August 29, 2008-The Jamestown Sun
Insurance Department proud to play role in Northwood recovery
North Dakota Insurance Commissioner Adam Hamm
The Jamestown Sun - 08/29/2008
When a tornado ripped through Northwood last year, people from all across the state sprang into action. Recovering from a disaster takes the cooperation of many people and organizations, and the North Dakota Insurance Department is proud to have been part of the community’s recovery.
When the Insurance Department heard of the ferocity of this tornado, we immediately went into action, calling on a disaster recovery team which was on the ground the following day. By the end of the first week, we had met with school and city officials. Insurance Department staff also found experts to do specific testing on buildings and computers and ultimately found free storage for the school’s undamaged library books.
By the end of the second week, Insurance Department staff set up shop in Northwood to help people with their personal and commercial business insurance questions. This continued into week three to attempt to make sure everyone was served. In total, the Insurance Department has handled more than 70 inquiries and 10 formal complaints, resulting in more than $250,000 in additional money paid to consumers.
Additionally, the Insurance Department appraised several buildings in Northwood, including school property, that were insured by the State Fire and Tornado Fund. The State Fire and Tornado Fund provides structure and contents insurance coverage to state entities and political subdivisions of the state (e.g. schools and city/county buildings). The fund functions much like an insurance company: its reserves are fed by policyholders’ premiums and claims are paid after determining property damage and the property’s level of coverage.
While some may claim for their own political purposes that the resolution of the insurance claims involving the school took too long, the reality is that the Insurance Department and school officials worked very hard to come to a positive agreement. The main sticking point was a $2 million difference between the opinions of the expert retained by the school and the expert retained by the Insurance Department. If both sides hadn’t worked diligently to get through those complicated issues, the claims could have easily ended up in lengthy and expensive legal action. Instead, both sides came together and reached a positive resolution. This resulted in a total payment of approximately $8 million, and allowed Northwood to start building a brand new school for its students and community.
Looking back over the last year, the employees of the North Dakota Insurance Department have a strong sense of pride and accomplishment at the role we played in helping to get Northwood back on its feet.
August 28, 2008-Bismarck Tribune Editorial
08-28-2008: news-opinion
Just a political pile-on
Some football players have been known to pile on a downed runner. Others have done some scabrous and nasty things to opposing players at the bottom of the pile, like pinching, pulling, gouging and grabbing various body parts.
Politics can sometimes be like football. Picture this:
Appointed Republican State Insurance Commissioner Adam Hamm’s television ad about the Insurance Department’s programs to benefit seniors becomes a political football. Democratic opponent Jasper Schneider hits him hard with a legal tackle by challenging the appropriateness of the ads.
So far, no harm, no foul.
But the Democratic Party then starts piling on, one after another, punching, pulling, gouging and grabbing – but not even under cover of the pile, but in plain view.
The culmination came last week when State Sen. Tracy Potter, D-Bismarck, said he would introduce legislation to ban the practice of elected officials appearing in taxpayer-financed public service announcements. He said his proposal would bar any North Dakota state official from using his or her name, image or voice in any public service ad about the services offered by their agencies.
What a bad idea.
It’s hard to believe Potter is serious. It’s easier to believe he is piling on as a good Democrat might be called to do, pinching, pulling, gouging and grabbing in what is shaping up to possibly be the closest state race of the mean season.
Could Potter’s rhetoric have been orchestrated by the party to keep the Hamm issue alive? We think it’s possible.
We remind Potter that the announcement timing of the proposal is suspiciously political and any proposal for such legislation should be DOA if it gets to the Capitol.
And we urge Sen. Potter not to be used as a political pawn, affecting his good image.
Tax Commissioner Cory Fong, a Republican, sounded the call for reason when he said that educating people about what any state agency does is best done by the elected official.
A good idea.
Yes, abuse should not be tolerated, but it makes no sense to silence all appropriate and effective voices that spread information and messages.
Democrats could – and did – make an argument that Hamm’s message was political and inappropriate. We don’t agree with their conclusion.
But what we hope we can all agree upon is it’s time to move past the interpretation, to stop piling on, and start talking about insurance issues affecting the voters. After all, the issue of equal TV time has been resolved.
The Chamber Connection (Bismarck-Mandan)
Businesses seek solutions to rising health insurance costs, By Teresa Oe, Clearwater Communications
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Rising health insurance premiums are taking a toll on the profitability of businesses nationwide. In turn, some employers are raising employee contributions and copayments, while others have altogether stopped providing health benefits. This results in more uninsured and underinsured people and higher insurance premiums. It’s a vicious cycle that has business owners asking, “What is the root of the problem, and how do we fix it?” North Dakota Insurance Commissioner Adam Hamm is taxed with these questions every day as he and other staff at the state Insurance Department seek to promote a healthy and vibrant marketplace for the good of the consumer, the insurance industry and North Dakota’s economy. Hamm says North Dakota’s problems are multifaceted. They include inadequate reimbursement for healthcare providers, limited health insurance competition and everincreasing use of healthcare services. All three drive up healthcare prices and, in direct correlation, insurance prices. Addressing reimbursement, Hamm says, “The federal government is not paying its fair share. Medicare reimbursements to North Dakota hospitals are approximately 30 percent behind the national average.” This inequity, coupled with a lag in reimbursement time, has been a major strain on providers, causing them to raise prices for services, he says. Having several insurance provider options can help businesses and individuals counter the effects of rising prices. “This is not the case in North Dakota,” Hamm says. “Providers are scarce. Therefore, there is little competition to help drive down prices.” Blue Cross Blue Shield of North Dakota (BCBSND), the state’s largest health insurance provider, says it already has the lowest individual and employer group premiums in the nation. “We believe that the current health insurance market in North Dakota is sufficiently competitive,” says Denise Kolpack, vice president for corporate communications at BCBSND. While the North Dakota Insurance Department works to improve some of these issues, Hamm says consumers can address the greatest factor contributing to rising health insurance premiums—the rapidly growing use of healthcare services. He recommends that business owners educate their employees on personal wellness, preventative medicine and disease management. “The key is education, education, education.” Kolpack agrees, saying 70 percent of healthcare costs are from preventable chronic illness. “Each of us needs to take responsibility for our own health and wellness. We all can complete a health risk assessment, know our own health ‘numbers’ like Body Mass Index (BMI) and blood pressure, and empower ourselves with knowledge and education.” Kolpack encourages businesses to assist their employees in these tasks by organizing company-wide wellness programs, which have many times proven their worth. “Research has shown that implementing worksite wellness programs can save employers money through productivity and less-absenteeism, as well as make for an overall better work environment,” she says. Bismarck business shows how it’s doneHedahls Parts Plus, an auto parts and accessories company headquartered in Bismarck, has been able to decrease its employees’ use of healthcare services with a wellness program that was initiated in 1993. As a partially self-insured company, Hedahls pays directly for its employees’ healthcare between the amounts of $500 (employee deductible) and $25,000 (employer deductible), at which point BCBSND, plan administrator, kicks in to cover catastrophic events. President Dick Hedahl explains if employees are generally healthy, the company does better financially with this setup than it would with a traditional insurance plan. If the opposite is true, costs can be devastating. He says the company’s wellness program has been instrumental in ensuring the former happens. “And, our employees and their families are healthier.” “Since we started the wellness program 15 years ago, the cost of insurance has probably doubled,” Hedahl says, “but we’re still paying 20-30 percent below the market.” Through the wellness program, employees receive credit toward their portion of the insurance premium above Hedahls’ base contribution. For example, if an employee doesn’t smoke, Hedahls will pay an additional $35 toward his or her monthly insurance bill. Another $35 is paid if the employee’s BMI doesn’t indicate obesity. Yearly cancer screenings and blood sugar, blood pressure, and cholesterol checks also increase the employer contribution. In this manner, employees can improve their health and get paid to do it. Hedahls benefits, too, with fewer doctor bills. This summer, the company is ramping up its efforts with enhancements to the wellness program. “We want employees to be more aware of their physical, mental and medical health, so we’re doing a wellness survey in August,” Hedahl says. The survey will be an assessment of individual eating habits, exercise, and other variables that affect personal health. Hedahl says it will allow employees to see where they are in terms of wellness and, if there are problems, find out what steps they can take to improve the situation. Hedahls employees will also be offered the opportunity to participate in a fitness discounts program announced by BCBSND earlier this year. The program pays for up to $20 a month in participating fitness center membership fees for people who work out a required number of times each month. In addition, Hedahls is promoting to employees the wellness tools that BCBSND has available online. NDWellnessCenter.com allows users to create a personalized health program and monitor medical conditions for more effective disease management. By keeping employees informed and involved in opportunities for improved lifestyles, Hedahls itself is making strides toward improved “business health.” |
August 24, 2008-Minot Daily News
Relevant facts about the ad
Adam Hamm , Insurance Commissioner
Given the amount of misinformation that is circulating regarding the recent North Dakota Insurance Department ad, I feel it is important to address this matter. Here are the relevant facts regarding the ad:
The ad was paid for by a supplemental federal grant that required 50 percent of the funding to be used to target low income Medicare beneficiaries. The Insurance Department had not planned on getting this funding.
The federal program that funded the ad, the Centers for Medicare and Medicaid Services, thoroughly reviewed our proposal for the grant. The ad cost was approximately one-third of the total amount and was explained in detail in the proposal. The ad is running in counties where CMS identified the highest amounts of low income Medicare beneficiaries eligible for the programs.
The Insurance Department tracks all of its inquiries and knows when Medicare Part D (prescription drug coverage) calls increase and decrease. It is correct that after Nov. 15, the open enrollment period begins and calls increase. However, the other very busy time is when beneficiaries reach the doughnut hole or coverage gap of their Part D plan, now usually in August and September. At that time, they must pay 100 percent of the cost of their prescriptions and the fact is many simply can’t do it. Informing those in need of assistance during this time is very important.
The reasons why we are seeing more North Dakotans reaching this coverage gap sooner are twofold: 1) the increased costs of medications result in the gap being hit sooner in the year; and 2) the plans themselves are implementing stricter guidelines on coverage of medications, which results in people having to look elsewhere for help.
The Insurance Department and I are extremely proud that we are reaching those in need through this ad. Since it began running, our weekly average number of individuals helped and applications completed have increased dramatically.
While I am relatively new to statewide office, I am not new to politics. I knew before the Insurance Department ad began to air that partisan criticism would predictably come my way. To me, the partisan criticism is worth it if the ad helps North Dakotans who need it.
Lastly, a large part of my job as Insurance Commissioner is to educate and inform people about the assistance the Insurance Department provides. Although it may not be easy in a politically charged election year, it’s what I promised to North Dakotans and I will continue to fulfill that promise every day.
August 23, 2008-Minot Daily News Editorial
Voters will be watching
By Bart Leath, Publisher; Bryan L. Obenchain, Editor
Jasper Schneider’s “plan” to create a state disaster fund to aid communities during emergencies might be a good idea. But with no details to speak of, it’s hard put much stock in the “plan” just yet.
The Democrat Schneider, a state representative from Fargo, is challenging incumbent insurance commissioner Adam Hamm.
Schneider’s plan, which is really more of an idea at this point, would have legislators set aside money to be used at the discretion of the insurance commissioner to assist communities trying to recover from a disaster.
How much money would be set aside? Schneider doesn’t know.
How would the money be distributed? Schneider doesn’t know.
Hamm has been right to criticize the plan as vague, because, well, it is vague.
We agree with Schneider that the state should have some sort of disaster fund. Most states already have such a program in place. But we’d need many more details or any details for that matter in order to determine if we’d support the plan or not. And legislators certainly will want to the fine-print details of any plan they’re asked to approve and fund when the 2009 Legislature convenes in January.
Schneider, meanwhile, will have a chance soon to criticize Hamm. Blue Cross Blue Shield of North Dakota has asked for a 14.9 percent increase to health insurance premiums for employee groups, which represents about a quarter of the members of Blue Cross Blue Shield, the state’s largest insurer. Hamm, as insurance commissioner, will decide to accept or reject the request. He has already rejected a request for a 14.8 percent increase in premiums for the bank depositor group, which represents individuals. Blue Cross Blue Shield is appealing that denial.
Much like in the case of ?Schneider’s disaster “plan,” the voting public will be watching how Hamm handles the latest rate hike request from the Blues.
August 22, 2008-Fargo Forum Editorial
A symptom of national dilemma
Opinion - 08/22/2008 The tussle between Blue Cross Blue Shield of North Dakota and the state Insurance Department over premium rate increases is a microcosm of the broader national problem. In the mess that is the American health care system, it’s easy to find villains. It’s the drug companies. It’s the doctors’ lobby. It’s a do-nothing Congress. It’s malpractice lawsuits. It’s the insurance companies, including the Blues.It’s all of the above and more. But characterizing them as villains misses the larger dilemma. Health care inflation has been racing ahead of the general inflation rate for years and shows no signs of abating. The cost of delivering the quality of care Americans demand is extraordinarily high. For those who access the system because they can afford it or have good employer-provided insurance, it’s the best system in the world. But the real scandal is the estimated 45 million to 50 million Americans who are not insured or, for one reason or another, can’t afford even minimal health care.
As they do routinely, the North Dakota Blues have requested approval of rate increases for two categories of their plans. Insurance Commissioner Adam Hamm has denied one increase and is examining another. He’s in a testy face-off with the company about denial of the first rate increase. BCBS has asked for a hearing before an administrative law judge.
There is nothing new in a confrontation between BCBS and the insurance regulator. When Rep. Earl Pomeroy, D-N.D., was commissioner, he embarrassed and angered company officials by criticizing the company for holding board meetings in Hawaii. The board quit doing that. More recently, Commissioner Jim Poolman, who resigned to go into the private sector, infuriated company executives by demanding BCBS return to premiumpayers a portion of a company surplus. It did. Now Hamm has been critical of the company because, he said, it failed to provide complete information regarding a 14.8 percent rate increase request.
The BCBS story is a symptom of the national health care morass. The company wants to keep rates as low as possible, but must respond to rising costs of medical care. The medical sector struggles to maintain quality of care in the face of rising costs, diminishing Medicare and Medicaid reimbursements and escalating demand. Recent layoffs and program cuts at Fargo’s MeritCare and the merger of Fargo’s Innovis with a large regional hospital company underscore the intensity of price pressures impacting providers. Employers want to provide health insurance to their workers, but as the cost of a policy rises, many smaller companies can’t afford it, so more American families go uninsured.
Something’s gotta give. It won’t happen before the November elections, but when the new Congress meets next year look for health care reform to be high on the agenda. What form it takes is anyone’s guess at this point. But as the local health care landscape confirms, trends are unsustainable.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board
August 21, 2008-Fargo Forum
ND BLUES REQUEST ANOTHER RATE HIKE
By Erin Hemme Froslie efroslie@forumcomm.com
Front page - 08/21/2008
Blue Cross Blue Shield of North Dakota asked for a 14.9 percent increase to health insurance premiums for employee groups, which represent nearly a quarter of its members. The North Dakota Insurance Department is reviewing the request, which was submitted Aug. 1. Insurance Commissioner Adam Hamm has at least 60 days to gather information and make a decision. He can grant the request, reject it or modify it.
Last month Hamm rejected the insurance company’s request for a 14.8 percent increase to premiums for the bank depositor group, which represents individuals, including the self-insured. BCBS is fighting that denial and asked for a hearing before an administrative law judge.
The hearing hasn’t been scheduled yet, according to the Insurance Department. Rates for the employee group are analyzed separately. The employee group represents 114,666 members and more than 57,000 contracts, according to BCBS spokeswoman Denise Kolpack. “We have a responsibility to file rates that result in adequate premiums that will cover the increasing cost of members’ claims and help us maintain reserve levels that ensure we’re financially sound,” she said.
Last year the insurance company requested a 17.3 percent increase for the employee group and the Insurance Department approved a 9.9 percent increase.
August 17, 2008-Minot Daily News
Senior help available
Harlynn N. Bjerke
Adam Hamm, Insurance Commissioner of North Dakota, is promoting the Prescription Connection for North Dakota, which might be able to help our senior citizens who are in the Medicare Part D donut hole.
With most plans, the donut hole for 2008 is reached when the prescription costs paid by the Part D insurance plan and the individual combined reaches $2,510 for the year. Then the plans quit paying on all brand name drugs and specialty drugs. Some may continue to pay on generic drugs.
Depending on a person’s taxable income, Prescription Connection for North Dakota may be able to help these individuals to get free or low priced co-pays on brand name drugs through existing patient assistance programs, while providing the highest level of service. To see if you can qualify, you can go to the Internet at rxconnectnd.org or call toll-free at 1-888-575-6611.
There are currently 48 different pharmaceutical companies participating in this program. Each company has their own income and eligibility guidelines. In my experience in helping people qualify, I have found that for single people their taxable income must be less than $16,000 to $21,000, and for married couples less than $26,000 to $40,000.
When patients get the guideline forms, they then take them to their doctors office, to have the office staff forward the required forms to the pharmaceutical company. Health care providers must sign the form and include the specific prescription information or simply attach the actual prescription. Depending on the program, the prescription medicines are either sent to the doctors office, or sent to the patient’s home, or some programs send the patient a pharmacy card that they can use at their local pharmacy.
If you feel you may be able to qualify for this program to help you pay for your prescription drugs, please contact the State Insurance Department.
August 6, 2008-Bismarck Tribune
08-06-2008: news-state
Bail set for Fargo insurance agent
By DAVE KOLPACK
Associated Press WriterFARGO - A judge has set bail at $100,000 cash or bond for a Fargo insurance agent accused of stealing more than $5 million from clients.
Larry Atkins, 65, appeared Tuesday in East Central District Court on charges of engaging in fraudulent practices, selling unregistered securities, transacting business as an unregistered agent and exploiting a vulnerable adult. In all, he faces 78 felony counts.
Defense attorney Jeff Bredahl asked Judge Steven L. Marquart to release Atkins on a promise to appear, or to set bail at a nominal fee. Marquart agreed with prosecutors’ recommendation for $100,000 bail.
“These are serious charges here,” the judge said. He set a preliminary hearing for Sept. 4.
Atkins kept his head bowed as attorneys argued about bail. Prosecutor Cherie Clark said Atkins is a flight risk and a danger to himself.
“We feel this is a serious crime. He has destroyed many people’s lives,” Clark said.
Bredahl said Atkins told authorities about the status of all his finances.
“To say that Mr. Atkins has not cooperated with the state Securities Department is a fallacy,” Bredahl said.
The defense attorney also said Atkins could have fled after his former business partner, David Skjerven, pleaded guilty in February to defrauding investors. Under a plea agreement, Skjerven was ordered serve two years in prison and repay more than $1.3 million.
“He (Atkins) knew he was next in line,” Bredahl said.
Atkins is accused of promising high returns to new investors and then using the money to pay off interest and principal payments of original investors. Clark said there are more than 30 victims, including 20 of retirement age whose net worth and homes were stolen.
“They’re left destitute and without resources because they’re past retirement age,” Clark said.
North Dakota Insurance Commissioner Adam Hamm ordered Atkins to stop selling insurance in late April.
July 24, 2008-Bismarck Tribune
07-24-2008: news-state
N.D. Blue Cross drops plan for medical payments cut
By DALE WETZEL
Associated Press WriterBlue Cross Blue Shield of North Dakota is dropping plans for a 2.5 percent reduction in payments to medical providers, even though doing so will worsen the health insurer’s money problems, chief executive Michael Unhjem said. They were scheduled to take effect next week.
Hospital administrators greeted the news with relief. Lawrence Blue, the top administrator at Cavalier County Memorial Hospital in Langdon, said the reduction may have forced the hospital to cut back hours among its 130 employees.
“We operate on a very slim margin,” Blue said. “Things are tight as it is.”
Roger Unger, the administrator of the Linton Hospital, said rural hospitals would have been particularly hard-hit by Blue Cross Blue Shield’s planned payment reduction. The company dominates North Dakota’s health insurance market, with more than 350,000 policyholders.
“If we break even, it is a good year,” Unger said. “You depend on grants and fundraisers and those types of things to make up a deficit … If a (payment reduction) costs you $1,000, you’ve got to sell a lot of doughnuts to make up $1,000.”
Unhjem, at a news conference in Fargo on Wednesday, said the Fargo health insurer has also requested a formal hearing on Insurance Commissioner Adam Hamm’s rejection last week of a proposed 14.8 percent rate increase for a policyholder group.
Blue Cross Blue Shield’s bank depositor group, so named because premium payments are withdrawn directly from bank accounts, covers about 40,000 people.
Unhjem said the denial of the rate rise will cost the company $950,000 monthly in lost premium income, and may require it to seek an increase of 28 to 30 percent next year, he said.
Hamm called Unhjem’s statements “predictable and unfortunate,” and said the request was denied in part because he was unsure Blue Cross Blue Shield would follow through with promised increases in payments to medical providers.
Last year, Hamm granted the health insurer a 9.9 percent increase on its group health policies. Blue Cross had sought an increase of 17.3 percent, including a projected 5.6 percent rise for medical provider payments.
Even though the company got less than it requested, it said it would keep the intended medical provider raise, only to decide later to cut their payments by 2.5 percent, the insurance commissioner said.
As a result, Hamm said, he doubts Blue Cross Blue Shield’s promises that it will use part of its requested rate increase for bank depositor customers to improve medical providers’ payments.
“That becomes an unreliable piece of information for me,” Hamm said. “Once (Blue Cross Blue Shield) tells this department they’re going to do something … then they have to live up to their word.”
Unhjem said Wednesday that Blue Cross Blue Shield was discarding the idea of cutting medical providers’ payments by 2.5 percent. Under the plan, which was to take effect Aug. 1, the insurer was to withhold the money, with the possibility of paying it later if medical expenses declined.
“It became apparent to us that this withhold, even though it’s a relatively small amount, could have been the tipping point for some of those providers, especially some of the smaller rural providers,” he said.
Even Fargo’s MeritCare Health System, which expected to lose between $800,000 and $1 million from the payment reduction, said it “would simply push their precarious financial situation even further,” Unhjem said.
MeritCare recently announced employee layoffs and cutbacks in hours, along with the closing of a clinic in LaMoure, in southeastern North Dakota.
Hamm said he believed Unhjem’s claims of financial distress were exaggerated. Even if the company’s projected deficits for its bank depositor insurance group come true over one year, the insurer’s surplus would be reduced by only about 5 percent, Hamm said.
“This is a company that is financially strong,” Hamm said. “The department’s financial examiners would not be concerned.”
Unhjem said the company has imposed a “hiring frost” in an attempt to cut $1 million in personnel expenses, and has left 75 to 80 positions unfilled. Layoffs are not being contemplated, said Unhjem, who said the move would be “a gross overreaction.”
He said the company, which is organized as a nonprofit mutual and owned by its policyholders, is an efficient operator, paying out an average of 94 cents in claims for each dollar of premium income.
“There is no better deal anywhere in the region, in terms of the operating cost of the company, for our members,” Unhjem said. “The choice for the consumer is, do you want your premiums to reflect the costs that you’re incurring as a group, or do you want to look for a new insurance company?”