2014 IHC FORUM West Conference Show Guide
ISSUE || September/October 2014
The Next Wave New Generation of Tech Innovators Leads Shift to Consumerism
Employer HSA Programs and the Cadillac Tax Making Health Care Payments Easier
INSIDE: www.theihcc.com
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INSIDE
FEATURES
41 The Next Wave: A New Generation of Tech Innovators Leads Shift to Consumerism Based on recent reports and analysis from Oliver Wyman and Accenture, it’s clear that there’s an unprecedented amount of venture capital and private equity flowing into health care and benefit solutions today. Building on shifts in benefit plan design that started over a decade ago, these technology entrepreneurs are leading the next generation of health care consumerism with solutions that are often similar to the user experiences of today’s e-commerce leaders, creating a familiarity and ease-of-use for consumers. By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism
48 The Cadillac Tax and Employer HSA Programs Since its enactment in 2010, the ACA has created nearly daily headlines. At first, the focus was on whether the new law would survive legal challenges. Once it became more certain that the ACA was here to stay, benefits professionals turned their attention to implementation of the numerous regulations issued by government agencies. Given the speed and extent of changes, it has been difficult to look out farther than a year or two. Now that some of the bigger issues related to health care reform have simmered down, attention is turning to provisions of the ACA that go into effect in 2018. Specifically, the Cadillac Tax. By Elizabeth Kappenman, J.D., Senior Counsel, Wells Fargo & Co.
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 final edition of HealthCare Consumerism Solutions for 2014, contributors will be offering a retrospective of
key trends in health and benefits management from the past year and a forecast of where we can expect the industry to go in the new year — as well as the compliance challenges employers will face when the calendar flips to 2015.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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Publisher’s Letter
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2014 FORUM West Show Guide
54-57
Solution Provider Member Profiles Resource Guide/Ad Index
By Ronald E. Bachman, Chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism
Five-Year Study Reveals Impact of Worksite Wellness Programs
21 Stats & Data: Health Savings Accounts By Jon Robb, SVP, Research & Technology; Lori Hansen, SVP, Corporate Services; and Eric Remjeske, President, Devenir
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39 Voluntary Benefits It’s Not Business As Usual: The New Face of Insurance Brokers By Alissa Gavrilescu, Director of Marketing, Solstice Benefits
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50 Wellness To Improve Workplace Wellness, Help Your Employees Become Better Shoppers
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By Cathy Kenworthy, Chief Executive Officer, Interactive Health
IHC FORUM & EXPO Las Vegas Nov 16-18, 2015 Red Rock Resort Spa & Casino Las Vegas
3PCC
Health Savings Accounts: Spender vs. Saver
Mar 31 - Apr 1, 2015 Renaissance Richardson Hotel Dallas June 20-23, 2015 Cobb Galleria Centre Atlanta
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By Stephen Doyle, MS MBA, Director, Health Promotion Account Management & Operations, UPMC Health Plan
Private Exchange FORUM & EXPO
IHC FORUM & EXPO Atlanta
#BDINBO
20 Stats & Data: Wellness
SAVE THE DATE Events
Bachman’s Banter Final Reinsurance Program Tax
Briefs & Innovations
11-18
58
DEPARTMENTS
53 Health Care Payments
Come LEARN, CONNECT and SHARE with the top thoughtleaders in health care consumerism, find more information at: www.theihccforum.com
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Making Health Care Payments Easier in a Complex Ecosystem By Joan Christensen, Vice President, Health Services, First Data
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ONLINE EXCLUSIVES What’s Next for the Affordable Care Act: The Cadillac Tax and Its Impact on the Market Since the passing of the Affordable Care Act, the implementation process has been very challenging, and the future holds much of the same. If we trace the progression of the implementation process, the stakeholders affected are: individuals through the Individual Mandate; employers through the Employer Mandate; and employers and plan participants that have a benefit plan that is viewed as expensive through the Cadillac Tax. By Perry S. Braun, Executive Director, Benefit Advisors Network (BAN) 4 September/October 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
The Emerging Shift to “Value� for Health Plans Movement has begun on the long journey from traditional “fee-forservice� health care to a model that emphasizes value and quality. It’s been underway for a little while now, but we expect to see real acceleration over the next 12-24 months. Astute observers of our health system have predicted this shift for some time, but the “market� is often slow to adapt to unfamiliar change. Health reform and many related initiatives have converged to help fully activate this new model. By Frank Hone, Chief Engagement Officer, Healthcentric Partners, Inc.
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LETTER
PUBLISHER www.theihcc.com VOLUME 10 NO. 7 | SEPTEMBER/OCTOBER 2014
Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Fax: 770.663.4409 CEO
Doug Field @ theihcc.com
As we head into FORUM West in Las Vegas, health care consumerism is thriving. Health savings account adoption is up; private exchanges are experiencing “hyper-growth�;
MANAGING DIRECTOR
Brent Macy 404.671.9551 ext. 103 ¡ bmacy@theihcc.com CHIEF MARKETING OFFICER
and new technologies are driving engagement in ways unimagined in the early days of
Andrew Dietz adietz@theihcc.com
consumer-driven health care.
MANAGING EDITOR
Jonathan Field
Over the past 10 months, technology entrepreneurs with consumer-focused health solutions have received venture capital and private equity funding at an unprecedented rate — and there’s no expectation for this trend to slow in the next five years. Along with the many startups, established health, retail and technology companies are also buying in to the vision of a new health care world: one that’s focused on creating engaged, empowered health care consumers.
SENIOR EDITOR
Heather Loveridge hloveridge@theihcc.com ART DIRECTOR
Kellie Frissell GRAPHIC DESIGN
Patrick Washington MARKETING COMMUNICATIONS MANAGER
Lana Perry
In this magazine’s feature, Jonathan Field, the managing editor, takes a high-level look at some of the new technologies and entrepreneurs driving Health Care Consumerism
ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS
2.0 — many of which will be taking part in the upcoming FORUM West conference. At the
CHAIRMAN OF IHC ADVISORY BOARD
show, attendees will have an early look at the results and analysis from this year’s Open Enrollment period. As seen in recent reports from PwC, Accenture and Oliver Wyman, this year’s Open Enrollment season will be crucial for the adoption of many new technologies, including
Dusty Rhodes 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,
private exchanges, price transparency tools, health management apps and wearable
Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC
devices. Earlier this year, Accenture notably announced that private exchanges were
Tim Hemendinger
growing faster than many had believed possible: will we see this same growth trend in the other aforementioned areas? As 2014 begins to wind down, the innovators in the health and benefits management
WEBMASTER
DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS
Rogers Beasley ACCOUNT MANAGERS
industry have more to be optimistic about now than in many years past. Following the many
Michelle Gatehouse
exciting IPOs, acquisitions, mergers and funding announcements from the past year, 2015
Ted Arvan
is set up to be another landmark year for health care consumerism. To meet this growth and excitement, I am excited to announce that The Institute for HealthCare Consumerism will be producing three major conferences for 2015: Private Exchange FORUM, FORUM & Expo Atlanta and FORUM & Expo Las Vegas. I hope to see
WEST COAST BUSINESS DEVELOPMENT DIRECTOR
Mike Allen PARTNERS/ALLIANCES
Joni Lipson BUSINESS MANAGER
Karen Raudabaugh
you there.
™ Volume 10 Issue 7 Copyright Š2014 by FieldMedia LLC. All rights reserved.
Sincerely,
™ is a trademark of FieldMedia LLC. ™ is published eight times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009.
TO SUBSCRIBE: Make checks and money orders payable to ™ magazine 292 S. Main Street, Suite 400, Alpharetta,
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at the following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 PRINTED IN THE U.S.A. ™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher
legal advice is required, the services of a professional adviser should be sought. The magazine is not responsible for unsolicited manuscripts or photographs. Send letters to the editor and editorial inquiries to the above address or to
6 September/October 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
Provide employees the right tools to make the most of their healthcare choices. At TSYS HealthcareÂŽ, our approach to client-driven innovation allows you to define and shape flexible, integrated payment solutions that meet your unique needs. Our independent industry partnerships and elite platform functionality help our clients build solutions that make sense. Our solutions include: Ĺ˜ 'HĹľQHG FRQWULEXWLRQ SODQ RSWLRQV WR DVVLVW ZLWK KHDOWKFDUH H[FKDQJH SUHPLXPV Ĺ˜ $ PXOWL SXUVH +6$ )6$ +5$ DQG :HOOQHVV FDUG SODWIRUP GHYHORSHG VSHFLĹľFDOO\ IRU KHDOWKFDUH Ĺ˜ (QKDQFHG +5$ FDUG IXQFWLRQDOLW\ Ĺ˜ $Q LQGHSHQGHQW SDUWQHU QHWZRUN Ĺ˜ ([SHULHQFHG KHDOWKFDUH DGYLVRUV Ĺ˜ 5HYHQXH JHQHUDWLQJ ĹľQDQFLDO PRGHOV Integrity | Relationships | Excellence | Innovation | Growth
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Š 2014 Total System Services, Inc.Ž All rights reserved worldwide. TSYSŽ is a federally registered service mark of Total System Services, Inc.
BACHMAN’S BANTER
BY RONALD E. BACHMAN FSA, MAAA CHAIRMAN, EDITORIAL ADVISORY BOARD THE INSTITUTE FOR HEALTHCARE CONSUMERISM
WHO: The reinsurance tax is paid by insurers and third-party administrators. It applies to each plan member, spouse and dependent covered in a health plan offered by a “contributing entity� — hence the nickname “belly button tax.� WHEN: The Transitional Reinsurance Program tax is required under the PPACA for 2014, 2015 and 2016. On March 11, 2014, the U.S. Department of Health and Human Services made a final ruling with changes effective for benefit years starting in 2015. WHAT: The final, three-part ruling from HHS: a. Defines a new 2015 and 2016 tax exception for self-insured, selfadministered group health plans, b. Establishes the 2015 reinsurance contribution rate and c. Implements a two installment collection schedule. EXECUTIVE SUMMARY: The Transitional Reinsurance Program is a threeyear declining tax to help insurers stabilize individual premiums for policies sold through government health insurance exchanges during the first three years. The reinsurance tax applies to all “contributing entities,� defined as, “health insurers or a third-party administrators working on behalf of a selfinsured group health plan, except that for 2015 and 2016 benefit years, self-insured, self-administered group health plans will not be considered
Year
Total Tax $ Required by ACA
Tax $ to Reinsurance Pool
Tax $ to U.S. Treasury
‘contributing entities.’� A. New Exception from Tax: A self-insured, self-administered plan will not lose its exemption if it uses an unrelated third party to obtain a discount provider network, claim re-pricing services — if it outsources core administrative functions for pharmacy or other excluded benefits such as dental or vision coverage — or outsources no more than five percent of core administrative services on non-excluded benefits. Excluded benefits are: 1. Health reimbursement arrangements that are integrated with major medical 2. Health savings accounts 3. Flexible spending accounts 4. EAPs, wellness programs and disease management programs 5. Expatriate health coverage 6. Stand-alone, self-insured pharmacy benefits 7. Stop-loss and indemnity reinsurance policies 8. Medicare (where group plan is secondary) B. Reinsurance Rate: Annually, HHS converts the ACA-mandated annual total dollars of tax into a per capita cost based on enrollments provided by the contributing entities’ “commercial book of business.� C. Tax Collection: The Reinsurance Pool (and administrative fees) tax will be paid at the beginning of the calendar year following the applicable benefit year, and the tax to the U.S. Treasury will be collected in the last quarter of that calendar year. Total Annual Per Capita The taxes are generally deductible as ordinary and Cost For necessary business expenses.
Contributing Entities
2014
$10B
$8B
$2B
$63.00
2015
$6B
$4B
$2B
$44.00
2016
$4B
$3B
$1B
TBD
8 September/October 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
ACTIONS: Employers should check with their insurers, TPAs, consultants and legal advisors to determine the data submittals required, the applicable tax amount and timing for payments. A form will be available at www.pay.gov where a contributing entity — or TPA on its behalf — can find help with the tax.
HEALTHCARE CONSUMERISM NEWS BRIEFS
HSA Bank to Acquire HSA Business of JPMorgan Chase Webster Financial Corporation, the holding company that owns HSA Bank, one of the nation’s largest and oldest health savings account administrators, announced that it has signed an agreement to acquire the HSA business of JPMorgan Chase Bank, including 700,000 accounts and an estimated $1.3 billion in deposits. Pending regulatory approval, the all-cash transaction will effectively double the number of health accounts under the bank’s administration. In June, the company announced $2.4 billion in assets, including 700,000 accounts, 30,000 employer relationships and integration with 15 health plans and third party administrators. The nearly three-quarters of a million accounts
bswift Expands its Employee Benefits Product Line with Springboard Specials bswift announced the introduction of Springboard Specials, a new module that can be enabled with Springboard Marketplace, the
With Springboard Specials, employers can instantly expand their
theft protection and more. Springboard Specials are featured on the
this time, the purchase price has not been disclosed.
offered by that employer.
BCBS of Texas Transparency Solution Helps Consumers Better Manage Health Care Services and Costs
American Well Integrates with Apple’s HealthKit Taking Doctor Visits to the Next Level
Blue Cross and Blue Shield of Texas, the largest provider of health
National telehealth leader American Well announced that when patients use the Amwell App on an iPhone or iPod touch running iOS 8, they will be able to share health data from Apple’s new health app with a doctor during their video visit. Consumers can choose to share metrics such as heart rate, blood pressure, body temperature, blood glucose levels, weight, nutritional information and respiratory rate. These metrics will allow physicians to better understand a patient’s lifestyle and provide a more comprehensive assessment of their health
online health care solution developed to enable members to more easily research and select physicians and hospitals, as well as estimate out-of-pocket health costs. The Provider Finder provides cost estimates for more than 400 common medical procedures, increasing to 1600 by the end of the year. Members can search and compare more than 400,000 health professionals and 21,000 facilities nationwide, estimate treatment costs, access clinical quality data and read and write patient reviews.
SpendWell and PaySpan Partner to Enable an Innovative Health Care Consumer Experience SpendWell Health has partnered with PaySpan, the leading provider of health care reimbursement and payment automation services. Through the partnership, the SpendWell consumer retail experience of shopping for routine health care services now reaches PaySpan’s network of more than 700,000 health care providers. Together the partnership to providers and promotes a patient experience that is more affordable,
give their permission to share the health data with their doctor, which will feed into the health summary section of their American Well account.
ADP Health Compliance Solution Helps Employers Navigate Complex Health Care Reform Requirements ADP announced the release of ADP Health Compliance, a comprehensive solution designed to help large employers manage the critical business challenges associated with the Affordable Care Act. ADP is adding ADP Health Compliance — targeted at large enterprises with at least 1,000 employees — to its growing portfolio of compliance solutions designed to help employers quickly adapt to emerging ACA compliance
and consumers to create a nationwide online marketplace to give consumers with high-deductible plans a way to shop for quality routine health care services at competitive and fair prices.
ADP Health Compliance combines SaaS with rigorous managed services staffed by ACA experts who can help to enable compliance while managing all of the complex regulatory requirements.
Picwell Launches First Predictive Recommendation Engine for Health Plan Selection
Stat Doctors Named Preferred eHealth Service Provider for Assurex Global
Picwell marries Big Data, predictive analytics, behavioral economics and machine learning with consumer friendly user interfaces and engagement tools that integrate directly into health care exchanges
Stat Health Services, provider of telehealth solution Stat Doctors™, signed on as the preferred eHealth partner for Assurex Global, a partnership of prominent independent agents and brokers worldwide. Assurex Global now offers Stat Doctors through the Assurex Global Private Exchange, a health care marketplace for businesses seeking
and seamlessly organize and analyze more than 900,000 variables that affect plan selection and present the highest recommended plans to
treatment of minor illnesses and common medical conditions, online
from Picwell’s technology is Aon Hewitt. The two companies recently
traditional employer-provided medical insurance coverage and other continued on page 10
HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
9
HEALTHCARE CONSUMERISM PEOPLE ON THE MOVE
Alegeus Technologies Announces Adam Hameed as Chief Revenue Officer veteran, bringing more than 20 years of experience in building highperformance sales teams and a unique passion and commitment to delivering outstanding value for his clients. In his position as chief including sales, account management, marketing and business team that is focused on transforming the health care marketplace to be more consumer-centric by empowering consumers to more effectively save and pay for the cost of their health care.
BioIQ Expands Team to Better Serve Customers, Opens New Office in Atlanta
Briefs, continued from page 9
focused on developing, enhancing, and extending the BioIQ platform, a health improvement technology solution that enables organizations to connect with their populations, measure vital health metrics, and achieve their health improvement goals. BioIQ’s technology platform has become the mainstay for corporate wellness programs and HEDIS compliance initiatives across the United States.
Maestro Healthcare Technology Appoints Joseph Kinnett as Vice President of Sales Maestro Healthcare Technology announced the appointment of Joseph Kinnett to vice president of sales. As a member of Maestro’s executive leadership, Kinnett will lead the sales strategy and development of the national sales team. Kinnett most recently served as a regional sales director for Maestro Healthcare Technology managing the Southeast Region. Prior to his position with Maestro, Kinnett was vice president of sales for UMR, UnitedHealthcare’s self-funded TPA business unit, where he played an instrumental role in UMR’s introduction and sales across the U.S. market.
HEALTHCARE CONSUMERISM FUNDING ANNOUNCEMENTS
WiserTogether Raises $9 Million in Series B Round
Jiff Closes $18 Million Series B Funding with Venrock
WiserTogether, Inc. announced the completion of its Series B funding of $9 million led by Martin Ventures and Merck Global Health Innovation Fund (Merck GHI). The company’s founder and CEO, Shub Debgupta, as well as all prior institutional investors, including Grotech Ventures, Harbert Venture Partners, 7Wire Ventures and Blue Heron Capital participated in the round. WiserTogether’s personalized health care comparison software enables consumers to compare over 4,000 of
Jiff, a digital health technology company, recently announced an $18 million Series B round led by Venrock. Jiff provides an enterprise solution for self-insured employers to connect to and manage hundreds of innovative digital health tools, and provides each employee an individualized health incentives program through an addictive mobile experience. Despite all the changes in American health care over the past few years, half of all Americans still get their insurance from their employer. With their costs still rising, large self-insured enterprises are searching for solutions to keep their workers healthy and bring down health care costs.
and to engage with the right treatment — most effective in outcome, most personally suitable and most cost-effective and affordable. The result is improved health and improved costs.
HEALTHCARE CONSUMERISM RESEARCH, SURVEYS & REPORTS
Alegeus Finds Employers That Have Adopted FSA Rollover Are Seeing Double-Digit FSA Enrollment Growth Alegeus Technologies announced that mid-year plan enrollment results reveal double-digit FSA enrollment and contribution growth by employers that have embraced the new FSA rollover allowance. Alegeus clients who have actively promoted the FSA rollover allowance to their employer groups and eligible employees are seeing 11 percent incremental growth in FSA enrollment and 9 percent growth in FSA
Accenture: Funding for Digital Health Care Start-Ups Expected to Reach $6.5 Billion by 2017 Driven by evolving consumer expectations, start-up funding for digital health care, such as telehealth or wearable technology, is expected to double in the United States over the next three years, growing from $3.5 billion in 2014 to $6.5 billion by the end of 2017, according to new research by Accenture. According to the report, an estimated $2.8 billion was used to fund digital health start-ups last year, growing at an start-up funding will grow to $4.3 billion in 2015, and it is expected to reach $6.5 billion by the end of 2017.
so-called FSA “use-it-or-lose-it� provision, allowing a rollover of up to $500 of unused FSA funds at the end of the plan year. Previously, unused employee FSA contributions were forfeited to the employer at the end of the plan year or grace period.
10 September/October 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
THE 4TH ANNUAL
Health Care Consumerism: The Solution for Health Reform
SHOW GUIDE November 10-12, 2014 路 Pre-Conference: November 10, 2014
Red Rock Casino Resort & Spa 路 Las Vegas www.theihccforum.com
LEARN. CONNECT. SHARE.
AGENDA AT A GLANCE Monday, November 10, 2014 – Pre-Conference Events 12:00 noon – 7:00 pm
1:00 pm – 2:15 pm
Exhibitor Set-Up & Exhibitor Registration
PRE-CONFERENCE EVENTS 11:15 am – 6:30 pm Familiarization Trip of Las Vegas – Domestic Medical Tourism 11:30 am – 1:00 pm Lunch & Learn: The Power of Employee Choice: The Game Changing Combination of Private Exchanges and HSAs 1:00 pm – 5:00 pm Pre-Conference Certification Courses (Choose One) t Making Health Care Consumerism Work: The Steps and Plan – CHCC Certification Course t Helping Employers Understand Defined Contribution and Private Exchanges t NAHU Certification Program on Self-Funding for Brokers
2:15 pm – 2:30 pm 2:30 pm – 3:30 pm
Track No. 2 Workshops (Choose One) LEARN SESSION 201 – Trends Review: Outcomesbased Strategies that Lower Costs, Improve Satisfaction and Increase Productivity LEARN SESSION 202 – A Case Study on Benefits for the Entire Workforce CONNECT SESSION 203 – ACA Compliance & Strategies Update CONNECT SESSION 204 – Evaluating a Private Exchange: What Should Brokers and Employers Look For? SHARE SESSION 205 – Panel on Healthcare Consumerism: Wellness, Incentives and Engagement SHARE SESSION 206 – Panel Discussion on TeleHealth: Improving Access Through On-Site Solutions, Telemedicine and Technology
3:30 pm – 4:30 pm
Track No. 3 Workshops (Choose One) LEARN SESSION 301 – CDH and The Private Marketplace LEARN SESSION 302 – Defined Contribution Health Care — Why Do It, How To Do It and What To Do In Renewal Years CONNECT SESSION 303 –Panel Discussion: Moving to Consumerism – Selling the C-Suite CONNECT SESSION 304 – A Panel Discussion on US Domestic Medical Travel: The Opportunities and Challenges for Self-Insured Employers SHARE SESSION 305 – Employer Panel: Employee Engagement and the Importance of Good Employer Communications SHARE SESSION 306 – Panel Discussion: Building Better Consumers of Health Care and Health
4:30 pm – 4:45 pm 4:45 pm – 6:00 pm
Networking Break / Exhibits Open Closing General Session: “Defined Contribution and Private Exchanges: a Panel Discussion with Leading Experts” Moderator: John Young, President, Consumerdriven, LLC, Former Senior Vice President, Consumerism, CIGNA Panelists: Jeff Yaniga, Vice President, Private Exchanges, Connecture; Mike Smith, Director of Exchange Solutions, Lockton Benefit Group; Clint Jones, Co-Founder and CEO, GoHealth; Nancy Vasta, Business Lead, Proprietary Retail Exchange, Cigna Opening Night Reception / Exhibits Open League of Leaders Dinner (invitation only)
Tuesday, November 11, 2014 7:30 am 7:30 am – 8:30 am 8:30 am – 8:45 am 8:45 am – 10:15 am
10:15 am – 10:30 am 10:30 am – 11:30 am
11:30 am – 1:00 pm 11:45 am – 12:45 pm
Registration Networking Breakfast / Exhibits Open Welcome by Doug Field, CEO, The Institute for HealthCare Consumerism Opening General Session: A Panel of Leading C-Level Executives share their Healthcare Strategies including the shift to HealthCare Consumerism and their look ahead. Speaker: Ron Bachman, Chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism Keynote Address CEO Panelists: Jeff Ellis, Vice President & CFO, Corporate HR Shared Services, MGM Resorts International; Jeff Noordhoek, Chief Executive Officer, Nelnet, Inc.; Joe Jackson, Chief Executive Officer, WageWorks, Inc.; Les McPhearson, Chief Executive Officer, United Benefits Advisors; Scott Matthews, VP, Product Marketing, CastLight Health Networking Break / Exhibits Open Track No. 1 Workshops (Choose One) LEARN SESSION 101 – The Future of Private Insurance Exchanges: How the increased demand for selffunded options is redefining the traditional private exchange model LEARN SESSION 102 – You Don’t Have to Wait Five Years: Challenging the Corporate Wellness ROI Myth CONNECT SESSION 103 – The Fundamentals of Health Care Consumerism and the Principles Behind The Institute for HealthCare Consumerism CONNECT SESSION 104 – A Session for Brokers: Best Practices – “A Broker’s Role in Supporting Consumerism and Patient Accountability” SHARE SESSION 105 – Panel Discussion – Retail Health Clinics 2.0: An In-Depth Discussion of the Value Proposition for Employers SHARE SESSION 106 – Panel Discussion on Health Care Transparency: The Facts are Obligatory! Lunch / Exhibit Open; Sponsored By Table Topic Lunch Discussion
Afternoon General Session: “Health Care Reform and Compliance Issues” Moderator: Jody L. Dietel, AFCFCI, CAS, Chief Compliance Officer, WageWorks, Inc. Panelists: John Hickman, Partner, Alston + Bird LLP; J. Kevin A. McKechnie, Executive Director, The ABA HSA Council, & Senior Vice President & Director, The ABA Office of Insurance Advocacy, American Bankers Association Networking Break / Exhibits Open
6:00 pm – 7:30 pm 7:30 pm – 9:30 pm
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2014 IHC FORUM WEST GENERAL SESSSIONS Day One: Opening General Session 5VFTEBZ /PWFNCFS UI t B N o B N
A Panel of Leading C-Level Executives share their Healthcare Strategies including the shift to HealthCare Consumerism and their look ahead. HealthCare Consumerism is gaining wide-spread acceptance across the healthcare landscape in general and inside the chief officers’ suite of many major employers, to be more specific. Those executives that are embracing HealthCare Consumerism as the solution for Health Reform are doing so by promoting and achieving healthcare freedom for their employees — in which individuals pursue personal healthcare preferences. According to a survey released in March of 2014 by Towers Watson, in which nearly 600 major employers representing nearly 12 million employees responded, a full 50% of employers plan to make significant to transforming changes in their health benefits plans during the period between 2015 and 2018. Nearly 95% plan to make modest change. In this session, learn about the specific ways leading C-Level Executives are promoting and achieving change inside their own organizations or in those of their clients. Learn what they have already implemented, where they plan to make additional changes, and what experiences they have gained along their way that can be beneficial to your organization. Come hear what several leading Chief Executive Officers have to share about their companies’ and/or clients’ Journeys into the New World of Health Care Consumerism. Learn about their healthcare challenges, strategies, and unique solutions for Health Reform. And get their perspectives on the evolving Private Healthcare Exchanges marketplace.
Bachman
Ellis
Noordhoek
Jackson
McPhearson
.PEFSBUPS Ron Bachman, Chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism 1BOFMJTUT Jeff Ellis, Vice President & CFO, Corporate HR Shared Services, MGM Resorts International; Jeff Noordhoek, $IJFG &YFDVUJWF 0GmDFS /FMOFU *OD +PF +BDLTPO $IJFG &YFDVUJWF 0GmDFS 8BHF8PSLT *OD -FT .D1IFBSTPO $IJFG Executive Officer, United Benefits Advisors
Day One: Afternoon General Session 5VFTEBZ /PWFNCFS UI t Q N o Q N
“Health Care Reform and Compliance Issues� The Patient Protection and Affordable Care Act (PPACA) is the law of the land and regulations are being issued at a record pace. What impact do these regulations have on Consumer Directed Health plans? What’s the future of HDHPs and HSAs or HRAs in the next
three to five years? What design changes will be necessary to comply with new regulations? These questions and more will be answered during this cuttingedge session. Panelists will give you an inside look at the implications of the PPACA and its impact on consumer directed health. They will offer practical, actionable strategies your company can use immediately to be alert to the upcoming requirements and be prepared. Moderated by Jody L. Dietel, Chief Compliance Officer for WageWorks, Inc., the discussion will be directed toward health care reform and compliance issues, to be followed by an interactive Q&A session.
.PEFSBUPS +PEZ - Dietel, AFCFCI, CAS, Chief Compliance Officer, 8BHF8PSLT *OD Dietel Hickman McKechnie 1BOFMJTUT John Hickman, 1BSUOFS "MTUPO #JSE --1 + ,FWJO " .D,FDIOJF &YFDVUJWF Director, The ABA HSA Council, & Senior Vice President & Director, The ABA Office of Insurance Advocacy, American Bankers Association
Day One: Closing General Session 5VFTEBZ /PWFNCFS UI t Q N o Q N
Discussion with Leading Experts� The health care law has changed the way brokers solicit health insurance and how employers provide health insurance to their employee population. The emergence of public and private exchanges and the concept of defined contribution, which encourages the philosophy of consumerism, is becoming a game-changer. Exchanges are meant to increase accessibility to affordable health care. Yet, employers and brokers need to examine how the different exchange models, whether private or public, best fit within their health benefit management strategies. For those employers, brokers and consultants who are trying to remain relevant in an ever-changing, dynamic world of benefits, they should understand that Exchanges are becoming the ‘Catalyst for Consumerism’ and will change the way benefits are delivered and acquired by the employee/consumer. In this general session, panelists will explain the different exchange models, the benefits of these different models, the timeline for implementation, compliance issues and how the concept of defined contribution fits into the exchanges. Equally important, the discussion will include how Exchanges are being received during this important Open Enrollment Period. Come learn what is working, what is not and where do we go from here?
Young
Yaniga
Smith
Jones
Vasta
.PEFSBUPS +PIO :PVOH 1SFTJEFOU $POTVNFSESJWFO --$ Former Senior Vice President, Consumerism, CIGNA 1BOFMJTUT Jeff Yaniga, Vice President, Private Exchanges, Connecture; Mike Smith, Director of Exchange Solutions, -PDLUPO #FOFmU (SPVQ $MJOU +POFT $P 'PVOEFS BOE $&0 (P)FBMUI /BODZ 7BTUB #VTJOFTT -FBE 1SPQSJFUBSZ 3FUBJM Exchange, Cigna
Day Two: Morning General Session
1BOFMJTUT Henry DePhillips, MD, FAAFP, Chief Medical 0GmDFS 5FMBEPD *OD #PBSE .FNCFS 5IF "MMJBODF GPS $POOFDUFE $BSF $BUIZ ,FOXPSUIZ 1SFTJEFOU BOE $&0 *OUFSBDUJWF )FBMUI *OD ,BSJTTB 1SJDF 3JDP 1I % $IJFG .BSLFUJOH 0GmDFS *OUFM o (& $BSF *OOPWBUJPOT™ 4DPUU .BUUIFXT 71 1SPEVDU .BSLFUJOH $BTU-JHIU )FBMUI
Day Two: Closing General Session 8FEOFTEBZ /PWFNCFS UI t Q N o Q N
8FEOFTEBZ /PWFNCFS UI t B N o B N
Employers are Doing Now and a Look Ahead!�
Clarity of information, improved communications, and real-time connectivity all can contribute to better leverage the consumer’s influence. In this general session, attendees will hear the latest trends and tools being designed to help promote the growth and acceptance of health care consumerism — trends and tools benefiting employers, employees and the entire community. Come listen to experts discuss the latest in connected care, health management, health incentives, engagement, and much more. Connected Care, for example, is the real-time, electronic communication between a patient and a provider, including telehealth, remote patient monitoring, and secure email communication. As the American health care system moves toward more accountable care, remote patient communication and monitoring will play an increasingly important role in patient services. Connected Care improves access to care, helps providers and patients avoid costly health care services, and increases convenience for patients. Despite rapidly developing technologies and increasing interest among patients and physicians in the use of Connected Care, legal and regulatory barriers continue to limit mainstream acceptance. To achieve the promise of Connected Care, there must be a renewed urgency among policy makers to develop a regulatory structure that enables safe and accessible use of this technology. Come get involved! .PEFSBUPS %S 8FOEZ -ZODI $P EJSFDUPS "MUBSVN $FOUFS for Consumer Choice in Health Care
Lynch
DePhillips
Kenworthy
Price-Rico
Matthews
Skyrocketing health care costs, the health care reform law and compliance concerns, shrinking budgets, low employee participation and improper use of benefits are just a few of the issues plaguing employers. Employers are facing immense challenges, while attempting to retain their best employees, provide the very best in employee benefits possible, and still maintain the company’s bottom line. In this general session, hear from a panel of the top national employers, who are practicing successful health care consumerism strategies that address these challenges head on! Receive proven strategies designed to make employees better, more educated consumers of health and healthcare. Learn from mid- to large-size employers who have faced challenges similar to those you now face. Hear how they have successfully implemented health care consumerism plans, resulting in reductions in health care costs, increased employee engagement and worker productivity. And get insights into how these employers engaged their personnel, resulting in well-informed health care and health decisions for employees and their families. Get real-time feedback from this fall’s open enrollment period and receive an enlightening look ahead into 2015, including hearing about the evolution of Private Healthcare Exchanges.
Comola
Socha
Ezzard
Andersen
Chapman
.PEFSBUPS Jon Comola, Founder, Wye River Group (WRG), BOE UIF (MPCBM ,OPXMFEHF &YDIBOHF /FUXPSL PO )FBMUI $BSF (,&/
1BOFMJTUT John Socha, Executive Director, Health Care Operations and Corporate Benefits, MGM Resorts International; Milt Ezzard, Senior Director, Global Benefits, "DUJWJTJPO %JBOB . "OEFSTFO &YFDVUJWF 71 $PSQPSBUF Benefits Director, Zions Bancorporation; Jill Marie $IBQNBO 4FOJPS %JSFDUPS #FOFmUT 0GmDF %FQPU.BY *OD
FREE!
The role of the consumer in health care is more important than ever. With the health care market at its critical juncture and with employers trying to bend the cost curve, it is the consumer who will shape the future of health care quality and cost. As key decisionmakers in selecting, managing and navigating their health care and health decisions, the commitment of consumers and employers alike is vital to improve health and health care delivery, by being more informed, more involved, and better prepared.
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STATS & DATA: WELLNESS
BY STEPHEN DOYLE, MS MBA DIRECTOR, HEALTH PROMOTION ACCOUNT MANAGEMENT & OPERATIONS UPMC HEALTH PLAN
O
n-site wellness programs have become a staple of the American workplace. A 2012 study by the Rand Corporation showed that 92 percent of all employers with 200 or more employees reported they offered such programs in 2009. A 2014 National Study of Employers indicated that the number of all employers providing wellness programs rose from 51 percent in 2008 to 60 percent in 2014. What is not as commonplace is any comprehensive look at the effectiveness of such programs in terms of health gains and cost savings. Workplace wellness programs hold the promise for managing the health and costs of the U.S. workforce, but these programs have not been rigorously tested in health care worksites. Recently, UPMC WorkPartners completed a five-year observational study to evaluate the impact of a wellness program instituted by UPMC, an integrated health care delivery and financing system headquartered in Pittsburgh, on the health and health care costs of UPMC health care workers. The study represents the largest and longest continuous observation of a financially incentivized wellness, prevention and chronic disease management program implemented in a health care worksite to date. The study looked at 13,627 UPMC employees who were continuously enrolled in UPMCsponsored health insurance and participated in UPMC’s wellness program, known as MyHealth. An additional 4,448 health care workers employed outside of UPMC who did not participate in the program were also studied as a comparison group. The choice of health care workers was made, in part, because employees of hospitals and health systems have poorer health status, higher rates of health care service utilization and higher health care costs than those in other industries. The study revealed that there were significant improvements in health risk levels over five years for those members who participated in MyHealth. In that time, 13.6 percent of members reduced risk levels, 76.4 percent maintained risk levels and 10.6 percent increased risk levels. The proportion of members at low risk increased significantly — by two percent. Proportions at moderate and high risk decreased significantly — by 1.12 percent and 0.88 percent. As was expected, medical, pharmacy and total health costs increased 20 September/October 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
significantly for persons in the increased-risk groups. For those in reducedrisk groups, total health costs decreased with the most significant changes coming for those who moved from the higher-risk to the lower-risk levels. Significant increases in preventive service use were observed for annual ambulatory or preventive care visits, colorectal cancer screening and breast cancer screening. Significant increases were also observed for use of diabetes and cardiovascular disease management services. Significant increases were also observed for use of diabetes and cardiovascular disease management services. The results of this study are consistent with published literature that shows total health care costs follow health risk and can be mitigated over time through financially incentivized workplace wellness programs. Savings will accrue for health care workers who reduce risks, primarily because of significant reductions in medical costs for those who achieve the lowest health risk levels and, therefore, require fewer or less expensive services than those who maintain or increase health risks. The study concluded that while incorporating incentivized health management strategies in employer-sponsored health benefit designs can enhance the health and wellness of health care workers, new approaches are also needed to encourage more workers to reduce health risks. Offering incentives that reward or penalize workers based on clinically relevant standards — such as not smoking and maintaining a healthy weight, normal blood pressure and cholesterol levels — is something that could be offered, rather than simply asking employees to engage in wellness program components. “It is gratifying to have evidence that wellness helps to keep our population healthy, as our workforce did not decline but actually improved in overall health even though it aged five years,� said John L. Galley, vice president of Human Resources and Shared Service at UPMC. “Nonetheless, we are moving to outcomes-based programs and broadening our on-site clinics to total health management centers to amp up the programs even further, so we can have an even greater impact in helping our employees to lead healthier and happier lives. “We actually hope that the ROI on these efforts will be even more dramatic over time.�
STATS & DATA: HEALTH SAVINGS ACCOUNTS
BY JON ROBB, SVP, RESEARCH & TECHNOLOGY LORI HANSEN, SVP, CORPORATE SERVICES ERIC REMJESKE, PRESIDENT, DEVENIR
W
ith health savings account assets growing rapidly to almost $23 billion among 12 million accounts, HSAs have been increasingly in the spotlight lately. With their new-found fame, many have wondered how to classify HSAs — are they a spending account or a savings account? Health savings accounts possess characteristics of both a checking and savings account, serving as a tax-advantaged savings vehicle for future medical costs, while at the same time having the ability to be only a swipe of the debit card away to pay for current eligible medical expenses. As we look at this conundrum from a data perspective utilizing our recent survey of HSA providers, it doesn’t get any easier to clearly delineate one way or another.
There certainly is a spending component of the account with our data showing HSA account holders withdrawing over $8 billion in the first half of 2014, demonstrating a desire to actively use their HSA. On the flip side of that, overall HSA consumers also contributed $6.6 billion more than they withdrew, allowing for valuable tax-advantaged dollars to grow for future medical expenditures. HSA balances have remained relatively low with the current average balance of an HSA at $1,935, which is effectively the same as it was three years ago. In addition, about 61 percent of accounts are what we would define as “spenders”, accounts with a balance of less than $1,000. While there clearly is a large segment of account holders who are focused on today’s expenses, these numbers can be a little misleading. Almost half of all Exhibit 1: HSA Account Holder by Balance HSA accounts have been opened within the last three years, and these young accounts often just haven’t had the time to build up a 40% HSA Account Holder by Balance 34% balance. 35% In order to compensate for this, we’ve Spenders: 61% 30% looked at how HSAs have grown based on the Savers: 28% 25% year they were opened, much in the same way Investors: 11% 20% the consumer retail market looks at same store 15% 14% 14% 15% 12% sales for year-over-year growth. When you do this, you begin to see much more of a savings 10% 7% trend with average balances increasing about 3% 5% 1% $500 for every year that they are opened. 0% Our research shows that account holders $0 $1-$499 $500-$999 $1,000-$1,999 $2,000-$4,999 $5,000-$9,999 $10,000-$24,999 Over $25,000 are both utilizing their HSA for current medical expenses, as well as saving for future health Exhibit 2: Average Balance by Year care expenses. In order to accommodate the Account was Opened this hybrid approach of spending and saving, HSA custodians might want to look at ways to provide features that not only empower Avg Balance by Year the Account Opened $7,000 consumers to get the most out of their HSA $6,147 $6,000 for current health expenses, but allows them $5,205 to maximize savings for future expenses as $5,000 $5,117 6/30/2014 $4,174 well. 6/30/2013 $4,000
$4,306
$3,000 $2,000
$2,937 $2,936
$4,213
$3,690
$1,000 $
$3,523
$3,578
2005
2006
$2,889
2007
$2,288
2008
$2,443 $1,978
2009
6/30/2012 $2,577 $2,069 $1,636 2010
$2,228 $1,751 $1,238 2011
$1,674 $1,160 $722
$1,192 $727
$775
2012
2013
2014
HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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September/October 2014
Exchange
Beyond the Hyper-Growth What’s needed for private exchanges to succeed?
Due Diligence on Private Exchange Solutions Consumer Expectatons for Exchange Technology
www.theihcc.com
Discover how we make wellness programs count www.OnlifeHealth.com
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WELLNESS COUNT Driving engagement and real results with private exchanges Physical activity is important. In fact, it’s the most important thing you can do to improve your health. Create powerful results by connecting to Onlife Sync TM. You can even reward trackable fitness activity to start improving the health of members today.
Onlife gives your employees the ability to choose from 70+ fitness devices and apps from companies including Fitbit ®, Garmin®, Jawbone®, Runkeeper TM, and more. Freedom to choose increases sustained engagement while empowering your organization to incentivize the right activities, at the right time.
INSIDE
FEATURE 11 Beyond the Hyper-Growth: Looking at What’s Next for Private Exchanges In the middle of the first Open Enrollment season since Accenture consultants stated the private exchange industry was undergoing “hyper-growth”, we have once again gathered a panel of leading private exchange experts — representing a mix of brokerage/ consulting firms, health insurers and technology providers — to offer their insights into the state of the private exchange market. In this panel, six contributors cover prospects and early results for this year’s enrollment season, emerging trends to look for next year and key components private exchanges will need to fulfill employers’ expectations. With Patty Fontneau, President, Private Exchange Business, Cigna; Jean Moore, Managing Director, Exchange Solutions, Towers Watson; Mike Smith, Director of Exchange Solutions, Lockton Companies; Don Garlitz, Senior Vice President, bswift; Frank B. Mengert, Director of Technology, ebenefit Marketplace; and Nancy Scola Lombaer, Partner, Laurus Strategies.
7 Exchange Profile Consumer Expectations Will Drive the Top Private Exchanges of the Future Everyone agrees that we are in the very early acceptance stage for private exchanges. While the Affordable Care Act pushed public exchanges, Accenture projects more than 40 million employees will be using private exchanges by 2018. What will those 40 million employees expect when they are shopping for medical, ancillary and voluntary insurance products? They will expect to find selfservice that works. By Gaston Gage, President and CEO, Empowered Benefits
9 Private Exchange Checklist The Private Exchange Checklist: Helping Employers Conduct Due Diligence Employers are continuously being challenged by advanced health care delivery models,
DEPARTMENTS
brand-new marketplace health management options and recently issued compliance requirements. Organizations — whether private, public or not-for-profit — now also have a broader array of options when it comes to offering health care coverage to their employees. One of the newer delivery options available is a private exchange. However, it’s important to remember that not all exchanges are created equal, and it may not be the best solution for a specific organization.
across our industry as well. These dynamics have changed the world of commerce, forcing manufacturers and service providers to innovate. The advent of private exchanges will accelerate this consumer-centric shift in the employee benefits sector. By Mike Sullivan, Executive Vice President and Chief Marketing Officer, Digital Insurance
By Bruce Davis, Principal and Health and Group Benefits Practice Leader, Findley Davies
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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.
15 Private Exchange Trends The Consumer Factor: Four Elements to Consider with Private Exchanges We are living in an era of the consumer. Advances in technology have given individuals more power than they have ever possessed to access products and services that best meet their needs. Price elasticity models are being reconfigured
Publisher’s Letter
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Briefs & Innovations Keeping you up-to-date with the latest news, research and innovation in defined contribution and health insurance exchanges.
HealthCare Exchange Solutions™ I www.TheIHCC.com I September/October 2014
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PUBLISHER
Exchange www.theihcc.com VOLUME 10 NO. 5 | SEPTEMBER/OCTOBER 2014
Providing Employers with the Right Information on Private Exchanges
Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Fax: 770.663.4409 CEO
Doug Field @ theihcc.com MANAGING DIRECTOR
The past year has seen a sharp increase in adoption of health care consumerism strategies from all types of organizations, including many of the nation’s largest employers, brokerage/consulting firms and health plans. While the rise in health savings accounts, consumer-focused technology and price transparency have been duly recognized throughout the industry, of course, no single trend has been maligned or lauded quite like private health insurance exchanges.
Brent Macy 404.671.9551 ext. 103 · bmacy@theihcc.com CHIEF MARKETING OFFICER
Andrew Dietz adietz@theihcc.com MANAGING EDITOR
Jonathan Field SENIOR EDITOR
Looking back five years, when private exchanges were really in their primordial days, so to speak, the potential for this new benefits delivery model to substantially change the way Americans receive health insurance was clear. Long before the hype, companies like Liazon, Array Health and Bloom Health were building the future of employee benefits.
Heather Loveridge hloveridge@theihcc.com ART DIRECTOR
Kellie Frissell GRAPHIC DESIGN
Patrick Washington MARKETING COMMUNICATIONS MANAGER
At the time and particularly now, the core philosophy behind private health insurance exchanges was very tightly aligned with the philosophy of health care consumerism. By educating and empowering employees to be consumers of health care, employee satisfaction would rise, employee health would improve and companies would save significant sums on health care spend.
Lana Perry ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS
Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD
Ronald E. Bachman, CEO, Healthcare Visions
As Gaston Gage opines in his article here, a good private exchange is essentially about providing employees with the same type of user experience they are already accustomed to in their daily lives through websites like Amazon and Expedia. A private exchange is not about employers discontinuing to sponsor health coverage or no longer caring about employees’ well-being. In fact, a well implemented private exchange — combined with the right set of tools and products — can considerably improve the employee benefits experience for all stakeholders. Misinformation about what a private exchange is or is not will not help employers make the appropriate decisions on employee health care moving forward.
EDITORIAL ADVISORY BOARD
Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River Group; John Hickman, Alston+Bird LLP; Tony Holmes, Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC WEBMASTER
Tim Hemendinger DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS
Rogers Beasley
Through HealthCare Exchange Solutions, PrivateHealthCareEXCHANGES.com and the inaugural, upcoming Private Exchange FORUM in Dallas, we’re deeply committed to providing employers — and the stakeholders that support them – with all the latest up-to-date information on private exchanges so that they can make the right decision for their employee population, members or clients. In this issue’s feature, we have asked for insights from many of today’s leading private exchange experts on what to expect this Open Enrollment season and what key components exchanges will need to successfully provide a top-notch experience for employers and employees. As we begin to analyze the data from this year’s enrollment period and look to next year, I hope all of our readers find a wealth of useful information herein. Sincerely,
ACCOUNT MANAGERS
Michelle Gatehouse Ted Arvan WEST COAST BUSINESS DEVELOPMENT DIRECTOR
Mike Allen PARTNERS/ALLIANCES
Joni Lipson BUSINESS MANAGER
Karen Raudabaugh
™ Volume 10 Issue 5 Copyright ©2014 by FieldMedia LLC. All rights reserved.
™ is a trademark of FieldMedia LLC. ™ is published eight times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009. Periodical postage
Doug Field CEO/Publisher dfield@fieldmedia.com
TO SUBSCRIBE: Make checks and money orders payable to ™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or PRINTED IN THE U.S.A. ™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher
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
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September/October 2014 I www.TheIHCC.com I HealthCare Exchange Solutions™
NEWS BRIEFS & INNOVATIONS
NEWS BRIEFS Maestro Healthcare Technology Acquires Leading Private Exchange Platform Maestro Healthcare Technology announced earlier this month that they have acquired Florida-based Workable Solutions from Alegeus Technologies. This strategic move strengthens Maestro’s unique benefit solutions with the addition of leading private exchange and billing capabilities. Combining the capabilities of Workable Solutions with Maestro’s integrated administration, medical management and consumer-driven payment solutions will create enhanced value by establishing an industry-leading, integrated platform designed to provide simple administration for employers and an easy-to-understand marketplace for consumers.
BCBS of Minnesota Launches Private Exchange for Employers Powered by Bloom Health Blue Cross and Blue Shield of Minnesota recently announced the creation of their private exchange solution, a “benefits hub” for employers with more than 50 employees. The hub goes beyond traditional health care offerings by including dental, life, disability and vision insurance — plus a vacation savings account — all in an online environment where employees can calculate, shop and purchase what is best for them and their families. The BCBSMN online marketplace allows employers to provide a defined contribution for their employees to use when shopping for their annual benefits. The exchange offers a variety of health plan designs on a spectrum of prices and networks.
Array Health Closes First Round of Institutional Financing to Accelerate Growth Array Health recently announced that it closed a $13 million funding round. Led by Noro-Moseley Partners, the round also included investment from Vocap Investment Partners. Healthcare Growth Partners represented the company in this transaction. Plans for the new capital include further investment in the company’s technology platform and accelerating growth to meet market demands. The company anticipates expanding its product development, sales and marketing teams. Founded in 2006, Array Health pioneered private exchange technology and ran multi-insurer exchanges in the Pacific Northwest before focusing on powering private exchanges for health plans.
AssuredPartners Launches Assured Options Private Exchange with Liazon’s Technology AssuredPartners Inc. has announced a new partnership with Liazon to launch Assured Options, a private exchange for clients of AssuredPartners. AssuredPartners will use Liazon’s platform to bring clients the Assured Options Exchange, which offers new health care options to organizations and their employees. The Assured Options Exchange is an online benefits store that is changing the way employers and employees buy benefits. Assured Options helps employers save money on their health care costs by setting predictable budgets while allowing employees to personalize their benefits package with a selection of health, dental, vision, life, disability and other benefits from top national and regional providers. Award-winning decision support and education helps employees make smarter benefits selections, and expense tracking tools help them manage and pay expenses yearround.
Aon Study Shows Early Cost Savings Aon Hewitt announced that employers and individuals participating in the Aon Active Health Exchange are seeing notable reductions in health care spend for the third straight year. More than 600,000 employees and dependents enrolled in health benefits through the Aon Active Health Exchange for the 2014 calendar year, and all 18 companies that participated in 2014 are returning to the to the exchange in 2015. Across the companies, rates for medical coverage increased an average of 5.3 percent. This is lower than the industry average and includes costs associated with the Affordable Care Act. According to industry estimates, average health care cost increases in 2015 for large U.S. employers with self-insured arrangements are projected to be between 6.5 percent to 8.0 percent.
Independence Blue Cross Launches Private Exchange for Mid- and Large-sized Employers Independence Blue Cross announced the introduction of a new private exchange that will offer medical, pharmacy, dental and vision to employers with more than 100 employees. Employers can begin to use the Independence private exchange immediately with coverage effective on or after January 1, 2015. The exchange allows employers to accommodate the diverse health care coverage needs of their employees through a range of plan options, while the guided online shopping tool gives employees the freedom to manage their own shopping experiences.
HealthPartners Launches Benefits for Me Private Exchange Solution with bswift Technology HealthPartners, the largest consumer-governed, non-profit health care organization in the nation, announced the launch of Benefits for Me, built on technology by bswift. This new private exchange solution enables employers to offer many health insurance plan choices to their employees, who can use the online tool to compare and choose the best plan for them. Benefits for Me can accommodate a wide variety of benefits offerings for employers with 51 or more employees using a defined contribution funding strategy.
ebenefit Marketplace Announces Partnership with ConnectYourCare ebenefit Marketplace, a leader in software and services for benefits administration technology specializing in private exchanges, announced that they have selected ConnectYourCare to provide a fully integrated health savings solution to be offered by ebenefit Marketplace. With this relationship, ebenefit enhances its existing services by integrating ConnectYourCare’s top-ranked CDHC platform to create a comprehensive product supporting employer demands for flexible, account-based benefit solutions.
Transitions RBG and ConnectedHealth Announce Partnership to Offer Benefits to Entire Population Transitions RBG, which provides innovative solutions for retiree benefit programs, and ConnectedHealth have partnered to expand current benefit offerings to each other’s clients. As part of the arrangement, ConnectedHealth will now make its Smart Choices™ Marketplace available to Transitions RBG’s non-Medicare-eligible consumers. These individuals will be able to shop and select among a variety of medical and ancillary insurance plans that best meet their needs. The new offerings will be available to clients and partners of both companies. HealthCare Exchange Solutions™ I www.TheIHCC.com I September/October 2014
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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,
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PRIVATE EXCHANGE PROFILE
Consumer Expectations Will Drive the Top Private Exchanges of the Future Exchange technology is consumer-centric BY GASTON GAGE » PRESIDENT AND CEO » EMPOWERED BENEFITS
Everyone agrees that we are in the very early acceptance stage for private exchanges. While the Affordable Care Act pushed public exchanges, Accenture projects more than 40 million employees will be using private exchanges by 2018. What will those 40 million employees expect when they are shopping for medical, ancillary and voluntary insurance products? They will expect to find self-service that works. Consumers expect ratings in product selection like Zappos, Sears and Northern Tool. They expect to see similar products like they find on Amazon, eBay and Staples. And they expect to find real product filtering like AutoZone or Cars.com where the result set may number in the thousands. Consumers expect to find meaning out of all the possibilities, and they expect to do it quickly. That is decision support. That level of consumer engagement can only be created by software firms who have deep expertise in making things easy for the user. The firms who pop up overnight don’t stand a chance to develop those tools simply by having a big marketing budget. Consultants and other companies entering the exchange space without a consumer software background have a very high barrier to success.
Usability is a Differentiator Empowered Benefits’ interface design expertise dates to a usability lab that we built in 1996. Our chief creative officer was instrumental in early online banking application interfaces for Wells Fargo and Bank of America. We designed interfaces for e-commerce stores that sold billions of dollars of retail products to consumers. We learned how to merchandise online with similar goods and services. We simplified patient portals and medical provider sites for hospitals, focusing on the patient experience. By the time we tackled consumer-driven health plans in 2001, we had a breadth of consumer Internet experience to leverage. Our BenAdmin customers got more than 30 percent voluntary product enrollment with no enrollers or call centers because of an application interface that was easy to understand. Our exchange platform started with a user interface and application flow that made the most sense for consumers. We developed business requirement documents and application specifications with that user experience in mind. This unique software development process guarantees that our online tools are understandable and easy to use.
Automated Enterprise Technology is a Requirement Consumers expect their exchange to be built on secure enterprise technology that works 100 percent of the time. The average consumer expects that from every website they use. True exchange expertise must be coupled with professional software development. We learned via BenAdmin that secure data feeds need to be built in a rules engine to automate the platform and remove customizations of the past decade of HR technology. If an exchange involves human interaction, then most likely it is a custom BenAdmin solution with a shiny new name. We leverage SaaS best practices for software development and have major quarterly functionality releases scheduled for the next two years. The platform has three different views that make it just as easy for brokers to manage all their groups as it is for HR admins to drill down on individual employees who need assistance. Empowered Benefits offers year-round communications for employees to compare benefits, review corporate initiatives and make sure they have their families in the correct plans. The platform is built on a proprietary content management system allowing HR administrators an easy solution for updating communications. The platform allows for products to be bundled on demographic, gender, age, price and other factors like conditions, medications or health care usage. Our decision support is integrated into the enrollment process and is based on analysis of the employee census data and our history of enrolling millions of employees. This allows us to provide a seamless user experience that produces real results — and even better, no one is forced to watch multimedia or interact with a cartoon character. We leverage Big Data to offer the employee what they want and expect — the ability to choose the products that are right for their families.
The Future of Exchange The Internet has already changed many industries. Health care and insurance products are next in line to make the transition. Just like 401(k) and financial services, the future of private exchanges will revolve around self-service, and as this space continues to evolve, the ones who will thrive are those who understand and deliver a superior consumer experience.
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Introducing
On Ramp provides you with everything you marketplace – one that integrates seamlessly even the most detailed nuances of individual brands, and intuitive enough to empower clients and users to select and enroll in the Visit Connecture at booth #311 to learn more about this powerful addition to your arsenal. 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
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PRIVATE EXCHANGE CHECKLIST BY BRUCE DAVIS PRINCIPAL AND HEALTH AND GROUP BENEFITS PRACTICE LEADER FINDLEY DAVIES
The Private Exchange Checklist: Helping Employers Conduct Due Diligence on Implementing a Private Exchange
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mployers are continuously being challenged by advanced health care delivery models, brand-new marketplace health management options and recently issued compliance requirements. Organizations — whether private, public or not-for-profit — now also have a broader array of options when it comes to offering health care coverage to their employees. One of the newer delivery options available is a private exchange. However, it’s important to remember that not all exchanges are created equal, and it may not be the best solution for a specific organization. To determine if a private exchange will provide the right amount of flexibility, customization and affordability, Findley Davies provides an objective approach to help its clients conduct their due diligence with this checklist of important questions to ask before making a final decision. When helping clients conduct due diligence on the feasibility of using a private health exchange, we consider a number of issues and pose questions to the private exchange vendor, such as:
Flexibility 1. Do you enable the employer to select the provider network(s)? Can you vary the network by geographic region to ensure minimal provider disruption for members and long-term stability? 2. To what extent can the employer select exchange medical and pharmacy plan designs? 3. Do you offer the employer a choice among several PBM partners? 4. Can you offer ancillary benefits using the employer’s existing dental, vision, life and disability carriers? 5. To what extent does the employer control the offering of employee-paid, voluntary products, such as critical illness, accident or hospital indemnity plans? 6. Can the employer elect to self-fund the medical/pharmacy benefits delivered through the private exchange? 7. Do you permit the employer to continue “legacy” plans off the exchange? 8. Do you offer the employer a choice among several HSA banking partners?
Operations 1. How do you interface with the employer to acquire health benefit eligibility information? 2. How do you interface with the employer’s HR/payroll function to facilitate employee contributions? 3. How do you facilitate required PPACA reporting under IRC § 6055 and 6056?
4. Do you provide or offer through a contractor proactive member services? Are you willing to provide performance guarantees that address: t First call resolution; t Sufficient and timely access to live member services representatives; t Outreach to medical providers for additional/missing information; and t Communication tools to enhance employee knowledge, comprehension, employee engagement, consumerism and cost transparency (including use of social media). 5. How do you provide employers excellent, client-centered account management? Do you offer performance guarantees not only for successful, on-time implementation, but also fully satisfactory on-going service? 6. If the exchange medical/pharmacy plans are insured, how does the underwriting/renewal process work? How are large, catastrophic claims normalized? 7. How do you support an employer’s chronic condition management program? 8. What specific chronic condition management programs do you provide? 9. How do you support an employer’s wellness initiatives? 10. What specific wellness programs, resources and tools do you provide? 11. If self-funded, do you provide actionable claims reports with meaningful industry benchmarks to reveal cost trends and drivers? 12. Under your HSA options, do you have real-time connectivity with all PBM partners?
Compensation/Indemnification 1. If insured, are compensation arrangements automatically built into the exchange medical/pharmacy rates? If yes, what are the compensation arrangements, including base commissions and overrides? 2. If self-funded, what are the compensation arrangements? 3. Are you willing to indemnify and hold the employer harmless against causes of action relating to employees who allege they were not provided with sufficient choice or plans, or their plan did not have sufficient choice of providers or the plan was not of high quality? Are you willing to certify that at least one of the plans offered to each employee meets both ACA minimum value and affordability requirements?
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BEYOND THE HYPER-GROWTH Looking at What’s Next for Private Exchanges In the middle of the first open enrollment season since Accenture consultants stated the private exchange market was experiencing “hyper-growth”, we have once again gathered a panel of leading private exchange experts — representing a mix of brokerage/consulting firms, health insurers and technology providers — to offer their insights into the state of the private exchange market, including early trends from this enrollment period and what exchanges need to offer in order to live up to the hype next year and beyond.
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Beyond the Hyper-Growth: Looking at What’s Next for Private Exchanges
X-Factor – The Results Employers Have Been Waiting for Are Here BY JEAN MOORE MANAGING DIRECTOR, EXCHANGE SOLUTIONS, TOWERS WATSON
I’m happy to report that the wait-and-see season is over. With the results of private exchange pioneers hitting
more ownership by employees) and trepidation (the back for quality and health improvement and ownership headaches for employees). As one of the early participants in this new channel, proprietary private exchanges, we at Cigna have learned a few things that suggest how the private exchange can be a positive force for the future as another option for our employers-clients to choose from to achieve their
what outcomes private exchanges can deliver. early results from our private exchange for full-time active employees. Employers using Towers Watson’s OneExchange for their full-time
cost increases employers see year-over-year. Here are other trends emerging this season: Engagement and consumerism – The things that make employees better consumers on private exchanges: choosing from a variety of plans, spending funds wisely and using services and medications for optimal outcomes – also make them more engaged employees. Transparency – Another key advantage for employers is that the private exchange model really highlights how much employers
things are far less transparent. Mandate support – As we approach the new ACA reporting provisions that will be required in 2015, a private exchange platform
personnel for more strategic activities.
substantially different a year from now, given how quickly things are changing. Last year, two-thirds of employers we surveyed told us they weren’t considering private exchanges for full-time active employees. This year nearly two-thirds think private exchanges are now or by 2016 will be
In large part, Cigna’s success in growing our business is a result of helping employers create a culture of health that improves their employee health and health care costs, well-being and productivity. In doing so, our average total medical trend cost is among the lowest in the industry. So why change our approach? The answer is we will not. For us, the key to compete and win in this new arena is to offer our private exchange costs and productivity. introduced, many were concerned that CDHPs would provide a temporal employees to avoid needed care. And frankly, there are a number of plans that embraced this approach. But the ones that are winning are those that offer quality networks, a wealth of health improvement and wellness programs, cost and quality transparency tools and information and properly aligned incentives. Our view is the same will work in the private exchange market. While private exchanges can provide tools to help some employers regulate their health care costs to a more predictable levels, the Cigna approach advantages to employees: Choice of multiple medical plan options, several dental plan choices, vision and group life, accident and disability plan choices Cigna’s national, high quality Open Access Plus physician group, ACO and hospital networks A full complement of wellness, health engagement and disease management programs 24/7/365 service
One thing we’re hearing across the board from employers is “We’re and mobile app. business, so we want to do the right thing. When we make a decision, we want it to stand the test of time.” coming year, we look forward to seeing more employers choose an exchange strategy, with employee engagement and consumerism taking big leaps forward, as well.
Balancing Cost Savings and Benefits Advantages BY PATTY FONTNEAU PRESIDENT, PRIVATE EXCHANGE BUSINESS, CIGNA
As with most innovations in our industry, the advent of the private exchange has been met with a combination of enthusiasm (the hope of new options for cost-weary employers, more channels for health plans, 12
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This is the formula by which the yea-sayers can prevail against the nay-sayers and create a viable and successful option for sustainable and productive private marketplace for years to come.
Exchanges Need to Focus on the Right Shopping Experience BY MIKE SMITH, DIRECTOR OF EXCHANGE SOLUTIONS, LOCKTON COMPANIES
The initial rollout of Healthcare.gov last fall was imperfect: site outages, long enrollment delays and overall consumer dissatisfaction. The new chief executive at Healthcare.gov, Kevin Counihan, announced an impressive stretch goal for the troubled
Beyond the Hyper-Growth: Looking at What’s Next for Private Exchanges service that users will, over time, become “raving fans” of the enrollment program and process. As consumers, we now have access to much more information for purchases than ever before. Think about how the process of buying a car has changed from an uncomfortable and frustrating “negotiation” to one where the buyer has all the necessary information to control the deal. less inclined to orient themselves around caveat emptor or “let the buyer beware.” In 2014, Healthcare.gov will introduce “window shopping” in the weeks leading up the enrollment period so that consumers can preview the plans that will be available to them. Unfortunately, consumers and employees consistently view the purchase of health insurance as a price-driven commoditized exercise focusing largely on premiums and deductibles. The Healthcare.gov site will not offer true comparison shopping this fall and will instead rely on the health plans and insurers for information regarding physician and hospital networks, prescription coverage, quality and wellness measures, etc. Fortunately, in the private exchange market, employees have access to many different, innovative and integrated decision support tools aimed at increasing engagement, cost transparency and plan selection on the path to becoming an active health care consumer. Private exchange technologies are doubling down on these investments as they build out services and look to differentiate themselves. However, once you’ve seen one decision support tool, you’ve seen one. Employers still control the decision regarding which exchange program to implement. These choices include approaches ranging from bundled services from brokers and consultants or a combination of some their organizations from the cultural to the practical. Should the exchange recommend a single plan or multiple plans? Can employees access these tools via mobile devices or the phone? How are vendors’ decision algorithms developed? Employers strive to change employees into true health care consumers. To create these “raving fans,” careful consideration of the shopping experience, decision support tools and end-to-end enrollment employee accountability and health care utilization.
Compliance, Wellness and Voluntary Benefits: Crucial to Private Exchange Success BY FRANK B. MENGERT, DIRECTOR OF TECHNOLOGY, EBENEFIT MARKETPLACE
Open enrollment is upon us again. As a private exchange solution provider for brokers across the
the board. To offset these costs, the growth rate of a lower-premium high deductible health plan is on the rise. Employers are still offering multiple plan choices for employees who wish to spend more money out of pocket for a richer plan but most employees have gravitated to the lower cost
illness coverage. of 50 percent in some cases. Tools included in a private exchange provide a great experience through recommendation technology and decision support for CDHPs and voluntary products, allowing employees to choose The hot topic these days has also been wellness. The number of programs that make it very easy for employers to implement and very easy for employees to participate in is on the rise. This has encouraged more employers to commit to a long-term plan of changing the health of their workforce. Most programs being adopted include biometrics and outcomes-based incentives along with smoking cessation and weight management programs. We see an increase in workplace challenges, getting everyone involved and having a team approach to participation. Incentives range from premium discounts and credits to awards and prizes. increase is compliance. Employers that have never had a system to track their employees are quickly realizing the clock is ticking with the ACA mandates and how they will have to report on their workforce. A private exchange makes it very easy to track data and produce those reports.
Private exchanges offer them exactly that.
Developing the Financial Long-term Business Case for Private Exchanges BY NANCY SCOLA LOMBAER, PARTNER, LAURUS STRATEGIES
When evaluating the feasibility of a private exchange solution, it is important for employers to consider a number of short and long-term factors. Some of these factors are employee focused; employers need to include competitive positioning in order to attract and retain high-performing talent and take care of the needs of current employees. However, businesses also need to ensure they organization — as well as its employees — for the long term. exchange solution, there are two provisions of the Affordable Care Act
in private exchanges but not many employers ready to As we enter into our second year of enrollments with our employer
tax and the potential expansion of the Small Business Health Options Program marketplace to large groups.
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Beyond the Hyper-Growth: Looking at What’s Next for Private Exchanges
The excise tax on high-cost health plans, commonly referred to as the “Cadillac Tax”, is scheduled to take effect in 2018. A key characteristic of most private exchanges is the ability to expand the number of health plans offered, which in turn may result in fewer participants enrolling in high-cost number of employees buy a plan that is of lower cost than the one they previously had vs. opting for a comparable plan or a higher-cost plan. This “buy-down” phenomenon helps alleviate the impact of any high-cost plan excise tax, but also may result in a cost shift to participating employees. Private exchanges need to encourage the insurance carriers, health plans and providers to make every effort to reduce the underlying cost and cost trend of health care by participating in payment and practice reforms like accountable care organizations and bundled payment arrangements, adherence to evidence-based medical practices, multi-disciplinary teams developing treatment plans, creating appropriate access to electronic medical records, etc.
Currently, individuals and small groups (over 50 or 100 employees, depending on the state) are able to participate in public marketplaces and SHOP. Starting in 2017, the SHOP Marketplaces are scheduled to expand to include employers with 100+ employees. According to a survey by late last year, 15 percent of employers are encouraging or will consider encouraging their full-time employees to obtain health care coverage in the public exchange before 2018. But more interesting with regard to the impact on private exchanges, the survey also reports that if employers are permitted to contribute toward employees’ coverage on the public exchanges in 2017 or 2018, 58 percent would consider doing so. The actual impact on the growth of these options vs. private exchange solutions will most likely depend on the size of the company – smaller companies in one or two locations are more likely to use the public exchanges than larger multi-state companies, the perceived stability and reputation of the public exchanges over the next few years, the ability to maintain employer tax deductions and employee pre-tax contributions, and in the most extreme circumstances, the prevalence of companies exiting health plan sponsorship all together, i.e., “pay vs. play”. These two ACA provisions will play a part in how employers develop their business case for or against the implementation of private exchanges. Much may still depend on the amount of change made to ACA
exchanges won’t grow in the longer term; we see an incremental adoption over the 2016 to 2018 time period and beyond. A common question is: “How is a private exchange different from what I’m doing today?” 1) “consumerism” — greater choice for employees, whether that be offering a range of medical plan designs and/or carrier/network choices or ancillary and voluntary plans; 2) a “retail” shopping experience with decision support tools to help employees/consumers make more informed selections; and 3) more standardized product offerings rather than each employer customizing plan designs. Many employers will adopt one or more of the above components over the next few years. Since there are several kinds of private exchanges, each with unique characteristics, employers are moving different populations into different solutions incrementally. Retiree exchanges serving the 65+ market have their own category as the most mature segment of the private exchange market. Exchanges serving individuals and part-time, COBRA-eligible or individuals being directed to the public exchanges to take advantage of subsidies. Our observation is that most employers are moving active employees into private exchanges incrementally, as they carefully consider when to introduce increased employee product choice, decision support tools, and/or standardized product offerings. One idea that’s been hyped — over-hyped in our view — is that employers want to “get out of health care” and move from self-insured to fully insured health plans. While this approach may appear to some employee market is that an employer group’s claims experience and risk is what will really drive their multi-year health care cost, whether one is fully insured or self-insured. In other words, there is no guarantee that health care costs will hold steady over a multi-year period simply because the plan is insured. Of course, an employer could decide to let the employees pay for any increases, but they could do that in any environment today, insured or self-insured. And there is a higher cost (in the range of six to 10 percent) to being insured. While some argue that carrier competition is the best way to bend the medical cost curve, we believe that narrow networks (including ACObased networks) — a new, less expensive option for consumers — and few years.
Employers and Private Exchanges: Trends, Definitions and Best Practices
If all health and welfare dollars are permitted to be allocated to medical, that’s where the money will be spent. And that buying behavior will have
BY DON GARLITZ, SENIOR VICE PRESIDENT, BSWIFT
earlier this year indicated that 18 percent of employers year for their active employee population. The actual adoption for January 1, 2015 is looking to be much less for mid-sized and large employers. But this doesn’t mean that private
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it where it makes sense and continue with traditional programs in certain lines of business. In sum, increased consumerism (meaning more choices for employees), engaging and thoughtful decision support tools and more standardized plans — including medical options with narrow or multi-tier networks — are likely to be three key trends affecting the active employee market for mid-sized and large employers for 2015 and beyond.
PRIVATE EXCHANGE TRENDS BY MIKE SULLIVAN EXECUTIVE VICE PRESIDENT AND CHIEF MARKETING OFFICER DIGITAL INSURANCE
The Consumer Factor: Four Elements to Consider with Private Exchanges
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e are living in an era of the consumer. Advances in technology have given individuals more power than they have ever possessed to access products and services that best meet their needs. Price elasticity models are being reconfigured across our industry as well. These dynamics have changed the world of commerce, forcing manufacturers and service providers to innovate. If we look outside the world of employee benefits, the transformation is epidemic. Customization has become de rigueur. There are pillow menus at hotels; myriad gluten-free, vegetarian and organic options at supermarkets — we’ve morphed into a nation of connoisseurs who order venti, half-caf, non-fat lattes. Just as the travel industry did years ago, more sectors are changing their supply chain processes and converting their business models from businessto-business to business-to-consumer. The advent of private exchanges will accelerate this consumer-centric shift in the employee benefits sector. Individuals and their family members can now select the combination of benefits that is right for their circumstances and budget. The days of one-size-fits-all is over.
the consumer at center stage. It also shifts more risk to individuals, who may need information and education to properly direct their choices.
1. Déjà Vu: Haven’t We Seen This Before?
3. Beware of Advisors Steering You Away from
2. Look Beyond the Software As employers sort through the confusion of a marketplace now teeming with private exchange options, consider that most — particularly those targeted to mid-sized and small businesses — involve variations in software. In many cases, the need to educate employees has been overlooked. While there may be abundant information available online, is it wise to put vital decisions about benefits — particularly health insurance — in an individual’s jurisdiction without having a knowledgeable professional hold their hand through the process? They once relied on their employer for expertise. That transfer of knowledge does not occur overnight. When exploring private exchanges, ensure the ones you consider have the manpower, bandwidth and resources to support a business-to-consumer relationship. At minimum, you should require call center support and online live chat capabilities.
For those unfamiliar with private exchanges, the concept seems foreign. Exchanges But the approach is almost identical to what happened in the 1980s with 401(k) Is your company’s benefits advisor recommending that you not explore plans. Once upon a time, many employers provided pensions to select workers a private exchange? He or she may have some valid points. The market is — a defined benefit. The company controlled the process and investment. The new, and it involves changing the way your business does things, which employee had no choice in the matter, can be uncomfortable. However, if you yet received a check each month after are interested in the cost control this At the moment, the vast majority of retirement. With a 401(k), employees approach provides, it may be worth businesses still want to participate in can contribute pre-tax earnings which a deeper look. If you turn to a private are often matched by the employer the benefits process, but they no longer exchange, how will this impact your — a defined contribution. How the advisor? There are few brokers serving want to own every decision. This puts funds are invested is determined by mid-sized and small businesses that the individual, not the business. The can sustain a profitable revenue stream the consumer at center stage. It also system has shifted as companies if their clients use private exchanges. shifts more risk to individuals, who have almost entirely migrated from They are seldom big enough to offer may need information and education to a program with the robust services an employer-based solution to one in which the employer frames the options required for long-term success and properly direct their choices. and conducts due diligence, then customer satisfaction, so they may turns the decision over to individuals steer you to other solutions. who determine the outcome based on personal preferences. Once employers feel there is a maturation of solutions in the private 4. Keep an Eye on Carriers exchange market, the benefits industry will again reach a tipping point. While Finally, here’s another thought: How will carriers be impacted by the rollout seems slow for those of us immersed in this every day, five years private exchanges? If they evolve as predicted, and consumers become from now the way employers, employees, carriers and brokers operate will be more engaged, then carriers will be pulled into the dynamic that completely different. And, 10 years from now, the system we’ve relied upon for now impacts benefits advisors and employers. They will be forced to the last 75 years will be unrecognizable. innovate. After years of operating with a model that targeted employers, At the moment, the vast majority of businesses still want to participate in carriers will have to compete on pricing at a consumer level. That could the benefits process, but they no longer want to own every decision. This puts be interesting. Stay tuned. The only thing constant is change. HealthCare Exchange Solutions™ I www.TheIHCC.com I September/October 2014
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BY ALISSA GAVRILESCU DIRECTOR OF MARKETING SOLSTICE BENEFITS
VOLUNTARY BENEFITS
It’s Not Business As Usual: The New Face of Insurance Brokers
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everal years ago, those who worked in the insurance industry had their day-today routines shaken up. Health reform legislation turned broker operations on its head, and independent insurance brokers,
grasp on things like MOOPs and EHBs and play. Fast forward to the here and now: There are still undeniable economic changes in our industry. You can’t hide from it. From the emergence and proliferation of private exchanges to the launch of government-run exchanges, a new sales strategy is in order. The question now becomes: What is your value-add to your clients as a broker? The Affordable Care Act has created a new avenue for your
substantially post-ACA. In 2014, voluntary sales increased by 60 percent according to the Eastbridge Marketplace Survey. The pre-ACA debate is over; reports indicate that these sales will see far more growth in the years to come compared to a broker’s non-voluntary sales. With all this change it’s time to revisit what’s inside your sales kit. voluntary to take center stage…what do you need to do? First, think about partnering with a private exchange. There are many broker-friendly private exchanges that offer some pretty fancy features for both the broker and the employer group, including their employees. Privately-run exchanges offer an excellent venue for hearty appetite for buying from traditional ancillary — dental, vision, employer contribution models and a variety of self-service products, these exchanges provide an ideal breeding ground for voluntary commission.
Creating Customer Value Your role as a broker is evolving into something new. Exchanges (both public and private) are forcing you to become more tech-savvy. Your clients are relying on you to navigate them through the twists, turns and changes of health reform. Business growth areas have shifted from medical to new sales
more diverse product portfolio.
With all these variables, what can you do to create a Embrace change. In my experience, change breeds opportunity. This is a fantastic time to position your brokerage business for success. Be open minded to private exchanges, selling more ancillary and consider talking to your Get up to speed on the latest technology tools like private marketplaces, CRM systems and even social media. (Yes, we went there.) Follow the news on health reform and update your clients with any impact to their organization. Don’t forward a link to an article; take the time to break it down for your clients and their employees. Understand the individual shopper so you can offer a product contribution group. Consider price, network, plan options and ease of use. Educate. With all this change, take the time to be consultative, caring and relevant. It’s not business as usual anymore in the insurance world. But with the right tools in place, you can weather the changes and navigate the new landscape. HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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THE NEXT WAVE: A New Generation of Tech Innovators Leads Shift to Consumerism BY JONATHAN FIELD Âť MANAGING EDITOR THE INSTITUTE FOR HEALTHCARE CONSUMERISM
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little over a decade ago, consumer-driven health care was in its infancy. Although many of the core concepts had been discussed and promoted for years, mainly in academic journals and offices on Capitol Hill, there were very few resources available that enabled consumerism in health care. The opacity of the health care system was accepted by most Americans without question. This began to slowly change when, on December 8, 2003, President George W. Bush signed the Medicare Modernization Act, which included a small provision on health savings accounts. Although medical savings accounts (the predecessor of HSAs) had existed for a few years by then, the restrictions on their use made adoption marginal. HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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With HSAs being enacted into law by Congress, the shift to consumerism began — albeit very thinking professionals began to encourage U.S. businesses to break away from the “maternal” approach empowered health care consumers, they argued, would reduce costs while increasing employee choice and satisfaction. But, at the time, very few Americans were actually decisions associated with health savings accounts and high deductible health plans. The steady increase
According to Oliver Wyman, the shift to consumerism in health care could be “brutally hard” on the status quo companies if they fail to respond and innovate. However, in the past year, there have been some promising changes as some of the nation’s largest health
health plans.
Health Care Consumerism 2.0 In the past few months alone, notably PricewaterhouseCoopers, Accenture, Strategy& (formerly Booz & Company) and Oliver Wyman — have released reports and analyses on the growth and future of consumer-focused health care and
insurers have begun to introduce
According to research published by Accenture in September, funding in the United private exchanges, transparency States for digital health technologies already had businesses increasing — wearable devices, telehealth and tools, health apps and other new deductibles, but there weren’t many incentive programs, for example — technologies. tools or services aimed at educating is expected to double by 2017. The or assisting members in HDHPs. report found that between 2008 and However, at some early adopt2013 funding totaled $10.2 billion, ers, employees started to become but in the past year alone, digital empowered consumers of health care. Through health start-ups saw $3.5 billion, slightly more account-based plans, they held more of the utilization. than one-third of the total raised in the last six And now, with an unprecedented volume to make the right decisions for themselves and $6.5 billion in digital health start-up funding. their families. solutions through venture capital and private Perhaps somewhat surprisingly, Accenture Over the past 10 years, as rising health equity investments (with no expectation of attributes the growth to consumer expectations. costs became more and more unsustainable it ending any time soon), consumer-focused Unlike the past decade, Americans today for employers, these trends continued to grow at a dependable pace. Businesses were forced care consumerism strategies are experiencing side (health insurance, health accounts) to increase deductibles to keep health costs widespread adoption from employers, under control, but innovative employers management apps) of their own health care. began to realize that they could do more than simply cost shifting to employees by years past. implementing any number of decisionReports from Oliver Wyman and PwC consupport tools. report The Patient-to-Consumer Revolution, An Environment Ripe for Tom Main and Adrian Slywotzky look at the Innovation trends that are doing for health and wellness This new environment — where what the likes of Apple, Google and Amazon employers were seeing unsustainable have done for retail and consumer technolhealth increases and employees weren’t ogy. The patient-to-consumer revolution, they always sure of how to act with these newargue, will be the greatest value migration in history with trillions of dollars at stake. In what the Oliver Wyman consultants of it coming in the past few years with are calling the Health Market 2.0, high-tech advances in technology. Then, with the health entrepreneurs could potentially create passage of the Affordable Care Act in a market in which costs are down 40 percent 2010, there seemed to be a perfect storm but consumer satisfaction is up an astounding for innovation. 300 percent. Aligning with what Accenture With mobile device adoption on the found, consumer expectations are driving many increase, exchanges being introduced of the changes. As consumers increasingly use and wearable devices proliferating, there technology solutions that improve the health became more channels for employers to care experience (from purchasing insurance to connect with employees and encourage utilizing care), they will no longer settle for the them to be more engaged in health care status quo. HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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The investment from venture technology has been nothing short of astounding lately. According to Oliver Wyman analysis, there were 89 funding rounds over $2 million for health care software and app companies in 2013. In 2011, there were 55, but in 2009, there were only
Whether you call it the “New Health Economy� or the “Health Market 2.0�, it’s clear that we are now entering the age of the consumer. With private exchanges, wearable devices, telehealth and other
expects to expand to other areas of physical and mental health over the next few years. On the East Coast, Maxwell Health, led by CEO Veer Gidwaney, is building a comprehensive platMaxwell’s proprietary “employee -
these companies that are impacting technology-driven solutions on the employer-sponsored health care are integrated private exchange, receive Castlight Health, ZocDoc, FitBit, care for acute illnesses through interise, the user experience in health GoHealth and Best Doctors. grated telehealth services and do Like Oliver Wyman’s Health care and employee benefits may Market 2.0, PwC’s recent analysis of Based on a holistic view of the “New Health Economyâ€? suggests finally be catching up to consumers’ the health and wellness experience, significant consumer-focused Maxwell provides one location changes ahead. According to analysts (accessible through the Web or expectations. at PwC’s Health Research Institute, mobile app) for all of an employee’s the consumer is the “new center of gravityâ€? in the health care world, platform now includes many and new entrants are already drawing revenue Castlight Health, Doctor on Demand and Omada partner solutions, including Health Advocate, from traditional health care companies. In 2012, Health — are bringing unique user experiences BioIQ, ID Watchdog and Jawbone, and the Americans spent over $2.8 trillion on health and top-notch technology in the areas of price company has been busy in 2014 partnering with care plus an additional $267 billion on related transparency, health care access and health manproducts and services, including mobile health agement respectively. While Castlight has been third party administrators and health insurers apps, gym memberships, wearable devices, a well-known innovator in health care trans- to distribute the platform. nutritional supplements, alternative medicine parency for a few years now (since securing an and more. PwC suggests that new entrants — incredible $100 million Series D round in 2012), Meeting Expectations whether it be a start-up or a 50 the company announced its Enterpise Healthcare As exciting as the past year has been, all Cloud earlier this year, expanding the suite of services offered to employers and employees. scratching the surface in the shift to consumershare from traditional health care businesses if With an easy-to-use interface and a network ism, and the aforementioned companies are they don’t evolve with the shift to consumerism. The current tech explosion in health and has made a notable impact on the telehealth needed change to the health care system. wellness is putting pressure on the “incumbentsâ€? space since raising $3 million from Andreessen With mobile technology and e-commerce in the health care industry. According to Oliver Horowitz, Venrock and others in late 2013. Led playing increasingly important roles in our Wyman, the shift to consumerism in health society, employees as consumers of health care care could be “brutally hardâ€? on the status quo will continue to demand user experiences in companies if they fail to respond and innovate. visit fee to consumers to receive fast, immediate However, in the past year, there have been care for acute conditions, including upper respi- Amazon, Google, Apple and the like. some promising changes as some of the nation’s Over the past decade, the rise of health largest health insurers have begun to introduce ries, urinary tract infections and more. The com- accounts and high deductible health plans laid private exchanges, transparency tools, health pany also announced integration with Castlight’s the groundwork for a more consumer-focused apps and other new technologies. Enterprise Health Cloud earlier this year and will health care system. While changes in plan be available to all Castlight customers. design were initially misunderstood by many Digital Disruptions: In April, Omada Health announced employers and employees, this has changed Telehealth, Wearable Devices, $23 million in funding (led by Andreessen rapidly in recent years. And, as the industry has Transparency and More Horowitz with Kaiser Permanente Ventures, matured, the number of solutions to support U.S. Venture Partners and The Vertical Group these employees has grown exponentially. health care space, who are some of the technology also participating) to tackle one of the nation’s Whether you call it the “New Health innovators? And what exactly do they do? As most crucial population health concerns — pre- Economyâ€? or the “Health Market 2.0â€?, it’s clear stated in the aforementioned reports, high-tech diabetes. Based upon the Center for Disease that we are now entering the age of the consumer. Control’s diabetes prevention program, the With private exchanges, wearable devices, telein the health care system across the whole company offers Prevent, a 16-week prevention health and other technology-driven solutions on program based on behavioral science that can be the rise, the user experience in health care and management to health care utilization. sponsored by health insurers, hospital systems In San Francisco, three companies — or employers. Led by Sean Duffy, chief executive consumers’ expectations. 44 September/October 2014 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
The Trend Toward Choice in Vision Benefits By Smith Wyckoff, Key Account Manager, Managed Care/Online Retail, Transitions Optical, Inc.
F
or the past several years, the wide-spread embrace of consumer-driven health care has compelled consumers to become better educated about their health care options. The private and public exchange formats, which require understanding of choice among benefit options, are accelerating this trend. Although medical benefits were on the forefront of consumer choice, it has been interesting to watch the trend extend to ancillary benefits, including vision, in the past several years. Recent studies and research offer compelling insights into consumers’ interest in vision benefit choices. In one study conducted by EyeMed Vision Care,1 the majority of EyeMed members expressed preference for choices in vision plan levels, and interest in buying up to enhanced plans that cover (or offer discounts on) lens options, like TransitionsŽ photochromic lenses. These results align with Transitions Optical’s Employee Perceptions of Vision Benefits survey. In addition to expressing a preference for coverage of premium lens options, nearly nine in 10 respondents to the Employee Perceptions survey say it is important that their vision benefit covers new lens technologies.2 Employers are also receptive to the trend of more choice in vision benefits. More than 71 percent of benefit professionals say that the ability to select from multiple benefits options is moderately or extremely important to employees in their organization.3 Data also shows that offering choice in vision plans can have a positive result for the employer in terms of increased enrollment and higher utilization among those who choose the enhanced plan option.4
Why Access to Enhanced Level Coverage Matters Higher-level vision coverage tends to allow more frequent visits to the eye doctor, which can have a positive impact on an employee’s overall health, helping to reduce health care costs. Many eye diseases
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can be treated — and even avoided if caught early — and eye exams can actually provide early detection of systemic issues, like diabetes and hypertension. Higher-level plans also tend to cover, or offer deep discounts on, premium eyewear options that many employees need to see their best at work. Consider that 80 percent of employees say they encounter visual disturbances on the job that could impact their productivity, with most taking a break at least once a day to rest their eyes, according to Transitions Optical’s most recent employee survey.5 The top complaint is tired eyes, followed by light reflecting off of a computer screen and bright, glaring light. Many of these disturbances can be alleviated with the right eyewear (like anti-reflective coatings and Transitions lenses) to reduce glare.
What’s the Catch? While offering tiered vision coverage has many advantages for employers, it is important to remember that consumers can become overwhelmed by choices they are unaccustomed to making. Traditionally, most people reviewing ancillary benefits decided whether they wanted the benefit or not, not which level of benefit was the best fit for them and
ADVERTORIAL
their families. Now, with a trend toward tiered levels of coverage, and particularly when in a public or private exchange environment, many consumers are in the unfamiliar position of choosing between two or more vision plan options and plan coverage levels. Consumers are not always clear about how to evaluate multiple plan options in order to make the smartest choice for themselves and their households, and may need extra education to understand the value they get with various options. Providing education during enrollment and throughout the year — on why regular vision care and quality vision wear matter — can help ready employees to make the right choice for them and their families, while reinforcing the value of coverage offered through the employer. Free education resources are available at HealthySightWorkingforYou.org, and a free customizable vision wellness communication planning calendar can be found at EyeSiteOnWellness. com/wellness-calendar. 1
3
5
ADVERTORIAL
Why “One-Size Fits All” Vision Plans May Miss the Mark By Kevin Hilst, Senior Vice President, Sales, EyeMed Vision Care
Over the past 10 years, major advancements have been made in lens technology, frame selection and eyewear shopping experiences; but most vision benefits have stayed the same. “One-size fits all” vision plans have become outdated and may miss the mark compared to today’s innovations in vision care and eyewear. EyeMed’s research shows that members with tiered plan options report greater satisfaction with their benefit. Vision plan members with a traditional base plan typically pay 30 percent of their vision cost in premiums and 70 percent at the register. This unbalanced out-of-pocket expense at the point of purchase is what contributes to dissatisfaction with the benefit. When members are dissatisfied, they are less likely to re-enroll, further reducing the chance that they’ll continue to care for their eyes. EyePrefer is a vision plan that closes the gap between all of the changes in vision care and outdated vision plans, by offering a multi-tiered solution. It’s a data-driven product design, validated by real-life employers, employees and benefit brokers, with the end goal of a healthy, happy employee. Offering a plan that reflects consumer product trends toward choice and customization is important, but also key is providing enrollees access to userfriendly tools that help them make the best choices to fit their situations. EyePrefer tiered plans come with a simple online decision tool for enrollees called EyeNav™, which recommends the best value plan for members’ needs based on their responses to a few lifestyle and vision questions. While more than half of employees with the choice will choose an enhanced plan over the traditional (base) plan, employees whose needs are basic can still enroll and take advantage of important vision benefits. Regardless of which type of plan is selected, the desired outcome is healthier, productive employees with the vision they need to be their best. HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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The Cadillac Tax and Em BY ELIZABETH KAPPENMAN, J.D. Âť SENIOR COUNSEL. Âť WELLS FARGO & CO.
ince its enactment in 2010, the Patient Protection and Affordable Care Act has
family coverage3. These amounts will be indexed
the focus was on whether the new law would survive legal challenges. Once it became more certain that ACA was here to stay,
With premium trends slowing in the past couple of years, how big of an impact will the Cadillac Tax have?
implementation of the numerous regulations issued by government agencies. Given the speed
will be affected by the tax. The past few years have seen annual health care cost trends in the mid-to-low single digits, reversing many years of double-digit growth. Regional trends could be higher, as could those for your company. As of 2014, the average annual family premium has not yet reached $17,000 and, as of 2018, the Cadillac Tax will affect family plans that are higher than an expected $27,500 annually. For individual plans, the average premium sits at about $6,000 today and the tax kicks in at $10,200 in 2018. It remains to be seen how premium rates will trend and how many plans will reach the Cadillac Tax limits.
look out farther than a year or two. Now that some of the bigger issues related to health care reform have simmered down, attention is turning to provisions of the ACA Fargo clients have begun asking about the impact to their health savings account programs of an excise tax on high cost health care under Section 4980I of the Internal Revenue Code (the “Code�), which was added by Section 9001 of the ACA — commonly referred to as the “Cadillac Tax�. The good news for our clients? It appears likely that HSA-qualifying health plans are not going to trigger this tax, given that they are relatively low-cost plans. In fact, a recent Towers Watson study shows that nearly all the “best performing� employers use account-based plans as one of their key strategies for managing costs and avoiding the Cadillac Tax.1 However, there is still uncertainty about the effect of HSA contributions on the tax. This article provides a general overview of the Cadillac Tax, explains its potential impact on employer HSA programs and discusses some of the open questions surrounding the tax.
What is counted in determining the value of “applicable employer-sponsored coverage�? The cost of coverage is calculated based on all “applicable employer-sponsored coverage� employee might have, including but not limited to: The full premium for accident and health coverage provided by the employer, which includes the portion of the premium paid by both the employer and the employee. Employer and employee salary reduction contributions. Employer HSA contributions, which, as discussed in more detail below, may include employee payroll deduction contributions if the IRS adopts a broad interpretation.
What is the Cadillac Tax? The Cadillac Tax is an excise tax on “high cost� employer-sponsored health coverage, provided for in Code Section 4980I.
When is it effective? January 1, 2018.
How is the Cadillac Tax calculated? The Cadillac Tax imposes a 40 percent
employer sponsored coverage� is coverage under long-term care insurance, accident and other things.
Who pays the tax? employer-sponsored coverage� that is in excess 2 Essentially, for 2018, that dollar limit is expected to be at least $10,200 for single coverage and $27,500 for
Under Code Section 4980I(c), the tax is assessed against “coverage providers�. Who the “coverage provider� is depends on the type of
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In the case of fully insured health plans, “coverage providers� are the health insurance issuers. For self-insured plans and FSAs, “coverage providers� are the entity administering the plan (for example, the third party administrator . For HSAs, the “coverage provider� is the employer making the contribution. But it’s still up to the employer to calculate the tax, and the employer could incur tax penalties for failing to do so.
Will employer or employee HSA contributions be included in the calculation? Code Section 4980I(d)(2)(C) states: “In the case of applicable employer-sponsored coverage consisting of coverage under an arrangement under which the employer makes contributions [to HSAs]. . . , the cost of coverage shall be equal to the amount of contributions under the arrangement.� (Emphasis added.) In other words, employer contributions to HSAs are included in calculating the cost of coverage. It is unclear, however, what counts as “employer contributions.� Do “employer contributions� include employer seeding contributions (e.g., employer contributes $500 to each employee’s HSA), wellness contributions, employee pre-tax payroll contributions made through a cafeteria plan and/or employee aftertax payroll contributions? It appears that employer seeding contributions will likely count in the calculation. Wellness contributions could also be seen as an employer contribution that counts. The impact of employee payroll contributions is less clear: Some industry groups have speculated that employees’ pre-tax HSA contributions are like FSA contributions and therefore should be included in calculating the tax. Other industry groups have speculated that employee HSA contributions should not be included in calculating the tax because, unlike FSA contributions, employee HSA contributions can be made outside of payroll and deducted on an individual’s tax return. Additionally, under the ACA, only employer HSA contributions — and not employee HSA contributions — are counted when calculating Actuarial Value and Minimum Value of HSA-qualifying
mployer HSA Programs health plans. It seems that if only employer HSA contributions are taken into account in other provisions of the ACA, the same principle should apply here.
How might the Cadillac Tax affect employer HSA programs? At this time it’s still unclear. A few thoughts on this: It seems that the lower premium typically
factor into the Cadillac Tax calculation. As explained above, the effect of HSA contributions on the calculation of the cost of “employer contributions”. For example, employer HSA contributions will be less likely to trigger the tax if only employer seeding and wellness contributions — and not employee payroll contributions — are Further guidance is needed in this area.
should not exceed the Cadillac Tax thresholds, meaning it’s unlikely that an employer will be hit with the tax for any employee due to the HSA-qualifying health plan alone. For this reason, the Cadillac Tax could lead more employers to less expensive health plan options, like HSA-qualifying health plans, to stay under the limits and avoid the tax. Such a move could result in more individuals being HSA eligible, thus increasing HSA enrollment and use. However, more guidance is needed on how employer HSA contributions will
When can we expect more guidance on the Cadillac Tax? It is hard to say for certain. Regulations have not been issued yet on the Cadillac Tax; to date we only have the statute to assess. We anticipate that regulations or other regulatory guidance will be issued in the next two years, timeline in light of upcoming elections and ongoing legal challenges to the ACA. We will keep you posted as new developments occur.
It appears likely that HSA-qualifying health plans are not going to trigger this tax, given that they are relatively low-cost plans.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
49
WELLNESS
BY CATHY KENWORTHY CHIEF EXECUTIVE OFFICER INTERACTIVE HEALTH
To Improve Workplace Wellness, Help Your Employees Become Better Shoppers
A
The reasons for ensuring a healthy workforce seem clear enough: Not only is it the right thing to do, it’s also good for the bottom line. Employees who engage actively in effective wellness plans are more productive, recover faster and miss less work. Moreover, a focus on wellness helps drive a positive company culture. So why can it be so challenging at times to get employees engaged? And what can employers do to engage their employees? Encouraging employees to think about their health and wellness can
fear of doctors; etc.). Many practical tactics exist to improve employee engagement. Many of them work, and they are discussed fairly frequently. What doesn’t get discussed enough is mindset: How can you change employees’ mindsets so they think of wellness as neither a burden nor a task, but as a natural and obvious part of who they are and how they think? Here’s a suggestion: Make your employees better shoppers. In other words, help them think like consumers and think of your engagement efforts as a brand marketer would. To be clear, I don’t mean this literally. Employees aren’t customers, and your connection with — and responsibility toward — those who work with you runs deeper than plain consumerism. But some of the theories behind consumerism may help evolve your employees’ mindset around health, health care and wellness.
1) Know your numbers. "MM HPPE TIPQQFST LOPX UIFJS OVNCFST UIF TJ[F UIF RVBOUJUZ BOE MJLFMZ NPTU JNQPSUBOU UIF DPTU The same mindset should be brought to wellness. Better choices about health care spend start with knowing your numbers — knowing and understanding your individual risk through a complete health evaluation. attention to activities that could reduce risk. They’ll pay more attention to — and become more engaged with — the available options.
2) Engage now to save later. .BOZ TIPQQFST VTF QSFWFOUJWF QSPEVDUT BOE TFSWJDFT UP BWPJE IJHIFS DPTU PS EJTDPNGPSU MBUFS #VZJOH UPPUIQBTUF OPX IFMQT BWPJE UIF EFOUJTU MBUFS VTJOH MBXO DBSF QSPEVDUT OPX IFMQT BWPJE XFFET MBUFS 4JNJMBSMZ QSFWFOUJPO BOE QSPBDUJWF IFBMUI NBOBHFNFOU IFMQT FNQMPZFFT BWPJE IJHIFS DPTU USFBUNFOUT MBUFS An example: Once our members complete their health evaluation (we draw blood and evaluate the results based on age, gender and health history, including the need for additional testing), we often identify three
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to four percent of employees with critical risks. We immediately connect these individuals with physicians. Acting now saves lives as well as money. Another example comes from our coaching. Members are contacted health coach who offers preventive measures based directly on the individual’s needs. In comparison, traditional outreach typically occurs after a medical claim is received — in other words, it’s reactive health management versus proactive and effective preventive care. changes that help lower risk. For example, on average, a pre-diabetic individual will face annual costs of $500. While that seems like a lot, an individual with diabetes can require approximately $11,000 in annual treatments, and more as complications set in. That’s why we focus on moving pre-diabetics back to a healthy state, in addition to assisting diabetics in managing their condition. Like good consumers, these individuals know their numbers. They also engage now (changing behavior) to avoid higher costs (and serious life complications) later.
3) Offer incentives. 8F BMM LOPX UIF QPXFS PG JODFOUJWFT JO UIF DPOTVNFS XPSME 'SPN DPVQPOT UP GSFRVFOU VTFS QSPHSBNT JODFOUJWFT BNPVOU UP DBTI CBDL JO SFUVSO GPS VTJOH B QSPEVDU PS TFSWJDF The same is true with wellness programs. Incentives can drive program engagement, create a culture of health and encourage employees to be better consumers.
An incentive can be an intermediary step before a high deductible plan or consumer-directed health plan. It also can fund a health savings account and directly impact a high deductible plan. Group survey shows that 74 percent of employers offering health and wellness programs tie them to incentives, with the median incentive at $500 (2013) up from $338 in 2010. Incentives can also be fun. Some of our clients use “Chance Incentives,� where employees who participate in or meet their health goal become eligible for a drawing. One client even gives away a new car! Not surprisingly, they always experience more than 90 percent participation in their wellness program.
Discover how we make wellness programs count www.OnlifeHealth.com H E A LT H
WE MAKE
WELLNESS COUNT Driving engagement and real results with Onlife Sync™ Physical activity is important. It’s actually the most important thing you can do to improve your health. Create powerful results for you and your organization by getting connected. You can even reward trackable fitness activity to start improving the health of employees today.
Onlife gives your employees the ability to choose from 70+ fitness devices and apps from companies including Fitbit ®, Garmin®, Jawbone®, Runkeeper TM, and more. Freedom to choose increases sustained engagement while empowering your organization to incentivize the right activities, at the right time.
Sustainable cost reductions. Healthcare Redefined.
Solutions that actually solve things.
TRANSPARENCY
PREVENTION
STEERAGE
Health Pro Decision Support
Health Prompt
Compass Premier Providers
Empower employees to make high-quality, lower-cost healthcare decisions.
Identify expensive diseases earlier in your employee population when they are easier and less costly to treat.
Connect employees to high-quality, cost-effective providers who support efforts to impact population health and lower costs.
Congratulations to ACAP Health for winning a 2014 Industry Innovator Award. Thank you for your innovative approach to healthcare consumerism and population health management. compassphs.com
BY JOAN CHRISTENSEN VICE PRESIDENT, HEALTH SERVICES FIRST DATA
HEALTH CARE PAYMENTS
Making Health Care Payments Easier in a Complex Ecosystem
T
he Affordable Care Act created many changes and opportunities within the health care system, including payment processing. Payments come from many different entities, including employers, individuals, health plans and the government, and the types of payments are varied, as well, covering premium payments, subsidies, wellness dollars, patient responsibility amounts, payer payments and out-of-pocket expenses for eligible items. In addition, the payment methods vary widely, but include cash, check, credit, debit, ACH/EFT, virtual card, DDA, with As an experienced payments solutions partner to hundreds of thousands of U.S. providers, First Data’s vision and strategy in this systems and solutions that are used by providers, payers and consumers determine how payments are made to each other. The bottom line is this: solutions need to provide options that use existing systems and overlay automated, electronic, easy-to-use tools for any form of payment being made by any stakeholder.
3.
is the ability to offer a virtual card capability for providers to receive payments from payers and consumers, thereby streamlining the payment process and easing the entry of the information using existing procedures. Health savings accounts that give employers the ability to incent health and wellness among employee base. To that end and through the rise of high deductible health plans, HSAs are increasingly allowing consumers to save and have access to tax-advantaged funds to pay for eligible items. For example, First Data offers prepaid cards
4.
purchase any item. The ability to do real-time analytics that determine a patient’s ability to make payments along with estimator tools that determine the cost of
First Data believes that solutions for the health care vertical need to be multi-faceted, allowing options for all stakeholders in the health care
1.
2.
Network and data services that provide all sizes of providers and hospitals with a solution for the movement of funds in any format and complies with all industry standards. Card issuing and payment processing as essential components of allow a consumer to check in while also creating an estimator to calculate the amount due prior to check out. Another example is a mobile payments tool for a consumer to easily make payments from
5.
for providers. Risk management and payment integrity are vital in the health care space and will continue to be important as the industry moves towards more electronic and automated manners of payment. Given the complexity of health care payments, along with the various stakeholders that make up revenue cycle management, it is imperative to have the right payment at the right time. With this approach, providers can provide all constituents the ability to choose their method of payment processing.
By carefully selecting a payment processor with extensive tools and assets, providers can allow all in the value chain the ability to select the proper method for ensuring compliant, innovative and secure movement of funds.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
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SOLUTION PROVIDER MEMBER PROFILES
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.
WWW.THEIHCC.COM
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.” ®
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
HEALTH DECISION SUPPORT AND COST-SAVING TOOLS
Improved Health. Improved Cost.
LOOKING FORWARD TO A CONSUMER DRIVEN FUTURE
FLEXIBLE BENEFIT SERVICE CORPORATION (FLEX)
10275 W. Higgins Road, Suite 500 Rosemont, IL 60018 888-353-9178 fpsales@flexiblebenefit.com www.flexiblebenefit.com
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
September/October 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
202.276.3074
selection & shared decision support
www.wisertogether.com praveen.mooganur@wisertogether.com
platform that helps patients make evidence-based, cost effective
treatment decisions across musculoskeletal, cardiovascular, mental health, diabetes, pregnancy and respiratory illnesses saving payers money. Currently 1.5 million members have access to the platform through employers and health plans in the country. WiserTogether was founded in 2008 and is based in Washington, DC. — Praveen Mooganur, COO, WiserTogether
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EMPLOYEE BENEFITS CONSULTING
Intrepid goes beyond the typical expectations of the benefits consultant. We take the time to understand each client’s unique culture in order to implement the most progressive, creative solution to their benefits needs.
INTREPID
Liz Frayer, RHU 400 Interstate North Parkway, Suite 600, Atlanta, GA 30339 888-612-4644
“Our mission is to empower clients 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.
AMERICA’S HEALTH INSURANCE PLANS 601 Pennsylvania Ave., NW South Building, Suite 500 Washington, D.C. 20004 Lindsey Miranda Canaley Tel: 800.509.4422 Fax: 202.861.6354 lmirandacanaley@ahip.org www.ahip.org/courses
SOLUTION PROVIDER MEMBER PROFILES
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 September/October 2014
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SOLUTION PROVIDER MEMBER PROFILES
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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? What I need? do I go? in healthcare: What do I do have? WhatWhere do I need? What will it cost? How do I connect? Where do I go? What will it cost? How do I connect? 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.� David J. Hines President and Founder
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
“CodeBaby is focused on creating solutions that communicate, educate, and elevate the entire healthcare consumerism experience throughout the consumer lifecycle. Our solutions provide organizations innovative ways to optimize their current platform while meeting the demand for an enhanced online experience.� — Dennis McGuire, CEO, Codebaby HEALTH DECISION SUPPORT TOOLS
TRANSITIONS OPTICAL 9251 Belcher Road Pinellas Park, FL 33782
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.
September/October 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
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.
SOLUTION PROVIDER MEMBER PROFILES
HSA ADMINISTRATION & FINANCE
At HSA Bank, we’ve been helping businesses HSA BANK optimize their health care spending for over 605 N. 8th Street Suite 320 15 years. We offer unmatched service and Sheboygan, Wisconsin 53081 expertise when it comes to health-based United States of America savings accounts. You can count on our 800.357.6246 dedicated business relations team for turnkey www.hsabank.com solutions and ongoing support that help your business and workforce save for a healthy future. To connect with your regional representative, call 866.357.5232 or visit hsabank.com.
“When implementing one of the first Medical Savings Account programs in the country, I had a belief that health care could be fixed with free-market principles. I still do. By adopting flexible and transparent practices that manifest core attributes of consumerism such as private exchanges, defined contributions, and self-funding; we will reform health care in our nation.” — Kirk Hoewisch, Co-Founder and President, HSA Bank, a division of Webster Bank, N.A. HSA / HRA / FSA ADMINISTRATION AND FINANCE
Evolution1 and our Partners serve more EVOLUTION1, INC. than 9 million consumers, making us 952.908.9056 the nation’s largest electronic payment, www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.
“The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.” — Jeff Young Chairman and CEO, Evolution1
HealthCare Consumerism Solutions™ I www.TheIHCC.com I September/October 2014
57
RESOURCE GUIDE
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ADVERTISING INDEX AHIP ...................................................... 55
HSA Bank .............................................. 57
Allstate .................................................... 5
IHC Certification ....................................45
Best Buy ........................Inside Back Cover
IHC FORUM West Show Guide ...........11-18
Castlight Health ...............................19, 55
insurexsolutions ..................................... 55
Cigna ..................................................... 40
Intrepid ............................................42, 55
ADVERTISING CONTACTS
CodeBaby.................................HCX 10, 56
MasterCard ............................................ 54
404.671.9551
Compass Health Care ............................. 52
Onlife Health ..............................HCX 2, 51
Connecture ......................................HCX 8
PrivateHealthCareExchanges.com ..........HCX 6
Consumer Medical ................................. 56
Transitions ..................................46-47, 56
DataPath ................................................ 54
Truven Health Analytics ......................... 56
DentaQuest.....................................HCX 16
TSYS Healthcare ................................7, 57
Evolution1.............................................. 57
UnitedHealthCare ..................... Back Cover
Flexible Benefit Service Corporation........ 54
WageWorks .....................................22, 57
HealthStat ......................Inside Front Cover
Wiser Together ...................................... 54
If you use the services of our solutions providers, please tell them you saw their ad in Solutions™.
CEO
Doug Field @ 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
Rogers Beasley 404.671.9551 ext 109 · rbeasley@theihcc.com ACCOUNT MANAGERS
Michelle Gatehouse Ted Arvan WEST COAST BUSINESS DEVELOPMENT DIRECTOR
Mike Allen
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September/October 2014 I www.TheIHCC.com I HealthCare Consumerism Solutions™
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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