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  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.


  02:11:20 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.


  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".


  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 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.


  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.


  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.


  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.


  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!


  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.


  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.


  02:53:32 pm, by MedBen5   , 224 words,  
Categories: Wellness, Health Plan Management

Power to the Patient!

Last week, we noted that the individual (a.k.a. “you") has the greatest control of personal health care costs – far more than government, doctors or insurers. Through exercise and proper diet, we greatly reduce the risk of chronic diseases, and the medical bills that accompany them.

But saving money doesn’t stop with a healthier lifestyle. It also helps to be a smart health care consumer – by doing research, asking questions and, above all, paying attention when your body is telling you that something isn’t “right".

CNN offers a helpful list of empowerment tips to help patients take a more active role in the care they receive. The article notes, not surprisingly, that the Internet has become the “go to” tool for health research. But while the web is indeed a great resource, when you have genuine health concerns, don’t hesitate to discuss them with your family physician. Being an intelligent consumer includes knowing when to call in the professionals!

Understanding your benefits coverage is another smart way to empower yourself. If you have questions about your MedBen health plan, speak to your plan administrator or call MedBen Customer Service at (800) 686-8425. Or, take advantage of the many online client services available 24/7 through – there’s plenty of useful information to be found there, and it’s all free to MedBen customers.


  04:02:33 pm, by MedBen5   , 103 words,  
Categories: Announcements, News

Claims Surveillance System Savings Surpass $13 Million in 2009

MedBen’s leading-edge surveillance system continues to find opportunies for significant client claim savings. Since its introduction in September 2007 through December 2009, this innovative, physician-based program has resulted in a total client savings of $13.3 million – and that’s on top of our provider discounts and other cost control methods.

In 2009 alone, our claims surveillance system – which uses over 80,000 physician-developed algorithms to search every incoming claim, regardless of size – saved clients $6.9 million. That’s over half of the overall savings to date in only 12 months!

For more information about MedBen’s cost containment tools, please contact the MedBen Sales and Marketing Department at


  04:22:57 pm, by MedBen5   , 246 words,  
Categories: News, Health Plan Management

All the News, "Twit" to Print

A recent survey of large-company employers found that they rely primarily on their benefit brokers and consultants to keep them informed on the latest health reform happenings. Here at MedBen, we have long recognized the importance of keeping our clients up to date on regulatory matters as well as other issues that affect their business.

Case in point: The blog you’re reading right now has tracked the progress of the Congressional health bills, COBRA subsidies and other timely topics – feel free to scroll down and see for yourself! Yet the MedBen Blog is hardly the only way MedBen keeps in touch with clients.

MedBen on Twitter. Every business day, we Twitter (or is it “Twit"?) news updates and links to web articles that we think clients will find interesting and useful.

MedBen e-briefs. This monthly e-newsletter highlights current MedBen activities as well as important regulatory developments. If you would like to be added to the e-briefs mailing list, please contact the MedBen Sales & Marketing Department at

Direct mailings/e-mailings. When legislative issues, policy changes or service modifications affect our clients, we notify them ASAP, either electronically or by regular mail (or both).

One on one. Should a matter arise when a client needs information quickly, a MedBen staffer will make sure it is received and understood – be it by phone, by e-mail or face-to-face if necessary. And of course, clients have multiple means to contact us anytime they have questions.


  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

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