Warwick, RI – AmWINS Group Benefits launched the nation's first Employer Group Waiver Plan (EGWP, pronounced Egg Whip) in 2006, and now in the wake of healthcare reform is re-launching their program as a direct and immediate approach to help reverse the negative effects of the Retiree Drug Subsidy (RDS), now taxable under the Patient Protection and Affordable Care Act (PPACA).

Since the PPACA was written into law, thousands of employers that accepted the RDS under Medicare Part D are now faced with provisions that reduce the value of the subsidy. Faced with instant write downs to their financial statements to the tune of billions of dollars in future liabilities, AmWINS Group Benefits delivers an innovative solution to repeal the unfortunate losses and relieve administrative burdens these companies are up against.

"Although the new tax status for the 28 percent retiree drug subsidy does not kick in until 2013, it has had an immediate impact on employer financial statements, often to the tune of millions of dollars. One way to eliminate this impact is to use an EGWP," said Sam Fleet, president of AmWINS Group Benefits.

EGWP allows an employer to contract with the federal government as a prescription drug plan (PDP) sponsor to provide drug benefits to retirees. Using a nationally based formula, the government pays the company a capitation fee that can exceed the retiree drug subsidy by $100 to $200 per member per year. Experts estimate that under EGWP, the federal government covers 35 percent or more of the drug prescription costs incurred by an employer, far exceeding the 20 percent average yield of the previous drug subsidy.

800 Series EGWP
A more appealing approach for many companies is what is known as an 800 Series EGWP. Under this strategy, a company can contract with a third party Part D sponsor, who interacts with the federal government. The sponsor retains a fee but passes through the bulk of government payments in the form of lower premiums or direct payments to the employer.

The 800 Series EGWP offers a number of benefits, including:

• The contracted PDP sponsor shoulders the expenses associated with verifying compliance each year
• Can be self-funded or fully insured
• The plan can be customized to match an employer's current benefits, allowing the company to meet its obligations, whether thanks to collective bargaining or to commitments made to employees in a non-union environment
• It maximizes the government contribution toward pharmaceutical expenses without imposing administrative burdens on the company

"As the ramifications and unforeseen consequences of the health reform act begin to unfold, many businesses will be looking for solutions to unexpected health benefit problems," Fleet said. "Being knowledgeable about all of your options, like the 800 Series EGWP, may be just the solution corporations need." For more information about EGWP, visit the AmWINS Group Benefits electronic press kit at amwinspresskit.com. Also, follow Sam Fleet on Twitter: @samfleetsays.



About AmWINS Group Benefits
AmWINS Group Benefits is a leading wholesale broker of comprehensive group insurance programs and administrative services. Working with benefit brokers and consultants, AmWINS Group Benefits designs, distributes and administers customized health benefit products and services for retired and active populations in private and public organizations. Its parent company, AmWINS Group, Inc. is a leading insurance wholesaler in the United States. AmWINS Group Benefits is headquartered in Warwick, RI. More information about AmWINS Group Benefits is available at groupbenefits.amwins.com.

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Warwick, RI – A powerful spotlight shined down on the future of benefits professionals this week at the Benefits Selling Expo in Washington, DC. Before an audience of top agents, brokers and insurance carriers from across the country, Samuel Fleet, President, AmWINS Group Benefits, outlined the impending “good, bad and ugly” from the recent health care legislation. His statements support remarks from many brokers, including Stefanie Pigeon from Affiliated Associates.

Speaking during an education session yesterday titled, “Healthcare Reform: A Brokers Survival Guide,” Fleet said. “Washington has made the broker a villain, and the U.S. taxpayers and our children will be paying for this piece of legislation for decades to come.” Wayne Weese, a broker with Dynamic Benefit Systems, conveys Fleet’s sentiments.

“Despite the fact that one year ago, over 50 percent of surveyed brokers did not believe reform was going to happen ¹, the attack on the broker is significant as ever,” said Fleet. “But opportunities do exist and the strong will survive and flourish.” Ryan Hatch, a Dynamic Benefit Systems broker, agreed that the time is right for change.

Fleet shared his insights into who the true winners are of new health care legislation, with the health insurance companies coming out on top, given their 30+ million new customers, as well as the hospitals that were left unscathed by reform and now have insurers to pay for patients that were previously uninsured. The losers? Fleet named the U.S. taxpayers, our children and the insurance brokers who have been especially hit by not only health care reform, but also the recent recession, expanding revenue pressures and the unfortunate decline in broker confidence.

In addition, Fleet provided his foresight into some of the unintended consequences of health care reform, which include higher premiums, deterioration of the employer market, more companies eliminating retiree coverage, a shift towards self-funded plans, as well as people electing to not be part of the new system.

However, Fleet did offer several solutions to agents and brokers, encouraging them “to be forward looking,” as well as to bring value through creativity. “You must demonstrate flexibility and quickly adapt in order to create the best choices for employers,” he said.

Specific examples that drew attention from the crowd involved a retiree drug subsidy, the idea of an early retiree re-insurance program and a fresh look at ERISA plans. Rob Shestack, a broker with Trion, is eager to react to the changing landscape and offer real solutions to his customers.

For more information or to view broker interviews from the Benefit Selling Expo, visit the AmWINS Group Benefits electronic press kit at amwinspresskit.com. Also, follow Samuel Fleet on Twitter:@samfleetsays.

About AmWINS Group Benefits
AmWINS Group Benefits is a leading wholesale broker of comprehensive group insurance programs and administrative services. Working with benefit brokers and consultants, AmWINS Group Benefits designs, distributes and administers customized health benefit products and services for retired and active populations in private and public organizations. Its parent company, AmWINS Group, Inc. is the second largest insurance wholesalers in the United States. AmWINS Group Benefits is headquartered in Warwick, RI. More information about AmWINS Group Benefits is available at groupbenefits.amwins.com.


¹ According to a survey published in the February 2009 issue of Employee Benefit Adviser.


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Warwick, RI – To help self-funded clients manage risk on the rising costs of specialty pharmaceuticals, AmWINS Group Benefits, a leading wholesale distributor of employee benefits and professional services, recently announced a new product now available – AmWINS Specialty Pharmacy Protection™. By offering an insurance product specific to the Specialty Drug market, AmWINS can now help protect employers with self-insured health plans from financially devastating pharmacy claims.

“The recent and projected market growth fueled by first-in-class products poses an elevated financial threat to self-funded employers – and unlike other prescription drugs, there are currently no generic alternatives for specialty drugs,” said Samuel H. Fleet, president of AmWINS Group Benefits. “Our clients are looking for a solution and this is it.”

Specialty Pharmacy programs are one of the fastest growing trends among pharmaceuticals today. Some treat relatively common conditions, such as rheumatoid arthritis, Hepatitis C and multiple sclerosis, while others treat uncommon conditions, like pulmonary arterial hypertension and severe combined immune deficiency. Specialty drug prices can range from $5,000 and $300,000 per year, per employee and the number of specialty products is projected to rise dramatically to more than 400 products by 2020.

In response to this new healthcare reality, AmWINS Specialty Pharmacy Protection is preparing clients to manage their overall specialty pharmacy spending and benefits. Administered by IdealScripts, AmWINS’ progressive pharmacy benefit management company, the fully insured program not only provides coverage for pharmaceuticals, but also includes crucial ongoing care management. Other benefits of the innovative Specialty Pharmacy Protection program include:

• 
  
• Effective formulary and plan designs that cover the majority of disease states
• 
  
• Clinically appropriate access to high quality care for employees
• 
  
• Progressive Utilization Management maintains appropriate dosing measures, thereby reducing waste and preventing misuse
• 
  
• Competitive differentials in the marketplace for medication costs and therapy administration costs
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“AmWINS Specialty Pharmacy Protection is the first of its kind in the industry and the solution to meet the demands of the rapidly changing pharmaceutical industry,” said Fleet. “Specialty prescriptions may have a low incidence of claims, but can be financially devastating for a company. With Specialty Pharmacy Protection, companies can now be confident that their health plans are protected in the face of catastrophic claims.”

AmWINS Group Benefits’ Specialty Pharmacy Protection is now available for self-funded health insurance plans in 38 states. For more information on Specialty Pharmacy, visit groupbenefits.amwins.com.

About AmWINS Group Benefits
AmWINS Group Benefits is a leading wholesale broker of comprehensive group insurance programs and administrative services. Working with benefit brokers and consultants, AmWINS Group Benefits designs, distributes and administers customized health benefit products and services for retired and active populations in private and public organizations. Its parent company, AmWINS Group, Inc. is the second largest insurance wholesalers in the United States. AmWINS Group Benefits is headquartered in Warwick, RI. More information about AmWINS Group Benefits is available at groupbenefits.amwins.com.


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Warwick, RI – A new dialysis management product is now available for brokers to offer their self-funded clients to help save their customers money and ease the stop-loss renewal process. AmWINS Group Benefits, a leading wholesale distributor of employee benefits and professional services, today announced the launch of Dialysis Management Solution™ (DMS). The program offers multiple techniques and re-pricing options to help control costs and meet employers’ most difficult dialysis claim situations.

Health insurance providers have increased their charges for dialysis claims by more than 65 percent over the last five years. Currently there are more than 27 million people with Chronic Kidney Disease nationwide, with over half a million with End Stage Renal Disease requiring dialysis or a kidney transplant to survive. More than 354,000 people receive dialysis treatments at least three times per week, and unmanaged dialysis claims can cost employers more than $50,000 a month for a single claimant.

Dialysis Management Solutions utilizes regional pricing data and a proprietary re-pricing methodology to adjust dialysis claims, reducing direct costs and, in turn allowing for more favorable stop-loss renewal terms. DMS clients are currently saving an average over 50 percent of billed charges. The product serves as a new solution for brokers with self-funded clients, as it gives them with more choices at stop-loss renewal time, whether it means reduced direct costs via lower premiums, or reduced soft costs via elimination or reduction of lasers.

“Dialysis Management Solutions uses one of the most sophisticated and accurate tools available for re-pricing – our savings stick,” said Samuel H. Fleet, president of AmWINS Group Benefits. “This program yields savings averaging more than 50 percent of billed charges. Our fees are based on a percentage of savings, so we don’t get paid unless the employer saves.”

AmWINS Group Benefits’ Dialysis Management Solutions is now available for any self-funded health insurance plan, whether a dialysis situation exists or not. All self-funded plans can benefit from implementing such a program as a proactive measure.

“It’s easy to implement, saves money and employees see no difference in care,” Fleet added. “Plus, DMS is a sure-fire solution that will allow brokers with self-funded clients to truly differentiate themselves from their competitors.”

For more information on Dialysis Management Solutions, visit dms.amwins.com or for

About AmWINS Group Benefits
AmWINS Group Benefits is a leading wholesale broker of comprehensive group insurance programs and administrative services. Working with benefit brokers and consultants, AmWINS Group Benefits designs, distributes and administers customized health benefit products and services for retired and active populations in private and public organizations. Its parent company, AmWINS Group, Inc. is the second largest insurance wholesalers in the United States. AmWINS Group Benefits is headquartered in Warwick, RI. More information about AmWINS Group Benefits is available at groupbenefits.amwins.com.


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October 14, 2009 – Warwick, RI – What Congress is doing about the healthcare dilemma that is currently facing them is flat-out wrong, according to Samuel H. Fleet, President of AmWINS Group Benefits. Not one of the bills being considered focuses on breaking the stranglehold the BUCA monopoly – Blue Cross/Blue Shield for profit plans, United Healthcare, CIGNA and Aetna – has on the health insurance market. In Fact, Fleet insists that many of the provisions of the health care reform bills will actually make the monopolies more powerful.

Today, Fleet released his second health care reform position paper, “Time to Stop Playing Monopoly with Health Insurance,” which proposes two key solutions that will help restore competition and allow smaller health plans to have new opportunities and thrive in the health insurance market.

Fleet compares the health care reform debate with two familiar examples: phone calls and razor blades. He draws a strong comparison between the BUCA monopoly with the 1983 breakup of AT&T, a regulated monopoly that the federal government encouraged for decades as a way to build a nationwide network of phone lines. Fleet believes that just like AT&T, the BUCA monopoly is growing so large that the initial benefits provided are now being overtaken by their ability to operate like an oligopoly.

“They are able to hold service providers hostage to lower and lower reimbursement rates, they generate larger and larger profits for themselves that are not passed on to consumers, and they protect turf by blocking entry for smaller firms,” says Fleet.

Fleet suggests the reason BUCA customers put up with this pattern is because the “razor” is cheap and no one pays attention to the cost of replacement blades. From a healthcare standpoint, Fleet explains that the BUCA promise very high discounts on the cost of healthcare procedures, but then charges very high rates for the administration of these plans.

Following are Fleets solutions to break up the monopoly power of the BUCAs:

➢    Apply the anti-trust Robinson-Patman Act to smaller service providers – This law protects small retailers from being forced out of the market by large stores that can demand special pricing from suppliers. Similarly, an amendment to include service providers will protect these smaller health plans by eliminating the ability of BUCA insurers to control the health insurance marketplace.

➢    Set procedure reimbursement rates at a fair cost – By doing so, dozens of companies stifled by the big health insurance monopolies can innovate, excel and compete to lower the cost of administering health insurance benefits.

“Ultimately, health care reform should be about affordability and accessibility,” says Fleet. Instead, Fleet suggests that instead of focusing on the rising cost of health care and its causes, politicians have chosen to focus on insurance reforms thus treating the symptoms of the illness and not the cure a for the disease.

For the complete white paper, “Time to Stop Playing Monopoly with Health Insurance,” please visit www.amwinspresskit.com or to speak with Samuel Fleet directly, contact Kristen Jones at (410) 821-8220.

About AmWINS Group Benefits
AmWINS Group Benefits is a leading wholesale broker of comprehensive group insurance programs and administrative services. Working with benefit brokers and consultants, AmWINS Group Benefits designs, distributes and administers customized health benefit products and services for retired and active populations in private and public organizations. Its parent company, AmWINS Group, Inc. is the second largest insurance wholesalers in the United States. AmWINS Group Benefits is headquartered in Warwick, RI. More information about AmWINS Group Benefits is available at www.groupbenefits.amwins.com.

July 7, 2009 – Warwick, RI – The fever for healthcare reform is running high in Washington, D.C., and politicians are lining up on both sides to offer “treatment plans," says Samuel H. Fleet, president and CEO of AmWINS Group Benefits. He adds, “But policy makers are missing many of the key opportunities to address what is really broken about the system.”

Today, Fleet released a healthcare reform position paper, “ The Six Ways to Fix Our Healthcare System,” www.amwinspresskit.com, which chronicles the main issues that should be clearly addressed for healthcare reform to truly make a difference.

Summary includes:

1. Restore Competition in the Marketplace
The four largest carriers in the country have 99% of providers in the network and in most states, the #1 carrier has 60-70% market share. Fleet comments that “in any other industry, this would raise antitrust issues, but for healthcare, no one seems concerned.” His solutions – break up the BUCA monopoly (Blue Cross Blue Shield, United Healthcare, CIGNA and Aetna) and restore competition to the marketplace.

2. Enable the American Consumer to Become an Astute Buyer of Quality Healthcare
Fleet insists that the key to cost control is to bring transparency to pricing. For example, a California patient who needs a chest X-ray is charged anywhere from $120 to $1,519; in fact within a few blocks in Sacramento the price climbs from $451 to $790 from one hospital to the next. The solution – every provider must disclose the net prices that they charge and consumers need to know how to find high-quality care.

3. Eliminate Hidden Revenue Streams
Fleet says to do away with fragmentation in the healthcare delivery system, and instead, all Pharmacy Benefit Managers must fully disclose all sources of revenue or profit, block doctors from owning the diagnostic machines they refer their patients to, ban trips, money and other incentives from drug companies to doctors and force hospitals to disclose profitability and markup to implant devices.

4. Our Health – NOT Healthcare – Crisis
“The nation is hysterical over 18,000 cases of Swine Flu, yet we have 100 million obese people in this country,” said Fleet. He contends that the current administration should create an aggressive public campaign to promote a healthy lifestyle, restore funding for physical education in schools, as well as institute the use of prevention-based healthcare.

5. Facilitate Administrative Efficiency
Real savings can be realized by ensuring that the government define a standard for claims submissions between providers and payors, drive a set of rules for dealing with pended claims that makes sense, among others.

6. Protect the Risk Pool
Finally, Fleet insists that the only way to make universal coverage work is to make sure it’s universal. The first step – mandate that all employers offer insurance or force them to contribute to a government fund. In addition, Fleet asserts that, “we need to limit coverage to basic minimums set nationally,” and to ensure that everyone can afford coverage, we should require carriers to pool risk above a certain amount per claimant.

For “The Six Ways to Fix Our Healthcare System,” please visit www.amwinspresskit.com or to speak with Samuel Fleet directly, please contact Kristen Jones at (410) 821-8220.

March 17, 2009 – Warwick, RI – Employees working in the health care industry, including those in hospitals, nursing homes and assisted living facilities now have more inexpensive options for health insurance. Recognizing that employers are struggling to provide major medical coverage due to escalating healthcare costs, AmWINS Group Benefits has extended its HealthWINS™ Limited Medical plan to workers in the health industry.

“An overwhelming percentage of people in this industry would benefit from less insurance at a lower cost,” said Sam Fleet, AmWINS Group Benefits President & CEO. “We have carefully designed a variety of limited medical plans specifically for the health care industry, which allow brokers and benefit consultants to package limited medical with a major medical plan or choose to custom design a plan to best fit their clients needs.”

Statistics show that 8 percent of workers covered by a employer-based health plan will have no claims at all, while 85% will have claims of less than $5,000. HealthWINS is designed to cover the bill for 97% of Americans’ annual health care needs at a fraction of the cost of a comprehensive major medical plan.

HealthWINS provides basic health coverage for physician visits, prescription drugs, inpatient services and preventive care. The plan charges a comparably low deductible to cover a portion of the first $20,000 to $30,000 of health care expenses, so that a low-wage worker can adopt a wellness approach to health care that is unavailable in today’s mini-medical plans.

HealthWINS gives companies providing major medical options for extending waiting periods, classing out entry level employees, providing benefits for part-time, hourly or seasonal workers.

“Rather than fall off or forfeit a plan, employers can now carve appropriate employees out of major medical and provide robust limited medical,” Fleet said. “For example, nursing home management would be offered major medical, while the rest of the staff can have a limited medical plan. It’s cost effective, especially for part-time, low-wage, and high turnover employees.”

In addition to HealthWINS limited medical benefits, there are products and services that can be added to AmWINS Group Benefit plans to make the benefits richer and of more value to employees, including prescription benefits, doctor visits over the phone, PPO networks and health advocacy.

“Employees in the heath care industry especially, need preventative medical care with affordable deductibles,” Fleet added. “It’s perfect for clients with a large number of hourly workers covered by low benefit mini-medical plans and those who elect no coverage at all.”

AmWINS Group Benefits’ program management capabilities include administrative excellence in fulfillment, billing accuracy and claims payment. By using advanced technology and deep expertise, AmWINS Group Benefits can deliver seamless, end-to-end services that keep all of the different functionalities in one center of responsibility and accountability.

About AmWINS Group Benefits
AmWINS Group Benefits is a leading wholesale broker of comprehensive group insurance programs and administrative services. Working with benefit brokers and consultants, AmWINS Group Benefits designs, distributes and administers customized health benefit products and services for retired and active populations in private and public organizations. Its parent company, AmWINS Group, is one of the largest independent insurance wholesaler in the United States. AmWINS Group Benefits is headquartered in Warwick, RI. More information about AmWINS Group Benefits is available at www.group.benefits.amwins.com.

Charlotte, N.C. – AmWINS Group, Inc. today announced the acquisition of three medical stop loss wholesalers - American Stop Loss Insurance Brokerage Services (“ASL”), Health Benefit Solutions Insurance (“HBS”) and National Insurance Wholesalers (“NIW”). The acquisition and concurrent merger of these three entities creates the nation’s largest wholesale broker of medical stop loss insurance. Terms of the transaction were not disclosed.

"Diversification is key to our company’s strategy and continued growth,” said M. Steven DeCarlo, CEO of AmWINS Group. “This acquisition not only complements our existing benefit product capabilities, but also allows us to strategically expand our products and services to a broader network of retail customers and markets."

The entities are located in three geographically diverse regions of the country with ASL in Worcester, MA; HBS in Benicia, CA and NIW in Houston, TX. The current management teams of each entity will continue to lead the day-to-day activities for their respective company – Gerry Gates and Walter Coolidge for ASL, Rebecca Bocek for HBS and Elizabeth Ogletree for NIW. Mark McGuire, the founder of NIW, will lead the combined operations going forward.

“Gerry, Walter, Rebecca, Elizabeth and I are excited to join the AmWINS family. As a combined entity, we have become the largest medical stop loss wholesaler in the country which we believe will create value for our retail producers, markets and the ultimate insurance buyer,” said Mark McGuire, President of National Insurance Wholesalers.

“Our division’s focus is to work directly with brokers, consultants and TPAs on a national level,” said Samuel H. Fleet, President and CEO of AmWINS Group Benefits. “This added stop loss expertise enables our Group Benefits Division to provide our customers with customized solutions and an increased level of service.”

About AmWINS Group, Inc.
AmWINS Group, Inc. (www.amwins.com) is a wholesale distributor of specialty insurance products dedicated to serving retail agents throughout the United States by providing property and casualty, group life and health, and program administration services. Based in Charlotte, NC, the company operates through more than 35 offices across the United States and handles premium placements in excess of $3.3 billion dollars annually.

October 28, 2008 – Warwick, RI – Responding to growing unemployment and the prospect of increased dislocation, AmWINS Group Benefits announces an expansion of its niche medical health plan offerings today with the launch of AmWINS BridgeCare. The product provides immediate short-term medical coverage for the newly unemployed and others in between coverage.

With the distress in the investment banking industry and the looming credit crisis, the number of unemployed Americans has increased by 2.2 million over the past 12 months1 – increasing the number of uninsured persons in the process. AmWINS Group Benefits, a leading distributor of wholesale retiree and employee health benefits and professional services, now provides a cost-effective alternative to temporary major medical coverage, such as COBRA, where the cost may be beyond the means of many.

AmWINS BridgeCare coverage is available for individuals under age 65, and their families, in need of medical insurance for a one-twelve month period (depending on state mandates). Others who can benefit from this new offering include new employees in a waiting period for their health insurance to begin, recent college graduates leaving their parents health plans, hourly wage earners not eligible for employer provided coverage, and seasonal workers.

“The credit crisis is taking jobs and its taking people’s health insurance,” said Sam Fleet, AmWINS Group Benefits President and CEO. “And more employers are cutting expenses by extending waiting periods for insurance to kick in from 30-90 days leaving even more Americans in health coverage limbo, ” Fleet added.

AmWINS BridgeCare is underwritten by Companion Life and administered by AmWINS Group Benefits, allowing individuals, businesses and brokers to leverage state-of-the-art administration and online enrollment services. Applicants can quickly apply online and have coverage issued as early as the next day.

AmWINS BridgeCare medical coverage includes:

• $2 million lifetime maximum coverage
• In-hospital and out-patient benefits
• Urgent care services
• Surgery in a hospital or ambulatory surgical center
• Intensive care
• X-ray and laboratory services
• Ambulance services
• 10 day “Free Look” period
• Generic prescription discount card

Short term medical does not cover all medical conditions including pre-existing conditions. Among the disqualifying conditions are cancer, pregnancy and heart disease.

1 Bureau of Labor Statistics of the U.S. Department of Labor

May 28, 2008 – Hot Springs, VA – The employee benefit market is undergoing a total transformation, as prospecting is more difficult, products are commoditizing, commissions are being cut, and additional competition from non-traditional sources is having a significant impact on business. Before an audience of top benefits professionals and insurance carriers, Samuel Fleet, CEO, AmWINS Group Benefits, today gave brokers the stark choice to either adapt to marketplace changes or become extinct.

Speaking at the Council of Insurance Agents and Brokers’ Employee Benefits Leadership Forum, Fleet said agents and brokers “must make a radical break with the past and reinvent how they sell employee benefits.”

He stated the key is to seek hot opportunities apart from the standard and bring fresh thinking and new innovative product offerings to customers.

“One of the best opportunities for brokers is where employers need to cut or drastically reduce retiree health programs. Look for businesses with a non-traditional workforce, government retirees, the daunting market of pre-65 retirees, and non-profit organizations,” Fleet said.

“A second opportunity is with today’s rapidly rising healthcare costs, many companies are finding that traditional, first-class health plans are beyond their budgets,” said Fleet. “That leaves them muddling through options that are too costly and impractical for their business.”

Fleet recommended several solutions when working with companies to help define the employee health insurance options and identify the best choices to help grow their business and deepen customer partnerships. He referenced expense incurred limited medical plans, as a good example, as these look much like the traditional health care plans workers are accustom to. “And with fewer dollars they will meet the diverse needs of almost all workers,” he said.

“Continued focus on cost savings will open the door to more opportunities and help position you [the broker] as a savvy consultant,” urged Fleet.

He suggested that agents recommend pharmacy and medical audits to both existing and potential customers. This value-added service will help them demonstrate their involvement in managing healthcare vendor relationships and help client meet requirements like the reviews mandated by Medicare Part D and ERISA plans.

“Offering an audit also helps your own book of business,” said Fleet. “You’ll demonstrate your ability to keep health premiums at a manageable level, which will entice new customers. It also provides an opportunity to cross-sell, offering alternative services and products.”

Fleet also expressed that availability of healthcare coverage for individuals not yet eligible for
Medicare is becoming increasingly elusive. Because the individual insurance marketplace is especially unfriendly to a group that may have more frequent and chronic health issues, Fleet encouraged brokers to jump on the opportunity to help bring products and solutions to those in pre-65 individual marketplace.

He also declared retiree health care as one of the profoundest issues facing the United States,
threatening employees and retirees with the loss of health coverage and putting employers in the unenviable position of cutting health benefits for workers and retirees.

“The number of employers looking for an exit strategy is staggering,” said Fleet. “One third of large employers are still offering retiree medical coverage, but that is down from 66 percent less than 10 years ago.”

Fleet recommended several solutions when working with employers trying to relieve themselves of the burden from retiree health business. They can terminate the plan and do nothing for their employees; increase the retiree contribution to the plan to 100 percent; establish a trust account known as a Voluntary Employee Benefit Association (VEBA) funded by cash or annuity; or set up a “notional” account so retirees can use an allotted amount of money for a range of care options they choose.

“Working with companies that want out of the retiree medical business to avoid leaving retirees on their own can instead create a group program that is more stable, less confusing and more flexible for its former employees.”

Fleet explained that for non-profits and other companies, a retiree prescription drug plan (PDP) around an existing benefit program or moving from a self-funded to an insured plan is a better idea.

Fleet also said that public employers are in the final year of phased reporting requirements under federal accounting rules, know as GASB 45. Cities, counties, school boards and others must account for their retiree health obligations or risk degrading bond ratings and the ability to borrow money for capital improvements.

May 1, 2008 – Charlotte, N.C.-based AmWINS Group Inc. acquired Beacon Risk Strategies, a Seattle-based managing general underwriter of excess-loss benefits insurance. Terms of the transaction were not disclosed.

Founded in 1999, Beacon Risk Strategies provides customized products and services to protect companies and their health plans from unexpected catastrophic claims. Beacon represents several carriers and can offer products in all 50 states, which enables the company to provide tailored packages to Blue Cross/Blue Shield plan markets and large self-funded employers.

"Beacon's stop-loss capabilities represent a new product offering for our company and will strongly complement our existing capabilities," Steven DeCarlo, AmWINS Group's CEO.

"Joining AmWINS makes terrific sense," said Wright Dickinson, Beacon Risk Strategies' president. "Combining our underwriting expertise and long-standing carrier relationships with AmWINS' national retail client network and existing product solutions allows us to instantly build new relationships and bring new services to our existing customers."

AmWINS (www.amwins.com) is a wholesale distributor of specialty insurance products dedicated to serving retail agents throughout the United States by providing property and casualty, group life and health, and program administration services. Based in Charlotte, NC, the company operates through more than 35 offices across the United States and handles premium placements in excess of $3.3 billion dollars annually.

Warwick, RI – AmWINS Group Benefits, responding to costly and rampant inaccuracies in claims processing, is today announcing a new tool to protect businesses from the reporting errors that drive up the price of health care for them and their employees. AmWINS Group Benefits, a leading distributor of wholesale retiree and employee health benefits and professional services, today launched AmWINS Benefit Watch™. The software-based tool audits prescription, medical and dental claims, to ensure that anything a managed care organization or TPA is charging a client is accurate and ordinary.

Millions of consumer dollars are wasted each year due to erroneous health care claims, a result of faulty IT systems, human error or premium benefit rules. Auditors have found that 3 to 5 percent of pharmacy benefit manager claims are processed incorrectly.

The implementation of an auditing process detects reporting errors and irregularities and ultimately stops the bleeding of dollars spent to cover exaggerated health care benefits. A thorough pharmacy audit program, such as AmWINS Benefit Watch™, will identify the plausible issue, support the refund negotiation process and assist in preventing future mistakes.

“Drug costs are increasing in double digits annually and are one of the fastest growing components of rising health care costs. Steps must be taken to control costs and preserve quality,” said Sam Fleet, AmWINS Group Benefits President and CEO. “Companies should start recognizing the value pharmacy audits bring to both the cost and quality of pharmacy benefits,” Fleet added.

While 80 percent of health care spending is in the area of medical services, some experts attribute a significant part of that to erroneous medical claims. Claims trends over the last decade have brought about new issues. Some are a function of the claims process, while others are related to trends in the delivery of health care.

“Recent flaws in reporting benefits have gained a lot of attention,” said Mark Lawlor, AmWINS Group Benefits Vice President. “Our goal is to prevent situations where the late payment by carriers results in physician re-submitted claims that become duplicate paid claim errors.

Lawlor added that, “our goal is to prevent the financial cataclysm of one patient having six colonoscopies in one week; which was really one colonoscopy and five consulting opinions.” AmWINS Benefit Watch™ is designed to prevent errors and irregularities and help companies get their money back when mistakes are made.

Benefit Watch™ prevents errors by conducting medical reviews for, among other things, duplicates and overpayments. Unlike many other pharmacy review services, the complete AmWINS Benefit Watch™ package also covers many categories of pharmacy review including pricing review, co-payment review, eligibility review, excess daily use review, and exclusions review.

AmWINS Benefit Watch™ examines critical aspects of health benefits to determine if:
•    All claims are being processed correctly according to contract and benefit terms
•    All fees are being charged correctly
•    Any claims appear irregular and heed further investigation


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September 10, 2007 Warwick, RI – AmWINS Group Benefits Division, one of the nation’s leading distributors of wholesale retiree and employee health benefits and professional services, announced today that it has acquired Carolina Benefits Association, a leading third party insurance and financial services administrator for employers, individuals, associations and businesses. The final terms of the acquisition were not disclosed.

“The addition of Carolina Benefits is in line with our overall strategy to expand and diversify our portfolio of product offerings and expertise for our customers,” said Sam Fleet, AmWINS Group Benefits Division President & CEO. “There already existed a natural synergy between the two companies and our new partnership will result in new products and increased solutions for a larger client base. This is not a case of opposites attracting. This is a very idealistic partnership.”

Carolina Benefits, based in Charlotte, N.C., is co-founded by Tim Vliet and Daryl Chapman. With over 25 years experience in the insurance industry, the owners fully understand the importance of providing high quality, effective, long-term health benefits to companies and individuals.

Throughout his career, Vliet worked with the Prudential Insurance Company and The Hartford, where he specialized in providing retiree life and disability benefits for the large and diverse customer bases of those two companies.

“We look forward to the possibilities and solutions this partnership offers in terms of meeting the needs of our clients and developing new products to meet changing needs of an ever-evolving market,” said Vliet. “We’re excited to be joining the AmWINS team to roll out a series of new, innovative custom products for a number of untapped markets.”

Chapman has held a myriad of positions during his 12-year career in the financial services industry, at companies including Marsh Inc., where he ran the third party administrative division. There he had profit and loss responsibility for a 500 person, $50 million, four site administrative unit. That unit provided health care administration and contracting for almost a million members in a combination of HMO, PPO and traditional fee for service settings.


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Warwick, RI – Navigating the maze of health care claims, network referrals and deductibles requires specialized training and often leaves employees, their families and human resources experts feeling ill. AmWINS Group Benefits, a leading distributor of wholesale retiree and employee group health benefits and professional services, today launches a Member Advocacy Program to supplement other health insurance plans.

The new program is designed to handle the sometimes overwhelming paperwork and processes resulting from health care claims. The Member Advocacy Program provides individuals and their families with a personal advocate team to coordinate, research and support their needs.

The Member Advocacy Program has three significant features, which include:
•    Member Advocacy: Provides support in situations when insurance companies or plan administrators are unable to resolve issues on behalf of the employees or their dependents
•    Member Outreach: Proactive outreach is made to members that have multiple health care claims or continuous contact with the insurance companies or health plan administrators
•    Benefit Exception Determination: Within defined limits and coverages, the Member Advocacy Program determines benefit exceptions and/or benefit determinations when the plan documents fail to provide clarity or when acting in the best interests of the plan or member. Additionally, the program ensures uniformity in the application of future benefit administration

“Ill employees, their families and their employers should be concerned with feeling better, rather than serving as the middle-man with their health insurance company,” said Sam Fleet, AmWINS Group Benefits President & CEO. “It’s in everyone’s best interest to have a specially-trained expert in their corner to settle claims and keep the paperwork moving.”

Employers who leverage the Member Advocacy Program will benefit by:
•    Minimizing or eliminating exposure to HIPAA related privacy issues
•    Achieving quick resolution of complex/complicated health care claims
•    Realizing real cost and time savings as both employee claimants and human resources personnel are relieved of managing the health care claimssettlement process
•    Maximizing the effectiveness of health insurance plans by analyzing issues and reports provided by program
•    Enhancing the quality of care provided to employees

“Member Advocacy Program advocates must meet specific criteria, including at least a decade of specialized training on how to mediate claims and advocate for patients,” said Mike McCabe, President of WEB-TPA, an operating company within AmWINS Group Benefits. “Who wouldn’t want the best in the industry serving as their guardian angel of health care? These days, we could all use one.”


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Warwick, RI – Designed to address the unique needs of multinational institutions with overseas workforces, AmWINS Group Benefits, a leading distributor of wholesale retiree and employee health benefits and professional services, today launches an international medical plan that helps to protect the health of employees while managing benefit costs for employers. The new plan is called No Borders™.

No Borders™ would provide quality care and peace of mind for the four million expatriate Americans while alleviating time-consuming administration and complex care coordination for employers. Plus, AmWINS Group Benefits includes a patient advocacy service to help patients secure second opinions 24/7 on medical decisions and diagnoses.

“What No Borders means to the huge population of expats is, no loopholes. Workers don’t need to get sick with worry that their health insurance will run out while living in Baghdad or Beijing or Bangalore,” said Sam Fleet, AmWINS Group Benefits President & CEO. “No Borders is worry-free, American-style health care with essential add-ons built specifically for the expatriate community,” Fleet added.

No Borders policy holders would also be entitled to:
•    Multilingual call center: In partnership with WorldWide Assist, the policy provides multilingual call services speaking 27 languages, manages all monetary exchanges on claim dollars, utilizing 400,000 providers worldwide
•    Evacuation services are covered in premium, unlike competitor offerings: Includes first class commercial airline transport with room for doctor/nurse “ride along”
•    Financial strength: Underwritten by Lloyd’s of London
•    Technological advances: Offers Web enabled pandemic and security warnings, online “chats” with doctors, online medical resources, optional ID theft services

The new international medical product is being marketed to brokers and benefit consultants whose clients include defense contractors, pharmaceutical companies and non-governmental organizations with substantial overseas workforces. No Borders can also be customized to provide protection for much smaller companies.


“Lots of companies will offer to evac a patient thousands of miles to a preferred hospital. And then they’ll stick them with a bill that will really make them sick,” said Fleet. “The value of the No Borders’ PPO network is that we’ll find the best hospital and doctors in close proximity to the patient to minimize stress and unnecessary costs.”


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July 30, 2007 – Warwick, RI and Stowe, VT – At a time when association membership is on the decline, Samuel Fleet, CEO, AmWINS Group Benefits, today warned practitioners of affinity group marketing to drastically modify their strategy or face extinction.
“We have been and continue to cannibalize each other,” Fleet said on July 27, at the Professional Insurance Marketing Association’s (PIMA) 2007 Summer Conference in Stowe, Vermont. He suggested that attendees instead create opportunities by developing niche products and apply their core expertise to new markets.
“Wake up and smell the coffee: Ozzie and Harriett-era insurance marketing is a dead-end when the prospects we target today gather in Google Groups or on MySpace pages,” Fleet added.
Fleet’s “state-of-the-state,” of traditional association programs (professional societies and trade associations) describes declining membership, demographic changes, commoditization of core products, and a mature market. Plus, increased competition from dot-com insurance sites and carrier direct selling puts added pressure on TPA business.
Fleet suggests that the argument to declining association membership can be countered by the fact that they have only changed in nature, style, and substance. There are people joining groups and participating in a different way than in the past. These changes are coming from the younger generations and immigrant populations, which do not see a welcome mat from traditional American associations, so they form their own affinity groups.
Fleet said to the PIMA conference that in order to create sustainable growth opportunities, TPAs and carriers must look to these other affinity groups, develop new products and redesigned marketing initiatives. He also suggests carriers practice group underwriting, take risks on new ideas and offer flexibility in delivery.
Some of the market opportunities include banks and credit unions, employers, even online communities, such as Yahoo! or Facebook groups. Fleet said, “it’s up to us to reinvent the affinity group wheel and create marketing opportunities as the nature of affinity groups have changed. We need to market to more diverse niches, such as cultural groups and community associations, and we should be targeting dog lovers and wine collectors.”
“There is little or no appreciation for the fact that taking over a block of mature business provides for short term gain, but that strategy sacrifices long term success. As industry leaders it should be our mission to create real sustainable growth opportunities,” Fleet added.
AmWINS Group Benefits, formerly known as NEBCO, has developed numerous new market opportunities since its inception in 1994. For example, it pivoted on 1996 FASB requirements by looking at retirees as an affinity group, developed an employer PDP in response to the Medicare-D prescription drug law and developed a new limited medical policy called HealthWINS® to target underinsured and uninsured workers. AmWINS Group Benefits has experienced six straight years of organic growth of 43%.


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July 11, 2007 – Warwick, RI – Designed to reduce the number of Americans with inadequate or non-existent health insurance, AmWINS Group Benefits, a leading distributor of wholesale retiree and employee health benefits and professional services, today launches the first affordable limited medical plan for low-wage workers. The new plan is called HealthWINS™.

HealthWINS™ provides basic health coverage for physician visits, prescription drugs, inpatient services and preventive care with an option to purchase catastrophic coverage. Plus, AmWINS Group Benefits includes a patient advocacy service to help workers negotiate better rates with hospitals.

The new limited medical plan is being marketed to brokers and benefit consultants whose clients include retailers, restaurants and other groups with large numbers of hourly workers covered by low benefit mini-medical plans and those who elect no coverage at all. HealthWINS™ is also an ideal option for early retirees and employer-based associations, which are also faced with the choice of partial or no healthcare.

“HealthWINS™ is a first line of health care defense for chain restaurants, big box stores and Mom & Pops,” said Sam Fleet, AmWINS Group Benefits President & CEO. “For other types of employers, all that high deductible and Consumer Driven Health plans accomplish is the health care equivalent of rearranging the deck chairs on the Titanic. By shifting costs from premium dollars to deductibles doesn’t help workers get affordable health care.”

HealthWINS™ is being introduced at a time when there are 47 million Americans with no coverage at all and when 50% of Americans spend a marginal amount, less than $1,000 per year, on medical expenses; 85% spends less than $5,000. Like their predecessor Major Medical Plans of the 1960s, AmWINS Group Benefits limited medical plan covers charges a comparably low deductible to cover a portion of the first $20,000 to $30,000 of health care expenses, so that a low-wage worker can adopt a wellness approach to health care that is unavailable in today’s mini-medical plans.

HealthWINS™ also allows a worker to plan for the worst by offering a catastrophic coverage “wrap,” that is similar to the Major Medical Excess plans that were prevalent in decades past.

Catastrophic coverage incorporates higher deductibles ($50,000 to $250,000) that are separate from deductibles for hospital days, prescriptions, and more. These can coordinate with the underlying limited medical plan and participants can pay varying amounts above the attachment point.

“Our aim with HealthWINS™ is simple: we want workers to have a health plan that offers real, preventive medical care with affordable deductibles, coverage for expensive emergencies and coupled with an advocacy program for members assistance.” Fleet said.


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June 18, 2007 – Warwick, RI – National Employee Benefit Companies, Inc. (NEBCO), a leading wholesale broker of comprehensive group insurance programs and administrative services, announced today that it is re-branding all operating companies under the division name AmWINS Group Benefits. The change comes as a result of a greatly expanded suite of products, exponential revenue growth and the new name and brand icon adopted by its parent company, AmWINS Group, Inc.

“The company has evolved tremendously over the past few years,” said Sam Fleet, AmWINS Group Benefits President & CEO. “We’ve brought several key capabilities in-house through mergers and acquisitions, added key staff and are launching exciting new products. Our name is more reflective of who we are, what we do and what we plan to be. Our new brand icon is a representation of our company’s commitment to providing a better way.”

In the past year, AmWINS Group Benefits has tripled its business and now administers over 380,000 lives. This year, the company plans to unveil a variety of new products and services that are unique to the market.

AmWINS Group Benefits specializes in retiree benefits, pharmacy benefit management, third party administration, affinity group benefits programs, community-based health plans, and other programs backed by specialized customer care and administrative services. The company assists benefit brokers, companies and organizations in developing, distributing and administering a full range of insurance programs and custom services.

“Our strength is designing benefit plans that are custom-tailored to each client's unique needs,” said Fleet. “The employee benefits industry becomes more complex every day and our clients’ needs can change on a whim based on a shift in the marketplace. The new products developed are flexible in design and truly innovative, putting us at the forefront of the industry.”

During 2007, the company will roll out new advertising, web site content and sales collateral to support the new branding, featuring the tagline, “There’s a better way.” The ads will appear in trade publications nationwide, the new web site address is www.groupbenefits.amwins.com.

AmWINS Group Benefits, which includes NEBCO, as well as Web-TPA and BrokerNetUSA, is a division of AmWINS Group, Inc.

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November 1, 2006 – Arlington, VA – With big city and county governments set to report future liabilities for retiree health obligations, Samuel Fleet, CEO, National Employee Benefit Companies (NEBCO), today predicted an uncertain future for retirees.

Speaking at the Strategic Research Institute’s conference, “Medicare Part D: What is the Future?,” Fleet, said “the question is whether retiree benefits will exist after GASB.”

GASB, the Government Accounting Standards Board, requires most large public employers to reflect the future cost of health care for retirees on their current balance sheets. The first reporting for the largest entities will come in December.

“As a result of the GASB requirements, government employers need to immediately focus on several key issues. Undoubtedly many will be surprised – even shocked – by the magnitude of the liability.” For example, the Los Angeles Unified School District – the second largest school district in the United States – estimates that its unfunded liability for retiree health care is $5 billion—a figure that is roughly 80% of its entire annual budget.

Fleet explained that public employers are about to take center stage as the new GASB reporting requirements for government agencies kicks in, and billions of dollars in unfunded liabilities move from obscure footnotes to a major item on the balance sheet.

“At the same time, Medicare Part D has made prescription drug coverage a complex headache for employers. The 28 percent federal subsidy that was supposed to sweeten the pot is proving to be worth far less to public employers than they had hoped,” said Fleet. There’s no tax advantage for municipalities taking the subsidy, Fleet said.

Fleet recommended a new strategy of contracting out retiree health benefits, that converts prescription drug costs from a future liability to an annual expense, reduces administrative headaches and continues to meet the commitment made to retirees.

One course government entities may consider is to apply for a federal waiver that allows them to become a Medicare D Prescription Drug Plan (PDP) themselves. While this decision enables employers to design their own benefit packages and share the risk with the federal government, it also carries several additional burdens. These include a complicated filing process, exposure to costly federal audits and the administrative burden of tracking employees who sign up for Medicare Part D independently.

Also, states, counties and municipalities can contract with a PDP to outsource the administration of Medicare D. While this makes them ineligible for the federal subsidy and requires that they educate their retiree population about the plan they are sponsoring, the benefits include shifting the risk to the PDP and the federal government and avoiding GASB 45 implications thereby protecting credit ratings and the ability to sell bonds.


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April 24, 2006 – Charlotte, NC – American Wholesale Insurance Group (AmWINS), the nation’s second largest wholesale insurance broker, announced today that it has completed the acquisition of Irving, Texas based Web TPA, Inc., a leading third party insurance administrator focused on improving the administration process for self-funded employers and insurance companies.

“The addition of Web TPA is in keeping with our overall strategy to provide increased product offerings and expertise to our retail agency customers,” said Steven DeCarlo, AmWINS President & CEO. “The synergy that exists between Web TPA and National Employee Benefit Companies (NEBCO), an AmWINS company, will result in new product offerings and increased customer service to a larger client base.”

“We are pleased and excited to be joining the AmWINS family,” said Web TPA President & CEO Mike McCabe. “Becoming part of American Wholesale will benefit Web TPA, its employees and customers immeasurably.”

“Bringing Web TPA into American Wholesale is significant,” said Samuel Fleet, President of AmWINS Group Benefits Division. “Web TPA’s services and community based health plan products complement NEBCO’s existing offerings and provide a platform for us to build new and innovative products around. What makes the acquisition so logical is that Web TPA has the best proprietary claims-paying platform in the industry and, like NEBCO, is known for its excellent customer service.”

WEB-TPA’s proprietary iii:PUTTM system allows each client to have a HIPAA-compliant private label offering, flexible benefit plan design and selection of third party vendors, such as networks and pharmacies.

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Bucking national trends, hundreds of companies, thousands of enrollees change their current drug benefit; retirees flood call center with questions

Warwick, RI, December 20, 2005 – National Employee Benefit Companies (NEBCO) is doing the unexpected: they have enrolled over 30,000 seniors in the new Medicare Part D prescription drug plan (PDP) which becomes effective on January 1, 2006. These new customers are retirees of the more than 60 new corporate customers NEBCO has signed through its Medicare PDP solution.

This increased volume of Medicare D customers sharply contrasts with predictions that many companies would maintain the status quo, keeping their current prescription benefit and applying for the tax subsidy from the US Center for Medicare and Medicaid Services (CMS). National studies, most recently a December survey of 300 companies from the Kaiser Family Foundation, have concluded that most larger employers are opting to continue offering prescription drug coverage at least as good as the Medicare benefit which qualifies them to receive the retiree drug subsidy.

NEBCO’s experience has starkly conflicted with such national studies. They have seen a 125% increase in business over the previous year – largely as a result of its unique approach in providing retiree prescription drug solutions for companies.

Sam Fleet, President and CEO of NEBCO said, “I expect that in 2006 and 2007 we will see fewer and fewer companies sitting on the fence about Medicare D or taking the government subsidy. Simply put, businesses realize that there is a better way to provide prescription drug benefits to retirees by integrating the new drug benefit into their program.

An indicator of the benefit’s popularity with retirees is the extremely high number of inquiries NEBCO’s senior-focused Customer Care Center has received. NEBCO has averaged 2,500 calls per 12-hour day since November 1st, when the NEBCO / Sterling Life PDP was approved by CMS to market the drug plan. Calls have also gotten steadily longer, growing to an average of 46 minutes per call - twice the normal call time than an average enrollment. NEBCO expects the call volume and length to continue up to and beyond the January 1 effective date.

“The magnitude of our call center’s workload is due to continued widespread confusion and concern among seniors who are making critical decisions about how to best cover their prescription drug needs,” said Fleet. “Our Customer Care Representatives are the best in the business and are specially trained to field the volume and type of important calls they are receiving.”

Fleet added, “as enrollees become customers on January 1st, our service specialists are trained to handle a new kind of call – customers adapting to the real world conditions of their new prescription drug coverage.”

Since Medicare Part D legislation was signed into law in 2003, NEBCO has been preparing for the six month enrollment period with staff training and a custom-built, internally developed information technology system to support customer calls. NEBCO’s dedicated Customer Care Center is staffed by representatives who have completed senior sensitivity training in order to best meet the needs of an older population. Additionally, retirees and their family members have access to web sites, customized by NEBCO for their former employer, to obtain information about their individual benefit plans.

As the only national PDP offered exclusively to employer groups and unions, the NEBCO / Sterling plan provides fully integrated solutions to companies seeking to enroll retirees in Medicare D and a supplemental policy that addresses the coverage gap in the base Medicare D plan. With this integrated coverage in place, all costs are adjudicated at the point of sale, freeing members from the process of filing for reimbursement of prescription drug costs.


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“Sterling Retiree Prescription Drug Plan” is a partnership between National Employee Benefit Companies (NEBCO) and Sterling Life Insurance Company
A Prescription Drug Plan to offer coverage and administration services exclusively to employers and unions on a national level

Warwick, RI – October 4, 2005 – National Employee Benefit Companies (NEBCO), a leading employee benefit wholesale insurance brokerage firm and third-party administrator, today announced that the company, in conjunction with its associate, Sterling Life Insurance Company, has been approved by the Centers for Medicare and Medicaid Services (CMS) as a national employer Prescription Drug Plan (PDP). An agency of the federal Department of Health and Human Services, CMS administers the Medicare program. The approval enables the companies to offer prescription drug programs to Medicare recipients under the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (commonly known as Medicare Part D). Sterling Life Insurance Company will function as the insurance carrier, and NEBCO will act as the plan administrator. Together they will offer prescription drug coverage under Medicare beginning January 1, 2006. Medicare recipients may begin enrolling in the new plan on November 15, 2005.

“We are very excited to obtain approval from CMS,” said Sam Fleet, President and CEO of NEBCO. “This enables us to bring information about our specialized retiree health benefit services to employers who want to take full advantage of the new Medicare prescription drug benefit.”

Specializing in the administration of employer health plans for retirees, NEBCO offers customized PDP solutions to employers and their retirees. As such, the NEBCO / Sterling association represents a PDP to offer coverage and administration services exclusively to employers and unions on a national level.

“Sterling is pleased to be working with NEBCO, a leader in providing retiree coverage”, says Debbie Ahl, CEO and President of Sterling. “Offering tailor made PDP coverage, complements Sterling’s other programs designed for employer retirees.”

In addition, NEBCO through its insurance partners have supplemental programs that employers may adopt to integrate with “Sterling Retiree Prescription Drug Plan” to provide seamless program and claims adjudication. CMS recently stated that working with a PDP that provides both base prescription drug coverage under Medicare D coupled with a supplement allows plan sponsors to achieve significant savings due to Medicare being the primary payor.

Outsourcing the administration of Medicare D and a supplement carries with it the potential for significant savings not only because Medicare is the primary payor, but because much of the risk is shifted to the PDP. Removing the administrative burden associated with retiree health benefits can significantly reduce employer costs. Additionally, segregating retiree health insurance into a third party insured plan enables companies to manage these commitments, and provide a tool to reduce balance sheet liabilities.


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WARWICK, R.I. March 3, 2005 – National Employee Benefit Companies (NEBCO) has formed a new group trust designed to help government agencies contain and better manage the skyrocketing cost of medical benefits.

NEBCO’s Government Agency Retiree Insurance Trust (GARIT) is a solution for public sector employers who are succumbing to the healthcare and prescription drug cost squeeze as more of their employees retire, said Sam Fleet, president of NEBCO, one of the nation’s leading wholesale retiree benefit administrators. Historically, both private and public sector employers have used their active employees’ lower costs to subsidize the higher costs of retirees’ medical benefits. In a time of double digit rate increases and decreasing benefits, this is no longer feasible.

“Runaway retiree medical benefits represent a financial time bomb for all government agencies and especially smaller ones,” said Fleet. “As baby boomers head into retirement, the financial burden on public sector employers is only going to get worse.”

By insuring retirees in a separate trust, NEBCO is able to pool retirees with a larger population, thus spreading the risk and stabilizing premium increases. Without the higher risk factors and higher claim levels typical of retirees, costs for active employees drop.

“Public employees in California and other states now have a new option for retiree healthcare that offers complete freedom from carrier networks,” said Bob Luthi, NEBCO regional vice president. “NEBCO’s systems are able to use any licensed providers in the country as long as Medicare is accepted. This gives retirees greater choice and greater control in meeting their healthcare needs. Additionally, participants don’t have to submit Medicare claims data and wait for reimbursement from an insurer, a process that often takes weeks”

Additionally, the trust can serve as a powerful tool for reducing legacy liability under new accounting rules put in place by the Governmental Accounting Standards Board (GASB), Fleet said. The trust also offers a way to develop a defined contribution plan that caps costs and allows for better strategic planning and stewardship of taxpayer dollars. In addition to offering this insurance solution designed to address the costs and administration of retiree healthcare, NEBCO is poised to help government agencies navigate through the challenges and opportunities presented by the Medicare Modernization Act.


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March 11, 2004 — WARWICK, R.I. - National Employee Benefit Companies (NEBCO), a leading employee benefit wholesale brokerage firm and third-party administrator, today announced the creation of IdealScripts, a Pharmacy Benefits Management (PBM) division.

Through IdealScripts, NEBCO will directly assist its customers in securing discounts from drug manufacturers and retail pharmacies, rather than relying on outsourced PBM vendors. As a PBM, IdealScripts will provide administrative pharmacy services and customer service to thousands of existing NEBCO customers, while also expanding pharmacy benefits for existing clients who do not already receive administrative services from NEBCO. IdealScripts services include, but are not limited to, claims adjudication, customer service, national pharmacy networks, preferred drug lists, mail order services, clinical services, online reporting, querying capabilities and internet pharmacy services.

“IdealScripts is a progressive PBM that provides personal first-class service and cost saving measures at fair and reasonable administrative fees,” said Samuel H. Fleet, President and CEO of NEBCO. “In this time of PBM scrutiny and acquisitions, it is critical for employers and other organizations to align with a company that offers strength and security. NEBCO and IdealScripts share the same management, commitment to quality and customer service, along with programs that are focused on the lowest net dollar amount for prescriptions while providing full disclosure, and quality of care.”

Fleet called IdealScripts a natural fit for NEBCO, given the company’s history of client-driven service. “Our strength is designing benefit plans that are custom-tailored to each client's unique circumstance,” Fleet said. “IdealScripts is committed to identifying the trends affecting costs and quality of care, and devising and implementing predictive modeling, and workable recommendations.

With IdealScripts in place, NEBCO can more effectively manage and administer the full medical and prescription drug program from a single source, resulting in enhanced customer service and improved cost efficiency.

NEBCO partners with A+ rated carriers to deliver the medical benefit component of its programs. The plans administered by NEBCO have typically included a prescription drug benefit with an uncapped annual maximum, making the program extremely popular among seniors.

NEBCO has begun the gradual transition of selected clients’ to PBM services offered by IdealScripts. However, NEBCO will also continue to work with outside vendors. Pharmacy benefits, co-payments, and pharmacy locations are unchanged for transitioned groups. Plan members can access their benefits and a health information resource center online at www.idealscripts.com.


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