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					       Claims & Benefits, Inc
                  The Noridian Companies             CBIUpFront                                           February 2005

952-835-3220 • 1-800-340-6881 • Fax 952-835-3235 • • 7801 East Bush Lake Road, Suite 240, Bloomington, MN 55439

WELCOME TO ‘CBI UP FRONT’                                        CBI WINTER EMPLOYER GROUP SEMINAR
Claims and Benefits, Inc. hopes you’ll enjoy reading              Join us in Eagan Tuesday, February 15, when we
the new newsletter, CBI Up Front. It’s a quick read              host an employer group seminar about consumer-
with lots of useful information about your health, your          directed health plans (Health Savings Accounts/Health
health plan and work-related issues.                             Reimbursement Accounts), HIPAA, COBRA and more.
                                                                 Our speaker will be Roger Stelljes of the law firm
                                                                 McGrann Shea Anderson Carnival Straughn & Lamb.
                                                                 Roger will explain HSAs and HRAs, including how they
                                                                 work and the pros and cons.
AdvancePCS, your prescription card, is now part of
Caremark. You will continue to receive the same level            Roger will also review HIPAA privacy compliance
of service you are accustomed to, along with new                 requirements and tell how these requirements will
opportunities to enhance your quality of care in the             impact your plan. And he’ll discuss the new COBRA
future.                                                          regulations, notices and procedures on how you
                                                                 should handle certain qualifying events. Three hours
Over the next few months, you will begin to see the              of continuing education credit are pending Minnesota
Advance PCS name transitioned to Caremark. Other                 Department of Commerce approval.
changes, such as prescription ID cards, will be phased
in over time. In the meantime, your can continue                 We’ll begin with a continental breakfast at 8:15 a.m.
to use your existing ID card to fill all of your retail           February 15, followed by the seminar at 8:30 a.m. The
prescriptions. Communication efforts are currently               event will be held at the Crown Plaza Hotel at 2700
under way with participating retail pharmacists and              Pilot Knob Road in Eagan.
doctors to educate them about the combination of                 Please call Gail Splitt of Claims and Benefits, Inc.
AdvancePCS and Caremark.                                         at 952-835-3220 or toll-free 800-340-6881 with the
Your service will not change. During this transition,            number of people who will attend from your company.
we intend to provide you with uninterrupted customer
service; in other words, “business as usual.” The
integration of Caremark and Advance PCS has                      ABOUT CLASS ACTION LAWSUITS
strengthened and enhanced their capabilities, enabling
                                                                 Groups often ask us about notices they get inviting
them to provide you even greater value through
                                                                 them to participate in class action lawsuits. Most
enhanced products and services.
                                                                 recently we have had inquiries on two prescription
If you have questions, please call 866-885-4944 or visit         drug suits.
                                                                 As you may imagine, attorneys are often the only
                                                                 people who get significant relief of a positive judgment
                                                                 in the class action lawsuit. In the case of prescription
                                                                 lawsuits, consumers typically get a meager sum, if
NOSE NEWS IS GOOD NEWS: KILLER KLEENEX                           anything at all.
Kimberly-Clark of Dallas now offers a Kleenex facial             The decision to join a class action lawsuit belongs
tissue designed to kill viruses that cause colds and the         to the employer group. However, we are in regular
flu. The company says the anti-viral Kleenex is gentle            contact with Caremark (Advance PCS), your pharmacy
enough for everyday use, according to medlineplus.               benefit manager, and we will forward any information
com. The new tissue is available in stores.                      we receive that may indicate that you may want to
                                                                 participate in an active lawsuit.
   If you take the brand-name antidepressant Prozac, ask                    Working in cooperation, some doctors and insurers
   your doctor if fluoxetine will work for you. Fluoxetine                   have begun using prescription “step therapy” programs
   is the generic equivalent of Prozac and costs much                       to help curb the widespread inappropriate use of
   less. A month’s supply of Prozac (20 mg doses) costs                     expensive Cox-2 inhibitors, such as Celebrex.
   $125.13, while a month’s supply of fluoxetine (20 mg
                                                                            A study by one Midwestern insurance company found
   doses) costs $6.75.
                                                                            that 75.9 percent of its members who took Celebrex
   Fluoxetine has the same active ingredients as                            and other costly prescription anti-inflammatory
   Prozac, works the same way and has the same risks                        medications gained no more benefit from taking them
   and benefits as Prozac, according to Brent Solseng,                       than they did from taking ibuprofen or other less
   Noridian Mutual pharmacist educator. Fluoxetine                          expensive treatments in treating osteoarthritis or other
   costs less because Prozac’s patent protection expired,                   pain-related conditions.
   providing the opportunity for other manufacturers to
                                                                            Step therapy programs promote the use of generic
   sell the generic version.
                                                                            non-selective, non-steroidal anti-inflammatory drugs
   A generic version of Celexa, another brand-name                          (NSAIDs), such as ibuprofen or naproxen, instead of
   antidepressant, also became available recently.                          branded Cox-2 inhibitors, except in a select group
                                                                            of patients considered at high risk for an upper
                                                                            gastrointestinal event. At high risk are patients 65 and
   ARE WE GOOD HEALTH CONSUMERS?                                            older, those with ulcers or gastrointestinal bleeding,
                                                                            and those on anticoagulant or steroid therapy.
           Employers versus employee views on how
                                                                            Step therapy programs include guidelines for
       effective employees are as health care consumers,
                      by percentage, 2004.                                  prescribing anti-inflammatory medication and are
                                                                            administered through the prescription software
           Employees are effective
                                                                            pharmacies use. When a claim for a Cox-2 inhibitor is
            health care consumers                                           submitted, the step therapy criteria are applied.

               Employees have taken
         advice consistant with being
    effective health care consumers,
             such as making positive
                                                                            STRETCHERS SUPERSIZED
                      dietary changes
                                                                Employees   Manufacturers are supersizing stretchers to
                                                                            accommodate the sharply rising number of obese
          Employees make regular                                Employers
            uses of tools supporting                                        Americans. “If the stretchers aren’t big enough,
        health care decision making
                                                                            a person may fall off,” said Dr. Richard Atkinson,
                                        0   20   40   60   80     100       president of the American Obesity Association.
                                                                            The Associated Press reported paramedics have gotten
   A recent health care consumerism survey shows                            hurt lifting heavy patients. One ambulance company
   many employees believe they’re effective health care                     previously used a tarp to carry patients too big for a
   consumers. Meanwhile, employers have a different                         standard stretcher. Five to 10 firefighters were needed
   view. Earlier this year, Towers Perrin polled 1,000                      to lift it.
   U.S. employees and 120 U.S. managers. “While our
                                                                            The new stretchers are being built with thicker
   employer respondents on average believe that only
                                                                            aluminum frames, bulkier connectors, extra spine
   about a third of their employees are effective health
                                                                            supports and other features to accommodate patients
   care consumers, the vast majority of the employees
                                                                            weighing up to 650 pounds, the report said.
   surveyed think they’re good consumers already,” the
   survey report said.                                                      The number of extremely obese American adults,
                                                                            those at least 100 pounds overweight, has quadrupled
   Fortunately, the survey also indicated employees are
                                                                            since the 1980s to about 4 million. That’s about one in
   open to changing their behavior if they believe it’s in
                                                                            every 50 adults, the report said.
   their interest. The report said, “For example, most
   employee respondents say they’re open to a range of
   health management initiatives that directly benefit
   them.” Many employers have moved toward strategies
   that encourage employees to take more responsibility
   for their health care and the cost of that care.

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