INDEPENDENCE BLUE CROSS - FUTURE SCRIPTS SOLD TO CATALYST HEALTH SOLUTIONS, INC
Posted: 8/5/2010 1:23:25 PM | By: Nanette Poserina
File Under: HISI News

Independence Blue Cross - eBulletin - FutureScripts Sold to Catalyst Health Solutions, Inc.
Date: August 5, 2010

Independence Blue Cross

FutureScripts Sold to Catalyst Health Solutions, Inc.

To enhance our ability to provide new and better pharmacy capabilities for our customers, we have entered into an agreement for Catalyst Health Solutions, Inc. to acquire our FutureScripts and FutureScripts Secure pharmacy benefits management (PBM) subsidiaries. This strategic alliance with Catalyst will allow FutureScripts to achieve enhanced scale and capabilities to continue to compete effectively in the rapidly changing pharmacy benefits management (PBM) arena. This alliance will:

§ Strengthen IBC’s competitiveness in positioning its pharmacy services, creating growth opportunities, maximizing client retention, and minimizing pharmacy carve-outs.

§ Maximize the financial value of pharmacy services for IBC’s customers.

§ Enhance IBC’s ability to bring new and improved pharmacy capabilities to serve its customers.

Why Catalyst is the right choice for IBC
Catalyst Health Solutions, Inc., the fourth largest publicly traded PBM in the U.S., is built on strong, innovative principles in the management of prescription drug benefits and has proven success in winning against the three largest PBMs. The company has a reputation for delivering best-in-class programs and services as well as seamless implementation and integration.

Catalyst will provide IBC a full complement of services, including: claims adjudication, member services, network administration, formulary management and rebate contracting, mail and specialty drug management, clinical services, data reporting and analytics, as well as client service and sales support. IBC and our customers will benefit from:

§ continuity of the FutureScripts brand;

§ expanded resources, technology, and services, including 24/7 customer service;

§ access to expert local clinicians to answer questions and resolve issues;

§ innovative formulary designs to drive safe, effective health care while continuing to keep net costs down;

§ strategic expansion of pharmacy and medical data integration to improve health outcomes and lower health care costs.

What this means for customers and members
For members and customers, there will not be any immediate operational changes. Catalyst will integrate FutureScripts into their business over the next 18 to 24 months. FutureScripts will continue to operate as FutureScripts and FutureScripts Secure and the FutureScripts staff will transition to the new company.

Pharmacy is, and will continue be, an integral component of IBC’s business. Our primary goal with this sale is to make sure that we continue to have the resources to provide our customers with best-in-class service and performance in managing pharmacy benefits that optimally integrates pharmacy and medical benefits.

For more information, please review the Frequently Asked Questions and press release. If you have additional questions regarding this, please contact your Independence Blue Cross account executive.

LOCAL SCHOOL BOARD OFFERS HISI PHARMACY CARVE-OUT OPTION - $1.3 MILLION IN INITIAL SAVINGS.
Posted: 7/26/2010 8:42:06 AM | By: Nanette Poserina
File Under: HISI News

Local school board offers new HISI health care option - Pharmacy Carve-Out with $1.3 million in savings.

July 22,2010

During talks Wednesday night, a local school board offered the teachers union a $1.3 million cost-savings option that would not impact employees by self-insuring the district’s prescription plans, officials said Thursday.The school's insurance broker estimates that would reduce the district’s Pharmacy costs by $1.3 million next year, with similar savings the following years, school board members said.

The district needs the consent of the Federation of Teachers to put the option into effect. The board noted there was little reaction or comment from the teachers union in regards to employees contributing towards health care premiums at the session.

The federation offered no counter proposals, but another negotiation session has been scheduled for Aug. 12, according to a statement the school board posted on the district’s website. The newspaper was unsuccessful in reaching teacher union President for comment Thursday.

July 22, 2010

SENATE PASSES MEDICARE PHYSICIAN PAYMENT FIX
Posted: 6/21/2010 3:19:12 PM | By: Nanette Poserina
File Under: HISI News

SOLSTICE DESIGNATES HISI AS EXCLUSIVE GA TO MARKET DENTAL & VISION IN NORTHEAST REGION.
Posted: 5/3/2010 8:21:13 AM | By: Nanette Poserina
File Under: HISI News

Health Insurance Solutions contracted as exclusive General Agency for Solstice Dental & Vision products.

Dental & Vision Products

Groups with2 or more employees

Health Insurance Solutions, Inc. Announces
Dental and Vision Products

Available starting with June 1, 2010 effective dates.

Attention Brokers and Consultants:

Health Insurance Solutions has been contracted as a General Agency for Dental & Vision through Solstice.

Announcing brand new dental and vision products for Pennsylvania and New Jersey! Solstice has an impressive variety of ancillary options based upon the needs of the group and/or individual. The dental network is based on a national product design.

Bonus Program For 2010

With the new 2010 Bonus Program, agents can earn additional commission. Between June 1, 2010 and December 31, 2010, the following Bonus Program applies:

2 cases with a combined minimum of 200 enrolled employees. (2% of premium)

5 cases with a combined minimum of 425 enrolled employees. (3% of premium)

8 cases with a combined minimum of 2,000 enrolled employees. (4% of premium)

10 cases with a combined minimum of 3,000 enrolled employees. (8% of premium)

Offer Expires: December 31, 2010

HEALTH REFORM SUMMARY & LEGISLATION OVERVIEW
Posted: 4/13/2010 8:18:55 PM | By: Nanette Poserina
File Under: HISI News

LEGISLATION OVERVIEW OF HEALTHCARE REFORMS MARCH 23, 2010

On March 23, 2010, President Obama signed H.R. 3590, the Patient Protection and Affordable Care Act and on March 30, 2010, H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, a companion package of "fixes" to H.R. 3590, was signed into law. These two measures make the most profound changes to our country's private-market health care system in 50 years. Many provisions of the new health reform law impact American employers and private health insurance consumers immediately, while others take effect over the course of the next eight years. Below is pertinent information that will assist you in understanding all the reforms and changes:

Text of H.R. 3590, the Patient Protection and Affordable Care Act.

Text of H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010.

View NAHU's side-by-side comparison chart outlining what was contained in each bill.

View NAHU's side-by-side comparison chart of all four pieces of legislation considered by the 111th Congress.

Read the Q & A from NAHU's health reform webinars.

The two final pieces of legislation total nearly 1,000 pages and contain market reforms, an individual mandate, the creation of exchanges, new taxes and more.

Timelines

Detailed timelime on health care reforms and their effective dates.

Simplified timeline of implementation that outlines how the health care reform legislation will impact your individual and employer clients.

New tax timeline that gives an overview of the taxes created by the health care legislation and when they go into effect.

Issue Briefs

One page summaries of the need-to-know facts on some of the major provisions in H.R. 3590.

The new Small Business Tax Credit

Medical Loss Ratio Requirements

Establishing SIMPLE Cafeteria Plans for Small Businesses

Grandfathered Health Plans

Reinsurance Program for Early Retirees

Presentations

Detailed PowerPoint presentation on health care reform implementation.

Simplified PowerPoint presentation on health care reform implementation targeted for use with your employer clients.

Recording of Health Care Reform: Changes You Need to Know by NAHU CEO Janet Trautwein

Other Resources

The IRS has created three new resources on the small business tax credit:

Joint Committee on Taxation (JCX-18-10): Technical Explanation of the Revenue Provisions of the Reconciliation Act of 2010, as amended, in Combination with the Patient Protection and Affordable Care Act.

SIMPLE Cafeteria Plans for Small Businesses (brief from the American Society of Pension Professionals and Actuaries).

Summary of Potential Employer Penalties Under PPACA (P.L. 111-148) - Congressional Research Service report, April 5, 2010.

Grandfathered Health Plans Under PPACA (P.L. 111-148) - Congressional Research Service report, April 7, 2010

PPACA Grandfather Rule Chart (courtesy of Groom Law Group)

Insurance Coverage of Adult Children up to Age 26 (CRS Memorandum)

Summary of Small Business Health Insurance Tax Credit Under PPACA (P.L. 111-148) - Congressional Research Service

HEALTH REFORM CHANGES FOR EMPLOYERS COULD START 'IMMEDIATELY'
Posted: 4/1/2010 7:34:12 AM | By: Nanette Poserina
File Under: HISI News

Health Reform Changes for Employers Could Start 'Immediately'

By Bob Graham

Posted: April 13, 2010

IFAwebnews.com . The nation’s homepage for insurance industry news

Nearly all employers – whether insured and self-funded – will be affected by the new health care legislation, with some of those changes coming in the near future, according to a health insurance lawyer.

Marcia S. Wagner

Those changes are likely to involving the need to revise health plan offerings and communications about coverage, said Marcia S. Wagner, managing director of The Wagner Law Group, a Boston-based practice specializing in employee benefits, executive compensation and Employee Retirement Income Security Act (ERISA) law.

The Patient Protection and Affordable Care Act signed into law by President Barack Obamaand then amended by the Health Care and Education Affordability Reconciliation Act, which revised some provisions and delayed certain effective dates, will impose new responsibilities on employers, individuals and insurers, as well as government programs such as Medicare and Medicaid.

“While most of the provisions of the amended reform act will not be effective until 2014, employers should be aware of the provisions that will take effect within the next few months and immediately reassess their plans,” Wagner said in a statement. “Employers should also assess their plans to prepare for plan design and administrative changes that will be required in the future.”

Among the provisions that could affect employers, either directly or indirectly, are those dealing with mandatory coverage, employer group health plans, premium assistance and premium tax credits, exchanges, insurance market, Medicare and Medicaid, and funding.

“These changes will affect both insured and self-funded group health plans and may require immediate action on the part of the employer,” Wagner added.

COBRA CHANGES: 2010 UPDATES
Posted: 3/23/2009 10:16:41 AM | By: Nanette Poserina
File Under: HISI News

COMPLIANCE UPDATE

THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 :

CHANGES TO COBRA FOR 2010

March 2009

THE GPAHU INSIDER

A PUBLICATION OF THE GREATER PHILADELPHIA ASSOCIATION OF HEALTH UNDERWRITERS

On Friday, February 13th, Congress passed a finalized version of the American Recovery and Reinvestment Act, a $787 billion economic stimulus bill, signed by President Barack Obama. The Act includes major changes to "COBRA" laws, which mandate the continuation of group health coverage for employees experiencing a "qualifying event" - such as the termination of employment - resulting in the loss of that coverage.

Before the passage of this Act, a qualified beneficiary who elected COBRA was wholly responsible for the payment of 100% of his or her COBRA premiums for the duration of the COBRA coverage period. The new Act changes this by allowing employees who were involuntarily terminated from employment between the dates of September 1, 2008 and December 31, 2009, to have 65% of their COBRA federally subsidized for nine months. This includes employees who have already declined COBRA coverage during this period.

This subsidy will only be available to participants with a modified adjusted gross income of less than $125,000 for the taxable year ($250,000 in the case of a joint return) and will be paid through credits against employers' payroll tax liability. The Act is to become effective immediately.

This is the most significant change to COBRA since it was enacted in 1986 and will have a major effect on how COBRA is administered.

There are a number of issues left open for plan administrators to grapple with, for instance:

When and how should notice of these new COBRA rights be given, especially to employees who have been termed in the past?
What is the definition of "involuntary termination"?
What are the exact procedures to follow if payroll tax credits aren't enough to cover an employer's 65% COBRA subsidy?
Whose ultimate responsibility will it be to determine whether a participant is below the income threshold (an initial reading of the bill indicates that this is the responsibility of the taxpayer, but what if the employer has notice of a discrepancy)?

These are just a few of the issues left open by this Act, and it will be up to the federal agencies with jurisdiction over COBRA, most notibly the United States Department of Labor ("DOL"), to settle them. It is expected that specific, comprehensive guidance will be made available soon, as the Act requires that the DOL draft model notices within 30 days of the Act's passage.

These legislative changes can and will be stressful and costly for businesses and plan administrators. It's important to remember that these amendments affect all employers who are presently subject to COBRA, virtually every employer in the country.

COBRA Continuation Coverage Assistance Under ARRA

The American Recovery and Reinvestment Act of 2009 (ARRA), as amended on March 2, 2010 by the Temporary Extension Act of 2010, provides for premium reductions for health benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly called COBRA. Eligible individuals pay only 35 percent of their COBRA premiums and the remaining 65 percent is reimbursed to the coverage provider through a tax credit. To qualify, individuals must experience a COBRA qualifying event that is the involuntary termination of a covered employee's employment. The involuntary termination must generally occur during the period that began September 1, 2008 and ends on March 31, 2010. (An involuntary termination of employment that occurs on or after March 2, 2010 but by March 31, 2010 and follows a qualifying event that was a reduction of hours that occurred at any time from September 1, 2008 through March 31, 2010 is also a qualifying event for purposes of ARRA.) The premium reduction applies to periods of health coverage that began on or after February 17, 2009 and lasts for up to 15 months. See Temporary Extension Act of 2010.

For more information, go to www.NAHU.org.or contact Health Insurance Solutions for assistance with your COBRA questions.

IMPORTANT QUESTIONS TO ASK BEFORE YOU PURCHASE HEALTH BENEFITS
Posted: 12/22/2008 7:43:10 PM | By: Nanette Poserina
File Under: HISI News

IMPORTANT QUESTIONS TO ASK BEFORE YOU PURCHASE HEALTH BENEFITS

When purchasing health insurance, is important to ask your insurance agent or consultant the right questions to make sure that you understand what your health plan does and does not cover. Read all of the "fine print" in your health plan brochure. When you receive your policy, take time to read through your policy. You usually have a 10-day free look period.

In order to make an educated decision, we have provided a list of ten important questions you should ask your Insurance Agent, Broker, or Consultant BEFORE deciding to purchase health insurance.

4What insurance companies do you represent?

n We have the largest selection of insurance plans available anywhere. We represent all the top insurance carriers. We will compare the plans for you and find the best match.

4Are you a Captive Agent or Independent Agent/Broker/Consultant?

n A Captive Agent usually represents ONE insurance company and can usually only sell that company's insurance products. An Independent Agent or Insurance Broker usually represents many insurance carriers and can sell a variety of insurance products. We are an Independent Consultant.

4What is the plan calendar year deductible?

n Most health plans have a per person calendar year deductible. Typically, they range from $250, $500, $1,000, or $2,500.

4Will I have to pay a separate deductible for each family member if everyone in my family became ill at the same time?

n Some plans will only require you to pay a two person maximum deductible each calendar year, even if everyone in your family needed extensive medical care.

4What is the plan's maximum out of pocket expenses per year?

n This expense is a total of all deductibles plus all coinsurance percentages plus all applicable "access fees" or other fees.

4What is the plan's coinsurance percentage and what dollar amount is this percentage based on?

n A plan with 80/20 coverage means you pay 20% of some dollar amount. This dollar amount is also known as a stop loss and can vary based on the type of policy purchased. Stop loss can be as little as $5,000 or as much as $20,000. Some policies have NO stop loss.

4What is lifetime maximum benefit if I have a serious illness?

n One of the provisions of the health care reform bill that goes into effect immediately is the removal of lifetime caps on insurance. Many don't pay attention to these existing caps -- which range from $1 million to $8 million -- but they can be devastating to the few who reach them and lose coverage during a catastrophic or chronic illness. By 2014 no annual limits will be allowed.

4Does the plan have unlimited doctor co-pays or is there a limited number of doctor co-pay visits per year?

n Many plans have a limit of how many times you can go to the doctor per year for a co-pay. Usually the limit is 2-4 visits.

4Does the plan offer prescription drug coverage?

n Some plans offer prescription benefits immediately. Other plans require you to pay a separate drug deductible before you can receive prescription medication for a co-pay. Today, many plans offer no outpatient prescription drug co-pay options and only provide you with a discount prescription card that gives you a 10-20% discount on all prescription medications.

4What if I have questions about my policy plan or a medical bill that is not processed?

n HISI is your insurance advocate and partner. Our staff will get answers for questions you may have about coverage or benefits. We will not redirect you to the insurance carrier. We will get the information you need. You will speak to a live person and after hours we have a toll-free hotline that is active 24/7.

Health Insurance Solutions is committed to assisting you with your health insurance choices by simplifying the decision-making process, explaining your options in simple understandable terms, and providing exceptional service to your account long after you have chosen your plan.

STUDENT GRADUATE HEALTH INSURANCE FOR 2010
Posted: 11/20/2008 10:29:42 AM | By: Nanette Poserina
File Under: HISI News

STUDENT GRADUATE HEALTH INSURANCE

Now that you have graduated, are you no longer covered as a dependent under your parent's health plan? We have solutions for student graduate health insurance needs. We specialize in individual health programs and insurance plans and provide tools and resources to guide new graduates through making health care choices.

We want to keep our graduates healthy, and affordably until they begin their careers. Single rates for student graduates are very reasonable and definitely affordable as you begin your search for a lifetime career or continue your education.

Contact Health Insurance Solutions for a no-hassle, no-obligation quote. Do not let time go by without adequate healthcare coverage in the event of accident or illness. You will receive a personal quote with options explained clearly and concisely - free!

ATTENTION BROKERS - INITIATE OR CLOSE A PROPOSAL WITH PHARMACY CARVE-OUT
Posted: 10/5/2008 9:36:54 AM | By: Admin User
File Under: HISI News

ATTENTION BROKERS !!! - INITIATE OR CLOSE A PROPOSAL WITH PHARMACY CARVE-OUT

Health Insurance Solutions is a leading provider of pharmacy and medical management services to employers nationwide - from small local municipalities to automotive dealerships to large school districts with multiple union contracts. Our clients benefit from a variety of comprehensive services offered, from case review, billing, COBRA, self-funding, to claims processing while managing pharmacy trends and costs.

With the sharp rise in benefits costs, particularly pharmacy drug, our most effective tool is PHARMACY CARVE-OUT from your medical benefits package. The potential for savings is substantial and targeted savings are accurate and predictable because of our underwriting skills and experience.

Health Insurance Solutions is a pharmacy benefit expert with extensive resources. Our focused carve-out solution gives your clients a much higher value than is possible with a direct PBM arrangement. Focused carve-out gives employers a higher level of direct decision-making power in areas such as plan design and formulary. It includes enhanced pharmacy reporting, enabling us to observe trends at a detailed level, and make recommendations for your clients.

Additional benefits of Pharmacy Carve-Out include:

No added burden for client Human Resources staff
Ability to administer current benefit
Choices in retail pharmacy coverage
Real-time support as Rx is filled
Integration of Rx and medical data
Demonstrated clinical management and cost containment
Service aggregation for best solution fit and deepest discounts possible
Seamless employee transition
Competitive prescription benefit plan markets
Proactive prescription management
Cost containment driven by business intelligence and trend plans
Risk reduction
Dedicated customer service and account management
Solutions for employee health behavior modification

Brokers, if your clients are experiencing escalating bundled health benefit costs, particularly pharmacy, we will develop a strategy that will reduce overall benefits costs, better manage drug spending, and even improve the quality of care for your client's employees. You will have a clear, distinct advantage over conventional proposals. Give us an opportunity to team up and give yourself a real, proven competitive edge. AND, your bottom line will not be affected.

Click on "Pharmacy Carve Out" on our Home Page Site Map for more detailed information.

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Independence Blue Cross - eBulletin - FutureScripts Sold to Catalyst Health Solutions, Inc. Date: August 5, 2010