Archive for the ‘Pennsylvania’ Category

The current provider contract between Cigna-HealthSpring and Crozer-Keystone Health System (CKHS) is set to expire on April 30th, 2014 and it appears that the sides are fairly far apart in their negotiations.  It’s not uncommon, however, for these contract disputes to run right up to the last minute, however, CKSH has posted a message on their website.

CKSH has provided services to a relatively small percentage of Cigna-HealthSpring members in the past 12 months, roughly 4,300 of their 70,000 members.  Cigna-HealthSpring payments represent about 4% of CKSH’s revenues.

Cigna-HealthSpring commented that they are keeping lines of communication open with CKSH.

It’s not 100% clear to me if this impacts primary care doctors and specialists, or only the CKSH facilities.  In the letter to Cigna-HealthSpring members, CKSH seems to indicate that the doctors are part of the termination (“our physician practices’ participation with Cigna HealthSpring is also terminated effective April 30, 2014.”), however, Cigna-HealthSpring’s perspective was that the PCP’s and specialists were not a part of the contract ending 4/30/14.

The story is also being followed by www.philly.com (Philadelphia Inquirer) and by the Delaware County Daily Times.


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Here is a link to the article from Philly.com.  Health Partners Plans (formerly Health Partners of Philadelphia Inc.) operated Medicare advantage plans 6 years ago which were sold to Elder Health (which moved to Bravo, then HealthSpring and now Cigna HealthSpring).  They have now filed with CMS for new plans for 2014.

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Here is the story from the Pittsburgh Tribune-Review.  Highmark is the largest health insurer in Pennsylvania and an affiliate of the BlueCross and BlueShield Association.  The closing of the deal with Jefferson, valued at $350 million, gives Highmark an anchor hospital in the South Hills of Pittsburgh.  Highmark is also trying to finalize an approximately $1.1 billion acquisition of the West Penn Allegheny health system.  The West Penn deal is pending regulatory approval of the PA State DOI.

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In unveiling his budget, PA Governor Tom Corbett revealed that PA will not participate in Medicaid expansion in its current form, but seemed open to compromise on this issue.  Here is the story for the Patriot News in Harrisburg, PA.

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Highmark is selling off their Medicare claims processing business in order to clear a regulatory path regarding their acquisition of West Penn Allegheny.  It appears that Highmark is more interested in vertical expansion within the health care space than growing horizontally with ancillary Medicare service businesses.  A Highmark EVP is quoted as saying that they plan to expand more into the medical provider business.

I’ve noted the vertical expansion into the health care space by managed care companies in prior posts, for example, Humana and United Healthcare.

Here is an article from the Pittsburgh Tribune.

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Ritter Insurance Marketing is committed to providing our agents with information about the insurance industry. Below are links to the lasted news in your state. (Must be logged into ritterim.zendesk.com/ to view forums) 

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Ritter Insurance Marketing is committed to providing our agents with information about the insurance industry. Below are links to the lasted news in your state. (Must be logged into ritterim.zendesk.com/ to view forums)

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The story is from the Pittsburgh Tribune-Review.  Highmark is looking for injunctive relief to block University of Pittsburgh Medical Centers (UPMC) from airing ads which talk about the termination of portions of their contract with Highmark in June of 2012.

UPMC is considered a very important medical provider in the Pittsburgh market.

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PA LTC Partnership Classes
Initial Mandatory Training (8 hr CE)
Refresher Mandatory Training Course (4 hr CE)

Are you LTCi CE partnership compliant?
Target Insurance Services of PA will be hosting a combination class to serve those that need the required 8 hour Initial Mandatory Training (course #117189) as well as those that need the 4 hour Refresher Mandatory Training Course (course #117190). The courses will be held on June 27th and will be held at our office. For more details and to register click on the appropriate link below.

The 8 hour CE program will run from 8:30am to 5:00pm 
The 4 hour CE program will run from 8:30am to 12:30pm  

8 Hour LTC CE Course  Register Now!
4 Hour LTC CE Course  Register Now!



LTCi Teleconferences/Webinars 

Mutual of Omaha
June 21st, 2011
Our LTCi Underwriting Philosphy
See how the Mutual of Omaha underwriting team strives to get your business issued quickly and learn what you can do to help.
Call Times: 10:00am EST (conf id 30820745)
                 4:00pm EST (conf id 30827920)
Phone number: 877-511-4819
Calls are scheduled to last 20 minutes and will include time for Q & A.

LTCi Carrier News  

Texas LTCi Partnership exchange. For more details Click Here.

Mutual of Omaha
Living Care Annuity coming soon to Washington D.C. and Montana. On June 20, 2011, United of Omaha is introducing an innovative new product providing customers with the best of both worlds: a deferred, fixed-rate annuity, with built-in long-term care benefits. View Details

Six ways you can help get business through underwriting faster. View Presentation 

John Hancock 

Product news
Download a side by side comparison of Custom Care III and Core Care Click Here.

Marketing News
Reprint of the latest AALTCi reprint in Kiplinger’s available for order. As a follow-up to the educational LTC planning insert that ran in the November 2010 issue of Kiplinger’s Magazine, reprints are now also available on the latest insert that ran in the Kiplinger’s May 2011 issue. Copies of each are available to download or order as follows:
    – May 2011 Insert: “Most Asked Questions About LTC Planning” Form: LTC-1146
    – November 2010 Insert: “A 3-Step Guide to Smarter LTC Planning” Form: LTC-1107

Add Value to your Sponsored Group sales with a co-branded website. We are pleased to announce a number of enhancements to our co-branded Sponsored Group educational websites. Highlights include banner ads, customized URLs and more. For producers with existing sites, we will be implementing new URLs, read this article for complete details and timing. Download the promotional flier. Form: LTC-6348

Compliance News
2011 Medicare Guides now available. The 2011, “Choosing a MediGap Policy: A Guide to Health Insurance for People with Medicare” is available to download and order from www.jhltc.com  .

Partnership News
CO and TN: Partnership inflation limitations on new products. For details Click Here

Now, through the Transamerica Business Advantage ProgramSM, you can help your employer clients meet the growing demand of their employees and respective families who are interested in Long Term Care insurance. The Transamerica Business Advantage ProgramSM provides your employer clients with multiple options to help make Long Term Care insurance available to their employees.

Business Advantage Program.
Whether employees are experiencing it first-hand as a caregiver to a loved one or they know someone who is experiencing the need, they are becoming aware of the need for Long Term Care insurance protection. They are realizing that a long term care need can impact all aspects of life. Long term care services can be a financial drain on a family, and caregiving can affect productivity at work.

We want to help your clients’ businesses and associations stand out from the rest by offering Long Term Care insurance through Transamerica Life Insurance Company’s Business Advantage ProgramSM. It is as simple as choosing one of three options or combining programs for a customized fit. We make it easy!
Click Here to Learn more about the Business Advantage ProgramSM

LTC3 Quick Start (Express Ticket) applicationprocess to be discontinued. Prudential Long-Term Care will be discontinuing the Quick Start application process. Effective Monday, June 27, 2011, we will no longer accept applications using Quick Start (Express Ticket) forms. Click below to see the full communication. Click Here.

Replay of Phil Sullivan’s June 8th presentation If you missed the June 8, 2011 eMeeting with special guest, Phil Sullivan, of Selling LTC.com, we have arranged an opportunity for you to listen to a digital replay of the session. Click below for dial-in information. Closing the LTCi Sale

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Ritter Insurance Marketing is committed to providing our agents with information about the insurance industry. Below are links to the lasted news in your state. (Must be logged into ritterim.zendesk.com/ to view forums)

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