When risk manager Judy Godfrey looked into a managed-care plan for the roughly 300 Ringling Bros. and Barnum & Bailey circus performers, most companies lacked physicians in at least some of the 100 or so cities the circus visits on each two-year tour.
Equally frustrating, the performers were ideal candidates for a managed-care plan. "Our people don't stay long enough in one place to develop relationships with a specific doctor," Godfrey said.
So when Hartford, Conn.-based Aetna Health Plans matched network physicians with the circus' itinerary, Godfrey scrapped Ringling Bros.' old indemnity plan, underwritten by Boston-based John Hancock Life Insurance Company of America, and in January began offering employees a PPO.
"We recognized that managed care was going to be the wave of the future," Godfrey said. "We had looked at other PPOs in the past, but no one matched for us because we're in a different city every week."
Godfrey is vice president of risk management for Irvin Feld & Kenneth Feld Productions, which produces the two traveling Ringling Bros. and Barnum & Bailey shows in addition to other entertainment features.
For Aetna, the biggest challenge wasn't finding physicians in each Ringling Bros. venue. It was distributing information to its globe-trotting performers.
So Aetna lists all its providers on a World Wide Web site, allowing Godfrey to plug in the ZIP code where the show will stop, identify all the physicians and hospitals in the area and fax a list to the insurance coordinator. She gets the list out five shows in advance.
Providing a new managed-care plan created another challenge for Godfrey: explaining it to performers who speak Romanian, Chinese or Bulgarian but not English.
Rather than translating brochures into several languages and mailing them out, Godfrey's staff and Aetna representatives went to circus performances and explained the PPO. With the help of several translators, they explained the program in employee meetings held by nationality.
