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The Catch: The Plans’ Plan

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Cigna Corp. will be marketing stop-loss programs from Sun Life Financial Inc. to third party administrators (TPAs).

Self-insured employers use stop-loss programs to protect the plans against catastrophic losses.

Cigna Payer Solutions, a unit of Cigna, Bloomfield, Conn. (NYSE:CI), that rents the Cigna provider network TPAs, has agreed to offer the TPAs Sun Life stop-loss protection, according to Sun Life, Toronto (TSX:SLF).

Sun Life’s Wellesley, Mass.-based benefits division has already been marketing Cigna’s organ and bone marrow transplant network to its own stop-loss customers.

Cigna will still sell its own stop-loss protection to employers that do not work with Cigna Payer Solutions TPAs.

High claims costs and fierce competition have roiled the stop-loss market in recent years, but interest in the market has increased because of the Patient Protection and Affordable Care Act of 2010 (PPACA).

PPACA exempts self-funded plans from many of its requirements but curbs use of annual benefits limits. Stop-loss market watchers say the law could increase the number of self-funded plans that need stop-loss coverage while also increasing those plans’ need for protection against catastrophic losses.

Mercer, a unit of Marsh & McLennan Companies Inc., New York (NYSE:MMC), today reported signs of increasing interest in self-funding in a summary of results from a recent survey of 2,844 public and private U.S. employers with 10 or more employees.

About 28% of the employers with 500 or more employees still have a fully insured preferred provider organization (PPO) plan. About one-third of those large employers with insured PPO plans said they are likely to switch to self-funding within the next 3 years.


CarePilot has started booking appointments for medical services, dental services and other health care services through its website.

Consumers can use the site to compare providers, find and schedule appointments at a convenient time, and pay for appointments in advance using credit cards, health savings accounts or PayPal accounts.

The provider’s office is supposed to call the patient to confirm the appointment and answer any questions.

The service organizers report that they have about $3 million in financing.


Digital Insurance Inc., Atlanta – a benefits firm that has been buying many benefits firms – has promoted Annette Bechtold to senior vice president of operations and strategic development, from senior vice president of operations. She will run initiatives related to PPACA.

The company also has promoted Julie Cape to senior vice president, client services, from vice president client services.

Health Net Inc.,Woodland Hills, Calif. (NYSE:HNT), has hired Scott Law to be chief Medicare officer. He will oversee sales and marketing of the company’s Medicare Advantage plans. He previously was senior vice president of health care delivery at WellCare Health Plans Inc., Tampa, Fla. (NYSE:WCG).

Lockton Companies L.L.C.,Kansas City, Mo., says its benefits arm has hired Nicholas Dobelbower to be a senior consultant in the international benefits services practice in its Washington office.

Dobelbower previously worked for IBIS Advisors Company, Los Angeles, an international human resources firm. He has a bachelor’s degree from George Washington University and a master’s degree and a doctorate from Duke University.