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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
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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
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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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