LOUISVILLE, Ky., June 6, 2013 /PRNewswire-USNewswire/ -- Experts from Kentucky Health Cooperative are available to discuss timely issues related to the implementation of the Affordable Care Act (ACA), including the roles of health insurance marketplaces, or "exchanges," and the role of the new health insurance cooperatives. These subject matter experts are available for interviews, educational presentations, panel contributions and other discussions and events, either about the ACA in general, or specific to their areas of expertise. They may be contacted at the email addresses provided.
"Think member-owned and member-operated credit unions. Think food and rural electric cooperatives. Think agriculture cooperative extension offices, and consider the impact such organizations have made," Miller says of cooperative organizations.
She is a former Kentucky Insurance Commissioner, former secretary for Kentucky's Cabinet for Health and Family Services, budget director for the Kentucky General Assembly and a former director of operations for a regional Health Maintenance Organization. [email protected]
Making the Dollars Work: Financial Nuts and Bolts of a 501(c)29 Organization
Len Sherman, Chief Financial Officer and Vice President, Finance
"Easy to get a nonprofit organization up and running? It's a myth. The Internal Revenue Service's new designation introduces unprecedented challenges, considerations and opportunities. Getting a good start isn't impossible, though," Sherman says.
His previous roles include a stint as senior vice president of financial operations with Universal American; chief information officer and senior vice president of group sales with Lafayette Life Insurance Company, and vice president of finance, Allstate. [email protected]
Sherman's management position with Deloitte and his stint at Smith Barney as a registered investment advisor also uniquely positions him to speak on an array of other topics.
Rick Schultz, Vice President, Clinical Care Integration
Kentucky Health Cooperative will facilitate patient-centered care coordination and member management throughout the health care continuum. This member/caregiver assistance approach focuses on coordinating services to promote quality, cost-effective services through benefit management, community resources and provider involvement in complex cases. This approach is designed to empower members with chronic conditions by assisting them with the understanding of their disease process or disability. It also allows the member a larger voice in their care and more personalized attention to their particular needs.
Schultz is former director of quality improvement with Kentucky Spirit Health Plan; senior advisor for retiree health with Kentucky Retirement Systems; director of population health management with Lexington, Ky.-based Bluegrass Family Health; director of quality outcomes and case management, also with Bluegrass Family Health; director of utilization review and quality assurance with Advantage Care; director of case management/preadmission services and director of quality management, Central Baptist Hospital, also located in Lexington. [email protected]
Challenges and Opportunities: Establishing a CO-OP
Steve Lariviere, Vice President, Government Relations and Compliance Officer
Cooperatives are a familiar concept in the United States, especially in rural areas. Healthcooperatives were around in the 1930s and 1940s when the Farm Security Administration sponsored them, a forerunner to the currently-recognized health insurance model. Fast forward to today, as 501(c)29 organizations vie for licensure approval. Starting an insurance company is more than a notion, and Lariviere summarizes what's involved from the regulatory standpoint from the federal and state perspectives.
He is a former associate director of compliance and audit with Navitus Health Solutions in Madison, Wisc., and subrogation manager with Humana Inc. His experience also includes management roles in the claims areas of both Bristol West/Farmers Insurance companies, as well as Progressive Insurance Corp. [email protected]
Mountains and Lakes, Rivers and Bluegrass: Challenges toAccess to Care in Kentucky
Jack Tillman, Vice President, Member and Group Services
There are multiple carriers appointed with the Department of Insurance to offer health insurance in Kentucky. This number often decreases when small businesses want more than one insurer to bid on a contract. A health cooperative has been established that will, beginning in 2014, provide small business owners with an additional choice.
Tillman's background includes business-to-business sales and marketing management; strategic and marketing planning; development of structured sales methodologies, and product development in the health care, health insurer, managed care, health systems and Third Party Administrator industries. [email protected]
Creative Class on the Rise: Health Insurance for the Self-Employed
Susan Dunlap, Director, Communications and Development
Author Richard Florida triggered an international focus in his 2002 publication, "The Rise of the Creative Class and How It's Transforming Work, Leisure, Community and Everyday Life." The work brought unprecedented focus to "free agents," or the self-employed. A growing number of Kentuckians are self-employed – organic gardeners, web designers, weavers, visual artists, writers, blacksmiths, attorneys, accountants, educational tutors, personal trainers, corporate consultants – either by choice or by economic circumstance. The introduction of nonprofit, consumer-driven health plans will offer affordable health insurance coverage to everyone beginning January 1, 2014.
If ownership of an editorial services firm wouldn't have taught Dunlap firsthand about applying as an individual for health insurance, then hearing about a similar experience shared by her late husband, a sole proprietor and attorney, would have. [email protected]
Health Insurance Options 101: The Changing Landscape
Has the Affordable Care Act and its implications left you scratching your head? Not sure about the differences between a health insurance marketplace, or "exchange" and a health insurance cooperative? Kentucky Health Cooperative education and outreach specialists Mary Volkerding and Carolyn Franklin cover the basics of individual and small employer group options that open for enrollment October 1, 2013, with coverage to begin January 1, 2014.
The Kentucky Health Cooperative (KYHC), based in Louisville, is sponsored by a coalition of providers and business leaders dedicated to improving health outcomes by providing member-focused, accessible, cost-effective and quality-focused health care to individuals and small groups living in the Commonwealth of Kentucky. KYHC was identified by the United States Department of Health and Human Services (HHS) to receive loans to create and operate a Consumer Oriented and Operated Plan, or CO-OP. CO-OPs are non-profit, member-governed health insurance companies. KYHC is on track offer health plan benefits starting January 1, 2014.
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