Keeping in Touch
May 2003

What's New?
Hello to all of you! I know it's been a long time since my last newsletter. I have found it's faster to communicate urgent information about benefit changes and rate increases via memo and e-mail. If you'd like to keep in touch via e-mail, please send your address to me at cjb@cjbconsulting.net.

RATES
Yes, health insurance rates have been steadily increasing. The CEO of Blue Cross recently stated that increased hospital costs are currently the driving force behind rate increases. There is also a direct correlation between rate increases and legislation that requires insurance carriers to increase coverage. For example, new legislation effective July 1, 2003 requires that health plans regulated by the Dept. of Managed Health Care cannot charge additional co-payments or deductibles for maternity services.

Several years ago, prescription drug costs spurred rate increases. Now every carrier has a separate deductible for brand name prescription drugs. This policy has helped curtail general rate increases by encouraging members to elect a generic brand of their medication or to contribute to the higher cost of providing a brand name prescription. The bottom line is that premiums are easier to contain when there is more cost sharing between a carrier and its members.

HIPAA
This affects us all. The Health Insurance Portability Act (HIPAA) was signed into law in 1996 and is being phased in. April 14, 2003 was the deadline for insurance companies, pharmacies and others in the medical field to comply with certain privacy rules. The privacy rules govern how, when and to whom health and other private information is disclosed and exchanged in health related organizations.

The HIPAA privacy rule pertains to what is termed Protected Health Information (PHI) and includes past, present and future physical or mental conditions as well as their treatment and any related reimbursements. Health information becomes PHI when it is linked to an individual by name, address, social security number or other unique identifying information. Because of the new HIPAA protections on your health information, I will need an authorization, signed by you, in order to assist you with any claims inquiries or problems. If you would like to have this authorization on file, please let me know. I will send you the appropriate form.

No medical insurance?
We all know people who don't have medical insurance; many because they have a pre-existing condition. I now offer several different programs where members purchase access to negotiated rates through a national network.

The company that offers these programs is called Care Entree. This is not insurance. You do not share costs with the company. There is no out-of-pocket maximum. It is simply a means of getting negotiated lower rates for your health care. (CEO112528)

Since Care Entree is not health insurance, there is no pre-existing condition clause. There are no medical claim forms. There are no annual or lifetime maximums. There are no age restrictions. There are a variety of programs available. Of these, the most comprehensive is the Total Care Program. This program includes negotiated rates for hospitalization, doctor visits, prescriptions, etc. The Total Care program costs $69.95 per month for one person or a family. Other programs include Essential Care and Dental Care. All offer negotiated rates to those who use providers in the network. One of these programs could be a great complement for people with only major medical insurance coverage or those people in HMOs who want access to another network. If you are interested in more info, please call me, send me an e-mail or feel free to check out www.negotiatedrate.com .

Prescription Savings
Many of you are aware that there are websites where prescriptions can be purchased at a discount. I have clients who have had positive experiences with two companies: http://www.canadianmedsusa.com & http://www.bestbuyrx.com. These companies have good track records and comparable prices. Bestbuyrx.com offers prescriptions from a variety of countries like Sri Lanka, Israel, and England. So, if supporting a certain country is comparably important to saving money, I suggest you look at the prices at Bestbuyrx.

Blue Cross
A quick reminder for Blue Cross clients. Blue Cross does not pay for any regular physicals at a doctor's office. If you submit a claim, it will be denied. A nice alternative to a doctor's office physical is HealthyCheck and it is a benefit available to all Blue Cross members. If you'd like more specific information, I can send you a detailed brochure or you can log onto http://www.bluecrossca.com Women, your annual OB/GYN visit is not subject to the deductible regardless of whether your doctor is in or out of the Blue Cross network.

Please look at the Blue Cross website: www.bluecrossca.com and review the Healthy Extensions program. This program offers discounts on a variety of products and services including yoga, massage and even teeth whitening. For a limited time Britesmile is offering Blue Cross members a $100 discount on their light-activated treatment.

Blue Shield
Blue Shield has recently renamed its Individual and Family Plans. These changes are in name only. The benefit structures will remain the same. Current ID cards will still be accepted by all Blue Shield providers.

Effective July 1, 2003, the current $1000 maternity copayment will be removed from the Blue Shield Spectrum PPO plans; now known as the $500, $750, $1500 and $2000 Deductible Plans. Blue Shield will soon send new encrypted ID cards to help its members avoid identity theft. To expedite this process, call Blue Shield at 800.431.2809.

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