The Lobbying Environment for the Self-Insurance/Alternative

Risk Transer IndustryPresented by Mike Ferguson

Chief Operating OfficerSelf-Insurance Institute of America, inc.

www.siia.org

Presentation Overview

Self-Insurance/ART Industry Lobbying Clout – ChallengesIssues to Watch – Workers’ Comp Self-InsurersIssues to Watch – Group Self-Insured FundsIssues to Watch – Captive Insurance CompaniesIssues to Watch – Risk Retention GroupsIssues to Watch – Self-Insured Health Care PlansIndustry Lobbying Clout – Opportunities to ImproveSIIA InitiativesConclusion/Q&A

Challenges to Harnessing Self-Insurance/ART Industry Lobbying Clout

Extremely HeterogeneousTop-Line (Service Provider) vs. Expense Line (Employer)

MotivationsLarge Service Providers – Self-Insurance/ART Business

Divisions Often Smaller Than Traditional Insurance Divisions

Smaller, Entrepreneurial Service Providers Not as Politically Active as Larger Organizations

Service Providers “Shield” Employers From Important Industry Advocacy Information

Industry Lobbying CloutContinued

● Employers – Minimal Lobbying Budgets for Self-Insurance/ART-specific Issues.

● Employer/Business Organizations Don’t Properly Prioritize Self-Insurance-ART Specific Issues

● Multiple Industry Associations

Issues to Watch Workers’ Comp Self-Insurers

Medicare Secondary Payer ReportingMedical Records Privacy (After PPACA Implementation)Raid on State Second Injury FundsState Guarantee Fund Coverage for Excess Insurance Carriers

- Louisiana passed legislation to in response to court decision.

Group Self-Insured Workers’Comp Funds (SIGs)

New York SIGs Threatened With Extinction California Considers New SIG RegulationsPossible Action by Other States

Risk Retention Groups

NAIC Accreditation Program – De Facto LegislationLack of Regulatory Separation – Traditional vs. ARTNon-Domiciliary Regulatory AbusesLRRA Modernization Legislation

Uniform Corporate Governance Standards RRGs Allowed to Write Commercial Property Coverage Federal Dispute Resolution Process

New GAO Study of RRG Regulation

Captive Insurance Companies

New IRS RulingsProtected Cell RegulationDomicile Regulatory “Environment”

Self-Insured EmployersGroup Health

Health Care Reform (PPACA) RegulationsNew Federal LegislationDOL/HHS Self-Insurance StudiesERISA Preemption ThreatsMedical Stop-Loss Assessments

Industry Lobbying CloutOpportunities to Approve

Tell More Self-Insurance “Success Stories”Emphasize the Employer’s InterestsPersuade Service Providers Not to “Shield” ClientsBenefit/Risk Executives to Take More Leadership Roles

Within Business OrganizationsEducate Large Service Providers About Importance of

Self-Insurance/ART Business Units

SIIA Initatives

Speaking EngagementsOutreach to Large Service ProvidersEmployer OutreachPublish Self-Insurance “Success Stories”Political Action CommitteeSocial MediaGrass Roots InitiativesMedia Relations

Conclusion/Q&A

Let’s Talk!

Mike FergusonChief Operating Officer

Self-Insurance Institute of America, Inc.800/851-7789

mferguson@siia.org