This seminar was designed specifically for group health actuaries, underwriters, and consultants.

This outstanding seminar will provide you with the information and strategies you need to price your experience rated groups PROPERLY in light of the many complications that have arisen as a result of Health Care Reform. This training program is an intermediate/advanced level program.

• At this seminar, we'll COMPREHENSIVELY EXAMINE what we feel is the ULTIMATE experience rating formula and process.
• We'll also demonstrate many INVALUABLE experience rating techniques that you should seriously consider implementing.
• We'll also show you how to PROPERLY experience rate those groups that pose the greatest experience rating CHALLENGES (which is nearly every group these days!).
  • Groups whose CHILD ELIGIBILITY RULE has changed in recent years (virtually every group!)
  • Groups that have a "GRANDFATHERED" health plan currently, but will lose their "grandfathered status" next year
  • Groups that have changed or will change their BENEFITS in the next plan year
  • Groups that have reduced or will reduce their EMPLOYER CONTRIBUTION percentage at the beginning of the next plan year
  • Groups that have UNUSUAL ISSUES facing them in the next plan year

"EXPERIENCE RATING" CHALLENGE

On 10/1/2012, Let's Assume That Your Company Will Be Calculating Renewal Premiums For A Group Whose Next Plan Year Begins On 1/1/2013. Let's Further Assume That Your Company Relies On 30 Months Of Recent Claims Experience Which Spans Three Plan Years: The Group's Entire 2010 And 2011 Plan Years Plus The First Six Months Of The Group's 2012 Plan Year. (NOTE: The Claims Experience From 7/1/2012 Through 9/30/2012 Is Essentially Ignored Since It's Fairly "Incomplete") To Keep Things Simple, Assume That The Group's Health Plan Is Identical Each Year Except In Regards To The Areas That Are Elaborated Upon Below.

• In Plan Year 2010, Health Care Reform Didn't Apply To This Group's Health Plan. The Employer Contributed 80% Of Premium, Covered "Children" To Age 23, Had A $15 Office Visit Co-Pay, And Had Co-Pays That Applied To Many Types Of Preventative Health Care Services.
  
• In Plan Year 2011, The Health Care Reform Law Applied To This Group's Health Plan And They Enjoyed "Grandfathered Status". The Group Had To Cover "Children" To Age 26, But On A "Grandfathered" Basis. Since They Had "Grandfathered Status", They Were Able To Keep Their CO-Pays For Preventative Health Care Services In Tact. They Also Continued To Require A $15 Office Visit CO-Pay And The Employer Still Contributed 80% Of The Premium.
• Plan Year 2012 remained unchanged from 2011
  
• In Plan Year 2013, This Group Will Lose Their "Grandfathered Status". Therefore, Starting On 1/1/2013, They'll Have To Cover "Children" To Age 26 On A "Non-Grandfathered" Basis Which Means That They'll Also Have To Accept Children Under Age 26 Even If They Have An "Offer" Of Health Insurance From Their Employer (Or Their Spouse's Employer If They're Married). They'll Also Have To Provide Preventative Health Care Services Free Of Charge. They'll Also Be Increasing Their Office Visit CO-Pay From $15 To $25 And Will Lower Their Employer Contribution From 80% To 75%.
  

CAN YOUR COMPANY EXPERIENCE RATE THE ABOVE GROUP PROPERLY?

This Group's Prior Claims Experience Will Generate Renewal Premiums For The 2013 Plan Year That Are GROSSLY INADEQUATE Unless The Claims Experience Associated With The 2010-2012 Plan Years Is Properly Adjusted Prior To The Calculation Of The Renewal Rates. This Is Accomplished By Scientifically Estimating What The Claims Would Have Been In The 2010, 2011, And 2012 Plan Years If The Group's Health Plan Was Identical To What It Will Be In 2013. We'll Show You How To APPROPRIATELY ADJUST The Prior Claims Experience For Each Plan Year And Then Price This Group PROPERLY!

This innovative seminar will be held in Orlando on April 12th & 13th and is an intermediate/advanced level program.

ATTN ACTUARIES: 12 CPD credits

This seminar was designed specifically for group health actuaries, underwriters, and consultants. Anyone who wishes to vastly increase their pricing knowledge would also benefit greatly by attending.

This INVALUABLE seminar will show you how to:

• MINIMIZE the negative impact on profitability resulting from the MINIMUM LOSS RATIO REQUIREMENT.
• Price your groups PROPERLY in light of the pricing-related provisions within the Health Care Reform law that are ALREADY IN EFFECT.
• How to make SUBSTANTIAL REFINEMENTS to your geographic area rating factors and the technique used to assign a geographic area rating factor to a specific group
• How to make DRAMATIC IMPROVEMENTS to your minimum participation requirement and your minimum employer contribution requirement
• How to develop a SOPHISTICATED NON-TRADITIONAL "community rating by class" (CRC) pricing methodology for "large groups" (i.e., experience rated groups that aren't "fully credible" and any large "fully insured" groups that you may have in force) that's far superior to the traditional CRC pricing methodology. [This method can also be used right now for "small groups" in a great many states.]
• EFFECTIVELY MONITOR the characteristics of the new business you're writing to identify problems and opportunities AS THEY UNFOLD and then act upon them appropriately and quickly
• Strategies regarding the provisions within the Health Care Reform law that will take effect in 2014

This seminar will be held on March 15-16, 2012 in Las Vegas and is an intermediate/advanced level program.

ATTN ACTUARIES: 12 CPD credits

This seminar was designed specifically for employer groups that have a self funded (or partially self funded) health plan, brokers, benefits consultants, actuaries, underwriters, and sales professionals.

This outstanding seminar examines cost reduction techniques that are SUBSTANTIALLY MORE EFFECTIVE than the approaches that companies are presently using to manage their health plan costs. We'll show you:

• Three effective contribution strategies to get employees who have one or more dependents in the health plan to pay a greater portion of the cost than they have in the past
• How to increase employee contributions for those employees (and spouses) who use tobacco
• How to REDUCE your company's health plan costs dramatically by:
  
  • Making benefit design modifications that encourage employees and dependents to forego medically unnecessary care and to obtain cost effective care
    
  • Implementing strategies involving incentives or disincentives to encourage employees with working spouses to take their spouse's health plan. [NOTE: If your company is covering 80% of these families that have access to two health plans, your company's health plan cost is approximately 16% higher than it would have been if only 50% (i.e., your "fair share") of these families were covered!]
    
  • Minimizing dependent fraud by conducting an effective audit
    
• How to effectively MANAGE your company's health plan costs by increasing co-pays and/or deductibles in an appropriate manner. We'll show you how to accurately estimate the employer cost savings associated with a wide range of options.
• How the various types of Stop Loss coverage work. We'll also provide guidance regarding which type(s) of Stop Loss coverage and which contract terms make the most sense for a particular employer.
  
• How to implement innovative employer contribution and/or benefit design strategies that favor low paid employees AND reduce employer costs at the same time.
• We'll examine how "Medical Tourism" can reduce health plan costs enormously for certain types of surgeries
• We'll examine the major provisions within the Health Care Reform law that will increase health plan costs in 2012 and beyond and present strategies that employers can use in certain instances to minimize or possible eliminate some of these additional costs
• We'll also have a group discussion regarding wellness programs and the types of incentives being used to encourage employee participation

This outstanding seminar will be held in Orlando on April 26th & 27th and in Las Vegas on May 3rd & 4th.

ATTN ACTUARIES: 12.3 CPD credits

"Maximizing Your Success Under Health Care Reform"

This seminar is being developed currently and is being designed specifically for brokers and benefits consultants.

Stay tuned for more information!

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