Denise Balch is the founder and Executive Director of the Prior Authorization Framework and Accreditation (PAFA) Program. Denise is one of three PAFA Directors, who provide oversight and governance of PAFA.
John Anacleto, Anacleto Consulting
anacletoconsulting@outlook.com
John is a seasoned Market Access Consultant with nearly two decades of experience in health and drug insurance. Recognized for his accountability and tenacity, he has led teams in developing innovative analytic tools for clients, enabling informed decision-making in the competitive market. John’s expertise spans forecasting market access uptake, strategizing Private Payer Product Listing Negotiations, and coordinating private payer submissions across therapeutic areas. A thought leader in the field, he has presented and written on trends in private group insurance impacting access to medicines, including prior authorization. John holds a Master of Business Economics and a Bachelor of Arts in English & Economics.
Chair – Denise Balch, BPHA, CEP-HW, President, Connex Health, Project Manager, Simplify Prior Authorization and Executive Director, Prior Authorization Framework and Accreditation (PAFA) Program
denisebalch@connexhc.com or denisebalch@priorauthframework.ca
Denise has worked in the benefits and private healthcare sector since the 1980s, spending time with both insurers and benefit consulting firms in technical, sales and management positions. She founded Connex Health in 2000, where she oversees the delivery of networking and educational events, blogs and podcasts, to the private healthcare sector. Denise also provides customized research and consulting solutions on the challenges in benefits and private healthcare. She has co-authored several industry research papers, developed many real-world evidence studies and advocacy work. At the Rogers Workplace Health and Benefits Awards – Denise was a 2013 Lifetime Achievement Finalist. She is currently the chair of the Temiskaming Hospital in New Liskeard, Ontario.
Naresh Misir, Associate Lawyer, Misir & Company Lawyers
nmisir@misirandcompany.com
Naresh Misir B.Sc. LL.B., graduated with two Bachelor of Science degrees (Political Science & Sociology) from the University of Ottawa and an LL. B from University of Windsor in 2001. While obtaining his law degree at the University of Windsor, Naresh completed the Johnson CIT program, a business law intensive program focusing on business transactions, initial public offerings and financing. He was also a member of the Intellectual Property Institute, a joint program between the University of Windsor and the University of Detroit Mercy focusing on Copyright, Trademarks and Patents. He is also a strong supporter for local charities and a member of the Indo-Canadian Chamber of Commerce. Naresh has been a guest lecturer in Professor Dev Misir’s Canadian Business Law course at York University and appears on Geetmala Radio (CHIN 100.7 FM) every second Thursday at 8:00 PM and 9:00 PM to discuss civil litigation and personal injury claims.
The Framework and Accreditation Advisory Board (FAAB) consists of nine seats. Gold level payer members or associate members can apply to sit on the FAAB. Non-members may be invited to join the group. The FAAB is responsible for updates to the Guiding Principles, Framework and Accreditation requirements.
John Anacleto, Anacleto Consulting
anacletoconsulting@outlook.com
John is a seasoned Market Access Consultant with nearly two decades of experience in health and drug insurance. Recognized for his accountability and tenacity, he has led teams in developing innovative analytic tools for clients, enabling informed decision-making in the competitive market. John’s expertise spans forecasting market access uptake, strategizing Private Payer Product Listing Negotiations, and coordinating private payer submissions across therapeutic areas. A thought leader in the field, he has presented and written on trends in private group insurance impacting access to medicines, including prior authorization. John holds a Master of Business Economics and a Bachelor of Arts in English & Economics.
Chair – Denise Balch, BPHA, CEP-HW, President, Connex Health, Project Manager, Simplify Prior Authorization and Executive Director, Prior Authorization Framework and Accreditation (PAFA) Program
denisebalch@connexhc.com or denisebalch@priorauthframework.ca
Denise has worked in the benefits and private healthcare sector since the 1980s, spending time with both insurers and benefit consulting firms in technical, sales and management positions. She founded Connex Health in 2000, where she oversees the delivery of networking and educational events, blogs and podcasts, to the private healthcare sector. Denise also provides customized research and consulting solutions on the challenges in benefits and private healthcare. She has co-authored several industry research papers, developed many real-world evidence studies and advocacy work. At the Rogers Workplace Health and Benefits Awards – Denise was a 2013 Lifetime Achievement Finalist. She is currently the chair of the Temiskaming Hospital in New Liskeard, Ontario.
Imtiaz Khan, MDCM, FRCPC, FACP
imskhan@rogers.com
Dr. Khan attended McGill medical school and completed his fellowship at the university of Toronto. He is the former head of Rheumatology at the Mississauga Hospital. He current practices rheumatology in Mississauga and is the Chair of Private Payers committee for the ORA.
Massimo Nini, Senior Vice President, Consulting, Underwriting & Actuarial at AGA Benefit Solutions
massimo.nini@aga.ca
Massimo Nini is a Fellow of the Canadian Institute of Actuaries (CIA) and holds a bachelor’s degree in actuarial science from Concordia University. Prior to joining AGA, he held leadership positions with firms operating in the employee benefits consulting and the reinsurance space. Over the years, he has provided actuarial, retirement and benefits consulting services to organizations of various sizes, including large pan-Canadian and international organizations. He is a member of the CIA’s Health Committee and is a licensed insurance agent in Ontario, Quebec and other provinces across Canada.
Abigail O’Neill, BSW, CEBS, ISCEBS Fellow, VP Strategic Initiatives, Mosey & Mosey Benefit Plan Consultants
aoneill@mosey.on.ca
Abigail O’Neill is a results driven professional, partnering with employers in the ongoing management of their group benefit programs. With over 20 years of experience, Abigail has proven to be an effective advocate for plan sponsors in navigating the industry and delivering quality solutions. Abigail has been a speaker on benefit trends at various professional conferences and regularly arranges educational seminars for plan sponsors featuring a wide array of subject matter experts. Abigail sits on the Board of Directors for the Toronto Chapter of the Society of Certified Employee Benefit Specialists as well as The Canadian Pension and Benefits Institute Regional Council of Ontario.
Antonella Scali, CEO, Psoriasis Canada
antonellascali@psoriasiscanada.ca
Antonella Scali is the CEO of Psoriasis Canada (PsoCan), a recent consolidation of the Canadian Psoriasis Network and the Canadian Association of Psoriasis Patients. Led by a board of directors made up primarily of people with lived experience, PsoCan is dedicated to improving the lives of people affected by psoriatic disease. Antonella is a registered social worker with a background in crisis counselling and in policy analysis in community mental health in Ontario.
Todd Stephen, CEBS, SelectPath Benefits and Financial
tstephen@SelectPath.ca
Todd is the Vice President, Employee Benefits & Pensions Advisor who has been with SelectPath since 2021. He has worked in consulting since 1996 after a successful career with a national insurance company. He is a leader in the benefits and pension field and a vocal advocate on issues impacting plan sponsors. Todd has served on several regional and national industry health, charitable and athletic boards.
The Accreditation Panel consists of five seats. Gold level associate members can apply to sit on the Panel. Non-members may also be invited to join the group. The Panel is responsible for the review and approval of accreditation applications.
Chair – Denise Balch, BPHA, CEP-HW, President, Connex Health, Project Manager, Simplify Prior Authorization and Executive Director, Prior Authorization Framework and Accreditation (PAFA) Program
denisebalch@connexhc.com or denisebalch@priorauthframework.ca
Denise has worked in the benefits and private healthcare sector since the 1980s, spending time with both insurers and benefit consulting firms in technical, sales and management positions. She founded Connex Health in 2000, where she oversees the delivery of networking and educational events, blogs and podcasts, to the private healthcare sector. Denise also provides customized research and consulting solutions on the challenges in benefits and private healthcare. She has co-authored several industry research papers, developed many real-world evidence studies and advocacy work. At the Rogers Workplace Health and Benefits Awards – Denise was a 2013 Lifetime Achievement Finalist. She is currently the chair of the Temiskaming Hospital in New Liskeard, Ontario.
Linda Lin, RPh, MBA, Linda Lin Consulting Services
lindalin8727@gmail.com
Linda is an accomplished and well-respected pharmaceutical and private payer executive with over 25 years of drug benefit management experience in the industry, with a proven track record of delivering creative solutions to customers.
While working at ClaimSecure Inc., she developed many innovative programs that not only delivered savings for private payers but also improved patient health outcomes. These included Drug Formulary Management, Prior Authorization Services, Step Therapy, Patient Coverage Navigation, Product Listing Agreement Negotiation, and Pharmacy Provider Network Management. She was also instrumental in creating cost effective electronic payment solutions for patients and healthcare providers.
In addition to providing consulting services to benefits management organizations and pharmaceutical companies, she is also currently working as a part-time, casual retail relief pharmacist.
Abigail O’Neill, BSW, CEBS, ISCEBS Fellow, VP Strategic Initiatives, Mosey & Mosey Benefit Plan Consultants
aoneill@mosey.on.ca
Abigail O’Neill is a results driven professional, partnering with employers in the ongoing management of their group benefit programs. With over 20 years of experience, Abigail has proven to be an effective advocate for plan sponsors in navigating the industry and delivering quality solutions. Recognizing that engagement is a key component to program management, Abigail strives to support employers in developing their benefit philosophy and creating an effective, customized communication strategy for all stakeholders. Abigail has been a speaker on benefit trends at various professional conferences and regularly arranges educational seminars for plan sponsors featuring a wide array of subject matter experts.
Abigail earned an honours degree in Social Work at Toronto Metropolitan University. Abigail has successfully completed numerous industry certifications including the CEBS designation where she has achieved Fellowship status and maintains CEBS Compliance. Abigail sits on the Board of Directors for the Toronto Chapter of the Society of Certified Employee Benefit Specialists as well as The Canadian Pension and Benefits Institute Regional Council of Ontario.
Kimberly Seguin, Senior Application Consultant, Harris Healthcare and Board Director and Secretary, Psoriasis Canada
seguin.kimberly@gmail.com
With other 20 years of dedicated nursing experience, including 10 years as a case manager helping patients navigate the world of biologic treatments, Kim has become a valuable support for patients living with psoriasis and other auto-immune and inflammatory conditions. Her journey in healthcare began with a passion for patient care and a commitment to making a difference in the lives of those affected by chronic conditions. Her extensive career has been marked by her dedication to patient advocacy.
Kim has worked as Field Reimbursement Specialist with Bioscript Solutions, a Client Care Nurse with McKesson and a Senior Field Nurse Case Manager- Specialty Services and Regional Patient Advocate with AmerisourceBergen.
As a Psoriasis patient and mother to a child with severe Eczema she has a unique perspective from both sides of the curtain. Having navigated the journey for herself, her son and many patients over the years she understands the art of advocating for what you need.