by Gordie Little

They say good things come in threes. If that’s the case, Fuller Insurance Agency, Inc. should be really good. They have North Country offices, in Carthage, Canton and Malone and their sterling reputation over the past 28 years seems to bear out that image of “goodness.”

Their web site proclaims that they have “Local service, local knowledge, combined with a variety of products for all your insurance needs.” It continues by listing insurance for “Home, auto, boat, business, cycle, sled, life, ATV and health,” and says they are “protecting what’s important to you without forgetting what’s most important…YOU!”

Another paragraph explains further who they are: “Fuller Insurance Agency, Inc. provides local service and local knowledge while delivering the highest quality insurance products to our customers in Northern New York. Wilfred T. Fuller founded our Agency in 1980 as ‘the insurance professionals who care.’ Today, we continue as the insurance professionals who care.”

According to members of the family who remain with the business, these are not just hollow advertising slogans. Sharing ownership and the top management spots in the corporation these days are the late Wilfred T. Fuller’s sons, Adam and Aaron, who say they are working hard to continue the guidelines set by their dad who passed away three years ago.

In a recent interview, Adam outlined the Fuller Agency history. His dad, who had a career in the United States Air Force, had worked previously as a life insurance agent and decided to launch his own business in a rented space on State Street in Carthage on September 1, 1980. Adam was born five days later.

At first, the elder Fuller worked with farmers and a few personal lines of insurance. As time went on, the business grew and moved in 1987 to the present locationat 110 South School Street. The building was renovated to accommodate the Fuller Agency and other professional offices.

In 1991, Wilfred Fuller purchased an agency on Court Street in Canton and expanded his business to that community. That was the year Fuller became incorporated. The next major move came in 1994 when Fuller began marketing life and health insurance products to individuals and business.

Also that year, the first of two agencies was purchased in Malone. A second Malone Agency was acquired in 1996 and both were consolidated into their present office at 368 West Main Street.

Adam Fuller explained, “When my dad started in 1980, it was primarily personal lines of insurance. In the early 90s, he got more involved with commercial lines, including service to businesses and municipalities. There was a big focus on that as well as branching out into health insurance.” He went on to say, “The year we started in Malone was also when we got more actively involved with life and health insurance here in Carthage.”

Fuller said he cannot stress strongly enough the importance of his company’s connection with the military presence at nearby Fort Drum. And, he added, “It’s not necessarily just the active duty folks, but also people who work there. A lot of our commercial line customers have contracts at Fort Drum. Many are running sub-contracts for larger contractors who are now picking up work at that facility.”

Fuller added that, at this point in time, they are seeing “guys who are part-time handy men, now coming to the point where they’re really needing insurance because it’s not just side work any more. It’s becoming their business— their livelihood. We’re seeing a lot of requests from people who are entering business— not just construction—but are looking to provide services to the military.”

Adam Fuller says that the insurance business is in his genes. His mom is also a licensed insurance agent, but never actually worked for Fuller. Adam joined the Agency in 2001. He and his brother Aaron work together every day at the Carthage office, along with their sister Diana Clement. Aaron is six years his senior and Diana is older than Aaron.

They also have a brother Jurgen who is known as “Jake.” Jake was previously in theinsurance business with them, but decided on a career change and left the area in the 90s.

When asked to enumerate some of the ways his business is set apart, Adam said, “What’s important to us is that we’re an independent agency. We’re not tied down to one company. We represent many.” Some are very well known, such as Allstate, Progressive and Travelers. “But,” he added, “there are many others that are smaller, New York State-only companies that offer a tremendous variety of insurance from homeowners to landlord policies, to commercial and contractors. For example, New York Central Mutual is the largest, regional, personal lines insurance company in New York State. We also do a lot of business with Dryden Mutual. For health insurance, we work with Excellus and GHI.”

Adam said that insuring municipalities is a large part of their commercial business and reported that the total number is probably close to 50. Long-time employee Michael Gillette focuses on the municipal work and Adam indicates that he is working more and more with regional fire departments.

Needless to say, the Fuller insurance business goes hand-in-hand with real estate in Northern New York. Adam said, “When the Fort Drum boom hit, it was a no-brainer that all the agencies in the area got busy. There were new people coming into the area that needed homeowners’ insurance. We weren’t aggressively marketing it. A lot of it was done through connections made with lenders and real estate agents. A few of them had done business with us before and liked us.”

He went on to say, “We started to market more toward the homeowner because of all the new people at Fort Drum. Construction boomed. 2005 saw a lot of growth coming from Fort Drum and it wasn’t just military people involved. That’s when local people were perhaps selling a home they had been in for some time and were capitalizing on rising real estate values.”

During that period of time, there was sustained growth in insurance business with homeowners as well as landlord policies. 2006 was probably the peak year, but growth continued through 2007. By 2008, it had diminished somewhat. According to Adam, that’s when more of the on-base housing came on line, causing the demand to slow. The so-called ‘housing bubble’ was good for the Fuller Insurance Agency and it set the tone for much that they are doing today.

Adam said during that three-year boom period, the agency began seeing people moving into real estate speculation, buying property, building houses and buying older buildings to renovate for multi-family use.

Now that on-post housing has come on line in greater quantities, that sustained growth has diminished somewhat and the Fuller insurance business is constantly changing direction to accommodate the market. Adam commented that deployment on Fort Drum is still ongoing with people leaving and more people coming in. He added, “As home values began to rise, insurance values followed—not just because of what was happening locally, but across the country and world, as building materials skyrocketed. Our clients were now paying more for their homes, new houses were costing more, and that sometimes made our job of explaining the difference of replacement costs and actual cash value a bit easier.”

As for the recent recession’s impact on his business, Adam said the major difference is that people have become a lot more cash conscious. That means they’re shopping around and looking for ways to save money. He added that his company is doing more re-marketing as they try to save money for their customers by giving them options they might not have considered.

He was quick to say, “We’ll never fail to offer you the coverage you need just to save you the premium cost. We’re probably not going to give you the cheapest rate. Other places will do that. They’ll quote you the highest deductibles and the lowest coverages and perhaps will not fully explain the repercussions.”

In summing up, Adam explained, “What happened here during our growth period and subsequent leveling out, would correlate with what you will hear from bankers and real estate agents. There was a huge shortage of housing at one point. More and more came on line and now it’s beginning to flatten out again. However, there are still lots of people out there who are busy building, and that’s a good sign for the recovering economy.”

Adam Fuller had high praise for all 14 employees in the company’s three offices. Experience is important for every aspect of the business and the total service years represented is impressive. Nadine McIntyre has worked with them for 27 years, starting at the Watertown location. Penny Ellis has tallied 20 years. Michael Gillette boasts 15. And the rookie at Fuller Insurance, Erin Gebo, has been with them five years, but came on as a licensed broker. The two brothers and their sister have been exposed to their dad’s business since childhood.

The Fuller family has always been very much interested, committed and involved in their community and their agency was selected as the Carthage Area Chamber of Commerce “Service Business of the Year” in 2007.

Aaron serves as secretary of the Carthage Area Hospital Board of Directors. He is a trustee and past exalted ruler of the Carthage Elks Lodge. Adam is treasurer of the Carthage Area Hospital Foundation Board of Directors. He is also president of the Greater Watertown Jaycees and is a member of the Carlowden Country Club’s Board of Directors and of New York Central Mutual’s Agency Council.

Their staff is also committed to their community with other employees active with the Carthage Lions Club, local churches, and the American Legion Auxiliary. Long-time employee Mike Gillette is a councilman for the Town of Rutland.

One of the main mottos is: “Fuller Insurance Agency—Local Service, Local Knowledge.” Adam said, “When you call any of our offices, you speak to a person and not some recording. We will always work to do our very best to find the right product that meets your needs. You don’t have to make dozens of phone calls to compare. We’ll do it all for you.”

Adam said, “We’ve built a name for ourselves serving new homeowners and those investing in rental properties. We’ll continue doing that, but we’ll also focus on insuring recreational products. Outdoor recreation is becoming more and more popular with lifelong residents courtesy of Fort Drum. It’s also requires significant investment that needs insurance protection.”

Fuller Insurance Agency, Incorporated— their theme song could be, “We are family.”

Insurance. Not a very glamorous topic, but one that is critical to the bottom line of all of our businesses, especially in this day of skyrocketing insurance costs. What do you need? How much is enough? What are your options? In this issue we attempt to make some sense of these questions in a straightforward, commonsense manner. There are options, but there are also potentially costly mistakes that many of us have made as well. Hopefully these stories will help you evaluate your own insurance situation in order to avoid future pitfalls or surprises.As our fifth issue hits your desks this month, we are anxious to know if Absolutely Business is serving as a useful resource for your business. We welcome your feedback. Best wishes for a prosperous New Year!

Hearing the TAP! TAP! TAP! of a hammer as it nails the board to the foundation, and the buzz of the saw as it cuts the raw wood into boards, one wonders how something can begin as a vacant lot and evolve into a community center that will be used by the entire town.  It will become a building with strong walls and a strong foundation, lights, heat and water, keeping people dry from the often inclement weather of the North Country.  It is through skill, technology and determination that this can occur.

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Insurance Costs: Even Greater Burden for NNY Employers

Insurance costs for small businesses are rising throughout the state. But it is worse for small businesses in areas like northern New York where lower wage rates drive the cost of insurance to a higher portion of operating costs, reducing net income.

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Rising health care costs can be attributed in part to the inflation of drug prices and the fact that Americans are taking more medications at a younger age. Our aging society has also led to an increase in the use of medications. So, in light of these facts and more drugs being available for more conditions, pharmacy benefit plan costs have markedly increased over the last several years.

ProAct is a pharmacy benefits management company (PBM) based in Gouverneur, which helps employers and organizations manage their pharmaceutical costs. The company contracts with over 55,000 pharmacies (which includes just about every pharmacy throughout the state) to provide prescription drugs at a price discounted from what an individual would normally pay.

ProAct was operated by Kinney Drugs under the name Kinney Managed Care Services in 1994. It was initiated to help the community deal with the high cost of medications. “Back then we recognized that Kinney was selling a lot of expensive drugs, and in our ‘giving-back to the community spirit’ started this company to help with that,” Mark Brackett, RPh, President of ProAct, says. ProAct became a wholly owned subsidiary in July 1999. ProAct separated from Kinney’s and obtained its own company name because of obvious contrasting viewpoints. While Kinney’s is retail-minded and wants to sell as many drugs as it can, ProAct often tells their clients not to buy these drugs because they are too expensive. “We had to separate ourselves in order to work with the clients in a realistic manner,” Brackett says. The company was named ProAct because of its “proactive” stance on health care.

ProAct has a reputation for exceptional customer service and a focus on the education of both its members and the prescribing physicians in order to help manage health care costs. The company has a business partnership with MedImpact Healthcare Systems, Inc. of San Diego, California, which allows ProAct to offer the latest in PBM technology.

Similar Values
Because it is part of Kinney Drugs, ProAct reflects the same values as Kinney Drugs. The company believes in giving back to the community and that customer service is more important than the profit line.

“We’ve actually been told to not worry so much about the profit line, but worry about the customer service,” Brackett says. “Our mission is to give the highest customer service possible.”

ProAct’s phone line is not automated but goes directly to a real person. Brackett notes that this policy is more expensive, and money could be saved in time and labor, but it is important to avail the customer of the services they require, and sometimes that means talking to a real person.

ProAct serves employers and organizations such as banks, school systems, corporations, hospitals and municipalities. To qualify for ProAct, the company must have at least 50 employees. Including spouses and dependents they cover about 2.2 times the number of employees in 52 such companies, even though ProAct itself only has eight employees. ProAct’s ideal market is groups that cover under 5,000 people, a segment that the PBM industry has traditionally under-served. ProAct serves people in the Kinney marketing area in New York state, as well as some companies in New Hampshire, North Carolina and Iowa.

Not Insurance
ProAct is a self-funding approach. An insurance company requires you to pay a premium every month and at the end of the year you will have paid a certain amount toward your health care. You may or may not have used the total amount of benefits you paid to the insurance company. ProAct is not an insurance company and its guiding principle is a belief in paying for what you use.

Brackett says ProAct can save its members 20 percent from what an individual would normally pay, which includes the cost of the drug and an administrative fee. ProAct’s program is flexible in its benefits. Co-payments may be calculated as a percentage of medication costs or as fixed dollar amounts. ProAct is able to offer up to three tiers of drug co-pays. Other options include annual maximums, mail service, benefit limitations and up front deductibles, as well as supply limitations.

Higher co-pays for more expensive drugs help keep overall costs down and encourages people to buy the cheaper, but equally effective drugs. If a person chooses, however, to purchase the higher priced drug they are allowed to do so, but must pay a higher co-pay for that item.

If a company does not have a lot of claims or high usage of costly drugs, co-pays may actually go down. Insurance company premiums on the other hand usually stay the same or go up, based on the previous year’s expenditures, Brackett says.

While the majority of ProAct’s clients are self-insured (using only ProAct’s services), they also serve clients who use health plan insurances. These companies have kept the medical insurance plan, however they have opted out of the prescription drug coverage and utilize ProAct’s services for this part of the coverage they offer.

When a client purchases a prescription at a pharmacy, his claim is processed through ProAct’s central computer which can effectively monitor the purchases of employees at any pharmacy where they buy prescription drugs. This protects both the employee and the employer. The employees are protected from possible drug interactions because the system can monitor any drug purchases made in the past under the program. Employers are protected from fraud because the system can detect when a prescription is being filled in duplicate. The system can also help prevent medication abuse. Costs are kept down because fewer drug prescriptions are filled. “We help manage the costs but also enhance the value of the pharmacy products they are taking for improved outcomes,” Brackett says.

ProAct officials meet with their clients in person on a quarterly basis to show them charts and reports that illustrate what they have spent every penny on. It is not like an insurance company that only sends you the bill at the end of every year, Brackett says.

Health Direct
ProAct had four negative experiences with mail-order pharmacies in the past. These relationships always started out all right, but then ProAct would receive terrible reports on the mail order services from its clients. Because ProAct officials were familiar with the quality and service offered by Kinney pharmacies, after these negative experiences with other companies they chose to contract with Kinney Drugs to establish Health Direct Pharmacy, a mail-in drug service. ProAct sends all of its business to Health Direct Pharmacy. They have heard no complaints, Brackett says. ProAct is Kinney’s only client for this service and so it has quite a bit of influence on Kinney’s. “It is a marriage but it is a Kinney Pharmacy,” Brackett says.

Challenges
Brackett says Direct To Consumer (DTC) advertising is one of the biggest challenges that ProAct has faced. With so many drug companies advertising DTC, the cost of drugs goes up. “Almost every time a drug is advertised on TV or in the media (there is) another drug that is less expensive,” he says.

The “purple pill” Nexium, for example, costs $4.32 a pill, Prilosec OTC is 71 cents a pill and they are almost exactly the same. “They’re so close it’s hard to even find a difference. That’s our biggest fight - fighting our major branded drugs which are always more expensive than the generic or other drugs,” Brackett says. The drug Prozac was the number one prescribed drug for depression until a generic was formed. The original Prozac costs about $75 a month while the generic only costs $9 a month. Doctors are constantly being bombarded with drug sales representatives who give them free samples and push them to prescribe their drugs. That is where the education comes in, Brackett says.

Education
ProAct educates its customers about the facts and benefits of generic drugs. “Some of the biggest fights we have are that generic drugs are ‘no good’… but generic drugs have all the same FDA (Food and Drug Administration) regulations as branded drugs do. They have to go through exactly the same testing,” Brackett says. “We push the lower cost alternatives where appropriate.”

They educate the physicians as well. ProAct runs reports and measures the percentage of high-cost drugs a doctor prescribes compared to the percentage of low-cost drugs available within that doctor’s specialty range. They then educate the cardiologists, for example, who are prescribing many more high-cost drugs than other cardiologists, on the need for and benefits of generic drugs as well. This helps keep the costs down for ProAct, for the employers and, ultimately for the consumers as well.

For some drugs ProAct requires prior approval and education of the doctor to ensure that the drug is not prescribed without a fitness or wellness plan in place, and that the patient has been educated on how to change the lifestyle that has caused the initial problem. If you take Lipitor, for example, that does not mean you can have bacon every morning for breakfast, Brackett says. “So you do (not) pop a pill and keep doing what you’re doing,” he emphasizes.

This helps to keep costs down as well. There is also a limit to the amount of a drug that a person can get. People cannot refill a prescription until one week’s worth of medication is left except for special circumstances like vacations, because “people by nature stockpile drugs, just in case something might happen,” Brackett says.

ProAct is about proactive healthcare. It is about taking charge of your health and wellness. It is about keeping costs down while providing you with the care you need. One thing they do not do (that would keep costs down) is use an automated system. ProAct believes when people call for assistance they should go directly to humans, Brackett says. And they have reaffirmed their mission to offer the highest level of customer service possible.

Individual Ownership
Brackett worries about the government becoming too involved in health care. He believes in ownership by the users. “When it is a self-funded plan we make sure everyone has ownership of it,” Brackett says. He feels people taking charge of their health care is more important than being given a “blank check.” Doctors often prescribe more medication than a person needs, and given a blank check by the government which will pay for it all, the patient will just take all of it, he says. However, if the person has to pay for the medication in some way, they will be more inclined to use it only if absolutely necessary. Brackett feels that is good sense and good business.

“People start thinking of (medications) as consumable product and they start becoming more wise about health care decisions,” he says. “They start thinking about wellness. When we start linking cost of drugs to co-pays to consumerism it is much more valuable than having almost a blank check and that is what worries me about government taking on health care.”

“We have to have more consumerism in the health care industry. It sends it in the right direction. It ties the cost of drugs to a co-pay to an educational program.”
Internet

The internet has also affected health care and ProAct. “In the last few years since the internet has become stronger, we get better questions, we have a more educated consumer patient and by all means it does help in health care,” Brackett says. People are much more informed about their symptoms and their illnesses and are able to do a lot of research on their condition and the drugs prescribed for it.

ProAct also has a Web site, www.proactrx.com, which contains a lot of marketing information. If a client has retired, for example, and moved out of the area, but is still covered by his company’s health plan, the Web site allows the person to find a pharmacy in their area so they can continue using their ProAct services.