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  07:54:00 pm, by MedBen5   , 221 words,  
Categories: Cost savings, Third party administration, Claims management, Plan language

Carving Out a Costly Provider

knee x-ray

Plan language carve-outs don’t have to be limited to medical procedures or drug classes. If a provider grossly overcharges above reasonable and customary prices, then an employer can amend their plan to direct that the provider’s claims should be processed using separate criteria. And recently, a MedBen client who received an overinflated bill for knee replacement surgery did just that.

In Spring of 2017, a hospital billed a MedBen client $45,275 for a plan member who received a knee replacement, a fairly typical charge for the procedure. After network discounts were applied, the plan paid $26,217.

Several months later, the member’s other knee was replaced, but this time at an outpatient surgery center recommended by the doctor who performed the first replacement. The billed amount for the second procedure was $106,905 – well above the normal cost.

In response to the bill, MedBen advised the client to amend their plan language to carve out the outpatient surgery center from their provider network. Then, following a review of the claim, MedBen recommended that the plan pay $35,772 – substantially less than the billed amount, but more in line with the true value of the services received.

Effective use of plan language can make a significant difference in your health care costs, and MedBen can help. Contact Vice President of Sales & Marketing Brian Fargus at to learn more.

  07:26:00 pm, by MedBen5   , 220 words,  
Categories: News, Wellness, Research, Hypertension

High Blood Pressure Raises Patient Bills, Study Says

blood pressure reading

Americans with high blood pressure may pay nearly $2,000 more on medical fees this year than those without the condition… a problem that could be alleviated through a focus on preventive care.

According to a 12-year study, adults with hypertension can spend up to $1,920 to treat the condition on top of other medical bills. Early diagnosis of the condition will help to decrease these costs, but if adults continue to skip annual check-ups, high blood pressure numbers will only continue to rise and become even more of a burden.

With fewer than one-quarter of U.S. adults getting regular wellness exams, there is clearly an opportunity to address unnecessary health care costs – which is where MedBen WellLiving comes in. We can help you develop a wellness strategy that includes annual check-ups to decrease the risk of high blood pressure and other chronic conditions.

MedBen WellLiving puts the primary care physician first and encourages members to see their family doctor for regular check-ups. Our program also encourages members to follow age- and gender- appropriate screening guidelines, further helping prevent high blood pressure and other chronic conditions as well as reducing the employer’s long-term costs.

MedBen WellLiving can make a difference in your employees’ health and your bottom line. Find out more by contacting Vice President of Sales and Marketing Brian Fargus at


  11:04:00 pm, by MedBen5   , 235 words,  
Categories: MedBen Employees

MedBen Employees Give of Themselves (Literally) for Charity

Blood Drive

MedBen employees give back to the community at large in a variety of ways, from gifting Christmas toys to underprivileged children, to power washing and painting local shelters. And in addition to sharing their time and talents, our team sometimes gives of themselves on, shall we say, a more personal level.

For the past two decades, MedBen has regularly hosted American Red Cross blood drives, most recently at our Morrow Conference Center on May 31. Through the donations of our employees – and, of course, many millions of others nationwide – the Red Cross helps save the lives of children and adults fighting to survive cancer, blood disorders, traumatic injuries and more.

MedBen has also for many years contributed to the Food Pantry Network of Licking County. Our staff participates in annual community food drives, and voluntarily pays a nominal cash donation to "dress down" for casual Fridays. Through these combined efforts, employees have donated over $10,000 to the Food Pantry since 2017.

In addition to the Red Cross and Food Pantry, MedBen has provided ongoing support to Families Helping Families, A Call to College, Big Brothers/Big Sisters, the Midland Theatre and the Licking County Community Health Clinic, to name a few. We're always pleased to do our part!

You can donate blood – or host a blood drive yourself – by visiting the American Red Cross website. Or check out the Food Pantry Network site to learn more about their work.

  07:48:00 pm, by MedBen5   , 270 words,  
Categories: News, Banking

New “Beneficial Ownership” Rule Requires Account Information


Recently, the Financial Crimes Enforcement Network (FinCEN), a federal banking regulator, instituted a new federal rule which affects banks and other financial institutions. The “Beneficial Ownership” rule, which went in effect May 11, requires banks to collect and verify specific information about the beneficial owners and the control person of the entity opening a new account or modifying a current one at the time the account is opened or changed.

Beneficial owners are any individuals who directly or indirectly owns 25% or more of the legal entity, whereas a control person is an individual with significant responsibility to control, manage or direct the legal entity.If you need to open a new account or modify an existing account, the bank will require the beneficial owners’ and control person’s social security number, date of birth, and a photocopy of a government-issued ID.

The intent of the Beneficial Ownership rule is to assist authorities in counteracting money laundering, tax evasion, and other financial crimes. Because MedBen works with your plan bank accounts, we wanted you to be aware of this new rule, which affects all financial institutions in the country.

If your plan’s account is with Park National Bank, the MedBen Accounting Department can assist with questions you may have regarding Park’s implementation of these new rules.

If your plan account is with a bank other than Park National and you have not received information about how it will be implementing these requirements, MedBen recommends contacting the bank at your earliest convenience.

If you have any questions, please feel free to contact your Group Service Representative or MedBen Vice President of Finance Ed Nydegger at 740-522-7317.


  04:46:00 pm, by MedBen5   , 207 words,  
Categories: Wellness, Reporting, Cancer, Heart, Diabetes, Preventive care, Population health management

Chronic Conditions Major Drivers of Health Care Costs

doctor and patient

The MedBen WellLiving program focuses on the prevention of chronic conditions that affect the quality of employees' lives as well as their cost to employers... and a recent survey emphasizes just how these conditions can financially impact the workplace.

In its Workplace Wellness Trends Survey, the International Foundation of Employee Benefits Plans asked employers to identify the top conditions that influence plan costs. Nearly half (44.3%) of respondents singled out diabetes as a major driver of health care spending. Other conditions mentioned include cancer, heart disease, hypertension, and high cholesterol.

The MedBen WellLiving approach to a healthier workplace begins with the annual wellness exam – a chance for your physician to identify and help you prevent the onset of diabetes and other conditions – as well as age-appropriate screenings that increase the odds of detecting cancers early.

Paired with our primary prevention program is specialty care that identifies members at higher risk for chronic conditions and offers individualized coaching. In addition, WellLiving provides regular employer reports that detail member compliance with various wellness categories and nurse coaching calls.

MedBen WellLiving helps you to encourage better employee lifestyles, while addressing the conditions that affect the bottom line. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at


  10:40:00 pm, by MedBen5   , 196 words,  
Categories: MedBen Analytics, Bundled Payments, Value-based care

Employers a Key to Value-Based Payment Transition

hospital bed

Value-based payment models are currently enabling Medicare to realize lower medical care costs... and MedBen is making these alternative payment methods available to self-funded employers as well.

In a recent MedCity News article, Dr. Poonam Alaigh notes that Medicare-based models like Bundled Payments for Care Improvement (BPCI) have generated provider savings while improving the quality of select acute care services. "Provider groups have demonstrated continued impact on a key driver of success, decreasing readmissions rates, as high as 23.3 percent," she writes.

Alaigh adds that for value-based care to truly succeed, the private sector must be open to new payment approaches, "cultivating an ecosystem for providers to collaborate and embrace multi-payer outcomes-based incentive strategies."

Since 2015, BPCI participants and other providers have used the MedBen Analytics reporting platform to convert raw Medicare data into actionable insights. And we expect it to eventually become the norm for employer claim payments, too.

MedBen offers commercial bundled payment services to self-funded groups. Through detailed reporting and assisting with customized plan design, we can help clients realize lower costs than fee-for-service payments without compromising quality of care. Find out more by contacting Vice President of Sales & Marketing Brian Fargus at


  10:43:00 pm, by MedBen5   , 265 words,  
Categories: News, Health Care Reform, Taxes, Compliance, PCORI

Reminder: PCORI Filing and Fee Deadline Approaching

As in years past, all self-funded employer health plan sponsors are required to file and pay their Patient-Centered Outcomes Research Institute (PCORI) fee no later than July 31, 2018. All self-funded plan sponsors are required to pay a fee based on the average number of covered lives under their eligible plans – including employees, retirees, spouses and dependents.

Self-funded plans subject to the requirements include self-funded medical benefit plans, including most non-ERISA self-funded plans and retiree-only plans. Other self-funded plans subject to the fee include self-funded health reimbursement arrangements (HRAs) and flexible spending accounts (FSAs) which are not integrated with a plan sponsor’s self-funded major medical plan. Dental-only, vision-only, employee assistance programs (EAPs), disease management, and wellness plans are exempt.


All plan sponsors must use the IRS Form 720 dated April 2018 to record and remit the amount due. The IRS Form 720 has been modified to include the payment amounts due this year. Make sure to complete the correct section of Part II for “Applicable self-insured health plans” and select the correct payment amount based on your plan’s plan year end date.

This year’s payment schedule can be found on the website along with more information about calculating and remitting the fee to the IRS. In general, if your plan year begins on November 1, 2017 (ending October 1, 2017), December 1, 2017 (ending November 1, 2017) or January 1, 2018 (ending December 31, 2017) you will owe $2.39 per covered life. All other plans years owe $2.26 per covered life.

As always, if you need more information about how to count covered lives under your plan or how to prepare and remit your payment, don’t hesitate to contact your Group Service Representative.


  03:29:00 pm, by MedBen5   , 347 words,  
Categories: Wellness

Asthma on the Rise

listening to heart

The number of people with asthma continues to rise. In 2001, nearly 20 million people had asthma, and now, this condition, which causes chronic inflammation of the lung airways and makes it hard to breathe (much like pinching a straw and trying to breathe through it), affects 26 million Americans.

As temperatures rise and you head outside for activities, you become exposed to more common asthma attack triggers. These include exposure to allergens such as ragweed and pollen, irritants in the air such as smoke and chemical fumes, or extreme weather conditions such as extremely dry air. Exercise or illness (especially respiratory illnesses) can also make you more susceptible.

Though most common among children, adults too can develop asthma. It is important to visit your family physician if you think you or your child are experiencing any symptoms (shortness of breath or breathlessness, tightness in the chest, wheezing) as it could be something even more serious, such as the progressive chronic obstructive pulmonary disease (COPD).

As with many other conditions, the sooner the condition is caught, the better. Your doctor may ask you a series of questions regarding your symptoms and the duration of those symptoms, as well as listen to the function of your lungs. The good thing is that asthma can be controlled with the right precautions and doctor-led medications.

Full story »


  08:50:00 pm, by MedBen5   , 257 words,  
Categories: Announcements, News, MedBen Employees

Crain Completes Chamber Leadership Program

Wendell Crain

MedBen Director of Security, Infrastructure and Web Development Wendell Crain recently completed the Community Leadership of Licking County program, offered through the Licking County (OH) Chamber of Commerce. For completing the nine-month program, Wendell received a Certificate of Achievement at a commemorative ceremony on Friday, May 11.

The Leadership program allows participants to interact with a diverse group of business experts from various job categories. Those accepted into the program are taught the importance of "strength-based" leadership in which the individual focuses on developing specific attributes at which they excel, while gaining useful exposure to area industry professionals.

When asked about the value of the program, Crain replied, "Rather than trying to balance your personal strengths and weaknesses, you learn to focus on maximizing your strengths and then working with others whose strengths complement yours to create an extremely effective team."

As for how completing the program will benefit him, Crain said, "The shift of my personal focus from balancing strengths and weaknesses is a huge change that should greatly benefit MedBen and myself. In addition, I believe that the networking of professionals within Licking County is a great asset and a tool to be used in the future."

Crain joined MedBen in 2003 as a Programmer and served as Manager of Technical Services and Web Development before being named a director in 2015. He holds a Bachelor’s in Business Administration from Mount Vernon Nazarene University and an Associate in Data Processing from Zane State, and has earned an MCP certification from Microsoft and a CCENT-RS from Cisco.

Congratulations, Wendell!

MedBen Closed Memorial Day, But We're Open Online 24/7

American Flag

The staff of MedBen hope you and your family have a safe Memorial Day weekend, and thank all those who have served and sacrificed for our nation's freedom.

Our home office will be closed on Monday, May 28 in observance of the holiday. We will reopen at 8:00 a.m. Tuesday, May 29.

During this time, please remember that clients can use the 24/7 online services of MedBen Access to check on benefit coverage and the status of any pending claims. Simply go to and select "MedBen Access". For those who use Ventegra or Pharmacy Data Management (PDM) as their pharmacy benefits manager, you can check on prescription claims and find lower cost drug options through MedBen Access by clicking on the "Rx" button located in the "My Claims" section of this website.

If you're a MedBen Flexible Spending Account (FSA) or Health Reimbursement Arrangement (HRA) participant in addition to having other coverage, you also can use MedBen Access to see your FSA/HRA balances, claims submissions and payments. When you log in to MedBen Access, you'll find an "FSA/HRA Online Inquiry" option (visible only to groups offering MedBen FSAs/HRAs) under the "My Plan" section located on the left sidebar. By selecting this option, users are automatically taken to the MedBen FSA/HRA Online System.

Once again, have a good holiday... and thanks for your continued relationship with MedBen!

  07:45:00 pm, by MedBen5   , 241 words,  
Categories: Announcements, News, Heart, Preventive care, MedBen Employees

Team MedBen Runs and Jumps (and Zumbas) for Better Heart Health

MedBen joined other local businesses on the Newark (OH) Courthouse Square to engage in good-spirited competition while promoting better heart health at the 2018 Licking County HeartChase on Saturday, May 6. Created by the American Heart Association (AHA), the event raised over $136,000 to fight heart disease... a record for Licking County and ranking it as the second largest HeartChase in the nation.


MedBen fielded 9 teams to participate in the event. Teams earned points by partaking in a variety of fun (and heart-healthy) feats, such as tossing swim rings on teammates' arms, catching badminton birdies in buckets, and even participating in a brief Zumba class.

MedBen also co-sponsored the local HeartChase, with Chairman Doug Freeman heading the event's executive leadership team and serving as its master of ceremonies.

"Today, our community takes a big step toward better health and stands together in the fight against our nation's number one and number five killers – heart disease and stroke," Freeman said. "HeartChase is about building healthier behaviors and collectively, as a community, to start making lifestyle changes that will lead us all to better health and wellbeing."

As for how MedBen fared in the competition, our Heart & Sole Mates team took third place overall... plus, the MedBen Brave Hearts won the Team Spirit Award for their stylish attire!

Learn more about how your business can have a good time for a good cause in your community by visiting the HeartChase page at the AHA website.

  07:34:00 pm, by MedBen5   , 212 words,  
Categories: Wellness, Cancer, Preventive care, Women's Health, Mental Health

Woman’s Health Week Promotes Physical, Mental Well-Being

woman walking

In May, we observe National Women's Health Week – a reminder to women of all ages to take the time to focus on their personal well-being, both physical and mental.

One key to better physical health is getting an annual wellness exam from your family doctor or OB-GYN. Not only does it allow the physician to monitor your fitness, it's a great opportunity to discuss your health goals... what you're currently doing to stay well and possible changes you can make.

Likewise, preventive screenings are important for better health – and for woman ages 50 and over, mammograms are a must. Saving lives is, of course, a major benefit of catching breast cancer in its earliest stages, and recent research indicates that mammograms also reduce the likelihood of needing more aggressive treatment (i.e., chemotherapy) in the future.

As for better mental health, it begins with getting enough sleep. Going through your day exhausted negatively affects your disposition and your productivity. Equally important is finding ways to manage stress, such as by taking time for relaxation and talking about your problems with a friend, family member, or therapist.
Finally, avoid unhealthy behaviors. If you smoke, quit. And when you drive, don't text.

Get additional tips for improving your health at the National Women's Health Week website.


  07:36:00 pm, by MedBen5   , 182 words,  
Categories: Announcements, News, Consumer-driven Health Plans, IRS, Health savings accounts (HSAs)

IRS Announces 2019 HSA Inflation Adjustments

IRS building

The IRS recently announced its annual cost-of-living adjustments affecting health savings accounts (HSAs) for calendar year 2019. The annual limit on deductible contributions to an HSA will jump by $50 for individuals and $100 for families next year.

Notably, high-deductible health plan (HDHP) out-of-pocket maximums for families will also increase in 2019, even though they were reduced earlier this year. HDHP minimum required deductibles remain unchanged.

  • HSA Contribution Limits – The 2019 annual HSA contribution limit for individuals with self-only HDHP coverage remains rises to $3,500, while the limit for individuals with family HDHP coverage goes up to $7,000.
  • HDHP Minimum Required Deductibles – The 2019 minimum annual deductible for self-only HDHP coverage stays at $1,350; for family HDHP coverage, $2,700.
  • HDHP Out-of-Pocket Maximum – The 2019 maximum limit on out-of-pocket expenses, including deductibles, for family HDHP coverage is $6,900... the same amount it was this year before it was lowered to $6,850 in response to the Tax Cuts and Jobs Act. The limit for self-only HDHP coverage (which was not affected by the Act) is $3,450.

MedBen clients with questions regarding these adjustments are welcome to contact Director of Administrative Services Sharon A. Mills at (800) 423-3151, Ext. 438 or


  06:37:00 pm, by MedBen5   , 355 words,  
Categories: Announcements, News, MedBen Employees

Harden Named MedBen CEO

Kurt Harden

Medical Benefits Mutual Life Insurance Co. (MedBen) is pleased to announce that at the Annual Meeting of the insurance and health benefits management company’s Board of Directors on May 17, President Kurt Harden was elected to serve as its Chief Executive Officer (CEO) as well. The Board also announced that current Chairman and CEO Doug Freeman has been named Executive Chairman.

Freeman praised the Board’s decision and Harden’s ascendancy to CEO. “Kurt has been a driving force with MedBen for over 25 years, and his leadership has been vital to our growth during that period. I can think of no better person to guide this company going forward,” he said.

As CEO, Harden will direct the company's daily operations and oversee the performance and promotion of its numerous service offerings, which include third party administration, worksite wellness (MedBen WellLiving), and bundled payment services (MedBen Analytics).

“I’m honored to be entrusted with this responsibility, and in my role as MedBen CEO I look forward to continue working with the great team we’ve assembled here to provide the best service available,” Harden said. “Together, we’ll build on our successes while finding new ways to innovate benefits management solutions for our clients.”

Freeman noted that these changes coincide with a significant benchmark in the company’s history. “MedBen just celebrated its 80th anniversary earlier this month, so it’s fitting that this should happen as we prepare for the next chapter in our story,” he said.

Full story »


MedBen Turns 80 Today

May 8 marks MedBen’s 80th Anniversary! Originally Hospital Service Association (HSA) of Licking County, we started out with two employees and a goal to provide employers and individuals with affordable health care coverage. And while our numbers have grown quite a bit since then, the goal remains unchanged.

MedBen 80th Anniversary

When HSA of Licking County (later HSA of Ohio) opened its doors in 1938, our business model was rather straightforward – we covered a plan member's hospital room and board, general nursing services, and drugs and dressing for up to 21 days per year. No coverage for physician or surgical fees, but at least the price was right: just a monthly premium of 60 cents for individual service (80 cents if you preferred a private room).

As we expanded our coverage to include such benefits as maternity, oxygen, and x-rays, we learned more about the specific health concerns of employer groups and how to best balance benefits and cost considerations. And it was this knowledge that ultimately led to our 1987 transition to a mutual life insurance company that provided comprehensive major medical care, including coverage of doctor charges.

Trust Building

MedBen Chairman & CEO Doug Freeman oversaw the changeover and has been instrumental in setting MedBen's direction for the past 31 years. "If our first 50 years of growth were slow but steady, I would say the last 30 were faster but focused," Freeman said. "We have always had a desire to find better solutions for our clients and expand our services to meet a wider range of employer needs."

MedBen has moved away from traditional fully-insured group coverage to offer of variety of benefits management services to self-funded employers, including third party administration and consumer-driven products like FSAs and HRAs. More recently, we introduced WellLiving, a worksite wellness program that promoted preventive care – and alters the way that employers see their health plan, says MedBen President & COO Kurt Harden.

"It's no longer just about, 'What benefits can we offer to our employees when they're sick,' to 'What steps can we take to help employees stay healthy in the first place?" said Harden, who joined MedBen in 1991 and was named President in 2012. "By approaching health coverage from a perspective of preventing disease or detecting it as early as possible, you cultivate a healthier workplace while reducing care costs."

Full story »

  06:20:00 pm, by MedBen5   , 179 words,  
Categories: Prescription, Cost savings, Specialty Drugs

MedBen Rx Strategies Help Employers Face Pricing Challenges


A recent Washington Post article highlights the machinations that drug companies will use to ensure that insurers and other private-sector sources pay for their products, rather than price-controlled public services like Medicare. One common manufacturer practice is making tax-deductible donations to charities that cover out-of-pocket costs and insurance premiums... where, in the case of rare diseases, "the needs of a single patient can generate millions in pharmaceutical sales," the article notes.

While drug companies feel it is in their best interest to do what they can to shield themselves from government price controls, that's no comfort to employers that bear the brunt of higher costs. But with decades of experience in prescription benefit planning, MedBen will assist clients in designing prescription plans that take the full advantage of manufacturer coupons and rebates, in addition to our new Rx Advocate program which goes against traditional practice and uses the pharmacy's actual purchase price to determine your plan's drug costs, rather than an inflated wholesale price.

Learn more by contacting our Vice President of Sales & Marketing Brian Fargus at


  10:52:00 pm, by MedBen5   , 174 words,  
Categories: News, Wellness, Cancer

Prostate Cancer Screening Guidelines Questioned

cancer definition

The pros and cons of prostate cancer screening have been debated since the U.S. Preventive Services Task Force (USPSTF) advised against the testing for most men in 2012 – and consequences of that advice may be surfacing.

In a recent Medscape commentary, Dr. Arefa Cassoobhoy called attention to recent studies that found decreases in incidences of low-grade disease, but increases in more aggressive prostate cancer. She suggests that the increases could be adverse consequences of the USPSTF's recommendation.

MedBen WellLiving currently follows American Cancer Society guidelines, which recommend that men age 50 and above (or younger, in cases of high risk) should discuss testing options with their family doctor. Decision about testing should be based on family history, lifestyle, and symptoms. However, some WellLiving clients do encourage all male plan members of appropriate age to get tested, so be sure to check your plan's guidelines before scheduling your annual wellness exam.

MedBen clients who have any questions about USPSTF preventive care requirements under the Affordable Care Act are welcome to contact Compliance Manager Erin Kelly at


  11:21:00 pm, by MedBen5   , 387 words,  
Categories: News, Compliance, Legislation, Regulatory

Fraker and Fellow SPBA Members Meet with Congressional Offices

Fraker and SPBA Board Members

MedBen Vice President of Compliance Caroline Fraker was among a group of self-funded benefits professionals who recently visited the Capitol to offer their expertise to Congressional offices in the drafting of health care legislation.

In a series of meetings on April 3, Fraker and other members of the Society of Professional Benefit Administrators (SPBA) Board of Directors spoke with staffers in both the Senate and House of Representatives, including legislative assistants for Ohio Senators Sherrod Brown and Rob Portman, and Representative Steve Chabot. The SPBA also met with members of the House Ways and Means Committee Health Subcommittee staff.

"As a group that represents the concerns of self-funded employers, the SPBA sees itself as a non-political information resource to government officials," said Fraker, who also serves as the Board's Secretary/Treasurer. "The purpose of these meetings was to introduce ourselves to the people responsible for drafting health care legislation and offer SPBA as a resource and sounding-board to bounce off ideas... to ask us, if we did this, how would it affect existing employee benefits and heath care laws?"

Staffers in attendance at the meetings were selected by their respective legislators and legislative committees because of their knowledge about health care issues.

Fraker noted that SPBA already has well-established relationships with multiple regulatory agencies, including the Internal Revenue Service and Department of Labor – agencies that enforce legislation already on the books. "Our goal is to assist in the process of drafting legislation, so any potential conflicts can be addressed and avoided before the bills are signed into law," she said.

SBPA Board members plan to return to the Capitol in June for additional meetings with the hopes of making the exchanges a regular event.

Formed in 1975, SPBA strives to advance the goals of benefits administrators as well as to provide advice that helps members better serve their clients and their clients’ plans. SPBA Board members meet monthly via conference call to discuss issues of importance to the Society’s members and their customers. Board members also host twice-yearly conferences open to all SPBA members, which are preceded by Board-only meetings.

A 30-plus year veteran of employee benefits, Fraker assists MedBen clients with regulatory compliance, contractual and risk management issues. In addition to her SPBA responsibilities, she also serves on the Government Affairs Committee of the Licking County Chamber of Commerce.


  03:51:00 pm, by MedBen5   , 328 words,  
Categories: Wellness, Diabetes

Diagnosing Diabetes

blood testing

Diabetes is a chronic condition that affects the body’s ability to use the energy found in food. The American Diabetes Association reports that 30.3 million Americans have diabetes. Shockingly, nearly 7.2 million Americans don’t even know that they have it.

Normally, the body is able to break down sugars and carbohydrates and turn them into glucose, fueling the body. However, insulin is needed to turn the glucose into energy. Type 1 diabetes is an autoimmune disorder in which the immune system mistakenly treats the cells in your pancreas that make insulin as invaders and destroys them. Type 2 diabetes is when your body does not or can not use insulin properly or is insulin-resistant.

Diagnosis of diabetes is imperative to your future health because if left untreated, it can lead to problems with the heart, blood vessels, eyes, and kidneys. Risk factors of developing the condition include family history, obesity, sedentary lifestyle, and an unhealthy diet.

Since symptoms of diabetes can take months or sometimes years to be detected, WellLiving recommends an annual visit to your family physician, who will decide if you need a blood sugar level screening. Common treatments for diabetes include insulin injections to manage type 1 diabetes, diet and lifestyle changes to treat type 2 diabetes, or sometimes, a combination of both.

The Screenings and the Numbers
Here are screenings your physician may use to measure your blood glucose levels.

  • The A1C test measures your average blood glucose levels for the past 2 to 3 months. Your doctor may administer this test more than once per year. Those testing 6.5% or more are considered diabetic.
  • Fasting Plasma Glucose (FPG) is a test that checks fasting (not eating for at least 8 hours) blood glucose levels. Those with fasting blood glucose levels of 126 mg/dl or higher, are considered diabetic.
  • An Oral Glucose Tolerance Test (OGTT) checks blood glucose levels before and after drinking a sweetened drink. Diabetes is diagnosed at 2 hour blood glucose of greater than or equal to 200 mg/dl.

SOURCES: American Diabetes Association (1,2), WebMD


  10:40:00 pm, by MedBen5   , 295 words,  
Categories: Prescription, Cost savings, MedBen University, Transparency

Rx Rebate Guarantees? Beware!

Brian Fargus

At a recent MedBen University event, MedBen Vice President of Sales & Marketing Brian Fargus warned attendees against drug rebate guarantees that promise a lot but deliver little… and end up costing the employer more.

“Some of the larger health care companies focus on getting as many rebates as possible and selling you on a guarantee of ‘per employee per month’ rebate savings,” Fargus said. But the only way to meet that guarantee is to encourage the use of the most expensive drugs, by placing them in your formulary’s preferred drug category. Meanwhile, lower cost equivalents that don’t offer rebates are considered “non-preferred” drugs, even when they cost less than a so-called “discounted” drug.

Fargus likened guaranteed rebates to a drugstore’s toothpaste aisle, in which Brand A offers a coupon and Brand B doesn’t… but even after the discount is applied, Brand A still costs more than Brand B. “The savings look good, but you still end up paying more,” he observed.

“Bottom line, you can go broke chasing rebates,” Fargus added.

MedBen opts for a different approach to pharmacy plan savings. While we return 100% of all paid rebates to the client, we don’t go looking for the rebate. Rather, we find the lowest net cost in every drug class, and help you point your plan members to those drugs.

And rebate transparency is just one way MedBen reduces your pharmacy costs. Our new MedBen Rx Advocate program eschews the standard industry practice of using a drug’s average wholesale price (AWP) as the starting price point in favor of the acquisition cost index (ACI)… the true price the pharmacy pays with no inflated mark-ups.

MedBen offers real savings on your pharmacy costs, with no gimmicks or artificial guarantees. To learn more, contact Fargus at

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