Designing your health plan for small groups over a multi-year strategy with a crawl, walk, run mindset.

No longer “What can I do to pay the lowest today” but how do we decrease the overall spend for 3-5 years without just transferring additional risk to my employees when they need healthcare the most?

How you can unbundle the black box that health insurance carriers have built for us but not just chase “shiny nickels.” Building a sustainable ecosystem that can provide efficiency and the ability to service understanding the small to midsize group market.

How Stop Loss Carriers look at the risk and overall financials is a key part being one leg of the three-legged stool being Admin, Stop Loss, and Claims. 30 years of experience with one of the largest reinsurance carriers in the world and managing 30,000 plus employees gives us a different insight into the model that is sustainable and fully transparent, aligned with employers and employees. Many products have been built and are being built with the level funded / self-funded products being hot again in the market. How not to get caught up in what is just a hot topic.

What are the different strategies, the pros and cons, along with the different levels of savings that can be achieved by different approaches, i.e. Networks, RBP, Fee Negotiation, etc?

How using a combination of RBP and Networks, while blending in Negotiations when necessary, can optimize either Professional or OON Savings.

What is the potential future of RBP and how can we make it more palatable for providers and employers?

Emma Fox will talk about lessening the RBP friction by using strategies like DPC, direct contracting and bundling, etc.

The discussion will continue with how we can continue to evolve RBP by using available pricing data to expand the “reference” price of the reimbursement to make RBP more acceptable and defensible.

Berkley discusses the value prop concepts of group captives and what their 10+ years in the business have actually demonstrated in terms of results, cost mitigation, and best practices.

Medical stop-loss group captives are designed to reduce the volatility of self-funding for employers and to provide more control and transparency in order to more effectively manage the risk of the health plan. As captives become a more common strategy for employers, how can employers validate that these concepts are coming to fruition?

Berkley conducted analysis across its block of stop loss group captive business to help support the value proposition of captive participation and will share some of the highlights of that analysis in this discussion.

In addition, Berkley will discuss the key attributes and best practices that produce the best results across its program portfolio. Join senior members of Berkley’s Business Development team for a deep dive into the powerful outcomes that stop loss group captive employers are realizing.

Federal price transparency and surprise billing activities, the debate around drug costs and PBMs, and access to healthcare data are becoming increasingly important from the perspective of cost and claims management. 

6 Degree’s April Fireside Chat will feature Ryan Work, Senior Vice President of Government Relations for SIIA, along with our own President, Katy Brant and Chief Growth Officer, Heath Potter. During the discussion, they will explore the implications of these policy developments and how the debate takes place behind the scenes.