The PBM Industry Is Cracking: FTC Settlements, New Rules & Fiduciary Risk

The PBM Industry Is Cracking: FTC Settlements, New Rules & Fiduciary Risk

This episode was filmed on March 19, 2026. The healthcare benefits industry is changing faster than it has in years... In this episode of The EOB Podcast, Justin and Julie break down the growing pressure facing Pharmacy Benefit Managers (PBMs), including the FTC settlement involving Express Scripts, new Department of Labor transparency proposals, the impact of CAA 2026, and emerging fiduciary litigation that could reshape the healthcare benefits landscape. Topics include: • FTC action against PBMs and what it means for employers • Spread pricing, rebate retention, and hidden compensation • The proposed DOL PBM transparency rule • Why fiduciary responsibility is becoming impossible to ignore • Direct contracting and the future of employer-sponsored healthcare • The role of transparency in reducing healthcare costs • What employers should be doing right now to protect their plans Justin and Julie also discuss why healthcare affordability has become a bipartisan issue, how employers can gain leverage during contract negotiations, and why simply accepting the status quo is no longer a viable strategy. If you're an employer, HR leader, CFO, advisor, benefits professional, or healthcare industry stakeholder, this episode is packed with practical insights on where the market is heading next. Because one thing is becoming increasingly clear: The healthcare industry is changing, and employers need to be ready.

The EOB Podcast Live! with Shawn Gremminger at Elevated Insights Summit 2026

This episode got a little… theatrical. 🎭 In the first-ever LIVE episode of The EOB Podcast, Justin and Julie are joined by Shawn Gremminger, President & CEO of the National Alliance of Healthcare Purchaser Coalitions, for a deep dive into one of the biggest issues in healthcare today: 👉 Why employers still struggle to access their own data 👉 How PBMs and carriers use opaque contracts 👉 And why healthcare pricing still feels intentionally confusing Through a mix of live skits, audience interaction, sarcasm, and real policy discussion, the episode breaks down: • Shared savings programs • Contract transparency • PBM reform and data access • Employer fiduciary responsibility • Hospital pricing and pharmacy spend • ERISA preemption • Why employers are finally pushing back Shawn shares insights from working with employer coalitions representing more than 90 million Americans and explains why this moment feels different than years past. One major takeaway: 👉 Employers are no longer willing to blindly trust the system. And yes… there’s also a fake Kohl’s rebate program skit.

Jamie Greenleaf | Healthcare Fees Are Hidden… And Employers Are at Risk

What if the biggest risk in your healthcare plan… is something you can’t even see? In this episode of The EOB Podcast, Justin and Julie are joined by Jamie Greenleaf, Co-Founder of Fiduciary in a Box, to break down one of the most important (and overlooked) issues in healthcare benefits today: 👉 Fiduciary responsibility — and why most employers aren’t prepared for it Drawing from decades of experience in the retirement space, Jaime connects the dots between what happened with 401(k) plans… and what’s now unfolding in healthcare. Because the pattern looks familiar: • Hidden compensation • Lack of transparency • Vague or missing contracts • And employers being held responsible anyway The conversation dives into: Why healthcare is following the same path as retirement plans What “reasonable compensation” actually means under ERISA How lack of disclosures creates real legal risk Why litigation may drive change faster than regulation The dangers of indirect compensation and conflicted advice And how employers can start building a defensible fiduciary process One of the biggest takeaways? 👉 If you can’t explain what you’re paying… you probably can’t defend it. This episode is a must-watch for employers, HR leaders, CFOs, and benefits advisors trying to navigate an increasingly complex and high-risk environment.

PBM Transparency Rule Sparks Chaos | Inside the DOL Comment Storm

This one couldn’t wait. In this episode of The EOB Podcast, Justin and Julie break down the proposed Department of Labor rule on PBM transparency — and the flood of industry responses submitted before the comment deadline. With over 500+ submissions from carriers, PBMs, employers, and other stakeholders, the conversation reveals a clear divide: 👉 Those pushing for more transparency 👉 And those… pushing back hard For the first time, the proposed rule would require PBMs to disclose all compensation — including rebates, spread pricing, administrative fees, and more — before a contract is signed. So why the resistance? Justin and Julie dig into real comment letters from major players in the industry, breaking down: * Common arguments against the rule (and what they really mean) * Why “this is too complex” keeps coming up * What employers are being told vs. what they actually need * How transparency impacts fiduciary responsibility * And where this could go next Along the way, they call out contradictions, questionable logic, and a few moments that are… unintentionally hilarious. Because when it comes to healthcare benefits: understanding how money flows isn’t optional — it’s the whole game.

What If Hospitals Were Treated Like Utilities? | Fixing Healthcare Pricing & more | Friends with Benefits 2: David Balinski of Wire Health

What if the solution to rising healthcare costs isn’t more complexity… but more structure? In this episode of The EOB Podcast, Friends with Benefits Episode 2, Justin and Julie sit down with David Balinski, Founder & CEO of Wire Health, to challenge one of the biggest assumptions in healthcare: 👉 Should hospitals be treated like utilities? From unpredictable pricing to lack of transparency and inefficient administrative systems, this conversation breaks down why the current healthcare model isn’t working — and what it might take to fix it. David shares a bold perspective on how regulating hospital pricing could: * Reduce extreme cost variation Improve access to care * Shift competition toward quality and outcomes * Eliminate billions in administrative waste * Create a more sustainable system for employers and patients The episode also dives into: * Why healthcare lacks a true free market * The illusion of price transparency * How networks impact pricing and access * The inefficiencies in claims processing and repricing * Why employers and employees are both feeling the financial strain If you’re an employer, HR leader, CFO, benefits advisor, or simply someone trying to understand why healthcare feels so broken… this episode connects the dots. Because when pricing doesn’t make sense… the system doesn’t either.