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Innovation Series

  • September 19, 2019
  • 7:30 AM - 10:00 AM
  • Washington Athletic Club, 1325 6th Avenue, Seattle

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September 19, 2019 EBPA Innovation Series 

Approved for two (2) hours of Insurance Credits*


      Thank you to our 

      Program Sponsor


INSURANCE FRAUD: Washington State Enforcement

Overview & Case Studies

       Insurance Fraud 

          Introductions 

          Overview

       OIC Regulatory Investigations 

       OIC Criminal Investigations 

          Overview 

          Referral Routing 

          Process Criminal v. Civil 

          RCWs in Title 48 

          Unit Activities

       Questions & Summary 

Phil Comstock, Detective Sergeant & Randi Osberg, Senior Investigator will present this topic.

SELF-FUNDING: A Deep Dive Into Innovative Solutions Including

RBP, Promoting Member Consumerism, Specialty Rx, Transparency, and Cost Containment


Join Tim Callender, healthcare attorney and Vice President of Sales & Marketing for The Phia Group, as he presents a discussion on the top, innovative solutions that self-funded health plans are implementing to drive costs down while assuring they are delivering the richest benefits possible. Learn how you can differentiate yourself as a consultant, as a plan-sponsor, or as any other stakeholder in the space, by gaining a deeper understanding of real solutions that you can implement across your book of business, today. 

Join Tim Callender, healthcare attorney and Vice President of Sales & Marketing for The Phia Group, as he presents a discussion on the top, innovative solutions that self-funded health plans are implementing to drive costs down while assuring they are delivering the richest benefits possible. Learn how you can differentiate yourself as a consultant, as a plan-sponsor, or as any other stakeholder in the space, by gaining a deeper understanding of real solutions that you can implement across your book of business, today. 

PHIL COMSTOCK, Detective Sergeant for the Office of the Insurance Commissioner's Criminal Investigations unit has over 36 years of law enforcement experience having worked for the Lacey Police Department as a police officer, narcotics detective and lieutenant. He has experience in crime scene management, evidence processing, writing and executing of search warrants, and field operations. 

Phil supervised a detective division responsible for responding to and investigating homicides, assaults, thefts, frauds, sex offenses, crimes against children and other felony crimes. He has been assigned to and supervised multi-jurisdictional responses to civil disturbances and officer involved shootings. 

Phil has a Bachelor’s Degree from The Evergreen State College. He is a graduate of the Washington State Criminal Justice Training Commission Northwest Law Enforcement Command College and a 2001 graduate of the FBI National Academy in Quantico, Virginia. He has obtained supervisory, mid-management, and executive level certifications from the Criminal Justice Training Commission. 

RANDI OSBERG, Senior Investigator for the Office of the Insurance Commissioner’s Regulatory Investigations Unit has over 10 years of experience in regulatory investigations ranging from identity theft, driver license fraud and insurance all with the State of Washington.   






Tim Callender, Esq; Vice President, Sales & Marketing

Tim serves as the Vice President of Sales and Marketing for The Phia Group, LLC. Prior to his current role, Tim served as a health care lawyer, staff attorney and lead PACE counsel for The Phia Group.

Before joining The Phia Group, Tim spent years functioning as in-house legal counsel for a third party administrator. Tim is well-versed in complex appeals, direct provider negotiations, plan document interpretation, stop-loss conflict resolution; keeping abreast of regulatory demands, vendor contract disputes, and many other issues unique to the self-funded industry.

DETAILS:

Date: September 19, 2019

Location: Washington Athletic Club - 1325 Sixth Avenue, Seattle, WA 

Time:      7:30-8:00 am Registration, Breakfast

               8:00-8:50 am Insurance Fraud 

               8:50-9:00 am Break 

               9:00-9:50 am Self Funding

               9:50-10:00 am Q&A, WAOIC sign out 

Fees:     $65 members; $85 non-members and guests before Sept 17

               $80 members; $100 non-members and guests after Sept. 17 

Online registration deadline is September 17. If you miss the online registration, call the office 206-623-8632. No refunds or credit for a future meeting can be granted after the deadline.

** NOTE:  This presentation has been approved for two (2) hours of Continuing Education Credit by the Washington State Office of the Insurance Commissioner.

In order to received these insurance credits YOU MUST be seated for the presentation within 5 minutes of the session beginning.  You are allowed a break, but you must limit your time outside the presentation. The Insurance Credits are for two hours.  NO PARTIAL CREDITS awarded. You cannot sign out early.   

The Washington State Office of the Insurance Commissioner requires that each producer requesting credits must sign the form with their licensed name and write the time of arrival. Only upon completion of the session, you must initial out and write the time.  






   


          

         

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