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Veriton Insurance Group, Canton, GA (2026)

05/27/2026

Modern Insurance Myths — Part 8

“If my employees have insurance, they know how to use it.”
This is one that a lot business owner assumes. “We offer good benefits. Our people are covered.”
But here’s what actually happens: Most employees don’t fully understand how to use their plan.

They don’t know:
• When to go to urgent care vs. the ER
• How deductibles actually work
• Which services are free vs. subject to cost
• Or how to check if something is in-network

So, what do they do? They guess.

And that leads to:
• Higher claims
• Unnecessary spending
• Frustration with the plan
• And employees thinking their benefits “aren’t that great”
Even when the plan itself is solid.

Here’s the disconnect:
Offering benefits ≠ equipping people to use them.
For most companies, enrollment looks like:
• A packet of information
• A few emails
• Maybe a quick meeting
And then everyone is on their own.
That’s not a strategy. That’s hoping for the best.
The companies that actually get value out of their benefits do something different. They educate their people. They guide decisions.
They make benefits usable, not just available.

Because a great plan used incorrectly, can feel like a bad plan.

And that’s where most benefit strategies break down.

05/22/2026

Modern Insurance Myths — Part 7
“We should go with Blue Cross Blue Shield… it’s the best.”
I have heard this numerous times over the years, “Let’s just go with BCBS. Everyone knows them.” And it’s understandable. They’ve been around for nearly 100 years. In Georgia, they’ve been the dominant name in the market for decades and have the largest provider network in the state.

So, it feels like the safe choice. But here’s the reality: Brand recognition ≠ best fit.

Blue Cross is a strong carrier for sure. But so are a lot of others. And depending on your company, your employees, and your goals…BCBS might not be the best option for you.

When you strip away the logo, what actually matters is:
• Network access in your specific area
• How competitive the pricing is for your group
• Plan design flexibility
• Customer service experience
• How claims are handled

I’ve seen plenty of situations where:
• Another carrier had the same doctors… at a lower cost
• A “less known” carrier had better service
• Or a different network actually fit the employees better

But none of that gets considered if the decision starts with: “Let’s just go with the name we recognize.”

That’s like choosing a restaurant because you’ve heard of it, not because the food is actually better. For business owners, this is where things go sideways. Because picking a carrier based on brand feels safe, but it’s not necessarily strategic.

The goal shouldn’t be to choose the most recognizable name. It should be to choose the plan that actually works best for your team. Because in group health benefits, the logo on the card matters a lot less than people think.

05/15/2026

Modern Insurance Myths — Part 6
“Other countries have cheaper drugs because their system is better.”

You hear it all the time:
“Why is this $500 here and $50 in Canada?”
“Europe gets the same drug for a fraction of the cost.”

So the conclusion becomes:
“Their system is better. Ours is broken.”

However, that’s not the full picture. Other countries don’t get cheaper drugs because they’re more efficient. They get them because they have leverage—and they’re willing to use it. In places like the UK, Canada, and much of Europe:

The government negotiates on behalf of everyone
They set strict pricing thresholds

And they can say:
“We’ll cover this… but only at this price.”

If the drug company doesn’t agree?
They don’t just pay more.

They can:
Delay access
Limit who qualifies
Or refuse to cover it altogether if it doesn’t meet their criteria

That’s how prices stay low. Now compare that to the U.S.
We don’t have one buyer—we have:
Dozens of insurance carriers
PBMs
Employers
Government programs

It’s fragmented. So instead of one strong negotiation…we get a bunch of smaller ones.

Here’s what most people miss:
Drug companies don’t charge more in the U.S. randomly.
They charge more here because this is the one market that struggles to say no. Other countries control costs by tightening coverage decisions.
The U.S. allows broader availability, but pushes the cost burden onto employers and individuals.

So why don’t we just copy Europe?
We could. But it would mean accepting trade-offs like:
Slower access to new drugs
More restrictions on who qualifies
More “no” decisions from the system

Other countries accept that, while historically, the U.S. hasn’t. Other countries lower costs by controlling access. The U.S. expands access…but at a much higher price.

So no, it’s not that their system is “better.” They’ve just made a different trade-off.

05/12/2026

Modern Insurance Myths — Part 5
“Insurance companies are the reason healthcare is so expensive.”

I hear this one all the time; and for obvious reasons. You see your premiums go up every year, your deductible reset, and a claim get denied… so it’s easy to point the finger at the insurance company and say, “they’re the problem.”
But that’s not actually how the system works.

Insurance doesn’t create the cost of healthcare. It sits in the middle trying to manage it.

So what’s actually driving the cost?

1. Administrative complexity
We’ve built a system with multiple carriers, plans, networks, and rules.
Every single claim has to be coded, processed, reviewed, and sometimes appealed. That means entire departments just to handle billing.
A big chunk of what you pay for healthcare… isn’t care. It’s the cost of processing the payment for the care.

2. Regulation & Compliance
Healthcare is one of the most heavily regulated industries in the country.
HIPAA, COBRA, ERISA, Medicare rules, state mandates, documentation requirements…

All of that requires:
Compliance teams
Legal oversight
More admin staff

It doesn’t just add cost—it slows everything down and makes the system less efficient.

3. Hospital and Provider Pricing
Hospitals set the prices. And in a lot of markets, there’s not much competition anymore. Large health systems have bought up smaller practices and control pricing. That's why an MRI can cost $400 at an imaging center and $3,000+ at a hospital. Same scan. Very different bill.

4. Drug and device costs
The U.S. pays more for prescriptions than almost anywhere else.
Some specialty medications are $50K, $100K, even $500K+ per year.
That cost gets built into the system.

5. Labor (yes, this matters too)
Healthcare runs on people, lots of people. And almost every role requires some level of training, certification, or specialization. Doctors, nurses, PAs, NPs, Nurses, Lab techs, billing departments, IT staff, compliance teams, etc. And most of these roles come with some form of training/educational debt.

Doctors often graduate with ~$200K–$300K in debt
PAs ~$100K
NPs ~$50K+
Admin Managers ~$20k+
IT/EMR ~$20k+
Annual training costs alone average ~$3k - $7k per employee, up to $10m - $25m per year across an entire hospital system!

That doesn’t necessarily mean these people are overpaid; it means there’s a floor to what it costs just to staff the system.

Here’s the reality:
There isn’t one villain maliciously gouging you. It’s admin complexity, regulation, pricing power, drug costs, and labor… all stacking on top of each other.
Insurance is part of the system—but it’s not the thing creating the cost.
It’s just the piece everyone sees.

05/07/2026

Modern Insurance Myths — Part 4
“Obamacare was repealed.”

I had a conversation the other day that was a bit surprising, but something that I hear more than you would think.

I was having a conversation with a friend when the topic of insurance prices came up, he made the comment that prices are higher because Congress repealed Obamacare. Of course it has been repealed, but he genuinely thought it had been.

And he’s not alone. But the reality is that the ACA (Obamacare) was never repealed. The ACA is still the foundation of the entire individual and small group health insurance market today.

What did happen is where the confusion comes from:

The individual mandate penalty was reduced to $0
Some regulations were loosened
The enhanced Covid subsidies expired as designed
Political messaging made it sound like it was gone

But the core structure? Still here.

Things like:
Guaranteed issue (no pre-existing condition denials)
Community rating
Essential health benefits
Subsidies based on income

That’s all ACA. Every ACA-compliant plan you see today is built on that framework.

And here’s why this misunderstanding matters. If you think the ACA is “gone,” you don’t actually understand what’s driving:

Premium increases
Plan design changes
Network structures

Because whether you like it or not…it’s still shaping the entire system and its not going anywhere anytime soon.

05/05/2026

Modern Insurance Myths — Part 3

“Insurance companies are making billions and not paying for anything.”

This one gets thrown around a lot. And I get it, when you see companies pulling in hundreds of billions in revenue, it’s easy to assume they’re taking a massive cut off the top.

But here’s the uncomfortable truth:
They’re really not.
When you actually look at the financials:
• The insurance product itself often runs on margins around 0%–3%
• Even at the total company level, most major carriers land around 1%–4%

That’s it.

So if they’re not taking huge profits, why does healthcare feel so expensive? Because insurance companies don’t set the prices.
Hospitals and provider groups do.

They:
• Set the rates
• Negotiate reimbursements
• Control the cost of care that premiums are built on

And even though many hospitals report low operating margins, they still:
• Generate cash flow over time
• Expand aggressively
• Build new facilities and acquire competitors

So the money is clearly going somewhere. Here’s the part most people don’t want to hear:
Insurance companies are the most visible part of the system, but they’re not the part driving the majority of the cost.
Costs go up → claims go up → premiums go up.
That’s how the system works.

So when premiums jump 15%…
it’s not because an insurance company suddenly decided to get greedy. It’s because the underlying cost of care increased.

People can tell something’s broken.
They’re just blaming the easiest target instead of the right one.

04/30/2026

Modern Insurance Myths - Part 2

Paying more with insurance?

Last year, I got into an argument with a guy while on an enrollment, which is probably not what you should do when you’re trying to get someone to enroll an in insurance plan, but he was frustrated that his doctor was charging him more for the same service with insurance than when he was paying cash.

He was rightly frustrated. He said, “What’s the point of even having it?”
I pulled up his plan, to see what was going on. And the crazy thing is, his plan was working exactly the way it was designed to.
Same doctor. Same service.

But the billed rate through insurance was higher than the cash price. So, in his mind it’s the insurance company that is the problem in this scenario.
But that’s not what the real problem was. The true problem was that the doctor was charging him more money because insurance was involved. He was only paying $90 cash for a primary care visit plus blood work, but when he signed up for insurance he was being charged $180.
He obviously felt ripped off; I would too, I mean who wouldn’t.

The only problem was that he was blaming the wrong person. It didn’t occur to him that he should ask his doctor “Why are you charging me twice as much with insurance?”. Because the dirty little secret is that providers get paid a negotiated rate on top of your copay and anything extra that you are billed. That means the provider gets paid more than what they charge for the cash price from the insurance carrier and charge the individual an additional price on top of what the carrier paid.

When I pointed that out to the guy I was arguing with, he didn’t have an answer. Because everyone thinks that insurance carrier is the problem with the healthcare system. I’m not saying that insurance carriers are as pure as the wind driven snow, but providers are the ones that set the costs, not the carriers.

This is the reason everyone gets mad at the system. Not because it doesn’t work. But because they don’t understand how the system really works.

04/28/2026

Modern Insurance Myths – Part 1
Insurance is a scam…

I hear this at least once a week from random people and even friends and family. And I get it… it feels like it is. You feel like you pay a bunch of money into something and don’t get anything out of it.
But here’s the truth — most people calling it a scam don’t actually understand the purpose of insurance.
They think insurance is supposed to make everything cheap. When I go to the doctor it should only cost me $20, never mind the fact that it cost that doctor $500k+ to become a doctor so he can only charge you $20 for that visit. That reality never enters that person’s mind (that’s another topic for another time).
Guess what – insurance wasn’t designed to do that in the first place. The original purpose of insurance was to protect you from catastrophic losses. It’s designed to be there when you wake up with appendicitis at midnight and now have a $35,000 bill from the hospital for emergency surgery.
Insurance is there for the big stuff, ie cancer, heart attacks, major illnesses.
The ‘this would financially wreck me’ stuff.
It’s not a discount card for every little thing and never was supposed to be. You can thank the introduction of HMO’s for that.
So, when people say, ‘this is a scam’…what they really mean is: ‘I thought I don’t have to pay for anything because I pay my premium every month’. That premium isn’t buying you a $20 visit for a sinus infection, its buying you protection against 5, 6, and even 7 figure losses.
That misunderstanding is the reason so many smart people can be so confident in there “scam” declaration, while being completely wrong in reality.

12/16/2021

Thank you from one of our carriers, Colonial Life for this amazing Holiday Basket!

As a business owner you can offer voluntary benefits to your employees at no cost to the employer. Voluntary Benefits can help protect employees’ finances when unforeseen medical bills arise. Please reach out for more information.

11/26/2020

We hope everyone has a great and safe Thanksgiving.

Veriton Insurance Group

05/27/2026

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