Conference Program

SPONSORED BY: HHC Group

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With a huge election day just six weeks after the SIIA conference, we will take this opportunity to preview what the results could be like with a presentation by one of the country's top political pollsters.
 

SPONSORED BY: HPC

This session will feature a panel of leading reinsurance executives participating in a discussion that is expected to cover major market trends affecting buyers of reinsurance, including primary underwriting companies, captives, MEWAs, and provider groups.

SPONSORED BY: Ochsner Health

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A majority of employees report challenges accessing mental healthcare, with barriers ranging from a lack of insurance coverage, difficulty determining covered services, not knowing which resources are available, difficulty finding providers, and long wait times to get appointments. Studies show that six out of 10 adults who say their mental health is only fair or poor have not been able to access services. SIIA's expert panelists have solutions to overcome the obstacles – from innovative education and communications strategies to introducing virtual mental health providers, creative ways to make the most of benefits that you have, arranging on-site mental health services at a reduced cost and a growing movement to hold partners accountable for expanding access. As substantial shortages of behavioral health professionals grow -- addiction counselors, marriage and family therapists, mental health counselors, psychologists, and psychiatrists are projected – this presentation will support self-insured employers with strategies to answer the urgent call for access to care.

As more pricing data becomes publicly available through various Federal and State initiatives, how is that data being used to help lower healthcare spending? Pricing information is also being used in provider contract negotiations. Are plan sponsors able to use the pricing data to negotiate a better deal on In-Network rates? This panel will discuss current and potential actions self-insured plans can take to most effectively put pricing data to work.

Anxiety. Depression. PTSD. Substance Use Disorders. Burnout. Remote Work Challenges. Health Equity. Economic and Political Uncertainties. The list of mental health challenges facing employers goes on and on, underscoring the need for a plan design and benefits delivery system that meets the behavioral health needs of employees while focusing heavily on ensuring quality, access and affordability, improving outcomes, lowering costs and prioritizing preventive care. Self-insured stakeholders will get real-world answers from industry experts who will provide benchmarks for choosing provider networks, designing plans, evaluating the service offerings of treatment centers or facilities, assessing the value and associated costs of various clinicians or professionals and understanding the benefits of including certain programs – or the consequences of omission.

The Department of Labor continues to ramp up its Mental Health Parity compliance audits, while self-insured plan sponsors – along with their third-party service providers – continue to struggle with developing their plans' NQTL analyses. Adding to the burden, the Biden Administration issued regulations that would require self-insured plans to collect specified data and undertake a detailed evaluation to assess the impact of NQTLs applicable to mental health benefits as compared to medical benefits covered under the plan. This panel will discuss the latest on Mental Health Parity compliance, how to navigate a Mental Health Parity audit, and what plan sponsors and their service providers should expect from the Biden Administration's regulations.

Self-insured plan sponsors have a fiduciary duty to keep health plan costs low, but plan sponsors cannot meet this obligation if they cannot access a complete and accurate set of claims data. The enactment of the Gag Clause Prohibition, along with ongoing regulatory efforts to increase the disclosure of pricing information, was intended to help plan sponsors get the claims and pricing data that they need. But roadblocks remain. This panel will explore ongoing litigation to access claims data, and panelists will discuss legislative and regulatory efforts to increase data accessibility.

SPONSORED BY: 4L Data Intelligence

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AI currently plays a role in claims administration, claims analysis, and health plan design, and this role is expected to increase in the future, but this marketplace evolution is raising important legal/compliance questions. In particular, self-insured employers need to know whether AI mitigates or exposes plans to litigation risks. For example, is AI-assisted claims administration consistent with ERISA's fiduciary duties? Does AI help or hinder compliance with the agencies' NQTL rules for mental health and substance use benefits? Can AI review plan designs and identify possible compliance issues? And if AI is utilized, do the plan documents need to reflect that? These questions and more will be addressed by one of the country’s top legal experts specializing in self-insured group health plans.
 

In this new era of artificial intelligence, machine learning will increasingly be integrated with analytics capabilities and underwriting expertise to more effectively stratify and mitigate medical financial risk affecting self-insured group health plans. This session will feature a multidisciplinary panel of leading industry experts who will discuss how this integrated approach is being employed today and preview how it may evolve in the coming years.

Utilizing captive arrangements to provide stop-loss coverage for self-insured plans continues to grow. Regardless of whether the captive is structured with multiple cells owned by the respective plan sponsors or whether a group captive is fronted by a licensed stop-loss carrier ceding the risk to the captive as reinsurer, there are many factors that must be evaluated, ranging from premiums ratios and risk tolerance to the number of lives covered and cost-containment programs. This panel will offer perspectives on evaluating various captive programs and financing structures.

Diabetes-related care continues to be a major cost driver for many self-insured group health plans, but it doesn't have to be that way. The good news is that diabetes can be effectively managed if affordable access is given to the maintenance resources those employees need. This session will feature a leading subject matter expert who will discuss this medical condition and provide several important takeaways, including 1) How diabetes impacts overall health plan risk/cost and why it's so difficult to manage, 2) Plan design pitfalls that reduce compliance of critical chronic disease management therapies, 3) How to determine if your pharmacy’s benefit manager is inadvertently driving up your plan costs, and 4) The impact of drug rebates on your plan and your people.

SPONSORED BY: EmpiRx Health

It's no secret that the continual rise in drug costs is adversely affecting both self-insured health plans and participants. Traditional pharmacy management strategies can help to various degrees, but there are now additional strategies coming to market that have the potential to help employers more effectively balance the competing priorities of access, utilization, and costs. Our panel of experts will discuss the pros and cons of several of these "non-traditional" options, including 1) accessing patient assistance programs, 2) international sourcing, 3) use of Biosimilar products, and 4) 340B options.

SPONSORED BY: EmpiRx Health

Each year, SIIA conducts a survey to gather insights into the current state of the captive insurance marketplace, which is intended to help inform captive managers and owners of trends and overall perspectives on business transacted throughout the year. This panel will take a deep dive into the results of SIIA's 2024 captive survey and analyze emerging captive trends, growth and challenges, and what to expect for the captive industry’s future.

Managing people is challenging enough in traditional work environments where older team members direct lead or manage instead of direct younger team members. Management dynamics can often become even more challenging when that common organizational structure is flipped, and younger team members have managerial responsibilities with older workers as direct reports. Join us for this session, where younger SIIA members who currently have such management responsibilities share their experiences and engage with the audience.

Stop-loss group captive programs continue to be the fastest-growing segment within the self-insurance marketplace, and this growth represents an important business development opportunity for TPAs, brokers/advisors and many types of specialty service providers. In order to be successful, it is critical that you know how these programs operate and how your services should be specifically positioned and priced compared to individual self-insured employer clients. This session will feature a panel of experts who will tell you exactly what you need to know to develop a successful business development strategy targeting this growing market segment.

It is common to hear that younger professionals should seek mentors. Senior executives often report that they enjoy helping develop careers of those they mentor, too. But how do these mentor/mentee relationships actually work in the real world? What should you expect as a younger professional (under 40) who is seeking out such guidance? This session will feature two current mentor/mentee pairs who will talk about how they have approached these arrangements and the progress they have been able to achieve.