5 Star Insurance Group - Patti-Jo Heinritz and Justin Zastrow

This week, Rick Sense and Terry Pinch get help cutting through the complexity of Medicare and other health insurance.   You will learn more about searching out the best healthcare for you, whether it be a Medicare plan or other health care plans.

Transcript

Host (Terry Pinch): SCORE Northeast Wisconsin and WHBY are pleased to bring you BizTalk, a chance for you to hear from entrepreneurs and professionals as they share their experiences. From starting to sustaining growth, learn the skills needed for your business to be successful. If you miss anything, you can catch the BizTalk podcast at score.org/Northeastwisconsin. And now, from the Myron Construction Studio, it's BizTalk on WHBY.

A good Saturday morning to everybody. I hope you're having a great June so far. My name is Terry Pinch, and I'm one of the co-hosts this week. Joining me as co-host for BizTalk with SCORE is Rick Sense. Rick, how are you this weekend?

Co-host (Rick Sense): I'm doing very well, Terry.

Terry Pinch: Been out biking?

Rick Sense: I have, actually, yes. Other than the rain we had this last week, which kind of put the kibosh on it a little bit, I've been enjoying myself quite a bit so far.

Terry Pinch: Thanks for joining us again this week, Rick. This week, we're talking to Five Star Insurance Group, and joining us are Patti-Jo Heinritz and Justin Zastro. Welcome to the show.

Patti-Jo Heinritz: Hello! Thanks for having us.

Terry Pinch: Okay, so let's start first with Patti-Jo. Can you let people know your background and how this ended up as your career path?

Patti-Jo Heinritz: Well, actually, I'm originally from Green Bay, Wisconsin, and I started in the insurance industry back in 1986. I worked at Employers Health Insurance in De Pere, so I've been in the business for almost 40 years. I worked in group insurance back then, underwriting, sales, and then I actually moved to Chicago for sales, and eventually Arizona. My father wasn't doing very well; he had cancer, so I ended up moving back to the area in 2004. I started working at UnitedHealthcare under Medicare in 2006, and I was offering Medicare Advantage plans. I just loved it so much. I loved the interaction with the seniors, and it just felt so fulfilling that I wanted to make this my business.

I moved to Menasha and built my own agency, PJ Tolner Insurance Agency—my maiden name—and I worked out of an apartment and did in-home appointments. I traveled throughout the state and educated people on Medicare. Once I realized that being captive with one company was not as beneficial to my seniors, I decided to go independent. As an independent insurance agency, I can give all of my clients better options—Medicare Advantage, Medicare Supplement—and I just grew the business. Right now, we have four salespeople, two admin people, and a team development manager.

Terry Pinch: Justin, let us know how you got into this field.

Justin Zastro: So, I originally was going to teach middle school. When I graduated college, trying to find a job that was actually going to keep me for a long time wasn't really feasible at the time. This was 2003, 2004, and it was hard to get something steady, so I just fell into health insurance. It turns out that having that teaching background worked really well when I transitioned into health insurance. I worked for Blue Cross Blue Shield of New Jersey for almost 13 years, and they had me travel all over.

Eventually, I wanted to move back to my home state, so I came back to Appleton. I wanted to do something independent, and that teaching background translated really well into working with seniors. They wanted to know the information I was providing instead of just sitting and suffering through it. I love the job, I love working with people and helping them find the right plan, and being there as both a salesperson and an educational resource.

Terry Pinch: Let's have an overview of the services that Five Star offers.

Patti-Jo Heinritz: We offer Medicare educational events monthly in our office. People turning 65 can sign up for one of our events, and we walk them through what Medicare is, how it works, and the difference between a Medicare Advantage and a Medicare Supplement. It's very informative. We also do meetings in Waupaca and have a video on our website for those who want to know more.

We also do consultations for people under 65 looking for health insurance—maybe they lost their job, or they just turned 26 and were kicked off their parents' plan, or they are retiring. We work closely with financial planners to help their clients find a plan within their budget. Most of our appointments are in the office, but we also do Zoom calls and in-home appointments.

Terry Pinch: A lot of people seem afraid when they start hearing about Medicare and retirement health insurance. Do you see that fear?

Patti-Jo Heinritz: Yeah, it's overwhelming because it's a lot of information. That's why we do the educational events. I've been doing these since 2011. People are afraid they're going to miss the boat or be penalized. There's also a lot of misinformation out there—people receive so much mail from insurance companies before they turn 65. We are here to navigate that and make it personalized.

Terry Pinch: Why should someone get training?

Patti-Jo Heinritz: So they can make an educated decision, rather than just choosing what their friend has or picking the cheapest option. Everyone's situation is unique—they might live in a different state, take different medications, or see different doctors. The more education you have, the better prepared you are to make a decision that won't cause you frustration later.

Terry Pinch: Why be an independent broker?

Patti-Jo Heinritz: Cost savings. We look at multiple carriers, not just one. We aren't going to pigeonhole you. We can find the best option in terms of cost and benefits.

Terry Pinch: How did you build your reputation for service?

Patti-Jo Heinritz: I always say, if I take care of my employees, they'll take care of my customers. If you look at our Google reviews, we have over 700 and they are 5-star because we provide 5-star rated service. We are also big on community involvement; we work with the senior center in Appleton and NAMI (National Alliance on Mental Illness), and we do an annual customer appreciation event. It’s an ice cream social where our clients can meet their carriers and ask questions.

Rick Sense: I have to ask about the name. Did you name yourself "Five Star" because of the 0-5 star rating system for plans?

Patti-Jo Heinritz: Yes. At the time, Medicare Advantage plans were rated 0 through 5, and I thought, "Five Star" sounds cool. People also associate 5-star hotels or restaurants with high quality. It was a bit of a process, but it’s been 12 years now, and I think it’s been a great choice.

Rick Sense: You mentioned having hundreds of reviews—have you had any that were not 5-star, and how do you handle those?

Justin Zastro: A lot of times, the frustration stems from miscommunication. Maybe the selection they made wasn't exactly what they wanted. We approach those situations with understanding and try to resolve the underlying issue. We want to fix the problem so it doesn't happen again. If they are unhappy, we don't just email—we call them to ensure they are taken care of.

Terry Pinch: Most people know about our website, which has had a significant update. You can access hundreds of different programs for small businesses at score.org/wi/Northeast-Wisconsin. There is a training and learning tab near the top with great resources for small businesses. Now, Patti-Jo, can you give us an overview of how Medicare works?

Patti-Jo Heinritz: Sure. Original Medicare is Part A and Part B. Part A is hospital/inpatient coverage, which is no cost to you if you've worked 40 quarters. Part B is your medical/outpatient coverage, which has a monthly premium—$202.90 for 2026. Medicare pays 80%, and you are responsible for 20%.

To combat the deductibles and that 20%, there are two main options:

• Medicare Advantage (Part C): A private company contracts with Medicare to pay your bills. You pay-as-you-go, and these often include dental, vision, hearing, and drug coverage.
• Medicare Supplement: Medicare is your primary insurance; the supplement pays the 20% that Medicare does not. There's no referral needed, but you typically pay a separate premium.

Terry Pinch: And what about Part D?

Patti-Jo Heinritz: Part D is prescription drug coverage. In 2026, the "donut hole" is completely gone, and there is a maximum out-of-pocket cap for medications at $2,100.

Justin Zastro: One thing to emphasize is that the cap applies to covered medications. If you take a medication not on the plan's formulary, it doesn't count toward that cap. That’s why we help clients compare plans annually.

Terry Pinch: And how do you handle retiring before 65?

Patti-Jo Heinritz: Figure out who you are covering, where you live, and what your income looks like. I recommend working with a financial planner. Income plays into tax credits for the marketplace. If you don't estimate your income correctly, you could end up with a tax surprise, so being prepared is key. These plans are state-based, so they don't always travel well, but we can help you find the right option.

Terry Pinch: And what about dental, vision, or travel insurance?

Patti-Jo Heinritz: We have several options for those, as well as hospital indemnity plans, which are becoming popular. We also offer life insurance and trip/travel insurance.

Terry Pinch: How can people contact you?

Patti-Jo Heinritz: We are located in Appleton on the corner of College and McCarthy. Our phone number is 920-831-3210. You can also visit our website to reach out to our salespeople or sign up for a Medicare educational event. We operate in Wisconsin, Florida, Texas, North Carolina, and Arizona.

Rick Sense: If someone is starting to feel nervous, at what age should they sit down and talk to you?

Patti-Jo Heinritz: For Medicare, 6 months before you turn 65. If it's for the marketplace (retiring before 65), about 3 to 6 months before you want to retire. Don't do it too early, though, because rates and plans change every year.

Rick Sense: Are you guys having fun?

Patti-Jo Heinritz: Absolutely. It’s fun helping people. They come in feeling frustrated and leave with a smile on their face.

Rick Sense: Patty-Jo and Justin, thank you for coming in. This was a great program. Make sure you check out their information on their website, and we will be back next Saturday morning. Have a great week, everyone