Health Program Administrator

Meridian Health Systems, recently entered into an Exclusive Healthcare Services and Project Teaming Agreement with Los Angeles Hispanic Health Network, (LHHN), a Los Angeles Metropolitan Chambers of Commerce initiative. Under the terms of this three-year automatically renewable agreement, Meridian will arrange for the provision of healthcare services on an exclusive basis to enrolled employees and relatives of small to medium sized Hispanic employer groups and self employed individual members of LHHN, in a culturally sensitive manner, through Meridian's network of affiliated physicians, hospitals and other ancillary services providers initially within Greater Los Angeles County, with later expansion to other areas of United States and abroad.
California's system of job-based health insurance -- the backbone of California's system of health insurance -- is declining, according to a report produced by the UCLA Center for Health Policy Research. The report also concludes that while job-based family coverage plummets, children's coverage is being protected by public insurance programs, such as Medi-Cal and Healthy Families.

Pushed by a 79 percent increase in the cost of job-based family coverage for the average worker, enrollment of dependents dropped four percentage points for children and two percentage points for adults from 2001 to 2003. According to this report, more than 6.6 million Californians under age 65 -- more than one in five non-elderly residents -- went without insurance for at least part of 2003, and more than 3.7 million lacked health insurance coverage for the entire year. Majority of the work force in Southern California for small and medium sized employer groups is comprised of Hispanic males and females, most of which lacked basic health insurance coverage. Those without health insurance were much less likely to have seen a doctor, gotten vital preventive screenings for cancer and diabetes, or taken medication for high blood pressure.

The rapid escalation in healthcare costs has placed considerable pressure The rapid escalation in healthcare costs has placed considerable pressure on insurance premiums in recent years. As premiums have risen, employers (those that continue to offer insurance) have been forced to pass more costs along to employees. As a result, some employees have chosen to bypass insurance rather than absorb the loss in disposable income. The result is a growing pool of uninsured working adults in California (and the nation).

There also exists a disparity between large businesses and small business in their ability to provide a choice of health plans to their employees. In 2003, 53% of large businesses provided a choice of more than one health plan to its employees, compared to 14% of small businesses. This lack of choice and flexibility can be just as troubling to small business employees as the relatively higher premiums they must endure.Meridian will provide a centralized administrative staff and the expertise that small firms are unlikely to possess on their own. Small firms typically lack the resources (both time and money) to hire a specialized staff to comparison shop for the best deal and to administer the plan most efficiently. Experience has shown that this service has been particularly valuable to small firms receiving insurance through a purchasing pool. Meridian will negotiate rates reflective of the risk characteristics of the entire group rather than as individual firms.

In addition, Meridian has entered into a management services agreement, with Superior Administrator, Inc., a Third Party Administrator, based in Santa Ana California, to facilitate consolidated billing, Custom Wellness Plan, Eligibility Administration, Custom Ad-hoc Risk Management reporting, Stop/Loss Reinsurance, Catastrophic Claims Management, Medical bill review, Benefit and insurance IT solutions, Web Enrollment-Employee, Employer, and Provider, Actuarial analysis and rate setting, etc.

Meridian has contract with various hospitals, primary and specialist healthcare providers within southern California, as well as an expanded network PPO Network of over 465,000 Healthcare providers through the CCN network. In addition, Meridian plans to implement a tele-medicine and tele-health based approach for specialty care, through an organized network of healthcare providers within and outside United States, using the ICE software developed by InterCare DX, Inc.
 

The increased purchasing power and collective bargaining capability associated with a group health insurance plan, will help address this problem among the LHHN membership.