Commonwealth Indemnity Plan News

Advance Care Planning Pilot Update
(fall 2005)

The Commonwealth Indemnity Plan's Advance Care Planning pilot program should help many members, based on early returns from the first mailing. Within the first two weeks of the initial mailing, over 6,000 state retirees completed and returned the survey, one-fifth of whom indicated their interest in attending a session in Massachusetts designed to educate and assist members in preparing advance directive documents. As reported in the summer issue of For Your Benefit, Commonwealth Indemnity Plan members age 65 and over will be mailed instructional materials this September. Massachusetts members who get this mailing will also receive advance directive forms and details about the sessions.

Congratulations UNICARE on First Place Awards
(summer 2004)

UNICARE, the administrator for the Commonwealth Indemnity Plans, recently was bestowed with two first place awards! UNICARE won "Best Health Plan Initiative for Consumer Directed Health Care" and "Best in Show" at the Consumer Directed Health Care Conference held in March for its Direct-to-Member Communication Program.

Many GIC members in the Indemnity Plans have benefited by this innovative program. With the Direct-to-Member Program, members with chronic health conditions receive periodic personalized health care statements. The statements provide personalized guidance on how the member can improve his/her own health and health care and how to reduce his/her out-of-pocket expenditures. The package also includes a companion report for the member's physician, which helps the physician provide high quality, cost-conscious care, as well as information critical for coordinating care with other physicians who may be treating the patient.

Congratulations UNICARE for being recognized for innovation in quality care!

Out-of-State Non-Medicare Indemnity Plan Information

The Indemnity Plan implemented schedule-based payments for all non-Massachusetts providers effective July 1, 2002. (This change does not apply to Medicare enrollees.) This payment change was necessitated because out-of-state providers were charging the Plan up to twice as much as what other plans were paying for the same service. For example, Massachusetts providers, among the highest paid in the country, receive on average $13,045 for a hip replacement. Out-of-state providers were charging the Plan an average of $22,848 for the same service.

Some out-of-state providers may "balance bill" members, charging the difference between the fee schedule and the charges they submit to the plan. Indemnity Plan members can avoid being balance billed by taking advantage of UniCare's nationwide provider network. If you move out of state, you must contact the Plan to notify them of the address change in order to receive the network card for your new location. UniCare will send you your areas provider network card and directory.

· Enrollees who live in Rhode Island and New Hampshire can avoid being balance billed by using the PLUS network or a Massachusetts provider. Call the Commonwealth Service Center (1-800-442-9300) or visit the Plan's web site for the PLUS providers in your area.

· UniCare will contact parents whose children have student coverage for out-of-state address confirmation. The Plan will provide corresponding network information.

· If your out-of-state provider is not in the UniCare network, encourage him or her to join by calling the Commonwealth Service Center for more information.

· If you don't use a network provider, talk to your out-of-state provider about his/her charges. It never hurts to have an honest discussion about prices, especially when they appear to be inflated.

Indemnity Plan Members Have Web-Based Health Research Tool

If you are an enrollee or covered dependent in the Commonwealth Indemnity Plan, PLUS Plan, or Indemnity Medicare Extension (OME) Plan, new tools are only a mouse click away. Members can check their claims status, and view and print an Explanation of Benefits (EOB) - the form you receive by mail listing the dates of service, amount paid by the Plan, and any amounts you are responsible for paying.

If you are interested in learning more about a health condition, or if you need surgery, the new Making Healthy Decisions section provides valuable assistance. This interactive section helps you to select a hospital. Enter your criteria and the site will identify hospitals that best suit your needs and preferences. You will also find out how many of the selected procedures the hospitals have performed, and each hospital's complication rate for that procedure.

Take advantage of the claims status tools and research assistance by logging onto UniCare's Indemnity Plan site. UniCare mailed a brochure to all enrollees, which included the code for accessing secured site areas. If you do not have this flier and are an Indemnity Plan member, call UniCare for the code 1-800-442-9300.

DO IT Diabetes Program
Garners Rave Reviews and Results

The Indemnity Plan's DO IT Diabetes Program, which debuted in FY 2000, has garnered rave reviews. More importantly, it has improved participants' health. The program, designed for patients having difficulty managing their diabetes, includes 3 1/2 days of outpatient training at the Joslin Clinic in Boston. Intensive education and support assists patients with controlling their blood sugar levels, measurements that indicate risk for heart disease and stroke. Overall, the DO IT Program resulted in improved member control of blood sugar levels. The average Hb-A1c level decreased 1.6 points to 8.9.

"I want to thank GIC for making this available to me. I found out a great deal. More insurance companies should offer this program," G. Eisenberg, Malden, MA

"It allowed me to learn about details that I didn't think to ask about when I first became diagnosed. This course brought me up to date with new advances that are occurring with this disease and the treatments being offered. The Joslin team …gave me better control of my blood sugars. I left feeling more inspired to manage my disease," P. Griffin, Malden, MA

"Perhaps the four most useful days of my life. The staff was superb", G. Riley, Medford, MA

"I came away from my workshop having met many wonderful people, who cared about my condition. I was taught proper dieting, what low and high blood levels are. Now I know what to do when I drop low. I know what foods to keep on hand to raise my glucose levels. I know that walking and exercise lower these levels. I was taught to count carbohydrates. I was given my own personal diet plan. I know that my health overall will improve and this I will manage diabetes. This is a wonderful feeling for me to be in control of me. I learned this all in my DO IT program", P.A. Ryan, Medford, MA

"Excellent program! Great staff -- non-judgmental, respectful, empowering. Important for anyone with diabetes", E. Banta, Watertown, MA

Free Pilot Health Management Program Underway for Selected Indemnity Plan Members (winter 2000)

Over 12,000 Indemnity Plan members with chronic health conditions were selected to participate in a free health management program called the Premier Program. This is a voluntary program and participants can elect to withdraw at any time. Participants receive Plan-sponsored customized health assessments, health education, interventions, and counseling over the one to two year pilot program. Additionally, selected individuals will also receive 24-hour patient advocacy support.

Participants receive a questionnaire two to four times a year. Healthtrac, a national leader in health promotion, evaluates each questionnaire using a sophisticated system developed by leading physicians at Stanford University. From this, Indemnity Plan doctors and registered nurses provide personalized support and recommendations. (This information and all medical records are confidential and not available to anyone at the GIC.)

The Plan's objective is to better manage chronic medical conditions, improving quality of life and longevity and efficient coordination of care. If this voluntary program is successful, the GIC will expand it to other Indemnity Plan members and to other facilities (the pilot program only comprises six selected hospitals.) If you have been selected for this program, and have any questions, call the special Premier Plan number at 1-800-942-7224.