Business in the Burbs » Health insurance

Mount Kisco Medical Group renews MVP contract

Jerry Gleeson — Wed, 10 Dec 2008 22:53:41 +0000

Mount Kisco Medical Group has extended its contract with MVP Health Care for three years effective the start of 2009, both sides said today. MVP is the third insurer with whom the medical group has renewed contracts. Cigna and Healthnet signed deals earlier, said Dr. Scott Hayworth, the practice’s chief executive officer. Talks are continuing with a fourth insurer, whom Hayworth declined to identify. The practice will continue to see patients covered by that insurer while talks continue, he said. Mount Kisco Medical Group has 11 offices in Westchester, Putnam and Dutchess counties, and 170 primary care and specialty physicians in MVP’s network. The extension covers all MVP plans except its Medicaid managed care and Medicare Advantage programs.

Universal American to reinsure life and annuity business

Jay Loomis — Mon, 01 Dec 2008 22:50:31 +0000

Universal American Corp., a Rye Brook-based health insurer and managed care company, said that it agreed to reinsure nearly all of its life insurance and annuity business through Commonwealth Annuity and Life Insurance Co., a subsidiary of Goldman Sachs Group Inc.

The agreement, expected to go into effect during the first quarter, will generate $55 million to $60 million of after-tax statutory profit in Universal American’s insurance company businesses and will reduce required capital by approximately by $10 million to $15 million, the company said.

“This transaction strengthens our capital base and further allows us to focus on our core businesses,” Richard A. Barasch, chairman and chief executive officer, said in a written statement.

Irvington company covers costs of organ transplants

David Schepp — Fri, 29 Aug 2008 21:47:22 +0000

The Maxon Co., an Irvington-based manager of health care plans, has begun offering insurance to cover the cost of organ transplants.

Maxon said it is the first third-party administrator in the state to offer the insurance, which is offered to employees of companies with self-funded insurance plans.

The coverage is underwritten by AIG Medical Excess, a specialty medical insurer, and covers costs related to transplants of the heart, lung, liver, intestine, kidney, pancreas, bone marrow and stem cells, Maxon said.

The insurance covers all transplant-related expenses, including physician, hospital and drug charges, when in-network resources are used, Maxon said. Coverage begins at patient evaluation and continues for a year after the surgery, it said.

Business group back greater insurance rate scrutiny

Jerry Gleeson — Fri, 06 Jun 2008 21:56:50 +0000

The head of the Westchester County Association called for greater regulation of the insurance industry in the wake of a recent settlement requiring Oxford Health Insurance to refund $50 million in overcharges to about 37,000 small businesses.
President William M. Mooney Jr. said he supports a proposal that would require the state Insurance Department to approve rate increases. The agency currently reviews increases after the fact; a review of Oxford led to the refund settlement.
â€œOur own Blue Ribbon Task Force on the Healthcare Crisis has been advocating this measure be passed for the past three years,â€ Mooney said in a statement. â€œWe are pleased that the governor also recognizes the need for lawmakers to restore the tools to better monitor and manage the marketplace for health insurance rates.â€

Oxford Health to refund $50 million to small businesses

Jerry Gleeson — Thu, 29 May 2008 21:13:08 +0000

Oxford Health Insurance Inc. will refund $50 million to about 37,000 small businesses in the New York metro area, including nearly 7,000 in the Lower Hudson Valley, who were overcharged on their policies, the state Insurance Department said today.
The department reviewed Oxford after the insurer reported that its loss ratio for small group policies in 2006 was below the 75 percent minimum. The company said the benefits it paid amounted to 70.6 percent of its overall premiums that year.
The affected products are Oxfordâ€™s small group Freedom Plan Direct, Freedom Plan Metro and Freedom Plan EPO. The settlement does not affect Oxfordâ€™s small group and direct pay HMO and â€œpoint of serviceâ€ policyholders.
The small business policyholders have about 300,000 employees and family members. The refunds average $1,360 per business, about 5.5 percent of the total average annual premium in 2006, but the refund will vary depending on the number of covered individuals.
The state said that Oxford will be contacting its clients about the settlement. It estimated that 15 percent of the affected businesses were in Westchester, 2.9 percent were in Rockland, and just under 1 percent were in Putnam.

Study shows drug prices vary considerably

David Schepp — Mon, 05 May 2008 23:00:42 +0000

For consumers who pay for prescription drugs out their own pockets, a new price study by Yonkers-based Consumer Reports finds it pays to shop around.

The consumer publication’s research showed that not only that prices vary from store to store for the same, but the differences can be dramatic â€” even within the same chain, depending on location.

Consumer Reports placed calls to 163 pharmacies nationwide to gauge price differences among four prescription drugs, three name brand medicines and one generic. For a three-month supply of pills for the urinary incontinence drug Detrol, for example, the price ranged from $365 to $551.

The magazine also found significant price disparities for the two other name-brand drugs it studied: for Plavix (which prevents blood clots), the spread was $382-$541, and for Levoxyl (for treating hypothyroidism), prices ran from $29 to $85. And for the generic alendronate (for osteoporosis), the price range was $124 to $306.

The magazine’s small scale market-basket study showed Costco was the cheapest for the four drugs CR sought quotes for, followed by AARP.com and Wal-Mart. Walgreens and Rite-Aid were among the priciest for the four drugs.

Besides calling different stores and comparison shopping, other cost-saving tips include:

â€¢ Donâ€™t rule out independents: Though theyâ€™re not the cheapest overall, many mom-and-pop pharmacies are highly competitive and offer top notch service.

â€¢ Talk to your employer: Benefits administrators can provide details about pharmacy benefit managers, also known as PBMs.

â€¢ Buy generics: They can cost 20 to 50 percent less than their brand name equivalents.

â€¢ See if thereâ€™s a discount program: Some stores have programs for those 50 and older; other programs are open to anyone without insurance.

The full report is available for free now at www.ConsumerReportsHealth.org, or in the June issue of Consumer Reports magazine available on newsstands tomorrow.