Healthcare Reform and Its Impact on Insurance Carriers
The tectonic changes ushered in by the new healthcare laws have affected every facet of the industry. First in line of course are the insurance carriers – how will the changes affect them financially? This is the question we aim to address.
The Knowledge Group has assembled a panel of experts and thought leaders to discuss the substantive key considerations for insurance carriers. A live interaction with the audience in a question and answer format is also included in this event.
Jane Cline, Commissioner
West Virginia Office of the Insurance
The Patient Protection and Affordable Care Act will impact Insurance Carriers in numerous ways. In this section we will discuss:
- What incentive plans and potential rebates will be put into place under the Medial Loss Ratio (MLR)?
- How will increased benefits impact companies?
- Will carriers see an increase of regulatory scrutiny? Will the rate review process change?
- What are some of the new data reporting requirements that will be put into place?
James J. O’Connell, Executive Consultant,
"Political Change and Healthcare Reform: What To Expect in 2011"
- The Patient Protection & Affordable Care Act was a key factor in the November 2010 election results. Republicans have taken control of the House of Representatives promising to change the controversial new law.
- What does political change mean for the Patient Protection & Affordable Care Act in 2011 and beyond?
- Will Republicans push a "Repeal and Replace" strategy? Or is the "Chip Away" alternative more viable?
- What aspects of PPACA are likely to be the main targets? What amendments will most impact carriers?
- And what might be the role of the States in affecting implementation of healthcare reform, particularly for health insurance exchanges?
These and other compelling questions will be answered in this timely analysis of healthcare reform and the impact of political change—what to expect in 2011.
Marcia Augusburger, Partner,
When the Patient Protection & Affordable Care Act was debated and enacted, health insurers lobbied for a law that would help to offset the increased costs of providing coverage without pre-existing condition exclusions – a law to ensure more individuals would buy health insurance so that the savings attributable to healthy subscribers would cover the costs associated with subscribers with pre-existing illnesses and injuries.
- What provisions of the Patient Protection & Affordable Care Act are State Attorneys General challenging?
- On what basis are State Attorneys General challenging the constitutionality of the Patient Protection & Affordable Care Act?
- Do the State Attorneys General and judges considering these challenges understand that without the mandate, the law's protection of people with preexisting conditions would mean that healthy people could wait until they get sick to buy insurance, which could conceivably bankrupt the entire health insurance system because no one would be paying into the pools?
- What considerations underlie their decisions?
- What will happen in the Courts between now and 2014 when pre-existing condition exclusions will be prohibited?
In this timely session, participants will hear the real stories behind the news reports on these and other issues and questions, learn about what to look for as new court decisions are reported – and what not to worry about – and what to expect by 2014.
Bernard Tubiana, Principal, Financial Services Industry Practice – Insurance
Deloitte Consulting LLP
Health Care Reform will impact market participants beyond health plans
- Will reform accelerate the convergence of the group life & disability, voluntary and worksite markets?
- What changes to product portfolios will be introduced? When? And by whom?
- How will the broker community evolve in response to reform?
- Who will become the source of information for employers and employees?
- What brands will dominate and who will own employee relationships?
Who Should Attend:
- Insurance Carriers
- Health Insurance Companies
- Health Services Professionals
- Health Industry Advisors
- Health Care Law Attorneys
- Senior Corporate Management
- Health Care Advisory Services Consultants
- Health Policy Directors
- State Health Executives/Professionals
- Healthcare Finance People
Jane L. Cline was appointed West Virginia Insurance Commissioner January 15, 2001. In addition to her responsibilities as Insurance Commissioner, Ms. Cline is a member of the National Association of Insurance Commissioners (NAIC), and serves as the organization’s Immediate Past-President. Ms. Cline is a member of the NAIC’s Executive Committee, the Internal Administration Sub-Committee and various other NAIC Committees. Ms. Cline served on the Management Committee of the Interstate Insurance Product Regulation Commission ad also serves on the Executive Committee of the International Association of Insurance Supervisors.
Ms. Cline is responsible for the regulation of the insurance market for the protection of insurance consumers. Commissioner Cline was responsible for the transition of the West Virginia Workers’ Compensation Commission from a state monopolistic system to a competitive system. Commissioner Cline’s workers’ compensation responsibilities include administration of the “Legacy” workers’ compensation claims and employer compliance with West Virginia Workers’ Compensation laws, including the appeals process.
Before her appointment as Insurance Commissioner, Ms. Cline operated a government consulting firm, Jane L. Cline & Associates.
Commissioner Cline served as Commissioner of the West Virginia Division of Motor Vehicles (DMV) from November 1989 to October 1997 where her focus was on making the Division’s services more accessible to all citizens of West Virginia. Prior to her appointment as DMV Commissioner, Ms. Cline served as Deputy Commissioner for the West Virginia Division of Highways. While she was DMV Commissioner she served on a number of leadership positions with the American Association of Motor Vehicle Administrators.
Ms. Cline earned a Bachelor of Science Degree from West Virginia University, and holds a Masters of Business Administration Degree.
Jane L. Cline was appointed West Virginia Insurance Commissioner January 15, 2001. In addition to her responsibilities as Insurance Commissioner, …
Jim O’Connell is Executive Consultant, Ceridian Corporation. With over thirty years experience in federal legislative and regulatory affairs, Jim focuses on HR and payroll policy issues, keeping customers informed about fast-changing and complex compliance regulations and workforce trends.
Jim is a frequent participant in HR and payroll industry meetings, including the American Payroll Association and the Society for Human Resources Management (SHRM). His publications include Health Savings Accounts: American Idol? in the November 2007 issue of Benefits & Compensation Digest’s Web Exclusives.
Jim is an Adjunct Professor at Georgetown University in Washington DC, specializing in International Business-Government Relations. He is a member of the American Payroll Association and the Society for Human Resource Management.
Before coming to Ceridian, Jim served in the U.S. Senate as chief legislative assistant to New York Senator Jacob K. Javits, who was a senior member of the Committee on Labor & Human Resources, and later with Connecticut Senator Lowell P. Weicker. Jim holds a Ph.D. in economics from New York’s Fordham University.
Jim O’Connell is Executive Consultant, Ceridian Corporation. With over thirty years experience in federal legislative and regulatory affairs, Jim focuses …
Marcia Augsburger is a partner in the litigation practice of DLA Piper. Her practice includes a broad range of civil litigation matters in both state and federal trial and appellate courts, as well as transactional work and counseling in healthcare law affecting providers, health plans, insurers, products manufacturers, pharmacies, ancillary providers, new ventures, third party administrators, agents, brokers, other fiduciaries and employers
More than 21 years of litigation experience in complex business disputes and class actions informs Ms. Augsburger’s work counseling clients and handling business transactions and complex negotiations, particularly in connection with new ventures and products in the health care industry, HIPAA and other privacy and security laws, the Patient Protection and Affordable Care Act of 2010 (“Health Care Reform”), evidence-based medicine, coverage and reimbursement issues, fiduciary duties, joint venture arrangements and partnerships, corporate practice of medicine, general regulatory compliance and integrity as well as federal and state regulatory compliance and licensing of insurance companies and Knox Keene Health Plans, brokers and others, unfair business and competitive practices, concierge medicine, pay-for-performance, billing and pricing, Medicare compliance and CMS initiatives and employee healthcare benefits, such as HSAs and wellness programs. Ms. Augsburger’s litigation matters include products and professional liability cases, breach of contract, managed care disputes and other complex business litigation.
Marcia Augsburger is a partner in the litigation practice of DLA Piper. Her practice includes a broad range of civil …
Bernard is a Principal in Deloitte Consulting’s Insurance Strategy and Operations practice leading the firm’s offering to the Group, Voluntary and Worksite sector. Bernard has worked with many senior management teams on developing their corporate, business unit, product and market strategies. He also advises clients on market trends, operational considerations, customer experience and their associated process, technology and people-related changes. In addition, Bernard has spearheaded Deloitte Consulting’s work applying innovation and disruption theory concepts to Financial Services firms. Bernard co-hosts a semi-annual forum for Group Benefit carrier presidents and is the lead sponsor for the industry’s leading expense benchmarking study. Bernard holds a Bachelor of Science degree in Marketing from NYU’s Stern School of Business and an MBA from INSEAD. In 2001, he received an Emerson Professional Services Monitor Thought Leadership Award. He is often quoted in insurance trade publications including A.M. Best and National Underwriter / Tech Decisions.
Bernard is a Principal in Deloitte Consulting’s Insurance Strategy and Operations practice leading the firm’s offering to the Group, Voluntary …
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West Virginia Office of the Insurance
Deloitte Consulting LLP