

    So what makes this new rule different? Justin and Julie explain:

    • Why employers cannot delegate fiduciary responsibility
    • How rebate retention clauses can cost millions
    • The impact of pharmacy clawbacks on independent pharmacies
    • Why spread pricing is still a major issue
    • What plan sponsors should be asking for in their RFPs right now
    • Why you don’t need to wait for the rule to pass to demand transparency

    If you are an employer, HR leader, CFO, broker, consultant, fiduciary, or compliance professional, this episode gives you a practical roadmap for reducing PBM risk and protecting your health plan. You don’t need a new law to start being proactive. Follow for more episodes breaking down healthcare benefits, ERISA compliance, fiduciary risk, PBM reform, and employer health plan strategy.
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    37 mins
  • The Voluntary Benefits Reckoning: Lawsuits, Hidden Commissions & the Fiduciary Wake-Up Call

    The Voluntary Benefits Reckoning: Lawsuits, Hidden Commissions & the Fiduciary Wake-Up Call
    Feb 12 2026
    In this episode of The EOB Podcast, Justin Leader and Julie Selesnick pull back the curtain on the explosive Schlichter voluntary benefits lawsuits—and why they could permanently reshape how employers, brokers, and carriers operate. This isn’t legal theory. It’s a real-world warning shot. Justin and Julie unpack how “voluntary” benefits quietly became a multi-billion-dollar profit machine, why hidden commissions and weak loss ratios are now under a microscope, and how many employers may already be sitting on ERISA exposure without realizing it. You’ll learn why the old “employees pay for it, so it’s not our problem” mindset is officially dead—and what a defensible, fiduciary-first approach to benefits actually looks like moving forward. If you’re responsible for employee benefits—or advising those who are—this episode is your early advantage.
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    55 mins