Claims & Benefits, Inc
The Noridian Companies CBIUpFront February 2005
952-835-3220 • 1-800-340-6881 • Fax 952-835-3235 • CBI@noridian.com • 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
ADVANCE NOW PART OF CAREMARK
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.
LOWER-COST ANTIDEPRESSANTS AVAILABLE DRUG ‘STEP THERAPY’ HELPS REIN IN COSTS
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
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.