HealthCare Consumerism Solutions Nov/Dec '14

2014 IHC FORUM West Conference Recap

ISSUE || November/December 2014

Innovative Health and Benefit Management

A Next Step

for Retail Health Care

The ACA and 2015: What’s Next The HSA Owner’s Manual

INSIDE: The Official Magazine of

www.theihcc.com

Changing healthcare by changing lives.

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41 Direct Pay Online Markets: The Next Step in the Retailization of Health Care While most of us would never frequent a restaurant that didn’t list prices but instead kept patrons guessing until they received a bill a month later, that’s exactly what happens in health care. The true costs of services are tightly held secrets. For many years, consumers have been left in the dark, but, as the health care market has shifted, that shift has allowed transparency to gain a bigger foothold. A major part of transparency? The direct pay market. While direct pay is nothing new (one hundred years ago, doctors were paid in cash and sometimes food, or chickens or other agreed-upon barters) one of today’s methods certainly is – the online marketplace.

By Heather Loveridge, Senior Editor, The Institute for HealthCare Consumerism

46 The Affordable Care Act and the New Year: Projections for 2015 This time of year, many begin to think about the start of a new year, and what it may mean to their industry and businesses. Some worry about what the year ahead may bring, while others look forward to change and growth. For the health care and benefits industry, what might be affected in the coming year? The bottom line for employers in 2015: not much will change. Laws — and plans to comply with these new regulations — are in place and currently being enacted. Plans that have been established for 2015 will most likely be implemented; however, there may be incremental adjustments that will modify an employer’s thinking and plans.

By Perry Braun, Executive Director, Benefit Advisors Network (BAN)

INSIDE The Industry’s Only Magazine Dedicated Exclusively to Health Exchanges 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: With the first issue HealthCare Consumerism Solutions for 2015, contributors will be looking at the key trends

in health and benefits management for the new year, including wellness, voluntary benefits, private exchanges, health law compliance and more.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

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DEPARTMENTS

Publisher’s Letter

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2015 Individual Mandate Exceptions and Penalties

10-11, 13 Briefs & Innovations t t t t

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2014 FORUM West Recap

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2015 Conference Preview

54-57

Affiliate Member Profiles

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Resource Guide/Ad Index

Bachman’s Banter

By Ronald E. Bachman, Chairman Editorial Advisory Board The Institute for HealthCare Consumerism

#BDINBO

21 Stats & Data On-site Health Clinics That Include Chiropractic Care Maximize Value and Yield Higher ROI

By Gerard W. Clum, DC President Emeritus Life Chiropractic College West

$MVN

39 Voluntary Benefits Employees Waste A Lot of Money by Making Open Enrollment Errors

SIGN UP TO ATTEND

By Tye Elliott Vice President of Core Broker Sales Aflac

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49 Wellness

Events

Engaging Millenials in Workplace Wellness

Private Exchange FORUM & EXPO Mar 31 - Apr 1, 2015 Renaissance Richardson Hotel Dallas

IHC FORUM & EXPO Atlanta

By Rajiv Kumar, MD Chief Executive Officer ShapeUp

51 Engagement Learnings from Obamacare, Year One

June 20-23, 2015 Cobb Galleria Centre Atlanta

IHC FORUM & EXPO Las Vegas Nov 16-18, 2015 Red Rock Resort Spa & Casino Las Vegas

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By Frank Hone Chief Engagement Officer Healthcentric Partners, Inc.

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53 Health Savings Accounts

Come LEARN, CONNECT and SHARE with the top thoughtleaders in health care consumerism, find more information at: www.theihccforum.com

The Owner’s Manual that Didn’t Come with Your Health Savings Account

By Jonathan Field Managing Editor The Institute for HealthCare Consumerism

ONLINE EXCLUSIVES Last-Minute Ways to Maximize Flexible Spending Accounts

DIY Health Benefits: Small to Mid-Size Employers Opting to Self-Insure

It’s December 1, and Renee is starting to panic. “I don’t want to lose any of my FSA money. When is the deadline? What expenses are covered?

How much money do I have left to spend? I have to find a way to spend this money ‌ fast! Where do I go to find my balance information?�

Traditionally considered a cost-control option for larger employers, self-insurance has become an attractive option for small to mid-sized companies in response to the continuing rise of health care cost and health care reform requirements.

Renee’s concerns aren’t unique. She is among the 35 million account holders who made tax-smart allocations to their flexible spending accounts (FSAs) for 2014. She’s also among the 51 percent that wait until December to spend their FSA dollars.

By Jeremy Miller, Founder and President, FSAstore.com

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By Joseph Berardo Jr., Chief Executive Officer, MagnaCare

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LETTER

PUBLISHER www.theihcc.com VOLUME 10 NO. 8 | NOVEMBER/DECEMBER 2014

Looking Forward to the Opportunities of 2015 With the new year around the corner, it’s a good time to reflect on the changes in the industry over the past year and turn an eye to the opportunities that await in 2015.

For those of us supporting the shift to consumerism in health and benefits, it would be a considerable understatement to say that 2014 has been an exciting year. Over the past 12 months, companies in this space have seen exponential growth, announced IPOs and significant investment rounds and launched next-generation products and services.

Right now, health care, especially consumer-focused health care technology, is where a significant amount of investment capital is headed and where many of the brightest minds are focusing their attention. After all, the patient-to-consumer revolution in health care will be the greatest value migration in history with trillions of dollars at stake, according to recent Oliver Wyman research.

The health and benefits industry is starting to wake up to the potential of employees as consumers, armed with the right tools and services to take control of their health, well-being and finances. And at this point, the shift is unstoppable and, as Oliver Wyman argued, will be “brutally hard� on any status quo companies that fail to change.

Yet as exciting as the past year has been, all indications seem to suggest that we are just now scratching the surface in the shift to consumerism. Wearable devices, private exchanges, health savings accounts, mobile health, price/quality transparency tools, telehealth and the like are all just in the early stages of adoption, but the future looks bright.

While many of these technological innovations hold great promise, their ability to educate human resource leaders on their cost-saving and consumer-empowering potential will be crucial to adoption.

Over the past year, we have seen many cutting-edge employers drive innovation; yet, at the same time, many organizations are hesitant to change long-standing practices. Right now, many employers are still wondering how these technologies can support their organizational goals. More education is needed.

To meet these education needs of employers — and the entities that support them, such as brokers, consultants and insurers — The Institute for HealthCare Consumerism is committed to providing in-depth, actionable insights and research through the new Private Exchange FORUM, the flagship IHC FORUM & Expo, FORUM West in Las Vegas, the quarterly editions of HealthCare Exchange Solutions and HealthCare Consumerism Solutions, PrivateHealthCareEXCHANGES.com and several other channels.

With this great industry shift, great opportunity is also emerging. As we enter the new year, I hope you’ll continue to be a part of the collaborative voice that’s driving a new consumer-focused health and benefits industry. Thank you for your readership and support in 2014. To find information on all of our 2015 events, media properties and more, visit us at theihcc.com.

Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Tel: 404.671.9551 • Fax: 770.663.4409 CEO

Doug Field 404.671.9551 ext. 101 ¡ dfield@ theihcc.com MANAGING DIRECTOR

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Jonathan Field 404.671.9551 • jfield@theihcc.com SENIOR EDITOR

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Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD

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

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

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Karen Raudabaugh 404.671.9551 ext. 108 ¡ kraudabaugh@fieldmedia.com HealthCare Consumerism Solutions™ Volume 10 Issue 8 Copyright Š2014 by FieldMedia LLC. All rights reserved.

Sincerely,

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

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BACHMAN’S BANTER

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

2015 Individual Mandate Exceptions and Penalties WHO: Every individual not otherwise exempted from the Affordable Care Act’s Individual Mandate (also called the Individual Shared Responsibility Payment). The guidance is to assist those preparing and filing federal taxes.

WHEN: Penalties effective January 1, 2015.

EXECUTIVE SUMMARY: Since January 1, 2014, the Patient Protection has required everyone to: t have qualifying health insurance (minimum essential coverage) for each month of the year, t have an exemption, or t make an Individual Shared Responsibility Payment when filing his or her federal income tax return.

The IRS guideline clarifies the exceptions and provides the penalty amounts that apply to 2015.

1. Exceptions: There are no tax penalties for being without health insurance if you: t Are part of a religion opposed to acceptance of benefits from a health insurance policy, or t Are a member of a health care sharing ministry, or t Are an undocumented immigrant, or t Are incarcerated, or t Are a member of an American Indian tribe, or t Have income below the 138 percent of the federal poverty guidelines and are ineligible for Medicaid because the state in

which you reside has not expanded eligibility, or t Have a family income below the threshold for filing a tax return, or t Have to pay more than eight percent of your income for health insurance, after taking into account any employer contributions to tax credits, or t Had insurance, lost it and secured coverage providing the gap in insurance was less than three consecutive months, or t Meet other hardship standards.

2. 2015 Penalties: The penalty for not having qualified health insurance is the greater of: a. $325 per adult and $162.50 per child (up to $925 per family), or b. Two percent of the household income.

ACTIONS REQUIRED: Tax filers and preparers should review the relevant IRS publications to determine whether or not they may owe a penalty that is to be paid at the time of tax filing. You may want to consult a tax expert, seek assistance from your employer, broker, lawyer or a government health insurance navigator.

The information presented and contained within this article was submitted by Ronald E. Bachman, president and CEO, Healthcare Visions, and chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism. This information is general information only, and does not, and is not intended to constitute legal advice. You should consult legal advisors to determine the laws and regulations applicable to your company. Any opinions expressed within this document are solely the opinion of the individual author.

2014 Federal Tax Filing Requirement Thresholds Filing Status

Age

Must File a Return If Gross Income Exceeds

Single Â

Under 65

$10,150

65 or older

$11,700

Head of Household Â

Under 65

$13,050

65 or older

$14,600

Married Filing Jointly

Under 65 (both spouses) 65 or older (one spouse)

$20,300 $21,500

65 or older (both spouses)

$22,700

Married Filing Separately Qualifying Widow(er) with Dependent Children

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Any age

$3,950

Under 65

$16,350

65 or older

$17,550

HEALTHCARE CONSUMERISM NEWS BRIEFS

Doctor On Demand Joins Castlight Health’s Enterprise Healthcare Cloud Community Castlight Health recently announced Doctor On Demand’s Video Visits are now available through Castlight’s Enterprise Healthcare Cloud to employers that work with both companies. Castlight empowers large businesses to understand and control health care spending and enables employees and families to make informed choices with a clear understanding of costs and likely outcomes. Doctor On Demand enables employees to quickly receive high-quality medical care for health needs ranging from the common cold to minor sports injuries from their homes and offices via smartphones, tablets and desktop computers.

Doctor On Demand is available in 46 states across the country; patients simply download the Doctor On Demand app, provide a list of their symptoms and can instantly connect to a board-certified doctor in their state. Doctor on Demand integrates into the Enterprise Healthcare Cloud through the Castlight Connect Solution Center.

Holmes Murphy & Associates Announces Partnership with Maxwell Health Holmes Murphy & Associates, a premier independent risk management and insurance brokerage firm, has announced a partnership with Maxwell Health, a revolutionary operating system for employee benefits. Founded in 1932, Holmes Murphy is committed to delivering both savings and simplicity to their customers in an industry that has becoming increasingly expensive and more complex. Holmes Murphy specializes in uncovering key cost-drivers and developing streamlined solutions to complex health care challenges. Maxwell Health features a beautifully designed user interface and an intuitive, lifestyle-based system for enrolling in benefits. With Maxwell, Holmes Murphy clients can combine insurance and financial products with best-in-class wellness services for their employees, including concierge services, telehealth solutions, child, pet, home and senior care services, identity theft protection and more.

Colorado HealthOP Selects Colibrium to Support Member Sales and Service Initiatives Colibrium has recently announced that Colorado HealthOP is the latest client to use Colibrium’s acquisition, engagement and retention business process outsourcing (BPO) solution. Colibrium will provide open enrollment assistance with the CO-OP’s member health and retention initiatives while integrating with existing processes and technology to provide a seamless customer-focused shopping experience. Colibrium leverages nearly a decade of health plan sales and technology implementation and consulting experience to lower acquisition costs, increase close ratios, increase revenue per lead and significantly improve the consumer experience for clients. Their team of industry experts leverages solution selling techniques, in-house licensed agents and customer service staffing in a world-class call center with industry-leading technology and techniques to meet the challenging requirements of their health payer clients.

Xerox and HealthSpot Partner to Expand Telehealth Access in the U.S. In a move that expands patient access to care, Xerox is investing in HealthSpot, Inc., a pioneer in patient- and provider-driven health care technology. The investment enables groundbreaking telehealth to be delivered to patients in convenient locations nationwide. Through

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proprietary cloud-based telemedicine software, the HealthSpotÂŽ platform allows patients to interact with nationally recognized doctors.

The average visit to one of HealthSpot’s fully enclosed, 40-square foot kiosks takes 15 minutes, offering patients convenient, timely access to doctors, specialists and prescriptions. The investment from Xerox means HealthSpot can rapidly scale deployment of its kiosks and access Xerox’s relationships across the health care industry. Over the next five years, HealthSpot plans to deploy kiosks to retail pharmacies, large employers, long-term care centers and emergency departments throughout the nation.

Evolution1 — a WEX Company Selected by CBIZ as Preferred Partner Evolution1 continues to strengthen its partner base with the addition of marquee partners such as CBIZ, Inc., the largest U.S. benefits specialist and a top 20 broker of U.S. business (as ranked by Business Insurance magazine in 2014). With nearly 100 offices and more than 4,000 associates in major metropolitan areas and suburban cities throughout the U.S., CBIZ delivers top-level financial and employee business services to organizations of all sizes, as well as individual clients, by providing national-caliber expertise combined with highly personalized service delivered at the local level. Through the relationship, Evolution1’s industry-leading consumer-directed health care administration platform will be available to CBIZ’s employer group clients through 1Cloud by Evolution1Ž.

Eight Health Care Facilities in Texas, Florida and Wisconsin Join the Price Transparency Movement Pricing Healthcare has announced the expansion of its website to include six endoscopy centers in the Dallas-Fort Worth market in Texas, an ambulatory surgery center (ASC) in Tampa-St. Petersburg, Florida and both an ASC and imaging center in the greater Milwaukee area. Procedures with newly published prices include colonoscopies, orthopedic surgeries, hernia repair and a long list of imaging procedures, such as MRIs, CT scans, ultrasounds and X-rays. Pricing Healthcare is a completely open, national online marketplace for direct-pay health care. Pricing information on the site is current, searchable and free to access from anywhere in the world, covering hundreds of procedures for facilities across the United States.

HEALTHCARE CONSUMERISM FUNDING ANNOUNCEMENTS

Oak HC/FT Leads $25 Million Investment in Limeade Oak HC/FT Partners recently announced that it will lead a $25 million investment in Limeade, the Seattle-based technology company that develops employee engagement platforms for large corporations. The $25 million financing will enable Limeade to expand its employee engagement platform through customer-driven innovation, including new products that meet the evolving needs of employers committed to improving the health, well-being and performance of their workforces.

Oak HC/FT’s investment, all of which will be going directly to the company, is the first from their newly launched $500 million Healthcare and FinTech fund. Existing investor TVC Capital is also participating in the financing, alongside Limeade employees and directors.

HEALTHCARE CONSUMERISM PEOPLE ON THE MOVE

SeeChange Health Names Bryce Williams as CEO and President

Teri Rae Olson Joins HealthFitness as Vice President of Business Development

SeeChange Health announced that Bryce Williams has been appointed as president and chief executive officer of the company. Williams succeeds Martin Watson, SeeChange’s founder who has been in the role since 2008, as SeeChange focuses exclusively on its consumer engagement and health improvement platform. SeeChange Health recently narrowed its focus from a two-subsidiary business providing both insurance and technology, to an emphasis on the company’s fast-growing consumer engagement and health improvement platform. The SeeChange health improvement platform was awarded Red Herring’s Top 100 Innovation award and is used by more than one million members across some of America’s largest and most respected health plans. SeeChange Health has delivered more than $100 million in cost savings for its customers to date through an innovative approach toward consumer engagement, incentives, valuebased benefit designs and individual health management.

HealthFitness has announced the addition of Teri Rae Olson as vice president of business development. In her new role, Olson will partner with large employer groups in the Midwest and Northeast regions to develop and implement strategies aimed at achieving positive health behavior change. Possessing 25 years of prior experience with two top industry vendors, Olson brings a unique vantage point to HealthFitness.

She recognizes that ongoing employee participation is key to corporate health management program success and sees HealthFitness as consistently providing hands-on, innovative workplace solutions.

Castlight Health Adds General Counsel, Chief People Officer and Chief Strategy Officer to Leadership Castlight Health recently announced three appointments to the company’s leadership team. Jennifer W. Chaloemtiarana joins Castlight as general counsel and chief compliance officer; J.C. Herrera joins as the company’s chief people officer; and Nita Sommers is promoted to chief strategy officer. These roles are new to the organization, and each executive has a successful track record helping companies scale during hyper-growth phases.

Rite Aid Announces Key Appointments at Health Dialog Rite Aid Corporation has announced that RediClinic’s CEO Web Golinkin will assume additional responsibilities as the chief executive officer of Health Dialog. In addition, Karen Staniforth, Rite Aid’s group vice president of pharmacy initiatives and clinical services, has been promoted to the role of chief operating officer at Health Dialog. Both RediClinic and Health Dialog are wholly owned subsidiaries of Rite Aid. As CEO of Health Dialog, Golinkin will lead the development of Health Dialog’s business strategy. In her new role, Staniforthm who will report directly to Golinkin, will execute Health Dialog’s business strategy and oversee day-to-day business operations.

HEALTHCARE CONSUMERISM RESEARCH, SURVEYS & REPORTS

One in Five Plans to Trigger “Cadillac” Tax by 2020, Truven Health Analytics Study Finds Twenty percent of benefit plans will trigger the “Cadillac” tax provision under the Affordable Care Act by the year 2020, according to a new study from Truven Health AnalyticsTM. Beginning in 2018, the ACA requires employers to pay a 40 percent tax on the net cost of high-cost health plans. Plans with costs that total more than $10,200 for employee only coverage and $27,500 for family coverage will be subject to this penalty, the so-called “Cadillac” tax. According to the Truven Health study, which analyzed recent MarketScan® claims data for over 13 million active employees and early retirees in nearly 2,600 self-funded plans to identify real-world health care spending trends, 15 percent of active employee plans are projected to incur the tax upon its activation in 2018, a rate that is expected to increase to 19 percent by 2020. Truven Health researchers estimate the tax would result in a cost increase of up to $480 per employee per year (PEPY) for plans expected to incur the tax.

Alegeus Research Reveals Consumers Want to Choose Their Own HSA Financial Institution Alegeus Technologies recently published research that explores consumer and employer attitudes and preferences toward HSAs and other health accounts. The research revealed that consumers are opinionated about HSA features — particularly about the selection of an HSA financial institution. Consumers expressed a desire for a variety of options and the freedom to choose which HSA financial institution is right for their unique situation. More than half of consumers indicated that they would

highly value the ability to choose their own HSA financial institution, rather than have their employer choose it for them. Forty-one percent of consumers want their HSAs to be managed by the same financial institution that manages their other deposit and investment accounts.

Almost universally, consumers value the security of an institution that is FDIC insured, but consumers expressed mixed opinions in terms of the type of institution they prefer — including national, regional and community banks, credit unions or other niche providers.

EBRI: Employers Increasingly Adopting Wellness Incentives During Open Enrollment for 2015 Few employers plan to eliminate or make major changes in their health care benefits in the near future — but changes are inevitable, especially the growth of wellness programs designed to address worker risks and behaviors, which drive chronic conditions, and account for a large percentage of overall spending, according to a new report by the nonpartisan Employee Benefit Research Institute (EBRI). The EBRI report, based on findings from the SHRM/EBRI 2014 Health Benefits Survey, finds that few employers expect to trigger the so-called “Cadillac” tax on high-cost health plans in 2018, and few are planning to eliminate their health benefits. Since this has been a topic of wide speculation, the Society for Human Resources Management (SHRM) and EBRI conducted a survey of private- and public-sector employers to find out what they are actually planning on. continued on page 10

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Briefs, continued from page 11

HEALTHCARE CONSUMERISM MERGERS & ACQUISITIONS

Vitals Acquires Compass Healthcare Advisers Vitals announced that it has acquired Compass Healthcare Advisers.

Together, the two companies are positioned to bend the cost curve by helping consumers achieve real, measurable savings on their health care. The companies will combine and extend their current cost and quality transparency solutions. The combination will allow health plans and employers to reduce costs, engage patients and deliver a “retail” way to buying health care services. Vitals is a leader in providing online transparency tools and data, helping consumers make informed decisions about their medical care. Compass Healthcare Advisers extends this capability, by aligning the economic interests of patients and their employers. A unique component of the Compass SmartShopper solution is providing financial incentives to patients who choose high-quality, low-cost health care providers for their care.

Optum, Alere Health to Combine to Help Health Plans, Employers and States Improve Population Health Optum and Alere announced that Optum has entered into a definitive agreement to acquire Alere Health and its subsidiaries, which provide leading condition management, case management, well-being, wellness and women’s and children’s health services to more than 200 regional and local health plans, 89 Fortune 500 employers and 29 states. Alere Health’s services are offered to more than 22 million people across the U.S. The $600 million cash transaction is subject to customary regulatory approval and other closing conditions.

Frenkel Benefits Announces Acquisition of The Moyer Group Frenkel Benefits, LLC recently announced the acquisition of The Moyer Group, Inc., a New York employee benefits firm. As part of the acquisition, The Moyer Group’s team will relocate to Frenkel Benefits’ headquarters. The Moyer Group is a firm that has focused on employee benefits for over 50 years and, under the leadership of Henry S. Moyer, Jr., carved an impressive reputation within the industry.

The Moyer Group team joining Frenkel Benefits has a long history of comprehensive employee benefits consulting illustrated in part by their long-standing client relationships. Frenkel Benefits considers this acquisition an ideal complement to the firm’s operations.

Emdeon to Acquire Change Healthcare Emdeon Inc. announced it has entered into a definitive agreement to acquire Change Healthcare, a market leader in health care consumer engagement and transparency. Change Healthcare will enable Emdeon to offer its customers additional solutions that marry cost and quality information with a robust inventory of consumer behavioral insights.

These solutions can help employees, health plan members and patients reduce costs and become better health care consumers. Emdeon is the largest financial, administrative and clinical health information network in the nation, processing more than seven billion transactions with a claims value of $1 trillion annually. Emdeon’s Intelligent Healthcare Network™ reaches 700,000 physicians, 81,000 dentists, 60,000 pharmacies, 5,000 hospitals, 600 vendors, 450 laboratories and 1,200 government and commercial payers. Change Healthcare was founded to transform the way consumers evaluate and utilize health care services by combining unique insights at the point of decision with sustainable engagement.

Hub International to Acquire Assets of Chicago’s Laurus Strategies Hub International Limited, a leading global insurance brokerage, announced that its Chicago-area Hub International Midwest has entered into a definitive agreement to acquire the assets of Chicagobased Laurus Strategies from CSIG Holding Company. Laurus is an employee benefits, human resources and human resource information system (HRIS) global benefits consulting business. Terms of the acquisition were not disclosed. Closing of the acquisition is conditioned upon customary closing conditions.

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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 Managing Editor, Jonathan Field at jfield@theihcc.com

4TH ANNUAL FORUM WEST RECAP Returning to the Red Rock Resort & Spa in Las Vegas, the recently completed FORUM West conference provided attendees with a collaborative experience that allowed them to LEARN, CONNECT and SHARE on health care consumerism trends and best practices.

W

ith nearly 500 attendees, the 2014 FORUM West was the most attended edition in the conference’s history. Speakers, sponsors, panelists and attendees gathered to discuss the most recent trends in health and benefits as of 2014’s open enrollment season.

General sessions speakers included many industry thought leaders, including Jeff Ellis, CFO, MGM Resorts International; Joe Jackson, CEO, WageWorks, Inc.; John Hickman, Partner, Alston + Bird LLP; Clint Jones, CEO, GoHealth; Nancy Vasta, Business Lead, Proprietary Retail Exchange, Cigna; and Henry DePhillips, MD, FAAFP, Chief Medical Officer, Teladoc, Inc.

Workshops included insights into the latest in private exchanges, wellness incentives, retail health clinics, price/quality transparency, health savings accounts, Affordable Care Act compliance, telehealth, consumer-driven health plans, defined contribution and other areas of health care consumerism.

With a full slate of pre-conference events, attendees could choose from many innovative sessions, including "Making Health Care Consumerism Work: The Steps and Plan", "Helping Employers Understand Defined Contribution and Private Exchanges", "NAHU

Certification Program on Self-Funding for Brokers", "Domestic Medical Tourism in Las Vegas" and "The Power of Employee Choice: The Game-changing Combination of Private Exchanges and HSAs".

The Institute for HealthCare Consumerism would like to extend a sincere thanks to all speakers, moderators, panelists, sponsors, exhibitors and attendees for helping make the show a resounding success. A special thanks is reserved for gold sponsors WageWorks, Connecture, GoHealth and Cigna.

The Institute for HealthCare Consumerism is excited to announce that FORUM West will be back at the Red Rock Resort in Las Vegas for the fifth annual edition of the conference from November 16 to 18, 2015. Registration to open in spring 2015.

Tune in Weekly, Join the Conversation…

The Collective Voice on Innovative Health & Benefit Management

HealthCare Consumerism Radio Show LEARN. CONNECT. SHARE. Listeners will LEARN about the latest trends and best practices in health care consumerism and CONNECT with health care industry thought leaders, brokers, advisors, third party administrators, HR and benefit managers and regional health plan providers. Listeners can also SHARE by contacting the hosts of the show and suggesting archives to industry associates.

The HealthCare Consumerism Radio Show is co-hosted by The Institute for HealthCare Consumerism CEO and Founder Doug Field along with Editorial Chairman Ron Bachman and Managing Director Brent Macy Listen LIVE or Catch Up on What You Missed: • Online every Friday 11am noon EST on www.theihcc.com/radio • Archives of each show are available at www.theihcc.com/radio

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The Institute for HealthCare Consumerism Announces Three Major Conferences for 2015 National conferences for employers, brokers and health insurers planned for Dallas, Atlanta and Las Vegas ATLANTA – Dec. 22, 2014 – The Institute for HealthCare Consumerism (IHC) is pleased to announce that it will be producing three national conferences for the upcoming year: the inaugural Private Exchange FORUM, the flagship IHC FORUM & Expo and the fifth annual FORUM West in Las Vegas.

With the addition of the Private Exchange FORUM, The IHC bolsters its already top-notch education efforts covering the shift of employees as passive participants to active consumers in health and benefits. At The IHC’s conferences, industry leaders — including employers (HR and benefits professionals, CFOs and CEOs), brokers, third-party administrators, consultants and insurers — gather to share leading practices, exchange ideas and arrive at real, implementable solutions that reduce costs and empower employees.

“Consumerism strategies are being quickly adopted by innovative employers nationwide, but we are really just beginning to scratch the surface,” said Doug Field, founder and chief executive officer, The Institute for HealthCare Consumerism.

“Today’s employers are asking for more education on the benefits of these next-generation solutions and practices. To meet these needs, we are excited to be producing three conferences in 2015, including the first Private Exchange FORUM.” The first conference of 2015 will be the inaugural Private Exchange FORUM in Dallas from March 31 to April 1. Building on a long-standing commitment to covering the emerging private exchange space, The IHC launched this new event to help employers, brokers/advisors and insurers gain a 360-degree perspective on private exchanges and defined contribution.

The Private Exchange FORUM is where professionals will find the education, collaboration and access to solutions needed to help them make the right decisions regarding private exchanges going forward. To register or for more information, visit PrivateExchangeFORUM.com. Super saver rates end on January 31, 2015.

The second conference of the upcoming year will be the flagship IHC FORUM & Expo at the Cobb Galleria in Atlanta from June 23 to June 25. After a record-setting attendance in 2014, The IHC’s anchor event expects to hit 1,000 attendees for the sixth annual edition.

With early sponsors WageWorks, Visa, PayFlex, Doctor on Demand, FAIR Health and more already announced and cutting-edge general sessions soon to be announced, the sixth edition of the IHC FORUM & Expo will be a mustattend event for all health and benefits professionals in 2015. Early registration is now open with rates starting at just $99. Visit www.theihccforum.com/2015atlanta/ for more information.

The third and final conference of 2015 will be FORUM West in Las Vegas on November 16 to 18. Back to the Red Rock Resort for the fourth time, the 2015 FORUM West will offer attendees a real-time look into the trends of 2015 open enrollment. With registration opening spring 2015, more information can be found at www.theihccforum. com/2015vegas/.

Interested sponsors and exhibitors for any of The IHC’s 2015 events should contact Brent Macy at bmacy@ theihcc.com. Interested speakers are invited to contact Doug Field at dfield@theihcc.com.

BY GERARD W. CLUM, D.C., PRESIDENT EMERITUS, LIFE CHIROPRACTIC COLLEGE WEST EXECUTIVE BOARD MEMBER, FOUNDATION FOR CHIROPRACTIC PROGRESS

STATS & DATA: ON-SITE HEALTH CLINICS

On-site Health Clinics That Include Chiropractic Care Maximize Value and Yield Higher ROI

T

he fragile and fickle state of the nation’s health care presents critical challenges to employers of every nature and size. One approach quickly gaining rapport within the marketplace is the on-site health clinic — found advantageous in areas of health care delivery, cost containment, employee health and satisfaction and corporate standing.

Today, the on-site health clinic model has evolved into a primary care center that can offer a variety of services, including adult medicine, pediatrics, obstetrics and gynecology, geriatrics, specialty services, pharmacy services, physical and other therapies, lab services, wellness programs, health coaching, chiropractic, acupuncture and massage services.1 By 2015, experts expect the number of on-site health clinics to increase from approximately 2,200 to over 7,000 nationwide — serving more than 10 percent of the U.S. population under the age of 65.

The steady growth of on-site health clinics has resulted in a broad spectrum of specialized models and an abundance of knowledge around particular strategies that drive value and yield a higher return on investment. In recent times, a rising number of employers with on-site health clinics have come to the conclusion that the addition of chiropractic services helps to reach desired outcomes.

Doctors of chiropractic practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and care.

Doctors of chiropractic have unique training in general wellness and neuromusculoskeletal disorders — a leading cause of missed workdays and reduced efficiency — and are able to positively impact a more rapid returnto-work. Low back pain is documented as one of the primary reasons for visits to U.S. health care providers, according to reports by both the Mayo Clinic and Cleveland Clinic.

Mounting evidence confirms the value of including chiropractic services at on-site health clinics. Just published in the September 2014 issue of the Journal of Occupational and Environmental Medicine, a study, “Impact of Chiropractic Services at an On-Site Health Center,” co-authored by Ross M. Miller, M.D., M.P.H., medical executive, Cerner Corporation; Sylvia L. Kindermann, M.P.H, senior research associate, Cerner LifeSciences; and Qingjiang Hou, M.S., scientist/biostatistician, Cerner LifeSciences, concludes that in comparison to off-site services, on-site chiropractic services are associated with lower radiology services, less emergency department utilization, reduced utilization of physical therapy services and lessening of costs.

This study serves as a follow-up to an earlier report, “Value of Chiropractic Services at On-site Health Centers,” (Journal of Occupational and Environmental Medicine; August 2012), which found similar advancements, including lower overall health care utilization, plus improved functional status of musculoskeletal conditions, when linked with on-site chiropractic care.

Having special involvement with the latest research as a co-author of both reports, Dr. Miller states “including services that facilitate improved musculoskeletal condition management and functional status within onsite health clinics offers great potential for reduced direct and indirect costs, including absenteeism and productivity losses. Based on current evidence, the inclusion of chiropractic services at these clinics provides employers with great potential to maximize value.”

Already, chiropractic services are seamlessly integrated into the complete service offering of many on-site clinics nationwide.

Standard Process Inc., a Wisconsin-based manufacturer of whole food supplements, established its on-site health center more than a decade ago with doctors of chiropractic serving as lead providers. After years of data collection, Standard Process has transparent documentation of a healthier workforce, reduced costs of health care and improved productivity and morale.

Based on the success of its program, Standard Process launched Cultivate by Standard Process, an innovative business component that helps improve employee wellness, organizational efficiencies and the financial bottom line for employers through on-site wellness centers led by doctors of chiropractic.

According to Charlie DuBois, president, Standard Process, “We established our on-site health center to ensure happy and healthy employees.

Throughout the years, we have gathered data and documented our very positive experience. Chiropractic care has always been a core service offered and is now recognized as a chief contributor to our program’s overall success.”

As the landscape for health care continues to evolve and more employers seek methods to modernize care delivery, the on-site health clinic will gain popularity for its advantageous operation. Simultaneous to this surge in implementation, services offering the highest ROI, such as chiropractic, are expected to gain positioning as a core component and, in some cases, the lead contribution.

To learn more about chiropractic services and on-site health centers, visit www.yes2chiropractic.org.

1 Boress, Larry S. The Landscape of Onsite Health Centers: Results of the 2014 NAWHC Benchmarking Survey of Employer-Sponsored Onsite and Near-Site Health Centers. Survey. 10 September 2014.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

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When you stop by, be sure to register to win our Wellness Basket, which includes a Withings Smart Body Analyzer Scale, Fitbit Flex Wireless Activity + Sleep Wristband, LG Electronics Tone+ Bluetooth Headset, Blue Apron Gift Certificate, and healthy snacks.

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November/December 2014

Exchange

out Innovative Health and Benefit Mar etplaces

The Other Pieces Examining How Private Exchange Adoption Will Affect Other Areas of Health and Benefits Survey: What do employees think about private exchanges?

Exchange Profile: GoHealth The Official Magazine of

www.theihcc.com

Projections from organizations like Accenture and Oliver Wyman suggest that 35 to 75 million Americans will receive their employee benefits via a private exchange within the next few years. Are you ready to make the transition?

With PrivateHealthCareEXCHANGES.com, The Institute for HealthCare Consumerism has aggregated 160+ private exchange solutions to create the industry’s premier guide to help you — employers, health plans, brokers, advisors and consumers — to navigate this sea of change in employee benefits.

The Only Online Guide Where Employers, Health Plans, Brokers and Consultants Can Navigate Private Exchange and Defined Contribution Markets Solutions and Models

Access the Complete Database for $99!

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INSIDE

FEATURE 12 The Other Pieces: Examining How Private Exchange Adoption Will Affect Other Areas of Health and Benefits Private exchange adoption is growing and will inevitably play a major role in realigning some other aspects of employersponsored health and benefits. Furthermore, the integration of other tools and services – such as transparency, telehealth, disease management – may actually be crucial for employers to maximize cost savings in private exchanges and for the exchanges themselves to deliver on promised results.

By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism

7 Exchange Profile Building a Better Shopping Experience In 2014, more than 7.3 million consumers enrolled in public exchange health plans. The Congressional Budget Office estimates that the number of Americans without health insurance will decline by another seven percent this year. And by 2018, Accenture projects that private exchange enrollments will reach 40 million. It’s clear that consumers want health insurance, and more than that, they want an enrollment process that’s efficient and customized.

By Scott Sullivan, Senior Vice President of Sales & Business Development, GoHealth

9 Stats & Data What Do Employers and Employees Really Think About Private Exchanges?

Periodically, we reach out to the employers and employees using our

DEPARTMENTS

Bright Choices® and other Liazonpowered private exchanges to find out what they think about the experience.

We do this not only so that we can continue to provide best-in-class products and service for our clients, but also so we can help the industry learn more about what’s really going on in the private exchange space.

Here are some of the exclusive insights we’ve uncovered in our 2014 Employer and Employee Survey.

By Alan Cohen, Co-Founder and Chief Strategy Officer, Liazon

“private exchange” label. So, how do employers properly evaluate all these exchanges? And what is the importance of looking at the different options available?

By Michael A. Martocci & Jennifer E. Jones, KTP Advisors

4

Publisher’s Letter CEO and Publisher Doug Field covers the latest trends in private exchanges and shares what’s happening at The Institute for HealthCare Consumerism around exchanges.

11 Private Exchange Evaluation Private Exchanges: Do You Really Know All the Questions to Ask? The private health insurance exchange market is very complex, and each exchange or marketplace is different. In fact, many employers remain largely unaware of the variety of solutions available today under the

5

Briefs & Innovations Keeping you up-to-date with the latest news, research and innovation in health insurance exchanges (both public and private) and defined contribution.

HealthCare Exchange Solutions™ I www.TheIHCC.com I November/December 2014

3

PUBLISHER

Exchange www.theihcc.com VOLUME 10 NO. 6 | NOVEMBER/DECEMBER 2014

Private Exchanges: A Year in Review

Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Tel: 404.671.9551 • Fax: 770.663.4409 CEO

With all of the speculation, doubt and, ultimately, success, it has been an exciting year to follow the emerging private health insurance exchange market. And with the landmark acquisitions, significant capital investments and accelerating enrollment numbers, private exchanges are set for

Doug Field 404.671.9551 ext. 101 · dfield@ theihcc.com MANAGING DIRECTOR

Brent Macy 404.671.9551 ext. 103 · bmacy@theihcc.com CHIEF MARKETING OFFICER

strong growth once again in 2015. Yet, like a pendulum, various industry experts have gone back

Andrew Dietz adietz@theihcc.com

and forth with projections that private exchanges won’t live up to the hype or that they are the future

MANAGING EDITOR

of employee benefits.

Jonathan Field 404.671.9551 • jfield@theihcc.com SENIOR EDITOR

However, there has been one significant, unarguable change in the past year: employers have shifted from asking “what is a private exchange?” to asking the specific questions to evaluate which private exchange will fit their organizations’ strategies. And by asking the tough questions about the capabilities of each private exchange model, employers are once again driving the innovation.

Private exchanges that cannot deliver on the promises will fall by the wayside while exchanges that listen to employers’ needs will prosper.

To further help employers and other stakeholders in employer-sponsored health insurance better understand this emerging model, The Institute for HealthCare Consumerism will continue its leading coverage of this space into the new year. In addition to the research, blog posts and in-depth articles provided by PrivateHealthCareEXCHANGES.com and HealthCare Exchange Solutions magazine, we will be launching our inaugural private exchange conference, Private Exchange FORUM & Expo, this March in Dallas.

Heather Loveridge hloveridge@theihcc.com ART DIRECTOR

Kellie Frissell 404.671.9551 ext. 107 · kfrissell@fieldmedia.com ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS

Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD

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

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

Tim Hemendinger timh@fieldmedia.com DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS

Rogers Beasley 404.671.9551 ext 109 · rbeasley@fieldmedia.com

With this new conference, we will be providing attendees with a complete overview of private

ACCOUNT MANAGERS

exchanges, including the different models, how voluntary benefits and health accounts fit, health

Michelle Gatehouse 404.405.3007 • mgatehouse@theihcc.com

plans’ and brokerage firms’ strategies, perspectives from employers that have implemented a

Ted Arvan 678.296.1906 • tarvan@theihcc.com

private exchange and much more. With rates starting at just $99 through the end of January, we hope to see you there. For more information, visit PrivateExchangeFORUM.com.

PARTNERS/ALLIANCES

Joni Lipson 800.546.3750 · jlipson@fieldmedia.com BUSINESS MANAGER

Sincerely,

Karen Raudabaugh 404.671.9551 ext. 108 · kraudabaugh@fieldmedia.com HealthCare Exchange Solutions™ Volume 10 Issue 6 Copyright ©2014 by FieldMedia LLC. All rights reserved.

HealthCare Exchange Solutions™ is a trademark of FieldMedia LLC. HealthCare Consumerism Solutions™ is published eight times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009. Periodical postage paid at Alpharetta, GA and additional mailing offices.

Doug Field CEO/Publisher dfield@fieldmedia.com

TO SUBSCRIBE: Make checks and money orders payable to HealthCare Exchange Solutions ™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA 30009 or visit www.theihcc.com. Non-qualified persons may subscribe at the following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or subscriberservice@fieldmedia.com for name/address changes.

PRINTED IN THE U.S.A. HealthCare Exchange Solutions™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher is not engaged in rendering legal, financial or other professional service. If legal advice is required, the services of a professional adviser should be sought.

The magazine is not responsible for unsolicited manuscripts or photographs.

Send letters to the editor and editorial inquiries to the above address or to jfield@fieldmedia.com. Permission to reuse content should be sent to, jfield@ fieldmedia.com.

4

November/December 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

NEWS BRIEFS & INNOVATIONS

NEWS BRIEFS Benaissance and Array Health Partner for New Private Exchange Solution Benaissance and Array Health have announced a partnership to integrate their insurance exchange solutions. Through this partnership, the Array Spectrum™ private exchange solution will include the Benaissance ExchangePoint platform for billing, payment collection and premium remittance processing. The combined solution will give consumers the streamlined and intuitive shopping and enrollment experience they want, while offering employers and insurers the advanced billing functionality they need.

The Array Spectrum™ solution enables health plans to deliver their own branded online exchange.

KTP Advisors Establishes Performance Standards to Evaluate Private Exchanges There are at least 170 private exchanges today, and almost every private exchange is different, leaving many employers unaware of the solutions available to them. KTP Advisors — a specialty advisory firm on retiree health benefits, private exchanges and pharmacy benefit management for active employees — believes it has a solution to that problem. The firm has launched the first unbiased, completely independent evaluation and comparative data service of private exchanges for employers, trade associations and insurance brokers who don’t have the time to shop through different private exchange solutions. The firm has assembled nearly 75 key performance characteristics on financial information, product offerings, technology and data security, consumer support, customer service and more.

Maestro Appoints Two Health Care Leaders to Its Board of Directors Maestro, an emerging industry leader in health exchange technology and service, recently announced the appointment of Robert Natt and Peter Hudson to the Board of Directors. With over 50 years of executive leadership experience in health care, Natt and Dr. Hudson have led prominent health care organizations in successfully bringing innovative technology and service solutions to employers and consumers. Over the past 20 years, Natt has successfully led the growth and sale of several leading health care companies. Currently serving as executive chairman of Alegeus, Natt also served as CEO of PayFlex until presiding over its successful sale to Aetna in 2011.

PlanSource Powers Tremendous Growth of Digital Benefits Marketplace PlanSource recently announced it is powering Digital Benefits Marketplace, a private exchange from Digital Benefits Advisors. DBA introduced Digital Benefits Marketplace in 2013 to help businesses address the rising costs of health benefits. Digital Benefits Marketplace enables employers to fix costs through defined contributions and offers more choices for their employees. Employees can choose their own benefits based on their personal needs. Digital Benefits Marketplace began its national rollout last October, starting in North Carolina, Virginia, Georgia, Tennessee, Florida and California. The marketplace has received an overwhelmingly positive response from participating employers and employees for its variety of options and ease of use.

Access Health CT Launches First Online Avatar to Help Consumers Enroll Access Health CT (AHCT) is the first state-based health exchange to launch an online avatar to help consumers through the process of comparing plans and shopping for quality, affordable health care coverage. Named “Tina,” this virtual assistant offers guidance and answers to consumer questions on the AHCT website. AHCT worked with CodeBaby, a global customer engagement and leading intelligent virtual assistant technology provider, to develop and launch Tina. Her guidance is available in 120 different places on the AHCT website in both English and Spanish.

Aetna to Acquire Insurance Exchange Technology Provider bswift Aetna announced that it has entered into an agreement to acquire privately held bswift, which provides a technology platform that offers a retail shopping experience for health insurance exchanges and employers nationwide. Additionally, bswift offers benefits administration technology and services to employers. The purchase price is approximately $400 million, which Aetna expects to finance with available resources. The transaction is subject to customary closing conditions, including HartScott-Rodino antitrust regulatory approval. The acquisition is expected to close before the end of the year. As financed, the transaction is expected to be neutral to 2014 and 2015 operating earnings per share.

BCBS of Michigan: Private Exchanges Lowering Employer Costs, Changing Employee Enrollment Behavior According to an analysis of GlidePath, Blue Cross Blue Shield of Michigan’s private exchange, employers and employees are benefiting from use of the private exchange by empowering employees as informed consumers of health care. The analysis showed GlidePath increased employee cost awareness, encouraged employees to make effective cost choices to meet their needs and strengthened knowledge and adoption of HSAs. Employers using GlidePath set a defined contribution amount and their employees use those funds to actively shop online to select a health plan using the exchange.

NFP Marketplace Expands Health Insurance Options NFP, a leading insurance broker and consultant that provides employee benefits, property & casualty, retirement and individual insurance and wealth management solutions, recently announced the expansion of NFP Marketplace, a private exchange designed to manage costs for employers and offer competitive benefit options for employees. Through new partnerships with GetInsured and HealthPlanOne, NFP Marketplace now enables employers to offer affordable health insurance options to retirees, COBRA-eligible individuals and employees who do not qualify for sponsored plans.

PlanSource Announces the Launch of the True Choice Private Marketplace PlanSource announced the launch of the True Choice Private Marketplace, an advanced private exchange for California employers formed through a partnership with leading brokers The Centennial, Bolton & Company and Sequoia. As the adoption of private exchanges continues to gain momentum, far-sighted brokers are designing their own marketplace offerings to address the needs of small and midsized employers.

HealthCare Exchange Solutions™ I www.TheIHCC.com I November/December 2014

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H E A LT H

CONNECTING

W ITH

WELLNESS A Mobile Option for Private Exchanges Onlife Health’s configurable AlwaysOn™ mobile platform allows members to easily improve their health and stay inspired anytime, anywhere.

On-the-go features such as:

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PRIVATE EXCHANGE PROFILE

Building a Better Shopping Experience

BY SCOTT SULLIVAN » SENIOR VICE PRESIDENT OF SALES & BUSINESS DEVELOPMENT » GOHEALTH

In 2014, more than 7.3 million consumers enrolled in public exchange health plans.

The Congressional Budget Office estimates that the number of Americans without health insurance will decline by another seven percent this year. And by 2018, Accenture projects that private exchange enrollments will reach 40 million. It’s clear that consumers want health insurance, and more than that, they want an enrollment process that’s efficient and customized.

According to a recent Gallup poll, half of uninsured Americans would prefer to get health insurance through an exchange. With so many options available to them, how will they choose where to go for coverage? It’s simple: They will look for a seamless experience, one that allows them to obtain the coverage they need quickly and easily.

As a private exchange with features unique to the industry, GoHealth enrolls consumers in a proficient manner. Taking the experience one step further, GoHealth puts the power of choice in the hands of consumers.

A Customized Experience Finding the right health insurance plan can be confusing, especially for those who have never had coverage. But with GoHealth, consumers can enroll either online without going anywhere else, or over the phone with the help of a licensed insurance advisor. GoHealth’s licensed insurance advisors are standing by to recommend specific health plans based on consumers’ budgets and needs, as well as to answer any health insurance-related questions. These licensed insurance advisors bring clarity to an often confusing enrollment process.

GoHealth’s enrollment platform can also estimate consumers’ tax subsidy eligibility. In fact, GoHealth became the first private exchange to connect with the Federally Facilitated Marketplace (FFM), enabling the company to sell subsidized health insurance plans under the Affordable Care Act. This integration is key because most people who shop for individual or family health insurance during open enrollment are eligible for tax subsidies that make health insurance more affordable. With subsidies, the average monthly premium payment during the last open enrollment period was only $69 per month, according to the Department of Health and Human Services.

In addition to offering subsidized health insurance, GoHealth offers all of the same health plans as the FFM — plus off-exchange and ancillary plans — all on one platform. GoHealth’s private exchange offers plan options from more than 300 health insurance carriers from across the country. GoHealth is focused on giving consumers options to ensure that they find the plan that’s right for them.

Adapting to Consumer Expectations GoHealth is always looking to improve the overall experience for consumers. For 2015 coverage, the private exchange focused on improving the enrollment process. GoHealth selected enrollment questions that were most important in finding consumers the right coverage, and the private exchange was able to reduce its application from 30 pages to less than five. Additionally, GoHealth’s updated software now automatically recommends the best health plan choices, rather than relying on agents to sort through as many as 100 plans to make suggestions.

An option that’s becoming more popular for employers and their employees is the defined contribution model. Defined contribution allows employers to provide a predetermined amount of pre-tax dollars to their employees for health insurance spending. This model is shifting the power of decision making to the consumer, and with more and more employers choosing this option, employees need somewhere to go to enroll in coverage. Individuals can take their employers’ defined contribution and enroll in coverage through GoHealth. This allows these individuals to make thoughtful health insurance decisions based on their specific needs and situations with the assistance of a licensed insurance advisor.

The Future of GoHealth As a result of the Affordable Care Act, the health insurance industry — and more specifically, private exchanges — will continue to evolve for years to come. GoHealth realizes the importance of adjusting and updating its enrollment experience as consumers’ expectations shift.

It will continue to simplify an otherwise complicated process, thanks to its technology, licensed insurance advisors and the customized experience that these individuals can provide to consumers. Purchasing health insurance is an important and necessary commitment, and GoHealth will ensure that it remains a top exchange choice for its current customers and for the 13 percent of Americans who remain uninsured.

HealthCare Exchange Solutions™ I www.TheIHCC.com I November/December 2014

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STATS & DATA

BY ALAN COHEN CO-FOUNDER AND CHIEF STRATEGY OFFICER LIAZON

P

What Do Employers and Employees Really Think About Private Exchanges?

eriodically, we reach out to the employers and employees using our Bright Choices® and other Liazon-powered private exchanges to find out what they think about the experience.

We do this not only so that we can continue to provide best-in-class products and service for our clients, but also so we can help the industry learn more about what’s really going on in the private exchange space. Here are some of the exclusive insights we’ve uncovered in our 2014 Employer and Employee Survey.

Employees Value Choice When it comes to employees choosing benefits for themselves, not only has our research found that they are willing and able to make these decisions, but they also prefer to do so.

Only two percent of the employees we surveyed indicated they’d prefer to let their employer choose for them, what we like to call, “the status quo.” Clearly, consumers are ready for private exchanges; they want to be in the driver’s seat when it comes to making the big decisions that affect their lives.

But that’s only part of the story. Consumers need education to help guide them to make the right choices for themselves and their family. Conventional wisdom may suggest that given the opportunity, employees will simply go with the cheapest plans available. But our research found that there are several reasons employees choose the benefits they do on our exchanges. t More than half say they select what provides the right coverage for them (52 percent in our survey). t Some choose products that were similar to what they had in the past (24 percent in our survey). t According to our survey, only 18 percent choose their benefits because they had the lowest costs.

There were also many other interesting findings from both the employers, as well as the employees, we surveyed who are using a Liazon-powered exchange:

t t

t

83 percent of employers reported that their exchange has helped them control benefits costs.

90 percent of employees were satisfied with the number of choices available on their exchange or wanted even more; in fact, 24 percent said there can never be too many choices.

79 percent of employees expressed satisfaction with the shopping and enrollment experience overall.

Our survey also looked at how employee engagement with private exchanges changes over time.

Is there a learning curve when it comes to private exchanges?

Anything new takes a bit of adjustment on the part of its users.

Heck, remember your first smartphone? So we decided to look specifically at how second-year employees feel about choosing their benefits through our exchanges, compared to first-year employees.

Employees are more comfortable with using a private exchange in their second year and beyond. Second-year employees are more likely to understand how much their employers care about their wellbeing (26 percent in our survey were more likely to indicate that they appreciate their company’s contribution to their benefits). They are becoming more engaged in their health care decisions overall and better understand what their benefits cover.

Private exchange adoption is still relatively new, but we’re confident that with early findings like these, more and more employees will react favorably to their employer’s decision to offer benefits through a private exchange. Employees are ready, paving the way for more employers to respond.

Founded in 200 , Liazon Corporation operates the industry-leading private benefits exchange for businesses. Its agship product, the Bright Choices Exchange, helps employers manage their health care costs by setting predictable budgets through a defined contribution funding strategy while guiding employees to purchase better coverage of health, dental, vision, life, disability and other benefits. Liazon was ac uired by Towers Watson, a leading global professional services company, in November 201 . Read more articles by Alan Cohen and other industry experts at the Liazon blog.

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PRIVATE EXCHANGE EVALUATION

BY MICHAEL A. MARTOCCI & JENNIFER E. JONES KTP ADVISORS

Private Exchanges:

T

Do You Really Know All the Questions to Ask?

he private health insurance exchange market is very complex, and each exchange or marketplace is different. In fact, many employers remain largely unaware of the variety of solutions available today under the “private exchange” label. So, how do employers properly evaluate all these exchanges? And what is the importance of looking at the different options available?

Brokers, carriers, technology vendors, associations and employer groups will all approach the private exchange marketplace with a wide variety of objectives and goals. In order to properly evaluate which exchange or marketplace is best for them, there are a number of questions that need to be addressed as private exchanges vary from the most basic level to differences that are more complex.

Basic questions about an exchange may include: 1. Does the exchange target Medicare retirees, non-Medicare retirees or active employees?

2. Is the exchange single-carrier or multi-carrier?

3. What carriers and products are available?

4. What decision-support tools are available to help consumers make the right decisions?

While the above characteristics are important and worth evaluating, there are even more complex considerations that need to be addressed before choosing an exchange to deliver employee benefits. Those considering utilizing an exchange or marketplace should also ask: 1. Who owns the exchange technology platform?

2. How is the exchange compensated for benefit delivery and technology solutions?

3. Who chooses the carriers and products placed on the exchange, and how do they negotiate product pricing and underwriting?

4. Is the exchange designed to increase competitiveness among its insurance carrier partners for the benefit of the consumer?

5. Is there a limited number of carriers on the exchange, or can any carrier be offered on the exchange?

The goal of private exchanges is to provide consumers access to quality care at a lower cost and to help individuals better understand their health care options. It is of great importance to supply the consumer with a wide variety of choice while providing guidance in the form of easy-to-use decision-support tools. One feature that makes a private exchange successful is allowing a health care consumer to shop from a wide variety of major medical health insurance and specialty products with varying plan designs. However, some exchanges are “single-carrier” driven or limited carrier models. Is that enough choice to drive down cost to the consumer? Time will tell.

Another factor to consider is who owns the exchange technology platform. Every day there seems to be an announcement for another

new private exchange. Brokerage firms, consulting practices, health plans, associations and other organizations are creating and launching private exchange solutions for their members and clients. As of November 2014, there are at least 175 private exchanges announced or launched in the U.S. market. While most private exchanges are relatively new, a trend of carriers and brokers buying exchange technology companies can already be seen. Others are simply whitelabeling another technology company’s product.

So the question remains: is the exchange you are considering a technology company or a marketplace offered by a broker, consultant, association or health plan?

The business relationships that exchanges will have with their constituents/customers in the open market (carriers, brokers, employers, associations, etc.) may very well be successful for all.

However, when choosing an exchange solution, this is something employers may want to consider.

With the increased popularity of health care exchange utilization — both private and government run — it is important to address the issue of security and compliance to protect sensitive data, as the opportunities for error or threat continue to grow. While individuals browse the exchange platforms, personal information such as names, Social Security numbers and dates of birth could be compromised. A “one-stop shopping experience” — including the interaction and intertwined relationships between providers, payers, employees, patients and partners that many private exchanges boast — requires additional security measures.

Other questions employers should consider when evaluating private exchanges include: 1. What technology platform does the exchange operate on, and is that platform susceptible to hackers?

2. Does the exchange have programmers and IT engineers on staff to manage security, or is it outsourced to a software technology vendor?

3. Do the exchange’s security measures comply with — and exceed — current federal and state guidelines for protecting protected health information (as defined by HIPAA)?

4. What are the exchange’s security procedures if there is a security breach?

When vetting and evaluating private exchanges, everyone needs to cover all of the bases. To properly evaluate all the players in the private health insurance exchange market, it is important to get an independent perspective and know the right questions to ask. At KTP, our goal is to provide a completely unbiased, objective and far-reaching evaluation as clients (employer groups, brokers, consultants, insurance carriers, associations, health plans and others) consider private exchanges.

HealthCare Exchange Solutions™ I www.TheIHCC.com I November/December 2014

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THE OTHER PIECES Examining How Private Exchange Adoption Will Affect Other Areas of Health and Benefits

BY JONATHAN FIELD » MANAGING EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM

The second annual study by the Private Exchange Evaluation Collaborative (PEEC), published in December 2014, found that employers are committed to providing health benefits to employees and that private exchanges will be a likely mechanism to do so in the coming years.

According to the report, over 40 percent of all employers may implement a private exchange for active employees by 2018.

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The Other Pieces: Examining How Private Exchange Adoption Will Affect Other Areas of Health and Benefits

D

espite reports on the lack of new “blue chip” clients during 2014’s open enrollment season and outlying studies that conflated implementing a private exchange with no longer sponsoring employees’ health insurance, as a whole, employers have become considerably more interested in the private exchange model in the past year.

This can be seen quite clearly in the evolution of the due diligence questions that HR and benefits leaders have been asking regarding private exchanges. Going back even as recently to 2013, many industry leaders did not yet understand the basics of private exchanges. The question for many was “what is a private exchange?”

However, over the past year, HR and benefits professionals have become demonstrably more knowledgeable on the variety of private exchange solutions. Employers are now asking questions focusing on the components and models of private exchanges and how these different models can help them meet varying organizational goals.

This is a positive sign for the private exchange market, and ultimately, it will push exchange technology providers to continue innovating.

Thinking holistically, many HR and benefits leaders have also begun asking how existing products and services can integrate with a private exchange platform. Simply moving to a private exchange may not be enough to result in significant cost savings for an employer, and the integration of other tools and services — such as transparency, telehealth and population health management — may be crucial for exchanges to deliver on promises of cost savings.

Private exchanges can be much more than just an enrollment platform with a few more options than a company’s previous benefits offerings. This can already be seen through the multitude of unique partnerships announced over the past year between exchange technology providers and other forwardthinking solutions.

Right now, the private exchange industry is in its early stages. Over time, these platforms will continue to expand their capabilities to better meet the needs of health care consumers.

In this article, we’ll explore some possible areas of integration into private exchange platforms and look at areas that are already being bolstered by early private exchange adoption.

Mobile Health Platforms Mobile devices are now the focal point of consumers’ lives, where they manage finances, connect with friends and colleagues, make dinner reservations and book travel. This is especially the case in the increasingly important Millennial demographic that will be so crucial for private exchange adoption.

In health care, mobile technologies are growing quickly. By the end of decade, the global mHealth market is expected to hit almost $50 billion, according to research published by San Francisco-based market analysis and consulting firm Grand View Research.

Private exchanges that wish to encourage year-round engagement 14

November/December 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™

from users will need to provide users with a seamless mobile experience.

Technology companies, such as Benefitfocus, bswift (now a subsidiary of Aetna) and Maxwell Health, have made the mobile user experience crucial to their private exchange offerings.

Whether a private exchange solution provides users a quality app should be top question for employers when conducting due diligence of private exchange vendors, particularly in workforces that skew younger.

By offering employees an engaging mobile experience, HR and benefits leaders can change the dynamic between employees and benefits enrollment. Employees can make their selections on their own time without the trepidation and rushed decisions often associated with benefits enrollment, and this relatively simple technology offering will go a long way toward increasing employee engagement in health care.

Voluntary Benefits The prognosis looks good so far for voluntary benefits in the private exchange arena.

Private exchanges have opened a new channel for the sales of voluntary benefits with an entirely new set of rules, and insurers and brokers are already seeing increased sales as a result.

Some industry experts have gone so far as saying that the term “voluntary benefits” takes on a whole new meaning in an exchange environment. In a private exchange with sufficient product offerings and robust decision-support tools, consumers are seeing an unprecedented level of choice.

Seeing the opportunities created by voluntary benefits in these cloudbased marketplaces, Aon Hewitt, Bloom Health and other key exchange operators have added full suites of voluntary products to their exchanges within the past year.

In August 2014, Aon Hewitt announced that critical illness, accident and hospital indemnity insurance — as well as life insurance and long-term disability coverage — would be available in the Aon Hewitt Active Health Exchange.

In June 2014, Bloom Health added a full array of “specialty offerings” — e.g. dental, life, long-term disability, short-term disability, critical illness, accident and hospital indemnity insurance solutions — to its Private Exchange Platform®.

The addition of a full slate of voluntary benefits offerings in an exchange platform creates benefits that are two-fold. Exchange operators (and/or brokers) will increase revenues while user satisfaction will generally go up.

Many employees will be pleased to be offered unique voluntary benefits — such as, pet insurance or identity theft services at a small cost each paycheck (or no cost, depending on the level of defined contribution funding). Provided with sufficient decision-support tools that help them “rightsize” their major medical plan, many employees will find that they have additional funds to purchase these products that can improve their overall well-being.

Employers that previously did not offer dental or vision plans, for example, may find that many employees can now obtain this coverage at no cost after selecting a lower premium plan in a defined contribution arrangement. In some cases, employers will be able to increase the array of benefits offered at no additional costs to them.

Price and Quality Transparency While private exchanges may be able to reduce employer health costs by providing a fixed defined contribution (aligned with CPI and not medical inflation) or through employees naturally selecting lower premium, higher deductible coverage, there may be a significant opportunity for price and

quality transparency tools to be embedded within private exchanges.

In November 2014, Buck Consultants at Xerox announced that they had established a partnership with Castlight Health to incorporate the San Francisco-based company’s transparency and engagement tools into the RightOpt private exchange. And it’s likely that more mature private exchanges will move to incorporate similar tools that improve the postenrollment experience.

As more and more consumers selecting high deductible health plans within private exchanges, price and quality transparency tools — such as FAIR Health, Wiser Together, ConsumerMedical or the aforementioned Castlight — would be very beneficial to employees and could potentially eliminate them incurring a considerable amount of out-of-pocket costs.

By incorporating tools that help consumers find the highest quality care and the best price, private exchanges could potentially go a long way toward reducing health costs for employer clients while improving the user experience post-enrollment.

Telehealth Platforms Telehealth is set for huge growth in 2015 and beyond.

Once seen, perhaps, as a technology that wouldn’t endear itself to the average consumer, telehealth is now entering the mainstream. Like many new technologies, it has taken time and word-of-mouth recommendations to work itself in with the average consumer. Now, the technology is poised to go beyond the early adopters and into the lives of the average American.

A smart next step would be the integration of a telehealth portal into a private exchange platform. Maxwell Health, a visionary in the integration of other key technology solutions into its private exchange platform, announced a partnership in 2014 with Doctor on Demand. This revolutionary partnership allows employees to purchase insurance and receive care in the same technology platform and should be a model for other cutting-edge exchanges to follow.

With the integration that we’re seeing at this point between private exchanges and telehealth solutions, there maybe future opportunities with private exchanges and other health access alternatives.

Earlier this year, Aetna’s new $400M acquisition bswift announced integration with a wellness vacation company. As stress management becomes an increasingly important topic of discussion for corporate leaders, members of bswift’s Springboard Marketplace can now book wellness vacations that include guidance from physicians, nutritionists, life management experts and exercise physiologists.

In this line of thinking, there may be future opportunities for more advanced private exchanges to integrate with medical travel companies, allowing exchange users to arrange lower cost operations at domestically or internationally renowned medical centers.

Regardless, as private exchanges mature, there will be more and more opportunities for the cloud-based platforms to incorporate health care access alternatives.

A New Retail Environment Provides Plentiful Opportunities Private exchanges can be much more than just an enrollment platform with a few more options than a company’s previous benefits offerings. This can already be seen through the multitude of unique partnerships announced over the past year between exchange technology providers and other forward-thinking solutions.

Today, it’s important to remember that we’re only in the very beginning of the evolution of private exchanges. As private exchanges mature to meet the needs of employers and employees, they will continue to expand, adding more avenues to save employers money while increasing benefits satisfaction among the employee population.

FOLLOW THE MONEY:

A Timeline of Investments, IPOs and Acquisitions in the Private Exchange Market

2010

JANUARY Minneapolis-based Bloom Health receives $2 million in funding DECEMBER Bloom Health lands an additional $5 million from BCBS Ventures

2011

APRIL Liazon secures almost $13 million from Bain Capital Ventures and others SEPTEMBER Bloom Health sells majority stake to major health insurers

2012

FEBRUARY PlanSource receives a $12 million Series A investment led by Lemhi Ventures APRIL Liazon receives additional $18.2 million from two firms MAY Towers Watson acquires Extend Health to create Exchange Solutions segment JUNE Chicago’s GoHealth takes on $50 million equity investment from Norwest Equity Partners

2013

APRIL Alegeus Technologies acquires Workable Solutions for undisclosed amount AUGUST Boston and New York’s Maxwell Health gets initial $2 million funding SEPTEMBER Benefitfocus raises $70.6 million from IPO NOVEMBER Towers Watson acquires Liazon for $215 million DECEMBER Maxwell Health nets $6 million in Series A1 financing

2014

JANUARY Lehmi Ventures invests an additional $12 million in PlanSource APRIL Great Hill Partners acquires minority stake in bswift for $51 million APRIL hCentive raises $35 million from undisclosed strategic investor SEPTEMBER Seattle’s Array Health closes $13 million round SEPTEMBER Maestro Health acquires Florida-based Workable Solutions from Alegeus OCTOBER Connecture plans IPO and expects to raise roughly $80 million NOVEMBER Aetna announces $400 million agreement to purchase bswift DECEMBER Maxwell Health secures $26.4 million in Series B

HealthCare Exchange Solutions™ I www.TheIHCC.com I November/December 2014

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BY TYE ELLIOTT VICE PRESIDENT OF CORE BROKER SALES AFLAC

VOLUNTARY BENEFITS

Employees Waste A Lot of Money

by Making Open Enrollment Errors

W

hat would you do if someone handed you $750 out of the blue?

Like most people, you’d probably be pretty excited about the windfall — and about the ways to spend it. After all, $750 isn’t chump change. With that amount of money, you could: • Buy a 64-gigabyte iPhone 6 outright for $749.

• Buy two premium tickets for the “So You Think You Can Dance” live tour for $290 and pay for several months of samba lessons.

• Prepare for the first NCAA college football playoffs by purchasing a new big-screen television for $700 and still have $50 left over for snacks.

No matter what a person’s interest or need, $750 can go a long way. According to the 2014 A ac WorkForces Report, it’s also the dollar amount 42 percent of employees waste each year by making mistakes while selecting their insurance benefits options.1 That’s a shame, since 76 percent of workers are living paycheck to paycheck, which makes wasting $750 per year even more painful.2 The truth is that many Americans are just scraping by as cautious employers continue to put the brakes on raises and bonuses, and consumer prices continue to rise. There seems to be no escape from financial pressure — even at work, where companies continue to shift more responsibility for health insurance costs to their employees.

According to the Aflac study, 49 percent of American workers have $1,000 or less on hand to pay out-of-pocket medical costs associated with an unexpected serious illness or injury. What’s more, 53 percent would have to borrow from a 401(k) and/or use a credit card to cover unexpected out-of-pocket medical costs.

The Value of Voluntary Insurance to Employees and Companies Instead of wasting money during open enrollment, savvy employees should carefully examine the voluntary insurance options their companies make available and consider how those options can help provide increased financial security.

Voluntary insurance is more important than ever in today’s financial climate: The benefits can be used in any way a policyholder sees fit — whether it’s to help pay out-of-pocket medical expenses that major medical policies don’t cover or to help pay the bills that keep rolling in when a breadwinner is sick or hurt and cannot work.

Companies also benefit by offering voluntary insurance options to workers. If helping their employees become better prepared for financial challenges isn’t enough motivation, they should consider that voluntary choices can help make a company more appealing to current workers and new applicants alike. Top-tier organizations — including those named by

Voluntary insurance is more critical than ever to a complete benefits package because of the changes in how major medical insurance is purchased and delivered in the U.S. Voluntary options benefit cash-strapped employees, and for companies, they re simply smart business. employees as The Best Places to Work in Fortune magazine’s annual survey — offer their workers a wide array of benefits options, perhaps because: • The financial safety net provided by voluntary insurance helps employees keep their minds on their jobs and not on money concerns.

• Voluntary insurance pays cash benefits regardless of any other insurance coverage employees have in place, including policies available through government health care exchanges.

• Employees who are offered and enrolled in voluntary insurance plans feel more empowered at work, report increased job satisfaction and believe they’re more financially prepared to cope with unexpected medical expenses.1 • Some companies that offer voluntary accident or disability insurance options report a corresponding decline in workers’ compensation claims.3 The bottom line? Voluntary insurance is more critical than ever to a complete benefits package because of the changes in how major medical insurance is purchased and delivered in the U.S. Voluntary options benefit cash-strapped employees, and for companies, they’re simply smart business.

Tye Elliott, a 20-year insurance industry veteran, is Aflac’s vice president of Core Broker Sales.

He is responsible for managing and implementing strategic sales initiatives for the Core broker sales division across the United States. Visit aflac.com/brokers, call 888-861-0251 or send an email to brokerrelations@aflac.com to learn more.

2014 Aflac WorkForces Report, conducted in January 2014 by Research Now on behalf of Aflac, accessed Sept. 23, 2014 – www.aflacworkforcesreport.com 1

CNN Money, “75 percent of Americans are living paycheck to paycheck,” accessed Sept. 23, 2014 - http://money.cnn.com/2013/06/24/pf/emergency-savings/ 2

“Impact of Voluntary Accident Insurance and Voluntary Disability Insurance on Workers’ Compensation Claims and Worker Absenteeism Study,” conducted in July 2014 by Research Now for Aflac 3

This article is for informational purposes only and is not intended to be a solicitation.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

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DIRECT PAY ONLINE MARKETS: The Next step in the Retailization of Health Care

BY HEATHER LOVERIDGE » SENIOR EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM

W

hile most of us would never frequent a restaurant that didn’t list prices but instead kept patrons guessing until they received a bill a month later, that’s exactly what happens in health care.

The true costs of services are tightly held secrets.

For many years, consumers have been left in the dark, but, as the health care market has shifted, that shift has allowed transparency to gain a bigger foothold.

A major part of transparency? The direct pay market. While direct pay is nothing new (one hundred years ago, doctors were paid in cash and sometimes food, or chickens or other agreed-upon barters) one of today’s methods certainly is — the online marketplace.

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WE’D REALLY CLICK

YOUR PLAN

BETTER HEALTH CARE

OUR TOOLS

Give your members a custom healthcare experience that shows you care while empowering them with online wellness tools they can access anytime, anywhere.

After all, 44% of people surveyed said they prefer an online wellness solution provided

by WebMD over any other option.* Wellness Works Better for Health Plans with

www.webmdhealthservices.com *Source: 2014 Blue Research® Study When shown a selection of brands that could offer an online wellness solution, 44% of eligible end users indicate that WebMD Health Services is the brand that would most entice them.

Realizing the need, technology companies have entered the health care space, focusing on enabling direct pay health care through online marketplaces.

In 2012, Randy Cox started Pricing Healthcare, a completely open, independent, online marketplace for direct pay health care after one of his family’s physicians raised rates on regular medical costs.

‘When rates go up and you want to compare prices but can’t find anything, you realize there’s a need,” Cox said. “I started the company to provide Americans with the ability to lower their costs by finding prices online. It’s blossomed from there.”

At first, health care facilities weren’t very interested in publishing prices. But Cox has seen a significant change in their outlook.

“In the last year-and-a-half, facilities have become very interested in getting the word out, branding themselves, publishing some of their prices,” he said.

“I think many things over the last five to 10 years have contributed to the shift. Certainly providers have a lot of administrative overhead and many regulatory restrictions, and insurers are becoming increasingly invasive.

“Providers see that there’s a real benefit to their business. They get paid upfront, and there’s much less overhead. In addition, employers are

starting to move toward direct pay as a way for them to cut costs. It’s a win/win for both.”

Creating Engaged Consumers Like Pricing Healthcare, SpendWell is also meeting a need among consumers. A national marketplace where employees on high deductible health plans can buy care directly from providers, SpendWell is a wholly owned subsidiary of Cambia Health Solutions.

“Prices go down and quality goes up when consumers have clear and known pricing,” said Marcee Chmait, president of SpendWell. “ Since price and quality transparency is becoming core to shopping, employers and their employees need to take advantage of this feature to enable

rationale, competitive, market-based pricing.”

According to Chmait, employees also become better shoppers for themselves and therefore their employer, creating more highly engaged consumers. Employees also become more satisfied with their plan as they can take control of their health care purchases and have fewer surprises and less complex plan administration.”

The online model also solves some of the issues surrounding high deductible health plans, as more employers are implementing HDHPs, which in turn creates issues for providers.

“Providers are collecting a fraction of their account receivables from patients that have high deductible plans because the ability to calculate benefits against real prices is not

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FOUR COMMON MYTHS SURROUNDING DIRECT PAY SpendWell’s Chmait responds to misconceptions 1.

2.

3.

4.

Myth: Direct pay prices are not as good as health plan prices. FACT: We have found that direct pay prices fall five to 20 percent below negotiated fee schedules as providers can price their services on a cost-plus basis. By not having to engage with the complex insurance rules, prices fall. Additionally, prices fall when providers compete. They want to attract and retain the price sensitive patient.

Myth: Direct pay cannot integrate with a consumer’s insurance plan. FACT: With our technology, orders made on our platform are processed as encounters. Most, if not all, TPAs and health plans process encounter data. This is similar to how prescription drug transactions are handled at the pharmacies.

Myth: Consumers will not shop online for health care services. FACT: Similar to how shopping behaviors changed 20 years ago with online companies such as Amazon, Zappos and Expedia, consumers are using these skills in health care. They have been waiting for companies like SpendWell to make shopping for health care services easy and clear. It’s about personalizing the consumer experience to offer a range of services, prices, hours, consumer reviews, health plan and financial integration into their preferences.

Myth: Employers are not ready to offer shopping for retail health care services to their employees. FACT: To the contrary. Employees are demanding state-of-theart tools to help them manage their HDHPs. With new plans, new tools are needed.

Since most employees never meet their deductible why would they buy services (or pay for in our current model) at rates (not prices) that are not known? It’s like ordering dinner at a restaurant and getting the bill two months later.

available. Providers have to spend considerable time and resource to check eligibility, estimate out-of-pocket costs, submit claims and reconcile reimbursement. What if providers no longer had to do any of these administrative processes? The price would go down! ” Chmait said.

“Retail models, also known as cash pay/ direct pay, are aiding in the simplicity and cost reduction. At SpendWell, our platform is able to systematically take on all of these functions using e-commerce technology. Providers get paid near real-time, the entire amount/price they posted as patients are checked out of the office.

“Additionally, we see providers practicing in retail clinics, setting up concierge practices and even house-call practices — all for cash or subscription. Providers want to practice medicine, not push paper … therefore, they are embracing retail or direct pay models like SpendWell.”

In a direct pay model, prices are typically bundled; they include the facility fee, the physician fee, the anesthesiologist fee, etc. It’s simplified in terms of billing for consumers and employers.

“That also means that the rates are not really comparable to insured rates, so there’s nothing the insurance carrier can say,” Cox said.

“Also, in terms of payment typically a direct pay is only offered to those who pay cash up front, but a trend is for providers to offer

44

employers 30-days same as cash. Employers are grateful for that and typically pay between 10-20 days. That flexibility is inherent in the direct pay system.

“When you’re working directly with someone you can get creative — you’re not bound by a list of a thousand rules. We are seeing creativity on both sides, which is great for health care.”

Purchasing Power, Simplified Experiences and More Online marketplaces also tend to provide employers who have employees scattered throughout the country with more purchasing power.

“Those employers with just a few employees in a location don’t have the negotiating power to ask for lower rate. With our platform though, we can get a few employees from many different companies, and suddenly there’s enough power for a provider to be interested in publishing rates,” Cox said.

“The direct pay model started out with direct contracting, and the only people that could do a direct contract was a Boeing-sized employer and a Cleveland Clinic-sized provider.

We are taking it to the smaller folks and actually the larger ones too. Sometimes when a company has a lot of employees in one location they can

November/December 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

overwhelm a small health care facility. Our platform allows us to bring on more of those smaller facilities so the larger employer doesn’t overwhelm anyone of them.”

Chmait encourages employers to start changing the way they do health care as soon as possible.

“As transparency becomes mainstream, and prices are known, the negotiated fee schedule will become extinct. Start demanding that an open marketplace where consumers and providers engage in commerce happen,” she advised. “We have seen that competitive pricing results in lower cost of services by nearly 20 percent. Consider platforms like SpendWell in place to move this discussion forward.”

She also emphasizes a very important part — listening to employees.

“Employees are consumers, but the health care plan does not work like other consumer products and services. By making their experience understood, simple and personalized — engagement will happen naturally,” she said.

“Nearly 73 percent of employers are or have implemented transparency tools1. Direct pay platforms are the next generation bringing e-commerce to bear. 20 percent of all health care spend is for routine care. By creating an open, competitive market and simplifying administration cash/encounters, more employers will be looking for these solutions.”

As Chmait has experienced, health care has become intentionally complex.

“If we can take standard retail principles and redefine the consumer experience so that prices and quality of health are known, consumers decide what is best for them alongside their providers and we personalize their experience, we will find that getting out of the way will save the system money,” Chmait said.“It will be person-focused, sustainable and, most of all, trusted.”

While the increase in health care regulations is typically viewed negatively, for good reason, there’s also a positive side.

“Sometimes heavier regulations create opportunity, and I think that’s what we’re seeing in this country,” Cox said. “There’s a great need for something to be done, and direct pay through online marketplaces seems a really good step toward lowering costs and giving people more choices.

“And, for physicians, many feel it’s a new start for their career. They feel like this is the way health care is supposed to be.”

U.S. Employers Changing Health Benefit Plans to Control Rising Costs, Comply with ACA, National Business roup on Health Survey Finds. National Business roup on Health. August 1 , 2014.

1.

The Affordable Care Act Projections for 2015

T

his time of year, many begin to think about the start of a new year, and what it may mean to their industry and businesses. Some worry about what the year ahead may bring, while others look forward to change and growth. For the health care and benefits industry, what might be affected in the coming year?

The bottom line for employers in 2015: not much will change.

Laws — and plans to comply with these new regulations — are in place and currently being enacted. Plans that have been established for 2015 will most likely be implemented; however, there may be incremental adjustments that will modify an employer’s thinking and plans.

Looking back over the 2014 election results, the takeaway is that the electorate seeks to feel secure. Whether it is financial security (jobs and wages), retirement security (Medicare and Social Security) or personal security (identity theft and Homeland Security), the electorate wants to feel confident that their future is secure and that the government is focused on those issues.

Discussions around dinner tables across the United States morphed from health care reform to threats of safety, terrorism and the economy. These key domestic issues and foreign policy challenges captured the attention of the electorate, pushing the Affordable Care Act (ACA) down on the list of priorities. In part, the slow walk of the implementation process — such as the delay of important mandates as well as other key elements of the bill, like the “Cadillac” tax — means the ACA has received less attention and is therefore not top-of-mind in the way it has been over the last few years.

Now with the elections over, the ACA will again become front-page news. It is no secret that ACA represents a challenge for many employers. These challenges will create noise which elected officials will be required to address as the legislative process has completed, giving way to the administrative process and moving into the implementation, adoption, and execution phase.

With the implementation, adoption and 46

execution phase comes a new round of costs and exposure for employers and consumers — as well as a new set of challenges.

Consumers: Keep Your Plan The American people have been told repeatedly that they will be able to keep their same plan and same doctor but still have affordable coverage. These expectations will be nearly impossible to meet, particularly because the first two promises were not clearly delivered.

For individuals who enrolled in the public exchanges, this is a time of renewal. During this time, most evaluate the plans, costs and whether they qualify for subsidies. This also requires verification of income and documentation to make certain the individual is in fact eligible for subsidies and to participate in the exchange.

During the open enrollment period over the next several months, the individual mandate will come under the microscope. Consumers will be heavily weighing whether their expectations were met — or not — with respect to affordability.

September/October 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

What sets this up for potential failure is the electorate has seen the promise of “keep your plan” or “keep your doctor” and the failure to deliver on the promise and the program.

Will the promise of “affordable coverage” be an element of the program that will fail to meet the consumer’s expectations in the second year Enrollment figures will provide a clear indication.

Employers: Mandates Employers are challenged on several fronts in the coming year. The first will be complying with the anticipated implementation of the employer mandate. The discussion for employers is both strategic (what should I do?) as well as tactical (how do I implement it?).

To arrive at the answers they need, it is

and the New Year:

BY PERRY BRAUN EXECUTIVE DIRECTOR BENEFIT ADVISORS NETWORK (BAN)

important to study their options and unique situations. Collecting data is important as a way to assist in understanding their options and arriving at the best decision for their particular situation. Worth remembering, many employers opted to take an early renewal versus going with the unknown. Will the employer mandate move forward or will it be delayed yet again? And how does an employer respond to that?

The second challenge for employers has to do with reporting and disclosure requirements.

A brand new set of terms have been introduced, which will cause considerable frustration for employers in 2015. What are some of the frustrations they may face? Determining whether they are considered an Accredited Large Employer (ALE) and the issues this represents for them. Determining their measurement

period, stability period and identifying all employees that are defined for each period of time. If audited, can they prove or show the data and explain their results?

These reporting and compliance requirements are an enormous undertaking if the employer is just starting. For example, 6055 and 6056 reporting along with 1094c and 1095c (if applicable) reporting is but one very small example of reports to be shared with the federal government in 2016, although it should actually be ready in 2015.

Also, are employers audit ready? Employers need to be ready for compliance audits. They need to have identified their gaps and developed action plans to address the gaps. Auditors today look for non-compliant plans to penalize.

To accomplish what is identified for the employer, 2015 and 2016 will most likely result in employers examining how and where to fix their technology and administration issues in order to support the reporting and compliance demands. This will be positive news for those industries that supply these services.

Specifically, employers should evaluate their payroll, time/attendance and their workforce management/scheduling systems to determine if they can support the administrative requirements of the law. If changes are needed to be made, technology and administrative investments will come with a cost. In some cases, if employers have not planned ahead, it will require capital that is not budgeted and divert money away from facilities, equipment and people.

Midterms and the Federal Government The results of the November midterm elections were evidence that many Americans are looking for government to bring stability and predictability to their future and to be focused on issues important to them. The health care and benefits industry has been in a state of significant change since ACA was passed as law — and many would like to see some, if not all, of it repealed.

But, is this likely to happen in the coming year? Can midterms really make that great of an

impact in such a short time? The reality is that the legislative window to act on any significant piece of legislation — such as the Affordable Care Act — is a short one. By September 2015, legislatures will turn to their attention to the 2016 presidential election.

But, this doesn’t mean there won’t be some adjustments to the Affordable Care Act. Washington has heard the rest of the county.

It would be expected that these adjustments would take effect late 2015, rather than early in the year. Elected officials will need the balance of the year to work through the law and enacted adjustments. This means the plans an employer has today will be executed in 2015. Again, if employers have not readied themselves, they need to do so now.

This also means that while the political process plays out, employers will be cautious regarding where they make their investments.

If possible, employers will take a wait-and-see approach until there is greater clarity from the federal government.

In Conclusion If an employer was hopeful that the election results were going to roll back the requirements of the Affordable Care Act, this will not happen in the near term. There may be specific areas within ACA that may be adjusted, but most likely that will be within the revenue and tax portions of the law.

Therefore, employers should continue implementing the administrative requirements of ACA that the federal government is just now beginning to implement. Employers will have to ready themselves for audits coming in their direction. Compared to the public exchange implementation, the heavy lifting is just beginning.

Perry Braun is the executive director of Benefit Advisors Network BAN and its sister organization National Benefits Center NBC together comprising an exclusive, national network of independent employee benefit brokerage and consulting companies known for their knowledge of the industry, ethical approach, business acumen and strategic vision. For more information or to contact the author, please visit www.benefitadvisorsnetwork.com or email pbraun@ benefitadvisorsnetwork.com.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014

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Discover how we make wellness programs count www.OnlifeHealth.com H E A LT H

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BY RAJIV KUMAR, MD CHIEF EXECUTIVE OFFICER SHAPEUP

WELLNESS

Engaging Millennials in Workplace Wellness

T

oday’s workforce is rapidly changing, and organizations are realizing that a one-size-fits-all approach to benefits and workplace wellness is simply no longer feasible. Companies can now see as many as four generations within their ranks. With Millennials, myself included, now comprising more than one-third of the workforce, employers hoping to engage this growing and influential demographic must tailor their wellness offerings accordingly to ensure success. That means letting go of many traditional notions in favor of several new “rules of engagement.”

Make it social and fun. Millennials like to have a voice and connect with others. After all, 75 percent have at least one social media profile.1 In the context of wellness programs, social strategies can build new connections, strengthen existing relationships, generate self-sustaining momentum, enhance the worksite environment, and produce positive health outcomes. Team-based competitions, peer-to-peer challenges and online communication tools foster meaningful interactions between employees, motivating them to take action and creating a valuable support network — for which Millennials are perfectly suited.

Millennials’ demand to weave wellness into all aspects of the workplace environment will inevitably grow stronger.

Already, my generation has altered the norms of what “wellness” even means.

Gamification is another crucial piece of the engagement puzzle.

Twice as many Millennials play video games on a daily basis compared to Generation and Baby Boomers.2 By making what used to be a chore into a fun and engaging experience, wellness programs that leverage game mechanics like points, levels and feedback loops can motivate people to work towards clear, step-by-step goals.

Make it intrinsically rewarding. Rather than thinking about incentives in terms of size, the focus should be on how appealing they are to employees. That’s where social incentives come into play. They are not based on dollar signs but linked to mental and emotional factors that affect us every day. Examples include teamwork, friendly competition, public recognition and altruism — all of which Millennials tend to value highly. Powerful results can be realized when financial and social rewards are combined.

Make it connected. Mobile access is a must-have to effectively reach young workers looking for options that are quick, convenient and

available on-the-go. The “quantified self” movement is another hot topic, as nearly half of Millennials track their health data.3 These wireless tracking devices boost employee engagement in wellness programs, and provide objective data about behavior change and health improvement that can be rewarded over time.

Make it part of the culture. The idea of a “culture of health” isn’t some abstraction; it can result in real-world impact. For example, employees at companies with a strong culture are three times more likely to report taking action on their health and rate all aspects of their performance higher.4 Workplaces with strong cultures of health typically leverage grassroots approaches that empower local employees to serve as onsite “wellness champions.” They nurture and grow the culture through ongoing communication, technology and environmental changes. They also emphasize work-life balance that’s critical to Millennials — with three out of four saying that it drives their career choices.5 Make it holistic. Millennials have a more expansive view of personal well-being. Successful programs can no longer simply be reactive to employee health risks; they must be proactive and provide positive, holistic experiences. That means breaking the mold of traditional wellness packages to offer unique benefits that Millennials desire around financial wellness and work-life balance.

Millennials’ demand to weave wellness into all aspects of the workplace environment will inevitably grow stronger. Already, my generation has altered the norms of what “wellness” even means. To be successful, employers must take a proactive approach to meeting our needs.

After all, Millennials — myself included — are accustomed to rapid innovation; we expect tomorrow’s wellness program today.

Dr. Rajiv Kumar is the founder and chief executive officer of ShapeUp, a venturebacked company that delivers social networking and gaming-based wellness programs to large employers and insurance companies. Under his leadership, ShapeUp now engages over one million participants across 128 countries. Dr. Kumar earned his medical degree from the Warren Alpert Medical School of Brown University and has focused his career on prevention, public health and innovation in health care. He also received his Bachelor of Arts in Business Economics from Brown University.

“Millennials: Confident. Connected. Open to Change.” Pew Research Center, 2010.

(Accessed online: www.pewsocialtrends.org/files/2010/10/millennials-confidentconnected-open-to-change.pdf.)

1,2

3 “Are Millennials the next great health generation?” Employee Benefit News, March 2014. (Accessed online: http://ebn.benefitnews.com/news/are-millennials-the-nextgreat-health-generation-2739645-1.html.)

4 “Culture of Health: A New Perspective.” Wellness & Prevention, Inc., 2011.

Twenge, J.M., Campbell, S.M., Hoffman, B.J., Lance, C.E. “Generational differences in work values: A review of the empirical evidence.” Journal of Management, 2010.

5

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BY FRANK HONE CHIEF ENGAGEMENT OFFICER HEALTHCENTRIC PARTNERS, INC.

ENGAGEMENT

Engagement Learnings from Obamacare, Year One

Y

ear two of Obamacare is here. Hopefully, it’s ready for prime time after last year’s fiasco. The initial rollout of 2013 brings to mind a number of lessons related to engagement and health care consumerism.

Beyond the technology failures, there were many other widelyreported consumer experience missteps.

Here are 10 takeaways that can be helpful for those planning consumer-centric, health-related initiatives:

6. Break down the silos.

1. Clear strategic direction.

A well-defined and fully-articulated strategy is essential for any meaningful behavior change initiative. Last October, The Wall Street ournal highlighted the absence of a cohesive overarching plan for the Healthcare.gov roll-out in an insightful piece titled Health Site Stymied

By Lack of irection.

Health care has to move beyond a clinical mindset to be more consumer-centric in outreach efforts. With Healthcare.gov, the consumer experience was not there. Smart sites let people shop before having to plunk down their credit card (e.g. enter all their personal data). Requiring full registration as Step One was a mistake. Consumers expect efficiency online or they will opt out.

2. Right resources.

8. Local market support.

Too often, planers of bold new ventures don’t have the proper level or amount of talent. We’ve learned about the government contractors behind the site development, and had to ask, where were the folks that brought us Amazon or Travelocity or Google? When the goal is creating a seamless and smart consumer web experience, we need those with expertise in doing so.

The truism that “all health care is local” also applies insurance enrollment. Government navigators were supposed to fan out across the country to help drive enrollment, but their numbers were small and efforts limited by technical problems.

3. Manage expectations.

In any sizable undertaking, it’s good to under-promise and overdeliver. Doing things right across multiple vendors and departments usually takes longer than it should. Unfortunately, the government was stuck on the October 1, 2013 launch date, and political will required that date to be firm, regardless of consequences. Smart testing and “soft” launches could have helped work out many of the unseen bugs.

4. Build a smart selling proposition to attract your audience.

We are often “selling the invisible” when promising something new, and it takes the right sort of effort to effectively position, package and promote the value proposition and selling story. Saying that premiums could be about the same price as your monthly cell phone bill is a weak attempt to “speak the language” without a meaningful “reason why.”

5. Do your homework on consumer insight.

Understanding the intended audience should help both program design and expectation setting, and identify segments of market demand.

Last year, those who needed health insurance diligently pursued the application process, while many of the young and healthy weren’t persuaded, despite penalties.

Creating an atmosphere of integration requires shared goals, clarity of roles, and good peripheral vision. This was not the case at CMS, as internal departments and external vendors operated in their own worlds, expecting that things would come together in the end — and they didn’t. Sponsors need to have a master integrator (e.g. a chief engagement officer) to help drive coordination.

7. Consumer experience.

9. Test small, then expand.

Most software is not ready for rollout when it comes out of development. The contractors testifying on Capitol Hill said testing time was vastly insufficient for such an undertaking. When trying something new, it’s better to begin with a small sample of the population, and then broaden after addressing bugs.

10. Scenario planning.

Many projects — especially big ones — rarely unfold as designed, so be prepared with back-up options. Healthcare.gov assumed that all would work well with the site roll-out and had to scramble to massively expand telephone access and paper applications. The adage that “anything that can go wrong, will go wrong” is a helpful reminder to prepare for the unexpected.

For 2014-15, we expect a better consumer experience for enrollment.

The new landscape created by health reform has opened up new opportunities for health care consumerism. The key is to effectively engage individuals in the right way, with targeted messaging based on smart consumer strategy and planning. Opportunities abound in this new and fast evolving market!

Frank Hone is chief engagement officer at Healthcentric Partners, Inc., an engagement strategy and marketing consultancy for employee health and well-being improvement. His 200 book Why Healthcare Matters: How Business Leaders Can Drive Transformational Change is an employer s guide to health care consumerism.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

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HSA FSA DCAP TRA

Congratulations to our 2014 SuperStars Carol Kraft, President & Chief Operating Officer of SelectAccount, Lisa Schlafmann, Director of Benefits and Compensation for MDU Resources Group, Inc. and Kim Wagner, President of Preferred Benefit Concepts.

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Thank you for your innovative leadership in the field of consumer directed health care and dedication to providing consumer value.

Trusted Medical Savings Administrator Since 1989.

Serving: Employers Brokers Consultants Health Plans TPAs Financial Institutions

For details contact Tony Frank (651) 662-4563 or Tony.Frank@SelectAccount.com

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BY JONATHAN FIELD MANAGING EDITOR THE INSTITUTE FOR HEALTHCARE CONSUMERISM

HSA BOOK REVIEW

The Owner’s Manual that Didn’t Come With Your Health Savings Account

W

hether through HealthCare.gov, a private IRS codes and regulations that HSA account holders health insurance exchange or during an may need to reference in certain situations. employer’s open enrollment, consumers today In the introduction to HSA Owner s Manual, are enrolling in health savings accounts (HSAs) at Berkley addresses the inevitable revolution in health record rates. At its latest census, America’s Health care leading toward health savings accounts. “The front Insurance Plans (AHIP) estimated that 17.4 million lines in this revolution include those who signed up Americans are now enrolled in an HSA-eligible health voluntarily and those who were conscripted,” Berkley plan, and projections for the rest of the decade show no writes. “It does not matter how you arrived or whether sign of this trend slowing. you’ve arrived yet. Your time is coming.”

Yet while the number of HSAs continues to Berkley then gives an important overview of grow each year, recent surveys have suggested that the two parts of HSA-based health coverage — the current communication and education efforts for high-deductible, HSA-eligible health plan and the health accounts may not be enough. Although some health savings account itself — and how they work employers, brokers and HSA administrators in conjunction to give consumers quality have succeeded in this area, others may be coverage at a lower cost. Examining the The goal, he says, lagging. With the many restrictions and economic reasoning behind HSAs, he makes regulations around the use of health savings an important declaration: “Moving to a higher is to encourage individuals accounts, the introductory materials provided deductible does not constitute a reduction in to consumers is often woefully insufficient. make the most of their health value of employer-based [health] insurance.

Fortunately, Todd Berkley, president Instead, it is often a rational change savings accounts and to help instituted by the employer that results in of HSA Consulting Services and one of the nation’s most respected HSA experts, has overall savings for most employees.” them see the worlds of health filled in the gap with his recently published Berkley addresses another HSA myth in HSA Owner s Manual, the Rosetta Stone for his introduction. When HSAs were initially care and financial planning all things health savings accounts. introduced (and, to some extent, still today), As the former HSA business leader critics argued that these accounts only in a whole new light. with OptumHealth Bank from 2005 to 2012, benefited wealthy and healthy individuals.

Berkley has been one of the principal leaders However, Berkley argues that the last decade driving the growth of HSAs over the past has proven this to not be the case. “In fact,” decade. During his tenure at Optum, the he writes, “many policyholders pay less in company’s HSA business grew from roughly 50,000 accounts to nearly total out-of-pocket costs (premium and cost sharing) than they did one million. He also participates in several industry organizations that under their old health plan with higher premiums and lower out-ofpromote the development of health savings accounts, including the pocket costs.”

ABA HSA Council, AHIP’s HSA Leadership Council and ECFC. The In the pages that follow, Berkley outlines in extraordinary detail result of this experience and expertise has been condensed into one nearly every topic one could think of related to health savings accounts. book, an essential guide to health savings accounts.

The goal, he says, is to encourage individuals make the most of their Berkley’s reference guide is divided into three main parts health savings accounts and to help them “see the worlds of health care (plus an appendix containing additional information and source and financial planning in a whole new light.” notations): 1) the “rules of engagement” (i.e. eligibility, contributions In the HSA Owner s Manual, readers can find answers to all and distributions), 2) HSAs and various life events (e.g. “HSAs and of their HSA questions. Written in a jargon-free manner that’s easy Retirement Planning”, “HSAs and Children” and “HSAs and Divorce”) to understand for individuals of all levels of financial and insurance and 3) HSA strategies “that allow you to turbocharge your tax savings literacy, Berkley’s book is essential reading for any HSA account holder and account balances”. The appendix conveniently includes relevant or any professional involved with health savings accounts.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

53

AFFILIATE MEMBER PROFILES

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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.

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

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.” ®

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HEALTH DECISION SUPPORT AND COST-SAVING TOOLS

Improved Health. Improved Cost.

LOOKING FORWARD TO A CONSUMER DRIVEN FUTURE

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It has been an exciting year at Flexible Benefit Service Corporation (Flex). We celebrated our 25th anniversary along with a decade of increasingly popular HSAs. We have been a trusted benefits administrator of these consumer-driven plans since day one and also offer FSAs, HRAs, Transit and COBRA Administration. In fact, we now offer the InsureXSolutions® private exchange to employers with part-time workers or retirees, as well as small businesses. At Flex, we look towards the future and leverage our consumer-driven experience as a way to help our clients move forward in the changing marketplace.

Contact your broker or consultant, call us directly at 888-353-9178 or visit www.flexiblebenefit.com to learn more.

54

November/December 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

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

WISER TOGETHER Praveen Mooganur

offers an innovative online treatment

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selection & shared decision support

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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, WiserTogether

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EMPLOYEE BENEFITS CONSULTING

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We take the time to understand each client’s unique culture in order to implement the most progressive, creative solution to their benefits needs.

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

— Liz Frayer, RHU, Intrepid

PROFESSIONAL DEVELOPMENT

Health Insurance 101: An Orientation is a new, flexible online course offered by AHIP. It is designed to teach health insurance basics to those new to health care or individuals who wish to review the fundamentals.

The course is formatted in short modules; you learn at your own pace and on your own time, moving through the materials as you choose. Plus, AHIP will customize the course to fit your organization’s specific learning requirements.

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HEALTH DECISION SUPPORT TOOLS

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

— Giovanni Colella, M.D. CEO and Co-Founder, Castlight Health HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

A PRIVATE EXCHANGE THAT SIMPLIFIES HEALTH INSURANCE

INSUREXSOLUTIONS

10275 W. Higgins Road, Suite 500 Rosemont, IL 60018 855-563-6993 info@insurexsolutions.com www.insurexsolutions.com

The InsureXSolutions® private exchange offers employers a simplified role in the new health insurance marketplace. Employers with part-time workers or retirees, as well as small businesses can utilize this exchange to empower their employees to choose the health and dental insurance that best fits their personal and family needs. Employers can reduce costs and administrative tasks, while employees receive interactive support tools and personal guidance from our licensed insurance professionals. Available in select markets, InsureXSolutions is exclusively offered and operated

by Flexible Benefit Service Corporation (Flex). Contact your broker or consultant, call us directly at 855-563-6993, or visit www.insurexsolutions.com to learn more.

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

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EMPLOYEE ENGAGEMENT TOOLS

Avoid the the Cadillac CadillacTax! Tax! Consumer’sMedical Consumer Medicalhelps ResourceŽ your(CMR) employees helps answer your the five most important in healthcare: employees answer the fivequestions most important questions What do I have?

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CMR CMR helps helps leading leading Fortune Fortune 1,000 1,000 companies companies improve improve engagement, quality, and satisfaction engagement, quality, and satisfaction through through informed informed clinical clinical decision-making decision-making with with guaranteed guaranteed savings. savings. drive 70%70% of your “10% 10%ofofemployees employees drive of your cost. only help cost.Our Ourservices servicesnot not only help companies in in areas such companiessave savemoney money areas such as elective as reducing reducingunnecessary unnecessary elective surgeries, empower employees surgeries,but butalso also empower employees to make thethe most important makesome someofof most important decisions decisionsofoftheir theirlives.� lives.�

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CMR delivers value by helping organizations take control of their healthcare costs. Find out what we can do for you. iÂ?Â?ÞÊ7>Â?Â?>Vi]ĂŠ ÂˆĂ€iVĂŒÂœĂ€ĂŠÂœvĂŠ >ÀŽiĂŒÂˆÂ˜}ĂŠUĂŠÂŽĂœ>Â?Â?>ViJVÂœÂ˜ĂƒĂ•Â“iĂ€ĂƒÂ“i`ˆV>Â?°VÂœÂ“ĂŠ Kelly Wallace, DiriVĂŒÂœĂ€ĂŠÂœvĂŠ >ÀŽiĂŒÂˆÂ˜}ĂŠUʓ>ÀŽiĂŒÂˆÂ˜}JVÂœÂ˜ĂƒĂ•Â“iÀ“i`ˆV>Â?°VÂœÂ“ĂŠ Çn£‡Ç䙇£ÇÓÇÊUĂŠĂœĂœĂœÂ°VÂœÂ˜ĂƒĂ•Â“iĂ€ĂƒÂ“i`ˆV>Â?°Vœ“ Çn£‡Ç䙇£ÇÓÇÊUĂŠĂœĂœĂœÂ°VÂœÂ˜ĂƒĂ•Â“iÀ“i`ˆV>Â?°Vœ“

SUPPLEMENTAL HEALTH

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

t 5IF #FOFmUT "EWJTPS TPMVUJPO HVJEFT DPOTVNFST UP NBLF GVMMZ JOGPSNFE JOTVSBODF BOE CFOFmUT DPWFSBHF EFDJTJPOT t 5IF )FBMUI "EWJTPS TPMVUJPO ESJWFT CFUUFS IFBMUI CFIBWJPST CZ FOHBHJOH QBUJFOUT PO XFCTJUFT 1)3T BOE DBSF NBOBHFNFOU QMBUGPSNT

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800.533.2081 ext. 2262 www.healthysightworkingforyou.org

Transitions Healthy Sight Working for YouÂŽ 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.�

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Millions of consumers via benefits, health CODEBABY plan, and healthcare providers depend on 111 S. Tejon St. Suite 107 CodeBaby customer engagement solutions Colorado Springs, CO 80903 to make personalized and informed 877.334.3465 healthcare decisions. These major healthcare codebaby.com/online-solutions organizations experience overwhelming info@codebaby.com engagement, accuracy, and form completion results by using CodeBaby virtual assistant and engagement technology.

November/December 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

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

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

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

WWW.THEIHCC.COM

AFFILIATE MEMBER PROFILES

Access these profiles online at 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 support consumer directed pre-tax benefit programs, including health care (FSA, HSA, HRA), wellness programs, commuting and

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

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

HealthCare Consumerism Solutions™ I www.TheIHCC.com I November/December 2014

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RESOURCE GUIDE

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Solutions to help your innovative health and benefit programs.

Listen Live Every Friday from 11a.m.-12 p.m. EST Listen on your mobile device.

Download on iTunes or Google Play Join the conversation by tweeting or emailing your questions to us in advance, during or after each show: Twitter: @The IHC Email: dfield@theihcc.com

ADVERTISING INDEX AHIP ...................................................... 55

IHC Call for Content...............................14

Allstate .................................................... 5

IHC Certification ......................................9

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

IHC Certification Testimonials ........HCX 12

Blossom Bariatrics ................................. 45

IHC Radio Show ....................................18

Castlight Health ...............................12, 55

insurexsolutions ..................................... 55

Cigna ..................................................... 20

Intrepid .................................................. 55

CodeBaby............................................... 56

MasterCard ............................................ 54

Compass Health Care ............................. 40

Onlife Health ..............................HCX 6, 48

Connecture ............................................ 22

PrivateHealthCareExchanges.com ..........HCX 2

Consumer Medical ................................. 56

SelectAccount........................................ 52

DataPath ................................................ 54

Transitions ............................................. 56

DentaQuest.....................................HCX 16

Truven Health Analytics ......................... 56

Doctor On Demand.................................. 50

TSYS Healthcare ................................7, 57

Evolution1.............................................. 57

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

Rogers Beasley 404.671.9551 ext 109 · rbeasley@theihcc.com

Flexible Benefit Service Corporation........ 54

WageWorks ...............................HCX 8, 57

ACCOUNT MANAGERS

GoHealth ........................................HCX 10

Web MD................................................. 42

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

Wiser Together ...................................... 54

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ADVERTISING CONTACTS 404.671.9551 CEO

Doug Field 404.671.9551 ext. 101 · dfield@ theihcc.com MANAGING DIRECTOR

Brent Macy 404.671.9551 ext. 103 · bmacy@theihcc.com CHIEF MARKETING OFFICER

Andrew Dietz adietz@theihcc.com DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS

Michelle Gatehouse 404.405.3007 • mgatehouse@theihcc.com Ted Arvan 678.296.1906 • tarvan@theihcc.com

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November/December 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™

HSA Bank .............................................. 57

BEST BUY® GIFT CARDS FOR BUSINESS

GIVE HAPPIER HOLIDAYS No fees. No expiration dates. Just happiness.™ CorporateGiftCards.BestBuy.com © 2014 Best Buy. All rights reserved.

3TEPPING UP

to empower your employees with award-winning health resources

At UnitedHealthcare, we offer innovative tools that put members in touch with their information.

We’ve made it easier for your employees to find the right information at the right time (even on the go). s MY(EALTHCARE #OST %STIMATOR provides relevant information on care and estimated costs. s MY#LAIMS -ANAGER helps members understand, track and pay their medical bills online. s 5NITED(EALTHCARE (EALTH -E4- is an award-winning* mobile app that provides instant access to a family’s important health information. s MYUHC COMŽ is a resource for members, providing easy access to personal health care benefit information – whenever they need it.

Empower your employees. It’s good for their health – and the health of your business. &OR MORE INFORMATION VISIT WELCOMETOMYUHC COM OR CALL

*Produced by MediaPost Communications, a media, advertising and marketing news and events publishing company based in New York, the annual Appy Awards’ aim is to acknowledge extraordinary Applications, whether they be mobile, social, or Web-based. The Appys don’t discriminate by format, platform or device; instead, they focus on simply honoring the best Apps in all imaginable categories: http://appyawards.net/.

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. Š2014 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. UHCEW686242-000