 Agent and Consultant Briefing
September 2009 |
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On My Mind: Health Care Reform |
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 By:Cheryl Demars
Health care reform continues to dominate the news (trumped only by Brett Favre's decision to play for the Vikings). The debate has become partisan and emotional and is often confounded by rumor and misinformation. The coverage will no doubt intensify now that Congress is back in session. The Alliance will bring you regular and unbiased updates to help clarify some of the information that is washing over us all. If you have not yet done so, please read our overview of the three legislative proposals most likely to be considered. While there will no doubt be changes over time, this piece will help familiarize you with some of the components of reform that are likely to be part of part of whatever final proposal is considered. Join Us For Issues in Focus: Taking a Closer Look at Comparative Effectiveness Research
You will also want to join us on September 22 for our next Alliance Learning Circle event, Issues in Focus: Taking a Closer Look at Comparative Effectiveness Research. The program will feature experts from Consumer Reports and QuadMed discussing what comparative effectiveness is, what it is not and the implications for employers, physicians and consumers. You can read more about this event below.
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| Last Chance to Sign Up: CE Credit Day is Tomorrow |
There's still time to sign up for The Alliance's Continuing Education Credit Day which will be held on September 10. This is your chance to update your skills and earn as many as 9 continuing education credits all at the same time. We're featuring sessions on:
- Health Benefit Funding Options, Diane Loram, The Alliance (2 CE Credits)
- How to Evaluate Health Networks, Mark Xistris, The Alliance (2 CE Credits)
- Dental 101, Sue Roseliep, Delta Dental (2 CE Credits)
- Ethics for Insurance Agents, Chris Ralston, WisconsinRx (3 CE Credits)
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Alliance/Health Solutions, LTD® Partnership |
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The Alliance has recently agreed to a partnership with Health Solutions, Ltd® to offer a complete suite of wellness programs. Health Solutions, Ltd® was chosen for its ability to help organizations reduce unnecessary health and workers' compensation claims, decrease absenteeism and short-term disability all while creating a higher quality of life for the individuals they cover.
Through an exclusive agreement, Alliance members are able to access the best pricing available in our market on Health Solutions, Ltd.® comprehensive solutions. Members choose the program level that fits their needs. Options may include:
- Health risk assessments
- Online wellness tools, library and monthly newsletters
- Coaching
- Program consultation
- Standard or customized communications
- Detailed reports
- Recommended intervention strategies
Health Solutions, Ltd® provides the interface for employers to evaluate, seamlessly integrate and maximize current available resources into the program. Watch for more information about the new partnership in the coming weeks and months.
We thank the group purchasing committee for all their hard work in researching and choosing this option. Committee members included:
Laurie Kelly, Park Bank
Kristi Schalow, Trek Bicycle Corporation
Brian Baumgart, Nord Gear Corporation
Wendy Culver, SPHR, Mead & Hunt
John Becker, Rock County
Colleen Esch-Smith, Clack Corporation
Lisa Reimer, Foremost Farms USA
Sheridy Zimmerman, Fiskars Brands, Inc. Jan Bruss, Lab Safety Supply For more information about Health Solutions, Ltd.®, contact Bobbi Jones, product management specialist, at 800.223.4139, x 6638 or bjones@the-alliance.org. Back to top |
Retail (Convenient Care) Clinic Reminder |
As mentioned in our March 2009 issue, Shopko Fast Care Clinics and Walgreens' Take Care Clinics, were added to The Alliance network this past winter. To help employees and their dependents learn more about these clinics, we've added some information to the Find a Doctor page on our Web site. You'll see that information in the right sidebar. Users can click there for a document that explains more about these clinics, as well as information about when to choose this type of care. Shopko Fast Care Clinics When an enrollee chooses to receive care at a Fast Care Clinic, they are required to pay the Fast Care Clinic fee at the time of service. At that time, they should ask the clinic to submit a claim to The Alliance, using the address provided on the back of the health plan identification card. Payment will be made to the provider and the enrollee will be reimbursed directly. The Alliance is working with these providers to ensure that these refunds are made within 30 days of receipt by the hospital or clinic. Participating Shopko Fast Care Clinic locations can be found on the flyer. Walgreens' Take Care Clinic
Our contract with Walgreens' Take Care Clinics covers all locations throughout the U.S, so employees and their dependents can receive care at any Take Care Clinic and the claim will be treated as in-network. When an employee or dependent receives care from a Walgreens' Take Care Clinic, Walgreens will file a claim on their behalf to The Alliance for repricing and then to the plan administrator for processing. Any co-insurance or deductible will be billed to the employee directly from Walgreens. If an employee does not present their health plan identification card, they may be required to pay at the time of service. In these cases, Walgreens will refund any payments to the patient after receiving payment from the benefit plan administrator. Members are free to print out this flyer and use with employees. To receive printed copies, they should contact Alliance Member Services Manager Jesse Oberloh or 800.223.4239, x 6645.
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| Issues in Focus: Taking a Closer Look at Comparative Effectiveness Research |
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Comparative effectiveness research (CER) offers the prospect of identifying the most-effective, cost-effective, and lowest risk treatments by comparing them against one another. It also continues to make the news as part of continuing health care reform initiatives. Join us September 22, at the Monona Terrace Community and Convention Center to learn more about comparative effectiveness research.
Our program will feature John Santa, M.D., M.P.H, director of the Consumer Reports Health Ratings Center and Raymond J. Zastrow, M.D., F.A.A.F.P., president, QuadMed.Topics will include:
- What CER is and isn't
- The potential implications for employers, health plans, providers and consumers
- How we might benefit from this type of research
- The implications of CER to value-based benefit design
Learn more and register today or e-mail events@the-alliance.org. Questions? Contact Bobbi Jones, 800.223.4139, x 6638.
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| Save the Date: Alliance Annual Meeting |
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Our Annual Meeting will be held October 21, 2009 at Monona Terrace Community and Convention Center. Watch for more information in the next month.
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| Guidance for Upcoming Influenza Season |
The CDC and HHS have updated their guidelines for businesses and employers to respond to the upcoming influenza season. We have created a summary of their recommendations or you can find the complete guide here.
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| Alliance Resources for Open Enrollment and Health and Wellness Fairs |
As Alliance members begin to prepare for open enrollment as well as health and wellness fairs, keep in mind the following resources The Alliance has to help promote wellness with employees: Brochures for Employee Education - More than 30 free brochures on various health topics. QualityCounts™ and Find a Doctor -The QualityCounts Outpatient Procedures and Tests Report is now available at www.the-alliance.org as well as through the Find a Doctor search. This flyer explains how to search for a provider using Find a Doctor and provides more information about our QualityCounts reports. The Alliance Web Site - Our Web site also has a section devoted to consumers with information to help individuals understand and be a better consumer of health care:
- Patient Safety Toolkit - Information about how to avoid medical errors, understand a diagnosis, manage medications, prepare for medical visits, and talk to a doctor.
- How to Be a Better Health Care Consumer - Easy-to-read presentations on how to become a wise health care consumer and information about the safety and quality of health care.
- BabyLove - This complimentary Alliance member program helps those who are expecting start pregnancy off on the right foot. Program includes a health screening and a free copy of one of the What to Expect books.
- Diabetes Toolbox - Tools to help those with diabetes learn how to manage and live well with it.
Customer Service - Our Web site also provides information to help consumers understand health care a little better. Contact information for our customer service department is also here.
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| Welcome Bobbi Jones |
 Bobbi Jones has joined The Alliance as product management specialist. In this position, Bobbi will be managing the Alliance Learning Circles program, ensuring relevant and cutting-edge content and handling event logistics. Bobbi will also provide employer and employee support of the QualityCounts™ report as well as managing Alliance partnerships with preferred vendors, such as Health Solutions, Ltd® ( see article). Bobbi brings a wealth of health benefits experience from her work at M3 where she helped shape, manage and support several consumer and employer programs. In addition, Bobbi has volunteered with many local agencies including the Wisconsin Health Literacy Committee. Please join us in welcoming Bobbi, 800.223.4139, x 6638. Back to the top |
| Building Our Cooperative |
Please join us in welcoming the following new members to the cooperative:
TrueNorth®
TrueNorth is a collaborative insurance and financial strategies firm providing services such as risk management/property casualty, employee benefits, qualified retirement plans, executive benefits and business continuation, consulting, personal financial planning, and investment management to the transportation and construction industries, association members, and other businesses and individuals. TrueNorth is located in Cedar Rapids, Iowa.
Cottingham and Butler
Cottingham and Butler is the 51st largest insurance broker in the United States. Privately held and headquartered in Dubuque, Iowa, Cottingham and Butler specializes in employee benefits and risk management and provides high-touch service combined with high-end expertise. Cottingham and Butler also owns Assurex Global, the world's largest association of privately held insurance brokers, and recently acquired Wisconsin based Baker Tilly Employee Benefits, LLC (formerly known as Virchow Krause Employee Benefits, LLC).
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| Alliance at WAHU and Wellness Council Conference |
WAHU 2009 Annual Fall Sales Conference
The Alliance is a SILVER partner of WAHU's upcoming Fall Sales Conference, September 16-18 at The Abbey Resort, in Fontana, Wis. For more information and a complete agenda, visit http://ewahu.org/news/annmeeting.aspx. Wellness Council Worksite Wellness ConferenceThe Alliance is a Bronze Partner of Support of the upcoming Wellness Council Worksite Wellness Conference Best Practices - Good Health is Good Business. This year's conference offers many sessions to help you learn more about wellness in the workplace as well as plenty of ideas to make your program even better. The event takes place at the Kalahari Resort & Convention Center on September 15, with an optional pre-conference program. To learn more, visit the event Web site.
If you attend either event, look for us at our booth.
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| News You Can Use |
The Alliance highlights health care and benefit management news for employers in News You Can Use with a link to take you to the original story or report.
- Creating a Successful Wellness Program using Incentives
Getting employees to improve their health can be difficult. There are many factors that go into individuals' behaviors. Knowing them can help you change them. This report, which summarizes a report issued by The Wellness Councils of America provides information about how to design an incentive program that will impact individual behavior.
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| Quality Counts ™ for Employees |
- What's the real cost for health care?
This third QualityCounts™ for Employees piece about the QualityCounts™ Outpatient Procedures and Tests Report asks consumers to consider the real cost of health care when making choices about their health care.
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| Alliance Provider Update |
The Alliance encourages employers to distribute the Provider Update listing to their employees.
 Just a reminder - always check the online provider directory for the most current provider information! |
| About The Agent and Consultant Briefing |
Each month, The Alliance Agent and Consultant Briefing delivers the latest news to insurance agents and consultants about Alliance services, programs and events as well as information on health benefit trends, issues, and ideas of interest to our mutual clients. Subscriptions are available on a complimentary basis. To subscribe, please send an e-mail message with your name and agency to the Marketing and Member Services Department.
Cathy Lanser, Editor Melanie Cannon, Designer Diane Loram, Business Development Manager | |
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The Alliance encourages employers to distribute the