Learn how connecting benefits, claims data, and culture can build a healthier, more resilient workforce.
In this episode of Captivating Health Insights, host Maddison Bezdicek sits down with Jennifer Lee—Vice President, Business Development Leader at QBE North America—to discuss organ transplant coverage and why it’s an essential protection strategy for self-funded employers.
Jennifer explains how QBE’s fully insured, first-dollar organ transplant carve-out policy works—transferring risk away from the plan, smoothing volatility, and protecting both the captive and excess layers. The conversation highlights the rising costs of transplants, from kidneys to complex heart and bone marrow procedures, and how coverage can shield employers from high-cost claims while enhancing employee benefits. Jennifer also shares how the policy supports participants with case management, travel and lodging benefits, and direct provider payments.
Listeners will understand why this proactive solution is growing alongside the shift to self-funding and how it can strengthen long-term benefit strategies.
Chapters
- (00:00:00) - Captivating Health Insights Podcast Intro
- (00:00:47) - Meet Jennifer Lee: From High School Intern to QBE Leader
- (00:02:03) - What Is Organ Transplant Coverage, Really?
- (00:03:19) - Risk Transfer 101: Why Underwriters See You Differently
- (00:04:00) - What Happens If You Don’t Carve It Out?
- (00:05:52) - The Odds of Needing a Transplant
- (00:08:01) - Protecting the Plan: How the Coverage Works
- (00:10:37) - What’s Not Covered (and Why That’s Rare)
- (00:11:07) - Premiums, Discounts & Stop-Loss Savings
- (00:12:05) - Networks vs. Carve-Outs: What’s the Difference?
- (00:14:18) - A-to-Z: The Transplant Process in Action
- (00:17:21) - What “Pre-Cert” Means and Why It Matters
- (00:19:01) - Market Momentum: More Employers Are Carving Out
- (00:21:51) - Proactive vs. Reactive: Protecting for the Long Game
- (00:22:14) - Wrap-Up & Key Takeaways
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