February 2020 edHEALTH Newsletter
Find out edHEALTH news and insights in the February 2020 digital edition o...
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Happy New Year Member Schools!
We have much to celebrate as this past year brought so much good news for edHEALTH and our member/owner schools. We now have 22 educational institutions and have members in three states. In July, we welcomed our first charter schools:Brooke Charter SchoolExcel Academy Charter SchoolsKIPP MA Public Charter SchoolsMatch Charter Public SchoolEffective January 1, 2020, two colleges joined our growing roster of member institutions:Dean CollegeSarah Lawrence College – our first New York school!Please join me in welcoming our newest members and I look forward to collaborating with you all as edHEALTH continues to grow.The numbers are in! Here are our latest counts:13,500 employee participants30,000 total participantsTotal premium equivalents for 2020: $225MAlthough we had some high-cost claims that impacted the 2020 renewal rates, our average overall renewals over time remain well below indu...
Read Full ArticleDecember 2019 edHEALTH Newsletter
Find out edHEALTH news and insights in the December 2019 digital edition of our newsletter.
Read Full ArticleNovember 2019 edHEALTH Newsletter
Find out edHEALTH news and insights in the November 2019 digital edition of our newsletter.
Read Full ArticleHow edHEALTH’s Captive Risk Financing Options Work
Under edHEALTH’s captive, member organizations pick their own self-insured retention level based on their risk tolerance, philosophy, financial status, and experience. In addition to the stop-loss coverage schools automatically receive, they can purchase aggregate stop-loss coverage to further protect their risk. Here’s how the risk financing works:If a school picks a Self-Insured Retention (SIR) of $100,000 per claim:The college will pay any single claim up to $100,000.The Educators Health Insurance Exchange captive will pay the next $1-$650,000 for each individual claim from this school.edHEALTH purchases excess protection from a stop-loss insurer. This insurer reimburses edHEALTH for any part of a particular claim that exceeds $750,000.Members work with the actuaries to pick a Self-Insured Retention amount that balances their claims experience with the risk of paying claims and sto...
Read Full ArticleThe ABCs of Captive Insurance
Twenty-two colleges, universities, and educational institutions own Educators Health, LLC (edHEALTH), a healthcare collaborative formed to address rising healthcare costs that were straining school budgets. By bypassing commercial insurers and pooling resources, edHEALTH leverages the combined schools’ purchasing power, thereby saving on healthcare costs for faculty, staff, and family members. But, did you know that edHEALTH’s wholly-owned subsidiary, Educators Health Insurance Exchange, is a group captive insurer?The captive insurance company’s main purpose is to insure its own risk. By joining colleges and universities together as a single purchaser, the schools gain market leverage. The captive manages its own risk through claims management, innovative programs aimed at loss control, and collaboration with strong business partners.Here are the ABCs on how the Educators Health Excha...
Read Full ArticleWelcome New Member Schools
Please extend a warm welcome to the following schools that are joining edHEALTH’s collaboration of colleges, universities, private and charter schools, effective January 1, 2020:Dean College: Located in Franklin, Massachusetts, Dean College offers associates and bachelor’s degrees and has a student enrollment of 1,300.Sarah Lawrence College: Located in Bronxville, New York, Sarah Lawrence is edHEALTH’s first New York-based member school. A private, liberal arts college, Sarah Lawrence’s student enrollment is nearly 1,400.Welcome Dean and Sarah Lawrence!
Read Full ArticleedHEALTH Plan Administrators Changing Their Names in 2020
Two of edHEALTH’s plan administrators are changing their names in 2020:CoreSource, our national healthcare administrator, is changing its name to Trustmark Health Benefits effective January 1, 2020. The company is rebranding to better tie the health division’s name with the parent company, Trustmark Mutual Holding Company. There will be no other changes. Trustmark Health Benefits will continue to use a customized approach to determine which of their 60 carrier- and provider-owned networks best meet the needs of our new member schools.BriovaRx, our specialty pharmacy vendor, is changing its name to Optum® Specialty Pharmacy in 2020. They have begun rolling out this change, which will continue into 2020. The new name is in keeping with the Optum parent company name. There will be no changes for existing BriovaRx members to benefits, services, or the phone number. Both of the following w...
Read Full ArticlePopulation Health Program Tackles High Cost Claims and Gaps in Care
In support of our goals of providing quality healthcare solutions at affordable costs, edHEALTH launched an innovative population health program in the spring. Did you know that 50% of edHEALTH’s claims come from just 5% of the population? The KnovaSolutions® Clinical Prevention Service focuses on those who need the most help. KnovaSolutions’ clinical team focuses on the highest risk, highest cost employees and their families with a holistic approach to support their needs.Privacy ProtectedThis program ensures privacy while using predictive modeling to identify those in need of support early in their care journey. Personal health data is secure; KnovaSolutions® doesn’t share it with member schools or edHEALTH. Additionally, they store all data consistent with Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy standards.Potential Reduction in High Cost ClaimsTh...
Read Full ArticleNew Share-it Employee Engagement Communications Are a Hit
In October, edHEALTH launched new share-it employee engagement communications to help member school employees navigate and maximize their healthcare benefits. These have been very popular with outstanding open and share rates. Check out these new communication tools:Tips for saving money and time using online health plan portalsTufts Health Plan: Tufts Online Portal Communication.pdf; Email versionHarvard Pilgrim Healthcare: Harvard Online Portal Communication.pdf; Email versionTrustmark Health Benefits: Online Portal Communication Trustmark.pdf; Email versionBenefit changes effective January 1, 2020Benefit Changes.pdf; Email versionTake advantage of telehealth convenience Tufts Health Plan and Trustmark Health Benefits: Telehealth Tufts Trustmark.pdf; Email version Harvard Pilgrim Healthcare: Telehealth Harvard.pdf; Email versionDownload and post the PDF versions of these communicati...
Read Full ArticleOctober edHEALTH news
Find out edHEALTH news and insights in the October 2019 digital edition of our newsletter. Check out our October 2019 Digital Digest!
Read Full ArticlePrevalence of Diabetes Growing: Chronic, Costly, and Deadly Disease Takes Toll on Patients and Payers
If you attended edHEALTH’s Annual Meeting, you saw the visual impact of diabetes in the United States. The prevalence has skyrocketed between 1990s and today, according to the Centers for Disease Control (CDC). Today:Diabetes prevalence: An estimated 30.3 million people have diabetes (9.4 percent of the U.S. population – an increase of 44% since 1998)Pre-diabetes prevalence: An estimated 84.1 million people (more than 1 out of 3 adults) have pre-diabetes: 9 out of 10 don’t know they have it.Diabetes, which occurs when blood glucose, also called blood sugar, is too high. The main types of diabetes are type 1 (also called Juvenile Diabetes where the immune system attacks and destroys insulin-producing cells in the pancreas), type 2 (as well as prediabetes where cells become resistant to the action of insulin), and gestational (in pregnancy, too little glucose gets into the mother’s cel...
Read Full ArticleWentworth Takes Home the Walking Challenge Prize
This year’s “Walk This Way Walking Challenge” was an overwhelming success. Fifteen member colleges and universities participated in the four-week challenge. Over 750 employees walked more than 200 million steps over the four-week period. Wentworth Institute of Technology (WIT) brought home the edHEALTH walking trophy and enjoyed an ice cream social for their winning scores:47 participantsOver 14.6 million steps walkedAverage of 311,900 steps per walkerMargaret Card, WIT’s HR Director, accepted the trophy on the School’s behalf. “Our employees relished competing against their fellow schools for the grand prize,” said Margaret. “It was a fun way to encourage healthy habits and the edHEALTH ice cream social was a lot of fun.”Each week during the challenge, the top 5,000 and 10,000 step walkers from each school won a themed gift basket: nutrition, exercise, relaxation, and mindfulness. Th...
Read Full ArticleedHEALTH President Tracy Hassett to Join VCIA Board
VCIA is pleased to announce the addition of two new captive professionals to its Board of Directors. Joining the VCIA Board in October 2019, both have been active in the captive industry for years. Tracy Hassett, SPHR, is the President and CEO of edHEALTH, the member-owned healthcare collaborative for 20 colleges, universities, and charter schools. She also is the President and CEO of Educators Health Exchange, edHEALTH's medical stop loss captive. Prior to edHEALTH, Ms. Hassett worked for 17 years at Worcester Polytechnic Institute in a variety of HR roles. She rose through the ranks to Vice President of Human Resources, and was the first person to hold this position. While Ms. Hassett was working at WPI, she joined Boston Consortium higher education finance executives who were looking for a solution to the healthcare cost conundrum. WPI was a founding member ...
Read Full ArticleAugust edHEALTH News
Find out edHEALTH news and insights in the first digital edition of our newsletter. Check out our August Digital Digest!
Read Full ArticleedHEALTH is Beating the Healthcare Cost Curve
edHEALTH is poised for growth. Our healthcare rates are beating the rising healthcare cost curve:Five year average increase is 1.7% compared with the industry average of 8.1%Last year we actually had an average 2.9% decrease in rates!In January 2019, we selected a coast-to-coast healthcare administrator so that we can expand nationally. We’ve added some innovative population health programs to improve quality and control costs. And, we’re expanding our website and social media footprint to improve our communications efforts.
Read Full ArticleNew Benefits Administrator Expands edHEALTH Reach Nationally
edHEALTH is now available throughout the country. For 2019, we entered into an agreement with Trustmark Health Benefits, a national employee benefits company. The company has access to over 60 carrier-owned and provider-sponsored networks. These include Aetna, Cigna, Empire Blue Cross Blue Shield of New York, Anthem Blue Cross of California, and Blue Cross and Blue Shield of Georgia.Trustmark Health Benefits uses a customized approach to determine which networks best meets the needs of new clients. They evaluate network panel scope, how strongly the network and types of care align with the client’s utilization patterns, and financial value. These findings are provided to the new member organization, edHEALTH, and Spring Consulting for final network determination.This same customized approach is used for plan design. Like all member organizations, the school determines its plan type of...
Read Full ArticleGet to Know Cindy Bartelson, edHEALTH’s Operations Whiz
If you’re a current edHEALTH member school, you’ve probably worked with Cindy Bartelson, edHEALTH’s Operations Manager. Cindy is the “go to” person for edHEALTH’s day-to-day activities:Troubleshooting health insurance-related issuesHR employee orientationPlan Design Committee logisticsNew group implementationTwo years ago, Cindy joined edHEALTH. She previously worked for 15 years in the HR Department at member school Worcester Polytechnic Institute (WPI). Cindy’s skills and experience make her uniquely qualified to running edHEALTH’s operations. She’s especially gratified to help member schools troubleshoot health-insurance related issues. “In HR there are a lot of urgent personnel-related issues,” says Cindy. “The school HR staff appreciates having one less item on their plates. And, through investigating member health insurance issues, I identify and find resolutions for larger conc...
Read Full ArticleNew Population Health Initiative Off to Strong Start
It was a pleasure to meet with all of you to discuss the new edHEALTH population health initiative, KnovaSolutions® Clinical Prevention Service. We’ve already heard from many of you that you want to participate in the program that targets the 5% of your population that comprises over 50% of claim costs. It’s a triple-win solution:1) Potential Reduction in High-Cost ClaimsThe program’s clinical staff provides personalized care for high-risk, high-cost employees and covered dependents. Through phone and secure email, participants receive support for medical decisions. Information, education, and decision support helps decrease unnecessary costs and utilization.2) Improves Healthcare Quality and Employee Satisfaction24/7 access to assistance: Questions about diagnosis, treatments, tests, and medicationsSupport for making lifestyle changesMedication review assistanceWork/life balance sup...
Read Full ArticleAward-Winning Optum Rx Program Effectively Tackles Opioid Abuse
Opioid abuse is a national epidemic: every 13 minutes there is an opioid-related death. Between 2015 and 2016 drug overdoses increased 21%, according to the Centers for Disease Control. Our prescription drug vendor, OptumRx, uses an innovative opioid management program that helps members and patients balance the need for powerful medications with the risk of abuse and misuse. Targeted drugs include Oxycodone, hydrocodone, morphine, hydromorphone, codeine, fentanyl, methadone, tramadol, OxyContin, Percocet, Lorcet, and Vicodin. The program takes a multi-pronged approach to help tackle abuse:Prevention and education: OptumRx provides education to patients and providers about the risks of opioids. Home delivery patients who fill opioid prescriptions through mail order receive education and promotion of proper leftover drug disposal. The drugs our dispensed with label and bottle cap warn...
Read Full Article2019 Annual Meeting
There was lots to celebrate at this year's Annual Meeting: 20 members before 2020; beating healthcare cost trends; financial performance; and $2 million in dividend distributions.Watch our presentation video here
Read Full ArticleNancy McConaghy Named Business Development Executive at edHEALTH
Nancy McConaghy Named Business Development Executive at edHEALTHLong-time Harvard Pilgrim Health Care Account Executive Brings Unique Expertise to the Role NORTHBRIDGE, MA, June 20, 2019 - edHEALTH, the member-owned healthcare purchasing collaborative for colleges, universities, private and charter schools, welcomed Nancy McConaghy, former Harvard Pilgrim Health Care Senior Account Executive, as its Business Development Executive. In this new role, McConaghy will be responsible for membership growth and retention.McConaghy was the account representative for edHEALTH’s Harvard Pilgrim Health Care Administrator and helped to ensure member satisfaction for the colleges, universities, and their employees enrolled in the Harvard Pilgrim health plan option. She served in that capacity since edHEALTH’s inception six years ago. With over 25 years of experience in account management for major ...
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