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S&S Benefits.....Opinion, Hearsay & News Review

S&S Benefits Consulting, Inc.  219 Darien , Dundee , IL 60118   Phone: 847-428-5353, Fax:847-428-9876

Email :jseiler@ssbenefits.net                                              http://www.ssbenefits.net/   August 2011 Issue


An article by the AP says the cost of prescriptions should go down over the next 14 months as generic versions of the world’s 20 best selling drugs lose their patents and go generic. Included in the list are Lipitor for cholesterol and Plavix for thinning the blood. A BCBS spokesperson estimates 15% of the population use drugs whose patents will expire in 2011 or 2012.

Express Scripts has announced an agreement to buy Medco. The agreement may have come about as UHC has started to take drug coverage currently with Medco into their own PBM. The price for Medco is estimated at $29.1 Billion. The purchase would solidify Express Scripts as the largest PBM in the United States. The FTC is expected to put the sale under heavy scrutiny since the market share of the combined company would be about 35%.

Aetna is purchasing PayFlex holdings for $202 million. The company provides web based benefits administration for consumer based products such as HRAs, HSAs and FSAs, plus COBRA billing services. In a bit of irony, PayFlex is the vendor for FSA crossover and debit card service for BCBS-IL.

In Illinois, Provena and Resurrection hospitals have struck a deal to combine. The merged network will have 12 hospitals, 28 long term care facilities and more than 50 clinics plus six home health agencies. The combination will also have nearly 5,000 doctors and more than 22,000 employees, with revenue of $3 billion.

And if you weren’t outraged by Obamacare before, this may boil your blood. HHS has announced it is making $3.8Billion in starter loans for the creation of Consumer Operated and Oriented Plans in each state. The new plans would supposedly add competition to the market in the form of private, non-profit entities. The HHS is projecting default rates of 40% for starter loans and 35% for solvency loans it makes under the program. The projections should probably be higher, since an organization that sold insurance before July 16, 2009 is Not allowed to participate. The last thing HHS would want is anyone with any knowledge of insurance to have access to the money.

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