Winter-weather woes bring insurance claims

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The early part of 2025 brought a good, old-fashioned winter to Central New York with plenty of snow, wind, and ice. That weather produced a number of damaged and collapsed buildings, which can create insurance headaches for owners. “This year has been super crazy,” says Kimberly Hendrick, personal-claims insurance manager at OneGroup NY, Inc., the […]

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“This year has been super crazy,” says Kimberly Hendrick, personal-claims insurance manager at OneGroup NY, Inc., the Syracuse–based insurance subsidiary of Community Financial System Inc. (NYSE: CBU).

Across Central New York, dozens and dozens of buildings have collapsed. Many of the incidents began with a multi-day storm that dumped large amounts of snow in mid-February. Some of the buildings include an Omega Wire, Inc. building in Oswego County, the Barneveld Fire Department in Oneida County, and the Miners Table banquet hall in Herkimer County.

The number-one issue when it comes to snow, Hendrick says, is the weight of ice and snow accumulated on the roof. Typically, damage from it is covered by insurance, but it’s important for a building owner to know for sure.

“You do have to educate yourself and know what you bought,” she says of insurance coverage.

Lots of snow and ice buildup may mean businesses and building owners need to do a little maintenance and try to get that snow removed before it causes any damage. If that’s not possible and it looks like a roof may collapse, they can try to try to empty the building before that happens to minimize losses.

For those hiring someone to remove snow, “make sure they have insurance,” Hendrick advises, and make sure that insurance covers the work the contractors are doing.

In the event of a building collapse or other damage from wintry weather, the most-important thing is timely reporting, she says. That means letting your insurance carrier know as soon as something happens. Don’t wait and potentially let other damage occur before reporting, she cautions, or you may find things are not covered.

Along with that, document the damage as soon as possible before any repairs or remediation efforts begin. It doesn’t have to be fancy, but photos and videos — even from a cell phone — are extremely helpful.

“The insurance company needs to look at something,” Hendrick says. Along with that, providing an early estimate from a contractor for repairs can also expedite the process. “The more information you give an adjuster, the faster your claim will go.”

Winter weather also produces insurance slip-and-fall claims from sidewalks and parking lots.

“Make sure to have them clear,” Hendrick says. Businesses leasing space should make sure it’s clear in the lease who is responsible for clearing the sidewalks and parking lots. If you hire a company to clear the snow, make sure they document their work — which can even include GPS location to show when a truck cleared an area.

Those records can help show that a business or building owner did their best to keep the sidewalks and parking lots cleared. And don’t forget about snowbanks, Hendrick adds. Make sure they aren’t blocking visibility and inadvertently causing a liability issue.

In the event someone does slip and fall, “document, document, document,” Hendrick says. “You have to take it seriously.” While there doesn’t need to be a fancy form, a business should make sure to cover the seven Ws — who, what, when, where, why, witnesses, and weather.

Finally, report any incidents to your insurance agent as soon as possible. This way, there are no surprises, she says.

It’s always a good idea to periodically review coverage with your agent to make sure the insurance is truly covering what your business needs. “You have to think about worst-case scenarios,” Hendrick says.

Finally, make a disaster plan and include information like who to call with phone numbers for your insurance agent, contractors, and more, and keep it handy. Hendrick recommends even storing that information in your phone.

“Have numbers so you’re not panicked when you get a call at 1 in the morning,” she concludes.

Evolving wellness programs benefit employees, employers

Employee Benefits & Human Resources, Health Care, Insurance & Financial Services, Subscriber Only

There is more to wellness than physical health, and it may benefit employers to consider adding a wellness program to their workplace, area benefits experts say. The wellness plan of today looks much different than the past, when all it may have done was encourage employees to get their annual physical or have their blood

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There is more to wellness than physical health, and it may benefit employers to consider adding a wellness program to their workplace, area benefits experts say.

The wellness plan of today looks much different than the past, when all it may have done was encourage employees to get their annual physical or have their blood pressure checked, says Jessica Albanese, VP, director of employee benefits at Community Financial System, Inc. (NYSE: CBU).

“Things have come a long way,” she says, and the wellness plans of today incorporate physical wellness along with emotional, social, and even financial wellness. From healthy recipes to financial workshops, wellness programs can be tailored to provide an array of information and benefits to employees. “There’s something out there for everyone.”

Businesses of any size can offer a wellness program, starting with simple in-house challenges and rewards, Albanese says. “You can start on a small level,” she advises. “We get wellbeing information from all our carriers.” Sharing that information with employees is a great start to a wellness program.

One action Albanese recommends when starting a wellness program is to have a focused team to work on the program. That can include surveying employees to see what they are interested in and outlining goals for the program and what the company wants to incentivize people to accomplish. Start by looking at data, especially medical-claim data, and identify problem areas to focus on.

There are also numerous wellness platforms available, which can make it easy to offer a program to employees, Albanese says. “We actually use an online platform. We need that platform to provide content, to collect data, and to make it easy for employees to participate.”

But why offer a wellness plan?

It can be the difference between whether a potential employee chooses to work for your business or for someone else, Maureen Gillan-Myer, executive VP and chief human resources officer at Community Financial System, says.

Today’s employee is looking closely at benefits, she notes, and offering a wellness plan can give a business a competitive edge when it comes to recruiting. Additionally, a wellness program can reduce absenteeism, boost productivity, and boost employee morale.

“There are a lot of ways you can look at the value of a wellbeing platform,” Albanese says. While it isn’t always easy to track a tangible number, a business can track things like employee engagement with the program, changes in absenteeism, and any impacts on medical claims.

When it comes to starting a wellness plan, it really begins at the top of an organization, Gillan-Myer says. “Have a discussion with leadership,” she says. “You’ve got to have buy-in from the top.”

That’s because there is often an element of cost to offering a wellness program, so leadership needs to be on board to support that.

“Don’t shy away from it because you feel like you can’t prove it’s going to work,” Gillan-Myer adds. “Not everything comes with a number. We know it makes a difference in our organization.”

NextGen Label names chief human resources officer

Employee Benefits & Human Resources, Manufacturing & Engineering, Small Business, Subscriber Only

CICERO — NextGen Label Group recently announced the promotion of Jessica McCarthy to chief human resources officer (CHRO), effective April 1. The move coincides with Dan Rosenbaum’s transition to president and CEO of the company. McCarthy is a proven leader in human resources and administration, bringing extensive experience in fostering a positive and productive workplace

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Preferred Mutual appoints chief information officer

Insurance & Financial Services, Subscriber Only

NEW BERLIN — Preferred Mutual Insurance Company named David Smith senior VP and chief information officer, effective Jan. 1, according to a Feb. 19 announcement. In this role, he will oversee the development and implementation of innovative technology strategies that enhance customer and agency experiences while driving business-process transformation at Preferred Mutual. Smith joined Preferred

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Excellus net income rebounds in 2024 despite operating loss

Employee Benefits & Human Resources, Insurance & Financial Services, Subscriber Only

ROCHESTER — Excellus BlueCross BlueShield says the health plan ended 2024 with a profit of $25.6 million, citing its annual report filed with the New York State Department of Financial Services on March 1. “While the health plan last year faced several challenges, stronger-than-expected investment results helped the insurer reach a small net margin of

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“While the health plan last year faced several challenges, stronger-than-expected investment results helped the insurer reach a small net margin of 0.4 percent, or $25.6 million,” per the Excellus fact sheet about its 2024 financial performance. That allowed Excellus to overcome its 2024 operating loss of $163 million (or 2.5 percent) on $6.5 billion in premium revenue.

The 2024 profit figure was an improvement from a net loss of $23.2 million at the end of 2023. In 2022, Excellus reported net income of $58.9 million on $6.6 billion in premium revenue in 2022.

“Health insurers nationwide continue to experience significant increases in the cost and demand for health care, and Excellus BlueCross BlueShield is impacted by these trends across upstate New York as well,” the health insurer said to open its fact sheet.

The health plan spent $6 billion in 2024 — or about $16 million daily — on medical and drug benefits for its members.

Rochester–based Excellus is Central New York’s largest health insurer. The health plan and its parent organization employ about 4,500 people across upstate New York.

Medicare Advantage

For the second year in a row, high claims payments and a change in how the federal government sets hospital reimbursement rates for Medicare have “financially impacted” Excellus.

The change to the Medicare wage index resulted in Excellus reimbursing hospitals in 2024 over $100 million more for Medicare Advantage members without a corresponding premium increase in government funding.

The health plan’s Medicare Advantage products overall lost more than $200 million last year due to both wage-index changes and health-care cost increases, Excellus said.

Premium dollars

The nonprofit Excellus in 2024 spent 92 cents out of every premium dollar collected on health care for its members. Over the last 20 years, the health plan has averaged a net margin of 1.6 percent, it says.

With 92 cents of every premium dollar spent on patient care, the remainder of every dollar is primarily spent on taxes and operating expenses, including expenses related to employees, customer service, claims processing, and IT (information-technology) infrastructure.

Reserves and taxes

Excellus says its reserves were $1.7 billion at the end of 2024, or the equivalent of 91 days of claims and operating expenses.

Reserves are like a savings account to be drawn upon for unforeseen higher expenses such as a pandemic. Excellus reported that it paid $461.3 million in 2024 in federal and state taxes and fees, an increase of 5 percent over the prior year, per its fact sheet.

Assured Information Security, of Rome, receives patent number 25

Manufacturing & Engineering, Mohawk Valley, Subscriber Only, Technology

ROME, N.Y. — Assured Information Security (AIS) recently received a new patent from the U.S. Patent and Trademark Office, bringing the company’s total to 25 issued patents with several more pending, the Rome–based company announced. “Expanding our patent portfolio reinforces our commitment to developing cutting-edge technology solutions that enhance system security and resilience,” AIS COO

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Strategic Executive Alliance partners with Greater Utica Chamber for monthly program

Mohawk Valley, Small Business, Sports, Entertainment & Tourism, Subscriber Only

UTICA, N.Y. — Strategic Executive Alliance (SEA) has announced a partnership with the Greater Utica Chamber of Commerce to host a monthly residency program beginning in April that will provide local businesses and entrepreneurs access to SEA’s expertise. Beginning Monday, April 7 from 10:30 a.m. to 4:30 p.m., SEA will hold sessions on the first

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Rome Health Community Recovery Center returns to original location

Construction, Design & Real Estate, Health Care, Mohawk Valley, Nonprofits, Subscriber Only

ROME, N.Y. — The Rome Health Community Recovery Center (CRC) recently returned to its original location at 264 W. Dominick St. in Rome, not far from the Capitol Theater. The center opened to the public starting Feb. 10. The Rome Health Community Recovery Center offers outpatient services for individuals struggling with substance-use disorders. These services

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Morse Manufacturing rolls out rebrand and redesigned website

Manufacturing & Engineering, Subscriber Only

SYRACUSE — Morse Manufacturing, a manufacturer of drum-handling equipment, recently launched a new brand identity, featuring a modernized logo, redesigned website, and an updated visual aesthetic that reflects the company’s future, while honoring its legacy. “For over 100 years, Morse has been at the forefront of innovation in drum handling solutions. This rebranding represents our

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VIEWPOINT: Revolutionizing Long-Term Care at Home Pharmacy Services

Business Mentors, Health Care, Subscriber Only

An aging patient, living alone and confused by the complex regimen of medications she must take, gets help from a pharmacist. Another patient, unhappy with the results he is getting from his prescriptions, has a visit with an in-home pharmacist for help with medication-therapy management. Both patients (and many more like them) are benefitting from

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Long-term care at home pharmacy — a comprehensive health-care model designed to meet the needs of aging patients in their homes — has emerged at a critical point in U.S. health-care history. While studies show that the U.S. health-care system is underperforming to a tragic degree, the U.S. population is reaching a point where more aging patients than ever need help. Long-term care at home pharmacy is bridging the gap by ensuring safety, convenience, and high-quality care for those struggling to get assistance for their health concerns.

While long-term care at home pharmacy is not a new practice, it is undergoing a revolution that promises to further enhance the assistance it can provide patients. By integrating the latest technological advances, long-term care at home pharmacy gains the ability to be more precise and provide more personalized service while reducing the burden on pharmacists.

Personalized medication management

For many patients, and especially aging patients, managing medication is a challenge that threatens the effectiveness of their health care. Key struggles include taking medications at scheduled times, taking the correct dose, and pairing medication with health monitoring, such as required with some pain-management medications.

As medication regimens become more complex, patients are often left on their own to identify dangerous interactions or combinations that can lead to ineffectiveness. What many need is personalized medication management that considers their unique combination of prescriptions.

To provide an adequate level of medication-management support, pharmacists providing long-term care at home pharmacy services can opt to leverage the power of artificial intelligence (AI). AI offers the potential to conduct detailed analyses of patient data to create personalized medication plans.

In the area of medication management, AI-powered tools can:

• Send patients personalized reminders.

• Monitor medication intake, alerting pharmacists or other health-care professionals when prescriptions are not followed.

• Monitor vital signs to detect abnormalities.

AI is poised to support the revolution of long-term care pharmacy at home, advancing far beyond simple reminders, monitoring, and alerts. A recent study published in the Journal of Medical Systems highlights the promise of generative AI as a sophisticated tool for managing complex medication regimens. In this study, researchers evaluated ChatGPT’s ability to handle the challenges of polypharmacy and assist in deprescription. They concluded that “AI-based tools can play an important role in ensuring safe medication practices for older adults.”

This breakthrough aligns perfectly with the goals of long-term care at home pharmacy, which focuses on delivering comprehensive and tailored medication management to patients who require skilled-level care in the comfort of their homes. For these patients, polypharmacy and chronic conditions are often the norm, making the integration of AI-driven tools a game changer.

Generative AI could enhance the care provided by long-term care at home pharmacies in several transformative ways:

Proactive Medication Reviews: AI tools could assist pharmacists in conducting thorough medication reviews and analyzing regimens for potential interactions, duplications, or medications that no longer align with the patient’s current health status. This aligns with the long-term care at home model’s commitment to ensuring optimal and safe medication use.

Support for Deprescription: Deprescription is often a critical, yet challenging, component of care for aging patients. AI can provide evidence-based recommendations to help pharmacists and prescribers identify medications to taper or discontinue, improving patient safety and reducing the risk of adverse effects.

Personalized Care Plans: Long-term care at home pharmacies prioritize individualized care. AI can complement this by generating tailored recommendations based on a patient’s unique medical history, current health conditions, and goals. This ensures the pharmacy’s interventions are clinically sound and patient-centric.

Enhanced Care Coordination: Effective collaboration among health-care providers, caregivers, and families is a cornerstone of long-term care at home pharmacy. AI can bridge communication gaps by synthesizing patient data, summarizing recommendations, and creating actionable insights for care teams.

Medication Adherence and Education: AI can empower patients and caregivers with personalized education on medication use, side effects, and lifestyle adjustments. For long-term care at home patients, this level of support can foster better adherence and reduce medication errors.

The integration of generative AI into long-term care at home pharmacy also has the potential to address systemic challenges. As the population ages and the demand for skilled-level care in the home increases, managing medications for these patients will become more complex. AI-driven tools can help scale the capacity of long-term care at home pharmacies, allowing them to serve more patients without compromising on safety or quality.

The study’s findings signal that AI is no longer just a future concept but an emerging partner in health care. For long-term care at home pharmacy, this partnership represents an exciting opportunity to further elevate the standard of care, improve outcomes, and support patients aging in place.

Remote patient monitoring

Telehealth technologies are another advancement that is allowing pharmacists to increase their capabilities. Those providing long-term care at home pharmacy services can use telehealth tools in several ways, including managing medications, coordinating care, and providing personalized delivery and education.

Wearables, which generally fall under the umbrella of remote patient monitoring, are one example of telehealth tools that are helping pharmacists provide better care. These tools allow pharmacists to monitor patients’ vital signs remotely, alerting them to changes that could indicate medication is not being administered correctly or not having its desired effect. To date, studies suggest that wearables have the potential to positively affect outcomes for those with chronic diseases.

Telehealth tools that allow remote video interactions also improve pharmacists’ capabilities to provide care by enabling real-time, face-to-face consultations, improving the quality of communication and care they can offer patients. For example, a patient who may need support administering injections can now receive personalized guidance via video communication with a pharmacist.

Furthermore, face-to-face video consultations let pharmacists build stronger relationships with patients. With video communication, pharmacists can see changes in conditions being treated and read nonverbal cues, which can give them a better understanding of the impact of treatment. By fostering stronger relationships, video-driven telehealth can also facilitate open communication about medication concerns, side effects, and adherence.

Long-term care at home pharmacy services have become a critical piece of the health care puzzle for many aging patients. By leveraging emerging technologies, pharmacists can further improve the impact of those services, giving patients higher chances of experiencing positive care outcomes.

Lindsay Dymowski is co-founder and president of Centennial Pharmacy Services, a long-term care-at-home pharmacy, and co-founder and president of the Long Term Care at Home Pharmacy Quality Commission.

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Personalized medication management

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