MLR DLR Updates

MLR / DLR Updates


Tuesday, September 24
3:00 PM - 3:45 PM (CT)

During this session, presenters will delve into research findings and discuss how dental plan leaders can revamp their engagement model to foster greater trust among their members. This shift in mindset has the potential to assist companies in prioritizing tasks, merging products and solutions, acquiring new business, and establishing more meaningful connections with their members.

 

Bianca Balale
State Affairs Manager
National Association of Dental Plans

Bianca joined NADP in 2023, bringing 10 years of experience working in government and healthcare. Prior to joining NADP, she served as the Director of Quality and Compliance at a non-profit behavioral health facility focused on integrated care and as a congressional staff member in the state of Ohio. Bianca earned a bachelor’s degree in political science from Youngstown State University and a Master of Public Health from Kent State University with a focus in Public Policy and Management.

 

Crystal McElroy
Vice President, Group Benefits Contracts and Compliance
MetLife

Crystal McElroy is the vice president of the Group Benefits Contracts and Compliance team at Metropolitan Life Insurance Company and is based in Irvine, CA. She oversees all contracts, compliance, and regulatory issues for MetLife’s Group Benefits products. Crystal is currently a member of the NADP Board of Directors, the Chair of the NADP Commission on Advocacy Policy, and a member of the Government Relations Workgroup.  She also volunteers on topics focused on NADP workgroups, such as the Medicare and Dental Loss Ratio Workgroup.  She also serves on the CADP Board as the Secretary and co-chairs the CADP Legislative and Regulatory Committee. Before joining MetLife in October 2013, she served as a senior attorney with the California Department of Managed Health Care in the Office of Plan Licensing for seven years. She was responsible for reviewing dental and health plan licensing documents related to plan benefits, disclosure documents, networks, and mergers and acquisitions. Crystal graduated from the University of California, Los Angeles, majoring in Biochemistry and a minor in Political Science in 2003. She obtained her Juris Doctor from the University of the Pacific, McGeorge School of Law, in 2006.

 

Joanne_Fontana_300x300.jpgJoanne Fontana, FSA, MAAA
Principal and Consulting Actuary
Milliman 

Joanne Fontana is a principal and consulting actuary in the Health Practice of Milliman’s Hartford office. She has been with the firm since 2006. During that time, she has consulted for insurance companies, including several major dental carriers, employers, government entities, and other organizations. Joanne’s focus has been mainly on managed care and dental, with experience in premium rate development, provider contract analysis, valuation of post-retirement health benefits and health care reform. Over the past several years, she has worked closely with the National Association of Dental Plans, the California Association of Dental Plans, the American Dental Association, and other dental clients to assess the impact of health care reform on the dental industry. She manages Milliman’s Dental Actuarial Analytics PPO Network Study. This product uses a vast contributor database of dental claims to provide competitive insights on dental network discounts and utilization to study participants. She has worked with carriers and employer groups on dental insurance procurement and Medicaid dental procurements with state entities and bidders. She has done core actuarial dental pricing and underwriting work for many dental carriers. Joanne is considered an industry expert in dental products and pricing; she has presented on dental-related issues at multiple industry forums and authored many topical articles. Before joining Milliman, Joanne spent more than 10 years as an actuary with Cigna, where she held various healthcare financial leadership roles, including Chief Actuary of CIGNA’s dental insurance business.



Sarah Snyder Rayel

Senior Director

National Opinion Research Center (NORC)

Sarah Snyder Rayel, a senior director, has over 15 years of experience in healthcare policy, strategy, and analysis. Her work at NORC supports payers, trade associations, life sciences companies, foundations, and others tackling difficult policy and strategic problems. She joined NORC from the Blue Cross Blue Shield Association (BCBSA), where she led regulatory and legislative policy work related to Medicare Advantage and Part D on behalf of 35 independent Blue Cross and Blue Shield companies. Before BCBSA, Sarah worked for Avalere Health, providing strategic support for clients navigating Medicare payment changes. Sarah began her career as a Medicare Program Examiner in the Office of Management and Budget, where she led a review of complex Medicare payment regulations, briefed senior officials on significant issues, and developed proposals for the President’s Budget.



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