Summer 2011

In this Issue:
CVS Minutes Clinics Offering Vitamin B12 Injections
Health Insurers Struggle to Plan for Post-reform Market Positioning
New Effort to Give Consumers Better Info About Quality of Care
BEST Life and Health Rating Upgraded
Take a Second Look at AFMC's POS Network Plan

CVS Minute Clinics Now Offering Vitamin B12 Injection

Vitamin B12 plays a key role in the normal functioning of the brain and nervous system, and in the formation of red blood cells. Without enough red blood cells to carry oxygen to the body, a person may feel tired and weak. Severe or long-lasting Vitamin B12 deficiency can cause damage to the heart, brain, and other organs. CVS Minute Clinics are now offering Vitamin B12 injections to help combat some of these systems and help restore energy to the body.   

 

AFMC is contracted with CVS Minute Clinics. To find a location near you, utilize the AFMC Provider Search or Custom Directory functions on this site or visit the MinuteClinic Web site to learn more about their Vitamin B12 Injections.

AFMC Contact Information

AFMC Sales Consultants   

 

Larry Dennis, RHU
direct: 602-417-2301
 

[email protected]  

 

Judi Hayer  
direct: 602-417-2813

[email protected]


326 E. Coronado Rd.
Phoenix, AZ 85004

800-624-4277
www.azfmc.com
 

Affordable network plans

You can rely on.

Looking for an alternative to the BUCA's?  

 

AFMC's flexibility, multiple network plans and medical management solutions can fit the healthcare needs of your clients.  

 

Ask your AFMC Senior Sales Consultant for more information.

 

Call: 800-624-4277

Click: www.azfmc.com  

Email: [email protected]   

Quick Links  

Custom Directory and Provider Search Instructions

Disease Management

Convenience Clinics

Network Plan Definitions

POS Network Plan Description

Foundation COMP Flyer

Urgent Care Listing

Includes new facilities: 

Cornerstone Pediatric Urgent Care, Gilbert, AZ

Desert Valley Urgent Care, Chandler, AZ 

1st Care Urgent Care, Buckeye, AZ

Laveen Urgent Care, Laveen, AZ

Doctors Express, Phx, AZ  

 

Self-Funded Guide

Fully Insured Guide

Post-reform Positioning (America's Health Insurance Plans annual meeting) 

Insurers struggle to align marketing to individual members and physicians with cost-cutting and new technology.

 

Like physicians, health plans are still waiting to see exactly where health reform leaves them, and in what condition. While they're waiting for health insurance exchanges and medical spending minimums to play out, they have to keep operating and planning for the future.

 

Some of that strategizing happened at the 2011 Institute hosted in San Francisco by trade group America's Health Insurance Plans.

 

Health insurance executives spent time and energy trying to prepare for a business climate that will look different in 2015 than it does today. Some of those key differences will affect physicians directly, increasing or decreasing their incomes, determining what technology ends up at their offices and how many patient visits per day it takes to pay the bills. Read more... 

Arizona Foundation for Medical Care

the Advisor

E-newsletter for Brokers, Consultants and Agents

 

Looking for a Health Insurance Plan for Clients that have a Pre-existing Medical Condition?

There is a health insurance plan for these individuals - Pre-Existing Condition Insurance Plan or PCIP.

 

About the PCIP

The PCIP was created as part of the Affordable Care Act and serves as a bridge to 2014 when insurers will no longer be allowed to deny coverage to people with pre-existing conditions, like cancer, diabetes and asthma. The PCIP provides a health coverage option if an individual has been without health coverage for at least six months; has a pre-existing condition(s) or denied health coverage because of a health condition; and is a U.S. citizen or resides here legally.

 

The Program:

  • Covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available, even to treat a pre-existing condition.
  • Doesn't charge a higher premium just because of a medical condition.
  • Doesn't base eligibility on income.

Costs and Incentives for Licensed Agents and Brokers 

As of July 1, 2011, some PCIP enrollees in the federally-administered plan will see a reduction in their monthly premium depending on the state they live.  And to make the enrollment process easier for the beneficiary, the PCIP program will accept a "decline of coverage" letter from a healthcare provider in addition to a letter from a carrier.  

 

PCIP applicants will continue to have a choice of three plan options - the Standard Plan, the Extended Plan, and the HSA Plan and there will be no other changes to benefits. Current enrollees will not have the opportunity to switch plans at this time. To see the premium rates effective July 1, 2011, go to the State Plans.

  

To further enhance the program, beginning this fall, HHS will begin paying licensed agents and brokers a flat fee of $100 per enrolled applicant by October 1, 2011. If interested, brokers should go to www.pciplan.com; click on BROKERS, then register their name and e-mail address to receive further information.    

 

HHS is also working with insurers to notify people about the PCIP option in their State when their application for health insurance is denied.

 

Accessing AFMC's Network of Providers

A long-term business partner of AFMC's - Government Employees Health Association (GEHA) - is administering the PCIP program in over 20 states, including Arizona.

 

GEHA's provider network of choice in Arizona is Arizona Foundation for Medical Care. Not only will you have a solution for potential clients who may currently be uninsured, you'll also have peace of mind knowing that they have access to the largest provider network in Arizona.

 

To learn more about healthcare options in all states, visit

 www.healthcare.gov 

 

To learn more about PCIP adminstered by GEHA, visit

www.pciplan.com or call 800-220-7898.

New Effort to Give Consumers and Employers Better Information About Quality of Care
The Centers for Medicare & Medicaid Services (CMS) proposed rules on June 3, 2011 that will enable consumers and employers to select higher-quality, lower-cost physicians, hospitals and other healthcare providers in their area.

The new rules will allow organizations that meet certain qualifications access to patient-protected Medicare data to produce public reports on physicians, hospitals and other healthcare providers. These reports will combine private sector claims data with Medicare claims data to identify which hospitals and doctors provide the highest quality, cost-effective care. This initiative is part of a broader effort by the Obama Administration, made possible by the Affordable Care Act, to improve care and lower costs. Read more...

BEST Life and Health Insurance Company Rating Upgraded by A.M. Best
A.M. Best Co. has revised the outlook to stable from negative and affirmed the financial strength rating of B (Fair) and issuer credit rating of "bb" of Best Life and Health Insurance Company.

The revised outlook reflects BEST Life's recent return to profitability and its corresponding increase in capital and surplus. The improved surplus level, combined with a reduction in the size of its book of business, strengthened BEST Life's risk-adjusted capitalization.

BEST Life's premium revenue and operating results are driven primarily by its dental, major medical multiple employer trust and medical stop-loss products to employer groups. While BEST Life's exposure to market and regulatory is somewhat mitigated by its ancillary product lines, two of its largest lines of business have reported declining premium and losses in recent years. Although the company implemented sizeable expense reductions over the past few years, A.M. Best expects its future operating results could remain volatile. Longer term, the regulations and requirements of national healthcare reform legislation will likely pressure operating results in BEST Life's major medical multiple employer trust line of business.

Take a Second Look at AFMC's POS Network Plan..

Brokers and Consultants are always searching for ways to keep healthcare costs down for their clients AND a network plan that fits both self-funding and fully insured arrangments.

 

Have you taken a look at integrating AFMC's POS Network Plan into your employer group's benefit package? 

 

AFMC's POS Plan includes our "Best Value Hospitals" and works much like a pharmacy benefit plan that has three tiers to choose from: generic, brand, and non-formulary drugs.

 

In like fashion, AFMC's POS network is broken down into three tiers - Best Value Hospitals (Tier One), Traditional Hospitals (Tier Two) and Out-of-Network Hospitals (Tier Three). Members can choose the better value hospitals/facilities (Tier One) and pay less than they would if they chose just any hospital in an all-inclusive PPO network.

 

AFMC can also recommend ways to accommodate both rural and metro employer groups. The best discounts depend upon plan design steerage into the Best Value, Tier One facilities and some customization of the network.

 

To learn more about AFMC's discount strengths and how our network plans will fit into a self-funded or fully insured benefit package, contact an AFMC Senior Sales Consultant or call 602-252-4277 or 800-624-4277.