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Life Health > Health Insurance > Health Insurance

The Catch: Oct. 20

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The North Dakota Division of Insurance says small group associations do have to file base rates for approval before increasing small employers’ rates.

Merle Scheiber, the division director, discusses the rules in Bulletin 11-07, which is supposed to help small group health insurers and small group association plans interpret a small group rate filing law that took effect in July.

The new law does not mention small group association plans, but the new law is an addition to a law that does cover small group association plans, Scheiber says in the bulletin.

“Therefore the filing requirements … apply to all small employer association plans,” Scheiber says.

The law does contain an exemption from rating band pricing rules for some associations.

But small employer carriers issuing association plans still must file base premium rates for those associations, Scheiber says.

Employer, multiple employer and association trusts that provide coverage for small employers are also subject to the new rate review rules, Scheiber says.


Alliant Insurance Services Inc., Newport Beach, Calif., has hired Ray Gallagher to be a senior vice president in the Los Angeles benefits practice.

Gallagher will focus on large and midsize accounts.

He previously worked in the Los Angeles office of Lockton Companies L.L.C., and he has been a national accounts producer at the health care arm of CIGNA Corp., Philadelphia (NYSE:CI).

Gallagher has a bachelor’s degree in English and mathematics from Middlebury College.

BeneCard PBF, Orlando, Fla., a unit of Benecard Services Inc., has hired Robert Cascarano to be executive vice president, sales, and Sidney Stolz to be vice president, client services and marketing.

BeneCard PBG helps health plans manage prescription benefits programs.

Cascarano previously was a producer at CVS Caremark Corp., Woonsocket, R.I. (NYSE:CVS). He has a bachelor’s degree from Butler University.

Stolz has worked for several managed care companies and pharmacy benefits managers. He has a bachelor’s degree from Bethany College and a master’s degree in business from the University of Texas.


TCS Healthcare Technologies Inc., Auburn, Calif., is introducing a new version of the Acuity Advanced Care care management system aimed at health insurers, health plans, independent plan administrators and others prepare for the United States’ shift to using ICD-10-CM, a modified version of the latest edition of a World Health Organization’s International Classification of Diseases (ICD) code set.

The United States is supposed to move to ICD-10, from ICD-9, by Oct. 1, 2013.

America’s Health Insurance Plans, Washington, estimated earlier this year that ICD-10 implementation costs are averaging about $12 per member, which could mean that the total bill could be about $3 billion for all health insurers.

The version of the Acuity system, version 6.0, can help clients comply with the Health Insurance Portability and Accountability Act (HIPAA) 5010 transaction standards shift as well as the ICD-10 shift, TCS says.

TCS introduced the new version early, to give clients time to focus on ICD-10 and the HIPAA 5010 standard, the company says.


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