LTCIF Forum Biographies
Patricia A. Bliujus BSN RN CHPN CCM
Manager – Case Management and Claims
Medico Group
Joined Medico Group in August 2003 as the company’s first RN Case Manager. Developed and implemented performance improvements for Medico Group’s claim management process. Develops and initiates policies and procedures for the better processing of medical information and claim processing at Medico Group. Responsible for evaluating the medical appropriateness, quality, and cost effectiveness of proposed services in accordance with established criteria. Reviews are conducted in collaboration with policyholders, physicians, health care professionals and claims staff. Through this review process, identification is made of those individuals and circumstances that would benefit from further care coordination. Assist in the maintenance of uniformity, quality, and consistency of benefit determination and administration. Provide documentation of and rationale for benefit determination. Analyzes all requests with the objective of monitoring utilization of services and ensures program integrity within constraints of benefit design, contract provisions, exclusions and policy limits. Piloting a new program that is rapidly becoming the front-line process to the handling of all new claims.
Due to respect and affection for the geriatric community, has eighteen years experience with long-term care of the elderly. Assisted in development of a Medicare Sub-Acute Rehab program in an Omaha facility and supervised at the only free-standing (non-hospital) ventilator unit in the early 1990’s. ADON of an assisted living facility during the mid - 1990’s. Case Managed homecare and hospice patients the eight years prior to joining Medico™, with emphasis on Hospice and the mentoring of medical and nursing students regarding end-of-life care.
- Earned Bachelors degree from Clarkson College of Nursing – Omaha NE.
- Obtained Certification as a Hospice and Palliative Care Nurse through the National Board for Certification of Hospice and Palliative Nurses in 2002. Re-certified in 2006.
- Obtained Certification as a Case Manager through The Commission for Case Manager Certification (CCMC) in 2005.
- Currently in accelerated Master’s degree program.
- Member of The Long Term Care Claim Advisory Committee working with other insurers to explore and create reference tools for long term care insurers.
Margaret A. Chance ASA, MAAA
Associate Actuary
Milliman
Current Responsibility
Margaret is an associate actuary with the Chicago office of Milliman. She joined the firm in 2003.
Experience
Margaret is a near-FSA with 10 years of experience, primarily working with individual and small group health insurance products, including Long Term Care. She has experience in product development and pricing, state insurance department rate filings, experience analysis, and financial modeling.
Prior to joining Milliman, Margaret worked for GE Financial (Genworth), primarily in the product development and pricing of Long Term Care insurance products.
Presentations
Margaret has served as a presenter at Milliman Health Consultant Forums.
>Professional Designations
- Associate of the Society of Actuaries
- Member of the American Academy of Actuaries
Education
BS, Mathematics, Cum Laude, University of Notre Dame, South Bend, Indiana
Cam Cook
Vice President - Underwriting & Claims
Aegon
Cam Cook is an experienced insurance professional with a unique broad-based experience that crosses most of the personal insurance lines. Over his 29 year career, Cam has served in management roles including Underwriting, Claims, Reinsurance and Marketing.
Cam first entered the LTC market with Fortis Long Term Care and currently is Vice President, Claims & Underwriting with the AEGON Long Term Care Division which marketed via Transamerica Occidental Life, Transamerica Life, Monumental Life, and Life Investors. As a strong supporter of innovation and education, Cam frequently helps organize or speaks at various Long Term Care Industry Meetings. He is a member of the new LTC Claims Advisory Committee ( LTCCAC ); past President and current Board Member of the Long Term Care International Forum (LTCIF).
Roger E. Desjardins
Corporate Vice President and Officer
New York Life - LTC Division
Roger E. Desjardins is Corporate Vice President and Officer for New York Life’s Long-Term Care Insurance Division, responsible for Claims and Policyowner Services. Roger has over 20 years of Risk Management experience in the LTC industry and has been responsible for LTC product development and service delivery strategies for several major US and international-based carriers. He is an Associate of Life and Health Claims with the International Claim Association and a graduate of Bates College. Prior to his insurance career, Roger worked in the geriatric rehabilitation and health care industries.
David W. Engleking, MD
Consulting Medical Director
Transamerica Life-LTC Division
Dr. Engleking joined AEGON LTC in 1990 as a part time consultant to the Underwriting Division at the request of Norm Kono. Over the last 17 years, his involvement with AEGON has progressed to Consulting Medical Director with emphasis in claims, in house education as well as special projects.
Dr. Engleking came to the LTC insurance industry naturally by virtue of nearly 15 years clinical experience in LTC. He also has leveraged his clinical background as a frequent speaker at prior LTCIF seminars as well as a defense expert for the industry in numerous litigations.
Dr. Engleking has been an actively practicing physician in Fort Worth, TX for 27 years. He serves as Physician Advisor to Case Management at Huguley Memorial Medical Center in Fort Worth, TX. He is board certified in Internal Medicine. He is a member of the American College of Physicians, the Society of Hospital Medicine & the American College of Physician Executives.
Becky Freeman
Manager, Long-Term Care and Medicare Supplement Claims Teams
Thrivant Financial
Becky is the Manager of the Long-Term Care and Medicare Supplement Claims Teams at Thrivent Financial for Lutherans in Appleton, Wisconsin, a Fortune 500 financial services organization and the largest fraternal benefit society in the nation. She has 15 years of health claims experience.
Thrivent Financial and its affiliates offer diverse financial products, superior service and comprehensive financial solutions. Its members provide approximately $200 million annually for outreach programs and activities that support congregations, schools, charitable organizations and needy individuals.
Jeff E. Frericks
Director of Underwriting
Combined Insurance Company of America
Combined Insurance Company of Canada
Jeff E. Frericks is the Director of Underwriting for Combined’s US and Canadian operations. Jeff has 20 years of underwriting experience across multiple product lines with a main focus on LTC for the past 10 years. In addition to his management role he has developed underwriting training programs for Combined’s newly hired Agents and works closely with Actuarial and Marketing on product development. Jeff has served as Vice Chairman of the National Long-Term Insurers Group and has his LOMA, HIAA and DIA designations.
Deborah A. Grant FSA, MAAA
Principal, Consulting Actuary
Milliman
Deborah is a principal and consulting actuary with the Chicago office of Milliman. She joined the firm in 1990 after two years as an actuarial student with Benefit Trust Life Insurance Company (now Trustmark).
Experience
Deborah specializes in individual health and small-employer group health insurance. She has experience in pricing and plan design, marketing and administrative management, financial reporting, and strategic planning and acquisitions. Recently, her focus has been long-term care insurance products, including plan design, implementation, and development, as well as state insurance department filings and valuations.
Presentations and Publications
Deborah is a frequent speaker at industry and professional meetings and has authored numerous articles and a chapter on long-term care insurance in the fourth edition of Group Insurance.
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Affiliations
Deborah recently served as chair of the SOA Spring Meeting Planning Committee.
Education
BA, Washington University in St. Louis
Stephen K. Holland, M.D.
Senior Vice President and Medical Director
Long Term Care Group
Dr. Stephen K. Holland is Long Term Care Group's Senior Vice President and Medical Director and he is responsible for the design and development of the Company’s long-term care underwriting criteria and protocols and benefit determination and care management criteria and technologies. Dr. Holland has been the Medical Director of the Long Term Care Group since its inception in 1990 and he is the lead author of LTCG’s Guide to Long term Care Underwriting, which is now in its sixth edition and licensed internationally. Long Term Care Group’s Underwriting Standards are recognized and accepted as an industry standard by leading LTCI insurers and reinsurers throughout the world. In addition, Dr. Holland has performed a number of Best Practice Claims and Underwriting Audits and Underwriting Criteria review projects for a number of this Country’s largest LTCI carriers and was recently selected by the U.S. Office of Personnel Management to review and critique the Federal Long Term Care Insurance Program’s Underwriting Standards. In addition, he was the Medical Director of LifePlans, Inc. from 1988-1990.
Dr. Holland was formerly a Senior Vice President and Medical Director of SHPS, Inc., a care management, disease management and employee administration services and software company. Dr. Holland has over 25 years experience working closely with physicians, consumers, managed care providers, health plans, and health insurers, both in the US and internationally. He brings a strong knowledge of clinical criteria and protocol development, care management strategies, call center management and patient education.
Dr. Holland graduated from Case Western Reserve University School of Medicine, completed his post-graduate education in Internal Medicine at the University of Washington and a fellowship in health care policy in the Robert Wood Johnson Foundation’s Clinical Scholar Program. He is board certified by the American College of Physicians and a past member of the Congressional Task Force on Technology-Dependent Children.
Linda Herlihy
Genworth
Linda Herlihy has been with Genworth for more than 20 years in various departments and roles, including Claims, New Business, and Business Development. She is currently in Genworth's SIU department.
Dean Knudson, MD
Medical Director
Nation's CareLink
Dean Knudson, MD, has been the Medical Director of Nation’s CareLink since 1996. Dr. Knudson is in private practice of general psychiatry and inpatient treatment at Allina Behavioral Health in Minneapolis, MN. He is a past Chairman and Vice President of the Department of Psychiatry at Abbott Northwestern Hospital. As an expert in cognitive testing of the elderly, Dr. Knudson devotes a large portion of his practice to Geriatric Psychiatry.
He is certified by the American Board of Psychiatry and Neurology and has a Certificate of Added Qualification in Geriatric Psychiatry. Dr. Knudson is an Associate Professor of Psychiatry within the Department of Psychiatry at the University of Minnesota Medical School.
Dr. Knudson was selected four times by local nurses and physicians to appear in the Minneapolis St. Paul Magazines "Twin Cities Top Doctors" list. He also was selected by local physicians and nurses to appear in the book "The Best Doctors in America, Midwest Edition".
Dr. Knudson has been involved in research examining high resolution MRI scans of the brains of schizophrenic patients, and also in research examining metabolic and cardiac risks in psychiatric patients taking new generation antipsychotic agents.
After graduating from George Washington University School of Medicine, Washington, DC, Dr. Knudson took his residency in Psychiatry at the University of Maryland Hospital in Baltimore, where he completed a fellowship in Geriatric Psychiatry. Dr. Knudson is one of the developers of the Minnesota Cognitive Acuity Screen (MCAS).
Linda Koco
Senior Editor, Products and Managing Editor, e-Publications
National Underwriter Life & Health
Linda Koko Senior Editor, Products, and Managing Editor, e-Publications, for National Underwriter Life & Health. In that capacity, she writes about cutting edge insurance product trends and also writes NU’s monthly “Inside Products” column. Ms. Koco also developed and now edits three NU e-newsletters — LTC e-Wire, Registered e-Report, and Income Planning, and will add two more e-newsletters in 2007. Based in Cleveland, Ohio, she holds an MBA with a specialty in e-business, and also the CSA designation.
Stephen R. La Pierre
Senior Vice President, Claim/Case Management
& Policyholder Services
Penn Treaty Network America
- Executive Officer with Penn Treaty Network America since January 2005
- Over 20 years healthcare and long-term care insurance risk management experience
- Former President of LaPierre & Associates, LLC, a consulting firm that provided comprehensive claim management and long-term care insurance operations risk audit services to insurance carriers and third party administrators
- Former VP Underwriting & Claims-for Fortis Long Term Care Insurance Company
- Administration of hospitals, nursing homes and rehabilitation centers for 15 years
- Master of Business Administration, University of Wisconsin-Milwaukee, B.S. Labor & Industrial Relations, University of Wisconsin-Parkside, Licensed Health Facility Administrator States of Wisconsin, Illinois and Indiana.
Denise Liston, RN, MBA
Vice President of Underwriting Products & Services
LifePlans, Inc.
Denise M. Liston, RN, MBA, is Vice President of Underwriting Products & Services at LifePlans. She has over twenty-five years of health and insurance experience. Ms. Liston is responsible for the servicing of products and systems to support its insurance clients. In addition, Ms. Liston is the President of LifePlans LTC Services, Inc. which is a Canadian subsidiary responsible for the development and implementation of long term care risk and care management services throughout Canada.
Prior to joining LifePlans, Ms. Liston was Director of Physician Recruitment and the Practice Management Center for a 400-bed acute care medial center, where she was responsible for strategic planning, managed care contracting and operations for all medical practices under the medical center. She has extensive expreience with insurance contacting and health care delivery systems. Ms. Liston has been involved in program development and regulatory approval of product line expansions in acute and managed care settings.
Ms. Liston received her nursing degree from the Peter Bent Brigham Hospital School of Nursing. She also holds a degree in Health Care Management from Lesley College, and a Masters in Business Administration.
Dr. Bruce Margolis
Medical Director - Long Term Care Division
Genworth
Bruce Margolis is the Medical Director for Genworth's Long-Term Care Division. He has been at Genworth for four years. Prior to that, he was the Chief Medical Director at MetLife. Bruce is board certified in internal medicine, pulmonary disease, and insurance medicine. He was in private pulmonary practice in Philadelphia for 14 years prior to entering the insurance industry in 1996. Bruce earned his MBA from Eastern University in 2003. His special interests include the morbidity of obesity and cognitive impairment.
Amy Pahl, FSA, MAAA
Principal and Consulting Actuary
Milliman USA
Amy is a Principal and Consulting Actuary in the Minneapolis office of Milliman. She has been with the firm since 2001.
Amy specializes in long term care insurance products with experience in pricing and plan design, implementation and development, state insurance department filings, inforce management, and financial reporting.
Prior to joining Milliman, Amy was Assistant Vice President and Product Actuary of LifeCare Assurance Company, a long-term care reinsurer. There she had responsibility for product development, pricing, and actuarial regulatory filing and rate approval for multiple client companies. In this role, she has performed long-term care reinsurance pricing, actuarial modeling and experience analysis.
Prior to joining LifeCare, Amy was the LTC Actuary at Allianz Life Insurance Company of North America where she was responsible for financial analysis and risk management of their LTC insurance program. Prior to her role as the LTC Actuary, Amy managed the actuarial functions for their traditional life and annuity blocks of business.
Presentations and Publications
Amy has been a frequent speaker at industry and professional meetings and has authored numerous articles.
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
Math and Economics, Macalester College
Mary Ann Wilkinson
Vice President
Gen Re LifeHealth
Mary Ann is a Vice President at Gen Re LifeHealth. She has several years experience in the design, implementation, and evaluation of medical expense management, administrative services and managed care programs. Currently, she is responsible for claims management and administrative oversight of business products in the Individual Health Division at Gen Re. Prior to joining Gen Re, she was General Manager of Innovative Clinical Solutions, a third party administrator for MCO's based in Florida. Mary Ann has been responsible for managing operations and contracts for MCOs, PPOs and MSOs.
She has developed utilization management, provider profiling, case management, and disease management programs for both commercial health insurance and Medicare/Medicaid managed care products. Mary Ann is also a registered nurse, with a Bachelor of Science degree.
Pat Zimmermann, RN, CFA, CLTC
Director of Underwriting
MetLife LTC Insurance
Pat began her career in the LTCI industry in 2004 as the Manager of the Underwriting Department for MetLife. In 2006, Pat became a Director of Underwriting.
Pat started her career as a registered nurse. Her nursing professional background includes experience in coronary care, in-patient long-term care, psychiatric care, and home care. She has worked both, in staff and management positions.
Pat also holds the designation of Chartered Financial Analyst (CFA). In this capacity she has managed back office and operations areas of investment companies. She also combined her medical and financial skills in the home care arena and has been a comptroller and CFO for Licensed Home Care Agencies.
Pat is a graduate of St. Vincent’s School of Nursing in Bridgeport, CT. She holds a BA in Psychology from Fairfield University in Fairfield, CT, and received her CFA from the Institute of Financial Analysts in Charlotte, NC.