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TABLE OF CONTENTS
The Healthcare Savings Quarterly Releases 3rd Qtr. 2015 Edition:
Establishing Healthy Companies
About The Healthcare Savings Quarterly
The Healthcare Savings Quarterly (HSQ) is a unique electronic publication designed to provide useful, timely and actionable information on a host of topics impacting the health insurance and healthcare markets. Each quarter we identify a "hot topic" in the market, and solicit articles from industry leaders to provide varying perspectives on issues and opportunities. Currently, HSQ reaches over 5,500 contacts nationwide.
HSQ is powered by United Claim Solutions (UCS), an innovative Medical Cost Reduction and Claims Flow Management company providing cutting edge and customizable cost-containment programs for payers, employers, unions, accountable care organizations, stop-loss companies, CO-OPs, ACOs and health plans.
About United Claim Solutions (UCS)
UCS offers end to end services including Bill Audits, Out-of-Network Bill Repricing, Bill Editing, Specialty Claim Negotiations, Medicare Plus Repricing, PPO Administration, Medical Management, Clearinghouse Services, Data Warehousing, OCR/Scanning, and Plan Modeling. We provide solutions for Group Health, Workers' Compensation, and Auto Liability. Contact Corte B. Iarossi, VP of Sales & Marketing at 866-762-4455 (x120), firstname.lastname@example.org and visit www.UnitedClaimSolutions.com.
Relevant Healthcare Becomes Preferred Vendor For National Alliance Of State Health Co-Ops (NASHCO)
MyHealthGuide Source: Relevant Healthcare, 8/17/2015, www.relevanthealthcare.com
Chicago, IL -- Relevant Healthcare, a national healthcare cost containment company, was recently nominated and added to the NASHCO Preferred Vendor Program as a valuable savings tool for the state self-funded health cooperatives across the country, and their combined membership that now exceeds 1 million people.
Over the past 10 months, Relevant has been working very closely with one of the NASHCO member CO-OPs where it has been successful in saving more than $1.5 million dollars on only a handful of claims for dialysis treatment - an area where all of the cooperatives are experiencing the same challenges. As a result of that success and global interest, as well as the many other areas in which Relevant can save significant healthcare dollars, Relevant was nominated to participate in this program.
"We are extremely excited about this opportunity. We have had the desire for some time to help the state CO-OPs in any way that we can, and are grateful to have been given the chance to prove our ability to do just that. We look forward to establishing a long term relationship with NASHCO and in working with each CO-OP to develop valuable programs that help them to grow and remain a successful component of our healthcare system," said Scott Fuqua, President.
Relevant's robust offering of savings solutions will provide NASHCO's membership with a valuable tool and resource. Combining the savings opportunity of all of its products, and depending on the size of the individual CO-OP, Relevant has estimates of savings that reach into the range of $50,000,000+ per year. With most products carrying a Contingency Model (no savings, no fees) and its National Radiology Network which involves no fees what-so-ever, Relevant is also able to offer NASHCO risk-free solutions that also include complimentary savings analysis and an extremely measurable ROI.
"We are proud to welcome Relevant Healthcare to our Preferred Vendor Program. Cost containment is a key goal for CO-OPs and all insurers, and Relevant Healthcare has the tools and resources to help our member CO-OPs achieve significant cost savings. We look forward to working with Relevant Healthcare in the coming months and years, and encourage CO-OPs to explore their range of services," said Kelly Crowe, President of NASHCO.
About Relevant Healthcare
Relevant Healthcare Cost Containment is a minority owned (MBE), and union affiliated organization that provides savings solutions in high cost areas of Healthcare for Employee Benefits and Workers' Compensation. Our services benefit self-funded employers, insurance carriers, CO-OPs and Medicaid Plans seeking to control healthcare costs, Third Party Administrators needing to carve out expensive procedures for their clients, workers' compensation insurance carriers/TPAs looking to lower costs, and any Broker or Consulting Firm that is looking to bring more value to their self-funded clients. Our solutions focus on specific areas of healthcare treatment that continue to drive the major increases in costs and utilization: Dialysis, Diabetes, Surgery, Large Dollar Claims, Pharmacy, Fraud/Waste/Abuse, and our flagship, FREE Advanced Radiology Network that offers significant discounts on procedures such as MRIs, CT Scans, and PET Scans while also providing a Concierge Service for the patient. Contact Scott Fuqua at 855-328-5100, email@example.com and visit www.relevanthealthcare.com.
INTERLINK CancerCARE Partners with McKesson Specialty Health's Clear Value Plus
MyHealthGuide Source: INTERLINK COE Networks & Programs, 10/1/2015, www.interlinkhealth.com
Hillsboro, OR -- INTERLINK COE Networks & Programs is pleased to announce the addition of McKesson Specialty Health's Clear Value Plussm technology as a fully integrated tool within its CancerCARE® initiative dedicated to improving the value and outcomes of cancer care across the United States.
Built upon the evidence-based NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Clear Value Plus technology utilizes information from a patient to determine regimens geared toward determining treatment with least toxicity and better cost-effectiveness for an overall better outcome. CancerCARE's clinical personnel then work with the community-based physicians in support of improved quality and patient satisfaction, lowered costs, and overall patient outcomes - the "Triple Aim" applied to cancer population management.
Combined with its diagnostic second opinion program (PathologyDiagnosticCOE), CancerCARE brings key components together to craft a value-based, optimized, accurate, and timely plan for each patient. Since the program collects patient-specific clinical information at care decision points, CancerCARE is recommending that Clear Value Plus courses of care be approved in their entirety in lieu of each individual component, further reducing administrative burden at all levels. Additionally, in this relationship INTERLINK continues its licensing and support of National Comprehensive Cancer Network® (NCCN®) efforts, and further improves those capabilities through McKesson Specialty Health's Clear Value Plus technology.
"Value-Based Purchasing is important to our clients, so it's important to us" says John Van Dyke, INTERLINK's CEO. "Clear Value Plus technology enables CancerCARE to share patient specific low risk/highly effective care options to physicians as they plan care. This technology creates a solid community management program, which compliments our highly effective COE ACCESS, Second Opinion and Clinical Trial programs currently in place."
Dr. Ron Potts, Chief Medical Officer for INTERLINK adds, "This opportunity to incorporate the outstanding leadership of the NCCN Guideline panels in evidence-based guidelines development with the highly-developed expertise of McKesson's Specialty Health gives us a unique set of tools to positively influence the care of patients enrolled in our CancerCare program".
Leading the Clear Value Plus implementation within CancerCARE, will be Kris Atkins, RN, CCM, Ronald G. Potts, MD and Tara Metzner, National Director of CancerCare Client Relations. Functions will include collection of essential clinical information by the Triage Center, communications with the physician offices, and treatment compliance notices to the plan. Included in this program is an itemized drug and biologics list for the agreed upon Clear Value Plus treatment program, thus enhancing the efficiency of client authorization and bill payment processes.
"The addition of Clear Value Plus to our already robust program will allow us to guide those members receiving care from local providers with the information they need to make informed decisions to obtain the best quality, patient-centric, value based care I have ever seen available in my 30 years of oncology nursing," says Kris Atkins, RN, VP of CancerCARE Quality Programs.
Benefit plans are evolving to include specific sections for cancer, transplants, dialysis and other high cost/low frequency care. With cancer costs now the #1 reinsured and plan claim for most, INTERLINK's program featuring Centers of Excellence networks and guideline management will play an important role.
About INTERLINK® COE Networks & Programs
INTERLINK® has 20 years of experience as an outcomes management company based in Hillsboro, Oregon. INTERLINK® builds Centers of Excellence networks for high-cost, low frequency medical procedures which are used by health plans all across the nation. Two of INTERLINK's seven COE networks have Affordable Care Act (ACA) adjusted benefit language, member education materials and fully integrated case management programs. INTERLINK® is well known for its transplant capabilities, which enables large plans to build their own COE network in our TransplantCUSTOM program, and a turn-key, narrowed TransplantELITE performance network for smaller plans. CancerCARE is our comprehensive cancer management program, using three custom built COE networks, NCCN Guidelines®, McKesson Specialty Health's Clear Value Plus Program, ACA adjusted cancer benefit language and fully integrated case management. Contact Tara Metzner at 877-640-9610, tara.metzner@interlinkhealth and visit www.interlinkhealth.com.
Xchange Group Celebrates Fifth Anniversary, 4th October 2015
MyHealthGuide Source: Xchange Group, 9/30/2015, www.xgrpllc.com
The Xchange Group and its main subsidiary Xchange Benefits are very proud to be celebrating fives year of delivering excellent service and high quality outcomes to our clients.
Peter McGuire President and CEO stated, "We are here today and thriving because of the loyalty of our clients and business partners who have supported us over the past five years. Our clients can continue to expect and receive un-rivaled service in the industry because of the dedication of our exceptional team members. We wish to express a huge thank you to all of our clients".
Over the past five years Xchange Group has diversified its brands to include; Xchange Affinity; Xchange Benefits; Xchange Consulting; Xchange Intermediaries; Xchange Specialty and Xchange Travel.
The Xchange Group looks forward to providing industry leading service and innovation to our current clients and to our future clients for many years to come. The Xchange Group management team also looks forward to welcoming new colleagues who share our passion and vision and who have an uncompromising drive to deliver only the very best outcomes to clients.
About The Xchange Group
Founded in 2010, The Xchange Group is a diverse Group of Business Units focused on the Global Insurance and Reinsurance Industry. Led by a Team who have industry leading experience; Xchange Group: Underwrites, Consults, Creates Products, Creates Retail Distribution, Structures Risk, Transacts Reinsurance, Advises on Capital Deployment and most importantly Listens to our Clients. Contact Peter Mcguire at PMcguire@xbllc.com, 914.437.7360, and visit www.xgrpllc.com.
NAEBA Releases Video, Discover The Benefits of Self-Funding
MyHealthGuide Source: The National Association of Employee Benefit Administrators (NAEBA), 9/24/2015, www.naeba.net
Editor's Note: This article is being published again this week with corrected website address (URL) for the video link below.
Burr Ridge, IL -- The National Association of Employee Benefit Administrators (NAEBA) has produced a new animated video, entitled Discover The Benefits of Self-Funding. Featuring a bold, fresh white board format, the program is brief, emphasizing the advantages of self- insured health benefit plans in under two minutes.
Produced by Barcelona Creative Group and licensed to the NAEBA, the video was created to serve as a marketing tool for Third Party Administration firms participating in the NAEBA. To view the program or to obtain information about the NAEBA, visit http://www.naeba.net/self-funding-video.
About the NAEBA
The National Association of Employee Benefit Administrators is a cooperative marketing association dedicated to helping member TPA firms market employee benefits administration in very innovative ways. By combining traditional media with new digital and social media tools, members are better able to convey the importance of self-funded health benefit plans, expert administration and the cost control strategies that set independent TPAs apart. Contact Thomas Barcelona, NAEBA Executive Director at 630/320-6424 ext. 1300, firstname.lastname@example.org and visit www.naeba.net.
About Barcelona Creative Group
Barcelona Creative Group is a strategic marketing and branding firm, specializing in insurance and employee benefits administration. Based in Chicago and established in 1990, the agency serves as the creative resource team for the NAEBA and leading, independent Third Party Administrators throughout the U.S. Visit www.barcelonacreative.com.
Reinsurance Group Of America (RGA) Names Dan Carlson as Senior Vice President and Head of Business Development, U.S. Group Re
MyHealthGuide Source: Reinsurance Group Of America, Inc., 10/1/2015, www.rgare.com
Reinsurance Group Of America (RGA) has named Dan Carlson Senior Vice President and Head of Business Development for its U.S. Group Re team. Dan comes to RGA from Marsh and McLennan, where he was Managing Director and National Team Leader for Health Plan Reinsurance and Provider Excess Loss Insurance.
Dan will coordinate business development activities throughout the group reinsurance division at RGA, and build relationships with clients and brokers across all group lines of business, including Life, Health, Disability, and Special Risk.
Prior to his 18-year tenure at Marsh, Dan held leadership roles at MMI Companies and The Travelers. Dan is currently a board member of the Managed Care Risk Association and Chairperson of the Colorado Healthcare Executive Forum.
Reinsurance Group of America, Incorporated is one of the largest global life and health reinsurance companies in the world. The company provides clients with individual life reinsurance, individual living benefits reinsurance, group reinsurance, health reinsurance, financial solutions, facultative underwriting and product development. RGA and its subsidiaries serve clients from operations in Australia, Barbados, Bermuda, Canada, China, France, Germany, Hong Kong, India, Ireland, Italy, Japan, Malaysia, Mexico, the Netherlands, New Zealand, Poland, Singapore, South Africa, South Korea, Spain, Taiwan, Turkey, the United Arab Emirates, the United Kingdom, and the United States. Worldwide, RGA has approximately $2.9 trillion of life reinsurance in force and assets of $47.5 billion. Contact Lynn Phillips, Executive Director, Public Relations, at 636.736.2351, email@example.com and visit www.rgare.com.
PartnerRe Health Announces Addition of Trevor Miller
MyHealthGuide Source: PartnerRe Health, 10/1/2015, www.partnerre.com
San Francisco, CA -- PartnerRe Health announced the addition of Trevor Miller to the Employer Programs team as Assistant Vice President, Business Development Manager.
Trevor will be a member of the team responsible for client development and retention for PartnerRe Health's products and services in the Employer market. He brings over 15 years of experience including expertise in self-funding and employer stop loss; in particular working with large brokerage firms, consultants and TPA's.
"We are very pleased to have Trevor join our team. Working with Adam Gottesman and Elizabeth Denne, his experience and knowledge will support the continued business outreach efforts and growth of our Employer Group," stated Matthew Leming, Vice President, Director, Employer Programs Health. "Trevor will play an integral role as we introduce and provide unique solutions to our stop loss clients."
PartnerRe Ltd. is a leading global reinsurer, providing multi-line risk management solutions around the world. Risks reinsured include property, casualty, motor, agriculture, aviation/space, catastrophe, credit/surety, engineering, energy, marine, specialty property, specialty casualty, multiline and other lines, mortality, longevity, health, and alternative risk products.
PartnerRe Health, the global Health Division of PartnerRe, is an acknowledged leader in providing risk management solutions to accident and health markets. Our team of experienced professionals develops innovative, client-specific solutions by thoroughly understanding our clients' goals, market, risk tolerance and exposures. Using a suite of proven proprietary financial and analytical tools, we design an effective risk management program with extensive support services. Ranked #1 on "America's 50 Most Trustworthy Financial Companies" -- Forbes, 2015. Contact Ali Duerr, Marketing Manager, at 415.354.1584, firstname.lastname@example.org and visit www.partnerre.com/health.
Berkley Accident and
Health Seeks to Add 3 New Positions
EmCap Product Director
Berkley Accident and Health is seeking a full time EmCap Product Director to be located in our Marlborough MA office. The ideal candidate will have the proven ability to be innovative and strategically focused. He or she will be integral to the development and market positioning of our next generation EmCap product . A Job Summary and its qualifications are outlined at:
Stop Loss Underwriter I
Berkley Accident and Health is seeking a full time, highly motivated entry level Underwriter looking to advance in a Stop Loss Underwriting career. This position will be located in our Marlborough Ma office. The ideal candidate will support a team of underwriters by preparing terms, census, benefit s, and experience information into a quoting system completely, accurately, and in a timely fashion. This position will also support underwriters by performing miscellaneous items to help meet sales and profitability goals. As the candidate gains experience he /she will start to evaluate risk and price new business and renewal accounts up to an assigned authority level. A Job Summary and its qualifications are outlined at:
About Berkley Accident and Health
Berkley Accident & Health is a wholly owned subsidiary of W.R. Berkley Corporation (NYSE: WRB) which was founded by William R. Berkley in 1967. The Company has been widely known for its entrepreneurial culture and unique decentralized corporate structure, having been recognized as the best managed insurance company in 2007 by Forbes Magazine. Our unique entrepreneurial approach focuses on customer needs for transferring risk and controlling costs. Our unique technical understanding of the medical marketplace, combined with our proprietary medical management capabilities, allows us to achieve superior results for our customers. Visit www.BerkleyAH.com.
Integro Re Enhances Managed Care Expertise With Addition Of Gary Cellini
MyHealthGuide Source:Integro Re, 10/1/2015, www.integrogroup.com
"Healthcare risk financing is undergoing a sea change of activity, particularly as it impacts insurers, provider-based health plans and other healthcare provider entities," said Peter Robinson, head of Integro Re's specialty practice. "Based on his impressive record of successes in the development of Medicare Advantage Special Needs Plans, CMS Demonstration Projects, and population health management in the renal and specialty pharmacy industries, we are confident Gary will help Integro Re's clients realize the best terms, high quality analytical modeling and innovation from the reinsurance markets nationally relating to population health, renal disease and specialty pharmaceuticals."
Cellini held CEO and senior leadership positions with several firms, including Satellite HealthCare, DaVita HealthCare Partners, Baxter International and Gentiva. He has developed nine Medicare Advantage health plans in eight states and the District of Columbia. He was responsible for two CMS ORDI demonstration projects that were instrumental in the early development of integrated care and medication management systems, bundled medical payments, and accountable care shared saving programs later implemented by the Centers of Medicare and Medicaid Innovation.
Cellini holds a Doctor of Pharmacy degree from the University of the Pacific's Thomas Long School of Pharmacy and a Master of Business Administration from the University of California Los Angeles's Anderson Graduate School of Management.
About Integro Re
Integro Re, a division of Integro USA Inc., is a full service reinsurance broker with particular expertise in healthcare, developing and implementing reinsurance strategies for a client base that includes insurance companies, alternative risk entities such as captives and risk retention groups, managing general agencies and third party administrators. Integro Re has locations in New York, London, San Francisco, Chicago, Denver and Boston.
Integro is an insurance brokerage and risk management firm. Clients credit Integro's superior technical abilities and creative, collaborative work style for securing superior program results and pricing. The firm's acknowledged capabilities in brokerage, risk analytics and claims are rewriting industry standards for service and quality. Launched in 2005, Integro and its family of specialty insurance and reinsurance companies, some having served clients for more than 150 years, operate from offices in the United States, Canada, Bermuda and the United Kingdom. Its U.S. headquarter office is located at 1 State Street Plaza, 9th Floor, New York, NY 10004. 1-877-688-8701. Contact Betsy Van Alstyne at Betsy.email@example.com, 212.295.5445 and visit www.integrogroup.com.
Top Marketing Company,
Ocozzio, Seeks Top Talent to Join Leadership Team
Visit www.ocozzio.com/careers.php to learn more about these openings and
information on how to apply. You may also stop by our booth at SIIA. We
would enjoy meeting you in person.
The healthcare marketing pros! We are a one-stop strategy, planning, design and execution marketing company. We specialize in the healthcare space with 12 years of hands-on experience serving more than 50 healthcare service provider companies. Our mission is to help our clients grow their business. Visit www.ocozzio.com.
IHC Risk Seeks Regional Sales
Executive for Western Region
Interested candidates should forward their resumes to firstname.lastname@example.org today! We are motivated to fill this position so do not delay.
About IHC Risk Solutions (IHCRS)
IHC Risk Solutions (IHCRS) offers medical stop-loss, group stop-loss captives, and an Organ Transplant Solution program. IHCRS is a full service direct writer for self-insured employer groups in all 50 states and is a member of the IHC Group, an insurance organization composed of Independence Holding Company (NYSE:IHC) and its operating subsidiaries. Coverage is underwritten by Standard Security Life Insurance Company of New York, also a member of the IHC Group. The IHC Group is built on financial strength and stability of IHC which has over $1 billion in assets as of December 2013 and over 25 years in the stop-loss business. Visit www.ihcrisksolutions.com.
D.W. Van Dyke & Co. Announces
2015 Stop Loss Industry Persistency and New Business Survey
About D.W. Van Dyke & Co. Inc.
D.W. Van Dyke & Co., Inc. is a privately held reinsurance intermediary with a 30+ year history of designing risk transfer programs and providing solutions for its clients. All of the intermediaries at D.W. Van Dyke & Co., Inc. have insurance and/or reinsurance underwriting backgrounds in a myriad of Life, Accident, Health, Financial, and Casualty product lines, and as a result, are able to provide unique solutions for their clients. Visit www.dwvd.com.
SIIA Submits Cadillac Tax Comment Letter
Why Tax Should Not Be Levied on TPAs
The Self-Insurance Institute of America, Inc. (SIIA) is a dynamic, member-based association dedicated to protecting and promoting the business interests of companies involved in the self-insurance/alternative risk transfer (ART) industry, both domestically and internationally. Call 800.851.7789 and visit www.SIIA.org.
Justice Changes Stance, Asks for
Contraceptive Mandate Ruling
The Washington archbishop case also addresses both key tests of the federal religious freedom law, which the plaintiff charities have argued protects them from participating in any activity that violates their religious beliefs, the Justice Department said.
Court Nixes Participant's Claims in Subrogation Dispute
MyHealthGuide Source: Bloomberg Law, 9/25/2015
Case: Cleveland v. Cent. States Se. & Sw. Areas Health & Welfare Fund. 2015 BL 310542, W.D. La., No. 5:14-cv-03350-SMH-MLH, 9/24/15. Court's Ruling
Article referred by John H. Eggertsen, Attorney at Law
Central States, Southeast and Southwest Areas Health & Welfare Fund properly denied benefits to a fund participant, who had sustained injuries in a car accident, based on its conclusion that the participant interfered with its subrogation rights under the plan, a federal judge in Louisiana ruled.
In a Sept. 24 order, Judge S. Maurice Hicks Jr. of the U.S. District Court for the Western District of Louisiana found it was within Central States's discretion to deny Joffrey Cleveland's claim for benefits because he filed a lawsuit in state court seeking to recover money from his and the other driver's auto insurance policies, which conflicted with Central States's subrogation rights under the plan.
Messaging Improves Risk Factors in Patients With Coronary Heart Disease
Researchers conclude that patients with coronary heart disease, the use of a lifestyle-focused text messaging service compared with usual care resulted in a modest improvement in LDL-C level and greater improvement in other cardiovascular disease risk factors. The duration of these effects and hence whether they result in improved clinical outcomes remain to be determined.
Medical Stop-Loss Providers Ranked by Annual Premium Survey (last updated 8/8/2015)
Editor's Note: The following is a recurring article. This Newsletter is often asked by readers for a list of medical stop-loss providers and their respective premiums. Below the first of a recurring article that attempts to lists stop-loss providers and annual premiums. Sources includes press releases, AM Best reports, conference presentations and more.
Other stop-loss leaders include the following list. However, we await reader response providing stop-loss premium volume (and additional carriers) so that each could be added to the table above.
Stop-loss Premium Volume is not the Whole Story
Industry executives question the purpose of a chart reporting only stop-loss premium without additional information such as:
Reader response and correction is encouraged. Sources will be cited. Please send updates / changes to Info@MyHealthGuide.com.
The Value of Self-Funding
MyHealthGuide Source: The Self-Insurance Educational Foundation, Inc. (SIEF), 2014, www.SIEFOnline.org The Self-Insurance Educational Foundation, Inc. (SIEF has published The Value of Self-Funding.
Self-funding is an important contributor to the financial and physical health of America's wellness future. Self-funding is more than processing claims and receiving premiums, it provides quality coverage and proactive healthcare management for employers of all sizes and industries.
About the SIEF
The Self-Insurance Educational Foundation, Inc. (SIEF) is a 501(c)(3) non-profit organization affiliated with the Self-Insurance Institute of America, Inc. (SIIA). The foundation's mission is to raise the awareness and understanding of self-insurance among the business community, policy-makers, consumers, the media and other interested parties. Visit www.SIEFOnline.org.
ICD-10 Readiness Tools
MyHealthGuide Source: Industry Study Group (ISG), 9/19/2015
In the early 2000s a group of industry professionals collectively known as
the Industry Study Group ("ISG") created a Standard Disclosure Notification
form and a standardized list of ICD-9 diagnosis codes, known as the Trigger
The original ICD Trigger list was endorsed by SIIA and SPBA. The updated ICD-10-CM is now endorsed by HCAA.
Below are useful links for members of the self-funded community including TPAs, stop-loss carriers, MGUs, and others.
October 18-20, 2015
The health care sessions are part of a larger educational program that includes nearly 40 general and breakout sessions related to the broader self-insurance marketplace. This top-notch educational program will be supplemented by the industry's largest exhibit hall and incredible networking opportunities throughout the event. Marriott Marquis, Washington, DC. Call 800-851-7789 and visit www.SIIA.org.
February 9-11, 2016
March 7-9, 2016
March 21-23, 2016
March 30-April 1, 2016
April 5-7, 2016
May 4-6, 2016
May 18-19, 2016
May 24-26, 2016
July 13-15, 2016
September 25-27, 2016
October 17-19, 2016
February 8-10, 2017
March 15-17, 2017
September 13-15, 2017