For Underwriters, Actuaries, Etc. From HMOs, Blue Cross Blue Shield Plans, And Other Health Insurance Companies:

Experience-rated "Large Group" business is the only segment of our business that is not burdened by legislation and industry-wide underpricing. If success is not achieved in the large group market, it is practically certain that there are problems with the experience rating formula.

This outstanding seminar provides you with in-depth knowledge of every aspect of prospective experience rating (i.e., HMOs refer to this as "adjusted community rating") which will enable you to dramatically improve your company's experience rating formula. Having a sound and comprehensive experience rating formula will ensure that your company will achieve solid profitability AND reasonable enrollment growth regarding its "Large Group" business. Your company will attract and retain "Large Groups" with above-average claims experience, and will appropriately price those "Large Groups" that have below-average claims experience.

For Sales Professionals, Brokers, & Consultants:

In order to comprehensively and professionally explain how an experience-rated group's renewal rates were determined, what's driving the group's rate increase, and what modifications/strategies are required to better control costs, it's imperative that you fully understand the experience rating process.

Having an in depth knowledge of experience rating will also enable you to identify those occasional groups whose renewal rates seem inappropriate for a specific reason or reasons. Challenging the renewal rates for these groups is appropriate. If you can explain precisely why you feel the group in question should get a rate adjustment, and your argument is logical and based on facts, it's likely that the group will receive reduced renewal rates.

All Insurance Professionals:

Underwriters, actuaries, brokers, sales professionals, and consultants ALL have a vested interest in groups receiving the most equitable rates possible.

This training program is an intermediate/advanced level program intended for Underwriting/Rating personnel, Health Actuaries, Brokers, Sales Professionals, & Consultants.

This seminar comprehensively examines traditional underwriting and pricing approaches. Besides analyzing these functions in depth, we'll also highlight their many shortcomings. We'll start off by examining over a DOZEN "dynamics" that impact a group's claims level (i.e., age, sex, participation rate, geographic area, and many more). Then we'll evaluate how well the traditional underwriting and pricing approaches reflect the claims impacts caused by these dynamics when developing a group's premiums. Lastly, we'll provide recommendations regarding how these traditional underwriting and pricing functions can be dramatically improved.

We'll also make recommendations regarding how an insurer can supplement their traditional underwriting and pricing approaches by using nontraditional (and more refined) approaches in certain instances to generate substantially more appropriate premiums for each group. "Thinking outside the box" will be an invaluable ally to us here.

Keep in mind that the traditional underwriting and pricing approaches being used today throughout the industry were developed in the 1950s! After 50 years, isn't it about time for us to enhance our underwriting and pricing techniques? By attending this seminar, you'll gain the knowledge and insights needed to make dramatic improvements to your company's underwriting and pricing functions.

This training program is an intermediate/advanced level program and is ideal for health actuaries, and underwriting/rating personnel.

We'll post the flyer for this outstanding program on this web site as soon as it becomes available. This seminar replaces our "Superior Underwriting and Pricing Techniques" seminar.

Health plan costs have increased approximately three times the general rate of inflation over the past twenty years. Obviously it's absolutely imperative for employers, and those they depend on for advice, to reduce costs in a sensible manner and control costs to the greatest extent possible! This seminar provides you with the information and strategies you need to enable you to:

• Recommend benefit reductions that will significantly reduce health plan costs, and accurately estimate the dollar savings associated with each proposed benefit reduction. Here we're talking about inpatient care, office visits, emergency room visits, Rx, etc. Sensible and creative approaches to benefit reduction will be stressed.
• Achieve cost savings in areas that do not involve benefit reductions or reducing employer contributions.
  • We'll explore the cost savings potential associated with "medical tourism"
  • Minimize the number of people covered by the health plan:
    • Using incentives or disincentives to strongly encourage "employees with working spouses who have access to health coverage" to take their spouse's health plan
    • Forcing working spouses of employees who have access to health coverage to enroll in their own health plan
    • Minimizing fraud by aggressively verifying dependent eligibility
  • Understand adverse selection and the techniques that can be used such that an employer can offer its employees multiple health plan options and drastically reduce or eliminate the tremendous extra cost caused by adverse selection.
• Explore some creative approaches to employer contributions and benefit design that will be increasingly attractive to employers as the years go by and the health care cost crisis worsens

Obviously, reducing health plan costs in a sensible manner and controlling them to the greatest extent possible is an extremely important activity, and an activity whose importance increases each and every year!

This seminar was designed for brokers, consultants, sales personnel, and employer groups who have a self funded plan. Naturally, underwriters and other insurance company personnel would also benefit by attending.