Sunday, July 22, 2012

Excellus sits on $1.26 billion emergency fund as it seeks double-digit rate increases

As it seeks double-digit rate increases, Excellus BlueCross BlueShield is sitting on a $1.26 billion rainy day fund to cover higher than expected claims.
Even though Excellus has nearly twice as much in reserves than the state requires, the health insurer does not want to use any of that money to offset rate increases, according to documents the company has submitted to the state justifying its request to increase rates by as much as 20 percent next year on some health plans.
Instead, it wants members to contribute even more to that fund.
Under its proposal, Excellus would take anywhere from $5.52 to $11.95 a month from some members’ premium payments and add that money to its reserves. Customers in one plan, the company's direct pay HMO, would pay nothing into the
reserve fund because Excellus is seeing a rate decrease for that product.
“These reserves are the ‘insurance’ that assures payment even when costs run higher than anticipated, or emergencies or disasters occur, and should not be used as an alternative fund to temporarily reduce rate adjustments,” Excellus says in documents filed with the state Department of Financial Services.
Excellus is seeking permission from state regulators to increase rates on some of its community-rated products Jan. 1. Community-rated plans for individuals and groups are policies that charge the same amount regardless of age, sex, health status or occupation. The proposed rate changes will affect about 90,000 of the company’s 700,000 members in Central New York. The increases do not apply to experience-rated large groups or self-insured plans.
The documents related to health insurers’ rate hike requests used to be secret. But late last year the state ordered insurers to make them public so customers can review them and submit comments to regulators who decide whether to grant the increases, reduce or reject them.
Excellus has come under criticism for amassing a big reserve fund while consumers struggle to afford health insurance.
“It’s a disservice to consumers that they’re (Excellus) not using their reserves to defray some of the proposed rate increase,” said Elisabeth R. Benjamin, a lawyer and co-founder of Health Care for All New York, a statewide coalition of more than 130 nonprofit groups pushing for more affordable health insurance options for state residents. “We would submit the state should not permit the rate increase to further allow this carrier to stockpile its reserves.”
Consumers Union, publisher of Consumer Reports, issued a report in 2010 that said Excellus and other BlueCross BlueShield plans across the country were salting away more money than necessary in their reserve funds. At that point, Excellus had $965.1 million in reserves.
Since then its reserve fund has grown by more than 30 percent.
Money in the fund comes from the company’s surplus or profits.
A portion of every rate increase by insurers is usually earmarked as a contribution to reserves, said Laurie Sobel, a senior attorney with Consumers Union. That’s why regulators reviewing a rate increase request need to look at an insurer’s reserve levels, she said. If those levels are excessive, regulators can protect consumers from unnecessary rate increases by disallowing additional contributions to reserves, she said.
The minimum amount of reserves Excellus must have to meet state requirements is $703 million.
That amount would not give Excellus, which has nearly 2 million members, a sufficient cushion, said Elizabeth Martin, a company spokeswoman.
“That’s like saying to someone that they should strive to have a minimum amount in their savings account, but that might not be enough if suddenly they need to cover large unforeseen expenses,” Martin said.
Excellus has about $792 in reserves per member, enough to cover claims for about three months, she said. The average amount of reserves per member held by other upstate nonprofit insurers is $1,179, she said.
Excellus last dipped into its reserves in 2008. It used $244 million from the fund to offset higher than expected medical expenses, declining enrollment and investment losses. If the fund had been at the minimum level the company would have had to impose steep rate increases in 2009, Martin said.
Excellus made a profit of $223 million in 2011 on revenue of $5.7 billion. The 2011 profit was about five times bigger than the $44.5 million profit it made in 2010. It also tripled the pay last year of its top executive to $5.2 million.
In its pending rate filing, Excellus says its proposed increases are designed to allow the company “ ... to achieve a modest operating margin.”
Excellus says it is “... sensitive to the fact that individuals and small businesses struggle to afford higher premiums.” But it warns that failure by regulators to approve the rate hike request would lead to the need for even greater increases in the future.
Excellus says the escalating cost of health care services, equipment and products continues to be the primary reason for rate increases.
In its filing, Excellus says rate increases are being driven by a combination of higher costs and greater use of medical services and equipment by consumers.
Health insurers come up with spending forecasts by multiplying the anticipated increase in cost of a medical service by the rate of consumption or use of the service or product. This is known as the “medical trend,” a measure of medical inflation.
Excellus is forecasting spending next year will increase 9.6 percent to 12.7 percent for hospital outpatient services, 7.8 percent to 8.7 percent for hospital inpatient services, 3.1 percent to 7.1 percent for professional services such as doctor office visits, and 5.7 percent to 7.9 percent for drugs.
The public has until Aug. 11 to submit comments to the state about the proposed rate changes.
Comments can be submitted online, by email to or by mail to: Charles Lovejoy, Health Bureau, New York State Department of Financial Services, 25 Beaver St., New York, NY 10004.
Proposed rate increases

Here are the rate increases proposed by Excellus BlueCross/Blue Shield:
High-deductible health plans, Preferred Provider Organization: Up to 19.9 percent
Direct pay indemnity plans purchased by individuals: Up 12.3 percent
Direct pay Health Maintenance Organization and Point of Service: Decrease 3.4 percent.
ValuMed Plus, a policy for individuals on limited incomes: Up 14.1 percent
Healthy New York, another plan for individuals with limited income: Up 3.6 percent.
Medicare Supplemental plans: Down 0.5 percent.
Source: Excellus

Monday, July 16, 2012

Unspoken 2nd Annual Human Rights Festival Oct 17-18 Utica, NY


Create Space for Gender-Peace
October 17-18, 2012 * Utica, NY

Rich Cultural Context, Active Conversations, Live Performances

Explore a gendered perspective of human rights. Local, national, and global perspectives bridge the universal nature of gender violence, particularly violence against women and girls, while opening possibilities for gender-peace™.
consent, coercion, conflict, impact of war, sexual violence, social norms, female genital cutting, forced/early marriage, community solutions, refugee resettlement, leadership, men as allies and
possibility for gender-peace™
Intended audience: local, national, international collaborators for social change
NGOs, refugee resettlement agencies, human rights advocates, domestic violence advocates,
legal professionals, criminal justice agencies, social service agencies, educators, healthcare professionals, faith leaders, and community leaders.

UNSPOKEN is the essence and experience of our commitment to our core values of community, education, and dignity. Unspoken is an annual human rights forum that combines film, art, music, and a conference into one festival. Held in Utica, NY in October of each year, this multi-faceted forum gives voice to upholding human rights for our world with global to local perspectives.

Radisson Hotel-Utica Centre
200 Genesee Street
Utica, NY 13502
website: click here

Wednesday October 17, 2012
at 7:45 AM EDT to
Thursday October 18, 2012
at 4:30 PM EDT

Connecting Via LinkedIn:
Registered Participants will be invited to join a select LinkedIn group.
There will be exclusive postings and a space for conference community development and gracious collaboration.


$ 225 (after Sept 7 $250)
$ 175 (students)


Wednesday (Oct. 17):
07:45 - 08:45 a.m.
Breakfast and Registration

09:00 - 10:30 a.m. Session 1
Protecting the Most Vulnerable

10:45 - 12:15 p.m. Session 2
Refugee Experience

12:15 - 01:15 a.m. Lunch

01:15 - 02:45 p.m. Session 3
Performance: Checkered Floors

03:00 - 04:30 p.m. Session 4
Creating Spaces for Economic Transformation

7:00 p.m. Key-note speaker
Mawi Asgedom

Thursday (Oct 18):
07:45 - 08:45 a.m. Breakfast

09:00 - 10:30 a.m. Session 1
Forced Marriage in the U.S.

10:45 - 12:15 p.m. Session 2
Social Norms, Social Change

12:15 - 01:15 a.m. Lunch

01:15 - 02:45 p.m. Session 3
Social Change & Community Led Development

03:00 - 04:30 p.m. Session 4
Create Space for Gender-Peace

Thu Oct 18 Film Festival
Fri Oct 19 Film Festival
Sat Oct 20 Film Festival

Contact us:

General Information:
Lisanne Divine
Mohawk Valley Resource Center for Refugees
+1 (315) 738-1083 x.146

Film Festival Information:
Mike Patrei
Thalita Bovo
Mohawk Valley Resource Center for Refugees
+1 (315) 738-1083 x.113

309 Genesee Street
Utica, NY 13501

Unspoken is a program of the Mohawk Valley Resource Center for Refugees

Sponsored by:

Logos Chobani Shephered Gifts

This project was supported by Grant No. 2009-UW-AX-0038 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.
Register Now!
I can't make it
Mawi Asgedom
Mawi Learning, President
Inspiring Author, Harvard Graduate
Commencement Speaker to over 30,000
Former Ethiopian Refugee
International Trainer, Youth Leadership Trainer, Professional Educator
"After I heard Mawi's story on the show,
I wouldn't tolerate 'can't' from anyone."
Oprah Winfrey
Cheryl Hamilton
RefugePoint and Checkered Floors
Journey to Africa with Cheryl. Experience her organization's role in protecting the most vulnerable refugees, particularly women and girls.
Leave "Checkered Floors" tingling with energy. This brilliant profoundly personal, brave, funny, honest performance illustrates immigrant needs, gender violence and justice.
Gil Garcetti
"high profile D.A. to stylish photographer." TIME Magazine
WATER IS KEY, water, women, and wells
Explore West Africa with Gil and discover why water is key. Experience his rich photo journey and commitment to safety and education for women and girls.
Global showings:UNESCO in Paris, the United Nations in New York, Fowler Museum Los Angeles
Gil is the Former Los Angeles County District Attorney...OJ Simpson, Menendez Brothers, Domestic Violence Prosecutions & Crime Prevention Programs, and Consulting Producer to the TNT hit television series, THE CLOSER.

Forced Marriage in the United States

Vidya Sri
Gangashakti Founder
Authentic and moving
National & International
Collaborative Advocacy
Educational Institution Outreach
Lena Alhusseini
Arab-American Family Support Center
Executive Director

White House Champion for Change
for child protection, domestic violence, and sex trafficking
Extensive International service on world issues of child protection and human trafficking
Lisanne Divine
Mohawk Valley
Resource Center for Refugees
Director for Community Integration
Coordinator for Family Peace program
Connecting local, national and international collaborators to cause a social shift away from practices that harm.
"Tostan Ranked as One of the 100 Best NGOs"
The Global Journal
Gannon Gillespie
Director of Strategic Development
"To date, over 5,000 communities from eight countries have joined in abandoning both Female Genital Cutting (FGC) and child/forced marriage."
Tostan International
"Molly Melching, Tostan's founder, named one of the 150 fearless women in the world"
Newsweek, Women in the World
March 2012
Cristina Bicchieri, Ph.D
Sascha Jane Patterson Harvie Professor
Director, Philosophy, Politics and Economics Program
Professor of Philosophy and Legal Studies
University of Pennsylvania
Cristina is the S. J. P. Harvie Professor of Social Thought and Comparative Ethics, Professor of Philosophy and Director of the Philosophy, Politics & Economics program at the University of Pennsylvania. She is a leader in the fields of rational choice and social norms. She has published six books and hundreds of articles.
Her work on social norms shows how changing collective expectations radically changes behavior. UNICEF is adopting her work on social norms in its campaigns to eliminate practices that violate human rights.
Loretta Pyles, Ph.D.
Associate Professor, School of Social Welfare
State University of New York at Albany
Creating Spaces for Economic Transformation

Developing critical thinking and community building skills that can facilitate sustainable economics and shared decision-making exploring systemic barriers based on race, gender and class and reconstructing community resources that are built on shared values.

Deirdre is an experienced executive and leadership coach. She currently serves as Board President for Support1000 and as the Director of the CultureSync Academy. Deirdre will be sharing the playful and values-based approach that Support1000 takes to affirming the dignity of women around the world.

Deirdre Gruendler
Support 1000
Board President

CultureSyc Academy


Conference Program:
With focus on gender violence and possibility for gender peace, the conference experience consists of two full days of active collaborative conversations, rich culture, and live performances.
The conference is followed by the Film Festival, showing short and feature length films indentifying actions that uphold human rights and exposing human rights violations from around the world.

Conference Registration:
The conference will start on October 17, 2012 at 7:45 am and end on October 18, 2012 at 4:30pm.

Participants are welcome to stay for the Film Festival portion that will start on October 18, 2012 and end on October 20, 2012.

Conference registration fees include full access to the 2-day conference sessions, breakfast, lunch, and snacks each day, admission to all Film Festival displays.
General Admission: $225 (after Sept 7: $250)
Student Admission: $175
OVW Travel Funds:
The grant manager for the Culturally and Linguistically Specific Services Program (CLSSP) has approved the use of OVW travel funds to attend the conference. Other OVW Grantees need to consult grant managers to use travel funds.

Sunday, July 8, 2012

United Way Receive $10,000 Grant For Technology From Community Foundation

Volunteers and staff at the United Way of the Valley and Greater Utica Area will be able to better serve the community, thanks to the replacement of old technology with the help of a $10,000 donation from The Community Foundation of Herkimer and Oneida Counties, Inc.
“Technologically speaking, our server and network were comprised of old and low-functioning hardware and software,” United Way Executive Director Brenda Episcopo said. “This grant from our long-standing community partner has allowed us to continue to serve our community and add new features to improve the efficiency of our work.”
For more information about United Way, or to donate to the annual campaign, visit or call (315) 733-4691.