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LOMA Health Underwriting Study Group
May 14-16, 2008
The InterContinental Kansas City at the Plaza, Kansas City, MO

 

Quick Reference

Register Online Now!  OR Download Registration Form (pdf)

Program

Registration Information

Hotel Information

Exhibitor & Sponsorship Information

For More Information

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

About The Health Underwriting Study Group
This group was created as an information source for underwriters, actuaries and executives from health insurance companies. Health Underwriting Study Group is open to vice presidents of underwriting, underwriters, actuaries, claims and law department executives; and executives of companies offering individual and small group health insurance and related products.

Membership is complimentary with full conference registration fee.

Members of Health Underwriting Study Group receive:

  • Complimentary subscription to JournalScan; a bi-monthly newsletter that focuses on the risk management implications of new developments in clinical medicine, pathology, epidemiology and medical research.

  • Annual Individual Medical Survey

  • Annual Small Group Survey

  • The opportunity to network with risk management executives. Members receive a roster with complete contact information of all HUSG members (you may opt out of membership and not have your contact information shared).

Program

Tuesday, May 13, 2008 

5:30–7:30 P.M.
Hospitality Suite, Sponsored by Heritage Labs

Wednesday, May 14, 2008 

7:30–8:30 A.M.
Registration and Continental Breakfast with Exhibitors


8:30 A.M.
Opening Remarks

Hank George, FALU, CLU, FLMI; Chair, LOMA Health Underwriting Study Group
Jim Huffman, FLMA, ACS, Assistant Vice President, Insurance Operations, LOMA

8:45–9:45 A.M.
Overview of Major Reform Proposals Related to Health Care
Robert Imes, Senior Policy Consultant, Blue Cross and Blue Shield Association

With growing voter concern about health care, Congress and this year's presidential candidates have responded with a wide range of health care reform proposals. Employer and individual mandates, new government-sponsored plans, market rule changes, and many more reform ideas are being discussed. It is not just tax credit and deduction proposals this year, and sometimes it is surprising to see who is supporting what. This session will provide an overview of the major reform proposals and the outlook for the future.

Robert Imes is a Senior Manager for Public Policy with the Blue Cross Blue Shield Association (BCBSA). He focuses on issues relating to federal and state insurance market regulation, antitrust, uninsured, medical research, and prevention and wellness. Previously, Imes was an associate at Groom Law Group where he counseled insurers and employers concerning ERISA, COBRA, insurance laws, tax law, and legislative issues. Prior to that, Imes researched private health insurance market issues at Georgetown University's Health Policy Institute. Imes holds a J.D. cum laude from Georgetown and a B.A. from the Ohio State University. 

9:45–10:15 A.M.
Refreshment Break with Exhibitors


10:15–11:15 A.M.
Everything You Must Know About Lab Testing

Betsy R. Sears, MSM, MT (ASCP), Executive Vice President, ExamOne

There have been many advances in insurance laboratory testing. Health underwriters see routine lab reports on most cases where they get medical records. This lecture will make key tests and their risk implications crystal clear and provide attendees with new perspectives on the role of testing in 21st century health underwriting.

Sears is EVP – Sales Support/Client Solutions at ExamOne and has over 21 years of experience in the insurance laboratory environment. She works closely with ExamOne's laboratory operations and medical staff on customer issues and supports insurance customers through a variety of presentations on laboratory, medical and risk assessment topics. Her duties also include managing some of the International sales initiatives and overseeing Insurance Client Solutions in the U.S. and Canada.

11:15–11:30 A.M.
Morning wrap up/Questions


11:30–11:45 A.M.
Morning wrap up/Questions and a few minutes from our sponsor


11:45 A.M.–1:00 P.M.
Lunch with Exhibitors

Sponsored by RSA Medical

1:00–4:30 P.M.
Interactive Sessions
2:45–3:00 P.M.
Refreshment Break with Exhibitors

Sponsored by MRS, Inc.

Individual Medical Underwriting

Individual Medical Underwriting sessions will address

  • First premium handling

  • Distribution channel issues

  • HIPAA

  • Application for insurance options

  • Electronic application challenges

  • Expert underwriting systems

  • Imaging in underwriting systems

  • Underwriting technology support

  • Telephone interviews

  • Underwriting contact with the applicant/agent

  • Telecommuting

  • Quality assurance/auditing

  • Underwriting metrics

Small Group Underwriting

Topics to be addressed in the Small Group Underwriting interactive session include:

  • Quotes vs. placements

  • Eligibility issues

  • Applications/health statements

  • Waiver of Health statements

  • "New" groups (no previous carrier)

  • Electronic enrollment

  • Distribution channel issues

  • Underwriting systems

  • Underwriting manual/rating engine

  • Expert underwriting systems

  • Technology support

  • Quality assurance/auditing

  • Telephone interviews

  • Role of the underwriting in decision-making

  • New business metrics

  • Process variation for risk assessment

  • Predictive modeling

  • Impact of negative publicity

5:00–6:30 P.M.
Reception

Sponsored by Milliman IntelliScript

Thursday, May 15, 2008

7:30–8:30 A.M.
Breakfast with Exhibitors
Sponsored by Ingenix

8:15–9:15 A.M.
Health Insurance Regulatory Landscape: The View From The NAIC

John Englehardt, FSA, MAAA, CLU, ChFC, Life & Health Actuary, Research Division, NAIC

The role of the National Association of Insurance Commissioners is to assist state insurance regulators in serving public interest and achieve fundamental insurance regulatory goals in a responsive, efficient and cost effective manner. Englehardt will provide insight into current initiatives effecting the development and delivery of health insurance in the United States.

As a Life and Health Actuary for the NAIC, Englehardt supports the Accident and Health Working Group of the Life and Health Actuarial Task Force. Prior to joining the NAIC, he was the Life and Health Actuary with the Alabama Department of Insurance, served as vice president and actuary of several life insurance companies, and was a consulting actuary specializing in product development and reserve valuations.

9:15–9:45 A.M.
Refreshment Break with Exhibitors


9:45–10:45 A.M.
Underwriting and Pricing Mental Health Benefits - Facts vs. Fiction

Stephen P. Melek, Principal & Consulting Actuary, Milliman

The real costs of providing insured mental healthcare benefits is often misunderstood. Some believe that mental health parity will cost a fortune and have fought against it for years. Others believe that mental healthcare benefit costs start and stop with the behavioral carve-out. This session will explore the various sources of costs of providing mental health benefits, including those in specialty and primary care settings. We will also discuss the impact of co-morbid psychological disorders on members with chronic medical conditions. Lastly, it will include a pro-and-con discussion of mental health parity benefits.

Melek is a principal and consulting actuary with the Denver office of Milliman. His areas of expertise include healthcare product development, management, and financial analyses. He has advised HMOs, PPOs, managed care organizations, behavioral healthcare firms and associations, insurance companies, employers, hospitals, physician groups, PHOs, and state insurance companies, and has written and published extensively on behavioral healthcare.

10:45–11:30 A.M.
The Insurability Implications of Rx Compliance

Hank George, FALU, CLU, FLMI; Chair, LOMA Health Underwriting Study Group

How does insurance applicant compliance with prescription drugs affect their insurability? Hank just did an educational program on this subject and he will be presenting a cross-section of evidence showing that Rx compliance is one of the cornerstones of assessing morbidity risk based on studies published in the worldwide medical literature.

Hank George, FALU, CLU, FLMI is founder and chair of the Health Underwriting Study as well as President of HGI Inc., a firm that specializes in underwriting education and other resources for risk appraisal. Hank is a 35 year veteran of underwriting, having been with Northwestern Mutual, Manulife, Lincoln Re and ExamOne before starting his own business in 2003. He writes for The National Underwriter and Best’s Review as well as publishing two e-newsletters.

11:30–11:45 A.M.
Morning wrap up/Questions and a few minutes from the lunch sponsor


11:45–1:00 P.M.
Lunch

Sponsored by MIB Solutions, Inc.

1:00–4:30 P.M.
Interactive Discussions
2:45–3:00 P.M.
Refreshment Break with Exhibitors

Sponsored by Fiserv

Individual Medical Underwriting

Roundtable discussion of the following Individual Medical Underwriting philosophy issues:

  • Eligibility for coverage

  • Use of preferred pricing/preferred underwriting

  • The current buzz in changes in treatment of medical conditions

  • Underwriting requirements

  • Distribution channel risk quality

  • Dietary supplement underwriting

  • Occupational underwriting for individuals

  • Laboratory trends/genetics

  • Prescription drug underwriting

  • Rating/ridering/underwriting-by-deductible

  • Pre-ex/misrep investigations

  • Renewal underwriting

  • Claims feedback/partnering

  • "Post issue" underwriting

  • Ancillary product underwriting

Small Group Underwriting

Small Group Underwriting discussion will address:

  • Participation/eligibility on in-force groups

  • Renewal process

  • Renewal systems

  • Renewal pricing

  • Predictive modeling

  • "Post issue" underwriting

  • Special issues relating to mid-size groups

  • Renewal metrics


Friday, May 16, 2008


7:30–8:30 A.M.
Continental Breakfast


8:30–11:30 A.M.
Interactive Sessions


This morning is devoted to interactive discussion of issues, situations and case studies submitted by the attendees:

  • Individual Health Underwriting

  • Small Group Underwriting

9:45–10:00 A.M.
Networking Refreshment Break


11:30 A.M.
Meeting Adjourned


Registration 
Register Online Now! OR Download Registration Form (pdf)

Register before April 18, 2008
Member: $645
Register after April 18, 2008
Member: $725

Refund Policy
All cancellations and refund requests must be received in writing. These requests carry a $75 U.S. administrative charge. Full refunds minus the administrative fee will be granted on written requests received no later than 3 business days before the meeting start date. No refunds will be granted if the request is received within 3 business days of the meeting. If for any reason a meeting is cancelled, LOMA will refund the total registration fee. However, LOMA will not be responsible for any travel, hotel accommodations or other costs incurred.

Hotel Information

The InterContinental Kansas City at the Plaza
401 Ward Parkway
Kansas City, Missouri 64112
Phone: 816-756-1500
Fax: 816-756-1635 
Reservations: 866.856.9717

Instructions for Room Reservations: Click on the following link
www.kansascityic.com


1. Click on “reservations” in the middle towards the top of the page.

2. Enter arrival and departure dates.

3. Click on “+” Corporate, Group & IATA.

4. Your 3 letter “group booking code” is 
LOM

Room rate: $169 single or double, plus 15.23% tax plus Arena Fee & Tax of $1.74. The group rate will be honored as early as May 10 and as late as May 18 based upon availability. Cut-off date: April 18, 2008. Check-in: 3:00 p.m., Check-out: 12:00 p.m.

  

Thank You to Our 2008 Exhibitors and Sponsors!

Clinical Reference Laboratory is a leading provider of laboratory testing for the life and health industry and recognized as the industry leader for providing new testing technology. We are committed to providing our clients with innovation in IT services, unparalleled personalize service, better risk selection tools and overnight processing of samples – all focused on providing a competitive advantage to our clients.

 

Colibrium Partners is a new breed of consulting partner offering strategic, business and IT solutions and consulting to the insurance industry. Colibrium Partners leverages Benchmark Requirements, a Benchmark Application and a BPM Insurance Framework to provide sales and service automation solutions. This approach maximizes the value provided by utilizing ROI based Benchmark Requirements as the starting point, a Benchmark Application to ensure user effectiveness and adoption and BPM to implement complex business rules rapidly while enabling the business to own and maintain the solution.

ExamOne, a Quest Diagnostics Subsidiary, is the nation’s leading provider of risk assessment information for the life insurance industry. Our integrated supply chain includes paramedical examinations, laboratory testing, attending physician statements, teleunderwriting and inspections. This integration simplifies the order, status and retrieval of these products, provides one source for all underwriting requirements and accelerates the policy application-to-issue cycle.

 

 

Fiserv is teaming up with hundreds of insurance carriers to align technology with business needs for every insurance process. Our life and health underwriting solution delivers powerful rules-based decisioning and case management. You can make smart decisions in a fraction of the time it takes today.

 

Hank George Inc. (HGI) offers the only independent underwriting education programs in North America for life, health, disability, critical illness and long term care underwriters. We also provide an online pharmaceutical guide with essential information underwriters need to assess the significance of medications used by insurance applicants. As a driving force in teleunderwriting, Hank George, Inc. offers a broad range of services to insurers embracing this revolutionary approach to risk appraisal, worldwide.

 

Heritage Labs provides laboratory testing services for the insurance and financial services industries. As the value provider, we were the first to offer BMI, eGFR and Cotinine Confirmations at no additional cost. As the innovation leader, we’ve long been one of the most automated labs in the country. Heritage Labs is also an FDA-registered manufacturer of medical devices and customized specimen collection kits.

 

 

Ingenix offers a full range of solutions designed to facilitate and streamline the day-to-day workflow. Combined with its Reden & Anders subsidiary - a leading actuarial and underwriting consulting firm - Ingenix provides integrated products, strategic consulting and change management services designed to automate standard processes that reduce costs while driving profitable growth. The company's advanced technologies provide compelling new ways for health plans to generate new business with faster, more accurate quotes, and protect renewal business. More information about Ingenix can be obtained at http://www.ingenix.com.

 

MIB Solutions, Inc. 
Undisclosed health conditions on an application can cost your company millions in early, unforeseen claims. MIB's Checking Service increases underwriting effectiveness by giving you more complete information to ascertain the risk. Stay competitive, maximize profit, and minimize risk by putting North America’s largest database of medical conditions on insurance applicants to work. Visit with us at the expo to learn more about the MIB advantage.

Milliman IntelliScript® delivers detailed prescription histories to underwriters' desktops. IntelliScript prescription histories are:
  • authorized in advance by the applicant
  • delivered online via the Internet within seconds
  • designed to uncover critical medical information

IntelliScript is quickly becoming a standard tool to enhance medical underwriting. If you're considering prescription histories, please contact us.

 

MRS has over 20 years of experience in providing quality risk assessment and claims investigation information to the life and health insurance industry. Tools include TeleInterviews, TeleUnderwriting, APS retrieval and more. Recently, MRS began offering SAS platforms to manage and automate new business and application flow.

 

 

Realtime Solutions Group provides Realtime STP™ software solutions that can help individual health insurers streamline their new business process. From a robust eApplication with eSignatures to a more efficient rules-based underwriting process, Realtime can help you reduce time to issue and create immediate and sustainable competitive advantage in your sales channels.

 

Risk Concepts LLC provides the most comprehensive underwriting manual available for individual health lines. The Risk Concepts Individual Medical manual was developed by underwriters, for underwriters. The manual includes suggested rating and surcharge actions for thousands of medical conditions. Underwriting actions are protective, yet designed for maximum rates of issue.

 

At RSA Medical, to strive for exceptional service and to exceed your expectations daily is both a corporate mission and a shared personal belief. We feel a brand is the sum of your experiences with a product or service—the intangible impression you’re left with, created over time. Brands are serious business, and RSA Medical takes its brands as seriously as money in the bank. We protect the value of our brands by delivering superior quality to our customers—every time. We hope this meeting will serve as a window through which you can see into, and better understand, the brand that is RSA Medical.

 

For information about Exhibitor and Sponsorship Opportunities, click here.

For More Information
Call 770-984-6446
Fax 770-984-6418
E-mail insops@loma.org

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