The AI Revolution: Transforming Employee Benefits

Kate Hubben
Vice President, NFP
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Artificial Intelligence (AI) is reshaping industries, and employee benefits are no exception. From healthcare to wellness programs, AI offers innovative solutions to improve efficiency, personalization, and decision-making. This blog explores key insights into how AI is revolutionizing the public sector and adjacent industries.

AI's Evolution and Its Role in Benefits

AI is not a new concept. Its roots trace back to 1958 with the development of the perceptron, an early neural network. Over the decades, advancements like IBM’s Watson and Generative Adversarial Networks (GANs) have paved the way for modern AI applications. Today, technologies like Generative Pretrained Transformers (GPTs) and Large Language Models (LLMs) are at the forefront, enabling AI to analyze data patterns and generate novel outputs.

In the realm of employee benefits, these advancements translate into smarter systems capable of predictive analytics, real-time monitoring, and enhanced decision support.

AI in Healthcare: A Game-Changer

One of AI's most significant impacts is in healthcare delivery. By leveraging machine learning (ML) and predictive analytics, AI enhances patient care through earlier diagnoses, personalized treatments, and operational efficiency. Key applications include:

  • Predictive Analytics: AI forecasts disease progression, provides evidence-based clinical insights, and predicts operational needs in healthcare settings.
  • Telemedicine Growth: Wearable devices powered by AI monitor patients in real-time, improving diagnostic accuracy while automating billing and follow-ups.
  • Machine Learning Applications: From accelerating drug discovery to predicting effective chemotherapy treatments, ML reduces costs and improves outcomes.

These innovations improve care quality and reduce costs by preventing avoidable hospital admissions.

Impact on Wellness Programs and Benefit Plans

AI is transforming wellness programs by introducing personalization, real-time monitoring, and mental health support. For instance:

  • Personalization: Tailored wellness initiatives cater to individual employee needs.
  • Real-Time Monitoring: Wearables track health metrics, enabling proactive interventions.
  • Mental Health Support: AI-powered tools provide accessible mental health resources.

In benefit plans, AI enhances decision-making by offering improved communication tools, fraud detection systems, and underwriting capabilities. These advancements streamline processes while ensuring compliance with regulations.

Challenges to Address

Despite its potential, integrating AI into employee benefits comes with challenges:

  • Trust and Data Privacy: Employees must trust that their data is secure.
  • Bias in Algorithms: Ensuring fairness in decision-making processes is critical.
  • Compliance Risks: Legal cases like Ryan v. UnitedHealth Group highlight the importance of adhering to regulations.

Organizations must address these issues by defining risk postures, ensuring transparency, and keeping humans involved in critical processes.

Opportunities and Next Steps

Generative AI alone could contribute $480 billion in productivity gains for the public sector. To capitalize on this potential:

  1. Define a clear risk management strategy for using generative AI in benefits plans.
  2. Collaborate with brokers to identify programs that simplify benefits for employees.
  3. Invest in roles like "Head of AI" to oversee implementation.
  4. Maintain a human-centric approach to balance automation with empathy.

By embracing these steps, organizations can unlock the full potential of AI while mitigating risks.

AI is no longer a futuristic concept—it’s here and transforming how we approach employee benefits. From healthcare innovations to personalized wellness programs, it offers immense opportunities for public employers willing to adapt. By addressing challenges proactively and keeping humans at the center of decision-making, organizations can harness the power of AI for a more efficient and equitable future.

Kate Hubben
Vice President, NFP

Kate Hubben is Vice President of NFP, an Aon company, a global insurance consulting firm. Kate is a strong advocate for her clients and consistently recognized for outstanding client retention.Kate is a licensed specialist in self-funding and works with companies to provide solutions for benefits technology, cost containment, pharmacy contracting and benefits procurement.

Prior to NFP, Kate was a Lead Consultant at Willis Towers Watson and Senior Director of Global Patient Services at the Cleveland Clinic. Kate has a Masters degree in Public Administration from Cleveland State University and a Bachelor of Arts from The Ohio State University.

Kate is active in the community and serves on the board of Austin Forum on Technology & Society, In Counsel with Women, Cuyahoga Community College Foundation, and the Cleveland Jewish News where she chairs the Human Resources Committee. She is a former board member of Laurel School,Edna House and the Cleveland Rape Crisis Center where she spearheaded the successful effort to extend the statute of limitations for rape victims in Ohio. Kate is a regular contributor to Crain’s Cleveland Business.

Kate has two grown children and teaches yoga part-time.

Education

  • M.P.A., Cleveland State University
  • B.A., The Ohio State University

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Risk Governance of the Few or the Many

Marilyn Rivers, CPCU, ARM, AIC
CEO, Rivers Risk Consulting, LLC
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Risk is glorious in its technicolor explosions of fact, fiction, supposition and opinion. For those of us who manage those explosions, we often wonder if our primary role in governance is the herding of cats. Cats, you say? Well, cats are highly intellectual and independent entities. My cat Sherlock can stand in the middle of an empty room and bring everyone in the house to its center as he loudly expresses his displeasure at well…life in general. The fact that he has the capacity to control the existence of our household is a testament to the strength of his voice and his ability to manipulate our reality. Good or bad, when Sherlock speaks, the loudness of his convictions stops our time.

Sherlock’s analogy is real within all our workplaces. There is and will always be that one individual who brings chaos to the best of our risk and safety objectives and goals. They are that one individual in life who believes that their one voice, shouted at its loudest, can manipulate the masses and determine the outcome of our best-laid plans and our reality. It begs the question we all ask ourselves in difficult interpersonal situations – do we govern risk for the many or the few?

I have had many situations in which an individual has entered my personal risk workspace, flailed their arms, jumped up and down and demanded their way or the highway. For those of you who have attended many of my classes, I continually promote the practice of the steady glare in the mirror on a regular basis. Each of us as risk professionals embraces the old saying…been there…done that. The yelling, threatening, self-promoting, and childish machinations of an outlier usually bring out my best practiced blank stare to which I embrace my own oblivion. I liken the negative machinations to a child’s temper tantrum or Sherlock’s attempt for attention.

Risk governance can only thrive on consensus and managing the risk of the center of the communities we serve. As we seize opportunities for improvement, we understand the value of our diversity, but also understand the importance of collectively needing to govern the needs of the vast majority of the communities we serve.

I will argue with my dying breath that COVID brought risk to its knees with all its emergency measures and demands. It skewed our approach to what governance means and what it in fact does. It gave opportunity for unilateral emergency orders and mandates that, quite frankly, often brought forth the very worst in governance and its role models. Let’s be retrospective, in your face risk management doesn’t work when it’s based on threat, fear and retaliation.

Best practice risk and safety governance is founded in its ability to embrace all the difficulties and diversified situations we face on a regular, ongoing basis with respect, the ability to empathetically listen, and our ability to achieve consensus through our non-biased communication of expectations, partnerships and opportunity. Govern for the few or the many? Let’s argue that we, as risk professionals, govern individually and collectively for the totality of our communities in a holistic approach by embracing all who participate. Grant patience to ourselves for our Sherlocks, but let us remember our strategic risk mission is to achieve consensus with all of our community partners – the many, not the few.

Marilyn Rivers, CPCU, ARM, AIC
CEO, Rivers Risk Consulting, LLC

Summary of Qualifications

Marilyn is a nationally recognized public entity leader, strategist and educator in the field of risk management with over 35 years of risk and safety experience. She has firsthand experience in establishing best practice standards for property and casualty fiscal risk management programming. Marilyn has expertise in establishing partnerships, helping folks overcome communication issues and achieving consensus.

Responsibilities

Marilyn is an educator, blogger and consultant managing risk and safety projects for public sector clients and private companies serving public entities

Business Experience

Marilyn's experience consists of 20 years of service in the public sector in risk and safety management, five years in national healthcare risk management at the executive level and 10 years working in the private sector in insurance and information technology.

Professional Affiliations

Marilyn is a member of PRIMA, CPCU Society and Lions International.

Education

  • Masters in Education, Tufts University
  • Bachelors of Science in Chemistry, Clarkson University

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Best Practices for Timely, Relative and Effective Communication with Your Pool Members

Diane Becker
Communications Director, League Association of Risk Management of Nebraska
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As a pool communications director, I occasionally wish I had the superpower to insert knowledge into our members' heads; instead, it's necessary to use the more effective power of communication. Here are a few thoughts about how to get information effectively, timely and relative to your pool members.

First, look at the goals of your pool. More than likely, you want to promote risk management, and also a sense of community in the pool. Another worthy goal is to develop trust between you and your pool members. Effective communication in all its beautiful ways and methods can help you accomplish these goals.

For effective communication with members you need to know them - not only their size and location but their individual organization's needs and concerns. Is risk management a priority for them? How do they best get information from your pool? You may need to go to their offices or ask them during a conference break. Communicating effectively begins with knowing, listening to and understanding your audience. You may find that no one is taking the time to read your witty Twitter posts but they are distributing your email safety tips.

Once you know the pool member needs and how they are more likely to accept information from you, it's tempting to force-feed them data, i.e. about cybersecurity. There is a lot of extremely technical information coming out every day on how to be cybersafe. To get pool members to actually read and implement these practices, take the time to see the need for cybersecurity from their viewpoint. Many people don't have a high level of computer knowledge but know ransomware is a problem. Communicating to them effectively may mean first giving them tips about changing passwords and safe backup methods. As they see that the information you provide them is useful and understandable, they are more likely to respond to requests for them to use multifactor authentication and other more complex cybersafe practices. It’s a relative and effective way to provide them with information but what about being timely?

Communicating is best when it is responsive to current needs. Keep updated on the issues and events that affect your members. A few years ago, in a matter of one week many of our pool members were getting bridges, roads, and buildings destroyed by spring flooding. Our board had a special meeting that week to provide emergency mini-grants for those who needed barricades and other safety items. Similarly, we put out a frozen pipes prevention article last winter when meteorologists predicted record sub-zero temperatures for much of the state. Our members still thank us for providing valuable information when they need it. You gain trust and loyalty from members when they see that your communication isn't a bucket of knowledge you're dumping on their heads but a service you're offering for their benefit at the time they need it.

Every day gives us a chance to better communicate with our pool members as we learn more about them and the world of risk management. Listening and learning is a superpower that's just waiting to be tapped into.

*The views and opinions expressed in the Public Risk Management Association (PRIMA) blogs are those of each respective author. The views and opinions do not necessarily reflect the official policy or position of PRIMA.*

By: Diane Becker

Communications Director, League Association of Risk Management of Nebraska

Bio
Diane has written for newspapers and magazines for over 30 years. She had a webpage design business and also taught Internet and Webpage courses before being hired in 2013 as the first Communications Director for a Nebraska city of 23,000. Five years ago she was hired as the first Communications Director for LARM, revamping and updating their website, newsletters and brochures and developing a communication strategy that allows LARM news to be featured regularly in Nebraska newspapers, radio and TV stations.

Responsibilities
Diane's responsibility is to find and implement ways to communicate with LARM members in a timely, effective, relative manner. This ranges from setting up a LARM booth at a conference that best attracts LARM members and potential members to delivering Safety Grant Award certificates and featuring LARM information and activities on social media and Nebraska news outlets. LARM sends out a popular calendar each year that features photos of member cities. LARM also emails a monthly Lean on LARM Risk Management Newsletter and other risk management news throughout the year. Diane develops marketing materials to be distributed to members that are considering LARM as a risk management provider.

Education
Masters of Science Degree in Education
Nebraska Property and Liability Insurance License

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The (Not So) Subtle Art of Issuing a Request for Proposal (RFP) for your Insurance Broker/Consultant

Patrick Haraden
President, Boston-Portland, Lockton Companies
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So, you have to issue a Request for Proposal (RFP) for insurance broker or consultant services, and you're dreading it. Guess what – the brokers and consultants are as well. RFPs are a common method used to procure insurance broker and consulting services in the public sector, whereas they are typically used only by larger organizations in the private sector. I have responded to hundreds of RFPs and have made several observations that could assist the issuer obtain their desired result from the process.

Although I understand this is not always the case, I have assumed that the issuance of the RFP is due to contract expiration, rule or regulation, or dissatisfaction with the current broker/consultant. Both sides in the RFP process would benefit from transparency, clarity, and most of all – brevity.

Some tips from the field:

  • An RFP for broker/consultant services (or any service) should not follow the standard company RFP template. The two main reasons for this are the responders get the feeling that their response will be “commoditized” or reduced to the lowest-price will-win process, and the issuer does not understand or will not value any response that is unique or unexpected (even though it may be more beneficial).
  • If not required by your purchasing rules and regulations, have the responders submit the price section of the proposal separately. It will demonstrate that the proposals will be evaluated without regard to price, at least initially.
  • When drafting the RFP, try to anticipate the basic questions that bidders may have and include that information. Also indicate what information you will not provide, or only provide to the selected vendor. I have found that the more transparency in the RFP, the better the quality of the responses. Some information to consider includes:
    • Current broker/consultant, how long, and annual compensation
    • Reason for the RFP
    • Schedule of insurance with carrier, premium, limits and retention
    • Timeline for the RFP (and make a concerted effort to follow it)
    • Criteria for scoring/evaluation
  • Ensure that your questionnaire or requirements do not ask the same question or request the same information in different ways – this eliminates duplication in responses.
  • Some of the best RFPs I have seen do not include too many basic or informational questions (e.g., years in business, office location, etc.), as you should already know the responders who will submit viable proposals. They ask a couple of open-ended questions (think essay from college application) as well as some creative ones – what would a sample program look like? what have you done for similar entities? etc.
  • When evaluating the response – consider your total cost of risk. Commissions, intermediaries, and any projected savings from selecting the new broker/consultant or program. Just looking at commissions or fees usually does not provide an accurate cost of selecting one broker/consultant over another.

Requests for proposals require a tremendous amount of work from both the issuer and the respondents. Being informative and transparent early in the process will allow you to receive better quality submissions and, ultimately, a better insurance and risk management program – and your selected broker/consultant will be appreciative as well.

By: Patrick Haraden

President, Boston-Portland, Lockton Companies

Bio

As president of the Lockton Northeast Series Boston/Portland office, Pat has overall responsibility for the strategy and growth of the Boston office, P&C and employee benefits business development, and client management. Pat is also in charge of increasing Lockton’s brand awareness in the Boston/New England market. Before joining Lockton, Pat was area president in New England and northeast regional director of the public sector practice for Gallagher, responsible for health and welfare compliance, new business development, and client management. Pat is a widely recognized industry leader with deep expertise in a wide spectrum of property & casualty insurance and employee benefits, as well as health care reform.

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Measuring the Effectiveness of Risk Begins with Assessing Risk

Christine Packard
Assistant Vice President, Enterprise Risk Management, University of Massachusetts
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In a previous blog, I discussed the importance of moving risk assessment beyond a heat map to ensure that leadership has enough detailed information to inform decision-making.  In today's blog, I will discuss the importance of this underlying risk assessment methodology for determining an accurate picture of residual risk.

Enterprise risk management (ERM) establishes processes to identify, assess, mitigate, and monitor risks across an organization. While each component of an ERM program is essential, the ultimate goal of an ERM program is to reduce an organization's exposure to risk. If the organization is aware of risks and their impacts but unaware of how successful the organization is at reducing risk exposure, the ERM program is not serving its intended purpose.

Many ERM programs, however, are challenged in progressing beyond the risk identification and assessment phase of an ERM program cycle, often being in the position of continually assessing risk and updating risk registries, and not focusing adequate attention on risk mitigation. Additionally, organizations may conflate the assessment of risk and the assessment of risk mitigation in the risk identification and assessment phase of its ERM program cycle. This might involve risk partners who may not have the appropriate degree of knowledge about risk mitigation strategies to inconsistently or inaccurately weigh in on the effectiveness of a mitigation strategy and unknowingly over- or under-assess the impact the strategy has in reducing the assessed risk exposure. In addition, the incorporation of risk mitigation assessment into the risk assessment process often involves a superficial assessment of the impact of mitigation strategies – assigning an overall value of mitigation by which the risk exposure calculation is reduced rather than comprehensively evaluating how impactful a mitigation strategy is across all categories of assessed risk (likelihood, consequence, etc.).  This approach can skew an organization's true understanding of its risk exposure.

A comingled risk assessment and mitigation assessment may also lead organizations to make decisions about risk acceptance, avoidance, transfer, or reduction by assuming the risk assessment provides a comprehensive understanding of risk exposure and the impact of risk mitigation strategies without having methodically assessed the effectiveness of mitigation on reducing the organization's risk exposure. A dedicated accounting of mitigation strategies layered with knowledge of the effectiveness of those mitigation strategies is integral to an organization's determination of risk tolerance.

To create a baseline against which the effectiveness of mitigation strategies can be evaluated, the University of Massachusetts (UMass) began assessing the inherent exposure of risks during the risk identification and assessment process. This means that during our risk assessment process, we intentionally do not account for mitigation strategies being implemented to reduce our risk exposure. This approach to risk assessment allows us to gauge our foundational risk exposure using established risk assessment tools and prevents us from inconsistently or inaccurately accounting for the effectiveness of mitigation strategies while assessing risk exposure.

By assessing inherent risk, UMass can conduct a separate but correlated assessment of mitigation strategies. The dedicated mitigation assessment process increases transparency by documenting all ongoing risk mitigation strategies and sets the stage for informed risk tolerance discussions by providing a detailed evaluation of the effectiveness of these strategies in reducing risk exposure.

Leveraging the concepts of our risk assessment process, the UMass ERM program created a mitigation assessment methodology that enables the university to document all ongoing risk mitigation strategies and evaluate their effectiveness through three different lenses: individual effectiveness, comparative effectiveness, and aggregate effectiveness.  The three assessments are completed through one evaluation process using a newly developed mitigation assessment tool called MATRX. Assessments are correlated to, but not a replacement of, the risk assessment process and the Inherent Risk Score.

The mitigation assessment results do not define whether the university is satisfied with the residual risk but inform leadership as they make determinations about accepting risk, further reducing risk, transferring residual risk, or altering activities to avoid risk. In addition, the mitigation assessment assists in identifying opportunities that risk presents by providing a comprehensive perspective of the university's risk-related activities.

By: Christine Packard

Assistant Vice President, Enterprise Risk Management, University of Massachusetts

BioChristine joined the University of Massachusetts (UMass) in August 2019 to serve in the University’s first position fully dedicated to enterprise risk management (ERM). In her role as assistant vice president for ERM, Christine is responsible for the systemwide enterprise risk management program, working with the five UMass campuses to ensure the identification, assessment and mitigation of systemwide risks. She has focused the UMass systemwide ERM program not only to understand what risks UMass faces as a public institution of higher education, but also to create transparency on how and how well the University is mitigating these risks.

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Transforming Losses into Learning: Root Cause Investigation

Melissa Simental
Senior Claims and Risk Control Manager; Wyoming Association of Risk Management
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In the world of risk control, preventing losses is a top priority. How do we achieve this? One way is through risk identification, analysis, and mitigation. Another critical approach is to extract every possible lesson from each claim or near-miss. If we can do that, we can implement real change that can reduce or eliminate future claims of the same type. The answer to all of this lies in conducting thorough and timely root cause investigations.

In our journey to define an effective process for our members, we reviewed several root cause methods. Ultimately, they all led to the same fundamental question: Why? Why did this happen? Why did the employee take certain actions? Why weren’t policies and procedures followed? Why wasn’t accountability established in the aftermath? Why, why, why! If we couldn’t sufficiently answer the why questions, it became clear that our investigation had not gone far enough—and this could lead to faulty conclusions.

To provide a streamlined yet effective process for our members, we developed a four-step approach to root cause investigation: document review, meeting preparation, site visit, and root cause determination. This framework is comprehensive yet user-friendly, ensuring that supervisors can handle investigations efficiently and effectively.

Step 1: Document Review
The first step is to gather and review all relevant documentation. This includes policies, procedures, incident reports, photos, videos, and police reports if applicable. Reviewing this information helps build a solid foundation for the investigation by identifying any discrepancies or gaps in protocols. Understanding what policies were in place at the time of the incident is key to determining whether deviations occurred. The insights gained from document review set the stage for the next steps and ultimately inform the root cause determination.

Step 2: Meeting Preparation
After reviewing the documents, the next step is to prepare for interviews with the employee involved in the incident and their supervisor. The goal here is to ask open-ended questions that get to the heart of why certain actions were taken. The questions should address the “who,” “what,” “where,” “when,” “how” and “why” of the incident. Meeting preparation is critical because it helps identify missing information and areas of concern. These conversations can provide valuable context, especially regarding why policies weren’t followed or what specific challenges the employee faced.

Step 3: Site Visit
A site visit is perhaps the most vital step in the entire process. Seeing the environment where the incident occurred and interacting directly with the employee and their supervisor often reveals insights that documents and interviews alone cannot. During the site visit, our first question is always to ask the employee to walk through the incident, explaining their decisions and actions step-by-step.

As the employee explains, what starts to happen is that they provide us with the “why” behind their actions: “I went this direction instead of that direction because..." “I didn’t do this because...” "I did this because...’”

Many of our prepared questions will be answered without us uttering a single one! This approach also helps the employee understand that they are a crucial part of this process and we are here to learn from what happened, not to find fault. This method often uncovers underlying reasons for behavior, such as environmental factors or miscommunications. The presence of the supervisor during the site visit is equally important, as it allows the investigator to explore supervisory decisions and policies in practice.

Step 4: Root Cause Determination
The final step is determining the root cause, which may be singular or involve multiple contributing factors. It’s essential to dig deeper than simply attributing the issue to “operator error” or concluding that an employee “should be more careful.” The goal is to understand why the error occurred. Was there a lack of training? Were procedures unclear or not enforced? Was there a breakdown in communication between the employee and their supervisor?

Understanding these nuances allows the organization to address the underlying issues and prevent future incidents.
Root cause investigations are essential for preventing future losses. Following the four-step process helps organizations uncover the true reasons behind incidents. By fully understanding the why behind each incident, organizations can implement effective changes that promote risk reduction across the organization.

By: Melissa Simental

Senior Claims and Risk Control Manager; Wyoming Association of Risk Management

Bio
Rodney’s work includes the development of a statewide return-to-work program. This began with a successful pilot program with the Tennessee Department of Corrections (TDOC) in 2014 and expansion across the state in 2015, helping position Tennessee as a leader in saving taxpayer dollars, and making health care professional service more readily available for injured workers. Since he was hired in 2013, Rodney has made customer service to the state and its citizens a priority. He has worked with agencies and institutions across the state to assess risk and protect resources. He has worked to implement and improve programs within the division, including the state insurance program, which covers 7,000 state buildings, various works of art, machinery, cyber liabilities and more. Rodney has been the recipient of risk management awards in the past, including the Public Risk Management Association (PRIMA)’s Public Risk Manager of the Year Award in 2017.

Responsibilities
Work with municipal and county risk pool members to reduce incidents in various areas of liability. This includes claim management, training, and risk management processes and programs.

Business Experience
Wyoming Association of Risk Management, April 2024 - Present

Education
Bachelor's Degree - Administration of Justice - University of Wyoming
ARM Designation
Currently working to complete ACRM Designation (Associate in Cyber Risk Management)

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The 2020 Nashville Tornado, COVID’s Impact on Property Claims and the Chaos It Created (Part 2)

Rodney Escobar
Director, Claim and Risk Management, State of Tennessee Dept. of the Treasury
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This is the second blog post in a 2-part series. Part 1 can be found here.

While Treasury’s transition was seamless, our response to the tornado damage was still impacted by COVID-19 restrictions. Our contractors faced challenges with the breakdown of supply chains and labor shortages, leading to excessive cost increases for building materials, labor, and construction in the last quarter of 2020. These issues impacted repair costs by roughly 15-30%.

The largest issue the State of Tennessee experienced due to COVID-19 was the hardening of property and cyber insurance markets. With lower interest rates and earnings in 2021, markets feared some insured lines would become uneconomical to write. The perceived uncertainties caused by the pandemic, along with wildfires and hurricanes, resulted in increased insurance rates for Property, Director & Officer, Cyber, and Umbrella/Excess Liability markets. The insurance market increases created significant financial impacts and non-renewals for governmental entities. The State of Tennessee experienced extremely high property renewal rates and received notice of a non-renewal status for coverage from the incumbent cyber insurance provider. The financial impact caused by the pandemic pushed the State of Tennessee to form a captive insurance program years earlier than originally planned.

Legislation authorizing the State Treasurer to create a State captive insurance company, with the approval of the Tennessee Board of Claims, was enacted by the Tennessee General Assembly on May 11, 2021. The captive is a separate legal entity, owned and controlled by the State. Administratively attached to the State Treasury, the State of Tennessee Captive Insurance Company is governed by the Board of Claims and regulated by the Tennessee Department of Commerce and Insurance. Officially formed on June 2, 2022, the State Captive has provided direct access to reinsurance markets, allowing the State to reduce overall costs and insure difficult risks.

Today, we see the fears that led insurance markets to raise rates in 2021 were unnecessary. The economics show insurance markets have not experienced extreme financial burdens. However, their concerns and expectations of operational issues for property and casualty markets pushed transformation to reduce manual processes and face-to-face interactions. The pandemic accelerated the emergence of Artificial Intelligence (AI) technology, which is expected to improve customer service, analytics, reporting, underwriting, marketing, invoicing, claims management, risk assessments, emerging or innovating risk management services, and insurance products. Going forward, governmental and non-governmental organizations will expect brokers and insurance carriers to utilize digital tools and platforms to support their needs.

The devastation of both the March 2020 tornados and the COVID-19 pandemic pushed Tennessee from complacency to preparation and action. Governments will continue to face black swan events. What was once considered an “unpredictable event,” beyond a normal expected situation or an extreme infrequency, has now become the norm. Catastrophic occurrences must be managed properly by simply understanding the known risks included in your budgets and reserves and investing in resilient financial portfolios that align with your organization’s business continuity and disaster recovery plans.

Fear creates panic for your organization, with both positive and negative consequences, especially when faced with an unprecedented situation like the COVID-19 pandemic. Engaging with leadership can result in the wisest decision-making during a time of crisis and unearth possibilities that lead to the best solutions.

By: Rodney Escobar

Director, Claim and Risk Management, State of Tennessee Dept. of the Treasury

Bio

Rodney’s work includes the development of a statewide return-to-work program. This began with a successful pilot program with the Tennessee Department of Corrections (TDOC) in 2014 and expansion across the state in 2015, helping position Tennessee as a leader in saving taxpayer dollars, and making health care professional service more readily available for injured workers. Since he was hired in 2013, Rodney has made customer service to the state and its citizens a priority. He has worked with agencies and institutions across the state to assess risk and protect resources. He has worked to implement and improve programs within the division, including the state insurance program, which covers 7,000 state buildings, various works of art, machinery, cyber liabilities and more. Rodney has been the recipient of risk management awards in the past, including the Public Risk Management Association (PRIMA)’s Public Risk Manager of the Year Award in 2017.

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The 2020 Nashville Tornado, COVID’s Impact on Property Claims and the Chaos It Created (Part 1)

Rodney Escobar
Director, Claim and Risk Management, State of Tennessee Dept. of the Treasury
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In March 2020, as the COVID-19 pandemic was creating increased fear and uncertainty throughout the world, Tennessee experienced a tornado outbreak lasting 10 hours, and 38 minutes. Seven tornados with the maximum rating of EF4, confirmed by the National Weather Service, struck the west and middle parts of the state on March 3, 2020. (https://www.weather.gov/ohx/20200303). This deadly weather event killed 19 people, injured 87 others, and was responsible for approximately $1.5 billion in property losses across Tennessee. The State of Tennessee and other covered entities incurred damages originally estimated at $205 million, with many of the losses in Nashville-Davidson County. The three major areas of property loss were the campus of Tennessee State University, the old Tennessee State Prison managed by the Department of Corrections, and various buildings damaged throughout the state under the management of the Department of General Services.

As COVID-19 began shuttering schools and businesses, the State’s initial response was no different from previous disasters. Our response team included the Tennessee Department of Treasury, the professional broker, and adjusting teams. The team-coordinated site assessments and in-person meetings, and deployed drone technology to record the devastation of each site destroyed by tornados.

With a clearer understanding of the magnitude and widespread destruction of State facilities, Treasury procured an emergency contract with a specialty disaster recovery service to assist with the response and recovery efforts. The services included FEMA project management, reviewing of overall loss estimates, developing a work plan for claims, prioritizing projects and deadlines, developing a communication and financial plan, scheduling weekly updates with all project teams, and preparing scope of work and damage assessments. These services have become permanent solutions in our response to natural disasters and recovery for the State.

On April 2, 2020, one month after the tornado outbreak, Tennessee Governor Bill Lee issued Executive Order No. 23 requiring Tennesseans to stay at home except for essential activities. With this order, our team was forced to adjust our disaster recovery response to meet the new provisions. Instead of a group of adjusters, facility managers, engineers, and essential staff meeting at damaged locations, COVID-19 restrictions meant only two to three individuals could survey the damage and report back to the larger response team through virtual platforms. Claims for major areas of damage were adjusted via Teams and Zoom meetings.

Ten years prior to the pandemic, Nashville suffered a devasting flood that kept state employees out of their offices for more than a week. Following the flood, Treasurer David H. Lillard, Jr. led the development and implementation of a disaster recovery plan for the Tennessee Department of Treasury. The disaster recovery plan included instituting a telework policy, allowing some employees to work remotely a couple of days each week, and equipping most divisions with laptops and equipment needed to work remotely at a moment’s notice. As a result, when the coronavirus crisis struck, Treasury seamlessly transitioned to full-time remote work with no lapse in the services we offered the public. Tennessee maintained execution of timelines and strategies by the recovery response team, TEMA, and FEMA.

The consistency during the COVID-19 crisis was crucial to the success of the State’s response and recovery efforts. The State of Tennessee’s property adjusting company noted Tennessee’s success in meeting the demands of the pandemic compared to other organizations with major losses in the Nashville area. Not being equipped to meet virtually, like the State of Tennessee, caused other organizations working with the adjusting company to experience delays and constraints in moving claims forward during this timeframe.

By: Rodney Escobar

Director, Claim and Risk Management, State of Tennessee Dept. of the Treasury

Bio

Rodney’s work includes the development of a statewide return-to-work program. This began with a successful pilot program with the Tennessee Department of Corrections (TDOC) in 2014 and expansion across the state in 2015, helping position Tennessee as a leader in saving taxpayer dollars, and making health care professional service more readily available for injured workers. Since he was hired in 2013, Rodney has made customer service to the state and its citizens a priority. He has worked with agencies and institutions across the state to assess risk and protect resources. He has worked to implement and improve programs within the division, including the state insurance program, which covers 7,000 state buildings, various works of art, machinery, cyber liabilities and more. Rodney has been the recipient of risk management awards in the past, including the Public Risk Management Association (PRIMA)’s Public Risk Manager of the Year Award in 2017.

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Winter Damage and Roof Inspections

Michael Neff
Loss Control Consultant, Berkley Risk
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Snow and ice can do a number on roofs over a long and cold winter, especially if there is no process in place for inspections and maintenance. You can minimize the risk of snow loading and roof collapses by planning, preparing, and taking prompt action to remove accumulated snow. This article will set out to highlight the main ways to focus on monitoring and preventing roof damage throughout the winter.

What to Look For

Visible damage and debris – The first step to inspecting a roof is looking for obvious signs of damage, including visible structural deformations, dirt and debris, standing water, and blocked or broken gutters and downspouts. Any obvious damage should be repaired shortly after discovering it.

Exterior structural components – All external structural components of the roof, including chimneys, vents, fascia, drip edges, and decking should be inspected for damage, missing components, rust, and rot. Leaks tend to form around chimneys, vents, and skylights; if they're not noticed in a timely manner, damage can occur to the underlayment, sheathing, and joists, leading to potentially expensive repair and replacement costs.

Interior roofing components – When roofs are not inspected regularly, interior structural damage can occur. Often, due to a lack of regular maintenance, interior damage is the first to be noticed. On sloped roofs, the location of the damage may not directly point to the location of the leak. Water follows the path of least resistance, which means the source of the leak is often not above the visible damage. If a leak has been left to linger, rafter and roof trusses should be checked for evidence of mold, mildew and rot, which could indicate extensive structural damage.

At a minimum, a comprehensive maintenance program for roofing systems should include these basic steps:

  • Keep roofs clean and free of debris.
  • Remove snow to prevent a buildup of snow and ice in particular spots on the roof.
  • Keep drainage systems clear and functional.
  • Train maintenance personnel on the requirements of working with the roof system.
  • Restrict roof access to authorized personnel.
  • Limit penetration of the roof system.
  • Use professional roofing contractors who stand behind their work.

When to Look

While a spring inspection would reveal potential damage that might have occurred from severe winter weather, a fall inspection would reveal any preventative action required before winter arrives. An inspection should be conducted after any major storm or construction activity that might cause damage to the roof, including any recent heavy snowfalls. Always take extra precautions and have someone with you when inspecting roofs in the winter.

During a winter storm, it can be dangerous to be on the roofs. It is best to be prepared to act after a snowfall.

  • Do not allow unauthorized workers/persons on to roofs. All workers should be properly trained on snow removal and equipment use.
  • Remove the snow systematically to maintain the balance of the structure. Use shovels and wheelbarrows. If using a snowblower, ensure that the auger is set to the highest level to prevent damage to the roof.
  • Do not create snow drifts by moving snow from one area on another.
  • Verify all drains are clear of ice and snow to allow melting and runoff. If the roof is pitched and without drains, open paths to the eaves to ensure drainage and prevent ponding.
  • Inspect for any other roof damage and make necessary repairs when it is safe to do so.

Safeguards When Doing Inspections

The following safeguards will assist with prevention of roof collapses:

  • Have a fall prevention plan that is compliant with local agency requirements before engaging in roof preparation activities.
  • Keep workers trained and the proper equipment available for snow removal, as well as proper PPE for the elements.
  • Continuously monitor winter storms and remove snow off roofs as soon as possible after each snowfall.
  • Keep all drains clear and unblock debris (leaves, dirt, etc.) year-round. The downspouts should also be clear.
  • Keep an updated winter emergency response plan in effect, especially for snow removal.
  • Confirm generators are in good condition and their fuel tanks are full.
  • Ensure fire hydrants and fire protection system control valves are visibly marked to avoid damage from snow removal equipment.

Roofing maintenance and inspection is a process that needs attention year-round, and preventative maintenance is something that goes a long way in making life easier for maintaining these roofs over a long period of time. Sticking with a diligent schedule and checking up on roofs after severe storms are fundamental for a comprehensive roof maintenance program. Combining these elements of preparation, planning and inspecting will make for great roofing care and less costs on repairs or replacement projects in the long-term.

By: Michael Neff

Loss Control Consultant, Berkley Risk

Summary of Qualifications
Michael holds a Bachelor of Science in Occupational Safety & Health Management and has six years of loss control consulting experience. This experience includes mainly working with cities and counties through both property & casualty and excess liability coverages.

Responsibilities
Schedule and put together agenda for in-person loss control meetings and walk-throughs with clients. These clients include cities, counties, roofing contractors, manufacturing, assisted living homes, foundries, etc. Review claim trends and create responses on loss control questions our clients reach out with.

Business Experience
2023 - Present: Loss Control Consultant with Berkley Risk
2019 - 2023: Loss Control Consultant with the League of Minnesota Cities
2018: Environmental Compliance and Safety & Health internship with EJ, Inc.

Professional Affiliations
- American Society of Safety Professionals
- Public Risk Management Association

Education
- Grand Valley State University 2019 - Bachelor of Science

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De-escalation Techniques in Special Education

Angela Nagle, Ph.D.,
 School Risk Management Specialist, Public Employer Risk Management Association
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Approximately 66 percent of all school injuries are unintentionally caused by interactions with special education students. Bites, scratches, punches, and facial injuries, among others, can be minimized by wearing personal protective equipment. However, once a student engages in a behavior, prevention has passed, and it is important to minimize the injury by wearing personal protective equipment.  The goal is to prevent injuries by de-escalating a student before an injurious behavior occurs. How can this be accomplished?

Teachers and support staff know students well. It is important to train and remind staff that if a student appears dysregulated, they should use de-escalation techniques before a behavior that can cause an injury is manifested. The most effective de-escalation technique is the use of sensory, and it is critical that teachers have sensory resources available and understand how they are successfully used to regulate students’ behavior.

Ideally, school buildings should have a sensory room where students can engage in various sensory-based activities designed to calm and regulate a student. The use of tactile walls, compression canoes, swings, and tunnels, among other resources, is very effective. Having a variety of sensory resources in a room allows a student to gravitate toward a personal preference.  A mobile sensory cart is a great idea if a school building does not have dedicated sensory space.  This cart can be shared among classrooms. A plethora of smaller sensory items can also be used within a classroom.

A student’s favorite is weighted animals. For students who are often out of their seats, placing a weighted animal on their lap provides compression and tactile sensory that comes from an animal with movable sequins or crinkle paper within the material. Often, this is enough to regulate a student so that they remain seated, the lesson can be completed, and potential behaviors can be extinguished.

It is important to provide staff with sensory resources and engage them in professional development, so teachers understand how to use such resources to de-escalate students. Taking the time to model the use of sensory in a classroom is necessary.  Simply handing out resources will not work. Teachers must understand the purpose and the variety of ways sensory materials can be used with students.  I have seen many cases where teachers try something once and give up. Teachers must be persistent. I give the analogy of learning to play basketball. How many times does it take for a student to make their first basket? Many attempts and then the student builds the skill and gravitates towards the activity because they achieved success. The same can be applied to sensory integration in the classroom. The student may push sensory items away many times before selecting a preference and validating that the sensory is calming. Introducing a culture of sensory will be an investment of time and training.

Remember, the sensory equipment investment is paid back by fewer claims, lower premiums, and engaged and happier staff.

By: Angela Nagle, Ph.D

School Risk Management Specialist, Public Employer Risk Management Association

Summary of Qualifications

Angela Nagle joined PERMA three years ago after retiring from public education in New York State. Angela is a former Superintendent of Schools, Assistant Superintendent for Curriculum and Instruction, Director of Pupil Personnel Services, and teacher.

Responsibilities

Angela provides risk management services to school districts and Board of Cooperative Educational Services (BOCES) throughout New York State. With approximately 66% of all staff injuries caused by interactions with special education students, Angela applies her expertise and risk interventions to lower this risk substantially through professional development-school safety trainings, use of personal protective equipment, and sensory integration throughout the school day.

Angela observes classrooms with reported staff injuries and through a process called (RISE) Reducing Injuries in Special Education, lowers staff injuries.

Professional Affiliations
- New York State School Boards Association
- New York State Council of School Superintendents
- AMCOMP

Education
- State University of New York at Albany, Doctorate of Philosophy, Educational Administration and Policy Studies
- College of St. Rose, Masters of Science, Special Education
- Siena College, Bachelor's of Science - Marketing/Management/Business Administration
- WCP Designation - AMCOMP

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