"The Big Picture" Newsletter

January 2008 Issue

COLORADO EDITION

Legislative Update

Republican lawmakers, the minority in both chambers, released their health care agenda for the 2008 legislative session on December 3. Their proposals include the following:

• Create a low-cost benefit plan with basic health care coverage that would have a low monthly premium.
• Allow individuals to purchase health insurance from other states.
• Allow qualified nurse practitioners in rural areas to have greater authority in addressing basic patient health needs.
• Allow Medicaid beneficiaries to voluntarily reduce their benefits in exchange for greater control over their accounts. 
• Urge Congress to pass legislation that would allow individual health coverage to receive the same tax incentives as corporate plans. 
• Provide $8.6 million to reduce the waiting list of about 4,000 residents for state-funded developmental disabilities services.

Also, The Blue Ribbon Commission for Health Care Reform approved final recommendations that it estimates will provide health coverage to 85 percent of residents. The commission will present its recommendations, which do not include a funding mechanism, to the legislature on January 31. Key recommendations include the following:

• Require every legal resident to have at least a minimum benefit plan.
• Establish a health insurance connector.
• Require employers to establish premium-only Section 125 plans.
• Provide subsidies for uninsured low-income workers below 400 percent of the federal poverty level (FPL) to purchase their employer’s plan.
• Require health insurers to offer a minimum benefit plan in the individual market
• Allow health insurers to set premiums based on their age and geographic location and disallow the consideration of past and current health conditions.
• Merge Medicaid and CHP+ into one program and expand eligibility to all uninsured legal residents earning under 205% of the FPL.

LOCAL SPOTLIGHT

Where We Are

3900 East Mexico Avenue #1100
Denver, CO 80210
Telephone: 303.782.1500
Fax: 303.782.1577

Who to Contact

Randy Savona
303.691.1005
Randy.Savona@CIGNA.com

Experienced Local Leadership

Daryl W. Edmonds, President and General Manager
Daryl Edmonds joined CIGNA HealthCare, as president and general manager of the Colorado health plan, in 1997. Responsible for sales and operations, Edmonds has led his management team into the 21st century as one of the only managed care organizations in the state to achieve profitability and maintain steady growth for the past eight consecutive years. Edmonds is President and Market Leader for Colorado, New Mexico, Utah, Wyoming, Montana, Idaho, Alaska, Washington and Oregon.

Edmonds, who has 19 years experience overseeing health plans, is a graduate of Kansas State University with a Bachelor of Science degree in business. He is active in the Denver Metro Chamber of Commerce; serves on the board of directors of the March of Dimes as well as Cover Colorado and was a past board member of Junior Achievement; was past president of the Colorado Association of Health Plans; and serves on the Business Council on Healthcare Competition.

Randy Savona, Vice President of Sales
Randy Savona began his career in Sales with UNUM in Cranford, New Jersey.  Over the past 27 years, he has had roles of increasing responsibility in the employee benefits field; including Regional Sales Manager for UNUM, New Jersey, as well as Vice President of Disability Claims for UNUM in Tarrytown, New York.

In 1999 Randy moved to Denver, Colorado as Regional Sales Manager for Sun Life and joined CIGNA in 2003 as Regional Sales Manager for CIGNA Group Insurance. In January of 2007 he assumed sales leadership for CIGNA HealthCare as well.

Edward Fenstermacher, M.D. - Medical Director for Mountain States Region
Edward Fenstermacher, M.D., is the medical director for the mountain states region. Based in Denver, Dr. Fenstermacher oversees member health care and services and continues to build upon CIGNA’s commitment to improving transparency and empowering members to be smart health care consumers. Previously he served as a medical director for CIGNA HealthCare in Arizona, overseeing inpatient utilization of the health plan’s offerings and services. He also served as chief medical officer for Maricopa Integrated Health Care System in Arizona, and medical director for Arizona Health Care Cost Containment System, the state’s managed care Medicaid agency.

Prior to entering the health benefits industry, Dr. Fenstermacher was a plastic surgeon specializing in hand and reconstructive surgeries. He served as chief of surgery at Desert Samaritan Hospital in Mesa, Arizona, and had successful clinical practices in Arizona and Wyoming. Dr. Fenstermacher also devoted a significant amount of time during his professional clinical career to performing pro bono reconstructive surgeries in Australia, Africa, South America and other impoverished areas around the world.

Dr. Fenstermacher received his M.D. from the University of Colorado’s School of Medicine in Denver. He earned a master’s degree in business administration and health services administration from Arizona State University in Tempe.