Defined Contribution Health Benefits:
The Next Evolution?
An EBRI-ERF Policy Forum
May 3, 2001
Arnold and Porter Conference Center
9:00 a.m. to 4:00 p.m.
Paul Fronstin is a senior research associate with the Employee Benefit Research Institute, a private, nonprofit, nonpartisan organization committed to original public policy research and education on economic security and employee benefits. He is also Director of the Institute's Health Security and Quality Research Program. Dr. Fronstin's research interests include trends in health insurance coverage and the uninsured, the effectiveness of managed care, retiree health benefits, retirement transitions, employee benefits and taxation, the role of nonprofit organizations in providing employee benefits, children's health insurance coverage and public opinion about health care. His most recent publications include an EBRI Issue Brief on defined contribution health benefits, and forthcoming papers in Benefits Quarterly and Social Security Bulletin.
In 1995, Dr. Fronstin testified twice before the U.S. House of Representatives' Ways and Means Committee, Subcommittee on Health, to discuss health insurance portability and how employers have responded to rising health care costs. In 1998, he testified before the U.S. House of Representatives' Committee on Government Reform and Oversight, Subcommittee on Civil Service, to discuss long-term care insurance. He also testified before the U.S. House of Representatives' Ways and Means Committee, Subcommittee on Oversight to discuss COBRA and small employers offering health insurance, and before the Senate Labor and Human Resources Committee to discuss health insurance of the near elderly population. In 1999, he testified on the uninsured in front of the U.S. House of Representatives' Ways and Means Committee, Subcommittee on Health.
Dr. Fronstin has appeared before many groups to share his expertise on employee benefits. He has spoken before the Alliance for Health Reform, American Economic Association, American Public Health Association, Association for Behavior Analysis, Dade County Economic Forum, Gerontological Society of America, Harvard School of Public Health, Healthcare Leadership Council, National Association for Business Economics, National Conference of State Legislators, National Education Association, National Health Policy Forum, National Press Foundation, Orange County Employee Benefit Council, Population Association of America, and the Southern Economic Association. He has also made numerous presentations for congressional staff and the media.
Dr. Fronstin has been quoted in numerous newspapers, including the New York Times, the Wall Street Journal, the Washington Post, the Miami Herald, and the Philadelphia Inquirer. In addition, he has appeared on CNN, CNBC, C-Span, ABC News, Fox Morning News, Money Watch, and America's Talking and has been repeatedly interviewed on National Public Radio.
Dr. Fronstin earned his Bachelor of Science degree from SUNY Binghamton and his Ph.D. from the University of Miami.
Ray Werntz was named President of the Consumer Health Education Council (CHEC) in May 1999. CHEC's mission is to build a diverse coalition of private and public sector organizations committed to raising public awareness and knowledge of the importance of health insurance coverage to health care access, quality, and personal health.
Previously, Ray was Vice President of Compensation and Benefits for Whitman Corporation in Rolling Meadows Illinois where he was a strong proponent of health and financial education for employees and their families. In addition to his over thirty years' experience as a human resources executive, Ray has been active on many Boards and in other private and public sector organizations established to address health care delivery, quality, education, and access.
Ray, a native of Chicago, has a BA and MA in history and philosophy from De Paul University and a JD from John Marshall Law School.
Dr. Jerome H. Grossman’s principal activity is as a Senior Fellow and the Director of the Health Care Delivery Project. At his new position at Harvard, he will be bringing his expertise in the health care system and information technology, and his expertise in community services to develop innovations and reforms in the medical care delivery system. He is Chairman Emeritus of New England Medical Center, where he served as Chairman and CEO from 1979 to 1995. In 1990, he was named a Director of the Federal Reserve Bank of Boston, and was appointed Chairman from 1994 to 1997.
John D. Abraham has been senior associate director, Research Department, of the American Federation of Teachers since 1989. Previously, he served as manager of the Bell Atlantic Account for Blue Cross and Blue Shield, associate director of research for the Communications Workers of America, and as CEBS instructor at George Washington University. He has written numerous articles and papers on health and pension issues, including “A Comparison of Income Replacement Rates in Defined Benefit and Defined Contribution Pension Plans,” “Health Plan Standards for Consumers,” “Planning for Retirement,” “A Union View of Worker Participation and Its Potential for Improving Worker Morale,” and “America’s Health Care Problems.” Mr. Abraham became a certified employee benefits specialist at the Wharton School & International Foundation of Employee Benefits and was the recipient of a national HMO fellowship. In addition, he holds a B.A in finance from Loyola University of Chicago and an M.B.A. in economics from the University of California at Santa Barbara.
Roger D. Chizek joined Medtronic, Inc. in 1996. His responsibilities include strategic planning, design and management of all U. S. employee benefit programs as well as the company’s health and wellness activities. Prior to Medtronic, he was with Novartis for 17 years where he held various human resource management positions.
His educational background includes an MBA from the University of St Thomas, St. Paul, MN and an undergraduate degree from Moorhead State University, Moorhead, MN.
Randy Johnson has recently assumed the role of Director, U.S. Human Resources Legislative Affairs with responsibility for representing Motorola regarding human resources legislation and regulations in both Washington D.C and state governments. Prior to 2001, he served as Director of North America Rewards, with responsibility for retirement, health care and insurance benefits planning, development and marketing of Motorola benefits programs covering 70,000 employees in the United States and Canada.
He has been a leader in the installation of Motorola’s Health Advantage Program, the “stigma-free” Mental Health/Chemical Dependency Program, Centers of Distinction, and Healthy Quality of Life Programs--customer-designed programs and networks designed based on input from Motorola’s employee and provider community.
He has also been a leader in the development and implementation of Horizons 2000, Motorola’s approach to retirement and investment programs, which includes the 401(k)/Profit Sharing Plan, the Motorola Portable Pension Plan, MOTshare, (a discounted stock purchase program) and “Take Charge of Your Financial Future”, a customized financial planning program designed to give Motorolans the tools by which they can establish a “secure financial future.”
He is a member of the ERISA Industry Committee (ERIC) Board of Directors, Retirement Committee and Health and Welfare Committee, and the American Benefits Council (ABC) Board of Directors, Retirement Policy Committee and Health Care Policy Committee. He also served eight years on the Profit Sharing Council of America Board of Directors. He has testified before the Employer-Employee Relations Subcommittee of the House Economic and Educational Opportunities Committee, the Department of Labor and the Internal Revenue Service on both health care and retirement plan proposed legislation and regulations.
He recently served on the WorldatWork Board of Directors. He served on the Benefits Committee in 1992 when the WorldatWork (then the American Compensation Association (ACA)) established its Certified Benefits Professional Program. He currently serves as an instructor in WorldatWork health care and retirement seminars.
He also recently served as Board of Directors’ Chairperson of New Moms, a Chicago-based organization providing services to homeless and teenage new mothers and their families. He also served on the Board of Michigan HMO Plan in the mid-1970s. Previously, he was with Northwest Industries, Inc. and Manufactures Bank in Detroit. He is a graduate of the University of Wisconsin.
William J. Dennis Jr. is currently a Senior Research Fellow at the NFIB Education Foundation in Washington, DC, and directs its research activities. He has been employed since 1976 in various research capacities by the National Federation of Independent Business, the nation's largest small business trade association. Prior to his affiliation with NFIB, he spent six years as a professional staff member in the United States House of Representatives.
Mr. Dennis' research activities focus on small business and public policy. Among other activities, he is or has been: Founder and Director of the National Small Business Poll; International Reference Group Member, Swedish Foundation for Small Business Research, 1997-; Team Leader - Entrepreneurship Research Consortium, 1996 -; and President, International Council for Small Business, 1996-97. He received a Special Advocacy Award for research from the U.S. Small Business Administration in 1998.
Kim Bellard is Vice President, Indemnity & Special Products in Highmark Blue Cross Blue Shield's Product Management & Development department. In this role, he is responsible for development and implementation of new products, as well as for the Highmark member website. His unit recently introduced BlueChoice, the nation's first fully Internet-based, customizable health insurance program, as well as My BlueLink, the Highmark member health & wellness home pages.
Prior to joining Highmark in 1999, Mr. Bellard spent twenty years with Prudential HealthCare in a variety of assignments, including underwriting, product development, health care policy, and Executive Director of Prudential's Cincinnati operations.
Arthur Lifson is Vice President for Federal Affairs for the CIGNA Corporation. As Vice President, Federal Affairs for CIGNA Corporation, Art Lifson head's CIGNA’s federal affairs office in Washington and serves as the Corporation's senior representative in the nation's capital. He is recognized as an expert on federal health care reform and related policy issues, has daily contact with members of Congress and the Administration and has testified before various Congressional Committees primarily on health care issues.
Lifson helped found and serves as finance committee co-chairman of the Health Benefits Coalition (HBC), which represents businesses, business trade associations, health plans and health trade associations. The HBC goal is to promote the employer-based health care system. It has been most successful recently in developing opposition to mandated health coverages and attacks on ERISA.
He also is an active member of the Healthcare Leadership Council (HLC), comprised of 60 companies representing a broad spectrum of the health care industry, including managed care companies, pharmaceutical firms and medical equipment manufacturers. He serves on the HLC's Policy and Steering Committees. Art chairs HLC's Lobbying Committee. He also held key positions in the Alliance for Managed Care and the Coordinated Care Coalition, comprised of the larger managed care companies.
Prior to joining CIGNA, Lifson served in senior health policy roles with The Equitable and Equicor. He has served on the Board of Directors of the New York Business Group on Health and the National Health Counsel. He's also chaired health related committees for the National Association of Manufacturers and Health Insurance Association.
Art's bylined article, "Enabling Informed Choice: The Health Plan's Role in Providing Information to Purchasers and Consumers", appeared in a special issue (September 1998) of Medical Care Research & Review.
He is a 1969 graduate of Case Western Review University with a Masters of Science in Social Administration.
Jay Silverstein is the Chief Marketing Officer for UnitedHealthcare. He joined UnitedHealthcare in mid 1999, and is responsible for guiding UnitedHealthcare’s efforts across all communications and services to become a consumer-focused brand.
Prior to UnitedHealthcare, Mr. Silverstein was a founding principal and Chief Imagineer of Oxford Health Plans. In that role, Mr. Silverstein was chiefly responsible for creating and executing on the consumer-driven vision which helped Oxford achieve unprecedented growth in the managed care industry.
Mr. Silverstein started his career at Ogilvy Mather Worldwide in New York City, after graduating from Harvard University in 1981. At Ogilvy, Mr. Silverstein supervised the American Express and Seagram International businesses.
Mr. Silverstein has won numerous marketing awards, including EFFIES, Caples, Clios and Addy Awards. He is co-author of the best-selling humor novel, “I Worship the Very Dirt She Treats Me Like.” He resides in Minneapolis with his wife Wendy, daughter Samantha and twin boys, Ben and Jake.
Len Nichols is an economist and Principal Research Associate at the Urban Institute who studies private health insurance markets and how they work in response to decisions by employers, individuals, regulators, and public insurance programs. He has written extensively on these and other issues under the general rubric of health reform at both the national and state levels. He has also been a consultant on health policy for the World Bank and the Pan American Health Organization. Len is currently a member of the Competitive Pricing Advisory Committee (CPAC) for the Medicare program as well the Technical review Panel for the Medicare Trustees Reports. He was the Senior Advisor for Health Policy at the Office of Management and Budget (OMB) during the development of and debate over the Clinton health reform proposals of 1993-94. Prior to OMB, Len was a visiting Public Health Service Fellow at the Agency for Health Care Policy and Research, and prior to that he was an Associate Professor and Economics Department Chair at Wellesley College. Ho received his Ph.D. in economics from the University of Illinois in 1980.
James D. Bentley, Ph.D., joined the AHA in 1991 and is presently the Senior Vice President for Strategic Policy Planning. His responsibilities include: developing AHA policy on long-term public policy issues, such as the potential employer move to a “defined contribution” approach to health benefits, the impact new information will have on consumers and the health care delivery system, and the change new technologies will have on health care; leading the AHA’s initiatives on workforce supply, including the redesign of both work and work environments; and financing and accreditation of graduate and continuing medical education.
Before joining the AHA, Jim spent 15 years with the Association of American Medical Colleges. Initially responsible for legislative and regulatory activities affecting teaching hospitals, he concluded his AAMC career as Vice President of Clinical Services with responsibility for the Association's program of services for teaching hospitals and faculty practice plans.
Jim spent five years in the U.S. Navy Medical Service Corps and has been on the faculty of George Washington University where he taught medical sociology and health care administration.
In 1998 and 1999, Jim was a member of the Board of Examiners for the Malcolm Baldridge National Quality Award. He has served two terms as a member of the Board of Trustee of Holy Cross Health of Silver Spring, Maryland and continues to serve on its Mission and Planning Committee.
He has published in a wide variety of journals, including Health Affairs, The New England Journal of Medicine, and The Journal of the American Medical Association.
Jim earned his B.A. in Health Facilities Management from Michigan State University and his Ph.D. in Medical Care Organization from the University of Michigan.
Donald J. Palmisano, MD, JD, a general and vascular surgeon from New Orleans, Louisiana, was elected to the AMA Board of Trustees in 1996 and re-elected in 1999. He serves on the Executive Committee, the Finance Committee and chairs the Compensation Committee. He is a former president of the Louisiana State Medical Society and has received numerous AMA Physician Outreach Awards for membership recruitment.
Dr. Palmisano serves as the AMA's point person on privacy and confidentiality as well as antitrust reform to allow joint negotiations by self-employed physicians. In addition, he is the spokesperson for the Litigation Center of the AMA and State Medical Societies. Other assignments include the Internet and patient safety. Dr. Palmisano is on the Board of Directors of the National Patient Safety Foundation and chairs the Development Committee. He is a member of the Board of Commissioners of the JCAHO, and serves on the Advisory Board of the Annenberg Center for Health Sciences.
In 2000, Dr. Palmisano was one of 60 American "opinion leaders" chosen by the Department of Defense to participate in the Joint Civilian Orientation Conference (JCOC 63) .This 9-day American Medical Association program allowed Dr. Palmisano to visit military bases of the Army, Navy, Air Force, Marine Corps and Coast Guard and learn about our fighting forces, their equipment and capabilities, and national defense strategies.
Board-certified in surgery, and a fellow of the American College of Surgeons, Dr. Palmisano is in the private practice of surgery in New Orleans with four other surgeons. He played a key role in the passage of the landmark Louisiana Medical Malpractice Act of 1975, helping to plan and implement the tort reform.
A graduate of Tulane University in New Orleans, Dr. Palmisano entered Tulane University School of Medicine and received his medical degree with honors in 1963. Internship and residency in surgery were at Tulane and Charity Hospital of New Orleans. He then served in the US Air Force as chief of surgery for the 821st Medical Group (SAC) and received the Air Force Commendation Medal for his skill, knowledge, and leadership after a major aircraft (B-52) crash. Dr. Palmisano's published clinical research efforts have included systemic heparinization during catheter angiography, the first documentation that copper is an essential nutrient to adult health, and the world's first published operative photograph of a double gallbladder. He is clinical professor of surgery and clinical professor of medical jurisprudence at Tulane. Dr. Palmisano was elected President of the Tulane Surgical Society for the year 1999-2000.
Dr. Palmisano attended Loyola University School of Law in New Orleans and was elected to the Blue Key National Honor Society. In 1982, he received his Juris Doctorate and is licensed to practice law in Louisiana. He has served on the Governor's Commission on Medical Malpractice, was chair of the legal subcommittee of die Governor's Commission on Organ Donations, and currently chairs the Louisiana Medical Disclosure Panel that determines therapy risks.
Dr. Palmisano was a founding member of a physician-owned professional liability company, and subsequently founded Intrepid Resources/The Medical Risk Manager Company, a firm providing professional liability claims handling and risk management consultation to physicians, clinics, and hospitals. He serves as president and he is a frequent lecturer on a wide variety of topics including risk management, patient safety, informed consent, managed care, and tort reform.
His medical and legal publications include co-authoring the monograph, Informed Consent -A Survival Guide, and writing the risk management section on informed consent for the American College of Surgeons' book, Professional Liability/Risk Management.
An accomplished photographer specializing in nature and macrophotography, Dr. Palmisano and his wife, Robin, reside in Metairie, Louisiana. He has three grown children.
Thomas R. Beauregard is chief strategist of Sageo, a Hewitt e-business that delivers benefits to companies’ employees and retirees. In this role, he leads the company’s health and benefits strategy.
Mr. Beauregard has more than 15 years of experience in health care and benefits, working with companies to design and execute programs that reflect their specific business needs. Prior to joining Sageo, he led health care consulting efforts on the East Coast for Hewitt Associates.
In the e-health arena, Mr. Beauregard created the first Internet HMO auction, where health plans compete directly for companies’ business.
Mr. Beauregard is a graduate of Hobart College and earned a master’s degree in business administration from the University of Connecticut.
Tom Valdivia, Definity Health.
Lee N. Newcomer, M.D., Executive Vice President of Vivius, Inc., pursues new incentive solutions to drive better medical care. He practiced medical oncology, served as a plan medical director for CIGNA and led the medical policy group at United Health Group for nine years. He is now building a new company that allows physicians and hospitals to contract directly with consumers for health care coverage. Dr. Newcomer comments regularly in the media on health care coverage and physician performance issues.
Mary Nell Lehnhard has over nineteen years of experience working for the Blue Cross and Blue Shield Association’s Washington Office representing the Association’s and member Plans’ policies to Congress, government agencies, and other associations. Her background includes responsibility for the Association’s issues on managed care, health care reform and financing and tax legislation. She has directed the activities related to the Association’s role in Medicare, Medicaid and CHAMPUS.
Ms. Lehnhard’s background includes working as a Legislative Analyst for the Congressional Research Service, Library of Congress concentrating in the areas of food, drug and cosmetic regulation, drug economics, the federal health budget, and federal and state programs for mental health, alcoholism rehabilitation and drug abuse. She was also a professional staff member for the Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives. Her responsibilities included policy development and legislation in areas of national health insurance, hospital cost containment, and competition proposals.
Ms. Lehnhard has a Bachelor of Science degree from the University of Arkansas.
Kathleen Sebelius is currently serving her second term as Insurance Commissioner of Kansas. As Commissioner, she regulates the 1500 companies and 49,500 agents who sell nearly $9.5 billion worth of insurance products in Kansas each year.
Originally elected in 1994, Sebelius is the 23rd Insurance Commissioner of Kansas and Kansas' first woman Insurance Commissioner. She has been and continues to be a champion for consumer rights, health care reform and progressive change in state government.
Kathleen Sebelius serves as President of the National Association of Insurance Commissioners.
Prior to being elected Insurance Commissioner, Sebelius was four-term legislator in the Kansas House of Representatives from Topeka.
Commissioner Sebelius and her husband, Gary, an attorney, have two teenage sons, Ned and John.
John H. Gilman, MD, JD has been Senator Paul Wellstone’s Health Policy Advisor since 1997. Dr. Gilman majored in Political Science at UC Berkeley, received his medical degree from UCLA, and his J.D. from Hastings College. His prior professional experience includes ophthalmology practice, legal counsel to the California Medical Association, and health care political consulting. While practicing medicine he also served as a board member and President of the Foundation for Medical Care of Sonoma County, which oversaw the operation of a multi-county prepaid Medicaid project and the establishment of a community based HMO.
Dean Clancy, 37, serves as a senior policy advisor to House Majority Leader Dick Armey (R-Texas). He advises the congressional leadership on legislative, policy, and political matters, with a special emphasis on health, welfare, Medicare, and Social Security. He has worked for Rep. Armey since 1993. Before that, he served as a speechwriter for HUD Secretary Jack Kemp (1991-93), a staff writer for Vice President Dan Quayle (1989-90), and in various capacities in the Reagan White House (1986-89), beginning with his first job as a mail reader in the White House basement. He holds a bachelor's degree in foreign service from Georgetown University (1986) and a master's in journalism from Columbia University (1991). He lists among his pastimes, "smoking, drinking, and avoiding exercise.