CONFERENCE — Public Exchanges: Translating Lessons Learned Into Insurer Strategies for 2015

AIS’s 2nd Annual Virtual Conference on Public Health Insurance Exchanges

Tuesday, May 6, 2014 – 11 a.m. to 5 p.m. (Eastern)

2013 was an unfortunate learning experience for every link in the health chain — from provider to insurer to purchaser to (potential) enrollee — as HealthCare.gov (and many state platforms) sputtered miserably and the launch of the Affordable Care Act disappointed the entire nation. Health insurers, especially, were the target of unprecedented demands from Washington as repeated policy changes were issued to iron out glitches in the ACA and its flawed websites.

With the worst (hopefully) behind them, health insurance executives and their advisers are busily translating the lessons of 2014 into strategies their plans can pursue in what promises to be a more efficient public exchange marketplace in 2015.

Four information-packed sessions, 13 expert panelists … all from the convenience of your own office

Join us May 6 for AIS’s second annual virtual conference on public health insurance exchanges. Hear directly from the nation’s top thought leaders from high-profile companies including Milliman, Deloitte, Leavitt Partners, Connect for Health Colorado, eHealth, Molina Healthcare, Independence Blue Cross, Venable and Medica.

For one registration fee, your team will gain valuable, practical intelligence on topics such as:

  • How to decode 2014’s lessons learned and turn them into strategies for success in 2015
  • Why Web-based entities are poised to be a game changer for health insurers participating on public exchanges
  • How carriers are designing, pricing and promoting their exchange-based products for 2015 — based on what they learned from the first year
  • How the “3Rs” are working so far, and what’s likely to change in 2015 and beyond

Each of the four sessions will conclude with generous time allocated to answering your individual questions. Register Now!


The Virtual Experience: Get intensive training from the convenience of your own office or conference room. No travel required! Gather your entire management team for the most cost-effective training in the industry. Register Now!


Schedule at a Glance

Go to AGENDA for full descriptions and speaker details on each session

AIS Virtual Conference: Tuesday, May 6, 2014

11:15 – 12:45 The Big Picture for Insurers (90 minutes)
With the chaotic first enrollment season behind them, insurance carriers and their advisers are now sifting through the wreckage to determine which courses of action are prudent for the year ahead. In this lead-off session, three experienced national observers of reform implementation will offer a “big picture” assessment of recent events and the resulting strategies they recommend for 2015.
See full agenda and speakers

1:00 – 2:00 Web-Broker Entities and Their Impending Impact on the Sale of Public Exchange Products (60 minutes)
Web-broker entities (WBEs) — which offer a potentially powerful channel through which enrollees can find and enroll in health coverage and apply for subsidies — could soon be a game changer for health insurers participating on public exchanges. What do health plans need to know about WBEs … and how should they be integrated into evolving sales strategies?
See full agenda and speakers

2:15 – 3:45 Applying Lessons Learned: Designing, Pricing and Selling Insurance Products (90 minutes)
A year ago, carriers were flying blind about who they would compete against and how products would be designed and priced. In this session, you’ll gain valuable perspectives on product design, pricing and sales from top executives at large and small insurance companies participating on state-run and federally facilitated exchanges. What did they learn from the first year? What are they planning to do differently for the year ahead?
See full agenda and speakers

4:00 – 5:00 Reinsurance, Risk Corridors and Risk Adjustment (the ‘3Rs’): Strategies for Mitigating Health Plan Risk (60 minutes)
The permanent and temporary risk mitigation programs established under the ACA (the “3Rs”) have offered some relief for carriers competing on the exchange in the face of significant overhauls to the market. But how are these provisions changing for 2015 and beyond, and what new challenges do carriers face as a result? An elite team of Milliman actuaries will provide you with practical insights on these issues and summarize the most important changes ahead for carriers.
See full agenda and speakers


Speakers at a Glance

Victoria Boyarsky, Milliman • Dannette Coleman, Medica • Christopher Condeluci, Venable LLP • Rosemarie Day, Day Health Strategies • Don Garlitz, bswift • Sam Gibbs, eHealth, Inc. • Kamran Hashim, Molina Healthcare, Inc. • Lindy Hinman, Connect for Health Colorado • John Janney, Independence Blue Cross • Paul Lambdin, Deloitte Consulting LLP • Hans Leida, Ph.D., Milliman • David Liner, Milliman • Daniel Schuyler, Leavitt Partners

Go to SPEAKERS for detailed speaker information


Who Should Attend?

  • Health plan:
    • CEOs, COOs and CFOs
    • Product developers
    • Marketing, branding and communications directors
    • Consumer experience and engagement leaders
    • Product development and management directors
    • Health reform implementation leaders
    • Customer acquisition and retention directors
    • Individual market directors
    • Provider relations directors
    • Customer service managers
    • Actuaries
    • Attorneys
    • Market research analysts
    • Government and public affairs directors
  • Insurance exchange directors and staff members
  • Health care vendors
  • Financial analysts
  • Brokers and agents
  • Attorneys and consultants

AIS's Second Annual Virtual Conference on Public Exchanges:
Tuesday, May 6, 2014 – 11 a.m. to 5 p.m. (Eastern)

Agenda

11:00 – 11:15 Welcome (15 minutes)

11:15 – 12:45 The Big Picture for Insurers (90 minutes)

With the chaotic first enrollment season behind them, insurance carriers and their advisers are now sifting through the wreckage to determine which courses of action are prudent for the year ahead. In this lead-off session, three experienced national observers of reform implementation will offer a “big picture” assessment of recent events and the resulting strategies they recommend for 2015.

You’ll discover:

  • Which carriers have the greatest public exchange presence? Which plans are looking to withdraw or reduce their participation? Which are expected to jump in or increase their stake?
  • Which areas of ACA regulation are the best candidates for additional tinkering by HHS?
  • What should plans anticipate related to the billing and collections snafus that have been plaguing the industry in recent months?
  • What steps can be taken to minimize and manage Medicaid/exchange enrollment churn?
  • What customer service lessons will reshape the health plan/consumer interface for 2015?
  • What role are agents and brokers expected to play in public exchanges for 2015?

Presenters:
ROSEMARIE DAY, president of Day Health Strategies
LINDY HINMAN, chief operating officer at Connect for Health Colorado insurance exchange
PAUL LAMBDIN, director of Deloitte's Health Plan Insurance Exchange and Retail Excellence Solutions Leader
DANIEL SCHUYLER, director at Leavitt Partners

15-minute break

1:00 – 2:00 Web-Broker Entities and Their Impending Impact on the Sale of Public Exchange Products (60 minutes)

Web-broker entities (WBEs) — which offer a potentially powerful channel through which enrollees can find and enroll in health coverage and apply for subsidies — could soon be a game changer for health insurers participating on public exchanges. What do health plans need to know about WBEs … and how should they be integrated into evolving sales strategies?

You’ll learn:

  • What are Web-broker entities and how do they operate vis-à-vis public exchanges?
  • What potential do WBEs have to boost enrollment in exchange-based coverage?
  • How attractive are WBEs likely to be to which customers (e.g., for part-time workers and those seeking COBRA)?
  • What are the key challenges that health plans face in working with WBEs?
  • How should health plans structure WBE commission rates?
  • To what extent will “slotting fees” seen in private exchanges impact WBEs? How many WBEs should a health plan contemplate working with?

Presenters:
CHRISTOPHER CONDELUCI, Of Counsel at the law firm Venable LLP
SAM GIBBS, senior vice president at eHealth, Inc.
DON GARLITZ, director of bswift’s Exchange Solutions division

15-minute break

2:15 – 3:45 Applying Lessons Learned: Designing, Pricing and Selling Insurance Products (90 minutes)

A year ago, carriers were flying blind about who they would compete against and how products would be designed and priced. In this session, you’ll gain valuable perspectives on product design, pricing and sales from top executives at large and small insurance companies participating on state-run and federally facilitated exchanges. What did they learn from the first year? What are they planning to do differently for the year ahead?

You’ll hear:

  • Which plans sold the best? Which metal tiers were most popular? Most profitable?
  • What evidence exists related to why enrollees chose some plans over others?
  • How accurately were plans priced? What lessons were learned that will result in new pricing strategies for 2015?
  • How effective were new consumer-centric outreach and marketing strategies? How will these be rolled out differently in 2015?
  • What strategies are plans employing to retain existing enrollees?
  • How are provider networks expected to change, whether driven by market forces or new legal or political initiatives?
  • How are plans now viewing their public exchange business in relation to that of private exchanges and the commercial marketplace?

Presenters:
DANNETTE COLEMAN, vice president and general manager for individual business at Medica
KAMRAN HASHIM, associate vice president of strategy, policy and implementation for health insurance exchanges for Molina Healthcare, Inc.
JOHN JANNEY, senior vice president of health care reform implementation and transformation consultant at Independence Blue Cross

15-minute break

4:00 – 5:00 Reinsurance, Risk Corridors and Risk Adjustment (the ‘3Rs’): Strategies for Mitigating Health Plan Risk (60 minutes)

The permanent and temporary risk mitigation programs established under the ACA (the “3Rs”) have offered some relief for carriers competing on the exchange in the face of significant overhauls to the market. But how are these provisions changing for 2015 and beyond, and what new challenges do carriers face as a result? An elite team of Milliman actuaries will provide you with practical insights on these issues and summarize the most important changes ahead for carriers.

You will learn:

  • What is the impact of late-breaking changes to 2014 rules for reinsurance and risk corridors likely to be?
  • How will recent extensions for non-ACA-compliant plans impact pricing for 2015 and beyond?
  • How will the transitional risk corridor program compensate carriers if the Obama administration’s extension negatively impacts the risk pool?
  • What long-term strategic concerns should issuers be aware of for the out-years?
  • What additional (non-3R) strategies should health plans consider for limiting the risks associated with their public exchange participation?

Presenters:
VICTORIA BOYARSKY, consulting actuary at Milliman
HANS LEIDA, Ph.D., consulting actuary and principal at Milliman
DAVID LINER, consulting actuary at Milliman

AIS's Second Annual Virtual Conference on Public Exchanges:
Tuesday, May 6, 2014 – 11 a.m. to 5 p.m. (Eastern)

Speakers

VICTORIA BOYARSKY is a consulting actuary at Milliman, where she specializes in health insurance and managed care consulting. Since joining Milliman, she has been involved in premium-rate development, insurer strategy, reviews of pricing and reserving methodology and development of actuarial models to project health care spending. Prior to joining Milliman, Ms. Boyarsky worked for large health insurers, where she performed rate and reserve calculations, rate filings and financial projections; developed product pricing models; and analyzed provider fee schedules and Medicare Advantage bids. She has worked with both large and small regional carriers, and participated in product development and IT initiatives. She also has extensive experience in analysis of health care claim data and trends.

DANNETTE COLEMAN is vice president and general manager for individual business at Medica, where she oversees the growth and development of the individual market. She joined Medica in 1992, and most recently she served as vice president of public policy and government relations. Ms. Coleman has more than 20 years of health care experience and is highly regarded for her knowledge of the health care industry. She earned her Bachelor of Arts degree from the University of Wisconsin-Madison and her Masters of Business Administration degree from the University of St. Thomas. She also has served as the board chair of the TwinWest Chamber of Commerce and President-elect of the Minnesota Council of Health Plans board. She is a member of the Governor’s Health Insurance Exchange Advisory Task Force.

CHRISTOPHER CONDELUCI is Of Counsel at the law firm Venable LLP in Washington, D.C. Prior to joining Venable, Mr. Condeluci served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Mr. Condeluci participated in the development of portions of the Patient Protection and Affordable Care Act (ACA), including the new health insurance exchanges, the state insurance reforms and the new taxes enacted under the law. He is one of the few senior congressional staffers who actively participated in the health reform debate to join the private sector since the law’s enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA and the ACA.

ROSEMARIE DAY is president of Day Health Strategies in Somerville, Mass., and is a senior advisor at McKinsey & Co.’s Center for U.S. Health System Reform. In 2006, Ms. Day was the second person hired to help launch and operate Massachusetts’ insurance exchange, the Commonwealth Connector. There she built the operations leadership team and defined the operational strategy to implement the state’s health care reform law.

DON GARLITZ is director of bswift’s Exchange Solutions division. Prior to joining bswift, Mr. Garlitz served as vice president and partner for FirstWest Benefit Solutions, a leading employee benefit consulting firm based in Utah. At FirstWest, Mr. Garlitz co-authored the white paper used by Utah’s legislative leadership as an outline for the creation of the Utah Health Exchange’s defined-contribution model. He served on the Utah Health Exchange Advisory Board, which advises on exchange, operations transparency and consumer issues, and received a formal commendation from Utah Gov. Gary Herbert for outstanding work as a health reform consultant to the Governor’s Office of Economic Development. Earlier in his career, he worked in the insurance industry in sales roles with Beneficial Life and Aflac, and also as an independent agent. Mr. Garlitz was recognized as the Utah Underwriter of the Year in 2007 by industry peers at the Utah Association of Health Underwriters. He holds a Bachelor of Science degree from Brigham Young University and is recognized by the American College as a Registered Health Underwriter.

SAM GIBBS is a senior vice president at eHealth, Inc. During his seven years in the health insurance industry, he has focused on helping companies understand the shifting health care/technology marketplace and plot company direction accordingly. Mr. Gibbs has a keen understanding of the shifts in how people search for and buy health insurance online, and the impact technology has had and will continue to have on the financial services and health insurance industries. He is a credible subject expert who is skilled at explaining the complexities of health insurance to consumers. He has worked with print and broadcast media, discussing business issues and as a consumer advocate.

KAMRAN HASHIM is associate vice president of strategy, policy and implementation for health insurance exchanges for Molina Healthcare, Inc. In this role, he is responsible for all corporate and health plan functions for the company’s exchange/marketplace business. Previously, he acted as the program director of health care reform at Molina, where he implemented a reform readiness framework to keep the company apprised of the evolving rules of the Affordable Care Act. Prior to joining Molina, Mr. Hashim served as the manager for business transformation at Mercury Insurance Group and for First Consulting Group of Long Beach. He graduated Magna Cum Laude with a Bachelor of Science degree in finance from Manhattan College.

LINDY HINMAN joined Connect for Health Colorado as Chief Operating Officer in August 2012, directing policy implementation and business operations. Ms. Hinman previously served at Horizon Blue Cross Blue Shield of New Jersey, where she coordinated the company’s preparations for and responses to national health care legislation. Prior to that, Ms. Hinman served as vice president of policy at America’s Health Insurance Plans and led strategic engagements on behalf of Avalere Health. She has also held positions with the White House Office of Management and Budget, and Centers for Medicare and Medicaid Services in Washington, D.C. She holds a Bachelor of Arts in history/biology from Washington University in St. Louis and a Masters of Health Services Administration from the School of Public Health at the University of Michigan.

JOHN JANNEY is the senior vice president of health care reform implementation and transformation consultant at Independence Blue Cross. In this newly created role, he has dedicated oversight of health care reform implementation and is helping to bring cross-functional coordination to health care reform-related projects and mandates to ensure IBC’s implementation of the law. He joined IBC in 1995 to lead a newly formed marketing systems department. Later, he led the initiative to address the eCommerce needs of physicians, hospitals, brokers, employers and members, and in 2006 was appointed vice president of eBusiness and enrollment services. He was promoted to senior vice president of eBusiness and support services in 2009 and led the marketing division from 2010 until accepting this new role.

PAUL LAMBDIN is the national leader for two Health Plan Sector solution areas, Health Insurance Exchanges and Retail Excellence, and a thought leader in the go-to-market functions of a health plan, focused on growth strategy in the era of health care reform. Paul has served as engagement leader for Exchange Strategy, Product Strategy, Exchange / Retail Distribution Strategy, as well as Retail Capability and Operational and Technical Exchange Readiness Assessments. Paul has over 25 years of previous health plan and group insurance experience. In 2010, Paul joined the firm from Health Net, Inc., where he served as president of Health Net of the Northeast, a multi-billion dollar revenue health plan. His assignment culminated with the successful sale of the unit to United Healthcare. Previously, Paul was the senior vice president of business development and distribution for United Healthcare’s middle-market segment.

HANS LEIDA, Ph.D., is a consulting actuary and principal at Milliman. He has consulted for insurance companies, Blue Cross Blue Shield plans, HMOs, government health programs and employers. Recently, he has been working on individual and small-group health insurance rate filings under the ACA’s health care reforms. Dr. Leida’s past projects involved individual and group health underwriting, pricing and rate filings. In 2007, he co-authored a paper for the trade group America’s Health Insurance Plans (AHIP) on the impact of guaranteed issue and community rating laws adopted by certain states in the 1990s. That paper has been widely cited with the advent of federal health care reform, including in amicus briefs presented to the U.S. Supreme Court. He also has significant experience with risk adjustment and predictive modeling of health care costs. He was the lead developer of the prescription-drug-based risk adjuster included in the Milliman Advanced Risk Adjusters (MARA) software product. He also performed firm-level research on the new federal ACA risk-adjustment model that will take effect in 2014. Prior to joining the firm, Mr. Leida taught mathematics while pursuing his Ph.D.

DAVID LINER is a consulting actuary at Milliman, where he advises a wide spectrum of clients across the U.S. health care sector. He specializes in commercial health insurance, employee benefits consulting, Medicare Part D, pharmacy benefit management (PBM) and stop-loss reinsurance markets. Mr. Liner’s clients include commercial health insurers, large employers, captive insurers, PBMs and Medicare Part D plan sponsors. Since the passage of the ACA, he has provided strategic and actuarial consulting services to help many clients navigate a dynamic regulatory environment.

DANIEL SCHUYLER is a director at Leavitt Partners, where he helps guide the insurance exchange practice. He brings to the firm applied experience in the development and implementation of health insurance exchanges. Prior to his work with Leavitt, Mr. Schuyler was director of technology for the Utah Health Insurance Exchange, where he was responsible for defining the technical goals and business processes associated with the exchange.

Moderator: Steve Davis is managing editor of Inside Health Insurance Exchanges and The AIS Report on Blue Cross and Blue Shield Plans (not affiliated with the Blue Cross and Blue Shield Association or its member companies). His journalism career includes more than a decade of health business reporting experience, including 10 years as the managing editor of Health Plan Week and Inside Consumer-Directed Care. Mr. Davis joined AIS in 2002.

AIS's Second Annual Virtual Conference on Public Exchanges:
Tuesday, May 6, 2014 – 11 a.m. to 5 p.m. (Eastern)

Why a virtual conference?

No travel, no hassles, no added expenses! Stay up-to-date on one of the most important issues in health care today … from the convenience of your own office. Send in your registration, and then all you need to do is log in to the live meeting in your office or conference room.

Just like at an in-person conference, our panel of experts will be available to answer your specific questions. But, if a question springs up in the middle of someone’s presentation, you don’t have to wait until the end to ask it. Simply enter your question in the “Chat” box on the webinar page to send in your questions during the session and they will be addressed during Q&A time.

And since your registration fee includes a free on-demand recording of each session, you can go back and review or repeat any agenda items you may have missed, need clarification on or want to share with your colleagues at your convenience.

Train your entire team without breaking the budget. You pay one low registration fee per access line so gather as many team members in the conference room as you want — for part of the day or the entire day.

How does a virtual conference work?

All you need to access the virtual conference is a computer (PC or Mac) with Internet access — no downloads or software installations required. You see speakers’ presentations on the Web as a slideshow, while listening to the audio presentation through your computer or on the phone. Presentations are followed by Q&A sessions with the speaker(s) and you can submit your questions by email at any time.

When you register, you will receive an email confirmation from AISconferences@aishealth.com (be sure to whitelist this address!) with the password and link you need to connect to the conference online, along with a toll-free dial-in number if you would prefer to listen to the presentation by phone. You will receive a PDF of the presentation(s) by email prior to the event.

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Can my colleagues attend with me?

Maximize your registration when you invite your entire team to participate. Register today for one log-in and invite as many participants as you wish.

There is no limit on the number of participants from your office, but the registration fee covers only one log-in for one computer. Additional log-ins for different computers can be purchased for $300 each if made at the same time as the full registration. To order additional log-ins, please contact AIS’s Customer Service at 800-521-4323 or email custserv@aishealth.com.

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What if I need to cancel?

To cancel your registration for this event and receive a full refund, you must contact customer service at 800-521-4323 no later than 48 hours prior to the scheduled start of the event.

Last minute change in your plans? Your registration includes a free On-Demand Recording of the entire conference, so even if you miss some of the conference as it’s happening, you’ll have the full recording available after the event. Or if you prefer, you can change your registration and free On-Demand Recording to an order for the CD and printed materials. Both the On-Demand Recording and CD include the entire audio presentations and a printed copy of the slideshow presentations and any additional materials. On-Demand recordings are available within one week of the event and CDs are available within two weeks.

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How will I get the On-Demand Recordings and/or CDs?

On-Demand recordings are delivered as a link contained within a PDF file of the accompanying printed materials. Shipping will NOT be charged for this item.

  • If you order the On-Demand recording before the conference date (complimentary with a registration to the live event), you will be sent an e-mail with the PDF file attached once the recording is available — approximately one week after the event.
  • After the On-Demand recording is available, if you order online through our secure shopping cart, you will receive an email immediately after submitting your order, with a link directing you to download the PDF file. If you order through our customer service department (by phone, mail, fax or email), you will be sent an email during regular business hours with the PDF file attached.

CDs are available approximately two weeks after the event. CD recordings (and accompanying printed materials) are shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes). You should receive the shipment within two weeks of placing your order (or two weeks after the event if you preordered the CD). Shipping and handling cost for CDs is $12. Rush Orders: Please call us at 800-521-4323 to place a rush order. We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

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AIS's Second Annual Virtual Conference on Public Exchanges:
Tuesday, May 6, 2014 – 11 a.m. to 5 p.m. (Eastern)

The Virtual Experience

Get intensive training from the convenience of your own office or conference room. No travel required! Gather your entire management team for the most cost-effective training in the industry.

Register today for the live event and get a complimentary On-Demand Recording of the entire conference. For more information, go to Virtual Conference Details or call AIS Customer Service at 800-521-4323.

CONFERENCE — Public Exchanges: Translating Lessons Learned Into Insurer Strategies for 2015

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