Vince Wolf was featured in a Pittsburgh Business Times article from the August 1 - 7, 2008 issue:

To cope with the rising cost of specialty drugs, some companies are creating a new prescription tier for employees that requires a bigger co-payment and directing patients on these drugs to a specialty pharmacy, according to Vice Wolf, executive vice president of Downtown-based Cowden Associates, Inc. But care has to be taken to set co-pays that are not prohibitively high.

"It's understandable that you'd want them to pay more, but you don't want to create a huge financial burden," Wolf said. "Where the savings are is in the management of the prescriptions, making sure that people stay compliant, which has a longer term savings."

The full article requires a subscription.

On June 19, the Supreme Court decided MetLife v. Glenn, ruling that a company that both administers and funds a benefits plan operates under a conflict of interest that must be considered as a factor in a court’s review of claim denials.

From the analysis on SCOTUSBLOG:

In its decision below, the Sixth Circuit explicitly considered that conflict of interest when reviewing MetLife’s denial of benefits to respondent Glenn, a Sears employee who filed for disability benefits after a heart condition impaired her ability to work. After MetLife rejected Glenn’s claim, asserting that she was still physically capable of performing full-time sedentary work, Glenn brought suit against the insurance company under ERISA, which authorizes federal courts to review the decisions of benefit plan administrators. Glenn lost her case in district court but prevailed before the Sixth Circuit... The Sixth Circuit [ruled] that the claim denial was unreasonable and should be reversed.

As always, plan sponsors should carefully evaluate how their claims are decided and paid. Any employer who both administers and pays benefits should take the ruling into account and put safeguards into place to separate benefit decisions from financial concerns.

A thorough discussion of MetLife v. Glenn can be found on SCOTUSWIKI.

The results of an Urban Institute survey show that Massachusetts health care reform has cut the number of uninsured by half since its inception in 2006. Residents also reported lower out-of-pocket costs and low-income adults are now more likely to have regular checkups and dental visits. The initiative has cost nearly a third more than projected and costs are expected to rise. In addition, around 86,000 taxpayers paid fines for not signing up for health insurance.

On May 21, 2008, President Bush signed into law the Genetic Information Nondiscrimination Act of 2008 (GINA), prohibiting employers from using genetic information for decisions on hiring, firing, promotions, or job assignments, and group health plans and health insurers from basing eligibility or premium determinations on genetic information.

SMB Human Resources interviews Cowden Associates' Executive Vice President, Vince Wolf. He discusses the results of the Cowden Associates 2007/2008 Tri-State Area Employee Benefit Survey, high deductible health plans and wellness.

Vince Wolfe of Pennsylvania-based Cowden Associates says that 84% of businesses responding to their 2007/2008 Employee Benefit Survey don't plan to adopt high deductible plans now or in the future. Wellness, he says, is the way to go.

Download the complete audio.

As reported by the Robert Wood Johnson Foundation, from 2001 to 2005 health care premiums increased at a rate 10 times that of the median income. The disparity was even more acute in the Ohio, Pennsylvania, and West Virginia tri-state area, where incomes either fell or rose at a rate less than the national average. The tri-state breakdown:

Other of-note findings:

• The employer share of health insurance premium costs has increased by 28% nationally
• Americans with private health insurance fell about 6%

Read the full report for national totals and state-by-state breakdowns.

Cowden Associates' 2007/2008 Tri-State Employee Benefits Survey featured in the Pittsburgh Business Times:

A survey by Downtown employee benefits consultant Cowden Associates Inc. found that the number of businesses adopting some form of the so-called consumer-driven health care plan more than tripled since last year, but 107 out of 274 respondents, or 62.9 percent, said they were unlikely to offer the coverage in the future. Another 37 respondents, or 21.8 percent, said they had no interest in the plans, which usually incorporate a health reimbursement or savings account.

"It's a big change, and employees are not necessarily looking for big changes in the way their benefits are structured," said Cowden Executive President Vincent Wolf. "We seem to have hit a threshold, a ceiling, with these types of plans."

The full article requires a subscription.

Cowden Associates' 2007/2008 Tri-State Employee Benefits Survey featured in the Pittsburgh Post-Gazette:

Cowden Associates' annual employee benefits survey reports that enrollment in [high-deductible and "consumer-driven" health care] plans, and the availability of the plans, increased over last year -- today, 8.8 percent of survey participants offered employees high-deductible plans, up from 2.5 percent in last year's survey.

That's a big increase, but the market for such plans is peaking, or at least appears to be, said Cowden Executive Vice President Vince Wolf. Of employers who don't offer such plans, 84 percent said they "are not likely" to or "have no interest" in offering them in the future.

Read the full article at the Post-Gazette website.

Cowden Associates' 2007/2008 Tri-State Employee Benefits Survey featured in the Pittsburgh Tribune-Review:

This year's Cowden survey included responses from 274 employers in the region, including for-profits and nonprofits, plus government employers. Company size ranged from 100 or fewer employees, to more than 10,000 workers.

The survey found that employers do view wellness programs as a way to hold down annual cost increases. This year's survey found that 50.3 percent of companies surveyed have wellness programs in place, up from 49 percent one year ago.

Read the full article on the Tribune-Review website.

Employers in Pennsylvania, West Virginia and Ohio believe the future of managing health care costs lies in helping their employees manage their health through wellness programs, according to Cowden Associates, Inc. Seventh Annual Tri-State Area Employee Benefit Survey.

Cowden Associates, the region's leading independent human resources, compensation and employee benefit consulting firm, compiled results of its 2007-2008 survey from 274 employers throughout the tri-state region. Survey participants include for-profit, nonprofit and governmental employers. Size of employers ranged from less than 100 employees to more than 10,000.

"Competition for talented employees is strong, and employee benefits play a critical role in attracting and retaining those employees," said Cowden Associates President and CEO Jere Cowden. "As regional employers work to attract and retain talent in part through strong employee benefits plans, our regional survey data allow them to benchmark themselves against their regional competition and develop attractive, cost-effective plans."

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