Tuesdays with Corey interview with Margaret O’Brien
Margaret O’Brien with Zentripy Global Insurance, is a Certified Employee Benefits Specialist (CEBS) and a registered Health Insurance Counselor (HIC) with over 25 years’ experience in the insurance market. Margaret approaches each client interaction as an opportunity to educate her clients on all aspects of the insurance market. She stays with her clients to ensure that they know they have an advocate when a claims occurs. Her primary insurance focus is in the individual, small group, and Medicare markets.
Connect with Margaret on LinkedIn.
Intro: Broadcasting live from the Business RadioX Studios in Atlanta, Georgia, it's time for Atlanta Business Radio, spotlighting the city's best businesses and the people who lead them.
Sanjay Toure: Welcome to this very special edition of Atlanta Business Radio. It's time for Tuesdays with Corey, brought to you by our good friends at the Long Term Care Planning Group. Now, who do we have the honor of speaking to today?
Corey Rieck: Sanjay, we have another great show today. And today, I'm pleased to have Margaret O'Brien on the show. Margaret comes to us as a subject matter expert on the issues involving individual health insurance, Medicare and small group benefits for businesses. Margaret has a company called Zentripy Global Insurance. Margaret, welcome.
Margaret O'Brien: Thank you. I'm excited to be here.
Corey Rieck: Well, we're excited to have you. Health insurance is certainly a hot topic, and you've put in a lot of time to get to the point where you're at now, almost 20 years in health insurance-related experience. Tell the listenership about that.
Margaret O'Brien: Well, I don't think anyone goes to college to become a health insurance person, but I was recruited out of college by Aetna, and I went into their management training program, moved up to Hartford, Connecticut, went through eight weeks of training, and then was given my first assignment. So, this would be at the time period when companies were first starting to talk about managed care, HMOs and PPOs. So, I cut my teeth in the managed care industry and that's where I got started.
Corey Rieck: So, where did you go to school?
Margaret O'Brien: My undergraduate degree is from a small school in San Antonio, Texas, called St. Mary's University. Got a marketing degree there. And then, later on in life, I quit my job and went back to school. And I got a master's in business administration from Georgia Tech right here in Atlanta.
Corey Rieck: You've lived in a lot of different places, though, when you started your journey to get to this place. Tell us about some of the cities that you've lived in and what you learned from each experience.
Margaret O'Brien: Well, when I took the job with Aetna right out of school, they told us they could send us anywhere. I didn't realize they meant they were going to send me everywhere. I was originally sent to Tampa, Florida. I spent 10 weeks there, was transferred to Orlando, Florida. I spent four and a half months there. I moved to Birmingham, Alabama, spent eleven months there. Moved to Charlotte, North Carolina, spent 13 months there. And then, I moved on to New York City. And I took the job in New York City because they promised me that I'd be there two years, and I've spent three years there.
And each experience was very different. Florida was not what I expected. I really enjoyed living there. I met a lot of nice people, did get to spend some time with the mouse. Birmingham, I always knew, was a short step, which was unfortunate because Birmingham was much prettier than I had anticipated. I pictured an old steel town and the days of the steel mills are gone. Charlotte was lovely, but I really spent most of my time up in Raleigh. And then, I moved up to New York City, and it was kind of scary. When I took the job, my boss said to me, "Hoboken." And I said, If I'm going to move to New York City, I want to be right there in the city. So, I lived in Murray Hill at 33rd and 3rd.
Corey Rieck: Which city did you like living in the best?
Margaret O'Brien: Well, of those cities, I think New York was the most exciting. I grew up a lot there. I'd always lived in smaller towns.
Corey Rieck: That's not really a surprise that you would say that.
Margaret O'Brien: Yeah, it was wonderful. I had a good friend from college who lived there and she happened to work for Anheuser-Busch. And so, I got to go to a lot of Budweiser events when I was there. And I took advantage of all the city had to offer. I went to all the Broadway shows. I did a lot of walking, got to see this city. And then, I do have to point out, though, later in life, I moved to New Orleans. And New Orleans, I moved to kicking and screaming because all I knew of New Orleans was the Bourbon Street side of it. There's a lot more to the city than that. I lived in the Garden District for three years, made great friends and still look at it as a home away from home.
Corey Rieck: It doesn't surprise me that you made great friends. I know that in the short time that I've known you, you've really helped a lot of the people that I've introduced you to. And you've done an excellent job of inspiring confidence with your expertise with these people. With all of your experiences that you've had, you grew up in Houston, right?
Margaret O'Brien: I did. I grew up in Houston, Texas.
Corey Rieck: And so, how did you decide to go to school in San Antonio, growing up in Houston?
Margaret O'Brien: Well, I actually went away to school for one semester to a small all-girls college in Frederick, Maryland called Hood College. And I decided very quickly that I wanted a more diverse environment, not a small girl school. So, the other school that I had gotten accepted to that agreed to take me and to give me credit for my classes was in San Antonio, Texas. And I went to San Antonio, made great friends, loved living in San Antonio. San Antonio is still one of my favorite places to visit. And then, I really hadn't seen much of the world at that point. And so, what I-
Corey Rieck: You've made up for that.
Margaret O'Brien: I have made up for that. When I got the opportunity to take a job and go somewhere different, I took advantage of it. I think that's a really scary thing. Many people are not willing to take that risk. They need to know what's next. And I've gotten to the point where more and more, I kind of jump off and then, see what's on the other side.
Corey Rieck: Well, it's certainly served you well. You've had all of this experience working for a company. Was there a jumping-off point or a singular instance where you decided, "Hey, I need to be an entrepreneur, I need to have my own business"?
Margaret O'Brien: Well, it was interesting. I left Aetna at the end of 2013 and I had the opportunity to spend some of the time while I was in severance traveling. And I spent some time doing volunteer work in Guatemala, in Nepal and Ecuador. And when I finished with those programs, I said that I did not want to just do the same job with a different shingle. I thought I'd take advantage of the opportunity and see if I could make it on my own. And there have been times that it's been really scary. But for the most part, I love working for myself. I miss the biweekly paychecks. But sometimes, I get excited. I look online and I'll see a deposit of $10 and I think, "Oh, I must have sold something." And that gives me motivation.
Corey Rieck: Well, you're certainly extremely helpful and you're filling a void that exists out there. Certainly, with my client base, we get asked questions all the time about individual health insurance. It's not our area of expertise. There's a lot of talk about health insurance in general. And certainly, to have a go-to resource such as yourself to answer those questions and to be able to look the person in the eye and help them is certainly advantageous. And so, I think that there's so many questions out there about health insurance and how have you seen what you do evolve over the last 20 or so years?
Margaret O'Brien: Oh, wow. It's a completely different industry.
Corey Rieck: Do we have enough time for you to answer that question?
Margaret O'Brien: Oh. I'll try and take it one step at a time. So, as I mentioned, when I entered the industry, we were starting in the managed care space, and I was the person who started talking to people about networks. And I have to say that when I went into some of these employee meetings, and I started talking to them about HMOs, people were convinced that the doctors who took HMO plans were the doctors who couldn't get patients any other way. The situation has evolved dramatically. When I came back to Aetna, we were starting to introduce what they called high-deductible health plans. And I was the person who said, "Those co-pays you got used to, all of the sudden, those are going away. We're going to start saying, 'You're going to take more responsibility for some of the upfront cost, and insurance is going to be there to protect you from catastrophic lost.'"
Margaret O'Brien: So, the industry has evolved dramatically. From an individual perspective, I can look at my own situation. I had COBRA when I left Aetna. So, when I was going to purchase my own insurance, I wanted an Aetna plan. I had an Aetna plan for a year. And at the end of that year, Aetna said they were pulling out of the individual market. So, my next plan was a Humana plan. I loved my Humana plan. I had it for a year. And then, at the end of that year, Humana said it was pulling out of the market. The next year, I had a Blue Cross plan. Blue Cross plan, if anyone would have told me that Blue Cross would have left the individual market, I wouldn't believe them, but they left the individual market.
Margaret O'Brien: And so, I came into the year, I think that was 2018, and the choices were Kaiser plan and Ambetter plan. And I said, "What if I don't want either of these?" And so, I started discovering these non-traditional plans, these non-credible plans, plans where you get underwritten on the front end, and I take more responsibility for my health care cost. I go into doctors' offices, and before I have anything done, I asked what's the cost of that service? And that way, I can make a decision about how is the most effective way for me to use my health care cost. And I'm having more and more of my customers come to me and say they cannot afford these credible plans and they are looking for alternatives. They say, I'm healthy, I'm willing to take more of the risk and what are my options?
Corey Rieck: So, it seems like you're a broker. Is that a good representation?
Margaret O'Brien: That is correct. I'm an independent broker. Yes.
Corey Rieck: What does that mean?
Margaret O'Brien: [00:09:37] That means that regardless of the plan you choose, I get paid by the insurance company. I have no incentive to push you one way or the other. The commissions are paid by the insurance companies and rates are filed. If you work with me, and you buy an X, Y, Z plan, or you buy it from their website, you pay the same amount. But if you work with me. I can help you through the process. I can help you with claims. I can help you find providers. I can help you objectively evaluate your alternatives and determine what is the best solution for you based on your individual situation. It's very difficult today. I'm a 52-year-old non-smoker, and I'm healthy, and I run, and if I went with a traditional plan, I would be charged the same as a 52-year-old non-smoker in Atlanta who is an insulin-dependent diabetic. Some people say, "Okay. Well, that's what you should do. Everybody should be charged the same amount." I look at it and say, "I have a lower overall costs of health care, and I'm willing to take some of the risk on the front end and pay less for that."
Corey Rieck: Would it be accurate to say then that you work for the client?
Margaret O'Brien: I work for the client. That is correct.
Corey Rieck: And you're trying to educate them and pair them up with the option that's best for them. Is that right?
Margaret O'Brien: That is correct. That is correct.
Corey Rieck: Tell us about the small group market. What does that mean and what does that entail?
Margaret O'Brien: So, the small group market has definitely gone through an evolution as well.
Corey Rieck: How so?
Margaret O'Brien: So, from an individual perspective, what is available in the tradition marketplace is strictly HMO. And some companies look at this or some organizations look at this and say, "But I want a PPO." And I say, "So do I." So, there's a way to get those. If you are actually an employer and you have W2 employees, there are options available to you from the small group perspective. And in some cases, you can even have a husband and a wife, a family be a group plan as long as the employees are W2. So, you can't just put your spouse on a plan and say, "She works for me," or "He works for me, and we're a company." There actually have to be W2s. But the market has evolved. There are some companies that would look at level funding where you underwrite the people on the front end, and you hold on to some of your reserves instead of paying it to the insurance company. If the claims go up, then you're going to spend out those reserves. If they're not, you're going to hold on to that money. So, there are options that were not available even a couple of years ago.
Corey Rieck: And with Medicare, tell us about that market, and tell us about how you help folks there.
Margaret O'Brien: So, Medicare is a very different market. I love working with Medicare employees. The people who think about it when they're approaching 65 are really in a unique position because they've got time to look at all their alternatives and make decisions. What I do with my customers is sit down with them, and I pull out a book that comes out from the CMS, the Centers for Medicare and Medicaid Studies. And we do what I call Medicare 101. We sit down, and we talk about the pieces. I talk about what is part A, what is part B. They're seeing all these letters, and they don't make a lot of sense to them. I help them understand what their choices are, what pieces they're going to pay for, because what people are often surprised to find out is Medicare is not free. Part A is paid for over your working life. It's that piece that comes out of your paycheck every two weeks. And the Medicare Part B, most people pay a premium for. And then, you might pay more of a premium based on your income. So, then, you look at Medicare supplements, and Medicare Advantage plans, and Part D, which is the drug plan. There are a lot of decisions to be made. And what I find is people get inundated with information. They're starting to get direct mail on a level that they've never seen before. And I help them sift through all of that and determine what's important and what's the best solution for them.
Corey Rieck: So, that seems, to me ... I don't delve in that business, but it seems to me like just part A, part B, part C, part D, that's a labyrinth that you need to sort of navigate. And what I'm hearing is that you have expertise with all of those four parts of Medicare.
Margaret O'Brien: I do. I've been doing this. I started doing this because my own father, who is a very intelligent individual, he said to me, "I really don't understand what I have.” He'd been in Medicare for many years. And I sat down with him and his wife, and I said, "Okay. Well, let's see what you have. Let's see what you understand." I helped them understand the various pieces. There were some benefits that they were completely unaware of. So, they were not taking advantage of it. I helped them understand the plans. And when I finished, my father said, "Well, can you talk to some of my friends?" And I said, "Yes, but they have to reach out to me." Medicare is very strict from a compliance perspective.
Corey Rieck: What do you mean by that?
Margaret O'Brien: So, what it means is every year, I have to get certified by Medicare and from each carrier.
Corey Rieck: What does that entail?
Margaret O'Brien: Well, the Medicare certification is something that's called AHIP. It is a test that I take every single year, and it takes a good bit of time, and it helps you understand what changes have been made in the plan. A lot of times, it's deductibles, it's how the programs operate.
Corey Rieck: What does AHIP stand for, Margaret?
Margaret O'Brien: I think it stands for American Health Insurance Plan. It's a testing service that Medicare puts forth. And if you are not AHIP-certified, you cannot sell Medicare. So, I do that. But then, each carrier, whether it's Aetna, Blue Cross, Cigna, United Healthcare, each carrier has its own testing, which includes something about fraud, waste, and abuse, because unfortunately there's a lot of Medicare fraud out there. And I get certified by each carrier that enables me to represent them to my clients and help my clients understand what is the best solution based on the individual circumstances.
And one of the things that I work with my clients about is understanding that, unlike in the under-65 market, husband or wife or spouses, it may not make sense for them to be on the same plan. You might have one spouse who's healthy and takes no medications. The other spouse needs a lot of different medications. They should be on separate plans. There's not an incentive for the most part for them to be on the same plan anymore. But unless someone is willing to sit down and sort through this, they're stuck with direct mail that is highly regulated, and it's very difficult to understand the differences among the plans without someone to take you through the step.
And I think one of the interesting things is people expect that they're going to pay me for that. Again, the insurance companies pay me. There's no charge to talk to me. The right answer might be, "You're in the right plan. Don't make any changes." In that case, I don't make any money, but I want to make sure that my customers are in the right place and in the right plan, so that when they need care, that's not when they find out that they didn't understand what their benefits were.
Corey Rieck: It seems to me that one outcome that's important to you is that whoever interacts with you about your expertise is better for having done so.
Margaret O'Brien: I think so.
Corey Rieck: Even if you don't make any money.
Margaret O'Brien: Even if I don't make any money, because the right answer might be to stay exactly where you are.
Corey Rieck: Yeah, I think that that speaks to sort of the sleepability component of this where, hey, if you do the right thing for somebody, that can sometimes be enough in some circumstances.
Margaret O'Brien: Absolutely. And what's interesting is every year, with Medicare, and individual plans, and small group, there's open enrollment periods. And-
Corey Rieck: When is that?
Margaret O'Brien: So, it depends on the plan. In a small group plan, it's based on when the renewal date is for your policy. For individuals, standard open enrollment is from November 1st through December 15th for changes that take place on January 1st. For Medicare, open enrollment goes from October 15th through December 7th. And again, for changes that take place January 1st.
Margaret O'Brien: Now, some people might have different enrollment periods. Let's say I'm leaving an employer, and I get a notice that says I have the opportunity to take COBRA, or I can look at my options. You have COBRA dates in that letter and that gives you open enrollment periods, access to plans because you have what they call a qualifying event. So, you can look at your alternatives at that time.
Corey Rieck: It seems to me there is a lot to stay on top of - the individual health insurance, the Medicare component, the group component. Do you think it's helpful that the carriers and AHIP have all of these sort of hoops that you have to jump through every year to stay on top of it?
Margaret O'Brien: I do. So, it starts off with the fact that I have to have a state insurance license, and I have to go through continuing education in order to keep that license. And then, for the particular plans that I sell, I go through ongoing education. Sometimes, it's a webinar. Sometimes, it's face to face. And for Medicare, again, I have to be certified every single year. And then, each of the carriers tends to have seminars and updates where I go in person, and sit down with someone, and hear what's new, what's coming this year, what changes have been made.
Margaret O'Brien: Keeping track of the legislative side of this is very difficult. You can be overwhelmed by the amount of information. And I'm getting a lot of questions from people as they hear what's going on in the federal government about, is Obamacare going away, what are my requirements now, what about Medicare for all. And trying to keep track of all of that is very difficult to do. And if you are using someone who is doing this off the side of their desk, it's hard to make sure that they're giving you all the information and keeping you apprised of all the changes.
Corey Rieck: How's the Affordable Care Act affected your business?
Margaret O'Brien: Well, frankly, the Affordable Care Act has been great for people who wanted to start their own business and before might not have been able to get health insurance because they had a preexisting condition. So, as long as they enroll during an open enrollment period, they can get on a plan, and they don't have to worry about preexisting conditions. They don't have to worry about waiting periods or lifetime maximums. From a lot of people, that has been very helpful.
The difficulty is that, as I mentioned before, everybody is kind of treated the same. And so, as long as you don't smoke, and I live in the same zip code or same county as someone else, I'm going to be charged the same amount. So, the difficulty has been those people who are not using a lot of care are paying for people who are using a lot of care. I've worked with families who look at the cost of a family plan and just say, "This is no longer affordable. What is my alternative? What if I say I'm willing to pay for all my routine care, I'm willing to pay for my urgent care visits?" What I want insurance for is to protect me in case of a catastrophe. Unfortunately, under traditional Obamacare plans, that's not an option. What you have to do is go to a traditional plan. And those are the kind of things that I have many of my customers coming to me about.
Corey Rieck: What do you think are the most challenging things about your business?
Margaret O'Brien: Well, I think one of the difficulties is it starts with the fact that it's highly regulated, and a lot of the people making the rules related to the plans are not affected by the changes. So, if you look at-
Corey Rieck: Why is that important?
Margaret O'Brien: Because if I have a problem with the claim, I'm going to deal with the system, and I'm going to have to make frequent phone calls. I had a very small dollar claim that I had to take all the way to the Georgia Department of Insurance to get paid. That was something that I was willing to do, even though it was small. It was $44, but it was something that I felt should have been claimed. I appealed it twice to the insurance company, and I didn't get what I thought was a suitable response. And then, I took it to the Georgia DOI, and I got my claim paid, and I consider that a badge of honor. The difficulty is if you're a legislative person, let's say you're a senator and a claim doesn't get paid, you might have an aide who calls the insurance company and says, "I'm calling on behalf of Senator So-and-so. Her claim was not paid." And all the sudden, that claim does get paid.
Margaret O'Brien: You've got individuals now who are looking at situations where they have what they call surprise billing. So, my child is sick, has a 104 degree fever in the middle the night. I take that child to the nearest emergency room. And under the plan, it's a true emergency, so it should be paid well. But what if that provider charges more than what the insurance company deems reasonable and customary? I, as the mom who took my kid to the hospital in the middle of the night, I'm caught in the middle. I did what was best for my kid. It's not my fault that it was a non-network provider. And I start getting these bills, and I am going to spend a lot of time working through that process. So, there's a lot of things that were unintended when these plans were set up. So, I think it becomes very cumbersome. For individuals trying to deal with this system, it's very difficult because they don't know what the right way something should happen.
Corey Rieck: I think one of the things that resonates with me about you is resource is a word that comes to mind. Advocate. And I think that it seems that there are multiple ways to solve this issue. And having somebody to kind of walk you through all this to help you understand what it is you know, and perhaps even more importantly, what you don't know. And then, matching you up with an instrument that is going to best address your situation. Having someone that is your advocate, I think is really important, especially with something that can be so difficult to understand.
Margaret O'Brien: Well, thank you. One of the things that I will tell you is I know what I know, and I know what I don't know. I'm frequently asked, how would you solve this problem? Well, I have a lot of ideas, but if I had the right solution, I'd be sitting on a beach in the Caribbean somewhere enjoying the fruits of my labor. The reality is there's a lot of different alternatives. I don't think any of us have found the right solution. But the cost of health care are escalating so dramatically. It's a big part of most people's budgets, and everyone is proposing solutions. I think the most important thing is for us to be willing to listen to all alternatives and realize that the right solution is not going to be something that makes every single person happy.
Corey Rieck: I want to come back to the second here. Would you think that one way to describe your relationship with the carriers as a conduit between the individual clients and the carriers? That's one way that I would kind of look at that. But knowing all that you know and your experience, to me, it seems that you would be a very, very sharp scissors that would allow the client to cut through a lot of the red tape.
Margaret O'Brien: That is my goal. So, one of the things that people may not realize is I have a broker help line. So, you have customer service, and I am not saying anything against the customer service people, but a lot of times, if I am truly your broker, as long as I am attached to your account, I can ask questions on your behalf, and maybe I can save you a little time.
Corey Rieck: Yeah, I think that's a significant factor in having an advocate and having a broker is, look, somebody to just kind of look at you, and answer your questions, and help you understand any gaps that might exist between your knowledge base and what's out there, but also to match you up with the right instrument that fits your needs. That's a crucial consideration, in my opinion, because it doesn't seem like what you do is sort of a one-size-fits-all kind of a thing.
Margaret O'Brien: No, it's not. And I think one of the difficulties is people think, "I should get this. I'm a smart person, why don't I understand this?" Why? I think the same holds true for anything else. I'm a smart person. Why can't I do my own taxes? I'm a smart person. Why can't I understand the legal system. If I'm going to long-term care, that is far beyond my skillset. I ask someone who focuses on that field. When I sit down and do Medicare 101 with people I've even worked with, people have spent a long time in the insurance field, and they say, "I don't get this. I'm a smart person. Why can't I figure this out myself?" Well, this is what I do. And even today, I will get questions, and I say, "Wow, that's a really good question. Let me follow up on that, and I'll get back to you." And I might have to make a couple of phone calls to get the right answer. It's very difficult to know everything. And that's why I think having a broker on your behalf in an insurance field makes a lot of sense.
Corey Rieck: I think as I get older that one of the things that's very important are relationships, but also people that have subject matter expertise in very, very narrow subjects. I think about how much time you have taken, and engaged, and spent studying, and doing 20 years to get to where you're at right now. I mean, why would I think that I could do what you do? Because I, clearly, don't have the extra ... you know what I'm saying?
Margaret O'Brien: Right.
Corey Rieck: So, I think part of where I sit is, look, she's forgotten more than I'm going to know about this. So, I'm just going to direct the client to you or direct the contact to you. Hey, call Margaret O'Brien. She's going to be a resource to you and help you."
Margaret O'Brien: Well, I will say Medicare.gov is a great resource. And the Medicare in You is a great book, but it’s a 137-page book. And the website has all sorts of information on there. But you have to know what you're looking for, and you have to know how to ask the right questions.
Corey Rieck: Well, here's what I want to know. I want to know what time it is. I don't want to know how to build a watch.
Margaret O'Brien: Yeah, that makes sense. That makes sense.
Corey Rieck: That's why I advocate and send people your way because I know that you do have a lot of experience. It's excellent experience. You have multiple carrier expertise, you're an advocate, and you can speak to these things that aren't what I do. And it doesn't mean that I'm not informed or not choosing to be informed. It just means, hey, there's somebody who throws out fastballs, and it's not me. And I don't have any problem sending people your way on that because it's a disservice for me to try to do what you do because you've been doing it for so long successfully.
Margaret O'Brien: Well, and I think that the insurance field is very complicated, but there are insurance people who focus on the areas that they best understand. As I said, with long-term care, people ask me, because I work a lot with seniors, I get asked a lot about long-term care. It's a very complex process. So, I stay out of it. I know what I do, and I know what I don't do.
Corey Rieck: What is the most satisfying thing about what you do?
Margaret O'Brien: When someone refers me to someone else, it means that they felt that their time was well spent. A majority of my business comes from word of mouth. I do very little advertising or marketing per se, except for to tell people what I do. But if you learn something from what I said, whether you purchase something from me or not, if you refer me to someone else, it means that I've done a good job. I work with a lot of people who are turning 65 for Medicare, who might get Medicare through their employer. They might get a Medicare supplement or retiree benefits through their employer. I'm not going to make any money off of you. But you're going to get inundated with your information, and you're not going to necessarily know what's important, and I'll help you review your information so that you know what you have, and then move on. And then, sometimes, I'll get a phone call from someone who says, "Hey, you helped my friend. She was on X, Y, Z, retiree plan. I don't have access to that. But can you help me as well?"
Corey Rieck: Yeah, I think that goes to the statement. everybody is somebody else's somebody. And so, you never know who's connected to who. And and just because someone doesn't become a client now doesn't mean that they won't become a client in the future or they perhaps won't send someone your way because they were impressed with how you handled them.
Margaret O'Brien: Well, I appreciate that, but I absolutely agree.
Corey Rieck: Well, I think the other thing that is interesting to me, so you're involved in individual health insurance, which in and of itself can be very, very difficult and cumbersome to navigate. The whole Medicare component, same thing. Very, very much to know. And small group business type benefits. Is there one area that you like working in more than another or is there one area that resonates with you more than another?
Margaret O'Brien: Well, I kind of have got into Medicare, I would say not kicking and screaming. I had always heard how complex it was, and it was not a field I wanted to pursue. But when my father needed to know about it, it made sense to understand it. And as I started working on Medicare, I found, I really like it, and I find that there's a lot of misinformation, and there's a lot of people who are in plans that they don't understand. I love working with my seniors. They will give me all the time in the world. And then, when they call me to follow up, they'll say, "You said such and such. Was that right?" And a lot of times, they'll pass me on to their friends.
Margaret O'Brien: I work in a variety of different retirement homes where I'll work with one person there, and she'll refer me to her friends who will refer me to his friends. And no one has spent the time to try and educate them. Someone just told them at some point, you need a plan F, and they have a plan F, and they don't know why. They enrolled in a drug plan when they first turned 65. They have that same drug plan regardless of the fact that they still take the medications. So, I think it's really important to continue those relationships and realize that my primary role is education.
Corey Rieck: Yeah, there's no question about that. I don't think any business relationship can be generated over the long term without starting from the standpoint of education, being an advocate, being a resource. Now, in our last component of our discussion, you referenced Plan F. What does that mean?
Margaret O'Brien: Okay. So, with Medicare, there are the pieces that come from the government. There's part A, which is hospitalization. And that's really the facility itself and skilled nursing facility. That's not anyone who walks through the door. That's part A. Then, there's part B. Part B is the part that is the doctors, durable medical equipment, physical therapy, all that kind of stuff. You pay a premium for that. So, there is $135.50 premium per month that most people pay. Some people may pay more based on their income. Some people might pay less if you qualify for Medicaid. But on part A, there's $1364 deductible every year. Part B has $185 deductible and a 20% co-insurance.
So, as you can see, if you just took Medicare, you could have some significant added pocket expenses. So, people buy Medicare supplements or Medicare Advantage plans to fill those gaps. So, Medicare supplement plans, common letters, A through N, and people are choosing a Medicare supplement when they first turned 65 or the first time they get part B. So, they might be coming off their employer plan. They work to age 70. So, they're just enrolling in part B. And you're making a pretty important decision when you choose that Medicare supplement because most people choose a Medicare supplement one time, and they have that same plan for the rest of their lives.
You can, at some point, let's say I chosen Aetna, Plan F, and at later date. I say, "I'm tired of working with that. Now, I want to move to a United health care plan F." You can apply. They can accept you, decline you, or they can rate you up. So, it's really important that you work with someone when you're first eligible for part B who helps you figure out which of those plans A through N makes sense. And the reality ... I'm sorry.
Corey Rieck: No. So, it seems like there's not a one-size-fits-all with the Medicare supplement component of this either, right?
Margaret O'Brien: No. So, the important thing to keep in mind with a plan F is plan Fs are closing as of January 1st, 2020.
Corey Rieck: What does that mean?
Margaret O'Brien: That means that no new entrants will be coming in to plan out.
Corey Rieck: Why are they doing that?
Margaret O'Brien: It was part of the Affordable Care Act. It has to do with the fact that they want people to have some cost sharing as part of their plans. So, in a plan F, it picks up everything that part A deductible, the part B deductible, and the 20% co-insurance. There's a costs associated with that. So, if you are enrolled in part plan F, you don't need to worry. You can stay in that plan for the rest of your life. But most people who are becoming 65 now or turning 65 now are enrolling in a Plan G. A Plan G looks like a plan F. The only difference is you pay the part B deductible. And 2019, the part B deductible is $185. But you're picking a plan-
Corey Rieck: There's not gonna be a quiz on any of this stuff. Is there?
Margaret O'Brien: No, no, no. And we use a lot of letters. I wish supplements didn't come in letters because people say, "Well, I already have a Part A? Why would I need a Plan A?" They're not the same, they just happened to have letters. Now, what we didn't talk about is D. D is in drugs. You can change your drug plan every year, and you should look at your drugs every year and determine-
Corey Rieck: Is that based on your medication usage and what you're spending?
Margaret O'Brien: Yes, it is. And based on the carriers formulary. So, a formulary is a list of approved drugs. And something else to keep in mind, there's been a lot of consolidation in the insurance industry. CVS bought Aetna last year. Cigna brought Express Scripts. Centene has just said it's buying WellCare. So, I anticipate there will be a good number of changes going into 2020. So, if you haven't looked at your drug plan in a while, this is a really good year to take a look at it.
Corey Rieck: Really? So, I just learned so much there. I feel like I'm trying to drink water out of a firehose there. Really a lot to know there. You've been invited on the show because you're successful and a former guest has highly recommended you. What do you think sets Margaret O'Brien apart from competitors?
Margaret O'Brien: Well, I've been in this industry for a very long time. I have the experience of working for a carrier, which is a great background to have because the carrier is trying to make sure you're successful, they're investing in you, making sure that you're very well educated in the field as a whole. But I also have the situation, I have now left a carrier. I, now, know the competitors. And so, I no longer look through an Aetna-centric lens. It's really important that the person who you're talking to about insurance is not worried about, "How many policies can I shell, so I can get the next big trip?" It really doesn't matter to me, those kind of things. I get paid the same. Whether you buy a policy from Aetna, Cigna, United, I get paid the same amount. What makes a difference is, is this the right solution for you? Because again, in some of these situations, you're making a one-time decision that you're going to live with. And another situation, when you have a claim, that's not what I want you to try and figure out what you purchased or that you bought the wrong plan.
Corey Rieck: You mentioned earlier that you do very well with referrals. What other ways are you getting clients?
Margaret O'Brien: I have joined a couple of networking groups that have been worthwhile to me. I belong to one with you. That's how we met. And what I find is that people that you deal with on a daily basis or that you see on a weekly basis, they really get to know you. And when a circumstance arises, they're going to remember, "Oh, by the way, didn't Margaret say something about that the last time she presented, maybe I had to introduce these two." And you realized very quickly that you cannot do this alone. I've found a lot of the people I've worked with through these - my web developer, my marketing person. All those kind of people are people I met through my networking, and they're people I'm very confident referring to, and they've helped me be successful.
Corey Rieck: Yeah, yeah. So, it seems to me, I use the like know trust chain. If I don't like somebody, it's hard for me to want to get to know them. If I don't know them, it's very difficult for me to trust them. And I think that when you refer somebody to a client, or a friend, or a contact, you are, in many ways, rubber stamping that person that you're sending to the client, or contact, or a friend. And you're certainly going to get asked about it if there's a less than satisfactory interaction. So, you have to know who you're sending to your client, contact, or friend. Would you agree?
Margaret O'Brien: Absolutely. And I have to be very confident that that person is going to deliver the kind of service that I would want my customer to receive. Again, I work with seniors. I work with a lot of my friends' parents. And the last thing I want is one of my friends to come to me and say, "You told my dad X," or "My dad is in this situation because you didn't fix this," or "You didn't really understand it." There's a credibility that comes with the fact that that's someone who knows me and is willing to put me in touch with someone.
Corey Rieck: I think the other side of this too is something that we referenced earlier along the lines of being a resource and an advocate. Even though a relationship may not be financially generated right away, a relationship of some sort has been generated, whether it's going to result in a referral of someone else or you just help somebody understand the coverage that they have and they don't do anything. There's satisfaction in all of those things. Would you agree?
Margaret O'Brien: Absolutely, absolutely. One of the things that I've found in working with friends' parents is the friend doesn't find out what mom or dad bought is not what mom or dad thought she bought until they go to file a claim, and then they figure out that they're behind the scenes. So, sometimes, I can't fix things, but I can help them understand it, and make sure that it doesn't happen, or look for alternative ways to get the same solution.
Corey Rieck: So, where do you see health care going now in 2019 going forward based on your experience, based on everything that you know?
Margaret O'Brien: Well, I do anticipate this is going to be a year of lot of change. There's a lot more conversation around Medicare for all and what the viability is of something like that. The tax penalty for not having credible coverage as an individual went away. So, many people this year embraced what they would call non-credible plans. And they're going to be looking at whether those are right solution for them for the future. Short-term medical plans, last year, you could only have a short-term medical plan for three months. This year, you can have a short-term medical plan for 360 days plus two renewals. So, to me, the short-term medical plans look like what insurance used to look like before the Affordable Care Act. As long as you stayed coverage, stayed covered, you could continue to have coverage. So, you're going to see a lot more expansion of that. I do anticipate you're going to see some carriers come back into the individual market.
Corey Rieck: Really? What makes you say that?
Margaret O'Brien: Because now that they can get some flexibility in what they can offer, and maybe you're going to see some of the major carriers come back and say, "As long as I can underwrite on the front end, I'm comfortable with the risks that I'm bringing in." What I don't want someone to be able to do is wait until they get sick and buy coverage. And unfortunately, that is a situation that's happening right now because if you enroll during an open enrollment period, you can enroll, and they don't ask any questions other than whether you smoke. So, if I can underwrite you on the front end and make sure I'm pricing my risk appropriately, that's what insurance is about, then I'm going to be willing to cover you. And if today you come in, and you're healthy; and two weeks from now, you get diagnosed with cancer, okay, that was a risk I took. When you were originally enrolled, you were medically underwritten. And I know what my risk is, and I priced accordingly.
Corey Rieck: With all of your expertise in health insurance, if you could wave a magic wand, how would you address the insurance matters related to health insurance across the United States?
Margaret O'Brien: Well, I would buy a policy that's similar to what I have today.
Corey Rieck: Which is?
Margaret O'Brien: I would buy you a high deductible health plan, and whatever the tolerance you're able to have. I'd be willing to buy $10,000 in a high deductible health plan because I want health insurance that protects me, so that I don't bankrupt myself. I'm willing to absorb all the smaller cost and protect myself in case of that. Now, the tradeoff is I also want to be able to put aside my money into a health savings account. My plan is not credible, so I can't put money into health savings account. I have a health savings account from my time at Aetna. On top of that, I want concierge medicine. So, in my case, I have what they call HIPnation. HIPnation is direct primary care. So, I have a doctor, and my doctor, I go to once a year for a physical. I went and saw her two weeks ago. And while I was in there, she said, "When are you due for your mammogram." I said, "Soon." She said, "You want to go ahead and get it now?" I said, "Okay." She said, "You can go right across the street for $150. You can get your mammogram."
Corey Rieck: Was at a good price?
Margaret O'Brien: [00:45:45] That's a fantastic price. Everyone thinks with Obamacare, you get a free mammogram. And I ask people, "What do you think mammogram costs?" They said $1000. Cash price, $150. So, I paid $150. Now, the tradeoff for me is if I had an Obamacare plan, I would be paying $300 more month and getting a free mammogram. So, $3600 a year to save $150. Now, either way, if they see something in my mammogram, I'm going to hit my deductible before I'm going to get care, whether I have an Obamacare plan, or whether I have a credible plan. So, to me, I like having direct primary care. I can go to this doctor. And for the things that she cannot handle, she can say, "Here's the price of it. Go to one of these providers. Here's the cost of it." But I know that should something horrible happen, I get diagnosed with cancer, I have a surgery, if something were to happen. I'm protected from a catastrophic loss.
Corey Rieck: But you're in excellent shape too, right?
Margaret O'Brien: Yes, correct.
Corey Rieck: So, it seems to me, from a novice perspective, that a high deductible plan for somebody that's in excellent shape, that makes sense because it's unlikely that you're going to have any issue happen to you. So, you're willing to take more risk in terms of the first $8000 to $10,000 because you are in such great shape. You just need sort of a safety net behind you if you go beyond that. Is that fair?
Margaret O'Brien:That is fair. But I think the important thing is as long ... the way it used to be, as long as you stayed covered, then you didn't have to worry about preexisting condition. The difficulty would be is if I left a big employer, and I went to go on my own, maybe then I couldn't get coverage. So, with Medicare, this is an interesting thing that people don't realize. When you go into Medicare, as long as you enroll, when you're originally eligible, you enroll, and there's no preexisting conditions, there's no waiting period, there's no late enrollment penalties. But let's say I decide I'm not ready to enroll in Medicare, or I want to wait on it, I'm okay, I don't think I need this right now. I can enroll at a future date during an open enrollment period, but I'm going to pay a late enrollment penalty.
And as we talked about before with Medicare supplements, I'm making a one-time decision about that. As long as I get into the plan, what I'm originally eligible, then I can stay in that plan, and they can never put preexisting conditions on it. So, I think that's a piece that was missed in designing the process of Obamacare. I think as long as you stay covered, you should be able to stay covered. You should be able to change carriers. So, with Medicare Advantage plans, which we haven't talked about at this point, you have an open enrollment every year. You can be in an Aetna plan this year. You can be in a Cigna plan next year, WellCare plan the year after that, and there is no difference in those plans. They cannot subject you to preexisting conditions. There's no waiting periods. You can change plans.
The difficulty is in an Obamacare plan, I only have three options. I can move from an Anthem plan, to an Ambetter plan, to a Kaiser plan back, but I have open enrollment. But let's say I don't have insurance. I never thought I needed it. I'm 28 years old and healthy. I never thought I needed insurance. And something happens and I get sick. Well, the way it's structured today is during an open enrollment period. I can enroll in a plan, and that cancer is not ... there's nothing about that. I'm going to pay the same as a 28-year-old male as any other 28-year-old male. I'm not going to pay for the fact that I have not been insured until I needed coverage.
So, it's very difficult. I think the key is looking at making sure you stay insured. It's same with your car insurance. I can't get in an accident right out here on Abernathy, and then call my insurance carrier and say, "Hey, I forgot to pay my premium for the last two months. Can you take care of this car accident?" They're going to say, "No, thank you. But we can get you covered today for a future date on a going forward basis."
Corey Rieck: What hobbies do you have?
Margaret O'Brien: So, travel is my number one hobby, I've now been to 46 countries, which is funny because as a kid growing up, I was one of five kids, we didn't go anywhere that you couldn't go by car. I grew up in Texas, so I had been to Mexico, but my first trip abroad was when I was 25 years old, and I went to Ireland. And now, I've been to 46 countries. I volunteered in seven countries. And the year I turned 50, I spent seven weeks traveling around the world. And I try and integrate my volunteering with my travel. So, travel is my top hobby. I work, so I have money to travel. So, that's really important to me.
Corey Rieck: You kind of like that Johnny Cash song, you've been everywhere, ma'am.
Margaret O'Brien: But the amazing thing is some of the places I haven't been to. China, I haven't been to China. I haven't been to Japan. I haven't been to India, but I've been to Sri Lanka, and I've been to Zambia. So, travel is my top hobby. I love to run. I used to have a gold, run a marathon in all 50 states. And I did quite a few of them. I've done 25 marathons. But now-
Corey Rieck: Really?
Margaret O'Brien: I've decided I like shorter distances.
Corey Rieck: What was your favorite one that you've done?
Margaret O'Brien: I did Midnight Sun up in Alaska. And so, it was very cool being out there. There was a moose on the course at Mile 23. And so, that was kind of an interesting thing. I did Big Sur on a year that the weather was perfect.
Corey Rieck: I've heard, I've got friends that they say that's their top one.
Margaret O'Brien: It is gorgeous. If the weather's perfect, you're running along the Pacific Coast Highway. You've seen it in car commercials for years. It's close to Mile 13. And there's a guy with a grand piano playing the piano as you get up there. It's pretty spectacular. So, that would definitely be a highlight. I ran Grandmas in Duluth, Minnesota. And that is where they have what they call Minnesota Nice. I swear, I think the whole town is out along the course cheering you on along the whole way. So, that was a pretty amazing trip.
Corey Rieck: What's your favorite country that you've been to?
Margaret O'Brien: I really love Thailand. I think Thailand was pretty spectacular. The food was as amazing as I expected. The people were great. Where else can you afford to get a massage pretty much every day. So, that was pretty amazing. I even tried the fish massage with a fish are eating the bottom of your feet. I never got comfortable with that. So, that was amazing. I always love going back to Paris. Paris, if I get a layover, Paris, I'm always going to take advantage of it, and spend some time walking along the sun, and just kind of walking along the Champs-Élysées. I guess those would be my two favorite places.
Corey Rieck:With any free time you get, is there anything that we haven't talked about where you would spend some time?
Margaret O'Brien: Well, I'm a Girl Scout troop leader, and I love my Girl Scouts. I feel very fortunate. There's a good group of girls there. We camp. But the last time we went yurt camping up in Cloudland Canyon. The girls loved it. We did hiking.
Corey Rieck: Did you see yurt?
Margaret O'Brien: Yurts.
Corey Rieck: What does that mean?
Margaret O'Brien: They kind of came from that Mongolian design. And they're a lot like platform tents, but a little nicer than that. We did have a space in there, but they've got room to move around. But there are quite a few ... I think there are six campgrounds in Georgia that have yurts. So, we slept in a yurt. That was a lot of fun. And I love spending time with my godchildren. I don't have any kids of my own. So, I've taken on my godchildren as my special people in my life. I love spending time with them.
Corey Rieck: Are there any other charities or issues that you feel strongly enough to get involved in?
Margaret O'Brien: So, human trafficking is a big target for me. I'm going to India this year. I'm going to be working with women and girls. I first got exposed to it as an issue through my rotary. I'm involved in the Buckhead Rotary, and I didn't realize how close to home it hits. Unfortunately, in Atlanta, it's pretty prevalent. And what you tend to think of is you think of older women or girls getting sold into slavery. What you don't realize is a lot of times, it is young girls from affluent families who just get taken down the wrong path. They meet someone on the internet, he pulls them in, and all the sudden, next thing you know, you're gone. It's far too common in Atlanta.
During the Super Bowl, I think there were several very large bust related to human trafficking. One of the things that I think our legislature has done a good job is, is they've stopped going after ... the people who are being trafficked, they're now going for the people who are doing the trafficking and the people who are buying the services. And what you've learned from some these busts that they've done as it's happening in affluent neighborhoods and it's happening-
Corey Rieck: You mean, like in residential neighborhoods?
Margaret O'Brien: It's happening in residential neighborhoods. Now that I've just mentioned this to you, the next time you go into a hotel in Buckhead, look ... I don't know if they do it in the men's room, I can tell you they do it in the women's room. There's a usually a flyer in each bathroom stall that says, "Are you being trafficked? Here are the numbers to call," because they're finding that these men, they're taking these girls through hotels, and you go where the money is. And so, higher-end hotels, those are the people who have money. That's who is buying these girls. And it's also happened into boys.
Corey Rieck: Well, certainly, I think it's admirable that you have spent so much time honing your craft and expertise in individual health insurance in the Medicare arena, small group benefits. You've certainly been very, very committed to that, and have had great results over the years. But I think it's even more admirable that you're giving back to your community by what you're doing with the trafficking that we just talked about. Also, you're committed to the Girl Scouts and all of the other volunteer work that you do. One of the things that I always ask every guest is if you could give the younger version of yourself advice, what would it be?
Margaret O'Brien: Say yes. Say yes. When you're given an opportunity, say yes to it and figured out how to do later. Don't be scared to try something new. Move somewhere different. Get away from your friends. Go somewhere you don't know anyone.
Corey Rieck: You've certainly done that more than once. If there were a young lady that wanted to follow in your footsteps and follow a similar arc, what would you tell her? What advice would you have for her?
Margaret O'Brien: Find a couple of good mentors. Find people who you trust and ask them all sorts of questions. Most people you'll find are going to be very willing to share.
Corey Rieck: Yeah. I think that's that's really, really certainly the case. Well, Margaret O'Brien, you've been a great guest. We appreciate and respect all the success and everything that you've done. Thank you for being such a great guest on the show. If the listenership wanted to get a hold of you, how would they go about doing that?
Margaret O'Brien: So, Zentripyglobal.com is my website. It's Z-E-N-T-R-I-P-Y. So, Zen, think peaceful, think peaceful. And my email address is Margaret@zentripyglobal.com. Thank you very much. I've really enjoyed this.
Corey Rieck: You've been an outstanding guest. And again, if any of you out there needs perspective on even individual health insurance, Medicare, or the small group market in terms of benefits, Margaret O'Brien is the one that you should contact. Thank you. You've been a great guest. Continued success, Margaret.