Category Archives: Uncategorized

Northwell combines with Western Connecticut System

DANBURY — The health network that runs Danbury, Norwalk and New Milford hospitals is joining forces with a four-hospital group in New York to form a $2.4 billion medical system stretching from the Hudson River to the shores of Long Island Sound.

The merger of the Western Connecticut Health Network and Health Quest Systems, which is subject to approval by the states of Connecticut and New York and the Federal Trade Commission, would create a seven-hospital network serving 1.5 million people.

“You have two health networks of similar size coming together in a powerful way to provide more access and capacity for our residents and community members,” said Robert Friedberg, the president and CEO of Health Quest, told Hearst Connecticut Media. “This is a pretty dramatic change, because usually with a deal like this, the health networks are not equals, and you don’t have this sharing of perspective.”

The merger, described as a mutually beneficial deal that brings together 2,600 physicians and 12,000 employees, is designed to strengthen the networks’ position in western Connecticut and the lower Hudson Valley.

“We think that collectively we will be able to bring in services that we currently don’t have, such as neurosurgical procedures that require a high volume in order to attract physicians,” said Dr. John Murphy, president and CEO of Western Connecticut Health Network. “We might be able to bring in pediatric specialties and certain types of cancer treatments.”

30% higher premiums, lower enrollment.

In the not-exactly-a-shock category, this newsbit from Reuters:

(Reuters) – About 11.8 million consumers nationwide enrolled in 2018 Obamacare exchange plans, a 3 percent drop from last year when 12.2 million consumers signed up, according to a final government tally released on Tuesday by the Centers for Medicare and Medicaid Services.

The tally includes both sign-ups on the exchange run by the federal government for 39 states, which was released on a provisional basis late in 2017, and on the 12 other exchanges run by Washington, D.C. and the remaining states.

CMS said the average premium before tax credits in 2018 is $621 a month, an increase of more than 30 percent from last year.

Aetna to pass on Drug Discounts

Aetna Inc. will pass on the discounts it negotiates on prescription drugs to about 3 million of its members, the latest move by a health insurer to address Americans’ complaints about the cost of medicine.

The discounts, which can amount to more than half a drug’s list price, will be passed on at the pharmacy counter for many people starting next year, Aetna Chief Executive Officer Mark Bertolini said in a telephone interview. The move by the No. 3 U.S. health insurer follows a similar decision earlier this month by its larger peer, UnitedHealth Group Inc.

Over the last year, drugmakers, insurers and pharmacy benefit plans, or PBMs, have blamed one another for the cost of prescription drugs in the U.S. PBMs and insurers have said it’s the fault of the pharmaceutical companies that frequently raise their list prices. Drugmakers blame insurers and pharmacy benefit plans for high copays, and for not passing on to patients the discounts they negotiate. People with high deductibles or co-pays are often hurt the most.

“We want people to see the truth, and now they see it,” Bertolini said. “When drug prices keep going up, and drug costs keep going up, they’ll have one place to look.”

Do you have missing participants in your 401K?

As employees terminate, they typically leave their balances with the prior employer.  In these cases, they are still participants – meaning you still pay to administer their account, and you have an obligation to communicate with them as much as any active employee.   This is not a problem, until you lose track of the ex-employee.  While it is not your Fault, it is still your responsibility under the law.

50% of Millenials in a recent survey learned of a retirement account with a previous employer they didn’t realize they had.

Enter the “Missing Participant IRA.”  The best solution is to get the ex-employee to take their balance with them when they leave.  Since that doesn’t always work, you need a mechanism to handle this.  With some of our clients we use a third-party outside service, but more and more high-end TPAs are providing this service automatically.

 

If you are concerned about COMPLIANCE in your 401k just give us a call.

CIGNA Opioid-related formulary changes

A communication is being sent to impacted Cigna clients in the next few days to announce updates on our July 2018 formulary changes.

Pharmacy costs are currently the number one driver of client expenses under both pharmacy and medical benefits.1 At the same time, opioid abuse continues to be a U.S. public health crisis according to the Department of Health and Human Services.2 To address these issues, Cigna’s formulary strategy will be updated to maintain high clinical value while continuing to use a low net drug cost approach to manage coverage for costly branded drugs. At the same time, we will build upon current steps to administer prescription drug coverage in a manner that promotes safe opioid use.

Effective July 2018* our formularies will be updated and Cigna will implement tighter utilization management around the use of opioids.

Customers (employees and dependents) affected by these changes (estimated to be less than 1% of customers3) will also receive a letter from Cigna in early April informing them of the change. Depending on the change, the letters contain steps to work with their doctor to find covered alternatives, prescribe lower quantity levels or apply for drug coverage approval through Cigna’s prior authorization process.

  • Click here to read a summary of Cigna’s July 2018 formulary changes.

Click the following links to view detailed (drug specific) changes for each of Cigna’s formularies. Clients will be sent the above summary and one of the flyers below based on their formulary:

May 2018
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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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