GLG News by Life & Health Insurance Consultants

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

BCBS Association:Will No Longer Disclose Financial Results

August 11, 2006

Analysis of:Transparency Has Its Limits | www.modernhealthcare.com

The Blue Cross Blue Shield Association has made a large public splash this week by announcing an initiative which will pool loss data from over 20 not for profit BCBS plans see link http://cms.nationalunderwriter.com/cms/nulh/Breaking%20News/2006/08/04-blues-ab At the same time they will no longer offer financial results in aggregate of their licensed nonprofit blue plans, something they have historically done. It is interesting that BCBS is just now aggregating data across multiple plans and the explanation of what they intend to do with that data can be found by viewing the commentary below.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Healthplans Race Toward, Predictive, Personal and Pre-emptive

August 4, 2006

Analysis of:Employers' Stock in Wellness Rises With No End in Sight | www.managedcaremag.com

This article presents an excellent summary of the current state of wellness in America while providing good insights into the perspective of employers, Health Plans and the U.S. surgeon General.

Competitive advantage for Healthplans will come to the first player to achieve proven competence at making health care "predictive, personal and pre-emptive" for their members. For healthcare companies with a large book of fully insured business this quest has enormous profitability potential that investors should hone in on now.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Linking Lifestyle Choices With Healthcare Costs

August 4, 2006

Analysis of:More Americans See Hiking Health Costs for Unhealthy as Fair | www.plansponsor.com

53% of Americans surveyed now believe charging more for health insurance to individuals with unhealthy lifestyles is fair, up from 37% in 2003. Several, recent polls suggest this majority opinion is widespread.

Investors in the healthcare sector should take note as this opinion is linked to workplace education on wellness as employers prepare for consumer driven health plans.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Healthcare Investors Must Evaluate Underwriting Innovation To Spot Good Bets

June 9, 2006

Analysis of:What We Have Learned In The Last 50 Years and Are Not using | www.milliman.com

Actuarial Science tends to attract orderly and precise minds who have historically been quite content to establish underwriting processes for Group Health Insurance in a manner that projects past experience to arrive at prospective cost. This is true on individual groups as well as blocks of pooled business and is a process which incidently has not changed in 50 years.The US Surgeon General has reported that lifestyle choices are responsible for over 70% of diseases and account for more than 75% of health care costs. Investors need to scrutinize the underwriting methodologies being utilized to see how effectively public healthcare companies are assimilating lifestyle based analytics into the evaluation and pricing of health risks. This competence, along with engagement and successful behavior changes can provide dramatic return on investment. Which Health Care Companies have the courage to change their sacred actuarial methods and act on the data they possess to boost profits? This is a must read article for investors long in the health care sector as well as those considering a position.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Preparing for Consumer Driven Health

June 1, 2006

Analysis of:Time is The Best Medicine in Making The Switch to Consumer Driven Health | www.workforce.com

Early adapters of consumer driven healthcare programs have a lesson to share with employers considering the approach--take the time to educate and to let your workforce adjust to the concept before implementing or face a revolt from your workforce.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Do Not Underestimate the Difficulty of Consumer Driven Full Replacement

May 25, 2006

Analysis of:CALPERS Ponders Benefit Changes | sacramento.bizjournals.com

CALPERS is considering health benefit design changes which could save $64M next year but heavy resistance is expected from unions. The article offers insights into how truly out of touch with actual  medical costs many public sector employees and their union representatives truly are and how difficult this fact will make execution of  a full replacement consumer driven healthcare strategy in the public sector.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Big Margins for Medical Device Makers Face Scrutiny By Consumers

May 25, 2006

Analysis of:Device Maker Pricing Has Big Impact On America's Healthcare Bill | www.healthleadersmedia.com

Medical device makers have been insulated from scrutiny of the public for their excessive margins. The issue has two components;

1. Inappropriate utilization by providers
2. Outrageous product costs

Investors should carefully consider which device makers can even justify their margin in the face of transparent pricing.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

The Health and Productivity Connection

May 18, 2006

Analysis of:More insurers Reimburse Doctors for Online Care | www.orlandosentinel.com

Non-emergency office visits account for 20-30% of the average physicians total. Many of these can be handled online via secure communication without costing an employee to miss work. Insurer are beginning to reimburse for online consults.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Opportunities for Health Insurers in Middle Market

May 18, 2006

Analysis of:Health Care Education Lacking at Work;Study | www.businessinsurance.com

This survey of middle market employers reveals much for investors following public health insurers wondering which of the big 4 will actually grow membership. Consider that 72 % of  the employers surveyed have fewer than 200 employees and another 22% have less than 1000 employees. 82% of these employers either reduced benefits or increased employee contributions for Healthcare this past year.

Daniel BucklePrincipalEmployee Benefit Resources of South Texas

Until They Build It, Consumers Will Not Come

May 5, 2006

Analysis of:Providers Nor ready For Consumer Driven Health Plans | www.aishealth.com

Consumer Driven Health Plans (CDHP's) are causing hospitals and physicians to modify their business practices. Competing on cost and quality will present new challenges to doctors and hospitals unaccustomed to competing on these terms and change how they require payment.

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