Episode: Blueprints for Better Benefits – How Triforta Is Fixing America’s Broken Healthcare System

Host: Rodney Jr.

Guest Expert: Rodney Sr., Founder & CEO of Triforta

In this episode, we’re pulling back the curtain on the rising costs, hidden mechanics, and overlooked opportunities inside America’s healthcare system. For decades, our team of actuaries, analysts, underwriters, and AI-engineers has been decoding the chaos employers face every renewal season. Today, we’re handing you the blueprint.

This conversation walks you through the forces driving year-over-year premium hikes, the truth behind BUCA-dominated fully insured plans, and the quieter budget-leaks hiding in pharmacy rebates and opaque claims practices. More importantly, we equip you with the strategies that actually work in the real world, strategies that help employers forecast, contain, and even reverse runaway medical spend.

You’ll hear how data-driven design, modern funding models, true risk management, and Triforta’s proprietary AI platform give forward-thinking employers a measurable advantage, often trimming 15–25% off total healthcare costs with better member experience, not worse.

If you’re an HR leader, operations executive, CFO, or business owner wondering whether there’s a smarter path forward, there is. And this episode spells it out step-by-step.

KEY MOMENTS

0:00 – Welcome & what today’s blueprint delivers

0:48 – Why America’s health-plan math is broken

3:30 – Mistake #1: “Set-it-and-forget-it” renewals

6:42 – The hidden pharmacy clauses draining your wallet

9:55 – Fully insured vs. self-funded: the real numbers

13:25 – Building a member-owned captive (blueprint walk-through)

17:40 – Case Study: Nevada mining company saves $1.5 M

21:10 – AI early-warning system for high-cost claims

24:58 – 3 data points every CFO must demand

28:15 – Your Quick-Win Checklist for the next renewal

30:40 – How to work with Triforta (next steps)

31:50 – Outro & final thoughts

Connect with Triforta

Website & playbooks: https://www.triforta.com/education

Book a 1-on-1 strategy call: https://calendly.com/rodney_8228/15min?month=2025-11

Rodney Jr. on LinkedIn: https://www.linkedin.com/in/rodneymattostriforta/

Rodney Sr. on LinkedIn: https://www.linkedin.com/in/rodneymattos/

Email: [email protected]

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