Prior to launching Self-funding Solutions, Mickey spent four years with The Rizza Group, a well-known law firm focusing on ERISA and other federal compliance issues that govern self-funded group health plans. She worked closely with the firm’s attorneys, assisting them through her knowledge of the technical aspects of administration, claims and operation of benefit plans, offering a perspective that few law firms have. She performed plan document compliance reviews, re-statement of plan documents and updates to plan language for the latest industry requirements and trends. She also assisted the firm’s clients in research and resolution of many day-to-day complex issues that arise in self-funded plan administration; including, for example, HIPAA, COBRA, Medicare Secondary Payer, and eligibility and coverage issues.
Mickey spent 19 years as Senior Vice President of a TPA, where she gained invaluable client-side experience and insight that allows
her to provide consulting that includes a comprehensive perspective of the industry. In this role, she was responsible for the operational
areas at its three locations including; claims, stop loss filings, plan document preparation and audit, intellectual technology/systems,
eligibility, HIPAA, COBRA, billing, customer service, employee training, quality assurance and auditing, as well as all compliance and legal issues.
Mickey's TPA experience includes working with risk-sharing arrangements and off-shore reinsurance where she was responsible for operational reporting, claim analysis, underwriting and reserves for IBNR liability. In addition, she established and managed a utilization review division for that company. Her prior experience also includes four years acting as Regional Claims Manager for three locations of another TPA.
Before her involvement with the self-funded industry, Mickey spent ten years with Aetna Life & Casualty, where she worked with traditional fully insured group plans, as well as life, individual accident and health, premium waiver and permanent total disability policies.