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Issue: # 60September 7, 2010 
 
78 pleasant
 
Dear

The last major insurance carrier, Fallon Community Health Plan, has settled with the Division of Insurance effective September 1st.  The new premiums will not be reflected till the October billing cycle. The October statement will include an adjustment to reflect the difference in September between approved and billed rates for that month.   Here is the final summary: 
 
  • Fallon  (settled effective September 1st)
  • Blue Cross (settled effective September 1st)
  • Tufts  (settled effective September 1st)
  • Health New England (September 1st)
  • Harvard-Pilgrim (settled effective August 1st)
  • Neighborhood Health Plans  (settled effective June 1st) 
 
The chaos and confusion is finally over, and the best news is that all groups that renewed since this past April were not billed retro-actively. 

If you have any questions email Bill or Vanessa.  We hope you find these newsletters are helpful, please forward to anyone who may find this of interest, by using the forward link at the bottom of this e-mail.   To learn more about Worcester based Advantage Benefits, click here. 

Sincerely,


Bill Randell CLU,CHFC,        Vanessa Costa CLU,CHFC,
Advantage Benefits Group,
Blue Cross 
Tiered Network/Options Plans Correction - Please review correction!

In the last newsletter we discussed Tiered Networks offered by Blue Cross that has different co-payments based on what tier your hospital falls under. 
    
   
  • Enhanced Tier:  lowest co-payment for the subscriber
  • Standard Tier:   middle level
  • Basic Tier:  highest co-payment for the subscriber,
 
The link in the last newsletter was incorrect, it was an older version, not the current one.   The most notable difference is that UMass is now considered a Basic Tier, not Standard Tier.
For your convenience, here is a short list of the Hospitals in the Enhanced Tier.  If your hospital is on this list, you may want to consider a quote for this product:
 
  • Bay State Mary Lane - Ware                 
  • Beth Israel Deaconess Medical Ctr - Boston
  • Brockton Hospital - Brockton
  • Caritas Norwood Hospital - Norwood
  • Emerson Hospital - Concord
  • Health Alliance - Fitchburg and Leominster
  • Heywood Hospital -Gardner
  • Holy Family Hospital - Methuen
  • Holyoke Hospital - Holyoke
  • Lahey Clinic- Burlington
  • Lawrence General - Lawrence
  • Lowell General - Lowell
  • Marlboro Hospital - Marlboro
  • Mercy Hospital - Springfield
  • Merrimack Valley - Haverhill
  • Metrowest Medical Center - Framingham & Natick
  • Nashoba Valley - Ayer
  • Newton Wellesley - Newton
  • Noble Hospital - Westfield
  • Saint Vincent - Worcester
  • Tufts Medical Center - Boston
  • Winchester Hospital - Winchester
Please let us know if we can help you.
Health Purchasing Cooperatives
What are they?
The Massachusetts Health Care Cost Containment Bill has now become law. The new law includes some relief for small business cooperative purchasing. Although it does not go far enough in our opinion, it is a good beginning. The approved language allows for six Cooperative Health Insurance purchasing groups to be formed. 

These groups, which will be formed in early 2011, will include a maximum total of 85,000 lives. Details on how the cooperatives will be formed, or who will be allowed to participate have not been established yet.  When details are released we will let you know.