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Spring 2001
Medical Committee Workshops
By Jim Wilmot
Blue Cross Blue Shield of Illinois
CoChair, Medical Committee
The twenty-fifth anniversary meeting featured five workshops by the Medical Committee. Sincere thanks go to the committee members for their creativity and extra effort in presenting a variety of topics of interest to the GUAA attendees.
The "Let's Talk Shop" session was facilitated by co-chair Kim Miller. Attendees discussed medical underwriting practices at the new business stage as well as renewals, with processes involving material misrepresentation. An item of interest was documenting group coverage eligibility at enrollment for very small businesses. Also of interest were eligibility of newly-hired employees after issue and eligibility verification at renewal.
Committee members, Patrice Hammond and Al Bemiss, facilitated a workshop on Stop Loss Underwriting. The speakers, Bob Olsen and Julie Bobak, presented current challenges and changing practices from a different perspective. Market pressures combined with various legislative influences continue to affect this area of underwriting.
The Committee continued the meeting theme of past and present with a look at HIPAA, inception to the present. Committee member Ann Bornsheuer facilitated, and led the discussion along with Jeanine Wilson. Besides the major impact on business practices over the past few years, many Companies are impacted by state requirements, some of which are more restrictive than HIPAA.
The Medical Committee's Broker Panel was moderated by committee member Elaine Owens who managed to allow three Chicago area brokers an open forum on dealing with different companies' practices and their underwriting variations. This frank discussion emphasized a need for underwriters to be forthright and honest in presenting clear and concise communication to the brokers, especially regarding rate increases and their justification.
The final workshop was the Internet as an Underwriting Tool by committee member John O'Connor. John summarized the multiple web sites and links of interest to an underwriter, and the ease at which detailed pertinent underwriting information is made available by the click of a mouse, such as business data, state insurance department sites, and various federal governmental agency sites. His handout is a superior reference document to any underwriter.
The Medical Committee looks forward to Montreal and will be presenting sessions of interest to the underwriting attendees.
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