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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.
Your feedback is
extremely important to us. Please contact Tracy Duffield at 215.947.7167 or
tduffield@modelconsultinginc.com to share your ideas, comments
and/or suggestions. We look forward to hearing from you! |
 Aetna: Elimination of Email Addresses for FSA, HRA
and COBRA Services
We
have changed the process in which members and employers currently contact us
with regards to the following products administered by Flexible Benefits:
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Aetna: New York State
Continuation Law
New York SB5471/AB8400, which extends state
continuation coverage for a period of 36 months, became effective July 1, 2009
for groups that renew or become effective on or after this date.
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AmeriHealth NJ: Amerihealthexpress.com Tools & Training,
ARRA, Prescription Drug Updates
In
This Issue - November 2009: Enhanced tools and resources for members now
available on amerihealthexpress.com, Reminder: Training available for the new
amerihealthexpress.com group portal, ARRA premium subsidy soon expiring for
first recipients, Reminder: Self-injectable drug coverage to change January 1,
Select Drug formulary update, and 2010 submissions guidelines are here.
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AmeriHealth NJ: Important Information About our Health
Benefits Programs
Periodically, we review and evaluate our
benefits plans against current industry standards and regulatory requirements,
and we update benefits as needed. Letters announcing these changes are
scheduled to be mailed to groups during the last week of November and members
during the first week of December.
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Capital
BlueCross: New Internal Process for
Fully-Insured Large Groups that are Delinquent on Payments
Due to
changing marketplace conditions and inquiries from regulatory agencies, Capital
BlueCross has formalized our payment policies, specifically regarding the
process for large groups that are delinquent on their payments. Capital
enforces the "prompt pay" clauses that are currently outlined in all group
policies - this contractual language is not changing.
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Horizon BCBS of NJ:
Dispense As Written System Edits
Beginning January 1, 2010, Horizon Blue Cross Blue Shield of New
Jersey will introduce new Dispense as Written (DAW) system edits to help your
clients optimize their pharmacy benefits while ensuring their employees receive
the safest and most effective treatments.
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Horizon BCBS of NJ: New
Recommendations on Breast Cancer Screening
Horizon Blue Cross Blue Shield of New Jersey issued a statement in
response to new guidelines from the U.S. Preventive Services Task Force on
breast cancer screening published Monday, November 16, 2009, in the Annals of
Internal Medicine. Dr. Richard Popiel, Vice President and Chief Medical Officer of Horizon BCBSNJ, issued the following
statement:
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Independence Blue Cross: Select Drug Formulary Updates
Independence
Blue Cross is making changes to the Select Drug Program formulary and updates
that support the safe prescribing of drugs, the release below communicates the
changes that will take effect January 1, 2010.
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UnitedHealthcare: Mammography/Cervical Screening Guidelines Remain Unchanged
The United States Preventive Services Task Force
(USPSTF) recently released new guidelines for mammography screening based
on a review of the medical literature. As a result, the
USPSTF is recommending that regular screening for breast cancer in
women begin at age 50. The previously recommended age to begin routine
screening was age 40.
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