The Uninsured ­ A Golden Opportunity for Prospecting

By Dave Helwig

Can any more be said about our uninsured crisis? The issue has not
diminished in its reach or its affect on our healthcare economy. However,
there are still misconceptions about the plight of the uninsured that should
be recognized. Even though the resources invested in addressing the problem have increased substantially, the number of uninsured Americans remains significant. I take the viewpoint that the uninsured are viable prospects to grow business, preserve our industry, and address one of the most pressing
social issues in our country.

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Health Insurance

updated 6/17/09
Web Portal for Expatriate Patients
CIGNA International launched the CIGNA Envoy Web Portal to help doctors and hospitals in the CIGNA International network better serve expatriate patients. The portal provides instant coverage details and benefits.

New World of Healthcare Forum
BenefitMall is hosting The New World of Healthcare Forum on July 28, 2009 at The Four Seasons Hotel in Dallas. This forum will bring together national healthcare leaders to discuss the most current legislation proposed for healthcare reform. For more information, visit www.benefitmall.com.

updated 5/06/09
HDHP With Critical Illness Coverage
Guardian Life is offering a, high-deductible healthcare plan with a triple tax-free health savings account (HSA) and supplemental critical illness coverage. The plan also includes 100% coverage for preventive healthcare and access to Guardian's network of providers. For more information, visit www.guardianlife.com.

updated 4/1/09
Wellness Services
Aetna is now offering worksite health and wellness services to employers. The Aetna Health Connections “Direct2You” product suite offers screenings that measure cholesterol, blood pressure, weight, and height. Also included are wellness services, such as counseling about preventive care, healthy eating and regular exercise, Employee Assistance Programs (EAP), prescription drug consultations with a licensed pharmacist, disease management, and acute care services. The information gathered at the worksite is connected to other health programs giving employers a complete health and wellness picture of their employee population, while ensuring confidentiality of personal health information. For more information, see www.aetna.com

updated 3/25/09
Managing Diabetes in the Workplace
Hewitt Associates launched “Diagnosis: Diabetes,” an assessment of how companies and their vendors can improve diabetes management practices. The goal is to help employers improve the health outcomes for their diabetic populations and see better financial results. For more information, visit www.hewitt.com.

Worksite Health and Wellness
Aetna is offering worksite health and wellness services to employers. The Aetna Health “Connections Direct2You” product suite offers a range of services in the workplace including biometric screenings that measure cholesterol, blood pressure, weight and height, wellness services such as counseling about preventive care, healthy eating and regular exercise, employee assistance programs (EAP), prescription drug consultations with a licensed pharmacist, disease management, and acute care services. The information gathered at the worksite is connected to other health programs purchased by the employer – giving them a complete health and wellness picture of their employee population, while ensuring confidentiality of personal health information. For more information, visit www.aetna.com.

Stress Management for Students
UnitedHealthcare StudentResources is providing college students enrolled in its health plans access to a free 24/7 support network to help them manage stress and other common issues that can detract from their wellness and academic success. For more information, visit www.uhcsr.com.

updated 2/18/09
Limited Benefit Plan
CIGNA launched www.starbridge.com. The site provides detailed insight into voluntary health plans for customers who are enrolled in the Starbridge limited-benefit health plan. CIGNA's Starbridge plans provide health insurance to part-time and hourly workers who do not have access to a comprehensive medical plan through their employer.

updated 2/4/09
Limited Benefit Health Plans
The Colonial Health Advantage limited benefit medical plans are for basic health coverage for employees with no major medical insurance. The coverage is now available in four streamlined plan designs that incorporate features of Colonial Life’s previous limited benefit medical products. Benefits for the most-demanded services — doctor’s office visits and preventive care visits — have been increased in several of the new plans. The new plans also offer affordable rates for employee-paid coverage, starting at less than $50 a month and less for employer-paid coverage.

Workplaces with as few as three employees can qualify. Minimum group sizes vary depending on the number of eligible employees in the account, whether the pre-existing condition exclusion is waived, and whether the employer is paying the premiums. For more information, call 803-798-7000 or visit www.coloniallife.com.


updated 1/14/09
Coverage For Retail Clinic Visits
Assurant Health plan members can now receive in-network benefits at all Take Care Clinics, located at 322 Walgreens drugstores in 35 markets and 18 states. Take Care Clinics are walk-in, professional health care centers open seven days a week with extended evening and weekend hours. Take Care Clinics are staffed by board-certified family nurse practitioners and physician assistants who diagnose and treat patients 18 months and older for common, non-emergency illnesses such as strep throat, ear and sinus infections, and poison ivy. Nurse Practitioners and Physician Assistants are licensed to write prescriptions that can be filled at the patient’s pharmacy of choice. For more information, visit www.assuranthealth.com.

updated 1/07/09
Disease Management
WellPoint Inc. expanded its disease management program to improve the care for members with Bipolar Disorder. Those who sign up for the voluntary Bipolar Condition Care Program get education and close monitoring by a behavioral health clinician. The program's tracking system mails educational information to members and physicians, manages staff refill reminder calls to members, and maintains the members' refill and case management history. The program uses daily pharmacy claims to identify members who are late in refilling their Bipolar medications. Care managers will also provide the support necessary to increase member adherence to a physician-prescribed treatment plan. For more information, visit www.wellpoint.com.

International Medical
International Medical Group Inc. is offering the Patriot Platinum Travel Medical Insurance plan and Patriot Green Travel Medical Insurance plan. Patriot Platinum offers up to $8 million of coverage with an extensive range of deductibles, IMG’s global concierge and assistance services, and premium coverage for in-patient and outpatient medical expenses. Patriot Green is designed for the environmentally conscious international traveler who is serious about sustainable and responsible tourism. For more information, call 866-368-3724 or visit www.imglobal.com.

updated 12/10/08
Emergency Medical in Mexico
MetLife Mexico has partnered with Assist America Inc. – a provider of global emergency services through employee benefit plans. Assist America will provide medical referral and monitoring, emergency medical evacuation, repatriation, hospital admission guarantee, bedside visit and more if members become ill or injured.  For more information, visit www.metlife.com.mx.

updated 12/03/08
Accident and Hospital Cash Back Plans
Nationwide Specialty Health launched accident and hospital product lines.
The “CashBack” plans are designed to protect individuals against potential coverage gaps with high-deductible health plans, such as unexpected accident or hospital expenses. For more information, visit: www.nationwide.com/cashback.  

updated 11/05/08
National Access to In-Network Benefits
Guardian Life is offering the national Extended Access travel network for health plan members. Members utilizing health services offered through most of Guardian’s regional PPO networks can get medical coverage across state lines at in-network prices when they travel or temporarily live outside of their network service area. For more information, visit www.GuardianAnytime.com.

updated 10/22/08
Individual Medical For People with Rheumatoid Arthritis
Assurant Health is offering individual medical coverage for people with rheumatoid arthritis (RA). Applicants who qualify will be offered a condition specific deductible (CSD) plan. The CSD will give them access to contracted provider discounts for any RA related claims. Once they meet their CSD and plan deductibles, they receive benefits for all eligible claims, including those related to RA. The Assurant Health plan provides cost discounts for certain biologic response modifiers or immunomodulators for RA patients who meet selection criteria. For more information, visit www.assuranthealth.com.

Price-Conscious Plans Targeted To the Uninsured
Anthem Blue Cross and Blue Shield introduced “SmartSense” the new price-conscious plan is targeted to early retirees, students, and the uninsured. SmartSense can be tailored to fit the consumer’s needs. Premiums range from as little as $33 to $178 per month for a healthy 25-year old male. For more information, visit www.anthem.com.

updated 10/15/08
2009 Medicare Plans
UnitedHealth Group introduced its 2009 portfolio of Medicare products. The company said that Ovations will offer the most comprehensive range of money-saving healthcare choices available in the market when open enrollment begins on November 15. Ovations’ Medicare portfolio includes the most popular Medicare Advantage plans, the leading Medicare Part D prescription drug plans, one of the largest Medicare Supplement insurance programs, and innovative special needs plans. Many of the company’s Medicare plans carry the AARP name. For more information, visit www.ovationshealth.com.

Limited Benefit Plans
Colonial Life & Accident Insurance Company is offering enhanced limited benefit medical plan available to smaller groups, which are priced better when the employer pays premiums and waives pre-existing conditions in some cases. Workplaces with as few as three employees enrolling in the plan can qualify for coverage. Discounted rates are offered when the employer is paying the premiums. For more information, visit www.coloniallife.com.

Updated 10/08/08
CIGNA Expands Medicare Offerings for Individuals
CIGNA today announced a variety of new programs that will be available to Medicare eligible individuals for 2009.  New offerings include Medicare Part D Prescription Drug plans with no costs for popular generic prescriptions for common conditions, such as high blood pressure, high cholesterol and diabetes. The new Medicare Advantage health plans include prescription drug coverage and up to 75% coverage for preventive dental care. In addition, there are plans with low amounts that individuals pay for doctor's visits and medications, as well as low monthly premiums. For more information, visit www.cigna.com.

updated 10/01/08
Health Analyzer
The Online Quick Life analyzer includes red, yellow, and green lights indicating which products are applicable to the client and what health factors may be affecting access to other policies. It also provides health ratings and quotes. For more information, visit www.quicklifecenter.com.

Health and Wellness for Expatriates
Aetna is expanding its Aetna Global Health Connections program to give international members additional resources to help manage their health while on assignment. Long-term disability offerings include enhancements to the International Maternity Management Program and the introduction of various weight-management solutions through the Weight Watchers program. For more information, visit www.aetna.com.

updated 8/27/08
Expanded Critical Illness Coverage
Guardian Life launched what it is calls the next generation of critical illness coverage. Unlike traditional critical illness insurance, it includes a hospital admission rider that provides a per-diem lump-sum cash benefit for hospital stays for conditions not covered under the company's base critical illness insurance plan. Guardian added the extra protection in response to feedback from brokers and clients who wanted a product that could help people cope with a wider range of illnesses, not just the most common ailments.  The hospital rider supplements Guardian's base coverage for six serious illnesses and health events: cancer, heart attack, stroke, major organ transplant, end stage renal failure, and coronary artery bypass graft. For more information, visit www.GuardianLife.co

updated 8/20/08
Limited-Benefit Plans
CIGNA introduced its Starbridge Advanced Medical Plans for management level or highly skilled hourly employees. These plans can also be used as waiting-period coverage for employees awaiting traditional major medical coverage. Employer contribution is required and pooled national rates ensure affordable pricing. The plan also offers access to CIGNA’s PPO network, which features deep discounts from thousands of providers nationwide. For more information, visit www.cigna.com.

updated 7/2/08
Health Education in a Game Format
Tired of playing SIMs? CIGNA developed a computer-simulated world called “Second Life Island,” where seminars, interactive displays, educational games, and virtual health consultations inspire behavioral changes to improve health. CIGNA’s virtual community provides 3-D video game-like interactivity that enables people to learn and interact anonymously with like-minded peers. For example, the nutrition zone helps participants gain nutrition knowledge, learn how to make healthier food choices, manage their weight, and understand portion sizes and food. Stress, physical activity, and sleep zones within the community will be developed following an evaluation of people’s experience with the nutrition zone. For more information, visit www.cigna.com or www.method.com.

updated 6/11/08
Healthcare Data Exchange
Kaiser Permanente and Microsoft will pilot health data transfers between Kaiser Permanente’s My Health Manager and the Microsoft www.healthvault.com. The goal is to expand consumer access to online health information and management tools.
With HealthVault, people can get a copy of their own health information and share information privately with whomever they choose in a security-enhanced environment.

Small Business HSA Platform
eHealth Inc. released “BusinessHSA,” an online health insurance platform for small businesses that cannot afford group health insurance. Employers co-fund and administer their contributions to employee individual health savings accounts (HSAs). It provides online payroll administration to manage employer and employee HSA contributions. It also provides research on affordable HSA-eligible health insurance plans. For more information, visit www.ehealth.com/BusinessHSA.

updated 5/7/08
Home Test Kits
A line of test kits from BioIQ allows people to monitor cholesterol, blood sugar, and other important biometric information. BioIQ also offers corporate health screening programs. For more information, visit www.BioIQ.com

updated 3/19/08
Wellness Solution
SHPS developed a wellness program for mid-size and large employers. It includes screenings, a consumer website, and health coaching. For more information, visit www.shps.com.

updated 3/12/08
Disability for Young Professionals
Guardian is offering individual disability coverage, based on future earnings potential, for advanced degree students, medical residents, and those working in the first year of their profession. For the first time, pharmacy students are eligible. For more information, visit www.GuardianLife.com.

updated 2/20/08
Health Tourism
BridgeHealth International purchased the assets of Medical Tours International (MTI). MTI nurse coordinators and healthcare professionals have been arranging medical procedures at healthcare facilities throughout Costa Rica, Brazil, Panama, Mexico, Singapore, Thailand, and India. For more information, visit www.medicaltoursinternational.com or www.bridgehealthintl.com.

Updated 2/06/08
Supplemental Health Coverage for Accidents
AIG launched AIG Accident Expense Plus, a health insurance product that provides accident medical coverage to fill the gaps in major medical policies. A critical illness rider provides benefits in the event of heart attack, stroke, or cancer. The following are some key features:

• Benefits are paid directly to the policyholder, not the provider.
• Policyholders choose the benefit amounts.
• Policyholders can choose any hospital, physician, or medical facility.
• Benefit payments are not coordinated with payments from the insured’s major medical plan.
• The plan covers individuals and their spouses and children.

For more information, visit www.aigag.com.

updated 1/30/08
Maternity Depression Screening
Blue Cross of California launched a program that provides depression screenings, education, and support to help new moms get behavioral health treatment during and post-pregnancy. The Maternity Depression Program also identifies members who are at high risk for depression. For more information, call 866-785-2789.

HRA for Small Groups
Flexible Benefit Service Corp. will provide self-funded health reimbursement arrangement (HRA) administrative services to Aetna’s small group market. The HRA will be available nationally for small group customers (groups with two to 50 employees). Group customers can choose among four reimbursement options. The HRA can cover eligible expenses, which include all section 213(d) expenses, expenses applied only to the deductible, all healthcare expenses (copays, coinsurance and deductible), or other limited healthcare-related expenses, such as dental, vision, and preventive care. For more information, visit www.Aetna.com.

Medicare Management
The TriZetto Group Inc. released CareAdvance Medicare, for care management of Medicare members. It does the following:

• Automates case and disease management activities.
• Provides case management support to Medicare beneficiaries
• Features a new Medicare health risk assessment for seniors
• Enables Medicare Advantage plans to align with new guidelines of special needs programs.
• Includes identification rules conditions and chronic diseases.
• Offers information systems on CMS and NCQA standards.

For more information, call 949-719-2200 or at www.trizetto.com.

updated 1/23/08
Medical Records
OptumHealth introduced portable lifetime personal health records. The system enables people who change employers, health plans, or doctors to retain access to their previous medical history based on their health insurance claims. As a division of UnitedHealth Group, OptumHealth is providing this portability service through its free, secure consumer Internet portal, www.healthatoz.com.

Medical Records
MediKeeper (www.medikeeper.com) is providing customizable health management tools including its flagship Personal Health Record. The goal is to make medical records secure, mobile, and accessible online. For more information, e-mail ryan.tarzy@medikeeper.com or call 858-240-2201.updated 12/19/07
Dental Plan
Guardian is offering dental plan enhancements covering cosmetic teeth whitening and has expanded its coverage of periodontal maintenance cleanings. Dental insurance companies usually do not cover cosmetic procedures, but demand from clients and brokers supported Guardian's decision to offer teeth whitening as a covered benefit. According to the American Academy of Cosmetic Dentistry (AACD), teeth whitening is the number one requested cosmetic service. Employees can get up to four periodontal maintenance cleanings per year, regardless of medical conditions. Traditionally, the employee needed a physician's certification that they had a disease with a known correlation to periodontal disease in order to qualify for more than two to three cleanings in a year. For more information, visit www.GuardianLife.com.

Supplemental Cancer Insurance
Physicians Mutual Insurance Company is offering a supplemental cancer insurance policy that can cover claims usually not covered by traditional, limited benefit or mini-med plans. For more information, visit www.physiciansmutual.com.