Risk Ready 2026: Developing a Winning Health Plan

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05 Feb

Risk Ready 2026: Developing a Winning Health Plan

Risk Ready 2026: Developing a Winning Health Plan

Thursday, February 5, 2026 (12:00 AM to 11:59 PM)
2.0 PDCs
Provider: Brown & Brown
Course Name: Risk Ready 2026: Developing a Winning Health Plan

Speaker: Ryan Rothrock, Courtney Nelson
Program Type: Seminar/Workshop
Registration URL: http://bbrown.com
Risk Ready 2026: Developing a Winning Health Plan, Nashville, Tennessee
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• Explain why healthcare spend is behavior driven and why actuarial steady state modeling misprices employer risk. • Define Risk Pool Management (RPM) and identify the 47 pre utilization behavioral variables that matter more than claims history. • Diagnoses how HDHP plan migration and contribution strategies can create leveraged trend and equity issues—and design corrective pricing. • Quantify the impact of tier ratio adjustments and composite rates on enrollment behavior, single rates, and trend. • Evaluate Rx adherence strategies (including $0 drug costs) versus high cost claimant alternatives to reduce future spend. • Identify hidden costs embedded in networks/TPAs (e.g., network access fees, EOB masking, completion factors) and implement transparent admin structures. • Assess fertility coverage, PBM carve in vs carve out dynamics, and infusion channel management to control medical drug spend. • Construct a phased RPM roadmap (outcomes first, education second) that avoids short term negotiation “aggression loads” and sustains savings.

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• Risk Ready 2026 delivers an outcomes first, education second approach to employer healthcare. Grounded in Risk Pool Management (RPM), the seminar demonstrates how manipulating pre utilization behavioral variables—rather than relying on historical utilization data—can drive a prolonged negative trend relative to current or budgeted costs. Attendees will learn why actuarial steady state assumptions fail in behavior driven healthcare, how HDHPs can inadvertently raise barriers and leverage trend upward, and how strategies like right pricing plan tiers, improving Rx adherence (e.g., $0 cost drugs), recruiting healthy waivers, exposing hidden fees, and managing PBM carve in/out decisions produce sustainable savings without compromising equity or access. Cohort case results (e.g., large populations achieving −2.6% trend vs 10%) anchor the session’s proof points.

Risk Ready 2026: Developing a Winning Health Plan
Risk Ready 2026: Developing a Winning Health Plan
5025 Harding Pike
Nashville, TN 37205-2801

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