MyHealthGuide Newsletter
News for the Self-Funded Community
8/30/2010

Published weekly by MyHealthGuide, LLC (www.MyHealthGuide.com). This Newsletter is for personal, non-commercial use only.  This weekly newsletter is FREE OF CHARGE to subscribers.  Subscribe free. Send news, press releases and announcements to mailto:Info@MyHealthGuide.com.


TABLE OF CONTENTS

General & Company News

TriZetto Acquires Tela Sourcing to Expand Business Process Outsourcing Services Capabilities for Healthcare Markets

Eldorado's Javelina™ Selected by American Postal Workers Union Health Plan

HCC Life Opens New Regional Office to Enhance Stop Loss Services to Arizona and California

USBenefits Expands with New Office Relocation

CAP Digisoft Solutions Introduces New Medical Management Services for TPAs, Others

S5Health Announces New Benefit Broker Renewal Program Reducing Claim Costs while Improving Diabetic Health Outcomes

SLG Announces Excess Loss Policy Changes and Clarifications Regarding PPACA Healthcare Reform

Vermont Issues 900th Captive Insurance Company License

Aon and Hewitt Clear Waiting Period for Pending Merger

People News

BEST Re Names Carolyn Shepherd  as New Director of Sales and Marketing

PHX Announces Addition of Bob Hemmer as Chief Financial Officer

Prime Health Services Names Todd Hurt as Vice President of Provider Contracting

Market Trends, Studies, Books & Opinions

change:healthcare Cites Studies Confirming Transparency Key to Reducing Healthcare Costs

UBA Survey: Consumer Driven Health Plan Growth Slow As Enrollments Decline for First Time

Legal, Legislative & Regulatory News

Supreme Court Reverses Lower Courts and Restores ERISA Plan's Discretion

Medical News

Herpes Antivirals in the First Trimester of Pregnancy Do Not Appear to Increase Risk of Birth Defects

Recurring Resources

Standard Stop-Loss Employer Disclosure Form Endorsed

Upcoming Conferences

Editorial Notes, Disclaimers & Disclosures


General & Company News



TriZetto Acquires Tela Sourcing to Expand Business Process Outsourcing Services Capabilities for Healthcare Markets

MyHealthGuide Source:  The TriZetto Group, Inc, 8/26/2010, www.trizetto.com

GREENWOOD VILLAGE, CO -- The TriZetto Group, Inc. announced that it has acquired all of the voting stock of privately held Tela Sourcing, Inc., a Baltimore-based business process outsourcing (BPO) services company that offers combined U.S. and India-based outsourcing capabilities to the healthcare industry. TriZetto is expanding its BPO capabilities to help its 350 payer customers more easily meet the cost challenges and new customer opportunities created by healthcare insurance reform. The combination of Tela's U.S. and Indian operations with TriZetto's current BPO capabilities in Baltimore is expected to add scale, scope and efficiency to the company's BPO capabilities.

"The significant impact of healthcare reform on payers and others in the healthcare supply chain means an increasing need for outsourcing solutions," noted Mike Jenner, TriZetto's executive vice president who leads the company's services. "Tela represents a significant expansion of both the range of BPO services we can offer, as well as increasing our capacity and flexibility to blend on-shore and off-shore capabilities to fit customer needs."

"Interest by health insurers in business process outsourcing (BPO) services blossomed in 2009 under the shadow of an economic downturn, demands for increased regulation and a renewed focus on healthcare reform," noted Gartner Analyst Maureen O'Neil in a January 2010 report titled BPO Gives Health Insurers the Opportunity to Shine Competitively. "To remain competitive in such a challenging environment, health insurers need new business and IT approaches that provide competitive differentiation, superior financial performance and regulatory compliance. Against this backdrop, BPO is becoming a key strategic option among many U.S. health insurers."

Added Brij Sharma, Tela Sourcing's CEO who will lead TriZetto's combined BPO operations, "In today's environment, outsourcing is a strategic choice made by payers to help contain premiums, improve customer service and increase administrative efficiency. We have worked with several TriZetto clients. The combined TriZetto BPO team will now have more than 700 professionals in the U.S. and India, dedicated to delivering business rules configuration, front-end claims administration, enrollment and billing solutions that meet the business and operational needs of health plans and TPAs. Together, we will have a world-class, industrial-grade end-to-end BPO capability that can provide the flexibility, capacity and cost efficiency to meet a wide range of customer needs."

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry, with its technology touching half of the U.S. insured population. TriZetto's vision for the industry, Integrated Healthcare Management, is the optimized coordination of benefits and care for healthcare consumers to improve the value of every healthcare dollar spent. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.  Visit www.TriZetto.com.

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Eldorado's Javelina™ Selected by American Postal Workers Union Health Plan

MyHealthGuide Source: Eldorado, a division of MphasiS, 8/25/2010, www.eldoinc.com and www.apwuhp.com

Phoenix, AZ -- Eldorado (ELDORADO), a division of MphasiS, an HP Company and a leading provider of health benefit and claims management platforms, announced that American Postal Workers Union Health Plan (APWUHP), the fourth-largest national health insurance plan in the Federal Employees Health Benefits (FEHB) Program, serving more than 84,000 postal, retirees and their families, went live with ELDORADO's state-of-the-art Javelina™ solution. The plan, which is part of American Postal Workers Union (APWU), is using the browser-based system to improve claim and benefit administration, increase employee productivity, reduce administrative costs and enhance operational efficiencies.

"The implementation was seamless," said Rocky Midgett, chief operating manager at APWU. "The go-live is a critical milestone for us, helping APWUHP to ensure accurate and consistent application of claims payment policies while accelerating the speed of reimbursement. ELDORADO worked closely with us to make sure Javelina met the plan's rigorous criteria for accuracy, speed, agility and flexibility."

Before Javelina, Midgett explained, it was difficult for APWUHP to quickly and easily change benefit plan design, respond to dynamic market and regulatory developments, and integrate software applications due to a cumbersome claims & benefit management system. "Javelina's robustness, scalability, configurability and Service-Oriented Architecture platform enable us to become more agile, improve business performance, facilitate exchange of information between disparate systems, reduce the total cost of ownership, and enhance services to members and physicians," he added.

"We are excited to be an integral part of APWUHP's success in navigating today's complex healthcare and business challenges," said Tom Castleberry, Vice Chairman of ELDORADO.

About APWUHP

The American Postal Workers Union Health Plan (APWUHP) provides health coverage programs to employees or retirees covered under the Federal Employees Health Benefits (FEHB ) Program. APWUHP is a department of the American Postal Workers Union, AFL-CIO. It has been serving more than 84,000 members since 1960 when the FEHB Program first began. Visit www.apwuhp.com.

About ELDORADO

Based in Phoenix, Ariz., Eldorado, a division of MphasiS, an HP Company, specializes in health insurance application development, business process outsourcing (BPO) services, IT engineering and operational consulting. The company serves the full spectrum of organizations nationally and internationally engaged in managing health benefit plans including third party administrators (TPAs), health plans, employers and self-insured organizations. Together, Eldorado customers manage 5 million lives and handle 35 million claims annually. Call 602.604.3100 and visit www.eldoinc.com.

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HCC Life Opens New Regional Office to Enhance Stop Loss Services to Arizona and California

MyHealthGuide Source: HCC Life Insurance Company (HCC Life), 8/27/2010, www.hcclife.com

ATLANTA -- HCC Life Insurance Company (HCC Life), a leading carrier of medical stop loss insurance, announced that it has opened a new regional office to provide underwriting, marketing and administrative support to medical stop loss producers in Arizona and California.

Located in Scottsdale, Ariz., this new regional office will be in addition to the organization's four other regional offices in Addison, Texas, Minnetonka, Minn., Wakefield, Mass., and Kennesaw, Ga., and will fit the company business model of placing regional offices in strategic locations that can provide a regional geographic presence for our producers and their client base.

This new office will be lead by Byrd Preston, III as the Regional Executive Vice President. Byrd brings more than 16 years of experience in the self-funded marketplace to HCC Life, most recently serving as vice president of underwriting for a managing general underwriter. He holds a Bachelor's degree from Liberty University and has been a resident of the Phoenix area community for 19 years.

"We look forward to developing this regional office and expanding our services to the growing Arizona and California markets," said HCC Life President and CEO Craig Kelbel. "With healthcare reform and the potential growth it creates in self-funding, this is an opportune time for HCC Life to open this office."

HCC Life producers in Arizona and California can contact Byrd Preston at (480) 278-7712 or bpreston@hcclife.com. The office's address and contact information is:

HCC Life Insurance Company
8925 East Pima Center Parkway, Suite 215
Scottsdale, Ariz. 85258
(877) 446-9042
RFP requests can be sent via email to rfp_west@hcclife.com.

Full functionality in the Scottsdale office will be transitioned over the next several weeks.

About HCC Life Insurance Company

For more than 30 years, HCC Life Insurance Company (HCC Life) has been leading the way in stop loss insurance for employers who self-fund their employee benefit plans. HCC Life Insurance  Company's products, including Medical Stop Loss, HMO Reinsurance, Medical Excess and Group Term Life Insurance, are backed by the financial stability of parent company, HCC Insurance Holdings, Inc. (NYSE: HCC), and hold a rating of A+ (Superior) for financial strength, awarded by A.M. Best Company ratings services. Visit www.hcclife.com.

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USBenefits Expands with New Office Relocation

MyHealthGuide Source: USBenefits Insurance Services, LLC, DBA Employer Stop Loss Insurance Services, LLC (CA only), 8/26/2010, www.usbins.net

Irvine, CA -- USBenefits Insurance Services, LLC, entering their fourth year of providing quality medical stop-loss products, is moving to larger facilities to accommodate the growth of the company.

Rick Paul, President of USBenefits, said, "Our future expansion in the self funded marketplace, with the introduction of MedCap to a select number of TPAs along with our traditional stop loss products, is exciting." Effective August 30th, the new address will be:

USBenefits
43 Corporate Park
Suite 101
Irvine, California 92606

Telephone numbers will remain the same.
(877) 877 4USB (4872)
(949) 468 3025 Direct
(949) 468 3029 Fax

Please Send all RFP's to: quotes@usbins.net.

About USBenefits

USBenefits Insurance Services, LLC is a full service Managing General Underwriter, providing Medical Stop Loss coverage for employee groups through qualified Third Party Administrators and select brokers. USBenefits has total responsibility for all administration, claims, and underwriting decisions pertaining to its Medical Stop Loss program. Staffing includes actuarial, claims, underwriting, administrative and marketing departments that work passionately to deliver financially stable Medical Stop Loss products.  Contact Rick Paul, ASA, MAAA, President at (949) 468-3022, rp@usbins.net.  Contact Marc Floyd, Executive Vice President, Marketing, at (949) 468-3023 and mf@usbins.net.  Call (877) 877-4USB (4872) and visit www.usbins.net.

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CAP Digisoft Solutions Introduces New Medical Management Services for TPAs, Others

MyHealthGuide Source:  CAP Digisoft Solutions, Inc., 8/27/2010, www.capdigisoft.com

Atlanta, GA -- CAP Digisoft Solutions, Inc., a global Business Process Outsourcing and Software Development Company, announces the introduction of advanced medical record navigational aids and file management support.

With offices in Dallas, Texas, Atlanta, Georgia and Coimbatore, India, CAP Digisoft Solutions is an experienced provider of medical record sorting, organizing, indexing and factual summarizing. Now, navigating even the largest and most complex files is made extremely efficient with the availability of hyperlinks embedded in Indexes or Summaries plus a customized keyword search application for instant source document review.

In order to meet the exacting needs of physicians, attorneys, payors and others who need to review all providers' records, a solution to identify and document Missing Records has also been created. Both textual medical records and handwritten notes are scrubbed to identify all mentions of medical providers such as physicians, hospitals, ambulatory surgery centers, imaging centers and laboratories. Identifiable source documents that cannot then be found in the assigned file are listed as "Missing Records" along with a citation to where the provider's name is mentioned.

Arun Kumar, CAP Digisoft Solutions' Founder and CEO, states, "CDS has listened to our market and responded with solutions to optimize our customers' Workflow, Decision-Making and Profitability. We have focused on taking what are considered mundane yet mission critical tasks and delivered time and cost efficient solutions in a totally scalable environment."

All records are sent via secure, HIPAA compliant File Transfer System protocol and managed by experienced, trained reviewers who utilize CDS' developed semi-automated software tool. This combination of applied technology and skilled staff allows CDS to work with both text and handwritten medical records and notes.

Typical clients include TPAs, insurance carriers, attorneys & legal nurse consultants, case managers, record retrieval companies…literally anyone handling Personal Health Information.

For more information or to submit a file for a free trial of any of CAP Digisoft Solutions' services, please contact Rick Litzky at 770-790-4780 or by email to rlitzky@capdigisoft.com.

About CAP Digisoft Solutions

CDS is a globally recognized Business Process Outsourcing (BPO) and Software Development Company, primarily focused on providing high-end business services that leverage manpower and technology to companies. With our efficient Business Process and IT Services, clients can have more time and energy to concentrate on strengthening their core management, consequently increasing overall productivity and substantially saving costs.  Visit www.capdigisoft.com.

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S5Health Announces New Benefit Broker Renewal Program Reducing Claim Costs while Improving Diabetic Health Outcomes

MyHealthGuide Source: S5Health, 8/24/2010, www.S5Health.com

Fishers, IN -- S5Health announced the development of a new program, the S5Health Benefit Broker Renewal Program 2010, specifically designed for health insurance professionals currently engaged in the 2010 Group Benefit Renewal Process.

For a limited time, S5Health will offer healthcare insurance professionals, discounted access to the S5Health Diabetic toolkit when they implement an employer group into the platform for the 2010 Renewal Season. S5Health's comprehensive toolset helps reduce healthcare claim costs for all stakeholders in the healthcare ecosystem and improve the quality and affordability of health care for members living with diabetes.

Innovative Tools Encourage Real Cost Savings thru Behavioral Change

The S5Health platform offers an innovative way to realize real employer cost savings and improve the lives of people living with diabetes. S5Health is designed for diabetic patients by diabetic patients. The system offers interactive online tools to easily track trends and trouble areas, and connect with caregivers, payors, suppliers and other patients. S5Health empowers diabetic patients to better manage their health with easy to understand, visual dashboards and actionable reports to make real behavioral changes. S5health is more than a set of diabetes management tools.

Many diabetic thought leaders agree that diabetic consumers currently do not have access to the tools they need. Consumers utilizing the S5Health Diabetes toolkit reported they better understand their personal biometric data and can make actionable changes to improve the way they feel. Brokers and employers will see an increase in adoption of disease management programs, saving employers money through reduced health costs for their employees, and reduced absenteeism.

Easier to Securely Communicate with Providers and Social Network

The S5Health toolkit is more than a set of consumer diabetes management tools. The S5Health platform solves healthcare insurance professionals' unique member portfolio management needs by providing brokers and their groups with a comprehensive and powerful online system that supports communication, customized branding, social and easy integration with existing programs and consumer facing platforms.

Researchers agree that empowering a patient to be engaged in their healthcare and greater levels of social support, particularly diabetes-related support from spouses and other family members are associated with better regimen adherence. Social support also serves to buffer the adverse effect of stress on diabetes management. Successful management of diabetes contributes to controlling healthcare costs short term and over the long term.

TPAs interested in realizing real employer cost savings and improvement of diabetes management, can access the tools for free by visiting https://s5health.sdmindy.com or learn more by contacting S5Health for additional information.

About S5Health

S5Health is a healthcare technology company located in Fishers, Indiana. S5Health was founded to empower diabetic patients to manage their health by providing interactive online tools to easily track trends and trouble areas, and connect with caregivers, payors, suppliers and other patients. S5Health's technology imports data from any diabetic pump or meter and creates simple to understand dashboards and reports to track blood sugar, insulin and carbohydrate levels. Our social media and secure email allows a patient to interact with other organizations or people that are involved in his/her care and build a personal support team. Alerts and reminders can be set for prescription refills or upcoming appointments. Visit www.S5Health.com.

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SLG Announces Excess Loss Policy Changes and Clarifications Regarding PPACA Healthcare Reform

MyHealthGuide Source: SLG Benefits & Insurance, LLC (SLG), 8/24/2010, www.slgbenefits.com

SLG Benefits & Insurance, LLC (SLG), QBE Insurance Company's (QBE) carrier direct stop loss underwriting and distribution platform, has recently announced Excess Loss Policy changes and clarifications with regard to the Patient Protection and Affordable Care Act (PPACA).

The management team at SLG/QBE has tailored product and services to align with the risk transfer needs of stop loss policyholders and production partners faced with the new regulatory requirements of PPACA. At this time of increased compliance obligations for business partners, the SLG/QBE carrier direct platform coupled with an industry leading Excess Loss Policy allows for the continued delivery of a core value proposition: Dedicated Service and Solutions. Upon review of the following information, please do not hesitate to contact your SLG Underwriter with any questions at 800.742.9279 or visit us at www.slgbenefits.com.

Please note the following SLG/QBE comments on the frequently asked questions with regard to medical Stop Loss and new health plan regulatory requirements:

  • Plan Unlimited Lifetime Maximum Benefits: The QBE Excess Loss Policy will accommodate a group's requests to cover unlimited lifetime maximum benefits under the Plan.
  • Specific Policy Period Maximum Reimbursement: SLG/QBE will offer annual stop loss policy reimbursements up to Unlimited per covered person. Producers may request annual reimbursement limits and options based on the risk transfer needs of our common clients.
  • Extension of dependant eligibility up to age 26: SLG/QBE Underwriting has determined that there will be minimal impact to stop loss rates and terms for the adoption of this provision upon plan anniversary.
  • Federal Temporary Reinsurance Program for Early Retirees: In the event a policyholder is reimbursed twice (under QBE Excess Loss and under the PPACA temporary program) for early retired employees over age 55 and not Medicare eligible; policy subrogation provisions may apply.

Additionally SLG/QBE Underwriting Management has determined that there will be no impact to stop loss rates for the adoption of the following provision(s) upon plan anniversary:

  • Elimination of pre-existing condition exclusions for participants under the age of 19
  • Elimination of cost-sharing on preventive services and immunizations
  • Addition of coverage for emergency services without pre-authorization
  • Elimination of requirement for authorization or referral for patients seeking OB/GYN services

Policyholders electing to amend their plan documents for early and/or timely adoption of PPACA provisions or electing to expand coverage beyond that which may be required will need to submit an Amendment or Restated Plan Document for coverage review and approval under the QBE Excess Loss Policy. Please note that the adoption and interpretation of the new federal guidelines appears to be fluid and subject to change. SLG/QBE reserves the right to change or modify Excess Loss Policy Provisions and Underwriting Guidelines based upon implementation and clarifications of the new regulations.

About SLG Benefits & Insurance, LLC

SLG Benefit's mission is to offer a medical stop loss product that will help our TPA and broker partners grow their businesses and support the self-funding concept. With increases in medical inflation, Plan Sponsors will increasingly rely on their brokers and TPA's to provide funding solutions. Our goal is to provide unparalleled product and expertise to our business partners. Our priority is to exceed the needs of our clients and deliver superior results to our risk takers. Visit www.slgbenefits.com.

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Vermont Issues 900th Captive Insurance Company License

MyHealthGuide Source: Vermont Department of Banking, Insurance, Securities and Health Care Administration (BISHCA), 8/10/2010, www.VermontCaptive.com

MONTPELIER, VT -- The State of Vermont has issued its 900th captive insurance company license according to the Vermont Department of Banking, Insurance, Securities and Health Care Administration (BISHCA).

The newest captive is owned by to Lincoln Financial Group. Vermont's 900th license means the state has issued more than four times as many captive licenses than its next closest domestic competitor.

"This benchmark gives Vermonters a strong sense of pride and achievement that our commitment to this industry for nearly 30 years has been heard loud and clear," said Governor Jim Douglas. "Vermont will continue to offer a stable regulatory environment, governmental officials that are accessible, and world-class professional support services."

"While reports show limited activity in the captive sector, Vermont is bucking the trend with a strong first half of the year and it is very encouraging that interest continues to be robust," said Dan Towle, Vermont's Director of Financial Services for the Vermont Agency of Commerce & Community Development. "We're going to continue our efforts to grow Vermont's captive industry and maintain our lead as the ‘Gold Standard' of captive domiciles."

Special purpose financial captives (SPFC) formed in the State of Vermont for the securitization of insurance reserves has been a strong growth sector for the Green Mountain State. Vermont currently has more than 20 SPFC's that wrote more than $6 billion in gross written premium last year.

About Vermont Captives

Vermont is the largest captive insurance domicile in the U.S. and the third largest in the world. Forty-two of the companies that make up the Fortune 100 and 18 of the companies that make up the Dow 30 have Vermont captives.  Visit www.VermontCaptive.com.

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Aon and Hewitt Clear Waiting Period for Pending Merger

MyHealthGuide Source: PRNewswire-FirstCall, 8/25/2010, www.hewitt.com and www.aon.com

CHICAGO -- Aon Corporation (NYSE: AON) and Hewitt Associates, Inc. (NYSE: HEW) announced that the waiting period under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, relating to Aon's proposed merger with Hewitt has expired, thereby satisfying a condition to the closing of the transaction. The transaction remains subject to the satisfaction of other customary closing conditions, including foreign regulatory approvals and approval by the stockholders of both Aon and Hewitt.

About Hewitt

Hewitt Associates (NYSE: HEW) provides leading organizations around the world with expert human resources consulting and outsourcing solutions to help them anticipate and solve their most complex benefits, talent, and related financial challenges. Hewitt works with companies to design, implement, communicate, and administer a wide range of human resources, retirement, investment management, health care, compensation, and talent management strategies. With a history of exceptional client service since 1940, Hewitt has offices in more than 30 countries and employs approximately 23,000 associates who are helping make the world a better place to work. Visit www.hewitt.com.

About Aon

Aon Corporation (NYSE: AON) is a leading global provider of risk management services, insurance and reinsurance brokerage, and human capital consulting. Through its more than 36,000 colleagues worldwide, Aon delivers distinctive client value via innovative and effective risk management and workforce productivity solutions. Aon's industry-leading global resources and technical expertise are delivered locally through more than 500 offices in more than 120 countries. Visit www.aon.com.

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People News



BEST Re Names Carolyn Shepherd  as New Director of Sales and Marketing

MyHealthGuide Source: BEST Re, 8/23/2010, www.bestre.net and www.besthealthplans.com

Meridian, ID -- BEST Re is delighted to announce that Carolyn Shepherd has joined our team as the Director of Sales and Marketing. Carolyn will oversee BEST Re's portfolio of stop loss products and expand business relationships with Third Party Administrators from our Forest, Virginia office.

Carolyn comes to us with over 20 years of sales and marketing experience in the insurance industry. During her career she has worked as a regional marketing director for Perico Life Insurance Company.

Carolyn Shepherd can be contacted at (877) 868-5775, ext. 225 or at cshepherd@bestre.net.

About BEST Re

BEST Re is a member of the BEST Life family of companies. As a full service managing general underwriter, we offer medical stop loss insurance for employee groups through qualified third party administrators and broker/consultants. All our administration, claims and underwriting decisions are made at one location, and we are fully staffed with actuarial, administration, claims, marketing and underwriting professionals. BEST Re can offer you responsive, viable and innovative solutions to meet your stop loss insurance needs. Visit www.bestre.net for more information.  Contact Ken Hockaday at 888.893.5041, ext.366, khockaday@bestre.net and visit www.bestre.net and www.besthealthplans.com.

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PHX Announces Addition of Bob Hemmer as Chief Financial Officer

MyHealthGuide Source: PHX, 8/13/2010, www.phx-online.com

Bedminster, NJ -- PHX announced that Robert M. Hemmer has joined the executive team as the company's first Chief Financial Officer. The establishment of this new position underscores PHX's commitment to growth and service excellence. Bob will be charged with helping to evaluate opportunities for investment, expansion, and acquisition as well as support the company's aggressive growth strategy by establishing world-class financial controls and processes and by providing for the capital needs of the business as it continues to invest in its future.

"We are very fortunate to find an executive of Bob's caliber to help us take our company to the next level of our growth strategies. Bob brings a great deal of experience to this team and will be an important asset to our continuing success." said Todd Roberti, Director, Corporate Strategy, PHX. "Bob will join PHX's Executive Committee and will be responsible for all major administrative functions."

Bob comes to PHX as a seasoned executive with over 12 years of C-level experience in privately held service companies pursuing growth strategies, including 10 years as CFO of NYCE Corporation. Earlier in his career, Bob spent 18 years with ADP Corporation, working in both its corporate office as well as several operating divisions, some of which were spun out as independent companies. He has also participated in numerous M&A transactions on both the buy and sell side.

About PHX

PHX delivers advanced cost management solutions for health plans. The company combines claim processing automation with professional services to deliver a centralized approach to cost management, increasing savings in both the near and long term while dramatically reducing errors and turnaround time. PHX services include data analytics, benchmarking, predictive modeling, PPO network management, out-of-network negotiations, claims editing, and clinical bill review and audit. The firm's solutions are used by the industry's leading insurance companies, Taft-Hartley Funds, HMOs, and TPAs. Visit www.phx-online.com.

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Prime Health Services Names Todd Hurt as Vice President of Provider Contracting

MyHealthGuide Source: Prime Health Services, Inc., 8/24/2010, www.primehealthservices.com

Nashville, TN  -- Todd Hurt has been named Vice President of Provider Contracting at Prime Health Services, Inc., one of the nation's largest non-risk bearing PPO and medical cost-containment companies. Hurt joined Prime Health in 2006 and most recently was Director of Provider Contracting. He assumes authority over the Contracting Division at Prime Health Services and answers directly to the company's Principles. His primary duties will include conducting all activity related to Prime Health Services national contracting efforts and custom contracting for clients.

"Todd has been an excellent asset to Prime Health over the years. Todd is one of the hardest working individuals I have ever met, and has a full understanding of the Prime Health model and the current market in relation to Non-Risk Bearing PPOs. Todd is a ‘get it done' kind of guy. Thus, I know that Todd will do an excellent job in overseeing our custom contracting efforts for our clients that choose this service as well as for the continued growth of our broad based PPO," said Brian A. Sharp, CEO of Prime Health Services.

Hurt has over ten years of healthcare experience, coming to Prime Health from Magellan Health Services. Todd has coupled over seven years of unique BHO customer and physician relations experience with four years provider contracting experience with Prime Health.

About Prime Health

Founded in 1996 and based in Brentwood, TN, Prime Health Services (Prime Health) is a managed care company that offers a full spectrum of services, including a Preferred Provider Organization (PPO) ready for access with customizable solutions, as well as repricing offerings. Prime Health's PPOs include Workers' Compensation, Group Health, and Auto Liability networks. Prime Health has over 500,000 providers and facilities nationwide forming the Prime Health National Delivery System. Prime Health offers our National Delivery System to the TPA, insurance carrier, and self-insured markets. Call 866-348-3887 and visit www.primehealthservices.com.

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Market Trends, Studies, Books & Opinions


change:healthcare Cites Studies Confirming Transparency Key to Reducing Healthcare Costs

MyHealthGuide Source: change:healthcare, 7/24/2010, www.changehealthcare.com

BRENTWOOD, TN -- With healthcare spending expected to increase dramatically over the next decade, two recent studies by the Society of Actuaries confirm what healthcare technology company change:healthcare has been saying all along. Transparency would be a boon to helping patients and consumers make better healthcare purchase decisions and lower healthcare costs in general.

"We've been calling for greater transparency in healthcare costs ever since we launched," said change:healthcare founder and CEO Christopher Parks. "This research simply underscores our point that consumers are begging for greater, better and more actionable healthcare cost information that will help them pay less for their and their family's care and lower what is spent on healthcare across the nation. The changes made recently by Congress to the American healthcare system will only make this need more critical."

Other recent news stories in media outlets including The New York Times, the Charlotte Observer and Kaiser Health News echo the need for cost transparency in the country's healthcare system.

The Society of Actuaries studies of both actuaries and consumers affirm that more transparency in the healthcare system is critical to lowering costs.

Key findings:

  • 86% of surveyed healthcare actuaries recommend making prices for treatments more visible and available for patients while
  • 66% of consumers felt they could better control their own healthcare costs if healthcare providers, or their insurance company, told them about costs.

Based in Brentwood, Tennessee, change:healthcare guides employers, employees and third party administrators in making more informed healthcare consumer purchase decisions that save money, without plan design changes or cost shifting. Specifically, the firm helps employers and their workers choose the most affordable providers for medical services by analyzing a company's medical claims and continually sending cost-savings alerts to employees when savings opportunities are found.

Their primary tool is a system of Ways to Save Alerts™ that proactively notifies users when there's a cost savings opportunity and tracks and reports savings. It recently helped employees at one client company realize an immediate savings, on average, of $112 per person.

"We've found that when you give people transparent information about their healthcare and the value-driven choices that are out there, invariably they make far more insightful decisions about their care, its cost and its quality." Parks said. "I have no doubt that with greater transparency placing more information and control into consumer hands, Americans could realize millions in healthcare cost savings. It's nice to see the Society of Actuaries agrees with us."

About change:healthcare

change:healthcare, inc. is a technology company offering over 750 highly personalized ways to save on prescriptions and medical services. The company's real dollar ROI-tracking solution is available through third party administrators, self-insured employers and health plans interested in helping employees and members better manage their out-of-pocket healthcare expenses.  Contact Frank Limpus at 615-668-9938, frank.limpus@comcast.net and visit www.changehealthcare.com.

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UBA Survey: Consumer Driven Health Plan Growth Slow As Enrollments Decline for First Time

MyHealthGuide Source: United Benefit Advisors (UBA), 8/23/2010, www.UBAbenefits.com

INDIANAPOLIS, IN -- Consumer Driven Health Plans (CDHPs) in the U.S. experienced continued growth this year -- albeit at a slower rate than in 2009 -- according to preliminary results released by United Benefit Advisors (UBA) from its 2010 UBA Health Plan Survey, the nation's largest health plan benchmarking survey, with 17,113 plans from 11,413, employers.

Survey findings

  • CDHPs grew at a rate of 18.1% this past year (about half that of 2009)
  • But HMOI plans (15.4%) now cover more employees than CDHP Plans (12.4%).
  • The Northeast region of the country had the largest concentration of CDHPs (26.7%), followed by the Southeast region (22.9%).
  • The average cost increase for all CDHPs at 7.3% was slightly lower than that of the average of all plan types, which increased 8.0% this year.

Employers often offset the higher out-of-pocket costs of CDHPs by offering employees a health reimbursement arrangement (HRA) or a health savings account (HSA) and contributing funds. The 2010 UBA Health Plan Survey found the average employer contribution to an HRA was $1,481 (up from $1,310 in 2009) for a single employee and $2,857 for a family (up from $2,502 in 2009).

Other key statistics from this year's Survey results:

  • The average increase for all plan types was 8.0%.
  • PPO plans have nearly two-thirds of all enrolled employees (65.7%).
  • Fee For Service Plans will no longer be reported as the plans remaining are insufficient to develop legitimate benchmarks.
  • The average employee contribution for plans with contributions for all plan types is $113 for single and $443 for family.
  • More than three-fourths of all wellness plans (77.1%) offered a health risk assessment.
  • Of all plans in the Northeast, 81.7% still have 100% coinsurance.
  • 52.9% of all covered employees also elected to cover their dependents.

The 2010 UBA Health Plan Survey will be available to the public on Nov. 1. Only UBA Member Firms have access to the more than 250,000 pages of granular state, region and industry data. Stafford also said the analysis of the 2010 UBA Health Plan Survey data will continue over the next several months and, as in past years, additional findings will be forthcoming. UBA has Member Firms in virtually every major U.S. market. To locate one and learn more about the 2010 UBA Health Plan Survey, visit www.UBAbenefits.com.

About The 2010 UBA Health Plan Survey

With responses from 17,113 health plans sponsored by 11,413 employers nationwide, the 2010 UBA Health Plan Survey is the nation's largest and most comprehensive survey of plan design and plan costs. As the largest survey of its kind, the UBA Health Plan Survey defines benchmarks by a greater number of specific industries, regions and employer size categories than is available from any other resource. The 2009 UBA Employer Benefit Perspectives (which delineates employers' positions and opinions on Employee Communications, Personal Health Management and Scope of Benefits Offered) and the 2010 UBA Employer Opinion Survey (including the Special Supplement on Health Care Reform) serve as companion pieces to the 2010 UBA Health Plan Survey.

About United Benefit Advisors

United Benefit Advisors, is an alliance of more than 145 premier independent benefit advisory firms with offices in more than 165 offices throughout the U.S, Canada and the U.K., and is one of the nation's top five employee benefits advisory organizations. As trusted and knowledgeable advisors, UBA Members collaborate with more than 2,000 professionals to seek out ideas, insight, expertise and best-in-class solutions that positively impact employers and make a real difference in the lives of their employees and families. Employers, advisors and industry-related organizations interested in obtaining powerful results from our shared wisdom should visit UBA online at www.UBAbenefits.com to locate your local UBA Member Firm.  Visit www.UBAbenefits.com.

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Legal, Legislative & Regulatory News



Supreme Court Reverses Lower Courts and Restores ERISA Plan's Discretion

MyHealthGuide Source: Employer's Guide to Self-Insuring Health Benefits, Thompson Publishing Group via PassionForSubro, 8/2010

Employers and other plan administrators are due greater deference in their benefits plan decisions than some lower courts have allowed, the U.S. Supreme Court ruled after admonishing two lower courts for failing to follow the High Court's prior decisions establishing ERISA law on plan administration.

The High Court also admonished the current administration as well as courts for attempting to introduce more complex, inefficient and costly requirements in plan decision-making, and for encouraging court interference in those plan decisions.

Indirectly, the Supreme Court opinion puts in stark contrast to ERISA's principles of uniformity and efficiency in plan administration the Patient Protection and Affordable Care Act's (PPACA) complex and less artful crafting of plan administration requirements, which undermine uniformity and efficiency — thus implicating much more costly reform requirements.

"A single honest mistake" does not justify stripping a plan administrator of deference for subsequent related interpretations of the plan, the U.S. Supreme Court said as it overturned a lower court ruling that would have stripped the plan of the more favorable abuse-of discretion standard of review. The High Court's reversal thereby preserves the administrator's broad authority to interpret benefit plan terms.

"People make mistakes. Even administrators of ERISA plans," Chief Justice John Roberts wrote in the Court's 5-3 opinion in Conkright v. Frommert, 2010 WL 1558979 (April 1, 2010), which allows ERISA plan administrators to retain deferential review even after an erroneous interpretation of the plan.

Deference was restored because the plan was acting in good faith, its miscalculations were honest, the errors were isolated, and a "one-strike-you're-out" approach was unreasonable, the Court held. Also, deference is necessary because if courts can toughen the standard of review mid-process, litigation becomes more labyrinthine and frequent, and plan administration becomes more complicated.

On the other hand, Roberts wrote, patterns of erroneous plan interpretations — even in good faith — are still grounds for forfeiting deference.

Although the case involved pension benefits, the High Court's affirmation of the plan's right to reserve deferential review is important to ERISA health plans. The case helps depict the circumstances under which courts may strip discretionary authority and when authority can be defended.

The Facts of the Case

The dispute was about whether Xerox Corp. improperly calculated employee retirement benefits. Xerox employees had left the company and been rehired. When they left Xerox, they got lump-sum distributions of accrued pension benefits. After they were rehired, the plan subtracted those distributions from future benefits.

The Xerox plan required the administrator to offset the employee's final benefits by an amount "attributable" to any prior lump-sum distribution.

To that end, the plan administrator used a "phantom account" method (which calculated the hypothetical amount the employee's investment would have reached had it remained in the plan) to calculate the amount offset from new benefits. The employees sued, arguing that the plan's method over-deducted from their current benefits, and violated ERISA. The employees further argued that the plan and the summary plan description (SPD) did not provide for the use of that method.

Lower Courts Strip Discretion

The U.S. District Court for the Western District of New York granted summary judgment for the Xerox plan administrator, holding that the use of the phantom account method was not improper and the employees had adequate notice of that method's use.

But the 2nd U.S. Circuit Court of Appeals overturned that decision (Conkright v. Frommert, 535 F.3d 111 (2nd Cir., July 24, 2008)), concluding that the phantom account method constituted a retroactive cut-back of benefits in violation of ERISA. The circuit court also determined that the plan and its administrator had impermissibly amended the plan to include that mechanism, and remanded the case to the district court.

On remand, the plan proposed a new interpretation to calculate the employee offsets. The district court refused to accord any deference to that interpretation and adopted the employees' approach (with a smaller offset). And on appeal, the 2nd Circuit upheld the district court's decision not to apply a deferential standard and rebuffed challenges to the district court's decision on the merits.

The plan brought the case to the Supreme Court, which held that the district court should have used the deferential standard of review.

Supreme Court Decision

The Xerox employees (backed by a U.S. government amicus brief) claimed that deference is less important once a plan administrator's interpretation has been found to be unreasonable. The Supreme Court rejected that, holding that deference is important because it makes it easier for administrators to govern plans, and encourages employers to sponsor ERISA plans. It looked at two important cases for precedent. A plan administrator with discretionary authority to interpret a plan is entitled to deference in exercising that discretion, the Supreme Court held in Firestone Tire & Rubber Co. v. Bruch, 489 S. Ct. 101 (1989). The High Court in that ruling stated that under trust law the

instrument creating the trust influences the standard of review. If the trust instrument reserves deference, then "the trustee's interpretation will not be disturbed if reasonable."

Building on that decision, the Court later held in Metropolitan Life Ins. Co. v. Glenn, 128 S. Ct. 2343 (2008), that when plan terms grant discretionary authority to the plan administrator, courts will review challenges to such decisions under a deferential standard of review, even when the administrator is operating under a systemic conflict of interest.

The Supreme Court criticized the 2nd Circuit for its holding that a court does not need to apply a deferential standard because an administrator had in the past interpreted the plan in a way that violated ERISA.

"We reject this one-strike-and-you're-out approach," Chief Justice Roberts wrote, adding that such an approach has no basis in Firestone's precedent, "which set out a broad standard of deference without any suggestion that the standard was susceptible to ad hoc exceptions."

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Medical News


Herpes Antivirals in the First Trimester of Pregnancy Do Not Appear to Increase Risk of Birth Defects

MyHealthGuide Source: Journal of the American Medical Association, Vol. 304 No. 8, 8/25/2010, JAMA Abstract

Pregnant women may be able to take some herpes drugs without fear of harming their developing baby according to a study published in the Journal of the American Medical Association.  The antiviral drugs acyclovir, valacyclovir, and famciclovir are prescribed to treat herpes viral infections, such as herpes simplex virus (HSV).

The study followed 837,795 live-born infants in Denmark from January 1, 1996, to September 30, 2008. Participants had no diagnoses of chromosomal aberrations, genetic syndromes, birth defect syndromes with known causes, or congenital viral infections. Nationwide registries were used to ascertain individual-level information on dispensed antiviral drugs, birth defect diagnoses (categorized according to a standardized classification scheme), and potential confounders.  The main outcome was prevalence of any major birth defect diagnosed within the first year of life by exposure to antiviral drugs.

Study findings

Among 1,804 pregnancies exposed to acyclovir, valacyclovir, or famciclovir in the first trimester,

  • 40 infants (2.2%) were diagnosed with a major birth defect compared with
  • 19,920 (2.4%) among the unexposed.
  • For individual antivirals, a major birth defect was diagnosed in
    • 32 of 1561 infants (2.0%) with first-trimester exposure to acyclovir and in
    • 7 of 229 infants (3.1%) with first-trimester exposure to valacyclovir.
    • Famciclovir exposure was uncommon (n = 26), with 1 infant (3.8%) diagnosed with a birth defect.
  • Exploratory analyses revealed no associations between antiviral drug exposure and 13 different subgroups of birth defects, but the number of exposed cases in each subgroup was small.

Researchers conclude that in this large nationwide cohort, exposure to acyclovir or valacyclovir in the first trimester of pregnancy was not associated with an increased risk of major birth defects.

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Recurring Resources


Standard Stop-Loss Employer Disclosure Form Endorsed

MyHealthGuide Source: Self-Insurance Institute of America (SIIA, www.SIIA.org), Society of Professional Benefit Administrators (SPBA, www.SPBATPA.org), Recurring article

Self-Insurance Institute of America ( www.SIIA.org ) and Society of Professional Benefit Administrators ( www.SPBATPA.org ) have endorsed a standardized stop-loss disclosure form, which also includes ICD-9 codes. The documents are intended to help facilitate the sharing of health data information between self-insured entities/TPAs and stop-loss insurers/MGUs for the purpose of medical stop-loss underwriting.

Stop-Loss Carriers and MGUs Adopt  the Standardized Form

The list below represents an estimated $3.3 Billion in Stop-Loss premium.  Assuming a medical self-funded community Stop-Loss market of $4 Billion, then over 80% of the market has adopted the form.

If you are a Stop-Loss carrier or MGU that has adopted the standard disclosure form, please let us know at Info@MyHealthGuide.com.

Latest Survey Results Recommending Adoption

Respondents from the self-funded community have voted 86% in favor of adoption of the standard form for Stop-Loss disclosure.  For all survey results, see www.MyHealthGuide.com/disclosures.htm.

Standard Form Adoption May Not Mean Standardization

While surveyed members (n=112) from the self-funded community voted 86% in favor of adoption of the standard form for Stop-Loss disclosure and a majority of the Stop-Loss market has adopted the form, complete standardization is still a goal.

LaRea Albert of Health First TPA (Tyler, TX ) complains, "The Standard Stop-Loss Employer Disclosure Form is not standard, we are getting a different standard from various MGUs and carriers."  Another colleague at Health First, said, "Each Stop-Loss source requires enough 'extras' that Health First concludes the form should not be called, "Standard."

"These comments show that, at least down at the operating level, many underwriters and their managers 'do not get it'! If the form is 'approved', but insist on the unique information carrier by carrier, then that's not accepting the standard, "  says John Lord, Vice President-Specialty Zurich Specialty Health, and a member of the Industry Study Group which developed the Standard Disclosure Form.  "Clearly we have work to do to get the message out to all the right people."

Disclosure Form, Codes, White Paper, Available

The following draft documents may be downloaded and viewed at www.myhealthguide.com/disclosures.htm

About Employer Disclosure

The Employer Disclosure, required by most Stop-Loss carriers and MGUs, has grown in sophistication and use. Today, most Stop-Loss sources require an employer disclosure before a new or renewal quote is offered. Ideally, the Employer Disclosure lists all known high cost claims, claims that have exceed a given dollar threshold, or patient/employees with certain diagnoses. Failure to disclose these individuals can later lead to claim denials.   For the past several years, an industry study group has worked on "standardizing" the reporting process with the objective that all insurers would come to accept the reporting system/form as an industry standard.

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Upcoming Conferences



September 9, 2010

One Day Forum on Consumer-Directed Health Care presented by CDHC Solutions. Forum helps employers prepare for and manage the new "Health Care Law" and Give A-to-Z Insight into Consumer-Directed Health Care Solutions. The health bill is law, so what changes does this bring now and in the near term for your company and/or clients health care benefits plans? Hear what leading experts are recommending and what your peers are doing. Cobb Galleria Centre, Atlanta, GA. Registration: Karen Raudabaugh (kraudabaugh@fieldmedia.com), Event Coordinator, 404-671-9551. Information: www.cdhcsolutionsmag.com/forum

September 13-14, 2010
TABA 2010 Fall Conference presented by Texas Association of Benefit Administrators (TABA), Marriott Sugarland Town Square Sugarland, TX. www.tpbaa.com

September 13-14, 2010
Second National Comparative Effectiveness Summit presented by Harvard Health Policy Review and Health Affairs.  A Hybrid Conference and Internet Event.  The Leading Forum on the Role of Comparative Effectiveness Research in Health System Change and Health Reform
Crystal City Marriott, Arlington, VA. www.ComparativeEffectivenessSummit.com

September 15-16, 2010
Fourth National Predictive Modeling Summit presented by Harvard Health Policy Review, Health Affairs and Predictive Modeling News.  A Hybrid Conference, Internet Event and Training Tool.  The Leading Forum on Health Care Predictive Modeling Implications, Strategies and Solutions for Care Management, Underwriting, Profiling and Related Activities
Crystal City Marriott, Arlington, VA. www.PredictiveModelingSummit.com

September 20-22, 2010
Self Insurance Employers Conference.  Attendees - Employers, Insurance Companies, Agents, TPAs, Reinsurers.  Los Angeles, CA.  Information: info@selffundingconference.com and www.selffundingconference.com

September 27-29, 2010
3rd Annual Centric Health Resources Ultra Orphan Drug Conference presented by Centric Health Resource. latest trends in the ultra-orphan therapy (drugs for exceptionally rare diseases) marketplace and an exchange of ideas with colleagues and industry participants.  St. Louis, Missouri at the Westin Hotel.  Information and registration: http:/http://centrichealthresources.com/event.aspx?eventid=4

October 6-8, 2010
SPBA Fall 2010 Meeting - Members Only presented by Society of Professional Benefit Administrators. Phoenix, AZ. www.SPBATPA.org 

October 12-15, 2010
30th Annual National Educational Conference & Expo
presented b presented by Self-Insurance Institute of America, Inc.  This is the world's largest business conference/trade show dedicated exclusively to the self-insurance/alternative risk transfer industry. Joe Plumeri, chairman & CEO of Willis Group Holdings, Ltd., will provide the keynote address and Weekly Standard Senior Writer and Fox News Political Commentator Stephen Hayes preview the mid-term elections during the other featured general session.  The event features more than 50 educational sessions and a trade show with about 150 companies showcasing their products and services.  Sheraton Chicago Hotel & Towers. Chicago, IL.  Sponsorship information: Justin Miller at 800-851-7789 or jmiller@siia.org. www.SIIA.org

October 17-20, 2010
Society of Actuaries 2010 Annual Meeting. New York City. www.soa.org

October 20-22, 2010
AHIP's Medical Leadership Forum presented by America's Health Insurance Plans.   As health care reform implementation takes shape, your ability to build lasting value during times of transformation is imperative to any organization's success. AHIP's Medical Leadership Forum is your opportunity to take time to focus on the leadership challenges of transforming health care reform, re-evaluate both short-term and long-term strategies, and create sustainable value for the future.  Jacksonville, FL.  Information and registration: www.ahip.org/links/medicalleader2010/

October 25-26, 2010
Kidney Disease: Best Practices for Prevention, Management and Improving Outcomes presented by OptumHealth Care Solutions. A conference to learn from experts in kidney disease and transplantation about recent advances and research in the treatment of chronic and end-stage renal disease, as well as the financial and clinical benefits of successfully managing these patients. Philadelphia, Pa. Information and registration: 800-847-2050, education@optumhealth.com and http://attendesource.com/profile/web/index.cfm?PKwebID=0x12446585c 

November 8-11, 2010
WEDI 2010 Fall Conference.  Hyatt Regency Reston, Reston, Virginia. www.wedi.orgwww.wedi.org

November 8-9, 2010
Compliance in the Post-Reform World: An HCCA (Health Care Compliance Association) Workshop.  Keynote: Tiana L. Korley, Esq., Senior Advisor, Center for Program Integrity, CMS.  Two-day workshop to cover Health Care Reform law and the many changes for health care providers and their compliance professionals. Topics:

  • The Economics of Health Care Reform

  • Dealing with the Future: New Service Lines and Arrangements

  • New and Expanded Fraud and Abuse Provisions

  • What to Expect from Payers

  • The Expanded Implications of Quality

  • Transparency and Data Reporting

  • Mandatory Compliance Programs

  • OIG Enforcement

A special rate of $159.00 (plus tax) per night has been arranged for the conference. The special room rate will be available until October 17, 2010, or until the group block is sold-out, whichever comes first.  Make your reservations online and enter Group/Convention Code: HCC. Or call Hilton reservations at 443-573-8700 or 800-445-8667 and mention Group/Convention Code: HCC or Health Care Compliance for the special rate. Information and registration: 888-580-8373, service@hcca-info.org, www.hcca-info.org

November 14-17, 2010
56th U.S. Annual Employee Benefits Conference presented by International Foundation.  capstone conference for U.S. International Foundation members is the educational opportunity of the year. Capture under one roof, at one time, the essential and imperative information you need to know to fulfill your fiduciary obligation. Understand the requirements of new legislation, recent regulations and how other, similar funds are handling some of the same issues.
Hawaii Convention Center, Honolulu, HI.  Information and registration: www.ifebp.org/Education/UsAnnual/

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January 31-February 1, 2011
20th Annual National Health Benefits Conference & Expo presented by HBCE.  Continuing Education: SHRM (Society for Human Resource Management). This program will be submitted for PHR, SPHR and GPHR recertification credits (always approved in the past - 8.5 HRCI credit hours). CHES - approved last time - expect approval again. For others, a Certificate of Attendance will be pro vided upon request to be applied to various continuing education professional requirements. Sheraton Sand Key Resort, Clearwater Beach, FL.  www.HBCE.com

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Editorial Notes, Disclaimers & Disclosures


  • Articles are edited for length and clarity.

  • Articles are selected based on relevance and diversity.

  • No content in this Newsletter should be construed as legal advice.  All legal questions should be directed to your own personal or corporate legal resource.

  • Internet links are tested at the time of publication.  However, links change or expire often.

  • Articles do not necessarily reflect views held by the Publisher.

  • Disclosure: MyHealthGuide is associated with CareHere, LLC® and LabInsight®

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Ernie Clevenger
President & Publisher
MyHealthGuide, LLC
Clevenger@MyHealthGuide.com