Financial Mines

News and notes from the business reporters for the Connecticut Media Group.

Archive for the ‘Insurance’ Category

Conn. gets piece of $500 million generic drug settlement from India

Tuesday, May 14, 2013 by:Rob Varnon

Connecticut Attorney General George Jepsen said Tuesday the state will get about $1.5 million from Ranbaxy, the India-based generic drug maker, who settled allegations this week that it was selling generics that were less than full strength or less than pure.

Ranbaxy agreed to settle the charges after a whistleblower made allegations about its drugs in court. The feds and states got involved because, ultimately because Medicaid, like private insurance policies, pushes patients to use cheaper generics when available. In all, the Indian pharmaceutical made 26 generic type of drugs between 2003 and 2010.

Ranbaxy agreed to pay fines and restitution to Medicaid programs, while not admitting it did anything wrong.

Banking and the other insurance industry’s response to Sandy

Thursday, November 1, 2012 by:Rob Varnon

Connecticut’s banking sector was lauded for riding out the devastation of Superstorm Sandy with minimal disruptions.

State Banking Commissioner Howard Pitkin, told The Mines Wednesday nearly all the banks are up and running with only one, The Bank of Fairfield, shut down because of a loss of power. One credit union in the New London area, also had to shut down due to power loss. He said the challenges were greatest along the shoreline.

“There are not cash shortages or operational shortages,” he said. “Some ATMs have connectivity issues or lack power.”

While the property and casualty insurers are getting a lot of attention due to the massive bills they face from Sandy, the state’s other major insurance industry, health was dealing with the storm from a different perspective.

Aetna and Cigna, two of the state’s major health insurers, liberalized their policies to help customers who were affected by the storm.

Susan Millerick, a spokeswoman for Aetna, said the insurer does not expect the storm to have a big effect on it from injuries or other health claims related to the damage.

“In times like this, we will liberalize our policies and will allow early refills of prescriptions. Will extend deadlines for filing claims and appeals on claims,” she said. “And we remind people of our employee assistance program.”

Particularly its behavioral health counseling option, which is now open to customers who don’t have that service. She said people are stressed and need someone to talk to and this is a great option for them.

She said in an emergency situation, people should remember out of network charges do not apply.

For more information on Aetna, visit www.aetna.com

Likewise, Cigna loosened its standards for customers. The company will allow early refills for prescriptions, is waiving all pre-certification, referral and hospital admission requirements. It will pay out of network services at in network rates and its telephone help line is staffed and open for people coping with anxiety, stress or their issues related to the storm.

For information on Cigna, visit its website at www.cigna.com

Insurance Department releases tips on filing claims for Sandy

Tuesday, October 30, 2012 by:Rob Varnon

Official release from Connecticut Insurance Department

Connecticut Insurance Commissioner Thomas Leonardi today reminded consumers that there are a number of important steps to follow when filing damage claims from Storm Sandy.

“Contact your agent or company as soon as possible and document your damage with photos or video,” Commissioner Leonardi said. “Keep a dairy of all conversations, e-mails and other correspondence you have with your company. Get the name of the representative you spoke to, note the date and time and what was communicated to you. Should any problems arise between you and your carrier, contact the Insurance Department. We are here to help you work through the process and will ensure that carriers comply with all state insurance laws.”

The Department is offering the following tips when filing claims:

Contact your insurer as soon as possible
Take photos of the damage
DO NOT make permanent repairs until your insurer has inspected the property
Keep a diary of all contact, conversations with your insurer
If you can still live in the home, talk with your agent about critical repairs that need to be made. Whether you make the repairs or hire someone, save the receipts for your claim.
If you need to find other lodging, keep records of expenses and all receipts. Homeowners and renter’s insurance generally provide limited coverage for expenses like: meals, rent, utility installation and transportation.
Your carrier will send an insurance adjuster to survey the damage at no cost to you. Public adjusters may offer the same services, but you would be responsible for any related fees. Check to be sure they are licensed with the Insurance Department.
Do not feel rushed or pushed to agree on a settlement. If there are disagreements, try to resolve them with your insurer. If you cannot reach an agreement, the Connecticut Insurance Department can help you decide if arbitration or mediation is an option.
Your full claim may come in multiple payments. The first will likely be an emergency advance and may include additional living expenses. The payment for your personal property and any additional living expenses will be made out to you. Payments for the structure may be payable to you and your lien holder if there is a mortgage on your home.
Even after settling your claim, if you think of items that were not in your initial loss list, contact your insurance company. Unless the company has paid the entire limit for the coverage of those types of items, it is possible the company will make an additional payment.
If your damages exceed the amount of your coverage, federal agencies will occasionally provide grants or low-interest loans to assist with recovery following major disasters.

The Department has provided a special “Storm Sandy” page with helpful claims guidelines, a list of toll-free claims phone numbers for insurance companies and other information for both consumer and the industry. For more information go to www.ct.gov and click on the “Sandy” link on the right side.

Ridgefield’s Boehringer Ingelheim to pay states $95 million over drug marketing practices

Friday, October 26, 2012 by:Rob Varnon

Boehringer Ingelheim's Ridgefield facility by Carol Kaliff

Connecticut Attorney General George Jepsen said Friday Ridgefield-based pharmaceutical Boehringer Ingelheim will pay the states $95 million to settle allegations the company paid kickbacks to doctors to push four drugs, sometimes for uses not approved by the FDA.

A complaint filed in Maryland federal court by a former sales director of the company, alleged that Boehringer and Abbot Labs participated in schemes to improve the sales of these four drugs, providing cash payments to doctors, free equipment and “bogus speaker training” seminars. The complaint further says the companies also paid certain advocacy groups to further claims regarding the drugs.

Connecticut’s Medicaid program is to receive $460,222 and will also receive $107,232 for state-only programs.

According to Jepsen, BI was promoting its stroke prevention drug Aggrenox to treat myocardial infarction and peripheral vascular disease, its hypertension drug Micardis for treatment of early diabetic kidney disease, uses for which the U.S. Food and Drug Administration had not approved them. Also, the states charged BI with marketing Atrovent and Combivent at doses that exceeded those covered by federal health care programs.

BI released the following statement after the announced settlement:

Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI) has entered into a settlement agreement with the Department of Justice (DOJ) and the Office of the Inspector General (OIG) of the Department of Health and Human Services to resolve allegations related to the marketing and sales practices of AGGRENOX®, ATROVENT®, COMBIVENT® and MICARDIS® during the years 2000 through 2008.

The company has been cooperating with the government since its investigation began. BIPI decided to resolve this matter in order to avoid the time and expense of continuing litigation. The settlement is civil only and is not an admission of liability by the company.

“The pharmaceutical industry as a whole has undergone significant changes over the past decade and continues to be under intense scrutiny. Likewise, our internal processes and compliance practices have evolved significantly over the years,” said Greg Behar, president and chief executive officer of Boehringer Ingelheim Pharmaceuticals, Inc. “We are confident that the voluntary steps we have taken to enhance our compliance program meet the high standards of ethical behavior, trust and integrity that our patients and customers expect and deserve.”

Under the terms of the agreement, BIPI has agreed to pay approximately $95 million and has also entered into a five-year Corporate Integrity Agreement (CIA). The CIA requires the company to establish certain policies, appoint a Compliance Committee, monitor certain activities and conduct internal training, among other things.

It’s unclear how many doctors were involved in this or whether any face disciplinary actions for taking kickbacks.

Thousands of Conn. residents to see health insurance rates rise

Wednesday, October 17, 2012 by:Rob Varnon

This month, the Connecticut Insurance Department has approved rate increases of 5.5-to-12.8 percent for policies covering more than 100,000 people.

Combined with high oil and gasoline prices, these hikes are another blow to the economy as consumer spending is becoming more concentrated in the areas of health care, energy and education, leaving many households facing the decision to reduce other expenditures or increase their use of credit. But so far, consumers have been loathe to put much to use loans other than for automobiles and education

Here’s what the department approved this month:

Oxford Health Plans received a 5.5 percent increase for its large employer group plans for 2,678 policy holders which are covering 5,867 employees. The new rates are effective Nov. 1 of this year.

Anthem Health Plans received two rate increases both of which go into effect on Jan. 1, 2013. It got a 12.6 percent increase for its individual health plans, which affects 30,000 policy holders in the state. Anthem had asked for a 14.6 percent increase, but the department scaled it back after a review found some administrative costs could not be justified.

The Insurance Department also reduced to 12.8 percent Anthem’s 13.8 percent request for its small employer group plans. In this case, the department said Anthem overstated the impact from the new health care law. The change is expected to affect 36,000 policy holders covering 65,000 employees.

State Insurance department trims Aetna AARP policy hike to 4 percent

Friday, October 12, 2012 by:Rob Varnon

Aetna Life Insurance Co. was looking for a 7.5 percent increase on its Essential premier Health Insurance plans provided solely to AARP members in Connecticut, but the State Insurance Department trimmed the increase to 4 percent.

There are about 1,200 Connecticut AARP members who will be affected, the department said in its decision.

Many other policies in the state are looking for similar hikes heading into 2013 but the department has continued to show a reluctance to provide the full requests of late.

Here’s the department’s official announcement on the decision as posted on it:

Decision – Disapproved as submitted, reduced to 4 percent increase

On August 15, 2012, Aetna Life Insurance Company filed a rate review with the Department on its Essential premier Health Insurance plans. The plan is only available to members of the American Association of Retired Persons (AARP) as part of a group association trust. There are approximately 1,200 AARP members in Connecticut covered under this plan. Aetna sought the new rates, citing a 12 percent in combined increase in medical costs and use of medical services, also known as “trend.”

Although an actuarial review by Insurance Department found the company’s impact of trend on the requested rate was appropriate, the review further found that Aetna over estimated large claims. As a result, the Department rejected the request as submitted on October 10, 2013 and instead lowered the increase to 4 percent. The new rates will take effect January 1, 2013.

This is the first time that Aetna has filed rates for this particular plan in Connecticut. The 2012 rates were previously filed and approved with the District of Columbia, where the association trust is located.

Health insurance premiums run more than double pay increases

Tuesday, September 11, 2012 by:Rob Varnon

The Kaiser Family Foundation’s annual report on insurance premiums found they only rose 4 percent this year, compared to last.

Unfortunately, hourly wages in the private sector are up 1.7 percent from a year ago, according to the latest U.S. Bureau of Labor Statistics report on employment and pay for August.

And, while there have been some indications that employers are starting to loosen the purse strings on raises, the Kaiser reported employers are expected health care premiums to rise by about 7 percent.

It is not a good sign for an economy still hoping consumers will lead the way out of the doldrums by spending.

The Associated Press lays out the issue including the political football it’s become on today’s website.

Here’s the link to Kaiser’s full report:

http://ehbs.kff.org/

Connecticut’s Health Insurance Exchange hires COO and CFO

Wednesday, September 5, 2012 by:Rob Varnon

Lt. Gov. Nancy Wyman announced Wednesday, the state’s Health Insurance Exchange now has a full complement of executives.

Here’s the release on it:

The Connecticut Health Insurance Exchange has completed the staffing of its executive leadership team with the hiring of a Chief Operating Officer (COO) and Chief Financial Officer (CFO), said Lt. Governor Nancy Wyman, Chair of the Exchange’s board of directors.

COO Peter Van Loon comes to the Exchange with more than 25 years of experience in health care technology and finance operations, including leadership roles at ConnectiCare, EDS and Aetna. A former Captain in the U.S. Navy, Van Loon holds a Bachelor of Science degree from Trinity College and an MBA in Finance from the Wharton School at the University of Pennsylvania.

CFO Steven Sigal is a CPA with more than 35 years of finance experience. His background includes senior finance positions for Aetna and Travelers, including several involving turnaround and start-up efforts. He also was an Audit Manager at PricewaterhouseCoopers. Sigal holds a Bachelor of Science degree in Accounting from Georgetown University, and a certificate from the Advanced Management Program at Duke University’s Fuqua School of Business.

Created in 2011 to implement elements of the federal Affordable Care Act, the Exchange is a quasi-public entity governed by a 14-member Board of Directors, which by 2014 will offer individuals and businesses a choice of health coverage plans.

Along with Sigal and Van Loon, the Exchange’s executive leadership team includes:

Kevin Counihan - Chief Executive Officer
Jim Wadleigh – Chief Information Officer
Jason Madrak – Director of Marketing & Consumer Outreach
Julie Lyons – Director of Policy & Plan Management, and
Virginia Lamb – General Counsel

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