Local Shakeup: What a Partners & Harvard Pilgrim Merger Could Mean For You

On Friday, May 4th, the local healthcare market was shocked by the news of a possible merger between Partners HealthCare and Harvard Pilgrim Health Care, two of the largest healthcare organizations in the Massachusetts and New England areas. From a regional standpoint, this would throw a large wrench in an already uncertain and increasingly unaffordable healthcare market, whether for good or for bad (which I will get into later).
Healthcare New England

For some background, Partners HealthCare is a Boston-based hospital and physicians network with over 23,000 employees. Partners already owns several large, New England-based healthcare institutions like Brigham and Women’s Hospital, Massachusetts General Hospital (MGH), Neighborhood Health Plan and Mass Eye and Ear. Harvard Pilgrim Health Care, on the other hand, is a leading national health insurance carrier. With over one million members, it has a large footprint in New England

While still merely a possibility, the unknown is causing a certain degree of uneasiness. There are a lot of questions around:

  • Will this survive the antitrust reviews, based on consumer impact and consistency of the two organizations’ missions?
  • Will this make healthcare in New England specifically more expensive?
  • What are the positives a merger could have from a consumer standpoint?
  • Beyond power, what would be the real reason behind the merger? Traditionally, a hospital system and an insurance carrier would have two different, often conflicting goals.
  • What would this mean for the local, independent health systems like Lahey Clinic?

Although it is not possible to know all of these answers, consolidation often means less competition and higher costs.  Whether you’re locally-based or not, you’ll want to stay tuned!

Boston Healthcare Merger

Spring Spotlight: Grace Giannattasio

We know you’ve been missing these, so we’re back and we’re giving you the deets on Grace.

Title: Consulting AnalystSpring Consulting

Joined Spring in: July of 2017, although she’s sometimes still referred to as the “new girl” for some unbeknownst reason.

Professional interests/skills: Grace is an integral part of the Integrated Disability Management (IDM) team. As such she works on leave and absence management projects of varying kinds, like those related to the FMLA or ADA.

Outside-of-work: Grace is always making us jealous of her awesome tan, so it’s no surprise that she spends a lot of time outside (when Boston weather allows – a very small window!). She also enjoys reading and going to the beach (reading at the beach is a favorite activity).

Favorite season: Summer because, obviously. This is the only time she can work on said tan and beach reading.

Favorite flower: Grace went with lavender because it smells nice and is also known for helping you relax and sleep well.

Favorite part about working at Spring: “My favorite part about working at Spring is definitely the team I work with. Everyone is collaborative and supportive and the whole group works really well together.”

If your house was burning down, what non-living thing would you save? Grace would, rightly so, save her great-grandmother’s jewelry. Proud.

 

2018 IBI Annual Forum: An Overview

The Spring team has been involved with the Integrated Benefits Institute (IBI) and its events for quite a few years now. The organization provides valuable resources for employee benefits and absence management professionals, and their annual forum is a great opportunity for industry experts to come together and share their experiences and strategies.

For these reasons and more (such as escaping winter in Boston), I was excited to head back to San Francisco earlier this month for the 2018 IBI Annual Forum. Over the course of the three days, I joined over 500 employers and service providers in helping each other advance our professional knowledge and capabilities. Acquaintances were made, colleagues were reunited, lessons were learned and cocktails were had. I even had the chance to join some clients on a panel to speak about, “Evolving Your Absence Management Strategy: Let’s Talk Best Practices.” In the spirit of shared learning, I like to relay what I found to be the most significant topics at a given conference.

So if you missed the IBI forum this year or lost your notes, here’s a brief overview:

1. Data
This was probably the biggest buzz word at IBI this year. Big data, small data, data of all kinds. In 2018, this is not surprising.Specifically, Dr. Bruce Sherman from Case Western Reserve University emphasized the importance of HR professionals incorporating health-related statistics into their strategy, and treating well-being as a means to improve business performance. Then on Monday afternoon, folks from UPMC discussed the power of Big Data, demonstrating their use of an integrated platform that ties in all sorts of metrics and allows employers to view customized reports from which they can act upon. Along the same lines, representatives from Aon and PSEG explained how PSEG was able to tap into data to increase employee safety and risk, productivity and well-being while decreasing absence. Lastly, another session entitled “Unlocking Data to Analyze, Benchmark and Diagnose Absence Drivers, Culture and Impacts on Outcomes” demonstrated how to use qualitative and quantitative data to better inform absence programs. The panel discussed the ability to use this data to modify plan design, improve administration, optimize plan expense, minimize plan liability and more.

2. Change
By this I mean that words like “innovation”, “new” and “revolutionary” were commonly heard at IBI 2018. This is to be expected, since many attend the event to hear the freshest ideas and trends, and they weren’t let down this year.Gary Earl presented on the rise in chronic diseases over the past several decades. He urged the audience to sway from the status quo by modifying systems, behaviors and environments to make positive changes in health. Then, a team from Morneau Shepell explained their innovative approach to a “total health strategy”, which looks at employee health at the individual level and demands dual-accountability from both employer and employee for better outcomes in the areas of physical and mental health as well as productivity.In “Work is Changing and Reshaping Return to Work”, Dr. Glenn Pransky of Liberty Mutual outlined the changes we are seeing in the American workforce: more automation, more remote workers, the incorporation of artificial intelligence, the emergence of the gig economy, the trend toward later retirement and so on. These changes, Pransky argued, warrant an aligned shift in return-to-work tactics through the use of more digitally-friendly systems in particular. This was a nice segue into a later presentation on virtual healthcare, which emphasized the efficiency and effectiveness of telehealth through actual case study results. A representative from Walgreens then spoke on a panel about the importance of employee engagement in their whole health program, which aims to make services more convenient.Lastly, as mentioned above, I spoke with colleagues from Robert Half, Guardian Life Insurance, Adventist Health System and Chevron about the need for organizations to evolve their absence management programs. Our focus was on offering results and experiences that exhibit how to identify trends within your company and within the market, how to choose and work with different vendors, the importance of gathering feedback post-implementation from all stakeholders, and the ways in which metrics can help inform all of these integrations.

3. Paid Leave
As more and more states are passing paid leave laws and regulations, and more employers are implementing their own policies whether or not they are mandated to, I was glad to see that this was one of the hot topics at IBI this year.One session included a case study from Norwell Health, a New York based organization with 60,000 employees who recently developed a new paid parental leave program. The presentation provided guidance on how Norwell Health considered things like benchmarks, predictive cost and productivity analysis, competitive advantage and measurement. On the second day of the conference, Michelle Jackson of Unum and Kristi Stormer of American Family Insurance provided an overview of several organizations who have implemented a paid family leave policy. They presented  on the business case for such programs as well as the time and funds needed to establish a PFL benefit.

4. Mental & Behavioral Health
Eliminating the stigma and getting to the core of mental health problems has been a core focus over the last couple of years, both within and outside of the workplace. The 2018 IBI Annual Forum helped continue and advance the conversation.One panel highlighted the importance of creating an understanding workplace environment where anxiety and depression are treated as normal issues and are allowed to be discussed and recognized. The speakers explained how creating such a culture will help an organization’s morale as well as its bottom line. During “Mental Health in the Workplace. Challenges. Strategies. Opportunities!” further addressed the problematic stigma of mental illness, citing that while 20% of the US workforce suffers from it, only 1/3 will seek help or treatment, for fear of prejudice. This presentation, led by on mental health specialist, one employer and one ADA attorney, focused on ways to increase access to education and support for mental health at work, including EAP programs and other accommodations. On the last day of the conference, a mental-health related session drew from the experiences of The Home Depot and Comcast in their efforts to destigmatize the issue. Specifically, speakers illustrated the role that sleep can play in mental illness and therapeutic solutions. Sleep is so often the answer, isn’t it?

 

I hope you’ve enjoyed this glimpse into the 2018 Integrated Benefits Institute (IBI) Annual Forum. Please don’t hesitate to reach out with questions about employee benefits, disability and absence management, or anything else related. Lastly, keep an eye out for a similar write-up regarding the 2018 Disability Management Employer Coalition (DMEC) 2018 Annual Compliance Conference at the end of April.

 

 

 

6 Buzz Words from CICA 2018

The Spring team has been participating in the CICA organization and events for about a decade now, and we find that their annual international conference yields one of the strongest turnouts and value in the captive industry. This year was no exception. Not only was the event enriching from a professional standpoint, but I was also pleased to have missed yet another Nor’Easter here in Boston as I soaked in some warmth in this year’s conference locale, Scottsdale, Arizona.

While it might take some time for me to put pen to paper to document all my thoughts, during such a busy conference season. As a team we like to recollect key learnings and themes from each event we attend. It helps us ensure we are up-to-date on industry trends, and, we hope, it helps you stay in the loop too! Here are my initial thoughts recapping of the 2018 CICA International Conference.

 

  1. Change

Given that the theme for this year’s conference was “The Challenge of Change”, I was not surprised that the topic was prevalent. The captive industry is just one of many that is facing changes on many aspects. One that everyone’s been talking about are the implications of the new tax law. Luckily we had a few speakers there to help and advice.Captive Insurance Innovation

The other major topic of discussion regarding change was the growing use of captives to address cyber risks. I spoke regarding the benefits of using a captive for cyber risks along with a high level overview of a survey Spring undertook with the objective of understanding captive owner’s outlook to cyber insurance and their interest in placing captive risks in the captive.

 

  1. Going Global

CICA, being the only non-domicile specific conference, is one that addresses issues both domestic and international. A session that particularly interested me was one where (insert names of the speakers) two representatives from the European Captive Insurance and Reinsurance Owners’ Association (ECIROA) provided a big picture overview of the European captive space, including domiciles and trends. A later session outlined lessons learned from setting up large captives for multinational organizations, going over things like baseline data and requirements, internal marketing, optimum capital retention and diversification. Further, Nicholas Frost, Gabriel Hoschneider and Esperanza Mead led a discussion on Latin American captives and other emerging markets, highlighting opportunities for growth and expansion.

 

International Captive Trends

 

 

  1. Future-ThinkingThe Future of The Captive Industry

     

It’s not enough to be armed for the present, but in all professions, captive and otherwise, it’s critical to be prepared for what the future might bring, and try to shape it positively. That’s why a panel from Butler University spoke to the CICA audience about recruiting and training millennials, emphasizing the importance of captives to further their knowledge of the insurance industry. The group went through a case study in which students conducted a captive feasibility study and established a process for implementation. They also offered tips on how to attract and retain young talent. On a similar note, Temple University students, staff and colleagues presented “Fueling the Quality and Quantity of the Next Generation of Captive Leaders”, which underlining mentorship as critical and explaining best practices for creating a mentor program.

 

 

  1. Actuarial

Actuarial work is obviously at the heart of risk management, but sometimes it doesn’t get a lot of spotlight at conferences. At CICA 2018, that wasn’t the case.

Firstly, a group of consultants, actuaries, regulators and captive managers offered a comprehensive view of actuarial reports – what should be included, how to pull it together, how it should be utilized and items often overlooked throughout the process. A later session, including legal and compliance professionals, provided a thorough review of risk distribution and how it can be achieved and measured.

Captives and Tax Reform

  1. Taxes

As I mentioned earlier, tax reform and its implications for captives were a major discussion items at the conference.

One group specifically addressed tax reform and how its code will affect captives and their entities, including tips on revisiting your strategy for sound tax efficiencies with your captive. A group of tax lawyers later closed out the conference with a presentation on the consequences of the Avrahami case, IRC modification due to tax reform, and tax provisions to consider state-by-state.

 

  1. Utilization

Due in part to emerging risks and markets, every captive needs a thorough review every now and then to ensure it’s having the maximum effect. This is what Spring’s Managing Partner, Karin Landry, presented on, along with Steve McElhinney and Brian Johnson. The group emphasized the need for regular captive refeasibility studies and highlighted new areas of opportunity for captives. Spring has led many projects involving captive optimization and refeasibility, and we have an effective, recommended process to help companies undergo such initiatives. From a needs assessment to new and emerging coverages, to restructuring your captive to allow for modifications, we are experts in finding a solution that’s right for you. You can learn more about our captive optimization practices and suggestions here.

Further, during “Expanding Your Captive Utilization”, a panel further expanded on the subject, pointing out the importance of regulatory changes, particularly when it comes to hospital-owned captives, in discovering and reassessing lines of coverage. Lastly, CICA attendees learned how to “spice up their captives” by exploring new benefits and advanced captive program placements that may now be an option due to changing tax and insurance landscapes. This session covered federal and state regulations, ERISA implications and more.

 

I hope you enjoyed my overview, whether or not you were able to make it to the CICA International Conference this year. I found it a valuable experience and particularly enjoyed meeting new people and visiting with existing clients and colleagues. As you can see, I wasn’t just in it for the Arizona craft beer tour that kicked off the three-day event. I was paying attention too!

Spring to Sponsor RIMS 2018 Annual Conference

RIMS 2018

Spring team at RIMS 2017

It’s been a busy conference season for us here at Spring, and it’s not over yet! We are excited to be sponsoring and exhibiting at this year’s RIMS (The Risk Management Society) annual conference in San Antonio, Texas from April 15th – 18th. Spring has been actively involved with the RIMS organization for over a decade and we are pleased to continue this partnership. Further, after having just endured three Nor’Easters in a two-week span, we are ready to pack our bags for warmer weather!

The event boasts an incredible turnout each year, and we’re sure this year will be no exception with an expected audience size of almost 3,000. This ties in well with the 2018 theme, “Go Big.” RIMS is one of the best events for risk managers to network, learn and share ideas. The four-day conference combines a good mix of work and play and brings an impressive list of talent when it comes to speakers and content. We’re particularly excited to see Jay Leno!

If you’re reading this, there’s a decent chance you will be at RIMS too, so please don’t forget to come say hi to us at booth #753. We’ll have giveaways, raffle prizes and more, and we’d love to chat with you!

Spring to Speak About Absence Management at the IBI Annual Forum

This is a busy time of year for the Spring team when it comes to conferences, and we’re excited to announce that one of our Partners, Karen English, will be speaking on a panel at this year’s Integrated Benefits Institute (IBI) Annual Forum. We have sponsored and been involved with the organization for many years now, and we look forward to continued participation as we join other benefits professionals for another thought-provoking summit. This year’s conference will be held from March 12th-14th in San Francisco and boasts about 25 different educational sessions, along with networking opportunities like a dinner cruise.Employee Benefits Conference

As a speaker, Karen will be in good company, with other IBI Forum sessions being led by representatives from companies including Delta Airlines, Prudential Financial, Walmart, Goodyear Tire & Rubber Company, Walgreens and many others. On Wednesday, March 14th  from 8-9 AM, Karen will join Gene Lanzoni of The Guardian Life Insurance Company, Claudia Ruggiero of Chevron and Kerry Daley of Robert Half International.

The presentation, entitled “Evolving Your Absence Management Strategy: Let’s Talk Best Practices” will provide an overview of the different companys’ absence management programs, best practices and how it all works for that company based on things like corporate culture. The need to constantly adapt and modify your program will be stressed, a concept that will be demonstrated with specific examples.

Attendees of this session can expect to come away with strategies for identifying trends in your absence management program, tips for how to take action and implement changes, an understanding of key metrics to consider and more. If you’re wondering how to keep your absence management program updated and running with optimal efficiency, don’t miss out on this presentation!

With a Nor’Easter coming our way, we’re especially excited to head out to California, and we’re never disappointed by the quality of content or turnout at the IBI Annual Forum. Hope to see you there!

Spring to Lead Two Sessions at This Year’s CICA Conference

The Captive Insurance Companies Association (CICA) Annual Conference is just about around the corner, and Spring is excited to be participating in two of the conference’s many valuable sessions this year.

The conference, penned with the theme, “The Challenge of Change” this year, is set for March 11th-13th at the Westin Kierland Resort & Spa in Scottsdale, Arizona. We expect about 400 of the industry’s best and brightest to attend, and hot topics are sure to include regulatory issues, preparing for the future of captives and global and emerging captive markets, among others.CICA Annual Conference

The Arizona sun and warmth, as well as the opportunity to meet and network with so many esteemed colleagues, isn’t all the Spring team has to look forward to this year. This will be our 10th straight year of involvement in the CICA annual conference, so we are excited to be speaking in two sessions: “Captives 201: Is It Time for a Captive Refresh?” and “The Risk Business of Cyber: From Traditional to Terrorism”.

Representing Spring and speaking to the importance of keeping your captive fresh and optimized will be Karin Landry, Managing Partner. She will be joining Brian Johnson of Risk International Consulting and Steve McElhiney, President of Tall Pines Insurance Company in discussing this critical issue. The session is scheduled for Monday, March 12th from 1:30-2:30 PM. 

In-house cyber expert and Senior Consultant at Spring, Prabal Lakhanpal, will be sharing his knowledge of cyber risk and its prevention and mitigation at this year’s conference, along with Stephen Vina from Marsh & McLennan who will be focusing on the relationship between cyber and terrorism. This session will take place on Monday, March 12th from 4:15-5:15 PM. 

If you’ll be attending the CICA conference this year, be sure to tune into the above presentations – you won’t be disappointed!

World Captive Forum Recap: 5 Hot Topics

The World Captive Forum, sponsored by Business Insurance, held its 27th annual conference earlier this month in Fort Lauderdale, Florida. From captive owners, reinsurers, brokers, regulators and more, the event brought together about 300 of industry thought leaders, and we were happy to have taken part (and not just because we got to temporarily escape winter in Boston).

It’s been a few weeks now and we’ve had time to reflect on the topics and issues that really stuck with us after leaving the conference. As always, we wanted to share our vieGlobal Captive Marketwpoint. So if your schedule didn’t allow you to attend the World Captive Forum, or you’re just a little fuzzy on the details several weeks later, we’ve got you covered! Stay in the loop with our event highlights below.

1. International Regulations & Markets

Being the World Captive Forum, it makes sense that there was a significant focus on captive happenings outside of the US. A panel including employees of Willis Towers Watson and the State of Delaware commented on Brexit,, BEPS, IAIS, US tax reform and other issues related to international regulations that are important for the captive market. Later, we heard an update on the Latin American captive market from regional thought leaders. Among other lessons, we learned that Mexico and Colombia have the leading captive markets, while Peru, Argentina and Brazil have various obstacles hindering their captive development and growth.

2. Captives & Benefits

Captives can be a powerful, advantageous funding mechanism for an organization’s employee benefits. But as the world of benefits continues to change and evolve, so too has that structure. Bill Fitzpatrick and Mark Cook provided updates on global (there’s that word again) employee benefits and captives best practices. They outlined some of the different considerations for benefits and captives in different countries. Marsh then led a session on using voluntary benefits to grow your captive. They highlighted the advantages (or benefits, you could say) of voluntary benefits, different products available, factors involving ERISA and other pertinent issues.

3. Medical Stop-Loss

Mark Weinstein of Independent Colleges and Universities Benefits Association (ICUBA) led a discussion around the adding of medical risk to a captive, and all that entails. His panel explored different medical risk structures as well as the significance of risk diversification. In a separate roundtable, representatives from companies like Coca-Cola and Kirkway International covered medical stop-loss captives – their advantages and factors to consider.medical stop-loss

4. Microcaptives & Cells

In light of last year’s Avrahami vs. Commissioner court case ruling, it’s no surprise that microcaptives have been grabbing more of the industry’s attention. Specifically, one panel including Jeremy Huish and Mary Ann McMahon focused on pooling in microcaptives: how it works, best practices, IRS considerations, a look at how pooling relates to Avrahmi and more. The presentation included a case study highlighting The Spinx Company. Later, David Provost of the Vermont Department of Insurance presented with colleagues on the innovative ways to utilize a cell company. The session highlighted benefits like stop-loss protection , outlined the various possible structures and demonstrated it all through a look at an actual client’s experience. Further, a roundtable discussion delved further into the topic of microcaptives and cells.

5. Captive Optimization

A captive is a worthwhile endeavor, but it is a large one. As such, it’s important to make sure you’re getting the most out of it and continually checking for new opportunities that may have arisen due to market or regulatory changes. This theme appeared in a few different sessions at World Captive Forum. In one, “Spicing Up Your Captive”, introduced pensions, cyber, intellectual property, climate risks, reputation and others as food for thought when it comes to new captive strategies.

In another session, our very own Karin Landry, along with Michael Lubben of Henry Crown and Company/CCI, highlighted the importance of undergoing captive refeasibility studies on a regular basis, to ensure there are no missed opportunities and that your captive is keeping up with the changing needs of your organization. The presentation also included a case study. The topic got even more stage time when it was discussed in a roundtable – “Doing More With Your Captive.”

Captive Optimization

 

We hope this recap helped you glean all of the most prevalent and highly discussed issues of the 2018 World Captive Forum, whether you were able to attend or not. As you can see, we weren’t just in it for the weather! We enjoy having the opportunity to look back at each event we go to and sharing our takeaways with like-minded professionals. Keep an eye out for a similar synopsis after the CICA Annual Conference next month!