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  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.”


  11:01:22 am, by MedBen5   , 114 words,  
Categories: News, Health Plan Management

Now, the Hard Part... Public Option Complicates Passage of Senate Bill

While the Senate voted to move the debate forward on Saturday, the government-run insurance plan provision promises to be the biggest stumbling block toward the passage of its reform legislation. Several moderate Democrat and Independent senators have made it clear that they will not support any bill that contains a public option, according to The Washington Post. Other Democrats, including Sen. Sherrod Brown of Ohio, insist that the bill will pass with the public option intact. So far, only two Republicans – Sens. Olympia Snowe and Susan Collins, both of Maine – have expressed any possibility that they would vote for the legislation.

Deliberations on the Senate bill will begin after the Thanksgiving break.


  11:33:25 am, by MedBen5   , 243 words,  
Categories: News, Health Plan Management

Friday Legislative Update: Senate Reform Bill Nears Initial Vote

The Senate may vote this Saturday on whether to proceed with its health care reform bill. According to The New York Times, the bill would provide coverage to 31 million uninsured people at a cost of $821 billion over 10 years. Many provisions of the legislation, including an individual mandate to carry insurance and an employer mandate to help pay for it, would not take effect until 2014.

The controversial government-run health insurance program, initially not part of the bill but later added by Senate majority leader Harry Reid, won’t have much of an initial impact. USA Today reports that the Congressional Budget Office found that the public option would cover up to 4 million people – less than 1.5% of the population. The Senate bill, unlike its House counterpart, would let states opt out of the public option – and in all likelihood, states representing one-third of the population would do so.

This report from the nonpartisan Joint Committee on Taxation adds up the various taxes that would be introduced to pay for the Senate bill – a total of $370 billion over the next decade. Among the larger revenue generators:

  • A 40% excise tax on benefit-rich health plans: $149 billion
  • Annual fee on health insurers: $60.4 billion
  • Additional 0.5% hospital insurance tax on higher wage earners: $53.8 billion
  • Annual fee on pharmaceutical companies: $22.1 billion
  • Annual fee on makers of medical devices: $19.3 billion
  • $2,500 annual cap on FSA contributions: $14.6 billion

For a comparison of the Senate and House bills, see this Washington Post interactive graphic.


  09:41:45 am, by MedBen5   , 143 words,  
Categories: Announcements, Wellness, Health Plan Management

Health and Human Services Secretary Dismisses New Mammography Guidelines

The head of the Department of Health and Human Services has come out against new guidelines for breast cancer screening, which we noted earlier this week. The Washington Post reports that Health and Human Services Secretary Kathleen Sebelius said the guidelines “caused a great deal of confusion and worry among women and their families across this country.”

Sebelius added that the U.S. Preventive Services Task Force, which made the mammogram recommendations, do not set federal policy, even though the panel was assembled by her department. White House officials have also distanced themselves from the panel’s guidelines.

From the Post article:

“The task force has presented some new evidence for consideration but our policies remain unchanged,” Sebelius said in the statement. “Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”


  11:17:15 am, by MedBen1   , 202 words,  
Categories: Announcements, Wellness, Health Plan Management

Preventive Services Task Force modifies breast-screening guidelines

The U.S. Preventive Services Task Force has modified breast cancer screening guidelines in what is being reported as a controversial move. The task force, which is funded by the Department of Health and Human Services, has recommended that routine mammograms are not necessary for women of average cancer risk in their 40s. Women in their 50s, according to the Task Force report, do not need a mammogram more than every other year. Further, the Task Force discourages physicians from teaching women to conduct self-breast exams.

The Wall Street Journal coverage of the report is here. The guidelines as reported in the Annals of Internal Medicine here.

According to The Wall Street Journal:

The National Comprehensive Cancer Network, the American Cancer Society and the American Medical Association recommend annual mammograms for women starting at age 40, while the American College of Physicians recommends women in their 40s decide for themselves whether to seek annual exams.

MedBen partially self-funded clients using MedBen’s Worksite Wellness program will continue under the current recommendations:

  • Mammogram for women every 1-2 years starting at age 40.
  • Annual mammogram for women with a positive family history for breast cancer, starting at age 35.

Please contact your group service representative with any questions.


  06:01:40 pm, by MedBen5   , 112 words,  
Categories: News, Health Plan Management

IRS Audits of COBRA Employer Subsidies Already Underway

A brief piece on the Miller Chevalier law firm website warns employers that the IRS has already begun to audit employers that claim the COBRA subsidy on their Employer Quarterly Federal Tax Returns (2009 Form 941). When filing this form, an employer must provide the identity of every subsidized individual, their requests for the COBRA subsidy, and a copy of the insurance premium invoice with proof of the individual’s payment.

To assist with the preparation of Form 941, MedBen provides its COBRA administration clients with a report detailing the amount of premium that the client subsidized for each eligible COBRA participant.

For additional information about MedBen COBRA services, please contact our Sales department at (888) 623-2365.


  10:33:20 am, by MedBen5   , 177 words,  
Categories: News, Health Plan Management

House Reform Bill Passes, But Senate Faces A Big Hurdle

One down, one to go. The House health care reform bill passed late Saturday night by a vote of 220-215. The vote fell mainly along party lines, although 39 Democrats voted against the bill and one Republican voted for it. USA Today provides a house roll call, so you can see how your Representative voted.

While the House debate on its reform bill ran fairly smoothly, passage of the Senate bill promises to be much more contentious. The biggest obstacle looks to be the provision for a government-run insurance plan, which was left off the legislation until Senate Majority Leader Harry Reid pushed for its reinstatement. Several moderate Democrats would likely not vote for a bill with a public option. As a compromise, Senator Olympia Snowe (R-ME) has proposed a “trigger” option in which the government plan would be introduced only if private insurer premium increases aren’t kept to an acceptable level (no specifics on what that level would be).

This AP article on offers a good synopsis of how the Senate battle is shaping up.


  09:09:25 am, by MedBen5   , 147 words,  
Categories: News, Health Plan Management

Legislative Update: House May Vote Bill This Weekend

The Washington Post reports that Speaker Nancy Pelosi insists that the House health care reform bill will be put to a final vote on Saturday, despite concerns that the bill has insufficient support from House Democrats. Prior to Pelosi’s statement, House Majority Leader Steny Hoyer stated that floor debate may be delayed until more Democrats come on board, and a final vote would take place Sunday or Monday.

On Thursday, the House bill received the support of the AARP, AMA and American Cancer Society.

The Congressional Budget Office has reviewed an alternative health bill by House Republicans and found that while being far less expensive that its Democratic counterpart, it would do little to increase coverage to non-insureds, according to The New York Times. House Republicans responded that the bill was designed to reduce insurance costs to make it more affordable, rather than to vastly expand coverage.


  11:32:03 am, by MedBen5   , 89 words,  
Categories: News, Health Plan Management

COBRA Subsidies May Extend into 2010

The potential postponement of a finalized health care reform bill may result in an extension of the COBRA subsidy program. Employer Benefit News reports that the eligibility date for COBRA coverage to involuntarily terminated workers may extend beyond December 31 if reform legislation is not agreed on by the end of the year. Currently, qualified COBRA participants whose coverage begins by December 31 are eligible to a 65% premium subsidy from their former employers.

The EBN article also notes that monthly COBRA enrollment rates rose 19% following the introduction of the subsidy provision.

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