The 2000 PELA conference was a great one. The PELA Board wants to thank all of the speakers and attendees for making this conference a valuable interaction.

Dr. Robert Chilcote, MD, MBA, Pediatric Hematologist/Oncologist kicked off the conference with an interesting discussion on how medical groups should use data in managing their capitated risks. His research concluded that capitated medical groups lack the accounting skills to effectively manage their risk. He encouraged the PELA members to help physicians manage risk as a value-added service.

The Partners In Care Executive Team: Dennis Wilson, President/CEO; Kevin O'Brien, Executive VP/COO; and Bruce C. Dees, Executive VP presented the perspective of a provider who has the infrastructure and knowledge to manage their risk. The group thanked us " for staying in the market" and challenged us as an industry to develop more creative reinsurance products to address the provider's needs.

Following their presentation, Charles Crispin Executive VP and Principal of Evergreen RE (Provider Excess/HMO RE broker) continued with a lively presentation on the Provider Excess Industry as it is today and what needs to be improved. From his perspective, carrier's need to design products that more effectively mirror the provider's underlying risk. He also encouraged us to get "smarter" about underwriting the risk.

Charles shared with us information from Evergreen Re's Managed Care Indicator. Copies of that can be obtained by contacting Charles directly. (Evergreen RE has allowed us to reprint excerpts of their report in this issue of The PELA Reporter).

Cathy Sussman, Account Manager and Wendy Radunz, Assistant Actuary from Allianz Life Insurance Company of North America, started the afternoon with an open forum discussion regarding current issues in the provider excess market.

This session incorporated full audience participation as they facilitated a dialogue regarding industry issues. Topics included the future of risk transfer, the declining trend of capitation and the limitations on coverage available in the marketplace. The shift of prescription drug coverage, including chemotherapy and blood products, to the physician side was also a hot topic of discussion. Provider insolvency coverage and direct contracting between provider networks and employers are areas of increased opportunity and regulatory focus.

Adria L. Bailey, Senior Consultant NiiS/APEX and Stephen Murphy, VP NiiS/APEX concluded our first day with an enlightening discussion on the link (or lack thereof) between the underwriter, contract and claims adjudication. Underwriters often include provisions such as limiting drugs to a percentage of AWP or UCR that is not defined. These provisions are often difficult for the claims staff to administer.

We started the second day off with Doug Dalrymple from Chubb Executive Risk. He presented "Provider Excess Insurance - An Underwriter's Perspective" which included a discussion of the past, present and future of the provider excess market. His presentation also addressed several of the issues currently affecting the provider excess market environment and suggested some actions that could be taken to correct some of the problems. He brought up several good ideas that could be used to add some stability to the marketplace.

Peter Van Loon with EDS Business Intelligence was the second speaker of the day. He discussed "Getting Positive Cash Flow with Investment Technology". In his presentation he pointed out that technology is useless, but information is extremely valuable. He stressed the importance of first addressing your business needs and making sure that the technology can help you meet those needs. Throughout the hour, he discussed the various keys to the successful use of IT.

The last speaker was Nathan L. Hays from Cairnstone, Inc. In his presentation "Contractual Issues - Product of Grays", he discussed the problems encountered due to the complexities presented by the provider excess coverage. He addressed the information that is needed within the contracts and why each item is needed to ensure the viability of the product. He ended his presentation with four characteristics of an ideal contract: clear, concise, easy to read and easy to understand.

The 2000 PELA conference was a great way to discuss current issues affecting all of us and hear opinions from all sides of the spectrum: the broker, the underwriter, the providers, the consultants and the carriers. If you missed this conference you missed out on some valuable exchange of information and interaction.

Thank you to all the speakers who helped make this year's conference a success.

Special thanks also to our corporate sponsors who helped make this conference possible.

Niis/APEX sponsored the Baseball outing on Saturday and the Welcome Reception on Sunday evening. American Re HealthCare continued their tradition of sponsoring the Pre-Conference Golf Tournament.

Allianz Life, Chubb Executive Risk, Evergreen Re, IOA Re, and R.E.Moulton sponsored a breakfast, lunch or break throughout the conference.

The Board would like to also thank Dorothy Gasparro, HR Options, who coordinated another successful PELA conference.