Judge: UPMC Must Provide In-Network Access To Highmark Medicare Members

DSC01842More than 180,000 seniors who rely on Highmark Inc. for Medicare Advantage will keep in-network access to UPMC at least until 2019, Commonwealth Court President Judge Dan Pellegrini ordered Friday.

His three-page decision commands the Downtown-based rivals into binding arbitration to resolve other disagreements they cannot settle on their own — a move that delighted Gov. Tom Wolf and Attorney General Kathleen Kane.

UPMC vowed to appeal to the state Supreme Court.

“The feud between these two companies must end — the people of Western Pennsylvania have had enough,” Wolf said in a statement.

Read more: http://triblive.com/news/adminpage/8465390-74/upmc-access-network#ixzz3bd7KLBrW
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UPMC Offering Buyouts To 3,500 Employees In Cost-Cutting Move

DSC01840UPMC is offering buyouts to 3,500 of its older workers in a move to cut costs as the Pittsburgh hospital giant adjusts to slowing demand for hospital-based care.

The nonprofit organization said Tuesday that it was offering the voluntary severance to employees who are 60 or older and have at least 10 years of service. The offer, which was made to 5.6 percent of UPMC’s total workforce, includes medical and dental benefits, severance pay and a one-time cash payment of $15,000, UPMC said in a statement.

“This program both honors and respects long-term staff members who are ready to move to the next phase in life and, simultaneously, helps achieve cost-savings for UPMC by adjusting our workforce to meet the demands of the health care marketplace,” the statement said.

UPMC is the state’s largest private employer, with about 62,000 workers.

Read more: http://triblive.com/business/headlines/8442119-74/upmc-health-largest#ixzz3bM0tSWNm
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What States Are You Most Likely To Hit A Deer While Driving Your Car

Where are you most likely to hit a deer while driving along, minding you own business:

#1 – West Virginia

#2 – Pennsylvania.  Your risk level is HIGH, 1/71.  We are the 42nd most expensive state for car insurance.  State Farm, Erie and Allstate are the top three providers.  Frankly, I was surprised it wasn’t number ONE!

To read the article and see the top 20, click here –


Allegheny Health Network’s $600M Plan To Expand Reach Depends On Highmark

Allegheny Health Network proposes investing part of $175 million from Highmark Inc. in renovations and technology upgrades at its Allegheny General and West Penn hospitals, anticipating that they will accommodate more patients when Highmark insurance subscribers lose in-network access to UPMC next year.

The Highmark-owned hospital system would build outpatient medical centers and expand emergency, trauma and women’s health services to underserved parts of Western Pennsylvania as part of a spending plan that executives say will help it better compete with UPMC.

“The entire amount … will be used for capital improvements at Allegheny Health Network to fill in certain service line gaps,” Chief Financial Officer Karen Hanlon said during a state Department of Insurance hearing Monday. “No portion of the requested funding will go to pay operating expenses.”

UPMC Treasurer Tal Heppenstall Jr. said Allegheny Health Network is in worse financial condition than Highmark has reported and chided the company for its “profound lack of financial transparency.” He said it appears Highmark is hiding huge losses in “sporadic, fragmented and murky” financial statements.

Read more: http://triblive.com/news/healthnews/8208546-74/highmark-health-network#ixzz3ZH4hmeqt
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Wilkes-Barre, Other Pennsylvania River Towns Hit Hard By Flood Insurance Rates

HARRISBURG, PA — Jeff King had put his house in Wilkes-Barre up for sale for $90,000 last year, put off by the city’s struggles with crime and the desire for a better school district for his four children, when he got a surprise: The prospective buyer discovered that her annual flood insurance premium would be $7,015, higher than 12 months of mortgage payments.

Even though President Barack Obama signed a law Friday to ease the sharpest premium increases for policyholders receiving subsidies from the National Flood Insurance Program, King is resigned to never selling the house, which is about a mile-and-a-half from the Susquehanna River. The writing, he said, is on the wall.

“Any educated buyer is going to stay clear from a home in the flood area,” King said.

Across Pennsylvania, with an estimated 86,000 miles of creeks, streams and rivers, the premium increases could deliver a gut punch to the state’s legion of old river cities and towns still struggling to recover from the loss of their industrial core.

Read more: http://citizensvoice.com/news/w-b-other-river-towns-hit-hard-by-rates-1.1655882

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7 Ways To Protect Yourself Against Credit Card Fraud

NEW YORKMainStreet) — You shopped at Target this holiday season. Bad news: your credit card is now one of the 40 million that may have been subject to a data breach that could cost consumers $4 billion.

What now?

There’s no panacea. “If you’re going to use a card there’s always this risk that the system could be compromised,” said Robert Heath, a consumer protection attorney in Pensacola, Fla.

But there are ways to mitigate your risk. Here are seven things you can do to protect yourself against fraud.

Read more: http://business-news.thestreet.com/philly/story/7-ways-protect-yourself-against-credit-card-fraud/1

Forget Obamacare: One In Four Americans Say They’ll Pay The Fine

NEW YORK (MainStreet) — The law of the land now goes as follows: either have healthcare insurance or pay a fine. Yet more than one in four Americans say they would rather pony up the penalty. A new Gallup poll reveals that 28% of those surveyed have no intention of signing up for health insurance, as required by the Affordable Care Act and will pay the fine instead.

The penalty in 2014 for remaining uninsured is $95 per adult and $47.50 per child or 1% of taxable income (up to $285 for a family), whichever is greater.

Fully 17% of U.S. adults currently do not have health insurance, according to Gallup. With the self-proclaimed holdouts who say they will refuse coverage, at least 5% of all U.S. adults will remain uninsured.

According to the nearly 4,000 interviews conducted with uninsured Americans since September, more than one quarter (26%) under the age of 30 say they are more likely to pay the fine, compared with 30% of those aged 30 and older.

Read more: http://business-news.thestreet.com/philly/story/forget-obamacare-one-four-americans-say-theyll-pay-the-fine/1

Pennsylvania Insurance Chief Doubts Obama’s Health Care Plan

Map of Pennsylvania

Map of Pennsylvania (Photo credit: Wikipedia)

The state Insurance commissioner cast doubt Friday on a plan by President Obama to stop insurers from dumping more than 250,000 Pennsylvanians whose medical coverage did not meet the minimum requirements of the new health care law.

Insurance Commissioner Michael Consedine questioned whether Obama had the legal authority to allow insurers to reinstate or extend those policies. He also said the state has limited power to force insurers to comply with a scheme that he said “heightens confusion” surrounding the law’s implementation.

“I think there are very fair questions being raised about the legal authority for the president to say we’re going to ignore what’s in the” Affordable Care Act, Consedine told the Tribune-Review.

The president acted to quell a firestorm over the chaotic rollout of the law known as Obamacare in proposing the administrative fix for consumers whose policies were being canceled. Many accused him of reneging on a pledge that no one would lose medical coverage if they liked it.

Read more: http://triblive.com/business/headlines/5078520-74/insurers-health-state#ixzz2kpOO1rvh
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Savings Slow In Reading Purge Of Insurance Rolls

A 1947 topographic map of the Reading, Pennsyl...

A 1947 topographic map of the Reading, Pennsylvania area. (Photo credit: Wikipedia)

The city had budgeted savings of nearly $900,000 this year by purging its health insurance rolls of ineligible employees, dependents and police retirees.

It also budgeted a contingency fund of $980,000, if the purges didn’t go as planned.

They haven’t.

Managing Director Carole B. Snyder said the city has seen little savings so far because the police retiree purge got bogged down in arbitration and in complex evaluations that may not be complete by year’s end.

Read more: http://readingeagle.com/article.aspx?id=505866

Wegmans To Change Health Benefits For Part-Timers Under Obamacare

English: President Barack Obama's signature on...

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

(MCT) — Et tu, Wegmans?

The Rochester-based grocer that has been continually lauded for providing health insurance to its part-time workers will no longer offer that benefit.

Until recently, the company voluntarily offered health insurance to employees who worked 20 hours per week or more.  Companies are required by law to offer health insurance only to full-time employees who work 30 hours or more per week, as required by the Affordable Care Act.

Several Wegmans employees told The Buffalo News that part-time health benefits had been cut and said the company said the decision was related to changes brought about by the Affordable Care Act, also known as Obamacare.

Read more: http://www.mcall.com/news/breaking/mc-wegmans-cuts-health-benefits-part-timers-obamac-20130712,0,2099072.story#ixzz2YqbvNng8
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Exchange To Offer Health Insurance To Nearly 81,000 In Northeast Pennsylvania

Exchange to offer health insurance.

Assistance available to those in need.

Nearly 81,000 Northeast Pennsylvanians will be eligible to buy subsidized health insurance next year through an exchange, according to a new report released Wednesday.

The report, “Help Is at Hand: New Health Insurance Tax Credits in Pennsylvania,” by Families USA, a Washington D.C.-based non-profit that supports President Obama’s Affordable Care Act, details who will be eligible to obtain health insurance through the Pennsylvania exchange.

Read more:  http://thetimes-tribune.com/news/health-science/exchange-to-offer-health-insurance-to-nearly-81-000-in-northeast-pennsylvanian-1.1464563

Highmark CEO Compensation Tops $6M

English: Highmark Place from PNC Park in Pitts...

English: Highmark Place from PNC Park in Pittsburgh, taken 2008 showing the new Highmark branding atop. (Photo credit: Wikipedia)

Last year, Highmark Inc. dished out more than $6 million to compensate its three CEOs.

In compensation figures filed with the state Department of Insurance this month, the state’s largest insurance company said it paid former CEO Kenneth Melani $3.3 million in 2012, even though he was fired April 1.  He was the highest-paid company employee for the year.

In fact, three of Highmark’s 10 highest-paid employees in 2012 are no longer with the company, having left early in the year.  In addition to Dr. Melani, former Highmark legal officer and corporate secretary Maureen Hogel and retired auditor and compliance officer Elizabeth A. Farbacher also had left Highmark by April.

Current Highmark CEO William Winkenwerder Jr., who was hired over the spring and began work July 16, took home $1.87 million in total compensation — $562,712 for his half-year of salary, plus a $1.18 million bonus and $131,000 in “other” compensation.

Read more: http://www.post-gazette.com/stories/business/news/highmark-ceo-compensation-tops-6m-679520/#ixzz2NiolPvSN

Geisinger Tops UPMC In Pennsylvania Member Satisfaction, J.D. Power Reports

Geisinger Health Plan was tops in member satisfaction among Pennsylvania health plans with UPMC Health Plan and Central Pennsylvania’s Highmark Blue Shield not far behind, according to a report released today by J.D. Power and Associates.

Geisinger finished with 739 points out of a possible 1,000 to claim highest member satisfaction for the second year in a row.

Read more: http://www.post-gazette.com/stories/business/news/geisinger-tops-upmc-in-pennsylvania-member-satisfaction-jd-power-reports-678839/#ixzz2NFD01q76

Reading Has Tossed 98 From Health Plan

In a move to save more than $1.3 million, the city so far this year has thrown 98 people off its self-funded health insurance policy, and plans to remove another 77 if arbitrators allow.

Carole B. Snyder, city managing director, said the total of 175 people includes 89 dependents of current city employees, nine nonpolice retirees, and 77 police retirees and/or their spouses, all of whom the city says are not eligible for city-paid insurance.

The Fraternal Order of Police has objected, and the city has agreed to wait on the police retiree purge until an arbitration panel rules. A hearing is slated for March.

Read more:  http://readingeagle.com/article.aspx?id=450169

Health Care Law Includes $63 Annual Fee Per Person

English: President Barack Obama's signature on...

English: President Barack Obama’s signature on the health insurance reform bill at the White House, March 23, 2010. The President signed the bill with 22 different pens. (Photo credit: Wikipedia)

WASHINGTON – Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Barack Obama’s health care overhaul.

The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say.  Most of that is likely to be passed on to workers.

Employee benefits lawyer Chantel Sheaks calls it a “sleeper issue” with significant financial consequences, particularly for large employers.

“Especially at a time when we are facing economic uncertainty, (companies will) be hit with a multimillion dollar assessment without getting anything back for it,” said Sheaks, a principal at Buck Consultants, a Xerox subsidiary.

Read more:  http://readingeagle.com/article.aspx?id=434478

Mount Joy Borough Agrees To $900,000 Payment To Family Of Man Who Died In Taser Incident

Map of Pennsylvania highlighting Lancaster County

Map of Pennsylvania highlighting Lancaster County (Photo credit: Wikipedia)

Mount Joy Borough Council  on Monday approved a $900,000 settlement agreement for the family of a man who died in 2010 after attempts to subdue him included repeated discharges from a police officer’s Taser.

The settlement will be paid to the family of Robert A. Neill Jr. by the borough’s insurance carrier, according to borough officials.

The borough’s insurance company recommended the settlement, according to a one-paragraph statement read by council President Chris Metzler.

The insurance company was not identified, and no other comments were made by members of council.

Read more: http://lancasteronline.com/article/local/788936_Mount-Joy-Borough-agrees-to–900-000-payment-to-family-of-man-who-died-in-Taser-incident-.html#ixzz2E7KMA9Gr

Arbitrators Slash Newer Reading Police Officers’ Pay, Benefits

A 1947 topographic map of the Reading, Pennsyl...

A 1947 topographic map of the Reading, Pennsylvania area. (Photo credit: Wikipedia)

City police, especially those hired this year and in the future, will take major pay and benefit cuts now and when they retire, according to a five-year contract handed down Friday by a panel of arbitrators.

The panel froze officers’ salaries and step increases for three years and cut starting salaries, vacation time and sick leave in the new contract, which is retroactive to January 2012.

In setting the terms, the panel followed the city’s Act 47 financial recovery plan to cut millions of dollars a year from police costs.

For employees hired before the old contract expired at the end of 2011, the panel kept that contract’s pension benefits – up to 70 percent of working salaries, the ability to buy years of service to raise that pension, and city-paid retiree health insurance.

Read more: http://readingeagle.com/article.aspx?id=428754

Health Insurance For Police Retirees Next Problem For Reading

As the city struggles to meet its soaring pension costs, especially for police, it discovered a new problem that’s costing what some say is an illegal $900,000 a year.

Map of Berks County, Pennsylvania, United Stat...

Map of Berks County, Pennsylvania, United States with township and municipal boundaries (Photo credit: Wikipedia)

Police officers retiring through the much-maligned DROP program continue to get their health insurance premiums paid by the city.

The contract requires that any retiree who gets a job with another department must use that agency’s health insurance plan and notify the city to drop them.  Many retired city police have gone to other municipalities or the county.

But many don’t, city officials say, because they’re more valuable to another department if it doesn’t have to pay that benefit.

Read more: http://readingeagle.com/article.aspx?id=418707