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Understanding the Health Insurer Rate Approvals, an Interactive Program

  • 2 Sep 2021
  • 12:00 PM - 1:00 PM
  • Live Webinar

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Save the Date for our Lunch & Learn September 2nd program

Understanding the Health Insurer Rate Approvals
an Interactive Program

PROGRAM DESCRIPTION:

This event will focus on the recent health insurer rate approval process for 2022.  Patrick Tigue, Rhode Island’s Health Insurance Commissioner, will discuss the rate approvals for RI’s small and large groups.  The presentation will touch on the actuarial process involved, the justification for the approved increases, and the balance between protecting the interests of consumers and guarding the solvency of health insurers. 

Join us for this interactive event; questions are encouraged.

Submitted for HRCI and SRHM CE credits

SPEAKERS DETAILS & BIOS: 


Patrick M. Tique

Health Insurance Commissioner
Office of the Health Insurance Commissioner
State of Rhode Island

Commissioner Patrick M. Tigue is an accomplished executive with experience leading and managing critical efforts to achieve strategic health policy goals on a statewide scale. He is a results-oriented, decisive leader with proven success in the government arena and payer arena across the commercial health insurance market and the Medicaid market. Commissioner Tigue has a track record of expanding access to care, driving value in the health care system through delivery system reform and payment reform, and overseeing budgets and initiatives to achieve financial goals. Prior to his appointment, he served as a principal at Health Management Associates where he provided executive advisory services to public and private sector clients related to publicly funded health care.

Previously, Commissioner Tigue served as assistant secretary for health and Medicaid director at the State of Rhode Island Executive Office of Health and Human Services where he led the Medicaid Program, serving approximately 300,000 residents and managing a $2.5 billion annual budget. He successfully managed the program within budget constraints while maintaining eligibility and benefits including expanding access to life-saving hepatitis C treatment. Commissioner Tigue also negotiated an extension of the Rhode Island Comprehensive Demonstration 1115 waiver with the Centers for Medicare and Medicaid Services to preserve critical federal flexibility and funding including support for the state’s Medicaid accountable care organization program. During his tenure, he served as east regional representative for the board of directors of the National Association of Medicaid Directors.

Earlier in his career, Commissioner Tigue served as director of commercial products and a product manager at Neighborhood Health Plan of Rhode Island where he oversaw commercial product line product design, rate development, federal and state regulatory compliance, and operational coordination with profit and loss responsibility. He also served as a principal policy associate at the State of Rhode Island Office of the Health Insurance Commissioner where he enhanced the efficiency of the Rhode Island health care system by managing the implementation, monitoring, evaluation, and revision of the office’s Affordability Standards for commercial health insurers—which require insurers to take actions to address the underlying drivers of rising health care costs to produce more affordable health insurance premiums. 

Commissioner Tigue earned his master’s degree in public policy from Brown University. He holds a bachelor’s degree in English from the College of the Holy Cross. 


James R. Borah, CEBS

Executive Vice President of Employee Benefits

Jim earned his current position in June, 2015 when The Cornerstone Group was acquired by The Hilb Group.  Jim joined Cornerstone in 2012 as a Senior Benefits Consultant with more than twenty years of experience in the insurance industry. In this role, Jim provides employer groups throughout southeastern New England with comprehensive benefit analysis, communication and compliance solutions, as well as healthcare reform guidance. Previously, Jim was President of Borah Associates, Inc., where he was responsible for the design, implementation and administration of employee benefit plans. 

Jim is an active member of Rhode Island’s brokerage community, having served as President of the Rhode Island Business Health Advisors Council and as a member of the Leadership Council of the Rhode Island HealthCare Reform Commission, Rhode Island Benefits Exchange Expert Advisory Board, Government Affairs Committee of the Small Business Association of New England, and the BCBSRI Broker Advisory Committee. Jim also served on various state committees to help shape the direction of the health insurance market in Rhode Island, including the Insurance Market Merger Task Force and the Health Hub RI Stakeholder Committee. 

For ten years, Jim discussed employee benefit issues with Frank Coletta as a regular guest on the Sunrise Show on WJAR Channel 10 and continues to contribute frequently to the local media. He graduated from Connecticut College with a BA in Economics and earned the prestigious Certified Employee Benefits Specialist (CEBS) designation, sponsored by the University of Pennsylvania’s Wharton School, in 2012.

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