# PBM Rebates and Who Really Pays. Mark Cuban. Source: https://ethosbenefits.com/podcast/pbm-rebates-mark-cuban Type: Podcast episode Series: The Business of Benefits, Episode 75 Published: 2026-04-09 Duration: PT49M59S Hosts: Chelsea Ryckis, Founder and President, Ethos Benefits; Talia Carbah, Fiduciary Benefits Consultant, Ethos Benefits Guests: Mark Cuban, Co-founder, Cost Plus Drugs Video: https://www.youtube.com/watch?v=1HGlqOeHxcw Publisher: Ethos Benefits Cite as: "PBM Rebates and Who Really Pays. Mark Cuban.," The Business of Benefits, Episode 75, Ethos Benefits, https://ethosbenefits.com/podcast/pbm-rebates-mark-cuban, 2026-04-09. **Summary:** Employers that rely on PBM rebates and partial claims data may be paying more than they realize. Mark Cuban joins Chelsea Ryckis and Talia Carbah to explain who really funds rebates, why every employer should demand all of its claims, how direct-to-employer drug programs work, and how to tell whether a benefits advisor's incentives are aligned. ## Key takeaways - Mark Cuban argues that PBM rebates are funded by a plan's sickest members, since a plan where no one needed medication would receive no rebates. - His first step for any employer is to request all of its claims, because he says most employers below half a million lives get only a subset. - Self-insured employers can dictate contract terms, such as a list of every denial over $5,000, because they are the customer. - Chelsea Ryckis says vendor contracts are where alignment is proven: new laws and good vendors mean little if the contract does not reflect them. - Direct-to-employer programs from drug manufacturers, carved out from the existing PBM, offer one regular price instead of a fight over rebates. - Mark Cuban recommends a dedicated internal person who reviews claims and manages the plan, and says that person will pay for themselves. ## Chapters - 00:00 Introduction: Mark Cuban and Talia Carbah join Chelsea Ryckis (https://www.youtube.com/watch?v=1HGlqOeHxcw) - 04:59 How one employer found it overpaid for generic drugs (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=299s) - 07:47 Why benefits RFP questions protect incumbent brokers (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=467s) - 11:53 Claim denials and the self-insured employer's responsibility (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=713s) - 16:53 Where PBM fees will hide after new transparency rules (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=1013s) - 19:37 Why vendor contracts decide what employers get (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=1177s) - 24:03 Should the CEO own the company health plan? (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=1443s) - 25:11 Who really pays for PBM rebates? (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=1511s) - 33:08 Can employers carve out GLP-1 drugs from their PBM? (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=1988s) - 35:46 How to tell a real fiduciary benefits consultant (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=2146s) - 38:20 Direct contracting and an internal health plan manager (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=2300s) - 46:18 Replacing health insurance premiums with a savings account (https://www.youtube.com/watch?v=1HGlqOeHxcw&t=2778s) ## Quotes > Nobody in this industry ever brags that, you know what, we're making less money because we found a better way to save money for patients. Mark Cuban, Cost Plus Drugs > If nobody or company was sick or needed any medications, how much in rebates would you get? You get zero. Mark Cuban, Cost Plus Drugs > So my belief for the longest time has been like the true power on the plan sponsor employer side not only comes from who they choose as their vendors, but those contracts. Chelsea Ryckis, Ethos Benefits ## In this episode. Many employers treat PBM rebates as savings and accept whatever claims data their carrier or PBM sends. In this episode, Chelsea Ryckis and Talia Carbah of Ethos Benefits talk with Mark Cuban about why both habits cost employers money, and what a self-insured employer can do instead. For more on his message to employers, read [Mark Cuban's wake-up call for employers](https://ethosbenefits.com/insights/mark-cuban-wake-up-call-for-employers). Mark Cuban describes comparing his own company's generic drug claims with Cost Plus Drugs prices as the moment he understood the business. The conversation moves from rebates and claims access to contract terms, direct-to-employer drug programs and how to judge whether an advisor is aligned with the employer. - **Rebates** are funded by the members who need medication, Mark Cuban argues, including members paying full price in the deductible phase. - **Claims access** comes first: ask for all of them, then audit them. See [why employers struggle to get their claims data](https://ethosbenefits.com/insights/health-plan-claims-data-access). - **Hidden fees** will move elsewhere as [PBM reform](https://ethosbenefits.com/insights/pbm-reform) closes gaps such as [PBM spread pricing](https://ethosbenefits.com/benefits-101/pbm-spread-pricing). - **GLP-1 carve outs** through direct-to-employer programs, covered further in [GLP-1 coverage for employers](https://ethosbenefits.com/insights/glp-1-coverage). - **Aligned advice** depends on the business model and the contract, which is why [broker compensation disclosure](https://ethosbenefits.com/benefits-101/broker-compensation-disclosure) matters. ## About the guest. Mark Cuban is an entrepreneur and self-insured employer who started Cost Plus Drugs in January 2022 and later Cost Plus Wellness. He says he got involved in his own company's health plan because he had to learn it, and he now argues that every CEO should do the same. ## Guests - **Mark Cuban**, Co-founder, Cost Plus Drugs. Mark Cuban started Cost Plus Drugs in January 2022 with 111 medications and later launched Cost Plus Wellness, where self-insured employers can view direct contracts. He runs his own company's health plan as a self-insured employer, with direct contracts, direct primary care, stop-loss coverage and an internal team that reviews every claim. ## Related guides - [Mark Cuban's call](https://ethosbenefits.com/insights/mark-cuban-wake-up-call-for-employers) - [PBM spread pricing](https://ethosbenefits.com/benefits-101/pbm-spread-pricing) - [How to choose a PBM](https://ethosbenefits.com/benefits-101/how-to-choose-a-pbm) - [PBM reform is now law](https://ethosbenefits.com/insights/pbm-reform) - [Health plan claims data access](https://ethosbenefits.com/insights/health-plan-claims-data-access) - [GLP-1 coverage decisions for 2027](https://ethosbenefits.com/insights/glp-1-coverage) - [Broker compensation disclosure](https://ethosbenefits.com/benefits-101/broker-compensation-disclosure) - [How does self-funded health insurance work?](https://ethosbenefits.com/benefits-101/self-funded-health-insurance) ## Frequently asked questions ### Who really pays for PBM rebates? Mark Cuban argues that a plan's sickest members fund PBM rebates. He points out that if no one on a plan needed medication, the plan would receive zero rebates, and that members paying a drug's full price during the deductible phase are effectively writing a check to the plan and the PBM. ### Why can't employers get full pharmacy claims data? Mark Cuban says that unless an employer has half a million or more lives, the PBM or carrier will often provide only a subset of claims and require the employer to use its auditor. His advice is to ask for all claims first, because without them an employer cannot see what is happening or forecast its costs. ### Should the CEO own the company health plan? Mark Cuban says yes. He got involved because he had to learn the plan, and as a self-insured employer he sees prior authorizations and denials as his ultimate responsibility. He also points out that health benefits are now the second-largest expense after payroll and that every dollar saved goes to the bottom line. ### Can employers carve out GLP-1 drugs from their PBM? Mark Cuban says direct-to-employer programs from drug manufacturers let an employer pay one regular price instead of fighting for a rebate. The employer asks its existing PBM for a carve out for those programs, and he calls GLP-1 drugs an easy place for an advisor to start. ### What can a self-insured employer ask for in its health plan contracts? Mark Cuban says a self-insured employer can dictate terms because it is the customer. His examples include counting employees' cash payments toward the deductible and receiving a list of every denial over $5,000. Chelsea Ryckis adds that contract terms are where a plan's alignment is actually proven. ### Will PBMs find new ways to make money after new transparency rules? Mark Cuban expects new fees. He says self-insured employers pay bills with line items but no detail underneath, and PBM contracts often reserve fees, chargebacks and 340B benefits that the employer never shares in. ### How can an employer tell a real fiduciary benefits consultant? Chelsea Ryckis says the test is whether the firm has an unconflicted business model and a contract that reflects it, not whether it uses the word fiduciary in its marketing. Mark Cuban adds that advisors paid by carriers have to watch what they say, while firms that work from outside the system can stay aligned with employers and patients. ## Full transcript [00:00] Mark Cuban: Mavs have spent $169,000 over 18 months, and we would have spent 19,000 with Cost Plus. And that was my, like, you had your aha moment. That was like, oh, my God, this is one business. [00:12] Chelsea Ryckis: Yeah. [00:12] Mark Cuban: Because like I've said many times, healthcare has been the easiest industry to disrupt because it's really simple. How much does it cost? How do you pay for it? And if you. If someone can't afford it, who pays for it? They realize that they have the advantage because you don't have the knowledge or the tools to do a continuous audit. And they're not even going to provide you the claims to allow you to do so. This is the reason. Why would you continue to do business with someone who just stole from you? You've got to be able to work from the outside in order to be truly aligned with patients and employers. Nobody in this industry ever brags that, you know what, we're making less money because we found a better way to save money for patients. Nobody. This is all you need to know. [01:00] Mark Cuban: Welcome. [01:00] Chelsea Ryckis: Welcome to the Business of Benefits Is your no bs, no sales guide to. [01:05] Mark Cuban: Real solutions, no gimmicks, just the truth about how to take control, transform your benefits, and care for your most valuable asset, your people. [01:13] Chelsea Ryckis: If you're tired of the same old sales pitch and you're ready to rethink your benefits, this podcast is for you. The truth is out there. Are you ready to hear it? Hi, everybody. Welcome to the Business of Benefits. I am your host, Chelsea Ryckis, president of Ethos Benefits. And today we've got some pretty exciting guests. Actually, two brand new guests to our podcast here. One you guys are all going to know, so we're going to save him for last. The other you don't quite know yet, but you will one day because she is an up and coming star in this industry, Talia Hanson. So, Talia, can you tell everybody who you are and how you got a seat on today's show? [01:52] Talia Carbah: Yeah, absolutely. Thank you so much, Chelsea. Well, I am Talia Hansen. I am a fiduciary benefits consultant here at Ethos Benefits. I got my start in the industry several years ago, but on the more traditional broker side and early on in my career, I was given the opportunity to actually partake in a mastermind with Chelsea. And during that mastermind, I started hearing her kind of talk about how she was doing a fiduciary approach to benefits, creating aligned incentives and taking out some of those mismatched carrier incentives on the broker consultant side. And that really inspired me. To reach out and see if she had the space to mentor me. [02:29] Talia Carbah: So for the first couple years of my career, she was a gracious mentor, kind of showed me the ropes and really taught me how to take on the industry head on and build really strategic, self funded programs that actually empower employers to take control back of the spending of their healthcare. And in doing so, I really learned that sometimes the best thing you can do is just ask. So I went ahead and sent a cold email to Mr. Mark Cuban and said, hey, we've got this really cool podcast. Everything you're saying online is very similar to what we've been kind of talking about on the broker side for 10 years now. So, love if we could have this conversation. And now we're here. [03:05] Chelsea Ryckis: So we have this saying. Mark or Talia has a saying where it's like, let's just shoot your shot, right? Like, don't hold back. Shoot your fucking shot. And here we are talking to you today. So. By the way, we cuss on this. You're welcome to say what you want. I'm Canadian. It's like second nature over here. I was like joking with my husband. I'm like, guaranteed I get an F bomb in before Mark does. But nonetheless, Mark, I think everyone knows who you are. So instead of you doing an intro, I was wondering, can you tell us something that maybe the listeners, the employers consultants in this space don't know about you? [03:38] Mark Cuban: Well, you nailed it, Chelsea. My true given name is Mark Frickin Cuban. And so you could just call me Frickin. [03:44] Talia Carbah: Okay? [03:45] Mark Cuban: You know, more people call me but Frickin works. [03:48] Chelsea Ryckis: I'm sure. I love it. Well, thank you so much for being here today. Thanks for having me about before. This is all for employers. So everything just like you're doing with Cost Plus Drugs, Cost Plus Wellness Ethos Benefits. My firm was designed, actually started by my husband about 12 years ago. He was a registered securities advisor. His first health plan came to him. He was doing 401k fiduciary advising. And a small employer, a couple hundred employees came to him with like a 40% renewal increase on their health plan and said like, hey man, can you look at this? We are going to go out of business. All he did was apply the same fiduciary principles under erisa on the 401k side and came in like, not rocket science. Came in with the plan, 40% under the renewal and against a publicly traded broker. [04:36] Chelsea Ryckis: And that was sort of like the light bulb moment of like, holy shit, what is happening over here? Where you can know absolutely nothing and make that big of an impact. So our firm is basically just for the last 10 years, eliminated, misaligned incentives, fee based, all the way. [04:49] Mark Cuban: Good for you guys. Yeah, good for you. [04:51] Chelsea Ryckis: So you know who we are. But yeah, let's get into you way more importantly. So Talia, I know you wanted to start us off with that first question. [04:59] Talia Carbah: Yeah, so what I'm really curious to know and anybody who's kind of watching this will see that I have a little bit of youthfulness to me. So my whole life healthcare has been a problem. It has been the number one or two expense of so many businesses. People have been going bankrupt. It's impacted people that I know and love. So I'm really curious for you as an employer, having kind of seen like the evolution of the healthcare industry on the employer side for the last couple of decades, what was that evolution like and where, like, if you could pick one thing that really made like either the biggest difference negatively or positively, what would that be? [05:35] Mark Cuban: You know, from both sides. For all my companies prior to Cost Plus, I, I always just had a broker, my guy, right, that I'd known for years who always told me, yeah, you know, costs are going up, but you're only paying 5% more. Everybody else is paying 8 or 9% more. So this is a great deal. And I was like, okay, I'll trust you because I've known you forever and I'm trustworthy, I'm trusting because it was not my core competency to learn my health benefits. And then we started Cost Plus Drugs in January of 22 with only 111 medications. And so I took a bunch of the generics that matched for the Mavs claims. And it was a battle just to get our claims, obviously. And when I compared them, the Mavs spent on generics that cost $30 or more. [06:22] Mark Cuban: And matched up with what Cost Plus had. The Mavs have spent $169,000 over 18 months and we would have spent 19,000 with Cost Plus. And that was my like you had your aha moment. That was like, oh my God, this is one fucked up business. You know, we're going to be able to have an impact. [06:39] Chelsea Ryckis: Yeah, I love that you know, it's like you looked at the industry the same way that we did and essentially just said like, oh, this is ass backwards. Imagine just doing the right thing, which this is my favorite conversation, right, like just doing the right thing, which also just happens to save people a bunch of money and produce better Health outcomes. Can we stop our regular programming just for a second? I want you to meet somebody. This is my six month old baby who just woke up from a nap. Congrats. His name is Bo Rus. And I wanted him to be able to say that he met you one day. So here we go. [07:14] Mark Cuban: Hey, Bo. You'll be like, why did my mom waste my time? [07:19] Chelsea Ryckis: He's like, who is this guy? Mark Cuban. [07:22] Mark Cuban: Right, Right. [07:23] Talia Carbah: Okay. [07:24] Chelsea Ryckis: Well, anyways, future CEO of Ethos, maybe you'll meet him one day. Thank you. [07:27] Mark Cuban: Hopefully. Congrats. [07:29] Chelsea Ryckis: Thanks. [07:30] Talia Carbah: Doing the right thing every single time, right? [07:34] Mark Cuban: Yeah. Because like I've said many times, healthcare has been the easiest industry to disrupt because it's really simple. How much does it cost? How do you pay for it? And if someone can't afford it, who pays for it? You know, that's it. [07:47] Chelsea Ryckis: That's literally, is so simple. And I really want to dive into Cost Plus Wellness in a little bit because that is the most simple way of like purchasing and paying for health care. And I absolutely love it. But I'm curious to know. So we come up a lot with RFPs, and when we're working with mid and large market employers nationwide, the question always is, well, how many years of experience like, or how long has your firm been around? Right. And we're 10 to 15. [08:13] Mark Cuban: That's the consultant's way of saying, you're not going to win the business. Exactly. That has nothing to do with the customer at all. Right. It's just their way of excluding companies. You know, you have to deal with at least one company that has 50,000 members, have been in business with Elite for at least 5 years and have a 10 year background with whatever. Right. That's just their way of saying to the big three insurance or PBMs, look, give me more money. And when you take me on that trip to Aruba, I want more. That's it. [08:49] Chelsea Ryckis: Yeah. So I'm glad you said that because it feels to me like a lot of plan sponsors, they're recycling RFP questions that are designed to protect incumbents. Right. And largely these large publicly traded and the business model of the large publicly traded brokerages literally do not allow for aligned incentives. It just doesn't. [09:08] Mark Cuban: No, you gotta hit your numbers. Right. It's not the same thing. Nobody in this industry ever brags that, you know what, we're making less money because we found a better way to save money for patients. Nobody. [09:21] Chelsea Ryckis: Right. [09:22] Mark Cuban: And this is all you need to know. [09:24] Chelsea Ryckis: 100%. 100%. Here's the story. A recent RFP, it came down between us and a publicly traded huge. The largest in the world. If, if anybody knows who that is also named in a shitload of lawsuits. But whatever, take that as you will. I also told them in the RFP you should include, do you have any open and active litigation currently? The answer to the question with the other broker was no, when they are quite literally named in every single of the first lawsuit, starting with the [name removed] one. But nonetheless, I digress. So it literally came down to the 100 plus years in business. And then the account management team for their firm had 250 years of collective experience. My account management team had 180 years of collective. [10:10] Mark Cuban: That should even matter. It shouldn't even matter. Right. You know, because brokerage business, again is easy. Here's, you know, here's what the patient, here's what the customer needs. Here's how you serve those needs. Now let's find the best way to do it. That's it. And then the game they all play, the game the brokerages play is, well, the benefits. People didn't want to switch. They didn't want to have to get a new logo on the card. And they're just so. Oh, right. I mean, every. If the insurance companies really cared about that, they wouldn't come up with new plans every year just increasing prices and doing so. You know, there's just so many games that they play. [10:54] Mark Cuban: But what I'll tell you guys is, you know, when you see a brokerage who does that or, you know, they're part of the coalition and they're getting, you know, kickback money, let me know. I will name and shame the fuck out of them. Right? I have no problem of going on LinkedIn and saying, this is what this company did. This is what you need to be aware of. Like you would take some heat. I don't care. Right. You got to pay the bills. I'm good. You know, so I get the difference. [11:22] Talia Carbah: It's, it's so interesting that you mentioned that with the name and shame, because obviously cancel culture is like a huge thing. But the way that you've been going about like the name and shame on LinkedIn, calling out corporations for not covering certain medications for certain employees. I, I've been sending them back and forth to Chelsea. Like our whole DMS right now is just like your posts going back and forth with the other. I'm really curious. [11:42] Mark Cuban: Like, that's kind of cool. That's kind of hot. [11:44] Chelsea Ryckis: You know, it's also. [11:46] Talia Carbah: And what was it like what was the first time that you decided that was like the way you were going to go about it? And what results are you seeing? [11:53] Mark Cuban: So it dawned on me that as a self insured employer, that for pre authorizations and denials, it's my ultimate responsibility. I get why Companies use their TPAs or whoever to decline some certain things because you don't want to be the bad guy. Okay, I get that. But when it comes down to an employee or their family member being in a life or death or, you know, healthy versus not healthy set of circumstances, that's not debatable. You can't make that about money. I mean, maybe if you're in a situation where, you know, you go out of business if you pay that bill, okay? But then you try to find a better solution. You don't just let the patient die, right? And so it wasn't something I was going to do unless it was life and death or something, you know, comparable in terms of severity. [12:46] Mark Cuban: You know, so you've seen some of the ones and that's part one. And once I decided to do it really, it also occurred to me that as a CEO, as an entrepreneur, I didn't know all the claims and what was going on. I mean, companies can't even get their claims, let alone know where the denials are. Right. And what the circumstances are. So I want, it was as much to tell the CEOs, look, you're in a bad situation because, particularly from a fiduciary responsibility because you have a member who literally could die or you know, need far more care that's being denied and you have no idea. [13:24] Mark Cuban: And if somebody happens to die on your watch, I mean, you don't want to see the lawsuits, let alone the guilt of letting somebody die because you weren't willing to spend $75,000 or $500,000 for that matter, you know, or you weren't smart enough to get reinsurance or stop loss insurance, right? So that's not your ultimate responsibility because the stop loss insurers, they understand, you know, causality and they recognize that they have to pay those bills because there's a lot at stake right there and then, and they're not nearly as bad as the big insurance companies are today. [13:58] Chelsea Ryckis: Are you seeing results? Like, are people. [14:01] Mark Cuban: Oh yeah, all of them. Yeah, all of them turned around and did something right? Every single one of them did. And they all did it within a day of my post. [14:12] Chelsea Ryckis: So you know what happens to me when I do stuff like that? Because I'm not Mark motherfucking Cavendish. You know what happens to me is so we did Ethos Benefits used to have a small business division where we worked with small companies because my dad and my mom, they own a roofing company in Canada. Like small business has always been so close to my heart. And we had to eventually sell that division of our company in 2023 because of this exact scenario where you get vocal about what you believe in, right? And there's as you know, there's certain size companies where you're kind of stuck like 5 insured, 10 insured. It's really going to be. Sometimes you can level fund depending on the state rules and the stop loss requirements. Like it's tough. [14:53] Chelsea Ryckis: So we had a chunk of business, about 100, 150 employers that were in that kind of shitty situation where it was the fully insured, totally against our values, totally against everything. But we gave compensation disclosures and were trying to help. Well, you know, you talk a little bit shit and you stay true to yourself and you're aligned and you're out there doing what you do. And a certain carrier to go unnamed heard about it and then also we happened to move one of the larger groups away from them after a 37% increase. Might I add to a reference based pricing direct contract epc, a full blown unbundled independent TPA fiduciary pbm, the works. A beautiful self funded program. We got terminated from that carrier the next day and lost hundreds of thousands of salary grants. [15:36] Mark Cuban: That's so fucked up. But that's what they do, right? That's what they do because they know where the leverage points are. These companies, particularly the big insurance carriers, they're too big to care and culturally right. We Talk about the PBMs on the pharmacy side, but guess who owns the PBMs? Or in one case the PBMS owns the insurance company. And so the culture is the same. They're always going to spread price. It may be a spread price between the contract with the hospital and the employer, it may be a drug that spread price between the farm between the manufacturer and the employer. But they're always looking for every single angle and where they can't get it directly or even when they can, they'll find the weakest players. So they'll underpay the pharmacies for brands, brand and specialty drugs. Right? [16:21] Mark Cuban: They'll underpay independent physicians or tell them they're out of network for any care. So the independent physicians have to sell, you know, their practices or their clinics and so they understand how they game that. And it's unfortunate, but you know, I'm in a good position. I don't give a fuck, right? I don't need their money. We work outside the system and so I can call them out. You know, it's not like, you know, maybe a manufacturer drops us at some point, but that's okay because if they drop us, it'll be the Streisand effect and I'll use it to our advantage. [16:53] Talia Carbah: That just makes me really curious too because we're talking, you're talking about like the spread pricing and a lot of the gaps that we're seeing. And a bunch of legislation did just come out in February with the CAA of 2026. So they obviously PBMs, obviously the hospital networks, everyone has figured out ways around this. And the 2026 legislation is intended to kind of close that gap, make disclosures, mandatory, ban spread pricing in different situations. So I'm curious where you think the gaps are going to continue to show up even after. [17:23] Mark Cuban: Oh, there's going to be fees. It's going to be fees, right? They're going to find new fees. Because think about what happens. And you guys have far more experience in this than me, than I do. And so the self insured employer in particular gets a bill every week, every two weeks, every month, whatever it may be, right? And they pay that bill and there's no detail in that bill whatsoever. Right? There's little, there's, you know, line items, but there's no substance underneath the line item to know exactly what you're paying. And so lots of times there's fees, right? There's other things that you paid for that may not match the contract at all, but you're not going to have somebody. At some point you have to trust your vendors, you know, even the insurance carriers. [18:06] Mark Cuban: So you don't have somebody that's going to be checking every single invoice because you don't even have the data to associate it back to a claim to determine if it's legit. You don't, you know, you're not checking your contract to see if those fees are legit. And when you look at the end of like a PBM contract, it says there may be fees, you know, or there may be chargebacks or we're not paying you for, we're not reimbursing you for fees. We're not, you know, if we get a benefit from 340B drugs, we're not allowing you to participate in that benefit. They don't know that. Right. [18:38] Mark Cuban: And literally what I'm telling every, like I just got up a call with the CEO and his team who's going to switch to self insured and I told him the contract that you currently have with the Blue, take that and put it into quad and just say to it, tell me where I'm getting ripped off. [18:52] Chelsea Ryckis: Yeah. [18:53] Mark Cuban: And what should I tell the vendor in order to try to get it fixed? I mean now it's, you know, this AI is going to make it a lot easier and we're trying to get companies also to start understanding agentic AI so when they get those bills they can start to compare it to what their costs are actually supposed to be. Because you can get use agentic AI to do all the detailed, you know, pain in the ass work that's just tedious, where you're not going to have a person that may be in a position to do it. [19:22] Chelsea Ryckis: So you know, I know with Cost Plus you've got, what is it, three internal staff that are managing your benefits program. [19:28] Mark Cuban: I don't even know. We use a TPA Sage, we have Ryan, we have Ramsey, we have Ansley and I think that's it. [19:37] Chelsea Ryckis: Okay, so one of the things you're talking about, which was at some point you have to trust your vendors. So my belief for the longest time has been like the true power on the plan sponsor employer side not only comes from who they choose as their vendors, but those contracts. Right. And everything is contract terms and the future of great, the CAA legislation is passed and you know, we're talking about ERISA fiduciary responsibility and we have vendors like you out there that are doing the right thing. But it doesn't mean shit if the contract doesn't reflect all of it. Right, right. [20:09] Mark Cuban: Because they're going to take advantage of it for sure. No, that's why I love what you guys are doing. That's why I love what Ethos is doing. Because you understand that the self insured employer, the risk based employer can dictate the terms. Right. You can say, look, I want all cash pays that my employees make to count against the deductible. Right. I want to get a list of any denials that cost more than $5,000. Right. I want to know, and I want to know the health care circumstances associated with each of those. You can ask for anything. You are the customer. You guys realize that. But the other brokers aren't telling anybody that stuff. [20:48] Chelsea Ryckis: Most of them 100%. And there's I think There's a couple reasons. One would be there's a lack of understanding of how all the different players play. Right. And like it is as you very well know from doing it and us from doing hundreds of these. Like building a custom health care plan is no easy feat. It's. It's a hell of a lot easier than telling your employees are getting 10 to 15% increases every single year. [21:10] Mark Cuban: Right, right, right. [21:11] Chelsea Ryckis: So choose your hard in the words of one of my good friend Stephanie Perino. But the vendor selection part I've noticed like has sort of been and the contracts have been the evolution of like taking these plans to the next level because you don't necessarily need to especially when they're already self funded. [21:28] Mark Cuban: They're already tell you is the underlying issue is the fact that all the pass through PBMs only have access to [company removed] right now to get a lot of those branded medications, the generics and biosimilars. We can get everybody anytime, right. And save everybody money on them. But for the brands, the only reason we don't have more brands and we don't work with more branded manufacturers is because the big PBMs tell those manufacturers if you work with Cost Plus Drugs we're going to nail you on the formula and you're going to lose a lot of money. So they don't work with us just you know and they do that many, many times. So and then part two to that is they're like, okay, well you can negotiate with [company removed]. Well [company removed] doesn't give us decent prices on anything. [22:11] Mark Cuban: And the fact that only one of the big three PBMs has an organization like [company removed] means that there's no competition between it. They all could do it. [22:20] Chelsea Ryckis: What's your leverage here? [22:22] Mark Cuban: Yeah, there's none. Right. And so that's why it keeps the branded prices higher than they should be. And that's one of the things we're working on. You know I just talked to a CEO of a big branded manufacturer this morning and we're working on doing a lot more with them, particularly on their direct to consumer because all the direct to consumer now which you guys know to carve out so you get the better pricing. Right. But all the direct to consumer is just a way to work around the PBMs. Yeah, that's it. That's the only reason they exist. [22:52] Chelsea Ryckis: Why didn't you just open a good pbm? [22:56] Mark Cuban: I could open a good pbm but we're not going to be big enough initially to get like we put out a rebate GPO to the top 12 manufacturers. We got legitimate responses from two of them. Wow. [23:09] Chelsea Ryckis: And you could have went to the, you know, scooped up a Bunch of Fortune 100 companies with and you know, done the carve out. You could have negotiated with the ASO their bullshit implementation fee for a carve out. Like it would have been. I just feel like if anyone could do it really well, it would have been you. [23:24] Mark Cuban: Well, it takes time, right. We've only been doing this for four years, right. And so you've got to be able to go to them and they're going to say, well, we need, you know, we need to have this exclusivity on your formulary. And by doing an exclusivity on formulary, that defeats the whole purpose of why we're in business. [23:39] Chelsea Ryckis: Misaligned. [23:40] Mark Cuban: Yeah. We want to carry every drug we're legally allowed to carry. The only reason we don't do controlled substances yet, we're working on it. But every other drug that we don't have, we'd like to have. I don't care if it's specialty drugs, I don't care if it's J code, I don't care if it's 340B. We want to carry them all. And the only reason we don't is the manufacturers won't work with us. [24:01] Chelsea Ryckis: Wow, that's so interesting. [24:03] Talia Carbah: Yeah. So you obviously are a very well known CEO of all kinds of successful businesses. But what we hear a lot on the ground when I go and I'm speaking with the C suite, a lot of times CEOs, CFOs are pushing me over to HR, making it a solely HR or a controller problem. So I'm really curious, was it fiduciary duty that specifically you were like, oh, I need to be involved in this. Why did you start being in the day to day decision making on the healthcare plan and what would your message be to other employer employees? [24:33] Mark Cuban: Because I had to learn, right? Because. And here's what here. So when I sit down with the CEO and I'm lucky, right? They'll see me just, you know, because they can take a picture and show their kids, right? You know, or they watch Shark Tank or whatever. But here's what I tell them. Number one, I say your PBM or your insurance company's lying to you, right? First thing you do is just ask to get all your claims. There's a really good chance, unless you have half a million or more lives, right, they're going to give you a subset and say this is all you get. And you have to use one of our auditors. That's the first thing, right? I'm like, if they won't give you all your claims, how are you going to be able to determine what's going on? [25:11] Mark Cuban: You know, are you going to be able to forecast your costs? All that stuff. So that's number one. And then I say number two, do you realize that those rebates you get are being paid for by your sickest employees? Oh, no, no. That's not what happens. I'm like, well, let me ask you a question. If nobody or company was sick or needed any medications, how much in rebates would you get? You get zero. So by definition, right? You know, somebody's got to get sick in order for you to get a rebate. And to make matters worse, right? Because a, you know, maybe the company is paying for it and there's a low copay. But not during the deductible phase, because during that deductible phase, if you have, you know, they just lowered the price. But we use Eliquis as an example. [25:56] Mark Cuban: Eliquis in December was $600. And if somebody you in a member at your company needed Eliquis, they had a 20, $500 deductible, which is reasonable, right? That's not a horrible deductible. And so for the first four months, they're paying $600 a month. And of that $600, probably 300 of it is going to you. And the PBM and the chunk of it, the biggest chunk of it is going to you. And so that member that's taking Eliquis during their deductible phase is writing you a check. But I said, wait, there's more. And it gets worse because most people, you're going to have employees that can't afford the $600. And if they can't afford the $600, they might get sicker. And let me give you an example of something I heard at a brokers forum. [26:52] Mark Cuban: Somebody stood up and said, mark, I have an example where somebody couldn't afford their deductible. It's a transportation company and they had drivers. And one of the drivers couldn't afford the $600 for anticoagulant, didn't take it, passed out while driving, killed four people. Tragic. Do you want the walls? Do you want that family showing up at your door? Do you want their lawyer calling the Wall Street Journal to show up at your door all because you didn't know or understand your Benefits. And oh, by the way, put aside the tragic part of it. If you're a public company or even any other company, every dollar you save on your benefits goes right to the bottom line, right? And so if you have 100 million shares outstanding for your public company and you save $25 million, that's 25 cents a share. [27:46] Mark Cuban: You tell me where else you're going to get 25 cents a share easily. [27:51] Talia Carbah: This way to make money. [27:53] Mark Cuban: Yes, it really is. And that's what I tell them. That's literally what I tell them. And now you can see, now that we're buds, you guys can see me under Mark fricking Cuban, right? When you, when you talk to the CEO. Because what you have to do is make them understand the risk patterns. The risk pattern isn't just that you're spending more because you know, they have a point. We'll go back and get you a little bit more in rebates. We'll get you know, instead of you going up 20%, you're only going to go up 15 and they'll eat it. And then, you know, then you know, the carrier knows that they'll try to come back next year and make it all up. Right. Especially in level funded plans. And so, you know, think so you just need to scare the, out of them. [28:34] Mark Cuban: And if you know, if they're not responding, you just CC me on the email and I'll be like, you dumbass, let me just tell you. [28:43] Talia Carbah: I love that. [28:44] Chelsea Ryckis: Oh well, so there's a recent one where when we did a PBM analysis, of course it's a big three and of course it's a broker coalition, PBM coalition that they paid hundreds and hundreds of thousands of dollars to be in the collective or the coalition, whatever the fuck it's called. So the 408B2 disclosure, which was absolute garbage, showed that there was literally $0 of quantifiable compensation for this brokerage. Right? But then upon further digging into the actual PBM contract and just all the things, we uncovered millions and yeah, and so like these are the things where it's like, you know, and when I say like we can't speak out, we absolutely can speak out and our entire business model is speaking out because we don't, I'm not paid by carriers anymore. It doesn't matter. Like I, you know, we're completely aligned so we can. [29:32] Mark Cuban: Right. [29:33] Chelsea Ryckis: But it's also like here's my dilemma with calling out brokers specifically. Like I want to Be the shining light in the industry. I think we are. We're very much. I believe that Ethos is the agency model of the future and that everybody's going to have to like shit or get off the pot. The misaligned incentives are not going to work like this will be the way that it works in the next. [29:53] Mark Cuban: Hopefully. [29:54] Chelsea Ryckis: Hopefully. I was actually going to ask you if you believe that to be true, so let's stop there. Do you think that there's a chance that this business. [30:00] Mark Cuban: So you're saying there's a chance? I mean, I think there is, but the reality is, if this is industry worked well, there'd be no need for Cost Plus Drugs. There'd be no need for Ethos. Right. You know, we're here because of the information asymmetry. And so if we really do our jobs well, we put ourselves out of a job. And for me, that's okay. For you guys, it's tougher, obviously,. [30:28] Chelsea Ryckis: Because in my opinion, as an entrepreneur, you adapt and there will be. [30:32] Mark Cuban: Yeah, no, you find another way. Right. Because you found the solution. Right. Yeah. You know, Chelsea, Talia, find a way. It's just like Jeff Goldblum in Jurassic Park. Right. Life finds a way. Always find a way. Yeah. And so, you know, I think there's definitely a place for alignment. Like, I talk to these companies all the time and I'll bring in an auditor, typically, but, yeah, I mean, I'm happy to. What you guys need to do is get your contract up on Cost Plus Wellness. [31:01] Chelsea Ryckis: Sure. [31:01] Mark Cuban: Because. Yeah, because we have an auditor that we're putting up there, Chris, from Beacon, and putting your guys up there as well. So if you want an independent organization to come in and look. [31:14] Chelsea Ryckis: The claims auditing. [31:16] Mark Cuban: Yeah, for claims auditing. Yeah. [31:17] Chelsea Ryckis: Yes. We have them in most of our plans. [31:20] Mark Cuban: Yeah. [31:20] Chelsea Ryckis: Which makes sense for claims over a certain threshold. Yes. I'll absolutely send in. [31:23] Mark Cuban: The worst case is people will see it and maybe, you know, one customer calls and now you've got another great. [31:28] Chelsea Ryckis: Customer, and best case scenario is a bunch of other consultants see it and they start to actually have to do these things. And especially. So I've been talking a lot about, like, ERISA fiduciary duty. [31:39] Talia Carbah: Right. [31:39] Chelsea Ryckis: And I keep hearing, well, we're not Johnson and Johnson. Right. You know, like. [31:43] Mark Cuban: Right. No, they are. Right, they are. But until they're sued, they don't care. Right. Everybody kind of just plays the odds. And I get that. I've been there. But what you tell them, you have to get them to get their claims first, yeah, and then you audit the claims. And then I would even go in there and say, look, if you're not saving X amount, if you're not saving at least our fee, then it's free. Then the next thing is if you save them a lot of money relative to what they expected, then you say, look, you trusted these guys. It's like the old movie Animal House when the one guy loans the car to John Belushi and John Belushi wrecks it. He goes, face it, you fucked up. You trusted us. [32:21] Mark Cuban: You know, and that's the whole thing where it's like you're trusting this company. And we just audited the claims and showed you that they're not trustworthy and that you should not trust them. Why would you still do business with them? And let me just tell you, every single PBM and or insurance company that is involved with the big three, right, they're going to do the same thing. They realize that they have the advantage because you don't have the knowledge or the tools to do a continuous audit and they're not even going to provide you the claims to allow you to do so. So this is the reason why would you continue to do business with someone who just stole from healthcare is like. [33:03] Talia Carbah: The one line item that doesn't get that speculation, doesn't get that audit. People don't ask questions what their consultants. [33:08] Mark Cuban: Are making because it's not their core competency. But now it's their second largest expense item after payroll. And it's growing so quickly. And GLP-1 is your best friend, right, because you can walk in and teach them how to carve it out. And then now, you know, Cost Plus is going to be working with Lilly and you know, hopefully some of the others with a direct to employee program. So instead of having to pay the 1300 and fight for the rebate, it's just a regular price all the time. And so, you know, we can work with you guys on that. There'll be other products will be direct to employer. [33:41] Mark Cuban: I think a big part of what you'll see that's really good for you guys are all these direct to employer programs that you can walk in and say, look, if you're not going to do everything with us, we understand, let us just help you with direct to Employer Pharmaceuticals because all you have to do is go back to your existing PBM and ask for a carve out for these direct to employees. Hopefully you also ask for a carve out for Cost Plus to add to the network Right. Because with Cost Plus, we don't ask for a contract if we're cheaper, you use us. And if not, it's up to us to be the best alternative. And so there's no incremental cost, there's no obligation. [34:21] Mark Cuban: It's just we already know that the incumbent PBMs and carriers don't like it because we're transparent and everybody gets to see the price. So. But bigger point is by being able to incorporate even just a little bit. Right. Sometimes you just want to get the foot in the door, you know, because I know you want to come in and do a whole consulting project and have all these different features and offer it, because that's your business and you should. But sometimes you just want to get your foot in the door and say, okay, keep on doing what you've been doing. Let me just prove that we add value and it costs you nothing. Here's the steps. You take. A, just get your claims because you know they're not going to give them your claims. Right? And so you need all your claims. [35:05] Mark Cuban: And I'll do it for free if I don't save you money, like you said, you'll do it on a savings basis or free or pay only if I save money. And two, add Cost Plus to your network, knowing that the PBM is going to say no, which again creates questions with the employer. And three, there's a reason why Lilly has this direct to employer program. There's a reason why Pfizer has this direct to employee program, or bms. I forget. And Johnson and Johnson will probably come out with one of what I read is true. So all these direct to employer programs are set up because of all these problems, right? Here's the price. Compare it to the price you're paying. If it's cheaper, use it. And if not. [35:46] Chelsea Ryckis: So what we've been doing, we have developed over the last like 10, 15 years this sort of proprietary advising model that we call our fiduciary framework. And so even before, fiduciary was a buzzword, which is a whole other conversation and really pisses me off, literally. [36:00] Mark Cuban: So, yeah, because people don't take it as seriously as they should. [36:03] Talia Carbah: No, dude. [36:04] Chelsea Ryckis: And I can't tell you how many vendors over the last couple years have been reaching out. And I'll get messages like, you do such a good job marketing fiduciary, like, can you teach me? And I'm like, do you have an unconflicted business model? Do you do the right thing? Does your contract reflect it no, literally vendors that are like, we're trying to add fiduciary language to our marketing. I'm like, no, that's the problem. Like you are. Yeah, right. [36:28] Mark Cuban: Either you aren't. Yeah, either you are or you aren't. [36:32] Chelsea Ryckis: And, but I feel really bad for employers sometimes because you know, like you are somebody they can trust. For sure they're going to listen, you've been in their shoes. But a lot of the times like they end up speaking to consultants or traditional brokers or vendors and it's all people who even like us. We're complete, the most aligned we could possibly be. Especially within performance based arrangements. Right. Everybody's saying something different and there's so. [36:55] Mark Cuban: Much freaking because they're inside the system. Right? The repaid by the carriers. You've got to watch what you say because like you found out they could drop you. And so, and so because you work from the outside in, you're going to have a different perspective. And that's what I tell people. Right. You've got to be able to work from the outside in order to be truly aligned with patients and employers. [37:18] Chelsea Ryckis: And that's what's been happening with this fiduciary framework. So we've been getting hired by plan sponsors who for whatever reason, ironically enough, have way too many conflicts in place to fire their broker, which is hilarious. So we get brought in to teach them how to better fiduciaries and identify all those conflicts. Identify all the. Basically the idea is the claims repricing that you're talking about on both RX and medical. And we come in and we do plan performance audits, vendor management, we set KPIs for vendors and it's this quarterly governance structure. Right. And it's a flat fee and we just come in and basically get to kind of do what you do to the industry, but with that individual. [37:51] Mark Cuban: Right, with that company. [37:52] Chelsea Ryckis: Yeah, that PBM sucks this. [37:55] Mark Cuban: Beautiful, beautiful. [37:56] Chelsea Ryckis: And then, and then usually what ends up happening is we, and it's not intentional, but we usually get asked to take over the program because we're like,. [38:02] Mark Cuban: Oh, so that's the whole point, right? That's the whole point. Yeah, of course it's intentional. Don't tell me it's not intentional, honestly. [38:11] Chelsea Ryckis: So there is certain situations where like I really don't want to take over. Keep me out of the bureaucracy. But yeah, no, you're right. So let's go to Cost Plus Wellness. [38:20] Mark Cuban: We get to see all the claims. So effectively we have an internal healthcare CEO yes. And that's Ryan Klein. And Ryan's job is to review every single claim to make sure it's processed the right way. So we don't just defer and deflect to the TPA or the claims engage that they use. Right. The, the value of direct contracting is we control it all. So we'll do, you know, we'll approve the, we'll be they'll be the group that does the pre authorization. Right. We'll get help to determine if we need to deny it. Right. For whatever reason. We won't just make that determination ourselves. But you know, it's all in our control. [39:01] Mark Cuban: And so even though we use a TPA and our TPA we think is good because, you know, it's trust but verify and we verify everything, our attitude, anything that's schedulable is negotiable and can be, you know, done at a cash price or a direct contract price, whatever it is. Because with our direct contracts they're not, there's no exclusivity. So you know, Baylor, Scott White is great. They're a leader. They're, they're way ahead of the curve. I strongly recommend anybody looking at direct contracting, you know, go to costpluswellness.com and look at their contract. But we don't have an exclusive with them. So if there's an ASC available for that, great. If there's a specialist, that's better, great. We're not, you know, locked in to anybody. [39:42] Mark Cuban: And so that's why having somebody internally and you know, I was on a call just before this with the company and I told them that exact same thing. You need somebody internally, that is your healthcare CEO that manages all this, watches all the claims, you know, and we only have hundreds of members, but whether you have thousands or tens of thousands, however many people you need, they will pay for themselves quickly because you can make sure you get the right price. You know, you can make sure the claim is processed correctly, you can make sure that it's paid at the right time. You can make sure that, you know, that the patient is happy and do a follow up ourselves without deferring to somebody all the time. [40:22] Mark Cuban: And plus we require to participate for our members, we require them to be part of direct primary care, which simplifies things and part two to that is because we're saving so much money. If they're using our network, our direct contracting network and, or Cost Plus Drugs for their Rx, there's no out of pocket for them. [40:42] Chelsea Ryckis: Yeah, you need to Do a tiered approach like that for incentive, for sure. On the plan design side. [40:47] Mark Cuban: And then plus we have reinsurance, which protects us. Right. The stop loss. And we have a wraparound because not all of our employees are in Texas. So we have a wraparound with that. Now, there's nothing special about it. Right. It's $18, I think, give or take. Per member per month or. Yeah, per member per month. And just in case somebody's in the middle of nowhere and something happens. [41:07] Chelsea Ryckis: So I've noticed that in my experience, and what I feel like we've really nailed the last 10 years is like understanding where in these custom health plans there's going to be points of friction for members. Because let's be honest, it's going, no matter what, fully insured or self funded, you're going to have points of friction. The difference is in fully insured, they just think that, you know, [company removed] doesn't give a. So I'm not going to complain. [41:26] Mark Cuban: Right. [41:26] Chelsea Ryckis: You have a self funded health plan, it's your employer, everybody complains. [41:29] Mark Cuban: Yeah, yeah. [41:31] Chelsea Ryckis: So, but anyway, and that's part of. [41:32] Mark Cuban: It, but at least we have somebody internally to deal with them instead of just pushing it off. [41:36] Chelsea Ryckis: Exactly. And I've noticed that you've said this, and I say it a lot too, which is basically like you can have the most innovative, you know, financially sound health plan in the world, but if your members aren't having a good experience, it doesn't mean shit. [41:49] Mark Cuban: Doesn't matter. [41:49] Chelsea Ryckis: Yeah, right. So I've noticed that you guys do what we do. And I find it interesting that this is on the plan sponsor side and not like a consultant or even a TPA role. Some could argue it could be, but the member communication. And I noticed, I read in your implementation guide on cost plus wellness that somebody on your team literally will call the providers. If there's a scheduled appointment, they will call the providers and they will ensure that they understand how to read the note. [42:14] Mark Cuban: So read the card. Yeah, read the card to know how to take it. Because initially they weren't doing it. Yeah. [42:19] Chelsea Ryckis: So we have for. We do a lot of reference based pricing, more so than direct contracting sometimes, but also direct contracting. It just depends on the area of the country. Right. And the size of the group and all the things. But we brought that program internal and it's essentially like a concierge service where employees will text and be like, I have an appointment with this gynecologist on this date and then we are calling ahead to let them know and you know, you have to build that into your fee because that's a shitload of work. But ironically, anytime I've tried to outsource something like that to a tpa, it's hard. [42:50] Mark Cuban: Yeah, it's hard because they don't have the same expectations. Right. They don't have the same commitment. This is your business, you know, it's make or break for your company. So. Right. The, the commitment is different, which is why, you know, we like to do it internally because we know the people, they know, their job depends on it. Right. So, you know, they're aligned with us to do a good job. And I think there's enough savings. And I think one of the opportunities for you guys is to train people to be an internal tpa. Those things that you do. [43:20] Mark Cuban: Imagine you bringing people on and then saying, okay, we'll train you on what to do and then we're going to place you at one of our customers and you'll either stay as an employee for us, or they'll just take you on and we'll just charge them a fee for one time. Because having that person in house, whether you pay them 100,000, 150, 200, whatever it may be, whether it seems high or low to you, they are going to pay for themselves in a multi hundred member company quickly. It's just one thing. And they pay for themselves. [43:52] Chelsea Ryckis: We're literally in a conversation with probably the most innovative CEO that I've met with the under a thousand employee space, and we're doing this exact, considering this exact thing where we've had this kind of concierge in house and he wants to bring it in his house and actually hire a nurse. And we're going to train and do all the things. [44:07] Mark Cuban: Right, right. Because HR has a ton of shit to do. [44:11] Chelsea Ryckis: Yeah. [44:11] Mark Cuban: You can't just. There's never. I've talked to companies with, you know, a million members and they have seven people in HR or whatever, Right. And they're worried about little Johnny, can't, you know, go to school. So, so and so has to call out or there's this denial from the aso and they're like, okay, I got to deal with that. I don't have time for this. No, you want to make it so that you have complete control and you, but your folks understand what's going on, so you can deal with it. You can't just throw it off on somebody else. Look, people, people. Yeah, people take the path of least resistance. [44:49] Chelsea Ryckis: Yeah. [44:50] Mark Cuban: People don't want to be mean. Don't tell me you don't do the same thing, right? We all do the same thing, right? Yeah. I haven't fired them. I know I should fire them, but they've been with me for 20 years. [45:01] Chelsea Ryckis: Quit, you hire slow, you fire slow, fire fast. [45:03] Mark Cuban: Right? But sometimes you get it wrong. Sometimes they change. It's not me, it's you. Right? It's not you, it's me. Right? Yeah. Right. So. But you get the point. People don't like to be mean. And so I understand that. And there's no way around that until something really bad happens, you know? And so what I would tell you is, you know, what if I can get you better seats? You know, what if I give that person. What if I give that person a job? Right? You know, because even so, if the bigger picture is you're saving this company from themselves, even if it means. And I've done this before, hiring somebody, you know, sucks, and all you do is tell them to stay home. It's just a cost of doing business. Yeah, I'll pay you for as long as we have this account. [45:50] Mark Cuban: You just stay home. And if I have any questions, you know, it's remote. Right. Send me these, you know, send me reports on a weekly basis on your suggestions and when I have questions to help us. [46:05] Chelsea Ryckis: Wow. Interesting. That's. That's something I never ever considered. Wow. Talia, what else do you got for Mr. Mark Cuban? [46:15] Mark Cuban: Because I gotta get out of here in about four minutes. [46:17] Chelsea Ryckis: Yeah, we're done. [46:18] Talia Carbah: Well, my. My last question is just. I know. So you've done the pharmacy, now you're working on wellness. What is the next space in the health care monolith that you. [46:27] Mark Cuban: To get rid of. To get rid of insurance completely? Because insurance, when you really think about, is just banking. They don't really take risks. They take, you know, they get capitated money from the government for Medicare Advantage that's more expensive than standard Medicare or traditional Medicare. Right. They act asOs for most of their big companies. They. They typically don't do smaller to medium size or fully insured. Right. And so they're just bankers. And so from that position, I'm like, okay, the one debt that everybody has that they never pay off. You can pay off your school debt in your car, your house. You're always going to be paying your health care premiums, no matter what, Always till the day you die. Even in Medicare. Right. Till the day you die. They're taking it from your Social Security. [47:11] Mark Cuban: And so what we're looking at doing is saying rather than depositing your premiums to the insurance company, and this isn't an HSA because you have to have an insurance program to do hsa, Right. You have to have a high deductible plan. So we're saying we're going to work with a bank or start a bank where you deposit on a monthly basis the amount you would be paying as a premium under an ACA plan. So let's just say you're a family of four and it's $1,200. You put that money in this bank account and you pay this in there monthly, monthly month. It's your money, it's your money. But there's restrictions in order to get that money spent. Any health care costs you pay out of that money. Right. We're going to verify the cost. [47:56] Mark Cuban: So there's nothing, you know, that you're not trying to take advantage of it. And in the event something messed up happens and you don't have enough money there, we'll loan it to you. Now, we're going to charge you for stopgap insurance, right? Because, you know, if above $30,000 or $50,000, whatever that number is, and we're going to make you go to direct primary care, and we're going to take the $150 a month out of the 1200 that you pay. But you're going to be able to accumulate if you never get sick. When you get to Medicare, that money's just yours. If you only get sick a little bit and there's some leftover, you're earning some interest, not a lot like a checking account, that money's yours. [48:32] Mark Cuban: But the promise is, for however much you don't have under the stopgap amount, we will loan you that money and you pay it back to us by continuing to pay your quote, unquote premiums that are your deposit. So if Your deposit was $1,200, it's yours until you borrow money. And when you borrow money for what you can't afford, that money goes to pay back what you owe us. That's it. [48:57] Talia Carbah: That's brilliant. That is so cool. I'm excited for that to happen. [49:02] Chelsea Ryckis: She's like, sign me up. Yeah. [49:04] Talia Carbah: I've got so many years left to be paying this debt of my insurance, so I might as well find a better way to do it. [49:11] Chelsea Ryckis: Yeah. [49:11] Mark Cuban: And if you can save it, if you can stay healthy, then you have every, you know, incentive to stay healthy because you get to keep the money. As opposed to it goes to the insurance company. And the minute you close out your deductible, you want to spend wherever you can, even if you don't need the surgery. You know, it's like, I got a stubbed toe. Let's go get it. You know, get surgery. [49:32] Chelsea Ryckis: Thank you so much. Mark, do you have any closing thoughts that you want to give to the employer? [49:38] Mark Cuban: No. You guys are great. I really appreciate the time. Post your stuff on Cost Plus Wellness. And, you know, let's keep in touch because I'd love to help you. I love to. Name and shame where it's applicable. And then we can come back on again. We can come back on again and talk about what we talked about. [49:52] Chelsea Ryckis: Sounds good. Thanks, Mark. [49:53] Talia Carbah: Thank you so much. [49:54] Mark Cuban: Thanks, guys. [49:59] Chelsea Ryckis: Sam.