PROGRAM AGENDA
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| Tuesday, February 18th |
| 2:00 p.m. – 6:30 p.m. |
Registration Open |
| 5:00 p.m. – 6:30 p.m. |
Welcome Reception with Exhibitors |
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| Wednesday, February 19th |
| 7:30 a.m. – 6:30 p.m. |
Registration Open |
| 7:30 a.m. – 8:30 a.m. |
Continental Breakfast |
| 7:30 a.m. – 6:30 p.m. |
Exhibitor Booths |
| 8:30 a.m. – 8:40 a.m. |
Welcome Remarks
Mike Ferguson
President & CEO
Self-Insurance Institute of America, Inc.
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| 8:40 a.m. – 9:15 a.m. |
Policy & Regulatory Update: Price Transparency, Data-Sharing, PBM Reforms, and Surprise Medical Billing
With the Presidential and Congressional elections behind us, SIIA’s Government Relations Team will discuss how 2025 will be a pivotal year for enacting legislation and promulgating regulations in the areas of Price Transparency, Data-Sharing, PBM Reforms, and Surprise Medical Billing.
SPEAKERS:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
Anthony Murrello
Government Relations Manager
Self-Insurance Institute of America, Inc.
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| 9:15 a.m. – 10:15 a.m. |
Fiduciary Issues, Lawsuits, and More
2024 marked the first year in which we saw employee-participant lawsuits filed against self-insured plan sponsors claiming that the sponsor breached their fiduciary duties. Lawsuits filed to get access to health claims data continue to make their way through the courts, while the Department of Labor and the Federal Trade Commission are also getting into the act by filing lawsuits against TPAs and PBMs. This Panel Discussion will talk about ERISA’s fiduciary duties, ongoing lawsuits, and more.
MODERATOR:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
SPEAKERS:
Herman Hofman, Esq.
Partner
Varnum Law Firm
Julie Selesnick, Esq.
Senior Counsel
Berger Montague
Patrick Williams
Co-Founder
Fiduciary In a Box
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| 10:15 a.m. – 10:30 a.m. |
Networking Break |
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| 10:30 a.m. – 11:30 a.m. |
PBM Payment Practices, Prescription Drug Pricing, and Claims Data
PBMs continue to be a target for increased Federal and State regulation. Why? Primarily because of PBMs’ harmful payment practices, profiteering, and anti-competitive behavior. Plan sponsors and their service providers are busy trying to access and understand prescription drug pricing and claims data so they can lower the plan’s costs. How are they doing that and how is that going?
MODERATOR:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
SPEAKERS:
Jennifer Johnson
Senior Vice President of Sales and Marketing
Liviniti
Estay Greene, PharmD, MBA
Senior Vice President of Strategic Initiatives
Amwins Rx
Alex Hartley
Director of Data Analytics
AssuredPartners, Upstate NY Platform
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| 11:30 a.m. – 12:30 p.m. |
Health Plan Audits, Ongoing Claims Monitoring, and Payment Integrity: What Should Plan Sponsors Be Looking For?
Plan sponsors have been put on notice that failure to examine and analyze health claims data and the failure to discover things like hidden fees and/or overpayments could expose them to fiduciary liability. Plan sponsors are also realizing that routine audits of their plans’ health claims data can help reduce costs. And, plan sponsors are finally pushing back on those service providers that have sought to limit the sponsors’ audit rights so they – or an independent third-party auditor – can conduct routine audits. This Panel Discussion will talk about these issues and more.
MODERATOR:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
SPEAKERS:
Rachel Fleming
Sr. Director of Carrier Relations
AMWINS
Rob Gelb
CEO
Vālenz Health
W. James Hamilton, Esq.
Partner
Bose McKinney & Evans LLP
Cereasa Horner
Director of Policy and Payment Integrity
CERIS
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| 12:30 p.m. – 1:30 p.m. |
Hosted Luncheon with Exhibitors |
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| 1:45 p.m. – 3:00 p.m. |
Real-World “Case-Studies” Analyzing Pricing and Claims Data
Back by popular demand, SIIA members will walk through real-world examples of how their organization has accessed pricing and/or health claims data, analyzed and consumed that data, and helped their self-insured plan sponsor clients lower health care costs, modify their benefit offerings, and/or incorporate cost-containment programs into the health plan.
MODERATOR:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
SPEAKERS:
David V. Cardelle, R.Ph.
Chief Strategy Officer
Advanced Medical Strategies (AMS)
Ahmed Marmoush
CEO and Co-Founder
Handl Health
Traci McGinnis
Vice President, Health Informatics
Benefitfocus
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| 3:00 p.m. – 4:00 p.m. |
Mental Health and Substance Use Disorder Benefits: Pricing, Reimbursement Rates, and Claims Data
The Federal government has made it a priority to increase access to
mental health and substance use disorder (MH/SUD) benefits. Self-
insured plan sponsors share this same policy goal. How can gaining
access to pricing information, reimbursement rates, and claims data for
MH/SUD benefits help to increase access to MH/SUD benefits? Will this
help plan sponsors improve their MH/SUD provider networks and
compliance with the Mental Health Parity law?
MODERATOR:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
SPEAKERS:
Matt Robben
Co-Founder & CTO
Serif Health
David Smith
CEO & Founder
Third Horizon Strategies
Jordan O. Smith
Chief Compliance Officer
& Practice Leader, Mental Health Parity
Healthcare Reporting
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| 4:00 p.m. – 4:15 p.m. |
Networking Break with Exhibitors |
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| 4:15 p.m. – 5:15 p.m. |
What Can the New Administration and Congress Do to Increase Price Transparency and Data-Sharing?
Now that the dust has settled on the 2024 Presidential and Congressional elections, both Congress and the new Administration are ready to get to work on policymaking. Because 2025 is a non-election year, there is no doubt that we will see increased legislative and regulatory activity on a number of issues, including transparency and data-sharing, and implementing the transparency provisions of the CAA. What improvements can be made to existing regulations? And what new requirements should be added to the law?
MODERATOR:
Chris Condeluci, Esq.
Washington Counsel
Self-Insurance Institute of America, Inc.
SPEAKERS:
François de Brantes
EVP, Payment Innovation and Performance
XO Health
Taylor Hittle
Senior Manager, Washington Council
Ernst & Young LLP (EY)
Gloria Sachdev, BS Pharm, PharmD
President & CEO
Employers’ Forum of Indiana
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| 5:15 p.m. – 6:30 p.m. |
Closing Networking Reception with Exhibitors
(Joint reception with attendees of SIIA AI Forum) |
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