SIIA 2024 Live Show: Legislative Efforts, SIIA ROI, Networking, And Q&A

This video provides an in-depth exploration of the Self-Insurance Institute of America (SIIA), detailing its core mission, legislative advocacy, educational initiatives, and the critical role it plays in networking and business development within the self-insurance and alternative risk markets. Recorded live at the SIIA National Conference, the discussion features SIIA board members Amy Gasbarro (President of ELMC RX Solutions) and John Capasso (CEO of Captive Planning Associates), alongside host Spencer Smith. The conversation establishes SIIA as the national organization representing the interests of the self-insured marketplace, focusing on how regulatory and legislative impacts connect directly to medical benefit services provided to employer groups across the U.S.

The speakers structure the value of SIIA around four core pillars: Advocacy, Networking, Thought Leadership (Education), and Continuity. Advocacy is highlighted as the organization's primary driver, involving active lobbying on Capitol Hill and monitoring state-level legislation to protect self-insured plans, citing historical battles dating back to the enactment of ERISA in 1974. Current advocacy efforts focus on mental health parity and combating state attempts to micromanage or outlaw self-insurance practices, particularly concerning medical stop-loss. A specific example of successful advocacy was detailed: SIIA’s efforts in 2015 to save micro-captive legislation from elimination by educating high-powered Senators and eventually gaining the ability to write proposed legislative changes.

Thought Leadership is presented as a crucial component, ensuring the industry remains current on complex and evolving topics. The discussion explicitly mentions specialized educational forums dedicated to Healthcare Transparency, Specialty Pharmacy, Cell and Gene Therapy, and, notably, Artificial Intelligence (AI). The AI forum, held recently, focused on the impact and applicability of AI in the self-insurance field, indicating the industry's proactive approach to emerging technology. The speakers emphasize that the educational content is dynamic, driven by feedback from stakeholders on pressing issues like rising specialty pharmacy costs and the need for better cyber security preparedness. Finally, the networking pillar is described as the "Super Bowl of Self-Insurance," where competitors become friendly collaborators, facilitating business deals and providing invaluable mentorship opportunities through programs like SIIA Future Leaders.

Key Takeaways:

• AI is a recognized and growing focus area in self-insurance: SIIA has hosted dedicated forums and established task forces on Artificial Intelligence (AI), recognizing its profound impact on the self-insurance field, including applications in predictive risk and underwriting (as mentioned in cocktail conversations).
• Specialty Pharmacy and Cell/Gene Therapy are top-tier educational priorities: Due to escalating costs and complexity, SIIA is dedicating significant thought leadership and educational events to these areas, including a planned Specialty Pharmacy educational event in 2025, directly relevant to pharmaceutical cost management.
• Advocacy is critical for regulatory stability: SIIA is the only organization with boots-on-the-ground lobbyists dedicated to the self-insurance market, actively fighting legislative threats at both the federal (e.g., mental health parity) and state levels (e.g., stop-loss regulations).
• The industry needs better data transparency solutions: A session highlighted the maddening difficulty in accessing, parsing, and trusting hospital price transparency data, underscoring a massive need for data engineering and business intelligence solutions to make this information actionable.
• Continuity relies on active mentorship and energy: The organization actively seeks to groom the next generation of leaders through the Future Leaders program and mentorship connections, prioritizing individuals who demonstrate high energy, inquisitiveness, and a passion for the self-insurance mission.
• Business is driven by collaborative networking: The conference environment fosters collaboration even among competitors, allowing CEOs and decision-makers to share perspectives on challenges (like managing healthcare costs) and form partnerships to deliver better solutions.
• Employers must adopt a long-term, data-driven view: A major impediment to improving population health is the short-term, 12-month myopic view of costs. Employers need to be encouraged to think on a 3-5 year horizon to realize the ROI of wellness and cost-management initiatives.
• Sponsorship provides direct ROI through exposure and thought leadership: Sponsors gain brand awareness, access to key decision-makers, and the opportunity to participate in panels, positioning themselves as experts and generating new business leads.
• New attendees should prioritize education outside their expertise: To maximize value, attendees new to the conference are advised to attend sessions outside their immediate field to gain a well-rounded understanding of the entire self-insurance ecosystem before focusing solely on networking.
• The self-insurance market is complex but influential: Despite impacting over 100 million Americans, there is a general lack of understanding of how the self-insurance model works, making the educational efforts directed at lawmakers and employers increasingly vital.

Key Concepts:

• SIIA (Self-Insurance Institute of America): The national organization representing the interests of the self-insured marketplace and alternative risk markets.
• ERISA (Employee Retirement Income Security Act of 1974): Federal law that provided the impetus for the growth and protection of self-insured plans.
• Micro-Captives: Small captive insurance companies, the legislative protection of which was a major success story for SIIA advocacy.
• Thought Leadership: The educational pillar of SIIA, focusing on specialized, current, and emerging topics like AI, Specialty Pharmacy, and Cell/Gene Therapy.

Examples/Case Studies:

• Micro-Captive Legislation (2015): SIIA successfully fought proposed legislation that would have eliminated micro-captives by engaging in extensive lobbying and education, ultimately gaining the ability to draft proposed changes to save the structure.
• Specialty Pharmacy Cost Management: The high cost of specialty drugs is driving the creation of dedicated educational forums and is a primary concern for members, leading to the development of new content tracks.
• AI Forum: SIIA recently held its first dedicated AI forum, bringing together industry leaders to discuss the application and impact of artificial intelligence within the self-insurance sector.