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4 March 2009 Wednesday 02:15 PM EST

448 words


Guardian Life To begin using the new database reimbursement rates

Fran Lysiak

NEW YORK

Guardian Life Insurance Company of America will cease to use the database operated by Ingenix and pay $ 500,000 to a nonprofit organization that will establish a database to determine the off-network reimbursement rates.

Guardian Life is the eighth insurer to conclude an agreement with New York Attorney General Andrew Cuomo about his investigation outside the network reimbursement rates. The company, one of the largest mutual life insurance in the United States, is also a national health insurance, with most of its users in the state located in New York City, Long Island and the County of Westchester, Cuomo's office said.

Launching more than one year, the Attorney General's probe centered on Ingenix, a database of billing health from UnitedHealth Group. The database, many insurers use to determine their rates for doctors outside their networks, had been rigged and defraud consumers by hundreds of millions of dollars, Cuomo charged.

In a statement, Richard C. Jones, Guardian's Senior Vice President and Chief Executive responsible for communications, said the company is pleased to take part in the development of a database that have no conflicts of interest that have been identified by Cuomo's investigation in the Ingenix database.

"This is an important initiative for health care reform that will ensure transparency, accountability and equity, and Guardian fully supports this initiative," said Jones.

Guardian Life and its subsidiaries offer life, disability, health, long-term care, critical illness and dental insurance for individuals, small businesses and their employees nationally. Its business unit of the group, which focuses on small and medium-sized market, serves more than 120,000 employers, 6 million employees and their families, according to the company.

In recent weeks, the four largest publicly traded U.S. insurers - UnitedHealth (NYSE: UNH), Aetna (NYSE: AET), Cigna (NYSE: APC) and Wellpoint Inc. (NYSE: WLP) has reached settlements, agreeing to contribute $ 50 million, $ 20 million, $ 10 million and $ 10 million, respectively, not yet named non-profit organization (BestWire, Feb. 20, 2009).

The agreement with Guardian Life "brings us within reach of the comprehensive reform of the industry," Cuomo said in a statement.

Smaller, New York's health insurers who also reached agreements with the Attorney General Healthcare Inc is MVP. / Preferred Care, Schenectady, NY, and health and HealthNow independent, both based in Buffalo.

Guardian Life Insurance Company of America currently has a Best's financial strength rating of A + + (Superior).

(By Fran Lysiak Matso, senior editor, BestWeek: fran.lysiak @ ambest.com)

5 March 2009

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