 Agent and Consultant Briefing December 2009/
January 2010 |
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| Save the Date: Alliance Learning Circle January 20, 2010 |
| It's all about the employee - keeping them interested and engaged that is. Our next Alliance Learning Circle will focus on fresh ideas for getting employees actively involved in your employer wellness programs. We will be featuring Vic Villanueva, managing consultant, from the ROC (Return on Communication) Group. With more than 26 years experience in employee communications with special expertise in benefits, wellness, and employee engagement, this is a session you won't want to miss. We'll also be featuring member campaigns and a networking session to share ideas with one another. Learn more and register today.
We want to hear from members! Do they have a creative wellness campaign that their employees really enjoyed? Maybe a wellness offering that employees can't get enough of? We're hoping to provide attendees with sample campaigns and a resource packet to take home. Members that would like to share ideas, contact Bobbi Jones, 800.223.4139 x 6638.
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| The Alliance Partners with Quantum Health |
| As mentioned at the Annual Meeting, The Alliance has partnered with Quantum Health to offer their Coordinated Health/Care program to our members with more than 200 employees across all networks. The strength of the program is its ability to reduce or eliminate health care events that never need to happen - and the unnecessary care and costs that come from a fragmented system. According to national studies over 33% of healthcare events that employers pay for are unnecessary.
The program features Care Coordinators who work with patients, their families and their physicians to offer information, guidance, and assistance in navigating the often complex health care process. The Care Coordinators represent a single point of contact for information and service on benefits, eligibility and claims, and integrate all medical management activities including; utilization review, case management, disease management and biometric data from wellness screenings within on system.
Care Coordinators also handle all provider-facing functions. They can see the patient's entire health care activity profile in one IT system, making it easy to pinpoint confusion, delay and other waste. Through a system of notification, education and direct intervention, Care Coordinators help patients navigate the health care system and deliver critical health information to the right place.
Quantum has an approved list of TPAs, but may be willing to work with other TPAs should an employer with more than 200 employees be interested. We are looking forward to working with agents and consultants to offer Coordinated Health/Care to our mutual clients. We will be reaching out with more information about this offering in the next few months. In the meantime, if you have questions, please contact Bobbi Jones, product management specialist, or 800.233.4139 x 6638.
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| Health and Wellness Discounts for Alliance Members |
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It pays to be a member of The Alliance - in more ways than one! Did you know many health clubs and fitness centers will give our members' employees discounts just for being a member of The Alliance? They don't need to sign-up through their health plan; they can simply show their Alliance medical ID at the door.
Discounts on services are available at more than 50 fitness locations in south-central Wisconsin. The same savings extend to hearing centers, nutrition and weight-loss clinics, karate classes and yoga sessions.
Offers vary, so members should check with participating businesses for details. Information about this program can be accessed directly through this link, and can also be found at www.the-alliance.org by clicking "Improve Your Health and Wellness" under the "Quick Links" on the home page, and then clicking the "Healthy Living Discounts" link. Members should also be sure to let their employees know about these great "Healthy Living" discounts - they'll find it's the perfect way to stay fit, and keep their wallets in shape too! Back to top |
Provider Directory Update:
Convenient Care Clinics Easier to Find |
The Alliance's Find a Doctor function has been updated to make it easier to find convenient care, or retail, clinics. They are now listed as Convenient Care Clinics under provider type.
- To find them, individuals choose Select Providers by Location/Specialty and then select Convenient Care Clinics from Provider Type.
- A list of convenient care clinics will be returned within a radius of up to 100 miles of any address entered.
Convenient care clinics are located in a retail setting, staffed by nurse practitioners, and specialize in care for minor illnesses and injuries as well as lab tests, vaccinations, or sports/camp physicals for those 18 months and older.
The Alliance offers access to some Shopko FastCare Clinics and all Walgreens' Take Care Clinics throughout the U.S. Should an individual need to find a Take Care Clinic while outside of Wisconsin, Illinois and Iowa, they can do so by using that ZIP code to orient their search.
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| Compliance Information on GINA from Health Solutions LtdŽ |
The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits discrimination in group health plan coverage based on genetic information and expands the genetic information protections included in the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
HIPAA prevents a plan or issuer from imposing a preexisting condition exclusion provision based solely on genetic information, and prohibits discrimination in individual eligibility, benefits, or premiums based on any health factor (including genetic information). GINA also prohibits a plan from collecting genetic information (including family medical history) prior to or in connection with enrollment, or for underwriting purposes.
Under GINA, plans and issuers are generally prohibited from offering rewards in return for collection of genetic information, including family medical history information collected as part of a Health Risk Assessment (HRA). Title 1 of GINA further regulates the use of genetic information including family history in health risk assessments that are offered by an employer as part of a corporate wellness program with incentives tied to participation in the group health plan including premium contribution level.
GINA is effective for plan years beginning after May 21, 2009 (January 1, 2010 for calendar year plans). Regulations implementing the provisions of GINA were made public on October 1, 2009.
In response to the new regulations the Health Solutions LtdŽ Health Risk Assessment (HRA) no longer includes a family history question. It has been eliminated from both the online HRA and from the paper HRA option version as of 11/09 to meet with the GINA provisions.
More information about GINA can be found here. The Alliance is encouraging members who are using other HRA vendors to speak with them to ensure that they are compliant with GINA regulations.
Our partnership with Health Solutions, LtdŽ allows you to offer this solution to mutual clients at a 15-25 percent discount. For more information about Health Solutions LtdŽ please contact Bobbi Jones, 800.223.4139, x 6638.
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| One Web Site: Scores of Health Care Answers |
The Alliance Web site is the one-stop shop for connecting employees to the multitude of tools and services we have to offer online. Are they looking for a health care professional in their area? All they have to do is access our Find a Doctor function. Do they want to manage their medications? Tell them to check out our patient safety toolkit. Do they need to increase their health care IQ? They can learn more through online presentations. Do they want to compare the quality and cost of hospitals in The Alliance network? They can access our QualityCounts™ reports. You name it, chances are we have it on The Alliance Web site.
And now we have a new flyer to help members spread the word about these online resources. Members can print this flyer and post it at their worksites, or contact Jesse Oberloh, member services manager, 800.223.4139 x 6645, to request paper copies.
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| WEA Trust Health Plan Tops in State |
Alliance member WEA Trust recently participated in the 2008 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The result? An 88-percent rating that was tops in Wisconsin and the third-best score in the entire country.
WEA Trust outranked health plans from state providers such as Unity (72 percent), Dean (71 percent), UnitedHealthCare of Wisconsin (63 percent for PPO, 43 percent for HMO & POS combined), Humana (59 percent), and WPS (58 percent), and bested the national average (61 percent) by a significant margin as well. The Trust also scored 95 percent on claims processing, and its 93-percent customer service rating was also the best in the state.
The independent CAHPS survey was administered by the U.S. Agency for Healthcare Research and Quality, and is considered the leading tool for assessing consumer health care experiences in the United States. Health-plan members were asked a series of questions concerning their health care experiences, and were asked to rate their health plan on a scale of 0 to 10.
A member of The Alliance since 1999, WEA Trust is a not-for-profit insurance trust serving Wisconsin public school employees and their families. The Alliance congratulates WEA Trust and its employees on this great accomplishment.
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| Alliance Donation to Second Harvest Feeds Thousands in Need |
When we think about "hunger," we might imagine a desperate scene in some faraway third-world country. Yet, in reality, hunger is all too local, especially in these economically trying times. It's estimated that as many as 100,000 of our neighbors in southern Wisconsin will go to bed hungry tonight, and that's why we're so proud to support the Second Harvest Food Bank of Southern Wisconsin again this holiday season. Each year, instead of sending cards or gifts to our business associates, The Alliance makes a donation to a charitable organization as a way of giving back to the communities in which our members live and work. Second Harvest distributes food to more than 400 charitable programs that feed the hungry in 16 southern Wisconsin counties. Our donation of $500 will deliver 3,500 meals to those in need this holiday season. Consider joining us in supporting your local food bank and give a very important gift to those in need this holiday season. From all of us at The Alliance, we thank you for your continued support and wish all our members and business partners a very happy holiday and a most prosperous new year!
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| Don't Forget to Check Your 'Whitelist' |
E-mail filters do a good job at keeping thousands of unwanted spam messages at bay. Sometimes, though, filters can be overeager in blocking important messages that you actually do want to read.
Now might be a good time to check and see if any of your colleagues should be receiving The Alliance newsletter, and make sure our e-mail address (@the-alliance.org) is on their "whitelist". If you know of others at your organization who should be receiving our communications, contact Tierney Jensen.
While you're at it, you might want to ensure your own e-mail filter rules are in order. You may need to contact your network administrator to make any necessary changes.
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| Building Our Cooperative |
Please join us in welcoming the following new members to the cooperative:
Raven Software
Raven Software of Middleton, Wis., will join The Alliance on January 1, 2010. Founded by brothers Brian and Steve Raffel in 1990, this video game developer has grown from a five-person start-up to an award-winning studio boasting some 150 employees. A subsidiary of Activision Blizzard Inc., Raven Software has produced such groundbreaking titles as "Marvel: Ultimate Alliance" and "X Men Origins: Wolverine," and was named a top-20 "most consistent" video game developer worldwide in a recent industry survey.
Women's International Pharmacy, Inc.Founded in 1985, Women's International Pharmacy, Inc., specializes in custom-made compound prescription treatments for individuals undergoing bioidentical hormone therapy. Hormone therapy is often used by women during menopause but can be used by anyone - including men - with hormonal imbalances. A "bioidentical" hormone medication is an exact chemical match of the hormones produced naturally in the body. Headquartered in Madison, Women's International Pharmacy, Inc., serves the entire nation, with laboratory locations in Arizona and Wisconsin. The company will join The Alliance effective Jan. 1, 2010.
Skipper Marine
Skipper Marine's Madison sales and service center will also join The Alliance on Jan. 1, 2010. Better known as Skipper Bud's at its location on the northeast corner of Lake Mendota, the company operates the largest marina in the Madison area. A family business started in Wisconsin more 40 years ago, today Skipper Marine operates 22 sales locations nationwide - on the Great Lakes, the Mississippi River and the Atlantic Ocean. A full-service dealer of Sea Ray, Malibu, Meridian and Four Winns yachts, pontoons and sport boats, Skipper Marine also operates marinas in five states.
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| QualityCounts™ for Employees |
 The Alliance encourages employers to distribute the
The 2009 QualityCounts™ Inpatient Hospital Report is Now Available
The report contains valuable, facility-specific information on hospital quality and costs that can help your employees make important health-care decisions. The report is available online, through either our Provider Directory or the QualityCounts homepage.
This month's QualityCounts™ for Employees information piece explains in more detail how to access the report. Along with the other pieces in our Employer toolkit to help employees understand and use the report to make health-care decisions based on both quality and cost.
To access the rest of the QualityCounts toolkit, visit the Employer Resource Center. In it you'll find newsletter articles and presentation materials that will help your employees access QualityCounts and understand the reports.
Alliance staff is also available to help benefits staff understand and use the report and educate employees about QualityCounts through employer education sessions. For more information or to schedule a session, contact Bobbi Jones, product management specialist, 800.223.4139 x 6638.
Agents/consultants who have not yet signed up for an Access Request Form and Non-Disclosure Agreement will need to do so before they can accept the online report. To do so, contact Bobbi Jones.
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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.
- Read an interview with Ken Shachmut, one of the architects of Safeway's health care reengineering program, which has managed to hold costs steady since 2005. From Purchasing High Performance, a quarterly bulletin from the National Business Coalition on Health and the Commonwealth Fund.
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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! Back to top |
| About The Agent and Consultant Briefing |
Each month, The Alliance 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 email message with your name and agency to the Sales and Members Services Deparment.
Reader comments, suggestions, and topics are always welcome.
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