HUMANA PROVIDES PRESCRIPTION BENEFITS SUMMARYLouisville, Ky.-based Humana Inc. has developed SmartSummary Rx, an in-depth, monthly prescription benefits summary tailored to individual Medicare members. As a companion to the SmartSummary program for commercial members, SmartSummary Rx provides Humana's Medicare enrollees with guidance on cost-savings opportunities, a consolidated prescription claims record and tools can help them budget for future health care and prescription spending.
INSURER INTEGRATES DIRECT SPONSOR FORMS INTO ORDER ENTRY SYSTEM
Santa Monica, Calif.-based National Planning Holdings Inc., an affiliate of Lansing, Mich.-based Jackson National Life Insurance Co., has integrated a library of direct sponsor forms and applications with its Web-based representative workstation system, Electronic Order Entry (EOE). The technology in EOE enables the system to continually look for updates and automatically replace outdated forms with current, approved versions.
NATIONWIDE PROVIDES ONLINE REPAIR UPDATES
Nationwide AutoWatch, an Internet-based software tool offered by Columbus, Ohio-based Nationwide Insurance, is designed to enable customers to monitor their damaged vehicle repairs online. Nationwide AutoWatch also provides an e-mail platform through which customers can communicate with the repair facility and their Nationwide/Allied representative. AutoWatch is currently being piloted in multiple states and may be rolled out as an optional service in the coming months.
MEDICAL MUTUAL RECOVERS $5.4 MILLION IN FRAUD
Through its investigations unit, Medical Mutual of Ohio, Cleveland, reclaimed $5.4 million in fraudulent claims in 2005, the largest amount in the company's history. Medical Mutual notes that Washington-based National Health Care Anti-Fraud Association (NHCAA) estimates more than $100 million is lost every day to health insurance fraud. Also, according to the NHCAA, health insurance fraud is responsible for upwards of 5% of the total cost of all health care in the United States annually. The Medical Mutual Financial Investigations Unit investigates 120 cases of potential fraud per year, and in the past two decades has produced more than 600 indictments. Since 2003, Medical Mutual has reclaimed nearly $14 million in fraudulent claims with the help of the ViPS STARSentinel software, an early-warning anti-fraud detection system, from Emdeon Business Services, a segment of Elmwood Park, N.J.-based Emdeon Corp.
WEB-BASED PLATFORM RECEIVES PATENT APPROVAL
InsuranceNoodle Inc., Chicago, has received U.S. Patent Office notification that the patent application relating to innovations for its "Methods and Apparatus for Selecting an Insurance Carrier for an Online Insurance Policy Purchase" have been allowed for issuance within the next few months. Approximately 2,500 agencies are active NoodleNetwork partners using InsuranceNoodle's proprietary, Web-based technology platform, which is designed for fast, efficient online quoting from multiple carriers for a variety of commercial products.
GENESYS ESTABLISHES PRESENCE IN BRAZIL
Paris-based Compagnie Financière Alcatel and Daly City, Calif.-based Genesys Telecommunications Laboratories Inc. have acquired GMK, a Brazilian company that will operate within the Genesys sales and customer support organization. The acquisition of GMK, a provider of contact center voice self-service solutions in Brazil, gives Genesys a major presence in Brazil and supports Alcatel's strategy to deliver advanced voice self-service solutions for contact centers and expand further into the Brazilian and Latin American enterprise markets.
OUTSOURCING: RISKY BUSINESS
An Economist Intelligence Unit survey in September 2005, sponsored by U.K.-based ACE European Group Ltd., part of The ACE Group of Insurance & Reinsurance Companies, revealed that more than half of the European companies that outsourced IT functions had suffered significant financial damage as a result of IT system failure, including damage or misuse of systems, by outsourcing staff or contractors during the previous twelve months. According to ACE, outsourcing computer operations increases the risk of security breaches-and does not eliminate a company's responsibility for the protection of its systems.
TOP COMPLAINTS ABOUT INSURANCE COMPANIES
The top three reasons consumers filed formal complaints against insurance companies in 2005 were delays, denials and unsatisfactory settlement offers, according to data collected by the Kansas City, Mo.-based National Association of Insurance Commissioners (NAIC). Following these claims handling issues, consumers complained most about policy cancellations and premiums/insurance rating issues.
A total of 199,639 complaints were filed by consumers in 2005, a 22.5% decrease from 2004. Auto insurance was the type of coverage that caused the most complaints, followed by accident and health, homeowners, life and annuity, and commercial multi-peril insurance. The NAIC maintains a centralized electronic Complaint Database System (CDS), through which states voluntarily report closed complaints.
PRINCIPAL SERVICES RECEIVES SAS 70 CERTIFICATION
The Principal Financial Group, a 401(k) provider and one of the largest administrators of nonqualified executive benefit plans, has completed a Type II Statement of Auditing Standards (SAS) No. 70 for its nonqualified deferred compensation plan operations. SAS 70 provides independent, industry-standard assurance regarding the effectiveness of the company's internal controls and processes for nonqualified deferred compensation plan administrative services. This certification came as the result of an audit by New York-based Ernst & Young LLP at the request of the Des Moines, Iowa-based financial services firm.
