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In This Issue

 

 

Aetna Introduces Welvie: The Online Surgery Decision Support Tool 

 

United Concordia Network Increases

 

Medicare Part D Creditable Coverage Determination Needed by Oct. 15

 

Mental Health Parity Requires Health Plan to Cover Autism Treatments

 

September is National Childhood Obesity Awareness Month

 

Eat Les Sodium: Quick Tips

 

 

 

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INSURANCE SPOTLIGHT

September 17, 2014

Carrier News

Aetna Introduces Welvie: The Online Surgery Decision Support Tool

aetna logo Upcoming surgery or hospital stay? Welvie, an online surgery decision support tool available to Aetna members, guides members from diagnosis through recovery.  From arming members with the questions to ask providers to ensure the most accurate diagnosis, to finding proper treatment options/doctors/hospitals, Welvie helps members get fully informed. To access Welvie, members can login to their Aetna Navigator, then click the box that says "Thinking of Surgery". 

  

United Concordia's Network Increases

United Concordia, Dental Network of America®, LLC and DenteMax®, LLC have entered into a network sharing agreement to provide greater access and deeper discounts to their members and clients. This agreement will take effect for United Concordia for 2015 business.  

 

DNoA and DenteMax are wholly owned subsidiaries of Health Care Service Corporation (HCSC), the nation's fourth largest health insurer. As a result of this partnership, United Concordia Dental's Advantage Plus network will now exceed 102,000 unique dentists and 283,000 access points.

Federal & State News

Medicare Part D Creditable Coverage Determination Needed by Oct. 15

The Medicare Modernization Act mandates that certain entities offering prescription drug coverage, including employer and union group health plan sponsors, disclose to all Medicare-eligible individuals with prescription drug coverage under the plan whether such coverage is "creditable."

 

Determining whether or not certain coverage is creditable is essential to an individual's decision whether to enroll in a Medicare Part D prescription drug plan. If you offer a prescription drug plan to Medicare-eligible individuals, understand that:

  • Annually, carriers test standard benefit designs to satisfy the actuarial value test of the creditable coverage determination.
  • Once the plans have been tested, the data becomes available to employers.
  • You then must communicate the creditable or non-creditable status to your members.
  • This determination is mandatory at least once a year and the deadline for completion is Oct. 15.

Mental Health Parity Requires Health Plan to Cover Autism Treatments

gavel A federal district court has interpreted regulations under the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) as prohibiting a health plan from denying coverage for a particular treatment for autism since the plan exclusion at issue applied solely to mental health conditions. Read more 

 

Separately, Premera Blue Cross has recently settled three separate lawsuits regarding neurodevelopmental therapy and applied behavior analysis therapy. Notices were sent to all past and current members. This settlement and the corresponding benefit impacts, only applies to individual and fully insured group plans in Washington State. This does not affect self-funded groups.


Health & Wellness

September is National Childhood Obesity Awareness Month

 

One in 3 children in the United States is overweight or obese. Childhood obesity puts kids at risk for health problems that were once seen only in adults, like type 2 diabetes, high blood pressure, and heart disease. The good news is that childhood obesity can be prevented. In honor of National Childhood Obesity Awareness Month, we encourage your family to make healthy changes together.

  • Get active outside: Walk around the neighborhood, go on a bike ride, or play basketball at the park.
  • Limit screen time: Keep screen time (time spent on the computer, watching TV, or playing video games) to 2 hours or less a day.
  • Make healthy meals: Buy and serve more vegetables, fruits, and whole-grain foods.
  • Taking small steps as a family can help your child stay at a healthy weight.

Eat Less Sodium: Quick Tips

Nine out of 10 Americans eat much more sodium (salt) than they need. Too much sodium increases your risk for health problems like high blood pressure. Use these tips to help lower the sodium in your diet.

 
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