Saturday, February 17, 2007

Shirlee Zerkel: Caremark pushing brand names? What do you think?

From Shirlee Zerkel, February 17, 2007
Subject: (no subject)
Hi All,
Another negative for Caremark! A retired teacher friend of mine received a letter today from Caremark. First of all you have to know that she has a serious cholesterol problem and is on medication for it. The letter from Caremark was more than a reminder to get her cholesterol checks, take her meds and see her doctor. It definitely was a letter pushing a certain drug to her the consumer. The drug mentioned over and over again was Vytorin. The letter even contained information on the drug and also said that her doctor may receive this same letter. I call that pushing a certain drug! When did Caremark become the expert on what medications we should be taking. Are they getting a kickback for every prescription they can sell of this drug? Needless to say, my friend was not happy about receiving such a letter. She is going to copy the 3 page letter and see that I get a copy. Are there other retirees out there that have a cholesterol problem and may have received such a letter?

Bullcrap Bingo -- A game for active teachers

Do/did you keep falling asleep in teacher meetings and inservice? Here's a way to change all of that.
1. Before (or during) your next meeting, inservice or staff development, prepare yourself by drawing a square. I find that 5" x 5" is a good size. Divide the card into columns-five across and five down. That will give you 25 one-inch blocks.
2. Write one of the following words/phrases in each block:
* no child left behind
* test scores
* core competencies
* communication
* standards
* multiple exposures
* benchmarks
* proactive
* win-win
* think outside the box
* action plan
* result-driven
* assessments
* knowledge base
* at the end of the day
* touch base
* mindset
* differentiated
* retention
* skills
* background knowledge
* effective learning
* exemplars
* implementation
* reflection
3. Check off the appropriate block when you hear one of those words/phrases.
4. When you get five blocks horizontally, vertically, or diagonally stand up and shout "BULLCRAP"
TESTIMONIALS from satisfied "Bullcrap Bingo" players:
-- "I had been in the meeting for only five minutes when I won." - Adam W., Atlanta
-- "My attention span at inservice has improved dramatically." - David T., Orlando
-- "What a gas! Staff development will never be the same for me after my first win." - Dan J., New York City
-- "The atmosphere was tense in the last inservice as 14 of us waited for the fifth box." - Ben G, Denver
-- "The speaker was stunned as eight of us screamed 'BULLCRAP!' for the third time in two hours. The Bullcrap Bingo Championship will be played at the next inservice."
I would also suggest you hang onto this vocabulary list, as it will come in handy when your administrator asks you to write your list of goals to bring with you to your evaluation. Your chance to throw it right back at 'em. KBB

Friday, February 16, 2007

Mary Ellen Angeletti's report on STRS February Board meeting

From Mary Ellen Angeletti, February 16, 2007
Subject: STRS/CORE Meeting, Fri., Feb. 16th
At the morning STRS meeting, Kim Nichol of Buck Consultants presented a review of the actuarial valuation of retiree health care benefits from the beginning of such plans in l974 to the present. The current information shared was very scary. Based on the plan in place now in 2007, the HCSF [Health Care Stabilization Fund] is projected to be solvent until 2021 assuming a 5.5% investment return and solvent until 2025 assuming 8.0% investment return. Many factors can impact a solvency period such as investment return, health care trend rates, enrollment rates, & contribution strategy. BUT as health care costs rise each year (thus the amount of principal needed increases each year), the HCSF balance will be depleted by 2025 with a shortfall of $481 million. Once principal is used as a funding source, the HCSF is rapidly depleted. As principal declines, the level of investment earnings also declines. Some alternative scenarios were touched on (raising the minimum age for subsidy, a switch to PERS eligibility structure, etc.) but Craig Brooks requested four or five additional & substantial scenarios rather than simple tweaking. Kim added that Medicare will run out in 2018.
Steve Mitchell presented his report from the Investment Dept.
Following lunch, Laura Ecklar reviewed the revised Board Member Travel & Expenses policy which includes ALL the revisions which Dr. Leone has been trying to accomplish. The motion passed unanimously. Dr. Leone then asked Dr. Asbury if the STRS staff would also follow the lead of the STRS Board and consider adopting a similar travel & expense policy, and Dr. Asbury assured him that it was going to be considered by staff. . . that they had been waiting until the final policy was determined by the Bd. Then Dr. Leone asked if the vendors doing business with STRS staff would also be held to the new higher standard of expenses & travel, and again Dr. Asbury assured him that this would certainly be the case.
Public Speaks portion of the STRS meeting followed Ms. Ecklar's report. There were three speakers.
1. Mary E. Angeletti requested that the Board try to maintain consistent STRS meeting dates to accommodate retired members' attendance at the meetings. Later Ms. Ramser spoke to this issue explaining that she (the Chair) was the one who set the meeting dates and times and that this month's meeting was set for Friday to accommodate her own teaching schedule. She promised to try to maintain the usual third Thursday as the STRS meeting date.
2. James Warner spoke to the Bd. for the very first time questioning the outrageous costs which Medical Mutual & STRS are paying for DME (Durable Medical Equipment). He held up a leg support as an example and shared that it had cost $400.00. He held up a finger splint which had cost $125.00. He tried to investigate why these items were so outrageously priced but said that he "got the brush-off from Medical Mutual as well as STRS". He ended up talking to the manufacturer of the items and learned that the cost to produce the leg support was $48.75 and the cost to produce the finger splint was $22.95. The difference was "money down the drain" he said. He quoted a procurement official at Medical Mutual who agreed that the price was not right and who stated that "they had to go along with the higher price due to Medicare." Mr. Warner reminded the Board that this is NOT cost containment. He volunteered that he thought that STRS would be going together with other pension systems to get the very lowest prices possible. His point is that the retired teachers are part of a large network of teachers who could go together and achieve lower costs for us. (Following his speech, Dr. Leone requested that the STRS staff look into Mr. Warner's cost complaints and get back to the Board and to Mr. Warner.)
3. Jim N. Reed praised Ms. Hayden, Mr. Brooks and Mr. Johnson for being independent thinkers on the STRS Board and for their support of Dr. Leone and John Lazares. His speech emphasized the hardships being experienced by the retired teachers especially the very elderly. He reminded the Board members that retired teachers had been PROMISED full and affordable health care. Promises were made to them by the STRS Board at that time and now the financially frail retirees cannot take care of themselves. These are dignified, graceful retirees who cannot pay to have lunch at the Retired Teacher Association meetings or who are forced to use the Emergency Rooms of hospitals. Mr. Reed said, "Yes, corporate America has had entitlement problems but educators expect better. One entitlement expense made at STRS is detrimental and could have made a difference to a retired teacher in financial need. He said, "WHAT A SHAME!"
The Executive Director's report followed the Public Speaks. It was interesting that Dr. Asbury reported on a possible collaboration on projects with other retirement systems (OPERS & PO&F) for 2007 and 2008. Exploring competitive bids for various health care services will be discussed.
We left prior to a scheduled review of Board Policies.
Glenna Barr will be sending out minutes from today's CORE meeting.
Mary Ellen Angeletti

Jim N. Reed’s speech to STRS Board, February 16, 2007

Good afternoon, ladies and gentlemen. Allow me to begin with a positive personal observation. I would like to express my appreciation, publicly, to Ms. Hayden, Mr. Brooks and Mr. Johnson for taking issue positions at the recent retreat that indicates to this retiree that they are independent thinkers and will examine issues without preconceptions, and apply the basic yardstick of ORC 3307.15 in making decisions that will directly affect 430,000 active and retired educators. Careful and caring decision making can only enhance the Renaissance at STRS begun in 2003 and orchestrated by Dr. Leone and Mr. Lazares, who is hopefully on the mend as the public speaks today.
I do have a few concerns that I would like to bring to your attention. I wonder if you all are fully aware of the hardships that have befallen many in our profession who have irreversibly chosen to leave the classroom based on an understanding, a promise that their three decades or more of service would be rewarded with a secure, affordable retirement. But now they find themselves scrambling, financially, to stay afloat with healthcare premiums that continue to escalate beyond their means and, more frightening, beyond their control. The fortunate ones, those with enough of their health, have managed to find retirement employment. But many just can't go back to work.
Healthcare costs have risen at least 75% in the past half dozen years, while COLA’s have totaled about 15%. That is a formula for a retirement nightmare.
Our retirement system is a failure if the financially frail cannot take care of themselves and their families with what their careers offered, but did not deliver.
Too many teachers are being forced to remain in the classroom after their health has waned, their patience grown short and their energy exhausted in order to keep pace with the out-of-control rising cost of covering their families’ healthcare needs.
What a shame to witness a teacher’s dedicated career and hard-earned reputation be placed in jeopardy by “hanging on” for just a few more years or until Medicare can help bail them out. What has happened to the dignified, graceful retirement we so much anticipated?
Is it possible that those beginning teachers with families who started their careers qualifying for food stamps may qualify again for those same food stamps in their retirement? Are there former educators who do not make it to their retired teacher meetings because they cannot afford the cost of the luncheon? How many may have to resort to the ER for medical attention? One is too many.
This should explain why we are so sensitive to each and every dollar of our money that you decide to spend. Certainly, the ill-conceived expenditures approved by this and past Boards would not right all the wrongs wrought by 9/11 and the burst bubble on Wall Street, but if one entitlement expenditure could have paid one healthcare expense for a needy retired teacher, then it was misspent.
And how would you like to be an education college recruiter? What financial incentive can you offer to attract those who are the brightest and the best that we all want teaching our grandchildren and great-grandchildren? Many of us were attracted by that promise of retirement security, following a fulfilling career in teaching. Working our way through college, working summers and moonlighting to supplement teaching salaries was expected. That was the norm. (However, I'm not sure how many of us realized at that time that Social Security would handicap us as teachers by withholding two-thirds of our earned benefits in retirement. Furthermore, how many self-motivated career changers are going to be persuaded to bring their expertise into the classroom and lose most of their previously earned Social Security?)
Lastly, I am both offended and shamed when I speak with STRS-illiterate educators about what has happened in our retirement system in the past 15 years. Some have responded by excusing the misadventures and indiscretions of past and present Board members and Directors, based on the grounds that much of corporate America has also proven rotten. It angers me to think that my retirement system would be identified and/or compared with Enron and Worldcom.
As retired professional educators, we expect better; we deserve better; we demand better.
Thank you for your audience.

February Board News from STRS

From STRS, February 16, 2007
[News] February Board News Details Retirement Board Actions and Discussions
This week, the State Teachers Retirement Board held its monthly meeting. Following the regularly scheduled meetings, a report titled "Board News" is posted on the STRS Ohio Web site, as well as mailed to a number of members and education organization representatives who have requested it. As a member of STRS Ohio with an e-mail address on file, you will also receive this report each month. The February report follows.
BOARD REVIEWS HEALTH CARE VALUATION REPORT FROM ACTUARY A significant portion of the State Teachers Retirement Board January Retreat, as well as its meeting on Feb. 16, 2007, focused on the results of the Jan. 1, 2007, actuarial valuation of the STRS Ohio Health Care Program presented by Buck Consultants, the system's actuary. Included in this discussion was a review of Governmental Accounting Standards Board
(GASB) Statement 43 -- which is already generating discussion in state capitols across the country and in the national media.
GASB 43 mandates that public pension plans, as well as local governments, must start reporting their estimated financial liability associated with providing retiree health care coverage in their financial statements, just like they currently do for pension benefits. In other words, STRS Ohio will report what percentage of teacher payroll is needed to fully fund health care for current and future retirees on a full-reserve basis (i.e., a 30-year funding period).
Fortunately, the State Teachers Retirement Board has been assessing these liabilities for more than 10 years through annual valuation reports, such as the one presented in February, and sharing these results with STRS Ohio's membership. Through these reports, STRS Ohio is able to determine the solvency of the Health Care Stabilization Fund. Data from these reports has shown that the funded status of the health care program is considerably higher than most other public pension plans in the United States, due to more than $5.4 billion in past allocations made to the health care fund by the Retirement Board and changes in plan design and eligibility. As noted at the board's retreat by the actuaries, "STRS Ohio has been significantly more proactive than other public sector entities in addressing the health care program funding issues. Most public sector health care plans are 0% funded."
Based on the contribution rate increases contained in the proposed STRS Ohio health care legislation, the annual required contribution for health care, or ARC as it is sometimes called, is slightly more than 4%. This is how the total contribution increase of up to 5%, split equally among STRS Ohio members and their employers, was determined.
However, one component of GASB 43 may cause some confusion in the coming months. If a retiree health care program is not fully funded, which is the case with STRS Ohio's program, GASB 43 requires that a lower assumed investment return rate for the existing health care funds be used. STRS Ohio has been using an 8% rate (the same rate it assumes for its pension fund). However, based on the current funding status of the health care fund, STRS Ohio must now lower that rate to 5.5%. This, in turn, lowers the funded status to 28%.
Consequently, in STRS Ohio's next financial statement, the ARC for health care liabilities will be listed as 6.55% rather than about 5%. But if the legislation passes and an annual contribution of 5% of payroll is ultimately contributed to the health care fund, GASB 43 allows the investment return rate to return to 8%. In short, based on the January 2007 valuation of the health care fund, the proposed 5% contribution increase is still adequate to fund the health care program on a full-reserve basis. (See the chart data below.)
Perhaps the best way to understand why different numbers are being discussed is to remember these two points:
- If STRS Ohio can fully fund the ARC (which it could do if the legislative initiative is successful), the ARC is lower because it is based on an 8% investment return rate. (See the first January 2007 entry in the chart data below.)
- If STRS Ohio is only able to partially fund the ARC (if the total 5% isn't received), the ARC is higher because it will be based on a 5.5% investment return rate. (See the second January 2007 entry in the chart data below.)
JANUARY 2006 (8%) Funded Status (ratio of assets to accrued liability) -- 36.7% Annual Required Contribution (ARC) -- 4.58% Fund Solvent Until* (with continuation of 1% employer contribution) --
JANUARY 2007 (8%) Funded Status (ratio of assets to accrued liability) -- 41.4% Annual Required Contribution (ARC) -- 4.13% Fund Solvent Until* (with continuation of 1% employer contribution) --
JANUARY 2007 (5.5%) Funded Status (ratio of assets to accrued liability) -- 28.1% Annual Required Contribution (ARC) -- 6.55% Fund Solvent Until* (with continuation of 1% employer contribution) --
*Solvency calculation includes projected Medicare Part D subsidies.
(This information is also available on the STRS Ohio Web site in a chart format at the following URL:
Updates about the legislation will be included in future newsletters and posted on the STRS Ohio Web site at
CALENDAR-YEAR INVESTMENT PERFORMANCE EXCEEDS TOTAL FUND BENCHMARK RETURNS STRS Ohio's investment returns for calendar year 2006 were 16.9%, exceeding the total fund benchmark return of 15.8% by 1.1%. All asset classes beat their benchmarks during the Jan. 1-Dec. 31, 2006, time period. In reviewing the pension fund's performance during the February board meeting, Russell Investment Group (the board's investment consultant) noted that total fund returns have now exceeded the total fund benchmark return over the past one-, three-, five- and 10-year periods. Russell also noted that the investment risk STRS Ohio is assuming through the active management of its funds remains low, while the diversification levels of the total fund remain high.
BOARD APPROVES CHANGES TO ITS TRAVEL POLICY As part of its annual review of its governance policies, the Retirement Board voted to approve several changes to its policy covering board member travel and expenses. These changes include decreasing the amount of money that may be spent on out-of-state meetings. The current policy allows for an expenditure of up to a maximum of $6,000 for each board member, excluding tuition or registration fees. The new policy would include tuition and registration fees in the $6,000 limit. Changes to reimbursements for meal expenses were also approved. Currently, the policy provides a maximum reimbursement of $60 per day. The new policy allows board members to be reimbursed up to $50 per day for meal expenses as follows: not to exceed $10 for breakfast, $15 for lunch and $25 for dinner. To be reimbursed for meal expenses, an itemized receipt must be provided; also, itemized receipts must be provided for any expenditures exceeding $15.
In compliance with Section 3307.041 of the Ohio Revised Code, all changes to the board's travel and expense policy must now be reviewed by the Ohio Ethics Commission and the Ohio Retirement Study Council. Assuming they concur with the changes, the board will then be able to formally adopt the changes.
RETIREMENT, INVESTMENT TRANSACTIONS APPROVED The Retirement Board approved the following retirements and investment transactions:
- 126 active members were approved for service retirement, 40 inactive retirements were approved.
- In January, fixed-income purchases totaled $1.084 billion, domestic equity purchases totaled $810 million and real estate purchases totaled $67 million.
STRS OHIO STAFF MEMBERS DISCUSS ISSUES IN WASHINGTON AND OHIO Executive Director Damon Asbury attended the annual legislative conferences of the National Council on Teacher Retirement, National Association of State Retirement Administrators and the National Council on Public Employee Retirement Systems with Terri Bierdeman and Marla Bump of STRS Ohio's Governmental Relations Department. Social Security, continued scrutiny of defined benefit plans and health care were prominent agenda items. Washington pension lobbyists and Capitol Hill staff members are forecasting a lot of debate ahead in the 110th Congress leading up to the 2008 presidential election. With Congress implementing the pay-as-you-go budget limits, it will be difficult to pass any significant legislation with revenue implications.
In addition to the conferences, the executive directors and governmental relations staffs of STRS Ohio, SERS and OPERS met with 13 of the Ohio congressional offices. Social Security and health care reform were the primary topics of discussion.
On Feb. 14, representatives of Health Care Advocates for STRS and STRS Ohio staff met with Treasurer of State Richard Cordray and his staff to discuss the health care legislative initiative. The meeting went well and Treasurer Cordray quickly understood the problem and the proposal. He did not voice a position, but assured everyone he would carefully review the proposal.
PURCHASED CREDIT REPORT SENT TO ORSC Last September, the Ohio Retirement Study Council directed its consulting actuary, Milliman, to compile additional information about the funding impact of purchased credit on both pension and health care benefits for the retirement systems. Each of the retirement systems submitted data to Milliman about additional pension liabilities created by purchased service credit. For STRS Ohio, slightly more than 7,000 members purchased some type of credit during the 2004-05 fiscal year. Buck Consultants calculated that the purchases created additional pension liability of about $176 million and additional health care liability of about $36 million for a total of $212 million. Members paid $49 million, or 23%, of the added liability.
TWO KEY REPORTS NOW AVAILABLE ON THE STRS OHIO WEB SITE The 2006 Comprehensive Annual Financial Report was published last month and has been submitted to the Government Finance Officers Association for consideration of its Certificate of Excellence in Financial Reporting. Copies are available to members and other interested parties upon request. The complete report can also be viewed and printed from the STRS Ohio Web site.
The Web site also includes a posting of the results of the fiduciary performance audit covering STRS Ohio that was completed by Independent Fiduciary Services, Inc., in December 2006, along with the staff analysis and recommendations approved by the board during its retreat.
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.
To view past news e-mails, go to
If you wish to comment on a topic, please either e-mail or call the Member Services Center toll-free at 1-888-227-7877.

Shirlee to Gary: How do you define 'non-resident alien?'

Shirlee Zerkel to Gary Russell, February 16, 2007
Subject: Re: Questions about 65 and over retirees
Gary, I have some concerns about your emails to me on 2-9-07 and 2-15-07. You told me that there are 210 retirees who have Medicare Part A only for the following two reasons:
1. These retirees are 65, working and covered by the employer's plan for Part B and STRS supplemental. You stated that they 'have STRS as the primary coverage for medical.' QUESTION: Does STRS co-ordinate benefits with the employer's plan since you state that STRS is primary and these people have to use STRS network providers? Just where does STRS fall in this whole picture?
2. These retirees are 'non-resident aliens who are not eligible Medicare Part B.' Medicare eligibility department has a different answer. Legal residents of the US, if they have worked 40 credits, are eligible for free Medicare Part A. They can also buy Part B or get an equivalent through their employer if they are presently working. Or they can buy Part A if they are a legal resident and have not worked in the US. Legal resident was the key word from the Medicare department I contacted.
So, Gary, where does your term 'non-resident alien' come from; certainly not the US government. According to Medicare, a non-resident is not eligible. What is your definition of 'non-resident alien,' since you are the one who used that term? I want answers that don't have a spin put on them. I want the whole truth, nothing but the whole truth when I ask a question.

February CORE meeting switched to Friday

Notice to CORE members:
Since the public portion of the February STRS Board meeting will be confined to one day instead of the usual two, CORE will meet on Friday, February 16, 2007. This is a departure from the usual Thursday meeting.

CORE Schedule for Friday, February 16, 2007
STRS Board meeting and CORE meeting to be held at the STRS building, 275 E. Broad Street, Columbus, OH 43215 Map/directions

9:00 a.m. Attend STRS Board meeting if you possibly can; Board Room is on 6th floor. Good time to sign up to speak at 1:00 Public Speaks session
11:30 a.m. Leave Board meeting to go to the 2nd floor cafeteria if you plan to get your lunch there.
11:45 a.m. CORE meeting in cafeteria room behind the Sublett Room; bring your lunch with you.
12:55 p.m. Leave for 1:00 session of Board meeting: Executive Director's Report and Public Speaks
Board meeting will probably resume after the Public Speaks; agenda will be posted when available.

February STRS Board meeting: Public session on Friday, February 16, only

Thursday, February 15, 2007
.....10 a.m. Final Average Salary Committee and Disability Review Panel (Executive Session only; no public meeting on this day)
Friday, February 16, 2007
.....9 a.m. Retirement Board Meeting (public meeting)

The Retirement Board meeting will come to order at 9 a.m. on Friday, Feb. 16, 2007. The Board is expected to receive the following reports: Member Benefits -- Health Care, Investment Department and Member Benefits -- Pension Benefits. The Board will also review Board Policies, address routine matters and any other topics that may require its attention. The public participation portion of the Board's agenda is expected to follow the Executive Director's Report (1 p.m.) on Friday.

Thursday, February 15, 2007

One retiree's experience with Weight Watchers

From Sondra Stratton, February 14, 2007
Subject: Re: Fw: med mut/ WW sequel

WW is a good program. They had added so much since I went years ago. The last time I went the program did not work for me. I am a lifetime member and to go, the cheapest I could go for would be $10 a week and that is a special. I have a problem with all weight loss plans. If they really cared about helping people loose weight, they would make their fees reasonable. I couldn't pay even $10 a week when I was working and now, there is NO money for even the cheaper rate. AND I would have to go every week and pay the money even if I didn't. Because I am over their expected weight I would have to pay every week. WW has gotten way out of line for the average person where costs are concerned. I say, have a plan and not spend on special foods like they do. We all have to live with regular foods and may as well do so when dieting.
I have had little success losing weight since I had Viral meningitis years ago. It did something to something in my head and there has just been nothing that works, even though when I take the time to go on a weight loss program, I STICK to it like crazy.
I went to the fast weight loss program that WW had right before I was hospitalized for the meng. and while a friend of mime went also and lost a load of pounds, I lost one pound. I watched the program like crazy and my Friend ate everything she could get her hands on!!!

RH Jones: Rep. Brian Williams moves into key position to help move Ohio forward

From RH Jones, February 15, 2007
Subject: Educ. Friendly Rep. Brian William's CMTE assignments
To all:
GREAT NEWS! Education friendly, and a retired educator, State Rep. Brian G. Williams announces that he is the Ranking Minority Member of the Health CMTE! And, even better, he is on the Economic Development, Environment & Education CMTEs. In my opinion all these are tightly tied together at the present time in Ohio. Brian, in his 2nd term, has the experience in the House of Reps. and from his years a Akron Superintendent with 37-yrs in education. He has the "know-how" to achieve his goals. To quote him: "...Health care is so critical, particularly to our senior citizens that I am looking forward to working on their behalf as the Ranking Member. ..." And, also, "... In the process of tallying my Legislative Survey -- education, jobs, and environmental were three key concerns..."
I believe that Brian's goals are exactly what Ohio needs to move forward. These are most certainly the goals of the CORE group as well. However, we must realize that progress will be difficult with many so many selfish and disagreeable politicians remaining in power, especially in the Ohio's senate. We can not expect forward movement to take place quickly. It is still going to be "a tough row to hoe" in Columbus.
After the past exploitation of the STRS retired educator members, especially when contrasted to the OPERS, we need to exercise our "gray power" numbers at every election, local, state and national. Do not miss any chance to vote. Personally, I use the absentee ballot and find that it is most convenient and gives me the time I need to review the candidates and the issues. And, I do not have to wait in lines.
May God assist our political friends to be successful in bringing Ohio back.
RHJones, a very proud CORE member.

Shirley Zerkel to Gary Russell re: Questions about 65 and over retirees

Gary Russell to Shirlee Zerkel, February 15, 2007
Subject: Re: Questions about 65 and over retirees
STRS Ohio premiums don't differentiate between primary and secondary coverage. Retirees who are under an employer plan and choose to enroll in an STRS Ohio plan for secondary coverage pay the same as everyone else based on their years of service credit. For example, a retiree with 30 years of service would pay $67 per month for the Plus plan or $40 per month for the Basic plan.
From Shirlee Zerkel, February 15, 2007
Subject: Re: Questions about 65 and over retirees
I have another question regarding the over 65 retiree who has Medicare PArt A only and is covered by their employer. What does that retiree pay STRS per month for their secondary coverage?
Gary Russell to Shirlee Zerkel, February 15, 2007
Subject: RE: Questions about 65 and over retirees
I don’t know how many are non-resident aliens, I just know that's one of the scenarios. For processing claims there isn’t a reason to know that. In regards to why someone would choose to enroll in the STRS Ohio health care plan, while also covered by their employer and Medicare, they may feel it is worthwhile for the secondary medical coverage. The employer plan would be primary for medical and STRS Ohio would be secondary.
From Shirley Zerkel, February 15, 2007
Subject: Re: Questions about 65 and over retirees
I have a question about your last email to me about the 210 retirees who have Medicare A only. How many are the non-resident aliens? Also if a retiree who is over 65, has Part A only and is covered by an employer plan, why is that retiree using STRS health care if he/she is covered by the government and also an employer?

Wednesday, February 14, 2007

Weather keeping some good CORE folks away

RH Jones to Molly Janczyk, February 14, 2007
Subject: Dr. Fluke & I can't make the STRS/CORE meeting Friday

Please give Dr. Fluke's and my regrets to CORE. Neither of us will be able to make this Friday's meetings. Instead, Dr. Fluke will "snail mail" his concerns to Dr. Leone. Publication will come later. The poor weather in N.E. Ohio is not helping, either.

Pharmacy Benefits Manager Fraud - Have you been a victim?

From John Curry, February 14, 2007

The text below these two paragraphs was taken directly from the federal government's Health and Human Services administration. They have listed the common types of pharmacy benefits manager (PBM) fraud. Several of the illegal acts listed below (prescription drug splitting or shorting and failure to offer negotiated prices) can be detected by you the patient. If you suspect you have been a victim of PBM fraud, ask a few questions of the PBM, take notes of the conversation or record it, take down the name of the person you talk to along with the time and date of the conversation, and save any correspondence -- this will aid in an investigation of any wrongdoing.

The violations below are not only federal violations but some also fall under violations of the Ohio Revised Code. If you feel that one of these illegal acts has happened to you I would suggest you file a complaint with the Ohio Attorney General's (Marc Dann's) office at his toll free number 1-800-282-0515. John

"70.1.2 – PBM Fraud, Waste and Abuse

(Rev.2, 04-25-2006)

The following section describes examples of PBM fraud, waste and abuse. Because many Sponsors operate their own PBMs or perform the PBM function themselves, some of the examples cited in the Part D Plan section are applicable here. Examples of potential fraud, waste and abuse include but are not limited to:

  1. Prescription drug switching: The PBM receives a payment to switch a beneficiary from one drug to another or influence the prescriber to switch the patient to a different drug.

  1. Unlawful remuneration: PBM receives unlawful remuneration in order to steer a beneficiary toward a certain plan or drug, or for formulary placement. Includes unlawful remuneration from vendors beyond switching fees.

  1. Inappropriate formulary decisions: PBMs or their P&T committees make formulary decisions where cost takes precedence over clinical efficacy and appropriateness of formulary drugs.

  1. Prescription drug splitting or shorting: PBM mail order pharmacy intentionally provides less than the prescribed quantity and does not inform the patient or make arrangements to provide the balance but bills for the fully-prescribed amount. Splits prescription to receive additional dispensing fees.


  1. Failure to offer negotiated prices: Occurs when a PBM does not offer a beneficiary the negotiated price of a Part D drug."

AG's letter re: representation of STRS and OPERS & a possible "backroom deal"

Attorney General Marc Dann questions UnitedHealth Group review panel

February 7, 2007

The Honorable Kathleen Blatz
The Honorable Edward Stringer
c/o Paul R. Hannah, Esquire
Kelly & Berens, P.A.
3720 IDS Center
80 South Eighth Street
Minneapolis, MN 55402

Re: In re: UnitedHealth Group Inc. Shareholder Derivative Litigation; Case No. 06-1216 (D. Minn.)

Dear Justices Blatz and Stringer:

I write to you to express my dismay at your unwillingness to meet with me on February 1, 2007, as originally scheduled. I also strongly urge that you, as the Special Litigation Committee (“SLC”) of the UnitedHealth Group, Inc. (“UHG” or the “Company”) board, refrain from reaching a settlement with UHG’s recently ousted CEO, William McGuire.

As the Attorney General of the State of Ohio, I am the attorney for the Public Employees’ Retirement System of Ohio (“PERS”) and State Teachers’ Retirement System of Ohio (“STRS”), two of the Lead Plaintiffs in the derivative litigation pending in the District of Minnesota. PERS and STRS collectively own in excess of 5.6 million shares of UHG common stock worth more than $295 million. At its peak value, that stock was worth more than $360 million. Of course, this decline in value is attributable to the options backdating scandal in which the UHG board cavalierly abdicated its oversight responsibilities and improperly allowed McGuire to set his own compensation. Consequently, it appears that McGuire backdated more than $2.3 billion in options and received more than $1.6 billion in options and nearly $60 million in other compensation under an employment contract that was improper and void.

It is my understanding that the SLC believes it has authority to negotiate a resolution of the Company’s claims against McGuire. I strongly urge you to involve the derivative plaintiffs in that process. We caution you that the entire institutional investor, law enforcement, and regulatory communities are watching how you conduct your assigned task. Quite frankly, your conduct to date gives us pause to wonder exactly what is going on at UHG and, more importantly, who is truly looking out for the best interests of the Company and its shareholders.

Our outside counsel, Grant & Eisenhofer, together with Karl Cambronne, Esquire, and the Plaintiffs’ Coordinating Committee, had arranged a meeting with you that was to take place in Minneapolis on February 1. On January 31, your counsel cancelled that meeting when he learned that I intended to attend the meeting personally. This is inexcusable arrogance. At that meeting, I intended to pose a number of questions to you to address some of my concerns with the SLC investigation. Just by way of example, I would have asked you the following questions:

  • Did the SLC, which purportedly holds all of the board’s authority to determine whether the claims asserted in this litigation should be pursued or not, authorize the motions to dismiss the action?
  • Does the SLC have any reason or basis to disagree with the finding by Wilmer Cutler Pickering Hale & Dorr in its October 2006 report (the “WilmerHale Report”) that millions of stock options granted to McGuire, current CEO Hemsley and other executives were backdated?
  • Does the SLC have any basis to dispute the fact that the grant dates for the options which the WilmerHale Report found to bear all the indicia of deliberate backdating were chosen by McGuire, and McGuire alone?
  • Is a settlement with McGuire – the chief wrongdoer in this matter – being contemplated by either the Company or the SLC?
  • Does the SLC have any reason to dispute that Hemsley received more than $700 million in backdated options, and if not, why did the SLC remain silent when Hemsley was appointed UHG’s new CEO?
  • Why, when it is abundantly clear that backdating has taken place, does the SLC, which has already been working for seven months, need more time to complete its investigation?

Perhaps if our scheduled meeting had taken place, you could have allayed my fears – particularly with regard to the possibility that a backroom deal with McGuire will be negotiated. The late cancellation of the meeting on what appears to be pretext, however, leaves me even more gravely concerned that UHG’s best interests are not being scrupulously guarded.

I believe a meeting between us would be most beneficial for all concerned. It would present an opportunity to clear the air of the suspicion and doubt that has surrounded the Company’s and, frankly, the SLC’s actions in the past several weeks. I urge you to reconsider your refusal to meet with me and plaintiffs’ counsel and to schedule a meeting to take place as soon as possible. Please let our outside counsel, Jay Eisenhofer of Grant & Eisenhofer, know as soon as possible if you will meet with us and the other Plaintiffs’ counsel.

Very truly yours,

Marc E. Dann
Attorney General
State of Ohio

For more information contact:

Jennifer Brindisi, Attorney General’s Office, at (614) 728-5418

Tuesday, February 13, 2007

Tom Cooper: The lowdown on the Medical Mutual reimbursement for Weight Watchers

From Tom Cooper, February 13, 2007
Subject: med mut/ WW sequel
ALL OF YOU POLITICALLY CORRECT PEOPLE..Please take a seat....this is not directed at anyone..male, female, big, little, it is for the financial and health benefit of all, based on the original question about Medical Mutual's offer to help ALL of us lose a few pounds, and get healthier.:
The following is what my wife has been able to determine from Weight Watchers about the Medical Mutual reimbursement;
You can call WW at 1-866-204-2878.
Tell them you are insured by Medical Mutual and want to enroll in the Medical Mutual reimbursement program for Weight Watchers.
You must choose to enroll for a 13 week plan, or an 18 week plan.
You pay up front for vouchers for the plan you select.
The 13 week plan vouchers costs you $142.35, or, $10.95 a session, which is the WW rate for the entire 13 weeks. When you have completed the 13 weeks, you send the vouchers to Med Mutual and they will reimburse you to the sum of $50. This makes the total cost to you of $92.35, or, or $7.10 a meeting, which if my numbers are correct, means you are saving about 35%
The 18 week vouchers cost $168.30, which is the WW best, lowest cost, at $9.35 per meeting. Medical Mutual reimburses you for $75, which brings your actual cost to $93.30, or $5.18 per meeting, which, again, remember, I didn't teach math, but should bring your savings over the WW rate to 45%.
So basically, if you are interested, the 13 week plan is a matter of $7.10/meeting vs WW rate of $10.95
The 18 week plan you are paying $5.18 v. $9.35.
Now..please allow me a disclaimer, here. My wife has expressed a concern that she or I will be seen as trying to sell people on WW. My wife is NOT a sales person for WW. Neither she nor I get one penny from WW...or Med Mut for that matter. In fact, she kicks my shins when I call her meetings "classes"! LOL!
This entire Thread was raised, by ME, ONLY because I knew people could be getting some financial help with their diet/nutrition information, and I knew there were others, (not teachers) who WERE getting that aid, and I was curious as to why.
I have plenty stories, as I am sure many of you do also, about trying to lose weight. But I finally got the hang of the WW plan I could live with and I have lost 20 since the day after Christmas. Actually, I was at that point about 2 weeks ago, and have stayed at my weight very easily, since, and am looking forward to losing more, but I am happy with the plan I have now, and will be patient until I can lose some more, and I know I will, But, I had to learn how, first.

Rep. Waxman To Investigate Profits of Medicare Prescription Drug Plans, Whether Plans Pass Negotiated Savings on to Beneficiaries

Monday, February 12, 2007

Capitol Hill Watch
    Rep. Waxman To Investigate Profits of Medicare Prescription Drug Plans, Whether Plans Pass Negotiated Savings on to Beneficiaries

The House Oversight and Government Reform Committee on Friday held a hearing about how private insurance plans and pharmacy benefit managers negotiate prices with drug manufacturers for government prescription drug programs and whether these discounts get passed on to consumers, CQ HealthBeat reports. Committee Chair Henry Waxman (D-Calif.) also on Friday said that he planned to send a letter to the Medicare program and to insurers that offer Medicare prescription drug plans requesting information about the discounts offered by drug manufacturers and how the discounts impact beneficiaries. At the hearing, witnesses discussed the impact of the 2003 Medicare law, which prevents public disclosure of the prices that drug plans pay manufacturers for prescription drugs. The lack of transparency means that the federal government cannot assess how well market forces are operating in Medicare Part D, according to Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public HealthHHS secretary would need to know the actual prices paid for drugs by private plans and PBMs, Anderson said. The administration counters that private plans and PBMs that negotiate with drug manufacturers on behalf of the government are able to negotiate lower prices and government inference is unnecessary. The hearing also discussed the prices paid by Medicaid and the "340B Program" run by the Public Health Service, which provides federally funded health clinics with access to lower-priced brand-name and generic prescription drugs. Meanwhile, CMS released data showing that prescription drug plans under the Medicare drug benefit are widely distributing generic drugs, accounting for 60% of drugs dispensed through Medicare drug plans (Reichard, CQ HealthBeat, 2/9). who spoke at the hearing. If legislation passes mandating government negotiation for prescription drug prices, the

Waxman said he worries that "billions of federal dollars that should be buying needed care are instead adding to drug company profits." He added that he would use responses to the letter to "assess whether high drug costs are increasing beneficiary costs and wasting taxpayer dollars in the Medicare drug program" (Brady, Congress Daily, 2/9). HHS spokesperson Christina Pearson said, "We have a substantial record showing that a competitive marketplace is working for seniors in Part D. Premiums have gone down, the Part D program costs less than originally estimated." She continued, "Those have gone down but enrollment and beneficiary satisfaction continue to go up as shown by multiple independent surveys. The numbers show that Part D is a very successful program for people with Medicare and taxpayers" (CQ HealthBeat, 2/9).

Medicare Fraud
At the hearing, Waxman also indicated that he will boost federal efforts to bring fraud cases against pharmaceutical firms, CQ HealthBeat reports (CQ HealthBeat, 2/9). James Moorman, president of Taxpayers Against Fraud, said that drug makers have "plenty of ways in the complicated system to inflate prices" (Congress Daily, 2/9). The Department of Justice has a backlog of 150 cases of alleged fraud by pharmaceutical companies, according to Associate Deputy Attorney General Ron Tenpas. Since 1999, the federal government has collected more than $5.3 billion from fraud investigations, Tenpas said (CQ HealthBeat, 2/9).

RH Jones re: "Jeers"....

RH Jones to John Curry, February 13, 2007
Subject: Re: "Jeers" to another former Ohio charter school and "Cheers" to a county prosecutor
Rep. Coughlin (R) avoided me like I had the plague. He keeps saying that he supports charter schools because they offer parents a "choice". In my opinion his is a "choice" to rob your child of a decent education that can be chosen in a public school system controlled by democratically elected school board members. This is not the case in for profit charter schools. There, you can only vote with your feet, not with your ballot. Walking away from a charter school is not controlling the educational setting. Voting is.
We need to get out to reasonably-thinking "Buckeye" parents that they can choose the school or school district they want their child to attend. Elected board members must respond to the wishes of the public or they face the wrath of the voting parent in the voting booth. That is choice to me! You even have the freedom to choose not to vote! This is true whether or not you live in a city, a suburb or in rural Ohio.
John Curry to Bob Jones, February 9, 2007
Subject: Re: "Jeers" to another former Ohio charter school and "Cheers" to a county prosecutor

Good. Make him stutter!
From Bob Jones, February 9, 2007
Subject: Re: "Jeers" to another former Ohio charter school and "Cheers" to a county prosecutor

I'm going to put this in the face of Rep. Kevin Coughlin (R) at the Akron Press Club luncheon debate with Rep. Brian Williams (D). Let's see how Coughlin slithers out oof this one.
From: John Curry, February 2, 2007
Subject: "Jeers" to another former Ohio charter school and "Cheers" to a county prosecutor
Cheers & Jeers
Friday, February 2, 2007

CHEERS . . .
to Cuyahoga County Prosecutor Bill Mason and the grand jury that indicted the owners of the Imani Institute Leadership School. State auditors reported last year that $800,000 of taxpayer money had either been spent inappropriately at the now-closed Cleveland charter school, or couldn't be accounted for at all. It's past time for a crackdown on shady school operators - wherever they work.

Generic Lipitor in your future?

Ranbaxy -- here comes generic Lipitor

February 13, 2007
Source: PharmaTimes

Pfizer has reacted angrily to the news that India's Ranbaxy Laboratories has launched a generic form of the drug major's Blockbuster cholesterol-lowerer Lipitor in Denmark.

Announcing the news, Ranbaxy chief executive Malvinder Singh said the introduction of atorvastatin in Denmark "is a significant milestone" and "heralds the beginning of the company's determined efforts to bring affordable atorvastatin to patients in Europe and other parts of the world." He added that the company's copycat Lipitor "will bring significant and immediate cost benefits to the Danish healthcare system."on Monday the move marked the beginning of the company's efforts to bring affordable atorvastatin, as Lipitor is known generically, to patients in Europe and other parts of the world.

Denmark is the first western country to sell generic atorvastatin, though Ranbaxy's version is already available in India and some other emerging markets, and Pfizer issued a statement saying that the decision to launch, "prior to the resolution of litigation on three Lipitor patents disregards normal Danish legal processes."

The firm went on to say that "Ranbaxy is fully aware that a court decision, which will determine whether or not Ranbaxy would be prohibited from selling a generic product before the patent litigation is concluded, is pending as a result of Pfizer's request for a preliminary injunction," and noted that a ruling on the latter is expected later this month.

The statement added that Pfizer is considering all its legal options to address the at-risk launch by Ranbaxy and if the Indian drugmaker should lose its patent challenge, it could be subject to financial penalties for lost sales of the drug suffered by the New York-based giant.

Pfizer can expect to see a lot more of Ranbaxy in courts around the world and the Gurgaon, Haryana-based firm was granted a favourable decision by a Canadian federal court in a case at the end of January which found Pfizer's Canadian atorvastatin patent to be invalid.
Note from John Curry: Don't get your hopes up for this generic or Lipitor prices to lighten the load on your wallet in your near future, remember -- OUR federal courts, the former majority in the U.S. Congress, and the FDA have remained extremely friendly with Big Pharma - no pfoolin'!

Monday, February 12, 2007

Molly Janczyk: Medicare questions for Gary Russell

Molly Janczyk to Gary Russell, February 12, 2007
Subject: STRS/Medicare: Definition: Indemnity:

To clarify, Gary.
Under Medicare ONLY, the recipient has to pay the first $992 of a hospital stay for the first 1-60 days; $248 a day for the next 61-90 days and $496 a day for the next 91-150 days.
But, under STRS, Medicare recipients pay ONLY their $500 deduc. and then 20% until they reach $1500 per recipient for their max put of pocket.
Please verify_________Yes_________No
This is good news if I understand it as written above as I approach 65 and learning about Medicare. We make out much better than I thought.
Gary Russell to Molly Janczyk, February 12, 2007
Subject: RE: Indemnity: 2nd request
Please see my answers below. When I refer to the Plus plan I'm speaking of the Aetna or Medical Mutual Plus plan under the STRS Ohio Health Care Program.
(Molly to Gary)
Gary, I remain confused. Please answer in Basic Class 101 verbiage.
Molly: Indemnity: 'defined as in paid back after the insured pays first.' Then, you say, No, retirees do not pay first if they have signed for crossover (meaning having both Medicare and Med. Mut./Aetna, etc. ). Does this mean :
1. Insured retirees with both Med Mut or Aetna, etc. NEVER pay first and wait until Medicare pays, sends paperwork, then Med. Mut. or Aetna, etc. pays , and then sends an EOB (explanation of benefits) telling retirees what to pay.
Russell: YES!
2. How do retirees have both Part A and Part B with Medicare as Primary? Med Mut. explained to me that retirees with no Part A have STRS (OPERS) as the primary acting as Part A and Med Mut (Aetna, etc.) as secondary acting as Part B for overnight stays. ???????????????
Medicare is always primary if someone has Medicare coverage. Medicare consists of two parts, Part A is Medicare hospital coverage and Part B is Medicare medical coverage. If someone is eligible for Part A for free, then she is required to enroll in Part A and it is primary to hospital coverage under the STRS Ohio plan. If a member is not eligible for Part A for free, then she does not have to enroll in Part A and STRS Ohio provides comprehensive hospital coverage at no additional cost to the retiree. If there is no Part A coverage, then STRS Ohio pays first since it is the only plan.
3. What is the Medicare deductible?
Medicare Part A enrollees pay $992 for days 1-60 in the hospital. An enrollee is responsible for $248 per day for days 61-90 and $496 per day for days 91-150. For a skilled nursing facility, the cost is $0 for the first 20 days, then $124 per day for days 21-100 and 100% of the cost for each day after 100. Medicare Part B enrollees have a $131 deductible then typically the enrollee pays 20% of the cost. For additional information regarding Medicare, the booklet Medicare & You is available on the Medicare website.
4. Is this Medicare deductible over and above the $500 deduc. we pay now or the Basic deduc. we pay now?
The STRS Ohio plan is going to cover the Medicare allowable amount that Medicare didn't cover. For example, let's say that there is a claim for $2,131 in allowable charges. Medicare Part B won't cover the first $131 which leaves $2,000 of which Medicare pays $1,600 (80%). This means that $531 has not been paid. Under the Plus plan the enrollee would pay the first $500 to meet her deductible and then the Plus plan would cover 80% of the remaining $31 and the enrollee would pay 20% of the $31. The difference with the STRS Ohio plan is that there isn't a separate deduction for hospital and medical coverage. So if in the example above there were hospital charge, then Medicare is not going to cover the first $992 for a hospital stay, but under the STRS Ohio Plus plan, $500 of the $992 would satisfy the deductible and then the Plus plan would cover 80% of the remaining $492.
From Gary Russell, February 12, 2007
Subject: RE: Indemnity: 2nd request
Please see my answers following your questions. In regards to any questions you get from older retirees about claims, I can't stress enough that they just need to call our toll-free call center at 1-888-227-7877 and we can answer any questions or resolve issues for them. We need to have the dialogue with them so that we can probe for the information we need to have to resolve either a breakdown in service or clarify any misunderstanding.
I hope this helps,
From Molly Janczyk, February 9, 2007
Subject: Indemnity: 2nd request
1. What does indemnity mean to the Medicare recipient under STRS?
Russell ans: It is defined as paid after the insured pays as in paid back after recipient pays bill first.
Molly: Surely retirees 65 and older are not required to pay up front and this not what happened to my mother under OPERS.
Russell ans.: Under the indemnity plan for Medicare covered individuals, the provider first files with Medicare and then if the member has signed up for automatic crossover, Medicare will forward the claim to Aetna or Medical Mutual. The retiree does not pay first.
2. So, does it mean after Medicare pays, STRS pays? Or a combination of the 2? See #1 above.
3. Isn't Part A: STRS primary with Medicare secondary Part B: Medicare primary with STRS secondary and then recipient pays 20% of what is left and allowed?
For both hospital (part A) and medical (part B) Medicare is primary to STRS Ohio. The retiree has to first meet the deductible for Medicare, then Medicare pays, Aetna/Medical Mutual will then begin coverage on what is left over after the Aetna/Medical Mutual deductible is paid.
4. Do we not receive paperwork from Med Mut or Aetna just like before 65?
Russell ans.: Yes, the retiree receives explanation of benefits (EOB)
5. After $500 deduc and out of pockets max of $1500 is reached, STRS pays 100% of Medicare recipients just like non Medicare, correct?
Russell ans.: Yes, the plan works the same way after Medicare pays.
I am getting questions from retirees (one of which I sent you) who say:
1. they don't receive paperwork telling them how much of their deduc and out of pockets have been met and
2. who do not seem to know that they are out of pocket max after which STRS pays 100%.
Russell: (ans. above): Yes they receive EOB (explanation of benefits)

RH Jones: Akron Press Club's meeting today 02/12/07; will be aired several times this week on TV

From RH Jones, February 12, 2007
Akron Press Club's meeting today 02/12/07. See it on TV!
To all in N.E. OH CORE:
Pro-Public Education ,OH Rep. Brian Williams (D), & Pro-Charter Schools, OH Sen. Kevin Coughlin (R), exchanged views and answered audience questions. 2nd term OH Rep. Bob Otterman (D) and Linda Omobien, Past Pres. of the OH School Bds. Assoc.(OBSA) were among the large audience.
I submitted 3-questions & one was chosen. The question was directed to Rep Williams concerning the hurt charter schools are giving our STRS funding. Between the 2 politicians, I thought Williams came out the winner. Education was the main issue. However, neither one of them back the Constitutional Amendment, but Williams said he wishes first to give Gov. Strickland a chance to develop his plan. And if nothing comes of it, he said he will: "Jump in on it with both feet."
To see for yourself how they explained OH politics, view Time Warner Cable Channel 23, this coming Thurs. Feb. 15 at 7:00 p.m.; or Sat., Feb. 17 at 7:00 p.m.; or Sun., Feb. 18 at 4:00 p.m.
Those of you who can, please watch this cable TV Bi-partisan discussion.
RHJones, CORE & SummitCRTA Leg. CMTE. Mem.

Tom Cooper: Why no word from STRS or Medical Mutual on Weight Watchers?

From Tom Cooper, February 12, 2007
Subject: med-mut/WW
Can anyone tell me why we retirees who are still on Medical Mutual have not received anything from STRS or Medical Mutual concerning Weight Watchers? Medical Mutual has announced they will reimburse the cost of Weight Watchers for those who are enrolled in Medical Mutual HC programs.
Insurer to pay for weight-loss efforts
Medical Mutual offers money to members who join Weight Watchers
Cleveland Plain Dealer

Thursday, February 01, 2007
Harlan Spector
Plain Dealer Reporter
If Atkins didn't pay off for you, here's something that might.
Medical Mutual of Ohio will pay its members up to $150 a year to weigh in at Weight Watchers meetings, regardless of whether they shed pounds.
The offer to Medical Mutual's 1.6 million members comes as more insurers and businesses dangle financial incentives to nudge people to get healthier.
The money, in this case, will subsidize the cost of joining the popular weight-loss program.
"This is another adjunct of what we're trying to do to get the message out to change lifestyles," said Mary Wnek, manager of clinical quality improvement.
The insurer in 2005 also began paying for nicotine replacement patches for members who sign up for counseling with the Ohio Tobacco Quit Line.
A number of health plans reward members who join fitness clubs, said Susan Pisano of America's Health Insurance Plans, a 1,200-member organization. Offers like Medical Mutual's "are on the leading edge," she said.
"We have an epidemic of chronic disease in the country," she said. "You have to come at it from a variety of perspectives, and providing incentives is one."
Last week, West Virginia's largest Medicaid provider, UniCare, announced that it would pay for up to 16 weeks of courses from Weight Watchers. UniCare's parent company said it might expand the program to 14 states where it provides benefits, including Ohio.
Tennessee's Medicaid agency, TennCare, completed a pilot program last year for 1,400 Medicaid recipients who paid nominal fees to participate in Weight Watchers. They lost a combined total of more than 8,000 pounds over six months.
The government says two-thirds of U.S. adults are overweight or obese. Excess weight drives up the risk of coronary heart disease, diabetes, stroke and some cancers.
Estimates vary on medical costs associated with obesity, but the Centers for Disease Control and Prevention put the number at $75 billion in 2003.
Mark Pauly, professor of health care systems, business and public policy at Wharton School of University of Pennsylvania, said the Medical Mutual program will pay off down the road if enough members lose weight.
"The real question is will the incentive be enough to get people to use Weight Watchers who otherwise wouldn't, and then whether the intervention is effective," Pauly said.
Medical Mutual will pay $50 to members who complete a 13-week plan that costs $142. Reimbursement is $75 for an 18-week plan that costs $168. The maximum annual payout is $150.
Members can call 866-204-2878 to enroll and must attend local Weight Watchers meetings.
To reach this Plain Dealer reporter:, 216-999-4543

Sunday, February 11, 2007

Dennis Leone's reponse to Gary Hollow's comments: Hollow and OEA are missing the point

From Dennis Leone, February 11, 2007
(Response to Gary Hollow)
Perhaps someone should point out to OEA-blind Gary Hollow that STRS pension money was used to buy that dinner at Lindey's for Ramser. He is conveniently leaving this out of his "follow-up." The reason I brought up the whole thing at a Board meeting was that STRS had paid for it.......and Hollow knows this is why I brought it up. Ramser's comment about not being reimbursed in the recent past -- this means nothing because the Lindey's bill was paid by an STRS-purchased credit card. I don't imagine when Jack Chapman spent $35,000 all by himself in 1995 (flying all around the country, staying in the nation's most expensive hotels, buying meals at lavish restaurants) that he was reimbursed one nickel. He didn't have to be. He used an STRS-purchased credit card. OEA and Hollow just refuse to understand these things.
Like I have said many times, had it been Leone and Lazares with STRS-purchased credit cards, $48 dinners, fax machines in their homes, personal long distance phone calls paid for, extra nights of lodging, etc., OEA and Hollow would be singing a different tune. Lindey's, by the way, is the place Herb Dyer took 7 board members and 3 staff members to for dinner AFTER a board meeting once in 2002. The bill for STRS for that one dinner and the booze associated it? Merely $987.00. (I have the receipt.) OEA and Hollow can't see the forest for the trees on this entire matter.
Dennis Leone
Posted by Gary Hollow on Ohio STRS Watch blog
Monday, February 05, 2007

Ramser Dined at Lindy's

In November Dr. Leone questioned Chairman Rasmer about a dinner at the upscale Columbus eatery Lindy’s that she denied having ever been in.
Dr Leone showed me a copy of a voucher from Debbie Scott listing Conni Ramser eating with her at Lindy's in December of 2004 with a bill of $60.
Chairman Ramser’s response:
I didn't remember having dinner there, but I must have. However, my vouchers for the last two years have not reflected any meals for which I have been reimbursed by STRS.
Conni Ramser
posted by Gary Hollow at 11:35 AM
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