|
The Benefits of Electronic Enrollment
By Shaun Herda, BSG IT Specialist – Programmer
EXCERPT: "Electronic transfer has become a standard medium for sending information from one location to another. Companies of all sizes use electronic transfer everyday, from simple processes such as money wiring to more advanced video conferencing. Now, electronic transfer is rapidly emerging as the logical next step in benefits enrollment and management. Companies using electronic enrollment can process their employees' benefit elections faster and more accurately than paper enrollment, thus freeing up human resource departments whose personnel are stretched too thin."
Full Article
3/1/03—The Benefit Services Group, Inc.
Administration's Proposed Tax Credit for the Purchase of Health Insurance Could Weaken Employer-based Health Insurance
EXCERPT: "While the tax credit would result in some currently uninsured individuals gaining insurance, the proposal is highly controversial. It poses substantial risks. In particular, the tax credit could materially weaken the employer-based health system through which the vast majority of insured Americans obtain their health insurance coverage and could cause some currently insured people — particularly people who are older or are in poorer health — to lose insurance altogether or to have to pay exorbitant amounts to retain insurance."
Full Article
1/25/03—Center on Budget and Policy Priorities
Reservists Being Called to Active Duty
The DOL Employee Benefits Security Administration has put together a list of frequently asked questions geared toward employees called to active duty, but of equal interest to employers who must deal with issues arising from USERRA, COBRA, and more.
Full Article
2/22/03—U.S. Department of Labor Employee Benefits Security
Administration
For more info on USERRA see:
Reinhart,
Boerner, Van Deuren, Norris & Rieselbach, s.c.
E-Newsletter
U.S.
Department of Labor elaws - USERRA Advisor
AAHP: Harvard/Rand Researchers Find Health Plan Appeals Process Is Working For Patients
EXCERPT: "The study suggests that the appeals process gives patients a more timely and effective recourse -- which they are more likely to utilize - than would be provided by a new right to sue. 'Compared with tort lawsuits such as medical malpractice,' the study suggests that the current system provides patients with 'the relative ease of lodging coverage appeals and reappeals - including no fees, options for telephone initiation, mandatory notification rules, and the absence of a need for representation.'
Full
Article
2/19/03—American Association of Health Plans
Savings Needed for Retirement Health Costs May Exceed $1 Million for Many
EXCERPT: "Many Americans at or near retirement age would require more than $1 million to prefund medical costs over their remaining life, according to new research from the Employee Benefit Research Institute (EBRI). The highest costs face the majority of future retirees—more than two-thirds—who receive no health insurance from their former employer to supplement Medicare. Such employer-provided health coverage for retirees is increasingly rare."
Full Article
2/12/03—Employee Benefit Research
Institute
Wisconsin Businesses Uniting for Health Coalition
EXCERPT: "Saddled with rising health care costs, 11 Milwaukee-area businesses and two business organizations have formed a coalition to examine ways to keep coverage affordable for companies and their employees. The coalition, the Business Health Care Group of Southeast Wisconsin, includes some big players in the Milwaukee market, including Harley Davidson Inc., Miller Brewing Co., and Briggs and Stratton Corp. The group members represent about 44,000 employees between them."
Full
Article
2/10/03—American Medical Association
National Health Expenditures Expected to Reach $3.1 Trillion by 2012, Significantly Outpacing Economic Growth
EXCERPT: ""Private health insurance premiums have been rising at rapid rates, budget shortfalls exist at both state and federal levels, a softer labor market has reduced the number of people with private insurance and increased Medicaid costs, and provider costs are continuing to rise," said Stephen Heffler, deputy director of the National Health Statistics Group in the Office of the Actuary at the Centers for Medicare and Medicaid Services. "We project that these pressures will work to slow health care spending growth over the next decade."
Full Article
2/7/03—Health Affairs
|
|
Shortage of Prescription Drug Omeprazole
(Generic Prilosec®)
The generic form of Prilosec® called omeprazole was recently released. This drug is indicated for heartburn and other symptoms associated with Gastroesophageal Reflux Disease (GERD). The generic drug manufacturer has been unable to produce the necessary quantities to maintain an adequate supply nationwide. As a result, many Pharmacy Benefit Manager (PBM) mail order programs have established alternative processing methods for omeprazole to avoid potential disruption to their clients.
BSG® has surveyed AdvancePCS and Medcohealth, two of the largest nationwide PBM mail order programs, regarding processing the limited quantity of omeprazole. Their responses were similar in that they will provide the member the brand-name Prilosec® in substitution of omeprazole so that members are receiving consistent medication through the mail order program. AdvancePCS stated this arrangement will provide a “net savings of approximately 20%” over what plan sponsors were paying before the generic was available, and “approximately 10% over what would have been paid if AdvancePCS elected to receive the limited generic allocation.”
The financial responsibilities for plan sponsors and members are outlined below.
Mail Order Services
Omeprazole (Generic Form of Prilosec®)
Plan Sponsors
Plan sponsors will pay for brand-name Prilosec® at their contracted generic discount rate unless the prescriber or patient has declined to permit substitution, in which case the brand discount and copayment will apply. This arrangement is in lieu of rebates for Prilosec® at mail order service.
Members
Members will pay a generic copayment for brand-name Prilosec® unless the prescriber or patient declined to permit generic substitution, in which case the brand copayment will apply. Members who receive Prilosec® for a generic copayment will be notified of this benefit on the mail order service invoice and patient advisory letter included in their medication order.
If you have any questions regarding how omeprazole is being processed for your plan, please contact your
BSG® Analyst or Consultant.
|
|
By providing links to other
sites, The Benefit Services Group, Inc. does not guarantee, approve or
endorse the information or products available at these sites, nor does a
link indicate any association with or endorsement by the linked site to
The Benefit Services Group, Inc.
The preceding is not
intended to be and is not offered as legal advice. We are prohibited
from the practice of law. Compliance is the responsibility of the
employer or Plan sponsor and affected employees, who should seek their
own legal counsel regarding questions about information presented in
this newsletter.
PlanAhead Direct is a
monthly newsletter provided free of charge to select BSG® client
representatives and associates. View and search back issues at www.bsg.com/news/index.htm.
To comment on newsletter
content, write to tessr@bsg.com.
If you would like to change
your subscription address, or request a plain text
version, please e-mail your request to carolz@bsg.com.
Copyright 2003 The Benefit Services
Group, Inc. BSG® is a registered trademark of The Benefit Services
Group, Inc.
|
W226 N887 Eastmound Dr., Suite F
Waukesha, WI 53186
tel 262-521-5700
fax 262-521-5710
www.bsg.com
|
