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Archive for April, 2009

In the Los Angeles Times (4/27) Opinion LA blog, Jon Healey wrote, “Paying more doesn’t guarantee getting better healthcare; in fact, there may be no relationship at all. Just look at the United States, which spends far more than any other country on healthcare, but still trails in some key indicators.” Yet, he noted, this “wide variation in the cost of healthcare also creates opportunities for those willing to travel in search of a better deal.” For instance, “WellPoint is conducting a pilot with Serigraph, Inc., a specialty graphics company with operations in Wisconsin, Mexico and Asia, that gives US employees the option to travel to India to have surgery on a non-emergency basis.” Notably, “the India option makes sense for Serigraph…given that a number of its employees come from that country.” In addition, the “cost of care is about 80 percent lower, largely because of dramatically lower charges for labor, drugs, and medical devices.” And, WellPoint contends “that the results of the care were at least as good.”

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On the front-page of its Personal Journal section, the Wall Street Journal (4/28, D1, Fuhrmans, subscription required) reports that companies have had “limited success” with paying employees to “stop smoking or lose weight,” and are “rewriting the rules.” Rather than “encouraging good behavior with small or one-time payments, some health and wellness plans have begun enrolling employees in lotteries for a chance to win a bigger reward. Other programs are testing whether workers are more likely to make healthy choices if they’ve staked some of their own money on the outcome.” For example, in a study currently in progress, workers at Pittsburgh-based MED3000 are participating in a lottery in which employees will be eligible for cash rewards and gift cards for completing health assessments. MED3000 will also be participating in “a weight-loss program” in which participants “will be asked to put their own funds at stake” toward achieving a weight-loss goal. Notably, a similar study, published in the Journal of the American Medical Association found that participants who put up their “own money lost an average 14 pounds” compared to members of a lottery group, which “lost 13.1 pounds” and a group with no incentives, which lost “just 3.9 pounds each.”

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The Denver Business Journal (4/27) reports, “Despite rising healthcare costs, employers in Colorado and Wyoming pay an average of 85 percent of the premiums for their workers’ health coverage, says a survey released Monday by the Mountain States Employers Council.” Michael Severns, the council’s president and CEO said, “Healthcare costs continue to be a major area of concern for employers.” As healthcare costs rise, “employers are increasingly turning to consumer-driven healthcare plans as part of employees’ benefit packages, such as health savings accounts (HSAs) and health reimbursement arrangements (HRAs).”

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For those employers who have terminated employees beginning with September 1, 2008 through 2009, ex-employees will only pay 35% of the continuation premium.  The government will give a subsidy to pay the other 65% for up to 9 months beginning March 1, 2009. 

Please advise if you have terminated employees for us to advise the next step.

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I’m often asked when conducting employee benefit meetings, what are a few steps we can all take to save money at the time of service or to help prevent unnecessary out-of-pocket expenses.  So many individuals have moved to higher deductible plans (weather by choice or not) that its now more important than ever to take extra time and ask questions than can potentially save you money.    Here are a couple of idea’s.

  • Tell your doctor if your insurance plan has a high deductible and ask if there are any ways to save money.  Physicians save on costs too if you pay cash at the time of service and will often offer an additional discount (very prevalent in dental and orthodontia services as well and in most cases, you may be able to utilize your FSA/Flex/Cafeteria Plan to help with the cash flow).
  • When an expensive test or procedure is ordered, ask if the results will change the treatment plan or if a decision can be made without the test. (You can also call the accounting department of a hospital or clinic and ask them the average cost of a procedure in most cases).Get a Second Opinion
  • Ask about the risk and benefits of taking a less expensive option if one is available.
  • Tell your doctor you’d like to seek a second opinion before you agree to a major test or procedure.  Often in my industry, we hear many examples of when a second opinion was obtained, surgery was cancelled or alternate methods were taken with great results.  In most cases, your health insurance plan with pay a higher benefit for second opinions as they see the justification for these services too.  If the second opinion physician agrees, then you have justification medically to more forward.
  • When your doctor prescribes a medication, ask if there is a generic or over-the-counter (OTC) available.  If they say no, ask if there is a  version available that is an “equivalent” drug in the same class that may have a generic or OTC available. 
  • Check your local stores for offers of free or $4 prescriptions for selected medications.
  • If your health plan offers mail-order prescription services, you may be able to save if you buy a 90-day supply of a medication you take regularly.  Typically you will pay a 2 or 2 1/2 month copay for a 3 month supply.  The prescription must be written as a 90-day supply or the mail order pharmacy will not accept.

Jacquey Tabcum
Vice President, Sales & Marketing
Trilogy Benefits, Inc.
www.trilogybenefits.com

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