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WINTER 2005
Univera Healthcare gains more than 600 new groups in 2004
TIME-SENSITIVE MATERIAL
Univera Healthcare
205 Park Club Lane
Buffalo, New York 14221-5239
Winter 2005
Area employers
have been
clearly
responding to
our array of
innovative
Mary Lee Campbell-Wisley
products and
Regional President
competitive
pricing structure. Employers have
embraced Univera Solutions, Univera
Value Plus and our experience-rated
products.
The year 2004 was a year marked by
a terrific increase in sales here at
Univera Healthcare: about 14% across
all lines of business in Western New
York. More than 600 new employer
groups have joined Univera Healthcare
and are now offering our products to
their employees.
More groups have joined us early in
2005. We welcome all employers and
look forward to serving their employees and their families.
Take Steps had a very successful
launch last fall and we are
continuing to add to that
program. Very soon we
will have an interactive
kiosk for mall walkers
installed in McKinley
Mall. Mall walkers will be able to
register, log their laps and earn prizes.
Our AfterHours program at three
Lifetime Health Medical Group
offices continues to grow to meet the
needs of our members, exceeding all
expectations. We served approximately 20,000 patients in 2004, which
put it on par with a medium size
hospital emergency room.
Our members are also taking
advantage of our 24
Hour Nurse Advice
Line, available 24 hours
a day, 7 days a week,
including holidays.
A new colonoscopy
program also increased our members’
access to care. The team at Empire
Drive is currently performing 30-40
procedures per week and is expanding their capacity to accommodate
80-100 patients per week. With our
colonoscopy program most patients
can be accommodated within two
weeks, while the wait time for an
appointment elsewhere in the community is typically 8 to 12 weeks.
In addition to once again receiving
NCQA’s highest level of accreditation, URAC, another independent
reviewer, recently conducted a site
visit audit of our Case Management
Program and gave it a spectacular
100% compliance on all standards.
We look forward to another successful year of serving our members,
employer groups, medical personnel
and the community at large.
Check out our new and improved Web site
Visit us at www.univerahealthcare.
com for help choosing the right plans
for your workforce. You will also find
plan rates and benefits by product
line.
All the information you need for
enrollment is here.
Just make your selection and send
the information to your account consultant.
Say goodbye to paperwork. Now
you can manage enrollment electronically. Update your group address,
phone number, contact person and
other features, paper-free. Submit
enrollment additions, cancellations
and changes.
When your employees are changing
plans, you can have them complete
their applications online on our
secure Web site. Then simply review
and approve the online applications
before we process them.
Get answers quickly and easily by
sending an e-mail to our Account
Service or Membership and Billing
departments and you will
receive prompt answers.
See the membership
enrolled in your group and
sort it by name, status,
member ID, date of birth
and more.
Request provider listings,
health plan brochures and
other materials and we will
send them to your office. No phone
calls are necessary.
Employees can do the following
online:
• Submit questions and get answers
fast.
• Change doctors or request a new
ID card.
• Read up on thousands of healthrelated topics at the Healthwise
Knowledgebase.
• Find a doctor with our online
provider directory.
• Find the right hospital with Click
and Compare Care.
• Get details about Member Rewards.
• Connect to local and national
healthcare organizations with our
Wellness links.
• Update personal information.
INSIDE
WINTER 2005
Medicare options
Free massage
Prescription savings
Still smoke free
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Reaching out to the community
Junior Achievement
Bowl-A-Thon
Univera Healthcare
is a sponsor of the 21st
Annual Junior Achievement Bowl-AThon. It will be Saturday, March 12.
Businesses, organizations, schools or
groups are invited to participate and
help support Junior Achievement.
Junior Achievement educates
thousands of school children each
year through hands-on programs
that explain and explore how our
free market economy works.
For more information or to sign
up call 853-1381, ext. 10.
Community Hero Awards
Wendy’s and Univera
Healthcare Discover
& Explore Music
Series
Univera Healthcare is once again
sponsoring the Community
Hero Awards with
partners from the
United Ways of Western
New York. These awards are designed
to encourage and salute volunteerism.
Volunteers will be selected in four
categories: youth, individual, senior
and group.
Awards will be presented at the
Community Hero Awards Breakfast
on April 19 at the Buffalo Niagara
Convention Center. For more information call 887-2671.
This series of concerts is
designed for children of all ages
and varied musical interests.
Upcoming concerts are:
The Arabian Nights, an adaptation
of the story of Scheherazade on
March 20 at 2:30 pm.
Mary Lee Campbell-Wisley
Regional President
Deborah Williams
Update Editor
Update, news for employer groups of
Univera Healthcare, is published three
times a year by:
Univera Healthcare
205 Park Club Lane
Buffalo, NY 14221-5239
We fit your business better
www.univerahealthcare.com
UEMP 2/05
delivering quality, uncompromising
coverage to our communities,
including Medicare beneficiaries
• A fitness program available for
some of our programs that encourages physical activity
• A personal health coach for members with answers from health care
professionals when members need
them: 24 hours a day, 7 days a
week
The retiree drug subsidy has been
in the news recently. It is designed to
encourage employers and unions to
continue providing high quality prescription drug coverage. It has highly
flexible rules that permit employers
and unions to continue providing
drug coverage to their Medicare-eligible retires at a lower cost while
retaining their current plan designs.
Univera Healthcare is currently
developing plans that meet the needs
of employer groups and members.
We will be keeping you informed as
these plans are developed and as the
federal regulations are finalized.
For more information on our
Medicare plans call your account
representative.
Symphonic Adventure,
includes kids in the action on
May 8 at 2:30 pm.
For more information call 885-9371.
Univera Healthcare offers array of
Medicare options
Univera Healthcare fits your business
better for your Medicare eligible
employees. We offer one of the lowest rates in the area.
Other features of our programs that
include SeniorChoice and Univera
Medicare PPO:
• Over 3,000 primary care physicians, specialists and ancillary
providers
• All area hospitals
• Emergency/urgent care coverage
anywhere in the world
• Allowances for hearing aids and
eyewear
• Prescription drug options
• Dedicated Medicare call center for
eligible retires
• Automatic notification for employees who have Univera Healthcare
products as they approach their
65th birthdays
• Close to 30 years experience in
• Judy and David’s
• Tales & Scales-
AfterHours offers night, weekend medical care
Univera Healthcare members have been
taking advantage of AfterHours Medical
Care at night and on weekends.
No appointment is necessary. A physician always is on duty, supported by
other medical staff. Pharmacy services
also are available.
For members the cost of an AfterHours
visit is the usual copay for a physician at
these Lifetime Health Medical Group
locations:
•Amherst University Health Center,
1185 Sweet Home Road, Amherst.
•West Seneca Health Center,
120 Gardenville Parkway West,
West Seneca.
•William E. Mosher Health Center,
899 Main St., Buffalo.
The hours are Monday-Friday 6-10 pm:
Saturday 1-8:30 pm and Sunday 10 am5:30 pm. For more information call
716/656-4355 and TTY 716/885-4955.
Univera Healthcare changing
chiropractic network
Beginning April 1, Univera Healthcare is
changing its chiropractic network to Prism
Health Network.
More than 95% of the chiropractors in
our current network also participate in the
Prism Health Network.
If a member’s chiropractor is not participating in the Prism Health Network, we will
notify the member before April 1, 2005, if
he or she has visited that chiropractor during the past year.
Members will have the opportunity to choose a new chiropractor from the
Prism Health Network. If members would like to inquire if their chiropractor
is participating with the Prism Health Network, they can contact PRISM at
712-2779 or toll free at 1/866-686-0674. In addition, members may go to the
PRISM Web site at www.prismnetwork.com to inquire if a provider is participating.
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Lockport woman receives free massage from ‘Univera Baby!’
Univera Healthcare’s Univera Baby!, a
Univera Healthcare for expectant
multi-media promotional campaign
parents at the Lifetime Health
designed for expectant mothers in
Medical Group locations.
Western New York, has ranWomen who register
domly selected Lockport-resifor Univera Baby! are
dent Tracy Farley as January’s
automatically entered for
winner of a maternity masa chance to win a presage from Univera
natal massage from
Healthcare and the Lifetime
Lifetime ComplementsSM,
Health Medical Group.
a program by Lifetime
Farley first heard about
Health Medical Group
Univera Baby! when she saw
providing a number of
a television commercial on
complementary services at
WGRZ-TV Channel 2,
its West Seneca Health
which led her to visit the
Center location.
program’s Web site
One way expectant
(www.univerababy.com) to
moms can treat the stressregister.
es that come along with
Farley looks forward pregnancy is by indulging
“I find the weekly emails Tracy
to her massage.
from Univera Baby! to be
in a therapeutic pregnanhelpful,” said Farley. “I’ve been back
cy massage. There are many benefits
to the Univera Baby! Web site a few
of massage, including the relief of
times since I’ve registered to read the
common aches and pains of pregnanweekly articles that are posted.”
cy. Also, pregnancy massage can
Farley also added that she will soon
work to reduce stress and its effects
be taking various classes offered by
on the mother and her baby, and can
Program highlights include:
• Week-by-week emails sent to expectant moms, containing information
regarding their pregnancy for each specific week.
• Weekly on-line articles available on the Univera Baby! Web site, spanning
topics regarding all phases of pregnancy, including nutrition and weight
management, balancing work and pregnancy, and birthing options.
• ‘On Call’ – in collaboration with the Lifetime Health Medical Group,
Univera Baby! participants can email specific questions to OB/GYN
pediatricians and providers. Responses to questions from expectant moms
will be posted to the Web site.
• Special benefits for Univera Healthcare members, including a free copy of
the book What to Expect the First Year, free prenatal classes at the Lifetime
Health Medical Group locations, and discounts on accessories needed for
motherhood. Also, all women who register are eligible to win a free
maternity massage each month.
• Downloadable journal marking pregnancy milestones, which can be
printed out, filled in, and kept as a reminder of prenatal events.
affect circulation and relieve some of
the swelling that pregnant women
may experience.
Univera Baby! is an interactive,
Web-based program that serves as an
information source and guide for
moms-to-be throughout the duration
of their pregnancy. Women can
enroll in the program by logging on
to the Univera Baby! Web site at
http://www.univerababy.com and
registering.
Members can save money on prescriptions
Prescription drug costs across the
country are skyrocketing. In fact,
these costs have quadrupled in the
past ten years and now amount to
about 15-20 percent of health care
costs.
Drug costs are continuing to
increase at about 10-20 percent a
year. These costs affect everyone—
whether you are currently taking a
prescription drug or not.
There are some simple steps members can take to save money:
• Compliance. It is very important
that members follow your physician’s instructions. Prescription
drugs are an investment in health.
When patients do not follow their
doctor’s instructions and fail to take
the correct dosage of a drug at the
correct time, the patient and the
community pay for both the prescription and the illness or condition that could have been prevented. If members are having problems
with side effects they should tell
their doctor immediately.
tion drug benefit. Tablet
splitters are available at most
pharmacies for about $3.
• Fewer tablets per day.
Occasionally, when starting a new
medicine members will increase the
dose until the desired effect takes
place. In this case, a member might
end up taking several tablets of the
same medicine at the same time.
There may be a higher strength
tablet available that will allow a
member to take one tablet. This
will cost a lot less.
• Generic trial program.
Under this program members
receive a free two-week
trial prescription for selected
generic medications.
Experience has shown that
more than 90% of all members
who start on a generic medication
will stay with it. On average
generics are one-quarter of the
price of the brand alternatives. A
generic drug is made with
the same active ingredients in the
same dosage form as a brand
name drug. The Federal Food and
Drug Administration strictly regulate the strength and purity of
generic medications.
• Trial size. Members can reduce
medication waste by requesting a
small quantity of pills to take for a
few days for new prescriptions.
This will determine if the medicine
will work. Paying for a month or
more worth of medication only to
find out a member can’t tolerate it
can waste hundreds of dollars.
• Tablet splitting. Members can
• Coverage of Prilosec OTC.
save up to 50 percent on prescription medications when they split
higher doses of some medications
in half to meet the prescribed daily
dose, depending on the prescrip-
The prescription heartburn medication Prilosec is available over-thecounter under the name Prilosec
OTC. To help members save
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money, Univera Healthcare covers
Prilosec OTC as a generic medication (at the lowest co-payment
amount) under the prescription
drug benefit when prescribed by a
physician.
UEMP 2/05
Univera Healthcare introduces Univera Value Plus
Univera Healthcare has announced
the introduction of Univera Value
Plus, a new managed care product
that offers members fantastic benefits with flexible copayments.
With Univera Value Plus, members get hospital coverage, worldwide emergency care, and access to
our Lifetime Health Medical Group
locations—where they can save time
and money with reduced copayments for adults, no copays for kids
18 and under, and the convenience
of on-site pharmacy, lab, and x-ray
services to serve their primary
needs.
“We are pleased to offer Univera
Value Plus, an enhanced product
that gives our members the option
of using the Lifetime Health
• Members can get their prescriptions filled pretty much
wherever they want–either
at a Lifetime Health Medical
Group location or at a community drugstore–with access to
every major pharmacy chain (and
most independent drug stores, too).
That includes more than 57,000
pharmacies across the U.S.
“Our partnership with Univera
Healthcare is just one way Lifetime
Health Medical Group strives to offer
affordable, convenient healthcare for
families in Western New York,” stated Lifetime Health Medical Group
President, Cynthia A. Ambres, M.D.,
M.S.
“At Lifetime Health, we’re sensitive
to the special bond that must exist
Medical Group locations at a
reduced copayment rate,” said
Mary Lee Campbell-Wisley, regional president of Univera Healthcare.
“Univera Value Plus equals flexibility and savings for all.”
From this flexible plan, members
can choose whether to get their care
at one of our six Lifetime Health
Medical Group locations.
Here is what else is available
through Univera Value Plus:
• Each family member chooses
where to go for care at the time of
service: health centers or community physicians.
• Members can go to any Western
New York hospital–as well as the
area’s major lab and radiology
facilities.
between a doctor and patient. Our
physicians–specializing in internal
medicine, pediatrics, ob-gyn and
family medicine—are caring, experienced professionals who practice
medicine together with a team of
other allied healthcare professionals
within convenient, modern medical
centers.”
Univera Value Plus is available
through employer groups. For more
information, visit our Web site at
www.univerahealthcare.com, or call
716/847-0881.
Still time for employees to join Take Steps South Buffalo woman still smoke-free year later
It’s not too
late to join
Take Steps, a
communitywide Univera
Healthcare
promotion
designed to
improve health in small steps.
Univera Healthcare has designed the
program so that anyone
can participate. It is particularly well suited for
employers.
Physical activity and
proper nutrition are
essential for a healthier workforce. So
Univera Healthcare has created the
Take Steps Healthy Competition. It’s
a fun, eight-week contest that challenges employees to eat smarter and
be more physically active every day.
The program is free to all and
because setting up and tracking is all
web-based, Take Steps is incredibly
easy to implement.
Wegmans Food Markets– Forbes
Top employer– has charted remarkable success with their wellness program. In fact, a recent poll of national businesses utilizing fitness initiatives proves the benefits:
• 20% saw increased productivity
and decreased absenteeism
UEMP 2/05
• 56% reported increased morale
Visit www.takesteps.univerahealthcare.com and click the
employer tab to learn
more and request your
free Take Steps kit.
To make the program
as easy to implement as
possible we provide you with the
following tools:
• Pre-written emails: An entire
series of emails designed to help you
inform and educate all members of
your organization, as well as recruit
help from supervisors and support
management.
• Daily tips: these email-ready tips
provide everyone with ways to be
healthier every day.
• Motivational posters: Can be
posted around your organization to
raise awareness and excitement.
• Online monitoring: From our
website, you can set up and track the
success of the competition. You’ll be
able to view the progress of teams.
4
In November of 2003, Univera
she’s glad to see her mother making
Healthcare’s youth smoking preventhe same decision.
tion program 2Smart 2Start visited
“Not only did I know I needed to
the third graders of
quit smoking for
South Buffalo Charter
my health, but
School. After the presenthe article that
tation, all the students
(2Smart 2Start)
signed their pledge cards
ran in the paper
and promised to be
last year let
smoke-free.
everyone know
One student went
that I quit….so
home and inspired her
I felt like everymother to quit and, after
body knew and
one year, Fran Desiderio
I didn’t want to
is still smoke-free.
let them or my
“I feel so much better
family down,”
now that I have quit
Fran Desiderio with her inspiration– commented
daughter Desiree.
smoking,” said Fran.
Fran. “So that
“I am exercising more and am saving
helped, too!”
so much money!”
2Smart 2Start reached a milestone
Fran is proud of Desiree for signing
May 18 when the 100,000th child in
the pledge card that day and for
Western New York signed the
encouraging her to stop smoking her2Smart 2Start pledge card, and curself. Fran admits that she was just
rently 104,000 kids are participating
thinking about the program recently
in the program.
when Desiree received her 2Smart
Children grades 3-12 can partici2Start newsletter in the mail, which
pate and based on the age group of
contains coupons for area merchants
the students, there is a theatre comso kids can use them as a reward for
ponent, a peer counseling program,
signing the 2Smart 2Start pledge.
and the national Tar Wars curricuFran’s mother quit smoking two
lum.
years ago as a New Year’s resolution,
The program is free and available
and she is still smoke-free.
throughout the academic year (call
Fran believes that it was just time
716/843-7878 or visit the Web site
for her to stop smoking herself and
at www.2smart2start.org).