Volume 2, Issue 4: February 9, 2007

Legislative Watch

A hot topic in the news media, healthcare reform is a serious concern for PacificSource as well. As lawmakers introduce a flurry of healthcare bills in this legislative session, we've formed an internal workgroup to carefully review them and develop our response. Beginning with this issue of the Agent Bulletin, we'll use this recurring column to keep you informed of our legislative activities and ask for your support of our position. Below is a summary of our stance on bills currently under consideration.

Senate Bills 355 and 426 (concerning Oregon school districts): We strongly oppose the passage of Senate Bills 355, 426, or their functional equivalent, which create a state-wide mandatory insurance pool for school districts. We oppose these bills for three fundamental reasons:

  • Existing data demonstrates that the bills will not decrease school districts' healthcare insurance costs (and may actually increase those costs).
  • School districts will lose flexibility, choice of plan design, and existing relationships with insurers.
  • Pulling school district business away from local Oregon carriers will have significant impacts on those businesses.

For more information, please read our position statement and the bill summaries: Senate Bill 355, Senate Bill 426.

House Bill 2213 (concerning transparency): We support the idea of making it easier for insureds to obtain information about their potential out-of-pocket costs and overall procedure costs prior to receiving healthcare services. Unfortunately, this is an easier concept to discuss than it is to implement. We believe that HB 2213, as currently drafted, will not provide accurate information to insureds, but will instead result in unnecessary added expense and confusion for healthcare consumers. In response to concerns over the bill language, the Chairman of the House Subcommittee on Health Care Access has appointed a committee to produce a revised draft.

For details, please read our official testimony and the bill summary: House Bill 2213.

If you have any questions or concerns about these legislative issues, as always, you're welcome to contact us.

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United Way Recognizes Ken Provencher and PacificSource

Both PacificSource and President Ken Provencher received accolades at this year's United Way of Lane County community celebration.

The Helping Hands Award was presented to six companies, including PacificSource, who significantly increased their donations during the 2006 campaign. Our employee fundraising campaign raised a total of $52,207 last year, which was an $11,000 increase over 2005.

Ken received the organization's highest honor, the Alton F. Baker Award, for his work as chairman of the 100% Access Coalition (healthcare initiative). This award is presented annually to one individual who demonstrates outstanding humanitarianism in our community.

In a taped interview, several community leaders expressed their thanks for Ken's dedication to the initiative. “The work we're doing to change the healthcare system wouldn't have gotten off the starting blocks without the work he's done,” said former Governor John Kitzhaber. “I'm convinced that without his leadership, this program would not have made the progress that it has.”

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Our Performance at a Glance

To maintain service levels and customer satisfaction that are consistently among the best in our industry, we continually poll our customers and measure our performance on more than 50 operational processes. The data below represents reporting period averages for a few of those measures.

Key Service Measures for Fourth Quarter 2006

Medical claims turnaround time

12.9 days

Medical claims accuracy as
a percentage of claims dollars

99.2%

Customer service phone answer speed

18.3 seconds

Customer service call abandonment rate

1.6%

SEHI proposal turnaround

97.3% within 2 business days

HIPAA proposal turnaround

81.7% within 5 business days

Large group proposal turnaround

96.0% within 10 business days

New clients – ID card turnaround

95.5% within 10 calendar days

New clients – plan materials turnaround

96.9% within 21 calendar days

These are just a few of the many operational metrics we assess continually to ensure that our service is top notch. If you'd like more information on our performance measures, contact your Marketing Representative.

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Mental Health Parity Update

As of January 1, we manage mental health and chemical dependency (MH/CD) treatments consistent with Oregon's new mental health parity rules. The criteria and benefits for MH/CD services are similar to our other medical benefits and treatment reviews. Changes become effective for members with their employer group's renewal in 2007. We are working to ensure a seamless transition for both members and providers. Here are the changes at a glance:

  • Providers need to submit treatment plans for outpatient MH/CD services exceeding eight visits for all members.
  • All group contracts issued in Oregon, including groups of fewer than 50 employees, are covered under mental health parity.
  • Mental health parity benefit changes are effective for PacificSource Portability contracts at renewal, April 1, 2007.
  • For the majority of groups, provider treatment plans will now be handled by PacificSource.

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Make February Heart Health Month

Hearts are everywhere as Valentine's Day approaches—in the office, at the store, and on stamps. Let's use Valentine's Day as a heart health reminder. To support heart health, we are pleased to offer the Healthy at Heart™ Reduce Your CV Risk program, one of our value-added disease management programs and services.

The program helps our members with high cholesterol or high blood pressure maintain cardiovascular health. It provides educational materials to improve understanding of the conditions and how to follow recommended treatments, as well as newsletters, “Healthy Hints” reminders, and gifts. The Diabetes Control Network (DCN) is part of the Healthy at Heart program. It's designed specifically for our members with diabetes, and provides a diabetes newsletter, a scorecard to track results, and more. PacificSource members identified by their medications are invited to participate in these free programs. You can download the Healthy at Heart member flier from the For Agents/Materials/Member Materials area of our Web site, www.pacificsource.com.

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Keeping Up with Marcella Soulagnet

Think of Marketing Office Coordinator Marcella Soulagnet as your Portland office point person. Much of her day is spent greeting callers and visitors to our PacificSource and Manley Services office in Lake Oswego. She answers questions, takes monthly premium payments, and assists with individual plans.

Legislative Watch

United Way Recognizes Ken Provencher and PacificSource

Our Performance at a Glance

Mental Health Parity Update

Make February Heart Health Month

Keeping Up with Marcella Soulagnet

 

Marcella Soulagnet
Marcella Soulagnet, Portland District Office Coordinator
Well suited to handle her many tasks, Marcella enjoys helping agents and members. “I love it when I feel as though my help has put a smile on their face or has made their work easier,” she says. Marcella can help get new enrollment packets together or connect agents with a Marketing Service Representative to schedule a benefit meeting. And if agents call ahead of time, she can also let them know of any recent policy or application changes. Around the end of the month, Marcella is usually very busy checking over new group applications and taking individual policy premium payments. "We have a fantastic team in the Portland office," says Marcella. "We are all happy to help agents.”

Since Marcella spent a few years as an independent insurance broker before coming to PacificSource, she knows about the joys, challenges, and frustrations that come with selling insurance. “I know how tough it can be to keep up with changes. That's why I'm glad we have all our forms and benefit summaries available online, so that agents always know where to find a current copy.”

This Portland native is always busy outside work, too. Last year, Marcella volunteered as the PacificSource Portland team captain for both the American Cancer Society Relay for Life and for the March of Dimes WalkAmerica events.

In her free time, Marcella loves to travel, especially to coastal places. She enjoys any chance to snorkel and spent six months volunteering at Ocean Park in Hong Kong (similar to Sea World). “While I was there, I helped care for dolphins and swam with them,” she says. “They pushed me around the pool by my feet! I enjoyed that experience so much, I also volunteered at the Oregon Zoo for a couple years."

Currently, Marcella is home on maternity leave with her husband and two young daughters. Her youngest was just born in December. Marcella will be back in the office the first week of March.

Marcella impresses us all with her dedication. Her philosophy, “embrace each day with anticipation and enthusiasm,” is evident in everything she does and mirrors PacificSource's dedication to excellent service. “Work—and life in general—are all about how we relate to others,” says Marcella.

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“I know how tough it can be to keep up with changes. That's why I'm glad we have all our forms and benefit summaries available online...”
Questions? You’re always welcome to contact us!

Eugene
(541) 687-7047 or toll-free (877) 657-9797
fax (541) 485-0915
Troy Kirk, Vice President Sales and Marketing
Doug Sheffer, Eugene District Manager

Bend
(541) 330-8896 or toll-free (888) 877-7996
fax (541) 330-8948
John Wright, Bend District Manager

Medford
(541) 858-0381 or toll-free (800) 899-5866
fax (541) 858-0486
Fred Cornett, Medford District Manager

Portland
(503) 699-6561 or toll-free (877) 657-9797
fax (503) 697-1075
Dennis Reed, Portland District Manager
Julie Doran, Marketing Representative

Manley Services
(541) 485-7488 or toll-free (800) 422-7038
fax (541) 681-8792
or toll-free (800) 575-1109
Stan Manley, President

Select Benefit Administrators
(503) 598-8908 • fax (503) 598-0197
Nancy Louris, President

Agent Bulletin is published by PacificSource Health Plans • Each issue is archived at http://www.pacificsource.com/for_agents_N.html
Copyright 2007 • PacificSource Health Plans • All rights reserved
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