Category: Latest Thinking

By Jill Ambrose, MBA, BSN, RN and Simon Leung, PharmD

Gene and cell therapies are potentially life altering treatments for employees with diseases ranging from cancer to genetic or infectious disease. The pipeline for these therapies is projected to grow in the coming years. Currently, nearly 40 gene and cell therapies are approved by the Food and Drug Administration with over 100 in Phase III clinical trials nearing FDA approval. And those numbers are increasing daily.

While these therapies offer hope for patients with rare diseases, they come with a high price point. As more and more gene and cell therapies hit the market, employers and plan sponsors will need to be prepared for the potential high costs of these treatments hitting their plans.

Breaking Down Gene and Cell Therapies

While they sound similar, gene and cell therapies are slightly different in the way they treat or prevent disease. Gene therapy alters the genetic code and gene transfer therapy adds new genetic material into the cells. There are gene therapies approved to treat conditions including cystic fibrosis, hemophilia, sickle cell disease, rare eye disorders, multiple myeloma and others.

Cell therapy is the transfer of specific cell types into a person. One type of cell therapy that’s talked about often is CAR T-cell therapy, a newer form of immunotherapy for cancer patients. Six cell therapies are FDA-approved for the treatment of blood cancers, including lymphomas, some forms of leukemia, and, most recently, multiple myeloma.

The prices of gene and cell therapies can range anywhere from around $500,000 to upwards of $4 million. A gene therapy approved by the FDA in March called Lenmeldy comes with a price tag of $4.25 million for a one-time treatment, making it the world’s most expensive drug. To put the price of gene and cell therapies into perspective, consider the cost of a specialty biologics drug such as Humira, used for patients with autoimmune conditions. The typical per-patient cost for Humira is about $5,000-$10,000 per month, with extreme cases reaching $150,000-$200,000 annually.

While gene and cell therapies are some of the most expensive treatments on the market, the population of patients using them is still quite limited – for example, only about 33,000 males in the United States are living with hemophilia and an even smaller portion of that with hemophilia B. Most patients receiving gene and cell therapies do so through clinical trials. Treatment generally takes a year from start to finish and rounds of testing are required to determine if the patient will respond to the treatment. If the patient doesn’t respond to the treatment, they will not receive the high-cost therapy.

However, there are several therapies currently in late stage Phase III clinical trials to treat more common diseases including stroke, breast cancer, Crohn’s disease, multiple sclerosis, heart attack and melanoma. These conditions are prevalent in most employer populations and these therapies will have an impact on employers’ bottom lines once they hit the market.

How to Start Preparing Today

While the impact of gene and cell therapies may not hit most employers’ bottom lines in the next year or so, there is innovation and movement in these markets that will start to move downstream sooner rather than later. By starting to prepare today, employers and plan sponsors will be better positioned as therapies for more common indications hit the market. Here are three strategies to consider:

1. Data warehouses

Data warehouses can help employers identify who in their employee population on their medical benefits plan has conditions treatable with gene and cell therapies and whether they may qualify for treatment. For current disease, a present diagnosis is needed for treatment, which can narrow potential exposure. For future conditions, like stroke for example, employers would be able to use the data warehouse to look for members who meet inclusionary criteria for the treatment. Without proactively utilizing data warehouses, employers are limited in their ability to predict that risk.

2. Utilization management controls

As more gene and cell therapies receive FDA approval, employers will want to ensure that their programs and pharmacy benefit managers have utilization management controls in place to ensure the use of these therapies is evidence-based and medically necessary. For example, adding the step of prior authorization can help ensure that only individuals who meet all the qualifications for gene and cell therapies, and where there is no other viable treatment option, are approved to receive the therapies.

3. Stop-loss protection

Most employers likely have stop-loss coverage in place already to shield from individual catastrophic claims and overall exposure, and they’ll want to be sure their plan is structured to support gene and cell therapies. For fully insured plans, it’s important for employers to know carriers are now starting to pass through their costs associated with coverage of these emerging therapies through premium increases.

Having sufficient stop-loss coverage in place will be more critical for employers with self-funded plans to ensure they’re protected from the impact of high-cost gene and cell therapy claims. As an alternative, these employers might consider a captive solution. Captives allow like-minded employers to form and manage their own insurance entity, retaining profits when claims are low and sharing the financial impact when claims are higher than predicted. In a group captive, stop-loss premiums are based on the claims experience of all the employers, shielding participating organizations from the drastic stop-loss premium volatility they might experience if self-insuring on their own. With a captive, employers also retain control of claims data and have better visibility into how members are utilizing the plan. This data can be used by employers to apply predictive modeling to make informed adjustments to the plan.

Get Ahead of Gene and Cell Therapies

As the gene and cell therapy market continues to evolve with a strong pipeline of new treatments, it’s important that employers and plan sponsors are proactive in planning ahead. The population health and pharmacy specialists at Conner Strong & Buckelew can help you understand the benefits of stop-loss and captive solutions and work with you to determine what coverage solution makes sense for your employee population. Our team is also equipped with data resources to help you assess your exposure as gene and cell therapies for more common conditions continue to evolve.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Tim Svoboda, CPCU, ACI, ARe

In Part 1 of this series, we explored the basics of parametric insurance — what it is, how it works and some the of risks it may help mitigate. In this article we will take a deeper dive into the key differences between parametric insurance and traditional indemnity insurance — and how they can work together.

It is important to understand that parametric insurance is not intended to replace traditional coverage. Instead, it can complement traditional insurance coverage by providing an extra layer of protection and/or providing coverage for risks not covered under a traditional policy.

The chart below compares key policy attributes and how they differ.

How Traditional and Parametric Coverage Can Work Together

Let’s look at a hypothetical example of how parametric insurance can provide an extra layer of protection.

Assumptions

A.B. Smith Construction Company: A construction company with a major project underway in Orlando, Florida, just over 84 miles northeast of Tampa Bay, Florida.

Traditional Coverage: Policy provides property damage and business interruption coverage for losses impacting the construction site and all on-site materials, equipment and assets.

Parametric Coverage: Because most of the materials and equipment required for the project arrive via the Port of Tampa Bay and are transported to the project site by trucking companies near the port, the company purchases a parametric insurance policy with the following parameters.

• Coverage amount: $5 million
• Trigger event: Hurricane
• Location: Within a 50-mile radius of the Port of Tampa Bay
  (Latitude/Longitude: 27.9504° N, 82.4450° W)
• Index: The policy index stipulates a payout of 90% of the total coverage amount if the defined location experiences a hurricane, verified by NOAA, with winds speeds between 130 and 156 miles per hour (Category 4).

Hypothetical Example

A Category 4 hurricane hits the west coast of Florida. By the time the storm moves inland to the Orlando area it has weakened considerably, but A.B. Smith Construction does suffer the loss of a crane and on-site construction materials. The company reports the claim to their carrier to get the loss adjustment process started. They are glad they have the coverage but know the claim adjustment and settlement process will take time.

While damage to the Orlando construction site was mild, the Tampa Bay area took the full force of the Category 4 hurricane. The Port of Tampa Bay and most of the trucking companies that serve it are shut down indefinitely due to severe storm damage. As a result, A.B. Smith Construction’s Orlando project site cannot get the materials and equipment it needs to resume operations.

This is where the parametric coverage comes into play. Because the storm struck within the specified location and exceeded the wind speeds stated in the parametric policy, A.B. Smith Construction will promptly receive a claims payout of $4.5 million (90% of the total coverage amount as specified in the policy index). The immediate payout will provide A.B. Smith Construction with the cash flow it needs to re-route incoming supplies and equipment through the Port of Miami and quickly get the project back on track.

This is just one example of how parametric insurance can enhance protection and provide quick access to resources when they are needed most. There are a myriad of other ways, such as providing coverage for perils excluded under traditional policies, providing additional capacity or filling in gaps left by high deductibles.

To determine if parametric insurance would be a good complement to your current coverage, you’ll need to talk to a broker with specific expertise in this coverage genre. Conner Strong & Buckelew has the in-house expertise to evaluate your coverage needs and provide the necessary guidance if parametric insurance makes sense for your organization.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Roger Ladda

Employers today are making significant investments in their workforce and facilities through safety and loss control programs. These programs can vastly improve worker safety and lower the risk of casualty insurance claims (workers compensation, general liability and automobile liability).

Captives that provide insureds with property and casualty insurance coverage can help organizations better control their overall insurance spend and allow them to reap the benefits of their investment in safety and loss control more efficiently than a guaranteed cost insurance plan.

P&C Captives Defined

A P&C captive is an insurance company formed under a special purpose statute with the primary purpose to finance the risk of its owners, participants or members. Captives are capitalized, licensed and regulated insurance companies under specific statutes, and are domiciled both on-shore and off-shore. Captives allow an individual company, or a group of like-minded companies, to form their own insurance entity. There are several types of captive insurance companies. Among the most common are:

• Single parent captives designed for larger companies (generally with annual premiums of $2 million or greater) seeking to insure the risk of a parent company and its subsidiaries/affiliates.
• Group captives designed for a group of companies that join together to form their own insurance company. Banding together provides risk distribution, risk diversification and ample spread of risk to operate a viable insurance company. Members have the opportunity to control their “frequency” risk (and premiums) and can share severity risk with other members, thus lowering overall costs.
  Rather than transferring all insurance risk to traditional commercial carriers, the captive assumes a level of calculated risk that is priced by a third-party actuary and transfers the catastrophic risk.

Reaping the Return

By taking on this risk, employers put themselves in a position to reap the financial rewards. When claims are low, captive members, not an insurance carrier, keep the underwriting profit and investment income. These savings are compounded when companies invest heavily in safety and loss control programs that reduce workplace injuries and insurance claims and help to create a culture of workplace safety.

Safety and loss control programs require financial investment to implement and maintain. But in a traditional, guaranteed cost (first dollar) program, the premiums paid are kept by the insurance carrier and employers don’t see any financial return from lowering their claims. In essence, the good performers in the traditional market are subsidizing the companies that are experiencing adverse loss experience. With captives, employers that invest in loss control measures that translate to lower claims costs reap the financial return on their investment.

Additional Benefits: The 3 Cs

Aside from keeping the financial return on investment in worker safety, captive insurance programs offer several additional benefits to employers:

• Consistency – In today’s environment, traditional insurance premiums are growing and coverage can be difficult to secure. Captives offer more predictable and stable pricing. They also have mechanisms to control costs when claims are high.
• Control – Captives remove many market factors from pricing. Cost is not based on what insurance companies think they can charge, but rather what organizations predict their losses will be.
• Customization – Captives allow an organization to build more specific coverage for certain lines at actuarially-derived premiums using the insured’s data, rather than being forced into off-the-shelf policies from insurance companies who dictate pricing. Captives allow for a more comprehensive approach to risk and long-term strategic thinking.

What Are You Waiting For?

Does your business have a successful safety and loss control program? Are you in a high-risk industry? Do you want to stop letting the insurance carriers benefit from your smart thinking and successful safety efforts? If you answered “yes” to these questions, a P&C captive may be able to improve your company’s bottom line. Captives provide employers with more consistency, control and customization that leads to superior results.

At Conner Strong & Buckelew, our team is deeply experienced in P&C captives and can help your organization reap these benefits. We also have close connections to industry-leading safety and loss control experts that can help our clients lower claims even further.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Lisa Vanore and Alexander Buzbee

All human services organizations that provide inpatient care face the risk of patients with a cognitive impairment or developmental disability leaving a supervised environment without proper authorization or supervision. Known as “elopement,” this situation can be prevalent in nursing homes, assisted living facilities or special care units for individuals with conditions like Alzheimer’s disease, dementia or autism.

Research shows that in cases involving elderly patients, if the resident is not located within the first 24 hours there is roughly a 25 percent chance they will not survive. But elopement risk is not limited to elderly patients. While the circumstances surrounding young people and children eloping from inpatient facilities may differ, the consequences can also result in severe injury or death. Faced with this daunting reality, it is incumbent upon care facilities to ensure the wellbeing of patients – and protect themselves from related liability – by preventing elopement.

The right human services broker can help facilities mitigate elopement risk in a number of ways, including:

1. Comprehensive risk assessment: A thorough evaluation of current protocols, elopement incidents, staff training and facility technology can help you find ways to identify which patients may be at greatest risk, where there may be safety gaps and opportunities for risk reduction.

2. Policy and procedure improvement: After the initial risk assessment, knowledgeable brokers can recommend strategic policy and procedure improvements, such as more robust chain of custody communications, employee and vendor background checks, visitor access changes and emergency response protocols.

3. Technology improvements: Your broker can introduce and help the organization source and adopt services and state-of-the-art technologies, such as updated surveillance systems and tracking devices, that have been proven to reduce elopement.

4. Training and Education: Your broker can provide guidance to help you develop a sustainable and repeatable staff and caregiver training program to help ensure the improved safety procedures, protocols and technologies are consistently communicated and applied.

5. Provider networking: Facilities can benefit from the knowledge gained through your broker’s relationships with other providers and the opportunity to network with other organizations that have been successful in reducing elopement incidents.

The Power of Partnership

At Conner Strong & Buckelew, our brokers serve as a valuable resource for service providers in the human services industry. When it comes to elopement, human services organizations must do everything they can to limit these incidents and keep their patients and participants safe. Our leading team of professionals can help these organizations implement effective strategies to prevent these incidents. In the event that elopement does occur, our claims advocacy department will review claims, assist in all claim issues and recoveries and advocate with our carrier partners on your behalf.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Tim Svoboda, CPCU, ACI, ARe

Although Parametric Insurance has been around since the 1990s, increasingly difficult market conditions and recent advancements in underwriting technology have caused a surge in popularity. The concept of parametric insurance is straightforward. Unlike indemnity policies that pay claims based on the insured’s actual losses as determined by a loss adjuster, parametric insurance claims pay out a predetermined amount based on the occurrence of a specific ‘trigger’ event, such as a hurricane or flood, that:

• Takes place within a pre-agreed geographic area
• Is quantifiable and measurable
• Can be confirmed by an agreed upon third party or index.

Streamlined and Predictable Claims Process

Parametric insurance claims are paid quickly – often in just a few days. This is because the payouts under these policies are tied to the occurrence of the trigger event, which eliminates the need for adjusters and settlement negotiations. The insured also has the freedom to use the claims proceeds in any manner related to the damage or interruption to the business caused by the trigger event. The combination of rapid payouts and flexibility around how claims proceeds may be used can help organizations recover more quickly after a catastrophic or disruptive event.

In addition to a swift claims process, payout amounts are defined in advance as part of the policy design, so there is no ambiguity. Parametric insurance, also known as ‘index-based’ insurance, is structured with a payout index. The index ties the payout amount to the severity of the trigger event relative to the organization’s business continuity plan and risk tolerance. Below is a hypothetical example of how a policy with a hurricane trigger might be structured.

Hurricane Trigger Event

Verifying Source: National Oceanic and Atmosphere Administration (NOAA)

In this example the organization was confident it could withstand and/or absorb all of the damage and disruption from a Category 1 hurricane and most of the damage and disruption caused by a Category 2 hurricane. So, the policy payout scheme was structured accordingly.

Parametric coverage does not have to be limited to the insured’s location. It can be designed to provide coverage for trigger events that occur within a pre-agreed distance from a “point of interest”, typically defined by a specific latitude and longitude. This approach, sometimes referred to as “Cat in a Box”, provides protection for trigger events beyond the insured’s immediate location that could interfere with infrastructure or activities critical to the organization’s operations.

More Than Natural Disaster Coverage

With climate change contributing to the frequency and intensity of storms, wildfires and flooding events, natural disasters will continue to be common parametric insurance coverage triggers. However, parametric insurance policies are not only for large natural disasters. This type of coverage is becoming increasingly popular for covering a wide range of disruptive trigger events, such as:

• Cyber risks, including data breaches and ransomware attacks
• Major cloud or power outages
• Early frost or drought conditions for agriculture
• Shortfalls in production or crop yields
• Lack of wind or excessive cloud cover for renewable energy
• Construction delays caused by excessive heat or rainfall
• Supply chain disruptions
• Future pandemics or disease outbreaks

There are a multitude of risks that can be covered by a parametric policy. The fundamental requirements are that the trigger event must be a:

• Fortuitous, unplanned event
• Quantifiable risk using reliably monitored and reported data
• Risk for which the insurance carrier can build a probability model.

In a Nutshell

Parametric insurance is not intended to replace traditional indemnity insurance. However, as a complement to traditional coverage it offers key advantages including:

• Ability to fill coverage gaps left by conventional insurance
• Coverage transparency due to the well-defined contract
• Fast, predictable claims process and payouts
• Flexibility around how claims proceeds may be used.

When considering parametric insurance, it’s important for organizations to partner with a broker that has deep knowledge in this coverage category and the ability to evaluate how it may support protection needs. Conner Strong & Buckelew has the in-house expertise to identify an organization’s specific exposures and determine whether parametric insurance can strengthen its overall protection strategy. And if parametric coverage is a good fit, we can leverage our relationships with the top parametric insurance carriers to help secure coverage designed to meet the organization’s unique needs.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Lisa Vanore and Alexander Buzbee

In human services, organizations have an ethical and legal responsibility to uphold their duty of care to protect and support the well-being of individuals. When a breach of duty occurs, it can have profound consequences.

The consequences of breaching the duty of care vary significantly depending on the nature and degree of the breach, the specific circumstances and the relevant laws and regulations. Consequences can consist of legal repercussions, professional sanctions and damage to the well-being of the individuals involved.

In the case of a 58-year-old resident, a health care services organization breached its duty of care after a resident suffered a serious fall which contributed to her death. Nursing home staff members did not notify the family until over a month after the incident, and one of the staff members allegedly believed the resident was faking her pain. When the resident was finally admitted to the hospital, it was revealed she had broken two of her vertebrae and that the fractures had become infected. The patient subsequently died from the infection, resulting in the facility facing a lawsuit from the family and being fined by the state for failure to meet care standards.

By implementing the prevention tactics and strategies outlined below, human services organizations can reduce the likelihood of duty of care breaches and minimize potential risk to the organization. Knowledgeable brokers can help human services companies seamlessly implement these tactics to ensure they are leveraged to their maximum potential.

1. Provide training and education: Human services organizations should require staff to attend ongoing training sessions on topics such as ethics, legal obligations, best practices for avoiding duty of care breaches and recognizing signs of abuse or neglect. Additionally, they should educate individuals under their care, and their families, about patient rights and available support services.

2. Maintain a safe environment: Creating and maintaining safe physical environments, including homes, facilities and community spaces where services are provided, can significantly limit the frequency and severity of safety incidents. This includes safety measures such as making sure fire exits are accessible and emergency protocols are in place.

3. Implement robust incident response and reporting policies: If an incident occurs, the organization must ensure the immediate safety and well-being of the individuals under their care. This may involve calling emergency services or providing first aid. Once the immediate situation is under control, documentation and notifications should begin. Reports should be factual, objective and should not contain any subjective opinions or judgments. Depending on the severity and nature of the incident, applicable laws and the organization’s policies, notifications could include supervisors, colleagues, family members, legal authorities or regulatory bodies. After the incident is documented and reported, the organization should investigate the root causes to determine what measures could prevent similar incidents in the future.

The Power of Partnership

In this environment, partnering with the right broker can be invaluable. Conner Strong & Buckelew’s brokers help clients design and implement proactive safety and risk control programs that can help them manage and prevent claims. Our clients also benefit from the guidance of our claims and advocacy professionals and safety experts.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Lisa Vanore and Alexander Buzbee

Auto liability risks pose significant challenges for various industries, and human services organizations are no exception.

Human services organizations play a vital role in supporting vulnerable individuals and communities, making it crucial for them to navigate the potential negative consequences associated with vehicle-related incidents.

In today’s environment of rising litigation costs and large jury awards related to social inflation, it is increasingly important for human services organizations to help safeguard their missions by taking proactive measures to mitigate risks. By recognizing the impact of auto liability risks and implementing strategies to reduce and address them, human services organizations can help protect staff and ensure the well-being of those they serve.

Auto liability risks can impact human services organizations in the following three ways:

1. Participant Safety: Human services organizations often rely on automobile transportation to provide essential services such as home visits, medical appointments and community outreach. However, operating vehicles exposes the organization to the inherent risks of accidents that can cause property damage and bodily injury. Such incidents can directly impact the safety and well-being of participants and staff, potentially hindering the organization’s ability to fulfill its mission.

2. Financial Implications: The costs associated with legal liability judgements, medical expenses, vehicle repairs and insurance premium hikes can quickly deplete an organization’s resources. These financial setbacks can hinder the delivery of essential services and strain the organization’s ability to support those in need.

3. Reputational Damage: Human services organizations heavily rely on the trust and support of their communities. Auto accidents involving their vehicles can lead to reputational damage, eroding public trust and jeopardizing relationships with stakeholders. Negative publicity surrounding incidents can create a perception of negligence and irresponsibility, potentially impacting future funding, partnerships and volunteer engagement.

Available Tools to Mitigate Auto Liability Risks

Thankfully, there are several tactics human services organizations can leverage to mitigate their auto liability risks. As experts in the space, we have compiled the following list of steps human services organizations can take to help limit exposure to these risks:

• Robust Training and Policies: Organizations should implement comprehensive training programs for their drivers, emphasizing defensive driving techniques, safety protocols and adherence to traffic laws. Clear policies and procedures should be established and enforced to ensure responsible vehicle use and maintenance.
• Motor Vehicle Record (MVR) Checks: Routine MVR checks should be conducted on all eligible drivers to ensure adherence with the organization’s driving qualifications and guidelines.
• Regular Vehicle Inspections and Maintenance: Routine inspections and regular maintenance of company-owned vehicles are essential to identify and address potential safety hazards promptly. Likewise, vehicle inspections required by the state should have to be maintained for hired-non-owned and staff-owned vehicles used for company business.
• Vehicle Monitoring Technology: GPS trackers, electronic logging devices and/or video cameras in vehicles used for company business can help ensure drivers are following traffic laws and adhering to company policy. Certain devices may also identify potential vehicle service needs. In some cases, such devices could be required by the insurance company.
• Adequate Insurance Coverage for Company-Owned Vehicles: Social services organizations must secure appropriate insurance coverage for company-owned vehicles, including comprehensive auto liability policies. Understanding policy terms, coverage limits and exclusions is crucial to ensure adequate protection in the event of an incident.
• Insurance Requirements for Non-Owned Vehicles: Organizations should establish minimum vehicle insurance requirements — equal to or in excess of state minimum limits — for hired-non-owned and staff-owned vehicles used for company business.

The Power of Partnership

Partnering with the right insurance broker is essential when it comes to minimizing your exposure. Conner Strong & Buckelew’s experts can deliver holistic risk control, claims management and safety programs designed to prevent catastrophic claims. And our brokers are leaders in the industry who take a consultative approach and have strong relationships with carriers to ensure best possible outcomes for clients.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

By Lisa Vanore and Alexander Buzbee

While human services organizations do amazing work keeping people on their feet, cared for and thriving, they are increasingly faced with accusations of sexual misconduct and abuse of patients and participants – and the related lawsuits that often follow. In a recent example, a jury ordered an Illinois behavioral health center to pay an unprecedented $535 million in a negligence case resulting from the sexual assault of a 13 year old patient by a 16 year old patient.

But regardless of whether sexual abuse accusations are proven, these kinds of accusations can have a devastating impact on an organization’s bottom line and reputation.

Human services firms are expected to maintain control of their facilities, staff, patients and participants at all times. However, without the right safeguards in place, there may be vulnerabilities caused by excessive workloads, untrained staff or insufficient policies and procedures that can significantly increase sexual misconduct and abuse risks.

Four key risk mitigation strategies

Working with the right insurance broker can help human services organizations put preventative measures in place to substantially reduce the risk of the organization being faced with a sexual misconduct or abuse accusation or lawsuit, including:

1. Implement strict staff and hiring policies: Your broker can help you develop strict screening procedures for all personnel – especially staff that will be interacting with, or working in close proximity to, patients and participants. These would include thorough background screenings for all current employees and new hire candidates performed by highly regarded third party firms.

2. Establish formal training and education programs: Your broker can provide insights to help you establish a culture of ongoing, role-appropriate education for all current staff and new hires. Such a program will set expectations, ensure a consistent understanding of current and evolving procedures and provide instruction on how to recognize, handle and report incidents.

3. Create a safe reporting environment: Your broker can provide guidance to help you create a well-communicated reporting process and an atmosphere that ensures your staff, patients and participants (and their families) have a safe space to report concerns and incidents without fear of repercussions. This will encourage prompt reporting and faster interventions and resolutions.

4. Investigate and take action: Your broker can educate you on what to do when an incident is reported – including taking every report seriously and investigating it thoroughly. The ability to act quickly, and knowing what steps to take before an incident happens, can help you more effectively mitigate the risk to the organization when an incident does occur.

The Power of Partnership

At Conner Strong & Buckelew, our team is deeply experienced in helping human services organizations reduce their risk of facing a costly sexual misconduct or abuse accusation or lawsuit. Our knowledgeable professionals can partner with you to help implement the strategies outlined above for the benefit of the organization and its participants. Our team of professionals are also insurance experts who can assist with the implementation, review and analysis of insurance coverage and claims.

For more information on how our team can help, please reach out to your Conner Strong & Buckelew representative, call us at 1-877-861-3220 or email [email protected].

Employee benefits captives are rising in popularity as an alternative solution to fully insured employee benefits plans.

These innovative solutions allow like-minded employers with 100 to 500 employees to form and manage their own insurance entity. Rather than paying premiums to an insurance company, the employers contribute to a shared pool for reinsurance (stop-loss coverage). As members of a captive, employers retain the profits when claims are low and share the financial impact when claims experience is higher than predicted. However, since the stop-loss premiums are based on the claims experience of a pool of employers, rather than a single employer, organizations in captives may benefit from better stop-loss pricing and are not likely to experience the drastic stop-loss premium volatility that can occur when self-insuring on their own.

An additional benefit of captives is increased control and access to data. Members retain control of their claims data and maintain better visibility into how participants are utilizing the plan. This data is extremely beneficial and can be used to tailor the plan in ways that help participants and the overall organization.

Identifying Captives With the Most Value
Employee benefits captives are beneficial for a wide range of organizations looking to lower their overall costs while regaining control of their plans. There are multiple structures to choose from. However, not all captives are created equal. When seeking a captive, it is important to ensure it offers the following additional advantages:

1. Limited volatility from large claims and high-cost years: In a stop-loss captive, employers should ensure they can set their stop-loss attachment point based on their preferred level of risk. The right captives will allow employers to secure lower stop-loss attachment points than they could in the marketplace and at more competitive rates. In doing so, these employers won’t have to worry about the additional risk from high claims year after year.

2. Enhanced control of spending through data transparency and access to larger data pools: Captives should provide their members with access to data around how participants are using the health plans. With access to this data, employers can apply predictive modeling to make informed adjustments to
the plan. They can also identify gaps in care and better direct participants to services that will keep them healthy and minimize long-term costs.

3. Access to pharmacy coalitions & rebates: Employers should ensure their captive also comes with access to pharmacy coalitions and rebates that can provide powerful savings in this area of healthcare that’s notorious for driving up overall costs.

4. Population health support: With population health support, employers can design their health benefits plans based on the needs of their population. By using data and analyzing trends, employers can tailor their benefits plans to provide improved access to needed services and better direct care to prevent costly claims down the line.

5. Catastrophic claims screening technology: As medicine continues to advance, large claims are becoming more frequent and self-funded employers must ensure these claims are being handled properly. Employers should make sure their captive provides access to new technologies that are able to closely examine large and catastrophic claims. Once identified, this technology can automatically ensure these claims are being properly managed by the complex healthcare system, adjudicated pursuant to the plan of benefits and paid properly.

6. Risk management expertise and best practices sharing: When like-minded employers band together in a captive, it becomes mutually beneficial for all members to share risk management expertise and best practices to keep total healthcare costs down for the group. Employers should make sure their captive offers member and consultant meetings where professionals can come together and learn from one another to improve safety and risk management expertise.

Reap the Return on Your Investment
Captives are well suited for organizations that invest in the health and well-being of their employees. By creating a healthier, happier workforce, captive members can reap the financial benefits produced by lowering their claims instead of passing them along to insurance carriers.

As healthcare costs continue to rise, captives remain an attractive option for a wide range of employers. But these organizations need to ensure they choose the best captive for their business. Joining a captive is best accomplished with the help and guidance of an insurance broker that’s deeply experienced in these innovative solutions. At Conner Strong & Buckelew, we offer our employee benefit captive clients expert guidance from our years of experience assisting clients joining captives and maximizing value. When we don’t have the expertise necessary to solve a problem, we’re known for forming partnerships with the best in the industry to provide it. We believe in captives so much that we’ve joined our own, called CREO.

If you think an employee benefit captive might be right for your organization, or just want to learn more, contact us today to ensure you maximize the value for your organization and employees.

HURRICANE SEASON
June 1 – November 30

2024 is expected to bring an aggressive hurricane season, with severe storms capable of causing catastrophic damage and devastation. Ensure the safety and security of your organization and property by having a comprehensive plan in place.

Before the Storm

• Print copies of emergency phone numbers, insurance cards and IDs, placing them in a secure, waterproof container.
• Prepare an emergency kit, including flashlights, batteries, generators, hand and power tools, bottled water and food supply.
• Create an emergency response team and define clear roles and responsibilities for each person.
• Install windstorm shutters over windows and doors and place sandbags outside any opening to your building.
• Secure your property, elevate any items on the ground, and secure outdoor objects or bring them indoors.

During the Storm

• Shelter in place, if necessary. Stay indoors during the hurricane and away from windows and glass doors.
• Keep your emergency supply nearby and accessible. Have your phone ready and limit use for emergencies only.
• In the event of a power surge, turn off electrical switches to avoid reactivation before necessary checks are completed.
• If safe to do so, patrol the property and make emergency repairs, as necessary.
• Listen to the radio or TV for information and the latest updates.

After the Storm

• Stay alert for extended rainfall and subsequent flooding.
• Assess any damage and take photographs and video of all property damage. Keep records of any expenses incurred.
• Protect your property from further damage by boarding up broken windows and covering torn roof coverings.
• Inspect and make repairs to drains, gutters, and flashing.
  Contact an emergency service & loss remediation vendor.

QUESTIONS?

Please call Conner Strong & Buckelew at 1-877-861-3220 or contact your Account Team.

Visit the National Hurricane Center to stay up to date.