"The Big Picture" Newsletter

May 2008 Issue

COLORADO EDITION

Senators Bob Hagedorn and Steve Johnson and Representative Anne McGihon unveiled their proposed “Centennial Care Choices” program at a meeting for interested parties on March 25. While legislative language is not yet available, the legislators have released summary documents indicating that under the program insurers would voluntarily design and offer low-cost health benefit plans with premium subsidies for low income individuals and families. The program would be designed to build upon the existing employer-based health insurance system in Colorado.

On March 20, a conference committee passed an amended S.B. 138 to require full disclosure by entities that make “physician designations,” defined as a representation of the cost efficiency, quality, or other assessments of the clinical performance of a physician that is disclosed to the public. The bill was sent to the governor for consideration. S.B. 138 describes acceptable criteria and a mandatory disclaimer for the designations. Additionally, this bill:

• requires that data and methodologies used in formulating designations be disclosed to the physician or the insurance commissioner upon request;
• entitles physicians to challenge designations and describes the processes to be used;
• makes violations of the act unfair and deceptive trade practices under insurance laws; and
• authorizes private rights of action as an enforcement mechanism

 

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.