HealthCare Consumerism Solutions Jul/Aug '13 by The Institute for HealthCare Consumerism

FORUM West Super Saver

September 6, 2013 Deadline

ISSUE || July/August 2013

TRULY HUMAN LEADERSHIP How treating your employees as humans may be the most important piece to your health and benefits puzzle How Health Plans Should Use Existing Data to Engage Members and Drive Exchange Decisions My Money or Other Peopleâ&#x20AC;&#x2122;s Money: Why Consumerism Works

NEW INSIDE:

www.theihcc.com

PRSRT STD U.S. Postage PAID Permit #104 Ft. Atkinson, WI

Healthcare is

Affordable

with a partner who doesnâ&#x20AC;&#x2122;t just talk lower costs, but guarantees them. Healthstat offers healthcare solutions that drive better employee health while reducing healthcare costs. Our experience, advanced technology, scalability and predictive modeling system can create an environment of wellness that works. As the leading provider of on-site primary care, health risk intervention, chronic care management and occupational medicine, Healthstat is here to change healthcare for the better. Inspire a healthy change today, by visiting healthstatinc.com.

Implemented Healthstat for his company last year. Used only 2 sick days. Increased her sales by 5%.

Generated a 2:1 ROI in year 1.

FEATURES

37 Truly Human Leadership

INSIDE

40 The Intersection of Consumerism and Data Unless something drastic happens in the next few months, Americans will wake up to a very new world on January 1, 2014. That is the day that we all will have a choice to make regarding the health plans we choose. This may seem a bit daunting to consumers, but it shouldn’t for it puts a lot of power in their hands — specifically the power of choice. This power to choose and the impact of new regulations should compel health plans to be proactive with scalable consumer marketing and engagement solutions, making a focus on the individual needs of members a major market driver. By Ben Gardner, Founder & President, Linkwell Health

At Barry-Wehmiller, a St. Louis-based industrial manufacturer with $1.5 billion in annual revenue, CEO Bob Chapman is working to change the way we understand corporate leadership. By placing a foremost interest in the lives of his team members, his company and his employees have flourished. His message of people-centric leadership has garnered interest in boardrooms across the country but has a particularly strong resonance for health, benefits and wellness leaders. By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism

INSIDE The Institute for HealthCare Consumerism Launches New Magazine Supplement HealthCare Exchange Solutions HealthCare Exchange Solutions helps you understand the choices in the health and benefit marketplace and make the best decisions among a complicated array of exchange solutions options.

COMING UP NEXT: In the next issue of HealthCare Consumerism Solutions, we will be featuring articles on transparency, health care reform, private exchanges, compliance and more. www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

INSIDE 6

Publisher’s Letter

Health and Benefits Industry Prepares for Historic Open Enrollment as the Institute Gears Up for FORUM West

Briefs & Innovations

t BenefitWallet Selects the ConnectYourCare Spending Account Platform t Evolution1 Selected by Cielostar as Preferred Partner t Acclaris Announces Dean Mason as New President

11 FORUM West Preview 14 What’s Happening at the Institute 15 Stats & Data

Transparency Study by Scott Decker, President, HealthSparq

DEPARTMENTS 8

Bachman’s Banter PPACA Health Exchange Navigators By Ronald E. Bachman, FSA, MAAA, Chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism

33 Decision-Support Tools The Rise of the Personal Health Assistant By Elizabeth Napolitano, Executive Vice President of Client Experience at Accolade, Inc.

34 Consumerism My Money or Other People’s Money (OPM): Why Consumerism Works By Wendy Lynch, Ph.D., Co-Director, Altarum Center for Consumer Choice in Health Care

42 Corporate Member Profiles 49 Resource Guide/Ad Index

35 Telehealth Consumer Engagement: No Ring Necessary

Events The 2013 IHC FORUM West Super Saver Rates Start at $99! www.theihccforum.com Sign up today for FORUM WEST. Join us December 5-6, 2013 in Las Vegas. We are back at the luxurious Red Rock Resort & Spa — a serene oasis set away from the hustle and bustle of the Las Vegas Blvd. The Resort’s exquisite rooms and breath-taking views of the canyon will make the perfect backdrop for our west coast event, not to mention all of the convenient amenities right there on-site (movie theater, bowling alley, restaurants, casino, spa, pools, and more). Registration will open soon. Come LEARN, CONNECT and SHARE with the top thought leaders in the rapidly growing health care consumerism megatrend.

By Patrick Spain, Co-Founder, Chairman, CEO, First Stop Health

ONLINE EXCLUSIVES Re-Forming What We Know about Health Care Reform

Wow, did someone get the license number from that truck? My head is spinning. I mean, one moment I was just minding my own business, peacefully thinking about clever ways to explain coverage options to employees, and the next — major changes to key provisions of the ACA! Well, I guess that means it’s time to re-form what I thought I knew about health care reform. Let’s see what that means now with a quick review. By Justyn Harkin, Communications Specialist, The Jellyvision Lab

A Closer Look at Choosing an HSA Administrator

Consumer-directed health care plans partnered with health savings accounts (HSAs) continue to gain popularity as a cost-effective option for both employers and individuals. However, picking the right HSA provider is not so cut and dry. Employers looking at consumer-directed health care plans with HSAs tend to pick providers based on one or two administrative details, but they really need to dig into what kind of benefit experience employees will get. The quality of that interaction can make all the difference, and yield happy, engaged employees.

Membership Become a Member, Reap the Rewards Have you become a member of The Institute for HealthCare Consumerism (www.theihcc.com)? Why wait? Visit The IHC website today and sign up for a premium membership. Got a story to tell about an innovative health and benefit program or best practice in health care consumerism? Share it with fellow members of The Institute for HealthCare Consumerism. Share a case study, white paper, article or post a blog at www.theihcc.com. Members of The IHC also receive special discounts to attend Institute events, such as IHC FORUM. 4 July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

By Dennis Triplett, CEO, UMB Healthcare Services, a division of UMB Financial Corporation

Key Dental Benefits Information Now Available through NADP 2012 State of the Dental Benefits Market Report

The National Association of Dental Plans (NADP) recently released its 2012 State of the Dental Benefits Market Report. The following is a summary of key data and trends of particular interest to health insurance brokers as they advise clients on employee benefit packages. The NADP has published the report annually since 2006. By Rene Chapin, Director of Membership & Communications, National Association of Dental Plans

Provide employees the right tools to make the most of their healthcare choices. At TSYS Healthcare®, our approach to client-driven innovation allows you to define and shape flexible, integrated payment solutions that meet your unique needs. Our independent industry partnerships and elite platform functionality help our clients build solutions that make sense. Our solutions include: Ř 'HŵQHG FRQWULEXWLRQ SODQ RSWLRQV WR DVVLVW ZLWK KHDOWKFDUH H[FKDQJH SUHPLXPV Ř $ PXOWL SXUVH SD\PHQW SODWIRUP GHYHORSHG IRU KHDOWKFDUH Ř (QKDQFHG +5$ FDUG IXQFWLRQDOLW\ Ř $Q LQGHSHQGHQW SDUWQHU QHWZRUN Ř ([SHULHQFHG KHDOWKFDUH DGYLVRUV Ř 5HYHQXH JHQHUDWLQJ ŵQDQFLDO PRGHOV Integrity | Relationships | Excellence | Innovation | Growth

Learn more at www.tsyshealthcare.com or call us at +1.706.649.5080

Get to know us. 1.706.649.5080 healthcare@tsys.com www.tsyshealthcare.com

LETTER

PUBLISHER www.theihcc.com VOLUME 9 NO. 5 | JULY/AUGUST 2013

Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Fax: 770.663.4409 CEO

Doug Field @ theihcc.com MANAGING DIRECTOR

Brent Macy

Open enrollment is almost upon us. Despite the White House's delay of the employer mandate, a number of key Obamacare provisions will still go into effect January 1. The much closer October 1 date is the deadline for employers to notify their employees of coverage options under public exchanges and the first date individuals can enroll in state-based health insurance exchanges. Needless to say, the industry is preparing for one of its most significant open enrollments to date.

MANAGING EDITOR

Jonathan Field

ACCOUNT MANAGER

Joni Lipson

ART DIRECTOR

Kellie Frissell

With these dates and deadlines in mind, the Institute for HealthCare Consumerism is gearing up for its fall conference, FORUM West, in Las Vegas this December 5-6. The timing

MARKETING COMMUNICATIONS MANAGER

Lana Perry

of the event will allow the industry's first real-time look-in to the fall's crucial open enrollment period. The industry will come together to collaboratively learn, connect and share to build better practices and stimulate innovation. In this issue of HealthCare Consumerism Solutions, we similarly bring you a number of articles from business and thought leaders that will help you better manage your health and benefits moving into open enrollment and beyond. From transparency to telehealth and health advisory to compliance, all is covered here for your benefit. I would be remiss if I did not mention and thank the subject of this issue’s cover feature, Bob Chapman, Chairman and CEO, Barry-Wehmiller. As leader of a St. Louis-based manufacturing company with $1.5 billion in annual revenues, Chapman has an inspirational message for leaders in the health and benefits industry. He will additionally be presenting the keynote address at FORUM West. Finally, I would like to announce the Institute’s 2014 FORUM East, which will be back in Atlanta next spring and promises to be our biggest event yet. Our call for speakers for the 2014 FORUM East is now open.

ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS

Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD

Ronald E. Bachman, CEO, Healthcare Visions EDITORIAL ADVISORY BOARD

Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River Group; John Hickman, Alston+Bird LLP; Tony Holmes, Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC WEBMASTERS

Kevin Carnegie Tom Becher ASSOCIATE WEB ADMINISTRATOR

Tim Hemendinger

DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS

Sincerely,

Rogers Beasley

BUSINESS MANAGER

Karen Raudabaugh

Doug Field CEO/Publisher dfield@fieldmedia.com

™ is a trademark of FieldMedia LLC. ™ is published eight times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009.

TO SUBSCRIBE: Make checks and money orders payable to ™ magazine 292 S. Main Street, Suite 400, Alpharetta, at the following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 PRINTED IN THE U.S.A. ™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher

legal advice is required, the services of a professional adviser should be sought. The magazine is not responsible for unsolicited manuscripts or photographs. Send letters to the editor and editorial inquiries to the above address or to

6 July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

Donâ&#x20AC;&#x2122;t lose a drop. Many banks add on fees, which means you could waste your HSA one drop at a time. SelectAccount, on the other hand, has no extra overdraft fees or minimum balances, just a tall glass of your savings, ready when you need it.

Call 1-866-309-8908 or visit www.SelectAccount.com to learn about our free HSA.

Itâ&#x20AC;&#x2122;s the benefit of knowing.

BACHMAN’S BANTER

BY RONALD E. BACHMAN FSA, MAAA CHAIRMAN, EDITORIAL ADVISORY BOARD THE INSTITUTE FOR HEALTHCARE CONSUMERISM

WHO: Any American seeking assistance in purchasing health insurance through health insurance exchanges (also referred to as federal or statebased marketplaces). The navigator programs may be especially helpful for those previously uninsured, personal without an private agent/broker, and those eligible to purchase health insurance through the exchange using federal premium tax credits. WHEN: Federal and state-based exchanges are to be operational on October 1, 2013 for enrollment effective January 1, 2014. WHAT: On July 12, 2013, the Department of Health and Human Services (HHS) published the final rule on Exchange Navigators and Non-navigator Assistance Personnel and Certified Application Counselors (CACs). These PPACA support personnel will assist individuals and groups in understanding insurance options and help them to enroll in federal or state-based exchanges available in each community EXECUTIVE SUMMARY: The new rule deals with the various programs that will assist consumers in learning about and enrolling in the ACA’s premium assistance programs and qualified health plans through government public health insurance exchanges. There are four recognized entities to support the purchase of health insurance:

2. Non-navigator Assistance Personnel – State-based marketplaces may use Non-navigator Assistance Personnel (also known as in-person assistance personnel) to generally perform the same functions as Navigators before its marketplace is economically selfsustaining, and before its navigator program is fully functional. 3. Certified Application Counselors – Certified Application Counselors may perform many of the same functions as Navigators and Non-navigator Assistance Personnel, including educating consumers and helping them complete an application for coverage. Federally-facilitated marketplaces may designate organizations to certify CACs including: Federally Qualified Health Centers; hospitals; other health care providers (including Indian health providers, behavioral and mental health providers, and Ryan White HIV/AIDS providers); non-profit social service agencies; and local governmental agencies, such as health departments or libraries. Medicaid-certified application counselor organizations are explicitly listed as organizations that may serve as exchange CACs. State-based marketplaces may choose to certify CACs directly rather than designate organizations to do so. 4. Agents and Brokers – To the extent permitted by a state and if all marketplace requirements are met, licensed health insurance agents and brokers may enroll individuals, small employers, and employees in coverage through federal and state-based marketplaces. Agents and brokers will be compensated by the issuer or by the consumer to the extent permitted under state law. Federal and state training and certification requirements will apply to agents and brokers who enroll or assist consumers in the marketplace. ACTIONS: Individuals and employers planning to enroll through government exchanges should seek information on the operational status of available exchanges in their market. There may be state specific, regional, multi-state, or federal exchanges serving your local(s). Local agents or brokers may be able to provided application and enrollment assistance and/or direct individuals to navigator programs.

1. Navigators – As required by PPACA, all government exchanges will utilize Exchange Navigators to educate the public; provide fair and impartial information concerning qualified health plans, premium tax credits, and cost-sharing reduction payments; and facilitate enrollment in qualified health plans (QHPs).

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

HEALTHCARE CONSUMERISM NEWS BRIEFS

Delay in Health Reform Penalties for Employers Leaves Many Issues Still to Resolve

Colonial Life Launches New Health Care Reform Tool For Employers

While the announcement that employer shared responsibility penalties will not apply until 2015 was a welcome relief for employers, addressing the fundamental challenges raised by the reform law remains a priority. At the heart of the matter is cost. In the short term, new fees, plan design changes and the expectation of additional enrollment will add an estimated 2 percent–3 percent or more to health plan cost in 2014, even if employers table plans to extend coverage to all employees working 30 or more hours per week. Longer-term, avoiding the excise tax on high-cost plans slated for 2018 remains a daunting challenge. More than a third of employers surveyed by Mercer in May said that they were taking steps in 2014 to help bring down cost by 2018.

Employers have a new tool to help them dig through the complex pile of health care reform legislation to better understand how the new laws will affect them and what they need to do now and going for-

BenefitWallet, A Xerox Solution, Selects The ConnectYourCare Spending Account Platform

HealthSparq, a leading provider of health care transparency solutions for health insurers, announced it has signed an agreement with MDLive to offer telehealth services through its transparency platform to health plans and employers across the nation. MDLive is a leading telehealth provider of online and on-demand health care delivery services and software, giving its users access to 24/7/365 online video

Broadening its portfolio of solutions that simplify the business aspects Solution. ConnectYourCare, a leading consumer-directed health care (CDHC) account administrator, was selected as the platform to bring

and solutions to help them implement changes. Making health care reform simpler and understandable might seem like a task that would

HealthSparq Announces Partnership with MDLive

emergency medicine, family practice and pediatric physicians. employer customers and manages accounts for more than 2 million account holders and dependents with an accumulated $1.4 billion of HSA assets.

Evolution1 Selected by CieloStar as Preferred Partner and cloud computing consumer-driven health care solution, continues to strengthen its partner base with the addition of marquee partners nology company. For 25 years, CieloStar (formerly OutsourceOne)

Castlight Health And WellPoint’s Affiliated Health Plans Introduce Reference Based Benefits and Castlight Health, a leader in health care transparency, today

component of controlling costs while increasing access to quality care.

trative processes.

a combination of both technology and service. Through the partner-

Evolution1®, 1Pay by Evolution1®, and 1Plan by Evolution1®.

Keas Accelerates Growth With New Funding, Customer Adoption, Strategic Partnerships And Deepens Team Keas, the market leader in corporate health and wellness, recently announced new funding, customers, partnerships, and additions to its executive team. The news caps a year of record growth for the company. Keas has raised $8M in funding from Ignition Partners and Atlas Venture. Driven by a skyrocketing demand for corporate health and wellness programs, enterprise compliance with the Affordable Care Act (ACA), and adoption of the 360/365 platform, the number of Keas registered users and enterprise clients has more than doubled in the last year.

American Benefits Group Transforms its Participant Experience with Mobile App from Alegeus ments, recently announced that it has experienced widespread demand for its mobile application (WealthCare Mobile), with twenty additional application since April 2013. A leading national third party administraTransit/Parking) as well as COBRA administration services, American competitive advantage, and reduce servicing costs by giving participants the ability to manage consumer-directed health care (CDHC) and

HEALTHCARE CONSUMERISM PEOPLE ON THE MOVE

Acclaris Announces Veteran Health Care Financial Services Executive, Dean Mason, As New President

reimbursement technology and services, announced the appointment

Acclaris, the leading provider of consumer-driven health care (CDHC)

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013 9

NOMINATE & RECOGNIZE INNOVATIVE HEALTH & BENEFIT MANAGERS

HealthCare Consumerism Solutions Magazine

Do you know someone who goes the extra mile as a creative problem solver and innovator? The Institute for HealthCare Consumerism (www.theihcc.com) is

brokers, TPAs and HR managers, who have excelled at implementing solutions to complex issues. Superstars will be published December 2013 in our annual issue and will be accessible to more than 70,000 readers.

Nominate a Superstar Today! John J. Robbins Sr., Memorial CEO Leadership Award: To an outstanding leader of any size organization who is an exceptional businessperson, as well as a successful parent and pillar of the community. CEO Leadership Award: To an outstanding leader of any size organization, who embraces supports and endorsed an innovative

■

Most Innovative Plan Design Award

■

Most Effective Plan Implementation Award:

■

and exceeded goals or reaped unanticipated awards. Most Innovative Employee Education/Communication Award: To an employer, who designed and implemented tools for their employees that exceeded plan participation.

Most Innovative Employee Empowerment Award: To an employer, who designed and implemented tools that had a high

■

program. Most Effective Population Health & Wellness Award: To an employer who uses the most innovative method to reduce absenteeism and chronic disease costs to improve overall employee health. Public Policy Leadership Award: An individual who encourages health care consumerism in public policy through legislation. Most Effective Solution Provider Award: To a solution provider

■

Most Innovative Partner-Consultant Award; To a consultant

■

■ Most Innovative Broker Award: To a broker, who learned employer.

NOMINATION CATEGORIES: Nomination Categories for 500 - 2500 employees, 2501 - 7500 employees, and 7500+ employees

For details, please visit www.theihcc.com. Nominations close October 1, 2013.

Real-Time Analysis, Thought-Leadership and Solutions from Experts and Your Peers.

December 5-6

LAS VEGAS

Red Rock Casino Resort Spa

SUPER SAVER RATE OF $99

Until September 6, 2013

WWW.THEIHCCFORUM.COM

LEARN. CONNECT. SHARE.

2013

www.theihccforum.com

5IF 0OMZ $POGFSFODF %FEJDBUFE UP *OOPWBUJWF )FBMUI BOE #FOFmU .BOBHFNFOU

/&8 "/% *.1307&% 130(3"..*/(

LEARN. CONNECT. SHARE. FORUM WEST 2013 puts you in the right place at the right time. Get hard stats and real-time feedback from peers, industry experts and thought-leaders on how the new marketplaces are performing during 2014 open enrollment. Through cutting-edge general sessions, workshops, intimate roundtable discussions and unlimited networking opportunities, the IHC FORUM, produced by The Institute for HealthCare Consumerism, is the ONLY place you can attend to be part of this valuable collaboration experience. t LEARN from peers successfully implementing healthcare consumerism initiatives. t CONNECT with forward-thinking experts and industry professionals on leading practices and successful strategies. t SHARE valuable insights and ideas, opinions and research, and more on the latest topics and current trends.

8IP 4IPVME "UUFOE *)$ '036. t t t t t t

CEOs/Presidents/CFOs HR and Benefit Executives Health Plan Administrators Corporate Wellness Directors Benefit Brokers and Consultants Third Party Administrators

0QFOJOH (FOFSBM 4FTTJPO .BLJOH )FBMUIDBSF $POTVNFSJTN 8PSL IHC executives Doug Field and Ron Bachman will examine the necessary steps for implementing Healthcare Consumerism, now that the model has begun to gain wide-spread acceptance. Successful consumerism is not simply about who pays the bill; it is about a persistent search for better value. To be true consumers, we all need better information, more transparency, and permission to be in charge of our own care. Similarly, employers need to become actively involved as consumers of insurance plans and design coverage that empowers its workers. In this session, learn about the ways consumers are changing the system, and where there is more work to do. Hear what it takes to engage consumers in selecting high-value health care and explore some innovative approaches used by employers to activate their employees to select safe, appropriately-priced services, procedures and hospitals. Specifically, attendees will hear: t 8BZT DPOTVNFST BSF BDUJWFMZ JOWPMWFE UPEBZ t 5IF FGGFDUT PG JOWPMWFNFOU PO DIPJDFT BOE DPTUT t 8IBU JOGPSNBUJPO DPOTVNFST TBZ UIFZ VTF UP NBLF DIPJDFT

FORUM WEST 2013

LAS VEGAS

The IHC listened to feedback from FORUM East 2013 evaluations and our growing demand for requests to speak â&#x20AC;&#x201D; weâ&#x20AC;&#x2122;ve responded to both by adding a fourth Workshop Track and adjusting our workshop format. Starting with IHC FORUM West 2013, our workshop format will now mirror our mission statement. Each of the four Workshop Tracks will now include: t LEARN sessions â&#x20AC;&#x201C; for introducing innovative solutions (usually led by solution providers) t CONNECT sessions â&#x20AC;&#x201C; for presenting industry strategies, best practices and case studies (usually led by users of the services or strategies being discussed) t SHARE sessions â&#x20AC;&#x201C; for open discussions on current industry topics of interest (usually led by employers)

Plan to attend a day early for CEU-eligible pre-conference sessions on â&#x20AC;&#x153;Making HealthCare Consumerism Work: The Steps and Planâ&#x20AC;? or â&#x20AC;&#x153;The Institute for HealthCare Consumerism: Continuing Education Course for Brokers â&#x20AC;&#x201D; HealthCare Consumerism in PPACA (includes updates on Health Care Reform Law) for Brokers, Advisors and Consultants.â&#x20AC;? Additional fees apply. Visit www.theihccforum.com for details.

Keynote Address 5SVMZ )VNBO -FBEFSTIJQ *OTQJSJOH 8FMMCFJOH JO B $BSJOH $VMUVSF As CEO and Chairman of $1.6 billion capital equipment and engineering solutions provider Barry-Wehmiller, Bob Chapman has seen the dramatic transformation of the companyâ&#x20AC;&#x2122;s Bob Chapman culture since adopting â&#x20AC;&#x153;Truly Human CEO, Barry-Wehmiller Leadershipâ&#x20AC;? more than a decade ago. This commitment to people-centric leadership has created an environment Doug Field in which people can realize their gifts, Founder and CEO, apply and develop their talents, and feel The Institute for HealthCare Consumerism a genuine sense of fulfillment for their contributions. Hear Chapman share the Ron Bachman story of Barry-Wehmillerâ&#x20AC;&#x2122;s journey as well Chairman, Editorial as the health and wellness initiatives the Advisory Board, The Institute for organization has undertaken to inspire a HealthCare Consumerism culture of wellbeing.

MAKING HEALTHCARE CONSUMERISM WORK Register Now and Save

)FSF T 8IBU :PV MM (BJO

Donâ&#x20AC;&#x2122;t miss this opportunity to be at the forefront of the health and benefit management movement. Reserve your spot at FORUM West before September 6, 2013 for the BEST SUPER SAVER RATES.

Early, up-to-the-minute 2014 open enrollment stats and analysis of Defined Contributions and Exchanges Compliance solutions for HealthCare Reform and the Affordable Care Act Advice for your 2015 budget planning

FORUM 8FTU t %FDFNCFS t 3FE 3PDL 3FTPSU t -BT 7FHBT

No industry event offers you more for your money. Join The Institute for HealthCare Consumerism for free and save even more. Already an IHC member? Check your inbox for our weekly e-blast and save using your exclusive member discount code. Visit www.theihccforum.com for details.

*ODMVEFE JO :PVS Registration

REGISTRATION RATES FOR FORUM WEST - DECEMBER 5-6, 2013 (ends 9/6/13)

Super Saver

Early Bird Rates (ends 10/31/13)

Standard Rates (ends 11/30/13)

(Starts Dec. 1)

Government & Non-Profit

$99

$295

$395

$595

Employer: Benefits/HR/Wellness Executives/CEOâ&#x20AC;&#x2122;s

$99

$395

$495

$795

Brokers, Advisors, Consultants

$99

$395

$495

$795

TPAs, Health Plans

$99

$395

$495

$795

Solution Providers

$595

$895

$995

$1195

Pre-Conference

$79

$99

$129

$159

Attendee Type

Onsite Rates

t t t t

'036. 8FTU 1SF $POGFSFODF Registration is available on a first come first served basis, with seating limited to 50 participants per workshop course offering â&#x20AC;&#x201C; Please select from either Workshop #1 or #2 below. Pre-Conference Workshops are at an additional cost to the Forum West Conference.

All Pre-Conference Attendees are invited to join us free of charge for the Pre-Conference Lunch and Learn sponsored by Alegeus Technologies. Lunch will be served to those who make their reservations in advance, by 11/30/13.

1SF $POGFSFODF Â&#x2030; -VODI BOE -FBSO

Ascertain anticipated interest and adoption rates of defined contribution/private exchange programs (interest & timing) Determine channel preferences for researching, identifying and purchasing defined contribution/ private exchange solutions Validate defined contribution/private exchange solution feature preferences & perceptions Understand current benefit offerings, and determine whether there is any likely correlation between existing benefit packages and defined contribution/ private exchange interest Obtain background on how/when employers make benefit decisions

8FEOFTEBZ %FDFNCFS t OPPO o Q N Sponsored by Alegeus Technologies and the IHC

Alegeus Technologies Research Results Discussed â&#x20AC;&#x201C; Employer Perceptions Regarding Private Exchanges and Defined Contribution

Join us for lunch as we discuss the results of this groundbreaking research and do some real-time analysis through our group discussions.

Alegeus Technologies commissioned an independent research initiative, polling more than 500 US employers on the topics of defined contribution and private exchanges. The survey audience included a cross section of employers â&#x20AC;&#x201D; from all industries and organizational sizes; contacts were decision-makers for health benefit decisions within their respective organization.

1SF $POGFSFODF 8PSLTIPQ

The objectives of the study were as follows: t

Gauge employer understanding and perceptions regarding defined contribution and private exchanges concepts

8FEOFTEBZ %FDFNCFS t o Q N Making Health Care Consumerism Work: The Steps and Plan Why should employers consider implementing Healthcare Consumerism? Can you show a clear healthcare benefit vision and strategy to your senior management? â&#x20AC;&#x153;Making Health Care Consumerism Work: The Steps and Planâ&#x20AC;? will show you why and how. This interactive, knowledge-rich workshop includes our exclusive 180page personalized workbook for your notes and exercise

Attend five cutting-edge general sessions Choose from 24 interactive workshops Tour an exhibit hall packed with industry leading solutions and the latest technologies LEARN from peers successfully implementing health care consumerism initiatives CONNECT and network with professionals from all corners of the industry SHARE collaborative discussions with leading thinkers and key policy makers Enjoy breakfast, lunch and an opening night reception Receive an information-packed conference workbook Gain access to all presentations online

results on all 12 sections to the program. You will leave this workshop equipped with the principles, strategies, and implementation options you need, unique to your company. Led by industry expert and former White House advisor Ron Bachman, â&#x20AC;&#x153;Making Health Care Consumerism Work: The Steps and Planâ&#x20AC;? will walk you through the entire planning process, from strategy to implementation. Also included will be an explanation and discussion of private & public exchanges, specific issues related to ACA implementation now thru 2018, and other timely and relevant advice for establishing an effective healthcare consumerism strategy.

1SF $POGFSFODF 8PSLTIPQ 8FEOFTEBZ %FDFNCFS t o Q N The Institute for HealthCare Consumerism â&#x20AC;&#x201C; Continuing Education Course for Brokers â&#x20AC;&#x201C; HealthCare Consumerism in PPACA (includes updates on Healthcare Reform Law) for Brokers, Advisors and Consultants As we move closer to the full implementation of health reform, Brokers, Advisors and Consultants are looking for answers to very specific questions. To help answer those questions, this pre-conference workshop will focus on The Individual Market, The Large Group Market, The Small Group Market and Exchanges. This is a continuing education course for brokers, advisors and consultants under The Institute for HealthCare Consumerism. CEU credits available upon completion of course.

Produced by The Institute for HealthCare Consumerism

Visit www.theihccforum.com to preview the agenda and register for the conference.

LEARN.CONNECT.SHARE. What’s Happening at the Institute BY DUSTY RHODES » ASSOCIATE DIRECTOR OF EDUCATION » THE INSTITUTE FOR HEALTHCARE CONSUMERISM

Editor’s Note: As we prepare to enter one of the most important open enrollments in the history of health and benefits, the Institute for HealthCare Consumerism is gearing up for a busy fall with a number of related initiatives. Dusty Rhodes, the Institute’s Associate Director of Education, runs down the list of what’s happening at the Institute in the lead up to FORUM West this December in Las Vegas.

the CEO Leadership Award, Most Innovative Plan Design Award, Public Policy Leadership Award, Most Innovative Broker Award and many others, the Institute will recognize a broad array of professionals who go the extra mile. Nominations are

The IHC University Webinar Series

categorized by company size and are now open at the Institute’s website. Superstar award winners will be recognized at FORUM West in Vegas, but don’t hesitate to nominate someone you know as nominations will close on October 1.

As part of the IHC University and our on-going education efforts, the Institute has already produced many webinars this year for respected, industry-leading companies, such as Aflac, Jellyvision and Truven Health Analytics. Later this summer and into the fall, we will also be producing a series of webinars for Alegeus Technologies on private exchanges, defined contribution and consumer-directed health care. All previously completed webinars can be found archived on the IHC’s website. We will also be aggregating webinars from across the industry as part of our webinar library. Have a completed or upcoming webinar you would like to showcase to our audience? Contact me at drhodes@theihcc.com.

Introducing Compliance Corner At the Institute, we understand that compliance issues are among the top organizational concerns today. With rapidly approaching deadlines for the Affordable Care Act on January 1, the need for dependable information on compliance issues will become increasingly important this fall. Compliance Corner, as part of IHC University, will debut this fall, anchored by columns and briefs from Ron Bachman, Chairman, the Institute’s Editorial Advisory Board. We will also be regularly featuring guest columns and Q & As with leading industry experts. If you’re looking to stay up-to-date on important regulatory and compliance issues, keep an eye out for the debut of Compliance Corner, coming this fall.

Nominations Now Open for Superstars Our annual HealthCare Consumerism Superstars issue will be back again this December, showcasing the creative problem solvers and innovators in the health and benefits space. With

May/June 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

3 Additional Coverage of Private Exchanges In our view — along with many others in the industry — the private health care exchange (or marketplace) represents a significant advancement in the shift toward consumerism in health care. In April of this year, we launched the HealthCare Exchange Solutions magazine supplement, the industry’s first magazine to focus solely on health care exchanges. To continue that tradition of coverage, keep an eye out for the Institute to launch a new exchange-related product in the near future.

Save the Date: 2014 FORUM East We are proud to announce the dates for our 2014 FORUM East in Atlanta. We will be back at the Cobb Galleria Centre from May 7 to 9. The 2013 FORUM East was our largest event yet with over 700 attendees and over 50 sponsors, and the 2014 FORUM East looks to build to on this success as we expand to accommodate increasing attendee and sponsorship numbers. Get an early jump on the 2014 FORUM East by visiting the FORUM website and signing up for email updates. We hope to see you there.

BY SCOTT DECKER PRESIDENT HEALTHSPARQ

he more consumers are responsible for paying a higher percentage of their own medical costs, the greater their need to know ahead of time how much they’ll spend on a treatment and be able to compare treatment options. Health care transparency tools to help consumers shop for care are increasingly available on the market, yet health insurers are lagging on utilization of these tools, and consumers—along with their employers and the health plans themselves—are paying the price. But health insurance executives are about to pick up the pace. A recent study by the Cicero Group, sponsored by HealthSparq, of 186 executives at 117 health insurance companies found: t Sixty-five percent expect the level of transparency within the health insurance industry to continue to increase. t Fifty-four percent expected insurance company budgets to increase to account for the financing needed to buy transparency tools. This finding is echoed by a recent study by research and advisory firm Aite Group indicating that the health care transparency industry is expected to grow to $3 billion by 2016. This investment comes none too soon. America’s Health Insurance Plans (AHIP) recently listed “Tackling Barriers to Transparency” as one of three key strategies for reducing health care costs. And in June, the American Medical Association called on insurers to provide physicians with better tools to automatically determine a patient’s payment responsibility before treatment. Increased health care transparency is woven into most discussions about solutions for lowering health care costs. According to Paul Ginsburg and Nicole Kemper of the Center for Studying Health System Change, this movement toward increased health care transparency results from the convergence of two trends:

STATS & DATA

1. Societal demand for accountability from institutions in general. 2. The “health care consumerism movement,” which makes consumers “assume more responsibility for and control over their health and health care.” According to Cicero’s findings, while most health plans (83 percent) currently provide just basic provider search tools to members, less than half of these companies offer additional online shopping options such as cost estimats for treatments. It’s clear that a significant competitive edge is gained by health plans providing a broader range of sophisticated and user-friendly transparency tools to consumers. Additionally, with the cost of health care rising faster than the rate of inflation, there is value in providing the technology consumers need to shop for health care online, much like they do other goods and services. In fact, the largest health plan in the Pacific Northwest estimated potential savings of $49 million over a two-year period when consumers shopped for treatments for specific conditions such as women’s health and digestive issues. Imagine the savings for all treatments across the board. Health care transparency is a powerful tool to curb spending. Health insurers have a big opportunity to bring transparency to members. Consumers want it, and employers are demanding it.

HEALTHCARE CONSUMERISM PEOPLE ON THE MOVE newly created position of President. Mason will assume his duties at Acclaris on June 26, 2013. Since 2008, Mason has served as the CEO of HSA Bank, one of the largest and most respected health savings account (HSA) custodians in the country, managing nearly 600,000 accounts and $2 billion in assets. There, he guided an operational,

HighRoads Expands Team with the Addition of Two Key Industry Veterans HighRoads, the industry leader in health care compliance and benthe addition of two key industry veterans. Continuing to build on its rapid growth strategy, HighRoads has named Tim Rochford as CTO and Vice President, Product Development and Bridget Lipezker as Vice President of Payer Services. Each executive brings compelling expertise and years of experience to their new positions.

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

Keep your company at the forefront of the fast-changing Health Care Consumerism mega-trend....

SAVE THE DATE FORUM EAST 2014

May 7-9, 2014

ATLANTA

Cobb Galleria Centre

THE ONLY CONFERENCE DEDICATED 100% TO HEALTH CARE CONSUMERISM

What the four boxes suggest.

WWW.THEIHCCFORUM.COM

The four simple boxes explain why consumerism strategies are

getting more value. Health savings accounts (consumers spending their own money), reference-based pricing, and price transparency allow that to happen. Imbalanced motives explain many of the troublesome behaviors we

LEARN. CONNECT. SHARE. ___________________________________________________ Free to Choose: a Personal Statement

FieldMedia LLC is the parent company to HealthCare Consumerism Solutions magazine, EmployersWeb.com, IHC FORUM and The Institute for HealthCare Consumerism. 292 South Main St., Ste 400, Alpharetta, GA 30009

ISSUE || July/August 2013

Which Way From Here? With the Exchanges Almost Upon Us, Experts Weigh in on Key Issues The ACA Opens Up Opportunities Where Few Existed Before Small Employer Private Exchanges: Wherefore Art Thou? Two Private Exchange Profiles Inside

www.theihcc.com

INSIDE

FEATURE 11 Early Retirees and Their Employers: The ACA Opens Up Opportunities Where Few Existed Before As CEO of Extend Health — and now Managing Director, Towers Watson Exchange Solutions — Bryce Williams has nearly a decade of experience in defined contribution and exchange technology. Here, Bryce examines how the PPACA — through guaranteed issue, public exchanges and other key provisions — will change the health care market for early retirees. By Bryce Williams, Managing Director, Towers Watson’s Exchange Solutions

DEPARTMENTS 4

Publisher’s Letter

discuss how they’ve created the industry’s most complete and comprehensive one-stop solution.

CEO Doug Field covers the latest in the private exchange and defined contribution industry and what’s happening at the Institute around exchanges

News Briefs & Innovations Keeping you up-to-date with the latest news, research and innovations in defined contribution and health insurance exchanges

By Dr. John Reynolds, Chief Executive Officer, and Pierce A. McNally, Chief Strategy Officer, Cielostar

In her second regulatory and compliance column, Elena Merino, a leading Atlanta-area benefits broker, discusses the state of public and private exchanges for small employers and the potential missed opportunities in this area.

Exchange Profile: The Cielostar Private Exchange Solution The Cielostar Private Exchange Solution represents the culmination of 25 years of work in the industry evolving toward technology-based solutions in the field of health care and benefits management, administration and payments platforms. The Minneapolis-based company’s leading executives

Regulatory & Compliance: Small Employer Private Exchanges: Wherefore Art Thou?

By Elena Merino, President/CEO, The Meridian Group

Exchange Profile: The Solstice Marketplace

benefits brokers will play after the launch of public and private exchanges. With the launch of Solstice Marketplace, Florida’s Solstice Benefits has created a private exchange solution to help brokers succeed. By Carlos Ferrara, Chief Operating Officer, Solstice Benefits, Inc.

10 Supplemental Health: Why Voluntary Insurance Matters Health care reform, primarily through the creation of public and private exchanges, has created a larger, more important role for voluntary and supplemental products. Michael Zuna, EVP and CMO, Aflac, discusses why voluntary insurance matters more than ever in the health reform era. By Michael Zuna, Executive Vice President and Chief Marketing Officer, Aflac

Much discussion of the last year has focused on the role that

www.TheIHCC.com I HealthCare Exchange Solutions™ I July/August 2013 3

PUBLISHER

Exchange www.theihcc.com VOLUME 1 NO. 3 | JULY/AUGUST 2013

Exchanges. Here They Come. The buzz surrounding health insurance exchanges created by the Affordable Care Act

Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Fax: 770.663.4409 CEO

Doug Field @ theihcc.com

has been growing this the year in media and throughout the business world. With October 1 less than two months away, we’re very close to seeing how these exchanges will — or

MANAGING DIRECTOR

Brent Macy

won’t — work. MANAGING EDITOR

Considerable attention has been given to public exchanges and whether or not they will be operable in time. The White House and Department of Health and Human Services have repeatedly insisted they will be ready, but many have reasonable doubt. On the other hand,

Jonathan Field

ACCOUNT MANAGER

Joni Lipson

employers will see for themselves how effective the different private exchange solutions are at meeting their health and benefits needs. Coming in early December, the Institute for HealthCare Consumerism’s FORUM West event

MARKETING COMMUNICATIONS MANAGER

Lana Perry

ART DIRECTOR

Kellie Frissell

will be the industry’s first real-time event to look at the success of both public and private exchanges. The Las Vegas conference will feature a panel discussion with public and private exchange experts in addition to several workshops focused on defined contribution and exchanges.

ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS

Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD

Ronald E. Bachman, CEO, Healthcare Visions

In this third issue of HealthCare Exchange Solutions, I am proud to feature many business and thought leaders on the upcoming exchanges and the issues surrounding their implemenation. Bryce Williams, Managing Director, Towers Watson’s Exchange Solutions, looks at how the ACA and public exchanges will affect early retirement options. Michael Zuna, Executive Vice President and Chief Marketing Officer, Aflac, delves into why voluntary products may become more important than ever in the era of the health insurance

EDITORIAL ADVISORY BOARD

Kevin Carnegie

exchange.

Tom Becher

In her regular column, Elena Merino examines small and mid-sized employers as they are both related to private and public exchanges. I am also excited to feature Exchange Profiles for both Solstice Marketplace and the Cielostar Private Exchange Solution, two unique products in the private exchange space. I hope you find this issue of Exchange Solutions of value as we move into a different era of employee benefits.

ASSOCIATE WEB ADMINISTRATOR

Tim Hemendinger

DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS

Rogers Beasley

BUSINESS MANAGER

Karen Raudabaugh

Sincerely,

™ is a trademark of FieldMedia LLC. ™ is published eight times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009. Periodical postage

Doug Field CEO/Publisher dfield@fieldmedia.com

TO SUBSCRIBE: Make checks and money orders payable to ™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or PRINTED IN THE U.S.A. ™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher

July/August 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com

BRIEFS

NEWS BRIEFS Towers Watson Selects WageWorks to Administer Health Accounts on New Private Exchange Towers Watson, a global professional services company and WageWorks, Inc., a leading provider of consumer-directed benefits, have announced an agreement for WageWorks to administer health savings accounts (HSAs) and health reimbursement arrangements (HRAs) on OneExchange Active, Towers Watson’s new private health insurance exchange. Under the agreement, WageWorks will be the exclusive administrator of HSAs and HRAs for OneExchange Active — Towers Watson’s offering for active full-time employees.

Initial Group Of 5 Major Employers Sign On To Offer Benefits Through Mercer’s Private Exchange Five major US employers have signed on to offer their employees a range of medical, dental, life, disability, and voluntary benefit choices for 2014 through Mercer Marketplace, with additional employers in active discussion to move in this direction in 2014 and 2015. The employers, which cannot be named publicly until their employees are informed during the upcoming annual enrollment process, represent a range of sizes and industries. Some will offer self-funded medical and dental plans on the exchange while others will offer fully insured plans. The industries represented are retail, transportation, media, food and beverage, and professional services; the employers range in size from 800 to 25,000 employees.

Guardian Joins Liazon’s Bright Choices Exchange The Guardian Life Insurance Company of America (Guardian), one of the nation’s largest mutual life insurers and a leading provider of employee benefits, announced today that it will be offering its dental, vision, life, disability and accident products on Liazon’s Bright Choices Exchange. By providing its full suite of benefits through Bright Choices, Guardian is expanding access to these important benefit options for employers and employees through an increasingly popular distribution channel.

Digital Benefit Advisors of Vermont Launches Private Exchange, Signs Blue Cross Blue Shield Digital Benefit Advisors (DBA) of Vermont, a division of Digital Insurance, the nation’s largest and most technologically advanced employee benefits-only agency, is launching Digital Benefits Marketplace, a private exchange that helps businesses with 50 or more employees control rising benefits costs. The new Digital Benefits Marketplace enables employers to offer a comprehensive array of benefits — including health insurance plans from Blue Cross Blue Shield of Vermont — at a fixed cost. It also streamlines administrative processes and empowers individuals to spend their benefits dollars where they determine they’ll receive the greatest value.

PrimePay Extends its Relationship with Alegeus, Adopts Private Exchange Platform Alegeus Technologies, the market leader in health care and benefit payments, announced that PrimeFlex Administrative Services, LLC, a subsidiary of PrimePay and a leading provider of payroll, tax, HR and benefit services, has selected the Alegeus WealthCare

Marketplace platform to power its fully-branded private exchange solution, called The PrimePay Marketplace. Designed for broker partners and employer clients, The PrimePay Marketplace will complement existing offerings to support a wider array of employer funding strategies — such as defined contribution plans.

Benefitfocus Adds Virtual Assistants to Marketplace Solutions Through CodeBaby Partnership Benefitfocus and CodeBaby recently announced their strategic initiative to add virtual assistance to the benefits shopping experience. Through this partnership, Benefitfocus will provide insurance carriers and employers convenient, on-demand consumer support by incorporating CodeBaby’s Intelligent Virtual Assistants (IVAs) within its private exchange offerings, BENEFITFOCUS® Marketplace and BENEFITFOCUS HR INTOUCH MARKETPLACE® Edition. This strategic alliance creates a leading solution for the health care and benefits market.

PEOPLE ON THE MOVE Bloom Health Names Jim Priebe Chief Operating Officer Bloom Health is pleased to announce the hiring of Jim Priebe as its Chief Operating Officer. Priebe will lead corporate development, legal and compliance, service center operations and account management for Bloom Health. He brings a wealth of experience in operations, strategy and business development from previous executive leadership roles at leading health care companies including Acclaris Inc., OptumHealth and Mayo Clinic Health Solutions. Most recently, Priebe was Chief Growth Officer at Acclaris, an industry leader in consumer-driven health and reimbursement account administration. Priebe delivered consistent year-over-year growth and significantly increased revenue.

Digital Benefit Advisors Selects Bob Gaydos to Head New Private Exchange Digital Benefit Advisors is launching Digital Benefits Marketplace, a private exchange to help employers of all sizes control rising benefits costs through defined contributions and fostering consumer engagement. In conjunction, they have appointed DBA Managing Principal Bob Gaydos to spearhead this initiative and coordinate the roll out, naming him national director of private marketplaces. In his new role, Gaydos will work closely with Digital’s leadership, carriers and technology solutions to drive adoption.

Towers Watson Names Woody Sides Exchange Solutions Regional VP of Sales in the West Towers Watson has announced it has hired Woody Sides as regional vice president, responsible for sales and business development efforts in the West for its Exchange Solutions business segment. Sides brings more than 20 years of experience in the health care and benefits industry to his new role. He served for over a decade as vice president of national accounts and managed care sales for Medco Health Solutions in addition to having national employer responsibilities with Kaiser Permanente and PacifiCare Health Systems. www.TheIHCC.com I HealthCare Exchange Solutions™ I July/August 2013 5

TWO FREE LIVE WEBINARS Research Results Unveiled – Employer Perceptions Regarding Private

< John Park Chief Strategy Officer Alegeus Technologies

During the months of June and July 2013, Alegeus Technologies commissioned an independent research initiative, polling more than 500 US employers on the topics of defined contribution and private exchanges. Join us as we unveil the results of this ground-breaking research. t

Gauge employer understanding and perceptions regarding defined contribution and private exchanges concepts

Ascertain anticipated interest and adoption rates of defined contribution/private exchange programs (interest & timing)

5IVSTEBZ t "VHVTU 1:00 PM EST

Terry McCorvie > President WealthCare Solution Alegeus Technologies t

Determine channel preferences for researching, identifying and purchasing defined contribution/private exchange solutions

Understand current benefit offerings, and determine whether there is any likely correlation between existing benefit packages and defined contribution/private exchange interest

Validate defined contribution/private exchange solution feature preferences & perceptions

Obtain background on how/when employers make benefit decisions

10 Things You Need to Know When Selecting a CDH Platform

5IVSTEBZ t 4FQUFNCFS 1:00 PM EST

< Chris Rodkey For health plans, third party administrators and financial institutions Director Product Management engaged in offering tax-advantaged benefit accounts to employers — the Alegeus Technologies selection of an account administration platform (and the effort and investment required to convert your existing portfolio) is significant. From system architecture to plan setup and administrator controls to branding opportunities and participant/employer self-service capabilities — what are the best-in-class features available in the market today? Which features have the potential to transform your business operations and deliver competitive advantage in the marketplace? What is the business case for making a change, and what is the opportunity cost loss of status quo? Join us as we discuss 10 things you need to know when selecting a CDH administration platform. During the presentation, we will hear from other administrators who have recently gone through a selection/conversion process — and the criteria, priorities and imperatives that weighed into their decision-making.

FREE LIVE WEBINARS AND AUDIO ARCHIVES

Access All Archives: www.theihcc.com/webinars

www.theihcc.com

To learn more, check out The Institute for HealthCare Consumerism’s website at www.theihcc.com

PRIVATE EXCHANGE PROFILE

The Most Complete and Comprehensive One-stop Solution: The Cielostar Private Exchange Solution

BY DR. JOHN REYNOLDS » CHIEF EXECUTIVE OFFICER » PIERCE A. McNALLY » CHIEF STRATEGY OFFICER » CIELOSTAR

The Cielostar Private Exchange Solution represents the culmination of 25 years of work in the industry evolving toward technology-based solutions in the field of health care and benefits management, administration and payments platforms. For 12 years, Cielostar, then known as OutsourceOne, Inc., pursued a broad-based business model focused on the outsourcing by corporations of their benefits management function. Virtually every aspect of the outsourcing function was handled by the company at one time or another, from claims administration to benefits management to billing to tax-advantaged accounts and COBRA. When it was decided to move into the technology of the administration and management process, it was done from a deep and thorough understanding of the practicalities necessary for a streamlined function in the real world. With the advent of Benefit Ready (version 1) in 2001, the company introduced the first and most important element of a fully integrated data base that by 2013 (version 7) established the first and industry-leading complete end-to-end solution on a single platform. This allows the company to offer seamless handling of eligibility, enrollment, decision support, carrier feeds, tax-advantaged accounts, voluntary benefits, COBRA, consolidated billing and EDI, all tied together with electronic cardbased financial interface. Far from being an enrollment software development project, it is the most complete and comprehensive one-stop solution available in the marketplace today. As a result of the changing marketplace and spurred by the passage of the Affordable Care Act, it became clear that more and more companies and individuals would be meeting their health care and benefit needs on web-based compare-and-shop platforms called private exchanges. A successful private exchange will need all the components just described to allow for an efficient comparative purchasing experience with a view in mind to

At Cielostar, we believe that the only way to pursue a winning strategy is to simplify and make it easy to perform a basic task: obtaining and deploying fundamental protection for employers, their employees and the employees’ families.

lowering costs. While private exchanges are particularly well suited to serve individuals shopping and buying in a defined contribution environment, they work equally well for employers who still seek the best value in the defined benefit environment. The private exchange is an open marketplace where consumers, be they individuals or corporations, can get information, research alternatives, choose plans, enroll in them and manage them on one environmentally cohesive platform without detours or cumbersome hand-offs. This is what the Cielostar Private Exchange Solution offers companies, their employees, affiliate groups, consortiums of commonly-owned enterprises and individuals in their search for affordable health care and benefits access. The current health care and benefits acquisition landscape has become ever more complex with the confusion and uncertainty injected by the passage and halting implementation of the Affordable Care Act, which will directly affect every person in the country. It may take years before the contours of the consequences of this legislation are in even fuzzy focus. Yet, the needs of corporations and individuals for health care and benefit deployment will continue apace and not abate just because there’s fog over the battlefield. At Cielostar, we believe that the only way to pursue a winning strategy is to simplify and make it easy to perform a basic task: obtaining and deploying fundamental protection for employers, their employees and the employees’ families. In short, complication is a disservice. It will lead to less protection and more anguish. So, at the heart of the Cielostar Private Exchange Solution is a simple and easy-to-navigate landing page that asks for identification by status (employer or individual) and if an employer, by size, and by clicking on one icon, the entire process is initiated. Behind that click resides 25 years of health and benefits experience coming from a deep understanding of the elements necessary to provide real customer service. From that one click, the customer can not only initiate the desired transaction, but complete the process in its entirety in one sitting if desired. Efficient, fast, simple, understandable, comprehensive: the Cielostar Private Exchange Solution.

www.TheIHCC.com I HealthCare Exchange Solutions™ I July/August 2013

REGULATORY & COMPLIANCE

BY ELENA MERINO » PRESIDENT/CEO » THE MERIDIAN GROUP

Small Employer Private Exchanges: Wherefore Art Thou?

hile private exchanges for employer groups with 500 or more employees are springing up at national risk management firms throughout the country, small and medium-sized businesses are asking “What about us?” What about firms with less than 500 employees that make up 99.7 percent of U.S. employer firms?1 Don’t exchange providers know that these firms make up 82.8 percent of all employment and 85 percent of all new employment?2 Isn’t technology the mother of economies of scale? While Mercer, Aon and Willis are competing for the elephants and Web-based brokers like eHealthInsurance are competing with public exchanges for individual consumers, only a smattering of agents working with small to medium employer groups are even talking about private exchanges. In a technology session at the most recent conference of the National Association of Health Underwriters (NAHU), a half-dozen hands went up when asked if they are even providing a multi-carrier enrollment solution to their groups. Why haven’t enrollment technologies reached smaller employers or their brokers? Will defined contribution change that? We hope so. Even the federal government SHOP exchange employee option has been postponed. While some states’ SHOP exchanges have teamed up with software vendors, such as bswift, Liazon and others, no state has received final approval to operate its own exchange.3 BenefitMall, a general agent in 11 states which adopted multi-carrier quoting and decision-support tools for brokers early on, is naturally maturing into a private exchange. Meanwhile, general agents in various states are playing catch-up in providing technology solutions to their brokers hoping to quickly blossom into full exchanges. But, will small group insurance providers sign up for these smaller private exchanges? In an unofficial survey of Georgia carriers, mum was the word. “We don’t know yet,” they say. While firms with up to 100 employees will be subject to community rating after 2016, most states elected the option to define small groups as employers with up to 50 employees until 2016. Even though groups with less than 50 employees comprise 43.2 percent of all employment, private exchanges are unlikely to target this market, not only because are they are exempt from the employer mandate, but because they know that small employers that offer minimum value and affordable coverage will in essence disqualify their employees for federal subsidies. Groups with more than 50 employees but less than 500 employees (39.6 percent of total U.S. employment) are, however, prime customers for private exchanges in 2014.4 Because community ratings and 8

July/August 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com

standardized metal plans will not apply to employers with over 50 employees (100 employees in 2016) employers in the segment will not only have more plan and rating variation but will be subject to an increasingly number of regulations, mandates and reporting requirements. Further, mid-sized firms in laborintensive industries like hospitality and retail that may not have traditionally offered major medical to hourly employees will look to private exchanges as a viable alternative to the employer mandate. Because offering access to private exchanges, regardless of the level of contribution, would be considered offering Minimum Essential Coverage (MEC), these employers will be able to avoid the 4980(a) penalty per employee by participation in a private exchange. Integrating the defined contribution as part of the total compensation, employers will not only be able to present a true compensation package to employees but also be able to fine tune their compensation to avoid the 4980(b) penalty as well. While Aon, Mercer and Willis clients will surely have the benefit of specialized counsel and accountants, mid-size employers will struggle not only with meeting the reporting requirements under the ACA but with control group issues, managing employee counts, variable hour employees and varying contributions levels. HR and benefits administrators who are already overworked and often underpaid will likely be unwilling, or unable, to take on the responsibilities and increasing liabilities of plan administrators and fiduciaries post-ACA. Will private exchanges step up, not just to provide defined contribution technologies and decision tools, but as plan administrators and legal fiduciaries as it relates to ACA compliance? Will private exchanges that collect and disperse contributions from employers to employees under the defined contribution model be ready to take legal responsibility as trustees? Will they be ready to manage FSAs, HRAs and HSAs for multiple employers? Will they step up to serve as liaison to HHS, DOL and IRS as it’s related to reporting and compliance? No, small and medium-sized employers don’t expect exchanges to be all things to all people, but in view of the increased compliance and reporting requirements, they are more than ready to see the menu. ___________________________________________________________

BLS…http://www.bls.gov/opub/mlr/2012/03/art4full.pdf

PRIVATE EXCHANGE PROFILE

Brokers, Enrollment Support, Data Security: Crucial to Private Exchange Success BY CARLOS FERRARA Âť CHIEF OPERATING OFFICER Âť 40-45*$& #&/&'*54 */$

The Patient Protection and Affordable Care Act. Itâ&#x20AC;&#x2122;s upon us â&#x20AC;&#x201D; as are the changes in the health care landscape. Employers with 50 or more employees are now required to offer employees group health insurance. All Americans will be required to purchase health insurance, either through employer-provided plans or privately. Health plans will be accessed through health care exchanges â&#x20AC;&#x201D; marketplaces where people can compare health plans and purchase policies independently. There will be public exchanges â&#x20AC;&#x201D; those run and funded by the federal government and states â&#x20AC;&#x201D; as well as private exchanges â&#x20AC;&#x201D; those run by non-government entities.

What does all this mean for brokers and their businesses? To survive in this ever-changing health care landscape, brokers will need to be tech savvy. Differentiating their services through benefits offered in exchanges like the Solstice Marketplace will keep them at the forefront with their clients â&#x20AC;&#x201D; as well as remaining a trusted adviser.

An Exchange to Help Brokers Succeed The Solstice Marketplace is an easy-to-use health care exchange platform that was designed to address the needs of brokers â&#x20AC;&#x201D; and HR professionals â&#x20AC;&#x201D; nationwide. Brokers can leverage the relationships they already have with multiple carriers and sell those services to their customers. We also offer standard plans to choose from. Brokers have unique business needs and this exchange allows them to create a personalized, branded landing page to drive more business their way. Plus, single source billing with the Solstice Marketplace alleviates the hassles of multiple bills and the issues that come with them. The safety and security of brokersâ&#x20AC;&#x2122; data and their customersâ&#x20AC;&#x2122; private information is a key feature of a health care exchange. The Solstice Marketplace has security measures that comply with â&#x20AC;&#x201C; and exceed â&#x20AC;&#x201C; current federal and state guidelines for protecting personal health information.

Enrollment Support: Supporting Employee Satisfaction The new exchange concept will already be confusing for enrollees, who likely are uncertain about choices. With an eye on health literacy, itâ&#x20AC;&#x2122;s important that employee enrollment is simple to understand through an easy-to-use enrollment system. Our goal is to reduce enrolleesâ&#x20AC;&#x2122; stress, making the entire process as user-friendly as possible.

Employees may need additional information about some of the terms or topics or help in choosing a plan. The Solstice Marketplace has a complete library of relatable and easy-tounderstand videos that are instantly available to viewers. For example, they can watch a video on the Solstice Marketplaceâ&#x20AC;&#x2122;s open enrollment, at a point when itâ&#x20AC;&#x2122;s the most helpful in their decision making process. Online tools can give employees peace of mind, knowing theyâ&#x20AC;&#x2122;re making a well-informed decision. The Solstice Marketplace offers helpful support such as: t Comprehensive enrollment video library t Articles written in plain language, passing a URACapproved health literacy policy t Exclusive online tools â&#x20AC;&#x201D; like our built-in calculator that shows how much the employer is contributing â&#x20AC;&#x201D; and how much the employee will pay

Manage and Grow your Business With Unique Broker Tools Brokers will need tools, too, to create their online presence. The broker-centric Solstice Marketplace allows brokers to custom-brand their own portal; add and administer the carriers with whom they have established relationships; create and manage medical, dental, vision and life plans they are licensed to sell; simplify their businesses; create and manage multiple groups all from one convenient dashboard; add plans to groups and set up and monitor enrollment for groups. As health reform continues to re-shape the health care landscape, employers will need reliable partners to help them navigate the changes. With the Solstice Marketplace, brokers can be just that.

www.TheIHCC.com I HealthCare Exchange Solutionsâ&#x201E;˘ I July/August 2013

SUPPLEMENTAL HEALTH BY MICHAEL ZUNA EXECUTIVE VICE PRESIDENT AND CHIEF MARKETING OFFICER AFLAC

Why Voluntary Insurance Matters

ealth care reform has had an impact on practically every aspect of health services for individuals and businesses. While many are confused about what it means for them, in the months ahead key provisions will take effect that will require businesses and individuals to make key benefits decisions. Health care reform and increasing health care costs continue to drive demand for supplemental benefits. Voluntary insurance (also known as supplemental insurance) has long served as a way to protect the policyholder when they are sick or injured — regardless of their major medical insurance coverage. Voluntary insurance plans are even more relevant and have importance as a key piece of a worker’s overall financial plan.

Workers gain responsibility; but face risks With rising health care costs, employers have been shifting to more consumer driven health plan options. In many instances consumers are making more of their health care choices — including how much they spend on health care coverage and what type of coverage they have. However, research shows individuals are concerned they may not be prepared to handle the numerous and complex details of managing their health insurance benefits as they should. The majority do not understand consumer-driven health care options, are confused about how they will be impacted by health care reform, and they have unrealistic opinions about their own morbidity risks, or the risk posed to their finances. In fact, more than half of workers (53 percent) think that they may not adequately manage their health insurance coverage according to the 2013 Aflac WorkForces Report1 — leaving their family less protected than they currently are. A similar percent (54 percent) say they’d prefer not to have more control over their health insurance expenses and options because they will not have the time or knowledge to manage it effectively.

Voluntary insurance help fill the gaps For many organizations, voluntary benefits may help solve a number of concerns and challenges that have surfaced during this time of health care and financial insecurity. For small businesses, supplemental insurance is becoming a more important component of the overall employee benefit and compensation package.

Voluntary insurance helps to: t

Support the overall benefits plan: Workers with supplemental benefits are more likely to be extremely or very satisfied with their benefits than workers who do not have supplemental benefits (69 percent compared to 48 percent).

July/August 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com

Provide additional robust benefits options: Voluntary benefits offer a variety of levels and types of coverage to meet individual needs and life stages. Policies include accident, disability, cancer, hospital and many more. These policies can be offered, sold or provided with any type of major medical plan. t Provide workers cash benefits to help pay out-of-pocket medical costs: Most employees (43 percent) are not very or not at all prepared to pay for out-of-pocket expenses related to an unexpected illness or accident. Additionally, 25 percent are only prepared to pay less than $500 (46 percent have less than $1,000) for themselves or family members for out-of-pocket expenses. t Guard workers against financial stress and anxiety: Employees who are offered and enrolled in supplemental benefits options are significantly more likely to say they have peace of mind (52 percent compared to 42 percent), and have a financial plan (49 percent compared to 39 percent). Facing so much uncertainty, developing a plan to manage health care costs can be an overwhelming task. As decision-makers seek health care benefits options, voluntary insurance continue to help soften the impact of the inevitable cost-shifting and rising out-ofpocket costs on its valuable workforce. These solutions have no direct cost to the company, but offer workers choice in additional coverage that best suits their needs.

1 2013 Aflac WorkForces Report, a study conducted by Research Now on behalf of Aflac, January 7 – 24, 2013

Early Retirees and Their Employers:

The ACA Opens Up Opportunities Where Few Existed Before BY BRYCE WILLIAMS » MANAGING DIRECTOR » TOWERS WATSON’S EXCHANGE SOLUTIONS

www.TheIHCC.com I HealthCare Exchange Solutions™ I July/August 2013

Healthcare Consumerism: Shifting to a Patient-Centered Organization FREE LIVE WEBINAR

5IVSTEBZ t "VHVTU t o 1. &45

As expressed by the Deloitte Center for Health Solutions: â&#x20AC;&#x153;. . . health policy experts and economists have . . . reasoned that costs would be lower, services better and quality substantially improved if the industry repositioned itself as a consumer market.â&#x20AC;? As promoted by PricewaterhouseCoopers: â&#x20AC;&#x153;Seeing things from the customerâ&#x20AC;&#x2122;s perspective â&#x20AC;&#x201D; outside-in â&#x20AC;&#x201D; and making that view the core of your strategy may be the most important thing that sets you apart from competitors. Companies that design this kind of organization â&#x20AC;&#x201D; focusing on the right metrics, an integrated approach, a thorough understanding of the customer, and strategic investments â&#x20AC;&#x201D; can reap real dividends.â&#x20AC;? Webinar Attendees will: t

Learn about the five developing generations of consumerism.

Find out how to optimize your products and services by becoming a â&#x20AC;&#x153;Patient-Centeredâ&#x20AC;? Organization.

Discover the realities of where the HealthCare Consumerism megatrend is today and where it is going.

Take away a better understanding of the benefits of HealthCare Consumerism (and of the next dimension of HealthCare Consumerism â&#x20AC;&#x201D; the patient-centered organization).

Who should attend: employer, consultant, broker, insurer, health provider, or administrator. Sign up for this FREE Live Webinar at www.theihcc.com/webinars/aflac

Ron Bachman

Chairman, Editorial Advisory Board The Institute for HealthCare Consumerism

Date: 5IVSTEBZ t "VHVTU Time: 2:00 - 3:00 p.m. EST Info: webinars@theihcc.com Live & On-Demand: www.theihcc.com/webinars/aflac

FREE WEBINAR ARCHIVES HealthCare Consumerism: Helping Employers Move from a Parenting Approach to a Partnering Approach On Demand

Access All Webinar Archives: www.theihcc.com/webinars Register today for the new Aflac webinar: www.theihcc.com/webinars/aflac

In the move towards a Partnering Approach vs. a Parenting Approach, employers partner with their employees and offer true choice rather than dictate plans and carriers in a limited fashion.

www.theihcc.com

To learn more, check out The Institute for HealthCare Consumerismâ&#x20AC;&#x2122;s website at www.theihcc.com

The problem is many people had to tap into their savings to get through the recession. Others are wary about taking the retirement plunge in the middle of such a modest pace of economic recovery. And let’s face it: even when the economy is booming, not everyone excels at retirement planning. And consider these findings from Towers Watson’s 2011 Retirement Attitudes Survey: Survey respondents, especially older workers, most often blame the rising costs of necessities and health care for retirement delays. Of workers who plan to retire later, 64 percent of those aged 50 and older cite keeping their health care coverage as the reason. Even more — 68 percent — cite higher prices for basic necessities. Of course, for Americans 65 years and older, retirement does not hinge on the availability of health insurance because they are eligible for Medicare. But for Americans 50 to 64 years old, the prospect of losing their health insurance if they leave their jobs can be a serious roadblock to retirement — no matter how much they might like to retire. There are lots of reasons why people want to retire before they turn 65. Workers of early retirement age are old enough to have grown children who have moved out of the house and are building their own lives and families. The chance to travel or pursue other interests might be especially be appealing for empty nesters. Americans in this age group also may have been in the workforce for 25 years or more and be ready for more freedom and flexibility in their daily lives. Or they might have health issues that, while not serious enough to make it impossible to work, might make being fully productive at work more challenging. But this age group is by far the most vulnerable when it comes to the availability and cost of health care. According to the AARP’s Public Policy Institute’s report on “Health Insurance Coverage for 50-64 Year Olds,” nearly one in three people between 50 and 64 are in families that spend 10 percent or more of their income on health care. This compares with just 18 percent of people between the ages of 18 and 49. Bottom line, for people in this age group, no matter how strong the desire to retire early, the risks of giving up their employer-sponsored health care may just be too high.

Workers delaying retirement also can make it harder for employers Older Americans delaying retirement because of health insurance can have a negative impact on employers, too. Because they are more likely to have health problems than younger workers, the costs of insuring them are greater — adding to the struggle to manage the high costs of health that many employers have been engaged in for decades. Even though health care costs in recent years have been rising less, health care is expensive and there is no end in sight to cost issues. These benefits are a crucial recruiting and retention tool for a highperforming workforce, and most employers want to stay in the game. For this reason, employers are trying just about everything they can to keep costs down. They have shifted some of the cost of health care coverage to their employees, trimmed benefits, outsourced benefits administration and initiated wellness programs to keep their employees healthier in hopes of cutting usage. All of these activities have worked to control costs somewhat, but not always in ways that are favorable to both employers and their employees: employees depend on affordable health insurance as much as employers depend on their employees.

www.TheIHCC.com I HealthCare Exchange Solutions™ I July/August 2013

Beyond the cost of health care for older workers, there are other challenges Americans delaying retirement create for employers. For example, with fewer older workers retiring, there may be fewer jobs or promotions available for younger workers looking to enter or advance their careers. And while the vast majority of employers seek a balance in their workforce between experienced workers who drive businesses today and young workers who will grow with training and time and add greater value tomorrow, a sharp skew in either direction can make managing a workforce much more complex and challenging. For example, many older workers are energized by work and remain extremely engaged and productive at any age. On the other hand, someone who is working primarily for health insurance may just be going through the motions. At the same time, while some younger workers may gracefully bide their time, others may believe their advancement opportunities are blocked and decide that if they can’t move up quickly enough in their current company, they’ll move to another.

New options for early retirees and their employers coming soon The good news in all of this is that starting in 2014, the Patient Protection and Affordable Care Act (PPACA) creates new options for workers between the ages of 50 and 64 who would like to retire. Most important, PPACA provisions will make the market for individual insurance plans more like Medicare for Americans of all ages. Specifically, starting in 2014, PPACA brings to the individual health plan market guaranteed issue, standard plan designs, community ratings, greater availability of affordable plans and federal subsidies to increase affordability. PPACA also provides for public health insurance exchanges also known as marketplaces. These PPACA provisions will immediately create options for people under 65 looking to retire because so many barriers to obtaining individual health care coverage will be removed: t Guaranteed issue means that for the first time, Americans under the age of 65 cannot be denied coverage or have pre-existing medical conditions excluded from individual health insurance plans — a benefit that Medicare-eligible Americans have enjoyed since Medicare was enacted in 1965. Guaranteed issue will help three categories of people: t Those who would like to retire early, but haven’t because of health insurance t Early retirees who are still covered by their employersponsored group plan but must now pay the full cost of it t Early retirees who are uninsured because they are not covered by an employer-sponsored group plan and have been unable to qualify for individual insurance t Standard plan designs will make it easier to evaluate individual health plans being offered on public exchanges, which enable side-by-side comparisons, quickly and efficiently. t Community rating rules will help make insurance more affordable for early retirees by limiting the factors insurers can use to vary premium costs for individuals. Early retirees historically have had the least favorable underwriting conditions of any other employee or retiree population and very high insurance premiums. New PPACA regulations mandate a maximum three times 14

July/August 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com

differential between premiums charged for the youngest and healthiest members of the risk pool and those in their 50s and early 60s. Federal subsidies will be available to any individual who makes less than 400 percent of the Federal Poverty Level (currently $44,680 for an individual and $92,500 for a family of four). Being able to leverage these federal subsidies can maximize the value of consumers’ health care spend. Public exchanges can add value by offering a wider choice of health plans, which means plans that better match an individual’s situation can be purchased. Exchanges can also off-load employer administrative burdens, further reducing costs and increasing efficiency.

Still, transitioning to individual health plans offered on public exchanges is a big change for people who are used to receiving their health insurance through employer group plans or having to evaluate and make choices about their own health care. Ensuring that early retirees fully understand how to get the most out of their new options is essential. Bottom line, in the fall of 2013 for coverage that will be effective on January 1, 2014, early retirees will have access to something Medicare-eligible Americans have enjoyed for 50 years — guaranteed access to quality health insurance at a reasonable price. Employers will see barriers to retirement fall, allowing employees who stay on only for benefits to move out of the workforce and giving younger employees more opportunity to advance. And the most powerful force in the American economy will be unleashed to tackle the problem of rising health care costs — knowledgeable consumers — consumers with the ability to buy their own health plans and switch plans should they get an unacceptable rate increase or receive poor service.

EXCHANGE SOLUTIONS SHOWCASE

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

TSYS HEALTHCARE TSYS HealthcareÂŽ provides end-toend strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment. â&#x20AC;&#x153;We built the TSYS Healthcare platform to meet UIF NBSLFU EFNBOE GPS SFMJBCMF DPOmHVSBCMF BOE intelligent solutions. Understanding the dynamic 6 4 IFBMUIDBSF NBSLFU PVS DVTUPNFST SFMZ PO PVS option-driven system to prepare them for the future.â&#x20AC;? â&#x20AC;&#x201D; Trey Jinks, Group Executive, TSYS Healthcare HSA / HRA / FSA ADMINISTRATION AND FINANCE

WageWorks helps employers

WAGEWORKS

support consumer directed

1100 Park Place, 4th Floor San Mateo, California 94403 United States of America

QSF UBY CFOFmU QSPHSBNT including health care '4" )4" )3" XFMMOFTT

888-9905099 www.wageworks.com

QSPHSBNT DPNNVUJOH BOE child and elder care. Wage Works also offers retiree health care and COBRA Services. More than 100 of Americaâ&#x20AC;&#x2122;s Fortune 500 employers and millions of their employees use WageWorks.

BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

4JODF $JFMP4UBS GPSNFSMZ 0VUTPVSDF0OF CIELOSTAR IBT IFMQFE CSPLFST FNQMPZFST BOE FNQMPZFFT 530 U.S. Trust Building navigate the ever-changing world of benefits. 730 Second Avenue South Now, with the dawn of â&#x20AC;&#x153;Defined Contribution Minneapolis, MN 55402 Health Careâ&#x20AC;? we are again on the leading edge. With a team of industry thought leaders, CieloStar makes navigating healthand benefits choices john.reynolds@cielostar.com easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology modelâ&#x20AC;&#x201D;most recently launching a proprietary private health insurance exchange.

â&#x20AC;&#x153;Fueled by the far-reaching impact and complexities of health care reform UBLJOH FGGFDU JO BOE FNQMPZFST BOE FNQMPZFFT JODSFBTJOHMZ mOE themselves in a â&#x20AC;&#x2DC;farmerâ&#x20AC;&#x2122;s marketâ&#x20AC;&#x2122; of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room UFDIOPMPHZ GPS FOSPMMNFOU EBUB CJMMJOH BOE DBMM DFOUFST UP DPNQMFUF TPMVUJPOT GPS $0#3" $%)1 BOE IFBMUI JOTVSBODF exchanges.â&#x20AC;? â&#x20AC;&#x201D; John Reynolds, CEO, Cielostar HSA / HRA / FSA ADMINISTRATION AND FINANCE

Evolution1 and our Partners serve more &70-65*0/ */$ UIBO NJMMJPO DPOTVNFST NBLJOH VT UIF OBUJPO T MBSHFTU FMFDUSPOJD QBZNFOU www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers SFJNCVSTFNFOU BDDPVOUT JODMVEJOH )4"T )3"T '4"T 7&#"T 8FMMOFTT and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloudâ&#x201E;˘, 1Directâ&#x201E;˘, 1Payâ&#x201E;˘, 1Viewâ&#x201E;˘, 1Planâ&#x201E;˘, and 1Mobileâ&#x201E;˘. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

â&#x20AC;&#x153;The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.â&#x20AC;? â&#x20AC;&#x201D; Jeff Young Chairman and CEO, Evolution1

www.TheIHCC.com I HealthCare Exchange Solutionsâ&#x201E;˘ I July/August 2013

ENGAGE AT EVERY STAGE

Ninety million consumers report having a hard time understanding their care choices, according to an Institute of Medicine study.* And as the healthcare landscape changes and insurance exchanges become available, consumers are likely to be more confused than ever. Though it remains to be seen what shape the new marketplace will take, it’s clear that consumers will require a range of tools to support their healthcare decision-making. From guiding individuals to their best-fit benefit plan to alerting them about gaps in care, Consumer Advantage from Truven Health Analytics™ provides a full array of solutions to engage consumers with personal, relevant, impactful information throughout the year. Consumer Engagement: The Key to a Successful Exchange Backed by more than 30 years of experience, our consumer experts, integrated platforms, and data management solutions have helped turn passive participants into active healthcare consumers. Recent successes include: Increasing adherence to colorectal cancer screenings by 22 percent Migrating 59 percent of employees from a PPO to a CDHP Reducing the number of “overinsured” employees by 14 percent Enrolling more than 1,000 new participants in a health savings account

Find the path to a healthier bottom line — visit booth #135 at AHIP Institute 2013 or go to truvenhealth.com/exchange

Consumer confusion about their care choices is directly responsible for 3- to 6-percent higher healthcare expenditures.* * Source: Institute of Medicine Report Brief

BY ELIZABETH NAPOLITANO EXECUTIVE VICE PRESIDENT OF CLIENT EXPERIENCE ACCOLADE, INC.

DECISION SUPPORT TOOLS

The Rise of the Personal Health Assistant

This personalized, one-stop approach, supported by an integrated

As a result, the consumer health care experience is often frustrating and dissatisfying. But who can individuals really turn to for help? Their doctors? Clinicians are critical partners, but with the average primary care visit 1 Their health insurers? Given their role in approving and denying claims, trust is a barrier. In fact, a 2012 Peppers & Rogers Group study revealed that only 38 percent of Americans trust their health insurer.2 To help close this gap, many employers offer their employees an array programs and price transparency tools to disease and case management. However, fragmentation across these programs can heighten consumer frustration. Individuals have to call multiple phone numbers and vendors

programs, so the same information has to be repeated multiple times.

costly, and avoidable, mistakes along the way. At Accolade, we believe the best way to improve and simplify the single, trusted resource to support them and their families across all of their health care needs. In fact, our whole model was purpose-built around what consumers said they wanted: a resource who knows them, who is on their side, who helps them get the right care and who takes on the legwork.3

population we serve. One reason we can deliver a greater impact than typical health management programs is simple: because we take the time to to identify more ways to help them over time.

Meet Kate, an Accolade Personal Health Assistant Kate started working with a woman in her mid-40s on minor claims questions. The calls were always short. Over weeks and months, she built a relationship with the client and found that, in addition to being sick, she was struggling financially and couldn’t afford the additional cell phone minutes to address her health care questions. Realizing there was a personal barrier to helping her client get the right care, Kate took a number of steps to remove these barriers. She arranged for free cell phone minutes, worked with the utility company to waive bills, identified local food pantries and even connected with a nutrition supplement manufacturer to supply needed supplements. These actions built trust between Kate and her client. With the financial barriers removed, Kate was then able to help the individual address her health diagnosis and related issues. Through numerous conversations, the client received the information she needed about her treatment options and recovery, including identification of doctors and specialists in her network, questions to ask her doctors and different payment plans. Kate worked with her to avoid unnecessary steps and return to a healthy state — and, because of their relationship, laid the groundwork for future support for both the client and her family. Sometimes the client calls Kate, her health care “person,” just to check in.

better outcomes for our employer customers. Large, self-insured employers reacting to symptoms, through treatment and compliance.

Personal Health Assistant (n.) – A specially-trained individual who brings empathy, knowledge and critical thinking skills to help consumers and their families understand their health care options and get the right care the first time.

reduction in annual health costs, an 18 percent reduction in readmissions and a 5 percent reduction in in-patient days along with increased outpatient care in areas such as preventive visits, mental health and well-baby visits. At Creating a great consumer experience in health care is possible, especially if we recognize that health care is always personal. Consumers are looking for an ally that they can rely on to navigate the complex system

By taking the time to build meaningful person-to-person relationships

“person,” someone they rely on and can talk to the same way they would separate programs or to repeat the same information. Every time someone calls, they reach a dedicated, caring health assistant, who gets to know them

help reverse the negative cycle of costs and discontentment by providing integrated health care decision support services and recognizing the power of personal trust in health care. Humans helping humans. That feels better already. ___________________________________________________ Family Practice

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

BY WENDY LYNCH CO-DIRECTOR ALTARUM CENTER FOR CONSUMER CHOICE IN HEALTH CARE

CONSUMERISM

My Money or Other People’s Money (OPM): Why Consumerism Works A simple principle changed my thinking. read changes the direction of your career, let alone your perspective. In fact, I can only recall one book that ever has:

QUIZ: What do the following situations have in common? t t t

page in the book. I remember exactly where I was (on a BART train, riding to a meeting in San Francisco) when

Parents of a young teenager who discover an extra 10 Gigabytes of data charges on their family-plan monthly wireless bill. Government division leaders spending tax-payer money on travel and celebrations. Legislators adding their favorite pet project to an immensely important budget bill. Homeowners who find that they can’t get the prepaid contractor to finish the last part of a remodeling project.

ANSWER: They are all predictable situations based on who bears the cost (someone else) and who receives the benefit.

Rather than quote his text, I will paraphrase what I learned. There are only four types of spending in the world. Those types are determined by two conditions: whose money one is spending and on whom the money is spent. Depending on those two conditions, spending falls in one of four boxes; and each box has inherent human motives. Friedman pointed out that the only box with balanced motives is the one at the top left: me, spending my own money on myself. Under those conditions, I am both the person spending money on a product as well as the

least more so than if the product was for me personally). Consider this in the context of pure human nature: if you gave a child $5 to buy a present for his sister, then told

to spend less on the sister. Lastly, Friedman (a known critic of virtually all government spending) explained the last box at the bottom right. When I am

on someone else, I have neither the incentive to spend less or get more. My choices will be driven by motives totally unconnected to the cost and value of the exchange. He pointed out that all government spending resides here. Without balanced motives, legislators will often be driven by ideology or re-election concerns,

operate in this box too.)

to spend less (money) and get more (utility).

So What?

No other type of spending has balanced motives.

Perhaps these four simple categories should not have come as such a revelation, but they did. Many issues suddenly made more sense: allinclusive versus fee-for-service health care; high versus low deductibles;

to spend more than if I am spending my own. Think of business dinners or company rental cars. This is the box representing classic economic moral hazard: where we are willing to consume more or take more risk if someone else will pay the bill or accept the consequences. When I spend my money on someone else (top right), I have motives

Many of our systems are created to operate with either unbalanced motives or no coherent motives at all. By design they are predetermined to create over-consumption, uncontrolled cost or compromised quality. We built them that way. When a teenager can stream as many videos online as she wants but is not expected to pay for them, she will watch more videos. If

may pay less attention to value and choose a less expensive option (at

Four Types of Spending Spent on Whom? Spent on someone else Spent on you Your money

Whose Money? Someone else’s money 34

Spend less and get more

Spend less

Get more

Neither. Depends on other motives

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

order more of them. And if the patient has insurance that will pay for the test, he is more likely to consent. maximize our own best interest. We inherently care more about protecting

convincing strategies will work. Can we be upset that doctors and patients alike are spending more and more on unnecessary health services when

BY PATRICK SPAIN CO-FOUNDER, CHAIRMAN, CEO FIRST STOP HEALTH

TELEHEALTH

Consumer Engagement: No Ring Necessary

s health care is transformed by the Affordable Care Act, the market forces of rising prices, primary care provider shortages and the need to navigate an ever more complex and increasingly opaque health care system, employers must make a number of changes. The key to a successful transition lies in putting power back in the hands of the consumer. Health care remains possibly the last industry in which consumers information before they buy, where someone else pays for the service we use. This is changing, but it will not be a simple change nor will it necessarily be received by consumers enthusiastically. Hardly anyone not raised in a Middle Eastern bazaar culture relishes the prospect of buying a new – or So it is with health care. Until we make it desirable, it will be hard to engage consumers in being good shoppers. But what if it could be convenient, quick, affordable and in retail restaurants. It worked for for Amazon in, well, everything. It can work for health care. In fact, Walgreens and CVS, among others, have already taken giant strides in making a medical visit quicker and more convenient by placing medical professionals in their making them available during the evenings and on weekends on a walkclinic costs almost as much as one to a doctor in many markets – but these outstanding retailers do understand that convenience and speed plus taking insurance will win the hearts of consumers. At my company, First Stop Health, we think we can make some aspects of health care even better for consumers by letting them talk to a doctor on the phone (or via email or video) from the relative comfort of their homes. Let me provide a personal example. Some months ago I took my kids to a crowded museum in Chicago. It was cold and blustery outside and hot

have a degree in ancient Roman history: what do I know about electrolytes? What I did know was that I should call one of the 300-plus doctors to the emergency room or maybe call an ambulance. Dr. Gifford answered the phone in less than 60 seconds. He listened to my symptoms and admitted that the itching hands and feet was an odd, but not unheard of symptom. He assured me that it would pass shortly and that I should not dash off to the emergency room. He reminded me to keep hydrated. The symptom passed in about 30 minutes. I got a quick, convenient, high-quality answer from my bed. And I got peace of mind. Beyond the small annual fee paid by my employer, I paid nothing. I saved myself three hours in a against a roughly $1,200 E.R. fee. I was happy. Blue Cross, my insurer, should have been even happier. I suspect, however, that they were both oblivious (they did not get a bill from anyone) and unconcerned as they merely pass costs on to my increase. I used our telehealth service because (a) I knew about it, (b) had heard good things from my fellow do something that was so quick and convenient? I was engaged. By trying the service and spreading the word about my excellent experience, I began to move my own awareness (and that of my fellow employees) of the power tangible and immediate. I knew I would use this again. And I did a month

campaigns to their employees via email, U.S. mail and the employer Intranet. We provide incentives for initial use of the service and encourage our members to rate the service and their experience. While it can take

Nothing stayed down or in me. In the interest of not deterring you from

of four. night of symptoms, the palms of my hands and then the soles of my feet started itching uncontrollably. I had never had a symptom like this. symptoms while having a heart attack and decided not to go to the hospital).

all use a search engine (do you remember which one?) before Google? Now better, simpler, easier, more engaging experience. First Stop Health is using telehealth to do the same in health care.

nutrition in four days, perhaps it was some sort of electrolyte imbalance? I www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

LEARN. CONNECT. SHARE.

BECOME A MEMBER of The Institute for HealthCare Consumerism! Members of The Institute to HealthCare Consumerism (IHC) join their peers and nationally-recognized leaders to LEARN, CONNECT and SHARE through the IHC’s collaborative, informational online community, industry magazines, IHC FORUM conference, IHC University Webinars, IHC Radio Show as the health care consumerism journey continues. Members of The Institute are: t t t t t t t t t t t

Employers Human resources benefits managers C-suite executives Financial management decision makers Brokers Advisors Consultants TPA’s Administrators of regional health plan providers Solution providers Thought leaders and industry leaders

Start Your FREE or Premium Membership Today! Sign Up at theihcc.com/membership

Benefits of Your Membership:

t Learn, Connect and Share with Network Peers and Industry Innovators as Fellow Members t Create a Member Profile and Join the Conversation by Commenting and Messaging t Read the Latest Breaking News Pertaining to Health Care Laws t Browse and connect with our Solutions Showcase Directory t Read Blogs from Industry Experts t Access to “communities” relevant to your specific position in the marketplace. Search and Read Content within a Specific Network t Receive the Official Print Publication of The Institute, HealthCare Consumerism Solutions: 6 bi-monthly issues plus our 2 annual issues: Outlook & Superstars t The IHC Today eNewsletter Delivered Bi-monthly t Listen to The Institute’s Weekly Online Radio Show, “HealthCare Consumerism Radio” t Create your own Blog and connect with our member community (Premium Only) t Access to archives of all publications, newsletters and radio podcasts (Premium Only) t Stay Connected to the Latest Buyer Trends in the Health Industry with our ConsumerPulse (Premium Only) t Access to The Institute’s Health & Wellness Video Library (Premium Only) t Unrestricted Access to White Papers, Surveys and Research and All Other Content (Premium Only) t Become a Student and Take Courses at The Institute’s University Launching April 2013 (Premium Only) t Receive a Member Discount for FORUM East and West Conference Series (Premium Only) t Learn more about our FREE and Premium Membership Levels and Sign Up at theihcc.com/membershiop

Truly Human Leadership

How treating your employees as humans may be the most important piece to your health and benefits puzzle BY JONATHAN FIELD » MANAGING EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM

ccording to a recent survey of CFOs by Bank of America Merrill Lynch, health costs unsurprisingly are at the top of CFOs' concerns for 2013, topping revenue growth, energy costs and taxes. With Affordable Care Act implementation looming, the C-suite is becoming increasingly aware of the effects to their bottom line that employee heath costs are having. As a result, companies are adopting potentially cost-saving measures at an unprecedented rate. According to an Aon Hewitt survey earlier this year, 83 percent of employers surveyed offer employees incentives for participating in programs that help employees become more aware of their health status. Despite significant doubts regarding the return on investment from prominent thought leaders, wellness programs are still booming. Corporate leaders are seeing their health costs rise, and they understand the need to act. www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

Furthermore, the strong, continued growth of consumer-directed health plans and health savings accounts has been well-documented by industry groups such as America's Health

macroscopic level.

When the Light Bulb(s) Went Off When asked whether there was a time when

Research Institute. Telehealth and mHealth alike are poised for huge growth as technology changes the way we access health care. Not to health care from both public and private health insurance exchanges. At the center of it all, however, is one word: engagement. The era of consumerism in health care is well underway and its tenets are being espoused from an array of innovative solution providers and employers. Whether from the head of an industry-leading wellness or telehealth provider, you will hear that engagement is the name of the game in 2013 and moving forward. Meanwhile, when all these industry leaders are pressing for increased employee engagement in health care, Bob Chapman, CEO of BarryWehmiller Companies, Inc., a St. Louis-based industrial manufacturer with $1.5 billion in annual revenue, proclaims we have a crisis on

Chapman really understood the need to develop responding, “I would describe it as a chandelier with a series of light bulbs that went off. It was an

education and the world as I see it.” The evolution in part began with something that many people would relate to: a wedding. Listening to the friends, family, neighbors and other celebrants describe how happy and beautiful the bride was, Chapman realized that

his daughter, Chapman began to realize that corporate leaders have a much greater responsibility that they may realize: stewards of the lives entrusted to them. Another particularly

Whether from the head of an industry-leading wellness or telehealth provider, you will hear that engagement is the name of the game in 2013 and moving forward. of corporate culture; and it is may be preventing your company from achieving its goals. Throughout the last few years, Chapman has traveled across the United States, speaking in universities, conferences and boardrooms, as well as his widely circulated TEDTalk, and his message has always resounded with audiences and leaders throughout a variety of industries. leaders, but it strikes a chord with many of the principles within the health care consumerism movement. The message is one of truly human leadership, a people-centric approach to management that values employees as humans For Chapman, this is a story about treating employees as humans and guiding them to

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

formative revelation came during church one Sunday morning. Thinking about sermon had been, Chapman the same positive manner. It was then that he realized that while the minister had his audience for only one hour per week, corporate leaders had theirs for at least forty times that. “We need to be better stewards of these lives,” he concluded. “We will profoundly shape what they will be become by the way we treat them.”

that formed the bedrock for what became truly human leadership. Of the formative years, he

adds, “There was not some book; there was not some consultant that came in. We did not have a problem that we were trying to solve. It was an evolution of some very unique experiences that created within me a clarity of being responsible for the lives entrusted to us each day in our organization.” Chapman is quick to emphasize what did and what did not lead him to people-centric leadership. Although Chapman has a degree in management and was trained in management, the revelation of truly human leadership was not something that developed from his educational background. In his TEDTalk, he says “I was never taught the awesome responsibility that by my leadership.” He was taught management but not

leadership. But Chapman would certainly be quick to add that this is not uncommon in U.S. business schools. The management styles taught often focus on employees in a bureaucratic sense

have had continued success in all three areas. Chapman elaborates future on the core meaning of truly human leadership:

employer does not care for them. Ultimately, the gist of truly human leadership can be summed up by a variation of The Golden Rule: “treat [your employees] as you would want your son or daughter treated in their careers,” Chapman says.

truly human leadership,” he concludes.

where people can discover their gifts, develop

A Message to Other Leaders

The Principles of Truly Human Leadership

doing so. This creates an opportunity for them to

began their initiative to create a truly human organization, they had the task of changing the culture of a 100-year-old industrial company into a workplace with a vibrant culture where everyone felt that they mattered. In his TEDTalk, he explains that the shift has been a huge success both in the change of culture and growth of the business: We have created an organization that has grown by about 20 percent per year since 1988 and created shareholder value in excess of 15 percent compound a year when in that same

meaningful life, a life of purpose where they feel valued and get the chance to be what they were brought on this earth to be. Chapman says that this way of approaching leadership can be the most powerful force for making the world a better place, and he makes a very logical point. While the C-suite has been receptive in recent years to the message of wellness in a strictly physical sense, there are other problematic areas where corporate leaders can help to drive change.

Throughout our discussion, Chapman talks a lot about the essential differences between management and leadership. And he provides a bevy of advice for other corporate executives who wish to implement his people-centric principles of leadership. Of the reception of his message in talks across the country, Chapman says, “Nobody where to begin”. Asking him about what advice he would give to other corporate leaders, he begins, He adds that the issue is not the employee population; they are hungry for this new leadership style and change in corporate environment. The problem is that those in leadership positions are unsure to how to change the culture of thinking

“There was not some book; there was not some consultant that came in. We did not have a problem that we were trying to solve. It was an evolution of

a fundamental truth, regardless of your faith, to treat them as humans” Through these initiatives, by caring about

some very unique experiences that created within me a clarity of being responsible for the lives entrusted to us each day in our organization.” period of time the S&P 500 has only created 3 percent value. So clearly, some combination of a vibrant business model and a vibrant culture that validates the worth of every individual and allows people to be who they were meant to be in a common purpose has created value.

simple maxim: “We measure success by the way we touch the lives of people.” And while traditional measures of corporate success also primary focus is on the personal growth of his team members. Other metrics of success are secondary. “We want to send people home safe, healthy

three categories. But Chapman adamantly insists that the aim of his leadership strategy is not to

Stress, depression and obesity are at high levels and are causing a notable impact in the U.S. workforce. Furthermore, work-related problems may very well be playing a large role in causing these issues. Truly human leadership has the potential to make a dramatic impact on the

parents and friends in our communities. For Chapman and his team, leadership is about creating an environment that fosters success not stress. While corporate leaders adopting a truly human leadership style may not be the panacea for all of our problems, it is a huge step in the right direction and, according to Chapman, the right thing to do. Chapman draws a direct broken families, broken marriages, broken lives

of the industry average, and the company is experiencing vibrant growth. Chapman, however,

to increase revenue. This is not their primary focus. And he tells leaders wishing to implement truly human leadership that these cannot be the reasons. You cannot do it simply for lower wallet.” As we move deeper into the era of health care reform, the industry will continue to offer consumerism, wellness and engagement strategies as means of alleviating the burden of health costs on the bottom line. And the numbers have shown that many of these strategies can be very successful. But the people-centric leadership strategies and holistic success of Barry-Wehmiller should serve as an example for companies that strive to go further, for those that understand the improvement of their bottom employees and the betterment of our workforce.

goes home each night believing that their www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

The Intersection of Consumerism and Data: How Health Plans Should Use Existing Data to Engage Members and Drive Exchange Decisions BY BEN GARDNER » FOUNDER & PRESIDENT » LINKWELL HEALTH

Unless something drastic happens in the next few months, Americans will wake up to a very new world on January 1, 2014. That is the day that we all will have a choice to make regarding the health plans we choose. This may seem a bit daunting to consumers, but it shouldn’t for it puts a lot of power in their hands — specifically the power of choice. This power to choose and the impact of new regulations should compel health plans to be proactive with scalable consumer marketing and engagement solutions, making a focus on the individual needs of members a brand preference and relinquish the negative regard in which health plans have been held for so long.

individual members. 40

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

Understanding Health Plan Consumers Like with any marketing plan, before health plans can effectively engage their members, they need to know who their members are. Fortunately, one thing health plans do have is a lot of data about their members. They need to utilize the data about members to understand consumers better, which will enable them to focus engagement on member needs and interests.

[an evangelist for the plan] is what health plan members can become if they are engaged by the organizations in a targeted, personalized manner.

stretched. From the data they will also extract membership, such as members with chronic conditions like diabetes or asthma. In most cases, are seeking three things: information, ways to make their lives easier and ways to save money.

From Understanding to Communicating Once health plans have determined from their data who their members are and where methods to engage their members effectively around this understanding. In this area, direct communications are essential to health planmember relationships. This communication needs to be more than welcoming members and/or thanking them for their business. In fact, those generic form letters are one of the many things consumers have hated about health plans because they show a complete lack of understanding of who they are. Drawing from the understanding provided by the data they have in-house, the organization needs to tailor communications to their members. Tailoring communications allows members to feel like unique individuals who have gained

communications reinforce a deeper engagement level between the plan and their customers. There are some plans that have already engaged their members through targeted communications efforts. Among the ways they are doing this is to engage consumers through a variety of methods, such as informational communications, helpful wellness tips, moneyincluding discounts for health clubs, nutrition or consumer-focused offerings enable a health plan to be relevant to its members in their daily lives, changes that improve their health.

Value Added Resource In a market where health plans will now need to compete for business, member approval and member endorsements will be vital to success…and data-driven consumer engagement has proven itself successful in accomplishing this. -

the health plan, it must ensure that the member sees the value in what he or she is receiving and understands how it will positively affect their lives. For the communicated effort to be valuable, it must resonate with the member on three fronts: 1. The health plan member must look upon whatever they receive as being something that will improve their lives – either by saving them money, saving them time or helping them to live better and healthier. 1. There must be some connection between the member and what is being offered. The connection can be something as general as lifestyle tips that save time or money saving coupons, or it could be a more targeted communication effort determined by understanding available member data. An example of this might be sending low-fat alternative recipes for popular dishes to those who are interested in losing weight or offering low-sugar dessert recipes to those trying to those with diabetes. 1. People today do not live in a “paper only” world, so while direct mailings are still very popular, engagement with plan members needs to be in their preferred medium. This may still be through plan direct mailings, but it may also be carried on websites, e-mail and mobile applications. Again, it comes down to a health plan utilizing the data and

preferences.

Making Consumers Advocates Health plans that engage customers through useful and interesting communications that are customized to their needs and methods by their members. This is a fact that has been corroborated through research. Studies have shown that 59 percent of plan members who received informational communications, discounts, recipes, coupons and other targeted wellness offerings rated their health plans as excellent or very control group, which did not receive such communications. to appreciate it, it is another thing to have them become evangelists for the plan; nevertheless, that is what health plan members can become if they are engaged by the organizations in a targeted, personalized manner. The same study found that nearly 80 percent of the members who received tailored communications said they health plans to others. must review their available data to gain a better understanding of their members and then leverage that understanding to drive engagement with them through targeted communication. With the age of health care consumerism upon us, those health plans that engage consumers and turn their members into advocates are the ones who will ultimately succeed.

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

CORPORATE MEMBER PROFILES

WWW.THEIHCC.COM

EMPLOYEE BENEFITS CONSULTING

Intrepid goes beyond the typical expectations of the benefits consultant. We take the time to understand each client’s unique culture in order to implement the most progressive, creative solution to their benefits needs.

INTREPID

Liz Frayer, RHU 400 Interstate North Parkway, Suite 600, Atlanta, GA 30339 888-612-4644

“Our mission is to empower clients to www.intrepid7.com achieve a more sustainable health care policy; it’s about more than just giving the client a plan — it’s a process of educating the client and their employees to better understand the plan and ensure its success. When we see the shift that occurs when employees have their ‘aha’ moment is when we feel we have done our job. —Liz Frayer, RHU, Intrepid

PROFESSIONAL DEVELOPMENT

Health Insurance 101: An Orientation is a new, flexible online course offered by AHIP. It is designed to teach health insurance basics to those new to health care or individuals who wish to review the fundamentals. The course is formatted in short modules; you learn at your own pace and on your own time, moving through the materials as you choose. Plus, AHIP will customize the course to fit your organization’s specific learning requirements.

AMERICA’S HEALTH INSURANCE PLANS 601 Pennsylvania Ave., NW South Building, Suite 500 Washington, D.C. 20004 Lindsey Miranda Canaley Tel: 800.509.4422 Fax: 202.861.6354 lmirandacanaley@ahip.org www.ahip.org/courses

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

HEALTH DECISION SUPPORT TOOLS

Castlight Health enables employers, their CASTLIGHT HEALTH 85 Market Street, Suite 300 employees, and health plans to take San Francisco, CA 94105 control of health care costs and improve care. Named #1 on The Wall Street 415.829.1400 Journal’s list of “The Top 50 Venturewww.castlighthealth.com Backed Companies” for 2011 and one of Dow Jones’ 50 Most Investment-Worthy Technology Start-Ups, Castlight Health helps the country’s self-insured employers and health plans empower consumers to shop for health care. Castlight Health is headquartered in San Francisco and backed by prominent investors including Allen & Company, Cleveland Clinic, Maverick Capital, Morgan Stanley Investment Management, Oak Investment Partners, Redmile Group, T. Rowe Price, U.S. Venture Partners, Venrock, Wellcome Trust and two unnamed mutual funds. Giovanni Colella, M.D. CEO and Co-Founder, Castlight Health HEALTHCARE DATA ANALYTICS

Med-Vision delivers health-plan risk MED-VISION LLC management and wellness strategies to Connie Gee, Vice President help employer groups achieve optimal connie.gee@med-vision.com employee health. Med-Vision’s healthcare 813-205-1577 data analysis tool, Med-View, guides www.med-vision.com employers in mitigating health risks. With www.med-view.net Med-Vision’s help, self-funded employers, healthcare facilities, municipalities, and school districts have reversed trends and decreased healthcare costs while enhancing care.

“You can’t change what you can’t measure. That’s why Med-Vision leverages Med-View’s analytics tool to investigate employee-health data and determine actionable solutions for employers. Med-Vision uses the data to implement innovative and customized plans for strategic wellness and disease management. Results include healthier employees, greater productivity, and drastically lower healthcare costs.” — Connie Gee, Vice President, Wellness Strategist & Health Data Analyst

WWW.THEIHCC.COM

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

TSYS Healthcare® provides end-toTSYS HEALTHCARE end strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.

“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. healthcare market, our customers rely on our option-driven system to prepare them for the future.” — Trey Jinks, Group Executive, TSYS Healthcare HSA / HRA / FSA ADMINISTRATION AND FINANCE

WageWorks helps employers

WAGEWORKS

support consumer directed

1100 Park Place, 4th Floor San Mateo, California 94403 United States of America

pre-tax benefit programs, including health care (FSA, HSA, HRA), wellness programs, commuting and

888-9905099 www.wageworks.com

child and elder care. Wage Works also offers retiree health care and COBRA Services. More than 100 of America’s Fortune 500 employers and millions of their employees use WageWorks.

CORPORATE MEMBER PROFILES

HSA ADMINISTRATION & FINANCE

At HSA Bank, we’ve been helping businesses HSA BANK optimize their health care spending for over 605 N. 8th Street Suite 320 15 years. We offer unmatched service and Sheboygan, Wisconsin 53081 expertise when it comes to health-based United States of America savings accounts. You can count on our 800.357.6246 dedicated business relations team for turnkey www.hsabank.com solutions and ongoing support that help your business and workforce save for a healthy future. To connect with your regional representative, call 866.357.5232 or visit hsabank.com.

“When implementing one of the first Medical Savings Account programs in the country, I had a belief that health care could be fixed with free-market principles. I still do. By adopting flexible and transparent practices that manifest core attributes of consumerism such as private exchanges, defined contributions, and self-funding; we will reform health care in our nation.” — Kirk Hoewisch, Co-Founder and President, HSA Bank, a division of Webster Bank, N.A. HSA / HRA / FSA ADMINISTRATION AND FINANCE

Evolution1 and our Partners serve more EVOLUTION1, INC. than 9 million consumers, making us 952.908.9056 the nation’s largest electronic payment, www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

“The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.” — Jeff Young Chairman and CEO, Evolution1

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

CORPORATE MEMBER PROFILES

WWW.THEIHCC.COM

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

MasterCard (NYSE: MA), is a global payments and technology company.

MASTERCARD WORLDWIDE 2000 Purchase St. Purchase, NY 10577-2509

It operates the world’s fastest payments processing network, connecting consumers, financial institutions, merchants, governments and businesses in more than 210 countries and territories. MasterCard’s products and solutions make everyday commerce activities—such as shopping, traveling, running a business and managing finances—easier, more secure and more efficient for everyone.

HEALTH ACCESS ALTERNATIVES

Carena provides 24/7, on-demand access to CARENA, INC. health care by phone, webcam, and house 1525 4th Avenue, Suite 300 call. Seattle-based Carena is committed to Seattle, WA 98101 delivering the best health care experience 800.572.2103 possible. Its technology-enabled care delivery www.CarenaMD.com model provides on-demand access to health James.Taylor@CarenaMD.com care 24/7, via phone, secure video, and house call. Carena provides health care solutions to patients through employers, health systems and through its consumer service, CareSimple.

“People are paying more out of pocket for care than ever—through higher co-pays and deductibles, reduced benefits, and in the rising costs of goods and services. Taken together, health care has become more expensive and less accessible. Our goal is to make health care more affordable by providing the right care at the right time for the right cost; to help people live healthier lives by removing the barriers to people taking control of their health care.” — Ralph C. Derrickson, President & CEO, Carena

TOTAL POPULATION HEALTH MANAGEMENT

Orriant helps businesses produce a better, more profitable product by creating a workforce that is healthier, more productive, and less expensive to insure.

ORRIANT

9980 South 300 West Ste. 100 Sandy, Utah 84070 801.574.2306 www.orriant.com suzanne.viehweg@orriant.com

Orriant’s proven strategy is to hold people accountable for improving their health as an integral part of your benefit strategy in a way that is fair and compassionate to all.

“Employers can fight back to control rising health care costs. Orriant’s strategies have helped major employers from almost every industry cut the cost of health care, improve the health and productivity of their workforce, and push hundreds of thousands of dollars to their bottom lines.” — Darrell Moon, Orriant CEO

FSA/HRA/HSA/TRANSIT/COBRA: ADMINISTRATION & MANAGEMENT

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

eflexgroup (eflex) is a nationwide eflexgroup administrator of pre-tax benefits 2740 Ski Lane and COBRA. Committed to providing Madison, WI 53713 fast answers, fast claims, and web 877.933.3539 ext 300 self-service, we set the industry www.eflexgroup.com standards for service. With a efgsales@eflexgroup.com customer focus and Lean Six Sigma methodology, we don’t talk about service, we prove it. See our metrics at eflexgroup.com.

“eflexgroup’s customer service department should be a model for ALL customer service departments. The courtesy, professionalism and knowledge surpass ANY customer service department I’ve encountered! I feel the outstanding, exemplary customer service of eflexgroup is simply the best!” — Kimberly Adams, Southeast Energy Assistance [testimonial]

WWW.THEIHCC.COM

HEALTHCARE ACCESS

HealthPerx is a health and wellness marketing company specializing in creative non-insurance benefit solutions that reduce absenteeism, increase productivity and decrease healthcare costs. Consultants: These benefits differentiate you from competitors.

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

HEALTHPERX Jeff Marks, CEO Jmarks@hperx.com Direct: 205 222-4062 Toll Free: 888 417-6187 www.hperx.com

Corporations: These will give you a far greater ROI than your wellness program while saving your employees thousands of dollars a year. Differentiator: Telemedicine Services: offering the entire family unlimited calls with no consult fees 24/7/365—anytime from anywhere Additional Health Benefits: offering significant savings for pharmacy, dental, vision, medical advocacy, travel assistance, telephonic counseling (EAP) and more Turnkey Program: billing, administration, fulfillment, call center, marketing HealthPerx benefits complement any and all existing benefit plans. — Jeff Marks, CEO PRESCRIPTION BENEFITS MANAGEMENT

Provider of Prescription Benefits Management services to self-funded employee groups, TPA’s, Brokers, and Consultants. Phoenix also offers a prescription savings card, RxAdvantage, for individuals and groups alike.

CORPORATE MEMBER PROFILES

PHOENIX BENEFITS MANAGEMENT

410 Peachtree Parkway, Suite 4225 Cumming, Georgia 30041 888.532.3299 main office 678.208.6257 marketing & pr 678.208.6252 sales 678.208.6255 fax

Phoenix Benefits Management is a prescription benefit manager sales@phoenixpbm.com providing traditional PBM services marketing@phoenixpbm.com to Self-Funded companies, TPA’s, www.phoenixpbm.com Brokers, and Consultants. We also provide comprehensive 340B services as well as our very own prescription savings card known as the Phoenix RxAdvantage Prescription Savings Card. Though our approach is scalable, our solutions are individualized. It’s been our experience and it is our firm belief that prescription benefit plans are not a one-size-fits-all proposition so we create a plan that is customized to fit the unique needs of each and every one of our clients.

DataPath, Inc., is one of nation’s largest providers of CDH solutions specializing in account-based administration systems.

DATAPATH, INC.

1601 WestPark Drive, Suite 9 Little Rock, AR 72204

501.296.9990 www.dpath.com Since 1984, service providers using DataPath systems have provided administrative solutions for over 1 million participants of FSA, HRA, HSA, and COBRA. DataPath is the only solutions provider to design and deliver a full Suite of systems for handling 125, 105, 132, COBRA, HSAs, Credit and Debit Cards all delivered to account holders through a single Internet portal, myRSC.com.

“With the significant changes in healthcare today, our software solutions allow users to create custom plans for clients that benefit both the employer and employee. Not only have we created a single platform for all systems with myRSC.com, with the integration of our mySourceCard Debit Card at Wal-Mart and other retailers, our clients are able to offer a hassle-free solution with 100% compliance.” ®

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

At Flex, we believe in making health FLEXIBLE BENEFIT SERVICE benefits more affordable for everyone. CORPORATION (FLEX) For 25 years, we have enabled thousands of clients to make their health care 10275 W. Higgins Road, Suite 500 dollars go further with our consumer Rosemont, IL 60018 driven plans and benefits administration +1-888-353-9178 services, including: fpsales@flexiblebenefit.com Flexible Spending Accounts (FSAs) www.flexiblebenefit.com Health Reimbursement Arrangements (HRAs) Health Savings Accounts (HSAs) Transit/Parking Reimbursement Accounts (TRAs) COBRA Administration And more! Flex continues to evolve and enhance our product portfolio with the addition of our scalable private insurance exchange, InsureXSolutions™. This latest innovation promotes a defined contribution funding model that allows employers to provide health and retiree benefits at a fixed cost, while offering employees with access to coverage options through our online insurance marketplace All Flex clients receive our personalized customer service and a wealth of resources that make our plans easy to use. Each plan we administer comes with online account access, simple transaction tools like debit cards, custom educational resources and unrivaled plan design expertise to keep you in compliance every step of the way. www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

CORPORATE MEMBER PROFILES

WWW.THEIHCC.COM

EMPLOYEE ENGAGEMENT TOOLS

Under the CIVA (CodeBaby Intelligent Virtual CODEBABY CIVA Assistant) brands of benefits and health 111 S. Tejon St. Suite 107 advisor, CodeBaby improves the healthcare Colorado Springs, CO 80903 consumer experience and optimizes online 877.334.3465 self-service on any web-based platform codebaby.com/online-solutions or device with absolutely no IT disruption. solutions@codebaby.com Benefits advisor offers guidance and selfservice options that help consumers and organizations alike to make better decisions about benefits selection. Health advisor engages new patient visitors on hospital or office websites or existing patients on wellness, prevention & disease management platforms.

“With the rapid changes in health care, our solutions provide organizations innovative ways to optimize their current platform while meeting the demand for an enhanced online experience. CIVA benefits and health advisor solutions are industryleading models that help consumers and organizations more efficiently navigate complex health benefit exchanges and patient portals. “ -Dennis McGuire, CEO BENEFIT ENROLLMENT AND ELIGIBILITY

Totem Solutions is a boutique benefits TOTEM SOLUTIONS consulting and administration firm offering highly 11330 Lakefield Drive specialized services and products. We serve Bldg 1, Ste 150 benefit management and HR professionals as an Duluth, GA 30097 extension of their team, allowing them to focus on key initiatives and core strengths. Our services 770-295-1600 include Employee Benefits Consulting, Benefits Toll-free 866-481-4917 Administration, Enrollment, & Communication, www.totemsolutions.com Health Care Reform Education, Enrollment, Reporting & Compliance, Leave and Disability Management Administration.

“We are hands-on benefits advisors for public and private sector companies throughout the country. Totem delivers employer-centric service that simplifies benefits administration and enrollment in order to facilitate employee understanding and ensure the best possible employee experience. Our goal is also our great passion and commitment: to offer organizations clear and accurate counsel accompanied by services and solutions that are easy to access, seamlessly implemented and custom fit, while providing a worry-free outsourcing solution.” — Debbie Schultz, President, CEO, Totem Solutions

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

HEALTH DECISION SUPPORT AND COST-SAVING TOOLS

WiserTogether Inc., helps patients choose the right care at the time. It

WISER TOGETHER Praveen Mooganur

offers an innovative online treatment

202.276.3074

selection & shared decision support

www.wisertogether.com praveen.mooganur@wisertogether.com

platform that helps patients make evidence-based, cost effective

treatment decisions across musculoskeletal, cardiovascular, mental health, diabetes, pregnancy and respiratory illnesses saving payers money. Currently 1.5 million members have access to the platform through employers and health plans in the country. WiserTogether was founded in 2008 and is based in Washington, DC. — Praveen Mooganur, COO SUPPLEMENTAL HEALTH

Delta Dental leads the DELTA DENTAL industry in designing 1130 Sanctuary Pkwy, Suite 600 Alpharetta, GA 30009 innovative dental coverage programs that keep costs 770-641-5196 down and deliver quality care. Our diverse client list includes everyone from Fortune 100 companies to public agencies to individuals and families. Our customer’s satisfaction is based on our expansive dentist network, cost-saving mechanisms and superior customer service. We are part of the Delta Dental Plans Association that provides dental coverage to more than 56 million people in the US.

WWW.THEIHCC.COM

HEALTH INCENTIVES

MedEncentive offers a patented, web-based incentive system that’s been independently validated

MEDENCENTIVE

Cecily Hall Executive Vice President medencentive.com chall@medencentive.com

to control healthcare costs. Doctors and patients earn financial rewards for declaring adherence to best practices and healthy behaviors, provided they agree to be accountable to the other party for doing so. Easy to implement and

EMPLOYEE COMMUNICATION AND EDUCATION

ExperienceLab has created a breakthrough, CDHCENTRIC patented communication program that saves 507 S. 8th Ave. Bozeman, employers money by increasing adoption and Montana 59715 usage of consumer directed health (CDH) 617.224.6223 insurance plans among their employees. www.experiencelab.com CDHCentric, sold on a subscription basis, rtravis@experiencelab.com delivers regular, multi-media communications that are tailored based on seven unique attitudinal segments developed from proprietary research.

Traditional health plans protect employees from having to learn the basic skills for making cost-effective healthcare decisions. Our segmentation research, which is based on 20 years of behavioral marketing, found 7 unique personality types, and each makes healthcare decisions differently. The result is that, when employee messages are correctly tailored to their personalities, employees become health care consumers! — Roger Travis, President

embraced by users. SUPPLEMENTAL HEALTH

Transitions Optical, Inc. is the maker of Transitions® lenses, the #1-eyecare professional recommended photochromic lenses worldwide.

CORPORATE MEMBER PROFILES

TRANSITIONS OPTICAL 9251 Belcher Road Pinellas Park, FL 33782

800.533.2081 ext. 2262 www.healthysightworkingforyou.org

Transitions Healthy Sight Working for You® is an education initiative that helps HR professionals and benefits professionals communicate the value of the vision benefit to employees. More information and complimentary education tools are available at HealthySightWorkingForYou.org.

“Don’t overlook your employees’ healthy sight when thinking about your business goals. A vision benefit that includes an eye exam and sight-optimizing eyewear helps ensure that employees see their best, so they can do their best work, directly affecting your business.”

HEALTH ACCESS ALTERNATIVES

WeCare TLC is a medical risk management company that leverages onsite primary care clinics to provide solutions to rising healthcare costs while improving patient health and wellness.

WE CARE TLC

120 Crown Oak Centre Dr Longwood, FL 32750 800.941.0644 www.wecaretlc.com raegan.garber@wecaretlc.com

Our holistic approach to care empowers the clinic staff to act as patient advocates, which increases compliance and decreases unnecessary expensive services.

“Healthcare is now a right and employers are faced with the challenge of truly managing their healthcare costs. We have created a unique medical home clinic model that properly addresses quality of care and cost. This requires constant, aggressive, creative, and directed attention to accomplish but it can be done.” — Lynn Jennings, CEO, WeCare TLC

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

RESOURCE GUIDE

WWW.THEIHCC.COM

HEALTH DECISION SUPPORT TOOLS

FSAstore.com is the only one-stop-shop FSASTORE.COM exclusively stocked with FSA eligible 244 5th Avenue, Suite J-257 products and services. At FSAstore.com, New York, NY 10001 consumers have access to more than 4,000 888.FSA.1450 (372-1450) FSA eligible products, a national database of FSA eligible services, and much-needed information through the FSA Learning Center. FSAstore accepts all FSA and major credit cards, offers 24/7 customer service, one-to-two-day turnaround for all orders, and free shipping on orders over $50.

“Each year consumers lose hundreds of millions of dollars simply because they do not deplete all of the pre-tax funds available to them in their FSA. But this year, more consumers than ever are realizing that they can use that money to buy many of the daily health products they need, and without a prescription. FSAstore.com strives to make it easy for participants to use and understand their FSAs.” — Jeremy Miller, Founder and President, FSAstore.com

BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

Since 1988, CieloStar (formerly OutsourceOne) CIELOSTAR has helped brokers, employers and employees 530 U.S. Trust Building navigate the ever-changing world of benefits. 730 Second Avenue South Now, with the dawn of “Defined Contribution Minneapolis, MN 55402 Health Care” we are again on the leading edge. With a team of industry thought leaders, CieloStar 612.436.2706 makes navigating healthand benefits choices john.reynolds@cielostar.com easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.

“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.” — John Reynolds, CEO, Cielostar

TOTAL POPULATION HEALTH MANAGEMENT

Dr. tools Steven Level1Diagnostics uses new to M. Helschien LEVEL1DIAGNOSTICS Founderhealth and CC&BW evaluate employees’ cardiovascular 11722 Lightfall Court Heart disease is the number one killer Columbia, MD 21044 www.level1diagnostics.com in the U.S. and costs millions of dollars 410-707-5667 ◆ doc@level1diagnostics.com Dr. Steven Helschien, Founder in medical care and time lost from Sales: Penny Aleo, Executive VP work. Detection and prevention is the 443.878.3087 key to heart health. Level1Diagnostics pbaleo@gmail.com is an innovative program that, unlike conventional cardiology tests, provides new advanced technology testing and methods to detect and prevent the earliest signs of cardiovascular disease and encourage optimal health. “The biggest problem with traditional cardiology is that it is not preventive—there isn’t a testing program to evaluate people who don’t have any symptoms of heart disease, but may be at significant risk. Drugs and surgery are offered to patients instead of lifestyle change programs and supplements.” —Dr. Steven Helschien, Founder, Level1Diagnostics

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

HEALTH DECISION SUPPORT TOOLS

Truven Health Analytics, formerly Healthcare at Thomson Reuters, delivers unbiased information, analytic tools, benchmarks, and services to the health care industry.

TRUVEN HEALTH ANALYTICS 6200 S Syracuse Way, Suite 300 Greenwood Village, CO 80111 734.913.3000

Hospitals, government agencies, employers, health plans, clinicians, and life sciences companies have relied on us for more than 30 years. We combine deep clinical, financial, and health care management expertise with innovative technology platforms and information assets to make health care better by collaborating with our customers to uncover and realize opportunities for improving quality, efficiency, and outcomes.

WWW.THEIHCC.COM

RADIO

CORPORATE MEMBER PROFILES

Listen Live Every Friday from 11a.m.-12 p.m. EST Listen on your mobile device. Download on iTunes or Google Play

Join the conversation by tweeting or emailing your questions to us in advance, during or after each show: Twitter: @The_IHC Email: dfield@theihcc.com

ADVERTISING INDEX If you use the services of our solutions providers, please tell them you saw their ad in Solutions™.

ADVERTISING CONTACTS 404.671.9551 CEO/PUBLISHER

Doug Field

MANAGING DIRECTOR

Brent Macy ACCOUNT MANAGER

Joni Lipson DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS

Rogers Beasley

AHIP ...................................................... 42

IHC Superstars ....................................... 10

Best Buy ........................Inside Back Cover

IHC Webinar - Aflac ....................... HXS 12

Carena ................................................... 44

IHC Webinar - Alegeus ..................... HXS 6

Castlight Health ..................................... 42

Intrepid .................................................. 42

CieloStar..................................HXS 15, 48

Level1Diagnostics .................................. 48

CDHCentric ............................................ 47

MasterCard ............................................ 44

CodeBaby............................................... 46

MedEncentive ........................................ 47

DataPath ................................................ 45

MedVision.............................................. 42

Delta Dental ........................................... 46

Mercer Marketplace......................... HXS 2

eFlex Group............................................ 44

Orriant ................................................... 44

Evolution1................................HXS 15, 43

Phoenix Benefits Management................ 45

Flexible Benefit Service Corporation ....... 45

SelectAccount.......................................... 7

FORUMWest ......................................11-13

Totem Solutions ..................................... 46

FSA Store ............................................... 48

Transitions ............................................. 47

HealthPERX ............................................ 45

Truven Health Analytics ...........HXS 16, 48

HealthStat ......................Inside Front Cover

TSYS Healthcare ..................5, HXS 15, 43

HSA Bank .............................................. 43

UnitedHealthCare ..................... Back Cover

IHC Corporate Member ........................... 36

WageWorks .............................HXS 15, 43

IHC Save the Date, FORUM West 2014.... 16

WeCare TLC ........................................... 47

IHC Radio............................................... 49

Wiser Together ...................................... 46

www.TheIHCC.com I HealthCare Consumerism Solutions™ I July/August 2013

Best Buy® gift cards reward healthy choices. Your health and wellness program pays. Wellness programs reward employees for their health and fitness achievements, and that can make for a healthier, happier workplace. But what’s the best way to reward your people? You could offer healthcare premium discounts, but linking rewards to costly premiums can feel more like avoiding a penalty than earning a personal reward. Employees may feel better about their accomplishments if, instead of a discount, they earn a tangible incentive for their efforts to: t t t t t

Exercise regularly Quit smoking Lose weight Reach blood pressure or cholesterol goals Achieve personal health goals

Motivating with things people really want. It’s easy to see why many companies are choosing Best Buy gift cards or Best Buy e-gift cards for their health and wellness rewards. Gift cards and consumer electronics are among the most-requested gift categories and incentive choices year after year. That makes Best Buy — the world’s largest multi-channel electronics retailer — a great choice for your corporate reward and incentive programs. By giving Best Buy gift cards in your health and wellness programs, you’re giving employees the power to choose the brands and product features they prefer. A Best Buy gift card is a powerful motivational incentive that lets your employees choose a special personal reward. Many employees use their wellness reward to purchase items that make their healthy activities all the more enjoyable — things like the latest MP3 player or noise-cancelling headphones. At BestBuy.com®, they can even choose exercise equipment and accessories, from treadmills and ellipticals to yoga mats and pedometers.

Best Buy makes it easy for employees… and employers. For your employees — At Best Buy or BestBuy.com, employees can redeem their gift cards for popular items like smartphones, tablets, music players, TVs, laptops and much more. Plus, Best Buy gift cards do not have expiration dates or fees. Whether you give e-gift cards or plastic cards, all Best Buy gift cards are redeemable in store or online, so your employees can shop when and where they want. For employers — Best Buy gift cards are not only easy to use; they’re also easy to give. Simplified ordering makes the process rewarding for program managers, with: t t t t t t t t t

No program fees Bulk discounts on high volume orders No minimum or maximum order requirements One business day delivery of e-gift cards Two business day order processing on plastic gift cards Individual and bulk fulfillment available Free 2nd day shipping on bulk orders Cards available in any amount from $5 to $2000 Friendly Best Buy gift card specialists to help

While your employees get healthier, you can help keep the planet healthy, too. Our gift cards are made from recycled plastic, and when you bring them to any Best Buy retail location, we’ll recycle them again. But there’s an even greener way to integrate Best Buy rewards into your motivational program. For the most environmentally friendly gift card program, choose our popular e-gift cards. With e-gift cards, there’s no physical inventory to manage and your employee wellness rewards are delivered in a personalized e-mail within 24 hours of your order. It’s the perfect fit for your fitness program. Offering the right incentive can help you generate the healthy results that benefit both your business and your employees’ lives. Find out more about using Best Buy gift cards to motivate greatness.

Want to know more about Best Buy gift cards or e-gift cards? Contact us today or visit CorporateGiftCards.bestbuy.com for easy online ordering. Phone: 877-¬370-¬1234 E-¬mail: Corporategiftcards@BestBuy.com ©2013 BBY Solutions, Inc. All rights reserved.

July/August 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

REWARD THEM WITH A HEALTHY DOSE OF FUN Staying healthy feels better with Best Buy® gift cards.

GIFT CARD INCENTIVES As powerful incentives, Best Buy gift cards energize your health and wellness program by motivating people with the things they want most, from TVs to tablets to smart phones. They’re hard to resist and easy to redeem online or in store. For instant e-mail delivery and easy personalization, choose our popular e-gift cards. Make your wellness program even more rewarding. Visit us online today.

NOW AVAILABLE AS PLASTIC AND E-GIFT CARDS

No fees. No expiration dates. Just happiness.™ CorporateGiftCards.BestBuy.com

myHealthcare Cost Estimator

TO TAKE CARE OF BUSINESS WITH INNOVATIVE TOOLS FOR THE JOB myClaims Manager UnitedHealthcare Health4MeTM

UHC.TVSM

The right health information can take you a long way. At UnitedHealthcare, we offer innovative tools that put members in touch with their information. myHealthcare Cost Estimator provides relevant information on care and estimated costs. myClaims Manager helps members understand and manage their health care claims. UnitedHealthcare Health4Me is a mobile app that provides instant access to a family’s important health information. UHC.TV presents exciting, engaging online content about good health and living well. Empower your employees. It’s good for their health – and the health of your business. For more information, visit welcometomyuhc.com or call 1-866-438-5651.

uhc.com All UnitedHealthcare members can access a cost estimator online tool at myuhc.com. Depending on your specific benefit plan and the ZIP code that is entered, either the myHealthcare Cost Estimator or the Treatment Cost Estimator will be available. A mobile version of myHealthcare Cost Estimator is available in the Health4Me mobile app, and additional ZIP codes and procedures will be added soon. This tool is not intended to be a guarantee of your costs or benefits. Your actual costs and/or benefits may vary. When accessing the tool, please refer to the Terms and Conditions of Use and Why Your Costs May Vary sections for further information regarding cost estimates. Refer to your health plan coverage document for information regarding your specific benefits. ©2013 United HealthCare Services, Inc. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates. Health plan coverage provided by or through a UnitedHealthcare company. UHCEW506202-004