MyHealthGuide Newsletter
News for the Self-Funded Community

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General & Company News

People News

Market Trends, Studies, Books & Opinions

Legislative & Regulatory News

Medical News

Recurring Resources

Upcoming Conferences

Editorial Notes, Disclaimers & Disclosures

General & Company News

Emdeon to Buy Change Healthcare for $135 Million

MyHealthGuide Source: Change Healthcare, 11/19/2014, Change Healthcare release

NASHVILLE, TN -- Emdeon Inc. announced it has entered into a definitive agreement to acquire Change Healthcare, a market leader in healthcare consumer engagement and transparency. Change Healthcare will enable Emdeon to offer its customers additional solutions that marry cost and quality information with a robust inventory of consumer behavioral insights. These solutions can help employees, health plan members and patients reduce costs and become better healthcare consumers. 

Emdeon will acquire Change Healthcare, a privately held company, for approximately $135 million in cash payable at closing, plus additional contingent payments of up to $50 million based upon the attainment of financial performance objectives of the acquired business through the end of 2017.

"Our customers are prioritizing information, insights and capabilities that enable individuals to be better healthcare consumers," said Neil de Crescenzo, Emdeon president and CEO. "While Emdeon has assisted payers, providers, pharmacies and our partner network with cost management, efficiency and maximizing revenues for many years, the addition of Change Healthcare's innovative, proven capabilities will further accelerate our customers' success. By combining our connectivity and scale with Change Healthcare's transparency and personalization capabilities, we can help our customers further increase member and patient engagement and add even more value to the services they provide their customers."

Emdeon is the largest financial, administrative and clinical health information network in the nation, processing more than seven billion transactions with a claims value of $1 trillion annually. Emdeon's Intelligent Healthcare Network™ reaches 700,000 physicians, 81,000 dentists, 60,000 pharmacies, 5,000 hospitals, 600 vendors, 450 laboratories and 1,200 government and commercial payers.

Change Healthcare president & CEO Doug Ghertner added, "Within the complex healthcare landscape, consumers are faced with increasing costs and more choices than ever. This transaction reinforces our commitment to transparency and consumer engagement and will enable us to deliver even more comprehensive, accurate and timely information to our users. By joining the Emdeon team, we will have access to the resources necessary to accelerate our growth and to become the premier platform for consumer engagement in healthcare."

Change Healthcare was founded to transform the way consumers evaluate and utilize healthcare services by combining unique insights at the point of decision with sustainable engagement. With a national customer base of health plans and employers and more than 10 million lives under contract, Change Healthcare is a leading provider of healthcare consumer engagement and value-based healthcare solutions that enable consumers to:

  • better understand and utilize their healthcare benefits and options;
  • receive proactive insights on a dynamic basis at critical decision points;
  • make informed healthcare purchasing decisions based on quality, cost and convenience; and
  • manage their out-of-pocket responsibility and realize savings.

Consumers continue to enroll in high deductible health plans at a rapid pace. Over 80% of employers now offer these plans and nearly 40% of employees have deductibles of $1,000 or more. In addition, an increasing number of healthcare consumers are choosing their benefits through public and private health insurance exchanges. These plans offer more flexibility but often have higher out of pocket expenses, requiring consumers to better understand their healthcare benefits and find ways to maximize the value of their healthcare spend. As a result, consumers increasingly need accurate cost and quality information before treatment as they learn to "shop" for affordable healthcare. Creating improved consumer and provider access to cost and quality data at the point of care is a core component of any value-based healthcare delivery system and will have a significant impact on on-going healthcare expenses.

Like Emdeon, Change Healthcare is headquartered in Nashville, Tennessee. The rapidly growing team at Change Healthcare will join Emdeon and form the core of the company's healthcare consumer engagement business. The business will be led by Change Healthcare's president and CEO, Doug Ghertner, who will report directly to Emdeon's CEO.

About Emdeon

Emdeon is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers, pharmacies and patients in the U.S. healthcare system. Emdeon's offerings integrate and automate key business and administrative functions of its payer, provider and pharmacy customers throughout the patient encounter. Through the use of Emdeon's comprehensive suite of solutions, which are designed to easily integrate with existing technology infrastructures, customers are able to improve efficiency, reduce costs, increase cash flow and more efficiently manage the complex revenue and payment cycle and clinical information exchange processes. Visit

About Change Healthcare

Established in 2007, Change Healthcare is on a mission to transform the way Americans purchase and utilize healthcare services by driving sustainable engagement at the individual level. With a national customer base of health plans and employers, Change Healthcare is a premier national provider of healthcare consumer engagement and transparency solutions, enabling consumers to: better understand and utilize their healthcare benefits; make informed healthcare purchasing decisions based on quality, cost and convenience; and manage higher out-of-pocket responsibility and realize savings. This, in turn, helps both health plans and employers: control their healthcare costs; successfully migrate to more cost-effective plans; optimize existing wellness programs; and improve employee satisfaction and retention. Visit


W9 Corrections, LLC Launches Convenient Tax ID Number Lookup Service for Self-Funded Plans

MyHealthGuide Source: BASELoad, Inc. and W9 Corrections, LLC, 11/20/2014,

Charlotte, NC -- W9 Corrections announces an exciting new Tax Identification Number (TIN) Lookup Service that revolutionizes the way payers search for provider TINs. With a convenient web portal, W9 Corrections will allow users to search for the IRS-validated name affiliated with a specific TIN. Only pay for the TIN/legal names that are returned.

"W9 Corrections has historically and continues to run entire 1099 files through our systems that produce results of 99% or greater accuracy. We have processes in place that eliminate all payer tasks involved with correcting CP2100 files," says president and CEO Gerard Szatkowski, who founded W9 Corrections. "With this new web portal, our clients can enter individual TINs and get the TIN/legal name combination required from the IRS. Enter the TIN into our web portal and retrieve the legal name for that TIN in just a few seconds. It's that easy. Eliminate mailings, tracking, handling, file maintenance, etc. If we don't have the legal name for that TIN, there is no charge for that record."

The new web portal launched November 19, 2014 and processes secure transactions via PayPal, one of the most trusted payment solutions in the world. With 1099 season upon us, there isn't a better time to see just how much time, effort and money that W9 Corrections and its new TIN Lookup Service can save your business.

About W9 Corrections, LLC

W9 Corrections, LLC is a daughter company of BASELoad, Inc, based 20 minutes outside of Charlotte, NC. Since 1999, BASELoad, Inc. has been serving clients with a variety of provider data solutions to increase auto-adjudication rates. From provider data cleanup services to electronic provider claims matching, expect BASELoad, Inc. and W9 Corrections to remain the standard for provider data.  Contact Brent Saltzman, Data Conversion Specialist, BASELoad Inc.& W9 Corrections, LLC, at 704-424-9889, and visit


United Claim Solutions' Healthcare Savings Quarterly Releases 4th Qtr. 2014 Edition; The Affordable Care Act: Where is the Market Today?

MyHealthGuide Source: United Claim Solutions (UCS), 11/21/2014,

PHOENIX, AZ. November 21, 2014. The Healthcare Savings Quarterly (HSQ) has released the 4th quarter 2014 edition of its growing educational publication. This edition focuses on the Affordable Care Act and the impact on self-insured business, and includes articles from industry leaders. You can access a FREE copy of this e-magazine, review past editions, and sign up to receive future editions via email by clicking on the following link:

If you are a Self-Insured Employer, Payer, Labor or Trust Organization, Stop-loss Carrier, Health Plan, or a business that services this market, this publication can be a useful source of information and guidance.

About The Healthcare Savings Quarterly

The Healthcare Savings Quarterly (HSQ) is a unique electronic publication designed to provide useful, timely and actionable information on a host of topics impacting the health insurance and healthcare markets. Each quarter we identify a "hot topic" in the market, and solicit articles from industry leaders to provide varying perspectives on issues and opportunities. Currently, HSQ reaches over 4,600 contacts nationwide.

HSQ is powered by United Claim Solutions (UCS), an innovative Medical Cost Reduction and Claims Flow Management company providing cutting edge and customizable programs for payers, employers, unions, accountable care organizations, reinsurers and health plans. UCS offers end to end services including Bill Audits, Out-of-Network Bill Repricing, Specialty Claim Negotiations, Medicare Plus Repricing, PPO Administration, Medical Management, Clearinghouse Services, Data Warehousing, OCR/Scanning, and Plan Modeling. We provide solutions for Group Health, Workers' Compensation, and Auto Liability. Contact Corte Iarossi, VP of Sales & Marketing at 602-393-4553 (x120), and visit


Starmark Self-Funded Plan Design Enhancements Offer Greater Flexibility

MyHealthGuide Source: Starmark, 10/21/2014,

LAKE FOREST, IL -- Starmark® HealthyEdgeSM and Starmark Healthy Incentives® self-funded plan design enhancements and healthcare reform changes for effective dates of January 1, 2015, and later, offer small to mid-size businesses additional flexibility to customize a plan to fit their unique needs.

Key enhancements:

  • New In-Network/Out-of-Network Deductible choices
  • New Individual Out-of-Pocket Limit choices
  • Prescription drug deductible and copays accumulate toward the out-of-pocket limit
  • Reinsurance Assessment Fee is changing from $5.25 to $3.67 per member per month

 State availability changes:

  • Utah - All four surplus options are available for Starmark HealthyEdgeSM self-funded plan designs and stop-loss insurance in Utah. Previously, only the Cash Surplus option was available.
  • New Hampshire - Starmark Healthy Incentives® self-funded plan designs with stop-loss insurance are available for groups with 51 or more eligible employees in New Hampshire. All four surplus options are available. Non-ERISA groups are not eligible.
    Brokers can access useful sales tools and appointment information by logging in to the Starmark website > Marketing Materials > Toolkit Library.

About Trustmark Companies

More than 100 years of Trust. Founded in 1913, Trustmark provides access to a full spectrum of employee benefit solutions, including benefits administration, payroll-deducted voluntary products, group medical benefits, and population wellness, health and fitness management programs. Trustmark's success is based on building and maintaining trust through personal, responsive service and flexible benefit solutions. Visit

About Starmark

With expertise in group healthcare benefits, Starmark offers self-funded plan designs, tools to manage healthcare costs, paperless employee enrollment, nationwide network access and seamless HRA administration for small to mid-size businesses. Plans are administered by Starmark, and stop-loss insurance and ancillary coverage are provided by Trustmark Life Insurance Company. Visit


H.H.C. Group Receives Nebraska Approval for Independent Reviews

MyHealthGuide Source: H.H.C. Group, 11/17/2014,

The Nebraska Department of Insurance has issued H.H.C. Group a license as an Independent Review Organization (IRO). The state will now start to assign H.H.C. Group cases for review.

IROs provide peer review services when insurers deny health insurance claims. The purpose of these reviews is to determine if a service is medically necessary, medically appropriate, experimental or investigational. The Affordable Care Act requires insurance companies to contract with at least three IROs that are nationally accredited.

H.H.C. Group is a URAC accredited IRO. URAC (formerly the Utilization Review Accreditation Commission) is a nonprofit organization promoting healthcare quality by accrediting healthcare organizations. URAC's IRO standards "assure that organizations that perform this service are free from conflicts of interest, establish qualifications for physician reviewers, address medical necessity and experimental treatment issues, {and} have reasonable time periods for standard and expedited reviews, and appeals processes."

H.H.C. Group provides Internal and External Independent Peer Reviews for insurance companies, health maintenance organizations, self-insured companies and ERISA plans. The team overseeing the review process utilizes its combined 125 years of healthcare experience to ensure that every review fully answers all questions being asked, cites the appropriate medical guidelines, and is clearly written and grammatically correct.

H.H.C. Group's Health Insurance Adjusters (H.I.A.) are licensed in Florida, New York, North Carolina, and Oregon. H.H.C. Group is a Utilization Review Agency in Alabama and is a Licensed\Certified\External Independent Review Organization in Arkansas, Georgia, Hawaii, Idaho, Illinois, Iowa, Kentucky, Mississippi, Nevada, New Hampshire, Ohio, Oklahoma, South Dakota, Tennessee, Utah, Virginia, Washington and Wyoming, a Private Review Agent in the Commonwealth of Virginia, and a Licensed Medical Claims Review Agency in the State of Indiana.

About H.H.C. Group

H.H.C. Group is a leading national health insurance consulting company providing a wide range of cost containment solutions for Insurers, Third Party Administrators, Self-Insured Employee Health Plans, Health Maintenance Organizations (HMOs), ERISA and Government Health Plans. H.H.C. Group utilizes a combination of highly skilled professionals and advanced information technology tools to consistently deliver targeted solutions, significant savings and exceptional client service.

H.H.C. Group's services include Claims Negotiation, Medicare Based Pricing, DRG Validation, Medical Bill Review (Audit), Claim Repricing, Claims Editing, Medical Peer Reviews/Independent Reviews, Independent Medical Examinations (IME), Case Management Utilization Review, Data Mining, Predictive Modeling, Disease Management and Pharmacy Consulting. H.H.C. Group is one of forty-six URAC accredited IROs. Contact Bob Serber at, 301-963-0762 ext. 163 and visit


Aquarius Continues Teaching at Columbia University, Masters in Actuarial Science -- Featuring Self-Funding, ACOs and More

MyHealthGuide Source: Aquarius Capital, 11/21/2014,

New York, NY - Michael Frank and Donald Rusconi of Aquarius Capital to continue to teach as professors at Columbia University in the Masters in Actuarial Science program. They will teach a course called "A Global Perspective on the Health Insurance Market." This will be the sixth semester for the course. The focus will include different aspects of the healthcare insurance industry including products available, delivery systems (US vs. International), actuarial services, underwriting, healthcare reform, accountable care organizations, CMS grants, finance, reinsurance, self-funding, specialty healthcare products, and capital markets.

The course will be expanded this semester to include research projects around healthcare reform (PPACA) with focus on the impact of health insurance exchange markets and accountable care organizations (ACOs) as well as technology advancements in the healthcare delivery system, specialty reinsurance, medical tourism and small group self-funding. The course will also focus on emerging issues in the international healthcare market and will include student research projects benefit the actuarial and insurance industry.

The program will also include opportunities for insurance and reinsurance professionals and organizations to participate in research as part of the program. If an interest in participating in research or alternatively access to graduate student for possible internships, then contact Michael Frank at (914) 933-0063 or To learn more about the Columbia University, Masters in Actuarial Science, visit

About Aquarius Capital

Aquarius Capital is an independently owned company with offices in New York and Connecticut. Aquarius Capital provides an array of services to its clients in the life, accident, health and special risk insurance industry including actuarial, underwriting, product development, financial analysis, practice management, mergers & acquisition, and reinsurance risk management services in the US and internationally. Contact Michael Frank at 914-933-0063,  and visit

About Columbia University, Masters in Actuarial Science Program

Columbia University was founded in 1754 as King's College by royal charter of King George II of England. It is the oldest institution of higher learning in the state of New York and the fifth oldest in the United States. In 2006, the University created the Masters of Science program in Actuarial Science. The program currently has more than 250 graduate students enrolled with students coming from more than 20 countries and 6 continents. It is an intensive eighteen (18) month program with students studying property/casualty, pensions, life insurance, reinsurance, ERM and health insurance with training in pricing, valuation, mergers & acquisition and other financial disciplines internationally. More than sixty (60) companies per year are active with the University including offering internships. The program currently has 23 credentialed actuaries as faculty (3 full time and 20 part time professors). Many of the courses are taught by practicing actuaries and insurance experts. As an example, Michael Frank and Donald Rusconi are two of the instructors teaching healthcare and reinsurance. Visit


Wellcentive Named Finalist for 2014 Intel Innovation Award

MyHealthGuide Source: Wellcentive, 11/20/2014,

ATLANTA, GA -- Wellcentive, the industry leader in end-to-end population health management (PHM) for healthcare organizations, announced being named one of the four finalists for the 2014 Intel Innovation Award. Sponsored by Intel, the world leader in computing innovation, the award, in its fourth year, recognizes companies developing leading-edge technology and unique approaches to improving health and healthcare delivery processes.

Wellcentive's Mason Beard, senior vice president of solutions and company co-founder, and Kirk Elder, chief technology officer, accept the finalist award plaque today at the 2014 Health IT Leadership Summit in Atlanta, Georgia (upload photo here). The Intel Innovation Award was presented to Jvion.

"We are greatly honored that such an innovative technology leader as Intel has recognized the unique value our solutions bring to the healthcare industry," said Tom Zajac, Wellcentive's CEO. "From the outset, we have focused on pragmatic solutions that meet healthcare organizations' needs to improve patient care. At the same time, we work constantly to anticipate upcoming industry trends. Because of that vision, we've been able to deliver sophisticated technology and insight that help organizations focus on both the health and wellness of their population and manage the complexities of the healthcare environment."

In October, a team of healthcare technology professionals selected Wellcentive as one of four finalists for the Intel Innovation Award. After a detailed evaluation of the finalists' offerings based on factors such as strength and selection of benefits, current and future impact, effect on workflow and implications for quality improvement, Wellcentive was named the 2014 award winner.

The strength of Wellcentive's solutions for population health management has been recognized extensively in the last year by prominent industry analysts such as IDC Health Insights, KLAS and Chilmark Research. Wellcentive empowers health systems, providers, payers, employers and other organizations to drive improved outcomes by aggregating data across the continuum of care, applying analytics to identify and risk-stratify patients, and delivering action-based workflow to manage the health of populations.

About Wellcentive

Built from the ground up to help customers improve clinical, financial and human outcomes, Wellcentive's population health management technology is cloud-based, scalable, and customized to meet the needs of providers, health organizations and payers. Wellcentive's technology, insight and services help care teams measure and report performance and implement actionable workflow to drive value-based reimbursement and the transition from volume to value. Wellcentive has gained recognition as a leader in population health management in reports recently released by IDC Health, KLAS and Chilmark. Wellcentive aggregates data from more than 3,000 interfaces, and its solutions improve outcomes for over 30 million lives. Call 877-213-8456 and visit


SIIA Announces Oxford Risk Management Group as a Gold Member

MyHealthGuide Source: Self-Insurance Institute of America, Inc. (SIIA), 11/19/2014,

The Self-Insurance Institute of America, Inc. announces that Oxford Risk Management Group as upgraded its membership to Gold.

This latest announcement of a new upgraded member is part of strategic initiative to increase membership support of the association so that it is better positioned to protect and promote the business interests of organizations involved in the self-insurance/alternative risk transfer marketplace.

Upgraded members (Silver, Gold and Diamond) receive a variety of additional membership benefits. Details can be accessed on-line at, or by contacting SIIA Membership Director Jenn Ivy at

About Oxford Risk Management Group

Oxford Risk Management Group specializes in conducting captive feasibility analysis and coordination of turn-key captive insurance company arrangements, both domestically and internationally. As an alternative risk and captive insurance research and consulting company, we focus on coordinating design, implementation, regulatory approval and management of new captive insurance companies. We have earned a reputation as one of the premier providers of conservative captive insurance structures in the industry.  Visit

About SIIA

The Self-Insurance Institute of America, Inc. (SIIA) is a dynamic, member-based association dedicated to protecting and promoting the business interests of companies involved in the self-insurance/alternative risk transfer (ART) industry, both domestically and internationally.  Call 800/851-7789 and visit


SIIA Introduces New Event: Self-Insured Taft-Hartley Plan Executive Forum

MyHealthGuide Source: The Self-Insurance Institute of America, Inc. (SIIA), 11/17/2014,

The Self-Insurance Institute of America, Inc. (SIIA) announced that it has opened registration for its upcoming Self-Insured Taft-Hartley Plan Executive Forum, scheduled for April 29-30, 2015 in Washington, DC. This is a new association-sponsored event!

There are several hundred Taft-Hartley plans operating across the country that sponsor self-insured health plans, and many other fully-insured plans that should be self-insured. This substantive, one-day forum features a focused educational program designed to showcase self-insurance strategies and information that is sure help unions provide even more robust benefits while more effectively controlling costs.

Conference discussion topics

  • Understanding the true value of a self-funded plan
  • Best in class plan design options
  • Choosing the best provider arrangements
  • How to obtain stop-loss insurance with the best terms and pricing
  • Innovative Approaches for providing coverage for early retirees
  • Recap session where presentation material will be reviewed and additional questions answered

All sessions will be presented by leading industry experts and focused specifically for Taft-Hartley plan administrators and trustees. In additional to the educational program, the Forum will feature dedicated networking sessions, including a welcome reception the evening prior to the program. To enhance your event networking experience, attendees have access to the NameSleuth App.

For companies interested in promoting their corporate brand at this event, please contact Justin Miller at for sponsorship opportunities.

Finally, here are some important dates for you to know. Register before February 27, 2015 and take advantage of discounted early bird fees. SIIA room block at the Marriott Metro Center will be released on April 7, 2015, so if you would like to stay at the host hotel, please register and make your room reservations at your earliest opportunity as we expect the hotel to be sold out.

About SIIA

The Self-Insurance Institute of America, Inc. (SIIA) is a dynamic, member-based association dedicated to protecting and promoting the business interests of companies involved in the self-insurance/alternative risk transfer (ART) industry, both domestically and internationally.  Call 800/851-7789 and visit


People News

CTG Names Joseph Eberle Managing Director, Data Analytics

MyHealthGuide Source:  CTG, 11/20/0214,

BUFFALO, NY -- CTG, an information technology (IT) solutions and services company, announced that it has named Joseph Eberle, managing director, data analytics.

Mr. Eberle's most recent position was a principal consultant in CTG's IT Solutions business. In this role, he served as the solutions architect responsible for leading the design and development of CTG's suite of proprietary data analytics products that are primarily targeted to the healthcare market. 

Over the course of his 27-year career with CTG, Mr. Eberle has led technical project teams and provided project oversight for consulting engagements for CTG clients in a wide range of industries including healthcare, financial services, government, manufacturing, retail, hospitality, and transportation. Mr. Eberle has extensive experience designing and developing knowledge- based management and business intelligence solutions, web-based applications, data warehouses, and enterprise-wide data architecture policies and procedures. His professional experience also includes serving as a consultant at Manning & Napier Information Services and operating his own independent IT consulting firm.

Brendan Harrington, CTG's Interim Chief Executive Officer commented, "This promotion recognizes Joe's leadership role in developing CTG's medical informatics solutions in the areas of medical treatment and claims analysis. Joe has significant experience and expertise in the practical, HIPAA-compliant application of large sets of medical data to business intelligence solutions that are configured to analyze and interpret this data according to the needs of healthcare providers and payers. As more health provider and payer organizations look to maximize the value of information assets through 'big data' solutions, Joe is the ideal person to lead the further development and marketing of CTG's data analytics products suite."

About CTG

CTG develops innovative IT solutions to address the business needs and challenges of companies in several higher-growth industries including healthcare, technology services, energy, and financial services. As a leading provider of IT and business consulting services to the healthcare market, CTG offers healthcare institutions, physician practices, payers, and related organizations a full range of offerings to help them achieve clinical, operational, and financial goals. CTG has developed for the healthcare provider and payer markets unique, proprietary software solutions that support better and lower cost healthcare. CTG also provides managed services IT staffing for major technology companies and large corporations. Backed by nearly 50 years' experience, proprietary methodologies, and an ISO 9001-certified management system, CTG has a proven track record of delivering high-value, industry-specific solutions. CTG operates in North America and Western Europe. Visit


Market Trends, Studies, Books & Opinions

Aon Hewitt Analysis Shows Health Care Cost Expected to Rise to 5.5% in 2015. Other Findings

MyHealthGuide Source: Aon Hewitt  (NYSE: AON) via PRNewswire, 11/13/2014, AON Release

LINCOLNSHIRE, Ill -- In 2014, U.S. companies and their employees saw a slight uptick in the rate of U.S. health care cost increases, according to an analysis by Aon Hewitt, the global talent, retirement and health solutions business of Aon plc.

Study findings

In 2015, Aon Hewitt projects,

  • Average health care premium increases will be 5.5% and average health care costs at $11,304 per employee.
  • Employees contributions toward this premium cost was $2,487 in 2014, compared to $2,355 in 2013.
  • Employees will be asked to contribute 23.6% of the total health care premium, which equates to $2,664 for 2015.
  • High-deductible health plans (HDHPs) are the second most popular plan choice offered by companies, surpassing HMOs.
    • 15% of companies offer a HDHP as the only health plan option today, and another
    • 42% are considering doing so in the next three-to-five years.

For 2014,

  • 22% of companies have reduced subsidies for covered dependents, while 18% added a surcharge for adult dependents with access to other health coverage. An 50% of companies are exploring such approaches over the next few years.
  • 52% of companies are considering using unitized pricing--where employees pay per person and not individual versus family.
  • 58% of companies have completed a program audit of covered dependents to ensure only those who are eligible will remain on the plan.
  • Adopting pay-for-performance strategies -- An increasing number of companies have adopted or plan to adopt a number of pay-for-performance strategies:
  • 24% of companies currently steer participants (through plan design or lower cost) to high quality hospitals or physicians for specific procedures or conditions and another 56% are considering doing so in the next three-to-five years.
  • 18% use integrated delivery models such as patient-centered medical homes to improve primary care effectiveness, and another 56% plan to do so in the next three-to-five years.
  • 10% have adopted reference-based pricing--where employers set a pricing cap on benefits for certain medical services for which wide cost variation exists with no discernible differentiation in quality. Another 58% plan to do so in the next three-to-five years.
  • Private health exchanges are becoming increasingly attractive to organizations that want to offer employees expanded choice of plans and insurance companies while lowering future cost trends and lessening the administrative burden associated with sponsoring a health plan.

Costs by Plan Type

Year HMO POS PPO National
2015* $11,386 $12,344 $11,141 $11,304
2014 $10,762 $11,711 $10,570 $10,717
2013 $10,356 $11,101 $10,127 $10,266
2012 $9,876 $10,621 $9,862 $9,934
2011 $9,360 $10,232 $9,420 $9,473
2010 $8,665 $9,176 $8,708 $8,729

*Projections †Costs are plan costs (premium or budget rate) on a per employee basis. They include employee contributions, but not their out-of-pocket costs (i.e., co-payments, coinsurance).

"Over the past few years, the overall economic situation kept consumer spending on discretionary items--including health care--down, and we observed a lower rate of premium increases," said Tim Nimmer, chief health care actuary at Aon Hewitt. "Now, with employment rates stabilizing, individuals are feeling more secure about their financial situation and have been willing to re-engage in using the health care system. As these utilization rates increase, we expect to see health care cost increases follow."

About Aon Hewitt

Aon Hewitt empowers organizations and individuals to secure a better future through innovative talent, retirement and health solutions. We advise, design and execute a wide range of solutions that enable clients to cultivate talent to drive organizational and personal performance and growth, navigate retirement risk while providing new levels of financial security, and redefine health solutions for greater choice, affordability and wellness. Aon Hewitt is the global leader in human resource solutions, with over 30,000 professionals in 90 countries serving more than 20,000 clients worldwide. Visit

About Aon

Aon plc (NYSE:AON) is the leading global provider of risk management, insurance and reinsurance brokerage, and human resources solutions and outsourcing services. Through its more than 66,000 colleagues worldwide, Aon unites to empower results for clients in over 120 countries via innovative and effective risk and people solutions and through industry-leading global resources and technical expertise. Aon has been named repeatedly as the world's best broker, best insurance intermediary, best reinsurance intermediary, best captives manager, and best employee benefits consulting firm by multiple industry sources. Visit


Legal, Legislative & Regulatory News

Judge Permits Honeywell to Continue Wellness Program in Spite of EEOC ADA/GINA Litigation

MyHealthGuide Source:

In a decision that's being hailed as a victory for employer-sponsored wellness programs, on 11/3/2014, the U.S. District Court for the District of Minnesota denied the Equal Employment Opportunity Commission's request for a temporary restraining order and preliminary injunction against Honeywell International Inc.

The EEOC claims the company's wellness program violates the Americans with Disabilities Act (ADA)  and the Genetic Information Nondiscrimination Act (GINA)  by imposing penalties on employees who decline to participate in the company's biometric screening program.

The American Benefits Council praised the court's decision, calling it "welcome relief for company sponsors of employee wellness programs."

"Unfortunately, the EEOC decided to pursue litigation before issuing guidance on this matter," says James A. Klein, president of the American Benefits Council. "This is very frustrating for employers who care about the well-being of their employees and take seriously their compliance obligations. It is impossible for employers to abide by rules that do not exist."

The EEOC's recent actions around wellness programs have created uncertainty for employers, says Mike Thompson, a principal with PricewaterhouseCoopers. "The sooner this gets clarified the better and, in many ways, I think many are assuming that ultimately the existing guidance will prevail," he says. "But the longer this shadow overhangs, the more the uncertainty in the market. More than anything, I think employers want clear guideposts in which to operate."

Since August, the EEOC has filed suit against three companies over their employer-sponsored wellness programs: Orion Energy Systems, Flambeau, Inc. and Honeywell.

Honeywell Case

A federal judge has rejected the U.S. Equal Employment Opportunity Commission's request for an order temporarily barring Honeywell International Inc. from penalizing workers who refused to participate in its workplace wellness program.

Minnesota District Judge Ann Montgomery ruled Monday that Morristown, New Jersey-based Honeywell can proceed with plans to assess a $500 surcharge against employees at its facilities in Minnesota for nonparticipation in wellness-related biometric screenings beginning in 2015, pending the outcome of a lawsuit filed by the EEOC against the company in U.S. District Court in Minneapolis on Oct. 27.

The company also plans to withhold contributions to employees' tax-preferred health savings accounts worth up to $1,500 annually and assess an additional $1,000 tobacco surcharge against employees who refused to submit to the wellness screenings, which include tests for their blood pressure, glucose, cholesterol and body mass.

Similar penalties would also be assessed against employees' spouses enrolled in Honeywell's group health insurance plan if they refused to participate in the biometric tests, the EEOC claims in its lawsuit.

"Honeywell is pleased that the court ruled against the Chicago EEOC and their attempt to stop our wellness program from moving forward in 2015," the company said in a statement emailed to Business Insurance on Monday. "Honeywell wants its employees to be well-informed about their health status not only because it promotes their well-being, but also because we don't believe it's fair to the employees who do work to lead healthier lifestyles to subsidize the healthcare premiums for those who do not."

The EEOC claims in its lawsuit that Honeywell's wellness program violates both the federal Americans with Disabilities Act and the Genetic Information Nondiscrimination Act by effectively forcing employees and their spouses to submit to the health screenings.


GINA Class Action Settled by EEOC for $187,500

MyHealthGuide Source: Richard B. Cohen, 11/13/2014, Employee Benefit News Article

Another employer has settled a GINA class action brought by the Equal Employment Opportunity Commission -- for $187,500.

The EEOC told a Practising Law Institute conference two years ago of a number of workplace issues which it planned to address, one of which was targeting violations of the Genetic Information Nondiscrimination Act. The law was new, and few cases had been filed.

What is GINA?

GINA makes it illegal to discriminate against employees or job applicants because of genetic information, which includes family medical history, and restricts employers from requesting, requiring or purchasing such information.

Under GINA, employers cannot, in the hiring process, request such genetic information and family medical history.

The first GINA lawsuit

The first lawsuit ever filed by the EEOC alleging genetic discrimination under GINA was settled in May of 2013. The EEOC alleged in that Oklahoma case that the employer refused to hire a woman who had been given an offer of a permanent position because tests it had conducted concluded that she had carpal tunnel syndrome. The company had sent her to an outside laboratory for a drug test and physical, and there she had to fill out a questionnaire disclosing the existence of numerous listed disorders in her family medical history.

According to the EEOC, "[t]he questionnaire asked about the existence of heart disease, hypertension, cancer, tuberculosis, diabetes, arthritis and ‘mental disorders' in her family. [She] was then subjected to medical testing, from which the examiner concluded that further evaluation was needed to determine whether [she] suffered from carpal tunnel syndrome (CTS)."

Although her own doctor found that she did not have CTS, her offer was revoked because the company's outside lab indicated otherwise.

GINA and the EEOC's Strategic Enforcement Plan

On May 17, 2013 we reported that in accordance with the priorities in its Strategic Enforcement Plan (and its promise to the PLI conference) the EEOC filed a GINA class action against a Corning, N.Y. nursing and rehabilitation center, its first systemic lawsuit under GINA.

The EEOC alleged that the company conducted post-offer, pre-employment medical exams of applicants, and annual exams if the person was hired, and requested family medical history. The case was settled for $110,400.

The new settlement

The EEOC has just announced that it has settled another GINA class action brought against three California farm suppliers who required job applicants to take physical exams and fill out questionnaires which asked about medical conditions, and the applicants' family medical histories.

One applicant was required to report disability-related information and family medical history which was unrelated to the job requirements, and ultimately refused hiring "due to his perceived disability."


An EEOC attorney cautioned employers: "The law with respect to genetic information is relatively new, and this is one of the first cases resolved in litigation by the EEOC in this district. … Employers need to familiarize themselves on the prohibitions with respect to pre-employment inquiries and maintaining the confidentiality of medical information."

Another EEOC attorney summed up compliance with GINA: "There are strict guidelines prohibiting inquiries into a job applicant's medical condition and disability prior to hire. Even after hire, employers should avoid asking questions about an applicant's medical condition if it is not job-related. With respect to genetic information -- or family medical history -- the law is even more restrictive in that most employers may never ask or acquire genetic information from applicants or employees."

About the Author

Richard B. Cohen is a partner at Fox Rothschild's New York City office. To contact the author: This Legal Alert is not intended to be, and should not be construed as, legal advice for any particular fact situation.


Medical News

High-Cost Generic Drugs -- Examples, Reasons and Recommendations

MyHealthGuide Source: Jonathan D. Alpern, M.D., et al., New England Journal of Medicine, 11/13/2014, NEJM Article

Some generic drugs, not protected by patents or market exclusivity, are now also extremely expensive.

Case of Albendazole

Albendazole is a broad-spectrum antiparasitic medication first marketed by a corporate predecessor to GlaxoSmithKline (GSK) outside the United States in 1982 and was approved by the Food and Drug Administration (FDA) in 1996. Its patents have long since expired, but no manufacturer ever sought FDA approval for a generic version.

One reason may be that the primary indications for the drug -- intestinal parasites, neurocysticercosis, and hydatid disease -- occur relatively rarely in the United States and usually only in disadvantaged populations such as immigrants and refugees.

  • In late 2010, the listed average wholesale price (AWP) for albendazole was $5.92 per typical daily dose in the United States and less than $1 per typical daily dose overseas.
  • By 2013, the listed AWP for albendazole had increased to $119.58 per typical daily dose.

 Medicaid data show that spending on albendazole increased from less than $100,000 per year in 2008, when the average cost was $36.10 per prescription, to more than $7.5 million in 2013, when the average cost was $241.30 per prescription.

Other Drugs

  • According to the National Average Drug Acquisition Cost pricing file, the price of captopril (12.5 mg), which is used for hypertension and heart failure, increased by more than 2800% between November 2012 and November 2013, from 1.4 cents to 39.9 cents per pill.
  • Similarly, the price of clomipramine (25 mg), a long-established tricyclic antidepressant also used for obsessive--compulsive disorder, increased from 22 cents to $8.32 per pill, and the price of doxycycline hyclate (100 mg), a broad-spectrum antibiotic that has been around since 1967, increased from 6.3 cents to $3.36 per pill.

Why the Dramatic Price Increase?

Numerous factors may cause price increases for non--patent-protected drugs, including drug shortages, supply disruptions, and consolidations within the generic-drug industry. These factors generally lead to a decrease in market competition. For example, between 2002 and 2013, some manufacturers of digoxin -- which is still used for atrial fibrillation and heart failure -- faced safety-related drug recalls and FDA inspections, and the number of manufacturers of oral digoxin (tablet) fell from eight to three. During that time, the drug's price reportedly increased by 637%. Similarly, the price increase for doxycycline was most likely exacerbated by a national shortage in 2013, which the FDA attributed to increased demand in the face of limited manufacturing capacity.

The case of albendazole reveals additional circumstances that may contribute to price increases for older drugs. Although GSK continues to manufacture albendazole, the company sold its U.S. marketing rights to Amedra Pharmaceuticals, a small, private firm, in October 2010.4 In 2011, Teva Pharmaceuticals discontinued manufacturing of the only therapeutically interchangeable antiparasitic agent, mebendazole (Vermox), for non--safety-related business reasons, and prescribing of mebendazole slowed.

Although many contributors to the price a manufacturer sets for a drug, such as shortages of raw materials or price markups elsewhere along the pharmaceutical supply chain, are out of a particular manufacturer's control, Amedra's business strategy may be to corner a niche market for a pharmaceutical agent. Amedra has similarly acquired from GSK dextroamphetamine (Dexedrine Spansule), a treatment for attention-deficit disorder, and pyrimethamine (Daraprim), which is used to treat toxoplasmosis. The prices of both drugs increased after their acquisition, though to a lesser extent than albendazole's price.

FTC and FDA Have Limited Impact

Although high prices charged for albendazole and other drugs by manufacturers that hold a monopoly (or a near monopoly) on them can hinder access for certain patients, U.S. antitrust laws protect consumers only from anticompetitive strategies such as price fixing among competitors. Manufacturers of generic drugs that legally obtain a market monopoly are free to unilaterally raise the prices of their products. The Federal Trade Commission will not intervene without evidence of a conspiracy among competitors or other anticompetitive actions that sustain the increased price. Amedra did acquire albendazole's only near-term potential competitor, mebendazole, from Teva in 2013, though that move may not rise to the level of anticompetitive behavior.

When shortages of generic drugs have led to high prices, the FDA has responded by temporarily approving drug imports or working with domestic manufacturers to help increase production by helping to expedite companies' ability to integrate new raw-material resources into their production lines.


The FDA may not be able to use the same mechanisms to address high prices of essential generic drugs that are made by only one manufacturer. Instead, we believe that special pathways should be created to promote competition and permit the private market to function more efficiently. In the case of albendazole, the recent increases in both prescriptions and price may make the drug more attractive to other generics manufacturers and encourage them to produce their own versions.

However, new generics manufacturers can experience delays before the FDA's Office of Generic Drugs approves their products. According to the FDA, the standard processing time for such applications is about 10 months, which does not include the time it may take the manufacturer to address any deficiencies in its proposal. Legislation passed in 2012 created new generic-drug user fees that promise to reduce such waiting times by increasing funding for FDA staff.

In addition, substantial increases in the price of an unpatented drug could trigger the FDA to issue a public announcement seeking other manufacturers for generic versions of the product. Companies responding to such a request could receive expedited reviews of their manufacturing processes and bioequivalence data. Generic-drug user fees could be waived in these circumstances to further increase incentives for potential competitors.

Entry into the market of more generics manufacturers should increase competition and reduce prices. Of course, other players along the drug-distribution chain, such as wholesalers or pharmacies, may also contribute to price markups, and further investigation is needed into the relative contribution of these different actors to the high prices of drugs such as albendazole.


Recurring Resources

Medical Stop-Loss Providers Ranked by Annual Premium Survey (last updated 11/1/2014)

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

  Stop-loss Provider Years Providing Stop Loss Associated Carriers / MGUs Annual stop-loss Premium
Capital /Equity
1. CIGNA     $1,907
  CIGNA 2013 10-K, page 46 2/27/2014
2. Sun Life Financial     $915.2
  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+)
2014 10Q (2x $431 for 6 mons)
$3,900 HCC Insurance Holdings, Inc. Release,
4. HM Insurance Group >30 Years HM Insurance Group
(A.M. Best Rated: A-)
Mike Sullivan, President & COO
5. Symetra >36 Years Symetra Life Insurance Company
(A.M. Best Rated: A)
(Block - $475M
MRM - $255M)
Michael Fry, Executive Vice President, Symetra;
Mike McLean, Chairman Medical Risk Managers, Inc.
6. ING Employee Benefits > 35 Years ReliaStar Life
(A.M. Best Rated: A)
Joe Keller, Lead Financial Analyst, ING Employee Benefits,
7. Companion Life > 20 Years   $440
  Philip Gardham, Vice President, Specialty Markets,
8. National Union Fire Insurance Company of Pittsburgh >35 Years AIG Benefit Solutions $215
  Jeff Gavlick, VP, Stop Loss Products, AIG Benefit Solutions
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
10. Zurich North America     $130   Tracey Brennan, Zurich North America.
11. Munich Re Stop Loss, Inc.   AIC, TransAmerica $110
  Susan McGrath Bowman,
Chief Operating Officer, Munich Re Stop Loss, Inc.
12. The Union Labor Life Insurance Company  (ULLICO) >25 Years ULLICO
(A.M. Best Rated: B++)
  Victor Moran, Second Vice President, Actuarial Operations.  3/12/2014
Markel Insurance Company <5 Years Markel Insurance Company
(A.M. Best Rated: A-)
$3 $$3,388
Mark Nichols, Managing Director.

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
  • 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  



December 1-3, 2014
HCISPP Training -- Nashville presented by Clearwater Compliance.  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

Cost of the Clearwater HCISPP training is $1,595. Registration dates:

• February 9-10-11, 2015 -- Miami, FL
• April 6-7-8, 2015 -- Nashville, TN
• June 1-2-3, 2015 -- Nashville, TN
• August 10-11-12, 2015 -- Nashville, TN
• October 5-6-7, 2015 -- Miami, FL
• December 2-3-4, 2015 -- Nashville, TN

Contact Helen Cuddeback at 615-913-4510, and visit

December 4-5, 2014
IHC Forum West presented by the Institute for HealthCare Consumerism. Las Vegas, NV. Contact Joni Lipson at and visit


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  Information and registration: and visit

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: and (502) 403-1122.  Ritz-Carlton, Laguna Niguel in Dana Point, CA.

February 4-5, 2015
11th Annual Executive Forum on Rewarding Healthy Behaviors presented by World Congress.  Featured: Nicholas "Dr. Nick" Yphantides, MD, MPH; Chief Medical Officer, Health & Human Services Agency, San Diego County.  With National Health Care reform and the emerging priority of population health, employers have the opportunity to think outside the workplace box with regard to design and implementation of their health and wellness programs. Dr. Nick will highlight and illustrate the opportunities for employers to be proactive in partnering or at least aligning with regional population health innovations. As someone who has spent much of his professional career as a "board certified medical hypocrite," he brings a very personal and passionate perspective to the current strategic opportunities for employer based transformational interventions. Bellagio Las Vegas.  Information and registration: 781-939-2400 or 

February 10-11, 2015
2015 Executive Forum presented by Heath Care Administrators Association (HCAA).  Featuring:  A Physician-Senator's Look Into the Crystal Ball of Healthcare Reform (Senator Bill Frist, M.D.), Will the Long Term Impact of ACA Expand or Shrink Self Funding? (Tim Jost, Law Professor and Commentator) and other experts. Encore at Wynn Las Vegas. Las Vegas, NV.

March 4-6, 2015
Self-Insured Health Plan Executive Forum presented by Self-Insurance Institute of America.  J.W. Marriott Camelback, Scottsdale, AZ.

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

April 13-15, 2015
International Conference presented by Self-Insurance Institute of America. Latin America is a promising new frontier for self-insurance/captive insurance. Based on this perspective, SIIA is taking its International Conference to one of the leading economic hubs in Latin America to explore and discuss emerging self-insurance business opportunities in this important region of the world. Consistent with this outlook, the educational program will cover the following topics:

• Evolving regulatory environment for self-insured health plans in Latin America
• Captive insurance opportunities in Latin America
• Multi-national pooling for group benefits programs in Latin America
• Evolving roles for TPAs, brokers and carriers in Latin America
• Insurance carrier panel discussion
• The Panama Canal - a self-insurance case study
• Self-insurance opportunities in the Caribbean
• Medical travel in Latin America

Hilton Panama, Panama City, Panama.  Call 800/851-7789 and visit

April 29-30, 2015
Self-Insured Taft-Hartley Plan Executive Forum (NEW EVENT!) presented by Self-Insurance Institute of America. This one-day forum features a focused educational program designed to showcase self-insurance strategies and information that is sure help unions provide even more robust benefits while more effectively controlling costs. Register before February 27, 2015 and take advantage of discounted early bird fees. SIIA room block at the Marriott Metro Center will be released on April 7, 2015, so if you would like to stay at the host hotel, please register and make your room reservations at your earliest opportunity as we expect the hotel to be sold out. Marriott Metro Center, Washington, DC.  Information and registration: 

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

May 12-14, 2015
Self-Insured Workers' Compensation Executive Forum presented by Self-Insurance Institute of America. Windsor Court Hotel, New Orleans, LA

July 21-23, 2015
MCIA Annual Conference presented by The Montana Captive Insurance Association, Inc. (MCIA) at the Lodge at Whitefish Lake in Whitefish, MT.  Contact and visit

October 18-20, 2015
National Educational Conference & Expo presented by Self-Insurance Institute of America. Marriott Marquis, Washington, DC

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


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

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


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

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


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.
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  • 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