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  10:52:34 am, by MedBen5   , 157 words,  
Categories: News, Health Plan Management

Reform Update: Hammering Out the Differences

Heading into the home stretch…

Behind the scenes, Congressional leaders are meeting to resolve differences between the House and Senate health reform bills, with the goal of having a final version ready before President Obama’s State of the Union speech. While there are roughly 50 key disparities in the two bills that need to be ironed out – this 11-page chart provides a detailed comparison – the grand desire to pass a bill, and pass it soon, should mean that most issues will likely be settled with minimal dispute.

This article on the Slate website highlights six potentially problematic differences, including national vs. state-based insurance exchanges, Medicaid expansion, and the big question of how to pay for it all. The controversial public option (the House bill has it, the Senate’s doesn’t) isn’t among the six – perhaps because the House will likely acquiesce to the Senate, which doesn’t have the wiggle room vote-wise to include a government-run plan.


  05:05:13 pm, by MedBen5   , 208 words,  
Categories: Wellness, Health Plan Management

Get Healthy and Save Money -- Exercise!

Amidst the clamor of our elected leaders arguing the best way to reduce health care costs, a simple truth goes unheard – that we, as individuals, possess the real key to lower health spending, simply by taking better care of ourselves.

This is not to deny that even the healthiest among us will inevitably need advanced (and often expensive) medical treatment. But most of us do have it in our power to reduce the frequency and degree of care required. And it starts by getting off the couch and exercising.

As many people are embarking on their New Year’s resolution to lose weight by going to the gym, it’s important to remember that dropping pounds is only one benefit of regular physical activity – it also reduces stress, builds immunities, and protects against chronic diseases. This Wall Street Journal article discusses the advantages of exercise in detail.

MedBen also offers a useful tool to improve personal well-being. Our Worksite Wellness program encourages healthier lifestyles through custom wellness guidelines for plan members and their dependents. Member with certain specific diseases or risk factors can also receive personalized disease monitoring and nurse coaching. To learn more, contact your MedBen agent or VP of Sales and Marketing Brian Fargus at (888) 627-8683.


  11:56:05 am, by MedBen5   , 256 words,  
Categories: Announcements, News

Kane Promoted to VP of MedBen Administrative Operations

As part of its Claims Department reorganization, the production component of claims will now report to Lori Kane, who is being promoted to Vice President of Administrative Operations for MedBen. Her previous role was Vice President of Administration for MedBen Administrators. In her new capacity, Kane will direct the claims process from examination through payment, as well as stop-loss submissions of specific and aggregate claims.

MedBen President and CEO Doug Freeman said, “Lori has repeatedly demonstrated a talent for handling a wide range of administrative responsibilities. Her acceptance of this new role will allow MedBen to have both our claims production and client service processes under the same management umbrella.”

In addition to overseeing the claims processing and stop loss units, Kane will continue to provide leadership for MedBen’s Group Service, Customer Service, Administration and Specialty Services Departments. Kane has performed a variety of administrative and client service functions since joining MedBen in 1989.

A lifetime resident of Newark, Lori recently served as Tri-Chair for the Special Gifts Division for the Salvation Army Capital Campaign in its successful effort to fund a new community homeless shelter.

In regard to the restructuring of MedBen’s claims submission and production processes, Freeman says it will make the company even more efficient in its operations. “Our business world is being driven more and more by technology, so it is critical that MedBen offer technological innovations as well as advances in customer service. This reorganization provides both claim operations with a new home consistent with our dual goals of service and technology.”

  11:53:06 am, by MedBen5   , 159 words,  
Categories: Announcements, News

McEntire to Oversee MedBen Claims Support

Effective January 1, MedBen will reorganize its Claims Department, which is currently comprised of two distinct operations for support and payment. Claims support operations will now report to Vice President of Information Systems Rose McEntire and become part of our technology division. McEntire’s new duties will include management of claims data prep, benefit configuration and internal quality auditing.

An information systems veteran of nearly 30 years, McEntire has served MedBen clients since 2004. President and CEO Doug Freeman said, “In her time with MedBen, Rose has introduced technology that ensures the security of electronic claim transmissions and protected health information. It’s only logical that she should manage the everyday operations for our claims support process.”

In addition to her new responsibilities, McEntire will remain in charge of MedBen’s Information Systems Department and serve as company Chief Security Officer and Management Representative for ISO 9001. Rose is a board member of United Way of Licking County and lives in Thornville with her husband, Greg.

  11:43:13 am, by MedBen5   , 244 words,  
Categories: Announcements, News

MedBen Introduces Business Development Department, Names Weisent VP

MedBen is dedicated to finding opportunities for additional client savings, be it through provider discounts, plan provisions or other cost containment measures. To that end, MedBen is introducing a new Business Development Department, headed by Jim Weisent, whose new title will be Vice President of Business Development. The mission of this area is to create savings opportunities by establishing and maintaining a wide variety of relationships with other organizations, such as PPO networks, cost control vendors, and employee benefit groups. By focusing on such relationships, we can continue to bring long-term stability – and consequently, even greater value – to our product offerings.

“The Business Development team will serve a vital purpose,” says MedBen President and CEO Doug Freeman. “It will strengthen our current vendor relationships while cultivating new partnerships with provider networks across the country, to ensure that what we offer, in terms of discounts and networks, is the best possible option for our clients.” He added that Weisent’s strong ties to MedBen’s current provider networks “makes him the obvious choice to head up the new team.”

Weisent, who has been with MedBen since 1992 and previously served as Vice President of Benefit Services, will continue to oversee MedBen’s PPO network team and offer direction on provider workflow issues. Jim is a Past President and Board Member of Catholic Social Services, and a Past President and current member of Newark Catholic Athletic Association. He currently resides in Newark with his wife, Pattie, and two sons.


  08:32:01 am, by MedBen5   , 73 words,  
Categories: News, Health Plan Management

Legislative Update: Senate Passes Reform Bill

In an early morning vote, the Senate passed its health reform legislation by a 60-39 vote, along party lines. The bill would make health coverage mandatory for most Americans, and offer subsidies to those unable to afford insurance. It would also expand Medicaid and forbid insurers from denying coverage to individuals with pre-existing conditions.

The Wall Street Journal Health Blog provides a numerical and financial breakdown of some of the bill’s key effects.


  11:18:59 am, by MedBen5   , 204 words,  
Categories: News, Health Plan Management

COBRA Premium Subsidy Extended

As we predicted last week, President Obama has signed legislation extending the COBRA premium subsidy for two more months.

Originally scheduled to end on the final day of 2009, individuals who experience an involuntary termination of employment from September 1, 2008 through February 28, 2010 are eligible to receive a 65% COBRA subsidy from their former employer. In addition, the subsidy period has been increased from 9 months to 15 months, although the overall length of COBRA coverage remains unchanged.

So what happens to those individuals who had COBRA coverage but dropped it once the subsidy period ended, or have paid the full amount since then? Those who let coverage lapse can retroactively pay their COBRA premiums at the subsidized rate (no later than February 19, 2010, or 30 days after the individual receives notice of the extension, whichever is later) for the additional 6 months. Individuals who maintained coverage must either be reimbursed by their employer for excess premium payments or provided a credit that reduced future payments.

MedBen is working on our current COBRA administration processes and procedures to accommodate the new requirements and will notify all affected participants. MedBen COBRA clients with questions regarding the subsidy extension can contact Sharon A. Mills, Director of Administrative Services, at (800) 423-3151, Ext. 438 or


  03:06:56 pm, by MedBen5   , 192 words,  
Categories: News, Health Plan Management

Legislative Update: Senate Bill Nears Final Vote

Over the past several days, we’ve heard numerous reports about Senate Democrats having enough votes to pass its health reform bill. So surely the legislation is ready to move forward, right?

Well, not quite yet. A final vote on the Senate bill – which is expected to pass 60-40, along party lines, though it requires only a simple majority – will likely take place this week, perhaps on Christmas Eve. In the meantime, the Senate has been voting on various amendments and procedural matters. You can read about the bill’s current status in this Wall Street Journal article.

Of course, assuming the Senate bill is passed, it must then be reconciled with the House of Representatives bill, which includes a public option and a different funding apparatus than its Senate counterpart. The Hill website reports that Congressional leaders will cut their holiday recess short in order to have a final bill prepared in time for President Obama’s State of the Union address in mid-January.

We’ve mentioned it before, but if you’re interested in comparing the Senate and House legislation, this Washington Post interactive graphic provides a useful overview of each bill’s components.

  09:12:47 am, by MedBen5   , 197 words,  
Categories: Announcements

MedBen Holiday Hours

Happy holidays from the staff at MedBen!

Our home office will be open on Thursday, December 24 from 8:00 a.m. to 12:00 p.m. We will be closed on Friday, December 25 and will reopen at 8:00 a.m. on Monday, December 28.

On Thursday, December 31, our home office will again open at 8:00 a.m. and close at 12:00 p.m. We will be closed on New Year’s Day and reopen at 8:00 a.m. on Monday, January 4, 2010.

Remember that even when our office is closed you can get the answers to most of your customer service questions by taking advantage of our user-friendly online services. With MedBen Access, you can check on benefit coverage and the status of any pending claims, or track your out-of-pocket expenses. Pharmacy Data Management (PDM) members can review prescription claims and compare generic alternative prices through MedBen Access by clicking on your name under “My Rx Claims” in the sidebar menu.

Flexible spending account (FSA) and health reimbursement arrangement (HRA) participants can check recent claims activity, reimbursement status and account balances 24/7 at our FSA/HRA Online System. FSA plan members in particular will want to check their current balance so they can spend any remaining funds before January 1, 2010.


  01:14:49 pm, by MedBen5   , 213 words,  
Categories: News, Health Plan Management

Congress Likely to Extend COBRA Subsidy for Two Months

A high likelihood exists that a COBRA subsidy extension will be approved by Congress, extending the current 65% employer subsidy until February 28, 2010. The extension language – which has already passed in the House as part of the Defense Appropriations Act – includes a provision for retroactive premium payments for individuals who may have failed to pay COBRA premiums because of the timing of the subsidy expiration, so those individuals will need to be notified of this.

An important piece of information is that the House language does not require the Department of Labor to issue sample notices. MedBen will be drafting such a notice. If you use MedBen for COBRA services, these additional requirements are part of our regular COBRA Service. If you aren’t a MedBen COBRA client, there has never been a better time to add the service. Contact your broker or call our VP of Marketing and Sales Brian Fargus at (888) 627-8683.

Incidentally – and, not surprisingly – the original COBRA subsidy resulted in a significant increase in the number of individuals electing COBRA coverage. On MedBen’s block of self-funded business, COBRA elections increased by 130% after the COBRA subsidy was put in place. Nationally, one of MedBen’s reinsurance partners reported election increases ranging from 20% to over 800% from the pre-subsidy to post-subsidy periods.

  11:01:00 am, by MedBen5   , 113 words,  
Categories: Announcements

New MedBen Client Satisfaction Survey Available Online

MedBen is pleased to announce the introduction of a new online Client Satisfaction Survey. You can register today and provide your opinions about our services by going to

The new survey format makes it easier than ever to tell us what you like (or don’t like) about what MedBen does, and takes only a few minutes to complete. As always, we appreciate your input and we look forward to receiving your valuable comments. Questions about the survey may be directed to Cara Delcher, Vice President of Quality Systems, at (888) 633-2369.

Of course, you can always call MedBen as well. We answer the phone and appreciate any feedback that makes us a better company.


  03:28:19 pm, by MedBen5   , 137 words,  
Categories: Announcements, Prescription, Health Plan Management

2010 MedBen Drug Formularies Available Online

Formulary updates for prescription plans administered by Pharmacy Data Management (PDM) are now available at the Forms area of The new formularies become effective January 1, 2010. If you still need a 2009 formulary, they will be available on the website until the end of December.

Self-funded (MedBen Adminstrators) groups use either the Focus formulary or the Outcomes formulary. Focus offers the most cost-effective drug options, while Outcomes offers broader choice while still delivering significant cost savings. If you are not sure which formulary your organization is using, contact your GSR team for clarification. All fully-insured (MedBen Mutual) and split-funded groups use the Focus formulary.

MedBen prescription plan members looking for a lower cost drug option also are encouraged to visit the RxEOB website. Just use the convenient link under the Claims section on the MedBen Access website.


  03:19:25 pm, by MedBen5   , 138 words,  
Categories: Announcements, Wellness, Health Plan Management

Time to Use Your Remaining FSA Funds

If you contribute to a flexible spending account (FSA), it’s nearly time to “use it or lose it". Qualified medical purchases made on or before December 31, 2009 can be reimbursed from your FSA using 2009 funds, once proper supporting documentation has been provided. Purchases made after December 31 will be reimbursed with 2010 FSA contributions, and any remaining 2009 funds will be forfeited by the plan member.

Need to know what purchases are considered “qualified"? The website features a broad list of IRS-eligible expenses – simply click here. Aspirin, contact lens solution, cold and flu medications and allergy medicines all qualify, so it’s a good time to stock up on these household necessities. And remember: Reimbursement requests and substantiation for your 2009 purchases will be accepted by MedBen for a limited time in 2010 – check with your plan administrator for the precise cutoff date.


  11:39:29 am, by MedBen5   , 97 words,  
Categories: Announcements, News, Health Plan Management

MedBen Client Surveillance System Savings Surpass $12 Million

MedBen has realized $12.2 million in client savings through its physician-driven claims surveillance system. Available to all Medben clients since October 2007, this system uses sophisticated software to thoroughly analyze every claim for cost-containment opportunities. Flagged claims are then evaluated by a physician panel to determine the potential for further cost savings. The $12.2 million amount is in addition to MedBen’s provider network discounts, plan provisions and other established cost controls.

To learn more about how MedBen claims surveillance system can benefit your group, please contact Brian Fargus, Vice President of Sales and Marketing, at (888) 627-8683 or


  10:49:58 am, by MedBen5   , 81 words,  
Categories: News, Health Plan Management

Public Option in Senate Bill May Be Replaced

The Washington Post is reporting that the public option provision in the Senate health reform bill may be replaced by a program that would create several privately-administered national insurance policies. The policies would be negotiated by the Office of Personnel Management, which oversees health plans for federal workers.

Other recent legislative developments include a proposal to allow individuals age 55 and over to buy into Medicare, and insurance regulations that require 90 cents of every premium dollar to go toward customer medical services.


  10:56:11 am, by MedBen5   , 176 words,  
Categories: News, Health Plan Management

Health Reform Proposals You May Have Missed

The public option gets all the headlines, but there are plenty of other provisions in the 2,000-page Senate health care reform legislation. Two articles on the NPR website spotlight several of the lesser-known plan details:

  • A requirement for vending machines to display calorie counts for the food they dispense. (The House bill has a similar provision.) Similarly, chain restaurants such as McDonald’s and Applebee’s would have to post calorie counts for menu items.
  • A requirement for employers to provide a private room and (unpaid) break time for nursing mothers in the first year after giving birth.
  • A $400 million provision for “adult preparation programs” from 2010 to 2015, that would promote “positive self esteem, relationship dynamics, friendships, dating, romantic involvement, marriage and family interaction.”
  • A temporary “reinsurance program” for retirees who are under 65 but still receive insurance coverage from their former employer. Under the program, the government would pay up to 80 percent of some high-cost claims – and in turn, the employer would reduce the retiree’s share of premiums.

You can read the two NPR articles here and here.


  09:56:29 am, by MedBen5   , 197 words,  
Categories: Announcements, Health Plan Management

HEART Act Offers Health FSA Fund Distribution Option for Qualified Reservists

A reminder to Health Flexible Spending Account (Health FSA) Plan Administrators: The recent Heroes Earnings Assistance and Relief Tax (HEART) Act of 2008 gives employers the option of allowing qualified reservists ordered or called to active duty to request a distribution of unused balances in their Health FSA plans.

This amendment does NOT require you to change your Health FSA plan – it merely allows your group the option of permitting a Qualified Reservist Distribution (QRD). A QRD is not permitted in Dependent Care Assistance Programs (DCAPs), Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs) or any other type of pre-tax benefit plans.

If your Health FSA benefits are administered by MedBen, we recommend that you contact us as soon as possible so we can amend your Flexible Benefit Plan document to accommodate the QRD requirements before the next plan year begins.

For additional information on the new subsection, please download this Q&A sheet. Should you wish to implement this change, qualified reservists can use this form to request a QRD.

If you have any additional questions or need additional information, please contact Sharon Mills, Director of Administrative Services, at (800) 423-3151 ext 438 or


  10:02:01 am, by MedBen5   , 110 words,  
Categories: News, Health Plan Management

COBRA Subsidy Law Nearing Deadline

The Hill website reports that little progress has been made on extending COBRA subsidies past the set December 31 deadline. Individuals who are involuntarily terminated from employment after this date will not receive a 65% employer-funded subsidy for the cost of COBRA coverage unless an extension is passed in the interim. Moreover, those who enrolled in COBRA when the law was enacted earier this year will not receive additional subsidies after nine months of coverage, as established in the original legislation.

Both the House and Senate are currently considering proposals to continue the program for at least six months, but all bills are currently under committee debate with no resolution expected soon.

  09:21:00 am, by MedBen5   , 69 words,  
Categories: Announcements

Special MedBen Hours on December 4

MedBen will be closing early on Friday, December 4 for a companywide end-of-year recognition banquet. Our operating hours that day will be from 8:00 a.m. to 12:00 p.m., and we will reopen for business on Monday, December 7 at 8:00 a.m.

The staff of MedBen wishes to thank its clients, consultants, agents, brokers and vendors for a great year. We look forward to continuing to work with all of you in 2010!


  11:18:15 am, by MedBen5   , 204 words,  
Categories: News, Wellness, Health Plan Management

CDHPs, Wellness Help Slow Benefit Costs in 2009

Employee health benefit costs rose less than expected in 2009, according to a study conducted by human resource consulting firm Mercer. As reported by Employee Benefit News, the average per-employee cost of health benefits rose just 5.5% to $8,945, despite concerns that increasing unemployment fears would spur employees to consume more health services than usual.

Mercer also found that small employees are using consumer-driven health plans to slow cost growth, while larger companies are putting a greater emphasis on individual wellness. Assuming employers continue to explore new benefit strategies, employee costs should rise no more than 6-7% in 2010.

Additionally, the Employee Benefit News article cites data from consulting firm Towers-Perrin that proposed health reform legislation could potentially increase the cost burden on employers, which would likely be passed on to employees:

“For example, the excise tax proposed by the Senate Finance Committee would apply, beginning in 2013 to health programs with combined coverage (medical, dental, vision, flexible spending accounts, etc.) valued at more than $8,000 per year for individuals and $21,000 for families. More than 50% of companies will hit these caps within the next three years if current cost trends continue, and the impact of the caps will only increase over time, even with indexing on the tax thresholds after 2013.”

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