MyHealthGuide Newsletter
News for the Self-Funded Community
7/28/2014

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

People News

Market Trends, Studies, Books & Opinions

Legal, Legislative & Regulatory News

Medical News

Recurring Resources

Upcoming Conferences

Editorial Notes, Disclaimers & Disclosures


General & Company News


Symetra Reports Q2 2014 Results, Stop-loss Premium Increases and Loss Ratio Improves

MyHealthGuide Source: Symetra, 7/24/2014, www.Symetra.com 

"We are pleased to report another solid quarter of earnings and a strong underwriting result in our Benefits segment. Each of the three divisions reported excellent year-over-year sales growth. Our successful sales efforts of the past several quarters are driving meaningful earnings contributions today, particularly in fixed indexed annuities," said Tom Marra, Symetra president and CEO.

Highlights

  • Adjusted operating income of $55.3 million was up 5% from second quarter 2013. Adjusted operating income per diluted share was $0.48, up from $0.40 in second quarter 2013.
  • Net income was $71.5 million, or $0.62 per diluted share, up from $45.0 million, or $0.34 per diluted share, in second quarter 2013.
  • Benefits loss ratio improved to 62.7% from 66.2% in second quarter 2013.
  • Benefits Pretax adjusted operating income was $19.9 million for the quarter, up from $16.3 million. The increase was driven by a lower loss ratio for medical stop-loss.
  • Prepayment-related income, net of amortization, of $4.3 million was offset by $4.3 million charge for prior years' state sales and use tax expense. Net prepayment-related income was $5.8 million in second quarter 2013.
  • All business segments reported strong year-over-year growth in sales:
    • Benefits sales of $26.1 million for the quarter were up from $21.3 million in the previous period, a 22.5% increase. Medical stop-loss, limited benefit medical, and group life and disability income insurance all reported year-over-year sales growth.

About Symetra

Symetra Financial Corporation (NYSE: SYA) is a diversified financial services company based in Bellevue, Wash. In business since 1957, Symetra provides employee benefits, annuities and life insurance through a national network of benefit consultants, financial institutions, and independent agents and advisors. Visit www.symetra.com.

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GlobalCare Partners with WLT Software to Increase Workflow Process Offerings

MyHealthGuide Source: GlobalCare Partners and WLT Software, 7/17/2014, www.globalcare.net and www.WLTSoftware.com

Alpharetta, GA -- GlobalCare, Inc., a PPO network management and cost containment company, is pleased to announce a partnership with WLT Software has been established to increase workflow efficiencies for its clients. The relationship between GlobalCare and WLT Software provides Payers the ability to attain greater efficiency operationally to facilitate growth in a competitive marketplace.

"We established a trading partner relationship with WLT Software in 2004 to provide workflow process improvements for a client. Over the years, we have established a thorough understanding of the WLT system and the ways in which we can improve our overall customer experience. It was a natural step to officially partner with WLT Software, as we only choose the best in class industry leaders as preferred partners," said Lindsay Evans, Strategic Sales Manager for GlobalCare.

"WLT is proud to partner with GlobalCare, a truly top notch company," said Tom Brooks, President and CEO at WLT Software. "We've worked hard to establish a partnership with GlobalCare that provides added value to clients, and we are pleased to bring it to the marketplace. Clients of both WLT and GlobalCare will notice improved efficiency with claim flow, easier setup and preferred pricing."

About WLT Software

Since 1979, WLT Software has been a leading provider of advanced claims administration and adjudication systems for Third Party Administrators, Insurance Companies, Government Employee Plans, Cost Containment Companies and Self-Administered Groups. Their core systems, MediClaims and CompClaims, were developed with the understanding that every organization has its own unique needs and requirements.

WLT's philosophy of Client Directed Development provides the flexibility to meet those needs and to proactively adapt to changes and trends in the Benefits Administration industry with tailored, scalable solutions. WLT's success has been built not only on its technological expertise in systems development, but also on the consistency of quality support their service team provides to Clients, with an ability to handle every situation in a proactive, efficient and timely manner. It is this process that has helped position WLT where it is today, one of the leading solutions providers in the world. Contact Mike Tuomey, Director of Business Development & Vendor Relations at (727) 282-1305 or MTuomey@WLTSoftware.com and visit www.WLTSoftware.com .

About GlobalCare, Inc.

GlobalCare, Inc. is a Georgia based corporation providing network management and cost containment services for over 19 years with its headquarters in Alpharetta, GA. Our core business is to maximize the savings on every medical claim by steering members into the most appropriate level of care at the time of any medical event. GlobalCare delivers network optimization and work flow management to return the greatest discounts with the lowest transaction costs. Through the deployment of proactive, interventionist measures medical costs are controlled at the outset. Payers attain greater efficiency both operationally and financially through utilization of GlobalCare's proprietary technology. Contact Robert Marcoux, Vice President of Marketing and Sales, at (800) 860-1111, rmarcoux@globalcare.net and visit www.globalcare.net .

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Berkley Life and Health Insurance Company Named to Ward's 50 Top Performers Company

MyHealthGuide Source: Berkley Life and Health Insurance Company, 7/28/2014, www.BerkleyAH.com and www.BenefitsCaptives.com
 
Hamilton Square, NJ -- Berkley Life and Health Insurance Company, a W. R. Berkley Company, has been named to the 2014 Ward's 50 group of top-performing companies. Each year, the Ward Group selects 50 insurance companies for achieving outstanding financial results in the areas of safety, consistency, and performance over a five-year period. This year, the Ward Group analyzed nearly 800 life-health insurers and identified the top 50, based on objective data and subjective quality measures.

"We are honored to receive the Ward's 50 designation," said Christopher Brown, President and CEO of Berkley Accident and Health. "We operate in selected niche markets, where risk management expertise and financial strength are critical. Our customers have benefitted from our strength and long-term growth, and we're pleased to be recognized for it by the Ward Group." Berkley Life and Health Insurance Company is the issuing carrier for Berkley Accident and Health.

About The Ward Group

The Ward Group is the trusted leader of benchmarking and best practices services for the insurance industry. To be selected for the Ward's 50 designation, insurance companies must pass safety, consistency, and performance requirements for: Surplus, premiums, income, and annual growth; Return on equity and revenue growth; Higher financial returns compared to the rest of the industry. The full list of Ward's top 50 performers is available on the Ward Group's website, www.wardinc.com .

About Berkley Accident and Health

Berkley Accident and Health is a member company of W. R. Berkley Corporation, a Fortune 500 company. Berkley Accident and Health provides an innovative portfolio of accident and health insurance products. It offers four categories of products: Employer Stop Loss, Group Captive, Managed Care (including HMO Reinsurance and Provider Excess), and Specialty Accident.  The company underwrites coverage through Berkley Life and Health Insurance Company, rated A+ (Superior) by A.M. Best and a Ward's 50 top-performing insurance company.  Contact Linda King, Marketing Manager, at (508) 573-6092, lking@BerkleyAH.com and  visit www.BerkleyAH.com and www.BenefitsCaptives.com .

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INTERLINK® Health Services, Inc. and INTERLINK® Care Management, Inc. Now Operate Under Common Name

MyHealthGuide Source: INTERLINK® Health Services, Inc., 7/22/2014, www.interlinkhealth.com

Hillsboro, OR -- INTERLINK® Health Services and INTERLINK® Care Management are pleased to formally introduce the name INTERLINK® COE Networks & Programs to its national clientele. INTERLINK® currently offers 7 Centers of Excellence Networks, and 2 full service programs employing multiple networks, custom written benefit language and integrated care management. The migration to a more encompassing name better communicates the services INTERLINK® currently offers.

"Twenty years ago the name INTERLINK® accurately described our mission, which was to "link" self-funded employer health plans to a transplant network" says John Van Dyke, INTERLINK's® CEO, "but the INTERLINK® of today does so much more. As the market moves to narrower networks and specialized networks, our mission expanded to meet that demand. We now offer specialty networks, and combinations of specialty networks, which often require ACA compliant benefit language and case managers to achieve our client objectives."

Clients can still access INTERLINK® COE networks as in the past, but more clients are moving into combinations of performance-based networks and custom developed benefit language to realize the network's fullest potential.

"From a client perspective, the more encompassing name makes sense. More often than not our clients are implementing two or more networks or programs at the same time," says Heath Potter, INTERLINK's ® Vice President of Sales and Development, "COE Networks & Programs more accurately describes the customization of COE network solutions, which is necessary to stay competitive in today's market place"

About INTERLINK® COE Networks & Programs

INTERLINK® is a privately held corporation based in Hillsboro, Oregon. INTERLINK® builds Centers of Excellence networks for high-cost, low frequency medical procedures which are utilized by health plans all across the nation. Two of INTERLINK's ® seven COE networks have ACA adjusted benefit language, member education materials and fully integrated case management programs. INTERLINK® is well recognized for its Predictive Modeling TransplantCARE Program, which enables health plans to build their own transplant COE network based on predicted outcomes for the upcoming 6-12 months. CancerCARE is a comprehensive cancer management program, using three custom built COE networks, ACA adjusted cancer benefit language and fully integrated case management.  Contact Heath Potter at 800-599-9119, heath.potter@interlinkhealth.com and visit www.interlinkhealth.com .

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People News



HM Insurance Group and RBS Re Name David Daley Vice President, Underwriting and Pricing

MyHealthGuide Source: HM Insurance Group, 7/17/2014, www.hmig.com

PITTSBURGH -- David Daley has joined HM Insurance Group (HM) as the vice president, underwriting and pricing, for the managed care reinsurance program marketed as RBS Re. David will be responsible for all aspects of underwriting, pricing and actuarial product development for this segment of the business.

"As part of our ongoing commitment to the managed care reinsurance space, this newly added role will continue to position us for growth and provide creative solutions to emerging health care risks," said Elizabeth (Liz) Midtlien, president of RBS Re. "We are excited to have someone with David's experience and industry knowledge."

As leader in risk management, HM sees first-hand the importance of reinsurance. The diversification that the RBS Re program delivers is very complementary to HM's employer stop loss business.

"We are pleased to have David join the organization and are confident that his experience and record in the industry will enable him to provide great insight into the strategy and growth of the RBS program." Alex Soria, executive vice president of RBS Re said. "I look forward to working with David and Liz to continue to grow this book of business."

David comes to HM from Reinsurance Group of America, where he served as vice president and chief underwriter for health care reinsurance. Prior to that, he held numerous insurance and reinsurance underwriting leadership positions both global and domestic.

About RBS Re

A program of HM Insurance Group, RBS Re provides reinsurance solutions for HMOs, health plans, providers, ACOs and self-funded employers by developing innovative products that reflect the changing dynamics of the health care market.

About HM Insurance Group

Headquartered in Pittsburgh, HM Insurance Group is a recognized leader in risk management. In addition to the RBS Re program, HM's product portfolio features employer stop loss nationally and workers' compensation in Pennsylvania.

About HM Life Insurance Company

HM Life Insurance Company, HM Life Insurance Company of New York, HM Casualty Insurance Company and Highmark Casualty Insurance Company have "A-" (Excellent) ratings from A.M. Best Company. Through its insurance companies, HM Insurance Group holds insurance licenses in 50 states and the District of Columbia and maintains 23 regional sales offices across the country.  Contact: Jennifer Mahan at jennifer.mahan@hmig.com, 412-544-1359 and visit www.hmig.com .

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IHC Risk Solutions Announces Stephanie Nampel as Executive Underwriter

MyHealthGuide Source: IHC Risk Solutions, 7/23/2014, www.ihcrisksolutions.com

IHC Risk Solutions, a leading provider of Stop Loss Insurance, has announced the addition of Stephanie Nampel, as an Executive Underwriter in their expanding office located in Phoenix, AZ.

Prior to joining IHCRS, Stephanie worked as a Senior Underwriter with HCC in their Phoenix, AZ office for two years. Much of Stephanie's background in Stop Loss Insurance was spent working for Munich Re Stop Loss out of their Chicago area office.

Stephanie received her Bachelors from Lawrence University and began her career in the Stop Loss Insurance industry in a customer service capacity before entering the then Health Benefit Reinsurance, Inc. Underwriting training program.

Joel McKeever, Executive Vice President of Underwriting commented, "We are very pleased to have Stephanie joining the IHC Risk Solutions team. Stephanie's experience and knowledge of the stop loss market is a perfect fit for the IHC Risk Solutions goal of continued profitable growth."

About IHC Risk Solutions

IHC Risk Solutions (IHCRS) offers medical stop-loss, group stop-loss captives, and an Organ Transplant Solution program. IHCRS is a full service direct writer for self-insured employer groups in all 50 states and is a member of the IHC Group, an insurance organization composed of Independence Holding Company (NYSE:IHC) and its operating subsidiaries. Coverage is underwritten by Standard Security Life Insurance Company of New York, also a member of the IHC Group. The IHC Group is built on financial strength and stability of IHC which has over $1 billion in assets as of June 2013 and over 25 years in the stop-loss business. Contact Joel McKeever, 856.392.0254, jmckeever@ihcrisksolutions.com and visit www.ihcrisksolutions.com .

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The Segal Group Promotes Michael Tesoriero

MyHealthGuide Source: The Segal Group, 7/22/2014, www.segalgroup.net

NEW YORK -- Joseph A. LoCicero, President and CEO of The Segal Group announced the promotion of Michael S. Tesoriero.

Mr. Tesoriero joined Segal's New York Health Practice as a Health Benefits Consultant in 1998. He works with many large multiemployer welfare plan clients across a range of industries.

He also serves as a key member of the firm's Stop Loss Practice, negotiating stop loss contracts and conducting internal and external training seminars on the stop loss insurance market. He received a BS in Mathematics and a minor in Business from the State University of New York at Albany. He is currently pursuing designation as a Certified Employee Benefits Specialist (CEBS) and holds a Producer License in Life, Accident/Health in the states of CT, DC, MD, DE, NY, PA and VA.

About The Segal Group

The Segal Group is a leading benefits and HR consulting firm. Segal Group is an independent organization, headquartered in New York with nearly 1,000 employees throughout the U.S. and Canada. It is the parent of Segal Consulting, Sibson Consulting, Segal Select Insurance Services, Inc., and Segal Rogerscasey. In 2014, The Segal Group is celebrating the 75th anniversary of its founding by Martin E. Segal.  Visit www.segalgroup.net .

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Brentwood Services Inc. Employs Betina as Accounts Payable Accountant

MyHealthGuide Source: Brentwood Services Inc., 7/25/2014, www.BWood.com

BRENTWOOD, TN -- Brentwood Services Inc., headquartered in Brentwood, Tenn., recently employed Betina Martin for the position of accounts payable accountant in the BSI Accounting Department, according to Jeff Pettus, chief operating officer of Brentwood Services Inc.

In her position as accounts payable accountant, Martin has general responsibilities over financial outflows: accounts payable, allocation of payments and posting in the accounting system; monitoring cash flow and transfer funds when necessary between bank accounts; and administrative tasks.

Prior to working for BSI, she was employed an accounts payable lead coordinator for Vanguard Healthcare in Brentwood.

About Brentwood Services Inc.

Brentwood Services Inc., an independent employee-owned company headquartered in Brentwood, Tenn., specializes in structuring and managing alternative market solutions for employers and insurance providers.

About Brentwood Services Administrators Inc.

Brentwood Services Administrators Inc. provides claims management and loss control services to employers and employer associations with self-insured and large deductible programs for workers' compensation and other casualty lines. BSA's aggressive coordinated approach to claims administration and loss control has a proven track record of reducing the cost of claims for its clients. BSA also provides underwriting, policy management and accounting services to association-sponsored pools and mutual insurance companies.  Call John Smitherman, vice president of sales, at (800) 524-0604 or (615) 263-1300 and visit www.BWood.com .

About Brentwood Reinsurance Intermediaries Inc.

Brentwood Reinsurance Intermediaries Inc. (BRII) provides insurance and reinsurance brokerage services encompassing self-insurance, guaranteed cost and deductible insurance with a focus on workers' compensation, excess liability lines, and accident and health reinsurance.

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Beacon Risk Strategies Seeks Stop Loss Underwriter

MyHealthGuide Source: Beacon Risk Strategies, 7/3/2014, www.beaconrisk.com

Job Title: Stop Loss Underwriter
Department: Underwriting
Reports To: President, Beacon Risk Strategies
Location: Seattle, WA or Atlanta, GA
Direct Reports: None
FLSA Status: Salary -- Exempt
Salary: Commensurate with Experience

Part of the Group Benefits division of AmWINS Group, Inc., Beacon Risk Strategies is a specialty underwriter, distributor and program manager of medical stop loss and other niche A&H products. As part of AmWINS, our vision is to create, distribute and service innovative insurance solutions that provide our employees, clients and markets with a first class experience.

Position Overview

This position will be responsible for underwriting medical stop loss quotes for new and renewal business. The successful candidate will have an in-depth understanding of underwriting principles and methodologies, the ability to analyze risk experience, ability to creatively problem solve and work well under pressure. Collaborating with other team members and meeting all internal and external deadlines are essential to this position.

Essential Duties

  • Review prospective clients for Stop Loss coverage and underwrite according to current underwriting and pricing guidelines to ensure that reinsurer standards for new business are met.
  • Renew business with existing clients based on current characteristics of the group, multi-year experience analysis, profitability or loss performance, future claim risk and liability to block of business.
  • Perform large claim analysis; research diagnosis and treatment plan.
  • Review plan change and legislative changes for impact to pricing and future claim risk.

Education/Experience

  • Qualified candidates will have a 4-year degree and a minimum of 3-5 years previous experience in successful stop loss underwriting, strong focus on detail, and excellent analytical, communication and time management skills. Experience underwriting other product lines is a plus (e.g. small group stop loss, voluntary or limited benefit products, etc.).

Skills & Qualifications

  • Demonstrate industry knowledge, applied experience
  • Exemplary internal and external communication skills, team and can-do attitude.
  • Solid understanding of underwriting operations and processes
  • Good time management skills

Contact Information

Interested candidates can email resumes to careers@beaconrisk.com .

About Beacon Risk Strategies

Beacon Risk Strategies is an AmWINS Group Company with offices in Seattle and Atlanta. Beacon understands that relationships matter. Our customers trust our expertise to deliver a competitive advantage in everything we do. Brokers, administrators and reinsurers expect a higher standard that comes from working with Beacon. We have a thoughtful approach to underwriting and a tenacious focus on delivering superior cost containment, claims administration and customer service.  Visit www.beaconrisk.com .

AmWINS Group, Inc. is among the largest and most diversified wholesale insurance distributors in the United States. AmWINS has expertise across a diversified mix of property, casualty and group benefits products. We also offer value-added services to support some of these products, including product development, underwriting, premium and claims administration and actuarial services. With over 3,200 employees located in 106 offices across 17 countries, our firm handles over $9.5 billion in premium annually through our four divisions: Brokerage, Underwriting, Group Benefits and International.  Visit www.AmWINS.com.

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Market Trends, Studies, Books & Opinions


Washington's King County Wellness Successful Due to Strong Incentives

MyHealthGuide Source: Christine Vestal, Pew Charitable Trusts, 7/22/2014, Pew/Stateline Article

Article referred by Health Care Administrators Association

SEATTLE – When King County, Washington, launched its employee wellness program seven years ago, its motive was clear. "We were being eaten alive by runaway medical costs," says the county's top executive Dow Constantine.

King County spends nearly $200 million per year to insure 14,000 workers and their families.  Labor unions took the unusual step of joining management in a plan that would ultimately shift more health care costs to workers.

Highlights

  • In its first five years (2007 to 2011), the county's "Healthy Incentives" program invested $15 million and saved $46 million in health care spending with sustained participation by more than 90 percent of its employees.
  • Two years ago, $61 million in surplus health care funds were returned to county coffers because cost growth was lower than actuaries had projected. Seattle, the state's largest city, is the county seat.
  • Employee health improved dramatically, raising King County employees' health status above the national average and keeping it there. Smoking rates dropped from 12 percent of employees to less than 5 percent, and more than 2,000 employees classified as overweight or obese at the start of the program lost at least 5 percent of their weight, more than halving their risk of diabetes.
  • With an average age of 48.5 years and practically no turnover, the county's worker population is getting healthier even as it's growing older.

What is Different about King County Wellness Program?

These results, documented in a 2012 internal report by former staff economist John Scoggins, are remarkable when compared to the generally lackluster performance of other wellness programs run by large U.S. organizations, including state and local governments. According to a 2013 report from the Rand Corporation, about half of all U.S. large employers offer some type of wellness program and the number is growing. But few end up saving any money and employee participation has been limited. Many fizzle out after a year or two.

On average, only 47 percent of employees participate nationwide, and only 2 percent of organizations that offer the plans report any reduction in health care costs, according to the study, which was funded by the U.S. Departments of Labor and Health and Human Services. Overall savings from wellness plans offered by the organizations Rand surveyed were too small to be statistically valid.

King County's intensive education and outreach effort cost the county nearly $7 million in the first two years. Since then, the effort has tapered, but six full-time employees still work to maintain the county's high participation rate. "We want to make sure that no one is left out because of lack of knowledge," said Brooke Bascom, who runs the program.

The biggest draw, Bascom said, has been the financial incentives King County offers its employees for participating. Other wellness programs offer much less substantial rewards, according to the Rand report.

Among the 10 percent of employees who don't participate in Healthy Incentives, most say it's because they don't want to share private information about themselves. A small number are given exceptions because of health conditions or family issues that prevent them from participating.

More Than a Wellness Plan

Healthy Incentives offers a model that state and local governments should replicate, said Stephen Goldsmith, director of the innovations award program at Harvard's Kennedy School of Government. Washington state is already emulating parts of King County's wellness plan and Oregon is trying to start a similar program.

Here's how the financial incentive part of the program works:

  • Healthy Incentives allowed workers to shave $200 off of their $500 deductible simply by filling out a health assessment form.
  • Another $200 credit off if they completed an "individual action plan," such as attending six Weight Watchers meetings at work, completing five phone sessions with a tobacco cessation coach or learning how to better manage diabetes.
  • Four years into the program, nonparticipants' deductibles went up to $800.
  • Employees who did not participate in the program had to pay a 10 percent higher co-insurance share of the cost of medical care after their deductibles were exhausted. When you put those two incentives together, the individual savings could come to more than $1,000 per year.
  • The program also encourages the use of less expensive generic drugs by increasing the co-pay for name-brand drugs from $15 to $30, while decreasing the co-pay for generic drugs from $10 to $7. These changes, put in place in 2010, resulted in $2.4 million savings to the county and a $1 million savings to employees by 2011.
  • To encourage employees to use Group Health, the county eliminated the deductible and added a graduated co-payment of $20 to $50 based on employees' Healthy Incentives participation levels.
  • Regence BlueShield patients remained subject to existing deductibles of up to $800. As a result, an additional 2,274 employees switched to Group Health, bringing its share of coverage to 30 percent. Between 2010 and 2011, the shift to Group Health reduced county expenditures by $6.5 million and saved employees $2.2 million.

Early Employee Objections Change to Support

Not everyone loved the program in the beginning. In its first two years, county employees objected to the time spent filling out forms and documenting their action plans. Some lodged formal complaints. Kathy Pompeo was one of them.

A supervisor in the Sheriff's Office, Pompeo runs a 24-hour crew of data-entry workers who have little time to fill out online forms detailing their daily wellness activities. "My staff was very frustrated and very negative," she said. They were spending more time reporting on their activities than working on their healthy behaviors. They participated, "kicking and screaming."

Bascom said the county took complaints to heart and made the process easier. With such a diverse workforce -- from bus drivers, road workers and custodians to law enforcement officers, doctors, attorneys and administrative workers -- the county had to make accommodations so that everyone could participate. Bus drivers, for example, didn't have access to computers, so the county developed a paper process.

Even the county executive complained that the process was cumbersome. "You'd get up in the morning and exercise and then have to sit down and log on to a computer. It didn't make sense," Constantine said.

Now employees can text their activity to the program: "I'm walking my dog," for example. And the county applies points toward their full participation status.

Has the county made it too easy to comply? Bascom doesn't think so. Research shows that healthy habits can be formed in just four weeks. As for employees gaming the system by not really performing the activities they say they are, Bascom and others said they doubted much, if any, of that was going on.

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Legal, Legislative & Regulatory News


US DOL ERISA Advisory Council Holds Public Meeting Aug. 19-21 to Address Benefit Plan Outsourcing, PBM Compensation

MyHealthGuide Source: DOL EBSA, 7/24/2014, Release Number: 14-1369-NAT

Editor's Note:  While this Public Hearing deals with Defined Contribution (DC) and Defined Benefit (DB) Plans, and Retirement Accounts, this editor has seen actions by the ERISA Advisory Council "spill over" into ERISA self-funded plans.  Therefore, this article is made available.

WASHINGTON -- The U.S. Department of Labor's Advisory Council on Employee Welfare and Pension Benefit Plans, known as the ERISA Advisory Council, will meet Tuesday, Aug. 19, through Thursday, Aug. 21. Council members will hear testimony from invited witnesses and receive an update from the Employee Benefits Security Administration.

Topics for discussion and study include:

Descriptions of these topics are available on the advisory council page of the EBSA website at www.dol.gov/ebsa/aboutebsa/erisa_advisory_council.html .

The three-day meeting will take place at the U.S. Department of Labor, 200 Constitution Ave. NW, Washington, D.C., 20210. The meeting will run from 9 a.m. to approximately 5:30 p.m. on Aug. 19 and 20 in C5320 Room 6, and from 8:30 a.m. to 4:30 p.m. on Aug. 21 in C5521 Room 4. The EBSA update is scheduled for the morning of Aug. 20, subject to change.

Organizations or members of the public who wish to address the council or submit a written statement should email their requests by Tuesday, Aug. 12, to the council's executive secretary, Larry Good, at good.larry@dol.gov, or call 202-693-8668.

Section 512 of the Employee Retirement Income Security Act provides for the establishment of the ERISA Advisory Council, which advises the secretary of labor and submits recommendations regarding the secretary's functions under ERISA.

Contact Mike Trupo at Trupo.Michael2@dol.gov or Laura McGinnis at McGinnis.Laura.K@dol.gov or all (202) 693-6588 or x4653.

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Medical News



Study Links Shift Work to Risk for Type 2 Diabetes

MyHealthGuide Source: Zuxun Lu of Huazhong University of Science and Technology in Wuhan, China, et al, 7/16/2014, Occupational & Environmental Medicine Extract and Mary Elizabeth Dallas, 7/24/2014, HealthDay News

Editor's Note:  Self-funded municipals should review shift workers and study possible correlation with these individuals' diabetes experience as this study indicates a link.

Shift workers, especially men, may be at higher risk for type 2 diabetes compared to people not on such schedules according to a study published in Occupational & Environmental Medicine.

"Physicians have long known that working shifts disrupts many key body chemicals, creating a ripple effect that can lead to ailments such as gastrointestinal disorders, cardiovascular disease and even cancer," said Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City. "Now type 2 diabetes can be added to this considerable list."

The study involved 226,652 people in China.  Researchers reviewed 28 independent reports involving these individuals and 14 595 patients with diabetes.   Led by Zuxun Lu of Huazhong University of Science and Technology in Wuhan, China, the study took several factors into account, such as workers' shift schedules, their body mass index (BMI, a calculation of height and weight), family history of diabetes and their level of physical activity.

Study findings

  • Any amount of shift work was linked to a 9 percent greater risk for developing diabetes.
  • For men engaged in shift work, the risk jumped to 37 percent.
  • Rotating shift work had a 42 percent greater risk for diabetes.

Males are at greater risk.  Researchers believe that testosterone levels may play a role. Prior studies have pointed to an association between low testosterone levels and insulin resistance and diabetes.

Daytime levels of this male hormone are regulated by the internal body clock, Lu's team explained.

According to Lu's team, erratic working schedules make it more difficult for the body to establish a sleep-wake cycle, and poor sleep may worsen insulin resistance, a precursor to diabetes.

Another expert said other factors may be at play as well.

"Growth hormone, known to elevate blood glucose when present in excess, peaks at 1 a.m.," noted Dr. Gerald Bernstein, director of the Diabetes Management Program at Friedman Diabetes Institute at the Beth Israel Medical Center in New York City. "Shift work also often makes it more difficult to schedule regular meals and exercise."

Employers are advised to

  • Screen shift workers regularly for pre-diabetes and intervene to slow the progression to full-blown diabetes
  • Consult their doctor, who can monitor cholesterol levels, blood pressure and insulin levels to detect if blood sugar levels are creeping up dangerously.
  • Doctors may also be able to prescribe sleep aids to help shift workers get the proper amount of sleep, even if that sleep comes during odd hours.

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Recurring Resources


Medical Stop-Loss Providers Ranked by Annual Premium Survey (last updated 6/30/2014)

Source: MyHealthGuide

Editor's Note: The following is a recurring article. This Newsletter is often asked by readers for a list of medical stop-loss providers and their respective premiums. Below the first of a recurring article that attempts to lists stop-loss providers and annual premiums. Sources includes press releases, AM Best reports, conference presentations and more.

Stop-loss Premium Ranking
Compiled by MyHealthGuide Newsletter

Reader response and correction is encouraged.
Sources will be cited. Please send updates / changes to Info@MyHealthGuide.com

  Stop-loss Provider Years Providing Stop Loss Associated Carriers / MGUs Annual stop-loss Premium
(Millions)
Capital /Equity
(Millions)
Source
1. CIGNA     $1,907
2013
  CIGNA 2013 10-K, page 46 2/27/2014
2. Sun Life Financial     $915.2
2013
  Scott Beliveau, Sun Financial 4/28/2014
3. HCC Life Insurance Company >35 Years HCC Life
(A.M. Best Rated: A+)
Perico Life
(A.M. Best Rated: A+)
$818
2013
  HCC Insurance Holdings, Inc. Release,
2/11/2014
4. HM Insurance Group >30 Years HM Insurance Group
(A.M. Best Rated: A-)
$762.4
2013
$507
12/31/2013
Mike Sullivan, President & COO
2/4/2014
5. Symetra >36 Years Symetra Life Insurance Company
(A.M. Best Rated: A)
(Block - $475M
MRM - $255M)
$730
2012
$3,429
6/30/2014
Michael Fry, Executive Vice President, Symetra;
Mike McLean, Chairman Medical Risk Managers, Inc.
1/7/2014
6. ING Employee Benefits > 35 Years ReliaStar Life
(A.M. Best Rated: A)
$560
2013
$1,942
12/31/2013
Joe Keller, Lead Financial Analyst, ING Employee Benefits,
3/18/2014
7. Companion Life > 20 Years   $310
12/31/2013
  Philip Gardham, Vice President, Specialty Markets,
11/20/2013
8. National Union Fire Insurance Company of Pittsburgh >35 Years AIG Benefit Solutions $215
5/2014
  Jeff Gavlick, VP, Stop Loss Products, AIG Benefit Solutions
6/20/2014
9. Independence Holding Company   Standard Security Life Insurance Company of New York,
Madison National Life, Independence American Insurance Company
$200   Roy T.K. Thung, CEO, Letter to Stockholders
3/31/2014
10. Zurich North America     $130   Tracey Brennan, Zurich North America.
7/22/2011
11. Munich Re Stop Loss, Inc.   AIC, TransAmerica $110
2012
  Susan McGrath Bowman,
Chief Operating Officer, Munich Re Stop Loss, Inc.
4/25/2013
12. The Union Labor Life Insurance Company  (ULLICO) >25 Years ULLICO
(A.M. Best Rated: B++)
$96
2/2014
  Victor Moran, Second Vice President, Actuarial Operations.  3/12/2014
13.
Markel Insurance Company <5 Years Markel Insurance Company
(A.M. Best Rated: A-)
$3 $$3,388
12/31/2011
Mark Nichols, Managing Director.
7/20/2012

Other stop-loss leaders include the following list. However, we await reader response providing stop-loss premium volume (and additional carriers) so that each could be added to the table above. 

  • ACE America
  • Aetna
  • Amalgamated Life
  • American Fidelity Assurance Company 
  • American National Life Insurance Company of Texas
  • Berkley Accident and Health
  • BEST Re 
  • Blue CrossBlue Cross Blue Shield (various regions)
  • Gerber Life Insurance Company
  • International Insurance Agency Services, LLC
    (IIS)
  • Lloyd's of London
  • Nationwide Life Insurance Company
  • Pan American Life
  • QBE Insurance Company
  • Trustmark Insurance Company
  • UnitedHealthcare

Stop-loss Premium Volume is not the Whole Story

Industry executives question the purpose of a chart reporting only stop-loss premium without additional information such as:

  • Ratings from Best, S&P, Moodys and others (data collection began 6/2012)
  • Capital size of the insurance company (data collection began 6/2012)
  • Reinsurance purchased and from whom
  • Length in the business (data collection began 6/2012)
  • Number of open litigation claims
  • Is stop-loss a core business or ancillary business?
  • % age of risk retained vs. ceded
  • Average stop-loss claim processing turn-around time
  • % age of claims denied
Should reader interest indicate such measures are important, this Newsletter will attempt to collect and report.  

Reader response and correction is encouraged. Sources will be cited. Please send updates / changes to Info@MyHealthGuide.com.  

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Upcoming Conferences


August 13-20-27, 2014 -- Web Event
Clearwater HIPAA Compliance Virtual BootCamp™.  Designed for busy professionals, this event is a series of three, 3-hour web sessions delivering an action-packed HIPAA-HITECH curriculum This virtual workshop series  provides critical information leaders need to know about the HIPAA Privacy and Security Final Rules and the HITECH Breach Notification Rule. The Clearwater HIPAA Compliance Virtual BootCamp™ has helped hundreds of professionals learn HIPAA-HITECH fundamentals in a highly interactive, online classroom setting.  Contact Clearwater Compliance at 800-704-3394 and info@clearwatercompliance.com.

August 18-20, 2014
Healthcare Information Security, Privacy Training presented by Clearwater Compliance, a designated Official Training Provider (OTP).  This official HCISPP training seminar is the most comprehensive, complete review of healthcare security and privacy concepts and industry best practices. The training specifically covers each element of the HCISPP common body of knowledge (CBK®), including foundational information on:

• The Healthcare Industry
• The Regulatory Environment
• Privacy and Security in Healthcare
• Information Governance and Risk Management
• Information Risk Assessment
• Third Party Risk Management

Comprehensive preparatory training for healthcare information security professionals who are working to earn the HealthCare Information Security and Privacy Practitioner (HCISPP) credential from (ISC)˛.  Nashville, TN. 

Cost of the Clearwater HCISPP training is $1,595. Click here to register.  Contact Helene Cuddeback at helene.cuddeback@clearwatercompliance.com and visit www.clearwatercompliance.com

October 15, 2014
Health Insurance Exchanges Forum hosted by America's Health Insurance Plans. An ongoing series to provide the latest and most critical exchanges information on the business of the exchanges, including best practices and how business processes have changed. Hear from the leadership implementing exchanges at the state and federal levels. Enjoy early registration rates before September 5, 2014. Contact: 202-778-3200 or registrations@ahip.org . See www.ahip.org/Conferences/OctoberExchange2014/

October 16-17, 2014
The State Health Issues Conference hosted by America's Health Insurance Plans. Brings together the leading authorities and thought leaders to discuss the state legislative and regulatory issues challenging health plans. Enjoy early registration rates before September 5, 2014. Contact: 202-778-3200 or registrations@ahip.org . See www.ahip.org/Conferences/StateIssues2014/

October 16, 2014
Clearwater HIPAA Compliance BootCamp™.  Designed for busy professionals, this event distills into one action-packed day, the critical information leaders need to know about the HIPAA Privacy and Security Final Rules and the HITECH Breach Notification Rule. The Clearwater HIPAA Compliance BootCamp™ has helped hundreds of professionals learn HIPAA-HITECH fundamentals in a highly interactive classroom setting. Los Angeles, CA.  Contact Clearwater Compliance at 800-704-3394 and info@clearwatercompliance.com.

November 5-12-19, 2014 -- Web Event
Clearwater HIPAA Compliance Virtual BootCamp™.   Designed for busy professionals, this event is a series of three, 3-hour web sessions delivering an action-packed HIPAA-HITECH curriculum This virtual workshop series provides critical information leaders need to know about the HIPAA Privacy and Security Final Rules and the HITECH Breach Notification Rule. The Clearwater HIPAA Compliance Virtual BootCamp™ has helped hundreds of professionals learn HIPAA-HITECH fundamentals in a highly interactive, online classroom setting. Contact Clearwater Compliance 800-704-3394 and info@clearwatercompliance.com.

October 5-7, 2014
National Educational Conference & Expo presented by Self-Insurance Institute of America (SIIA). The event typically attracts more than 1,700 attendees from throughout the United States and from a growing number of countries around the world.  The program features more than 40 educational sessions designed to help employers and their business partners identify and maximize the value of self-insurance solutions. Highlights:

  • Click here for speaker listing
  • Self-insured group health plans from every angle
  • Plan design and cost containment
  • Financial risk transfer
  • Broker involvement
  • ACA compliance
  • Stop-loss captive programs
  • 831(b) captives
  • Workers' Comp self-insured funds (SIGs)
  • Over 150 Exhibitors
  • SIG Roundtable Discussion
  • Sessions Provide Unique Learning and Industry Collaboration Opportunities
  • Featured speaker: Dr. Richard Pimentel, senior consultant with Milt Wright & Associates, Inc., His presentation focus will be Updating Yesterday's Disability Management Solutions to Address Today's Workers' Compensation Dilemmas.

J.W. Marriott Desert Ridge, Phoenix, AZ. contact Justin Miller at 800/851-7789, or jmiller@siia.org.  Information and Registration: www.siia.org/i4a/pages/index.cfm?pageid=6300

October 15-17, 2014
SPBA Fall Meeting (members only). Nashville, TN. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

December 4-5, 2014
IHC Forum West presented by the Institute for HealthCare Consumerism. Las Vegas, NV. Contact Joni Lipson at jlipson@theihcc.com and visit www.www.theihccforum.com/2014-ihc-forum-and-expo/

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January 18-20, 2015
The 2015 Taft-Hartley Benefits Summit presented by Financial Research Associates, LLC.
Caesars Palace in Las Vegas. Contact Jennifer Clemence at jjclemence@frallc.com.  Information and registration: www.frallc.com/register.aspx?ccode=B940 and visit
www.frallc.com

January 25-27, 2015
AAPAN 2015 Annual Forum presented by American Association of Payers Administration & Networks.  The theme for this year's forum is "Thinking Forward -- Rethink, Retool, Realign." This will be your opportunity to join industry leaders and an exciting lineup of speakers as we examine how best to position our businesses in this fundamentally changed healthcare environment. You will hear firsthand from experts and colleagues about challenges and opportunities at the state and federal level that are unique to TPAs, PPOs, and Workers' Comp professionals. Information: aseiler@aapan.org and (502) 403-1122.  Ritz-Carlton, Laguna Niguel in Dana Point, CA.

February 10-11, 2015
2015 Executive Forum presented by Heath Care Administrators Association (HCAA).  Encore at Wynn Las Vegas. Las Vegas, NV. www.HCAA.org.

March 18-20, 2015
SPBA Spring Meeting (members only). Washington, DC. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

May 6-8, 2015
Northshore's 26th Annual Claims Conference.  Salem, Massachusetts. This is an invitation only event. If you are interested in attending or presenting at next year's conference, you may contact Steve Murphy at smurphy@niis.com

September 28-30, 2015
SPBA Fall Meeting (members only). Scottsdale, AZ. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

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March 30-April 1, 2016
SPBA Spring Meeting (members only). Washington, DC. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

October 17-19, 2016
SPBA Fall Meeting (members only). Minneapolis, MN. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

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March 15-17, 2017
SPBA Spring Meeting (members only). Washington, DC. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

September 13-15, 2017
SPBA Fall Meeting (members only). Cincinnati, OH. Society of Professional Benefit Administrators (SPBA). www.SPBATPA.org

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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: Owner of MyHealthGuide also has ownership interest in CareHere, LLC® and LabInsight®

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