Management Health

DWIGHT FLAX, J.D.

*** ***** **** *********, **** 43062

Tel: 888-***-**** Email: *****@******.***

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REGULATORY COMPLIANCE, CONTRACTS, HEALTHCARE REFORM & PRIVACY LEADER

with proven experience and accomplishments in these core areas:

HEALTHCARE REFORM

CONTRACTS & TRANSACTIONS

REGULATORY & LEGAL COMPLIANCE

FEDERAL AND STATE LEGISLATION LEGAL WRITING/RESEARCH

HIPAA-ARRA/HITECH PRIVACY

TOP PRODUCING, RESULTS-DRIVEN REGULATORY AND LEGAL COMPLIANCE, CONTRACTS, HEALTHCARE

REFORM IMPLEMENTATION & PRIVACY LEADER. Fifteen-plus (15+) plus years of diversified and professional management

responsibility, the last five years with a Fortune 500 corporation in the health, managed care and insurance industry. Proven ability to identify,

develop and implement solutions-oriented approaches to problems. Nationally published author, thought leader and natural communicator

(internally, externally and cross-culturally) with strong motivational skills and the ability to build, produce and succeed.

SELECTED LEADERSHIP ACCOMPLISHMENTS

Designated Implementation Manager for Healthcare Reform and Reform Operational Readiness to help customers understand the

requirements, implement changes and realize opportunities created by the new Patient Protection and Affordable Care Act.

Developed, implemented and maintained an enterprise-wide HIPAA Privacy compliance program, together with policies, procedures and

training, saving the entities from any potential DOL fines and litigation costs.

Together with a team of managers, saved an MCO $2.3 million by identifying under-performing products, developing a product strategy

by market segment, networking and contracting changes to cost drivers such as primary care providers, specialists, and pharmacy and

revamping the product distribution strategy of high performance brokers.

PROFESSIONAL EXPERIENCE

UNITEDHEALTHCARE, a UNITEDHEALTH GROUP COMPANY, Columbus, OH 2005 to Present

UnitedHealthcare (UHC), an operating division of UnitedHealth Group, Inc. (NYSE: UNH), is the largest single health carrier in the United

States, managing $100 billion in aggregate health care spending and $83 billion in revenue. UHC's nationwide network includes 560,000

physicians, 80,000 dentists and 4,800 hospitals. UNH is ranked No. 21 on Fortune’s 500 and one of the top 3 most admired healthcare

companies, since 1995.

Associate General Counsel & Senior Director of Compliance

Serve as the legal and regulatory compliance lead and co lead on segment wide compliance initiatives (such as HIPAA ARRA/HITECH

Privacy, Healthcare Reform Implementation) and project management of the implementation of such initiatives at the business level.

Create and manage a compliance program for Innoviant, a pharmacy benefit administrator, to mitigate risks associated with the provision

of pharmacy benefit services to commercial and Medicare prescription benefit plans (MA PD) and review, negotiate and draft

pharmaceutical company rebate contracts and other agreements.

Provide legal operational support for the Southeast Region (AL, AR,, FL, GA, LA, MS, NC, SC, and TN) to resolve issues related to claims

processing and adjudication, HIPAA privacy, pharmacy benefit management, and data driven business process improvement to drive

operational excellence.

Direct and oversee nine offices of Fiserv Health, Inc. in all ongoing activities related to HIPAA Privacy and the development,

implementation, maintenance, accounting, responses and adherence to the policies and procedures covering the privacy of and access to

PHI, resulting in a URAC Certificate of Full Accreditation.

Provide legal and regulatory compliance support to Avidyn Health, a medical management firm, on the state and federal laws affecting its

programs, including tax code considerations in plan design and the affect of HIPAA’s nondiscrimination rules on wellness and disease

management programs.

Act as the functional expert on compliance issues and matters that affect business operations to provide remediation (and as such,

consulted on operations, client relations, and account management, addressing business specific compliance questions, and new state

and federal legislation, and rules and regulations impacting the business.

Provide counsel on a variety of matters for Harrington Health Service, Inc., including strategic initiatives and core services such as

enrollment, premium billing, collection and reconciliation, provider network management and care management.

Draft, negotiate, and manage hundreds of contracts and transactions, including but not limited to Administrative Service Agreements,

Business Associate Agreements, RFPs, RFIs, MOUs, vendor, supplier, sourcing/purchasing, distribution, licensing, confidentiality, joint

venture, non disclosure, software, privacy and security and other specialized agreements in a manner that helps achieve business

objectives while at the same time protecting legal, regulatory and financial directives and considerations.

Conduct briefings and seminars on the laws, policies and procedures and practices affecting health and welfare plans for internal

staff/segments, executive management, and customers.

EMPLOYEE BENEFIT MANAGEMENT CORP., Dublin, OH 2004 to 2005

EBMC is an independent privately-held Central-Ohio TPA of self-funded corporate employee benefit plans and full-service managed care

consulting firm, specializing in the management and servicing of benefit programs.

Director, Legal Affairs & HIPAA Privacy & Security Officer

Wrote, prepared and managed all employer and client Plan Documents, Summary Plan Descriptions, Plan Amendments (SMM), Flexible

Spending Accounts (FSA), Administrative Service Agreements, vendor agreements and other specialized agreements and contracts.

Designed and established comprehensive corporate regulatory compliance program and compliance solutions segment wide, resulting in

a URAC Certificate of Full Accreditation.

Trained workforce on HIPAA Privacy and Security Policies and Procedures enterprise wide as well as privacy programs and training for

health care clients and ERISA covered benefit programs.

Managed the responses to regulatory inquiries, complaints, and investigations from the Ohio Department of Insurance and other state and

federal agencies.

MERITAIN HEALTH (formerly E V BENEFITS MANAGEMENT, INC.), Columbus, OH 2002 to 2003

Meritain Health, based in Amherst, NY, is the third largest employee benefits third-party administrator (TPA) in the U.S. and ninth-largest

claims administrator of self-funded health benefits, paying more than $1.7 billion in claims annually.

Manager, Contracts & Compliance

Developed, implemented and maintained an enterprise wide HIPAA Privacy compliance program, together with policies and procedures.

Wrote, prepared and managed all employer and client Plan Documents, Summary Plan Descriptions, Plan Amendments (SMM), and

Flexible Spending Accounts (FSA), as well as all contracts and agreements.

Researched state laws, regulations and administrative rules and responded to various internal and DOI inquiries.

FIREMAN’S FUND INSURANCE CO., Southfield, MI 1997 2001

A top 20 property-casualty insurer and flagship U.S. property and casualty insurer for Allianz, SE of Munich, Germany (the world's 2nd

largest insurance company with $1.2 trillion under management and 60 million clients) since 1863. FFIC is a premier property and casualty

insurer, providing personal, commercial and specialty insurance products nationwide.

Legal Services Compliance Specialist

Managed and monitored case assignments to align with retention agreements and conducted periodic surveys with Claims Adjusters to

validate service levels and network satisfaction; served as an advisor and subject matter expert for the Claims department on coverage

matters.

Assisted in managing and overseeing corporate, bad faith and extra contractual litigation matters, including those assigned to outside

counsel.

Tracked metrics and oversaw Service Level Agreements (SLA’s) and complied with and/or enforced general service requests made by the

law firms or FFIC.

Administered training, quality surveys and audited Coverage Portfolio Firms; provided timely answers to Claims staff; monitored trends

associated with coverage questions; and create action plans to address findings.

TALON LLC, Detroit, MI 1995 1996

Talon LLC is a Detroit-based private investment holding company focused on acquiring lower middle-market businesses with revenues

below $50 million, employing a differentiated investment approach that provides substantial liquidity, retained control of day-to-day

management, and up to 49% of equity ownership.

Assistant Benefits Group Leader

Served as Assistant Team leader for plan design and development of ERISA and non ERISA plans, communications, vendor

management, financial and fiduciary management, participant data management, and legal and regulatory compliance.

Co Directed the ongoing review of plan design to ensure alignment with organizational changes in support of the overall corporate strategy

while continually ensuring the highest standards of service to the participants.

THE HONORABLE THOMAS K. MOORE, Chief Judge, U.S.D.C., St. Thomas, United States Virgin Islands 1992 1994

The District Court of the Virgin Islands is a member of the Third Circuit and a federal trial level court and a court of intermediate appeal for

appeals from the Territorial Court of the Virgin Islands with two divisional offices: St. Thomas/St. John and St. Croix. In addition, there are four

(4) judicial officers, two district court judges and two magistrate judges.

United States District Court, (D.V.I.)

Federal Judicial Law Clerk

Drafted, and prepared published opinions, legal and factual memoranda and orders in civil, criminal and commercial matters for the court

and three judge intermediate appellate panels, involving complex litigation, multiple parties, jurisdictions, and claims and cross claims.

Worked on cases before the court ranging from commercial agreements to insurance, pension benefits, taxation and taxation issues,

administrative hearings to ERISA, tort, property and civil procedure and trademark and copyright, requiring a mastery of legal research

and writing, analysis, citation usage and editing.

Cited cases include, but not limited to United States v. Benjamin, 816 F. Supp. 373 (D. Virgin Islands 1993) and In Re: Tutu Wells

Contamination Litigation, 29 V.I. 41 (1993).

EDUCATION

LL.M. (Master of Laws) Studies, Corporate Finance & Taxation, Wayne State University, Detroit, MI, 1996 1997

J. D. (Juris Doctor), Seton Hall University School of Law, Newark, NJ, 1991

B. A. (Bachelor of Arts), Political Science, Michigan State University, E. Lansing, MI, 1986

ABA Corporate Legal Assistant Honors Certificate, Roosevelt University, Chicago, IL 1986

High School Diploma, Interlochen Arts Academy, Interlochen, MI, 1981

PUBLISHED WORK

A nationally published author, thought leader and speaker on health law and healthcare reform, regulatory and legal compliance, contracts and

privacy, Mr. Flax is a frequent contributor to the following business and industry publications:

Columbus Business First, “New Federal Law Will Require True Parity In Mental Health Benefits” February 13, 2009

Columbus Business First, “Employers Will Need To Be More Accommodating Under New ADA” December 12, 2008

Baltimore Business Journal, “ADA Expansion Opens Disability Protections To Additional Workers” November 28, 2008

Tampa Bay Business Journal, ‘Genetic Information’ Discrimination Ban Meets 21st Century Dangers” October 3, 2008

Columbus Business First, “Genetic Information Discrimination Ban Answers 21st Century Dangers” Sept. 26, 2008

Columbus Business First, “Law Firms Preparing Clients For Long Awaited Changes To FMLA” September 19, 2008

Columbus Business First, “Proposed Changes To Family Leave Act Biggest Since 1993 Enactment” March 28, 2008

Tampa Bay Business Journal, “Fed Proposes New Health Care Rules For Benefits Service Providers” Feb. 15, 2008

Columbus Business First, “Fed Proposes New Health Care Rules For Benefits Service Providers” January 25, 2008

Memphis Business Journal, “Proposed HIPSA Legislation Would Add Urgency To Enforcement . . . ” October 22, 2007

Baltimore Business Journal, “Businesses Should Be On Lookout For Tax Changes To Cafeteria Plans” Oct. 12, 2007

Portland Business Journal, “Counterpunch Rising Health Costs With Wellness Program” July 20, 2007

Tampa Bay Business Journal, “Providers Explore Details Of New HIPAA Regs And Wellness Programs” July 13, 2007

New Mexico Business Weekly, “Wellness Programs Are Being Used To Cut Health Care Costs” July 13, 2007

Memphis Business Journal, “Health Savings Accounts Are Making The Way Into Consumer Mainstream” May 18, 2007

Columbus Business First, “Health Savings Accounts Becoming More Attractive To Consumers” March 23, 2007

Baltimore Business Journal, “Health Savings Accounts Making Way Into Consumer Mainstream” March 2, 2007

Portland Business Journal, “Oregon Joins Other States In Search For Health Care Reform” February 2, 2007

New Mexico Business Weekly, “Agencies, Politicians Call For Transparency In Health Care Plans” November 24, 2006

San Antonio Business Journal, “States See Employers As Cure For Uninsured” November 17, 2006

Boston Business Journal, “More Calls Going Out For Health Plan Transparency” November 17, 2006

Dallas Business Journal, “States See Employers As Cure For Uninsured” October 20, 2006

Memphis Business Journal, “Still A Work In Progress, HIPAA Celebrates A Decade Of Protections” October 20, 2006

Austin Business Journal, “Agencies, Politicians Call For Transparency In Health Plans” October 13, 2006

Cincinnati Business Courier, “One Decade After Enactment, HIPAA Still Work In Progress” October 6, 2006

Pittsburgh Business Times, “Feeling Pain Of Lost Productivity, Firms Try To Bridge Gap . . .” September 22, 2006

Austin Business Journal, “Despite Complexities, Plan Helps Meet Coverage Needs” August 18, 2006

Charlotte Business Journal, “States See Employers As Key To Serve Uninsured” August 11, 2006

Memphis Business Journal, “Despite Complexities, Many Hope Prescription Drug Plan Will Work” July 21, 2006

Columbus Business First, “Despite Complexities, Many Hope Prescription Drug Plan Will Work” May 26, 2006

Charlotte Business Journal, “States Seek Remedies To Rising Rolls Of Uninsured” May 12, 2006

Cincinnati Business Courier, “HIPAA Compliance Requires Providers To Get ID Numbers” April 21, 2006

Columbus Business First, “OK For Private Companies To Define Spousal Benefits” February 10, 2006

New Mexico Business Weekly, “New Fed Rule Assigns Health Providers Single ID Number” December 2, 2005

Columbus Business First, “New Federal Rule Eliminates Duplication For Providers” September 16, 2005

Columbus Business First, “Take Measures To Update Medicare Claims Procedures” June 17, 2005

The Self Insurer®, “New ‘Dependent’ Definition May Affect Employee Benefits” April 2005

Columbus Business First, “Take Measures To Protect Electronic Health Information” March 25, 2005

PRESENTATIONS/LECTURES

Speaker, “Legislative and Regulatory Developments” SPBA Spring Conference, Washington, D.C., April 4, 2008

Moderator, “HSA Expansion Provisions and Debit Cards” SPBA Spring Conference, Washington, D.C., April 12, 2007

Lecturer, “HIPAA Privacy & Security Compliance For Covered Entities/TPAs” 20 Presentations, 2004 05

Lecturer, “HIPAA Privacy & Security Compliance For New Employees” 4 Presentations, 2004 05

Lecturer, “Alternative Career Opportunities In Corporate & Business Law” The Corporate and Business Law Association, Capital University

School of Law, October 21, 2004

AWARDS & HONORS

Award of Merit – Health Compliance and Strategic Planning, 1998

Award of Merit – Compliance Manager of the Region, 1999

Certificate of Merit – Regional Award, 1999

Who's Who Among American Law Students, 1990

Editor Res Ipsa Loquitur, 1989 1991

Appellate Advocacy Moot Court Competition, Best Respondent's Brief, 1990

Wolverine Bar Association Scholarship, 1990

Seton Hall Centennial Scholarship, Seton Hall University School of Law, 1988 1991

Executive Board Mentor Program, Seton Hall University School of Law, 1989 1991

SPECIALIZED TRAINING AND SEMINARS (FRANKLIN COVEY LEADERSHIP SERIES)

(1) Principled Centered Leadership; (2) First Things First; and (3) Seven Habits of Highly Effective People

TECHNOLOGICAL COMPETENCIES

Proficient in Microsoft Office Suite (Word, Excel, PowerPoint and Access), Lexis-Nexis, Westlaw, and Lotus Suite (Notes)

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