New insurance carrier to offer more options to Western employees

Mai Hoang

Western employees will have more options for hospital care when Western changes its third-party administrator for faculty and staff health insurance in 2003.

The university dropped Medical Benefits Administrators, Inc. earlier this month and will go with Anthem, Blue Cross and Blue Shield in January.

That will bring some changes for employees.

For the past year under MedBen, employees could only go to The Medical Center for hospital visits and receive in-network coverage – full coverage by the university’s insurance plan minus a deductible.

The in-network coverage was outlined in an exclusive one-year agreement between Western, MedBen and The Medical Center. The agreement could be renewed for up to three years.

With the change to Anthem, Western had to cancel that agreement with The Medical Center, said Bob Edwards, vice president for University Relations.

Medical Center representatives are concerned about Western’s decision.

In a Daily News article Monday, Doris Thomas, vice president of Marketing for Commonwealth Health Corporation, said: “At this time, we’re looking into whether there was a fair and open process in determining who would serve as Western’s third-party administrator.” Commonwealth owns The Medical Center.

When contacted by the Herald yesterday, Thomas referred all comments to Commonwealth’s attorney, Murray Raines.

Raines could not be reached for comment.

Under Anthem, employees will now have in-network coverage for The Medical Center and other hospitals in the region, including Greenview Regional Hospital here, and Summit Medical Center, Vanderbilt University Medical Center and Skyline Medical Center in Nashville.

Under Western’s previous agreement with MedBen and The Medical Center, an employee who wanted to receive hospital treatment at any other hospital would only receive out-of-network coverage that funds about 20 percent of medical costs, Edwards said.

“You have a wider range of choices in where you go for medical treatment,” he said of the new plan.

Edwards said having more options was a good way to help Western and its employees deal with the nationwide problem of rising insurance premiums.

Employee insurance premiums at Western will increase 17 to 68 percent next year.

But changing third-party administrators was not responsible for the increasing premiums, Edwards said.

Edwards said The Medical Center was notified Oct. 31 that its agreement with Western would be terminated on Jan. 1, or when the new insurance plan year begins.

President Gary Ransdell said the opening of in-network options to employees will not cause a lot of change.

“The reality is, The Medical Center has had all our business,” he said. “. They’ll keep nearly all our business in the future. Our employees have been pleased by the medical service provided by The Medical Center.”

He said the increased in-network options are an asset for employees who travel frequently.

“We have faculty who travel all over the world with research initiatives and exchange programs,” he said. “The network Anthem, Blue Cross and Blue Shield brings is something that our faculty finds very attractive.”

Reach Mai Hoang at [email protected]