The 2^nd Annual
Supplemental Benefit
Innovations to Drive Health Outcomes

Workshop Registration

2:00-5:00 Navigating the Supplemental Benefit Landscape for 2026 and Beyond

This pre-conference workshop is dedicated to providing comprehensive insights into the future of supplemental benefits. Designed for industry professionals, this interactive workshop offers a deep dive into strategies that will shape the supplemental benefits landscape in the coming years. Register to gain access to a proven framework focusing on cost reduction, data optimization, and actuarial approaches to benefit design.

Key focus areas will include:

• Strategies to reduce costs while maintaining attractive and robust benefits
• Techniques for optimizing vendor relationships to obtain the best data possible
• In-depth analysis of supplemental benefits design from an actuarial perspective

Join us to equip yourself with the knowledge and strategies needed to excel in the evolving landscape of supplemental benefits. This workshop promises to provide valuable insights and practical approaches for future-proofing your benefit offerings

Workshop Leaders:

Networking Continental Breakfast

Chairperson’s Opening Remarks:

Christine Leo,

Vice President, Medicare Advantage Products,

Cigna

The View from DC on Medicare Advantage and Outlook for Supplemental Benefits

John Gorman,

Founder and Chairman

Nightingale Partners

Panel: ROI of Supplemental Benefits: Unlocking the Value Proposition

• Exploring worthy options based on transparency and numbers.
• Crunching the numbers and dissecting the ROI of supplemental benefits.
• Showcasing the undeniable long-term value in improving health outcomes and quality of life.
• Gain actionable insights into the financial implications of benefit enhancements to drive informed decision-making and strategic investments
• How are supplemental benefits improving health outcomes?
• How are plans providing data?
• Discover how strategic enhancements can directly impact the payer's bottom line, driving sustained growth and profitability
• Investing in benefits that do quality of care? Is anyone doing that? How?
• Coping with the myriad of data demands

Moderator:

Jim Knebel,

Head of Growth,

Kaizen Health

Panelists:

Panel:
THE SQUEEZE
Navigating the Negative Payment Trend: Curated Supplemental Benefits, Necessary Cutbacks, and Tradeoffs

• 2024 squeeze, 2025 squeeze, and 2026 squeeze - Macro policy updates and how payers feel about it?
• Looking at condition-specific benefits
• How do plans walk back supplemental benefits?
• How do you manage growth vs adverse selection
• What can you afford vs. what you need
• Will 2025 and 2026 have the most member shopping activities and transitions?
• How much do you want to grow or stay profitable?
• Balancing benefit richness / competitiveness in a constrained financial environment given rate compression, IRA impacts, V28, other financial impacts

Moderator:

Nicole Hungate,

Product & Quality Consultant

Brightstar Health Solutions, LLC

Panelists:

Networking Refreshment Break

Navigating the Regulatory Landscape for Supplemental Benefits: How Did We Get Here and How Do We Comply with All the New Restrictions?

• Decoding the complex regulatory landscape shaping the provision of supplemental benefits
• Ensuring compliance and innovation
• What has happened to lead up to these regulatory changes and why? Sketchy industry observations
• Identifying opportunities to streamline processes and reduce administrative burden
• Enhance operational efficiency and cost-effectiveness
• Best practices and red flags

Jenn Kerfoot,

Chief Strategy & Growth Officer,

DUOS

Jessica Assefa,

President and Senior Consultant,

Ameropia Advisors

Tying Together Impacts of Supplemental Benefit Utilization on Star Rating, Quality, and Clinical Outcomes

• Using supplemental benefits to boost member satisfaction and retention
• Keeping the member lifetime value and retention top of mind
• What is increasing customer access and satisfaction?
• What is hurting your Star Rating?
• How are plans using supplemental benefits to drive Stars/quality and clinical aspects?
• Are plans looking at supplemental benefits as a value proposition?
• AI and clinical reviews: Looking at CMS’ stance on AI for reviewing prior authorizations
• Improving health outcomes for disease management and overall patient satisfaction

Panel: Demystifying Reporting and Encounter Data Requirements: Utilization, Pricing, and Transparency Expectations

• How do new marketing rules impact the presentation of supplemental benefits to prospective members?
• How to collect encounter data for supplemental benefits that have not, to date, generated encounter data?
• The reporting checklist
• Next steps if your reporting gets rejected
• Vendor readiness
• CMS reporting on the OTC flex spend
• Collecting, reporting and submitting encounter data
• What are the flex dollars really being used for and validating those finds
• Dental nuances

Moderator:

Ashish V. Shah,

CEO,

Dina

Panelists:

Jennifer Simms,

Director, Government Products

Blue Cross and Blue Shield of Kansas City

Lori Rund,

Vice President, Government Programs

Blue Cross and Blue Shield of Kansas City

Naiwin Chang,

Senior Manager, National Supplemental Products

Kaiser Permanente

Networking Lunch

Panel: The Politics of Medicare Advantage and Its Impact on Supplemental Benefits

The growth of Medicare Advantage (MA)—and the billions of dollars spent on it—makes it an ever-more political program and supplemental benefits are among the most funding- sensitive parts of a typical Medicare Advantage Organization (MAO)’s MA spend. In this session, two veteran Washington DC insiders with deep knowledge of the politics of Medicare Advantage, will discuss the results of the November 2024 elections and how those election results could impact Medicare Advantage. Far from being an election overview, this session will feature in-depth discussion of specific Medicare Advantage policies and processes that might be impacted by the recent elections. Speakers will discuss, among other topics, potential changes to:

• Medicare Advantage funding
• MAO oversight from the Centers for Medicare & Medicaid Services and Department
• of Health & Human Services Inspector General
• New rules regarding offering and marketing supplemental benefits
• The continuing focus on health equity and addressing social determinants of health

Panel: Preparing for 2026 Mid-Year Notification: What Should Plans Anticipate?

• Materials/templates for the communication
• Systems of record, sources of truth for utilization data inputs
• Prep for and implications of increased utilization
• Updated financial forecasts
• Bid impacts
• How to implement new regulatory requirements regarding midyear notice on benefits that are not being utilized?
• How are you implementing it?
• Utilization expectations and setbacks

Moderator:

Lori Rund,

Vice President, Government Programs

Blue Cross and Blue Shield of Kansas City

Panelists:

Lisa Franklin, MS,

Director of Product and Marketing Strategy and Individual Medicare P&L, Leader, Strategic Growth and Government Programs

CareFirst BlueCross BlueShield

Abby Katabaro

Managing Director of Medicare Product

Blue Cross Blue Shield of Michigan

Medicare Advantage Supplemental Benefits: Where Do We Go From Here?

More than 30 million Americans are enrolled in MA plans and more than half of Medicare- eligible beneficiaries participate in the program—a number that was less than 30 percent just a decade ago. While this expansion has brought significant innovation in care delivery models, it has also brought questions around validating benefit value. This panel will cover how to understand MA supplemental benefit growth and the current regulatory environment, and the opportunities and challenges MA plans face in administering supplemental benefits.

Moderator:

Panelists:

Streamlining Success: Strategies to Improve Data Collection, Member Experience, and Cost Efficiency in MA Supplemental Benefits

Join us to learn about cutting-edge strategies designed to refine data collection, elevate member experiences, and achieve cost efficiency in MA supplemental benefits. This session offers actionable insights to drive operational excellence and member satisfaction.

Networking Refreshment Break

Moving Beyond the Swipe: Creating an Integrated Experience Across Supplemental Benefits and Quality

The average person aged 65 and older visits their doctor just five times a year yet sees their pharmacist three times a month and visits a grocery store more than once a week. These figures are even higher amongst Medicare Advantage members with OTC, food, and other supplemental benefits available to be spent in store.
Given their strong engagement with retail, what can we learn about the wants and needs of Medicare Advantage members from their shopping habits? And what opportunities exist to transform a member’s visit to the store and engagement with their supplemental benefits into a measurable ROI for your quality teams?

Panel: SSBCI & VBID: Criteria, Applications, Cut Points, and New Challenges

• SSBCI evidence requirements finalized by CY 2025 final rule
• Navigating the new application process for each
• Advantages and limitations for each
• Approval and rejection expectations
• Bibliography, sources, and relevant information
• Part C reporting requirements
• DSNP – how to engage some of those integrated benefits
• Looking at how to administer past qualification: The Wild West
• Can you be disenrolled?
• Partnering with the right vendor for offer more data

Moderator:

Panelists:

Additional Speaker TBA

Networking Cocktail Reception

Networking Continental Breakfast

Chairperson’s Recap of Day One:

Christine Leo

Vice President, Medicare Advantage Products

Cigna

Panel: Creating an Enhanced Relationship Model with Your Partners

• Partnering 2.0
• Aligning with vendors who are truly plugged in.
• Communicating what you need – demand more (pricing, competitive bidding, actuarial expectations, reporting)
• Managing the inflow
• Solutions that work well together – turning to a complimentary vs competitive arrangement with vendors
• Non-traditional partnerships - innovative delivery systems
• Accountability measures

Moderator:

Julie Crawford,

Senior Director, Enterprise Solutions

Modivcare

Panelists:

Integration of Supplemental Benefits Between Multiple Vendors to Support Increased Utilization and Awareness

• Operationally sustainable processes for multiple vendors/supplemental benefits
• Sourcing/contracting, implementing, managing, and reporting
• Simplifying a complicated roadblock for all health plans
• Improving Operational nuances for working with multiple vendors
• How are vendors working together toward one goal?

Utilizing Supplemental Benefits to Close the Gaps of Care for SDoH and Health Equity: Offering Non-Clinical Benefits that Go a Long Way

• Identifying and targeting SDoH needs
• What products are you offering to help with SDoH and which supplemental benefits make the most sense?
• What can you afford and will it be enough for the under-served?
• Which supplemental benefits address the social needs of members?
• Outreach and data for SDoH

Moderator:

Winnie Grim

Supplemental Benefits Manager

Zing Health

Panelists:

Harnessing the Power of Data Analytics and Technology for Supplemental Benefits

• Discover how data analytics and technology solutions can aid in the alignment process
• Provide insights into our data-driven approach to identifying gaps in care and effectively targeting interventions
• Explore how Health Equity Plan leverages data analytics to generate comprehensive social risk profiles and identify SDoH associated with concurrent health outcomes
• Examine an effective closed-loop referral system which utilizes sophisticated algorithms to predict service areas and health barriers, ultimately recommending tailored interventions
• Technology-driven solutions employed to enhance the delivery and monitoring of supplemental benefits, including our resource marketplace and real-time referral capabilities
• Analyze utilization and health outcome trends, measuring intervention effectiveness, and demonstrating return on investment (ROI).
• Using data analytics to make data-driven decisions
• Embrace the data revolution to optimize interventions and personalize care delivery
Explore advanced analytics techniques to identify high-risk members
• Drive improved health outcomes, reduced costs, and enhanced member engagement
• How are you using the data and where does it make the most sense

Moderator:

Panelists:

Networking Refreshment Break

Exceptional Hearing Care Through Transparent Analytics

• Increase engagement and positive member outcomes for the hearing care of your members through personalized care plans
• Proactively address hearing health among your patients
• Long term effects of reducing the risk of comorbidities
• Improving impact of overall cost of care and improve MLR

Flex Card 101: All cards and programs are not created equal

Flex cards can be an invaluable tool for boosting member engagement, rewarding healthy choices and reducing long-term care costs – but only if you have the right partner and technology powering your program. In this session, you will learn about essential topics to consider when selecting a vendor to support your flex card program, including:

• Flex Card Basics: How flexible are they? What types of benefits are supported? How about purse configurations and reward offerings?
• Vendor First Impressions Are Everything:  Consider what specifically they bring to the table, including experience, equipment, oversight, safeguards, print-on-demand (POD) versus traditional print processes, and service level agreements (SLAs)
• Compliance:  How programs based on SKU-level data compare to MCC/MIDs
• Network:  Should your program directly integrate with retailers or use third parties? What are the advantages of direct and indirect? Is there a strategy for independent or smaller chain merchants? What network size and configurability does a vendor offer?
• Fraud/Security: How does your vendor detect and prevent potential fraud? What resources, experience and processes do they follow in the event they are compromised?
• Member Services Tools:  Are you taking tier-1 calls or your vendor?  What are the tradeoffs of first-call resolution versus vendor outsourcing? How do you manage metrics and grievances?
• Member Experience:  What to consider for websites, apps, network and APIs.
• Reporting: The data and analytics you and your vendor should monitor
• Fees: How your program can manage PMPM, Card production, One-time fees and other ongoing fees – as well as the return of unspent funds

Dental Benefit Demand and Utilization Trends: How is the Most Utilized Supplemental Benefit Impacted by Recent Industry Turmoil?

• Dental benefit trends and upticks
• What’s on the regulatory watchlist for dental benefits
• How have plans adjusted the most widely used supplemental benefit? How are those changes affecting members to date?
• New reporting requirements for dental benefits

End of the Conference