Meritain Health® - In the Booth

Meritain Health discussion on COVID-19 and Stop Loss

March 26, 2020 Meritain Health Season 1 Episode 5
Meritain Health® - In the Booth
Meritain Health discussion on COVID-19 and Stop Loss
Chapters
Meritain Health® - In the Booth
Meritain Health discussion on COVID-19 and Stop Loss
Mar 26, 2020 Season 1 Episode 5
Meritain Health

Key points include:

  • Meritain Health’s preparedness and response to the COVID-19 pandemic and an update about what's new and what is in the works. 
  • We are continuously responding to the federal legislation updates.
  • How Meritain Health is proactively trying to help our customers manage risk. 
  • Meritain Health’s Preferred Stop Loss partners and how our relationships with them benefits our customers.
  • Continue to talk with your Meritain Health client management team or your Meritain contact. 
  • Our business continuity plan has allowed Meritain Health to keep business as usual, with all employees working from home.

     


Show Notes Transcript

Key points include:

  • Meritain Health’s preparedness and response to the COVID-19 pandemic and an update about what's new and what is in the works. 
  • We are continuously responding to the federal legislation updates.
  • How Meritain Health is proactively trying to help our customers manage risk. 
  • Meritain Health’s Preferred Stop Loss partners and how our relationships with them benefits our customers.
  • Continue to talk with your Meritain Health client management team or your Meritain contact. 
  • Our business continuity plan has allowed Meritain Health to keep business as usual, with all employees working from home.

     


Speaker 1:

BC: Thank you for joining me In the Booth for our second installment of our special edition of Meritain Health’s response to COVID-19. My name is Bridgette Cassety and I'm in the broker engagement department here at Meritain Health. And today I am joined by Michael Ciarrocchi, our chief market development officer and Mark Morgan, who's one of our senior directors that oversees our underwriting and business analytics here at Meritain. So, thank you so much for joining me today and Michael, last week we had the opportunity to have a discussion and you are joined by a few of our other leaders within Meritain to sort of talk about the Meritain and preparedness and response to the COVID-19 pandemic. And I thought it might be helpful to kick off our conversation for our listeners with just an update about what's new since we last talked. So if you could maybe just give us a quick update about what's been new since we talked last week, that would be great. MC: Sure. And thank you very much, Bridgette. I think our listeners will remember from our last episode that, we fast tracked some benefit enhancements for any of our customers who wanted to enable their members to access COVID testing, as well as waiving member cost sharing associated with Teladoc. Now since we last got together, there was federal legislation that actually mandated that COVID testing was to be covered without member cost sharing. So we have actually executed on that. We still have the ability to fast track and enhance our plans for customers who want to waive any of the cost sharing associated with Teladoc. BC: So could you talk a little bit about what's gone on this week and what else is in the works that our listeners would want to know about Michael? MC: Sure. So this week we have also enabled some additional enhancements. We have enabled the fast track option for customers who want to make available more broadly telehealth visit. So typically when a member sees a provider, it's in an office setting for the most part, and typically those in-network providers, there's not coverage related to those types of visits if they are done virtually; in a telehealth environment. Well as this pandemic continues to increase and increasingly providers are doing more virtual visits and frankly we're trying to encourage social distancing for members to keep them out of doctor's offices and out of hospitals. Many more providers are turning to telehealth in order to enable that. And so what we've done for our plan sponsors who wish to do this is we can employ a fast track mechanism to enhance their plan benefits that would enable coverage for all telehealth, regardless of whether or not it's a very traditional telemedicine vendor. And so we've made that available and our client directors are speaking with our plan sponsors and any plan sponsors interested in making that kind of fast track enhancement is something we have been able to enable them to do. BC: So access is certainly on the top of mind for our listeners. I'm sure access to health care being primary during this current time. And can you talk a little bit about what you're hearing around stop loss? What's on people's minds related to that Michael? MC: Yeah, for sure. So as our clients now start to settle in and recognize beyond access, there's more concerns about how do I protect my business? How do I protect my plan? As I start to recognize the longer term nature of where this goes and stop loss is a critical component of making sure that those businesses and that risk is managed and protected. And so leaders like Mark Morgan and his team have taken some real leadership in terms of having conversations with some of our preferred stop loss vendors so that we can make sure that we're proactively trying to help our customers manage that risk and settle in for what continues to be an extended period of time and manage the risk associated with it. BC: And you're right, Michael, Mark and his team has been providing a lot of leadership around this topic as it's certainly top of mind for many of our listeners. So Mark, do you want to talk a little bit about what Meritain’s preferred stop loss strategy is for the organization? MM: Yeah, I’d be happy to. Thank you. So from a preferred stop loss strategy, what we really look for is a couple of things and they're basic, right? When we're talking to carriers, we want to understand how strong their contract is, meaning limit as much as possible limitations and exclusions so that claims are paid, right? It's to underwrite the risk. You're also there for the liability. Financial integrity and stability. What is the ratings, whether it's A++, A+++, what have you, how strong are they financially to make sure that those claims are paid when occurrences happen. But by far, the biggest component that we look for is relationship. Because if we have strong relationships with our partners and insurance is a relationship business. When situations happen or pandemics like this or when there's grey claims, meaning there's uncertainty of who's liable. Our partners have stepped up and we're seeing that today. In regards to what we're going through today. But it's really just those three components, financial integrity, stability, how strong is the contract. But by far the most important is relationship that helps us get through situations like we're dealing with today. BC: Mark, when you talk about those key three things, can you talk a little bit about why that's so important? Valuable right now for listeners, either brokers or clients on the phone, especially when many of them are facing, you know, temporary furloughs or layoffs. Can you talk a little bit about why that's so meaningful and what you're hearing from our partners on that? MM: Yeah, absolutely. I'll start off on the front end. So we heard about the fast track in the last podcast, Michael just referenced it, as well. Prior to all the federal legislation that came out, our stop loss partners stepped up and said, okay, we understand this as good, access to care is good. We need to make sure we're supporting our employer sponsors and plan members. So before it was in the legislation, they are on board with us to do that. What it also means is when we're talking about the long haul or what's coming up next, as States are mandating closure of businesses or restaurants and bars have to close that impacts employees’ lives. So we don't want partners that just look at the black and white a financial aspect, we want them to work with us, especially in times where the plan documents actively at work provisions, what have you, may not reflect a pandemic situation cause stop loss insurance isn't necessarily pandemic insurance but there's a grey middle part there that we have to make sure our partners and us are all stepping up to the plate. So what I mean by that Bridgette is a couple things. The first thing is if an employer has to do some furloughs, there's going to be a short term closure of a location or what have you. The carriers thus far have been very, very receptive to working around amendments. Now highly encourage amendments. But we also know that in this fast paced world that we're all just trying to catch up with. We may not have the ability to get everything outlined in a formal process so we're seeing situations where they’re saying if the employees on the census and they're paying premium and they are covered. Even if the employer has changed what they're actively at work means and it may not reflect in the, in the plan design or actively work provision. So we're seeing accommodations like that. But I will say the reason why I think we're probably getting that is because of certainly the relationship, but more so it's proactive conversations. So every group is different. Some are going to need amendments, some are going to be able to have work arounds. And in most cases that flexibility goes a long way. But that's driven by proactive conversations and understanding what the need of the businesses during this time. BC: And Mark, if somebody has one of those situations that you're talking about, what is, what is the best thing that they can do or what's your advice to them in order to manage through that right now? MM: Yeah, absolutely. I think, you know, there's going to be situations here because Meritain we’re very accommodating in regards to how and our partners want to run the business. And what I mean by that is some of the stop loss is placed by our broker and consultant partners; some of that business is placed with Meritain, or through Meritain I should say. So if it's a Meritain place case, making sure you're talking to your client management team or your Meritain contact, they’ll get the information to the right parties internally. So the underwriting team itself, if it’s broker placed, we're here to help without question, but since that placement was done by the broker, we will help to coordinate efforts between the broker and the carrier on that regard. But communication, Bridgette, if I gives you one blanket statement proactive communication, asking some questions in regards to furlough, layoff, duration, are claims going to be paid, things of that nature and just making sure that you're sharing that with a carrier, whether it's Meritain placed or not. BC: Thanks so much Mark. And I think a couple things that came through and your discussion is around that we've got a strong preferred partnership with our stop loss carriers, that they're open to making accommodations in this unprecedented time and that communication is key. So, so thank you so much for that. And also I also think I heard you say that, you know, we are continuing to fast track those options and respond to the federal legislation, but we're keeping a keen eye making sure that we create access, access to health care, which is what we all want at the end of the day. And so with that, Michael, I'm not sure if you have any additional thoughts or comments or just sort of maybe sharing with our listeners, you know, what you think about when you think about what's next and how we move forward from here. So I'll give you the last minute or two of our podcast to sort of just share your thoughts with our listeners. MM: Sure. for sure. I think the way to think about it is there's a team of people right here that is trying to really anticipate what's coming next to try and help navigate that for our customers so that we can continue to be good advisors and provide some coaching or ideas about strategies to them to employ. I think the first thing I would reiterate like last time is that we have been able to deploy virtually our entire team to a work at home environment and have been able to secure a remote connectivity for them all. And so what that means is that our customers can feel comfortable that whether it's from a client management perspective, from a call center perspective, from a claim payment perspective, we are, we are able to continue to be supportive, not without an interruption in terms of their plans being administered and can being here for them and for their members. So that's, that's number one is the next thing I think that we're thinking about is as the pandemic continues and particularly in areas that are hard hit, how can we continue to administer our plans for the benefit of our customers while at the same time making smart decisions about helping to ease the burden on the system of healthcare delivery, where that makes sense and where we can be supportive to help facilitate that in the midst of that. So that is certainly the set of items that we are contemplating and we'll certainly be looking to share those ideas with our plan sponsors. The more we learn and the more we listen. So I would encourage every one of our, our customers to please continue to use their client management team, their account executives, their sales teams, continue to use them as resources as we try and provide additional support and coaching throughout this process. BC: And Michael, I think that you're absolutely right in the sense that, you know, as we require some creativity around solutions in an unprecedented situation, that Meritain is a TPA, has the flexibility to embrace that and respond to that quickly. And I think that's important for listeners to know. So with that, I want to thank both Michael and Mark for joining me today for this special edition of In the Booth, Meritain’s response to COBIT 19. We will continue to use these podcasts as a way to keep you informed and we appreciate you joining us. Have a great day.