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Category: Blog

25 Jan 2021
Janae Sorenson - VP Product Strategy & General Manager Ancillary Markets

Meet the Team – Product Strategy

Vice President, Product Strategy & General Manager Ancillary Markets, Janae Sorenson joined BCS a few months back, amid a pandemic and the years-long strategy to roll out new ancillary/voluntary benefit products. Janae, who lives in Portland, Oregon, is a remote BCS employee, regardless of our current COVID environment. Here, she shares her first impressions of BCS, her typical day as a remote employee in a different time zone, and the projects she’s focused on to lead our ancillary/voluntary lines of business.

Q: What does a typical day look like for you at BCS?

A: I am on Pacific Standard Time so I have to take into account the two-hour time difference.  Some days I may have a 6:30 am call so don’t expect to see me “camera ready” on those days! I set my West Coast calls for later in the day so most of you have gone home and I have a few hours to focus on business development for the West Coast. My role is a blend of product development, strategy and sales.  My main focus is growing our ancillary/voluntary lines of business.

Q: Tell us about a project you are working on.

A: I am working on the Ancillary Sales Strategy for 2021. We work through different distribution channels, and each of these channels has unique characteristics so we are trying to modify our plans to make sure we are differentiated and efficient in each channel.  Unlike national carriers that have a large sales force all over the country, we are getting creative about how we market, sell and enroll voluntary products.

Q: What about a project you’ve got on the horizon?

A: We are developing some co-branded product opportunities for ancillary/voluntary products, and marketing our suite of products to current customers and broker partners.

Q: What was your first impression of BCS? 

 A: Because my interview and hiring process were done during COVID, I have only gotten to know people virtually.  I have been surprised at how welcomed I have felt even though I haven’t met people in person yet.  Everyone has been so helpful, thoughtful, collaborative and creative.  The talent is so strong. I am continually amazed at everything we are involved in – especially given the number of employees we have. The “can do” attitude has been inspiring.

 Q: Do you have any New Year’s resolutions? 

A: My resolution is to be better at fitting in my workouts on days that I start my meetings before my “normal” work hours.  I just can’t seem to wake up, exercise and shower in time for 6:30 meetings! Walking at lunch would be ideal but the winters in Portland are so rainy so I am exploring online workouts and trying to use my elliptical machine for actually working out vs as a clothes rack.

14 Jan 2021
Top Women in HR Award Honoree Susan Linquist

Chief Human Resource Officer Susan Lindquist Named Top Women in HR 2020

BCS’s Chief Human Resource Office Susan Lindquist has been honored by Ragan’s Top Women in HR Awards 2020. Susan was named “Culture Czar” for her work to build engagement during the pandemic, and her focus on keeping employees engaged as they adjusted to working from home, with an emphasis on employee health and wellbeing.

At the onset of the pandemic, Susan led a team called the Employee Safety, Engagement, and Resilience Taskforce, which quickly developed a strategy to support employee health and well-being, keep employees engaged while working remotely, and enable them to remain productive. To keep the culture strong, employees posted photos of their home office setups (using #viewfrommydesk), shared tips for working in their home environments, and participated in virtual networking lunches and happy hours, among other activities.

As a Top Women in HR honoree, Susan joins a list of accomplished women leading the charge in Human Resources and ensuring that quality, productivity and morale are at its highest.

Congratulations to Susan, and all the honorees! For the full list of awards and winners, visit Ragan Media.

13 Jan 2021

Gene Therapy Poses Volatility Concerns for the Self-Insured Community: An Actuarial View

In recent years, science and technology have been rapidly innovating, bringing the cure to many genetic diseases within reach. Along with excitement is an equal level of nervousness as the costs of gene therapy poses significant financial concerns to risk-bearers. For large self-insured employers who do not typically purchase stop loss coverage, they are exposed to these new treatments that can cost over $2M.  For example, a 20,000-employee plan sponsor may be spending roughly $200M per year in health and benefit expenses, and is expected to have between zero and four Zolgensma treatments within their population. If they have one, it can be absorbed with the margin built into the premium equivalent rates. If they have four, the expense could exceed $10M, creating volatility that these large plan sponsors just haven’t seen before.

Smaller self-insured plans cannot manage this type of volatility, which is why they purchase employer stop loss coverage. But even the stop loss carriers are not immune to volatility. Take for example a $100M stop loss carrier that expects to run at a 75% loss ratio – one additional Zolgensma claim could impact the loss ratio by 2%, eating into margins that are already suppressed. That impact will eventually make its way down to the self-insured plan upon renewal. It is common for stop loss carriers to purchase excess of loss coverage that provides catastrophic protection, but it doesn’t provide the frequency protection that many carriers, and large self-insured plan sponsors, currently assume (i.e. getting more than your fair share of gene therapy claims).

The gene therapy pipeline is rich with several new treatments in the works and several with expected price tags ranging between $2M and $4M dollars. Expect risk management activities to expand for those in the self-insured community, whether it be large plan sponsors or even employer stop loss carriers. Contact BCS today to find out how we can help with risk mitigation, and provide protection against these treatments, which are creating financial volatility, but also bringing much needed curative therapy to members suffering from genetic disease.

14 Dec 2020
Dean Korolis - Vice President - Financial Planning and Analysis

Meet the Team – Finance

As we close out 2020, BCS checks in with Vice President, Financial Planning and Analysis, Dean Korolis, as he reflects back on the past year and the work his team has done in response to the pandemic.

Q: Describe your/your team’s role at BCS.

A: My team is responsible for the financial planning and analysis function of the organization. The team’s goal is to be communicative; both in terms explaining the financials to our operational and management teams as well as listening for changes that could affect our profitability. We interact with teams across the company to assess the progress and effectiveness of the company’s strategic plans and investments. We strive to be a resource to support decision-making.

Our work product ranges throughout the year given the circumstances impacting the company. During the first half the year, the team completed models to calculate the impact of COVID on our business and supported our acquisition of Medical Risk Managers. During the last half of this year, we shifted our focus to forecasting and long-term capital planning. The team is also working diligently to develop more analytics using business intelligence solutions.

Q:What’s your favorite project you’ve worked on?

A: At the onset of the pandemic, we as a company quickly rolled out communication updates to our customer base, reevaluated business lines and expense structures, monitored statutory requirements all the while adapting to a work-from-home environment.  With a chance to now look back, with a prospectively brighter 2021 ahead, I am proud of how the company rallied and responded to change brought on by COVID. Through it all, our company leadership and Culture Team ensured we remained positive, connected, and had fun.  The pandemic really put into focus how many truly amazing people we have in our organization. 

Q: How long have you been with the company? What’s kept you at BCS?

A: I have been with BCS for almost five years and each year brings a new set of challenges. During my time with BCS, we have engaged in major initiatives to improve our data processing and analytics platforms, launched a handful of new products to the market, assessed new reinsurance structures and expanded our distribution capabilities either through investments or acquisitions. The ability to touch all areas of the company and not just be a specialist in a certain role has kept me motivated and engaged. Further, the family atmosphere and the ability to work with great people each day keeps me at BCS.

Q: Describe your department in three words.

A: Analytical, communicative, and responsive.

Q: Do you have any special holiday traditions in your family?

A: The holidays are all about family and we are fortunate to have all our immediate family close – like really close — 10 minutes or so away. We head to church on Christmas Eve followed by dinner. Elf usually finds its way on to the TV and all kids unwrap the Saran Wrap Ball that is packed with odd gifts.

08 Dec 2020
New Board Members

BCS Appoints Three New Members to its Board of Directors

BCS has appointed three new additions to its board of directors, effective immediately: Walter Bell, former chairman, Swiss Re America Holding Corporation; Diane Gore, CEO, BCBS of Wyoming; and Gary St. Hilaire, CEO, Horizon Blue Cross Blue Shield of New Jersey.

“Our newest board members bring a wealth of experience and expertise, and we look forward to their contributions as we work to fulfill our mission to protect customers with innovative and easy-to-use insurance and financial solutions,” said Peter Costello, president and CEO, BCS Financial. “We are very fortunate to have them join us as we execute our strategies, and provide value for our customers and shareholders.”

Bell, Gore, and St. Hilaire were appointed in November, joining Dr. Craig E. Samitt, M.D., appointed in May, as new board members in 2020.

Walter Bell is a former Chairman of Swiss Re America Holding Corporation, where he provided supervisory governance of Swiss Re’s Americas businesses and oversaw and directed regulatory and public affairs for all the North America businesses from September 2008 to October 2012. Bell served as Alabama Insurance Commissioner, leading efforts to streamline the Alabama Department of Insurance, and also served as President of the National Association of Insurance Commissioners (NAIC) and Vice Chairman of the International Association of Insurance Supervisors (IAIS) Executive Committee.

Diane Gore is President and CEO of BCBS Wyoming, Wyoming’s oldest health insurer. She began her decades-long career at BCBSWY shortly after graduating from the University of Wyoming, and has been involved in the company’s financial area since she began her employment. She was named Chief Financial Officer and Treasurer in 2002, Chief Operating Officer in 2017, Executive Vice President in 2018, and President and CEO in 2019.

Gary D. St. Hilaire is President and CEO of Horizon Blue Cross Blue Shield of New Jersey. St. Hilaire joined Horizon BCBSNJ from Capital Blue Cross in central Pennsylvania, where he served eight years as CEO. During St. Hilaire’s tenure with Capital BlueCross, he led the company’s transformation into a nationally diversified family of companies, stressing the importance of leadership and corporate citizenship, and driving innovation with patient-focused care models, growth in ancillary services, and leading-edge data analytics.

The full Board of Directors roster can be found on bcsf.com.

30 Nov 2020
Melody Bautista, Director Clinical Data Analytics

Meet the Team – Case Management

From new product launches to partnerships with 2nd.MD and the National Hemophilia Foundation, there’s a lot going on in our Large Claim Solutions vertical. Director of Clinical Data Analytics, Melody Bautista, shares what she’s been working on, and is the perfect example that no two days are the same here at BCS!

Q: Describe your/your team’s role at BCS. 

A: I am the Director of Clinical Data Analytics and work mostly on BCS’s large claim solutions products and services.  My role/responsibility includes data analytics, clinical claims review, risk/cost management, and R&D. We are using an integrated data approach to bring together relevant clinical and claims data in a form that supports a variety of tools and analytics that we can leverage to improve outcomes, quality, and cost for our Blue Plan partners and payers. We identify high cost claimants (HiCCs) using predictive analytics tools and trigger reporting (diagnosis, specialty drugs, Gene Therapy/CAR-T) to identify members that are most likely to incur at least $250,000 in claims spend, then perform clinical claims review and identify BCS Risk Navigator solutions for our customers to contain costs and help their members achieve quality outcomes.

Q: What does a typical day look like for you at BCS?

A: Every day brings plenty of variety.  In a single work day I can work on press release and webinar content with marketing, on development of our HiCC database with Data and IT, conduct clinical claims review from trigger reporting, have meetings with our Blue Plan partners, review a specialty vendor Master Service Agreements with legal, work with account management and sales on an XOL Operations deliverables, assist coordination of SFTP set up with the Data and IT teams, work with our business analyst on clinical data analysis, research Specialty Pharmacies for a limited distribution drug, work on diversity and inclusion initiatives with our Culture Team, and work on process improvement activities with my Six Sigma team. Unlike Phil from Groundhog Day, I can honestly say that I have never had the same day twice and every day is an unknown adventure waiting to unfold.

Q: What trends are you watching in the healthcare industry right now?

A: There are many healthcare trends to watch right now from COVID-19 impact, to changes in healthcare delivery systems, and factors contributing to rising healthcare costs and premiums, but my main focus is always on HiCCs.  That includes paying attention to trends in million-dollar claims, emerging high cost therapies (Gene Therapies, CAR-T, immunotherapy cancer treatments) and specialty drugs, Stop Loss data trends, payment financing models (VBAs/OBAs), and more.  We use the knowledge of these healthcare trends and combine that with our claims/clinical data analytics information to develop highly relevant HiCC solutions to help our customers mitigate risks and improve outcomes.

For example, our actuary department provides us with an annual reports of the highest cost claims conditions and we combine that information with national healthcare information and our data analytics tools, predictive analytics outputs, and clinical claims review reports to identify what conditions we need to target for specialized solutions.  Out of that comprehensive data collection process and analysis, we determined we needed to find the best solutions to address members with oncology conditions like lymphoma and leukemia that persistently sits at the top of the highest cost conditions categories for the healthcare system nationally. That is why we partnered with 2nd.MD to provide top-tier medical navigation, expert consultation, and personalized second opinion services.  With this partnership, BCS can help members get the appropriate care they need, connecting them with board-certified, elite specialists from top medical institutions, and reducing their costs along the way.  In many cases, the second opinion can change the treatment trajectory – 85% of 2nd.MD’s consultations result in improved treatment plans, 35% lead to alternative diagnoses, and nearly 30% of surgery consults result in surgery cancellation.

Using this data, we developed two other customized solutions to support the approximately 20,000 individuals with hemophilia.  With the average annual cost for a patient with hemophilia topping $350,000 – $500,000 a year, we made it our priority to bring to market a solution set for health plans and their members to improve the quality and cost of care for members with hemophilia.  We partnered with the National Hemophilia Foundation (NHF), a trusted advocacy organization aligned with our focus on assisting with quality and cost of care. In addition, we also partnered with Audaire Health to provide hemophilia treatment management that improves patient adherence for high-cost therapies through real time tracking and pharmacy notifications.

We are looking to expand our customized specialty solutions to target more conditions, including Hereditary Angioedema/Defects in the Complement System, Cystic Fibrosis, Multiple Sclerosis, etc.  There is great interest and excitement for these customized solutions and we are currently working with our partners on implementation.  We are also excited to have recently joined our partners at the NHF, who are working on a collaborative with a mission to connect payers and patient advocacy groups to improve access to high quality care and address issues surrounding high-cost claimants through open dialog and shared solutions. I must say, I am truly proud to work for a company that strives to mitigate risks with cost containment solutions and improves quality of care outcomes for members.

Q: What are the most important skills you bring to your role?

A: The most important skills for this role are; flexibility/agility, a collaborative spirit, a strong interest in R&D/innovation, analysis, problem solving, and a having very curious mind.  Anyone who knows me knows how much I love solving puzzles and my keen interest in analysis is a great fit for this position because I enjoy recognizing patterns, looking for outliers or anomalies that help identify opportunities, and using data analytics to help guide better business decision making.  It also helps to be resilient and to view setbacks not as “failures” but as challenges or an opportunity for improvement.

Q: You have quite the commute. Pre-pandemic, what are your favorite ways to pass the travel time?

A: I have always had a long commute even when I used to live in the suburbs and took the train to the city but with this reverse commute, I actually use my commute time for prayer. Oddly enough, it is a good way to stay nice and calm during my long commute from the city. It’s tough to get upset with bad drivers when I’m thinking about the people in my life that I am grateful for.

17 Nov 2020
BCS Important News

BCS Financial Announces Partnership with the National Hemophilia Foundation

Emphasis on quality of care, cost containment for members

BCS Financial (BCS), a market leading insurer and reinsurer today announced its partnership with the National Hemophilia Foundation (NHF), bringing to market a solution set for health plans and their members to improve the quality and cost of care.

Founded in 1948, NHF strives to provide better treatments and cures for inheritable bleeding disorders and prevent complications of these disorders through education, advocacy and research.

“The partnership with NHF, a trusted advocacy organization aligned with our focus on assisting with quality and cost of care, is a first-of-its-kind in the industry,” said Peter Costello, President and Chief Executive Officer of BCS, “NHF’s unique ability to advise on optimal care management truly benefits our customers not only with cost but the level of service we strive to provide.”

According to NHF, there are approximately 20,000 individuals with hemophilia, and hemophilia consistently ranks within the top 10 highest catastrophic case spends. Costs range several hundred thousand dollars per year, with more than $1 million in annual costs is not unheard of for patients with the most severe forms of the disease (Source: Optum).

“The partnership between the NHF and BCS and its member plans allow us to establish baseline data on payment claims for people with hemophilia and develop strategies for Blue payers to facilitate the delivery of high-quality care through the network of federally-funded hemophilia treatment centers,” said Leonard A. Valentino, MD, President & CEO of the NHF. “BCS supports our goal to ensure optimal patient outcomes at the lowest possible cost.”

The three major factors affecting hemophilia cost containment include:

  • Site of Care – hemophilia treatment center Gold Standard
  • Assay Management
  • Prescription Management

The partnership addresses all three factors providing customers with increased access to BCS and its broad portfolio of complementary products including Excess of Loss, Stop Loss, International Health, Limited Benefit, and Group Supplemental insurance.

To learn more about BCS and its offerings visit: bcsf.com.

About BCS Financial Corporation:

For over 70 years, BCS Financial Corporation has delivered a wide-range of insurance and financial solutions primarily designed for Blue Cross and Blue Shield organizations and their customers nationwide. Through its subsidiaries, BCS Insurance Company and 4 Ever Life Insurance Company, BCS is licensed in all 50 states and is rated A- (Excellent) by A.M. Best. BCS Financial is headquartered in Oakbrook Terrace, Illinois. Learn more at bcsf.com.

About the National Hemophilia Foundation

NHF (the National Hemophilia Foundation) is a 501(c)(3) nonprofit organization dedicated to finding better treatments and cures for inheritable bleeding disorders and to preventing the complications of these disorders through education, advocacy and research. NHF’s programs and initiatives are made possible through the generosity of individuals, corporations and foundations, as well as through a cooperative agreement with the Centers for Disease Control and Prevention (CDC). Additional information on hemophilia and NHF can be found at www.hemophilia.org.

View the full release on Newswire: https://www.newswire.com/news/bcs-financial-announces-partnership-with-the-national-hemophilia-21254639 

26 Oct 2020
Susan Lindquist - Chief Human Resources Officer

Meet the Team – Human Resources

There’s perhaps no one better to offer insight into what it takes to succeed at BCS than Chief Human Resource Officer Susan Lindquist. This month, read on for insights from Susan – plus more about her role, her go-to resources for professional development, and the number one thing she’s sharing with employees about benefits enrollment.

Q: Describe your/your team’s role at BCS.

A: Our team’s role is to ensure we have the right talent available to meet our strategic goals.  To that end, we need to create a compelling employee experience that includes highly competitive rewards, opportunities to learn and grow, a vibrant workplace and strong personal connections within our BCS community.  We have almost 40% of our company engaged in culture-building activities including wellness, recognition, diversity and inclusion, community involvement and event planning.

Q: What do you like most about your job? What do you like least?

A: I enjoy the diverse responsibilities of my job.  I can be working on a strategic project in the morning, interviewing a potential new team member at lunch, and then finish my day by approving payroll.  I love that our small company size allows me to know all of our team members!  I least enjoy proofing Summary Plan Documents and Certificates of Insurance for our benefit plans.

Q: What skills does someone need to succeed at BCS?

A: In the last several months, we updated our company Beliefs to reflect both our values and our aspirations.  It’s very important that our current team members continue to embrace these beliefs and we hire new associates who commit to them:  diversity, transparency, simplicity, agility, integrity, and unity.  We can teach most skills!

Q: As we approach annual benefits enrollment, what is the number one thing you’d like to share with employees?

A: Make sure you use our wellness benefits!  Last year, we initiated a Lifestyle Spending Account which reimburses employees for up to $500 annually for expenses related to their wellbeing like gym membership, athletic equipment, financial planning and so much more.  Our Wellness Team also has created some great programs like virtual Cooking Conversations, 1:1 nutrition coaching and meditation.

Q: You are a big advocate for professional development. What are your go-to resources?

A: I am very proud that BCS prioritizes learning with such strategic importance that it is included in our Performance Scorecard.   I love the thought leadership that I find at Gartner and Center for Creative Leadership, and the quick wins I get from Harvard Business Review’s Management Tip of the Day and Daily Alert.  I also enjoy a good read and enjoyed sharing Mindset by Carol Dweck with a small book club last year at BCS.

21 Oct 2020
Whitepaper

New Whitepaper from BCS Highlights Healthcare Alternatives for Post-Pandemic Workforce

The U.S. Congressional Budget Office estimates that the economy could take the better part of a decade to fully recover from the coronavirus pandemic and related shutdowns.

Employers may be cautious about returning to business as usual; instead, many are cutting costs and managing expenses, filling vacancies with part-time roles, and/or increasing their intermittent employee population. This post-pandemic workforce brings forward new challenges about how to provide healthcare to part-time and intermittent employees.

Download the whitepaper today to learn about alternatives that may be available for your clients.

20 Oct 2020
Critical Illness Awareness Month

Offer a Solution Your Clients Need This Critical Illness Awareness Month

2020 marks the 10th anniversary of National Critical Illness Awareness Month, recognized annually in October.

This year over 1.8 million Americans will be diagnosed with cancer[1]. Some 790,000 individuals will have a heart attack and almost as many will have a stroke[2]. These critical illnesses can leave many in financial ruin – as high deductibles, copays, and coinsurance add up.

As clients offer benefits enrollment in the Fall, October is an ideal time to highlight the ancillary products like critical illness that can play a pivotal role in a member’s healthcare solution, by offering them financial support when they need it most.

EssentialCare Group Critical Illness[3] pays a lump-sum benefit upon diagnosis of a covered illness or life-changing health event. Employees can use payments to pay for major medical copays and deductibles, or additional expenses like transportation, child care, and more to help fill gaps in their healthcare coverage. EssentialCare Group Critical Illness includes:

  • Coverage for up to 35 adult and 8 childhood illnesses, plus support service coverages including wellness, dependent adult and child care, and more
  • Modular, adaptable plan designs that can be tailored to complement client need and underlying major medical
  • Easy administration with a simple RFQ process, best-in-class administration and claims adjudication
  • Award-winning, first-of-its-kind mental health rider that provides coverage for a severe mental illness event

For more information, contact BCS today, or visit essentialcare.com.

[1] Cancer.org, 2020 Facts

[2] Heart Disease and Stroke Statistical 2020 Update, American Heart Association

[3] Coverage for the Critical Illness plan underwritten by BCS Insurance Company is considered guaranteed issue provided: 1) the employee is actively at work; and2) the employee and all covered dependents are enrolled in a major medical health plan that meets minimum essential coverage requirements as provided under the Affordable Care Act (ACA).

 

ESSENTIALCARE PRODUCTS ARE LIMITED BENEFIT POLICIES—READ YOUR POLICY CAREFULLY. THESE POLICIES ARE NOT MAJOR MEDICAL INSURANCE AND ARE NOT INTENDED TO BE A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE.

BCS EssentialCare insurance is underwritten by BCS Insurance Company, OH (Administrative Offices: Oakbrook Terrace, IL). See policy documents for a complete description of benefits, exclusions, limitations, and conditions of coverage. Not all benefits available in all states. Features and availability vary by location, and are subject to change. Some products may be pending regulatory approval in certain states.