2015 Private Exchange FORUM Conference Agenda
ISSUE || First Quarter • 2015
Innovative Health and Benefit Management
Finding Middle Ground The HSA Future in the Exchange World
Wearables, Gaming and Apps in Wellness Stats & Data: Health Plan Trends
INSIDE: The Official Magazine of
www.theihcc.com
INSIDE
FEATURES 37 Finding Middle Ground What’s needed to successfully marry exchanges and HSAs in 2015 and beyond In some ways, it’s déjà vu. A little over 10 years ago, health savings accounts were the talk of the benefits world. Today, as HSAs have become more mainstream, the chatter has switched to exchanges, with more realizing the two are perfect partners. After last year’s open enrollment, some definite challenges and opportunities became apparent. “Last year, Todd Berkley and John Young did a study, The Power of Choice: The GameChanging Combination of Private Exchanges and Health Savings Accounts, that showed about 20 percent of the entire product offering is HSA-qualified plans,” said Kevin McKechnie, executive director of The HSA Council. “One problem we have found, though, is that many exchanges have been branded to catch your eye instead of being more explanatory and saying they are HSA qualified.” BY HEATHER LOVERIDGE, SENIOR EDITOR, THE INSTITUTE FOR HEALTHCARE CONSUMERISM
39 Improving Health and Patient Outcomes through Personalized, Interactive Engagement Solutions Technology influences health care in many ways: from how people get information about conditions, procedures and providers, to the way they manage and improve their health. According to a Pew Internet survey, 60 percent of U.S. adults use technology (mostly apps) to track weight, diet or exercise routines, and 21 percent use technology to track personal health data. Wearable devices used to track health data will become commonplace, with the market projected to grow from $949 million in 2013 to $19 billion by 2018. In addition to wearables, elements of gaming are popping up everywhere in health care. Most research indicates this trend will continue because it aligns well with broader consumer behavior and trends: in particular, the affinity consumers have toward online communities and gaming. BY EILEEN CIANCIOLO, CHIEF PRODUCT OFFICER, STAYWELL
INSIDE The Industry’s Only Magazine Dedicated Exclusively to Health Exchanges HealthCare Exchange Solutions HealthCare Exchange Solutions helps you understand the choices in the health and benefit marketplace and make the best decisions among a complicated array of exchange solutions options.
COMING UP NEXT: The 2015 HealthCare Consumerism Outlook magazine is just around the corner! In this special annual issue,
contributors from leading industry organizations — including Oliver Wyman, Altarum Institute, The Alliance, PBMI, Catalyst for Payment Reform, HERO and the ABA’s HSA Council — will provide insights into what can be expected in 2015 in key areas of health and benefits. HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
3
INSIDE 6 Publisher’s Letter
DEPARTMENTS 14 Stats & Data: Health Plans
8 Bachman’s Banter
Survey Reveals Key Trends in Employer-Provided Health Care
9 Briefs & Innovations t t t t
#FOFmU "EWJTPST /FUXPSL 1BSUOFST XJUI 4ZOD4USFBN BOE (P)FBMUI /FX &#FOFmUTÂĽ 4PMVUJPOT &NQMPZFS %FDJTJPO 5PPMT )FMQ &NQMPZFST %FBM XJUI "$" 5ISFF 2VBSUFST PG $POTVNFST 8BOU &NQMPZFST 5P 0GGFS )FBMUI *ODFOUJWFT 3BMMZ )FBMUI -BVODIFT /FX %JHJUBM &OHBHFNFOU 4PMVUJPO
By Les McPhearson, Chief Executive Officer, United Benefit Advisors
15 Stats & Data: Transparency Help Consumers Help Themselves By Francois de Brantes, Executive Director, Health Care Incentives Improvement Institute (HCI3)
11 Private Exchange FORUM Preview 47 Affiliate Member Profiles 50 Resource Guide/Ad Index
.D1IFBSTPO
EF #SBOUFT
33 Voluntary Benefits Post-Heath Care Reform, Voluntary Benefits Options Take Center Stage By Tye Elliott, Vice President, Core Broker Sales, Aflac
SIGN UP TO ATTEND
&MMJPUU
35 Brokers/Advisors Voluntary Benefits: A Consumerism Strategy
Events
By Nelson L. Griswold, President, Bottom Line Solutions, Inc.
Private Exchange FORUM
Mar 31 - Apr 1, 2015 Renaissance Richardson Hotel Dallas
43 Education The Importance of Smart Shopping for Health Care
IHC FORUM & EXPO Atlanta June 20-23, 2015 Cobb Galleria Centre Atlanta
By Margie Rodino, Vice President, Global Human Resources, Sloan Valve Company
44 Telehealth
IHC FORUM West Las Vegas
Nov 16-18, 2015 Red Rock Resort Spa & Casino Las Vegas Come LEARN, CONNECT and SHARE with the top thoughtleaders in health care consumerism. Find more information at: www.theihccforum.com
3PEJOP
.BSLT
The Evolution of Telehealth By Jeff Marks, Chief Executive Officer, healthPERX
45 Plan Design 2015: A Pivotal Year for Health Care Coverage By Joseph Berardo Jr., Chief Executive Officer, MagnaCare
#FSBSEP +S
ONLINE EXCLUSIVES Latest Research Says Consumers Ready to Embrace Telehealth Forget FaceTiming your friends and relatives. How about “FaceTiming� your doctor when you’re sick? What could be more convenient, especially if you’re sick after hours, than grabbing your iPad or opening your laptop and chatting with your doctor via video? For many, telehealth is the wave of the future. Those in the health care field have been singing its praises for a while. But are consumers really ready for 24/7 access to a doctor? In December 2014, American Well and Harris Poll surveyed consumers in order to find out what they really think about telehealth. By Heather Loveridge, Senior Editor, The Institute for HealthCare Consumerism
4 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
HSA Contribution Limits, Plan Requirements Projected to Increase for 2016 Most contribution limits and high deductible health plan requirements for health savings accounts (HSAs) will increase for 2016, says one industry expert. Todd Berkley, president of HSA Consulting Services and author of the recently published HSA Owner’s Manual, recently released his 2016 projections on the heels of the December inflation figures from the Bureau of Labor Statistics (BLS). By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism
TSYS processes an average of
44 million
transactions a day.
Provide employees the right tools to make the most of their healthcare choices. At TSYS Healthcare®, our approach to client-driven innovation allows you to define and shape flexible, integrated payment solutions that meet your unique needs. Our independent industry partnerships and elite platform functionality help our clients build solutions that make sense. Our solutions include: • Defined contribution plan options to assist with healthcare exchange premiums • A multi-purse HSA, FSA, HRA, and Wellness card platform developed specifically for healthcare • Enhanced HRA card functionality • An independent partner network • Experienced healthcare advisors • Revenue-generating financial models Integrity | Relationships | Excellence | Innovation | Growth
Learn more at www.tsyshealthcare.com or call us at +1.678.797.8506.
Get to know us.
© 2015 Total System Services, Inc.® All rights reserved worldwide. TSYS® is a federally registered service mark of Total System Services, Inc.
+1.678.797.8506 healthcare@tsys.com www.tsyshealthcare.com
LETTER
PUBLISHER www.theihcc.com VOLUME 11 NO. 1 | FIRST QUARTER 2015
A Look at the Year Ahead
Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Tel: 404.671.9551 • Fax: 770.663.4409 CEO
Doug Field 404.671.9551 ext. 101 ¡ dfield@ theihcc.com
Based on the first six weeks of the year, 2015 looks to be quite the exciting year in the health and
MANAGING DIRECTOR
benefits industry. The wearables craze is in full swing; private exchanges are growing and becoming a
Brent Macy 404.671.9551 ext. 103 ¡ bmacy@theihcc.com
divisive issue; the EEOC is challenging aspects of workplace wellness programs; and a pending King v.
CHIEF MARKETING OFFICER
Burwell ruling will decide the future of President Obama’s signature legislation. The aforementioned trends and events only scratch the surface of change that we can expect this year. Technology is coming to employee benefits in a way previously unseen. Telehealth is inching its way toward to the mainstream as solution providers streamline technology and consumers warm to the concept of meeting with their physician via mobile device. Mobile devices themselves are enabling all kinds of solutions that engage employees in new ways. To help all stakeholders in employer-sponsored health care keep up with the fast-moving marketplace, The Institute for HealthCare Consumerism is excited to be producing three major conferences in 2015 — including the first-ever Private Exchange FORUM in Dallas. Early bird rates are available through March 1 for the inaugural event and can be accessed at PrivateExchangeFORUM. com.
Andrew Dietz adietz@theihcc.com MANAGING EDITOR
Jonathan Field 404.671.9551 • jfield@theihcc.com SENIOR EDITOR
Heather Loveridge hloveridge@theihcc.com ART DIRECTOR
Kellie Frissell 404.671.9551 ext. 107 ¡ kfrissell@fieldmedia.com ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS
Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD
Ronald E. Bachman, CEO, Healthcare Visions EDITORIAL ADVISORY BOARD
This June will host the sixth annual FORUM & Expo back at the Cobb Galleria Centre in Atlanta. With an expected attendance of over 1,000, this year’s event will be the largest in its history. Super saver rates — starting at $99 for employers and brokers – are currently available. Speakers for the June conference include Steve Grieco, CEO, ConnectYourCare; Jamie Benton, managing director, compensation & benefits, Rollins, Inc.; Patti Taylor, director, global benefits, NewellRubbermaid; Dawn Bading, vice president, Human Resources, Kaiser Permanente; Shannon Skaggs, COO, Quantum Health; and many more to be announced. Finally, this year will also host the 10th annual HealthCare Consumerism Superstars awards and magazine. Nominations for this special edition of our annual issue will open during the Private Exchange FORUM on March 31 and will close on July 31.
Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River Group; John Hickman, Alston+Bird LLP; Tony Holmes, Mercer Health & Benefits; Marc Kutter, Aflac; Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC WEBMASTER
Tim Hemendinger timh@fieldmedia.com DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS
Rogers Beasley 404.671.9551 ext 109 ¡ rbeasley@fieldmedia.com ACCOUNT MANAGERS
Michelle Gatehouse 404.405.3007 • mgatehouse@theihcc.com Ted Arvan 678.296.1906 • tarvan@theihcc.com
Sincerely, PARTNERS/ALLIANCES
Joni Lipson 800.546.3750 ¡ jlipson@fieldmedia.com BUSINESS MANAGER
Doug Field CEO/Publisher dfield@fieldmedia.com
Karen Raudabaugh 404.671.9551 ext. 108 ¡ kraudabaugh@fieldmedia.com HealthCare Consumerism Solutions™ Volume 11 Issue 1 Copyright Š2015 by FieldMedia LLC. All rights reserved. HealthCare Consumerism Solutions™ is a trademark of FieldMedia LLC. HealthCare Consumerism Solutions™ is published six times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009. Periodical postage paid at Alpharetta, GA and additional mailing offices. TO SUBSCRIBE: Make checks and money orders payable to HealthCare Consumerism Solutions ™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA 30009 or visit www.theihcc.com. Non-qualified persons may subscribe at the following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or subscriberservice@fieldmedia.com for name/address changes. PRINTED IN THE U.S.A. HealthCare Consumerism Solutions™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher is not engaged in rendering legal, financial, or other professional service. If legal advice is required, the services of a professional adviser should be sought. The magazine is not responsible for unsolicited manuscripts or photographs. Send letters to the editor and editorial inquiries to the above address or to jfield@fieldmedia.com. Permission to reuse content should be sent to jfield@ fieldmedia.com.
6 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
DataPath Summit is our cloud solution that will integrate the administration of FSAs, HRAs, HSAs, transit, COBRA, and a multitude of Premium Billing options with streamlined financial processes including debit cards, electronic payments, custodial banking and investment services. • Not a ‘flex system’ – an ‘everything you can imagine’ solution • Built from the ground up with leading-edge system architecture (SQL2014 and HTML5) • Intuitive navigation and global search functionality • Unsurpassed reporting capabilities • The industry’s simplest data migration process • Fully customizable with your brand Are you ready for a higher level of account administration? Get there with DataPath Summit.
800-633-3841 | dpath.com
Let’s work together. Visit IHC Private Exchange Forum & Expo, March31-April 31-April11in inDallas Dallas Visit with withUs Usatatthe the2015 2015 IHC Private Exchange FORUM, March
BACHMAN’S BANTER
BY RONALD E. BACHMAN FSA, MAAA CHAIRMAN, EDITORIAL ADVISORY BOARD THE INSTITUTE FOR HEALTHCARE CONSUMERISM
Insurers Affected by 2015 Budget Change to Risk Corridors WHO: Health insurers and health insurance co-ops offering qualified health plans (QHPs) that provide individual and group products through federal and state-based health insurance exchanges. WHEN: The FY2015 omnibus appropriations bill was signed into law on December 16, 2014. The law (Public Law 113-235) is effective for fiscal year 2015, which is the period from October 1, 2014 to September 30, 2015. WHAT: The FY2015 omnibus law includes a potentially significant change to risk corridor payments, one of the three insurance product pricing stabilization components of the Affordable Care Act (ACA). Risk corridor transfer payments are processed through the Department of Health and Human Services (HHS) and are used to require profitable insurers to share a portion of their profits to others who are unprofitable. The law prohibits the use additional government funds if the transfer funds from profitable carriers to unprofitable carriers are insufficient.
However, the risk corridor funding requires annual budget appropriations, if the “excess profits� from some carriers are insufficient to offset the “excess losses� of other carriers. The first payment under the risk corridor process will be in 2015, based The lack of government on results of 2014 experience. The FY2015 omnibus law prohibits the use additional funding for a short-fall government funds if the transfer funds from profitable carriers to unprofitable carriers are could have an effect on insufficient. Impact of FY2015 Omnibus premiums charged and how Appropriations Bill: HHS believes that over the aggressively products will be three-year life of the risk corridor payments will be “budget neutral� and the FY2015 omnibus marketed through government law will at worst delay some payments from one fiscal year to another. exchanges. Individuals or However, the FY2015 omnibus bill restriction was passed following The House groups insured in government Committee on Oversight and Government study that found that “[t]he insurers exchanges should be alert to Reform and co-ops expect net payments through the rate increases and consult risk corridor program of about $725 million in the 2014 plan year. The total taxpayer bailout expected by insurance companies likely their agent/broker about approaches $1 billion.�
EXECUTIVE SUMMARY: Health premiums are options to change carriers. based on projected claims. Insurers have little ACTIONS REQUIRED: Insurers will need to experience to project claims for products offered under the ACA, especially analyze their likely role as a giver or receiver of risk corridor payments. with the removal of underwriting and exclusions for pre-existing conditions. Insurers should have their actuaries, brokers, consultants and lawyers It takes a year or more for health claims under ACA plans to occur, be analyze the possible scenarios. Insurers may need to consult with their processed and analyzed. To give insurers time to base premiums on actual tax professionals and auditors regarding any delayed or uncertain deferred paid ACA product claims, the ACA included three “premium stabilization� government payments. features for products sold during the transition period from 2014 to 2016: In addition, the lack of government funding for a short-fall could have 1. Risk adjustment payments (transfers among insurers based on the an effect on premiums charged and how aggressively products will be relative health of enrollees); marketed through government exchanges. Individuals or groups insured in 2. Transitional Government Reinsurance Pool (transfers among government exchanges should be alert to rate increases and consult their insurers based on individual large claims); agent/broker about options to change carriers. 3. Risk corridor payments (transfer among insurers based on profitability). The information presented and contained within this article was submitted by Ronald The three premium stabilization features allow insurers to keep premiums lower than would otherwise be needed during the startup years of 2014 to 2016. The first two are funded by health plan fees and taxes, so there is no obligation for any additional federal funding.
8 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
E. Bachman, president and CEO, Healthcare Visions, and chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism. This information is general information only, and does not, and is not intended to constitute legal advice. You should consult legal advisors to determine the laws and regulations applicable to your company. Any opinions expressed within this document are solely the opinion of the individual author.
HEALTHCARE CONSUMERISM NEWS BRIEFS
USA Business Choice Introduces New Intelligent Virtual Assistant from CodeBaby CodeBaby, a provider of interactive virtual assistant technology, announced recently that USA Business Choice has implemented a CodeBaby interactive virtual assistant on their website, recognizing that an engaging customer experience is critical to connecting with brokers and small businesses seeking health care solutions. Introduced on the USA Business Choice homepage, the intelligent virtual assistant, Brooke, handles the critical first few seconds to capture a visitor’s attention. Brooke interacts with the visitor as she welcomes them to the site, helps them navigate their next step and provides additional information so they get started down the right path. As a result of this engagement, Brooke is able to guide a visitor based on interest. This reduces the amount of time a visitor spends searching and delivers them to the right location more quickly.
Trotter Wellness Announces New Products, New Name Trotter Wellness recently announced a corporate name change to Well Nation, the name given to its newly launched integrated wellness platform. Well Nation combines 10 years of proven wellness experience into a new seamless, fully customizable technology platform that is simple to set up and easy to use. Employers are provided with communications, tools, resources and real-time reporting to assist them in efficiently and effectively implementing an onsite wellness program. Well Nation meets an organizations needs from basic introductory programs to complete health contingent campaigns. In addition, Well Nation’s integrated Champion Rewards™ Program allows employers to support, engage and reward employees for making positive lifestyle choices.
UMB Surpasses $1 Billion in Health Savings Account Deposits and Assets UMB Healthcare Services, a division of UMB Financial Corporation, announced that it has surpassed $1 billion in health savings account (HSA) deposits and assets as of Jan. 31, 2015 – a 36 percent increase over the previous 12 months. In addition, the number of its HSAs has grown to more than 600,000 individual accounts as of Jan. 31, 2015, up 34 percent from its nearly 450,000 accounts as of January 31, 2014. UMB Healthcare Services also saw an increase in the number of benefit cards it provides for flexible spending arrangements (FSAs), health reimbursement arrangements (HRAs) and HSAs. At 2014 year-end, cards numbered more than 4.3 million, up from 3.6 million cards at year-end 2013.
Benefit Advisors Network Partners with SyncStream and GoHealth Benefit Advisors Network (BAN) – a national network of independent employee benefit firms – has partnered with and SyncStream Solutions and GoHealth. These strategic partnerships will provide additional benefits BAN members can offer exclusively to their employer clients. As part of an enhanced set of features for Version 2.0 of BAN’s Smart Compliance Portal, the SyncStream partnership will provide a variable hour tracking and reporting solution. These new features are important since they help ensure continued compliance with the Affordable Care Act (ACA) and simplify reporting requirements employers are obligated to meet in 2015 and beyond. GoHealth will give agencies access to a turn-key individual exchange solution, allowing them to work with
individuals to compare plans, estimate tax subsidies and enroll in a plan that’s best for them — all on one integrated online platform.
MBGH Launches Price and Quality Transparency Program to Support Employers in Reducing Medical Costs Consumers have an increasing amount of “skin in the game” when it comes to medical and financial decisions for their care, and their interest to access credible information and user-friendly tools and resources about cost and quality is growing. To help employers provide this information to their employees, the Midwest Business Group on Health (MBGH) is collaborating with two leading transparency service providers: Change Healthcare and Compass Professional Health Services. One of the nation’s leading non-profit business groups of private and public employers, MBGH is implementing this program through its affiliate, the Midwest Health Purchasers Foundation (MHPF).
FlexMinder Partners with Consumer-Driven Health Care Leader Acclaris FlexMinder, a Seattle-based technology startup, has announced a new partnership with Acclaris, a leader in account-based health plan technology and services. The partnership and integration of technologies between the two companies is a step toward revolutionizing a heavily paper-processed industry. With FlexMinder, Acclaris’s 6,000 employer groups will now have the option for automated carrier claim data to be pushed straight to their platform, eliminating the need for participants to manually submit paperwork. Leveraging this technology allows Acclaris clients to significantly improve their customer satisfaction, reduce costs, increase participation rates and win new business.
Retrofit Unveils New Weight Management Solution For Corporate Market Retrofit recently announced the launch of a comprehensive weight management solution that helps employers successfully tackle the obesity epidemic and associated costs. The solution brings a first-ofits-kind approach to the marketplace, combining one-on-one video coaching with real experts, interactive classes and the social support needed to help the overweight and obese population achieve lasting weight loss. Initial outcomes among current clients are so promising that the company is now offering a weight loss performance guarantee exclusively to its corporate clients adding Retrofit to their overall wellness portfolios. Several of the nation’s largest corporations are joining Retrofit, including Google, Salesforce.com, the American Hospital Association and DeVry University.
New EBenefits® Solutions Employer Decision Tools Help Employers Deal with the Affordable Care Act EBenefits® Solutions – a powerful online solution that streamlines benefits enrollment and administration – is now offering two integrated ACA Employer Decision Tools: the ACA Navigator and the ACA Compliance Module. Many companies lack the time and resources to be current with the changing regulations of health reform. Moreover, many companies lack the internal technology necessary to carry out the record-keeping, enrollment and reporting requirements that are legally necessary to be compliant with the law. These tools enable companies continued on page 12
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
9
Get An Insider’s View Of The Private Exchange
FORUM GENERAL SESSIONS DAY ONE Tuesday, March 31 OPENING GENERAL SESSION 2:00 to 3:00 p.m. Private Exchanges: What’s Working, What’s Not and What Lies Ahead Moderator: Doug Field, CEO, The Institute for HealthCare Consumerism Panelists: Paul Rogers, President & COO, Pacific Resources; Bruce Sammis, CEO, Lockton Dunning Benefits; Barbara Gniewek, Principal, GHRS, PwC; Scott Brown, Private Exchange Offering Lead, Accenture DAY ONE AFTERNOON GENERAL SESSION 3:15 to 4:15 p.m. Understanding Private Exchange Models and Platform Options
March 31 to April 1, 2015 Renaissance Richardson Hotel Dallas, Texas
MID-MORNING GENERAL SESSION 10:00 to 11:00 a.m. Defined Contribution Health Care: Why Do It, How to Do It and What to Do in Renewal Years Moderator: John Young, CHCC, CEO, Consumerdriven, LLC (Conference Co-Chair) Panelists: Jeff Bakke, Chief Strategy Officer, Evolution1; Barb Vasko, Vice President, Aon Hewitt; Michelle Murray, Manager of Benefits, Tennant Company AFTERNOON GENERAL SESSION 1:45 to 2:45 a.m. Providing the Right Consumer Experience: The Value and Importance of Building the Complete Exchange Solution
Moderator: Barbara Gniewek, Principal, GHRS, PwC Panelists: Rob Butler, CEO, Maestro Health; Robert Steele, Chief Sales and Marketing Officer, Quadrant 4 Health; Eugene Sayan, Chairman, CEO, & President, Softheon; and Shandon Fowler, Director of Product Management for Marketplaces, Benefitfocus
Moderator/Lead Speaker: Dr. Wendy Lynch, Founder, Lynch Consulting, and Research Fellow, Altarum Center for Consumer Choice in Health Care Panelists: Barbara Boudreau, Senior Vice President of Member Experience, ConnectYourCare; Dr. Bruce Sherman, MD, FCCP, FACOEM, Medical Director, Population Health Management Health Exchange Solutions, Xerox. Speaker from Optum to be announced.
DAY ONE CLOSING GENERAL SESSION 4:30 to 5:45 p.m. What Defined Contribution & Exchange Solutions Are Leading Brokers/ Consultants Are Offering Their Clients?
CLOSING GENERAL SESSION 4:30 to 5:30 p.m. Perspectives from Leading Employers That Have Implemented Private Exchanges
Moderator: John Young, CHCC, CEO, Consumerdriven, LLC (Conference Co-Chair) Panelists: Eric Grossman, Senior Partner, Marketplace Active Exchange, Mercer; Sherri Bockhorst, Principal and National Practice Leader, Health Exchange Solutions, Buck Consultants; Eric McMurray, Managing Director, Client Development – Exchange Solutions, Towers Watson
Moderator: Marianne Fazen, Ph.D, Executive Director, Dallas-Fort Worth Business Group on Health Panelists: Joseph Scudiero, Senior Vice President and Chief Labor Counsel, Entertainment Partners; Leslie Vander Gheynst, Director of HR/Recruiting, Keller Williams Realty, Inc. Additional employer speakers to be announced.
DAY TWO Wednesday, April 1 OPENING GENERAL SESSION 8:30 to 9:45 a.m. Leading Health Plans Reveal Product Strategies for Their Own Exchange Solutions and Inside Other Exchanges Moderator: Jody L. Dietel, AFCFCI, CAS, Chief Compliance Officer, WageWorks, Inc. Panelists: Lisa Feddema, Director, Exchange Management, Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma and Texas; Patty Fontneau, President, Private Exchange Business, Cigna. Additional health plan executives to be announced.
10 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
WORKSHOPS TRACK ONE Wednesday, April 1 from 11:15 a.m. to 12:15 p.m. SESSION 101 Providing the Right Benefits Mix in Your Exchange Moderator: Rick A. Strater, Division VP & National Exchange Practice Leader, Gallagher Panelists: Brian Latkowski, EVP, Global Sales, New Benefits; JoAnne K. Novak, AVP, Business Development, Hartville Pet Insurance Group/ASPCA Pet Health Insurance; Thomas Dimmer, VP, Business Development, Individual Markets & Exchanges, Renaissance Dental, Renaissance Life & Health Insurance Company of America; and Mark Parabicoli, Managing Director for Exchanges, ARAG Group
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
11
HEALTHCARE CONSUMERISM NEWS BRIEFS
continued from page 9
to successfully manage the administrative requirements of the ACA, including eligibility tracking, notifications to employees, enrollment, standardizing of reports and monitoring the latest changes to the ACA.
with its strategy, HSA Bank has added key partnerships with multiple large employer HSA clients as well as two of the five largest health insurance providers in the U.S.
Webster Financial Completes Acquisition of Health Savings Account Business from JPMorgan Chase
Rally Health Launches New Digital Engagement Solution
Webster Financial Corporation recently completed its acquisition of the health savings account (HSA) business of JPMorgan Chase Bank, N.A., a subsidiary of JPMorgan Chase & Co. The transaction, announced on September 23, 2014, solidifies HSA Bank, a division of Webster Bank, as a leading administrator and depository of health savings accounts. Based in Sheboygan, Wis., HSA Bank is one of the oldest, most experienced HSA providers in the nation. Webster acquired approximately 785,000 accounts, including approximately $1.3 billion in deposits and $185 million in other assets under administration. Webster’s HSA Bank division now has approximately 1.6 million accounts with over $4 billion in assets under administration, including $3.2 billion in deposits. As a result of this acquisition and in alignment
Rally Health, a leading developer of data-driven solutions for consumer health engagement, announced the launch of its flagship product, RallySM. The HIPAA-compliant platform leverages the power of personal health data, social networking and gamification to encourage consumers to take control of their health. Rally is a digital health platform that gives consumers the support and tools they need to better manage their health and well-being. The gateway to Rally is the Health Survey, which uses industry standards, research and best practices to give consumers a measure of their overall health. Based on the consumer’s self-reported and digitally captured data, Rally provides multiple layers of engagement through personalized recommendations, rewards, coaching, tools, community and content that promote healthy lifestyle behaviors.
HEALTHCARE CONSUMERISM RESEARCH, SURVEYS & REPORTS
New Research Finds U.S. Employees Are More Engaged When Employer Cares About Well-Being
Aflac Survey Reveals Nearly Nine in 10 American Workers Say Voluntary Benefits Are Important
Employee engagement is higher when workforces are satisfied with the health and well-being benefits their employer provides, according to new research from Quantum Workplace, a leading workplace survey and employee feedback technology company, and Limeade, a technology company that helps companies build high-performing workforces. The study also highlights a wide-ranging discrepancy between the benefits that employees want and the benefits they actually receive. The report, Workplace Well-Being: Provide Meaningful Benefits to Energize Employee Health, Engagement, and Performance analyzes nearly 2,000 survey responses from participants in Quantum Workplace’s nationally-recognized Best Places to Work program.
Most American employees (88 percent) at least somewhat agree they consider voluntary insurance benefits a part of a comprehensive benefits program, according to the 2014 Aflac WorkForces Report. With plans such as accident, critical illness and hospital confinement, employees view voluntary benefits as a way to fill in coverage gaps. In fact, 63 percent see a growing need for voluntary benefits options in 2014 compared to previous years, and 48 percent of employees say they are more knowledgeable about voluntary benefits than they were last year. Due to increasing health care costs and an evolving health benefits landscape, the demand for voluntary plans is on the rise. According to a LIMRA survey, voluntary health product sales were $2.6 billion in 2013, which represents a 13 percent increase over 2012.
Three-Quarters of Consumers Want Employers To Offer Health Incentives, Survey Finds While the EEOC is working in earnest to develop rules and guidelines for voluntary employer wellness programs, consumers overwhelmingly want their employers to offer incentives and rewards to help them manage and improve their health. These results were revealed in a January 2015 HealthMine™ survey of 562 consumers with employersponsored health plans. The survey indicated that 71 percent of consumers desire help from their companies in the form of programs and guidelines for health management. Moreover, more than 75 percent of respondents believe an incentive level would motivate them to take action to improve their health towards personal goals or needs. Additionally, 67 percent of survey respondents believe that colleagues who are in a healthy weight range should be rewarded with a discount on their health insurance. And 52 percent believe that colleagues who adhere to medication for chronic disease should be rewarded for it.
12 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
Survey: Costs and Employee Productivity Top Priorities for Benefits Programs According to a recent survey from Wells Fargo Insurance, C-suite executives and benefit managers cite managing costs and maintaining employee productivity as the most important goals in both the short (12-18 months) and long term (five years). Additionally, C-suite executives (88 percent) and benefit managers (85 percent) agree that benefit programs have the most impact on improving employee loyalty as well as increasing employee engagement and lowering company medical costs. Wells Fargo Insurance designed the Employee Benefits Trends Survey to better understand how companies are responding to health care reform requirements while also providing their employees with competitive benefits programs. Surveying C-suite executives and benefit managers from companies with more than 50 employees, the survey generated 950 responses and covered topics including cost containment strategies, employee attraction and retention, outlook on health care reform and financial impact of employee health.
STATS & DATA: HEALTH PLANS
BY LES MCPHEARSON CHIEF EXECUTIVE OFFICER UNITED BENEFIT ADVISORS
Survey Reveals Key Trends in Employer-Provided Health Care
W
ith the Patient Protection and Affordable Care Act (PPACA) bearing down on corporate America like a mighty nor’easter, many employers have found ways to delay some of the impacts of this storm. The tactics they’re using — along with other significant health plan trends—are revealed in United Benefit Advisors’ (UBA) latest Health Plan Survey, which annually gathers input from thousands of employers across the nation regarding their health plan offerings, their ongoing plan decisions in the face of significant change, and the impact of these changes on their workforces and businesses. As the 2014 survey shows, two of the most common tactics employers used to delay costs and compliance implications of PPACA were: Early renewal of their health care plans — In fact, there was a nearly 322 percent increase in the number of plans utilizing an early renewal strategy. Early renewals of Pre-PPACA plans largely kept rates increases in check. Premium renewal rates increased an average of 5.6 percent for all plans—up very slightly from last year’s 5.5 percent increase. (By constrast, employers who had to move to PPACA plans or didn’t have the benefit of being in a grandmothered state are facing staggering rate increases of 30 to 160 percent!) Increasing out-of-pocket costs for employees — While average in-network deductibles remained fairly level at $1,901, out-of-pocket maximums for 2014 increased more than six percent over last year. The median single out-of-pocket maximum is $3,500 (an increase of $500), and the median family out-of-pocket maximum is $8,000 (an increase of $1,000). Interestingly, the survey also shows the nation’s smallest employers (those with fewer than 50 employees) experienced the lowest overall increases in plan costs due to an unusual option they had to remain with non-PPACA-compliant plans. And plans in the Northeast U.S. continue to be the richest and most expensive, putting them at risk of the looming Cadillac tax. Following are 10 more key findings from the 2014 Health Plan Survey: 1. Health Plan Options—More than half (55.1 percent) of all employers offer one health plan to employees, while 28.6 percent offer two plan options, and 16.3 percent offer three or more options. 2. Health Plan Costs—The average annual health plan cost per employee for all plan types is $9,504, with an average employer cost of $6,276 per employee, and an average employee cost of $3,228. As you can see from this table, health maintenance organizations (HMOs) have lower annual costs per employee (by 4.7 percent) than the average plan. On the other hand, point of service (POS) plans, exclusive provider organizations (EPOs), and preferred provider organizations (PPOs) all have higher annual costs per employee than the average plan: PPO plan costs are 3.4 percent higher, POS plan costs are 5.3 percent higher, and EPO costs are 8.5 percent higher. Despite this, PPOs continue to dominate the market in terms of plan distribution and employee enrollment.
14 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
3. Costs and Contributions by Industry—Total costs per employee for the construction, retail and hospitality sectors are 5.5 percent to 20 percent lower than the average, making employees in these industries among the least expensive to cover. By contrast, government plans have the highest average cost per employee ($11,329 or 17.5 percent higher than average) and employee contributions are 45.1 percent less ($2,040) than the average employee contribution of $3,228. Employees in the construction sector contributed approximately 11.4 percent more ($3,620) toward plan costs than average. 4. Prevalence of Plan Type by Region—PPO plans are most prevalent in the Central U.S. while consumer-driven health plans (CDHPs) are most prevalent in the Northeast. 5. Enrollment by Plan Type by Region—PPO plans have the greatest enrollment in the West, while CDHPs see the greatest enrollment in the North Central U.S. 6. Dependent Coverage—47.8 percent of all covered employees also elect dependent coverage, with the highest percentage being covered by CDHP, POS, and PPO plans. The dependent coverage percentages have remained essentially unchanged for the past three years, which means there hasn’t been a rush to drop family coverage as some pundits had predicted. 7. Spouse/Partner Coverage—62.3 percent of all employers provide no domestic partner benefits (a trend that has remained unchanged for the past three years); 28.4 percent provide coverage for both same-sex and opposite-sex domestic partners; 5.5 percent provide same-sex coverage only; and 3.7 percent provide opposite-sex domestic partner benefits only. 8. Comprehensive Wellness Programs—18.4 percent of all employers offered comprehensive wellness programs, which is a 0.8 percent decline from last year. This holding pattern is largely due to pending litigation and an increasingly restrictive regulatory environment. As a result, many employers have become more focused on health care reform rather than on supplemental programs such as wellness. Additionally, the health of an employee population is no longer a rating factor for smaller employers, so this also adds to a decrease in their adoption of wellness programs. Of those employers offering wellness, 80.3 percent included health risk assessments; 67 percent offered employee incentives for participation; 63.4 percent offered biometric screening or physical exams; 51.9 percent included on-site or telephone coaching for high-risk employees; and 40.3 percent included seminars or workshops. 9. Grandfathering—Only 8.2 percent of plans are considered grandfathered plans. 10. Self-Funding—11.1 percent of all plans are self-funded. By contrast, 80 percent of all large employer (1,000+ employees) plans are self-funded. Many experts believe that self-funding will be increasingly desirable to employers of all sizes in the coming years as a way to avoid various cost and compliance aspects of health care reform.
BY FRANCOIS DE BRANTES EXECUTIVE DIRECTOR HEALTH CARE INCENTIVES IMPROVEMENT INSTITUTE (HCI3)
STATS & DATA: TRANSPARENCY
Help Consumers Help Themselves
A
cross America, very few states take the protection and rights of failures of the market continues to impact them in the form of higher consumers seriously when it comes to making available health care premiums and costs. While state budgets are strained by higher costs — quality and cost information. including the costs of covering state employee health benefits — the leaders This is of significant concern as consumers are sharing a growing of these states fail to acknowledge the importance of making information on burden of the cost of care. More than half of all insured Americans spend the cost and quality of health care providers widely available. less on health care during the course of any year than the total amount of States aren’t alone. The federal government, who in the past led the pace their deductible, meaning these consumer-patients are in a full retail market. in collecting and disseminating information on the quality of hospitals, has Every penny paid for routine sick care, or for the management of a condition, also fallen behind. Earlier this year, the Health Care Incentives Improvement including, for some, the full cost of a pregnancy and delivery, is coming out of Institute (HCI3) conducted a thorough study of available hospital quality their pocket. And yet, in two-thirds of the states these consumer-patients have measures with a very simple objective: to consolidate them into a single no information with which to compare the quality of physician care. What they score by disease or procedure in order to better help consumers differentiate might get through their health plan’s website is nonexistent, incomplete and/ the quality of care from one hospital to another. What we discovered is also or judged to be subjective. alarming. The upshot is that in 2014, fifteen years after the publication of “To A few states have made the decision to collect and publish information Err Is Human” by the Institute of Medicine, there was little, if any, useful and that can help consumers make more informed choices. What they have meaningful information on the quality of care provided by hospitals. shown through their efforts is that the process of measuring physician quality Consumers are flying blind when it comes to selecting hospitals and is achievable and that designing a website to publish that information is physicians, and public and private sector purchasers cannot hope to improve perfectly feasible. In other words, by their actions, they accentuate the failure the overall quality and affordability of American health care if they don’t find of the other states. a way to solve this problem. Some states have, and every other state in the Many studies show the variations in quality of care and the harm to union should follow suit. patients from the underuse, overuse and misuse of STATE REPORT CARD on Transparency of Physician Quality Information health care services. Even medical specialty societies, through the Choosing Wisely campaign, promote that certain tests and procedures are significantly overused and provide little value to patients. In fact, some can be harmful. Yet even when faced with all this evidence, many states fail to take action to offer the most basic protection to their residents. It’s a well-known economic theory that markets cannot function when the buyer does not have adequate information from which to make a purchasing decision. In At a time when consumers are being asked to share more of the health care costs, finding objective and useful information on the quality of doctors still remains largely unobtainable causing most Americans to shop blindly for their care. The 2014 State Report Card on Transparency of Physician Quality Information, developed by the Health Care Incentives Improvement Institute, states across the country, highlights the states making an effort to aid consumers in their health care decision making, but also reveals the overall lack of objective quality information available. This report grades states on the percentage of clinicians with publicly available quality the buyers of health care information, the type of measurement reported, and how accessible and useful the information is to consumers. — ordinary citizens — have no information on which to 13 SUGAR STREET, NEWTOWN, CT 06470 / EMAIL: INFO@HCI3.ORG / WWW.HCI3.ORG base their decision, and the Source: Health Care Incentives Improvement Institute (HCI3)
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
15
NOMINATE & RECOGNIZE INNOVATIVE HEALTH & BENEFITS MANAGERS
The Leading Annual Awards Issue from TheIHCC.com — Publishers of HealthCare Consumerism Solutions Magazine
Do you know someone who goes the extra mile as a creative problem solver and innovator? The Institute for HealthCare Consumerism (www.theihcc.com) is looking for the industry’s true superstars — professionals in health care and benefit management, including: employers, solutions providers, brokers, TPAs and HR managers, who have excelled at implementing solutions to complex HR Visionary of the Year health care benefits Award, Sponsored by: issues. Superstars will be published November 2015 in our annual HealthCare Consumerism To formally recognize human Superstars issue and resource and benefits professionals will be accessible to more than 70,000 who are promoting healthy sight to readers. their workforce through superior
Nominate a Superstar Today! ■
■
■
■
■
■
John J. Robbins Sr., Memorial CEO Leadership Award: To an outstanding leader of any size organization who is an exceptional businessperson, as well as a successful parent and pillar of the community. CEO Leadership Award: To an outstanding leader of any size organization, who embraces supports and endorsed an innovative health care or benefits program. Most Innovative Plan Design Award: To an HR/Benefits executive who identified and solved a problem using an innovative health care or benefits program. Most Effective Plan Implementation Award: To an HR/Benefits team that successfully implemented a health care or benefits program and exceeded goals or reaped unanticipated awards. Most Innovative Employee Education/Communication Award: To an employer, who designed and implemented tools for their employees that exceeded plan participation. Most Innovative Employee Empowerment Award: To an employer, who designed and implemented tools that had a high
vision care benefits offerings and education.
engagement of employee participation in a health care or benefits program. ■ Most Effective Population Health & Wellness Award: To an employer who uses the most innovative method to reduce absenteeism and chronic disease costs to improve overall employee health. ■ Public Policy Leadership Award: An individual who encourages health care consumerism in public policy through legislation. ■ Most Effective Solution Provider Award: To a solution provider who introduces the most innovative health care or benefit solution. ■ Most Innovative Partner-Consultant Award: To a consultant who worked most effectively with an HR/Benefits team to implement a health care or benefits program. ■ Most Innovative Broker Award: To a broker, who learned a client’s needs and provided the most effective solution for the employer. ■ Health Plan Innovation Award: To a health plan that actively promotes consumerism and engages members in their health through innovative product offerings, tools and communication.
NOMINATION CATEGORIES: Nomination Categories for 500 - 2500 employees, 2501 - 7500 employees, and 7500+ employees
For details, please visit www.theihcc.com. Nominations close July 31, 2015. E-mail your Superstar nomination to nominations@fieldmedia.com or nominate online.
First Quarter 2015
Exchange
About Innovative Health and Benefit Marketplaces
Investigating Private Exchanges The Second Annual PEEC Study 2015 Perspectives from Industry Leaders Exchange Profile: Genius Avenue The Official Magazine of
www.theihcc.com
Projections from organizations like Accenture and Oliver Wyman suggest that 35 to 75 million Americans will receive their employee benefits via a private exchange within the next few years. Are you ready to make the transition? With PrivateHealthCareEXCHANGES.com, The Institute for HealthCare Consumerism has aggregated 160+ private exchange solutions to create the industry’s premier guide to help you — employers, health plans, brokers, advisors and consumers — to navigate this sea of change in employee benefits.
The Only Online Guide Where Employers, Health Plans, Brokers and Consultants Can Navigate Private Exchange and Defined Contribution Solutions and Models
Access the Complete Database for $99!
Submit your FREE Listing. Enhanced Listing and Premium Profile Opportunities Available.
www.PrivateHealthCareExchanges.com
INSIDE FEATURE 13 More Employers Investigating Benefits of Private Exchanges Private exchanges have been creating a buzz in the employersponsored health care marketplace. After a flurry of activity in 2013 and 2014 among large employers, many feel we have moved beyond the “early adopter” stage and are poised for broader acceptance. Private exchanges are becoming more commonplace with more organizations than ever before implementing exchanges or actively considering them. The second annual study by the Private Exchange Evaluation Collaboration confirms that interest in private exchanges continues among employers for full-time active and retirees. The national survey, based on the responses of 446 employers, reports 47 percent of respondents have already implemented or are considering a private exchange for full-time employees by 2018, and 37 percent of respondents are doing the same for retirees. This year’s survey is also the first national survey that captures the experience of early adopters of private exchanges for active employees as well as retirees. By Barbara Gniewek, Principal, PwC, and Jasmine Macies, Associate, PwC
4
Publisher’s Letter CEO and Publisher Doug Field covers the latest trends in private exchanges and shares what’s happening at The Institute for HealthCare Consumerism around exchanges.
5
Briefs & Innovations Keeping you up-to-date with the latest news, research and innovation in health insurance exchanges (both
PERSPECTIVES 7
Private Exchanges: An Evolving Option... But Not a Silver Bullet It’s the beginning of a new year, and employees and employers alike are ready for a fresh start. And, the first item on many agendas is to restrain ever-increasing health benefit costs. As this price trend continues on the steep slope north, with the passing of the Affordable Care Act (ACA) in 2010, proactive organizations have been on the hunt for ways to minimize the cost of their health benefit plans, harboring increased awareness of private health insurance exchanges, better known as private exchanges. By Jim O’Connor, President, Employee Benefits, CBIZ, Inc.
9
What’s Next for Private Exchanges? Four Considerations Last year, as the clock ticked down to 2015, private exchanges experienced modest levels of adoption. By and large, the first significant cohort to embrace this approach were large employers with sophisticated benefits personnel and ample money at risk in “pay or play” analyses. They found private exchanges to be a viable strategy, and many chose this route rather than abandoning health insurance and sending their employees to public exchanges. By Mike Sullivan, EVP and CMO, Digital Insurance and Digital Benefit Advisors
10 APIs Enable Speed to Market with Consumer Friendly Benefits Exchanges The Affordable Care Act offers consumers a much wider array of health care choices. In the past, employers handed employees a packet of paper with pre-selected options for health care and benefits. Now a whole new world is opening up for employees to shop and compare all kinds of plans in online exchanges to assemble a personalized package that includes both traditional and non-traditional benefits. By Dayne Williams, CEO, PlanSource
public and private) and defined contribution.
6
Exchange Profile Why “Blended” Exchanges are the Right Solution for Employers Looking to Recruit and Retain Lower-Wage Workers A main focus around benefit strategies for 2015 and beyond has been on offering health coverage to eligible employees, and for good reason since employers who don’t
offer qualifying plans to these workers will face hefty fines. However, as the job market for quality part-time workers becomes much more competitive, it will also be important to have recruitment and retention strategies in place throughout the year for this segment of the workforce. By Ben Rozum, President, Genius Avenue
HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
3
PUBLISHER
Exchange www.theihcc.com VOLUME 2 NO. 1 | FIRST QUARTER 2015
Private Exchanges: A Catalyst for Consumerism? In the health and benefits industry, there has been no hotter topic than private exchanges over the past 18 months. While other new technology trends — such as transparency tools, mobile health apps and wearable devices — have garnered significant attention, private exchanges have seemingly polarized the industry in a way we haven’t previously seen with these other trends.
Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Tel: 404.671.9551 • Fax: 770.663.4409 CEO
Doug Field 404.671.9551 ext. 101 · dfield@ theihcc.com MANAGING DIRECTOR
Brent Macy 404.671.9551 ext. 103 · bmacy@theihcc.com CHIEF MARKETING OFFICER
We have heard from the naysayers: private exchanges are nothing more than an enrollment platform that shifts more and more costs to the employee population. And we have heard from the soothsayers that proclaim private exchanges will be the future of employee benefits in just one or two more enrollment cycles. But what is the most likely path of the private exchange future? And realistically, how will the adoption of private exchange solutions affect the employer-sponsored health and benefits? In this issue, we have provided insightful perspectives on the future of private exchanges from three industry veterans: Mike Sullivan, EVP and CMO, Digital Insurance; Dayne Williams, CEO, PlanSource; and Jim O’Connor, president of Employee Benefits, CBIZ.
Andrew Dietz adietz@theihcc.com MANAGING EDITOR
Jonathan Field 404.671.9551 • jfield@theihcc.com SENIOR EDITOR
Heather Loveridge hloveridge@theihcc.com ART DIRECTOR
Kellie Frissell 404.671.9551 ext. 107 · kfrissell@fieldmedia.com ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS
Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD
In addition to these commentaries, for this issue’s feature, we are excited to have Barbara Gniewek and Jasmine Macies at PwC condense the latest research on private exchange adoption by the Private Exchange Evaluation Collaboration (PEEC), a business collaborative between the Northeast Business Group on Health, Midwest Business Group on Health, Employer’s Health, Pacific Business Group on Health and PwC. While I hope our readers find significant value in these pages, the articles herein are only a part of our efforts to illuminate the facts and possible pathways of the private exchange future. This March, we are excited to be hosting the first-ever Private Exchange FORUM, a new conference aimed at providing participants with a complete view of the private exchange landscape. The two-day event in Dallas will unravel the confusing tangle of models, choices and offerings that is the current private exchange market. With speakers from leading employers, brokerage firms, consulting practices, solution providers and health insurance plans, the Private Exchange FORUM agenda is designed to take attendees on a journey through the process of evaluating and selecting a private exchange model. Speakers and panelists include Paul Rogers, president, Pacific Resources; Bruce Sammis, CEO, Lockton Dunning Benefits; Scott Brown, private exchange offering lead, Accenture; Rob Butler, CEO, Maestro Health; Eugene Sayan, chairman, CEO and president, Softheon; Patty Fontneau, president, Private Exchange Business, Cigna; and many more. As you and your colleagues investigate the role of private exchanges in the future of your business, I hope you find the insights inside this issue of HealthCare Exchange Solutions and at our inaugural Private Exchange FORUM to be valuable guides in the process. Sincerely,
Ronald E. Bachman, CEO, Healthcare Visions EDITORIAL ADVISORY BOARD
Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River Group; John Hickman, Alston+Bird LLP; Tony Holmes, Mercer Health & Benefits; Marc Kutter, Aflac; Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC WEBMASTER
Tim Hemendinger timh@fieldmedia.com DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS
Rogers Beasley 404.671.9551 ext 109 · rbeasley@fieldmedia.com ACCOUNT MANAGERS
Michelle Gatehouse 404.405.3007 • mgatehouse@theihcc.com Ted Arvan 678.296.1906 • tarvan@theihcc.com PARTNERS/ALLIANCES
Joni Lipson 800.546.3750 · jlipson@fieldmedia.com BUSINESS MANAGER
Karen Raudabaugh 404.671.9551 ext. 108 · kraudabaugh@fieldmedia.com HealthCare Exchange Solutions™ Volume 2 Issue 1 Copyright ©2014 by FieldMedia LLC. All rights reserved. HealthCare Exchange Solutions™ is a trademark of FieldMedia LLC. HealthCare Consumerism Solutions™ is published eight times yearly by FieldMedia LLC., 292 South Main Street, Suite 400, Alpharetta, GA 30009. Periodical postage paid at Alpharetta, GA and additional mailing offices. TO SUBSCRIBE: Make checks and money orders payable to HealthCare Exchange Solutions ™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA 30009 or visit www.theihcc.com. Non-qualified persons may subscribe at the following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or subscriberservice@fieldmedia.com for name/address changes.
Doug Field CEO/Publisher dfield@fieldmedia.com
PRINTED IN THE U.S.A. HealthCare Exchange Solutions™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher is not engaged in rendering legal, financial or other professional service. If legal advice is required, the services of a professional adviser should be sought. The magazine is not responsible for unsolicited manuscripts or photographs. Send letters to the editor and editorial inquiries to the above address or to jfield@fieldmedia.com. Permission to reuse content should be sent to, jfield@ fieldmedia.com.
4 First Quarter 2015 I www.TheIHCC.com I HealthCare Exchange Solutions™
NEWS BRIEFS & INNOVATIONS Assurex Global Partners with GoHealth to Provide Employers with an Individual Exchange Solution Assurex Global recently announced a strategic partnership with GoHealth, the nation’s leading private health insurance exchange for individuals and families. The partnership addresses employers’ growing demand for non-group benefits solutions. Through the collaboration, all 48 of Assurex Global’s partner agencies in the United States can offer GoHealth’s private exchange to their employer clients at no cost. GoHealth’s exchange is tailored for individuals who are ineligible for group health insurance, including part-time employees, early retirees and COBRA-eligible individuals. Using GoHealth’s integrated enrollment platform, individuals can easily compare prices and benefits online from the nation’s top insurance carriers and obtain one-on-one enrollment support by phone from GoHealth’s licensed insurance advisors.
Sun Life Financial Offers Suite of Employee Benefits on Gallagher Marketplace Private Exchange The U.S. business group of Sun Life Financial has expanded the availability of its private exchange offerings to Gallagher Marketplace, including a comprehensive suite of employee benefits. Customers of this private exchange can select Sun Life products, including voluntary short-term disability, long-term disability, life and accidental death & dismemberment, accident, critical illness and cancer insurance. Now, Sun Life’s employee benefits are available through five private exchange partners. The Employee Benefits Consulting and Brokerage operations of Arthur J. Gallagher & Co. launched Gallagher Marketplace to help employers set predictable budgets for their employee benefits programs and to provide employees with a consolidated online benefits store.
Empyrean Selected as Technology Platform for New Private Exchange Partners Empyrean Benefit Solutions recently announced that it has added two companies to the growing list of partners using Empyrean’s technology to power their private exchange solutions. As brokers and insurance carriers look to expand their programs to meet the demands of a more consumer-driven health insurance industry, they have selected Empyrean’s integrated software platform as the technology to support an exchange option for their clients. Brokers and carriers recognize the growing need to support companies that wish to offer private exchanges to their employees while still offering traditional benefit plans. Empyrean’s technology platform was purpose-built to enable brokers and carriers to easily provide an exchange model and accommodate the evolving benefits strategies of their clients.
Time Inc. Selects Towers Watson’s OneExchange to Deliver Health Benefits to Employees in 2015 Towers Watson recently announced that Time Inc. has chosen Towers Watson’s OneExchange to deliver medical, prescription drug, dental and vision benefits to its full-time active employees and their dependents for the 2015 plan year. The new health and wellness program features choice in medical plans and in medical, dental and vision insurers. Time has also introduced a new voluntary wellness program that gives employees and dependents who actively participate the chance to earn well-being dollars. The company is adding benefits such as legal services and identity theft
protection to its existing voluntary benefits, as well as continuing to offer life insurance, flexible spending and commuter benefits.
PlanSource Appoints Nancy Sansom as Chief Marketing Officer PlanSource®, provider of the leading cloud-based health exchange and benefits engagement platform™, recently announced that Nancy Sansom has joined the company’s executive leadership team as chief marketing officer. A seasoned and dynamic executive with deep experience driving marketing, demand generation, business unit management, product management, software design and business development for high-growth SaaS companies, Sansom will be responsible for all aspects of marketing and communications for PlanSource.
Regence Marketplace Private Exchange Increases Options, HSA Adoption for Employees Regence Marketplace is gaining traction in its first full year in Idaho, Oregon, Utah and Washington. Available to employers with 100 or more employees, Regence Marketplace offers businesses a number of advantages, including the ability to control health insurance costs, predictably plan for future benefit needs and cater to a demographically diverse workforce. Through Regence’s private exchange, employees have the freedom to choose coverage that best fits their unique needs and budget, enabling more ownership over their health care decisions. According to a participating Idaho employer, one early result is an increased desire on behalf of employees to choose health savings account (HSA) plans through the private exchange.
WEB EXCLUSIVE Three Predictions for Private Exchanges: Version 2015 By Jeff Yaniga, Executive Vice President, Maestro Health Those of us old enough to remember the early days of e-commerce remember when all our customers had to have a website where they could sell stuff... whether it made sense or not. Board rooms everywhere were trying to figure out this wave and how they could serve their customer base via the Web. Over time, “killer applications” developed and companies figured out how to use the Web in a way that made sense. Is history repeating itself in the employee benefits space? If you attended a benefits conference in 2014, you were inundated with the buzz topic of the year: “private exchanges”. Trends are forming, which means we all start polishing off our crystal ball in an attempt to determine where this is all going: The consumer learning curve will spike upward. Consumer inertia. A consumer at rest remains at rest unless acted on by an equal and opposite force. The Affordable Care Act enables auto-renewal for those that do nothing, and do nothing is the expected action. The equal and opposite force will come in the form of narrower networks and premium increases. To read the full article, visit The Private Exchange Blog at PrivateHealthCareEXCHANGES.com. HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
5
PRIVATE EXCHANGE PROFILE
A New Era of Employee Benefits:
Why “Blended” Exchanges are the Right Solution for Employers Looking to Recruit and Retain Lower-Wage Workers BY BEN ROZUM » PRESIDENT » GENIUS AVENUE
A main focus around benefit strategies for 2015 and beyond has been on offering health coverage to eligible employees, and for good reason since employers who don’t offer qualifying plans to these workers will face hefty fines. However, as the job market for quality part-time workers becomes much more competitive, it will also be important to have recruitment and retention strategies in place throughout the year for this segment of the workforce. To capitalize on this opportunity, organizations should consider offering affordable, easy-to-administer benefits to non-eligible employees, along with targeted engagement strategies. Benefits could include comprehensive health coverage, as well as voluntary benefits without employer contribution that can be offered year-round.
t
Blending these elements into an integrated model Blended exchanges have emerged and offer the advantages of a traditional private exchange, while also giving non-eligible workers the ability to access voluntary benefits and government-exchange plans — all in one place. This is essential since sending lower-wage workers who qualify for subsidies to a federal or state exchange does nothing to further an employer’s recruitment and retention objectives. It’s important to realize that certain private companies have received government certification to become Web broker entities, allowing them to instantly quote rates and enroll consumers in subsidized coverage, while using their own institutive Web interfaces and customer support. Employees can enroll through blended exchanges during the traditional open enrollment period for government exchangesponsored plans. They may also be eligible to enroll anytime they experience a Qualifying Life Event (QLE) such as the loss of qualifying coverage or the birth of a child. However, various voluntary benefits can be offered year-round. This gives individuals access to affordable benefits outside of the traditional open enrollment period, while also gaining familiarity with the blended exchange and their health options by the time the next open enrollment period for comprehensive health coverage starts. In addition to providing easy access to benefits, blended exchanges also feature integrated engagement capabilities that include targeted health education and information about the products available. Several key elements must be in place for a blended model to be effective. t The power of choice. Individuals should have access to 10-20 health insurance options in order to find a plan that meets their
6
First Quarter 2015 I www.TheIHCC.com I HealthCare Exchange Solutions™
t
t
out-of-pocket costs, network access and premium preferences. Access to a wide variety of voluntary benefits is a significant plus because this allows individuals to access affordable options all year long. Year-round engagement strategies, like nurture email campaigns that are customized based on an individual’s benefit eligibility and interests. By highlighting a mix of products and general health information (both during and outside open enrollment), these campaigns ensure that individuals receive fresh content on a regular basis that is useful, educational and informative. Comprehensive support services. Licensed benefit specialists must be available to assist individuals with everything from comparisonshopping to product purchase. These highly trained individuals can offer expert guidance that considers an individual’s health requirements, budget and preferences. Streamlined administration. The best blended exchanges make offering multiple benefits easy by integrating enrollment, billing, administration, reporting, and product communication — so plan sponsors don’t have to manage these cumbersome tasks.
A platform for the future Genius Avenue is one organization that has launched a successful blended model called Genius Benefits, an online benefits marketplace that can be offered year-round. Genius Benefits includes major medical plans and voluntary benefits from trusted carriers. Individuals can access a variety of online selfservice features, but trained benefit specialists are available to walk them through the entire process. This support is provided whether an individual is looking for government-exchange plans, voluntary benefits or discount programs. A variety of strategies, such as nurture marketing emails and health information, are also utilized to engage individuals at every stage in this process. Blended exchanges can dramatically transform the way that employers engage, recruit and retain quality workers. Many forwardthinking organizations are already adopting these models to address the needs of non-eligible employees — a growing and critically important segment of their workforce.
PERSPECTIVES
Private Exchanges: An Evolving Option… But Not a Silver Bullet BY JIM O’CONNOR » PRESIDENT, EMPLOYEE BENEFITS » CBIZ, INC.
I
t’s the beginning of a new year, and employees and employers alike are ready for a fresh start. And, the first item on many agendas is to restrain ever-increasing health benefit costs. As this price trend continues on the steep slope north, with the passing of the Affordable Care Act (ACA) in 2010, proactive organizations have been on the hunt for ways to minimize the cost of their health benefit plans, harboring increased awareness of private health insurance exchanges, better known as private exchanges. A private exchange is fundamentally an online marketplace for an organization’s employees, allowing them to pick and choose health care and other benefit options suitable for their needs – much like an online 401(k) platform. Given a menu of different health insurance options, life insurance options, medical and dental insurance, employees have numerous selections from which to design their personalized baskets of benefits for themselves and their families. Essentially, the strategy with private exchanges is for employers to set their spend on health & welfare benefits at a specific dollar amount for each employee (i.e. a defined contribution); so, by capping dollars spent, employers hold the line on their expense of these benefits while turning over the specific decision making on design to their employees. They will no longer have to produce a plan that will fit all employees’ medical and other benefit needs. Though the media has stirred up discussion around these platforms in recent years, the conversation hasn’t necessarily brought about wide employer adoption. Since large numbers of employers have yet to make the move toward these platforms, it is clear that
there is still some caution; because, despite the interest around this innovative solution to rising costs, the implementation of private exchanges as a staple of organizations’ benefit offerings presents many challenges. One thing to keep in mind is that, absent any cost containment strategy, private exchanges are at heart a cost shift; the employer locks in its expense and if premiums rise over time, the employees’ shares rise disproportionately. With this in mind, if the employer doesn’t put in continued efforts to rein in the health insurance cost increases and adjust the employer spend over time, the originally set amount is locked in, and nothing can be done to combat inflationary pressures that are driving up health care costs. Second, keeping in mind that the goal of a successful employee benefits program is to attract and retain top talent, the thoughtful employer has to understand that relinquishing responsibility for keeping health benefit costs low could lead to unhappy employees. Employers still need to be committed to cost containment, wellness and employee health management programs. Finally, though private exchanges give the employee the ability to choose between health care offerings, health insurance carriers are hesitant to offer themselves alongside their competitors. This is especially true for smaller organizations looking to set up private exchanges. A key driver for private exchange growth will be if, and when, health insurance carriers are willing to be offered side by side in the smaller and mid-size employer markets. With all of these factors taken into consideration, and despite the seemingly significant benefits associated with
setting up a private exchange, such as providing more employee choice (which is a very positive development), employers seem to be more inclined to stay the course with single health insurance carriers, spend the time to design plans with human resource departments and consultants and work on cost containment strategies – at least in the near future. The jury is out on exactly how much market share private exchanges will command in the near term. It could be years until private exchanges play a meaningful role in the health benefit space, as employers continue to evaluate the best solutions to providing high quality benefit programs. With that having been said, however, as private exchanges or other benefits administrative platforms that make it easier for employees to have more benefit choices evolve, we will see growing interest in the market. Until these changes occur, employers need to remain committed to health care cost containment and establishing employee benefit strategies that retain and attract top talent if they want to remain competitive in 2015 and beyond. CBI , Inc. provides professional business services that help clients better manage their finances and employees. CBI provides its clients with financial services including accounting, tax, financial advisory, government health care consulting, risk advisory, real estate consulting, and valuation services. Employee services include employee benefits consulting, property and casualty insurance, retirement plan consulting, payroll, life insurance, HR consulting, and executive recruitment. As one of the nation’s largest brokers of employee benefits and property and casualty insurance, and one of the largest accounting and valuation companies in the United States, the Company’s services are provided through nearly 100 Company offices in 34 states. www.cbiz.com
HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
7
WHAT’S YOUR EXCHANGE STRATEGY? WHAT’S YOUR Let Softheon help plan your next move. EXCHANGE STRATEGY? Let Softheon help plan your next move.
PERSPECTIVES
What’s Next for Private Exchanges? Four Considerations BY MIKE SULLIVAN » EXECUTIVE VICE PRESIDENT AND CHIEF MARKETING OFFICER » DIGITAL INSURANCE AND DIGITAL BENEFIT ADVISORS
L
ast year, as the clock ticked down to 2015, private exchanges experienced modest levels of adoption. By and large, the first significant cohort to embrace this approach were large employers with sophisticated benefits personnel and ample money at risk in “pay or play” analyses. They found private exchanges to be a viable strategy, and many chose this route rather than abandoning health insurance and sending their employees to public exchanges. Yet private exchanges are still on the periphery of benefits solutions. Don’t for a second misconstrue the current level of adoption with long-term applicability, because they will become a central force in benefits strategies for a significant subset of employers. Surveys, prognosticators and news articles all agree that many employers expect to deploy them in the near future but are hesitant to immediately pull the trigger. Those of us offering exchange solutions celebrate the early adopters and continue to invest in product choice and solution functionality, while we wait for the inevitable tipping point. So what happens next? Just as they did with the individual-based public insurance marketplaces, carriers will lose their fear of the unknown and develop tolerances to private exchange business models. Also, the SMB (small and medium-sized business) market typically lags behind large employers when it comes to benefits trends. The next 18 months will bring continued growth among employers of all sizes, and then expect sea change. Meanwhile, here’s a look at four incremental ideas that few in the industry are discussing that will expand the adoption levels of private exchange solutions.
1. Declining Cost of Adoption Fee structures for exchange software
will drop significantly and mirror those of widely available basic enrollment solutions. Employers and advisors alike will begin to understand it is less about the software and more about everything else that will drive adoption into private exchanges.
offerings. In today’s evolving market, you can’t take a cookie-cutter approach. You need flexibility to enable employers to dip their toes in the water and position their workforce for bigger changes down the road.
2. All or Nothing? Consider a Transitional Approach
While there is tremendous focus on the design of exchanges and the reluctance of employers to matriculate, everyone seems to overlook the role of another key player: carriers. While their participation is crucial to the short- and long-term success of these benefits solutions, they seem to be dragging their feet for one core reason: control. Private exchanges present challenges to these organizations relative to control. Carriers have to rethink pricing and underwriting strategies. In addition, they need infrastructure to support the transformation.
One reason businesses are cautious about diving into private exchanges is the all-or-nothing proposition. Most exchanges offer a purist model: you either convert to a defined contribution strategy with predetermined “storefronts” or you continue to offer traditional benefits. Our company is testing an option that bridges these worlds. This transitional approach enables employees to shop online for their benefits, but they are not limited by a defined contribution model. Employer funding does not change, but it introduces employees to the concept of selecting their own benefits among a broader selection of plans and taking more responsibility for their coverage. Such an intermediary strategy could work well for companies that have diverse pay scales, for example in a business where a lot of employees earn $35,000 annually and another faction makes six figures. In addition to setting up different classes of employees, it also can accommodate contributory and non-contributory components of a benefits package. For instance, the company pays 100 percent of life insurance, but contributes nothing toward disability coverage. The key is that the employer does not yet have to lock in to a defined contribution. Many players are struggling to create and define the boundaries of private exchanges. Our company discovered we don’t have to deliver standardized product
3. The Carrier Factor
Carriers that have the most market share experience the greatest trepidation to change. For example, the Blues generally maintain the largest market share in every state, particularly down market among small- and mid-sized business. Yet, in our experience, these organizations often lack technological flexibility. At present, many carriers are so concerned about building and perfecting their own private exchange solutions they are not able to collaborate well with other solutions they often deem as competitors. This comes on the heels of an almost exclusive focus on preparing for public exchange activities largely focused on the individual marketplace. As the market matures and carriers work through these challenges, expect to see greater cooperation and more plan options available through everybody’s exchanges. To find out Mike’s final consideration, visit our website at www.theihcc.com.
HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
9
PERSPECTIVES
APIs Enable Speed to Market with Consumer Friendly Benefits Exchanges BY DAYNE WILLIAMS » CHIEF EXECUTIVE OFFICER » PLANSOURCE
T
he Affordable Care Act offers consumers a much wider array of health care choices. In the past, employers handed employees a packet of paper with pre-selected options for health care and benefits. Now a whole new world is opening up for employees to shop and compare all kinds of plans in online exchanges to assemble a personalized package that includes both traditional and non-traditional benefits. All this choice means consumers face more complexity: health insurance plans are not easy to understand, and the ACA doesn’t make it any easier. For insurance carriers and brokers, more choice means more competition. Carriers will see their products displayed side-by-side with competing products on exchange marketplaces. Virtually every carrier in the country — medical, voluntary or ancillary — is right now trying to decide which exchange (or exchanges) they should offer their products on, or whether they should perhaps build their own exchange. Brokers are pondering the same question. All are wondering how best to compete in this evolving game. The winners will be those who make it easiest for consumers to shop and enroll online. For larger brokers and carriers who want to be in the enrollment business, the key to success is to get to market fast with a beautifully designed consumer experience that addresses the needs of their unique markets and differentiates themselves from the competition. This should be coupled with a technology back-end that makes it easy for everyone in the ecosystem — carriers, brokers, TPAs, employers and employees — to do business together. Building the back-end is a complex undertaking, and an end-to-end shopping and enrollment platform with all the
capabilities for business rule configuration and transaction processing requires tens of millions of dollars and several years to fully develop. Furthermore, as we all know, the project is never done. The regulatory environment and consumer expectations will continue to change, requiring substantial ongoing investments. But, this need not be a barrier to entry. There is a better way. Companies can design a front-end experience that reflects their brand and user experience needs and use APIs (application programming interfaces) to connect to an existing back-end processing engine. This is a great option for large insurance carriers, brokers or even HCM companies that have already invested in consumer-facing technology and want to maintain control of the user experience without waiting years to build out the full solution. In addition, this can be done for about one tenth of the budget, offering speed to market without compromising the consumer experience. If you don’t have the resources or desire to develop a custom front-end, you can buy a complete exchange platform — front-end and back-end — and differentiate your offering through the products that you sell. The main point here is to focus on the consumer experience. There is a lot of technology innovation going on in the area of decision support that you can bring to bear on creating customer delight. Here are some things to consider:
Ease of use With the first generation of decision support tools, buyers had to fill out lengthy questionnaires in order for backend analytics engines to evaluate their health care needs, tolerance to risk and recommend a plan. That’s not a user-
friendly experience, and shoppers today won’t tolerate long forms if they can avoid it. The next generation of tools can bring in third-party data, such as claims and prescription information, to lighten the burden on the buyer, shorten the process and make better recommendations.
De-mystifying the SBC The ACA mandates that every plan has to have a standardized Summary Benefits Comparison (SBC), such that consumers can make apples-to-apples comparisons between plans. The government dictates what the SBC looks like — a big grid with numbers on it and a lot of acronyms: HMO, PPO, ACO, etc. For the most part, the consumer doesn’t understand how to read it, or more importantly, what it means. Translation is needed. Providing tools to help buyers understand the ramifications of different plans will make it a lot easier for them to shop and compare on your platform.
Surfacing the network Network choice also has big ramifications. Every plan has an in-network cost and an out-of-network cost that’s much higher, so obviously consumers want to be able to easily look at the network before making their choice. The ACA has also created an additional choice of health care network called an accountable care organization (ACO). If people have doctors who are important to them, it’s important to know, “Is my doctor part of this network or ACO?” It should be really easy for them to get that information while they’re shopping for plans. Delivering complex information in a way that’s easy to understand and making it dead simple for employees to enroll is the winning formula. To read the rest of the article, visit our website at www.theihcc.com.
HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
11
MORE EMPLOYERS INVESTIGATING BENEFITS OF PRIVATE EXCHANGES BY BARBARA GNIEWEK » PRINCIPAL » PWC & JASMINE MACIES » ASSOCIATE » PWC
HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
13
Private exchanges have been creating a buzz in the employer-sponsored health care marketplace. After a flurry of activity in 2013 and 2014 among large employers, many feel we have moved beyond the “early adopter” stage and are poised for broader acceptance. Private exchanges are becoming more commonplace with more organizations than ever before implementing exchanges or actively considering them. The second annual study by the Private Exchange Evaluation Collaboration (a business collaborative between the Northeast Business Group on Health, Midwest Business Group on Health, Employer’s Health, Pacific Business Group on Health and PwC) confirms that interest in private exchanges continues among employers for full-time active and retirees. The national survey, based on the responses of 446 employers, reports 47 percent of respondents have already implemented or are considering a private exchange for full-time employees by 2018, and 37 percent of respondents are doing the same for retirees. This year’s survey is also the first national survey that captures the experience of early adopters of private exchanges for active employees as well as retirees. This year’s results show that employers remain committed to providing benefits to their full-time employees, with 96 percent of respondents saying they were very likely to offer coverage in 2016. That number is up from 77 percent in last year’s survey and remains high over the near term, declining to 88 percent of respondents very likely to offer benefits in 2018. Though employers seem committed to provide benefits to their active employees, interest in the public exchanges for other population segments has grown. Most notably, 26 percent of respondents have implemented the public exchange for COBRA participants, and 11 percent have implemented for pre-65 retirees, both up from 6 percent in 2013. Commitment to retirees appears to continue to deteriorate with only 33 percent of respondents very likely to offer coverage to post-65 retirees in 2015, decreasing to 24 percent in 2018. While employers are more committed to full-time active coverage, the cost of care is still a concern and employers are beginning to consider alternative strategies, albeit with caution. Private exchanges are one of the strategies being considered. Twenty percent of respondents are considering a private exchange for full-time actives in 2016, 11 percent in 2017 and 10 percent in 2018. Four percent of respondents have implemented a private exchange for full-time actives before 2015, and 2 percent are implementing in 2015. As results from early private exchange adopters continue to emerge, many employers appear to be taking a step back to more carefully evaluate private exchanges, their features and the costs before jumping in. Some hesitation stems from employers wanting to be fast followers rather than leaders, with 57 percent of respondents indicating that if an industry 14 First Quarter 2015 I www.TheIHCC.com I HealthCare Exchange Solutions™
peer moved to a private exchange they would be more likely to do so. Due to the various private exchange models, the sheer number of exchanges and the wide variation in private exchange offerings, employers are seeking help to evaluate the different exchange solutions. Seventy-two percent of respondents agree it is very important that their advisor is independent of any exchange they are considering. Only 6 percent of respondents are not worried about the potential conflict of an advisor with an exchange.
Key Private Exchange Attributes
Important capabilities Employee communication support
Variety of plan options and designs
Level and transparency of fees
Broad network access
Cost of plan options
Ease of use
Experience & track record
Financial stability
In this year’s survey, experience and track record emerged as the key consideration of an exchange vendor, with 96 percent of respondents indicating experience was an important consideration. Respondents also placed increased importance on tools that aid in plan selection, with 85 percent of 2014 respondents saying it is very important, up from 70 percent in 2013. Respondents considering post-65 retirees exchanges agree, with 67 percent saying tools that aid in plan selection is an important exchange trait. For actives, additional important attributes include single sign-on (83 percent) and ease of use (98 percent), while 71 percent of respondents considering post-65 exchanges feel member satisfaction is important for private exchange selection. Transparency tools are also at the top of the list of important exchange features for fulltime actives, with 91 percent of respondents saying it is somewhat or very important. Heightened importance on shopping tools matches the HR goal of creating educated health care consumers and engaging employees so they are more accountable for health decisions. In addition to the shopping experience, 89 percent of respondents said the variety of health plan/carrier/network options was important. Sixty-five percent of respondents considering a post-65 retiree exchange agree that it is important to have plans from multiple vendors. Broad networks are still at the top of the list for full-time actives; however, this year interest in other networks grew. Seventy-one percent of respondents said availability of ACOs and new delivery models is important, up from 65 percent in 2013, and 48 percent agreed availability of plans with narrow networks is important. 2013 Respondents
2014 Respondents
Cost of plan design options
72%
76%
Administrative fee levels
87%
90%
Discloser of exchange fees and revenue
89%
90%
Attribute
But, the biggest consideration among employers remains cost. Over 95 percent of respondents agreed cost of plan design options, administrative fee levels and disclosure of exchange fees and revenue are key considerations of a private exchange. Those considering retiree
Though adoption may not have reached the expected targets in 2014, interest in private exchanges is still high. Some employers are hesitant to be first movers, and others are taking the time to evaluate exchange options.
exchanges are also concerned about cost, with 68 percent saying level of fees is somewhat or very important and 73 percent saying availability of low cost benefit options is important. Leveraging alternative networks helps drive costs down, and employers this year more than last are connecting the dots between network, cost and increased employee choice. Networks are currently one of the best sources of savings on exchanges.
Adoption Risks/Barriers While interest remains high, barriers to adoption still linger. More than 90 percent of respondents agreed that the immaturity of the exchange market is an adoption risk that employers struggle with. The survey revealed 88 percent of respondents agree the exchange administrator’s stability track record is very important. Regulatory uncertainty emerged as a bigger obstacle in 2014, with 80 percent of respondents indicating concern. Other barriers to adoption include employee readiness and loss of control / stewardship. When asked more specifically, respondents want to retain control of plan design, advisor relationships, carrier relationships and financing decisions (self vs. fully insured). These attributes were the top of the list, with over 70 percent of respondents agreeing that retaining control of those aspects was somewhat or very important. Those considering post-65 retirees also saw difficulty for retirees to use online enrollment tools and noted decision support as a barrier to adoption.
Results Though there is a long list of requirements for exchange adoption, early adopters have seen positive results around savings and employee engagement. While only 21 percent of respondents considering a private exchange for actives agree that moving to a private exchange will save the organization money (53 percent are unsure), the majority of implementers say they did save money, although 24 percent said it’s too soon to tell. Among post-65 retiree implementers, 71 percent agree retirees saved money by selecting lower cost plans. In addition to saving money, 60 percent of respondents agreed that full-time active employees valued having greater choice in health plans and benefit options, and employees are more engaged in understanding health plan costs. Seventytwo percent of post-65 retiree exchange implementers also agree retirees’ value having greater choice in health plan and benefit options. And, while use of technology and decision-support tools was deemed a barrier for retirees, 64 percent of post-65 implementers indicated that retirees did not have difficulty navigating through plan benefits and/or provider selection. Though adoption may not have reached the expected targets in 2014, interest in private exchanges is still high. Some employers are hesitant to be first movers, and others are taking the time to evaluate exchange options. The results of the Private Exchange Evaluation Collaborative’s second annual employer survey provide insight to employer’s requirements of and concerns with private exchanges. As we move beyond the early adoption phase, it will be interesting to see how the new models fair in this competitive marketplace. HealthCare Exchange Solutions™ I www.TheIHCC.com I First Quarter 2015
15
Private Exchange
FORUM
March 31 to April 1, 2015 Renaissance Richardson Hotel Dallas, Texas
Exploring the New Benefits Delivery Model for Employers, Brokers and Insurers Private E changes
The Catalyst for Consumerism
As confusion and frustration persists over health costs and retention of benefit, private exchanges and defined contribution have stepped into the lead as a viable solution. As the ultimate form of consumerism, exchanges force consumers to think about their health and health care decisions — while providing the choice, transparency, engagement, convenience and education they are looking for. This is a 100% focused event that will compliment IHC’s current commitment to defined contribution and exchanges. The Private Exchange FORUM will deliver a unique opportunity for all stakeholders to LEARN, CONNECT and SHARE on the complete life-cycle of private exchanges use — including: t &WBMVBUJPO DSJUFSJB t 1PTU JNQMFNFOUBUJPO MFTTPOT MFBSOFE t #VJMEJOH PG UIF OFYU HFOFSBUJPO PG CFOFmU TUSVDUVSF
You Will Learn About: t " $POTVMUBOU T 1FSTQFDUJWF PO 1SJWBUF &YDIBOHF 4PMVUJPOT ‰ 4FMFDUJOH BOE *NQMFNFOUJOH 1SJWBUF &YDIBOHFT t 6OEFSTUBOEJOH UIF 1SJWBUF &YDIBOHFT .PEFMT ‰ 5IF &YDIBOHFT 5IFNTFMWFT t 'VOEJOH :PVS 1SJWBUF &YDIBOHF 4USBUFHZ ‰ 5IF 3PMF PG %FmOFT $POUSJCVUJPO )4"T BOE .PSF t )FBMUI 1MBOT BOE 5IFJS 1SPEVDUT GPS 1SJWBUF &YDIBOHFT t $SFBUJOH UIF $PNQMFUF #FOFmUT 4PMVUJPO ‰ 4VQQMFNFOUBM )FBMUI BOE .PSF t )FBMUI $BSF 3FGPSN BOE $PNQMJBODF *TTVFT t 1SJWBUF &YDIBOHFT ‰ "O 6QEBUF PG 3FHVMBUJPOT BOE $PNQMJBODF t )FBMUI .BOBHFNFOU 1SJWBUF &YDIBOHFT t 5IF 3PMF PG UIF $POTVNFS JO 1SJWBUF &YDIBOHFT t &OHBHFNFOU %FDJTJPO 4VQQPSU $POTJEFSBUJPOT GPS 1SJWBUF &YDIBOHFT t )FBMUI $BSF 3FGPSN BOE $PNQMJBODF *TTVFT t 1SJWBUF &YDIBOHF 4USBUFHJFT GPS 3FUJSFFT t 5IF 3PMF PG 1VCMJD &YDIBOHFT JO )FBMUI $BSF 3FGPSN t 8IFSF *OOPWBUJPOT BSF %SJWJOH UIF 1SJWBUF &YDIBOHFT .BSLFUQMBDF t &NQMPZFS 1BOFM ‰ 1SJWBUF &YDIBOHF 1MBUGPSN *NQMFNFOUBUJPOT ‰ &NQMPZFS &YQFSJFODFT
REGISTER NOW
Rates starting at $395 for employers and $495 for brokers, consultants and health plans For more information, registration, sponsorship and speaking opportunities — visit www.PrivateExchangeForum.com today!
BY TYE ELLIOTT VICE PRESIDENT CORE BROKER SALES, AFLAC
VOLUNTARY BENEFITS
Post-Heath Care Reform, Voluntary Benefits Options Take Center Stage
I
n a health care landscape that According to the Aflac study, Many successful companies are also using is constantly evolving, one thing 49 percent of people surveyed — is certain: voluntary insurance voluntary benefits options to drive employee representing all age groups — said is in demand. At one time, they had $1,000 or less on hand to voluntary products were offered engagement, perhaps because they understand pay out-of-pocket medical expenses, primarily by large employers as 66 percent said they would that engaged workers are the most productive and a means to increase engagement not be able to adjust to the large and simultaneously curb the rising financial costs related to a serious workers and that they outperform their cost of health care — because injury or illness.1 These findings are non-engaged coworkers. voluntary benefits options can be echoed by those of the Consumer added by employers for no extra Financial Protection Bureau, which cost, businesses saw no downside found that nearly 20 percent of U.S. to offering them. Today, in an era of cost cutting, organizations of all sizes consumers — or almost 43 million people — have unpaid medical debts.2 are broadening their menu of voluntary benefits options to offset holes in coverage, especially as they further reduce their contributions. And Voluntary insurance is the logical choice employees are saying “sign me up.” Voluntary benefits options such as accident, critical illness and disability plans have long served as a way to help protect workers when Employers see the value in voluntary they are sick or injured — independent of major medical coverage. As health As health care reform legislation is implemented through 2018, includ- care costs continue to rise and workers take more control of their benefits ing the tax on expensive health plans, employers are adopting consumer- decisions, voluntary insurance plans are even more relevant as key pieces driven health plans and offering voluntary insurance, which pays employees of a company’s overall benefits strategy, regardless of the way they structure directly (unless otherwise assigned) for out-of-pocket costs associated with a their major medical plans. covered illness or injury, to complement these consumer-driven plans. Many successful companies are also using voluntary benefits options to Supplemental insurance also enables employers to offer a broader drive employee engagement, perhaps because they understand that engaged benefits package to employees. According to the 2014 Aflac WorkForces workers are the most productive workers and that they outperform their nonReport, benefits play a larger role in retention and recruitment than many engaged coworkers. In fact, a new LIMRA study finds seven in 10 employers employers may realize and, in many cases, may be the primary factor offer voluntary benefits to improve morale for their existing employees as pertaining to employment decisions. Workers overwhelmingly agree that well as to attract and retain new talent. And according to LIMRA voluntary benefits influence job satisfaction, employer loyalty, work productivity and benefits sales research, the voluntary market has grown in four of the past the decision to leave a company.1 According to the Aflac study: five years, averaging a five percent annual gain.3 Given the value voluntary • 88 percent of employees consider voluntary insurance part of a benefit options bring to companies and the security they offer employees, the comprehensive benefits plan. demand for voluntary is sure to continue to grow. • 52 percent of employees who do not currently have access to voluntary Tye Elliott, a 20-year insurance industry veteran, is Aflac’s vice president of Core Broker benefits options said they’d be likely to apply for coverage if their Sales. He is responsible for managing and implementing strategic sales initiatives for the Core broker sales division across the United States. Visit aflac.com/brokers, call 888-861employers made voluntary plans available. 0251 or send an email to brokerrelations@aflac.com to learn more. • 57 percent of workers surveyed believe they’d be at least somewhat likely to accept a job with a more robust benefits package but slightly lower compensation. 1 2014 Aflac WorkForces Report, conducted in January 2014 by Research Now on behalf of
Employees aren’t financially prepared Changes to the U.S. health care system have turned workers’ attention to their personal health care spending. They want to know where their insurance dollars are going and what they’re getting for their money. What’s more, they’re taking a close look at their existing coverage to identify gaps that might leave them vulnerable to medical expenses they’re ill-equipped to pay.
Aflac, accessed Feb. 2, 2015 – www.AflacWorkForcesReport.com 2 Consumer Financial Protection Bureau, “CFPB spotlights concerns with medical debt and reporting,” accessed Dec. 11, 2014 - http://www.consumerfinance.gov/newsroom/cfpbspotlights-concerns-with-medical-debt-collection-and-reporting/ 3 LIMRA Voluntary Benefits Sales Research, accessed Jan. 28, 2015 - http://www.limra. com/Posts/PR/News_Releases/LIMRA_Study_Finds_Employers_Interested_in_Offering_ Voluntary_Benefits.aspx
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
33
Put the Empower Pack to work for you today. Provide your clients with a more thorough benefit solution that will drive up employee satisfaction and drive down healthcare costs. The Empower Pack, exclusively offered through New Benefits, includes telehealth services, health advocacy assistance and wellness support. It’s time to differentiate yourself. Become Empowered.
Call 800.800.8304 or visit NewBenefits.com today to learn more.
Visit our booth at the IHC Private Exchange Forum Dallas, TX, March 31 – April 1, 2015.
Copyright © 2014 by New Benefits, Ltd. All rights reserved. This plan is NOT insurance and does not meet the minimum creditable coverage under the Affordable Care Act.
BY NELSON L. GRISWOLD PRESIDENT BOTTOM LINE SOLUTIONS, INC.
BROKERS AND ADVISORS
Voluntary Benefits: A Consumerism Strategy* 1BSU * )FBMUI $BSF $POTVNFSJTN %PFTO U 8PSLy"OE )FSF T 8IZ This series examines the valuable role worksite voluntary benefits can play in supporting a robust and effective health care consumerism strategy both by eliminating the key breakdown point with employees that undermines consumerism and by providing employers with powerful tools to encourage and incentivize strong consumerism behavior in their employees.
H
ealth care consumerism doesn’t work‌with many employees at least. An inherent breakdown point in the design undermines its very intent and, thus, its success. More about that shortly. “Health care consumerismâ€? is about people, your employees. It’s a strategy that puts economic purchasing power and decisionmaking in the hands of the employee-consumer. It lets employees — rather than health care bureaucrats — control health care decisions. It encourages employees to become more engaged health care consumers, make smart and educated health care buying decisions, and get the health care they need. With a background in health care policy, I’ve long been an advocate of health care consumerism. In fact, in 1996 I was among the first in the country to sign up for the forerunner of the health savings account (HSA) — the Archer medical savings account (MSA) — paired with a high-deductible health plan. I had two infants and a wife on my plan. And I knew well how consumer-directed health care was supposed to work. In 1996, however, working at a non-profit, I wasn’t earning a lot, and my wife was at home with the children. My children’s every medical need got met without hesitation. But when my wife or I needed medical care or tests‌we often put it off, hesitant to spend what little savings we had in our MSA and with precious little extra cash to spare. As a result, we often didn’t get the health care we needed.
Consumerism’s Key Driver So even with an educated and sophisticated consumer, consumerism didn’t work as intended. And the problem wasn’t just with me. Even when incentivized with a high-deductible plan and equipped with an HSA, your employees today often don’t have the financial means and/or the willingness to get the health care they need. While it works in theory, consumerism often breaks down in practice because the key driver in consumerism is the employee’s out-of-pocket costs for health care. This increased cost share in the health care expense — the employee’s “skin in the game� — is intended to create a more engaged and smarter health care consumer. Spending their own money, these consumers should make wiser decisions around treatment and cost.
Breakdown Point But these same out-of-pocket expenses that are supposed to drive better health care decisions cause the breakdown point in consumerism. Because they can’t or won’t pay their out-of-pocket costs, many employees defer or never get the health care they need. The impact of this breakdown point on an employer’s health care costs is obvious. When employees refuse either to seek minor, early health
care interventions or to comply with maintenance treatments, their health problems often get worse. These untreated injuries and conditions can lead to very serious and costly medical treatments and procedures that negatively impact a company’s experience rating. Even most employees enrolled in a HSA aren’t prepared for high outof-pocket health care costs. Almost three-quarters (74 percent) have less than $2,000 in their HSA account and, like me, many won’t spend that unless they absolutely must.1 And these are some of the more financially prepared Americans.
Treading Water in the Deep End A large majority of Americans are in far worse financial shape. Like people treading water in the deep end of the pool, many of your employees are fighting just to keep their heads above water. Over three quarters (76 percent) of Americans live paycheck to paycheck, using their entire paycheck just to cover essentials such as rent, utilities, groceries and car payments.2 Almost as many Americans (71 percent) say they would be hard pressed to pay their bills if they missed just one week of pay.3 These are your employees. When the whole paycheck goes to basic living expenses, there’s nothing left for savings. That helps explain why almost two-thirds of Americans (65percent) report that they don’t have enough savings to survive a year without their paycheck, while 38 percent couldn’t make it more than three months.4 These are your employees. These statistics expose the financial distress many of your employees live with every day. They explain why the added risk of out-of-pocket expenses from an illness or accident threatens not just these employees’ financial security but also their emotional stability and peace of mind. You can see why for too many employees consumerism doesn’t work like it should. When money is tight, when there is no savings or so little that you’re afraid to spend it, the logic of consumerism breaks down. When they get sick or hurt, these employees simply can’t afford to make smart health care decisions‌to get the health care they need. Next, we’ll look at how voluntary benefits can eliminate this consumerism breakdown point and empower employees to get the health care they need. * This article series is based on a keynote presentation given in September 2014 to the 15th Annual Health Care Symposium sponsored by the Pittsburgh Business Group on Health. Nelson Griswold is one of the most recognized thought leaders in the employee benefits industry. He is author of the new book, Doing More With Less, a playbook for any HR professional or business leader who wants proven, innovative methods to manage costs, maximize capital & drive dollars to the bottom line. To view footnotes, visit the online version at www.theihcc.com HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
35
Finding Middle Ground: What’s needed to successfully marry exchanges and HSAs in 2015 and beyond BY HEATHER LOVERIDGE » SENIOR EDITOR THE INSTITUTE FOR HEALTHCARE CONSUMERISM
I
n some ways, it’s déjà vu. A little over 10 years ago, health savings accounts were the talk of the benefits world. Today, as HSAs have become more mainstream, the chatter has switched to exchanges, with more realizing the two are perfect partners. After last year’s open enrollment, some definite challenges and opportunities became apparent. “Last year, Todd Berkley and John Young did a study, The Power of Choice: The Game-Changing Combination of Private Exchanges and Health Savings Accounts, that showed about 20 percent of the entire product offering is HSA-qualified plans,” said Kevin McKechnie, executive director of The HSA Council. “One problem we have found, though, is that many exchanges have been branded to catch your eye instead of being more explanatory and saying they are HSA qualified.” One of the first challenges (and opportunities as well) resulting from exchange enrollment is finding a more functional way to brand products. This, in turn, will help consumers make
more informed choices. “We care about this, because we know that these provide the best coverage, the best value there is. But what if your exchange doesn’t say anything about an HSA and you don’t know to ask? And there isn’t anyone to ask? The answer needs to be clearer to more people,” McKechnie said. While everyone agrees the territory is still new, there are some definite patterns becoming apparent. “The exchange realm is still very much in development, but there is one natural law I see in play,” said John Young, CEO of Consumerdriven. “A quote by John Maxwell, a leadership development expert, says it well: ‘Everything rises and falls on leadership’. HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
37
“We are seeing enormous growth in entities where the CEO of those organizations housing an exchange strategy is saying ‘This is a business I want to grow; this is a business I’m excited about’, so they have pushed through the ranks how to make it happen.� As exchanges start to report more HSA adoptions, there’s still a long road ahead. The exchange/HSA partnership must be focused so when someone does selected a qualified medical plan allowing for an HSA, there is automatic guidance in place to help the consumer make educated decisions. “Private exchange companies are growing very rapidly, and it’s a bit of a land grab – trying to find new models and market. What type of plan consumers choose is really not top of mind,� said Todd Berkley, president of HSA Consulting Services. “It feels to me like they are making minivans, and they don’t realize that young mothers with two children are the ones buying them. It could be useful information to know half your people are buying a certain kind of plan that has a lot of education components. There’s a need to say, like as in buying a car, ‘Look at all the features I’ve built around the way you live’.� Berkley related a conversation with a client who migrated to a private exchange. Previously, the client had been a benevolent, Cadillac Taxtype of employer with very rich benefits. They were shocked to find that a large percentage of their people were on an HSA plan. “They were pleasantly surprised, because they really had no idea that was coming. To me that’s the kind of thing a private exchange could have helped them prepare for,� he said. “We’re seeing that happen over and over again so let’s help pave the way to really make that happen successfully.�
Careful Evaluation Key to Moving Forward Consumer behaviors play a large part as well. “I’m finding that in this kind of environment almost everyone is changing. Roughly half to two-thirds of people are choosing HSA-qualified plans but just kind of doing it as a function of economic situation, not necessarily because they have researched a plan and it’s the best one,â€? said Berkley. While that kind of economic behavior creates opportunity, it also comes with potential risks. If those choices are not supported and consumers really have chosen the plan for the wrong reason, there will be a backlash. “One of my biggest fears is that all kinds 38 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
“Our goal is to get the marketplace to see that private exchanges equal HSAs,� he said. “It just takes slowing down and marrying these possibilities together, but everyone’s moving so fast. It’s still very early in this conversation.� of HSA plans are going to be sold, but then no one’s going to follow up to ask if they know they can get an account. They’re going to miss out on all the tax savings, all the benefits of having that spending and saving and investing behavior that reinforces their high-deductible health plan,� Berkley said. Berkley advocates incorporating the HSA into the decision-making process, making it part of the analysis of which plan is best for the consumer. “Almost like a financial planner approach, tell me about yourself and your health situation, etc. To me that’s a beautiful model,� he said. “There’s a little bit of that out there but it’s still pretty early. Most are still saying here are six health plans, here’s the price of each, the deductible of each.� A key component to a successful exchange implementation and HSA adoption is funding. “It is our biggest wish that there is always an employer funding in these. There needs to be some seed money so that people automatically get an account when they select the player,� Young said. “We think that’s absolutely critical. “You need the right people in the room for the employer to make the decision and there needs to be an equal amount of foot on the gas and foot on the brake. There should be enough leadership saying this makes sense, this is what we’re going to do – essentially pushing the gas pedal. But leadership also needs to say ‘let’s make sure we roll this out and implement it correctly, that we take the time to get our employees to understand and appreciate it, especially the HSA choices they will have’. So do it, but do it right.� As far as investment trends, as consumers become more savvy, the options increase. According to the Devenir semi-annual HSA research report, the average number of mutual fund investments options have increased from 17 at the end 2012 to 21 at the end of 2014, and the average number of mutual funds held by customers from 1.5 to 3.4. In addition, the average total balance (HSA cash
plus investments) of those that invest in their HSA has gone from $8,000 to over $13,000 in that same time frame. “We continue to see a great deal of interest in HSA investments, as well as an increase in adoption and expansion of available options to invest in,� said Eric Remjeske, president and co-founder of Devenir.
Legislative Buy-in The legislative landscape is also changing, fueling even more anticipation for the future. “This industry has never before had people in the places it has now. People who essentially want to see it expand and have a greater role, especially in the employer world,� said McKechnie. “For years, our champions have been Senator Hatch, Senator Rubio, Congressman Paulson and Congressman Ryan, now chairman of the Ways and Means Committee, and so we have very prominent Republicans who are looking to help. It’s very interesting that we have Democrats as well who are trying to come to grips with this new technology. It looks very promising that bipartisanship may break out. I find this very encouraging — our Congress is listening. “Something truly extraordinary also recently happened. Indiana, under Governor Pence, was allowed by HHS to implement its HIP 2.0 program. HIP 2.0 is not an employerprovided HSA-qualified plan, but it’s very ‘HSAish’. It puts the incentives in the right place like HSAs do; allows for individual ownership and stewardship of the money, just like HSAs do; and so it’s building consumers in a population of people that has not had those abilities. It’s a shift to be celebrated.� As Berkley said, the possibilities are endless with exchanges and HSAs. “Our goal is to get the marketplace to see that private exchanges equal HSAs,� he said. “It just takes slowing down and marrying these possibilities together, but everyone’s moving so fast. It’s still very early in this conversation.�
Improving Health and Patient Outcomes
Through Personalized, Interactive Engagement Solutions
BY EILEEN CIANCIOLO « CHIEF PRODUCT OFFICER « STAYWELL
Technology influences health care in many ways: from how people get information about conditions, procedures and providers, to the way they manage and improve their health. HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
39
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.
According to a Pew Internet survey, 60 percent of U.S. adults use technology (mostly apps) to track weight, diet or exercise routines, and 21 percent use technology to track personal health data. Wearable devices used to track health data will become commonplace, with the market projected to grow from $949 million in 2013 to $19 billion by 2018. In addition to wearables, elements of gaming are popping up everywhere in health care. Most research indicates this trend will continue because it aligns well with broader consumer behavior and trends: in particular, the affinity consumers have toward online communities and gaming. According to market research firm, NDP Group, 37 percent of the U.S. population nine years and older play video games for an average of 6.4 hours per week. Based on these numbers, it would stand to reason that gaming and technology can be efficient conduits to engaging a broad audience of individuals and demographic groups. An intentional approach to connecting apps, gamification and a comprehensive wellness program can improve a population’s health. Take the example of the leading developer of fitness trackers, which integrated the devices into a StayWell-led campaign for a client with more than 20,000 dispersed employees. The 52-week program targeting weight management and physical activity used a combination of onsite coaching and health assessments, online classes and support, and onsite clinical services. In addition, the company provided participants with a free wearable tracking device that recorded their physical activity and allowed them to compete with and support their coworkers in their quest for better health. At the end of the program, not only did the average participant exceed the goal of one million steps (while the company total exceeded 23 billion steps), but the organization saw a company-wide decrease in overall health risks of 8.6 percent, and an 11.1 percent risk decrease among people who participated in a lifestyle management program. In addition, the overall health care spend for the company decreased by 3.5 percent.
Three tips for achieving your population health goals Being intentional about engaging people in their health, whether you’re trying to increase employee participation in a workplace health management program or if you’re trying to get patients to follow a specific protocol, you need
Companies that can provide individuals with the technology and tools to become and remain engaged in their health will be ahead of the game and on track to improving the health of their employee population. the right tools and a personalized approach to break through the clutter, engage people and generate results. Here are a few things that could help your organization and clients achieve their health goals: Make it personal. One size does not fit all, so use tools that capture communication preferences by individual and that communicate relevant health care information triggered by patientcentric data. This enables your organization to focus on engaging individuals in ways that they choose with information that is relevant and personalized to them. For example, a segment of your population may be more receptive to text messaging than to Webbased programs, so offer behavior change interventions in a variety of modalities to meet different learning and communication styles. Show them that you know them. Integrate data into your communications and program tools to create a sense of familiarity, approachability and authenticity, and to show participants that you know them and understand what they want. Recognize that biometric tracking devices and results from team or individual challenges can serve as data sources. Accommodate a variety of devices and provide interactive and engaging gaming technologies that ultimately are focused on behavior change and outcomes. Use this data to deliver a more personalized program that builds on an individual’s past participation and encourages them to take the next step forward and to build on past successes. Utilize health coaching to change behaviors. Consider telephonic coaching in wellness programs that drive behavior change by
providing one-on-one, personalized guidance that helps people identify and remove barriers to a healthier lifestyle. Interactive, digital coaching programs can also drive positive behavior change by guiding individuals with techniques that help them achieve their goals in short, interactive, engaging paths while incorporating proven gaming techniques. This can include using interactive tools, videos and text messaging programs to reward people by “unlocking” additional tools and virtual prizes as they achieve small, obtainable milestones. This approach provides a form of ongoing engagement for participants that can help sustain long-term change. Gamification, social media and new technology are becoming ubiquitous in health care and health management and, based on early research, it appears these elements can help move the needle on outcomes. For example, research conducted in 1994 using Nintendo’s game Packy and Marlon, which challenges players to manage a fictional character’s diabetes, showed that children who played the game saw a 77 percent decrease in emergency care services compared to kids who did not play the game, according to an interview with Debra Lieberman, published by the Robert Wood Johnson Foundation. At the end of the day, a health care organization — be it a hospital system, a health plan, a wellness provider or a large employer — needs to understand that meeting individuals where they are on their health journey is not a trend, but a reality and a growing consumer expectation. Companies that can provide individuals with the technology and tools to become and remain engaged in their health will be ahead of the game and on track to improving the health of their employee population. Eileen Cianciolo is chief product officer at StayWell, where she is responsible for product innovation, informatics, coaching and development of StayWell programs and products. She can be reached at ecianciolo@staywell.com.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
41
BY MARGIE RODINO VICE PRESIDENT, GLOBAL HUMAN RESOURCES SLOAN VALVE COMPANY
EDUCATION
The Importance of Smart Shopping for Health Care
W
hy don’t we shop for health care services the same way we shop for major appliances, furniture or clothing? In my circle of friends and family, there are very few individuals I know who can just go out and purchase a $2,500 refrigerator without shopping around first. Some of us even go so far as to research Consumer Reports to determine the best model in our price range. It’s only once we figure out the make, model, fit and finish that we actually go out and purchase a major appliance like a refrigerator. So, why don’t we do this with health care? If any of you are like me, I visit the doctor who I’m familiar with, and if he tells me I need an ultrasound, I get it done at his office or wherever he refers me. Before buying, always research the product, investigate resources I trust his recommendation. I don’t ask how much the ultrasound and comparison shop. If, at the end of the day, you still costs or what the difference is between his ultrasound machine go with the most expensive service, that’s okay because and the one down the street. There you have made an educated choice based upon research. are so many reasons why we don’t challenge the doctor. It’s easy to treat health care services like a Band-Aid. We use the “get in, get out” approach when sight of the fact that there are other options that may provide the same it comes to our medical needs. The truth is that it’s very important to exact service at a much lower cost. approach health care services the same way we treat other purchases. By The next time you seek medical attention, try picturing a large putting in a little extra effort, we can make ourselves better, smarter health refrigerator, a big screen TV or a new dishwasher. Do a little research care consumers. before you purchase. By putting in a little extra effort, you’ll become a We should approach health care services the same way we approach smarter health care consumer! shopping, be it online or at a store. Before buying, always research the product, investigate resources and comparison shop. If, at the end of the Margie is an HR executive with over 30 years of professional work experience. Her blog focuses on topics such as leadership, performance management, company day, you still go with the most expensive service, that’s okay because you culture, customer service, health & wellness and (of course) human resources. Read have made an educated choice based upon research. You’ve done the work more at https://medium.com/@TheHRdish. to determine what is best for your current situation. However, don’t lose
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
43
TELEHEALTH
BY JEFF MARKS CHIEF EXECUTIVE OFFICER HEALTHPERX
The Evolution of Telehealth 5FMFIFBMUI JT CSJOHJOH EPDUPST BOE QBUJFOUT UPHFUIFS MJLF OFWFS CFGPSF
E
fforts to manage health care costs and provide access to quality care are becoming increasingly difficult for employers. Costs are increasing; there is a national shortage of physicians; more people are entering the system; and we continue to see a dramatic misuse of medical services, primarily when it comes to urgent care and ER visits. While it almost sounds hopeless, emerging telehealth technologies have the potential to help with all of the above issues. Since the Affordable Care Act became a reality, telehealth has come to be recognized as a game-changer. Employers large and small are restructuring their benefit plans, moving to higher deductible and defined contribution strategies. All the rules are different. However, as many of us in the industry know that telehealth offers an affordable, efficient and effective means to access health care for many medical conditions: it reduces health care costs, decreases absenteeism and increases productivity. What business in America doesn’t want those results? Experts around the country agree. Towers Watson expects a 68 percent increase in the number of employers offering telemedicine in 2015. According to the company’s 2013 Health Care Changes Ahead Survey, 37 percent of employers expect to offer “telemedicine consultations as a low-cost alternative to emergency room or physician office visits for non-emergency health issues.â€? Thirty-four percent are considering telehealth solutions for 2016 or 2017. Mercer’s 2013 National Health Survey of Employer-Sponsored Health Plans also found rapid future adoption for telehealth. The key features of most telehealth programs are: • Affordable and convenient access to Board-Certified physicians who can treat routine health issues 24/7. • Conditions typically treated include cold/flu, sinusitis, respiratory infections/bronchitis, pink eye, allergies, ear infections, urinary tract infections and more. Telehealth physicians are able to successfully treat over 90 percent of those who use their services and refer those who can’t be treated to appropriate care. • Of those who are treated, there is a significant redirection of care, and when you do the math, the numbers are staggering. Of those who call, close to 40 percent who would have used a PCP, another 40 percent would have used urgent care, and 10 percent would have used the ER. This means that an employee who picks up the phone and talks to a doctor is reducing the cost of his/her health care expenditure by more than $250 – before even considering the cost of absenteeism and lost productivity. Although the telehealth industry is growing rapidly, telehealth vendors still have a bit of a challenge. Very few of those employees with the benefit are using it. The reasons vary, but I believe it’s all about behavioral change. Simply put, it’s a new concept, and there are barriers that need to be overcome.
44 First Quarter 2015 * XXX 5IF*)$$ DPN * HealthCare Consumerism Solutions™
Barrier 1: Cost Most telehealth plans require the employer to pay a monthly administration fee and the employee to pay a medical consult fee. That may not be a problem in a few years when telehealth has gone mainstream and it’s a household word, but right now, it’s a huge obstacle because employees still don’t understand what it is and fear they may pay for a consult only to find they still have to go to a clinic and pay again. Only about three to five percent of those with medical consult fees use their benefit.
Barrier 2: Awareness Most companies make a big deal of their new telehealth benefit at enrollment and leave it at that. By the time an employee gets sick, they often forget they even have it. A proactive communication plan directly addressed to employees is essential for driving utilization. As these barriers are addressed, the utilization can grow by 400 to 500 percent and the return-on-investment will soar. Employers considering adding telehealth to their benefit package really need to evaluate how these challenges are going to be addressed by their provider. Telehealth should not be viewed as commodity; rather, it is service that needs a success strategy.
Other New Developments: Telehealth Kiosks Telehealth kiosks offer businesses a way to have a medical clinic within their business without the cost of building a medical clinic. Kiosks come in all sizes, shapes and price points, but what’s important is that they offer employees a private place to have a video consult with their telehealth physician. Kiosks can be designed to have biometric equipment that feed vital health information to the doctor, just like an in-person office visit. Heart rate, blood pressure, pulse, weight, temperature, stethoscope and other equipment can be included, allowing the doctor to make a more informed diagnosis. Keep an eye out for innovative and affordable kiosks that make telehealth benefits even more effective. In conclusion, it is clear the health care industry is undergoing radical change. Using our existing system, we have to spend more time and more of our own money to get routine health care, even when we know exactly what’s wrong and what we need. It’s not easy to get in to see a doctor and it won’t get any better. Besides, who wants to sit in a waiting room full of sick people just to take care of a routine issue that can be handled by a telehealth physician? And what do we do after hours when we’re away from home or when our kids get sick on Saturday morning? Telehealth truly offers an innovative and highly effective solution to a rapidly changing health care system looking for answers. It offers a convenient and affordable way for patients to get treated quickly and effectively.
BY JOSEPH BERARDO JR. CHIEF EXECUTIVE OFFICER MAGNACARE
PLAN DESIGN
2015: A Pivotal Year for Health Care Coverage
E
mployers have already spent time, energy and resources preparing for the employer mandate deadline of January 1, 2015 in order to identify opportunities to avoid tax penalties, make changes to health coverage, adopt cost-cutting strategies and, in general, respond to financial pressures, new regulations and innovations. Now that they have cleared that hurdle, employers have an opportunity to go further and find more cost-saving opportunities from a number of health benefit trends that many anticipate occurring in 2015: • Increased health care data transparency for employers and consumers • A shift to self-insurance among small and mid-sized employers to avoid fees and health care reform mandates • A rise in high deductible health plans to avoid “Cadillac Tax” penalties • Expanded reliance on high-performance networks to provide higher quality care at lower costs
Transparency Growing pressure by policymakers, employers, consumers and the media have compelled health care providers to begin revealing more information related to quality of care, treatment outcomes and price than they typically have in the past. Much of this demand comes from Americans covered by high deductible health plans who now pay more out of pocket. Armed with price performance information, consumers can make informed decisions and choose providers who offer the highest quality care at the best value for their dollar. Providers, in turn, are motivated to be competitive based on quality, price and service. As for employers, they can use data transparency to structure benefits in a way that encourages the purchase of health care services and health care coverage with the highest value.
Self-Insurance A number of companies of all sizes are opting to self-insure. With selfinsurance, employers pay for individual employee health claims out of cash flow rather than as a monthly fixed premium to a health insurance carrier. Costs are based on actual plan member health care use, which makes selfinsuring cost-efficient and more effective than commercial plans. Among its biggest selling points, self-insurance is exempt from the many new federal health insurance tax under the new health care reform legislation, which will be onerous for the commercial plan market. Also, self-insured companies do not have to offer the government-mandated Essential Health Benefits (EHBs), which allows them to tailor benefits to the needs of a company and the demographics of its workers. What’s more, the Affordable Care Act (ACA) does not subject selfinsured health plans to the jurisdiction of the states, while fully-insured plans must comply with the varying coverage mandates, insurance statutes
By limiting the number of providers that health plans can integrate and partner with, greater efficiency can be achieved and costs lowered. and regulations of the 50 states. Self-insured plans continue to be exempt from state mandates and regulation by virtue of ERISA’s preemption of state action in connection with self-insured health and welfare benefit plans. Also, for the most part, self-insured plans are not subject to litigation in state courts or the appeal and complaint procedures of the insurance departments of each of the states.
High-Deductible Health Plans The Cadillac Tax, a 40 percent tax on employers that provide highcost health benefits to their employees, is scheduled to take effect in 2018. The concept is to reduce health care usage and costs by encouraging employers to offer plans that are cost-effective and engage employees in sharing in the cost of care. In response, a growing number of companies now offer highdeductible health plans (HDHPs) in order to encourage employees to be more cost-aware when choosing an expensive and potentially unnecessary treatment or procedure — and make better choices in general. Typically, the HDHP is tied to some form of personal health care spending account and an employer contribution that can be used toward the deductible.
High-Performance Networks In an effort to improve efficiency, clinical effectiveness and value in order to slow unsustainable levels of health care spending, more employers are adopting “high-performance networks,” also known as “narrow networks.” These networks make health care more affordable — at a price point that is potentially 15-20 percent below broader networks. High-performance networks are exclusive groups of quality health care providers and health professional organizations recruited to serve a defined patient population. By limiting the number of providers that health plans can integrate and partner with, greater efficiency can be achieved and costs lowered. Providers are selected for inclusion in these networks via sophisticated data analysis that identifies those with better outcomes, higher efficiency and best practices overall. Health plans and employers anticipate that, by choosing the highestquality providers, they can better meet the health care needs of plan members, improve individual outcomes and enhance personal satisfaction with health care coverage. Joseph Berardo Jr. is CEO of MagnaCare, an administrator of self-insured health plans for employers in New York and New Jersey.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
45
WWW.THEIHCC.COM
AFFILIATE MEMBER PROFILES
Access these profiles online at www.TheIHCC.com. EMPLOYEE BENEFITS CONSULTING
Intrepid goes beyond the typical expectations of the benefits consultant. We take the time to understand each client’s unique culture in order to implement the most progressive, creative solution to their benefits needs.
INTREPID
Liz Frayer, RHU 400 Interstate North Parkway, Suite 600, Atlanta, GA 30339 888-612-4644
“Our mission is to empower clients 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
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 ADMINISTRATION AND FINANCE
WageWorks helps employers support consumer directed
601 Pennsylvania Ave., NW South Building, Suite 500 Washington, D.C. 20004
pre-tax benefit programs,
Lindsey Miranda Canaley
(FSA, HSA, HRA), wellness
Tel: 800.509.4422 Fax: 202.861.6354
programs, commuting and
lmirandacanaley@ahip.org www.ahip.org/courses
including health care
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.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
47
AFFILIATE MEMBER PROFILES
WWW.THEIHCC.COM
Solutions to help your innovative health and benefit programs. HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
MasterCard (NYSE: MA), is a global payments and technology company.
MASTERCARD WORLDWIDE 2000 Purchase St. Purchase, NY 10577-2509
It operates the world’s fastest payments processing network, connecting consumers, financial institutions, merchants, governments and businesses in more than 210 countries and territories. MasterCard’s products and solutions make everyday commerce activities—such as shopping, traveling, running a business and managing finances—easier, more secure and more efficient for everyone.
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
DataPath, Inc., is one of nation’s largest providers of CDH solutions specializing in account-based administration systems.
DATAPATH, INC.
1601 WestPark Drive, Suite 9 Little Rock, AR 72204 501.296.9990 www.dpath.com
Since 1984, service providers using DataPath systems have provided administrative solutions for over 1 million participants of FSA, HRA, HSA, and COBRA. DataPath is the only solutions provider to design and deliver a full Suite of systems for handling 125, 105, 132, COBRA, HSAs, Credit and Debit Cards all delivered to account holders through a single Internet portal, myRSC.com.
“With the significant changes in healthcare today, our software solutions allow users to create custom plans for clients that benefit both the employer and employee. Not only have we created a single platform for all systems with myRSC.com, with the integration of our mySourceCard Debit Card at Wal-Mart and other retailers, our clients are able to offer a hassle-free solution with 100% compliance.” ®
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
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 It has been an exciting year www.flexiblebenefit.com 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. 48
First Quarter 2015 I www.TheIHCC.com I HealthCare Consumerism Solutions™
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
TSYS HEALTHCARE TSYS Healthcare® provides end-toend strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment. “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
WWW.THEIHCC.COM
AFFILIATE MEMBER PROFILES
Solutions to help your innovative health and benefit programs. 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.
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. 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.�
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.
HealthCare Consumerism Solutions™ I www.TheIHCC.com I First Quarter 2015
49
RESOURCE GUIDE
WWW.THEIHCC.COM
Solutions to help your innovative health and benefit programs.
Listen Live Every Friday at 11 a.m. (ET) Now on Blog Talk Radio! www.blogtalkradio.com/theihcradio Join the conversation by tweeting or emailing your questions to us in advance, during or after each show: Twitter: @The IHC Email: dfield@theihcc.com
ADVERTISING INDEX AHIP ...................................................... 47
IHC Private Exchange FORUM Preview ...10
Aetna ....................................... Back Cover
IHC Radio Show ....................................50
Castlight Health ..................................... 47
IHC 2015 Superstars .............................16
Cigna .............................................HCX 10
Intrepid .................................................. 47
CodeBaby............................................... 49
MasterCard ............................................ 48
ADVERTISING CONTACTS
Connecture ............................................ 42
New Benefits .......................................... 34
404.671.9551
ConnectYourCare ...........Inside Back Cover
Onlife Health .......................................... 40
Doug Field 404.671.9551 ext. 101 · dfield@ theihcc.com
Consumer Medical ................................. 49
PrivateHealthCareExchanges.com ..........HCX 2
MANAGING DIRECTOR
DataPath ............................................7, 48
Softheon ..........................................HCX 8
Flexible Benefit Service Corporation........ 48
Transitions ............................................. 49
IHC Certification ....................................13
Truven Health Analytics ......................... 49
IHC FORUM West ...................................46
TSYS Healthcare ................................5, 48
Michelle Gatehouse 404.405.3007 • mgatehouse@theihcc.com
IHC FORUM & EXPO Atlanta ...........HCX 12
Quadrant 4 Health .................................. 36
Ted Arvan 678.296.1906 • tarvan@theihcc.com
IHC Private Exchange FORUM ........HCX 16
WageWorks ............ Inside Front Cover, 47
If you use the services of our solutions providers, please tell them you saw their ad in HealthCare Consumerism Solutions™. Re uests for Permissions to reuse content: contact Copyright Clearance Center at info@copyright.com.
CEO
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
50
First Quarter 2015 I www.TheIHCC.com I HealthCare Consumerism Solutions™
How do you effectively roll out an HSA program to your employees? Education and communication are the keys to your success.
We know how to simplify things, and drive account enrollment through uniquely tailored strategic communication solutions. Our clients have enjoyed a 23-29% increase in account enrollment. Stop booth 110 by to learn more. www.connectyourcare.com
Financial Healthierwell-being living Intelligent solutions Financial well-being Quality health plans & benefits Intelligent solutions Healthier living Financial well-being Intelligent solutions
Building a healthier worldSM SM Building a healthier world Aetna is proud to sponsor The Institute for SM for Aetna is proud to sponsor The Institute HealthCare Consumerism. Building a healthier world HealthCare Consumerism. Aetna is proud to sponsor The Institute for HealthCare Consumerism. Aetna is the brand name used for products and services provided by one or more of the Aetna Aetna is brand name used for products and group of the subsidiary companies, including Aetna services provided by one of the Aetna Life Insurance Company andor itsmore affiliates (Aetna). group of subsidiary companies, including Aetna Š2015 Aetna Inc. Life Insurance Company andused its affiliates (Aetna). 2014015 Aetna is the brand name for products and Š2015 Aetna Inc. services provided by one or more of the Aetna