Archive for ‘Medical Insurance’

A Jet Tour of Northeast Indiana’s Medical Device Hub

A Jet Tour of Northeast Indiana’s Medical Device Hub

A Jet Tour of Northeast Indiana’s Medical Device Hub

This past week, Medgadget was invited to take a tour of Northeast Indiana, a region of ten counties surrounding and encompassing the city of Fort Wayne. You might already know about Warsaw, about 30 miles from Fort Wayne, as the headquarters for DePuy, Biomet, Zimmer, and a number of other companies that make the city the leading orthopedic device leader in the world. However, the rest of Northeast Indiana has also been evolving into a thriving medical device manufacturing hub, as labor is available, land is plentiful, and the region is very open and friendly toward the medical device manufacturing industry. In fact, according to the Northeast Indiana Regional Partnership, our host for the two day tour, the region has consistently been a leader in terms of dollars invested and jobs created in the industry. Over two days, we toured a number of different companies and talked to a number of executives about what makes their businesses successful and why they’re at a good place being in Northeast Indiana.

Micropulse offices A Jet Tour of Northeast Indianas Medical Device HubOur first stop was Micropulse, a contract manufacturer of implants and instruments for a number of large medical device clients. Micropulse was originally founded to produce parts for the automotive industry, but in the early 2000?s, founder and CEO Brian Emerick saw his business growing stagnant, and so he switched to medical devices and has Iotron A Jet Tour of Northeast Indianas Medical Device Hubnever looked back since. What’s interesting about Micropulse is that its facilities are also headquarters to the OrthoVation Center, a new incubator for Emerick’s other medical product ventures. The OrthoVation Center currently is home to four companies: Del Palma Orthopedics, Nanovis, BioSpine, and Sites Medical.

The next stop on our tour was a company that uses state-of-the-art technology to sterilize medical devices and other products. Vancouver-based Iotron recently opened a $15 million sterilization facility in the area and wanted to show us around.

Unlike current sterilization technologies that use gamma radiation or ethylene oxide gas, Iotron uses an electron beam for irradiation, which allows for much faster processing and greater flexibility in terms of applications, which in turn leads to lower cost for both the company and client. Electron beam technology also causes less material degradation compared to gamma radiation.

Our tour included a cool look at the electron beam generator and emitter (pictured), which is housed in the maze-like “shield”. Pretty cool stuff.

Precision Medical Technologies A Jet Tour of Northeast Indianas Medical Device HubNext, we traveled to Warsaw to visit Precision Medical Technologies, another contract manufacturer of orthopedic implants and surgical instruments. PMT has been extremely successful and is building another facility to handle their instrument manufacturing division in a neighboring county. Much of PMT’s success can be attributed to investing money in expensive, yet more sophisticated machinery that reduces the number of steps that it takes to manufacture a part, resulting in fewer variances and greater productivity. PMT also works very closely with local high schools and colleges to develop talented and experienced individuals to support the industry in the region.

Next was LH Medical, a division of LH Industries, which manufactures parts for a number of different types of businesses. Their medical division was started only about five years ago and has seen great success. Part of their vision is to manufacture all the parts that the other companies feel are too difficult or too low volume to manufacture. LH Medical also has its own team of design engineers to assist their clients in refining the design and manufacturing process.

Notre Dame Innovation Park A Jet Tour of Northeast Indianas Medical Device HubOur last stop was the campus of the University of Notre Dame to visit Innovation Park, an organization that provides facilities, funding, and other support for startups in life sciences and other industries. We had the opportunity to learn about some of the life science startups currently housed within their beautiful, new facility overlooking the Fighting Irish athletic complexes. CareX, founded by a Notre Dame management professor, is developing web-based point-of-care systems for physicians, caregivers, and extended/assisted living home nurses to track changes in their patients’ health. Altapure A Jet Tour of Northeast Indianas Medical Device Hub

Altapure, whose device we wrote about back in February, has developed a room/area sterilizer using ultrasonic technology to produce a highly dense cloud of liquid that can eliminate dangerous pathogens. F Cubed is developing and commercializing lab-on-chip technology to rapidly detect the DNA of dangerous bacteria in recreational and drinking water, food, and human fluid samples.

Overall, we got the sense that there’s a lot of innovation in the region, and we’re optimistic that, given the high rate of growth in the area, Northeast Indiana will join the ranks of the major medical hubs in the U.S.

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Biochemical signature predicts progression to Alzheimer´s disease

Biochemical signature predicts progression to Alzheimer´s disease

Afflicting millions of patients, Alzheimer’s disease is becoming a growing burden to healthcare systems around the world. The condition is typically diagnosed after symptoms of mild cognitive impairment arise. Not all patients with mild cognitive impairment, however, develop Alzheimer’s. To understand what sets Alzheimer’s patients apart, scientists at the VTT Technical Research Centre (Espoo, Finland) set out to use biomarkers to look at the molecular changes behind the disease.

The new research indicates that a biochemical assay from a serum sample could be used to predict Alzheimer’s disease months or years before symptoms begin to take a toll on a patient. Professor Matej Orešič from the VTT Technical Research Centre believes that the disease is preceded by a molecular signature indicating potential involvement of hypoxia and an up-regulated pentose phosphate pathway.

The research could lead to the development of a clinical test that could complement the neurocognitive assessment now used by physicians to help diagnose Alzheimer’s.Game Controller Uses Your Guns to Find the Princess

As the announcement explains:

The team used metabolomics, a high-throughput method for detecting small metabolites, to produce profiles of the serum metabolites associated with progression to AD. Serum samples were collected at baseline when the patients were diagnosed with AD, MCI, or identified as healthy controls. 52 out of 143 MCI patients progressed to AD during the follow-up period of 27 months on average. A molecular signature comprising three metabolites measured at baseline was derived which was predictive of progression to AD. Furthermore, analysis of data in the context of metabolic pathways revealed that pentose phosphate pathway was associated with progression to AD, also implicating the role of hypoxia and oxidative stress as early disease processes.

The unique study setting allowed the researchers to identify the patients diagnosed with MCI at baseline who later progressed to AD and to derive the molecular signature which can identify such patients at baseline.

Though there is no current therapy to prevent AD, early disease detection is vital both for delaying the onset of the disease through pharmacological treatment and/or lifestyle changes and for assessing the efficacy of potential AD therapeutic agents. The elucidation of early metabolic pathways associated with progression to Alzheimer’s disease may also help in identifying new therapeutic avenues.

Alzheimerin tauti on yksi suurimmista terveydenhuollon ja talouden haasteista kehittyneissä maissa. Miljoonat potilaat kärsivät taudista, ja sairastuneiden määrä lisääntyy väestön ikääntyessä.

Alzheimerin tauti etenee asteittain, ja oireettoman vaiheen uskotaan kestävän jopa parikymmentä vuotta. Varhaisessa dementian vaiheessa eli lievässä kongnitiivisessä heikentymisessä (mild cognitive impairment, MCI) ilmenee lieviä muistihäiriöitä. Lievää muistihäiriötä pidetään normaalin ikääntymisen ja Alzheimerin taudin välivaiheena ja se lisää riskiä sairastua Alzheimerin tautiin. Kyseessä on kuitenkin tila, joka voi edetä hyvin vaihtelevasti tai jopa palautua normaaliksi.

Millaisia ovat molekyylimuutokset ja prosessit, jotka määrittävät ne MCI-potilaat, joilla on suuri riski sairastua Alzheimerin tautiin? VTT:n Matej Orešičin johtama tutkimusryhmä sekä Hilkka Soininen Itä-Suomen yliopistosta tarttuivat tähän kysymykseen tutkimuksessaan, jonka tulokset julkaistiin 13.12.2011 Translational Psychiatry -julkaisussa.

Tutkimusryhmä hyödynsi metabolomiikkaa, joka on tehokas menetelmä pienikokoisten aineenvaihduntatuotteiden määrittämiseen. Havaintojen perusteella kartoitettiin Alzheimerin taudin etenemiseen liittyvä veren aineenvaihduntatuotteiden profiili keräämällä verinäytteet henkilöiltä, jotka oli diagnosoitu Alzheimerin tautia sairastaviksi, MCI-potilaiksi tai terveiksi verrokeiksi. Tutkimukseen osallistuneista 143 MCI-potilaasta 52 potilaan tila eteni Alzheimerin taudiksi 27 kuukautta kestäneen seurantajakson aikana. Tutkimuksessa löydetyistä kolmesta aineenvaihdunnan merkkiaineesta kehitettiin Alzheimerin taudin etenemisen ennustava malli. Aineenvaihduntareittien analysoinnin yhteydessä tutkijat saivat lisäksi selville, että pentoosifosfaattireitti liittyy Alzheimerin taudin etenemiseen, mikä osoittaa hypoksian (keskushermoston hapenpuute) ja oksidatiivisen stressin (solujen hapetuspelkistystilan epätasapaino) merkityksen taudin synnyssä.

Ainutlaatuisen tutkimusasetelman ansiosta tutkijat löysivät ne molekyylimerkkiaineet, joiden avulla voitiin tunnistaa jo varhaisessa vaiheessa ne MCI-potilaat, joiden sairaus eteni myöhemmin Alzheimerin taudiksi.

Vaikka Alzheimerin tautia ei tällä hetkellä voida ehkäistä, varhainen taudin havaitseminen on silti erittäin tärkeää sairauden puhkeamisen viivyttämiseksi lääkehoidon ja/tai elämäntapamuutosten avulla tai uusien Alzheimerin tautiin käytettävien lääkkeiden tehon arvioimiseksi. Alzheimerin taudin etenemiseen liittyvien varhaisten aineenvaihduntareittien selvittäminen voi myös auttaa kehittämään uusia hoitokeinoja.


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Buy Health policies From Life Or General Insurers?

Buy Health policies  From Life Or General Insurers?

There are more restrictions on policies from life insurers as compared to a mediclaim.

Need to visit a hospital for a minor surgery? Given the rising healthcare costs, it could set you back by at least Rs 20,000. For anything serious, be ready to pay in lakhs.

Though most of us agree that a health policy is a necessity, picking the right one remains tricky. Especially with life insurers offering medical policies like traditional mediclaim policies of general insurers.

The sales pitch: Traditional mediclaims, being indemnity plans, cover hospitalisation-related expenses for an ailment. Health polices from life insurers pay the entire sum assured as soon as an illness is diagnosed. That would mean the latter is better. But here’s some fine print. Limited coverage: A mediclaim policy is an indemnity-based plan that settles claims, either on a cashless basis or by reimbursing bills. Life insurers have similar plans where hospital cash benefit (HCBs) is offered. Additionally, some companies also offer surgery benefits. But the benefits are defined and fixed components come into play. There are more limits — on both per day amount and the number of days one can avail that amount. Depending on the insurer, the amount could be between Rs 1,000 and 5,000 per day. Such restrictions may not always work in favour of the customer. If you were to get paid Rs 25,000 for a surgery, you will get it. If the actual expenses were Rs 40,000, then the extra Rs 15,000 will have to be borne by you. According to Mahavir Chopra, head, e-business and retail,, “If one were to only opt for hospital cash policies, not getting covered for the entire amount is the risk taken.” Exclusions: HCBs permanently exclude pre-existing ailments. But a general insurer will cover pre-existing diseases after four years of continuous cover. “Life insurance policies usually have a longer cooling period of 90 days from the effective date of the policy. So, even those ailments mentioned in their policy documents, will not be covered if diagnosed within this period,” says Shreeraj Deshpande, head–health insurance, Future Generali Insurance. However, both mediclaim and HCBs cover hospitalisation due to accidents within the first 30 days of buying the policy. Premiums: Typically, premiums are marginally cheaper than a mediclaim. But if one opts for a surgery benefit product, the premium rates rise substantially. For instance, if a person aged 32 buys New India Assurance’s family floater policy for a sum insured of Rs 2 lakh, he pays Rs 5,725. He would be paying Rs 5,365 for Tata AIG’s Wellsurance family-classic, a standard HCB. His premium would rise to Rs 13,794 for an additional surgery benefit of Rs 50,000 from Aegon Health Insurance. If the same person underwent an angioplasty and hospitalisation that costs Rs 1.75 lakh, his standard HCB would pay him the least. With a fixed payout of Rs 2,000 per day, he would get only Rs 6,000. Had he opted for the surgery benefit, too, he would get Rs 6,000, plus the Rs 50,000 for surgery benefit. Indemnity-based products that cover the entire hospitalisation expenses are a must, say insurance experts. Benefit-based products like HCBs could be bought as an add-on, as the lump sum amount can help cover additional expenses like loss of income, conveyance and so on, that one incurs during hospitalisation.


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First Professionals Insurance Company, Inc. Files Overall Rate Reduction Proposal for Illinois Physicians and Surgeons

First Professionals Insurance Company, Inc. Files Overall Rate Reduction Proposal for Illinois Physicians and Surgeons

JACKSONVILLE, Fla.–(BUSINESS WIRE)–First Professionals Insurance Company, Inc. (First Professionals) recently submitted a proposed medical professional liability rate and rule filing for physicians and surgeons in Illinois. First Professionals is pleased to announce that because of excellent claims experience and a strong commitment to risk management, current insureds will not see a base rate increase for their First Professionals policies in 2011.

“We expect the program to continue to provide positive results as Bentley maintains its commitment to the elite physicians and surgeons in Illinois.”

First Professionals has proposed changes for certain specialties along with changes to territory factors that may result in significant decreases for some insureds. The overall impact of the changes is a 3.8% premium income decrease. Some insureds will see no change, while others may see decreases of as much as 18% or more, depending upon their specialty and where they practice. These changes are effective for new and renewal business written on January 1, 2011 and thereafter.

The 3.8% premium decrease is attributed to First Professionals’ strict philosophy to only provide medical professional liability insurance to Illinois physicians and surgeons with favorable loss histories. This unique approach was established in 2008 when First Professionals joined forces with an exclusive risk purchasing group, Bentley RPG, LLC (Bentley).

“The results of Bentley’s program, including the continued positive loss experience and consistent increase in the number of new and existing policyholders are major contributing factors in our decision to file for the rate change in Illinois,” said First Professionals’ President Robert E. White, Jr. “We expect the program to continue to provide positive results as Bentley maintains its commitment to the elite physicians and surgeons in Illinois.”

“We credit the success of the Bentley program to the strong partnership we have built with First Professionals, superior risk management services provided by ELM Exchange, the professionalism of the agents and brokers who represent the program and unparalleled customer focus,” said Jack Ahern, President of Bentley. Ahern also commented, “We value the experts at First Professionals and are confident that they will continue a long-term commitment to the program.”

The Bentley program is available to licensed Illinois physicians in private office practices or hospital-based practices who meet all qualifications for membership and coverage in the program.

About First Professionals Insurance Company, Inc.

First Professionals Insurance Company, Inc. (First Professionals) has served the medical and healthcare community with reliable professional liability insurance since 1975. First Professionals offers a wide range of products and services to meet the unique needs of physicians, dentists, and other healthcare professionals. First Professionals, headquartered in Jacksonville, Florida, offers products and services in the states of Florida, Georgia, South Carolina, Ohio, Arkansas, and Illinois. First Professionals is a subsidiary company of FPIC Insurance Group, Inc.

Bentley Insurance Group

The Bentley Insurance Group was formed for the benefit of preferred physicians and surgeons in Illinois. Membership in the Bentley RPG, LLC (Bentley) requires physicians to adhere to strict eligibility guidelines and participate in risk management programs designed to improve practice and reduce losses. As a result, physicians meeting Bentley’s membership requirements may enjoy substantial savings in their medical professional liability insurance premiums. Physicians interested in Bentley’s program should contact their insurance broker or Jack Ahern at (312) 529-5513 begin_of_the_skype_highlighting              (312) 529-5513      end_of_the_skype_highlighting for more information.

In what states does First Professionals provide coverage?

Florida, Georgia, Arkansas, South Carolina and Ohio.

How long has First Professionals been providing insurance for physicians?

Since 1975, First Professionals has maintained a strong commitment to its policyholders. With over 30 years of experience, we have the expertise to effectively protect our policyholders.

What physician specialties does First Professionals insure?

First Professionals insures all medical specialities in states where we provide medical professional liability insurance. While coverage varies from state to state for other healthcare professionals, First Professionals also covers allied healthcare practitioners, dentists, optometrists, and healthcare facilities. For further details, please visit the Products and Services section of our website and review the information provided within the Insurance Programs link.

How can I find out more about coverage provided by First Professionals?

We encourage you to send your request via e-mail, or you also have the option to Contact a Local Agent or call our Underwriting Department directly at (800) 741-3742 begin_of_the_skype_highlighting              (800) 741-3742      end_of_the_skype_highlighting, ext. 3218.

How can I get some of the risk management materials that are offered?

Send your request to or call us at (800) 741-3742 begin_of_the_skype_highlighting              (800) 741-3742      end_of_the_skype_highlighting, ext. 3016

Is there a fee to receive some of the risk management materials?

No. All of our risk management products and services are available to our policyholders at no additional charge.

How should I submit an incident or claim?

It is essential that you notify First Professionals immediately if an incident occurs that may lead to a claim or if a claim has been made against you. Our experienced staff will respond to any claim or incident matters on your behalf. Your prompt notification is crucial to our efforts to limit potential exposure. For immediate assistance, call (800) 741-3742 begin_of_the_skype_highlighting              (800) 741-3742      end_of_the_skype_highlighting, ext. 3047. More information about your nearest claims office can be found in the Claims Center section of our website.

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high cost of health care ,Health insurance doesn’t come cheap

Providence Church

Not even men of God are immune to the high cost of health care.

Jim Hagen, director of administration at Providence Church in Avon, said skyrocketing health insurance costs pushed the congregation to switch providers last year. And two years ago, the church was forced to increase the amount of the deductible per family – from $500 to $5,000 – for the four full-time pastors who receive coverage.

The church’s health care costs increased 40 percent between 2004 and 2007, he said.

“I don’t think we’re any different” than any other business dealing with higher health costs, he said. “Rates keep going up and up, especially in the last three or four years. It got so high we shopped around two years ago and found out that our provider was the cheapest. That’s not good news.”

Although it was necessary to raise the deductible to keep costs low for the Detroit Road church, doing so helped the pastors because their premiums were also lowered. Pastors are paid a compensation package instead of a separate salary and benefit package, so their salary is the amount left over after health insurance premiums, housing allowance and other benefits are deducted.

With a lower premium, Hagen said the pastors get to keep about $6,000 more of their money, although the tradeoff is the high deductible.

“Essentially, the savings are passed on to the employees,” he said.

Hagen did not want to comment on how he felt about the government getting involved in health care because the issue has become a political one, and the church is a tax-exempt entity.

- Adam Wright

Berki & Nehr

Health insurance doesn’t come cheap, even when only one employee at a small company is covered.

Dave Nehr, senior partner with the law firm of Berki & Nehr in Elyria, said only one of the three full-time people at the firm eligible to do so has opted into the group health insurance he offers. It costs the company between $385 and $400 per month for coverage for that one employee, he said.

If all five of the people at the firm, including two part-timers, were covered, it would cost the company between $1,200 and $1,600 a month, Nehr said.

“It’s insanely expensive,” he said.

And because the person at the firm who receives health care coverage is a woman, the insurance is more expensive because – according to the insurance company – she might become pregnant, he said.

Nehr said he used to take advantage of the company’s insurance before marrying a teacher and going on her insurance policy.

Berki & Nehr has been in business for 5½ years and has changed health insurance providers three times in an effort to get better rates, but Nehr said that in spite of the effort, the cost goes up each year.

“It’s almost as if the insurance companies conspire to, no matter what, raise rates,” he said. “All they care about is making money.”

Nehr said he doesn’t know if the health care reforms currently being debated will result in any changes.

“How long have we been saying health care needs to be reformed?” he said.

- Brad Dicken

Turtle Plastic Products

Turtle Plastic Products Vice President Michele Norton said her company is always looking for ways to save on health care costs.

And one way to do that was to improve the health of the company’s 10 full-time employees so that they’d require less health care.

“We had the Biggest Loser weight-loss contest here, and we offered a smoking cessation incentive where two employees quit smoking for six months and got a $500 bonus,” Norton said. “They’ll get another $500 if they go another six months.”

In addition, several female employees have been spending their breaks walking in the industrial park where the business is located on Industrial Parkway Drive in Lorain, and they recently spotted two male workers following suit.

The employees also bring in from home fresh fruit, protein powder and flax seed and try to make smoothies four times a week, Norton said.

Having healthier employees helps reduce the need for expensive health care, Norton said.

Turtle Plastics has had to increase employee co-pays for their insurance and has a set amount it can afford for health plans.

“We tell them, ‘This is how much money we have, these are (the plans) we can offer’ and then they choose what kind of coverage they want or can afford,” Norton said.

She said she doesn’t know how government involvement would impact health care in the long term but said she doesn’t want government regulating the industry.

“This is just my opinion, it’s not the opinion of my company, but I think there’s too much government involvement in our lives right now,” Norton said.

Turtle Plastic Products manufactures tiles, flooring, plastic cribbing and other products using recycled plastic.

- Alicia Castelli

Benko Products

Jennifer Visalden said health insurance premiums for the 40 or so full-time employees at Benko Products in Sheffield have increased an average of  9 percent a year over the past several years, said Jennifer Visalden, a spokeswoman for the company.

“We used to pay 100 percent for coverage for our employees,” Visalden said. “Now, we’re having the employees pay 50 percent, and we’re thinking about dropping it altogether.”

A number of employees at the plant, which manufactures industrial ovens, dropped their coverage when the employee share went to 50 percent, Visalden said.

“There are several people with no insurance right now,” she said. “For a family, it kills you.”

While she’s not sure what she’d like the government’s involvement in health care to be, she said the recent change to COBRA coverage was a devastating change for businesses, and she’s not anxious to see what the government would do next.

COBRA insurance is offered to employees who are laid off and lose their health insurance as a result. In the past, employees paid for 100 percent of their COBRA coverage. Now, employees only pay 35 percent, leaving their previous employer to pick up the remaining 65 percent for as long as 18 months.

Benko Products manufactures industrial products including Sahara Drum Hot Boxes, Sahara Industrial ovens, gangways, self-leveling stairs, post hole diggers, hazardous material storage buildings and other material handling equipment.

- Alicia Castelli

Saxton Industries

Kyle Saxton said he believes that the government needs to stay out of the health care industry.

Saxton, owner of Saxton Industries in Sheffield Lake, has been in business for 10 years and employs four people.

“I don’t think the government has proven to compete well with private enterprise,” Saxton said.

All of his workers are eligible for health insurance through the business, although the coverage offered has been slightly reduced over the years.

Saxton said the increase in co-pays and premiums has had a definite impact on the company’s bottom line.

“They are an expense that drives the cost of doing business up,” he said. “There are more and more out-of-pocket expenses.”

Saxton said he thinks government involvement in health care would hurt business in the long run.

“The government hasn’t proven to me that they can be a cost-effective buyer or supplier or manager of goods and services,” he said. “So why would I think they could do this better than the private sector? No matter how I like it today, I don’t think I’d like it better if the government got involved.”

Saxton Industries manufactures lubricants designed for severe applications, extended service cycles and energy efficiency for use in high-temperature environments such as kiln cars, furnace table bearings and ingot buggies.

- Alicia Castelli

National Association of College Stores

Use of wellness and safety programs has allowed the National Association of College Stores in Oberlin to keep increases in health care premiums at 2 to 5 percent the past several years, according to company spokesman Charles Schmidt.

“It’s not by luck, it’s by design,” Schmidt said. “We have been successful through the focus on wellness at keeping our health costs managed for the employees and company and still offer a comprehensive health care package.”

NACS, a trade association for college bookstores, and its related companies employ about 190 people.

Schmidt declined to state the overall cost of offering health care, but said NACS is pleased with coverage over the past several years from Ohio Medical Mutual.

He said NACS’s employee contribution rate is less than 20 percent of the health care premium, which is lower than the Cleveland and national average.

Wellness initiatives have resulted in NACS Inc. being awarded the American Heart Association’s “Fit Friendly Company” award at a gold level of achievement.

Promoting health and safety has also earned NACS three awards from the Ohio Bureau of Workers’ Compensation:

n The 100% Award, for working the entire year without a lost-time injury.

n The Group Award, for having the lowest incident rate in its group.

n The Special Award, the workers’ comp bureau’s highest award of all, for going six years without a lost-time injury.

In addition, NACS Inc.’s wholly owned subsidiary NACSCORP received the bureau’s 100% Award and the Achievement Award for decreasing its incident rate by at least 25 percent from the previous year.

Schmidt said the NACS Safety Team provides input to the company on ways to improve health and safety. It is headed by Human Resources Manager Karin Mayfield and includes Facilities Director Ben Ryba, who is a volunteer firefighter in Oberlin. Each safety team member is certified in First Aid and CPR.

Initiatives spearheaded by the safety team over the past several years include purchase of two portable heart defibrillators; guest speakers on nutrition and quitting smoking and promotion of exercise through NACS’s annual walking competition.

The safety team also helped create the annual Health Fair, held every November, which provides employees with blood screenings, blood pressure checks and education about health and wellness, Schmidt said.

- Cindy Leise

Poppee’s Popcorn

The national debate over health care is making many business owners nervous, including Jennifer McGuire, who owns Poppee’s Popcorn in North Ridgeville with her brother, Tom.

“I would not like to see the government involved,” McGuire said. “They’re taking over too many private industries as it is. It ruins the whole concept of free enterprise. The less involved they are, the better.”

Poppee’s employs 26 people, nearly all of whom receive employer-provided major medical, dental and vision health insurance coverage. Workers pay only $20 a month, and the company covers 50 percent of costs for dependents.

In 2008, that coverage cost Poppee’s a little more than $100,000. That figure will rise this year, thanks to a 14 percent increase in costs that the company was notified of in June.

“Our costs were increased a bit for their coverage, but we want them to take it,” McGuire said. “We don’t want anyone not taking it, because they have to pay a higher deductible,” which she estimates to be between $1,000 and $1,500 per person.

All but a few employees who have insurance through spouses or other means take advantage of the company-provided insurance. Everyone gets free life insurance, and employees have the option of getting supplemental insurance.

When the cost of insurance goes up, it has an impact on the bottom line.

“The more overhead we have, the more we have to charge our customers,” McGuire said. “Costs are going up for just about everything. Everyone is hurt by it. We try to keep (increases) to a minimum.”

- Steve Fogarty

Automotive Equipment Inc.

As controller for Automotive Equipment Inc. in North Ridgeville, Al Jenkins shops around for health insurance every year, ever watchful for a more cost-effective plan.

But steadily rising costs have led the automotive tool and equipment shop to go from paying 100 percent of health care costs for employees to splitting the bill 50-50 with the seven of 16 workers who opt for coverage.

“We’ve worked our way down from paying 100 percent of it to 50 percent, but we’re still paying more than we were 20 years ago,” Jenkins said.

When Jenkins started with the company more than 20 years ago, health care insurance cost the firm about $4,000 a month.

“And that was when we had 30 people on the plan. It was better coverage, but there was no dental,” he said.

Now, Automotive Equipment, which also sells and repairs new tow trucks and used vehicles, pays about $5,700 each month, including dental coverage, to insure the seven, each of whom pays a $750 deductible.

Employees’ monthly costs range from a couple hundred dollars for a young single man to roughly $1,400 for family coverage for a worker in his late 50s.

“Each side pays half. It still costs a ridiculous amount,” Jenkins said.

Two of the remaining nine employees receive benefits through Medicare, as they are older than 65.

“The others are on their wife’s plan, or simply can’t afford anything,” Jenkins said.

The firm’s medical insurance includes major medical coverage plus prescription coverage, Jenkins said. Workers also have the option of taking a separate dental insurance plan, which costs $100 a month for family coverage and $35 for individual.

Ten of the 16 workers opt for the dental package.

“We had one person who could not afford medical but could afford the dental,” Jenkins said.

Jenkins said that despite the costs to the company now, a federally mandated insurance plan scares him.

“If the government forces employers to offer some form of insurance, God only knows what other rules and regulations they will put on it. I only see costs going up if the government is involved. How are we going to keep these employees if it costs them money to work for us?”

- Steve Fogarty

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500 thousand children in California could lose their health insurance money

500 thousand children in California could lose their health insurance money

Up to 500 thousand children in California could lose their health insurance money because of California’s $24 billion shortfall, including a $1.4 billion cut to Medi-Cal, the state’s version of Medicaid.California Budget and Health Insurance

To address the economic crisis the government slashed nearly $179 million from a total of 228 million dollar funding dedicated to a regional program called Healthy Families. It is estimated that 500 thousand children could be among the losers in the facilities provided, said Rebecca Stark from the PICO national network of community organizations.

Meanwhile, cuts to the Healthy Families program are likely to be magnified. Because the federal Children’s Health Insurance Program pays $2 for every $1 California spends, the cuts mean the state program will lose an additional $357 million in federal funding. In all, the program is losing almost half of its annual funding, said Ginny Puddefoot, a spokeswoman at the Managed Risk Medical Insurance Board, which administers the Healthy Families program. She told that to Wall Street Journal.

Registration for the Healthy Families program, created 10 years ago, was frozen on July 17. While Governor Arnold Schwarzenegger tried to eliminate the plan, he had to settle by reducing it, while facing a stiff opposition from the California Congressional Democrats

Parents of these children are in fear that the program may be eliminated one day leaving their children without health insurance coverage. These people say we can’t pay for doctoral visits or for prescription medications

Recently, a research organization, called Children Now, found that more than one million children in California lack health insurance coverage. It says that unfortunately, the situation with child health insurance in California has become much more difficult.

“We believe that the state is wrong in endangering the health and education of poor children by the budget cuts and changes to eligibility rules,” said Ted Lempert, president Children Now. He called the cut to Healthy Families “particularly galling.” He said a coalition, including his group, is spearheading a campaign to put a universal children’s health insurance measure on the fall 2010 ballot. “A struggling family puts their kids first,” Lempert said. “What the governor and what the state has done is the opposite,” he told to L.A. Times.

The bureaucratic measure to rewrite children’s health program every six months threatens their well being, and if this does not change soon, MediCal and Healthy Families would lose most most children that hold health insurance policies through these programs, said Lempert.

Written by Armen Hareyan
Materials from WSJ, LA Times and Prensa Latina are used in this report.

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tips before Buy medical Insurance

Health Insurance Glossary

Agent – Insurance agents are insurance professionals that serve as an intermediary between the insurance company and the insured. As a broad statement of law, an agent’s liability to their customers is administrative. That is, agents are only responsible for the timely and accurate processing of forms, premiums, and paperwork. Agents have no duty to conduct a thorough examination of your business or to make sure you have appropriate

Age limits – Most of the Insurance plans have stipulated minimum and maximum ages below and above which the Insurance Company will not accept applications or may not renew policies.

Assignee – Assignee is the person to whom the benefits under a life or Travel policy are assigned.

Beneficiary – The person(s) or entity(ies) (e.g. corporation, trust, etc.) named in the policy as the recipient of insurance proceeds upon the death of the insured.

Broker – An Insurance Broker is someone who represents you with your insurance transactions, unlike an insurance agent, who represents the insurance company. Broker can provide you with a number of quotes from different insurance companies for comparison, ensuring that you receive the best deal possible.

Insurance brokers can be best described as a kind of super-independent agent. Brokers can offer a whole host of insurance products for you to consider. Brokers are required to have a broker’s license which typically means the broker will have more education or experience than an agent.

Brokers can deal in many different types of insurance including: health insurance, life insurance, travel insurance, business insurance and home insurance.

Claim – An insurance claim is the actual application for benefits provided by an insurance company. Policy holders must first file an insurance claim before any money can be disbursed to the hospital or repair shop or other contracted service. The insurance company may or may not approve the claim, based on its own assessment of the circumstances. Usually, this process is handled by a service provider to the insurance company. This service provider is called a “Third Party Administrator”.

Cashless Claim – The insured can make a claim without paying any cash upfront. The insurer or its Third Party Administrator has tie-ups with network of hospitals and nursing homes called a “network hospital” across the country. The insured can get themselves admitted in these specified network hospitals and take treatment for the disease contracted without any cash payment to the hospital at the time of discharge. However cashless settlement is subject to the limits and sub limits which is subject to the sum insured of the policy.

Coverage Amount – Coverage amount is the maximum amount payable in the event of a claim. It is also known as “sum insured” and “sum assured”. The premium of the policy is dependent on the coverage amount chosen by you.

Critical Illness Policy – A Critical Illness is a serious possibly terminal disease, which is strictly defined by the insurer. Conditions such as cancer, multiple sclerosis, major organ transplants are deemed as “Critical Illness”. Most critical illness policies provide for the payment of a lump sum benefit if the policyholder is diagnosed as suffering from one of a number of specified terminal conditions.

Cumulative Bonus – In case of some Insurance Companies, each claim free year ensures that you get a benefit known as “cumulative” bonus – it is similar to “no claim discount” in concept. The only difference being that instead of giving an upfront discount, the health insurance company adds more benefits for the same premium paid. However, the overall amount of these benefits will not exceed a certain percentage as specified in the policy.

Deductible – The amount of loss paid by the policyholder before the Policy benefits become payable. It can either be a specified dollar amount, a percentage of the claim amount, or a specified amount of time that must elapse before benefits are paid. The bigger the deductible, the lower the premium charged for the same coverage.

Domiciliary Hospitalization – Domiciliary Hospitalization is the treatment of the patient taken at home due to the lack of accommodation in the hospital/nursing home or the patient’s condition being such that he/she cannot be moved to the hospital. This needs to be as per the doctor’s recommendation. Most health insurance companies do cover domiciliary hospitalization subject to a certain limit depending on the sum insured.

Exclusions – Exclusions are diseases and conditions for which medical expenses are not covered by the health insurance policy. Exclusions can be of two types – Permanent and First year/Second year. Permanent exclusions are never ever covered by the policy for example, AIDS or expenses incurred on cosmetic surgery. First/Second Year exclusions are ailments which are not covered for the first/second year of health insurance cover, but are covered subsequently. For example, surgery for cataract is usually not covered in the first year but is covered starting the second year.

Family Floater Policy – A family floater policy is issued with a single sum insured covering number of individuals of the same family. Simply put, it is a one premium and one policy for all members of the family. The cover can be used by any member of the family any number of times. For example, there are four members in your family- you, your spouse and your two children. You purchase a floater policy with a sum insured of Rs 500,000. This means that if you fall sick and utilize Rs 200,000 in treatment- the balance Rs. 300,000 can be utilized by any member of the family including you. Your total expenses across the family would however be capped at Rs. 500,000.

Group Insurance – A firm or an association may buy a policy to insure members of a group. For example a Company may take a policy to cover a large group of its employees.

Insurance – Insurance is a contract in which an individual or entity, pays the insurance company in return for the insurance company bearing the risk of loss against specified conditions. The individual receives reimbursement against losses from an insurance company. The company pools the clients’ risks to make payments more affordable for the insured.

Insured – The person who is covered by a policy of insurance.

IRDA – IRDA stands for “Insurance Regulatory and Development Authority”. It was established in 1999 under an act of Parliament to promote and regulate the insurance industry in India including all its constituents like Insurance Companies, Agents and Brokers.

Medical Tests – Medical tests may be required for persons over 45 years to get the health policy. Generally it needs to be done by a MD doctor.

Network Hospital – Network Hospitals are hospitals and nursing homes which are associated with the “Third Party Administrator”. Cashless claims are facilitated through these network hospitals as the TPA directly pays these hospitals.

No Claim Discount – No Claim Discount is a discount on the Basic Premium if there is a claim free year of the policy. If the insured does not make any claim on his policy, then he gets a discount from 5% to 25% on basic Premium for every claim free year.

Personal Accident Policy – Personal Accident Policies are issued as fixed benefit policies whereby specified sums are paid on the occurrence of specified events. These events could be death or disability. This payout is not related to the expenses incurred. For Example: Shyam has a personal accident policy. He meets with an accident and is permanently disabled. He would automatically get 100% of the sum insured and this would be in no way linked to the expenses he has incurred in treatment of the same.

Policy – A contract of insurance, describing the term, coverage, premiums and deductibles is called policy.

Policy Period – The period during which a Policy is valid.

Policy Year – Period between a Policy’s anniversary dates.

Pre-existing Disease – A pre-existing disease is any ailment or disease that a person is already suffering from at the time of purchasing health insurance.

Premium – Premium is the amount paid by the insured (the buyer) to the insurer for the policy. It’s generally calculated based upon the age, duration, sum assured and type of policy.

Proposal forms – Proposal forms are used to give the insurance company full particulars of the risk against which insurance protection is desired. This proposal form is the basis of the insurance policy. Any misrepresentation or non disclosure of facts would make the insurance null and void.

Proposer – Proposer is the insured who seeks protection against loss he may suffer due to happening of a contingency.

Renewal – Health insurance policies are usually annual contracts. At the end of the policy period, the policy has to be renewed by the insurers. But renewing a contract of insurance is at the discretion of the insurer. There should be continuous renewal of the policies. If there is a break in insurance, the insured would lose the benefits of insurance in the event of any contingency.

Reimbursement – Under a Health Insurance policy, the cost of various hospital charges (such as bed charges, medicines, lab tests, surgeon’s fees etc) are paid back to the insured who makes the claim. In other words, the insured pays the (hospital) expenses incurred, but thereafter gets reimbursed by the insurance company.

Third Party Administrator (TPA) – A third party administrator (TPA) is an organization that processes insurance claims of the Insurer on behalf of Insurance Company. They scrutinize the expenses incurred vis-à-vis coverage under the policy and ensure compliance of the policy terms and conditions and warranties and subject to the limit of sum insured. The insured needs to interact with them for settlement of claims. The TPA also empanels hospitals to be part of the network to facilitate cashless settlement of claims.

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Health Insurance also known as Mediclaim Policy

Health Insurance also known as Mediclaim Policy

Health Insurance also known as Mediclaim Policy in India cover you and your family from medical expenses during sudden illness, surgeries and accidents including room charges, doctor’s fees, medicines, tests etc. that may arise in future.insurance_pandit_blue

At Insurance Pandit, We offer a convenient way to Buy and compare Health Insurance Plans offered by leading Insurance companies. Not only you can select the best product but also save money by comparing plans.

Start your quote to see how companies compete for your business. You could save up to 25% on your Health Insurance Premium by comparing plans offered by different Insurance Companies.

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Reaches out to 3748 underprivileged children and 8,000 individuals across the country in its ‘Global Month of Service’

Gurgaon, July 9, 2009 : As a part of Global Month of Service Max New York Life, in association with Max India Foundation, conducted immunization and blood donation camps across the country to bring in a renewed focus on community service among the employees. Over 650 employees participated as volunteers, spent more than 40,000 hours to provide a comprehensive immunization program to 3,748 children through immunization camps in 30 cities. 2118 units of blood were collected through 67 blood donation camps that will potentially benefit over 8,000 individuals. This one-month of concentrated effort formed part of Global Month of Service started from this year in 8 countries including USA where New York Life Insurance has presence.

“Our International agents and employees truly embraced New York Life’s first Global Month of Service and turned out in large numbers to contribute their time and energy to the communities we serve,” said Dick Mucci, Chairman and CEO, New York Life International. “I’m delighted with the impact we’ve made on the lives of young people and this important work continues all year long through our community social responsibility programs in all of our markets.”

“With an objective to contribute towards the society we live in, Max New York Life participated in CSR activities since inception. Global Month of Service was an opportunity to extend our existing agenda of providing comprehensive immunization to underprivileged children across the country. Blood donation camps helped large number of our employees and agents to contribute towards a social cause that will ensure that no life is lost for the reason where we can be of help. We will continue these CSR activities throughout the year with Max India Foundation and other NGOs working for underprivileged children across the country,” said Mr. Debashis Sarkar, Sr. Director and Chief Marketing Officer, Max New York Life Insurance.

New York Life Insurance Company celebrated May as the Company’s first Global Month of Service, with over 3,500 employees and agents on more than 200 community projects in eight countries to champion the Supporting Youth Worldwide theme. Volunteers gave over 50,000 hours of voluntary service in their local communities where the company does business – the equivalent of 29 people working full-time for an entire year and the estimated value of this volunteer time is more than $1 million.* New York Life designated May as Global Month of Service to expand its long-standing tradition of giving back; providing New York Life employees, agents, family members, friends and policyholders an opportunity to make a global impact in local communities.

About Max New York Life Insurance Co. Ltd. (

Max New York Life Insurance Company Ltd. is a joint venture between Max India Ltd., one of India’s leading multi-business corporations and New York Life International, the international arm of New York Life, a Fortune 100 company. Max New York Life Insurance, incorporated in 2000, is one of India’s leading private life insurance companies. The company offers both individual and group life insurance solutions. It has established a wide distribution network across India. Through its wide network of highly competent life insurance agent advisors and flexible product solutions, Max New York life Insurance is creating a partnership for life with its customers in India to facilitate them to achieve more.

*Independent Sector calculates the hourly value of volunteer time based on the average hourly wage for all non-management, nonagriculture workers as determined by the Bureau of Labor Statistics, with a 12 percent increase to estimate for fringe benefits.

For Further Information, Please contact:

Arpan Basu
Max New York Life
+91 9818083556

Aparna Sankaran
+91 9899957559

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