Saturday, October 31, 2009

Aetna Signs Agreement with WellStar Health System

(BUSINESS WIRE)--Aetna (NYSE: ΑET) and WellStar Health System of Marietta, Ga. announced today that they have reached agreement on a three-year contract that provides access for Aetna’s Medicare Advantage members to the hospital’s facilities and physicians.

Under this new agreement, Aetna Medicare Advantage plan members will be able to receive covered services, at in-network rates, from WellStar facilities in the greater Atlanta area. Earlier this year, Aetna and WellStar reached agreement on a contract that applied to members of Aetna’s commercial plans. Aetna members also will be able to continue receiving covered services from WellStar physicians.

“Aetna is very pleased to expand its relationship with WellStar,” said Ramzy Elgomayel, Aetna’s vice president of network operations for Georgia. “WellStar has provided excellent care to our commercial-plan members for several years, and we’re delighted to be able offer in-network access to their facilities and providers for our Medicare Advantage plan members.”

“The expansion of the Aetna contract to cover the Medicare Advantage members further solidifies our relationship,” said Barbara Corey, senior vice president of managed care for WellStar. “We look forward to providing exceptional health care services to these members.”

Aetna provides health benefits to approximately 600,000 members in Georgia. Those members have access to a network that includes 80 contracted hospitals and more than 9,500 primary care physicians and specialists.

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Friday, October 30, 2009

Policymakers Have Many Options to Make Social Security Both Solvent and More Adequate

/PRNewswire/ -- Social Security, the foundation of economic security for millions of America's seniors and working families, can be made more adequate and solvent for the long term, according to a new report released today by the National Academy of Social Insurance (NASI).

The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.

"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.

"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."

Benefit adequacy options in the report target such financially vulnerable groups as:

-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.

Other adequacy options would increase benefits across the board for current and future beneficiaries.

Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.

A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."

The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.

The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.

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Thursday, October 29, 2009

New Report Highlights How Health Insurance Reform Will Reduce Costs for Small Businesses

HHS Secretary Kathleen Sebelius today released a new report, "Lower Premiums, Stronger Businesses: How Health Insurance Reform Will Bring Down Costs for Small Businesses." The report outlines the many ways health insurance reform will lower health care costs for small
businesses and is available now at

"Small businesses drive our economy and create jobs, but they are struggling as health care costs continue to rise," Secretary Sebelius said. "The high cost of care is making it difficult or impossible for these businesses to offer care or grow their business. Health insurance reform will bring costs down and give small businesses the relief they need."

The report notes:
* Small businesses, the backbone of job creation in our economy,
are disproportionately burdened by the financial strains caused by
rising health care costs. On average, small businesses pay up to 18
percent more than large firms for the same health insurance policy. This
difference is due in part to high broker fees (which can be up to 10
percent of premiums), and health plan administrative costs that are
three times those in the large group market.
* In a recent national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
* Nearly half of workers covered by a small business employer have
insurance that limits the total amount the plan will pay for medical
care and nearly one in ten small business workers have a health plan
that does not offer prescription drug coverage.
* Workers in small firms are more likely to shoulder burdensome
out-of-pocket health care costs. Thirty-six percent spent more than 10
percent of their household income on out-of-pocket medical expenses in
2007, compared with 27 percent of workers in larger firms.

Health insurance reform will bring down costs for small businesses by creating a health insurance exchange, providing a small business tax credit, ending the "hidden tax" on small businesses that provide health insurance and preventing arbitrary premium hikes. Reform will also ensure Americans have stable, secure insurance coverage, limit out-of-pocket spending and eliminate caps on benefits.

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Wednesday, October 28, 2009

Selecting Medicare Coverage: Four Considerations to Help Seniors Choose

/PRNewswire/ -- Open enrollment, the six-week period during which seniors can select healthcare coverage for 2010, begins Nov. 15. Health plans have begun sharing their costs and coverage, but making a choice can be a daunting task. Here are four considerations to help Medicare-eligible seniors select which Medicare coverage best meets their individual needs:

1. Understand the A, B, C and Ds of Medicare. There are four primary parts
to Medicare. Parts A and B cover hospital and medical expenses,
respectively. Parts C and D provide benefit and prescription drug
coverage through health insurance companies that are approved by
Medicare. Medicare Advantage plans include all of the coverage offered
by Parts A and B and can include prescription drug coverage under Part
2. Compare costs. Premiums can range for $0 to hundreds of dollars per
month, depending upon the type of organization (nonprofit or
for-profit) and the type of coverage. Total plan costs include
premiums, co-payments and deductibles for everything from preventive
care to hospitalization.
3. Compare benefits and doctors. Does the plan have a large network of
doctors and specialists for you to choose from? Is your doctor and
preferred hospital in that network? Does the plan cover your
prescription medications?
4. Compare quality. Call the customer service number for the plans you're
considering. Does a live person answer the phone? Are they friendly,
helpful and knowledgeable? Does the plan offer value-added programs
that help you maintain or improve your health and independence? Does
the plan offer services to help your loved ones take care of you if
needed? Will the plan coordinate your care between doctors and

Selecting Medicare coverage is an important decision, especially since Medicare rules indicate that members must maintain the coverage they've chosen for an entire year. Seniors currently enrolled in Medicare Advantage plans will soon receive letters from their health plans explaining any changes in coverage for 2010. "We recommend that people read this letter thoroughly to avoid any surprises in the coming year," said Tom Lescault, president of SCAN Health Plan Arizona. "Changes in government funding has forced many health plans to reduce benefits or increase costs. People need to make sure they are able to make informed decisions during open enrollment."

As part of an ongoing commitment to improving the lives of seniors, SCAN Health Plan Arizona is an exclusive sponsor of "Healthy Tips for Successful Aging" with ABC 15. Each week, the station airs 30-second health tips provided by SCAN. The health plan also is the exclusive studio sponsor for KOY radio and co-hosts "Senior Focus," a broadcast dedicated to senior-related issues.

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Tuesday, October 27, 2009

Overriding State Insurance Protections Should Not Be Part of Financial Re-Regulation Package, Writes Consumer Watchdog to Geithner, Frank

/PRNewswire/ -- Consumer Watchdog sent a letter to Treasury Secretary Geithner, House Financial Services Committee Chair Barney Frank, and Financial Services Subcommittee Chair Paul Kanjorski today, arguing that legislation intended to undermine state insurance protections (H.R. 2609) is inconsistent with the re-regulatory promise of the financial reform package. The bill will be marked up in the House Financial Services committee today.

"We are at a loss to understand why you have proposed a measure to deregulate the insurance industry by preempting state laws as part of the financial re-regulation package," wrote Consumer Watchdog. "Each version of the bill would restrict the ability of state lawmakers and regulators to protect insurance consumers by granting the Treasury Department and a new Federal Insurance Office the authority to preempt state laws and regulations on prudential matters on behalf of foreign insurance firms."

"This proposal is even more perplexing in light of the strong fight, on the part of both the administration and majority members of the Financial Services committee, to preserve states' ability to protect their citizens during the debate over the Consumer Financial Protection Agency," the letter continued.

As Assistant Treasury Secretary Michael Barr put it to the Washington Post last week:

"'Washington doesn't always know what's best'... He said the administration wanted to restore the right of states 'to protect their citizens with the rules that they think make sense.'"

"If Washington doesn't always know what's best for American consumers, why would you expect foreign diplomats and regulators to know what's best for American insurance policyholders?" asked Carmen Balber, Washington Director for Consumer Watchdog.

The letter concludes: "Wall Street firms are again riding high a year after the crash, but the rest of the country continues to suffer rising foreclosures, increased unemployment, and a dearth of credit. With American homes, jobs and businesses already on the line, now is hardly the time for Congress to place our insurance policies at risk as well."

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Friday, October 23, 2009

Sebelius Releases New Report on Benefits of Health Insurance Reform for Women with Breast Cancer

As Americans mark breast cancer awareness month, Secretary of Health and Human Services Kathleen Sebelius today released a new report, Health Insurance Reform and Breast Cancer: Making the Health Care System Work for Women. The report details how health insurance reform will help women diagnosed with breast cancer and is available now at

"Thousands of women and their families are impacted by breast cancer," Secretary Sebelius said. "We are fighting for health reform that will help improve treatment for women with breast cancer and doing all we can to encourage women to take the simple steps that can help prevent this disease."

The new report highlights the problems in the health care status quo that significantly impact women who are diagnosed with breast cancer or are breast cancer survivors. The report notes:

* Breast cancer is the second leading type of cancer among women.
The disease will affect one in eight American women during their
lifetime, with treatment costs totaling $7 Billion in 2007.

* Breast cancer patients with employer-based insurance had total
out-of-pocket costs averaging $6,250 in 2007, higher than out-of-pocket
spending for patients with asthma, diabetes, chronic obstructive
pulmonary disease (COPD), or high blood pressure.

* Breast cancer patients, even when in remission, are unlikely to
find meaningful insurance coverage in the individual insurance market. A
full 11 percent of individuals with any cancer said they could not
obtain health coverage in the individual insurance market.

"Today, breast cancer patients incur thousands of dollars in debt, and breast cancer survivors struggle to get the affordable care they need," Sebelius added. "Health insurance reform will bring costs down, make care more affordable and prevent insurance companies from discriminating against breast cancer survivors."

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Wednesday, October 21, 2009

Humana Will Cover H1N1 Vaccine for Members

(BUSINESS WIRE)--Humana Inc. (NYSE: HUM) today announced that the company will cover the administration cost of the H1N1 (swine flu) vaccine for all fully insured members including those members who have a benefit plan that excludes immunization coverage. All co-payment, coinsurance and deductibles will be waived for the administration of the H1N1 vaccination regardless of the preventative-services benefit currently provided in these members’ plans.

“The safety and well-being of our health plan members, country, communities and associates is of utmost concern to Humana,” said Lisa Weaver, M.D., Humana segment vice president, clinical strategies. “Our initial focus is to encourage the CDC-identified priority groups to get vaccinated.”

Humana is taking this step to support its members’ ability to get the vaccination. The company will continue to monitor and respond to guidance from the Centers for Disease Control and Prevention. For the most up-to-date H1N1 information, log on to their website: To reach the CDC by phone call 800-CDC-INFO (800-232-4636) or email:

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Tuesday, October 20, 2009

Sebelius, Mills Release New Report Insurance at Risk: Small Business Employees Risk Losing Coverage

Secretary of Health and Human Services Kathleen Sebelius and Small Business Administration Administrator Karen Mills today released a new report, Insurance at Risk: Small Business Employees Risk Losing Coverage. The report examines the health care status quo that has left
employees at risk of losing their insurance and underscores the financial difficulties small businesses face when providing health insurance to their employees. The complete report is available now at

"More Americans who work for a small business have lost their health insurance coverage, and those who still have coverage have seen their costs go up," said Secretary Sebelius. "Health insurance reform will drive costs down and make it easier for small business owners to give
their employees the quality coverage they need."

"The cost of health insurance is the number one concern of small business owners. On average, small businesses pay 18 percent more than big businesses for the same health insurance policy. This has left small business owners in an untenable situation, having to choose between their employees, who are often like family to them, and the bottom line," Administrator Mills said. "Health care reform will provide small business owners with greater access to the affordable, quality coverage they want and need for themselves and their employees."

The report notes:

* Employees of small businesses are 50 percent more likely to lose
coverage as workers at large businesses. Half of workers in small firms
that do not offer health benefits remain uninsured.
* Premiums for employer-based health insurance have more than
doubled since 2000, rising three times faster than wages. As a result,
fewer small businesses provide coverage for their employees. In 2000, 57
percent of firms employing less than 10 workers provided coverage. In
2009, only 46 percent of similar-sized firms provided coverage.
* In one national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason, and on average small businesses pay up to 18 percent more than
large firms for the same health insurance policy. This is due in part to
high broker fees (which can be up to 10 percent of premiums) and health
plan administrative costs that are three to four times those in the
large group market.

Health insurance reform will stabilize health insurance coverage for Americans who work for small businesses. Health insurance reform will provide small businesses with tax credits to help them provide health insurance for their employees. This will make health care more affordable for small businesses and their workers, solidifying and strengthening employer-based coverage for years to come.

Health insurance reform will also create a health insurance exchange so Americans without access to affordable insurance on the job can compare prices and health plans and decide which quality affordable option is right for them. The exchange will also significantly reduce
administrative costs for small businesses by enabling them to easily and simply compare the prices, benefits, and performance of health plans.

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Thursday, October 15, 2009

Blue Cross and Blue Shield of Georgia to Provide First Dollar Coverage of H1N1 Vaccine for All Members

/PRNewswire/ -- Each year, influenza causes illness, hospitalizations and deaths, and severely strains the health care delivery system. This year, seasonal flu is complicated by the emergence and rapid spread of the H1N1 virus. In an effort to ensure that individuals and their families can take the appropriate actions to help protect themselves against the H1N1 virus, Blue Cross and Blue Shield of Georgia (BCBSGA) will cover the administration of the H1N1 vaccine without co-pay or deductible for all of its members. BCBSGA is also are encouraging self-insured employers to cover the cost of the vaccination for their employees.

"At BCBSGA, our priority is to ensure that our actions and communications support public health," said Dr. Bob McCormack, BCBSGA medical director. "Our goal is to keep our members as healthy as possible. We are committed to working with the CDC and HHS on an information campaign to ensure that members and the public are vaccinated to prevent H1N1, and if they develop H1N1 flu, they are treated effectively and appropriately."

Since a significant proportion of the vaccine is likely to be administered through non-traditional providers such as pharmacies, retail clinics and public health clinics, BCBSGA is currently working to complete agreements with these providers to increase access to the H1N1 vaccine. In addition, the antiviral medications Tamiflu and Relenza will move to an economical tier in plan formularies.

The CDC has recommended that certain populations receive the 2009 H1N1 vaccine when it becomes available. Initial prioritization includes pregnant women, people who live with or care for children younger than six months of age, children and young adults from 6 months to 24 years old, and people from 25 through 64 years old if they have chronic medical conditions that increase their risk of complications from influenza infection.

The CDC also recommends people take common-sense steps like washing your hands frequently; covering your mouth with your arm when you cough and sneeze; and staying home when you are sick to help protect others from the flu.

"The U.S. health care system has a responsibility to achieve maximal vaccination and effective treatment of H1N1 flu and its emerging risks, and we are eager to do our part to be sure that populations at high risk are immunized against this virus," said Monye Connolly, president, BCBSGA.

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Tuesday, October 06, 2009

Insurance Deregulation Is Not Financial Reform, Says Consumer Watchdog

/PRNewswire/ -- Consumer Watchdog called on Congress to reject legislation allowing the Treasury Department to use international agreements to override state insurance laws, including those requiring insurers to hold enough money to pay all claims. The proposal is under consideration in the U.S. House Financial Services Committee today.

"State insurance regulators made sure that insurance companies had enough money in the bank to pay policyholder claims and weather the financial storm. Congress should not give a political appointee the power to take away that authority on behalf of foreign insurance companies," said Carmen Balber, Washington Director for Consumer Watchdog. "This bill promotes insurance deregulation as Congress should be strengthening financial service sector regulation."

Download Consumer Watchdog's letter with Public Citizen and US PIRG here:

The proposal, a discussion draft amending H.R. 2609 offered by Rep. Kanjorski, would give the Treasury Secretary unilateral new authority to negotiate international insurance agreements on prudential issues, determine if state insurance laws are "inconsistent" with such an agreement, and then preempt those state laws. Safeguards intended to exempt specific state insurance laws from preemption do not go far enough to protect important consumer protections, wrote the groups.

The letter reads: "Never before has the U.S. government allowed a federal agency to unilaterally interpret or enter into international agreements on subject matter under the authority of the legislative branch, and then preempt states through rule-making on the basis that state policies are in contradiction to those agreements."

Consumer Watchdog also objected to the lack of consumer representation on the Financial Services witness panel today.

Rep. Kanjorski offered similar legislation last year, which was pulled back in the wake of AIG's dramatic collapse.

Download Consumer Watchdog's letter opposing last year's legislation here:

Download last year's letter from Public Citizen and US PIRG:

The groups supported efforts to develop greater federal information and expertise in insurance but noted that the proposed legislation goes far beyond information gathering.

In California, where voters enacted the nation's toughest system of insurance regulation with Proposition 103, consumers are protected from unfair or excessive insurance rates, illegal surcharges and other abusive and discriminatory practices. Any move to federalize insurance regulation would jeopardize these consumer protections, said Consumer Watchdog.

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