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November 07, 2005 01:00 AM

TIA unveils 2 insurance plans

Miles Moore
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    The Tire Industry Association has unveiled a new program, ``TIA-Care,'' which it said will provide high-quality, affordable health care to members, as well as a plan that will offer workers' compensation coverage.

    Working with Triveris, a health plan management firm based in Eatontown, N.J., TIA will offer through TIA-Care a partially self-funded plan for association members with more than 15 employees, said TIA Executive Vice President Roy Littlefield.

    The plan integrates medical care management with claims processing and emphasizes plan members taking the steps necessary to improve their own health, such as getting regular checkups and cancer screenings.

    ``I'm really excited about this,'' Mr. Littlefield said. ``This is the kind of program which, if it works, will be a great boon to our members. This program is unique in its approach to health care, and five years down the line we should see that we've achieved major savings on health care costs during that time.''

    For TIA members with 15 or fewer members, Mr. Littlefield said, there will be a ``Mini-Med'' program available that offers more limited benefits. More traditional health care policies also will be available to members if they want them, he added.

    Founded in 1991 under the name Health Network America, Triveris operates on the principle that the highest quality of medical care is also the least expensive, according to Dr. Stephen Kardos, Triveris founder and president. Triveris' staff comprises doctors, nurses and other health care professionals whose job is to give compassionate, common-sense advice to plan members to help them make the best choices regarding their own health care, according to publicity from both Triveris and TIA.

    ``We're not an insurance company, but a medical advocacy company,'' said Dr. Kardos, who had his own practice in pediatrics before founding Triveris.

    The main reason health insurance plans fail, he said, is that too often only the sickest members join, so insurance companies aren't willing to take the risk of underwriting them-at least at a reasonable price. ``What traditionally has happened with associations is that they set up health care plans which then fail because as premiums go up, members drop out, and there isn't enough money to cover the costs,'' he said.

    By partial self-funding, Dr. Kardos noted, neither TIA nor Triveris carries the whole financial burden. But the key to keeping premium and claim costs down, he added, lies with the plan members themselves.

    ``In order to stabilize health care costs, people have to take action to stay well,'' he said. ``We encourage them to get their mammograms and Pap smears, and to take care of their diabetes. If you do all those things, your costs will be lower.''

    Mr. Littlefield said he first heard of Triveris from a member of TIA's insurance committee who also is a board member of a New Jersey hospital. ``The hospital signed on with Triveris, and after a year it had saved a million dollars,'' he said. He added that he was extremely impressed by his visits to Triveris headquarters. ``I've never met a member of the staff who didn't at least have a master's degree in some branch of health care,'' he said.

    Triveris reps planned to be at TIA'S SEMA Show booth in Las Vegas to explain TIA-Care to members, according to a press release.

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