"The Big Picture" Newsletter

October 2009 Issue

TENNESSEE EDITION

Legislative Update

On June 18, the Tennessee General Assembly completed the 2009 regular session three weeks late. The General Assembly ultimately supported the Administration’s budget including an increase to the HMO premium tax from 2 percent to 5.5 percent, which permits the state to receive additional federal matching funds. The following is a summary of legislation of interest:

Bills signed by Governor Bredesen

S.B. 1382 - Notice of inpatient admission - prohibits a health insurance carrier from requiring notification by a provider within less than one business day of an inpatient admission if the notification or admission occurs on a weekend or federal holiday.
Enacted as Public Chapter 333 (effective 6/1/2009)

S.B. 774 - Calculation of out-of-pocket costs for prescription drugs This bill establishes methodology and disclosure duties for carriers and PBMs concerning calculation of out-of-pocket costs for prescription drugs.
Enacted as Public Chapter 355 (effective 1/1/10)

S.B. 582 - Social Security Numbers - prohibits printing social security numbers on any card, identification, or badge that the consumer must display in order to receive a service or make a purchase.
Enacted as Public Chapter 269 (effective 5/21/2009).

S.B. 2240 - Market Conduct Information - requires certain insurers to file an annual statement of market conduct with the Commissioner of Commerce and Insurance.
Enacted as Public Chapter 383 (effective 6/9/2009).

Bills awaiting action from Governor Bredesen

S.B. 2357 - HMO Premium Tax This bill increases the HMO premium tax from 2 percent to 5.5 percent.

H.B. 2289 – All-Payer Claims Database - requires the Commissioner of Commerce and Insurance to establish an all player claims database. In order to overcome the objections of legislators with data privacy concerns, the bill was amended to include a list of specific data elements that may not be transmitted to the database. A commission will be established to further develop requirements and uses of the database with two seats designated for health insurers.

S.B. 549 - Claim Denials - prohibits a health insurer from retroactively denying a previously paid claim instead of recouping amounts previously paid to health care providers. In addition, the bill prohibits a successor health insurer from denying a claim if the claim was submitted within 180 days of the date the claim was denied by the original health insurer or the covered person did not receive prior approval, but the successor insurer would normally grant authorization for the services rendered.

S.B. 693 – Rental Networks - requires provider notifications upon granting access to a provider contract to a third party. The bill exempts affiliates and self-funded plans. Carriers are required to maintain a website or toll-free phone number through which a health care provider can obtain a listing of the third parties to which the individual or entity has executed contracts to grant access to such provider's health care services and contractual discounts pursuant to the provider network contract.

Bills Defeated

S.B. 218/H.B. 338/S.B. 920/H.B. 65 – Autism and Developmental Disabilities Mandate
S.B. 526/H.B. 354/S.B. 1700/H.B. 1359 – Prosthetics Mandate
S.B. 669/H.B. 1548 – Prescription Drug Continuity of Care
S.B. 1324/H.B. 39 – Expansion of State Plan to all residents
S.B. 1717/H.B. 1661 – Uniform Credentialing Application
S.B. 2274/H.B. 2269 – External Review
S.B. 727/H.B. 912 – Standardized Small Group Application
S.B. 160/H.B. 636 – Children’s Hearing Aids Mandate 

LOCAL SPOTLIGHT

Where We Are

Chattanooga
1111 Market Street, BR6A
Chattanooga, TN  37402

Who to Contact

Chattanooga Sales Office
CIGNA HealthCare
1111 Market Street, BR6A
Chattanooga, TN  37402

Brent Wick
Vice President of Sales, Mid South East/West
423.321.4714
800.852.7616, Ext 321.4714
brent.wick@cigna.com

Brenton Johnson
New Business Manager
423.321.4599
800.852.7616, Ext. 321.4599
Brenton.Johnson@cigna.com

 

Knoxville Sales
CIGNA Healthcare,
1111 Market Street, BR6A
Chattanooga, TN 37402

Brent Wick
Vice President of Sales, Mid South East/West
423.321.4714
800.852.7616, Ext 321.4714
brent.wick@cigna.com

Brenton Johnson
New Business Manager
423.321.4599
800.852.7616, Ext. 321.4599
Brenton.Johnson@cigna.com

Diana McClurg
New Business Manager
(888) 244-6264, Ext 75804
Diana.McClurg@cigna.com

 

Nashville Sales Office

CIGNA HealthCare
1000 Corporate Center , Suite 500
Franklin, TN  37067

Brent Wick
Vice President of Sales, Mid South East/West
423.321.4714
800.852.7616, Ext 321.4714
brent.wick@cigna.com

C.J. Shah
New Business Manager
(615) 595-3383
chintan.shah@cigna.com

Ryan Kocher
New Business Manager
423-321-4672
ryan.kocher@cigna.com

 

Memphis Sales Office

CIGNA HealthCare
3400 Players Club Parkway
Suite 140
Memphis, TN 38125

Mary Tate-Smith
Vice President of Sales
901.748.4111
mary.tate-smith@cigna.com

Bart Alley
New Business Manager
(901) 748-4105
Bart.Alley@cigna.com

Dan Cottrell
New Business Manager
(901) 748-4106
Dan.Cottrell@cigna.com

Katie Collier
New Business Manager
(901) 748.4141
Katie.Collier@cigna.com

Experienced Local Leadership

John W. Sorrow, President and General Manager
John W. Sorrow is the President of CIGNA HealthCare’s Mid South Health Plan (Tennessee, Kentucky, Arkansas and Mississippi). John was promoted to this position in 2004. Since then, John has led the Mid South Health Plan to the number one region (out of 19) in the country in membership growth in 2006, and finished number two (out of 19) the other two years in overall health plan performance.

John currently serves as Chief Executive Officer for Mid South Administrative Group, a CIGNA HealthCare company based in Memphis, TN. John has held various health plan executive roles with increasing responsibility over the last 10 years with CIGNA. Prior to joining CIGNA in Memphis in 1996, John held roles in sales, underwriting and actuarial science with Blue Cross Blue Shield of Tennessee, where he began his career in 1990.

John holds an MBA from the University of Tennessee at Chattanooga. As part of his MBA, John studied abroad in Great Britain and Australia, comparing health care delivery systems of those countries to the United States. John also earned a BBA majoring in Risk Management and Insurance from the University of Georgia. The Chattanooga Times Free Press recently named John to their list of Top 40 Young Executives “40 under 40”.

Based in Chattanooga, John currently serves on the Executive Board of Directors for the Tennessee Life and Health Guarantee Association. John was also nominated this month to serve on Tennessee Governor Phil Bredesen’s eHealth Advisory Council. John is active in the community raising corporate funds for Siskin Children’s Institute, is a member of Chattanooga Rotary, and a part of the Georgia Educational Enhancement Fund and the Chattanooga Athletic Scholarship Fund.

Knoxville
Brent Wick, V.P. Sales for Chattanooga, Memphis, Arkansas and Mississippi
Brent began his career in the healthcare industry with ACMG, a TPA.  In 1996, Brent joined Healthsource and moved to the Tri-Cities region to assist with marketing small group products.  He then moved to Chattanooga in 1998 after CIGNA acquired Healthsource.  Brent eventually took responsibility for CIGNA’s Chattanooga, Memphis, Arkansas and Mississippi markets as Vice President of Sales. 

Brent holds a Bachelor of Accounting degree from the University of South Florida.

Diana McClurg, New Business Manager (Knoxville)
Diana began her career in the insurance industry with Tennessee First Health as a Marketing Rep and then as Customer Service Rep.  Healthsource purchased Tennessee First Health and Diana became an Account Manager.  CIGNA purchased Healthsource in 1998 and Diana was promoted to a New Business Manager in 2002.  She is located in the Knoxville area and is responsible for handling new business opportunities for employer groups with 50 to 400 benefit eligible employees.

Diana is a graduate of the University of Tennessee with a Bachelor of Science degree in Marketing Education.

Nashville
Chintan Shah, New Business Manager (Nashville)
Chintan Shah (CJ) is a graduate of Tennessee State University. After receiving BBA in Accounting, CJ began his career with CIGNA HealthCare in 1999 as a Large Group Underwriter. After three years in Underwriting and two years in new business support role, CJ accepted a New Business Manager position in 2004. He has since established himself as a talented and responsive Sales Executive for CIGNA's Kentucky and Nashville, Tennessee regions.

Ryan Kocher, New Business Manager (Nashville)
Ryan Kocher was named New Business Manager in Nashville for CIGNA's Middle Market Segment in September 2009. Most recently he was a Senior Client Manager for CIGNA in the Memphis market working on large government entities and complex private accounts. Prior to this position, Ryan was a Financial Underwriter focused on Consumer-Driven pricing. He graduated summa cum laude from the University of Richmond (B.S., 2002).

Chintan (C.J.) Shah, New Business Manager (Kentucky)
C.J. began his career at CIGNA Healthcare in 1999 as a Large Group Underwriter.  After spending two and one-half years in Underwriting and two years as a Presale Specialist role, C.J. became a New Business Manager.  Since then he has established himself as a responsive sales representative in the Nashville Sales Office.

Chintan is a graduate of Tennessee State University.

Memphis
Bart Alley, New Business Manager
Bart has over 20 years experience in the healthcare industry, both as a Financial Underwriter and a New Business Manager.   Bart works with producers and prospects with 51 to 199 eligible employees.

Katie Collier, New Business Manager
Katie rejoined CIGNA in 2007 after serving as an account manager with Mercer Employee Benefits and Willis, both in New York.  Previously, she was with CIGNA in both project management and service roles.

Katie holds a B.A. in Psychology from the University of Tennessee.  Katie is responsible for group sales of 50-500 eligible employees.

Daniel Cottrell, PAHM, New Business Manager
Daniel has more than a decade of successful healthcare experience.  He began his career with Blue Cross Blue Shield of Tennessee in 1996 and achieved that organization’s highest accolades in each of his five years.  In 2001, Dan joined Willis of Tennessee and served as a HealthCare Consultant to middle market employers until he joined CIGNA in 2005. 

Dan was educated at California University and also has his PAHM professional designation.  With CIGNA, Dan provides healthcare financing solutions to large middle market employers, brokers and consultants in Mississippi, Arkansas and West Tennessee.