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: New Reimbursement Methodology for
Out-of-Network
Benefits
To
better align middle market business (applies
to groups with 100+ employees in Pennsylvania) with
the reimbursement methodology that was applied to our small group portfolio a
few years ago, Aetna is making the following change for both new and renewing
fully-insured business.
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Health Net:
Withdrawal Notifications Sent to All August 2010 Renewing Groups and
Members. (SBG and 51+)
On December 11, 2009 we announced that the sale of our Northeast
subsidiaries and renewal rights to UnitedHealthcare had been finalized. Health Net began sending monthly mailings in December to begin
the withdrawal of our products in the marketplace commensurate with the July
2010 renewal cycle.
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Independence Blue Cross:
Spine Surgery, Knee and Hip Replacement Added to Blue Distinction
Centers
Two specialties were recently added
to the list of Blue Distinction Centers®: spine surgery and knee and
hip replacement.
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UnitedHealthcare: Continuum Health Partners' Network
Participation
In November, we sent
you a notice about a potential hospital termination with Continuum Health
Partners (Continuum), a five hospital system located in Manhattan
and Brooklyn, consisting of Beth Israel Medical
Center - Petrie Division, Beth Israel Medical Center
- Kings Highway Division, New York Eye and Ear Infirmary, Long
Island College Hospital, and St. Luke's Roosevelt Hospital.
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UnitedHealthcare/Oxford: Update on New York COBRA and State Continuation
Coverage Extension
As of July 1, 2009, New York law was amended to
increase the maximum continuation of coverage period under New York State
Continuation from 18 months to 36 months for employer group policies that were
renewed, modified, altered or amended or became effective on or after July 1,
2009. On Nov. 24, 2009, the New York
law was updated again to include all employer groups regardless of the group's
renewal or effective date.
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