Archive for March, 2009

Trilogy Benefits, as members of Metro Denver Association of Health Underwriters, assisted in answering phone calls along with Child Health Plan plus and the Colorado Department of Health Care Policy and Finance.  Jacquie Healy, Kathy Minister and Jacquey Tabcum offered assistance to callers concerning availability of health insurance plans for individuals and other services for those unable to qualify for traditional health plans.  Tuesday’s Health Insurance Helpline 9 was sponsored by 9 News, Rocky Mountain PBS and the Colorado Health Foundation.

Over 800 phone calls came in during this 3 hour period and with that in mind, access to a Toll Free line has been set-up to assist individuals who have additional questions – 1-877-230-2009, Option 1.

Additional dates are being set to offer this service to Coloradans again.

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NAHU Newswire

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Today’s News for the National Association of Health Underwriters from Newspapers, TV, Radio and the Journals


Customized Briefing for Jacquey Tabcum

March 24, 2009

Leading the News
Legislation and Policy

Public Health and Private Healthcare Systems
Also in the News




Study suggests one in five workers uninsured.

The AP (3/24, Alonso-Zaldivar) reports that “nearly one in five workers is uninsured, a statistically significant increase from fewer than one in seven during the mid-1990s,” according to a study released today by the Robert Wood Johnson Foundation. The researchers say “the problem is cost. Total premiums for employer plans have risen six to eight times faster than wages, depending on whether individual or family coverage is picked.” The study found that “about 20.7-million workers were uninsured in the mid-1990s. A decade later, it was 26.9 million, an increase of about 6 million.” Hence, in the “1990s, there were eight states with 20 percent or more of the working age population uninsured. Now there are 14: Alaska, Arizona, Arkansas, California, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina and Texas.” The report entitled, “At the Brink: Trends in America’s Uninsured 1994-2007” chronicles state-by-state health coverage trends.

        USA Today /AP (3/24) points out that the RWJF study, which was “conducted by the State Health Access Data Center” found that “about one in five Nevada workers have no health insurance.” The study shows “19.8 percent of Nevada workers ages 19 to 64 had no health insurance in 2006 and 2007. That’s slightly higher than the national average of 18.4 percent.” The study shows “the worst states on the list are Texas and New Mexico, each with about 28 percent of their workers uninsured. The best states are Hawaii at nine percent and Massachusetts at 9.4 percent.”

        Little change seen in Utah’s uninsured rate from 2007 to 2008. The Salt Lake Tribune (3/24, McCann) reports that some 10.7 percent, or 298,200, of Utahans had no healthcare coverage in 2008, “a rate that essentially remained steady from 2007, according to a newly-released state study. Results of the annual Utah Healthcare Access Survey showed a small increase of an additional 11,000 Utahns without coverage. But healthcare advocates believe the state’s results undercount the uninsured, arguing the survey via land line phones isn’t as effective in reaching low-income families or young adults who use only cell phones.” The piece continues to note the “good news” that the rate of uninsured children declined by 13 percent.

        The AP (3/24) adds that the Utah Healthcare Access Survey was “released as part of Cover the Uninsured Week.”

        Study reveals more employees look to workplace benefits for financial safety. The Boston Globe /AP (3/24) reports, MetLife’s 7th Annual Employee Benefits Trends study released Monday “shows workers are relying more than ever on workplace benefits to be their financial safety net.” The study found that “46 percent of workers surveyed say they are taking a greater interest in understanding the benefits they get through their employer. More than half say they appreciate the benefits more than ever before, and 41 percent said their workplace benefits are the foundation of their financial security.” Still, at least “one-third of workers are worried that their company will cut benefits in the next 12 months although the study shows only 15 percent of employers said they planned to make such cuts.”


Do you really know all the benefits of being a member of NAHU? In these economic times, your membership is more important than ever before. We encourage you to share with your coworkers, friends and acquaintances the important role membership in NAHU plays in the health care insurance industry.

Here are just a few of the reasons to encourage others to join NAHU:

  • Your voice in Washington-Each year, NAHU spends over $1,000,000 to represent your interests before Congress and regulatory agencies. This representation is especially critical now to ensure that private health insurance not only thrives, but is also enhanced, and that agents, brokers and consultants continue to have a role in working with both business and individual consumers on their health insurance needs.
  • HUPAC-It’s important to get the right people elected to office, and in these times when campaigns are won or lost on television, it takes a lot of money to make that happen. Since NAHU and similar organizations are prohibited from making political contributions, HUPAC was created to allow contributors to combine their financial support to candidates to achieve maximum effect.
  • Educational opportunities-In an ever-changing market, NAHU provides members with premier educational opportunities to help them stay informed about important issues and policy changes and to help them bring more value to their clients.
  • Publications-Members receive free issues of our award-winning HIU magazine and a variety of newsletters that keep you informed on industry news, business opportunities, as well as legislative and regulatory issues.
  • National meetings-Twice a year, NAHU provides members with the opportunity to really make a difference in their industry. Our Capitol Conference in Washington, DC, brings the voice of our members directly to lawmakers. Our annual conference which will be held in New York City this year offers outstanding general session speakers and educational sessions in addition to providing a venue for our annual business meeting and chapter leader training.

Encourage your friends and coworkers to visit NAHU’s website and become a member.

Tip of the Hat: Thank to you our Capitol Conference Gold Sponsor Assurant Health. For information on exhibiting or sponsoring at our 2009 Annual Convention, please contact Dianne Sautkulis at dsautkulis@nahu.org.

White House holds healthcare forum in Des Moines.

In its 44 blog, the Washington Post (3/23) noted that the third Regional White House Forum on Health Reform began Monday, “in which policy experts, business executives and others tasked by President Obama to devise plans to improve our nation’s healthcare system [gathered] to exchange ideas.” The group met “in Des Moines, Iowa and director of the White House Office on Health Reform Nancy-Ann DeParle” represented the administration.

        The AP (3/24, Glover) adds that at the forum, DeParle “told hundreds of people” that the “nation’s economic crisis merely adds to the urgency of reforming the healthcare system…arguing that the administration has learned from past mistakes and will succeed in this effort.” Afterwards, “President Barack Obama addressed the forum via videotape, and said fixing healthcare is a key to jump-starting the economy.” He also “stressed his process would be open to different viewpoints. The last large-scale health reform effort under President Bill Clinton was criticized for being written largely in secret with little outside involvement.” The Des Moines “meeting was hosted by Iowa Gov. Chet Culver, a Democrat, and South Dakota Gov. Mike Rounds, a Republican. They were joined by Democratic US Sen. Tom Harkin, Iowa legislative leaders and more than 500 healthcare activists who support reforms.”

        Dow Jones Newswires (3/24, Yoest) adds that at the meeting “DeParle expressed confidence that Congress and the president could agree on health overhaul legislation this year. In the past, proponents of changes to the healthcare system have simply left the bargaining table without attempting to compromise, according to DeParle.” Meanwhile, Sen. “Harkin, a senior member of the Senate Health, Education, Labor and Pensions Committee, said efforts are well under way in Congress to pass a bill by the end of the year. Harkin said the health panel has a May 22 deadline by which senators have to submit input on legislation, which he said would be followed quickly by consideration of a healthcare bill by the full committee.”

        Single-payer protestors seize attention at Des Moines forum. Local TV coverage of the Health Forum in Des Moines was thin, and not covered as a top story. NBC’s WHO-TV (3/23, 11:07 p.m. EST) focused primarily on the small group of single-payer protestors gathered outside, one of whom wielded a placard that read: “health insurance is not healthcare.” WHO reported, “An Obama Administration healthcare forum hosted by Governor Culver this morning in Des Moines attracted dozens of protestors. The head of the White House Office of Health Reform came to Des Moines today to hear Iowans’ concerns about the nation’s healthcare system … but a group of doctors and nurses said the administration has already ruled out a single-payer system that they say would create truly universal healthcare.”

        The FOX affiliate KDSM-TV (3/23, 10:37 p.m. EST) went into slightly more detail, reporting that the Des Moines event was “the third of five forums the Obama Administration is holding across the country.” But FOX also focused on the “dozens of angry Iowans” outside the event who were “shouting for the President to hear their pleas.” One protestor, Dr. Jess Fiedorowicz from the University of Iowa, told FOX that Obama’s plan “does not truly cover everyone.” FOX reports that the single-payer advocates were pushing a plan that was “kind of like Medicare for everyone that needs it.”

        CBS’ KCCI-TV reported that Nancy-Ann DeParle, Obama’s healthcare advisor “listened carefully for two hours as people from all over the region talked about what was wrong with the current healthcare system, and she heard lots of suggestions for changes.” The report also noted that it was not too late to weigh in, listing De Parle’s website. KCCI-TV closed with a mention of the single-payer protestors, including footage of a small group chanting “Nobody out! Everybody in!”

        The only local station to ignore the protestors entirely was the ABC affiliate, WOI-TV (3/23, 11:04 p.m. EST), which devoted only a brief 40-second story to the forum, noting that the event covered “everything from prescription drugs and digitized medical records… to the importance of preventative care and oral health.” The piece closed with a sound bite from Senator Tom Harkin who told those in attendance, “I just want you to know this is not something we’re going to kick the ball down the field, this is going to happen this year.”

Health insurance lobbyists warn premiums may increase under Obama’s proposed Medicare Advantage cuts.

CQ Healthbeat (3/24, Adams) reports, “Health insurance industry lobbyists warned Monday that seniors could face significant premium increases next year if the Obama administration does not change its proposed cuts to insurance plans participating in Medicare.” The warning by the Blue Cross Blue Shield Association “underscores the tensions between Democrats and the insurance industry as Congress prepares to write comprehensive healthcare legislation.” Medicare Advantage “has been a target of the administration as it looks for ways to shave healthcare costs.” In addition, the BCBS Association called on CRS “to revise its proposed 2010 payments,” otherwise, it warned, “seniors who are enrolled in the Medicare Advantage program could face premium increases or benefit reductions valued at $50 to $80 per month,” a hike that would be “devastating.”

Bill would mandate study of Nevada’s Medicaid system.

The AP (3/24) reports, “Senate Health and Education Committee members were urged Monday to support a bill calling for a study of Nevada’s Medicaid system. The panel was told the study mandated by SB307 would be the first of its sort for the program, which provided insurance to an average of more than 180,000 people, including the elderly, disabled, children, and pregnant women, in fiscal 2008.” This endeavor “would determine how Nevada can keep the Medicaid program going, and look at rates that Medicaid charges in Nevada, compared with other states. Nationally, the state Medicaid program ranks 51st in per-capita spending, and is near the bottom in enrollment.”



Kansas House approves Sebelius’ plan to expand SCHIP.

The AP (3/24) reported that the “Kansas House has endorsed Gov. Kathleen Sebelius’ (D) proposal to expand a state health insurance program for children.” On Monday, the Kansas House ‘voted 75-48…for an amendment to add Sebelius’ plan to a bill containing a proposed state budget for the fiscal year that begins July 1.” The amendment would “use $1.2 million in federal stimulus funds to expand the State Children’s Health Insurance Program.”

        The Kansas City Star (3/23, Klepper) Prime Buzz blog added that the “move would bring the state an additional $6 million in federal funds.” In all, “the money would allow the state to raise eligibility for SCHIP to 250 percent of the federal poverty level. For a family of four, that’s about $55,000 in annual income or less. (Right now eligibility tops out at 200 percent of the federal poverty level).”

        In a separate story which also discusses education funding, the AP (3/23, Hanna) noted that the proposal “to expand the state’s health coverage for children had bipartisan support.” Still, “some Republicans suggested an SCHIP expansion would encourage families with private insurance they can afford to drop it in favor of government coverage.”

        Michigan may not expand SCHIP before 2011, state official says. Crain’s Detroit Business (3/24, Greene) reports, “Michigan expects to receive $50 million in additional federal funds in the next several weeks from the recently approved State Children’s Health Insurance Program Reauthorization Act of 2009, said acting state Medicaid Director Steve Fitton.” However, he added that he “isn’t sure when the money will arrive.” According to Michigan’s Department of Health, “Approximately 31,389 children are covered in MIChild, a program that began in 1998 to decrease the estimated 160,000 children without health insurance in Michigan,” while “another 928,909 children are enrolled in the Medicaid program.” However, Fitton said that the state “won’t come up with any kind of plan to expand eligibility or dramatically increase the number of covered children until fiscal 2010 and 2011.”

GAO report indicates evidence that SCHIP crowds out private insurers is unclear.

CQ Healthbeat (3/24) reports on a new GAO report which seeks to determine the degree to which “the availability of health coverage” under SCHIP “crowds out” private insurance. The report “says the available evidence on the issue is unclear” and that CMS “should improve its efforts to assess whether crowd-out is a concern in SCHIP.” In order to gain better understanding of the situation, “GAO studied a sample of nine states representing 40 percent of SCHIP enrollees in 2007.” Investigators found that “none of the officials from the sample states viewed crowd-out as a concern.”


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Wisconsin attorney general says Pfizer unit should pay $225 million for overcharging state Medicaid.

Bloomberg News (3/24, O’Reilly) reports, “Pfizer Inc.’s Pharmacia unit should pay $225 million in compensation, punitive damages and interest after a jury found it illegally overcharged Wisconsin’s Medicaid program for drugs, the state’s attorney general said.” According to court documents, “Wisconsin Attorney General J.B. Van Hollen recommended the company be ordered to forfeit $100 to $200 for each of the more than 1.4 million times the company was found by a jury to have violated Wisconsin’s Medicaid Fraud law.” Last month, jurors “found that Pharmacia should pay $9 million plus interest to compensate the state for overcharges using the Average Wholesale Pricing (AWP) system.” But, “a judge will hear arguments in May on the amount of profit that should be forfeited as a result of the violations.”

        Wisconsin’s Journal Sentinel (3/23, Boulton) reported, “The lawsuit centers on the complex formula used to determine what Medicaid should pay for prescription drugs.” The company was accused of providing “fraudulent information on their prices to inflate payments.” For its part, however, “Pfizer reiterated its position that it adhered to all applicable laws and regulations.” The company stated that it “strongly disagrees with the excessive demand proposed by the State of Wisconsin in its recent court filing.”

Data indicate number of Americans without adequate healthcare up by four million.

The Washington Times (3/24, Lengell) reports that a study to be released Tuesday by the National Association of Community Health Centers “shows that the number of Americans without access to adequate healthcare increased last year by 4 million.” The report notes that “the number of medically disenfranchised grew three times faster than population growth, a sign…that access to primary care is worsening and even reaching the doorstep of middle-class America.” Last week, the “Department of Health and Human Services announced…it would spend $268 million that was included in the $787 billion economic stimulus package passed by Congress last month ‘to support hospitals serving uninsured, vulnerable Americans.'” Hospitals “that serve a disproportionate share of low-income or uninsured individuals and are known as Disproportionate Share Hospitals (DSH)” are eligible. “The stimulus measure increased the amount of federal money states receive for DSH hospitals to $11.33 billion for 2009, compared with $11.06 billion the previous year.”

Patients with Alzheimer’s have higher healthcare costs than other seniors, study shows.

The AP (3/24, Tanner) reports, “The healthcare costs of Alzheimer’s disease patients are more than triple those of other older people, and that doesn’t even include the billions of hours of unpaid care from family members, a new report suggests.” Data show that, “compared with people aged 65 and older without Alzheimer’s, those with the mind-destroying disease are much more often hospitalized and treated in skilled-nursing centers. Their medical costs also often include nursing home care and Medicare-covered home health visits.” Overall, this “adds up to at least $33,007 in annual costs per patient, compared with $10,603 for an older person without Alzheimer’s, according to a report issued Tuesday by the Alzheimer’s Association

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angry-adultLosing your temper not only alienates others, it can contribute to health problems, including headaches, upset stomach and heart attack.  Here are a few tips that can help you take control of these outbursts at home and in the workplace:

  • Count to 10  When something angers you, give your body time to defuse before you react. Take three or four deep breaths and ask yourself, “will this really matter a week or a month from now?”
  • Walk it off  Go for a short stroll until you calm down. Find a quiet place where you can think things through calmly and take a second look at how you’re reacting to a situation.
  • Distract yourself  It’s easy when driving to work to pound on the horn when traffice is moving your way.  Try playing soothing music or listening to an upbeat program.  At work, dive into a task to turn negative energy positive.
  • Keep a log  Monitor hostile thoughts to discover how frequently your temperature rises.  This will help you sort out the real causes of your anger, which are often things over which you have no control.
  • Ask for help  If managing outbursts seems impossible, don’t be afraid to try counseling, meditation, lifestyle changes or other kinds of ongoing psychological help.  Your health AND your relationships may depend on it.

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FOR IMMEDIATE RELEASE: Tuesday, March 10, 2009

Lawmakers look to make health care more affordable; allows insurers, for the first time, to offer discounts/rewards to small businesses for participation in wellness

DENVER — Looking for another way to stem rising health care costs, the Colorado Senate passed a bill Tuesday allowing insurers to offer discounts and financial incentives to small businesses and/or their employees who participate in wellness and prevention programs.
House Bill 1012 — sponsored by Rep. Joe Rice, D-Littleton, and Rep. Amy Stephens, R-Colorado Springs — allows insurers to provide premium discounts or rebates, reduced co-payments and deductibles, or other incentives for participation in a range of programs designed to help employees improve their health. Those programs, for example, could help employees quit smoking, lose weight or manage stress.
Current law prohibits insurers from offering these kinds of incentives or rewards to small businesses and/or their employees, as well as to people in the individual market. The Senate sponsors of the bill are Sen. Shawn Mitchell, R-Broomfield, and Sen. Linda Newell, D-Littleton.
“Right now this kind of discount is illegal,” Mitchell said. “We talk an awful lot about trying to make insurance affordable, but we don’t do very much about it. House Bill 1012 actually does something about it.”
Experts, including the Partnership for Prevention, have identified smoking, obesity and substance abuse as among the top areas in which employers can save lives and reduce health care costs. According to the American Heart Association, U.S. employers face $12.7 billion in annual medical expenses due purely to obesity.
“House Bill 1012 is a creative way to help make health care more affordable at a time when premiums are up and state revenues are down,” said James Sugden, legislative co-chair of the Colorado State Association of Health Underwriters. “We know offering discounts and incentives are an effective way to encourage people to make healthier choices, and those choices can lead to a number of benefits, including lower health care costs.
Large employers have long benefited from wellness and prevention programs, but current law prohibits insurers from offering discounts and other incentives to small employers and their workers who participate in wellness and prevention programs.
“This would allow for some flexibility for the carriers to do the same thing in the small-group market where they are not able to do so now,” said Ben Price, executive director of the Colorado Association of Health Plans.
For the purposes of insurance regulation, small employers are sole proprietors and businesses with 50 or fewer workers. House Bill 1012 also applies to the individual market.
HB 1012 defines “wellness and prevention program” as a program designed to promote health or prevent disease. Insurers and employers are allowed to decide what kind of programs would qualify for financial incentives, but some examples include:
·   Health screenings
·   Internet, telephone-based or live coaching; or consultation-based wellness programs
·   Education and training about dietary habits
·   Lunch-and-learn seminars on health and wellness topics, wellness handouts, a wellness library, videos, or newsletters and a wellness intranet site
·   Wellness programs geared only to children
·   Corporate health fairs that may combine health screenings with educational opportunities
·   Stress management programs
·   Employee Assistance Programs for employees and their families
·   Disease management
·   Diabetes Care programs
·   Tobacco cessation programs
·   Nurse-on-call programs
·   On-site or external health club or fitness center memberships or facilities.
In addition to improving people’s health, these initiatives also save employers money. According to the Small Business Wellness Initiative, research suggests that for every $1 invested in health promotion, a company can save up to $3 to $5 in health and safety costs, such as medical expenses, absenteeism and workplace accidents.

About the Colorado State Association of Health Underwriters
The Colorado State Association of Health Underwriters (CSAHU) is a professional organization of agents and insurance company representatives. These professionals meet with businesses and consumers every day to discuss their health insurance needs and options, and help them select appropriate coverage. They are also the messengers that ultimately deliver premium renewals, making them knowledgeable about issues facing employers and consumers. They have a mediator role with the health insurance carriers and advocate on behalf of their clients. CSAHU has taken an increasingly active role in the Legislature to educate elected officials on how “band-aid fixes” affect today’s health insurance market.

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