The problems stem from a huge volume of requests to UnitedHealthcare’s call centers in Colorado Springs, Colo., and Phoenix, Ariz., since the [...]]]> The Pentagon is allowing UnitedHealthcare more time to fix chronic delays in the insurer’s handling of referrals and authorizations for medical treatment of active-duty and retired military families in the western U.S.

The problems stem from a huge volume of requests to UnitedHealthcare’s call centers in Colorado Springs, Colo., and Phoenix, Ariz., since the health insurer took on a massive new contract in April.

As a result of the delays, the Department of Defense is waiving a requirement that patients affected in the western region do not need authorization before getting specialty care. Ordinarily, a referral from a primary care provider would have to be approved by the insurer before a patient could get specialty care.

The initial waiver for specialty-care authorizations started in April, has been extended twice, and currently lasts through July 2, according to the Department of Defense TRICARE website.

Starting April 1, UnitedHealthcare has been a sort of third-party administrator for the $20 billion the federal government spends during a five year period on health care for active-duty and retired military in the western U.S. It means about $1.4 billion in revenue over the course of the five-year contract for UnitedHealthcare’s Military & Veterans Services business unit, which processes claims, manages costs and risk as well as detecting fraud and abuse.

UnitedHealthcare manages a 21-state TRICARE West contract that includes 2.9 million beneficiaries in Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa except for Rock Island Arsenal area, Kansas, Minnesota, Missouri except for the St. Louis area, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, portions of Texas including El Paso, Utah, Washington and Wyoming.

The problem is a call center capacity issue, though UnitedHealthcare hasn’t been penalized by the defense department yet, and it is too soon to know if it will have an affect on second quarter earnings, said Ana Gupte, an analyst with Dowling & Partners Research in Farmington who researches health insurers.

UnitedHealthcare has not said if it will hire more people at its call centers in Colorado and Arizona to handle the surplus of work that came with the new contract.

“United Healthcare has made real, measurable progress in many aspects of its TRICARE West Region contract, working collaboratively and effectively with the TRICARE West Region Office and the Military Treatment Facilities,” a spokesman for the insurer, Bruce Jasurda, said in a prepared statement. “To enable TRICARE beneficiaries to continue to receive timely and necessary access to care, the waiver for referral for specialty care for TRICARE Prime beneficiaries in the West Region has been extended through July 2, 2013.”

UnitedHealthcare is part of UnitedHealth Group of Minnetonka, Minn., which employs about 4,200 people in Connecticut. The TRICARE West delays are not related to the insurer’s work in Connecticut, Jasurda said.

 “We are operating in a business as usual mode while monitoring the situation closely, particularly as it relates to the well-being of our employees and [...]]]> Cigna Corp. is monitoring its operations in Istanbul, Turkey, where riot police fired tear gas and sprayed some of the thousands of protesters with water cannons over the weekend.

 “We are operating in a business as usual mode while monitoring the situation closely, particularly as it relates to the well-being of our employees and customers,” Cigna spokesman Matthew Asensio said in a prepared statement on Tuesday.

In August 2011, Cigna opened an office in Istanbul to sell personal accident and life policies, with plans to add other insurance products later. The company declined to say how many employees it has working in its Istanbul office or for Finansbank. It’s also not clear how many of those employees are citizens of Turkey or of other countries, including the U.S.

Police and anti-government protesters clashed Sunday after an 18-day sit-in in Istanbul’s central Taksim Square, according to the Associated Press. There is an increasing rift between those for — and against — Turkey’s Prime Minister Recep Tayyip Erdogan, a religious conservative.

Cigna has increasingly expanded its presence in Turkey in recent years. In November, 2012, the Bloomfield health insurer finalized its purchase of a majority stake in a Turkish insurer owned by a bank that is one of the largest distributors of life insurance and pension products in the country. Cigna spent 85 million euros — $108 million at the time — to buy a 51 percent stake in Finans Emeklilik, the sixth largest life and pension provider in Turkey.

In an interview with The Courant last fall, Cigna CEO David M. Cordani said, “…we identified two key geographies that were key strategic [entry] points: one being Turkey and two being India. And that’s where our focus has been thus far.”

Five employees, and one Aetna employee’s son, are featured on billboards in the Hartford region this summer as part of the health insurer’s $50 million national campaign to attract and [...]]]>   

Five employees, and one Aetna employee’s son, are featured on billboards in the Hartford region this summer as part of the health insurer’s $50 million national campaign to attract and retain individual customers.

While health insurance has been marketed to businesses in the past, federal health care reform and the introduction of public health exchanges later this year shifted part of the marketing emphasis to individuals.

Aetna’s national campaign, “What’s Your Healthy?” is $50 million for media advertising including television and billboards, business-to-business marketing, digital marketing and community events, among other efforts. The campaign is above and beyond what Aetna ordinarily spends on advertising, the company said.

One person featured on a billboard is Jake Montross, 12, whose father, Chris Montross, is Aetna’s managing director of community relations and urban marketing. The photo (above) is of Jake bicycling at The Village Ride, a fundraiser, in June 2012 at Ski Sundown in New Hartford.

“He had just finished up a baseball game and we were on the way home, and I just couldn’t hold it in any longer, I guess, and I said, ‘Hey man, look at this picture, you’re going to be on a billboard!’” the father said of his son. “And he was like, ‘What?! I’m going to be on a billboard?’ I wish I had a video of it. Honestly, the response was just so cute I couldn’t get over it.”

Aetna CEO Mark T. Bertolini said in a prepared statement: “Asking ‘What’s Your Healthy?’ is an opportunity to engage all consumers in a conversation around achieving their best health. Beyond simply creating a dialogue, we’re helping people take action through CarePass, which empowers users to create, track and achieve their health and wellness goals. Wellness is different for different people. I practice yoga and meditation every morning because it helps me be present during the rest of the day.”

The billboards feature a photo and an answer to the company’s question, “what’s your healthy?” For example, a photo of a person with a foot cast answers “getting back on my feet,” and a person on a mountain bike responds “making it to the top.” Only some of the 10 different billboard images have employees and others have publicity photos, such a woman doing yoga with her dog.

Aetna bought time on five digital billboards: two on Interstate-91 on the Colt building, two on I-91 south of Jennings Road and one on Interstate-84 east of Route 72. The stretch of I-91 around the Colt building had average daily traffic of 89,100 to 117,700 at different points on the highway, according to 2012 data from the Connecticut Department of Transportation. Daily traffic on I-84 in the West Hartford area ranges from 92,100 to 164,900, according to DOT data.

The billboard advertisements will rotate with other ads from June 17 through August 11. Aetna also bought television advertising that will be shown from 7 p.m. to 10 p.m. on local affiliates for NBC, CBS, Fox and ABC.

The marketing is both a buildup to enrollment in public exchanges, which starts Oct. 1, as well as people who buy individual policies directly from a broker or the insurer or on a private health exchange.

Aetna also has two websites to encourage people to live healthier lives: www.whatsyourhealthy.com and www.carepass.com.

CarePass vice president Martha L. Wofford said in a prepared statement: “CarePass helps consumers connect different pieces of health data to create a fuller, more personalized picture of their health.”

Miss Connecticut, Erin Brady of South Glastonbury, was chosen to be Miss USA on Sunday night in Las Vegas. She worked for about a year at the Prudential Retirement office in Hartford. She told her employer in advance that, if [...]]]> Prudential Retirement on Monday commended its 25-year-old employee who worked as an accountant in the Hartford office until being crowned Miss USA.

Miss Connecticut, Erin Brady of South Glastonbury, was chosen to be Miss USA on Sunday night in Las Vegas. She worked for about a year at the Prudential Retirement office in Hartford. She told her employer in advance that, if she won, she would leave her position to serve as the reigning Miss USA.

“We are proud of Erin and congratulate her on this accomplishment. We are glad to have had the opportunity to work with such a talented person and we wish her well as she embarks on this new and exciting chapter in her life,” Prudential Retirement’s vice president of Finance, Michael Brandt, said in a prepared statement.

For a complete story on Brady, click here.

Anthem Blue Cross and Blue Shield and St. Vincent’s Health Partners announced Friday a new reimbursement contract for chronic disease patients that is based on outcome and quality of care rather than traditional fee-for-service models.

The agreement — called an accountable-care organization — links St. Vincent’s insurance reimbursements [...]]]> By BRIAN DOWLING | The Hartford Courant

Anthem Blue Cross and Blue Shield and St. Vincent’s Health Partners announced Friday a new reimbursement contract for chronic disease patients that is based on outcome and quality of care rather than traditional fee-for-service models.

The agreement — called an accountable-care organization — links St. Vincent’s insurance reimbursements from Anthem to certain metrics related to hyper tension, diabetes, tobacco use and obesity.

Health insurers increasingly are using accountable-care organizations, which often include using electronic medical records and clinical coordinators to follow up on patients. In March, Aetna and ProHealth Physicians Inc., a doctors’ network, announced a similar agreement, the first of its kind in the state.

“Healthcare is being shifted from volume-based reimbursement to value-based reimbursement,” Dr. Thomas A. Raskaukas, chief executive of St. Vincent’s Health Care Partners, said in an interview.

To do this, Bridgeport-based St. Vincent’s will increase patient follow-ups, for instance, making sure they get their medication or receive preventative treatments. The healthcare group will also examine service trends to see where treatments, varying in method or price, produce similar outcomes. A major target is to avoid hospital readmissions and emergency room visits.

“The goal is to improve the fractionated care that goes on by having more coordinated care and by looking at outcomes and quality metrics,” Raskaukas said.

Anthem and St. Vincent’s will share in savings from the program, the groups said in a joint statement.

Dr. Peter Power, Anthem’s chief medical officer, said in a written statement: “As Connecticut’s largest commercial health insurer, we believe we have a unique opportunity to use our size, scope, and experience to bring about substantive improvements in health care delivery that will benefit people in Connecticut,” added Dr. Bowers.

Courant Staff Writer Matthew Sturdevant contributed to this report.

The Hartford health insurer was chosen to help the National Health Insurance Company of Qatar in developing a disease management program and to help generally in improving the country’s health insurance program.

“We are honored to be chosen to play a significant [...]]]> Aetna has a key role in Qatar’s new national health care system.

The Hartford health insurer was chosen to help the National Health Insurance Company of Qatar in developing a disease management program and to help generally in improving the country’s health insurance program.

“We are honored to be chosen to play a significant role in the creation of a modern, efficient and integrated health insurance system,” head of Aetna International, Sandip Patel, said in a prepared statement.

The national health care system will be built on a foundation of preventive and primary care, Patel said. Aetna will apply its clinical health management and technological capabilities to Qatar’s national health care system.

The Qatari government on Monday announced the new National Health Insurance Company to manage the nation’s health care system. An insurer in the country, Al Khaleej Takaful, will act as a third party administrator to manage administration of the insurance plan and Aetna is one of two subcontractors. The other subcontractor, GlobeMed, will manage enrollment, claims administration and call center functions.

Qatar’s universal health care coverage program will be fully operational for all citizens, expatriates and visitors in 2015. Launched in stages, it will first provide coverage to girls and women 12 and older for maternity, obstetrics, gynecology and other related health care concerns. Coverage for Qatari citizens for all medical treatment starts in early 2014.

Aetna declined to say the value of the contract. Work related to the contract will be done in the Middle East, primarily by Aetna workers in Doha and Dubai.

Among reasons they said they won’t be able to hire, 47 percent said the can’t afford to hire; 39 percent said their business isn’t growing and [...]]]> Two-thirds of small business have not hired anyone in the past 12 months, according to a survey commissioned by The Hartford of 1,000 small-business owners across the U.S.

Among reasons they said they won’t be able to hire, 47 percent said the can’t afford to hire; 39 percent said their business isn’t growing and 39 percent said they are taking on additional responsibilities themselves.

The lack of hiring is part of a generally conservative tone among small business owners, according to results from a telephone survey of business owners conducted by Braun Research between April 19 and May 1. The Hartford Financial Services Group released its Small Business Pulse survey today.

Small business owners are less likely to take risks than a year before, according to The Hartford. In three different surveys, the percent who identify themselves as “conservative” in terms of taking risks increased from 49 percent to 73 percent to 80 percent in the spring 2012, fall 2012 and spring 2013 respectively.

“The decrease in the level of risk small business owners are taking is a significant concern,” The Hartford’s Chairman and CEO, Liam E. McGee, said in a prepared statement. “Entrepreneurs’ drive, determination and readiness to take risks are what fuels small business creation, innovation and success, and we need to instill an environment that encourages their growth and development.”

The survey found that 73 percent of small business owners “feel successful.”

There’s a decline in the percent of people who feel optimistic that the national economy will strengthen this year. When asked that question a year ago, 63 percent of survey respondents said they were optimistic about the economy improving. This spring, only 47 percent of respondents said they are optimistic.

When asked about major risks to their business, 52 percent of the survey respondents cited slow economic growth, 44 percent cited health care costs and 40 percent cited taxes.

Asked about whether federal spending cuts caused by the sequester would affect their business, 49 percent said it would and three-quarters of those said it would be a negatively affect their business.

The arrangement builds on an agreement that Catamaran had with Cigna’s subsidiary, HealthSpring. At stake is the pharmacy benefits program for [...]]]> Cigna Corp. announced late Monday it has a new 10-year agreement with Catamaran, a company that buys prescription drugs in bulk and provides technological advantages to manage drug inventories for the health insurer.

The arrangement builds on an agreement that Catamaran had with Cigna’s subsidiary, HealthSpring. At stake is the pharmacy benefits program for about 8 million Cigna customers who stand to benefit from savings as Catamaran negotiates behind the scenes with prescription drug companies.

The customers are Cigna members who get prescriptions through home delivery, or at retail stores that have negotiated arrangements with the insurer. Cigna will continue to manage the pharmacy programs for its 8 million customers and Catamaran will fulfill orders for prescriptions for Cigna’s home delivery programs and the insurer’s retail network, in addition to processing claims.

Cigna said the arrangement will save the insurer 50 cents per share starting in 2015, which analysts at Credit Suisse estimated to be about $213 million annually.

“This strategic [pharmacy benefits management] partnering agreement will complement Cigna’s strengths of partnering with physicians to engage customers in their overall health and wellness,” Cigna CEO and President David M. Cordani said in a prepared statement. “Connected to Catamaran’s industry-leading health care information technology and service solutions, we will deliver differentiated options for clients and more affordable customer solutions in a rapidly evolving market.”

Catamaran is planning to open an office in Hartford, though none of the details of the move are publicly available yet. The company has, as it takes on new clients, opened offices in other cities, such as a 13,000-square-foot office that opened in December in Indianapolis, Ind., to support the state’s Medicaid customers.

During its second quarter earnings this year, Cigna expects to record a one-time transaction cost of about $25 million for advisory fees related to the agreement.

The Auto Body Association of Connecticut, which comprises more than 1,000 auto body shops, filed [...]]]> A Superior Court judge awarded $20 million in punitive damages — in addition to nearly $15 million previously awarded by a jury in compensatory damages — to Connecticut auto repair shop owners in their 10-year legal battle against The Hartford.

The Auto Body Association of Connecticut, which comprises more than 1,000 auto body shops, filed a lawsuit in 2003 against Hartford Fire Insurance Co., which is part of The Hartford Financial Services Group.

The association alleged that The Hartford engaged in a pattern of unfair and deceptive acts and practices, violating state law, by steering customers who had been in a crash to certain preferred auto body shops. The lawsuit also alleged that The Hartford provided incentives to its appraisers to establish artificially low hourly rates for auto body repair work.

On Nov. 17, 2009, a jury hearing the case awarded $14.77 million to the auto body association, saying that the insurer engaged in a practice that resulted in a loss to the repair shops. Superior Court Judge Alfred J. Jennings Jr. added $20 million in punitive damages in a ruling on June 5.

The Hartford’s spokesman, Thomas Hambrick, said: “We are disappointed in the ruling and plan to appeal.”

None of the money has been paid to auto body repair shops yet. At the end of the legal process, there will be a fund of money that includes the $14.7 million in compensatory damages and the $20 million in punitive damages, said the auto body association’s attorney, David A. Slossberg of the firm Hurwitz, Sagarin, Slossberg & Knuff in Milford.

“In most class actions, when you have a common fund like that, you then allow each member of the class to apply and there will be a process that will be set up to distribute the money to members of the class,” Slossberg said.

Ultimately, payment will depend on whether The Hartford wins an appeal.

Travelers is buying The Dominion of Canada General Insurance Co. of Toronto from E-L Financial Corp in what will be the biggest acquisition since the [...]]]> The Travelers Cos. said Monday it will spend $1.125 billion to acquire a Canadian insurer, it’s biggest acquisition in almost a decade and a major move into international markets.

Travelers is buying The Dominion of Canada General Insurance Co. of Toronto from E-L Financial Corp in what will be the biggest acquisition since the April 2004 merger of Travelers Property Casualty Corp. and The St. Paul Cos. in Minnesota.

“This transaction is consistent with our strategy to make thoughtful investments in attractive markets outside the United States,” Travelers Chairman and CEO Jay Fishman said in a prepared statement. “The Dominion is a great franchise, and this is a very good opportunity for Travelers to significantly improve its market position and scale in a meaningful market.”

The acquisition propels Travelers from the 20^th largest property-casualty insurer to 10^th in Canada, by one set of metrics.

“The deal will make Travelers a top 10 player in the country, and we believe that it’s safe to assume that Dominion likely lacked the scale to adequately invest in the technology platforms that are necessary to compete in today’s personal lines marketplace,” Janney Montgomery Scott LLC analyst Larry Greenberg wrote in a note to investors.

“With Travelers quantitative approach to the business and technical capabilities, there would appear to be ample opportunity to improve financial results and leverage the Dominion platform to grow commercial lines in the areas where Travelers is most skilled (small to middle markets),” Greenberg wrote.

Commercial lines is insurance for businesses, as opposed to personal lines, like auto and home coverage.

The acquisition is expected to close in the fourth quarter of this year, provided it is approved by regulators and passes customary closing conditions.

Dominion was founded in 1887 and has regional offices in Vancouver, Edmonton, Calgary, London, Ottawa, Halifax and other cities.

The Dominion’s chief executive and president, BrigidÖ Murphy, will remain in her role as the head of the company. The CEO of Travelers Canada, George Petropoulos, will be vice chairman of The Dominion and will serve as executive vice president of the company’s Bond and Financial Products.

“The combination will substantially enhance Travelers’ product breadth in Canada by coupling The Dominion’s commercial and personal portfolios with Travelers Canada’s surety, management liability and commercial middle market products,” Petropoulos said in a prepared statement. “We plan to leverage the expertise of both companies, and we will work closely with The Dominion team to assure a smooth transition for employees, customers and brokers.”

E-L Financial is a multi-line insurer. In addition to The Dominion, it owns 80 percent of The Empire Life Insurance Company which underwrites life and health insurance policies. Empire also sells mutual funds, annuities and other products.

Barclays analyst Jay Gelb said in a note to investors that the transaction was expensive for Travelers at 1.3 times the stated book value in light of Dominion’s “low return on earnings.”

“We view Dominion as a turnaround story,” Gelb wrote in the note. “Our sense is TRV [Travelers] would have been better off repurchasing more of its own stock.”

E-L Financial CEO and President Duncan N.R. Jackman said in a prepared statement: “We are extremely proud of what The Dominion team has achieved over the years. We could not be happier that Travelers, a highly respected and well capitalized firm, will be the platform for future growth and success.”

This is the second international acquisition in recent years for Travelers, which is primarily a U.S. property-casualty insurer. In June 2011, Travelers acquired a 43 percent stake in Brazilian surety insurer J. Malucelli Participacoes em Seguros e Resseguros SA for about $410 million. J. Malucelli is the market leader in surety insurance in Brazil, with a market share greater than 30 percent. In December, Travelers increased its stake in the company from 43.4 percent to 49.5 percent.