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03/17/10

  05:41:21 pm, by MedBen5   , 190 words,  
Categories: News, Health Plan Management

New Bill Would Extend COBRA Subsidy Until Year's End

Once again, Congress is likely to entend the COBRA employer subsidy – and this time for more than a month or two. Business Insurance reports that the Senate has passed a bill that will take the COBRA subsidy extension through the rest of 2010. The House is expected to take up the bill this week.

The multiple extensions to COBRA employer subsidies – this would be the third in 2010 – plus a recent provision that added terminated part-time workers to the eligibility ranks, has succeeded in making COBRA administration more complicated than ever. An article on the NPR website details the difficulties both employers and former employees are having in navigating the current COBRA landscape.

MedBen is equipped to help your company avoid the potential pitfalls of COBRA non-compliance. We take care of all the details of COBRA administration, leaving you free to concentrate on the issues most important to your business. And we can do it at a fraction of what it would cost you to perform these services in-house.

For further information about MedBen COBRA services, please contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

03/12/10

  03:42:47 pm, by MedBen5   , 159 words,  
Categories: News, Health Plan Management

Reform Update: Health Reform Legislation to Include Student-aid Bill?

Now that it is almost certain that Congressional Democratic leaders will try to pass a final health care reform bill using budget reconciliation, which would require only a simple majority to get the bill through the Senate, they may not be content to stop there. According to The Washington Post, key Democrats are seriously considering adding a student-aid bill to the reform legislation. By doing so, two of President Obama’s top domestic priorities could be accomplished in one fell swoop.

One of the more controversial provisions in current legislation – well, controversial to our industry, anyway – is the creation of a new federal agency to regulate health insurance premiums. But as The New York Times notes, keeping insurance rates down and reining in health care costs are two very different things. So while the federal government regulates premiums, state governments are put in a potentially untenable situation of ensuring that insurers remain solvent while charging artifically low rates.

03/11/10

  06:27:56 pm, by MedBen5   , 234 words,  
Categories: Wellness, Health Plan Management

Wellness Trends Parallel Established MedBen Services

Employee Benefit News reports on the latest wellness survey (apparently, wellness is a rich subject for researchers these days), this one conducted by DMAA: The Care Continuum Alliance. At MedBen, we find such studies a useful resource to gauge how successful our own wellness offerings are at meeting the needs of potential clients.

For example, the DMAA survey finds that 92% of employers who offer a wellness program consider the telephone a key outreach tool to participants. Perhaps not a particularly surprising response in and of itself, yet it does speak to the fact that even in an era of Internet ascendancy, people still believe verbal interaction to be a more productive way to communicate in some circumstances. And in the case of wellness, we have found one-on-one phone counseling with a RN Health Consultant – supplemented by e-mails and letters – to be most effective in helping participants with a chronic disease to manage their conditions.

Another key finding, quoted from the EBN article: “Purchasers are adopting the population health management approach and have expanded from programs that target individuals to a spectrum of programs that cover the population, from wellness to chronic conditions.” Again, this is precisely the approach that MedBen subscribes to through its primary prevention and specialty care programs. For more information about these services, we invite you to contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

03/08/10

  10:45:10 am, by MedBen5   , 305 words,  
Categories: News, Health Plan Management

CHIPRA Requires Employer Action to Provide Notice

Employers are now required to distribute to their employees a notice regarding their employee enrollment rights under the Children’s Health Insurance Program Reauthorization Act of 2009. The Department of Labor and the Department of Health & Human Services have issued the 2010 model notice, which you can download here.

The notice tells employees who are eligible for group health coverage, but are unable to afford the premiums, that they may be eligible for premium assistance that can help pay for coverage from their state of residence. These states use funds from Medicaid or Children’s Health Insurance Program (CHIP) to help people pay their health premiums.

Per CHIP regulations, an employer must issue this notice to their employees by the later of 1) the first day of their first plan year on or after February 4, 2010, or 2) May 1, 2010. An employer is only required to distribute the notice to employees residing in a state offering a premium assistance program, but is welcome to distribute the notice to all employees, without regard to their state of residence. However, all employees who reside in one of the applicable states must receive a notice, even if they are not a member of the employer’s health plan.

The employee notice can be distributed with initial and/or open enrollment materials, or with the summary plan document. While it is not required that the notice be distributed in a separate mailing, we do strongly recommend that it be provided separately from other materials so that the employees can reasonably be expected to understand its significance. The notice also can be mailed electronically as long as the rules applicable to the electronic distribution of summary plan documents and other plan materials are followed.

This is an annual notice requirement. DOL/HHS will periodically update their website for other states that may be added to the list.

03/03/10

  01:19:48 pm, by MedBen5   , 83 words,  
Categories: News, Health Plan Management

COBRA Employer Subsidy Extended through March

President Obama has signed into law a one-month COBRA subsidy extension, the Business Journal website reports. As previously mentioned here, a provision in the legislation will also make the 15-month subsidy available to workers who had earlier lost group coverage due to a reduction in hours, then were terminated from their jobs.

According to The Orange County Register, the newly-signed bill serves as a stop-gap while Congress complete a broader $150 billion bill including a further COBRA subsidy extension, possibly until the end of 2010.

03/02/10

  02:23:39 pm, by MedBen5   , 163 words,  
Categories: News, Wellness, Health Plan Management

More Employers Offering CDHPs to Control Costs

Worksite wellness is not the only strategy employers are relying on to slow health cost growth. According to a Mercer Survey of Employer-sponsored Health Plans, both small and large companies with an eye on the bottom line are increasingly offering consumer-driven health plans.

Mercer found that CDHP usage among employers with 10-499 employers increased from 9% to 15% in 2009. For employer with 500+ employees, 20% offer at least one CDHP option. Overall, the percentage of all covered employees enrolled in CDHPs rose from 7% to 9% last year. The survey also noted the health FSAs are the most popular type of CDHP offerings.

MedBen has been providing the tax- and claim-saving advantages of CDHPs for over a decade, and offers online account management and debit card technology for maximum impact. Currently, almost 60% of MedBen self-funded clients offer at least one CDHP, either alone or in concert with other health plans.

For further information about MedBen CDHPs, please contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

02/25/10

  11:35:04 am, by MedBen5   , 195 words,  
Categories: News, Wellness, Health Plan Management

Survey Demonstrates Employer Need for Unique Wellness Approach

Poor employee health is the biggest obstacle to keeping benefit costs under control, according to a new report by Towers Watson and the National Business Group on Health. When asked about the top three challenges to maintaining affordable health coverage, 57% of employers sited employees’ bad health habits, followed by high-cost catastrophic cases and end of life care (41%) and under use of preventive services (also 41%).

As to changing employee health habits, respondents far and away considered a lack of employee willingness to take advantage of wellness programs and preventive care opportunities as the most difficult hurdle to overcome – 58%, compared to 31% who cited a lack of financial incentives to encourage participation in such programs.

When MedBen designed its worksite wellness program, it recognized that getting plan members on board often proves difficult. That’s why rather relying on employees completing health risk assessments in which information can be inaccurate or incomplete, MedBen uses each member’s actual claim history. In this manner, all plan members are automatically enrolled in the wellness program, allowing for maximum outreach and involvement.

To learn more about MedBen Worksite Wellness, please contact Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

02/22/10

  02:02:35 pm, by MedBen5   , 126 words,  
Categories: News, Health Plan Management

Reform Update: The President's Proposal

As promised, President Obama today released his own health reform proposal drawing on elements of both the Senate and House bills. The Washington Post reports that provisions in the proposal include:

  • A higher threshold for an excise tax on so-called “Cadillac” health plans, not to be implemented until 2018;
  • A closing of the Medicare presciption drug “donut hole"; and
  • Federal subsidies to low-income families and individuals who cannot afford insurance, exceeding those proposed in the Senate bill.

According to The Wall Street Journal Health Blog, the President’s Proposal would also create the Health Insurance Rate Authority (HIRA), a seven-member panel working under Health and Human Services to determine reasonable rate increases for health insurance policies.

The White House website provides a summary of the proposal’s key features.

02/19/10

  04:31:19 pm, by MedBen5   , 161 words,  
Categories: News, Health Plan Management

Reform Update: President Obama Preparing Combined Proposal

Lost track of where we stand in the continuing health reform saga? The Wall Street Journal blog provides a tidy overview of the current happenings in Washington D.C.

In spite of earlier speculation that Democrat leaders in Congress would push the Senate bill through intact or use reconciliation to pass a combined piece of legislation, the goal now is apparently to get some Republicans on board. To that end, President Obama is putting together a single proposal using what HHS Secretary Kathleen Sebelius calls “some of the best ideas” from the Senate and House bills, in hopes of discussing it with Republicans at a televised health summit next week.

Though the President’s proposal will not be unveiled until February 22 at the earliest, it will likely maintain an individual coverage mandate and put an end to pre-existing condition exclusions by health insurers. A controversial Senate bill provision allowing special federal Medicaid money for Nebraska will probably not make the final cut.

02/16/10

  10:54:33 am, by MedBen5   , 147 words,  
Categories: News, Health Plan Management

COBRA Subsidy Extension Delayed

With the February 28 expiration of COBRA subsidy benefits fast approaching, talk of a further extension has been surprisingly muted. Such a provision was included in a Senate jobs bill that was on the fast track for passage, but last week Majority Leader Harry Reid removed it in favor of adding it to less expansive legislation.

Business Insurance reports that should the COBRA proposal pass in its current form, it would extend the 15-month premium subsidy to employees who are involuntarily terminated from March 1 through May 31. A new provision would also extend the subsidy, in certain situations, to employees who lost group health coverage due to a reduction in hours and then were involuntarily terminated later. The subsidy would be effective from the date reduced hours began (as far back as September 2008), not from the date of termination – a potentially problematic element as far as administration goes.

02/12/10

  06:29:24 pm, by MedBen5   , 170 words,  
Categories: Wellness, Health Plan Management

Many Employees Not Utilizing Vision Benefits

A new study reveals that many people apparently aren’t seeing the benefits of vision coverage. (Sorry, couldn’t resist the obvious pun.) Transitions Optical, a manufacturer of photochromic eyeglass lenses, found that 24% of U.S. workers do not enroll in their employer’s vision plan, and 30% of those who do enroll don’t get eye exams, according to an Employee Benefit News article. Of those who do not enroll, most cite “I don’t have vision problems” as their reason.

MedBen strongly encourages plan members with access to vision coverage to take advantage of this important benefit. The Vision Counsel of America reports that 12.2 million adults need some type of vision correction but don’t use any. Moreover, regular exams can reduce major medical costs through the early detection of eye disease.

MedBen VisionPlus promotes preventive vision care by covering in full exams, basic lenses and selected extras when using a network provider. To learn more about MedBen VisionPlus, please contact your MedBen broker or Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

02/09/10

  02:11:20 pm, by MedBen5   , 158 words,  
Categories: News, Health Plan Management

MedBen Municipality Clients See Low Cost Increases in 2009

MedBen Senior VP Kurt Harden Speaking at Gov't Roundtable

MedBen municipality groups experienced health plan cost increases far less than the national average in 2009, reported Senior Vice President Kurt Harden at a government roundtable in Burlington, Kentucky on February 4. Speaking about key performance measures for the past year, Harden revealed benchmarks for its government and overall business blocks and showed client attendees how their health plans performed in comparison.

“In 2009, per employee per year (PEPY) costs for MedBen’s municipality block increased less than 2% from 2008,” Harden reported, noting that the government benchmark continued a trend of low cost increases for government employers in recent years. He added that MedBen’s overall block costs rose only 3% compared to the national average of 9%.

Harden also observed that the number of average government claims PEPY decreased slightly in 2009, while the percentage of plan costs from deductibles and coinsurance remained consistent. For more information regarding key benchmarks and employer plan performance, MedBen clients are welcome to call Kurt Harden directly at (888) 633-2364.

02/04/10

  01:14:09 pm, by MedBen5   , 189 words,  
Categories: Prescription, Discounts, Health Plan Management

Employers Demanding Transparency from PBMs

Employee Benefit News reports that rising prescription drug costs are spurring employers to push pharmacy benefit managers (PBMs) harder than ever for greater transparency and maximum rebates on generic and brand-name medications. But for MedBen clients, such cost control methods are nothing new.

MedBen has long insisted on full pricing disclosure with its prescription plan, and all discounts and paid rebates go to the client, saving money over traditional Rx programs. On average, employers using the MedBen prescription plan with a focus formulary experience cost trends of 5% lower than national, while more open plans experienced an average increase of 5% in plan amount paid.

As prescription drug usage increases, its proportionate cost relative to overall health care spending goes up as well. But on the flip side, the sheer variety of Rx options available nowadays means a higher likelihood that a lower-price generic alternative exists for a brand-name medication. MedBen’s RxEOB website, available to clients using Pharmacy Data Management (PDMI) as their PBM, is a great resource to research medications and search for equivalent, lower-cost drugs. Just go into MedBen Access and click on your name under “My Rx Claims".

02/02/10

  09:08:36 am, by MedBen5   , 219 words,  
Categories: News, Health Plan Management

MedBen President Participates in Heath Reform Forum

MedBen President and CEO Doug Freeman

MedBen President and CEO Doug Freeman was among the panelists at a University of Akron community forum about health care reform on January 21. The event was covered by the Akron Beacon Journal, and you can read the complete article on the Ohio.com website.

Freeman participated in the forum discussion “What Does Health Care Reform Mean to You?” along with governmental and health industry representatives. Speaking on Congress’ recent health reform legislation, he observed that it shied away from the “tremendous ethic issues involved in cost control", and cited as an example a MedBen client who had to decide whether or not to cover a new prostate cancer treatment for a plan member – a treatment with less risk of side effects than standard therapy, but at more than twice the price.

Freeman also commented that government chooses to focus on health insurance costs over patient care costs. ‘’Cost control has been defined as insurance premium control,'’ he said, adding that employers do not want to be burdened by extra costs in the current economic climate.

A veteran of the health insurance industry for over three decades, Freeman became MedBen President in 1987. He has served on the Ohio Department of Insurance Advisory Committee of Governor Strickland’s Healthcare Reform Task Force, as well as numerous health advisory committees.

01/28/10

  04:32:46 pm, by MedBen5   , 204 words,  
Categories: News, Health Plan Management

Reform Update: So What's Next?

Just last month, Congressional leaders were promising to have a finalized health care reform bill ready for President Obama in time for his State of the Union address. Obviously, that deadline has fallen by the wayside. And with last week’s election of Massachusetts Republican Scott Brown taking away the Democrat supermajority in the Senate, the future of reform legislation is murky at best.

The Washington Post reports that senior Democratic aides hope to work out a revised course of action by next week in order to keep reform moving forward. One frequently heard suggestion is for the House to pass the Senate bill in its current form – thus requiring no further Senate votes – in order to circumvent the Senate’s new party balance. But disagreements about how to fund health reform, among other issues, make such an occurence improbable.

Other proposed approaches would to scale back the bill in the hopes that some additional Republicans would come on board, or agressively promote Medicaid enrollment to the roughly 8 million people who are eligible for coverage but haven’t joined. But whatever the next move is, the future of reform certainly appears to be on much shakier ground than it was just a few weeks ago.

01/25/10

  11:21:25 am, by MedBen5   , 160 words,  
Categories: Announcements, Health Plan Management

MedBen Average Client Savings Takes a Big Jump Up

MedBen clients saved, on average, an additional $11.57 per employee per month without a single plan design change in 2009, according to year-end information from AWAC, MedBen’s cost control claim review vendor. That is up from an average of $8.00 in the first couple of years that MedBen used the claim review organization.

“Those savings are in addition to all of the usual things the MedBen does to control costs,” said MedBen President Doug Freeman. “Over the years MedBen has developed hundreds of our own claim review ‘edits’ that ensure a claim is payable. We also work to find our clients the most appropriate discounts for their plan participants,” said Freeman. “Our pharmacy program delivers industry-leading discounts to clients as well. The AWAC review adds to the those savings so that clients can deliver the best possible benefit to employees at the best price.”

For more information on AWAC or MedBen, contact Brian Fargus, MedBen’s Vice President of Sales and Marketing, at (888) 627-8683.

01/22/10

  05:51:31 pm, by MedBen5   , 102 words,  
Categories: Announcements, Health Plan Management

MedBen Receives Claims Savings Achievement Award

At a January 21 meeting of MedBen executives and Claims Risk Management team members with AWAC, a cost containment and medical consulting firm, Vice President of Cost Containment Dr. Luke Burchard presented MedBen with a plaque to recognize its achievements in client claim savings.

The plaque reads: “Be it known to all, MedBen, through its participation in the AWAC Alliance has achieved cost reductions for its clients in excess of $13,000,000.” You can read more about this accomplishment here.

The AWAC Alliance is a select network of third party administrators who have partnered with AWAC to provide their clients with advanced claims surveillance services.

01/21/10

  04:46:34 pm, by MedBen5   , 218 words,  
Categories: Announcements

MedBen Is (Happily) Not Among Companies on ODI List

Sometimes it’s good to be conspicuous in your absence. The Ohio Department of Insurance’s 2008 Patient Protection Report lists insurance carriers and administrators who received an external review from ODI (requested by a plan member or provider) for denial of a claim. We’re pleased to report that MedBen was not among those listed – neither in 2008 nor in the 5-year accumulative list (2004-08). You can view the lists here.

Commenting on the ODI report findings, President and CEO Doug Freeman said, “While MedBen is by no means perfect, we take a lot of pride in working with our clients whenever there is a disagreement about a claim payment. Our goal is ensure that in such cases that we have the information needed to make the right decisions, and if the claim is ultimately denied, that the client clearly understands the reason why.” He added, “Not making the ODI list is a good sign that we’re communicating effectively with our customers.”

If you would like more information about the Patient Protection Act, you can read the full report at The Ohio Department of Insurance website. We suggest you bookmark the site, as it offers a wealth of useful consumer information. And while you’re browsing, check out the most recent Carrier Consumer Complaint list – MedBen’s a no-show there as well!

01/19/10

  04:19:13 pm, by MedBen5   , 185 words,  
Categories: Wellness, Health Plan Management, Incentives

Assessing the (Wellness) Problem

A recent article in Employeer Benefit News chronicles the difficulties one employer has had in persuading employees to take a health risk assessment (HRA), a tool for gathering personal information to ascertain potential health risks for wellness intervention and management. The author, a risk management director, writes that in the first year her employer offered an online HRA, only 97 employees out of 5,000 took the assessment. In year two, just 38 employees completed it – despite dangling the carrot of a raffle to win one of eight Wii game consoles (complete with Wii Fit game)!

Encouraging participation in a worksite wellness program can frequently prove problematic, which is why MedBen offers a wellness service that avoids HRAs in favor of electronic claims data analysis. Using a plan member’s company claims history, MedBen Worksite Wellness detects health patterns that would benefit from specialized nurse coaching. Moreover, our program uses an “opt-out” approach – all health plan members are considered participants in the wellness program unless they indicate otherwise.

For additional information about MedBen Worksite Wellness, please call Vice President of Sales and Marketing Brian Fargus at (888) 627-8683.

01/15/10

  09:49:03 am, by MedBen5   , 288 words,  
Categories: News, Health Plan Management

Updated Model COBRA Notices Available

The US Department of Labor has updated its model COBRA notices to aid group health plans in complying with the recent COBRA subsidy extension. Using the links below, group plan administrators can download and modify these notices for distribution to qualified individuals.

A complete collection of employee and employer COBRA continuation coverage materials is available at the Department of Labor website.

COBRA Continuation Coverage Election Notice
This model notice includes updated information on the premium reduction as well as information required in a COBRA election notice. It must be provided to all qualified beneficiaries who experienced a qualifying event at any time from September 1, 2008 through February 28, 2010 who have not yet received an election notice.

Premium Assistance Extension Notice
This model notice includes information about the recent premium reduction changes. It is designed for individuals who were receiving premium assistance as of October 31, 2009, including individuals who received nine months of subsidies and either dropped COBRA afterward or continued making full payments. This notice is also for individuals who became Assistance Eligible Individuals or experienced a qualifying event that was the termination of a covered employee’s employment on or after October 31, 2009 but who were not provided a notice that included the information about the COBRA subsidy extension.

Please note that forms may change at any time. Check the Department of Labor website before personalizing forms to ensure that you are using the most recently versions of these forms.

If you’re a MedBen COBRA client, you need not worry about distributing these notices. We have already notified qualified individuals as part of our standard service package. Not a MedBen COBRA client? Learn more about our services by calling your broker or our VP of Marketing and Sales Brian Fargus at (888) 627-8683.

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