Emerging Trends in Private Health Insurance Exchanges (PHIX) Explored in 2015!
Health insurance exchanges are central to the Patient Protection and Affordable Care Act. Some states have established such exchanges. But, increasingly, Private Health Insurance Exchanges (PHIXs) also are being formed. A PHIX provides a competitive, private health insurance marketplace for individuals and employers. A PHIX is a private business operated by brokers, insurers, 'benefit technology companies', and consultants selling health insurance. These range from regional to national private entities.
In a two-hour LIVE Webcast, a notable panel of experts and professionals assembled by The Knowledge Group will provide the audience with an overview of PHIXs, discusses how they differ from the public exchanges or marketplaces, and explain the five primary models emerging nationally. The speakers also will discuss how interested employers are in such exchanges and what services are chosen.
Key topics include:
- Private Health Insurance Exchange (PHIX) - An Overview
- Public vs. Private Exchanges
- Primary PHIX Models
- Cost Reduction or Increase?
- Private Health Insurance Exchange Models
- Regional Business Association Exchanges
- Regional Insurer Exchanges
- National Broker, Employer, and Individual Exchanges
- Regulation and Enforcement
- Trends in 2015 and Beyond
Samuel C. Gibbs, III, Executive Director
- Government Marketplaces and Obamacare
- Rising Costs of Obamacare
- Private Marketplace Alternative
Adam Beck, Esq., Director, MassMutual Center for Special Needs, Assistant Professor of Health Insurance
The American College
- The impact of private health insurance exchanges on workers’ individual responsibility and choice
- The role of HR and the health broker in private exchange markets
- Do private health exchanges improve quality and lower cost?
- How does the growing strength of private health exchanges impact the future of other employee benefits?
Kimberly J. Donovan, Partner
Squire Patton Boggs (US) LLP
Narrow network challenges facing private health insurance products available through PHIXs
- The use of narrow networks among private health insurance products
- Do health insurance products offered on PHIXs rely on narrow networks, and how do they compare to the narrow networks found in insurance products offered through the state and federally-facilitated exchanges?
- Non-participating litigation trends among private health insurance products
- Are private health insurance products experiencing an uptick in non-participating litigation due to narrow networks?
- State and federal regulatory response to narrow networks used in private health insurance products
- What are state and federal regulatory authorities doing to address the narrow network issues as applied to private health insurance products?
Who Should Attend:
- Health Care Law Attorneys
- Health Insurance Attorneys
- Health Industry Advisors
- Medical Directors
- Health Insurance Companies
- Health Services Professionals
- Medical Providers
Professor Adam Beck joined The American College in August 2013 and has since been the program champion for the Chartered Healthcare Consultant(r) (ChHC(r)) designation. He is also the director of the MassMutual Center for Special Needs. He has consulted with major insurance companies and industry associations on the implications of the Affordable Care Act, and advocated for small business brokers before the U.S. House of Representatives. He is an attorney who most recently practiced law in Philadelphia and has worked for Sellers Dorsey, a national healthcare consulting firm. Previously, he was active in public policy as a staffer on two presidential campaigns and an aide to the governor of Louisiana. Beck has long been active in the disability rights community, including time at the Disability Rights Section of the Civil Rights Division, U.S. Department of Justice, where he was responsible for investigating violations of the Americans with Disabilities Act in public accommodations. During law school, he was a legal intern with the Office for Civil Rights at the U.S. Department of Education, where he handled claims dealing with violations of Title VI of the Civil Rights Act of 1964. Professor Beck received a bachelor's degree in political science from The George Washington University and a juris doctorate from Temple University's Beasley School of Law, where he was a Rubin Public Interest Scholar.
Professor Adam Beck joined The American College in August 2013 and has since been the program champion for the Chartered …
Sam Gibbs is an acknowledged expert on healthcare public policy and the implementation of the Affordable Care Act and is a featured speaker at the annual World Health Care Congress and the National Health Insurance Exchange Summit. He also frequently appears on national news outlets including Fox News, NBC, ABC, CBS, Bloomberg, The Wall Street Journal and Reuters. He currently is the Executive Director for AgileHealthInsurance.com focusing on consumer engagement and public affairs. Mr. Gibbs was formally the president of government systems at eHealth, Inc. (NASDAQ: EHTH) responsible for new technology solutions for public and private health insurance exchanges. He founded and was president/CEO of AVCOM, Inc. a $100 million nationwide CAD and systems integration concern. He has held engineering positions at Northrop Grumman (TRW Space Systems) and Beechcraft Corporation. Mr. Gibbs holds a BS degree in aeronautical technology from Arizona State University and a Master’s degree with a concentration in public affairs from the University of North Carolina at Asheville. He is on the Board of Directors at Verner Center for Early Learning in Asheville, NC.
Sam Gibbs is an acknowledged expert on healthcare public policy and the implementation of the Affordable Care Act and is …
Kimberly Donovan is Board Certified in Health Law by the Florida Bar. Kimberly’s extensive knowledge and understanding of complicated healthcare laws and issues provides her with a strategic advantage in representing healthcare clients in arbitrations and litigation in federal and state courts. Her experience litigating healthcare issues and understanding of the business of healthcare, as well as her pragmatic style, makes her a trusted client advisor on a variety of issues, including resolving disputes prior to litigation, policies, procedures and best business practices, and litigation risk assessments. She helps clients develop strategic business goals early in the representation and strives to efficiently achieve clients’ goals. Kimberly advises clients on federal and state privacy laws to ensure that proper safeguards are implemented to protect this information. She also advises clients on many important issues affecting the healthcare industry, including federal preemption, Medicare programs, Medicare Advantage plans, provider contracts, Medicaid programs, state and federal prompt pay laws, federal and state anti-kickback laws, telemedicine, reimbursement rates, overpayments, patient notifications, peer review privilege, point of service payments, and federal and state “any willing provider” laws. Kimberly is noted among a select group of lawyers recognized by the Martindale-Hubbell Peer Review Rating for legal ability and professional ethical standards. She has recently been named a Rising Star by the Daily Business Review and recognized in the Florida Super Lawyers-Rising Stars 2015.
Kimberly Donovan is Board Certified in Health Law by the Florida Bar. Kimberly’s extensive knowledge and understanding of complicated healthcare …
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Method of Presentation:
NASBA Field of Study:
Specialized Knowledge and Applications
NY Category of CLE Credit:
Areas of Professional Practice
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The American College
About The American College
AgileHealthInsurance®, is committed to providing consumers with affordable solutions to their health insurance needs. Many consumers are not completely satisfied with the government marketplace plans sold on HealthCare.gov or state exchanges (“Obamacare plans”). We offer less expensive alternatives to Obamacare plans and our plans allow consumers to choose from a broad range of deductibles and out-of-pocket payments, so they can find the health plan that best fits their personal budget. - See more at: About Us - AgileHealthInsurance.com - Your Source for Affordable Short Term and Supplemental Health Insurance
About Squire Patton Boggs (US) LLP
Squire Patton Boggs is a full service global law firm with a keen focus on the healthcare industry. The firm provides insight at the point where law, business and government meet, giving their clients a voice, supporting their ambitions and achieving successful outcomes. Squire Patton Boggs’ multidisciplinary team of more than 1,500 lawyers in 44 offices across 21 countries offers unrivalled access to expertise and invaluable connections on the ground. It’s a seamless service that operates on any scale – locally or globally, encompassing virtually every matter, jurisdiction and market, and placing their clients at the center.
Squire Patton Boggs client base spans every type of business, both private and public, worldwide. They combine sound legal counsel with a deep knowledge of their clients’ businesses to resolve their legal challenges. Whatever is needed, they are able to deliver the cross-practice, cross-border and industry-specific support that clients require for success in today’s competitive markets.