FORUM East Official Show Guide
iSSUE || March/april 2013
DENTAL INSURANCE
NEW INSIDE:
Will Be Part of Health Care Coverage for Many, What Is Your Solution?
Moving for Wellness Moves Employees and Companies to Success Employers with 50+ Employees Must Comply or Share Cost of Insuring Employees Get the Facts
www.theihcc.com
PRSRT STD U.S. Postage PAID Permit #104 Ft. Atkinson, WI
Healthcare is
Predictable
Implemented Healthstat for his company last year.
Reduced his health claims. Saved the company $700.
Found out he had diabetes. Learned to manage it at work.
FEATURES
31 Dental Intelligence: Dental Benefits in the Health Care Reform Environment
The second article in a three-part series exploring the impact of the ACA on dental benefits. Pediatric dental benefits are part of the minimum package of benefits that must be offered in some markets. This article examines various exchange models and the new challenges and opportunities for stakeholders. Rene Chapin Director of Membership & Communications National Association of Dental Plans
34 Strategic Movement in the Workplace Improves Employee Performance
Turning the tide on disengagement doesn’t have to be complicated — it can be as simple as rewriting the story of corporate culture. The current “business story” illustrates the old school practice of long meetings and even longer calls in a sedentary workplace. The new story is about not just embracing a culture of health, but a simple and cost-effective culture of movement. Jack Groppel, PhD Vice President of Applied Science and Performance Training Wellness & Prevention, Inc.
INSIDE 37 Never Too Old to Learn a New Trick: Mobile Health Solutions Can Help Employees Manage Their Chronic Diseases The second fastest-growing smartphone penetration rate is the 55-to-64 yearold age group. An mHealth innovation shows that no matter how long patients have had diabetes, no matter how old patients are, and no matter how “tech-savvy” patients may be, they use the technology to effectively manage their care. Geeta Nayyar, MD, MBA Chief Medical Information Officer AT&T ForHealth
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: Look for the next issue of both HealthCare Consumerism Solutions and HealthCare Exchange Solutions in June. Stay tuned weekly with HealthCare Consumerism Radio; daily content and blog updates at www.theihcc.com; and weekly eNewsletters HealthCare Consumerism Today and HealthCare Exchange Solutions Today. www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
3
INSIDE 2
7
Editor and Publisher’s Letter
Heading into FORUM East, the Institute launches new magazine supplement.
Studies, Research & Surveys
t Only two states earn an A in health care price transparency. t Employers expect average total health care costs for active employees to be the lowest cost increase in 15 years.
8
News Briefs
9
People on the Move
9
Consumerism Innovation t t t t t
DEPARTMENTS 11 Bachman’s Banter Overview of PPACA coverage mandates for large employers. Ron Bachman
The full range of departments will return next issue. Stay tuned for more cutting-edge analysis.
Benefitfocus Reveals Humana Voluntary Benefits App HealthSparq Delivers Consumer Transparency Solutions The Hartford Enhances Voluntary Benefits Capabilities Aflac Shows the Real Cost of Accident and Illness Castlight Health to Deliver Prescription Cost Transparency
42 IHC FORUM West 2013, Save the Date
SPECIAL FORUM ISSUE
43 Corporate Member Profile 50 Resource Guide/Ad Index
Events The 2013 IHC FORUM West Save the Date! www.theihccforum.com We are excited to announce our dates 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.
Membership Become a Member and 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 March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
2013 Making HealthCare Consumerism Work in the Year Ahead and Beyond May 9-10, 2013, Atlanta, Georgia Page 13
Featured Speakers
Page 14
What You’ll Learn
Page 15
Agenda at a Glance
Page 16
Professional Credits for RCs and HR Professionals
Page 16
Conference Location and Hotel Information
Page 17-26
Sponsors
Page 27-30
Exhibitors
The latest updates, program details, speaker bios, and registration information are available at www.theihccforum.com or call 404-671-9551.
THIS TIME, MAKE IT PERSONAL.
In today’s world, consumers are inundated with information. Only the most relevant and personal messages will cut through the clutter.
A recent study
Get Noticed With Targeted Communications Targeted Communications from Truven Health Analytics™ uses datadriven messaging — based on age, gender, ethnicity, and household structure — to help you communicate highly personalized, relevant information.
96 percent of
From enrollment decision-making to wellness program participation, Targeted Communications empowers consumers to take charge of their healthcare and related expenses.
reminders.
Ensure Your Messages Are Meaningful — and Effective Join us Tuesday, April 23, for an IHC-sponsored webinar, “Drive Behavior Change With Innovative Communications.” Visit www.theihcc.com/webevents/truven042313 to register, or stop by booth #301 at IHC Forum East to learn more about our consumer solutions.
TRUSTED. PROVEN. ©2013 Truven Health Analytics Inc. All rights reserved.
showed that consumers value personalized healthcare Harris Interactive study, 2012
LETTER
PUBLISHER www.theihcc.com VOLUME 9 NO. 3 | March/apriL 2013
Heading into FORUM East, the Institute Launches New Magazine Supplement
published by FieldMedia LLc 292 South Main Street, Suite 400 alpharetta, Ga 30009 Fax: 770.663.4409 cEO
Doug Field @ theihcc.com MaNaGiNG DirEctOr
I am proud to be bringing you an important issue of HealthCare Consumerism Solutions, coming at a very important time for the industry. As we get ready for the 4th Annual FORUM East, which many readers may be attending, we are also proud to be launching, within these pages, HealthCare Exchange Solutions, a magazine supplement exclusively covering public and private exchanges and defined contributions. In this debut issue we are proud to feature articles by Mercer, a global HR consulting leader which has become a key player in the private exchange arena with Mercer Marketplace; Flexible Benefit Service Corporation, which, with its InsureXSolutions exchange, has made a considerable impact in the individual exchange market; and Buck Consultants, another major HR consulting firm that has developed an exchange. This year’s FORUM East could not be timed more aptly. We are now only months away from key deadlines for public and private exchanges, and FORUM East is specifically designed
Brent Macy
prODUctiON EDitOr
Alison Amoroso, M.Ed. MaNaGiNG EDitOr
Jonathan Field
aSSOciatE EDitOr
Kelvin Hosken
accOUNt MaNaGErS
Joni Lipson Rogers Beasley
art DirEctOr
Kellie Frissell
to help employers, brokers, consultants, and other stakeholders navigate the changes set to take place in health benefits. This conference is packed with three pre-conference events, five general sessions, twenty-four workshops and almost fifty sponsors — the largest event we have
aSSOciatE DirEctOr OF EDUcatiON SErVicES aND prOGraMS
Dusty Rhodes chairMaN OF ihc aDViSOry BOarD
produced yet.
Ronald E. Bachman, cEO, healthcare Visions
We hope to see you at FORUM East in Atlanta, starting on May 8th with an important preconference event: the Employee Benefits Forum 2013, produced with WEB Atlanta. If you cannot make it to Atlanta in May, mark your calendars for FORUM West at the Red Rock Resort & Spa in Las Vegas on December 5-6. And finally, I would like to mention our radio program, HealthCare Consumerism Radio, produced with America’s Web Radio, airing live every Friday from 11 a.m. to noon (EST). Recent guests have included key executives from companies such as Mercer, Benefitfocus, Acclaris, Jellyvision Lab, Truven Health Analytics, and more. We’ve also been proud to host IHC League of Leaders members like Dr. Wendy Lynch, Roy Ramthun, Dr. John Reynolds, Leah Binder, and Praveen Mooganur. Tune in by visiting www.theihcc.com and clicking Media Center.
EDitOriaL aDViSOry BOarD
Kim adler, allstate; Diana andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DcS health; Jon comola, Wye river
hSa rewards; roy ramthun, hSa consulting Services LLc; John young, ciGNa WEBMaStErS
Kevin Carnegie Tom Becher
DirEctOr OF cONFErENcE SpONSOrShip/ cOrpOratE MEMBErShip/rEpriNtS
Rogers Beasley
BUSiNESS MaNaGEr
Karen Raudabaugh
Doug Field CEO/Publisher dfield@fieldmedia.com
HealthCare Consumerism Solutions™ Volume 9 issue 3 copyright ©2013 by FieldMedia LLc. all rights reserved. HealthCare Consumerism Solutions™ HealthCare Consumerism Solutions™ is published eight times yearly by FieldMedia LLc., 292 South Main Street, Suite 400, alpharetta, Ga 30009. HealthCare Consumerism Solutions ™ magazine 292 S. Main Street, Suite 400, alpharetta,
priNtED iN thE U.S.a. HealthCare Consumerism Solutions™ is designed to provide both accurate and
Send letters to the editor and editorial inquiries to the above address or to Permission to reuse content should be sent to
6 March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
HEALTHCARE CONSUMERISM SURVEYS, RESEARCH & STUDIES
Workers Want Better Benefits Communication
only 14 states a “c” or better. Only two states, Massachusetts and
important — and there’s a lot their employers could do to improve doctors and hospitals; sharing data on a public website and in public online by harris interactive in February. the survey queried 2,111 receiving a “D” or an “F.”
Employers Plan Aggressive Response to Shifting Health Care Landscape Employers remain committed to providing active employee health and 67 percent say it’s very important.
Employers and Employees Agree on the Value of Voluntary Benefits
annual towers Watson/National Business Group on health (NBGh) , but are more aggressive actions to improve health care delivery and manage
, 63 percent lowest cost increase in 15 years.
37 percent in 2013. in the coming years, more than 80 percent
Important Role of Incentives in Employers’ Efforts to Improve Workforce Health surveyed nearly 800 large and mid-size U.S. employers representing
Physicians Perform Poorly in Patient Values Before Recommending Care
treatment. Solid evidence proves that when physicians’ decisions are centered around patients as whole individuals, patient outcomes
Only Two States Make the Grade in Health Care Price Transparency for Consumers
the patient-centered care index (pcci), a nationwide, quarterly
care incentives improvement institute — aims to improve the Wisertogether, inc., a company that helps patients and doctors better achieve patient-centered care.
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013 7
HEALTHCARE CONSUMERISM NEWS BRIEFS
Mercer Taps Keas to Take Social Wellness Mainstream
Word & Brown Launches Health Reform Resource Center to Provide Insurance Brokers Tools for Success
By combining games, educational, and interactive content with supportive the aca. included in the online resource center are tools and
United Benefit Advisors Launches PPACA Resource Center to Help Employers Navigate Health Care Reform
public exchange.
aimed at helping employers understand their obligations and
Alegeus Technologies Outpaces Market in Growth on Benefit Account Administration Platform
percent compounded annual growth. company data also shows that industry are doing has never been more critical.
UnitedHealthcare Honors Employers for Outstanding Worksite Wellness Programs Unitedhealthcare presented 16 organizations with its 2012 “Well Deserved” award, an annual honor given to employers which demonstrate an exceptional commitment to helping their employees
annually, average transaction values have grown by more than 12
Jellyvision Takes Employee Benefits Counselor Tool on the Road
the road between april 22 and May 9, showing human resources the award three times with a leadership award to honor their long-term their employee communications. through panel discussions and
SoloHealth Inks Partners with Safeway to Rollout Health Kiosks Nationwide
costs, and achieve results.
Humana Pharmacy Solutions is Ranked Top Performer in Pharmacy Benefit Manager Survey
Solohealth, a consumer-driven health care technology company, humana pharmacy Solutions topped the Flaspohler research North america, signed a multiyear deal to place a Solohealth
eflexgroup Honored for Fourth Time by Evolution1
develop and deliver innovative, creative concepts and stand out in
8 March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
their personal experiences with the pBM‘s cost management, pricing options, technology, and customer service. humana was rated “excellent” or “good” in all nine categories.
HEALTHCARE CONSUMERISM PEOPLE ON THE MOVE
Acclaris Names Senior Vice President of Finance & Administration Christine Lundquist has been promoted to senior vice president, finance & administration. Lundquist has been a member of the Acclaris management team since the start of the company in 2001.
Change Healthcare Names Tiffany Pack Vice President of Implementation and Engagement Change Healthcare, a cost transparency and consumer engagement provider, promoted Tiffany Pack to vice president, Implementation and Engagement. Pack, who has been a part of the Change Healthcare team since 2010, brings more than 20 years of experience.
ConnectYourCare Expands its Sales Force with Three Key Additions ConnectYourCare, a consumer-directed health care (CDHC) and administrator of all tax-advantaged health care accounts, added Meghan O’Shea, Brian Walker, and Rob Westra. O’Shea is responsible for new business
development with employer clients throughout Central United States. Walker promotes the brand and services throughout the Southeast. Westra has more than 18 years of experience selling consumer-directed health care products in the employee benefits industry.
Truven Health Analytics Names Michael L. Taylor, MD, Chief Medical Officer Truven Health Analytics, formerly the Healthcare business of Thomson Reuters, appointed Dr. Michael Taylor, MD, chief medical officer. He joined Truven Health Analytics in 2011 from Caterpillar Inc., where he was responsible for its wellness program.
Bravo Wellness Welcomes John Harris and Gregory Seeley to Advisory Board Bravo Wellness, an outcomes-based wellness program provider, added John H. Harris and Gregory D. Seeley to its advisory board. Harris has more than 35 years of experience in the health promotion field. Harris is a founding partner at Performance pH and serves as chairman of the Health Enhancement Research Organization.
HEALTHCARE CONSUMERISM INNOVATIONS
Benefitfocus Reveals Humana Voluntary Benefits App will support enrollment and medical underwriting, but employers BENEFitFOcUS hr intouch, providing employers and employees
HealthSparq Delivers Consumer Transparency Solutions healthSparq, a health care company that enables online shopping,
Aflac‘s New Calculator Shows the Real Cost of Accident and Illness launched the real cost calculator, an online tool that helps consumers understand the costs associated with common illnesses
latest health insurer to contract with healthSparq. healthSparq
Evolution1 Introduces New Product Identity Evolution1, an electronic payment, on-premise, and cloud computing health care solution unveiled its products, solutions, and services under six brands within one product suite, serving partners, employer groups, and consumers.
Castlight Health to Deliver Transparency in Prescription Drug Costs
The Hartford Enhances Voluntary Benefits Capabilities
capabilities, an expanded sales and service team, and increased
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013 9
A winning combination Our unique experience in both the healthcare and payment services industries means unmatched expertise and reliability. Known for our elite levels of customer service and a long-term commitment to the industry, TSYS Healthcare速 is focused on lasting relationships and people-centered payments . SM
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
息 2013 Total System Services, Inc.速 All rights reserved worldwide. TSYS速 is a federally registered service mark of Total System Services, Inc.
BACHMAN’S BANTER
BY RONALD E. BACHMAN FSA, MAAA » CHAIRMAN, EDITORIAL ADVISORY BOARD » THE INSTITUTE OF HEALTHCARE CONSUMERISM PRESIDENT & CEO » HEALTHCARE VISIONS, INC.
Large Employers Have Coverage Mandates under PPACA and Shared Responsibility Payments for Those which Are Noncompliant EXECUTIVE SUMMARY: PPACA’s employer penalty is referred to as the employer’s shared responsibility payment. This is also sometimes called “play or pay.” Under the mandate the large employer is subject to two penalties if it does not comply: t Large employers must offer “minimum essential coverage” to substantially all full-time employees and their dependents or become subject to a penalty of $2,000 per employee if even one full-time employee buys insurance in a public exchange and qualifies for a financial subsidy. The penalty is calculated based on the total number of full-time employees minus 30. t Large employers that offer “minimum essential coverage” but the coverage is either unaffordable to employees or fails to cover 60 percent of employees’ total expected plan costs are subject to a fine for each full-time employee who applies to a public exchange and qualifies for a financial subsidy. The penalty is $3,000 per affected employee. The penalty is calculated based only on the number of full-time employees who qualify for a subsidy.
WHO: t
Employers with 50 or more full-time employees (defined as “large employers”) are mandated to provide coverage to employees
t
Employers with fewer than 50 full-time employees are not subject to the coverage mandate or penalties
WHAT: The Patient Protection and Affordable Care Act (PPACA) imposes a penalty on large employers that do not offer “minimum essential coverage” to all full-time employees and their dependents. Large employers that offer coverage may be liable for a penalty if the coverage is unaffordable for their employees or does not provide the required minimum value. WHEN: The mandate for large employers is effective Jan. 1, 2014. The Internal Revenue Service released proposed regulations
Dependents do not include spouses.
on Jan. 2, 2013 regarding the employer shared responsibility
Employees must have an opportunity to accept coverage at least once during the plan year. An employer will be deemed to have offered coverage to substantially all full-time employees and their dependents if insurance is offered to 95 percent of full-time employees and their dependents. Dependents include son, daughter, stepson, stepdaughter, adopted child, child placed for adoption, and foster child up to age 26. For this mandate, dependent does not include spouses. Coverage is unaffordable if an employee’s required contribution to health insurance coverage exceeds 9.5 percent of the employee’s household annual income. The determination that insurance coverage is unaffordable will be based on what the employee pays for self-only coverage, not family-coverage. In other words, the affordability of coverage will not take into consideration the portion of the annual premium the employee might pay for family coverage. Most families in such a situation won’t have to pay a penalty if they choose not to buy family insurance. Otherwise, most
Americans are required to buy insurance beginning January 1, 2014, with a maximum penalty of $285 per family or one percent of income if they don’t. The penalty rises to $2,085 or two percent of income by 2016.
provisions under PPACA. Although the proposed regulations are not final, employers may rely on them until further guidance is issued.
ACTIONS: Large employers will need to determine if their coverage is in compliance with PPACA and if they are exposed to potential penalties. Employers should check with their compliance and legal teams, insurance brokers, agents, consultants, third-party administrators, and insurers to determine if their plan benefits or premium contribution levels need changing. The information presented and contained within this article was submitted by Ronald E. Bachman, President & CEO of Healthcare Vision. This information is general information only, and does not, and is not intended to constitute legal advice. You should consult your legal advisors to determine the laws and regulations impacting your business. Ronald E. Bachman, FSA, MAAA, is also a senior fellow at the National Center for Policy Analysis, Georgia Public Policy Foundation, and Wye River Group on Health.
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
11
Health(&)Care.
At Target, we believe in a simple approach to healthcare. Here, health is front and center with all the products and services that make good-for-you decisions easier and more accessible. Because simplicity in healthcare is better for us all. Please join us on Friday, May 10, for the following presentations: Helping Employees Become Better Consumers of Healthcare and Health Brian Cooper, Senior Group Manager, Clinics Main Ballroom 8:30–10:00 a.m. What Leading Employers Are Doing To Make Healthcare Consumerism Work Steve Lafferty, Senior Director, Clinics and Health Partnerships Main Ballroom 12:00–1:00 p.m. Health.Target.com ©2013 Target Brands, Inc. The Bullseye Design and Target are registered trademarks of Target Brands, Inc.
ATLANTA MAY 9-10, 2013
2013
MAKING HEALTHCARE CONSUMERISM WORK in the Year Ahead and Beyond FEATURED SPEAKERS: Patti Taylor
Maurice Evans, Jr.
Newell Rubbermaid
Director of Human Resources, The Integral Group LLC
Helen Nelling
David Seem
Director of Compensation and
EVP / CFO Miller Zell
Wayne Farms LLC
Steve Eno
Dawn Bading
Manager Healthcare Programs GE Capital
Vice President, Human Resources Kaiser Permanente
Chris Covill Mercer
Steve Lafferty, Sr. Director of Clinics and Health Partnerships, Target
Deanna Baker Human Resources InteliSpend Prepaid Solutions
John Hickman Partner Alston+Bird LLP
WHO SHOULD ATTEND? CEOs/Presidents/CFOs Third Party Administrators Health Plan Administrators Corporate Wellness and Medical Directors
WWW.THEIHCCFORUM.COM
2013
WWW.THEIHCCFORUM.COM
WHY SHOULD YOU ATTEND?
%FBS )FBMUI #FOFmUT .BOBHFNFOU 1SPGFTTJPOBMT
Forum Provides a Unique Laser Focus on Consumerism Best Practices!
At the IHC FORUM, the only conference 100% dedicated to innovative health and benefit management, we continue to deliver programming that is engaging, educational and packed with networking and new business opportunities. This content not only cuts at your bottom-line, but also gives you a deeper look at the existing megatrends and challenges within our industry. No matter where you are on your journey, the IHC FORUM will equip you with the money-saving strategies you need to successfully navigate the health care consumerism landscape and avoid the bumps along the road.
It helps you to lower your cost while improving overall employee population health through innovative techniques and solutions.
LEARN FROM EXPERTS AND EACH OTHER AT THE IHC FORUM t Understand what the latest regulations and changes in the health care law mean for you t -FBSO IPX UIF DPNJOH &YDIBOHFT DBO JNQBDU ZPV BOE ZPVS employees t /FUXPSL XJUI ZPVS QFFST ‰ )FBS XIBU IBT XPSLFE GPS UIFN and share your successes t -FBSO OFX TUSBUFHJFT UP FOIBODF ZPVS DVSSFOU IFBMUI BOE benefit offering t $POOFDU XJUI LFZ JOEVTUSZ MFBEFST TFF UIF MBUFTU TPMVUJPOT and be able to implement them right away t #VJME ZPVS IFBMUI CFOFmU TLJMMT JO PVS FEVDBUJPOBM workshops, earn CE and SPHR credits, and start your path towards HealthCare Consumerism Certification
5IJT ZFBS T *)$ '036. &BTU 8FTU BSF NVTU BUUFOE FWFOUT GPS $ MFWFM executives, corporate wellness directors, HR professionals, health care brokers and regional health plan providers interested in engaging their FNQMPZFFT JO DPOTVNFS EJSFDUFE IFBMUI QMBOT 8IFUIFS ZPV BOE PS ZPVS company attends one or both events, the same premium conference experience and measurable results can be expected. 8F VOEFSTUBOE ZPV IBWF NBOZ DPOGFSFODFT UP BUUFOE BOE B MJNJUFE amount of time and budget, so we provide Early Bird Rates and Team %JTDPVOUT GPS UIJT EBZ FWFOU UP NBLF UIJOHT B MJUUMF FBTJFS Look forward to seeing you there,
WHAT YOU’LL LEARN At IHC FORUM EAST 2013 attendees will experience a full day and a half of activities that provide the most up-to-date information related to healthcare consumerism, the health reform law, and continuously emerging regulations available anywhere. The Forum’s valuable pre-conferences provide classroom learning for PHR, SPHR and GPHR recertification through the HR Certification Institute and for the IHC Level 1 Broker Certification and should not be missed. From networking with your peers and top industry thought leaders to general sessions and informative workshops, you will learn how to successfully implement the most effective and compliant health care benefits strategies. Selected sessions at Forum East include: t 1VCMJD WFSTVT QSJWBUF FYDIBOHFT GSPN QMBO EFTJHO UP FNQMPZFF participation t &NQMPZFS 1BOFM 8IBU -FBEJOH &NQMPZFST BSF %PJOH UP .BLF )FBMUI$BSF $POTVNFSJTN 8PSL t )FBMUI$BSF 3FGPSN )PX UP $PNQMZ‰-BUFTU 6QEBUFT GSPN &YQFSUT
Doug Field Founder and CEO The Institute for HealthCare Consumerism
NEW AT THE FORUM Our Employee Benefits Forum Pre-Conference (produced in conjunction with WEB Atlanta) is exclusively designed for employers. This is your chance to talk shop— uncensored—with your professional counterparts.
t .BLJOH )FBMUI$BSF $POTVNFSJTN 8PSL
IF YOU CAN’T MAKE EAST, THEN START PLANNING NOW FOR IHC FORUM WEST 2013 AT THE RED ROCK RESORT IN LAS VEGAS! DETAILS WILL BE AVAILABLE SOON AT
Visit www.theihccforum.com to preview the agenda and register for the conference.
LAS VEGAS
t &YQFSU 1BOFM $SFBUJOH $POTVNFST PG )FBMUI BOE )FBMUI$BSF t 1PQVMBUJPO )FBMUI .BOBHFNFOU *NQMFNFOUJOH B 4VDDFTTGVM 8FMMOFTT 1SPHSBN
WWW.THEIHCCFORUM.COM
DEC 5-6, 2013
WHAT IS IMPORTANT TO YOU AND YOUR COMPANY’S BENEFIT STRATEGY? UNDERSTANDING DEFINED CONTRIBUTION AND PRIVATE/PUBLIC EXCHANGES | COMPLIANCE WITH NEW REFORM REGULATIONS | RISING COST | HEALTH INCENTIVES AND ENGAGEMENT HEALTHCARE CONSUMERISM TECHNIQUES | WELLNESS AND SUPPLEMENTAL BENEFITS
FORUM EAST PROVIDES REAL WORLD TAKE-AWAYS THAT DELIVER IMMEDIATE RESULTS FOR YOU AND YOUR COMPANY.
2013 FORUM EAST AGENDA AT A GLANCE WEDNESDAY, MAY 8, 2013 7:30 am – 5:15 pm
Pre-Conference: Employee Benefits Forum 2013
1:00 pm – 5:00 pm
Pre-Conference: A Roadmap for Making Healthcare Consumerism Work
12:00 pm – 7:00 pm
Exhibitor Set Up
THURSDAY, MAY 9, 2013 7:30 am
Registration
7:30 am – 8:45 am
Networking Breakfast / Exhibits Open
8:45 am – 9:00 am
Welcome by Doug Field, CEO, The Institute for HealthCare Consumerism
9:00 am – 10:30 am
Opening General Session: “Making Health Care Consumerism Work”
10:30 am – 11:00 am
Networking Break / Exhibits Open
11:00 am – Noon
Track No. 1 Workshops (Choose One) 101 – Achieving My Goals; A Trip Through the Financial Wellness Workshop 102 – HSAs: After 2014 a Partnership 105 – Health Pays: Using Incentives to Drive Wellness and Behavior Change 106 – The Right Care (Not Just Cost)! 107 – Pre-Paid Card Programs to Engage Consumers and Help Employers Manage Costs in 2014 & Beyond
Noon – 1:00 pm
Table Topic Lunch Discussion
Noon – 1:30 pm
Lunch / Exhibit Open
1:30 pm – 2:45 pm
Afternoon General Session: “HealthCare Consumerism is Here to Stay!”
2:45 pm – 3:00 pm
Networking Break / Exhibits Open
3:00 pm – 4:00 pm
Track No. 2 Workshops (Choose One) 201 – Advanced Broker Course 202 – Ownership and Incentives: Creating Multiple Incentive Channels 204 – SHARE SESSION: Health Care Access When You Want It, How You Want It and Patients 206 – SHARE SESSION: How to More Effectively Engage Consumers and get Increased Participation from your Employee Population 207 – Consumer Engagement: The Key to a Successful Exchange 208 – Ten Steps to Delivering on the Promise to Employers: ACOs Enhance Quality of Care, Improve Patient
4:00 pm – 4:15 pm
Networking Break / Exhibits Open
4:15 pm – 5:15 pm
Closing General Session: Defined Contribution and Public/Private Exchanges: A Panel Discussion with Leading Experts
5:15 pm – 7:15 pm
Opening Night Reception / Exhibits Open
速
速
速
速
R
PHR
P HR t G
PH
tS
e
HR
rt i fi
tit
ut
Ce
c a t ion I n s
OFFICIAL SILVER SPONSORS
2013
MasterCard Dual Value Health Card TM The first dual network health spending card at point of sale
accounts on one card
and loyalty programs
To learn more call (612) 605-6038 or visit: www.dualvaluehealthcard.com
Partner with the market leader in consumer-driven healthcare technology and services.
W
hether you’re a broker wanting to recommend the best solution to your clients, a financial institution expanding your product offerings, a health plan provider seeking greater efficiency gains, a software developer providing payment solutions or a benefits administrator driving greater profitability, we can help address your needs.
Our advantages:
3 The nation’s largest electronic payment, on-premise and cloud computing healthcare solutions 3 Solutions administer HSAs, HRAs, FSAs, Defined Contribution, VEBAs, Wellness and Transit Plans 3 Serving over 75,000 companies and 9 million consumers 3 Industry-leading prepaid benefits card with innovative auto-substantiation technologies
Simplifying the Business of Healthcare
©2013 Evolution1, Inc. All rights reserved.
18
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
OFFICIAL SILVER SPONSORS
2013
CHAMPIONS OF
CHIROPRACTIC Performing surgery is tremendously hard on one’s spine. My chiropractor is an important healthcare provider in my life – without him, I could not continue to practice.
ER’S DR. SINGACTOR CHIROPR
RAYMOND SINGER, MD Cardiac Surgeon C arola, D Gary T
Learn more about chiropractic care and what you can do to raise awareness at: www.yes2chiropractic.com.
Achieve the Triple Aim — with MedEncentive MedEncentive provides a patented, scientific, web-based incentive platform, designed to control healthcare costs. Patients and doctors are financially rewarded for engaging in a way that improves health literacy. The effectiveness of this approach has been proven in multiple, multi-year trials and the results and ROI have been confirmed by independent analysts and independent researchers. Easy to implement and embraced by users. For more information, contact Cecily Hall, Executive Vice President of MedEncentive E: chall@medencentive.com W: medencentive.com www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
19
2013
OFFICIAL SILVER SPONSORS
MANAGE COST.
MAXIMIZE CARE.
A SMART WAY FOR EMPLOYEES TO PAY FOR HEALTHCARE " " "" ! ! "" ""
THE CHASE
HEALTH SAVINGS ACCOUNT
20
March/April 2013 I HealthCare Consumerism Solutionsâ„¢ I www.TheIHCC.com
IHC_HalfPageCatAd_01.pdf
1
4/1/2013
OFFICIAL SILVER SPONSORS
4:19:22 PM
Being boring sucks.
2013
And it’s expensive. Start using a benefits communication solution that gives back more than you put in. ALEX®, the Jellyvision Benefits Counselor, is funny, helpful, and easy to use. Employees adore him (true story—he’s even received marriage proposals), and when you see how he boosts engagement, increases participation in CDHPs, and drives benefit savings, you’ll love him too.
® Perhaps the most engaging benefits communication tool. Ever. See more at meetalex.com/IHC/
To your clients, a worthwhile health benefit. To you, a hassle-free business benefit. As a national leader in Health Savings Accounts for over 15 years, we can offer you unmatched service and expertise. When you come to us, you can rely on turnkey solutions that help you build strong relationships with your clients. For them, it’s an opportunity to customize a better health savings option. And for you, it’s a chance to partner with a dedicated support team that works hard to make sure your experience is hassle-free. To learn more, call 877-525-7118. PROVEN TRACK RECORD
r
DEDICATED SUPPORT TEAM
r
CUSTOMIZABLE SOLUTIONS
Visit us at hsabank.com/learnmore for information about our HSA programs.
© 2013 HSA Bank. HSA Bank is a division of Webster Bank, N.A. Member FDIC.
Agent/Broker “Worthwhile” Studio Number: 014552013 Ad Code: WFC-HSA-NA
3/29/13 GD: Jessie IHC
Size: 7” x 4.875” Color: 4C MM: Joanne Renna
©2013 Webster Bank, N.A. Member FDIC. All rights reserved.
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
21
2013
OFFICIAL SILVER SPONSORS
Take your business to a higher level with a Workable benefits marketplace. Consumers will rejoice in a benefits marketplace that makes shopping for insurance easy and painless. Workable Choice matches employees with the products that best meet their unique needs. Our defined contribution options give employers the flexibility to deploy a benefits program tailored to their specific needs. We simplify billing and payments with full reporting capabilities. Workable Choice works the way you want it to, using your eligibility and underwriting guidelines. We capture all the information your systems need to import enrollments and maintain eligibility. With our experts as your guide, launching a private exchange begins with a phone call and ends with your customized solution.
Request a demo at WorkableChoice.com.
p:800-946-6342
it’s simple.
|
W WW.W ORKABLE CHOI CE . COM
At ConnectYourCare, we believe that consumer directed healthcare accounts should be simple. From HSAs to FSAs and HRAs, we manage all of the complications and leave you with the savings. Learn how simple it can be. Email simple@connectyourcare.com.
22
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
OFFICIAL SILVER SPONSORS
2013
IT’S TIME TO GET MORE When it comes to employee benefits, more is better. Across the country, employers trust UnitedHealthcare to provide their employees with quality medical plans. But did you know that we also offer many other types of benefits? From critical illness and accident insurance to dental plans, vision, life and disability, we offer insurance products that help protect your employees and their families. And when you choose UnitedHealthcare for all your benefits, you’ll save time with a single point of contact. To learn more, call your broker or visit uhc.com.
Visit us at Booth 211 at IHC Forum East 2013 ©2013 United HealthCare Services, Inc. UnitedHealthcare Critical Illness product is provided by UnitedHealthcare Insurance Company on Form UHICI-POL-1 (01/12). UnitedHealthcare Accident product is provided by UnitedHealthcare Insurance Company on Form UHCAC-POL-1 (01/12) and in Texas on form UHCACPOL-1-TX (01/12). Products may not be available in all states. UnitedHealthcare Vision® coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by Spectera, Inc., United HealthCare Services, Inc. or their affiliates. UnitedHealthcare Dental® coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by Dental Benefit Providers, Inc., Dental Benefit Administrative Services (CA only), United HealthCare Services, Inc. or their affiliates. UnitedHealthcare Life and Disability products are provided by UnitedHealthcare Insurance Company; and in California by Unimerica Life Insurance Company; and in New York by Unimerica Life Insurance Company of New York. UnitedHealthcare Insurance Company is located in Hartford, CT. Insurance coverage provided by 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. UHCGA636701-000
the prescription for complicated health-benefit programs.
Visa Healthcare. the more efficient way to go. more people go with Visa visa.com/healthcare ©2013 Visa. All rights reserved.
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
23
OFFICIAL SILVER SPONSORS
2013
BUILDING A BENEFITS FOUNDATION
BECAUSE EMPLOYEES AND EMPLOYERS RELY ON TAX-ADVANTAGED PLANS TO SAVE MONEY . . . we help them save EVEN MORE .
I T’ S AL L I N CLU D ED 1. Debit cards for all members and eligible dependents; 2. One debit card for all of your tax-advantaged account needs, including FSA, CRA, DCA, HRA, HSA; 3. Online enrollment tool and discrimination testing for FSAs; 4. Electronic connection to our enrollment system, or to your current HRIS system, to expedite the enrollment process—no paper required; 5. Dedicated
account management team.
EXPECT MORE
VISIT BOOTH 315 to discover business solutions that support healthcare consumerism.
AMERIFLEX ÂŽ | BUSINESS SOLUTIONS PROPOSAL REQUESTS: info@flex125.com CALL TOLL-FREE: 888.868.FLEX (3539) www.flex125.com
AmeriFlex Convenience CardÂŽ
COBRA & Special Plan Billing Services
Consolidated FSA/HRA/HSA/CRA Debit Card Platform
Enterprise Class, Web-Based Solution for COBRA Administration
AmeriFlex Convenience Portal
Compliance Services
Web-based System for Administration of CDHC Plans
Workforce
Resources and Guidance to Help Keep You Up-To-Date and in Compliance with Evolving Regulations
Payroll, Time and Attendance, Human Resources, and Benefits Administration
Order POP Documents Instantly Through Our Online Portal
ePOP
Helping you navigate the rapidly changing benefits landscape. Defined Contribution Healthcare 0RIVATE %XCHANGES s #/"2! s #$( !DMINISTRATION 0ROVIDER (EALTHCARE 0AYMENT 3OLUTIONS "ILL #ONSOLIDATION s 7ELLNESS s (EALTH #OACHING
24
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
Navigate Your Health Choice
c OOO ;A=DGKL9J ;GE
OFFICIAL SILVER SPONSORS
2013
Flexible Spending Accounts Commuter Benefits Health Savings Accounts Health Reimbursement Arrangements COBRA
! ! ! ! !
Our programs provide savings to both Employers and Employees – a win-win proposition. Employees reduce their taxes by participating in FSA, HSA and Commuter programs.
Fantastic. Just what working families need. © 2012 WageWorks, Inc. All rights reserved. WageWorks® is a registered service mark of WageWorks, Inc. © 2012 Visa. All rights reserved.
www.wageworks.com
Healthcare is
Affordable
&
H E A LT H P R
M
OTION
W ELL NE
S
O
S
with a partner who doesn’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.
A C C R E D I TAT I O N
WITH PERFORMANCE REPORTING
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
25
2013
OFFICIAL SILVER SPONSORS
Industry-leading benefit and payment solutions to process every financial transaction across the benefit value chain
Come see us at the IHC Forum – Booth #115 Hear us speak: Thursday, May 9th from 3 – 4 pm Topic: “Defined Contribution: The Next Frontier of Healthcare Consumerism� alegeus.com
ALEG6209 IHC Ad Workbook 7-5x4-875Ć’.indd 1
3/28/13 9:27 AM
11768-AD-280213
PRIVATE EXCHANGES ‌ WHAT’S THE BUZZ?
26
Mercer Marketplace enables employers to:
Mercer Marketplace provides employees with:
t 3FEVDF DPTUT t 4JNQMJGZ BENJOJTUSBUJPO t &NQPXFS FNQMPZFFT UISPVHI DIPJDF
t $PTU FGGJDJFOU DPOWFOJFOU CVZJOH t $PNQSFIFOTJWF DPWFSBHF t 1FSTPOBMJ[FE QPSUGPMJPT
Visit us at www.mercer.com/exchangesuite, or contact us at mercermarketplace@mercer.com. Mercer is a global consulting leader in talent, health, retirement, and investments. We help clients around the world advance the health, wealth, and performance of their most vital asset — their people.
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
iSSUE || March/april 2013
Exchange
Endless Options Understanding How to Make the Best Choices Among a Complicated Array of Exchange Solutions Options Could Small Businesses Drive the Private Exchange Marketplace? Private Exchanges Are More than a One-Stop Shop for Benefits, They Bring Value Too Exchange Profile: Buck Health Exchange Solutions
www.theihcc.com
INSIDE
FEATURES
9 It’s All about the Value Private exchanges allow small and large employers to show employees the value of providing them health and voluntary benefits while containing costs. By Christopher Covill National Specialty Practice Leader and Partner Mercer Marketplace Exchange Initiative
11 The New Normal? Private exchanges offering individual plans are emerging as an ideal business solution for small businesses and may even become the norm. By David Lindgren Product & Compliance Manager Flexible Benefit Service Corporation
DEPARTMENTS 4
5
Publisher’s Letter
7
Regulations & Compliance
Introducing HealthCare Exchange Solutions, the first magazine with concentrated coverage of exchanges and defined contributions.
Private exchanges may provide a transition to consumer-centered insurance while offering competitive coverage to large populations currently in or shut out of individual plans.
News Briefs
By Ronald E. Bachman FSA, MAAA Chairman, Editorial Advisory Board The Institute of Healthcare Consumerism
Keep up to date on new exchange innovations hitting the market.
14 Private Exchange Profile This inaugural issues features group health benefits, with an overview of RightOpt, a private health insurance exchange for self-funded and fully insured employers, offered by Buck Consultants.
www.TheIHCC.com I HealthCare Exchange Solutions™ I March/April 2013
3
PUBLISHER
Exchange www.theihcc.com VOLUME 1 NO. 1 | MarCH/apriL 2013
HealthCare Exchange
published by FieldMedia LLC 292 South Main Street, Suite 400 alpharetta, Ga 30009 Fax: 770.663.4409
Solutions The emergence of health insurance benefits exchanges represents perhaps the most significant shift in how Americans purchase health insurance in many years. We’ve already witnessed a number of innovations by the industry recently, and more are sure to come. The exchanges, simply put, represent an important opportunity for advancing consumerism in health care. I am pleased to introduce to you, HealthCare Exchange Solutions, a magazine supplement to HealthCare Consumerism Solutions covering this momentous shift, focusing exclusively on exchanges and defined contributions. This supplement is a major addition to the commitment the Institute has given to understanding and discussing exchanges and defined contributions during the past year. In February we introduced a new online community, Exchange Solutions, and its accompanying e-newsletter. This year’s FORUM events will feature a number of timely exchange-related workshops and general sessions, and our weekly radio show, HealthCare Consumerism Radio, has recently featured many segments about exchanges. Through timely news coverage and analysis in this magazine supplement and related media and events, we aim to resolve many of the questions and concerns employers, brokers, consultants, and consumers alike have regarding exchanges. We will feature the opinions of many key players in the emerging exchanges. In this debut issue, we are proud to feature an article by Mercer, a global HR consulting leader which has added a key component to the private exchange arena with Mercer Marketplace, as well as Flexible Benefit Service Corporation, which, with its InsureXSolutions exchange, has made a considerable impact in the individual exchange market. In each issue, we will feature an Exchange Profile, which introduces a key exchange player to the market. For this issue, we profile Buck Consultants’ RightOpt exchange. Also, in each issue, you will find Regulatory & Compliance coverage, aimed at helping stakeholders understand the complex legal and compliance issues involved in moving into the exchanges. I believe this new array of editorial content will be of huge value to the industry. No one else has concentrated coverage of exchanges and defined contribution in a regular publication, written by thought-leaders and industry experts. We invite you to share your feedback and suggestions about the supplement and consumerism as we enter this exciting era of health care exchanges.
CEO
Doug Field @ theihcc.com MaNaGiNG DirECtOr
Brent Macy
prODUCtiON EDitOr
Alison Amoroso, M.Ed. MaNaGiNG EDitOr
Jonathan Field
aSSOCiatE EDitOr
Kelvin Hosken
aCCOUNt MaNaGErS
Joni Lipson Rogers Beasley
art DirECtOr
Kellie Frissell
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
HSa rewards; roy ramthun, HSa Consulting Services LLC; John young, CiGNa WEBMaStErS
Kevin Carnegie Tom Becher
DirECtOr OF CONFErENCE SpONSOrSHip/ COrpOratE MEMBErSHip/rEpriNtS
Rogers Beasley
BUSiNESS MaNaGEr
Karen Raudabaugh
™ Volume 1 issue 1 Copyright ©2013 by FieldMedia LLC. all rights reserved.
™
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
™
magazine 292 S. Main Street, Suite 400, alpharetta, Ga
priNtED iN tHE U.S.a. ™
is designed to provide both accurate and
Send letters to the editor and editorial inquiries to the above address or to
4 March/April 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com
BRIEFS
PUBLIC EXCHANGES
CieloStar Launches National Private Exchange
Recent news from Washington, D.C. regarding delays in the small business functions of the federal exchange won’t affect Minnesota businesses because Minnesota is establishing MNsure, a state-based exchange, independent of the federal program. MNsure’s Small Business Health Options Program (SHOP) will allow small businesses to employ a defined contribution model for health insurance beginning in 2014. MNsure will also be able to distribute lump sums received from small businesses for employee health insurance to the insurance companies based on which plans the employees choose, easing the administration of providing health insurance for small employers.
CieloStar announces the launch of a broad health insurance and benefits exchange, leveraging 25 years of technology and programs to navigate the full range of health care and other benefits. Its new onestop exchange is called CieloChoice. CieloChoice allows employers, associations, affinity groups, and brokers to offer employees and members a one-stop online marketplace. Similar to travel websites that allow consumers to shop in one place, CieloChoice offers a variety of plans for consumers to choose from, including health, dental, medical, and vision. Coupled with competitive price comparisons, employees can create a plan based on their specific needs and budget. Combining its technology platform with its health benefits experience, CieloStar can simplify enrollment, engagement, and administration for both administrators and consumers.
PRIVATE EXCHANGES
InsureXSolutions Adds Assurant, Blue Cross Blue Shield of TX, and Humana to Portfolio
MNsure to Offer Small Businesses Competitive Health Insurance Options in 2014
Arizona Businesses Offered New, More Flexible Way to Purchase Health Care Coverage Blue Cross Blue Shield of Arizona has introduced a private health plan marketplace, available to Arizona employers, through a defined contribution plan. Employers set a fixed dollar amount they‘ll contribute to employees‘ health benefits, employees use the contribution dollars to shop the online marketplace and evaluate the ten plan options available. Employees pay toward the monthly premium only if their plan premium costs exceed the contribution set by their employer.
Buck Consultants Unveils RightOpt, a National Health Insurance Exchange Buck Consultants, A Xerox Company, plans to launch RightOpt, a private health insurance exchange for employers with 3,000 or more benefit-eligible employees for fall 2013 enrollment. RightOpt can help employers through health insurance provider relationships that are negotiated and managed by Buck. RightOpt allows employers to use a national network of providers based on the value each provider delivers in a specific metropolitan area. Employees located across the country access the more deeply-discounted networks of providers; a model many employers have avoided historically due to the administrative complexities. RightOpt personalizes the member experience based on family health status, adversity to risk, and preferences. A single access portal supports the personalization in three areas.
Capital BlueCross’ Private Exchange Working Well for Group Customers Capital BlueCross group customers are responding favorably to the company’s private health insurance exchange called MyCoverage Selector, which is powered by ConnectedHealth platform and launched in the fall of 2012. Miners Bank is one of the first Capital BlueCross employer groups to provide its workforce with health coverage through MyCoverage Selector. The easy-to-use online platform lets employees shop for and choose their health insurance from a wide range of options, using a set dollar amount (a defined contribution) from their employer. Employees have the flexibility to select the plan they prefer and receive the platform’s personalized recommendations.
InsureXSolutions recently announced these three insurers have joined the list of health insurance companies available through its exchange. The products from these carriers include individual health plans and offer a variety of premium and deductible options. InsureXSolutions offers small businesses a defined contribution benefits strategy. Employees access the online insurance marketplace to shop and compare plans from national, regional, and local individual health, dental, Medicare, short-term, and vision insurance companies. Employees interact with a decision engine that makes buying insurance coverage as simple as making an online travel reservation. Employees answer questions and set search parameters, and the decision engine helps them narrow down their choices to select a plan that best fits their budget, needs, and lifestyle.
PlanSource’s Exchange to Support a Defined Contribution Benefits Marketplace PlanSource, a cloud-based, on-demand technology company that provides benefits administration, payroll, and HRIS solutions to employers through its insurance carrier and broker partners, has announced the launch of MyPlanSource, a private health care and benefits exchange platform designed to support defined contribution retail benefits marketplaces. Employer shopping, employee shopping, personalized plan selection guidance and decision support, defined contribution, enrollment, plan administration, billing, and data management are all integrated in a single- or multi-carrier environment and delivered securely online.
Simplee and Liazon Creates the First Benefits Exchange with Expense Management Tools Simplee and Liazon announced a partnership to provide all Liazon Bright Choices Exchange users with integrated access to the Simplee health care expense management platform. This partnership forms the first private benefits exchange that allows consumers to both select a personalized benefits portfolio and then track and manage their health care expenses throughout the year. Liazon’s flagship product, the Bright Choices Exchange, is an online benefits store that helps employers save money on their health care costs by setting predictable budgets while allowing employees to personalize their benefits package with a selection of health, dental, vision, life, disability, and other benefits from top providers. www.TheIHCC.com I HealthCare Exchange Solutions™ I March/April 2013
5
Take your business to a higher level with a cloud-based benefits marketplace. Consumers and employers alike will rejoice in a benefits marketplace that makes shopping for insurance easy and painless. With Workable Choice, employees are easily connected with the products that best fit their unique lifestyles. Our defined contribution options give employers the flexibility to deploy a benefits program tailored to their specific needs. With our one-invoice, single payment a solution, billing has never been easier. Workable Choice integrates flawlessly with your eligibility and underwriting guidelines, just the way you’d want it to. And we capture all the information your systems need to import enrollments and maintain eligibility, so you don’t have to worry about a thing.
Decision Support / Plan Cost Comparison Online consumer shopping experience Integrated educational and analytical tools Plan Recommendations and Cost Comparisons
Online Enrollment Data validation tools and custom pages to minimize enrollment errors Direct, electronic data exchange with plan providers Detailed activity and enrollment reporting
Eligibility Maintenance Portal access for admin, broker, employer, consumer Online management of employee adds, terms and changes Automated updates sent electronically (EDI) to all impacted providers
Consolidated Billing & Payment Management Single invoice, single payment for all employer sponsored benefits Direct bill/payment capabilities for individual benefits Detailed reconciliation and activity reporting for benefit providers
With our experts as your guide, launching a private exchange begins with a phone call and ends with your customized solution. Request a demo at WorkableChoice.com.
p: 8 00-946-6342
|
W W W . W o Rk a b l eC h o iC e . C o M
REGULATIONS & COMPLIANCE
BY RONALD E. BACHMAN FSA, MAAA » CHAIRMAN, EDITORIAL ADVISORY BOARD » THE INSTITUTE OF HEALTHCARE CONSUMERISM PRESIDENT & CEO » HEALTHCARE VISIONS, INC.
Private Exchanges may Be the Free Market Solution to Cost Control and Health Care Consumerism Private exchanges may provide a transition from employer-based insurance to consumer-centered insurance while offering competitive coverage to large populations currently in or shut out of individual plans.
A
lthough the Patient Protection and Affordable Care Act (PPACA) is sometimes shortened to the Affordable Care Act or ACA, the act has few features that will make insurance more affordable. Government studies and industry experts has indicated that strict coverage mandates, limited premium classifications, community rating, added benefits, single risk pools, and price compression will raise premiums more rapidly than if the ACA had never been passed. The development of exchanges, both government and private, are part of an evolution that will change the way insurance is sold and bought. It is a new way of connecting products with customers. It may be that the main population using government exchanges are those who qualify for a federal subsidy. The standards and restrictions on government exchanges are likely to attract buyers that are high-risk and are high-cost claimants. The government exchanges will use government paid “navigators” rather than independent licensed agents. In addition, government exchanges and navigators are not expected to offer supplemental products, life insurance, or other such products and services. Private exchanges may be the free market solution to real cost control and lowering the number of people in the country that are uninsured. Given that there are nearly 50 million Americans uninsured, the traditional agent distribution system for insurance is not working. About 60 percent of the uninsured are under age 35. Studies conducted in Georgia by the Center for Health Transformation Uninsured Working Group, a former think tank founded by Newt Gingrich, found that 35 percent of the uninsured could afford insurance but did not know it. Another 40 percent needed lower cost options that were not available to them either because insurers emphasized high premium products, or because existing state laws or legislative mandates increased premiums and favored insurers over consumers. Many uninsured people work for small businesses that do not offer insurance. They may be self-employed, part-time, or doing contract work. In most cases, they qualify for individual insurance, not group plans. Selling single policies can be time consuming with little financial rewards for an agent. Many potential individual sales are halted at the kitchen table when, in the process of completing an application, they find issues that could cause insurers to decline to cover them and their family. Information derived by an insurer during the underwriting process is typically fed into an industry association called the Medical
Information Bureau. That information is shared across companies and a declined health application could have ramifications for future applications of life insurance, disability coverage, and other forms of insurance. Private exchanges are developing that will offer individual and group products that emphasize wellness and treatment compliance for those under medical care. PPACA requires insurers to “community rate” their products. That is, individual or small groups will not get direct credit for healthy activities. New entities are forming that will likely attract healthy lives and the less healthy members interested in getting better. Private health cooperatives, captive mutual companies, and new insurers may be unencumbered by an existing unhealthy membership or a current business model that limits attracting customers willing to be engaged in healthy behaviors. Health care consumerism is more likely to emerge through private exchanges than government exchanges. Private exchanges will provide a transition from employer-based insurance to individual-centered or consumer-centered insurance. In theory, both large and small employers will be able to purchase health insurance through the private exchanges, and their employees can choose an individual health plan from those offered by participating insurers. Time will tell. We are in the beginning stages of a major market revolution. We already know that small business government exchanges as originally planned have been delayed one year until 2015. As private exchanges come on line, I believe each will each be a little different and offer varying levels of products and services. For a while it will be a “wild west” show. Ultimately, the success and failure of each exchange’s product and distribution model will lead to consolidation and better products, services, convenience, help, and information for the consumer. In the end, more product competition and price transparency will lead to more citizens being insured and lower insurance costs will prevail. This is the way free markets create successful products and services that consumers want to buy.
www.TheIHCC.com I HealthCare Exchange Solutions™ I March/April 2013
7
A Full-Service Private Exchange Is all about Its Value to Both Employers and Employees
BY CHRISTOPHER COVILL » NATIONAL SPECIALTY PRACTICE LEADER AND PARTNER » MERCER MARKETPLACE EXCHANGE INITIATIVE
I
n a today’s benefits landscape, the changes enacted through the Patient Protection and Affordable Care Act (ACA) are profound for employers and employees as health care reform introduces new levels of complexity and choice that require new and dramatic solutions. As the rising cost of health care has become a challenge for all stakeholders, public policy has shifted along with the responsibility for managing cost and risk. During the last 20 years, the evolution from defined benefit to defined contribution (DC) in retirement plans
has provided a model whereby the DC approach to health insurance benefits funding now can be deployed. This shift limits the openended costs of traditional arrangements and gives employers more control over future premium cost increases. A key tenet of the ACA is the establishment of public exchanges to allow Americans to directly purchase health insurance. This has also been the impetus for the emergence of private exchanges, which allow employers to offer ACA-compliant health insurance with a new efficiency, providing access to a range of health plans along with a full
www.TheIHCC.com I HealthCare Exchange Solutions™ I March/April 2012 9
suite of employer-sponsored and voluntary benefits. The private-exchange mechanism for delivering health insurance benefits can greatly facilitate the transition to a DC model — a key value proposition for employers — while empowering employees to build their individual benefit risk portfolios, a clear value to themselves and their families. The private exchange market is growing quickly, as a number of players, including Mercer, have introduced private marketplaces for both large and small firms. The Mercer Marketplace, for example, stocks core and voluntary products across many benefits types and is available to employers with as few as 100 and as many as 100,000+ employees. For employers and employees, such a private-exchange model delivers on the value proposition vital to both groups by: 1. Allowing both the employer and the employee to realize the economic benefit of negotiated costs and services 2. Providing overall cost transparency, including full visibility of the employer’s contribution to the employee’s benefit costs Together, these have the combined advantage of creating a positive perception for the organization and its workforce. In the case of The Mercer Marketplace, the solution enables employers to deliver a total benefits package to employees, with the advantages cited above. The solution offers a comprehensive range of benefits including core medical coverage, supplemental coverage (including gap programs), traditional benefits (such as life, disability, dental, and vision) and ancillary benefits (such as home and auto, group legal, identity theft, and even pet insurance). These benefits are provided and managed through a state-of-the-art technology platform that include intuitive, user-friendly online enrollment applications, coupled with decision-support tools for calculating cost and the types of plans (PPOs, HMOs, high-deductible consumerdirected plans, etc.) that will best meet the needs of individual employees and their families. Private exchanges drive a consolidated efficiency that can be realized in reduced internal and external expenses. For example, exchanges offer employers: t an enrollment protocol that is supported through a call center staffed by seasoned, salaried, and licensed benefit 10
March/April 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com
t t
t t
counselors, thus relieving pressure on human resources and benefit staff within the organization who are often challenged to counsel employees on benefit specifics and choices enrollment functionality and technology support streamlined administration of benefits, including integration with payroll systems, eligibility management billing services
A full-service private exchange model is all about its value and how it translates to both the employer and employee. For employers, a private-exchange solution facilitates the transition to a DC strategy for benefits, providing full transparency with regard to an employer’s total contribution to its employee’s benefits package, helping to create a more positive employee perception of the employer, which plays a proven role in enhanced employee engagement and productivity, as well as the retention of key talent.
In addition, by consolidating and streamlining benefits management and reporting, the private-exchange model provides competitive benefits while reducing the traditional burden of managing them in-house. Moreover, enhanced employee perception is achieved by empowering employees to personalize their risk portfolios through a seamless technology platform supported by call-center professional benefit counselors, reinforcing the employer’s continuing commitment to providing valuable benefits. It’s worth reemphasizing the bottomline value proposition for employers. Cost efficiencies of the private exchanges are derived from the streamlined administrative aspects, as well as from the competitive brokering and bundling of all benefit products. Efficiencies also accrue as employees’ benefit-buying behavior leads them to less costly plans. And finally, the
DC funding model is a clear advantage for employers in the benefits marketplace. Employees tend to have three buying profiles when it comes to making benefit choices. There are those who: 1. Like to “Do it yourself” 2. Prefer that someone “Do it with me” 3. Want the organization to “Do it for me” The private-exchange strategy works for all three of those constituencies, empowering each of them to build their own portfolios of personal protection. Support for these employee types is achieved through a combination of the intuitive, user-friendly nature of a private-exchange technology platform and the personalized service of the benefit counselors staffing the call center. Both methods provide employees greater visibility into the costs and financial options. For many, this education process will lead to the realization that they can reduce their medical coverage and costs while still protecting their out-of-pocket exposure — with, for example, supplemental medical gap coverage. It all points toward an enhanced employee appreciation of their employer’s financial and service commitment to them. This improved employee perception will be reinforced by the clear cost-efficiency employees can realize from reducing their overall medical spending by balancing insurance costs and out-of-pocket risks in constructing their personal benefits portfolios. The goal is for employees to become more effective and efficient health care consumers. Ultimately, private exchanges can provide a meaningful long-term solution for the challenges that persist in the health-andbenefits landscape, but the value of private exchanges must be clear to both employee and employer. For employees, that value proposition is driven not purely by an employer’s financial contribution and by access to a benefits platform, but also — and perhaps more so — by the strong sense that the employer has a continuing commitment to employees’ security, to their evolving needs, and to the availability and affordability of quality health benefits. That is a sustainable proposition bred from values as much as from the transactional notion of value.
The Largest
(Small) Business Segment Is Adapting to Private Exchanges
T
BY DAVID LINDGREN » PRODUCT & COMPLIANCE MANAGER » FLEXIBLE BENEFIT SERVICE CORPORATION (FLEX)
he most talked about subject in the health insurance industry since the Affordable Care Act (ACA) was passed is the exchange. This critical component of the ACA will serve as the backbone for millions of individuals and families to purchase health insurance coverage. The public exchanges are expected to be open for business starting October 1, 2013. Only individuals and small businesses will have access to public exchanges initially. Although they will be supported by federal and/or state funds, they will offer private insurance plans from local and regional insurance companies.
with retirees, or mid-sized groups (500+), looking for group health benefits.
Public Exchanges for the Big (Small) Marketplace
Private exchanges, on the other hand, are operated by private companies, such as insurance companies, brokerages, or tech-based firms. Many private exchanges are already operational today and provide significant flexibility for businesses. These exchanges typically target specific market segments, such as large groups (1000+)
Public exchanges may be the fallback for many small businesses, which have no requirements to offer health insurance under the ACA, but are impacted significantly by its requirements otherwise. Small employers will eventually have the option of the Small Business Health Option (SHOP) exchanges, which are intended to assist small businesses provide affordable group health insurance options for their employees. Once the public exchanges are www.TheIHCC.com I HealthCare Exchange Solutions™ I March/April 2013
11
www.buckconsultants.com
In today’s economic climate, properly managing your health care plans helps both your people and your bottom line. But finding the time and the resources can be a challenge.
Buck can help. Together with Xerox, we: • Touch two out of every three insured Americans who use health care annually • Process 900 million health care claims every year • Have contracts with 36 state Medicaid organizations
• Provide RightOpt™, our private health insurance exchange, to manage costs for both you and your employees • Supply Accountable Care Organization technology to 2000+ hospitals • Support every major insurance carrier
By leveraging our experience across the health care industry — from providers and payers to employers and government agencies — you can make your health care plans more accessible, affordable, and efficient. To learn more, visit www.buckconsultants.com
will require personal assistance to understand, filter, and compare their options. Exchanges that provide t .PTU TUBUF HPWFSONFOUT EFmOF TNBMM CVTJOFTTFT BT UIPTF decision-support tools to aid FNQMPZFST XJUI VQ UP FNQMPZFFT employees in their shopping t /FBSMZ NJMMJPO PVU PG B UPUBM NJMMJPO CVTJOFTTFT JO experience may achieve the best UIF 6 4 BSF DPOTJEFSFE TNBMM CVTJOFTTFT BDDPSEJOH UP results. For example, our private UIF MBUFTU EBUB GSPN UIF ,BJTFS 'BNJMZ 'PVOEBUJPO exchange — InsureXSolutionsŽ t "O BTUPOJTIJOH QFSDFOU PG UIF PWFSBMM CVTJOFTT — is integrated with a Plan NBSLFUQMBDF JT DPNQSJTFE PG TNBMM CVTJOFTTFT Finder for employees to assist t 0OMZ 35.7 percent PG TNBMM CVTJOFTTFT OBUJPOXJEF PGGFS them to navigate the individual insurance marketplace. IFBMUI JOTVSBODF UP FNQMPZFFT DPNQBSFE XJUI This smart, online resource QFSDFOU PG CVTJOFTTFT XJUI PS NPSF FNQMPZFFT provides personal guidance to individuals and families shopping allow the employer to cap their costs and for insurance coverage. Through a series provide a fixed dollar amount to employees of questions answered by the individual, to purchase insurance coverage. Whether the Plan Finder matches insurance plans Marketplace Uncertainty Currently, the majority of those small it’s provided with pre-tax or after-tax dollars, to his or her specific needs and lifestyle. businesses that offer health insurance this approach changes the employer’s role in Taking less than one minute to complete, the outcome of this interactive process recomprovide fully-insured group health insurance the delivery of health benefits. Rather than dealing with administrative mends insurance plans based upon cost, plans to employees. Employees receive a package of group insurance options, which burdens and other logistical issues, the benefit levels, coverage needs, insurance may include health, life, disability, dental, employer’s role in providing health insurance company, and more. From there, employees vision, and more. The employer selects the to employees is significantly decreased with apply online for the insurance plan that fits group health insurance options available for a private exchange. They simply set a health them best. their employee population and pays for all or care budget, establish a relationship with a private exchange, and let their employees do The Future Is Bright a portion of the group health plans. Many small businesses originally had the rest. Some private exchanges even have Today, the individual insurance applicathought they would stop offering health a dedicated team that is available to assist tion process still includes medical underinsurance in light of the ACA. Although some employees through the enrollment process. writing and taking a medical history, which Whether the employer contributes $50 insurance companies use to assess rates for may still pursue this as an option, many small businesses have increasingly changed or $500 per month, there are no require- consumers to pay for their individual health their opinion. A recent small business survey ments or restrictions for the employer to con- insurance plans. Starting in 2014 underwritindicated that two-thirds of small business tribute a specific dollar amount to employ- ing will be eliminated, making all individual owners say they will continue to offer insurance ees. The employer just needs to make sure health insurance plans guarantee issue. they provide the same contribution amount to employees. For those small businesses uncertain Although the number of small busi- to similar employee populations, with some about their future health care strategy, a nesses offering employees insurance has classification types allowed. private exchange offering individual plans The employee can then use the funds as can be that ideal business solution. In fact, grown since the ACA was signed into law in 2010, there is still a lot of skepticism in the part of their individual or family health care there are whispers that private exchanges marketplace. Many small businesses are budget. That’s where the private exchange may quickly become the norm for small still unclear of how it will impact them and comes in. The intent of the private exchange businesses. what they will need to do to comply. In fact, is to provide a simple, seamless health care When we think of “big business,� we the small business survey found that more shopping and purchasing experience for usually think of businesses with thousands than half of the respondents incorrectly the employees through an online insurance of employees. As private exchanges grow believe they must provide health insurance marketplace. This business solution avoids in popularity, and that trend continues as to employees or be penalized. However, the “one size fits all� benefits approach and we head toward 2014, it’s actually the small the new law will not require businesses creates a win-win experience for employers business employer that may redefine the with fewer than 50 employees to provide and employees alike. way we look at the big business of health insurance nor will they be subject to any insurance. penalties. Employee Choice Is Key Many private exchanges offer employees, The Benefits of Private Exchanges for through their employers, the ability to shop online for health, dental, vision, Medicare Small Businesses With the emergence of the ACA, many Supplement, and other insurance plans. And, small businesses may quickly adapt to private since many employees will be navigating exchanges. Many private exchange models these insurance plans as consumers, they available to small businesses, initially they will be able to offer only one plan to employees in most states. The Department of Health and Human Services (HHS) recently delayed the availability of expanded SHOP exchanges until 2015. This defeats one of the primary goals of the ACA — to provide more plan choices. Since the SHOP exchanges are being delayed and small businesses have no requirements to offer health insurance under the ACA, individual plans may be the ideal solution for their employees.
The Majority of Small Businesses do Not Offer Health Insurance to Employees
www.TheIHCC.com I HealthCare Exchange Solutions™ I March/April 2013
13
PRIVATE EXCHANGE PROFILE
Group Health Benefits RightOpt: A private health insurance exchange for self-funded and fully insured employers, offered by Buck Consultants, A Xerox Company. Leadership Sherri Bockhorst is the principal and leader of Buck Health Exchange Solutions, Buck Consultants. RightOpt, together with Xerox, positions Buck to support all three segments of emerging public and private health exchanges: government, payer, and employer. Xerox is administering Medicaid programs in 36 states and the District of Columbia, and providing technology and services support to the 20 top commercial health plans in the U.S.
Solution Benefits Buck explains that its solution is designed to reduce health care spend and trend by placing continued downward pressure on health care delivery and improving employee health, not just transferring costs from an employer to its employees. It also states that both employers and employees will benefit from RightOpt’s decreased health care costs, increased member engagement, and improved business results. A summary of RightOpt’s solution benefits includes: t Buck Consultant’s preferred partner strategy regionally aligns provider networks based on quantitative criteria, including network breadth, provider discounts, unit cost guarantees, and quality. It plans that this “quilted network” approach will deliver savings of up to 10 percent on eligible charges for the employer the first year. Employers offer this national network of providers to employees based upon the value each provider delivers in a specific metropolitan area. Employees located across the country would access the more deeplydiscounted networks of providers; a model many employers have avoided historically due to the administrative complexities. t It negotiates program expenses for a suite of services integrated into the exchange, including pharmacy benefit management and wellness programs. This negotiated purchasing for volume-based contracting allows its clients to use unit cost and pricing that improves for all participating employers as its exchange membership grows. t It leverages the Xerox Palo Alto Research Center (PARC), alongside its data warehouse partner, to expand its ability to make evidence-based decisions regarding what actions truly drive outcomes and incorporates these recommendations to drive incremental value. A current research team is working to identify the effectiveness of emerging trends in health care such as gaming theory and technology — drawing upon PARC’s research in social computing, behavior analytics, and ethnography.
14 March/April 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com
t
t
t
t
t
Its portfolio of plan designs and incentive structures can be customized to fit an employer’s organizational culture and meet its needs. Using a single access point portal, RightOpt personalizes the experience for each member based on his/her health, adversity to risk, communication preferences, and readiness for change, and engages the participant throughout the year on all health-related decisions. Members choose a preferred plan options at enrollment, use those options throughout the year, and work to improve or maintain their health risks over time. The portal includes educational information, decision support tools, and health engagement resources to encourage more informed decisions. Additional services for the employee, including lifestyle coaching, employee assistance programs, and member advocacy, are available to help participants stay on track to reduce health risks. Buck’s communicators develop a communication program to support the implementation of RightOpt, introducing employees to the exchange and encouraging them to take advantage of the tools and services available throughout the year to help them make more informed decisions about their overall health and well-being. The member-facing portal integrates disparate vendor systems behind the scenes to ensure participants have access to the information they need from a single location.
Bottom Line Buck Consultants states the goal of RightOpt is to create a sustainable, benefit delivery platform built on its belief that the health of a business is dependent upon the health of its employees.
CALL FOR CONTENT LEARN. CONNECT SHARE.
The Collective Voice on Innovative Health & Benefit Management
Share Your Opinions, Strategies, Case Studies, Blogs, White Papers, Podcasts and Videos Online, in Our eNewsletters or in Print to Our Widespread Audience of More Than 70,000 Readers! Contribute to the Health Care Consumerism conversation by submitting an article, blog, case study, white paper, podcast or video to The Institute for HealthCare Consumerism’s collaborative, membership-based online community (www.TheIHCC.com), as part of its bi-monthly eNewsletter or in the print and digital publication, HealthCare Consumerism Solutions. We are actively looking for content including, but not limited to: t Health care reform and how it pertains to employers t Pharmacy and drug benefit management t Population health and wellness t Health care consumerism decision support tools t Trends in health care access
t Trends in supplemental and voluntary health benefits t Broker and consultant trends t Trends in health incentives t Trends in employee communication education t Trends in account-based and other plan designs
Platforms for Your Content: 1.
The Institute for HealthCare Consumerism’s Online Community If you’re not already a member of our online community, simply sign up for your FREE membership (at www.TheIHCC. com) and you can begin posting blogs and commenting in forums immediately. Your blog will be read by your fellow members who are employers, solution providers, brokers, advisors, consultants, human resources and benefits managers, C-suite executives, financial management decision makers, TPAs, executives and administrators of regional health plan providers.
2.
HealthCare Consumerism Solutions As the official publication for The Institute, each issue is focused 100 percent on innovative health and benefit management solutions. In addition to publishing this magazine eight times each year, you also can contribute to the annual Outlook edition, where the top industry thought leaders share their perspective on the coming year, and the Superstars edition where the top health care consumerism contributors are named. Each magazine is available digitally and in print.
3.
HealthCare Exchange Solutions To better cover significant changes in health benefits, The Institute has created a new magazine supplement that is dedicated exclusively to covering exchanges and defined contributions. Debuting in the March/ April issue of HealthCare Consumerism Solutions, Exchange Solutions will help employers, brokers, consultants and other stakeholders successfully navigate the changes ahead.
4.
HealthCare Consumerism Today eNewsletter Within this bi-monthly email newsletter, subscribers and members of the The Institute’s online community can expect a collection of fresh content, including recent blogs and posts delivered right into their inbox. Your content could be featured in the eNewsletter as a stand-alone piece, or linked from our online community.
By Sharing Your Voice or Research with Us, You are Sharing it with the Health and Benefit Management Community and the Health Care Consumerism Conversation At-Large! To Submit Content: For more information, please contact The Institute for HealthCare Consumerism CEO and Founder, Doug Field at dfield@theihcc.com
SAVE THE DATE December 5-6, 2013
LAS VEGAS
Red Rock Resort & Spa
2013
JOIN THE INSTITUTE AND GET A DISCOUNT TO THE FORUMS WWW.THEIHCCFORUM.COM
FieldMedia LLC is the parent company to The Institute for HealthCare Consumerism, THEIHCC.COM, HealthCare Consumerism Solutions magazine, EmployersWeb.com, and The Institute for HealthCare Consumerism FORUM. 292 South Main St., Ste 400, Alpharetta, GA 30009
EXHIBITORS EXHIBITORS ARAG www.araggroup.com
ARAG® is a leading provider of voluntary legal insurance products and services for employers, membership groups and associations. More than 400 organizations count on ARAG to expand their benefits programs and gain a competitive advantage in attracting employees and members. We offer fully insured legal plans — not just discount services — which we believe results in greater satisfaction. Our turnkey solutions require minimal administration and are available at no cost to your organization.
Acclaris www.acclaris.com
Acclaris delivers financial technology and services that power and simplify the complex administration of HSAs, HRAs, FSAs and much more for HR outsourcers, benefits administrators, financial institutions and health plans. Acclaris offers clients an innovative approach to faster, more profitable growth, greater agility and higher member satisfaction.
America’s Health Insurance Plans (AHIP) www.ahip.org
2013 Benefitfocus is creating a better way to manage benefits.
Castlight Health www.castlighthealth.com
Castlight Health enables employers, their employees, and health plans to take control of health care costs and improve care. With engagement rates up to 70% Castlight helps companies create true behavior change among employees so they can achieve proven, measurable results. Named #1 on The Wall Street Journal’s list of “The Top 50 VentureBacked 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.
CDHCentric www.experiencelab.com ExperienceLab has created a breakthrough, patented communication program for employers that want to increase adoption and usage of consumer directed health (CDH) insurance plans among their employees. CDHCentric, sold on a subscription basis, delivers regular, multi-media communications that are tailored based on seven unique attitudinal segments developed from proprietary research.
Ceridian www.ceridian.com America’s Health Insurance Plans (AHIP) is a national association representing nearly 1,300 member companies providing health insurance coverage to more than 200 million Americans.
Benefitfocus www.benefitfocus.com
Ceridian is a global business services company that provides a variety of human resource solutions. From benefits to payroll services, we help organizations maximize their human, financial and technology resources. Whether an organization’s goals are to save money or improve productivity, Ceridian provides the insights and solutions that ensure success.
Benefitfocus is a leading benefits technology provider. Over 18 million members and 300,000 employers use the Benefitfocus cloud-based platform to shop, enroll, manage and exchange all their benefits in one place. From consumer engagement and enrollment to communication and billing,
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
27
2013 Change Healthcare www.changehealthcare.com
blending people and technology to provide high-quality customer service and administration.
empowris www.empowris.com Change Healthcare’s mission is to engage consumers in obtaining personalized, actionable cost-savings information that changes the way they purchase health care. Built on a database of claims from a national client base, CHC delivers savings to health plan members and employers, and offers the only tool able to generate and proactively communicate savings opportunities customized to the individual, their plan and their local area.
Consumer’s Medical Resource www.consumersmedical.com
empowris is a qualified, accountable marketplace of the country’s top weight management programs, designed to provide your employee’s choice to drive engagement and create healthy outcomes. By qualifying programs, empowris ensures that employees are using programs designed for results. And, by building in accountability parameters for both programs and employees, success rates can be measured against employee investments.
First Stop Health https://www.fshealth.com Consumers Medical Resource (CMR) provides Medical Decision Support® (MDS) services to help its members become more empowered and accountable consumers of health care. MDS addresses all medical conditions and supports decisions at any point in the continuum of care, including: facilitating expert second opinions, confirming diagnoses and treatment plans, and uncovering new treatment options.
Delta Dental www.deltadentalins.com Delta Dental leads the industry in designing innovative dental coverage programs that keep costs 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 59 million people in the US.
Discovery Benefits www.discoverybenefits.com
Discovery Benefits is the 6th largest third party administrator of FSA, HSA, HRA, Transportation and COBRA plans. Discovery’s philosophy is to provide responsive and flexible administrative services creating value for our clients and their employees. We are a consumer-focused organization
28
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
First Stop Health is your personal online medical advice service. We offer 24/7 access to our US-based and licensed doctors for you and your entire family. Whether it’s advice, a prescription or just the peace of mind that you don’t need to go to the ER, our doctors can help.
Health Partners America www.healthpartnersamerica.com
Health Partners America creates tools, training and technology for financial service professionals to help them sell more effectively. Through our thought leadership white papers, media appearances and keynote speaking, we build awareness around the REAL solutions to America’s health care crisis.
HealthSparq www.healthsparq.com
HealthSparq offers an integrated health care transparency solutions platform that brings the online shopping experience to health care by leveraging provider and claims data with cost and treatment data linked together with community reviews and discussions. HealthSparq’s software-as-a-service platform is designed to be integrated into health plan and employer websites. HealthSparq is part of the Cambia Health Solutions family of companies and is located in Portland, Oregon. To learn more about HealthSparq, visit www.HealthSparq.com
EXHIBITORS and follow @HealthSparq on Twitter. To receive a HealthSparq demo, please send an email to info@HealthSparq.com or call 503-220-6200.
InsureXSolutions www.insurexsolutions.com
MedServ Global www.medservglobal.com
InsureXSolutionsÂŽ is a private exchange that helps businesses of all sizes in the new healthcare landscape. Available in select markets, InsureXSolutions offers defined contribution funding options, an online marketplace with multiple coverage options from leading insurance companies, decision support tools and a call center with licensed insurance professionals. InsureXSolutions is operated by Flexible Benefit Service Corporation (Flex), a leading provider of consumer driven benefit programs for the past 25 years. Learn more at www. insurexsolutions.com.
MedServ Global is leading the way in delivering effective and flexible healthcare solutions that save money and improve health. Our Integrated HealthShare Solutions Platform transforms health benefit plans by putting economic, health, and wellness choices into the hands of the people that are directly affected and provides the support to help them be better health care consumers. Each component is tailored to encourage personal involvement in altering health and health care purchasing behaviors which saves money for employers and employees while improving overall population health. By integrating components such as Education and Engagement, Access and Affordability, and Wellness and Incentives, these solutions create an environment that drives maximum adoption and effectiveness.
Kaiser Permanente www.healthy.kaiserpermanente.org
New Benefits www.newbenefits.com
Kaiser Permanente is committed to helping shape the future of health care. Our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 9 million members nationwide, including more than 240,000 members in metro-Atlanta.
Mayo Clinic www.populationhealth.mayoclinic.com
Mayo Clinic extends medical expertise to people throughout their lives through its population health and third-party benefits administration solutions. An integrated suite of online, phone and print programs aim to facilitate wise health care consumerism by improving population health and increasing productivity. Benefits administration services include consumer-drive health plan options and reimbursement account options. Contact us to learn more about Mayo Clinic resources to improve health and increase engagement.
New Benefits provides a full range of valuable non-insurance health and lifestyle benefits. Thousands of clients trust New Benefits to deliver superior products, customer service, administration, print services, billing and compliance. Stop by our booth to hear how DefiniteBenefits can help your employees save money on health care.
Orriant www.orriant.com
Orriant helps businesses produce a better, more profitable product by creating a workforce that is healthier, more productive, and less expensive to insure. 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.
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
29
2013 Protocol Driven Healthcare, Inc. (PDHI) www.pdhi.com
Protocol Driven Healthcare, Inc. (PDHI) is a health care technology company that licenses the ConXus® health improvement platform for the delivery of workplace wellness programs and wellness analytics. The ConXus Platform is used by wellness providers servicing many end clients and large employers delivering comprehensive wellness programs with coaching. ConXus modules can be deployed in multiple configurations to match client service levels, with additional localization for each end-client.
QuadMed www.quadmedical.com
QuadMed is a nationally recognized leader in innovative healthcare solutions, and offers comprehensive healthcare services tailored to your company’s goals and employee health needs. QuadMed specializes in staffing, managing and operating employer-sponsored primary care centers that offer services spanning the care continuum to ensure a model that best meets our clients’ needs. This includes onsite, nearsite, multiemployer/shared sites, corporate health suites and telehealth options.
SelectAccount www.selectaccount.com SelectAccount is one of the largest spending account administrators in the nation. Known for service excellence, health care expertise, and product innovation, SelectAccount offers a full line of spending accounts for one competitive fee and high interest rates. To learn more, visit www.selectaccount. com, or contact Larry Deegan at 1-847-273-1649.
Tango Health www.tangohealth.com
Tango Health helps reduce the total cost of health benefits for employers and employees by driving adoption of HDHP+HSA, eliminating the HSA administrative burden and maximizing the tax savings. Employers that are focused on containing or reducing their health care costs have come to rely on Tango’s software and services.
30
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
EXHIBITORS TSYS Healthcare www.tsys.com TSYS Healthcare TSYS Healthcare provides end-toend strategic payment solutions for consumer directed healthcare. We partner with benefits administrators, financial institutions, health plans and software providers to navigate all aspects of HSAs, HRAs, FSAs, cash reimbursements and lines of credit, rewards and claim payments. 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 contribute to improved return on investment.
WeCare TLC www.wecaretlc.com
WeCare TLC is a medical risk management company that leverages onsite primary care clinics to provide solutions to rising health care costs while improving patient health and wellness. Our holistic approach to care empowers the clinic staff to act as patient advocates, which increases compliance and decreases unnecessary expensive services.
Wiser Together www.wisertogether.com
Wiser Together, helps patients choose the right care at the time. It offers an innovative online treatment selection & shared decision support 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.
DENTAL INTELLIGENCE
Are You Ready to Sell Dental Benefits in the New Health Care Reform Environment? Part two of a three-part series. BY RENE CHAPIN » DIRECTOR OF MEMBERSHIP & COMMUNICATIONS » NATIONAL ASSOCIATION OF DENTAL PLANS
This is the second article in a three-part series exploring the impact of the
W
Pediatric dental coverage will be required for children up to age 19. www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
31
Programs designed for results. Incentives designed to motivate.
When your wellness program is the right match for your goals and your people, it delivers results. gBehavior structures wellness programs for measurable success. And InteliSpend creates incentives to focus participants on your goals. Together, we help you realize new levels of wellness. Email wellness@intelispend.com for intelligent answers to your wellness needs.
888-949-0541 gBehavior.com
888-874-5602 InteliSpend.com
Visit us at the IHC Forum East in Atlanta, May 9-10, Booth #101. Reward cards are issued in connection with a loyalty, award or promotion program. MasterCard® prepaid cards are issued by MetaBankTM, Member FDIC, pursuant to license by MasterCard International Incorporated. MasterCard is a registered trademark of MasterCard International Incorporated. © 2013 InteliSpend Prepaid Solutions, LLC 32
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
Exchange Models
State-based Exchanges
State-based: 18 (all conditionally approved) California Colorado Connecticut Hawaii Idaho Kentucky Maryland Massachusetts Minnesota Nevada New Mexico New York Oregon Rhode Island Utah Vermont Washington Washington, D.C.
State Partnership: 7
Federally Facilitated (FFE): 26
Arkansas: conditional approval Delaware: conditional approval Illinois: conditional approval Iowa Michigan New Hampshire West Virginia
Alabama Alaska Arizona Florida Georgia Indiana Kansas Louisiana Maine Mississippi Missouri Montana Nebraska New Jersey
North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Virginia Wisconsin Wyoming
State Partnership Exchanges
Federally Facilitated Exchange (FFE)
Dental Benefits in State Exchanges
Dental Benefits in Federally Facilitated Exchanges
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
33
Strategic Movement in Improves Employe
I
34
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
3
the Workplace e Performance
BY JACK GROPPEL, PhD VICE PRESIDENT OF APPLIED SCIENCE AND PERFORMANCE TRAINING WELLNESS & PREVENTION, INC. CO-FOUNDER HUMAN PERFORMANCE INSTITUTE
Changing Corporate Culture Can Be Simple
The Performance Paradigm
The Physiology of Movement
The Test
6
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
35
You could change everything.
fusionhealth.com
1.888.505.0280
Never Too Old to Learn a New Trick Can Help Manage Chronic Diseases
M
BY GEETA NAYYAR, MD., MBA CHIEF MEDICAL INFORMATION OFFICER AT&T FORHEALTH
Managing With mHealth
3
Technology Can Help
“Somehow, doing it on the phone gave me a little more motivation. It’s like having somebody there to remind you.” — Art Schwab, pilot participant www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
37
Don’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. Stop by booth #111 at the IHC Forum East, call 1-866-309-8908 or visit www.SelectAccount.com to learn about our free HSA.
It’s the benefit of knowing.
Put to the Test — Will Patients Actually Use the Solution?
Will They Embrace it?
6
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
39
WEBINAR
Drive Behavior Change With Innovative Communication Tuesday, April 23, 2013
In today’s world, consumers are inundated with information — but personalized messages break through the clutter. A recent Harris Interactive study found that 96% of consumers value personalized health care reminders, while only 10% appreciate generic messages. Join Truven Health Analytics and
Terry Villines
Director of Analysis PhaseOne Communications
Shannon Graham
Communications Analyst Manager/Analytical Unit Lead PhaseOne Communications
PhaseOne Communications for an hourlong web seminar and learn how you can increase the impact of your messages through personalization and advanced analytics. You’ll learn best practices for connecting with consumers on an
Matt Collins
Director, Consumer Products Truven Health Analytics
emotional level to overcome barriers to behavior change. In addition, you’ll see case studies of how personalized, actionable reminders have encouraged individuals to become actively involved in managing their care — resulting in improved wellness and reduced costs.
Date: Tuesday, April 23, 2013 Time: 2:00 p.m. ET Info: info@theihcc.com Live & On-Demand: www.theihcc.com/en/events/webinars/
To learn more, check out the Institute for Healthcare Consumerism’s website at www.theihcc.com
Result Highlights Will It Stick?
End-user feedback from an online survey of AT&T DiabetesManager employee pilot participants indicate: t 72 percent rated DiabetesManager “highly useful” as a tool to help them manage their diabetes [rated 4-5 on a 5-point scale] t 81 percent would continue to use the solution after the initial pilot period t 91 percent would recommend the solution to someone else
Will It Impact Behavior?
“When my blood sugar would plummet, I had nobody here to monitor and follow up. When I test my sugar now and put in the fact that my blood sugar is 42, the machine says, ‘holy smokes’ and tells me to eat.” — Anne McQuade, pilot participant
The Results Are In
_________________________________________
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
41
The Results
In
The Corporate Athlete The Corporate Athlete . ___________________________________________
aspx.
Implications for Employers
™ ™ Consumerism Consumerism Solutions Solutions 42 September/October March/April 2013 2012 I HealthCare I HealthCare I www.TheIHCC.com I www.TheIHCC.com
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 March/April 2013
43
CORPORATE MEMBER PROFILES
WWW.THEIHCC.COM
FSA/HRA/HSA/TRANSIT/COBRA: ADMINISTRATION & MANAGEMENT
HEALTH DECISION SUPPORT TOOLS
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.
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.
“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] 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.
44
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
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
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 data analysis tool, Med-View, guides 813-205-1577 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
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.
CORPORATE MEMBER PROFILES
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
TOTAL POPULATION HEALTH MANAGEMENT
LifeSynch changes behaviors to improve lives. LIFESYNCH Our approach integrates care of the mind and body to enhance health, increase productivity and 2101 W. John Carpenter Frwy Irving, Texas 75063 minimize unnecessary medical expenses. Built 800-207-5101 on a solid foundation of understanding human www.lifesynch.com behavior and how to motivate behavior change, we deliver proven outcomes through: Proven methods that lead to increased Customizable programs that easily engagement and sustained behavior incorporate into existing benefits and change. services. Clinicians and coaches who provide Scientifically proven best-practice personalized attention and form trusted guidelines to proactively manage care. relationships with members. Scalable, user-friendly technology.
“Whether it’s LifeSynch’s health coaching, EAP/Work-life, integrated medical-behavioral health or utilization management services, we integrate our behavioral health and behavior change expertise to ensure our members reach their goals and achieve sustainable, long-term improvements toward their health and well-being.” – Sean Slovenski, President of LifeSynch,
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 March/April 2013
45
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 801.574.2603 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
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT/PRIVATE EXCHANGE
Workable Solutions is based in WORKABLE SOLUTIONS, LLC Orlando, FL and provides a full array of 7120 Lake Ellenor Dr. employee benefit solutions including Orlando, FL 32809 HSA, HRA, FSA and commuter accounts, COBRA administration, and benefits 800.946.6342 administration outsourcing. They offer Fax: 407.540.1749 a comprehensive benefit exchange www.workablesolutions.com application, Workable Choice, which provides plan selection assistance, comparison-shopping technology, eligibility management, enrollment, consolidated billing, and more. Workable also offers a myriad of defined contribution options, which allow employers to control their employee health care costs while giving their employees greater choice and flexibility.
“As a small business, we understand first-hand what challenges a small business faces. At Workable Solutions, we can help you control the cost of employee benefits. Workable Choice is a private exchange solution that makes offering defined contribution and a multitude of consumer-driven products easy and affordable.” — Terry McCorvie, President/CEO, Workabe Solutions, Inc.
46
March/April 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com
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 March/April 2013
47
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
48
March/April 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 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
CORPORATE MEMBER PROFILES
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.”
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.
—Dr. Steven Helschien, Founder, Level1Diagnostics
www.TheIHCC.com I HealthCare Consumerism Solutions™ I March/April 2013
49
RESOURCE GUIDE
WWW.THEIHCC.COM
If you use the services of our solutions providers, please tell them you saw their ad in
ADVERTISING CONTACTS 404.671.9551 CEO/PublIshEr
Doug Field
™.
aCCOunt ManagErs
@
Joni Lipson Rogers Beasley
ManagIng DIrECtOr
Brent Macy
rEPrInts
Rogers Beasley
ADVERTISING INDEX
50
Acclaris ................................................. 27
First Stop Health .................................... 28
Mayo Clinic ........................................... 29
AHIP ................................................27, 44
Flexible Benefit Service Corporation ....... 45
MedEncentive ..................................19, 47
Alegeus Technologies ............................ 26
Foundation for Chiropractic Progress ...... 19
MedServ Global...................................... 29
AmeriFlex............................................... 24
FORUMWest Save the Date ...........HCES 16
MedVision.............................................. 44
ARAG ..................................................... 27
Fusion Health ......................................... 36
Mercer Marketplace.................26, HCES 2
Best Buy ........................Inside Back Cover
FSA Store ............................................... 49
New Benefits .......................................... 29
Benefitfocus ........................................... 27
GBehavior .............................................. 32
Orriant .............................................29, 46
Buck Consultants .........................HCES 12
Health Partners America ........................ 28
PayFlex .................................................. 20
Carena ................................................... 46
HealthPERX ............................................ 45
Protocol Driven Healthcare, Inc. (PDHI) .. 30
Castlight Health ...............................27, 44
HealthSparq ........................................... 28
QuadMed ............................................... 30
Ceridian ................................................. 27
HealthStat ............... Inside Front Cover, 25
SelectAccount..................................30, 38
CieloStar..........................................24, 49
HSA Bank ........................................21, 43
Tango Health ......................................... 30
CDHCentric ......................................27, 47
IHC Call for Content......................HCES 15
Target GiftCards ..................................... 12
Change Healthcare................................. 28
IHC Corporate Member ...................HCES 8
Totem Solutions ..................................... 48
CodeBaby............................................... 48
IHC Webinar - Truven ............................. 40
Transitions ............................................. 47
ConnectYourCare ................................... 22
InsureXSolutions .................................... 29
Truven Health Analytics .....................5, 49
Consumer’s Medical Resource................ 28
Intellispend ............................................ 32
TSYS Healthcare ........................10, 30, 43
DataPath ................................................ 45
Jellyvision .............................................. 21
UnitedHealthCare ............... 23, Back Cover
Delta Dental .....................................28, 48
JP Morgan.............................................. 20
Visa ....................................................... 23
Discovery Benefits.................................. 28
Kaiser Permanente ................................. 29
WageWorks .....................................25, 43
eflexgroup .............................................. 44
Level1Diagnostics .................................. 49
WeCare TLC .....................................30, 47
empowris ............................................... 28
LifeSynch ............................................... 45
Wiser Together ................................30. 48
Evolution1........................................18, 43
MasterCard ......................................18, 46
Workable Solutions ............22, 46, HCES 6
March/April 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
© 2013 BBY Solutions, Inc. All rights reserved.
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