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2015 Executive Forum Speakers



speakers and topics subject to change


Tuesday, February 10th, 2015

9:00am - 10:30am: Keynote 

A Physician-Senator's Look Into the Crystal Ball of Healthcare Reform

presented by: Hon. William Frist 

Senator Bill Frist is a doctor, teacher, public servant, and active humanitarian. He is both a nationally recognized heart and lung transplant surgeon and former U.S. Senate Majority Leader. Uniquely qualified to address the challenges and solutions in health care policy, Senator Frist is consistently recognized among the most influential leaders in American healthcare. 

Dr. Frist is a citizen legislator. He represented Tennessee in the U.S. Senate for 12 years, the first doctor in the U.S. Senate since 1928, where he served on both committees responsible for writing health legislation (Health and Finance). He was elected Majority Leader of the Senate, having served fewer total years in Congress than any person chosen to lead that body in history. His leadership was instrumental in passage of prescription drug legislation and unprecedented funding to fight HIV at home and globally. 

Senator Frist majored in health policy at Princeton University’s Woodrow Wilson School of Public and International Affairs, then graduated with honors from Harvard Medical School, and completed advanced surgical fellowships at Massachusetts General Hospital and Stanford University under transplant pioneer Dr. Norm Shumway. Returning to Nashville, he founded and directed the Vanderbilt Transplant Center, where he performed over 150 heart and lung transplants and authored over 100 peer-reviewed medical publications, and seven books on topics such as bioterrorism, transplantation, and leadership. He is board certified in both general and heart surgery. 

Today Senator Frist is focused on health reform, the basic science of heart transplantation, global health policy, K-12 education reform, economic development in low-income countries, health care disparities, and medical mission work around the globe. 


10:45am - 11:40am: Session 

ACA Requirements and Actionable Data

presented by: John Barlament, Quarles & Brady, LLP

John Barlament is a partner with the national law firm of Quarles & Brady LLP, a law firm of 425 attorneys with seven offices in four states. He practices exclusively in employee benefits law. John represents third party administrators, employers, brokers and benefit consultants in all aspects of employee benefits law. He is a noted national author and speaker.

1:05pm - 2:05pm: Session 

Will the Long Term Impact of ACA Expand or Shrink Self Funding?

presented by: Tim Jost, Law Professor and Commentator

Timothy Stoltzfus Jost, J.D., holds the Robert L. Willett Family Professorship of Law at the Washington and Lee University School of Law.  He is a coauthor of a casebook, Health Law, used widely throughout the United States in teaching health law and now in its seventh edition. He has written numerous monographs on legal issues in health care reform for national organizations and blogs regularly for Health Affairs, where he is a contributing editor, on regulatory issues.  He is a consumer representative to the National Association of Insurance Commissioners and a member of the Institute of Medicine.

2:35pm - 3:30pm: Session 

Applying Alternative Risk Strategies to Stop Loss Underwriting Solutions

presented by: Gary Hudgins, Prodigy Health Insurance, Doug Thomas, Northwind, LLC., John Youngs, Prodigy Health Insurance, Barbara Tomlin, RGA Reinsurance 

John Youngs entered the insurance industry in 1983 working as a broker selling group medical, life and disability products.  He quickly moved to the insurer side in 1989 with a focus on large group self funded, group life and LTD and development of Community Health Plans, the forerunner of ACOs.

Over the next thirty years, he has have served in various management positions with Anthem,  Acordia, and Lincoln National including underwriting, compliance, network development, disease management and marketing.  Since 1996 he has run several organizations focused on medical stop loss, custom network development and disease management.  

John is currently the CEO of Prodigy Health Insurance Services and the CEO of Physician Choice Network.  He is also the managing principal of PCN Care Solutions.

Barbara Tomlin is a graduate of Duquesne University in Pittsburgh, PA. where she received her Bachelor of Science Degree in Nursing. She later received a Master’s Degree in Health Administration from St. Joseph’s University in Philadelphia. 

She is employed by Reinsurance Group of America (RGA) where she is a Director of the ROSE medical management program in the quota share and excess reinsurance division.  Her duties include reviewing large claims notifications to RGA, assessing catastrophic claims for potential reserves, assisting client managing general underwriters (MGU’s) with potential claims mitigation and medical underwriting inquiries, and serving as the medical liaison to RGA’s quota share underwriters and actuaries. Prior to her employment at RGA she was a Vice President for Medical Management engaged in managed care, worker’s compensation and self-funded claims at an MGU in the Philadelphia area. She has been employed in the self-funded industry for 15 years. 

Gary Hudgins graduated from the University of New Mexico in 1994 with a BA in Financial Management. He has been in the insurance industry since 1997. Beginning in the actuarial department of a managing general underwriting company (New York Underwriters), he worked in the rating and compliance area with a fully insured product and gradually moved into self funded underwriting. Since that time, he has worked for a brokerage and consulting firm (BenefitMall Self-Funded Division) as well as regional and national carriers (First Health/Coventry, Cigna, HCC Life). 

Gary is currently the Vice President of Underwriting forProdigy Health Insurance Services.


Douglas Thomas, CPCU, ARe - for most of his 28 year career, Doug has been underwriting employer stop loss; the last 17 of them as President of NorthWind, LLC.    This long tenure has provided a vast breadth of experience over numerous market cycles and changing self-insurance trends.  In addition to ESL, Doug has experience underwriting Prescription drug carve out, provider excess, life insurance, and D&O liability coverages.

Doug holds the Chartered Property Casualty Underwriter and Associate in Reinsurance designations from The Institutes, and has passed numerous CLU and CEBS exams.  He received his MBA from Villanova University, as well as a BSBA in Insurance and Finance from Drake University.


4:00pm - 5:00pm - Breakout Sessions

A: Medicare Reference Based Benefits Plans - "What a Difference a Year Makes, or Does it?"

presented by: Jim Farley,  J.P. Farley and Steve Rasnick, Self Insured Plans, LLC


Jim Farley has spent 40+ years in the employee benefits industry. He has spent significant time and
effort driving innovation within his own company and as president or chairman of several national
TPA industry organizations, including SPBA. He has also been quoted in the media, authored articles, and testified before state and national legislative committees. A serious student of the business, Jim has been an early adopter of many cost management techniques. In the
late 90’s Jim implemented reference based pricing and, coupled with an understanding of the plan document’s
power to influence costs, the adoption of specific benefit carve-outs. Since 2006 he has worked with customers
on implementing and running successful fee schedule based plans with limited or no networks. Like many other
ultimately successful cost containment techniques taken on by early adopters the initial reaction was “You really
can’t do that, people will not accept that kind of thing.” Jimcontinues to embark on things “you really can’t do”.

 Steve Rasnick’s broad insurance background includes previouspositions as President of Gem Insurance Company, President of Foundation Health National Life Insurance Company, managed care organizations covering more than 800,000 members; Chairman of ProAmerica, a national PPO organization; President of The Travelers Plan Administrators, the third largest national benefits administrator, covering more than 1,000,000 members; President and founder of Claims Administration Services Inc., at the time, the largest TPA in Illinois. He has over 35 years of employee benefit experience, having held senior level consulting positions with Reed Stenhouse, a division of Alexander & Alexander in Chicago, as well as having provided insurance consulting services to more than 300 groups in Illinois. Mr. Rasnick is a founding Director of the Self Insurance Institute Of Illinois, participated
on the Steering Committee that drafted the Illinois TPA Licensing Regulations, is a past Director and Officer of
the Self Insurance Institute of America, and has served on the boards of numerous insurance, managed care
organizations, community hospitals and venture capital organizations. Mr. Rasnick became a full time resident
of Naples, Florida in 1995, where he established a TPA to serve the interests of small to medium Florida
employers. He was elected President of the Southwest Florida Association of Health Underwriters in 1998. He
is a graduate of Roosevelt University, attended John Marshall Law School, is a Fellow of The International
Claims Organization and is a frequent national speaker on benefit issues, managed care, Consumer Directed
Healthcare, self funding, the development of Community Based and Provider Sponsored Health Plans, third party
claims administration, Accountable Care Organizations and GASB.


B: Emerging Technology Implications for the Improvement of Population Health Outcomes

presented by: Dr. Ashish Abraham, Altruista Health

Dr. Ashish Abraham is a primary care physician and healthcare management executive with more than 12 years of diversified experience in direct clinical care, health management operations and strategic consulting for government and commercial clients. His experience and expertise extends across a wide range of areas including, disease management, health program/benefits design, health service rate development and performance measurement and improvement.

At present, Dr. Ashish Abraham is the President & Chairman of Altruista Health, a health and wellness services and technology company that he helped cofound in June 2007. Besides providing strategic leadership to a team of clinical and technology staff across two continents, Dir. Abraham is also a consultant to State governments and other organizations in the area of health reform and quality improvement initiatives.


Wednesday, February 11th, 2015

8:40am - 9:35am - Session

How Strategic Planning Blends Passion, Achievement & Wealth

presented by: Ernie Clevenger, CareHere, LLC

Ernie Clevenger is President of CareHere, LLC, a Brentwood-based company CareHere provides onsite medical, wellness and pharmacy management for public and private employers. He is widely known for the weekly MyHealthGuide Newsletter, going each week to over 5,000 subscribers. The Newsletter provides a compilation of selected articles impacting TPAs, Stop Loss Carriers and MGUs, selffunded employers and others in the self-funded medical and work comp arena.CareHere onsite medical, wellness and pharmacy centers offers appointment scheduler, electronic medical records, patient lab reporting, and more, enable over 600,000 appointments annually. Physicians are recruited from the local area. CareHere operates 120 clinics in 20 states. Ernie’s education includes and a B.A. in Mathematics from David Lipscomb University, M.B.A. from Vanderbilt University, and FLMI from the Fellow Life Management.

9:55am - 10:50am - Session

How to Boost Your Brand

presented by: Russ Krueger, Ocozzio

Russ Krueger is the founder/leader of Ocozzio, a national brand and marketing solutions company focused on the health insurance marketplace. Ocozzio's clients are located in 35 states.  The company is headquartered in Augusta, Georgia.

Krueger earned a BS in Psychology at Mercer University and holds an MBA in Marketing from the Kellogg School at Northwestern University. For 20 years he worked for the Newell-Rubbermaid company. Krueger has held positions as Chief Marketing Officer, President, Group President and Chief Executive Officer of national, mid-market companies. In 1991, Krueger started a giftware company in Columbus, Ohio. He was name USA Today, Earnest & Young Entrepreneur of the Year in 1996. In 1997, he sold the company to a Boston investment banking firm. Krueger retired to play golf and write books. His "SteppingUP" book for middle schoolers has sold over 600,000 copies. In 2000, he "accidentally" started Ocozzio when a former employee asked for consulting help. Today, Krueger serves on a variety of corporate and charitable boards. He is currently the Vice Chairman of the Augusta Chamber of Commerce.

10:50am - 11:45am - Session

Accountable Care Organizations and Third Party Administrators - Changing the Future Landscape of Healthcare

presented by: Jack Hill, Accountable Care Solutions Group and Dan Holets, Consultant

Jack Hill has over twenty nine years’ experience and a strong record of achieving results in the managed care, practice management, risk management, technology, reinsurance, and property and casualty industries. Jack has excelled in senior management and ownership positions with Independent Practice Associations (IPA) and Physician Hospital Organizations (PHO), HMOs, insurance companies, technology start-ups, and consulting/underwriting firms. Jack has a large and diverse client base representing consumer oriented and operated plans (CO-OP), accountable care organizations (ACO), physician groups, hospitals and hospital systems, national employer purchasing groups, HMOs, PPOs, TPAs, employer groups, insurance companies and insurance brokerage firms through a variety of consulting and product development engagements. Jack is the author of numerous publications for the employee benefits and healthcare industry, most notably “Electronic Data Interchange: The Physicians’ Guide” written for the American Medical Association, and has written for Employee Benefit News, Employee Benefit Advisor, the Health Insurance Underwriter, and the Self Insurer publications. He is a member of the Healthcare Financial Management Association (HFMA). Jack is a graduate of Taylor University and has completed postgraduate work at the Wharton School of Business and Ball State University. 

Daniel B. Holets is founder, President and CEO of Assured Management Insurance Services, a Third Party Administrator with a focus on fully capitated service models for healthcare systems. In this role, Mr. Holets has developed and implemented an innovative full-scale capitated services model for a large Los Angeles based hospital system with the goal of transferring risk to the groups that can best control the costs – the providers. With this and other innovative approaches to controlling costs, Mr. Holets is helping large employers to continue to offer robust benefit packages with predictable costs in a volatile healthcare market.

Mr. Holets has over 39 years of experience in the healthcare industry, covering a wide spectrum of managerial and executive level responsibilities in both insurance and the managed care fields. Prior positions include CEO of Assured Investors Life Company, a subsidiary of Tenet Healthcare, and Vice President of Cascade Insurance Company. In addition to these executive positions, Mr. Holets has used his highly technical expertise as a consultant to the biggest names in healthcare in Southern California on issues ranging from complex regulations and compliance to health plan and benefits management. 


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