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OutcomeRx, a unit of CareMetx, announces First Independent Reinsurance Product for Rare Disease Specialty, Cell and Gene Therapies

BETHESDA, Md. -- OutcomeRx (ORx), a division of CareMetx, LLC, announced today a new reinsurance product to provide coverage access to high-cost specialty drugs including therapies in the emerging cell and gene therapy market(1)(2).

The Patient Access to Costly and Curative Therapies (PACCT)(3) carve-out reinsurance product initially provides first-dollar coverage for payers including PBMs, health plans and employers related to three costly therapies: Spinraza®(4) and Zolgensma®(5) for Spinal Muscular Atrophy (SMA) and Luxturna®(6) for Leber Congenital Amaurosis (LCA)-an inherited retinal disorder.

By offering a first-dollar coverage reinsurance product, PACCT provides payers coverage (without deductibles) for these therapies with the goal that payers will in turn lower the cost burden on patients with SMA and LCA. The new reinsurance product will be available with a coverage effective date of January 1, 2021.

OutcomeRx has partnered with Crum & Forster Accident and Health and IronHealth, a division of Ironshore to bring the reinsurance carve-out to leading PBMs, health plans, employer groups and benefit administrators to help change how high-cost therapies, including emerging cell and gene therapies are covered and reimbursed.

"We are excited to create this innovative reinsurance product in partnership with Crum & Forster to help ensure that families and patients needing these life-changing therapies are not hindered by the cost and coverage of treatment," said Mark Hansan, President and CEO of CareMetx, LLC. "We are confident PACCT is the most comprehensive and cost-effective reinsurance product to help protect payers from the sudden financial impact of the high-cost therapies needed to treat these rare genetic conditions."

Gene therapies are among the newest pharmaceutical innovations to treat and potentially cure disease. It is estimated that by 2025, 10 to 20 new gene therapies will be approved each year(7)(8). Today, the drug cost to treat a patient with these gene therapies ranges from $850,000(9) to ~$2.1 million(10), and future cell and gene therapies are estimated to cost $2-3 million(11).

Gary Nidds, Senior Vice President and head of Crum & Forster's Medical Business Unit, said "Our support for this program continues our tradition as an innovator in the accident and health insurance space. We are excited to sit at the cutting edge of coverage solutions for therapies that could, and likely would, otherwise be unattainable for those most in need."

Added Lainie Dorneker, President of IronHealth, a division of Ironshore, "We are excited about this opportunity to provide a much-needed solution to employers and patients and to partner with OutcomeRx and Crum & Forster in the pursuit of achieving positive outcomes and driving patient access."

"We invite all payers to sign up for PACCT as we have developed it as a carve out product available to all payers that purchase reinsurance, regardless of insurer affiliation, to help patients and their families have streamlined access to innovative SMA therapies," said Brooks Wildasin, Associate Vice President of Strategy for OutcomeRx. "The PACCT solution covers multiple therapies in the SMA disease state to ensure that most treatment journey scenarios are addressed, such as a need for both Spinraza and Zolgensma. Coverage will include a per patient per therapy cost limit for the two SMA therapies as well as for Luxturna and be available on a Per Member Per Month (PMPM) basis. We believe all types of payers can benefit from PACCT including health plans of all sizes, reinsurers, commercial group plans, and even state Medicaid plans that require financial risk containment."

Hansan added "Our team at CareMetx has been working for ten years with pharmaceutical and biotechnology manufacturers to help patients access and afford specialty therapies. Our division, OutcomeRx is creating the next generation of affordability solutions including insurance and financial products that are supported by both payers and manufacturers. We are really proud to launch PACCT and we look forward to expanding to other rare diseases that have high cost therapies, such as CAR-Ts and traditional specialty drugs."

For more information on the PACCT reinsurance product please contact Brooks Wildasin at admin@outcomerx.com.

About OutcomeRx

OutcomeRx (ORx) is a division of CareMetx, LLC formed in 2019 to address the patient, manufacturer, and payer challenges in the evolving Cell and Gene Therapy (CGT) market. CareMetx's founding team members have a 35-year commitment to helping patients through advocacy, services and technology. OutcomeRx represents the culmination of these efforts by creating next generation reinsurance and financial products that bridge the divide between drug manufacturers and payers. OutcomeRx, in conjunction with its partners, develops and markets financial, reinsurance, and warranty products that address the efficacy and actuarial risk associated with specialty therapies including Cell and Gene Therapies, while lowering the access and affordability burden on patients and their families.

Learn more at: https://caremetx.com/outcomerx/

About Crum & Forster

Crum & Forster,* rated A (Excellent) by A.M. Best (2019), is a national property and casualty insurance company wholly owned by Fairfax Financial Holdings Limited. Since 2000, Crum & Forster's Accident & Health Division has offered a robust portfolio of specialty insurance and reinsurance products nationwide, including medical stop loss, pet, travel and other voluntary and affinity benefits.

In 2019, following seven years of writing product in the captive insurance space, the division scaled to include international product capabilities through its wholly owned offshore captive facility, Crum & Forster Segregated Portfolio Company (SPC). Situated in the Cayman Islands and registered with the Cayman Islands Monetary Authority, Crum & Forster SPC is a Cayman Islands company that reports through United States Fire Insurance Company. Additional global relationships with other Fairfax entities provide our partners with even broader flexibility in underwriting solutions.

We place a strong focus on product development and creative distribution methods, along with excellent client service and support. The qualities and capabilities of Crum & Forster Accident & Health demonstrate our philosophy of building meaningful, long-term partnerships and our dedication to providing alternative strategies in an ever-changing insurance market.

Learn more at: https://www.cfins.com/

*Crum & Forster is a registered trademark of United States Fire Insurance Company.

About Ironshore Specialty Insurance Company

Ironshore, a Liberty Mutual Company, provides broker-sourced specialty property and casualty insurance coverages for varying risks. Ironshore is prepared to meet clients' complex needs promptly, with a local service and in-depth underwriting experience across a broad spectrum of industries.

Following Ironshore's acquisition by Liberty Mutual in 2017 and integration as a key part of the newly formed Global Risk Solutions, Liberty Mutual enables us to bring even greater scale, expertise, innovation and product offerings to market. As a combined operation with approximately $17.5 billion in gross written premium, brokers have access to a top-tier insurer with greater capacity and product lines for a wide range of risks.

Within the Stop Loss space, our mission is to be a leader through outstanding services, relationship building and innovative products. We understand that relationships are one of the driving forces in our industry today. We are committed to meeting the special needs of our broker partners and, most importantly, our self-funded employers. Through every step of the way, we pay great attention to details and respond promptly to all different aspects of the industry. When you partner with Liberty Mutual, you benefit from the financial strength, security, and capacity of a Fortune 100 carrier.

The information contained herein is for general informational purposes only and does not constitute an offer to sell or a solicitation of an offer to buy any product or service. Any description set forth herein does not include all policy terms, conditions and exclusions. Bound insurance policies, rather than summaries thereof, govern. Not all insurance coverages or products are available in all states and policy terms may vary based on individual state requirements. Some policies may be placed with a surplus lines insurer. Surplus lines insurers generally do not participate in state guaranty funds and coverage may only be obtained through duly licensed surplus lines brokers

*Notes

(1) Not affiliated with any specific health plan or PBM and available to all financial risk takers.

(2) Availability subject to applicable state insurance department approval

(3) PACCT offered through OutcomeRx Insurance Management Services LLC

(4) Registered Trademark of Biogen MA Inc.

(5) Registered Trademark of Novartis AG

(6) Registered Trademark of Spark Therapeutics, Inc.

(7) Quinn, Casey, et al. "Estimating the clinical pipeline of cell and gene therapies and their potential economic impact on the US healthcare system." Value in Health 22.6 (2019): 621-626. Available at https://www.valueinhealthjournal.com/article/S1098-3015(19)30188-3/fulltext

(8) FoCUS Paying for Cures Toolkit. Expected availability to 2031. https://www.payingforcures.org/toolkit-overview/pipeline/ Accessed April 2020.

(9) Luxturna: FDA documents reveal the value of costly gene therapy. https://www.sciencedirect.com/science/article/abs/pii/S1359644618305282. Accessed August 2020.

(10) Sinal Muscular Atrophy Therapies: ICER Grounds the Prcie to Value Conversation in Facts. https://www.jmcp.org/doi/pdf/10.18553/jmcp.2019.25.issue-12#page=12. Accessed August 2020.

(11) Hopkins, Jared. https://www.wsj.com/articles/biomarin-explores-pricing-experimental-gene-therapy-at-2-million-to-3-million-11579190318. Accessed August 2020

MULTIMEDIA:

*LOGO link for media: https://www.Send2Press.com/300dpi/20-1119s2p-OutcomeRx-300dpi.jpg

Related link: https://caremetx.com/outcomerx/

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Advertising and Marketing, Business, Free News Articles, Insurance

Integro USA Inc. Completes Transition to EPIC Brand

NEW YORK, N.Y. -- Edgewood Partners Insurance Center, which operates as EPIC Insurance Brokers and Consultants (EPIC), announced today that Integro USA, Inc. (Integro USA), acquired by EPIC in January 2019, has completed their adoption of the EPIC Insurance Brokers & Consultants name and brand.

The Integro USA brand will now be retired and the 400 former Integro USA associates working from 22 U.S locations will now do business as EPIC Insurance Brokers & Consultants.

The acquisition and rebranding to EPIC adds significant resources and expertise that highly complement EPIC's diverse insurance distribution platform and broad offerings.

Areas of deepened expertise include:

Entertainment & Sports: focusing on music & events; theatre & venues; film, TV & media; athletes, sports associations, sports teams, amateur sports; and equine insurance.

Specialty: leading provider of insurance brokerage services to Professional Services Firms (accountants, lawyers, hedge funds, asset managers, architects & engineers, consulting firms) and Transportation & Logistics businesses.

Risk Management/Complex Accounts: deep technical resources and services for the Fortune 500 and complex risk accounts. Specific industry expertise includes Healthcare, Real Estate, Financial Institutions, Industrial/Manufacturing, and Retail/Consumer.

Reinsurance: expertise in Specialty Accident & Health, Property & Casualty, and Professional Liability.

Middle Market Accounts: property/casualty, employee benefits, and private client services for small to medium sized companies and individuals

Employee Benefits Consulting: added expertise for mid to large employer groups as well as unique services for the private equity sector.

Said Marc Kunney, formerly President of North America Operations for Integro USA and now EPIC's President, Risk Management, "Joining forces under the EPIC brand allows us to continue offering our collective client base the highest level of service and expertise, while providing depth and scale to further invest in our combined capabilities."

Pete Garvey, EPIC Insurance Brokers & Consultants CEO and a founder and former CEO of Integro Ltd., noted, "I know firsthand what a high quality group we have added to EPIC. We can't be more delighted to have Integro's U.S. team onboard to make us one larger, fully integrated, more successful EPIC."

Steve Denton, President of EPIC Holdings Inc., added, "We have spent the last several months combining the large account and specialty businesses of Integro with EPIC's existing capabilities. The complementary strengths and resources match up perfectly. We are very excited to introduce our combined capabilities under a united banner."

About EPIC Insurance Brokers & Consultants:

EPIC is a unique and innovative retail property and casualty and employee benefits insurance brokerage and consulting firm. EPIC has created a values-based, client-focused culture that attracts and retains top talent, fosters employee satisfaction and loyalty and sustains a high level of customer service excellence.

EPIC team members have consistently recognized their company as a "Best Place to Work" in multiple regions and as a "Best Place to Work in the Insurance Industry" nationally.

EPIC now has more than 2,000 team members operating from more than 70 offices across the U.S., providing Property and Casualty, Employee Benefits, Specialty Programs and Private Client solutions to EPIC clients.

With run rate revenues greater than $600 million, EPIC ranks among the top 15 retail insurance brokers in the U.S. Backed and sponsored by Oak Hill Capital Partners, the company continues to expand organically and through strategic acquisitions across the country. For additional information, please visit https://www.epicbrokers.com/.

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Business, Free News Articles, Insurance

Founders of RBS Re Join EPIC Insurance Brokers and Consultants as Part of Growing EPIC Reinsurance Unit

MIAMI, Fla. -- EPIC Insurance Brokers and Consultants, a retail property and casualty insurance brokerage and employee benefits consultant, announced today the additions of Alex Soria, Tony Rodriguez, Randy Baker and Ken Knopp, a well-known and highly regarded team of Healthcare Reinsurance specialists, who spent nearly 20 years together as RBS Re and more recently as Cardinal Point, LLC (a South Miami based firm).

Soria, Rodriguez, Baker and Knopp bring their exceptional knowledge of Managed Care Reinsurance products and solutions for HMOs, health plans and provider organizations to EPIC. The group of industry experts will add support and enhance the growing operations of EPIC Reinsurance (EPIC Re) which formerly operated as Integro Re, prior to EPIC's January 31, 2019 acquisition of the U.S. operations of Integro.

"We have known and highly respected Alex, Tony, Randy and Ken for many years," said Peter Robinson, Managing Principal of EPIC Re. "Their addition to our team is another exciting step forward for EPIC Re and our Health Plan Reinsurance Advisory strategy."

Added Steve Denton, President of EPIC Holdings, Inc., "The Healthcare Industry has become increasingly complex and challenging and our new colleagues will compliment and further expand EPIC Re's existing strength in analytics and risk mitigation. We are very happy to have Alex, Tony, Randy and Ken as a key part of our growing Reinsurance Advisory Practice."

"I'm very proud of the team and positive reputation we built together at RBS Re and Cardinal Point over the years and believe that joining EPIC is the ideal path forward," said Alex Soria. "We couldn't be more excited about the future as a part of EPIC Re."

Added Tony Rodriguez, "Joining EPIC provides us with an extraordinary, complementary portfolio of products and services as well as a significant distribution opportunity. It was an easy decision for us to join Peter and the EPIC Re team."

The team's addition is just the latest move in further building EPIC's Healthcare Reinsurance expertise. In January 2019, EPIC added Senior Vice President and Principal Blake Kirk in San Francisco. Kirk has worked extensively within the Healthcare industry, focusing on HMO reinsurance and provider excess of loss coverage, and holds a Master's Degree in Healthcare Administration.

About EPIC Insurance Brokers & Consultants:

EPIC is a unique and innovative retail property and casualty and employee benefits insurance brokerage and consulting firm. EPIC has created a values-based, client-focused culture that attracts and retains top talent, fosters employee satisfaction and loyalty and sustains a high level of customer service excellence.

EPIC team members have consistently recognized their company as a "Best Place to Work" in multiple regions and as a "Best Place to Work in the Insurance Industry" nationally.

EPIC now has more than 2,000 team members operating from 65 offices across the U.S., providing Property and Casualty, Employee Benefits, Specialty Programs and Private Client solutions to EPIC clients.

With run rate revenues greater than $575 million, EPIC ranks among the top 15 retail insurance brokers in the U.S. Backed and sponsored by Oak Hill Capital Partners, the company continues to expand organically and through strategic acquisitions across the country. For additional information, please visit https://www.epicbrokers.com/.

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