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Life Health > Health Insurance > Health Insurance

The Catch: Oct. 19

By Allison Bell

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HealthSmart Holdings Inc. is planning to expand its medical third-party administration (TPA) business by acquiring a medical TPA business from Wells Fargo Insurance Services USA Inc., a unit of Wells Fargo & Company.

HealthSmart, Dallas, has been handling about $4.2 billion in benefits claims per year with about 400 employees.

The Wells Fargo operations HealthSmart is acquiring are handling about $800 million in claims.

HealthSmart would assume leases for offices in Charleston, W.V.; Juneau, Alaska; Fayetteville, N.C.; and Newnan, Ga.

HealthSmart would be taking on about 600 Wells Fargo TPA employees.

HealthSmart and Wells Fargo are not saying how much HealthSmart is paying for the TPA unit, but HealthSmart says it hopes to complete the deal by the end of the year.

The combined TPA operation would have about $100 million in annual revenue, HealthSmart says.

Neal Aton, president of Wells Fargo Insurance Services, says his business would offer HealthSmart TPA services to Wells Fargo customers.

HealthSmart has offices in California, Colorado, Ohio and Texas. The Wells Fargo deal should help HealthSmart build volume in the East, according to HealthSmart Chairman Daniel Crowley.

CONSORTIUM EXPANDS

The Benefit Advisors Network (BAN), Cleveland, has signed Peel & Holland Inc., Benton, Ky.

Peel & Holland is now one of 42 members of the BAN benefits firm group.

BAN offers independent benefits firms technology support, compliance services, specialty products, and other products and services.

METLIFE ADDS GLOBAL PROGRAM

A unit of MetLife Inc., New York (NYSE:MET), has introduced the International Business Travel Medical program.

The program will provide coverage for emergency and urgent medical care for employees traveling on short-term assignments outside their country of residence.

The program includes a direct settlement network that can reduce the risk that patients will end up having to pay for care out of pocket.

The program also offers translation services, emergency medical evacuations and emergency cash transfers.

There are no exclusions for pre-existing conditions, MetLife says.

MetLife notes that it has been in the expatriate benefits market for about 35 years.

MetLife’s Delaware American Life Insurance Company writes the coverage.

MUNEY RISES AT CIGNA

The Bloomfield, Conn., health insurance arm of CIGNA Corp., Philadelphia (NYSE:CI), has named Dr. Alan Muney chief medical officer.

Muney began working for CIGNA as a senior vice president in charge of network contracting operations in 2010.

Muney also has worked at a private equity firm and as a chief medical officer at other managed care companies. He has a bachelor’s degree and a medical degree from Brown University, and he is board-certified in pediatrics.

MONEY POOLS IN CALIFORNIA

Gary and Mary West, residents of the San Diego area, have formed the West Health Investment Fund L.L.C.

The $100 million fund will focus on investments in programs that can lower health care costs, according to program representatives.

The Wests founded the West Wireless Health Institute in 2009, and they say lack of financial support is interfering with efforts to get new health care ideas out into the market.

“The fund’s areas of interest include health care technologies, data analytics, technology-enabled services, cost transparency, and interoperability,” fund representatives say.

One company in the portfolio, Change Healthcare, is developing a Web-based tool that can give consumers personalized health care pricing information and alerts about availability of health care discounts.

TANSTAAFL

The American Enterprise Institute, Washington, plans to hold a discussion on benefits cost tradeoffs 9:30 a.m. Oct. 28 in Washington.

One panelist, Sylvester Schieber, will take about research suggesting that health care inflation is limiting the prospects of many low-wage and moderate-wage workers.

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