Benefits Executive Roundtable

Host Dorothy Cociu interviews two of her self-funded group health plan clients, Bill Struett of Heimark Distributing and Randy Sims of Tri-West, LTD, about their experiences with reference-based pricing. They discuss the positives and negatives, the opportunities for additional cost savings over PPO networks, and the administrative process. Was it easy? What types of problems did they have and how did they overcome them? Learn about their experiences first-hand, and how to overcome provider...

In Part 2 of our 3 Part Series on Health Plan Financing & Cost Containment, Host Dorothy Cociu interviews Brad Gossen, President, and Dan Baker, Vice President, Sales, of EBA&M Corporation, a Third-Party Administrator specializing in self-funded health plans. In this post-COVID world, employers are trying to get back to what they do, and in order to do that, they are looking at long-term cost containment in their health plan financing. Is Self-Funding the way to help your company’s bottom...

Part 1 of a 3 Part Series on Health Care & Health Plan Financing & Cost Containment Host Dorothy Cociu interviews Bob Quaid, Senior Broker Representative for California Choice, a health plan option available for small groups (under 100 employees) in California, on how their 1990’s created Assembly Bill private exchange product has developed into an effective way for fully insured employers to set their health plan budgets and stick to them, while offering employee choice. We’ll discuss...

Host Dorothy Cociu interviews Elizabeth Holman, President of The Holman Group, which is a Managed Behavioral Healthcare Provider and Employee Assistance Program. We discuss the importance of providing assistance to employees in times of crisis, stress and anxiety, such as the COVID-19 era and beyond. What effects did the lack of normalcy, the economic pressures and lockdown have on employees and their families? How can employers help in times like these, and going forward, to better assist...

Host Dorothy Cociu interviews Faith Borges, Legislative Advocate for the California Agents and Health Insurance Professionals (CAHIP) and Dawn McFarland, VP of Legislation for CAHIP, on the latest and most serious threat to our current health care system in California, with the recent single payer healthcare bill, AB-1400, and the companion Assembly Constitutional Amendment, ACA 11. This was the second serious scare of single payer in 5 years for California, but this one was a double threat,...

Host Dorothy Cociu interviews Ted Flittner and Ted Mayeshiba, principals of Aditi Group, an IT services and consulting firm, on the importance of a Business Electronic Risk Assessment in today’s cyber world. We examine the applications of HIPAA and other privacy laws, plus the day-to-day business needs across all industries, in protecting business data against breaches, cyber-attacks, and ransomware, and the importance of business continuity amidst all of these risks. This podcast is a must...

Host Dorothy Cociu interviews Marilyn Monahan of Monahan Law Office on the changes to the ACA Reporting forms and requirements for 2022 in a 2-Part Series. In Part 2, they discuss recent increasing activities with IRS 226-J letters and Marketplace Appeals, and how to best handle them, the penalties for 2022 (2021 forms), and state filing requirements for those states with similar reporting requirements, including California, and...

Host Dorothy Cociu interviews Marilyn Monahan of Monahan Law Office on the changes to the ACA Reporting forms and requirements for 2022 in a 2-Part Series. In Part 1, they will discuss the latest changes to ACA Reporting Forms 1094 and 1095; who needs to file, ALEs and full-time employment clarifications, affordability safe harbors, and all of the latest developments with reporting, including changes to the actual reporting...

Early November saw the new OSHA guidance released on the federal Vaccine Mandate for employers with 100 or more employees, followed immediately by a rush of lawsuits, resulting in the 5th Circuit Court of Appeals issuing a temporary stop on the guidance going into effect. Where do we stand now? Should employers be preparing for this mandate? Hear the latest from HR Consultant and Trainer Kathy Ruffino, Vice President of Train Me Today. Kathy will also update us on the new California...

Host Dorothy Cociu discusses what’s new and what listeners should know about Medicare during the current Open Enrollment Period between October 15thand December 7th with Medicare experts Maggie Stedt, Immediate Past President of the California Association of Health Underwriters (CAHU) and Medicare Agent, and David Garcia, Medicare Specialist and CAHU Medicare Chair. We discuss what’s new for 2022, answer the most common questions from seniors, how to sign up, and the pros and cons of...

Host Dorothy Cociu interviews Ryan Work, Vice President, Government Relations, and Chris Condeluci, Washington Legal Counsel for the Self-Insurance Institute of America, who share their insights and analysis on the new rules regarding the Independent Dispute Resolution process laid out in the No Surprises Act regulations, Part 2. We discuss the reaction of providers, insurers, and self-funded health plans, the new CMS IDR Portal where all disputes will be managed, and how the process will...

Host Dorothy Cociu interviews Ruth Tello-Di Leva, MS, BCBA, on the affects of COVID on kids with Autism. In Part 2 of our 2-part series for Mental Health Awareness Month, we discuss the way external factors, such as a pandemic, affect kids with autism. We dive into the stress, the anxiety, and the little things that make lives better during such unprecedented times. How did these kids deal with the loss of routines and changes during 2020-2021? Have the availability of vaccines and the...

Host Dorothy Cociu interviews experts from Hines & Associates, a Utilization Management & Case Management firm, who discuss the negative impacts COVID has had on mental and behavioral health. Included in this discussion are Anna Hansen, Senior Vice President, Client Solutions & Retention, Suzanne Casel, RN, PMH-BC, Director of Behavioral Health & Wellness, and Karla Weiner, RN, CCM, AATMC, Director of Medical Case Management Operations. We discuss the differences between gender, race or...

Host Dorothy Cociu welcomes once again Marilyn Monahan of Monahan Law Office on Federal and State Legislative Updates for fall, 2021. Marilyn will discuss the ACA Transparency Rules, the CAA’s No Surprises Act & Transparency, and how grandfathered health plans are affected. In addition, she provides updates on ARPA COBRA Subsidies, FFCRA & ARPA wrap-ups, Long COVID & disabilities, and more. She will also discuss ACA reporting updates, as well as how employers can find a path out of the...

In Part 2 of our 2-Part Series on Surprise Billing Legislation, host Dorothy Cociu interviews Ryan Day, President, and Collen Dempewolf, Director, Strategic Product Development, of HS Technologies, a Referenced Based Pricing Vendor, on the No Surprises Act’s impact on health plans. They discuss how plans without networks will be treated under the Act, how referenced based pricing plans are impacted, and how communication and cooperation with claims administrators will be required. They also...

Host Dorothy Cociu and special guest Marilyn Monahan, of Monahan Law office, discuss the Consolidated Appropriations Act (CAA) interim final rule for the No Surprises Act, Part 1, as well as some ACA Transparency in Coverage rules that relate to the CAA. The No Surprises Act focuses on surprise billing for emergency services, as well as billing practices in certain non-network situations by limiting the amount payable to the network rate. Marilyn and Dorothy share the employer plan sponsor...

In Part 2 of this 2-Part Podcast, Host Dorothy Cociu continues her discussions with Ted Mayeshiba and Ted Flittner, Principals of Aditi Group, an IT Security/HIPAA Security/Cybersecurity firm, and Bruce Benton, a life and health and P&C agent, and Vice President, Public Affairs of the California Association of Health Underwriters on how to be better protected against Cyber Attacks. We discuss how to stay safe while traveling, working from home risks, potential new cybersecurity regulations,...

In Part 1 of this 2-Part Podcast, host Dorothy Cociu interviews Ted Mayeshiba and Ted Flittner, Principals of Aditi Group, an IT Security / HIPAA Security / Cybersecurity firm about the importance of Cybersecurity and how employers can protect themselves. Bruce Benton, a life and health and P&C agent, and Vice President, Public Affairs of the California Association of Health Underwriters is also on-hand. In Part 1, we discuss the growing trend of electronic hacking and cyber attacks that...

The American Rescue Plan Act (ARPA) 2021 and Other Legislative Updates – Spring, 2021 – A Special Off-Season Release! Host Dorothy Cociu and Guest Marilyn Monahan of Monahan Law Office discuss the details of the $1.9 trillion relief package called the American Rescue Plan Act (ARPA) 2021, as well as the changes to the Outbreak Period, which threw the health insurance industry into turmoil. Dorothy and Marilyn discuss the outbreak period and timeframe extensions from DOL/EBSA Relief Notice...

Host Dorothy Cociu interviews principals of Aditi Group, our Technology Partners, on cybersecurity in the workplace and home. Dorothy sits down with Ted Mayeshiba, Ted Flittner and Steve Saitman to discover what can be done to protect your business from cybersecurity threats, whether your employees are in the office or working remotely from home. We discuss the differences between threats at the home and in the office, the most common threats we're seeing now, how to examine email phishing...