Saturday, November 18, 2006
Friday, November 17, 2006
Shirlee to Sandra re: Questions about preventive services in basic policy
Subject: Re: Questions about preventive services in basic policy
I still feel that a member can only make the best decision about which plan to take for 2007 if they know all the services provided in each policy offered.
At this time I am asking for a copy of Basic Plan Preventive Services Coverage Enhanced for 2007 to be sent to my; home, and I still expect to see the mailing that you spoke if that is to be sent to us in December.
Also, have the health care premiums and benefits (both for single and family) for employees of STRS been decided yet? If so I want a copy sent to me.
Sandra Knoesel to Shirlee Zerkel re: Questions about preventive services in basic policy
From Sandra Knoesel, November 17, 2006
Dear Mrs. Zerkel:
I received your e-mail about the information retirees receive regarding their health care options. STRS Ohio agrees it is important for members and retirees to receive information they need about their health care options. We appreciate feedback from our retirees and will take your suggestions into consideration.
Based on previous overwhelming feedback from multiple member surveys, STRS Ohio learned retirees wanted the health care information they received to be simplified. Based on this feedback, STRS Ohio now sends retirees an/a:
- Annual Open-Enrollment Guide,
Health Care Plan Options and Premiums Sheet, and Ohio
- Plan Overview Chart.
Regarding your questions about the Basic Plan’s preventive services coverage, we send a handout entitled “Basic Plan Preventive Services Coverage Enhanced for 2007” to retirees who ask questions about this enhancement. As you referenced, this information may also be found on the STRS Ohio Web site. It is important to note the “designated services” covered have not changed; the only change is whether the services are subject to the deductible. STRS Ohio and its plan administrators followed national guidelines.
STRS Ohio is working with the plan administrators to ensure patient services are coded and paid correctly; however, when an enrollee goes into a provider’s office for a preventive service and also indicates they have another health concern that may result in additional testing, proper coding can be complicated. That is why it is important for doctors to keep track of patients’ preventive services versus other routine services. To continue educating Basic Plan enrollees, STRS Ohio will be sending an information piece in December that further explains the preventive services benefit.
Health care issues are complex. STRS Ohio is committed to providing information you and other retirees need to make informed decisions about the STRS Ohio Health Care Program. You may also call the
Thank you for sharing your thoughts and opinions with us.
Sandra L. Knoesel
Deputy Executive Director - Member Benefits
Dennis Leone: Proposed Amendment to Board Policy Entitled “Board Member Travel and Expenses”
“Board Member Travel and Expenses” (Pages 17-19 of Policy Manual)
By Dennis Leone
- STRS funds will not be utilized to purchase credit cards for Board members and board members will not be issued credit cards by STRS.
- STRS will not permit payments or reimbursements to Board members for long distance telephone calls that are not connected to STRS business.
- STRS will not pay for overnight lodging in
for Board members after Board meetings, absent adverse weather-related conditions and/or a mechanical breakdown of said Board member’s motor vehicle. Columbus
- STRS will not pay for overnight lodging for Board members on the day AFTER conferences end, absent adverse weather-related conditions and/or the cancellation of Board member’s airline flight.
- STRS Board members who wish to attend conferences requiring airline transportation are required to secure their reservation at least 30 days in advance. Board members who choose not to secure airline reservations at least 30 days in advance will be required to pay the difference in cost between the two tickets.
- STRS will not pay any additional fees charged by airline companies when ticket reservations are charged by Board members due to personal reasons – before or after conferences.
- Board members will not be reimbursed for expenses associated with attending a meeting unless documentation can be provided by the organization inviting the Board member that stipulates the Board member was invited to speak at said meeting.
- Exceptions to the above policy amendments will require a majority vote of the full STRS Board.
Proposed Amendment to Board Policy Entitled “Code of Ethics”
- STRS will not pay for or provide computers, home Internet connections, home telephones, cell phones, or fax lines for Board members. Board members will be permitted to check out STRS laptop computers immediately prior to the first day of business associated with a Board meeting or an approved conference, assuming – of course – that said laptop computer will be used only for STRS-related business and not for personal business.
Wal-Mart nails Caremark once again -- Pravachol now available for $4 a "pop"
By Melissa Davis
11/17/2006 2:25 PM EST
Wal-Mart (WMT) has given pharmacy benefit managers another bitter pill to swallow.
This week, the heavyweight retailer added the generic form of Pravachol -- a popular cholesterol-lowering medication -- to its new $4-a-month prescription drug program. The addition of the drug, which lost its exclusivity just weeks ago, ranks as the biggest threat yet to PBMs that enjoy fat margins on non-branded drugs.
UBS analyst Ricky Goldwasser sounds worried.
"The significance of adding a drug such as Pravachol to the list is twofold," he explains. "First, as a newer drug, it is a more profitable drug to pharmacies and PBMs compared to other drugs on the list. Second, it raises the question as to whether Wal-Mart will add additional drugs as they exit (the) 180-day exclusivity period."
Importantly, Goldwasser asks, could generic forms of blockbusters Zocor and Zoloft - both expected to boost future PBM profits significantly - be next on Wal-Mart's list? Given the latest development, he says, the chances for this look higher.
Goldwasser therefore remains on the sidelines with neutral ratings on all three PBM stocks. Medco (MHS) fell the hardest on Friday, dropping 4.3% to $49.46. Express Scripts (ESRX) slid 3.8% to $67.41. Meanwhile, Caremark (CMX) - which is merging with CVS (CVS) in a move viewed defensive by some - got off the easiest. Its shares slipped 2.4% to $47.46
From STRS: November Board News Details Retirement Board Actions and Discussions
2011. Petition forms can be obtained from STRS Ohio by calling toll-free
1-888-285-2192. The deadline for return of petitions is Feb. 23, 2007.
2003 reimbursement amount for calendar year 2007. This means the reimbursement amount will be 1.8835% for each year of service credit. The maximum amount STRS Ohio will pay is $52.83 a month for retirees with 30 or more years of service. The benefit recipient is responsible for the balance of the basic Medicare Part B premium, which totals $93.50 per month for calendar year 2007. Reimbursement amounts are based on years of service, with the minimum monthly reimbursement from STRS Ohio remaining at $29.90 for benefit recipients with less than 17 years of service.
The STRS Ohio news e-mail list is designed solely to provide timely and accurate news and information about legislation, benefits and other issues affecting the STRS Ohio membership.
Jim N. Reed to Senator Hottinger: Dr. Thomas Hall and The STRS Needs Your Support
Senator Hottinger, we met once briefly when you were a rookie in the General Assembly and you came to Baltimore, Ohio, to participate (on foot) in a community parade. As I introduced myself as a career teacher you assured me that education would always be a most important legislative priority during your tenure.
Jim N. Reed to Senator-elect Schaffer: STRS needs Dr. Thomas Hall
Jim N. Reed
Liberty Union-Thurston Local Schools
Proud Member of CORE
June Hughes to Molly Janczyk: Soooooo, we lose more!!!!
From June Hughes, November 17, 2006