Latest news with #Point32Health
Yahoo
4 days ago
- Business
- Yahoo
Parent company of Harvard Pilgrim Health Care and Tufts Health Plan, Point32Health, recognized as one of the most community-minded organizations in the country
Named by Points of Light to The Civic 50 for the fifth time CANTON, Mass., June 4, 2025 /PRNewswire/ -- The parent company of Harvard Pilgrim Health Care and Tufts Health Plan, Point32Health, was named to Points of Light's The Civic 50 for the fifth time. The Civic 50 recognizes the top socially responsible organizations in the United States and showcases how leading companies are moving social impact and community into their practices, values and core business. "Our colleagues' dedication to the people and communities we serve is evident across all aspects of our organization – from our Foundation community investments to colleague engagement in service and giving to business practices that prioritize people and their well-being," said Eileen Auen, executive chair of Point32Health. "We know that for our business to thrive, communities must also thrive. That's why community is central to our purpose to guide and empower healthier lives for everyone." In 2024, Point32Health and the Point32Health Foundation gave nearly $14 million in grants, matching gifts, sponsorships, volunteer time, in-kind and other contributions to support nonprofit organizations in local communities. Colleagues volunteered 13,215 hours, valued by Independent Sector at more than $525,000. "In an ever-evolving landscape, companies are looking to ensure that they can meet the needs of their communities, customers and stakeholders," said Jennifer Sirangelo, president and CEO, Points of Light. "Companies like Point32Health are leading the way in showing how social impact benefits their employees' well-being, strengthens the communities where they do business, and brings value and meaning to their work. Their efforts provide a model for others looking to bring the benefits of volunteering and social impact to their workforce and they're extremely deserving of this recognition." Point32Health was one of only six New England-based companies named to the list. The Civic 50 survey is administered by True Impact, and the results are analyzed by VeraWorks. The survey instrument consists of quantitative and multiple-choice questions that inform the scoring process. The Civic 50 is the only survey and ranking system that exclusively measures corporate community engagement. To view the Points of Light report and see the full list of The Civic 50 2025 honorees, visit View original content: SOURCE Point32Health
Boston Globe
6 days ago
- Business
- Boston Globe
Amid financial challenges, Point32Health hires a new chief executive
Gilligan said his appointment at Point32Health, which serves nearly 2 million members, comes at a 'pivotal time in the health care industry.' 'As we enter this important next chapter for our organization, we will position Point32Health to perform at its full potential and to drive growth,' he said in a statement. Advertisement Point32Health, which was formed in 2021 by the merger of Tufts and Harvard Pilgrim, has suffered serious financial setbacks in recent years. Point32Health struggled last year. For the first six months of 2024, the insurer reported an operating loss of $155 million on $4.7 billion in revenue, according to an Aug. 15 news release. Advertisement Like other health insurers, it has faced skyrocketing costs for prescription drugs, including medications that fight obesity. Last month, following the lead of Blue Cross Blue Shield, Point32Health said it was significantly scaling back its coverage of costly Starting Jan. 1, Point32Health will dramatically change how and when it pays for Zepbound — the insurer's Similar to Blue Cross Blue Shield, Point32Health will give large employers the option of paying extra to continue covering the weight-loss drug for its workers. But for patients who are insured by a smaller employer or who purchase their plans through the state's marketplace, Point32Health is ending coverage of the popular but pricey drug for weight loss altogether. The change comes as Eileen Auen, executive chair of Point32Health's board of directors, had served as interim head of the insurer since Hayes's departure. A selection committee of the board oversaw the recruitment of a new chief executive and retained a national executive search firm to assist in the process. Gilligan is a native of New England and graduate of the College of the Holy Cross, according to Point32Health. Advertisement Jonathan Saltzman can be reached at
Boston Globe
09-05-2025
- Health
- Boston Globe
The health insurance agency for Mass. state employees will run out of money on Monday
'However, the GIC does not know how soon the Legislature will pass the bill and when the GIC will receive the requested funds, which is why the GIC's health plans are being asked to [delay] payment of members' claims,' Point32Health said. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up Related : Advertisement According to the letter, payments will be delayed until the state approves a budget or until July 1, when the new fiscal year starts and the agency receives more funding. 'It's our hope that this will be resolved really quickly,' said Erika Scibelli, deputy executive director of the GIC. 'We're doing all of our advocacy and working with the legislature and our partners in the administration to advocate to get this moving.' The funding delays dismayed officials at the Massachusetts Health & Hospital Association. In a statement, the industry group noted that the GIC announced as early as December that it had been over budget every month of the fiscal year. In February, the GIC then publicly stated it was spending approximately $20 million monthly above budgeted amounts. Advertisement Expanded use of GLP-1 drugs such as Ozempic are one reason why healthcare spending has surged in Massachusetts. David J. Phillip/Associated Press 'The GIC apparently does not have any other contingency plan to handle the problem that it has seen developing for at least the past five months,' MHA said in a statement. 'The disruption in GIC claims payments will undoubtedly result in serious financial consequences for the hospitals and health systems that are providing care to the Commonwealth's employees and retirees, and their dependents and survivors that are covered under the GIC umbrella.' Though it provides insurance benefits to current and retired state employees and their families, the GIC doesn't directly manage its benefits. Instead, it works with four insurers — Point32Health, Mass General Brigham Health Plan, Health New England and Wellpoint — to administer benefits. Providers send bills to the insurers, which then charge the GIC. The governor had provided roughly level funding in this year's budget for the Group Insurance Commission, said Matthew Murphy, a spokesperson for the Executive Office of Administration and Finance. But the numbers have since proven insufficient. The agency has struggled in particular with surging prescriptions for pricey weight loss drugs, Scibelli said. Demands for reimbursement increases from providers have also exacerbated spending. Those challenges have pushed premiums higher for GIC members, up between 10.5 percent and 17.1 percent for next year, depending on the plan. Related : The Governor's supplemental budget was expected to fill the gap through the rest of this fiscal year, allocating $240 million to the GIC through June 30. Advertisement But the legislation has stalled on Beacon Hill, where lawmakers were already juggling a series of other bills that created a crush of major spending decisions. Days after Healey filed her supplemental budget, for example, the House passed a $1.3 billion bill While the Legislature has had a lot on its plate, the funding delays come at a perilous time for the health care industry, noted Mike Sroczynski, executive vice president and general counsel for the MHA. 'While we appreciate the financial situation of the GIC, this directive is an unacceptable contingency plan to those challenges,' Sroczynski said. 'We implore the GIC to seek an immediate, alternative resolution to its budget deficiency that will not further exacerbate the financial condition of healthcare providers.' Matt Stout of the Globe Staff contributed reporting Jonathan Saltzman can be reached at
Boston Globe
30-04-2025
- Health
- Boston Globe
Are you taking Ozempic, Wegovy, or other GLP-1 drug for weight loss? Here's what to know about the costs.
The state's second-largest insurer, Whether GLP-1s are covered by insurance has huge implications nationally because the drugs, which were first approved to treat diabetes and later obesity, are also being studied for possible future treatment of a Advertisement Here's what you should know about GLP-1s and how they're covered. How much do GLP-1 drugs cost out of pocket? The monthly price ranges from about $950 to $1,350, which adds up to more than $11,000 a year, at a minimum, before insurance and discounts. Advertisement What are the brand names of GLP-1s? Ozempic and Wegovy are two of the most well-known, due to extensive TV and marketing efforts. Others are Mounjaro, Saxenda, Trulicity, and Zepbound. GLP-1s are currently considered the world's hottest pharmaceutical products. What does GLP-1 stand for? Glucagon-like peptide. It is a hormone that plays a crucial role in regulating blood sugar, appetite, and digestion. It works primarily by stimulating insulin release, suppressing glucagon secretion, slowing gastric emptying, and increasing a feeling of fullness after eating. Will other insurers follow Blue Cross's example by eliminating GLP-1 coverage? Blue Cross is the dominant and most influential commercial health insurer in the state, with 3 million members. It's hard to imagine that Point32Health, the next largest commercial insurer with 1.5 million members, will continue to compete with Blue Cross at a significant financial disadvantage by covering expensive GLP-1s. Will my employer help defray the cost if my GLP-1 coverage is ended? There is a chance your employer will pick up at least some of the cost because doing so may help in employee recruitment and retention. But there is less flexibility for employers to do so if they have fewer than 100 employees and are 'fully insured,' as opposed to 'self-insured.' (Blue Cross and Point32Health offer both types of plans — more on this below.) How does a fully insured plan work? Smaller employers often avoid some of the risk of health insurance losses by contracting with an insurer such as Blue Cross to assume the risk of huge, unforeseen spikes in claims. (Those insurers also administer the plan.) When an insurer assumes the risk, it controls all aspects of the plan, including what drugs are — and are not — covered. In these circumstances, an employer has little discretion to add coverage of a drug such as GLP-1s. They must strictly adhere to the plan as designed by their insurer. How does the size of the company affect insurance? Because of the popularity of GLP-1s, Blue Cross is allowing more flexibility than usual for fully insured companies. Ordinarily, it would allow no variances in its plans. But for GLP-1s, it is allowing employers to continue to offer coverage of GLP-1s, so long as the companies agree to pay significant increases in premiums. But the option to continue coverage of GLP-1s is not available to companies of 100 or fewer employees because it is deemed too risky to the insurer. Advertisement How does a self-insured plan work? Self-insured employers are bigger companies with more resources that hire an insurer like Blue Cross to administer an insurance plan, but the employer assumes the risk of claims exceeding premiums. Because they pay their own claims, they are free to make changes in the plans they offer, including by adding coverage of GLP-1s (with an increase in premiums paid by employees). How should I approach my employer about what drugs are covered in my insurance plan? Insurance coverage is among the most important benefits offered by employers. (More than half of the state's residents are covered by an employer-sponsored health plan.) If you belong to a union, health insurance is a major component of contract negotiations. If you are choosing between job offers, the quality of the offered insurance may be a big factor in your decision. If GLP-1 coverage is important to you, make sure your views are communicated to your employer's decision makers. Why would an employer opt to cover GLP-1s? Besides recruitment and retention, a company may see GLP-1s as a path to lower its costs in the long run because weight loss generally improves health and could result in fewer and less expensive claims later. Some see GLP-1s as possibly significantly lowering overall future health costs. How do I know if my employer is fully insured or self-insured? Contact your company's HR department or check your health insurance paperwork. On the back of my insurance ID card it says my insurer 'administers claims payments and does not assume financial risk,' meaning my plan is self-insured. Advertisement Are GLP-1s covered by Medicare? Medicare does not cover GLP-1s prescribed solely for weight loss. But it does cover GLP-1s prescribed to reduce the risk of heart attack and stroke due to cardiovascular disease and obesity or being overweight. President Trump upon taking office reversed the Biden administration's plan to expand Medicare coverage by including GLP-1s for weight loss. Do Medicare supplemental plans cover GLP-1s? They usually follow Medicare policies, so, generally, no, GLP-1s are not covered for weight loss. Are GLP-1s covered by MassHealth? MassHealth covers Zepbound for treatment for weight loss. What's the future of the industry? Drug companies are racing to produce GLP-1s in the form of a daily pill instead of requiring weekly injections, among other potential advances. They are also trying to reduce the side effects of these drugs. Will the cost of GLP-1s eventually decline? Yes, prices are expected to drop due to increased competition, generic versions, potential price negotiation in Medicare, and other factors. But increased demand could Are 'compounded' versions of GLP-1s available? Compounded drugs are made by pharmacies and are typically allowed by the Food and Drug Administration to augment supply when there's a shortage of the brand-name drug (though they are not FDA-approved). Such a shortage existed for some GPL-1s, but the FDA this month said the shortage has been resolved. The compounded drugs are Got a problem? Send your consumer issue to
