This seminar was designed specifically for group health actuaries, underwriters, consultants, brokers, and sales professionals

A Message For Underwriters And Actuaries Who Work For 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.

A Message 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, there's a very good chance that the group will receive reduced renewal rates.

A Message For 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.

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 seminar starts off by examining over a dozen "dynamics" that impact a group's claims level. Unfortunately, the vast majority of these "dynamics" are either ignored in the pricing process or are improperly reflected in a group's premiums. Then we'll walk you through a Monte Carlo simulation that demonstrates how making relatively small refinements to your rating factors results in an enormous increase in profitability. We'll show you how you can use this simulation technique to predict your future business results under many different scenarios. The rest of day one (i.e., 10:50AM - 4:30 PM) is devoted to showing you how to maximize the effectiveness of the Community Rating by Class (CRC) pricing methodology by making dramatic refinements to your Industry Rating Factors and Geographic Area Rating Factors. These two types of rating factors are the main reasons why insurers are currently pricing groups so inappropriately. We'll also have a group discussion regarding many scenarios where a premium adjustment is in order. Your company will benefit greatly through 12/31/2013 by making vast improvements to your CRC pricing methodolology.

BONUS MODULE: We just added a module that runs from 4:30PM to 5:20PM on day one that will show you how much you'll need to increase "family" premiums by to cover "Children" To Age 26. We did this because we recently learned that most insurers are substantially underestimating how much extra their "family" claims will increase by due to these "older children" joining the health plan.

In day two, we'll examine a modified version of CRC that can be used starting 1/1/2014 for groups with "100 employees or less" which complies with the provisions of Health Care Reform AND minimizes your exposiure to adverse selection at the same time. In our final module, we'll examine a non-traditional approach to CRC that's far superior to the traditional CRC pricing methodology. This non-traditional approach can be used for groups with "101 employees or more" starting on 1/1/2014. It can also be used NOW FOR ALL GROUP SIZES in many situations and will generate premiums that are far more appropriate than would be the case if the traditional CRC approach was used.

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 make some DESPERATELY NEEDED enhancements?

This training program is an intermediate/advanced level program.

This seminar was designed specifically for employer groups that have a self funded (or partially self funded) health plan, brokers, benefits consultants, and sales professionals. Insurance personnel would also benefit greatly by attending.

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 manage costs to the greatest extent possible! This seminar provides you with the information and strategies you need to enable you to:

• Minimize the extra costs that will result from Health Care Reform.
• Accurately project health plan costs
  • Under the "status quo"
  • After the proposed cost reduction methods are implemented
• 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 cost reduction will be stressed (like requiring generic drugs if they're available).
• Achieve cost savings in areas that do not involve benefit reductions or reducing employer contributions.
  • 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
    • Banning working spouses of employees who have access to their own health plan
    • Minimizing fraud by aggressively verifying dependent eligibility
• Explore some creative employer contribution and/or benefit design strategies that favor low paid employees AND reduce employer costs at the same time.

We'll focus on the health plan of the XYZ Company throughout this seminar.

This program is also ideal for those employers who are thinking about converting their "fully insured" or "experience rated" plan over to a self funded plan. The cost advantages of self-funding will FAR OUTWEIGH the disadvantages starting in 2014 when Health Care Reform fully kicks in.