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GLG News by Group Life & Health Insurance Experts: Actuarial Consultants

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September 7, 2007
Medical Tourism Has Price Transparency - The United States Has Opaque Pricing
Analysis of: American's Gamble for Bargain Surgery Abroad | www.medpagetoday.com
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
The United States has very limited price transparency for medical providers and facilities. The lack of price transparency artificially raises costs in the United States because there is very little price competition for services.  This is true even in areas where there is excess capacity.
July 24, 2007
Transparency to the Client is Paramount
Analysis of: Insurance brokers reconsider taking insurer commissions | www.marketwatch.com
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
Contingent commissions, if not disclosed, can result in brokerage clients not knowing how much they are paying for the services they receive from their risk brokers. A commission should be viewed as just an alternative to fee-based consulting.  In theory the amount of commissions received should...
May 29, 2007
You Need to Consider Drug Mix and Plan Design
Analysis of: Comparison of Mail Order with community Pharmacy Cost | www.amcp.org
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
It is universal that the mail order distribution channel has lower generic utilization than the retail channel.   PBM pricing is always better for mail order scripts versus retail.  In addition, plan design is a major component of net claim costs.
May 28, 2007
Quality and Service Will Suffer With Outsourcing
Analysis of: Insurance Outsourcing Focuses on India | www.insurancejournal.com
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
Outsourcing won't work well until the Indian outsourcing firms develop the core competencies of key insurance operations.  
December 4, 2006
Is PBM Transparency a Good Thing?
Analysis of: PBM transparency: More than meets the eye | www.benefitnews.com
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
This article discusses transparency in the context of retail pharmacies; however, PBMs are most profitable in the mail order distribution channel.Transparent PBM deals have more guarantees than implied by this article.
November 24, 2006
High Performance Networks
Analysis of: Pay-for-Performance Plans Now Common Among HMOs | www.nlm.nih.gov
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
One product the major healthplans are starting to sell are benefit plans (HMO's/PPO's) that utilize a high performance network (HPN).  The HPN is a more limited network of doctors who have shown that they are providing quality service and good value from a cost standpoint.
November 24, 2006
Walmart Program Beneficial to Consumers
Analysis of: Wal-Mart Expands Generic Drug Program | www.newsinferno.com
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
Many people with health insurance have pharmacy plans with generic copays with flat dollar minimums of at least $5.Walmart may gradually expand the program or add additional pricing tiers.
November 24, 2006
Why Are They Dumping?
Analysis of: Trend: Consumers dumping HMO plans | www.fiercehealthcare.com
Author: Michael Berman, Assistant Vice President, AON Consulting & Insurance Services
HMO Plans have become very similar to PPO without an out-of-network benefit.Member cost sharing is typically lower than PPO plans making them more expensive.

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