Introducing HealthVault for Members

We're empowering our members with life-long access to their medical records with Microsoft HealthVault, an online health records tool. Once members transfer their medical records and health information to HealthVault, they will have free, permanent access whether they change health plans, doctors or even jobs.

Initially, members will be able to transfer their HealthPartners explanation of benefits to HealthVault. Later this year, members will be able to transfer additional health-related information to their HealthVault account, including: benefits and copays, lab results, immunizations, allergy and medication lists, health and wellness information such as results from HealthPartners health assessments and other information stored in HealthPartners Clinics and Regions Hospital electronic medical records.

This enhancement is part of our overall strategy to give members access to the best online tools in the market and put them in control of their health information. Members can use HealthVault to store copies of their health records obtained from their providers, plans, pharmacies, government or employers; upload information from health and fitness devices; share information with healthcare providers and trainers; and access products and services.

Learn more about HealthVault.

Oral Oncology Formulary Change

Starting September 1, we will require members on 14 oral oncology (cancer) medications to obtain their prescriptions through SpecialtyScripts^TM Pharmacy, our preferred specialty vendor. This transition will have significant health and financial benefits for the 250 commercial plan members affected by this policy change.

We’re making this switch to:

1. Improve member safety and experience
   Many oncology medications are now available in oral versions that can be obtained at retail pharmacies and taken by patients at home. These oral oncology medications have significant toxic potential and are often used as part of complex treatment regimens. SpecialtyScripts has an active and effective clinical management program for oral oncology medications, which includes patient education, monitoring of medication-related side effects and adherence support. Adherence is critical to the effectiveness of oral oncology chemotherapy. SpecialtyScripts Pharmacy also provides support and refill reminders – 24/7. This level of patient support and clinical expertise is essential to safety and the member experience.
   

2. Better manage cost
   The monthly costs for oral oncology medications can be several thousand dollars - SpecialtyScripts Pharmacy offers more aggressive pricing on oral oncology products and is experienced with complex coordination of benefits. Additionally, SpecialtyScripts actively works with the manufacturers and third-party assistance programs, which can help to minimize any financial burden for members.

The 14 oral oncology medications we are focusing on include: Gleevec, Nexavar, Revlimid, Sprycel, Stutent, Tarceva, Tasigna, Temodar, Thalomid, Tykerb, Vesanoid, Xeloda, Zolinza and Afinitor.  Those members affected will be notified in the mail and SpecialtyScripts Pharmacy will do outreach calls to help with the transition.

Starting January 1, 2010, members with a specialty pharmacy benefit will pay their specialty medication copay or coinsurance amount. We are allowing this grace period in order for members to reset their Flexible Spending Account (FSA) contribution, if applicable. They will be notified about this change in the initial letter and again in December 2009. Any new prescriptions after September 1, 2009 will follow the specialty medication benefits, if applicable.

To learn more, please contact your HealthPartners Sales Executive.

CHIPRA Signed Into Law

In February, President Obama signed the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009 into law. CHIPRA both funds and expands the State Children’s Health Insurance Program through 2013. The Act changed the name of the program from SCHIP to CHIP. Some provisions of this Act created new obligations for employers that apply regardless of the number of employees, or whether the plan is fully or self-insured.

Life events
Effective, April 1, 2009, CHIPRA creates the opportunity for two new special enrollment rights or “life events” for eligible employees. Employers need to allow employees a special enrollment period when they or one of their dependents:

1. Become eligible for a state premium subsidy (if the state in which the employee resides offers a subsidy)
2. Lose eligibility for Medicaid or CHIP

The employee must request coverage within 60 days of the event.

HealthPartners is ready to administer these new life events. We will be updating self-insured plan documents effective July 1, 2009, as groups renew and fully insured plan documents on January 1, 2010, as groups renew.

Notification requirements
Employers must provide written notice to their employees regarding any available premium assistance opportunities offered by their state. The Department of Labor and the Department of Health and Human Services have until February 4, 2010, to provide employers a model notice that will satisfy this requirement. Employers have until the first plan year after the date the model notice is issued to distribute the notice to employees.  We expect to have clear information about which states adopted a premium subsidy program by the time the notification requirements take effect.

The Act offers employers several opportunities to distribute the notice:

1. Provide to employees when they first become eligible under the employer’s group health plan
2. During open enrollment
3. As part of the plan’s Summary Plan Description (SPD)

The Department of Labor may assess up to a $100 per day penalty against any employer who fails to meet the notification requirement.

Please note that this information is intended to provide a summary of select requirements under the Children’s Health Insurance Program Reauthorization Act of 2009. It is not intended to provide legal guidance or advice. If your clients need additional information, they should seek legal counsel.

Dental Rate Calculator Revisions

Thanks to your input, we’ve already been working on enhancements to the new Dental Rate Calculator that went live last month. Your ideas and suggestions are invaluable and we are committed to the calculator’s continuous improvement. 

Creating PDFs
We are working on a long-term solution to address this issue across the board. In the meantime, if you use Adobe Acrobat, you can generate a PDF by:

• Clicking “Print Proposal”
• Selecting “Adobe PDF” when the print options appear
• “Saving” a copy to your desktop or folder

Formatting headers and footers
If you don’t want headers or footers to appear on your printed quotes, or if you want to change the margins, here’s how:

• On the top navigation bar, click “File” and then “Page Setup”
• At this point, you can delete headers and footers and also change the margin settings, just like when you’re working in Word

Notes

• If you haven’t used the new calculator yet, just log on to your HealthPartners account at healthpartners.com/broker. The calculator will appear in the upper right portion of the screen under “Get A Small Group Dental Quote.” If you don’t have an account, please take a few moments to create one.
• Don’t forget that we’re currently offering a two-year dental rate guarantee for groups that add a dental plan to their HealthPartners medical plan.
• All rates generated with the dental rate calculator for groups with 50 or less enrollees include the Little Partners and enhanced periodontal benefits. Little Partners offers free coverage for plan benefits to kids 12 and younger and the periodontal benefit offers additional services to pregnant and diabetic members.

Learn more about HealthPartners Dental plans.

Minnesota Price Guide Revisions

Wisconsin COBRA Subsidy Update

As covered in previous editions of Broker Flash, in February 2009 the American Recovery and Reinvestment Act of 2009 was signed into law by President Obama. This new law includes a 65 percent federal subsidy for COBRA premiums for up to nine months.

In May 2009, the State of Wisconsin passed the look-back period. This period applies to individuals who were involuntarily terminated by Wisconsin-based employers that are not subject to Federal COBRA law (generally those with fewer than 20 employees). The look-back period, also called the special election period, allows individuals who were involuntarily terminated and previously declined or dropped continuation coverage a new opportunity to elect coverage.

The rules for Wisconsin’s look-back period are slightly different from the State of Minnesota’s rules:

• If an individual is involuntarily terminated from September 1, 2008, to February 16, 2009, they have a new opportunity to elect continuation coverage with coverage and premiums beginning on March 1, 2009. (This is the same for the State of Minnesota and the State of Wisconsin.)
• If an individual is involuntarily terminated from February 17, 2009, to May 19, 2009, (the effective date of the law), they have a new opportunity to elect continuation coverage with coverage and premiums beginning on the date they became eligible for continuation coverage. (State of Wisconsin only.)

If you have Wisconsin-based clients impacted by this law, they are required to send a notice to eligible individuals. If we are notified by an involuntarily terminated employee that the employer failed to provide this notice, we will provide it on their behalf.

If you have additional questions, please visit www.dol.gov/COBRA or healthpartners.com/employer.

Freedom Group Plan Service Area in Wisconsin

The service area for the HealthPartners® Freedom Group plan has been expanded to include eight counties in Western Wisconsin. It now includes Barron, Burnett, Douglas, Dunn, Pierce, Polk, St. Croix and Washburn counties in Wisconsin.

Medicare Secondary Payer Reporting

Time is running out for employers to provide HealthPartners with critical information to comply with Medicare Secondary Payer Reporting requirements. We need this information by June 30, 2009.

HealthPartners will be contacting employers via phone, e-mail or letter throughout June to obtain their group size and Federal Tax Identification Number if we do not currently have this information. Groups can also go to healthpartners.com/msp to provide the information. It will be used to properly identify them within the Medicare system. We also have a handy Frequently Asked Questions for employers to review.

If you or your groups have any questions, please contact the group’s Membership Accounting contact or your HealthPartners Sales Executive.

Wells Fargo HSA Update

Did you know that Wells Fargo is one of the nation’s top HSA administrators? As of March 2009, Wells Fargo administered 11,250 employer-group HSA relationships, 200,000 HSA account holders and $325 million in HSA assets.

If you need assistance in submitting new HSA business to Wells Fargo here are some tips for getting started on the right foot:

• Individual clients: Direct individuals to wellsfargo.com/hsa, where they can quickly enroll and fund their accounts online.
• Large employers: A dedicated Wells Fargo sales executive will give you customized support in enrolling employers with 100 or more potential HSA accountholders.
• Small and medium employers: The new account manager team enrolls employers with fewer than 100 HSA accountholders.

Implementation Improvements
Wells Fargo has re-engineered its implementation model to ensure the best possible customer experience. Survey results from January 2009 speak for themselves:

• The percent of customers rating their implementation experience as “excellent” or “very good” increased 52 percent year-over-year.
• The percent of customers rating their satisfaction with our Implementation Associates as “excellent” or “very good” increased 70 percent year-over-year.
• 96 percent of customers rated their Account Managers as “excellent” or “very good.”

One Point of Contact
For more information on the Wells Fargo HSA, call the broker support line at 1-866-449-9929, Monday through Friday, 7:00 a.m. to 8:00 p.m. CST. Visit us online, or access our “Broker Update”.

In Every Issue

Frequent Fitness Update

Frequent Fitness Update
Our Frequent Fitness program continues to grow. Members now have even more choices and chances to save money while achieving a healthy lifestyle.  Now, members who enroll or are enrolled in the Frequent Fitness program will have access to more than 875 locations in the HealthPartners service region.

The Frequent Fitness program offers fully insured members (two per household) up to a $20 reimbursement for working out 12 times a month.

New club to join Frequent Fitness effective June 1, 2009
1.  LA Fitness – Oakdale
2.  Women’s Club Fitness Center – Virginia

Learn more about Frequent Fitness.

Network Updates

As our client base and membership continues to expand, so does our network. In fact, we’ve recently added a large number of providers. We’re committed to providing access to the providers your clients demand – nationwide. No matter where your clients live, work or travel, we’ve got them covered. Additions last month included:

Medical – North Dakota
Central Valley Health District – Jamestown

Dental – Minnesota
Stephen G. Dahlgren, DDS – Hermantown
Jerome E. Euteneuer, DDS, PA – Edina
Medical Arta Dental, PA – Sartell
Twin Cities Dental Studio, PLLC – Wayzata

Dental – Wisconsin
Mahler Family Dentistry, SC – Eau Claire

Try out our new search function to see just how easy it is to find a network provider quickly and simply. Provider Search.