2015 CONVERGE Program

nadp conference 2015

EVENT PROGRAM SEPT 28 OCT 1, 2015 JW Marriott Desert Springs Resort & Spa PALM DESERT #nadpcon15

CALIFORNIA

September 28, 2015 Dear Attendees: Welcome! We are pleased you’ve joined us for CONVERGE 2015, the National Association of Dental Plans’ annual conference. We look forward to sharing the next two and half days of professional development and connection opportunities with you all.

The dental benefits industry has entered a new frontier – one filled with opportunities and endless questions. Challenges range from Affordable Care Act implementation issues, shifts in the marketplace and provider concerns.

Over the next two and a half days, CONVERGE 2015 will broaden your industry perspective and knowledge through stimulating general sessions, in-depth breakout presentations and informative exhibits. The breakout sessions explore industry challenges through three educational tracks: Government Relations, Professional Relations and Business Development.

Session locations are published on the pocket schedule and in the mobile event app. And as an added bonus, the Discovery Zone will offer DZ Demos to enhance your learning experience.

Before we close, we’d like to thank each of you for attending our conference and bringing your expertise to our gathering. You, as industry leaders, have the vision, the knowledge, the wherewithal and the experience to help pave the way to an even brighter future. You are truly our greatest asset today and tomorrow, and NADP could not accomplish what we do without your support and leadership. Throughout this conference, we ask you to stay engaged, keep us proactive and help us shape the future of the dental benefits industry.

Our personal respect and thanks goes out to all of you.

Sincerely,

Chris Swanker NADP Board Chair

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Evelyn F. Ireland, CAE NADP Executive Director

about your CONVERGE PUBS Event Program CONVERGE offers professional development opportunities designed for various industry disciplines. This program book offers brief summaries of the breakout sessions, while the mobile event app provides additional details. To help you determine which session best meets your needs, session titles are displayed in this order using the following coding system:

Government Relations Professional Relations

Business Development

Use your smart phone to scan the QR code to download the mobile event app

Pocket Schedule

This pocket-sized schedule provides a quick-glance, daily schedule including events, session names and locations, breaks, receptions and lunches.

Mobile Event App sponsored by Milliman

The updated online schedule can be found within our mobile app which provides detailed session descriptions, speaker biographies, exhibitor and sponsor information that you can access on any tablet or smartphone.

Check the online session descriptions for further details that are not included in the print edition due to space limitations. To download the app, either scan the QR code above or go to your app store and search “NADP CONVERGE� password:

nadpcon15

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CONTENTS

7

agenda events

14

education sponsors

45 exhibitors about PUBS

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12

2016 CONVERGE

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STAY CONNECTED .org

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To download the mobile app, on your phone please visit

nadpconverge.org

This year’s mobile event app is a one-stop-shop for all your CONVERGE needs.

Full schedule which can be personalized Session details Session handouts Interactive Attendee list 2015 exhibitor list

nadp conference 2015

sponsored by Milliman

2015 sponsor list Discovery Zone interactive map & exhibitor booths NADP award recipients Speakers Real-time updates

Access code: nadpcon15

Built in QR scanner

Registration code: (yourfirstnameyourlastname)

Note-taking module

no spaces, all lowercase

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e h t SAVE DATE SEPTEMBER 12-15, 2016

Hyatt Hill Country Resort & Spa

SAN ANTONIO

TEXAS

nadp conference 2016

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monday, sept 28 7:30a - 12:30p Golf Tournament sponsored by Ameritas shotgun start at 7:30a 8:00a - 4:00p

Exhibitor set-up (all booths must be set up by 4pm)

11:00a - 8:00p

Registration Open

Discovery Zone

AGENDA

4:00p - 5:00p Exhibitor / Floor Manager Meeting in Discovery Zone

VOLUNTEER GROUP MEETINGS 1:00p – 2:30p

STI Codes

Salon 5

1:00p – 2:00p

Communications

Salon 4

1:00p – 2:00p

STI EDI

Salon 3

1:00p – 3:00p

Government Relations

Salon 1 & 2

2:00p – 3:00p

Education

Salon 6

3:00p – 3:30p

BREAK

West Foyer

3:30p – 5:00p

STI Clinical

Salon 5

3:30p – 5:00p

STI Operations

Salon 3

3:30p – 5:00p

Exchange Policy

Salon 1 & 2

3:30p – 5:30p

Research

Salon 6

4:30p – 6:00p New Member Welcome hosted by Membership WG

Salon 4

5:00p – 6:30p Commission on Advocacy Salon 1 & 2 Policy (closed meeting) 6:30p – 8:00p Opening Night Reception Springs Patio The Grove / Pavilion * STI = Standards & Transactions Initiative

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tuesday, sept 29

AGENDA

7:00a – 6:00p Registration (Discovery Zone)

8:00a – 8:30a Breakfast sponsored by Stratose (Discovery Zone)

8:45a – 10:15a Opening General Session sponsored by Anthem, Inc. of Presentation

The Dental Benefits Industry in 2020 Gabryl Nominees Michael Rogers, The Practical Futurist and Star Awards (Discovery Zone) 10:15a – 10:30a

Transition Time

10:30a – 12:00p

Dedicated Discovery Zone Time

10:40a – 10:52a 11:00a – 11:12a 11:20a – 11:32a 11:40a – 11:52a

Interleukin Genetics, Inc BFC RedCard Strenuus

12:00p – 1:30p

Luncheon in Pavilion

DZ demos

Presentation of Don Mayes Award

1:30p – 2:30p ACO Impacts on the Dental Marketplace

Dr. Jeffrey Sulitzer, Interdent; Matt Sinnott, Willamette (Desert Ballroom) Dental Reference Set

Dr. Fred Horowitz, Primecare Benefits, Inc;

Dr. Mark Jurkovich, SNOWMED CT; Krishna

Aravamudhan, American Dental Association

(Salon 1, 2 & 3) Cyber Security in Healthcare

Will Hinde & Sean Curran, West Monroe Partners

(Salon 4, 5 & 6) 2:30p – 3:00p

BREAK sponsored by Aspen Dental

3:00p – 4:00p

The Future of the Affordable Care Act and Public Exchanges • Leanne Gassaway, AHIP (Desert Ballroom / Discovery Zone)

Driving Member Satisfaction with Dental Plans

Rick Johnson, JD Power (Salon 1, 2 & 3)

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Customer Loyalty – The Art and Science

Kristin Irving & Paul Hagen, West Monroe

Partners (Salon 4, 5 & 6)

#nadpcon15 4:00p – 4:15p

Transition Time

4:15p – 5:15p State Advocacy: The Do’s, The Don’ts and

What is on the Horizon Kimberly Robinson, Funk & Bolton, PA;

Nicole Evans, California Association of Health Plans; Paula

Dierenfeld, Nyemaster Goode; Ellie Nieves, Guardian (Desert Ballroom / Discovery Zone) Dental Plan Accreditation Standards (DPAS) Lynn Green,

GEHA; Tim Ferree, Humana; Andrea Garrett, Dentemax; Amy

Spaulding, Pacific Dental Services; Kristen Smith, United

Concordia Dental (Salon 1, 2 & 3) The Dental Insurance Company of the Future

John Schaak, Scion Dental ; Brad Johnson, UHC;

Bruce R. Hentschel, Principal Financial Group

(Salon 4, 5 & 6) 5:15p – 6:15p

Cocktail Hour sponsored by Guardian (Discovery Zone)

stayconnected

nadp.org

download the mobile event app

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twitter @nadpCONVERGE @nadp_consumers @nadp_members @nadp_research @nadpgov #nadpcon15

You Tube .../nadporg Linked in

Search “NADP”

mynadp.org

wednesday, sept 30 6:30a – 7:30a Dental Dash fun run / walk

(JW Marriott Spa Entrance) sponsored by Pacific Dental Services 8:00a – 8:30a Breakfast sponsored by Heartland Dental (Discovery Zone) Registration

8:45a – 10:15a

2015 Gabryl

Award Presentation

General Session CEO Panel: The Future of Dental Benefits Ed Murphy, Life & Specialty Ventures; Steven Pollock, Dentaquest; Tameeka Smith, Aetna; Barbara Williams, Careington (Discovery Zone)

10:15a – 10:30a

Transition Time

AGENDA

8:00a – 6:00p

10:30a – 11:45a Providing a Window into the Post ACA Dental Landscape • Donna Smith, FAIR Health

(Desert Ballroom / Discovery Zone) Is Dental Provider Data Ready for it’s Close up,

Learning from Medical Plans’ Mistakes

Joe Proctor of Strenuus (Salon 1, 2 & 3) The Role of Dental in the Senior Markets

Marc Milanowski, HealthScape Advisors

(Salon 4, 5 & 6) 12:00p – 1:15p

Walk Around Lunch (Discovery Zone)

12:05p – 12:17p 12:20p – 12:32p 12:35p – 12:47p 12:50p – 1:02p

Dear Doctor, Inc Health Solutions Plus MEA | NEA FraudLens

DZ demos

1:15p – 1:45p Discovery Zone Break sponsored by Assurant Employee Benefits (Exhibitor Giveaways - Must be present to win) 2:00p – 5:00p

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Exhibitor Tear Down

#nadpcon15 2:00p – 3:00p ACA – Developments in Dental Network

Adequacy Issues • Kathy Larkin, Dentemax; Crystal

McElroy, MetLife; Jim Mullen, Delta Dental of CA (Desert Ballroom) Effective Interaction with Practice Management Consultants • Chuck Stewart, DentalAdvisors, LLC;

Amy Miller, BCBST; Michaela Muniz, Ameritas

(Salon 1, 2 & 3) Rebranding Discount Dental Plans – Why

Consumers, Dentists and Regulators Cringe When “Discount” is Mentioned • Jennifer Stoll, :Dentalplans;

Stewart Sweda, Careington (Salon 4, 5 & 6) 3:15p – 4:15p Dental ACA Update: Exchanges and Medicaid

Expansion • Joanne Fontana and Teresa Wilder, Milliman (Desert Ballroom) Dental Networks and Exchanges

Aaron Groffman, The Ignition Group (Salon 1, 2 & 3) Private Exchanges

Matt Graham , Leavitt Partners; Lance Hood, Array Health

(Salon 4, 5 & 6) 4:45p – 5:45p NADP Business Meeting – Open To All Members (Santa Rosa Ballroom) 7:00p – 10:00p

2016

Evening on your own

SAVE t he DATE

January 25 27, 2016 Leadership conference

Hyatt Regency Crystal City @ Reagan National Airport

Arlington, VIRGINIA

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thursday, oct 1 8:00a – 8:30a

Breakfast

8:30a – 10:30a Closing General Session sponsored by Delta Dental of CA The Changing Landscape of Publicly-funded Dental Programs • Dr. Lynn Mouden, CMS

Dental Director (Salon 7)

AGENDA

EVENTS GOLF TOURNAMENT

When:

Monday, September 28

Where: JW Marriott Desert Spring Resort & Spa Golf Course Time:

7:30a – 12:30p (7:30a shotgun start) Pre-registration was required.

Dress Code: No denim and shirts must have collars.

DENTAL DASH FUN RUN/WALK

Sponsored by When:

Where: Time:

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Sponsored by

Wednesday, September 30 Meet at JW Marriott Spa Entrance at 6:15a 6:30a – 7:30a

e h t SAVE DATE

ACTION

in

>>>>>>>>>>>

the dental benefits industry’s advocacy fly-in

January 27-28, 2016 • Washington, DC (in conjunction with NADP Leadership Conference) For more information, please visit

nadpadvocacy.org

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OPENING GENERAL SESSION

EDUCATION

Tuesday, September 29 8:45a – 10:15a Desert Ballroom

Presentation of Gabryl Nominees and Star Awards

The Dental Benefits Industry in 2020 Michael Rogers, the Practical Futurist, presents an entertaining and common-sense vision of what world the future dental benefits industry will inhabit at the beginning of the ‘20s by blending his knowledge of trends in technology, economics, demographics, culture and human nature. He will incorporate scenarios of what the dental benefits market might be at that same time. He’s done it for lawyers, health care professionals, transportation companies, and financial services companies—and now for the dental benefits industry.

Michael Rogers studied physics and creative writing at Stanford University with additional training in finance and management at the Stanford Business School Executive Program. He has worked with companies ranging from FedEx, Boeing and GE to Microsoft, Pfizer and American Express, as well as both NASA and the Department of Defense.

He addresses groups ranging from venture capitalists and corporate executives to educators, students and the general public and is also a regular guest on radio and television, including Good Morning America, the Today Show, PBS, CNN and the History Channel. Michael is a dynamic speaker who delivers an entertaining and common-sense vision of change for business and individuals.

sponsored by:

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BREAKOUT SESSIONS • tues

EDUCATION

ACO Impacts on the Dental Marketplace Desert Ballroom

Accountable care organizations (ACOs - groups of doctors, hospitals, and other healthcare providers) are a model currently being utilized throughout the country to improve quality of care and decrease cost. ACO success requires a population health management approach, which provides a tremendous opportunity for partnership with state and territorial health agencies, whose primary focus is population health. For ACOs to be successful, and for any health system to be truly integrated, dental health must be added to the equation.

Matthew Sinnott, MHA, currently is Director of Government Affairs and Contracts at Willamette Dental. Willamette Dental is an integrated family of companies that includes a dental practice, Willamette Dental Group (“WDG”), and insurance companies in Oregon, Washington and Idaho. The insurance companies exclusively utilize WDG – including salaried dentists, hygienists and specialists as well as 54 offices in Oregon, Washington and Idaho – to deliver the dental benefits for the insurance companies.

Dr. Jeffrey A. Sulitzer is the Chief Dental Officer for Gentle Dental, one of the leading Dental Service Organizations in the United States. He is responsible for the clinical leadership of Gentle Dental’s 500 dentists and 225 dental hygienists, which includes Clinical Support, Quality of Care, Provider Engagement, and Practice Management.

Dental Reference Set Salon 1, 2 & 3

The promulgation and eventual adoption of standardized dental diagnostic coding will support better understanding of outcomes of various treatments for different patient populations. It will also pave the way for more meaningful quality measurement of dental care. The application of quality requirements will first be broadly applied in public programs and exchanges but will eventually apply to all products, much like what happened in medicine about 15 years ago.

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Krishna Aravamudhan has been with the American Dental Association (ADA) for 13 years and, since 2014, serves as the Director for the Council on Dental Benefit Programs (CDBP), directing and overseeing all of the program activities of the Center for Dental Benefits, Coding and Quality (DBCQ). It is in this position that she oversees the work of the Dental Quality Alliance.

september 29 • 1:30p – 2:30p Dr. Fred Horowitz is a founder and President of Nevada Dental Benefits, Ltd. and its parent organization, Primecare Benefits, Inc. based in Las Vegas. He also serves as President and COO of Primecare Administrators, Inc. Previously he has served in executive positions (president, CEO, COO, EVP) for companies ranging from small local Third Party Administrators to head of the dental division of a major national insurance company. Immediately prior to Nevada Dental Benefits, he was CEO of a technology company in the medical and dental electronic transaction industry. He has also served as a registered state lobbyist on health care issues, representing clients across the country.

Dr. Mark Jurkovich has chaired the Dentistry Special Interest Group for SNOMED CT since it was added to the IHTSDO three years ago. In addition to continuing to care for patients on a limited basis, he owns and operates Northstar Health Analytics, a consulting firm specializing in health information exchange, terminology, and strategic planning for organizations in the dental community.

Cyber Security in Health Care Salon 4, 5 & 6

Healthcare organizations face an increasing threat from cyber attacks. Security needs to be addressed at an enterprise operational level as it touches and impacts all parts of an organization.

In this discussion we will cover the reality of the threats (internal, external), identifying risks to your organization and outlining a defense in depth approach to addressing security at an enterprise level.

Sean Curran is a director in West Monroe Partners Technology Infrastructure & Operations practice, based in Chicago. He has more than 20 years of business consulting large-scale infrastructure experience across a range of industries and IT domains, including extensive work in the areas of data and information security. He is a Certified Project Management Professional (PMP) and a Qualified Security Assessor (QSA) for the Payment Card Industry Data Security Standards (PCI DSS).

Will Hinde is a senior director in the West Monroe Partners healthcare practice and primarily focuses on health Insurance organizations. Will has more than 15 years of experience in management and technology consulting and is currently responsible for strategy and delivery our healthcare insurance clients. Will is an accomplished healthcare consultant and industry expert with extensive experience across multiple disciplines including healthcare reform, business and IT strategy formation, customer experience, operational assessment and improvement, mergers and acquisitions, and systems integration and consolidation.

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BREAKOUT SESSIONS • tues

EDUCATION

The Future of the Affordable Care Act and Public Exchanges Desert Ballroom

The ACA has impacted every facet of the health insurance industry, with more changes expected on the horizon. Looking at the big picture by reviewing where we are today and what to expect in the future, this industry expert will discuss a myriad of industry concerns from HHS to NAIC and FFM to SBM issues, with all the acronyms in between. Learn what may be in store as we focus on the future and how it may impact your company to get ahead of the curve.

Leanne Gassaway is a passionate health care advocate and is currently the Vice President for State Affairs for America’s Health Insurance Plans. AHIP is a national trade association that represents over 1,200 health insurance plans covering more than 200 million Americans. In this capacity, she is responsible for assisting in legislative, regulatory and policy advocacy efforts in the states, and activities at various political and regulatory organizations, such as the National Association of Insurance Commissioners (NAIC) and National Governors Association. She also is focused on federal and state driven efforts regarding the federal Patient Protection and Affordable Care Act (ACA).

Driving Member Satisfaction with Dental Plans Salon 1, 2 & 3

Learn about key drivers of member satisfaction from the J.D. Power 2014 Member Dental Report, including: • The top five factors in satisfaction • How satisfaction with dental plans compares to satisfaction with vision, health and P&C plans • Cross industry comparison of satisfaction with dental plan contact centers • The relationship between plan satisfaction and likelihood to recommend

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Rick Johnson is the Practice Lead for Healthcare at J.D. Power.

He is responsible for the overall direction of the Healthcare Practice, including developing new products, partnering with clients on conducting actionable research and serving as a thought leader in the industry. Prior to joining J.D. Power in 2014, Mr. Johnson served as a senior vice president at Lake Research Partners, where he conducted extensive research on the Affordable Care Act for various non-profit and corporate organizations. Previously, he worked at General Mills, where he served as an internal consultant for the company’s consumer insights unit, and for Synovate (now Ipsos).

september 29 • 3:00p – 4:00p

Customer Loyalty - The Art and Science Salon 4, 5 & 6

This session will explore techniques to help organizations build loyalty, promote advocacy, and increase cross-sell capabilities by delivering that effortless customer experience—starting with a true understanding of what it’s like for customers to interact with your organization.

It will cover ways to measure critical components of an organization’s customer experience and compare them against industry benchmarks. It will also explore the rise in the digital consumer and how successful companies today are shifting business as usual to prepare for the digital customer.

Paul Hagen is a senior principal with West Monroe Partners in Los Angeles where he heads the firm’s customer experience and innovation strategy.

He is an experienced strategy, customer experience, and marketing professional with more than 20 years of market research, human-centered design, technology and digital strategy, facilitation and project management experience and a track record for creating solutions that enable business goals through innovative technology and systems.

Kristin Irving is a director for West Monroe Partners in Chicago. She has more than 16 years of experience in consulting and solution development, focused primarily in the healthcare industry. Kristin has led many successful client projects in the areas of IT strategy and planning, Health Insurance Exchange Plan Management (HIX) strategy development and execution, customer experience enhancements to support business-to-consumer (B2C) transactions, software selections and implementations, application development and other disciplines, including change management.

EXTRA space

Handouts are available in mobile app or at nadpconverge.org/handouts2015

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BREAKOUT SESSIONS • tues

EDUCATION

State Advocacy: The Do’s, The Don’ts and What is on the Horizon Desert Ballroom

A panel of experts representing state health, life and dental trade associations discuss best practices in working with state assemblies, insurance regulators, and Exchanges. The panel will also forecast upcoming trends impacting the health and dental benefits industry. Join us for a lively discussion about getting engaged at the state level, managing critical coalitions and the emerging issues states will tackle in the coming year.

Nicole Kasabian Evans is Vice President of Communications, California Association of Health Plans. Nicole leads the development of the California Association of Health Plans’ strategic communications agenda, promoting the value of CAHP’s 40 member health plans in improving health care affordability, quality and coverage.

Paula Dierenfeld is an attorney in private practice with the Nyemaster Goode law firm in Des Moines, Iowa. Paula also serves as the executive director of the Federation of Iowa Insurers, the state trade association for life insurance, health insurance and financial services companies in Iowa.

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Ellie Nieves is Vice President & Counsel, Government Affairs at the Guardian Life Insurance Company of America where she is responsible for the company’s government relations activities at the state and federal levels.

Kimberly Y. Robinson is a member of Funk & Bolton, P.A, resident in the firm’s Baltimore office. Ms. Robinson leads the firm’s Government Relations Practice Group and is a member of the firm’s Insurance Regulation Practice Group.

Dental Plan Accreditation Standards (DPAS) Salon 1, 2 & 3

Interest in dental plan accreditation standards has been renewed by the Affordable Care Act. While there is no accreditation system in place for dental plans today and CCIIO has waived the application of accreditation standards to SADPs offered on Exchanges, there are elements of current medical accreditation systems that a few dental plans have obtained. NADP’s Foundation published a dental HMO accreditation framework in 1996 which was never implemented due to the product trend away from DHMOs to dental PPOs. NADP’s STI Content Workgroup has reviewed and updated the NADP Foundation Dental

september 29 • 4:15p – 5:15p Plan Accreditation Standards for the current market to put NADP and the dental benefits industry in the forefront of standard development that is appropriate to the dental plan market. Members of that workgroup review the standards and the issues that arise in application of accreditation systems to dental plans in this panel discussion of next steps.

Tim Ferree is the National Contracting Manager, Dental Networks for Humana.

He has more than 20 years of experience with Fortune 100 Corporation with an emphasis on managed care products and network development and management. Prior to his current position he served as Humana Midwest Regional Manager Specialty Networks for seven years.

Andrea Garrett is the Director of Dental Network Operations for Dental Network of America and DenteMax. In her current role, she is responsible for DenteMax provider enrollment, network data management, and provider relations. Additionally, she is responsible for enterprise dental network credentialing and relationships with Dental Support Organizations.

Lynn Green is the Network Contract Administrator for GEHA’s Connection Dental Network. During her 18 years with GEHA she has had roles in contracting, compliance and accreditation. Lynn manages the administration of network accreditation, credentialing, quality assurance, and manages crossdepartmental processes related to URAC accreditation standards. Lynn also handles state filings and assists dental clients with their state filings.

Kristen S. Smith is the Director, Provider Network Operations at United Concordia. She has overall leadership responsibility for all Credentialing, Delegated Credentialing, Provider Data and Support Services functions. Kristen has more than 25 years of clinical and administrative dental experience. She has worked for United Concordia for 24 years.

Amy Spaulding is the Senior Billing Operations Manager for Pacific Dental Services. The vision of Pacific Dental Services is to be the Greatest Dental Company in America. Pacific Dental Services currently assists 400 practices in Arizona, California, Colorado, Georgia, Idaho, Kansas, Minnesota, Missouri, Nevada, New Mexico, Oregon, Texas, Utah and Washington with a goal to support more than 60 additional offices per year in these existing markets while continuing to open new markets, which will soon include Florida, Tennessee and Louisiana.

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BREAKOUT SESSIONS tues, september 29 4:15p – 5:15p The Dental Insurance Company of the Future Salon 4, 5 & 6

Look up the headquarters of many large insurance companies on Google Earth and what will you likely find? Sprawling, well-manicured campuses with multi-story buildings that house thousands of employees, acres of call centers and a labyrinth of file rooms archiving mountains of paper. The dental insurance company of tomorrow will live largely in cyberspace. Innovations driven by state-of-the-art software will offer dental payers flexible and configurable systems; seamless integration with existing platforms; a newage of benefits to providers including the ability to instantly check patient eligibility and determine patient pay responsibility, submit claims and receive payment in days (not weeks or months), and support a variety of new reimbursement methods beyond fee-for-service including capitation, global budgeting, and value-based payments.

Brad Johnson is Vice President of Specialty Products at UnitedHealthcare.

In that role, he is responsible for product development and management for Dental and Financial Protection products. Prior to UHC, Brad held similar positions at ING Employee Benefits and Assurant Employee Benefits. He received his Master of Business Administration in Marketing and Finance from the University of Minnesota, Carlson School of Management.

Bruce R. Hentschel has more than 30 years of experience serving the benefits industry, including all facets of company operations. In 2010, Bruce was asked to lead Strategy for the Specialty Benefits Division, which includes group dental, vision, life, disability and critical illness insurance, and individual disability insurance. In this role, he focuses on developing strategic plans and evaluating opportunities to grow and expand the Principal Financial Group’s foot print nationally.

John Schaak is the President of Scion Dental and is responsible for ensuring that clients receive the highly innovative and ever more efficient services that they have come to expect from Scion Dental as their partner, and as a leader in the dental benefits management industry. This includes continuing to leverage its unique technology to significantly reduce the cost to clients in delivering dental benefits. It also includes providing leadership within the industry by, among other things, overseeing the company’s initiative to help protect children from fraud and abuse within the Medicaid dental program.

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#nadpcon15

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GENERAL SESSION • wed CEO Panel: The Future of Dental Benefits Desert Ballroom

EDUCATION

Presentation of 2015 Gabryl Award

CONVERGE 2015 examines all the forces at work shaping a new future for our industry, i.e. the effects of the Affordable Care Act, employer trends, consumer purchasing, Accountable Care Organizations development, private exchanges, accreditation, diagnostic codes, cyber security, discount plans, Dental Support Organizations and practice management consultants, loss ratios, Medicaid expansion, Children’s Health Insurance Program reauthorization and more.

Four dental plan CEOs with different tenures and market perspectives offer their perspectives on the future of the dental benefits industry on oursecond morning at CONVERGE. Get insights from leaders within a multi-line carrier involved in the current acquisition trend, a standalone dental plan, a discount or savings plan, and a Blue Cross plan— four critical views to NADP’s future.

Edward Murphy is Executive Vice President, Dental for Life and Specialty Ventures (LSV), a Little Rock, Arkansas-based holding company that owns and operates USAble Life of Little Rock and Florida Combined Life of Jacksonville, Florida. The combined entities have more than 500 employees and cover more than 2.7 million members.He is currently responsible for LSV’s Dental Programs Management area, which comprises four functional areas—network, product and sales support, operations and clinical management—in support of LSV’s six Blue Cross plan partners—Arkansas, Florida, Hawaii, Massachusetts, Tennessee and Pennsylvania/Highmark Inc. Prior to joining LSV, Murphy had co-founded Dental Benefit Providers (DBP) in 1984 and served as its CEO from its inception.

Steve Pollock is the president and CEO of DentaQuest, the third largest dental benefits administrator in the United States, and the largest for Medicaid. In addition to dental benefits, the company also includes care delivery, healthcare plan integration, eyeQuest, the DentaQuest Foundation and the DentaQuest Institute. Pollock has been with the organization since 1999, most recently serving as Chief Operating Officer, with oversight for all business segments. As COO, Pollock was responsible for strategic planning, sales and marketing, technology, operations, and mergers and acquisitions. During his tenure at the company, he has led the growth of DentaQuest from 2.3 million members in 1999 to more than 23 million members in 30 states today.

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september 30 • 8:45a – 10:15a Tameeka Smith is the Vice President of Dental and Vision at Aetna. She is responsible for strategic leadership, as well as profit and loss for these businesses.

Together, Dental and Vision businesses represent approximately $1.2 billion in revenue and serve more than 15.4 million members for the company. Tameeka has more than 15 years of sales and leadership experience. At Aetna, Tameeka led the National Distribution Strategy and Sales Force Effectiveness for Aetna’s Public and Labor business with a focus on sales and service process excellence in order to improve overall business performance. She provided leadership for the development of critical sales and client retention processes and maintained oversight of Customer Relationship Management strategy, broker relations, strategic alliances, go-to-market strategy and sales performance management.

Barbara Williams is CEO of Careington International Corporation since 2001.

She oversees one of the largest discount health care administrators in the country.

During her 23-year career at Careington, Barbara has helped the company build a stellar reputation as an innovator, serving some of the nation’s most respected Fortune 500 companies. From 2001 to 2008, Barbara served as President of the board of the Consumer Health Alliance (CHA) and is currently the Vice Chair of the association. CHA represents more than 28 million households in the United States and advocates for consumers’ rights to choose affordable and practical health care programs and products. CHA has been recognized as a resource for the discount health care industry. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Handouts are available in mobile app _______________________________________________________________________________ or at nadpconverge.org/handouts2015 _______________________________________________________________________________ _______________________________________________________________________________

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BREAKOUT SESSIONS • wed

EDUCATION

Providing a Window into the Post ACA Dental Landscape

Desert Ballroom

This presentation will help attendees understand how they can use claims data and visual, interactive dashboards to: 1) Compare utilization by geographic regions: a. Within a state b. One state to another c. Urban vs rural, 2) Compare utilization by age and gender, and 3) Identify trends over time, with the ultimate goal of measuring policy impact, informing benefit and reimbursement decisions, understanding market forces, driving prioritization and reducing risk.

This session will explore; both utilization and cost.

Donna Smith has more than 25 years of experience in the healthcare industry, concentrating on payor and claim technology solutions. With this experience, Donna brings a wealth of knowledge to her role. Prior to joining FAIR Health, she was an independent consultant to a variety of entities serving the healthcare and benefits industry, including thirdparty administrators, health plans and other companies serving the health insurance payer and self-funded employer markets. Consulting services concentrated on marketing, sales and organizational strategic planning.

Is Dental Provider Data Ready for Its Close Up?

Learning from Medical Plans’ Mistakes

Salon 1, 2 & 3 Provider networks are under the spotlight, now, more than ever. The consumerization of healthcare has brought to light the many challenges of delivering consumer-friendly, accurate provider data and has already resulted in numerous class action lawsuits. Aside from the potential legal liability, these challenges have already exposed health plans to a PR nightmare and loss of revenue. While the focus has historically been on the medical space, dental provider data is next. CMS is developing new network adequacy and provider directory standards and regulations for Qualified Health Plans (QHPs) and Standalone Dental Plans (SADPs). As the consumer shapes the industry, giving them the ability to use accurate provider data is the key to success. Unlike medical plans, dental plans have the opportunity to get out in front of these issues. Is dental data ready to be under the consumer microscope?

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september 30 • 10:30a – 11:45a Joe Proctor is Director of Customer Success at Strenuus. He has been with Strenuus for more than 6 years and is currently responsible for managing its national health and dental plan relationships. He has more than 20 years of experience working in the healthcare industry, beginning on the payor side with Blue Cross Blue Shield plans in Kansas and Kansas City. Since then, he’s spent the bulk of his career focusing on helping dental and health plans analyze and understand the overall strength and adequacy of their provider networks, including more than 6 years at GeoAccess/Ingenix (now part of Optum).

The Role of Dental in the Senior Markets Salon 4, 5 & 6

This session will focus on Medicare Advantage and the role of dental addressing the overall trends within the Medicare and senior markets. It will discuss the senior buying patterns / habits, how Medicare Advantage members acquire dental benefits (i.e. buy-ups vs. riders v. embedded benefits), identify what products are in the market (i.e. rider price points, rider designs) and the capabilities needed to be successful in Medicare Advantage and senior dental.

Marc Milanowski is the managing director at Healthscape Advisors. He helps his clients address and resolve many of the complex operational and financial issues that face the healthcare industry. Marc has a wide breadth of knowledge that he leverages on his client engagements, from developing growth strategies and navigating the complex government markets, to identifying and implementing cost containment savings and transforming traditional business models during a time of complexity and change in all aspects of healthcare. Marc has also assisted clients with core business activities, including major system migrations, reorganizations, and cost accounting redesigns. During his career, Marc has assisted clients across the healthcare industry (commercial, Medicare, Medicaid, TRICARE), including national medical, dental, and vision payers. Marc is a frequent speaker and attendee at national conferences such as those sponsored by the National Association of Specialty Health Organizations (NASHO), the National Association of Vision Care Plans (NAVCP), and the National Association of Dental Plans (NADP). Marc started his consulting career at Arthur Andersen and was a Director for Huron Consulting Group’s Pharmaceutical and Health Plan practice. He earned his bachelor’s degree in finance from DePaul University.

Handouts are available in mobile app or at nadpconverge.org/handouts2015

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BREAKOUT SESSIONS • wed

EDUCATION

ACA - Developments in Dental Network Adequacy Issues Desert Ballroom

The fastest growing trend within the benefits industry is the onslaught of network adequacy oversight. Both in regulatory and legislative arenas, policymakers are pursuing more stringent rules for both medical and dental networks, from carrier filings to provider directories. A panel of member carriers will discuss how they are working with the states on specific dental issues, implementing changes, and preparing for the future.

Kathy Larkin has 25 years of legal, regulatory and governance experience. She currently serves as the Compliance Manager for DenteMax, where she oversees the management and implementation of the company-wide compliance programs including training, policy review, and education.

Crystal McElroy is the Assistant Vice President over dental and vision product compliance and regulatory at Metropolitan Life Insurance Company in Irvine, CA. She currently oversees all compliance and regulatory issues as it relates to MetLife’s PPO and DHMO Dental and Vision business and oversees MetLife’s Health Care Reform/ Exchange operations.

James Mullen is the Manager of Public & Government Affairs for Delta Dental of California and its affiliated companies.

Since joining Delta Dental in 2001, Mr. Mullen has assumed responsibility for the company’s legal and regulatory advocacy and compliance activities in 15 states plus the District of Columbia.

Effective Interaction with Practice Management Consultants Salon 1, 2 & 3

Practice Management Consultants (PMC’s) are a growing influence in today’s dental network environment. They can also add cost to operations and create a drag on your team’s productivity. This session will focus on why PMC’s exist, how to distinguish the ‘good from the bad’, and how to interact effectively with them on fee negotiations and other issues. Panelists include colleagues from the insurance, dental support organizations, and PMC sectors, each providing unique perspective on this latest industry trend and the challenges it brings.

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september 30 • 2:00p – 3:00p Chuck Stewart is founder and managing consultant for DentalAdvisors, LLC, a full-service dental consulting firm. Chuck and his team apply a unique combination of both provider and carrier experience to help insurance carriers, DSO’s, and individual dental practices become best-in-class in their chosen markets.

Amy Miller is the Manager of Specialty Networks at BlueCross BlueShield of Tennessee. She is responsible for the development and retention of the DentalBlue (PPO) Network. Her other duties include recruitment of dental providers, assist in the resolution of issues and address any contract issues.

Michaela Muniz, joined Ameritas in 2001 as a Provider Network Representative and held a variety of positions within the team before assuming her current role in 2014. Michaela has been involved in the medical and dental provider network marketplace for more than 24 years, working in a variety of positions at Medical HMOs, Third Party Administrators and an Independent Provider Network throughout the Southeast.

Rebranding Discount Dental Plans Why Consumers, Dentists and Regulators Cringe When “Discount” is Mentioned Salon 4, 5 & 6

Find out what consumers really think about the term “discount” dental plans and what industry leaders are doing to change it. Join Jenn Stoll, Chief Commercial Officer for :DentalPlans as she presents consumer research findings that will change your perspective on the industry vernacular. Plus, hear from a panel of industry experts who will share perspective on the topic.

This interactive session will focus on how the industry is moving away from the term “discount dental plans” and how doing so will help consumers, dentists and even regulators benefit from this affordable dental savings option.

Jennifer Stoll joined :DentalPlans in 2003 as Vice President, Marketing and now serves as the company’s Chief Commercial Officer. Stoll has more than 15 years of digital marketing experience in the e-commerce industry and a passion for educating and empowering consumers with affordable and accessible dental care solutions. Under Stoll’s leadership, the DentalPlans. com marketing engine has become the largest online provider of dental savings plans having been recognized by the Inc. 5000 list 3 years in a row.

Stewart Sweda has been an integral part of Careington’s growth since 1992.

Beginning as a member service representative, Stewart has worked in many areas of the company and is intimately familiar with all aspects of the business and the health care industry at large. Stewart’s comprehensive product knowledge, expansive market awareness and visionary leadership contribute to his and Careington’s success in the marketplace.

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BREAKOUT SESSIONS • wed Dental ACA Update: Exchanges and Medicaid Expansion

EDUCATION

Desert Ballroom

Since the Affordable Care Act was implemented, dental coverage has changed dramatically due both to the advent of public exchanges and enhanced Medicaid eligibility. With respect to exchanges, this presentation will provide an update on the benefits seen in the dental marketplace and commentary on uptake rates of both pediatric and adult dental via exchanges. On the Medicaid front, calendar years 2014 and 2015 have seen increased coverage of adult dental benefits under Medicaid for several states as well as coverage for adults newly eligible in states which have implemented Medicaid expansion. This presentation will highlight dental coverage for Medicaid adults on a state-bystate basis including the status of Medicaid expansion states. The dialogue will include observations on reimbursement levels as well as network access related issues and potential solutions.

Joanne Fontana, CT, FSA, MAAA is a consulting actuary in Milliman’s Hartford healthcare practice and has been with the firm since 2006. During that time her clients have included insurance companies including several major dental carriers, employers, government entities, and other organizations.

Joanne’s focus has been largely on managed care and dental, with experience in premium rate development, provider contract analysis, valuation of post-retirement health benefits, and health care reform.

Teresa Wilder is an actuary with the Indianapolis office of Milliman. She joined the firm in 1997. Teresa’s primary consulting focus includes Medicaid healthcare financing and population programs. She has developed expertise in providing consulting services related to budget and population forecasts, longterm financial analysis, and new program initiatives, as well as 1915(c) waiver filings and cost-effectiveness calculations for the Developmentally Disabled, Aged and Disabled, Medically Fragile Children, and Seriously Emotionally Disturbed Children waivers.

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Dental Networks and Exchanges Salon 1, 2 & 3

The second Open Enrollment season for Obamacare has ended and more standalone dental plans are available on more exchanges. This session will build on previous presentations by discussing trends that shape provider networks on- and off-exchanges. It will include a state-by-state analysis of dental networks as well as updated enrollment data.

september 30 • 3:15p - 4:15p Aaron Groffman is a 20-year veteran of the employee benefits industry. He is currently President of The Ignition Group, a business intelligence firm he founded in 2004. The Ignition Group specializes in providing competitive intelligence about provider networks to health care companies via its innovative NetMinder web-based platform. The Ignition Group’s clients include the leading national healthcare companies as well as many regional and local players.

Private Exchanges Salon 4, 5 & 6

Private exchanges are on the rise as a distribution channel for all types of insurance products. In 2014 they served 6 million consumers and are estimated to grow to 40 million by 2018. But the myriad models, platforms and market orientations of these exchanges makes their use somewhat daunting for dental and vision carriers. Our presenters share trends specific to ancillary products and offer two solutions-- connectivity and standards. Leavitt Partners is leading a coalition of exchanges focused on standards development for private exchanges. Array is a founding member of that coalition and is focused on creating carrier specific exchanges that enable them to more effectively connect to their clients. Learn about the opportunities ahead for dental to help establish standards and capitalize on this new channel to expand your customer base.

Matt Graham is a Director at Leavitt Partners and works in the Salt Lake City office. He has a background in tracking and evaluating the evolving capabilities and business models of exchange technology vendors and the platforms they support. Mr. Graham has over a decade of project and client management experience in both the public and private sectors. Mr. Graham has led primary research efforts exploring and writing about various health insurance topics, including: payer and broker employer engagement strategies in an ACA context; payer sales cycles and compliance documentation processes; and health plan, employer, and broker sentiment regarding health insurance exchange adoption. Mr. Graham frequently speaks on how public and private exchanges are fundamentally altering how health insurance is being purchased and sold.

Lance Hood is responsible for marketing at Array Health including branding, product positioning, demand generation and marketing communications.

Most recently, Lance served as AVP of product marketing for Edifecs, a healthcare software vendor. Prior to this he held executive positions at security vendor Epok, social network provider OneName, and Health Systems Technologies. Lance also serves on the Advisory Council of the Washington Health Benefit Exchange. Outside of work he enjoys spending time with his family and two dogs. He is an avid cyclist and enjoys hiking and backpacking throughout the Northwest. Lance holds an MBA from the University of Washington.

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CLOSING GENERAL SESSION

EDUCATION

thursday, october 1 8:30a - 10:30a

The Changing Landscape of Publicly-funded Dental Programs Desert Ballroom Change is becoming the constant for publicly funded dental programs.

Federal and state marketplaces refer eligible children to the Children’s Health Insurance Program (CHIP) and Medicaid programs—expanding enrollment in these programs. State expansion of Medicaid eligibility income levels has positive impacts on the number of adults with some access to dental care as well. Across the nation, states are redesigning their health care systems to promote higher quality health care, healthier populations, and lower per capita costs. And there are more calls for inclusion of adult dental in all state Medicaid programs and a dental benefit in Medicare. The Centers for Medicare and Medicaid Services (CMS) is supporting these changes with new satisfaction measurement tools and focus on quality measurement. While some of these trends are not immediately impactful for publicly funded dental programs, they establish a direction that will move into these programs as well. Dr. Lynn Mouden, CMS Chief Dental Officer profiles how we got here and what is ahead for publicly-funded dental programs in this final NADP general session.

Dr. Lynn Mouden earned his Doctor of Dental Surgery degree from the University of Missouri-Kansas City in 1975. He worked in private practice for 16 years in the small town of Weston, Missouri, before moving into dental public health. He earned his Master of Public Health degree from the University of North Carolina and worked as an associate chief for the Bureau of Dental Health at the Missouri Department of Health and Senior Services before moving on to Arkansas, where for 12 years, he served as the Director of the state Department of Health Office of Oral Health. Dr. Mouden took over as Chief Dental Officer at CMS in February.

sponsored by:

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2015 SPONSORS

GOLD

SILVER

速

BRONZE

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2015 EXHIBITORS

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company • (booth #)

Actuarial Worksite Marketing Services (305)

Aldera (104) Apex Revenue Technologies (315) Avesis (213) BFC (109) CAQH (115) Chetu, Inc. (110) Dear Doctor (209) DentalXChange (111) Dentistat / go2Dental (214) EyeMed Vision Care (216) FAIR Health (105) Firstsource (116) FraudLens (108) Health Solutions Plus (303) Healthcare Excel (317) Information Capture Solutions (117) InterLeukin Genetics (113) National Guardian Life (103) NEA (217)

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company • (booth #)

One Mind Health (210) P&R Dental Strategies (204) Perio Protect, LLC (309) PLEXIS Healthcare Systems (107) PPO USA, Inc. (206) Quest Analytics (313) RedCard (208) Tesia Clearinghouse (106) Revolv (215) Santech Solutions, Inc. (114) SKYGEN USA (301) Strenuus (307) The Concept Group (212) The Ignition Group (202) The Premier Dental Group (205) VSP Vision Care (207) West Monroe Partners (311) WLT Software (118) Z Dental (211)

For more information on the 2015 exhibitors, download the event app by using the QR code below or search “NADP CONVERGE” in your app store. Access code: nadpcon15

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e h t SAVE DATE SEPTEMBER 12-15, 2016

Hyatt Hill Country Resort & Spa

SAN ANTONIO

TEXAS

nadp conference 2016

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