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Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
Model Consulting Thanksgiving Holiday Schedule
Please be advised that Model Consulting will be closed on Thursday, November 26th and Friday, November 27th in observance of the Thanksgiving Holiday. We will re-open at our normal business hours
on Monday, November 30th.
We wish you and your family a safe and happy Thanksgiving Holiday! |
 House Passes Health Reform
Bill
With a vote of 220 to 215, the House of
Representatives passed the "Affordable Health Care for America Act"
after several hours of debate on November 7th.
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Capital
BlueCross: Member Effective Dates &
Coverage Termination Reminders
Account
Administration has recently made a change to how effective dates are determined
for all new members. In the past, most members were made effective on the 1st
or 15th of each month to coincide with the group's billing cycle. Currently,
initial and newly eligible members are considered effective as of the date specified
by the employer group and approved by Capital BlueCross* (regardless of
the billing cycle).
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HealthAmerica: Creditable Coverage Notification for Medicare
Beneficiaries
Annually we send employer letters that
provide guidance in determining creditable coverage for Medicare
beneficiaries. The Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 ("MMA") requires employers to
disclose whether their group coverage is "creditable prescription drug
coverage". Notices must be sent to all
group members - employees, retirees, their spouses, and dependents - who are
eligible to enroll in Medicare Part D coverage.
Notification is required whether the employer's group health plan
coverage is primary or secondary to Medicare.
Additional details about HealthAmerica's prescription drug options can
be found in the attached guides.
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HealthAmerica: Important
Benefit Reminders
Several laws may impact the health care coverage you provide to
your employees. Some of these benefits can only be added to your policy during
the renewal period, so it's important to consider your options and review your
obligations under the law.
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Independence Blue Cross: Important Information about our Health
Benefits Programs
Periodically, we review and evaluate our
benefits plans and, as needed, update and clarify benefits. The purpose of these updates is to provide
our members with a better understanding of their benefits information. The attached Summary of benefit changes flyer
contains information about the changes to our health care benefits
program. To help you better understand
these changes, it includes a brief summary of each change as well as the plans
that are affected by the change. Please
read the information carefully and keep it for you records.
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UnitedHealthcare: All Members Eligible for Health Expense
Tracker Dec. 4
A full
release of the Quicken HealthSM Expense Tracker to all
eligible UnitedHealthcare customers is scheduled for Dec. 4. Currently
the online tool is available to more than 700,000 UnitedHealthcare
non-consumer-driven health (CDH) members.
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UnitedHealthcare: Dr. Oz and UnitedHealthcare Team Up to
Promote Better Health
UnitedHealthcare and renowned doctor and
bestselling author Dr. Mehmet Oz are partnering to promote health-related
topics on his Web site, DoctorOz.com, and his new daytime talk show,
The Dr. Oz Show, which airs daily on TV stations across the U.S.
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UnitedHealthcare: Rheumatoid Arthritis ProgressionRx Program
Change
We previously announced a new
ProgressionRx (step therapy) program that would be implemented for certain
rheumatoid arthritis (RA) medications effective January 1, 2010. This change will not take effect. However,
all four RA medications - Cimzia, Enrel, Humira, and Simponi - will move from
Tier 3 to Tier 2 effective January 1, 2010 due to improved contracted rates
from the pharmaceutical manufacturers.
This will positively impact members who will pay less for these
medications and will save money for self-funded customers. A Prescription Drug List and pharmacy benefit
changes effective January 1, 2010 is attached.
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