A STRATEGIC PERSPECTIVE    Evolving with the industry is a proven recipe for success for this Georgia agency's benefits division The Patient Protection and Affordable Care Act will bring a tidal wave of change next year-transforming the employee benefits industry for agents and brokers everywhere. But experienced producers know that the benefits business has never been static-and change has been the only constant. Bob Shulman, vice chairman and employee benefits producer of Pritchard & Jerden in Atlanta, Georgia, has been marketing employee benefits programs and advising commercial clients for the agency since 1974 and he has seen plenty of evolution in his 39-year career. The new law is just the next in a long line of changes-but he admits that it is a big one for the industry and his agency. "The new law may be the biggest source of change in our time, but the business has been undergoing changes steadily for many years-new plan designs, new technology, and a new business environment. We have all had to learn new things." P&J was founded in in 1960 as a commercial property/casualty insurance agency, specializing in building long-term relationships with local businesses. The agency hired its first benefits producer in 1971 and its second, Shulman, in 1974. "The agency began like many others of its time, as a property/casualty insurance sales agency," he explains. "But the founders recognized a growing need among their clients for group benefits services and individual coverage such as life and accident insurance," he recalls. Click here for the complete article …

HEALTH PLAN CALLS IN THE DOCTOR    NJ insurer's outcomes-based health program is built on cooperation with medical practices The largest health insurer in New Jersey has developed a program that encourages employees to take responsibility for monitoring and improving their health, instead of waiting to treat episodes of sickness. That sounds like what a traditional wellness program tries to accomplish, but what's different about this program, offered by Horizon Blue Cross Blue Shield of New Jersey (Horizon), is that it revolves around the employee's own physician. Horizon's Patient Centered Medical Home Program (PCMH) provides some initial funding for doctors' offices that sign on to the program's goals for chronic condition care. Horizon also reimburses participating medical practices based on patient outcomes, rewarding long-term results instead of volume of services. The idea is to get all the key players in the health care delivery and reimbursement system-the employer, employee, medical provider and insurer-working together to improve both the physical health of the employee and the fiscal health of all parties. Horizon launched the program in January 2011. So far, some 200,000 Horizon members are participating in conjunction with 700 physicians and health care professionals in Horizon's network. When Horizon signs up a medical practice as part of the PCMH program, it provides the practice with funding to hire a Population Care Coordinator, a nurse whose job it is to monitor health concerns of the Horizon members. The health conditions monitored by this professional are those involving long-term conditions such as blood pressure and diabetes control, and routine screenings that are part of preventive care. Click here for the complete article …