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LOMA Health Underwriting
Study Group
April 29 - May 1, 2009
Rosen Plaza Hotel, Orlando, Florida
Thank
you for your interest in the 2009 Health Underwriting Study Group (HUSG). Online
registration has closed; however, we welcome you to register on-site beginning
at 7:30 a.m. on Wednesday, April 29 at the Registration Desk outside Ballroom
C/D. We look forward to seeing you in Orlando and thank you for your
participation in this year’s HUSG!
Quick
Reference
Download
the Registration Form (PDF)
Registration
Information
List
of Last Year's Attendees and Companies
Hotel Information
Exhibitor
and 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
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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).
2009
Meeting Program
Wednesday,
April 29, 2009
7:30–8:15
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, Second Vice President, Management Solutions, LOMA
8:45–9:30
A.M.
Obesity, Hypertension and Metabolic Syndrome:
What Health Underwriters Must Know
Hank George, President Hank George, Inc.
This session will examine the various clinical presentations
of:
- Body
weight and blood pressure/hypertension
- Review
and critically evaluate key aspects of the so-called "metabolic
syndrome" as well as certain conditions associated with this
ostensible syndrome
The
focus will be on aspects significant to health underwriting
9:30–10:30
A.M.
Impact
of Smoking and Height/Weight on Medical Claim Costs
Mary van der Heijde, FSA, MAAA,
Consulting Actuary, Milliman
This session presents recently published research about the impact that smoking,
height, and weight actually have on the expected claims costs for members, which
will likely change the way many of us have thought about how to underwrite for
these factors. This research concludes that:
- Within
the context of underwriting, height and weight are much more powerful
predictors of cost than is smoking
- Body
Mass Index (BMI), the popular measure of height/weight, is not the most
accurate way to predict healthcare costs.
10:30–11:00
A.M.
Networking and Refreshment Break with
Exhibitors
11:00–Noon
Practical
Advice for Dealing with Consumer Misrepresentation of Health History
Brad Seiling, JD, Partner, Manatt, Phelps and Phillips LLC
Health
insurance is a carrier’s promise to finance some portion of an insured’s
future cost of health care. This
promise is predicated on a consumer’s truthful disclosure of health history.
- What can
carriers do to prompt full disclosure?
- How do
carriers partner with regulatory agencies around material misrepresentation?
- In those cases where litigation occurs, what factors are key to the outcome?
Morning
wrap up, questions, and a few minutes from our sponsor
Noon–1:15
Lunch
Sponsored
by RSA Medical
| 1:15–4:30
P.M.
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2:45–3:00
P.M.
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Interactive Sessions:
Individual Medical Underwriting
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Refreshment Break with Exhibitors
Sponsored by
Stone
River |
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
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- Underwriting
technology support
- Telephone
interviews
- Underwriting
contact with the applicant/agent
- Telecommuting
- Quality
assurance/auditing
- Underwriting
metrics
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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
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- Underwriting
manual/rating engine
- Expert
underwriting systems
- Technology
support
- Quality
assurance/auditing
- Telephone
interviews
- Role
of the underwriting in decision-making
- New
business metrics
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5:00–6:30
P.M.
Reception
with Exhibitors
Sponsored by MIB
Solutions
Thursday,
April 30, 2009
7:30–8:30
A.M.
Breakfast with Exhibitors
Sponsored by MRS
8:30–9:30
A.M.
HSAs
and Your Company
Beverly Gossage, HSA/HRA Specialist, Director and Founder, HSA Benefits
Consulting
An
HSA is a tax-free account that consumers can use to cover health care expenses
if they have a Qualified High Deductible Health Plan – QHDHP. This
session will provide insight and knowledge into:
- How
these accounts and/or their accompanying qualified health plans can affect
their clients and their book of business.
- Determining
if an HSA and QHDHP can work for them and their policyholders.
- Practical
information to answer policyholder questions and be a resource to their
brokers and agents.
9:30–10:30
A.M.
Using Prescription Histories in Underwriting
Mark
Franzen, FSA, Ph.D., Managing Director, Milliman IntelliScript
Prescription histories have become a proven underwriting tool for Health and
Life insurers. This session will look at some of the creative ways
insurers have been using Rx histories for the past few years – and the results
they are seeing. In addition, we'll briefly review the results of an
Rx-based mortality study that RGA recently completed.
10:30–11:00
A.M.
Networking and Refreshment Break with
Exhibitors
11:00–Noon
Is
Change Coming? The Health Reform Outlook
Linda
J. Blumberg, Ph.D., Senior
Fellow, The Urban Institute Health Policy Center
Wondering
what types of health care reforms are being discussed at the federal level?
The changes being contemplated would undoubtedly have significant impacts on the
business of insurance.
- Learn
about the policy options being considered by Congress and the White House.
- Hear
about the status of the comprehensive reforms implemented in Massachusetts,
a possible model for national reform.
- Gain
an understanding of the possible barriers to change.
Noon–1:15
P.M.
Lunch
Sponsored by Milliman IntelliScript
| 1:15–4:30
P.M. |
2:45–3:00
P.M.
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Interactive Sessions:
Individual Medical Underwriting
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Refreshment Break with Exhibitors
Sponsored
by
Ingenix |
1:15–4:30 P.M.
Interactive Discussions
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
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- Laboratory
trends/genetics
- Prescription
drug underwriting
- Rating/ridering/underwriting-by-deductible
- Pre-ex/misrepresentation
investigations
- Renewal
underwriting
- Claims
feedback/partnering
- “Post
issue” underwriting
- Ancillary
product underwriting
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Small
Group Underwriting
Small
Group Underwriting discussion will address:
- Participation/eligibility
on in-force groups
- Renewal
process
- Renewal
systems
- Renewal
pricing
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- Predictive
modeling
- “Post
issue” underwriting
- Special
issues relating to mid-size groups
- Renewal
metrics
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Friday,
May 1, 2009
7:30–8:30
A.M.
Continental
Breakfast with Exhibitors
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9:45–10:00 A.M.
Networking
Refreshment Break
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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
11:30
A.M.
Meeting Adjourned
Registration
Register after April 1, 2008
Member: $775
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 three business days before the meeting start date. No refunds will be
granted if the request is received within three 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
Rosen Plaza Hotel
9700 International Drive
Orlando, Florida 32819
Reservations: 800.627.8258
To Reserve a Hotel Room:
Group Name: Health
Underwriting Study Group
Meeting: Tuesday, April 28, 2009–Friday, May 01, 2009
Group Access:
Group ID: 29590
Password: 1041013355
Mention LOMA to receive group rate.
Rosen Plaza Hotel is located on International Drive, adjacent to the Orange County Convention Center. This premier hotel is at the center of Orlando’s famous theme parks, only 15 minutes from downtown Orlando, across the street from Pointe Orlando shopping, dining and entertainment complex, and only 15 minutes from Orlando International Airport.
Room rate: $169 single or double plus 12.5% tax. Rate is available April 24-May 4, 2009
based on availability.
Cut-off date: April 1, 2009. Check-in: 3:00 p.m.,
Check-out: 12:00 p.m.
For information about Exhibitor
and Sponsorship Opportunities, click here.
Thank
you to our Exhibitors and Sponsors
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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. www.crlcorp.com
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At Colibrium
Partners our mission is to create unparalleled value-added services and
solutions for our clients through a comprehensive, balanced approach to
business and technology innovation. Our objective is to provide our clients
with products, services and solutions that ultimately reduce total cost of
ownership, minimize exposure to risk, improve quality of service, and
increase speed to market.
www.colibriumpartners.com
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ExamOne,
a Quest Diagnostics company, 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. www.examone.com
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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 on-line 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.
www.hankgeorgeinc.com
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Medical
Health Review Professional Services, LLC. (MHR) is a world class Independent
Review Organization, which specializes in evidenced-based third party
reviews. MHR’s Independent Peer Review (IPR) group concentrates on post
issue actions, specifically pre-existing condition claims review and
contract or policy rescission. MHR provides truly independent
professional Peer Review Services and Board Certified Clinical Reviews to
clients in the health insurance industry, including small group and
individual health insurers, BCBS plans, third party administrators and
managed care plans.
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Sponsor of Reception
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MIB
Solutions, Inc.
Undisclosed
medical conditions on an application can cost your company millions in
unforeseen early 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 (www.mibsolutions.com/health).
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Sponsor of Thursday's
Refreshment Break
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Ingenix
unites the brightest minds to transform organizations and improve health
care through information and technology. We employ more than 8,000
professionals worldwide, including consultants, medical doctors, nurses,
actuaries, biostatisticians, certified coders, epidemiologists, economists,
engineers and software developers. We believe information is
the lifeblood of health care. Applied at the right time and at the right
place, when decisions need to be made, information can enhance the
affordability, quality, usability and accessibility of care. For more
information about Ingenix and its products and services, please visit www.ingenix.com
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Sponsor of
Thursday's Lunch
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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
has
become widely accepted as a catalyst for fast and effective medical
underwriting. If you're considering prescription histories, please contact
us.
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Medwise
Partners, Inc. is the answer to your Underwriting needs. We
were founded in 1996, providing you with:
- Outsourced Medical,
and Small and Large Group Underwriting Services
- Interim
Health Plan Management (CFO, COO, Chief Underwriter)
- Healthcare Operation
Process Improvements, Redesign, and Automation
- Financial Consulting
and Plan Turnarounds
- Customized
Underwriting Training
www.medwisepartners.com
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Sponsor of
Thursday's Breakfast |
Underwriting
Services, including
- APS
Retrieval
- APS
Summaries
- mRx
Profiles
- Tele-Interviews
- Tele-Underwriting
- Outsourced
Underwriting
Scalable
and modular workflow management platform
- New
Business Acquisition
- Underwriting
Case Management
- Systems
Integration
- Web-based
SaaS (Software as a Service) delivery
www.mrswi.com |
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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. http://riskconcepts.net/
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Risk-Consulting
and several leading health insurers have joined forces to develop the
world's deepest database of application and claims data. Insurers use this
database to predict future claims costs and calculate the appropriate risk
loading for every applicant. The AktuarMed® system delivers instant risk
assessment and comprehensive documentation. www.risk-consulting.de
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Sponsor of
Wednesday's Lunch
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How
will your business differentiate itself in a world that’s becoming
increasingly commoditized? In a world that’s becoming increasingly
automated, how will you continue to show your clients that you’re
hands-on and you care?
It’s
critical that we look at the world with fresh eyes and are willing to
learn new things, new business practices. It’s critical that we take
nothing for granted. That we assume nothing. That we question everything.
RSA
Medical…Bringing the Medicine back to the concept of assessing Risk. |
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Sponsor of
Wednesday's Refreshment Break
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Hundreds
of insurers, thousands of agents and brokers, and tens of thousands of
pharmacies rely on StoneRiver software and processing solutions to achieve a
competitive edge. StoneRiver promotes client success by streamlining complex
business processes. StoneRiver was formerly Fiserv Insurance Solutions.
Visit www.stoneriver.com for more
information.
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Superior
Mobile Medics was founded in 1995. On a national level, we coordinate all
aspects of the paramedical exam from our one office in San Diego, CA. We
go above and beyond to cater our services to meet the needs of our
customers. Our success is driven by a company-wide attitude of total
customer satisfaction and a promise to provide industry-leading services.
We specialize in servicing the brokerage market on a national level. www.superiormobilemedics.com
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For
More Information
Call 770-984-6446
Fax 770-984-6418
E-mail insops@loma.org
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