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A free monthly newsletter for plan sponsors and employee benefits 
professionals published by The Benefit Services Group, Inc.

Patients Face Cost-Choice Trade-offs With Tiered-Provider Networks
EXCERPT: "Conceptually similar to tiered-pharmacy benefits, tiered-provider networks allow patients to make trade-offs between provider choice and what they pay out of pocket instead of health plans restricting access to certain providers. However, sorting hospitals and physicians into tiers is considerably more difficult than tiering pharmaceuticals with the same or similar therapeutic effects but different prices."
Full Article
November 20, 2003—Center for Studying Health System Change 

Supreme Court's ERISA Decisions Could Increase Health Plan Costs
EXCERPT: "Considering how few lawsuits reach the Supreme Court, it is remarkable that the nation's highest judicial body has ruled on four cases involving benefits questions in the past two years. Even more notable is that all four cases involved ERISA, and three verdicts went against health plan providers and, by proxy, employers... For health plan providers and sponsors, he says, the majority of the Court's decisions are likely to create confusion and raise costs."
Full Article
September 15, 2003—Employee Benefit News 

Making The Case For Worksite Back-Hardening Programs: Back Pain Costs More Than $90 Billion
EXCERPT: "In one of the largest analyses of its kind, a team of Duke University Medical Center researchers has found that patients suffering from back pain consume more that $90 billion annually in health-care expenses, with approximately $26 billion of that amount directly attributable to treating the back pain. The researchers said that their results not only demonstrate the enormous economic impact of back pain, but provide concrete data that policy makers and researchers can use in determining how health-care resources should be allocated."
Full Article
February 19, 2004—Wellness Junction 

Over-the-counter Drugs Allowed Under HSA, HRA and Section 125
A list of eligible and ineligible over-the-counter drugs that can be purchased on a pre-tax basis as allowed under Health Savings Accounts, Health Retirement Accounts and Section 125 plans (Flexible Spending Accounts) is provided.
See List

Fraud Kicks in Months Ahead of Medicare Drug Discount Card
EXCERPT: "Federal officials said Monday that they had detected evidence of fraud in the marketing of drug discount cards under the Medicare law signed 10 weeks ago by President Bush. In some parts of the country, people have gone door to door offering "Medicare approved" cards, though none have been approved and enrollment does not begin until May, federal health officials said.
Full Article
February 17, 2004—The New York Times 

James, who works second shift, has never had a routine check-up and visits the ER when he needs medical care. Lois, in marketing, insists her doctor only prescribe brand-name medications, believing generics to be inferior. Sharlene, a customer service rep, was recently diagnosed as a diabetic. She’s confused and in denial.

These examples are typical of health care consumers in your organization. They lack the resources to make wise choices but their choices directly and indirectly impact health plan costs. Creating wise health care consumers begins with information. But how many HR departments have the time or the resources to roll out education programs?

That’s why BSG is excited to introduce a new service, “Benefits Buzz,” to help build better health care consumerism. 

Beginning in March we'll produce and make available a series of brochures, flyers and enhanced e-mails that our clients can distribute to their employee populations. Each month we’ll focus on a different benefits topic: prescription drugs; enrollment terminology and choices; primary, urgent and emergency care; and maximizing wellness care, to name a few. 

The best part of this program is that standard materials are provided free of charge to BSG clients. You pay only for shipping in bulk. For more details, visit BSG.com or contact your BSG account manager.

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. 

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Copyright 2004 The Benefit Services Group, Inc. BSG® is a registered trademark of The Benefit Services Group, Inc.

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