Benefits Executive Roundtable

In this week’s episode, Host Dorothy Cociu interviews Mike Sigal, VP of Sales Development and Omar Arif, Senior VO of Growth from ClaimDOC, a Reference Based Pricing vendor. As we continue to examine cost containment in self-funded health plans, we take a look into ClaimDOC and how they differ from other vendors, the effectiveness of single case agreements, ways to deal with Balance Billing, and h...

Host Dorothy Cociu discusses with Marilyn Monahan of Monahan Law Office all of the Employer Requirements for the Transparency in Coverage Machine Readable Files Disclosures and CAA Pharmacy Benefits Reporting Requirements for employers and their vendors . Whether you are fully insured or self-funded, there are a myriad of new requirements that have employers, third party administrators, pharmacy b...

Host Dorothy Cociu interviews Kathy Ruffino , Vice President, Train Me Today, on Human Resources and California Legislative Updates for 2022-2023 . We discuss AB 152 (COVID Supplemental Paid Sick Leave), AB 257 (The Fast Act), AB 1041, SB 1044, AB 1601, AB 1751, AB 1949 and more. We also discuss what employers are dealing with post-Dobbs, the Great Resignation current trends, and ways employers ca...

Post-COVID-19, employers are struggling to attract and retain employees, and employee benefits are one of the leading ways to sway prospective employees to your companies. In this week’s podcast, Host Dorothy Cociu interviews John Evangelista and Sarah Knapp from Colonial Life on the ways that Voluntary Benefits can enhance your new hire benefits package to help you attract the best candidates, an...

Host Dorothy Cociu interviews Maggie Stedt and Rosamaria Murrajo from the California Agents & Health Insurance Professional’s Medicare Committee on the Medicare updates needed for 2023 enrollments. We discuss the important things consumers need to know, the new rules that affect agents, and the Inflation Reduction Act’s Medicare provisions . In addition, we discuss what seniors themselves need...

In Part 2 of our Two-Part Series on Cybersecurity during Cybersecurity Awareness Month, Host Dorothy Cociu interviews Adriana Mendieta, Cybersecurity and Cyber Liability Coverage Expert , on the current state of the Cyber World… whether it’s harmful hacks or ransomware, everyone is at risk for a cyber attack. Adriana shares her thoughts as a Database Manager, member of a federal government cyberse...

In part 1 of this two part series, host Dorothy Cociu interviews Ted Mayeshiba and Ted Flittner of Aditi Group, an IT Technology, HITECH, Electronic Security and Cybersecurity firm on the current threats in electronic security, cybersecurity and the importance of risk assessments and training employees to protect your electronic data. We discuss the recent cyber and ransomware attacks and trends,...

Host Dorothy Cociu interviews Dan Baker, Vice President, Sales and MaryAnn Wessel, Senior Account Manager of EBA&M Corporation, a Third-Party Administrator specializing in self-funded and level-funded health plans on the best practices for renewal and open enrollment, and strategies for making your upcoming renewal efficient and successful. We discuss timelines for quoting and sales steps, rep...

Host Dorothy Cociu interviews Ryan Work, Senior VP Government Relations and Chris Condeluci, Esquire, Washington Counsel for the Self Insurance Institute of America (SIIA), on the No Surprises Act Final Rules and how they impact health plans, including updates on the Federal Independent Dispute Resolution (IDR) Process, which finally opened in April, 2022. How was the Federal Portal’s operations i...

Host Dorothy Cociu interviews Jeff Strong , Vice President, Sales, Sterling Administrators on health plan compliance, the good, the bad, and the scary! In this week’s episode, Jeff and Dorothy discuss ERISA disclosure requirements, the best tools for and preparing for audits, fiduciary liability, the Prudent Man Rule, Form 5500 filing and auditing, COBRA, ICHRAs, and more compliance information. I...

Host Dorothy Cociu continues her discussions on federal and state legal and regulatory updates with Marilyn Monahan. In part 2 of this 2-part series, we discuss the hottest two Supreme Court cases that were settled this past summer, including Dobbs v. Jackson Health (which overturned Roe v. Wade) and Marietta v Davita (which was a huge victory for self-funded health plans). What happened and what...

S4 E1 - Host Dorothy Cociu interviews one of the Roundtable’s favorite guests, Marilyn Monahan of Monahan Law Office. In part 1 of this two -part series, we discuss Federal & California State Leave Laws and how they inter-relate, updates on the current and future employer requirements for the Transparency in Coverage (TiC) rules, including Machine Readable File and online self-service tool req...

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...

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...

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...

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 t...

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 s...

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 ransomwa...

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 require...

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 chan...

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 Ruf...

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,...

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 heal...

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 th...

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, R...