Lunch and Learn

Thomas Hamilton Live on Dec. 16th.

Presenting

The New Way to Health Plan Freedom

 

Come see and learn for yourself at our corporate office located at: 

5960 Fairview Rd

 Ste. 400

Charlotte, NC 28210

704-375-1112

 

The New Way to Health Plan Freedom

Lunch and Learn Summit

from 11:30-1:00 pm.

This session is limited to the first 15 who register!

Reserve your seat today, have lunch on us and learn about the biggest Health Insurance breakthrough in the last 20 years.

Testimonials:

“We were captivated by this alternative after hearing about it.”

Jennifer Morgan – MGI, Inc.

“This may be the future of health insurance.”

Nick Trickolas – CEO, Ilios Parnters

“The biggest thing for us : No More increases!”

Helen Griffin – IT Pros

“After hearing about this program, I signed on.  With the plans to double the size of my company, I expect to still save at least $360,000 this year with the new program.”…”I had to worry about healthcare costs every year.  We are no longer in the Healthcare Business!”

Bret Berneche - Cardinal Homes

 

To register for this event please visit www.e2beneflex.com

 

UnitedHealthcare Uses Financial Incentives.

UnitedHealthcare uses financial incentives to encourage people with diabetes, pre-diabetes to take care

Posted:

MINNEAPOLIS, Minnesota – Insurer UnitedHealthcare is trying to encourage people with diabetes to take better care – and to save themselves, and eventually their employers and the insurer, a lot of money.  
 
The Diabetes Health Plan goes beyond traditional diabetes wellness programs by giving patients financial rewards for taking routine preventive-care steps, such as having regular blood sugar checks, routine exams and preventive screenings, according to the Minneapolis health care insurer.  
 
These steps are aimed at improving patients’ management of their disease, which cost the U.S. economy $175 billion in 2007, according to the American Diabetes Association. The steps also get diabetic patients involved in their own care, which costs an average of more than $22,000 per person a year, according to the insurer’s data.  
 
“One of the best ways to control escalating health care costs is to encourage people to adopt healthier behaviors and take preventive steps,” said Dr. Deneen Vojta, senior vice president of UnitedHealth Group. But it’s impossible for people to live healthier — with the goal of managing or avoiding diabetes — if they don’t know they have the disease.  
 
While nearly 24 million people in the United States had diabetes in 2007, only one-in-four knew they had the disease, the association said. Another 57 million people were considered pre-diabetic –having higher-than-normal blood sugar but not high enough to count as diabetes. Again, about a fourth of pre-diabetics were unaware of their condition.  
 
The Diabetes Health Plan promises to identify people who have diabetes or pre-diabetes and then equip those who are identified to manage or avoid the disease, Vojta said.  
 
To get an idea of where to go with its benefits, UnitedHealthcare piloted its Diabetes Health Plan among three big employers — General Electric, Hewlett-Packard and Affinia Group this year. The employers liked the plan so much, they’ve renewed or expanded their participation for next year. UnitedHealthcare is rolling out the plan for employees of other large, self-insured employers on Jan. 1.  
 
“We’re definitely keeping it,” said Keith Clark, health and safety director for the Gastonia, N.C.-based Global Filtration Division of Affinia, a maker of after-market automotive parts and supplies.  
 
Diabetes Health Plan benefits vary by employer and can include some free diabetes supplies and prescription drugs, as well as lower co-payments for related doctor visits. The benefits could save patients up to $500 a year, UnitedHealthcare said. The plan also requires people with diabetes and pre-diabetes to be educated about the disease and its management.  
 
In addition to the cost savings offered by UnitedHealthcare, Affinia contributes $200 to a health reimbursement arrangement account (HRA) when an employee signs an agreement to work with a doctor to manage their diabetes, Clark said. The company contributes another $200 to the HRA account when the employee completes an educational program about the disease and its management. Another $200 is contributed if the employee complies with a schedule for tests, exams and other measures.  
 
“So that’s up to $600 you can get in your HRA account” per year, Clark said. Spouses of employees can earn another $600 for a total of $1,200 in contributions per couple, he said. Employees can pay medical expenses not covered by employers’ insurance with tax-free contributions to their HRA accounts.  
 
Money may not be the best way to encourage people with diabetes to live healthier, said Dr. Paul Robertson, president of Medicine & Science, the research arm of the diabetes association. “In my experience, the patients I work with typically are turned off if they’re offered money,” said Robertson, who does clinical research with patients who have diabetes. “They would rather do it because they would rather do it. Money spoils that.”  
 
Even pregnant women who develop gestational diabetes may not be motivated by money, Robertson said. But healthy people who have adult-onset diabetes in their families might take cash to change some behaviors to avoid developing the disease, he said.  
 
Dr. Randy Cebul, director of Better Health Greater Cleveland, applauded the health plan because it gets diabetic patients engaged with their doctors and their care. Better Health Greater Cleveland is an alliance of hospitals, doctors and health care organizations, agencies and insurers in Northeast Ohio committed to improving the health and care of people in the region who are living with chronic diseases, starting with diabetes.  
 
“Is this a novel idea? Yes,” said Cebul, who has several appointments in Greater Cleveland, including professor of medicine and director of the Center for Health Care Research and Policy. “I think it’s a good idea. I think physicians would like it. It makes patients part of the picture.”  
 
Cebul said there’s little research evidence to indicate that financial incentives motivate people who have diabetes. But the idea of using clever incentives to require patients to do better for themselves — and for things that the doctor can’t fix — is a good one, he said.

United Healthcare Screenings are not Changing.

UnitedHealthcare Mammography/Cervical Screening Guidelines Remain Unchanged

The United States Preventive Services Task Force (USPSTF) recently released new guidelines for mammography screening based on a review of the medical literature. As a result, the USPSTF is recommending that regular screening for breast cancer in women begin at age 50. The previously recommended age to begin routine screening was age 40.

Our coverage for mammography and cervical cancer screening is unchanged.

Mammograms

We consider mammography an important screening procedure, one that has resulted in the ability to detect and treat breast cancer at earlier stages of the disease and save lives:

UnitedHealthcare will continue to offer coverage of mammograms for women covered by a UnitedHealthcare insured plan when recommended by their physicians.  

Customers with a self-funded plan may modify coverage based on the recently reissued guidance but must provide us with specific instructions prior to the implementation of any coverage changes. However, we strongly recommend customers follow our policy and continue with the coverage for mammography unchanged. 

Cervical Cancer Screening

In addition, the American College of Obstetricians and Gynecologists (ACOG) recently changed its recommendations for cervical cancer screening, advocating less frequent screening for women in their 20s. However, UnitedHealthcare is not changing its coverage policy on cervical cancer screening. As is true for mammography, we recommend that women discuss with their physicians how frequently they should undergo cervical cancer screening.

An employee communication template outlining this issue is included for you to use with your employees, as appropriate. If you have questions, please contact your UnitedHealthcare representative.

Free Annual Medical Report…

Check Your Annual Medical Report

Health and life insurance companies have access to powerful technologies for evaluating whether to cover individual consumers: “medical report” files.  Consumer medical report files, sold by the Medical Information Bureau, Inc. (MIB), Ingenix, Inc., and Milliman, Inc. enable health and life insurance companies to charge higher premiums and powered the technology behind rescission of coverage.  Most dangerously, medical report files may include both medical and non-medical information about consumers.  For instance, data collected by the Medical Information Bureau (MIB) may include medical conditions, credit report history, driving records, criminal activity, drug use, participation in hazardous sports, and personal or family genetic history.

Under Federal law, all consumers are entitled to free annual medical reports from the Medical Information Bureau, Inc. (MIB), Ingenix, Inc., and Milliman, Inc. No consumer should pay for health or life insurance without first checking their free annual medical report files.  However, all consumers should be aware that the Medical Information Bureau, Inc. (MIB), Ingenix, Inc., and Milliman, Inc. do not offer a single, secure website to request, review, or dispute your medical report file.  To obtain a copy of your free annual medical report file, you must contact the Medical Information Bureau, Inc. (MIB), Ingenix, Inc., and Milliman, Inc. individually, by telephone or postal mail.

(1) INSTRUCTIONS ONLINE: Contact the Medical Information Bureau, Inc. (MIB) to request your medical report file.

(2) INSTRUCTIONS ONLINE: Contact Ingenix, Inc. to request your medical report file from the MedPoint prescription profiling database.

(3) INSTRUCTIONS ONLINE: Contact Milliman, Inc. to request your medical report file from the IntelliScript prescription profiling database.

outofpocket.com

 

 

 

OutOfPocket.com is a social-networking portal to help consumers find the best value for routine health care services in their neighborhood. The site includes a directory of true prices for common services based on actual visits by individual consumers. The website is free and everyone is invited to participate, including the insured and under-insured, by anonymously posting prices they paid for routine health care services (such as MRIs, mammograms, x-rays, CT scans, vaccinations, office visits, dental and vision), along with their personal recommendations on the provider.

Quest for Answers

Quest to Find Answers in Cost Savings with Government Controlled Healthcare

To all those who say that health care reform with the “public option” is the way to reduce medical cost through competitiveness and better controls in the health care marketplace, I say bunk!  The sad part is; those who want the “public option” to offer more government control on health care, coverage for all with better savings, better quality and on and on, can’t show historically how that is possible.  

The “programs” implemented by our government have never stayed with in the beginning estimates of budget.  In fact, their ending costs have gone as high as 10 times the initially projected cost.  I would love for anyone to find me wrong!  Please tell the American, realistically, how this can be done?

“With cost savings through reduction of waste, fraud, and abuse in the Medicare system being offered as a key funding source for health care reform currently under consideration on Capitol Hill, eliminating this corruption could require Medicare to adopt private-sector reforms, “ says Thomas Cheplick, with The Heartland Institute. 

The proposal, authored by Sen. Max Baucus (D-MT), currently pending in the Senate relies on such reductions of more than $400 billion in funding over the coming decade.

“Officials estimate that Medicare is annually cheated out of some $60 billion in improper claims payments—an eighth of its entire budget,” said Kevin Wrege, regional state affairs director for the Council for Affordable Health Insurance in Alexandria, Virginia.

 Private Firms Can Do Better

Fraud is rampant and unchecked throughout the Medicare system, while private carriers do a much better job of preventing it.

“Private carriers spend a lot on efforts [to prevent fraud], raising their administrative expenses in the process,” stated Wrege.  “By contrast, the Medicare program does not regularly review bills for accuracy and to prevent fraud.”

Medicare typically pays claims in full, and the Department of Health and Human Services’ Office of Inspector General (OIG) operates as a post-claim payment cop, flagging and investigating only those that appear suspicious.

“Recovered funds, if any, are often only a fraction of the often millions of dollars taken,” Wrege added.

 Scrutiny Advocated

Many Medicare abuses happen in the market for durable medical equipment (DME), such as wheelchairs and oxygen equipment. A draft OIG audit released in August 2008 flagged almost a third of the 2006 DME claims, as having been improperly reimbursed.

“A July report by the Government Accountability Office found that Medicare paid as much as $92 million since 2000 for equipment purportedly prescribed by doctors who were dead,” said Wrege. “Claimants have submitted counterfeit documents, forged doctors’ signatures, and filed bills on behalf of patients who were dead or had never been seen by the prescribing physician.”

In 2008 a single Florida businessman was convicted of submitting more than $5.5 million in fake Medicare claims. He had operated for months, using some of the money to purchase a Rolls-Royce, despite giving the agency an address that was actually a utility closet.

For more information…

“Medicare’s Hidden Administrative Costs,” Council for Affordable Health Insurance: http://www.heartland.org/policybot/results/26241/

“Improper Payments: Responses to Posthearing Questions,” Government Accountability Office: http://www.heartland.org/policybot/results/26242/

“Medical Review of Claims for the Fiscal Year 2006 Comprehensive Error Rate,” Office of Inspector General, U.S. Department of Health and Human Services: http://www.heartland.org/policybot/results/26243/

Blue Fridays.     

Very soon, you will see a great many people wearing blue every Friday. The reason? Americans who support our troops used to be called the ’silent majority’.  We are no longer silent, and are voicing our love for God, country and home in record breaking numbers.

We are not organized, boisterous or overbearing.  Many Americans, like you, me and all our friends, simply want to recognize that the vast majority of America supports our troops.

Our idea of showing solidarity and support for our troops with dignity and respect starts this Friday — and continues each and every Friday until the troops all come home, sending a deafening message that every red-blooded American who supports our men and women afar, will wear something blue. By word of mouth, press, TV — let’s make the United States on every Friday a sea of blue much like a homecoming football game in the bleachers. If every one of us who loves this country will share this with acquaintances, coworkers, friends, and family, it will not be long before the USA is covered in BLUE and it will let our troops know the once ’silent’ majority is on their side more than ever, certainly more than the media lets on. The first thing a soldier says when asked ‘What can we do to make things better for you?’ is ‘We need your support and your prayers.’ Let’s get the word out and lead with class and dignity, by example, and wear something blue every Friday.

The Real Reason We Need Reform…

The Real Reason We Need U.S. Health Care Reform – Cost 

by Paul Zane Pilzer

Every U.S. entrepreneur is challenged getting affordable health insurance for themselves and their families. Congress and The White House seem completely out of touch with the real issue since most elected officials receive free lifetime care for themselves and their families. 

Note: If and when Congress passes a major health care reform bill, I will be posting an article on what entrepreneurs and small businesses should do to maintain affordable health care for themselves and their employees. 

The single most important problem with U.S. health care is that it costs too much. The U.S. spends much more per person than any developed nation and our population is the unhealthiest of any developed nation. 

There are hundreds of reasons U.S. health care costs so much relative to how little we get for our money. Some of these reasons include: 

1. We pay medical providers for each procedure (even if the procedure is fatal) rather than pay medical providers based on the outcome of each procedure or on the health of the patient. 

2. We have no caps on legal liability for medical mistakes–this causes medical providers to waste billions on tests and procedures of dubious value, some of them dangerous, just to limit court settlements. 

3. We have very limited competition–incredibly, it is still illegal for a health insurance company to sell coverage across a state line. 

4. We pay virtually anything for sickness industry costs once a patient is ill, but virtually nothing for wellness industry costs to keep patients healthy in the first place. 

5. Medical providers immorally charge different patients wildly different rates–from $10 to $100 for the exact same procedure or treatment, based on the network in which the patient is a member. These different rates are hidden from the public and, generally, the poorer you are the more you pay. 

Yet, incredibly, almost all the proposals now being considered in Washington do nothing to reduce or even slow the growth in health care costs. 

The reason is pork–more pork than we may have ever seen in our lifetimes. 

When the debate began earlier this year on how to reform U.S. health care, each medical provider special interest group lined up their favorite legislators to buy their support. Quiet backroom deals were made one-by-one. 

1. The AMA (doctors) was promised that nothing would be done to cut payments to physicians or tie doctor payments to performance. 

2. Trial lawyers were promised that no caps would be put on legal liability for medical mistakes. 

3. Big Pharma was promised that nothing would be done to their net revenues–even obvious fixes like giving Medicaid patients generic vs brand-name drugs were taken off the table. 

4. Inefficient, bloated local insurance companies were promised that they would not have to compete with larger, more efficient national insurers over state lines. 

5. Medical network providers were promised that there would not be “transparency”–the wildly-varying charges medical providers immorally charge each patient would never be disclosed to the public or to the patient. 

U.S health care reform started out with a noble goal–get health insurance coverage for the millions of Americans who want coverage and are currently slipping through the cracks for two primary reasons: (1) They have a pre-existing medical condition and reside in a state with poor state-guaranteed coverage; or (2) They cannot afford coverage but are either not poor enough to join the 45 million Americans receiving Medicaid or not old enough to join the 47 million Americans receiving Medicare. 

Unfortunately, at the time of this writing, just after the House has passed its version of health care reform. we have been sold out. 

We, the American people, deserve better. 

Small Firms Drop Insurance!

New York’s small businesses are dropping their health insurance at record pace because of massive increases.  Are other businesses in other states far behind?  We have a solution!  visit www.E2BeneFlex.com for more information and resources on Employer Defined Contribution.

 

November 18, 2009 3:22 PM

Hard-pressed small firms drop health insurance

By Barbara Benson

Cancellation rates run as high as 50% at Empire Blue Cross Blue Shield as rates continue to rise in the face of the economic downturn.

Empire BlueCross BlueShield is reporting a sharp increase in small businesses terminating coverage that started around the first quarter of this year.

Senate Bill Update…

Senate Bill Would Boost, Extend Federal COBRA Subsidy

With hundreds of thousands of laid-off employees soon to lose a federal subsidy of their COBRA health insurance premiums, more lawmakers are introducing legislation to extend and increase the subsidy.

November 13, 2009

Senate Bill Would Boost, Extend Federal COBRA Subsidy

With hundreds of thousands of laid-off employees soon to lose a federal subsidy of their COBRA health insurance premiums, more lawmakers are introducing legislation to extend and increase the subsidy.

Under bill S. 2730, proposed by Sens. Sherrod Brown, D-Ohio, and Bob Casey, D-Pennsylvania, the nine-month subsidy would be extended by six months, to 15 months, and the 65 percent federal premium subsidy would be raised to 75 percent.

In addition, workers who lose their jobs through June 30, 2010, would be eligible for the subsidy. Under the current law, employees who lose their jobs after December 31 will not be eligible for the subsidy.

And because of the unusual way the current law is written, employees laid off before December 31 but whose COBRA eligibility doesn’t begin until next year also would not be eligible for the subsidy. That could happen, for example, if an employee is laid off in mid-December and the individual’s former employer voluntarily extends group coverage through the end of the month.

“This legislation will make health care coverage more affordable for laid-off workers and bring some security in troubling times,” Sen. Casey said in a statement.

A somewhat similar bill was introduced in the House last month by Rep. Joe Sestak, D-Pennsylvania. The Sestak bill, though, would keep the subsidy at 65 percent.

The proposals come as the subsidy soon will run out for laid-off employees who became eligible for the subsidy when it started, which generally was March 1.

A Hewitt Associates study found that the percentage of involuntarily terminated employees opting for COBRA doubled to 38 percent compared with the opt-in rate in the several months before the subsidy.
Filed by Jerry Geisel of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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