cmonfils | January 17, 2012
During the past year, Lowe’s Companies paid for 38 employees or their dependents, including three children, to travel to Cleveland Clinic for heart surgery that was fully covered by health insurance with no co-pays or deductibles. PepsiCo announced on Dec. 8, 2011, that a similar arrangement will be available for their employees to travel to Johns Hopkins Medicine in Baltimore for care.
cmonfils | January 17, 2012
The beginning of 2012 ushered in seven new requirements for health insurance coverage provided by employers to Connecticut residents that proponents say will save lives and money in the long run.
“An ounce of prevention is worth a pound of cure,” said state Sen. Joseph Crisco Jr., D-Woodbridge, co-chairman of the state legislature’s Insurance and Real Estate Committee, referring to the new requirements for breast MRIs, colonoscopies and prostate cancer screening and treatment.
cmonfils | January 17, 2012
Empire BlueCross BlueShield’s decision to pull back from the small group market this fall merely reinforced what most company owners already knew: They are facing a tumultuous market for health insurance, one in which prices continue to climb, plan designs are growing skimpier and skimpier, and there are fewer insurance companies to pick from.
cmonfils | January 17, 2012
Corporate wellness programs are one way that employers can help improve the health of their employees and decrease spiraling health care costs. However, getting employees to participate in such programs can be challenging. Now a new study in the American Journal of Health Promotion suggests that group lotteries might increase employee participation in one component of wellness programs—filling out health risk assessment questionnaires.
cmonfils | January 17, 2012
BEWARE STATISTICAL DISTORTIONS: SPBA is often asked “How many TPAs are there?”. The answer is multi-facetted and (not by design) may sound like double-talk. It is best if you read it once, open-minded, purely for the insight. Then re-read for specific reference to your situation. I have to start with a big disclaimer. I always warn that every number or statistic about TPAs, health care & costs, employee benefits, etc. have a built-in 1,000% distortion factor. It is not that anyone is lying. It is merely that even the most simple vocabulary terms have vastly different meanings & usage in the employee benefits, insurance and medical communities in which TPAs operate. For example, one “life” can refer to one individual in a plan….or it might be an employee + spouse + 10 children. Even highly-respected sources of statistics get distorted results. Let me demonstrate by anecdote. A few years ago, I was asked to serve as a judge of a federal government panel of experts. It was about 20 of the top statistical research agencies of government, such as GAO, CMS, Bureau of Labor Statistics, Congressional Research Service, White House Office of Economic Advisors, etc. My role was purely ceremonial. About 25 of the same questions had been planted in studies of these research organizations. These were all very basic questions (including number of self-funded plans & size of TPA market). Each group came before me and was very proud of their methodology & credentials. However, their findings for the same items were tens of millions of people different and tens of billions of dollars different. So, the moral of the story is even if you find some very official & impressive-seeming sources for a statistic…..variations of 1,000% will be found.
cmonfils | January 17, 2012
H-E-B is sharing with the public what it’s learned about its own employees’ wellness and on Friday will launch “Healthy at H-E-B” at the store at 2950 Southmost Blvd.
The company describes the effort as a “comprehensive commitment to improve the health of Texans.” As part of the initiative, H-E-B will showcase chef-inspired recipes at in-store cooking demonstrations designed to show customers how to make healthy, inexpensive meals
cmonfils | January 17, 2012
Breast-feeding avengers may be coming to a workplace near you.
Women want to be able to breast feed their babies when and where they want to. Witness the “nurse-ins” at Target stores on the West Coast last week that were prompted by a shopper who was mocked for breast feeding by employees at one Target. Moms, however, also want to be able to breast feed when they’re on the clock.
cmonfils | January 17, 2012
With little fanfare and little attention from the media, the Obama Administration recently issued proposed rules to crackdown on health insurance scams that use ERISA to avoid state law enforcement and regulatory actions.
Since the 1974 enactment of ERISA — the federal law governing employee pension and health benefit plans — crooks have used it to promote health insurance scams. There have been bipartisan Congressional attempts to address this problem, e.g., the passage of the 1982 amendments to clarify state authority and the 1996 HIPAA amendments to increase penalties for health fraud. But until the passage of the Patient Protection and Affordable Care Act (ACA), the federal government has had limited administrative authority to fight health insurance scams.
