Spring / Summer Spring / Summer 2006 2006 Volume 5, Issue 2 Volume 5, Issue 2 International Truck and Engine Corporation is the operating company of Navistar International Corporation (NYSE:NAV). The company is a leading producer of medium trucks, heavy trucks, and severe service vehicles sold under the International® brand and the world’s largest midrange diesel engine manufacturer. In addition, the company provides a comprehensive line of parts for its trucks and engine products. IC Corporation, a wholly owned subsidiary, produces school buses. The company has been building school buses since 1907 and is still one of the industry’s largest manufacturers. International Truck and Engine Corporation also is a private label designer and manufacturer of diesel engines for use in the Group’s Class 6 and 7 medium trucks, school buses and selected Class 8 heavy truck models. This segment also sells engines for industrial, agricultural and marine applications. In addition, the Engine segment provides customer with proprietary products needed to support the International engine lines, as well as other standard engine and aftermarket parts. Products, parts and services are sold through the industry’s largest dealer network in the United States, Canada and Mexico and more than 50 dealers in 50 countries throughout the world. Additionally, through a joint venture with Ford Motor Company, the company builds medium commercial trucks and sells truck and diesel engine services parts. International Truck and Engine Corporation have the broadest distribution network in the industry. Financing for customers and dealers is provided through a wholly owned subsidiary Navistar Financial Corporation in the United States and General Electric Canada Equipment Finance G.P. in Canada. The Financial Services segment provides retail, wholesale and lease finance for products sold by the truck segment and its dealers, as well as finances the company’s wholesale accounts and selected retail accounts receivable. Additional information can be found on the Company’s web site at http://www.internationaldelivers.com . International Truck and Engine Corp. 1 Ontario Drug Benefit Program 2 Macular Degeneration 3 Bad Breath — Why Me? 4 Customer Satisfaction Survey Results 5 Dental Pre-Determinations 3 Inside this issue: ClientSide ClientSide ClaimSecure is pleased to profile International Truck and Engine Corporation, a valued client since 1996. International Truck has recently expanded its benefit program with Claim- Secure to include Extended Health Care and Dental Benefits.
Transcript
Spring / SummerSpring / Summer
20062006
Volume 5, Issue 2 Volume 5, Issue 2
International Truck and Engine Corporation is the
operating company of Navistar International
Corporation (NYSE:NAV). The company is a leading
producer of medium trucks, heavy trucks, and severe service vehicles sold
under the International® brand and the world’s largest midrange diesel engine
manufacturer. In addition, the company provides a comprehensive line of
parts for its trucks and engine products. IC Corporation, a wholly owned
subsidiary, produces school buses. The company has been building school
buses since 1907 and is still one of the industry’s largest manufacturers.
International Truck and Engine Corporation also is a private label designer and manufacturer of diesel engines
for use in the Group’s Class 6 and 7 medium trucks, school buses and selected Class 8 heavy truck models.
This segment also sells engines for industrial, agricultural and marine applications. In addition, the Engine
segment provides customer with proprietary products needed to support the International engine lines, as well
as other standard engine and aftermarket parts.
Products, parts and services are sold through the industry’s largest dealer network in the United States, Canada
and Mexico and more than 50 dealers in 50 countries throughout the world. Additionally, through a joint
venture with Ford Motor Company, the company builds medium commercial trucks and sells truck and diesel
engine services parts. International Truck and Engine Corporation have the broadest distribution network in
the industry. Financing for customers and dealers is provided through a wholly owned subsidiary Navistar
Financial Corporation in the United States and General Electric Canada Equipment Finance G.P. in Canada.
The Financial Services segment provides retail, wholesale and lease finance
for products sold by the truck segment and its dealers, as well as finances
the company’s wholesale accounts and selected retail accounts receivable.
Additional information can be found on the Company’s web site at
http://www.internationaldelivers.com.
International Truck and Engine Corp. 1
Ontario Drug Benefit Program 2
Macular Degeneration 3
Bad Breath — Why Me? 4
Customer Satisfaction Survey Results 5
Dental Pre-Determinations 3
Inside this issue:
ClientSide ClientSide
ClaimSecure is pleased to profile International Truck and Engine Corporation, a valued client since 1996. International Truck has recently expanded its benefit program with Claim-Secure to include Extended Health Care and Dental Benefits.
Page 2 C l ientS ide Volume 5, I ssue 2
In April 2006, the Ontario Ministry of Health and Long-Term Care introduced the “Transparent
Drug System for Patients Act”. This proposed legislation impacts many healthcare stakeholders.
To assist you in understanding these changes, we have highlighted some of the key features of
this plan as well as identifying potential areas that may affect our clients.
The primary objectives of this proposed legislation are to ensure:
• patients get better access to the innovative drugs they need,
• taxpayers get value for the money they spend,
• drug companies are fairly compensated for the money they spend on critical research and innovation.
What does this change mean to ClaimSecure clients?
Some of the proposed recommendations will help private plans reduce their costs:
• Non-ODB (Ontario Drug Benefit) formulary drug interchangeability – Pharmacists will now be allowed to substitute the non-ODB brand name drugs with an available generic equivalent product.
• Generic Pricing Rule – Reduce the reimbursement price of generic drugs to 50% from 70% of the reimbursement price of the equivalent brand-name product.
• Change Pharmacy Reimbursement Structure – increase the dispensing fee to $7.00 from $6.47 and decrease the drug ingredient cost mark-up from 10% to 8% with an overall maximum of $25.
Some of the proposed recommendations MAY increase costs to private plans. These proposed changes include:
• Secondary Payer – It is the intent of the Ministry to be the second payer for working seniors with private insurance plans.
• Pharmacist Cognitive Fee – intend to introduce a new payment schedule for specific services that pharmacists provide for patients, e.g., trial prescriptions.
Note: There is no proposed change in the government plan with respect to the current annual deductible, co-
pay or eligibility criteria.
Although this proposed legislation HAS NOT yet been passed, ClaimSecure wants to ensure that our clients are aware of the legislation and the potential cost impact on their drug benefit program.
As more information becomes available to the public, ClaimSecure will review and summarize the pertinent details of the ODB changes and ensure you continue to be in-formed of all relevant changes. If you have any questions regarding this proposed legisla-tion, please contact your ClaimSecure Client Service Associate at 1-888-479-7587 or if you wish more details regarding this announcement, please visit the government website:
ClaimSecure Bulletin: Ontario Drug Benefit Program Announcement
Linda Lin,
B.Sc.Phm.,MBA
ClaimSecure
Macular Degeneration is the #1 cause of blindness in North Americans over age 50 - a condition where, over time, the light sensing cells in the macula part of the eye no longer work. Eventually, someone who suffers from macular degeneration will suffer from missing or blurred vision in the central (reading) part of vision with the outer peripheral vision remaining normal.
The age-related form of macular degeneration (there is also an inherited juvenile form) is further divided into “dry” and “wet” types. Fatty tissue slowly builds up behind the retina in dry macular degeneration, which comprises 85% to 90% of all cases. 10% to 15% of macular degeneration
cases are “wet”, meaning there is leakage of blood and other fluid from behind the retina into the eye. In both cases, if left untreated, the macula will be completely destroyed.
Although no one really knows why macular degeneration starts, there are some definite risk factors. The condi-tion is found more commonly amongst elderly Caucasians. There appears to be a genetic factor in developing the disease. Other risk factors include, hypertension, smoking, high blood cholesterol levels and high fat die-tary intake.
The question remains as to an effective prevention for macular degeneration. A major study completed in 2001 showed that a specific mixture of vitamin C, vitamin E, beta-carotene, zinc and copper did slow the progress in some patients who had the disease, but the mixture did not prevent the development of macular degeneration in previously normal eyes. At present, there is no study that conclusively demonstrates any benefit from supple-ments in healthy individuals.
10% to 20% of wet macular degeneration may be treated with lasers. There is much investigation currently go-ing on for new medications which stop the formation of new blood vessels. Existing medications which are approved for the treatment of wet macular degeneration include verteporfin (Visodyne) and pegaptanib (Macugen).
Only verteporfin (Visodyne) is partially or fully covered by provincial health plans (OHIP). The cost of each
treatment is about $2000, with patients typically receiving three to four treatments in the first year and about
two treatments in the second. A typical total average cost is about $14,000 per eye over two years.
Macular Degeneration
Page 3 C l ientS ide Volume 5, I ssue 2
David Wong, MD
Medical Consultant
Dental Pre-Determinations .... Streamlining in Progress
In our efforts to continually improve customer service, ClaimSecure is pleased to announce a change in our dental predetermination procedures.
Effective this fall, predetermination responses will be communicated as a separate Explanation of Benefit (EOB), similar to our regular EOB format.
This change in procedure means two things – it speeds up the response process with a clear expla-nation to a member and dental provider, and it ensures that both the patient and the dentist are ad-vised of pre-determination results at the same time.
Page 4 C l ientS ide Volume 5, I ssue 2
Possible Causes of Bad Breath . . . .
Bacteria: Food particles left in your mouth combine with bacteria to create a bad odour. These bacteria are often on the back of
your tongue and produce volatile sulphur compounds (VSC’s); the most common are hydrogen sulphide and methyl mercaptan.
Gum Disease: Inflammation or infection of the gums can also result in an overgrowth of these bacteria which produce odors.
Dry Mouth: This is an often overlooked cause of breath problems. Saliva (water produced in your mouth) naturally cleanses
your mouth, washing away many odours causing bacteria. Your mouth may become too dry when you sleep, possibly because you don’t drink enough fluids. Dry mouth is also a common side effect of some fairly common prescription medications.
Certain Foods: Common culprits include garlic, onions, fish, cabbage, coffee and alcohol.
Tobacco: Smoking or chewing tobacco can cause problems even for many hours after you stop using them.
Sinus Problems: Often sinuses drain into the throat and may sometimes lead to mouth odour.
Medical Conditions: Certain conditions may also cause problems.
Halitosis - Bad Breath . . . .
Everyone’s nightmare!
Read on for some of the possible causes for this condition and perhaps some solutions...
Bad Breath—Why Me?
Detection . . . The gold standard for detection of these volatile sulphur compounds is gas chromatography using flame photometric detectors. This type of equipment is not portable and often found in labs at universities etc. but would not be practical for an average dental office.
Portable sulphide monitors are available for dental offices. These devices measure air expelled by the patient. Although they are highly sensitive to hydrogen sulphide, they have a low sensitivity to methyl mercaptan which is a significant contributor to halitosis.
. . . . Possible Solutions for Bad Breath
- Clean the tongue twice a day using a tongue scraper (can be abrasive to tongue) or soft toothbrush.
- Limit coffee intake as it is a heavy contributor to dry mouth.
- Avoid the certain foods listed above.
- During dry weather, a humidifier can prevent drying of the mouth and nasal passages.
- Chewing sugarless gum can be effective in stimulating saliva.
- Avoid rinses and mouthwashes that have a high alcohol content, as they dehydrate the mouth and contribute to dry mouth.
- Mouth rinses (low in alcohol) work by:
1) merely masking the odour (like a perfume)
2) *neutralizing the sulphur compounds that cause odour
3) *drawing off volatile sulphur compounds or contain ingredients that actually eliminate bacteria producing odour
*Note: These products usually have to be obtained by a prescription and can’t be purchased over the counter.
They contain special ingredients such as chlorine dioxide, cetylpyridinuim chloride or triclosan that actually work.
The good news is that some of these products are becoming more available over the counter as regulatory hurdles are passed. However, there are many conservative solutions to these problems which we all can try before we get into the more complicated treatments.
Mark Donnelly, D.D.S
Dental Consultant
Page 5 C l ientS ide Volume 5, I ssue 2
Our Annual Customer
Satisfaction Survey
The Results are in . . .
The Winners Declared
Special thanks to those clients who took the time to respond to ClaimSecure’s annual customer satisfaction survey. We are extremely pleased with the high level of participation and sincerely appreciate the many positive comments, as well as suggestions for future improvement. Here is a summary of areas/topics we thought would be of interest.
Benefits: 100% have Drug, 89% have Dental, 80% have Extended Health Care.
Clients: 74% have been with us for 0-5 years, 24% have been with us 6-10+ years.
Satisfied with Card Acceptance: 94% at Pharmacies, 85% at Dental Offices.
Satisfied with Claims Adjudication and Payment Services: 98% (rating criteria: accuracy and turnaround time)
Satisfied with Bilingual Customer Response Centre: 98% (rating criteria: hours of operation, time taken to have calls answered, professionalism, accuracy of answers)
Satisfied with Benefit Plan Set-up and Maintenance: 95% (rating criteria: Member cards delivered on time or ahead of schedule and printed accurately; Plan set up accurately; Member changes processed on schedule and accurately; replacement cards issued in a timely manner; plan changes processed accurately and within 10 days.)
Satisfied with our Dedicated Service Associates: 98% (rating criteria: Time to receive a response, accuracy of answers received)
Satisfied with our Internet Reporting Capabilities: 89%
Regarding Electronic Claims Payments for Members: 52% of the respondents felt that less than 50% of their employees would be interested in having payment made directly to their bank account.
www.claimsecure.com
91% have visited the website
98% found it easy to navigate
77% have obtained claim forms
45% consulted the Health Library
52% read the Clinical Newsletter
59% read the ClientSide Newsletter
56% have utilized eProfile
(employee access to claims payment and history)
98% of respondents
indicated that they
would recommend
ClaimSecure to others.
The articles contained herein are not meant to provide medical or other profes-
Your feedback is important to us. If there is anything you would like to see
in this newsletter, or you have any suggestions or comments, please contact:
Editor:
Ellen Trotman,
Senior Manager, Client Services
1-888-479-7587 ext. 3014
Fax: 905-949-3029
Associate Editor:
Rita Moxam,
Client Services Representative
1-888-513-4464 ext. 2585
Fax: 705-673 5968
Visit our health library which has
recently been updated.
http:/www.claimsecure.com
When the survey was launched, we offered a prize to the first 5 respondents – a pair of “ClaimSecure” designer sunglasses. We are pleased to announce the following winners (in order of receipt): Ontario Ironworkers, Progress Energy, Heath Benefits Consulting,
Ad Culture Group, City of Orillia.
ClaimSecure is always looking for ways to improve the service to our clients and the products we offer. Your feedback is an extremely important tool that we utilize, to not only recognize our strengths, but more importantly to assist us in better identifying areas for future development.
