SPECIAL PRIVATE EXCHANGE COVERAGE FROM HEALTHCARE EXCHANGE SOLUTIONS
ISSUE || January/February 2014
Weighing the Future of Health Benefits
ANNOUNCING
Leading Experts on What’s to Come from Private Exchanges Health Savings Accounts in the Era of Exchanges
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FEATURES 31 Experts Weigh in: Private Exchanges’ Past, Present and Future At the beginning of 2013, questions swirled concerning private exchanges. Would employers actually transition to private exchanges? If they did, would they work? Would employers cut their health care contributions even more? Would employees want to utilize private exchanges? Would the many hiccups surrounding the public exchanges hurt or help adoption of private exchanges? Last fall’s open enrollment answered some of those questions and raised a few more. Here’s a look at some industry experts’ opinions on the past, present and future of private exchanges, including John Young, CEO, Consumerdriven; Chris Condeluci, of counsel, Venable LLP; Bob Natt, executive chairman, Alegeus Technologies; Don Weber, managing director, PricewaterhouseCoopers; and Shandon Fowler, director of marketplaces, BenefitFocus. By Heather Loveridge, Senior Editor, The Institute for HealthCare Consumerism
35 Defining the New Normal: What Are Private Exchanges and How Will They Change Employer-sponsored Health Insurance? Nearly every day seems to bring the announcement of another new private exchange. Brokerage firms, consulting firms, health plans and other organizations are launching private exchange solutions at an increasing rate for their members and clients. In the first days of February alone, we have witnessed major announcements from Cigna, bswift benefits and a number of national and regional brokerage firms. Yet with all the movement from these players, many employers remain largely unaware of the variety of solutions available under the “private exchange” label. Fully insured, self-funded. Defined contribution, defined benefit. Single-carrier, multi-carrier. These are but a few of the characteristics employers need to examine when looking at private exchanges. After all, if you’ve seen one private exchange, you’ve seen one private exchange. By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism
HealthCare Consumerism Solutions™ I www.TheIHCC.com I HealthCare Exchange Solutions™ I January/February 2014
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DEPARTMENTS
6-7
What’s Happening at The Institute
8
Publisher’s Letter
13-15
FORUM & Expo Preview
16-17
Briefs & Innovations
t t t t
19
Financial Tradeoff on Health Benefits Savings Sacrifice
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43
Solution Provider Member Profiles
50
Resource Guide/Ad Index
11 Bachman’s Banter Death of a Salesman? By Ronald E. Bachman, Chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism
% willing to increase their deductible
$75
83%
$50
81%
$25
72%
($900 annually)
($600 annually)
Stats & Data
Premium $ discount per month
($300 annually)
Source: Accenture’s Private Exchange Research, Dec. 2013
27 Defined Contribution Defined Contribution: Learning from the Past, Looking to the Future By David Urbaniak, Product Manager, Evolution1
21 Voluntary Benefits In An Era of Health Care Volatility, Supplemental Benefits Offer Security People Can Count On
By Ron Fields, Vice President of Core Broker Sales, Aflac
23 Ask the Broker Selling Voluntary Benefits in The New Era of Health Care Exchanges: A Conversation with Anthony Glaub, President, Professional Insurance Enrollers 4
29 Health Savings Accounts The Future of Health Savings Accounts: Exchange Opportunities and Challenges By Cynthia Piazza, Marketing Communications Manager, ConnectYourCare
41 Regulatory & Compliance Why Health Insurers are Leery of Playing in SHOP or Small Group Private Exchanges By Elena Merino, President/ CEO, The Meridian Group & Tony Roehl, Of Counsel, Morris, Manning & Martin, LLP
January/February 2014 I HealthCare Exchange Solutionsâ„¢ I www.TheIHCC.com I HealthCare Consumerism Solutionsâ„¢
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What’s Happening at the Institute BY DUSTY RHODES » DIRECTOR OF EDUCATION » THE INSTITUTE FOR HEALTHCARE CONSUMERISM Editor’s Note: The Institute for HealthCare Consumerism is busy gearing up for another important year in health and benefits. Entering the new year, the industry is already moving at a fast pace with employers continuing to search out new solutions in this ever-changing landscape and solution providers continuing to innovate. At The Institute for HealthCare Consumerism, we’re getting ready for our May conference and rolling out the Certified HealthCare Consumerism Specialist (CHCS) designation. We’re also excited about our initiatives around private exchanges, including PrivateHealthCareExchanges.com. Over the following pages, Dusty Rhodes, Director of Education, runs down the list of what’s happening at The Institute for HealthCare Consumerism in the lead up to the 2014 FORUM & Expo in Atlanta.
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The 2014 IHC FORUM & Expo Is Only a Few Months Away
Frequently Asked Health Care Reform Questions
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By Josie Martinez, Senior Partner and Legal Counsel, EBS Capstone, A UBA Partner Firm
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______________________________________________ ONLINE EXCLUSIVES Visit www.theihcc.com to read the rest of these articles and many more
Fortune: Castlight Health Files for IPO By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism "DDPSEJOH UP BO FYDMVTJWF SFQPSU CZ 'PSUVOF DPN TFOJPS FEJUPS %BO 1SJNBDL MFBEJOH IFBMUI DBSF USBOTQBSFODZ DPNQBOZ $BTUMJHIU )FBMUI IBT iTFDSFUMZw mMFE UIF QBQFSXPSL GPS JUT JOJUJBM QVCMJD PGGFSJOH
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January/February 2014 I HealthCare Exchange Solutionsâ„¢ I www.TheIHCC.com I HealthCare Consumerism Solutionsâ„¢
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______________________________________________ Introducing the Certified HealthCare Consumerism Specialist
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PUBLISHER www.theihcc.com VOLUME 10 NO. 1 | JANUARY/FEBRUARY 2014
On the Cusp of the New Normal
Published by FieldMedia LLC 292 South Main Street, Suite 400 Alpharetta, GA 30009 Fax: 770.663.4409 CEO
Doug Field @ theihcc.com MANAGING DIRECTOR
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Brent Macy
MANAGING EDITOR
Jonathan Field
SENIOR EDITOR
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Joni Lipson
MARKETING COMMUNICATIONS MANAGER
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ART DIRECTOR
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GRAPHIC DESIGN
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Dusty Rhodes CHAIRMAN OF IHC ADVISORY BOARD
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Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River Group; John Hickman, Alston+Bird LLP; Tony Holmes, Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC WEBMASTERS
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4JODFSFMZ
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Become a Certified HealthCare Consumerism Specialist (CHCS) For forward-thinking individuals and groups to take their businesses and professional development to the next level. Complete all your coursework at the upcoming 2014 IHC FORUM & Expo May 7-9th in Atlanta! www.theihcc.com/university/certification
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Provide employees the right tools to make the most of their healthcare choices. At TSYS HealthcareÂŽ, our approach to client-driven innovation allows you to define and shape flexible, integrated payment solutions that meet your unique needs. Our independent industry partnerships and elite platform functionality help our clients build solutions that make sense. Our solutions include: Ĺ˜ 'HĹľQHG FRQWULEXWLRQ SODQ RSWLRQV WR DVVLVW ZLWK KHDOWKFDUH H[FKDQJH SUHPLXPV Ĺ˜ $ PXOWL SXUVH +6$ )6$ +5$ DQG :HOOQHVV FDUG SODWIRUP GHYHORSHG VSHFLĹľFDOO\ IRU KHDOWKFDUH Ĺ˜ (QKDQFHG +5$ FDUG IXQFWLRQDOLW\ Ĺ˜ $Q LQGHSHQGHQW SDUWQHU QHWZRUN Ĺ˜ ([SHULHQFHG KHDOWKFDUH DGYLVRUV Ĺ˜ 5HYHQXH JHQHUDWLQJ ĹľQDQFLDO PRGHOV Integrity | Relationships | Excellence | Innovation | Growth
Learn more at www.tsyshealthcare.com or call us at +1.706.649.5080
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Š 2014 Total System Services, Inc.Ž All rights reserved worldwide. TSYSŽ is a federally registered service mark of Total System Services, Inc.
BACHMAN’S BANTER
BY RONALD E. BACHMAN CHAIRMAN, EDITORIAL ADVISORY BOARD THE INSTITUTE FOR HEALTHCARE CONSUMERISM
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HealthCare Consumerism Solutionsâ„¢ I www.TheIHCC.com I HealthCare Exchange Solutionsâ„¢ I January/February 2014
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You imagined it. We built it. Introducing RedBrick 5—the newly enhanced platform from RedBrick Health. Easier to administer and better to use—RedBrick 5 offers a true health engagement and behavior change hub that goes far beyond traditional wellness portals or mobile apps. Grounded in behavior design, RedBrick 5 brings together an expanded array of tools to help consumers make wiser choices, save money and get the care they need. Plus, you can seamlessly integrate in your own activities or third-party programs making administration and management easier than ever—now, and well into the future. To schedule a demo or to learn how RedBrick Health has what it takes to power your population health strategy, visit or call:
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855-776-5515
ATLANTA, MAY 7-9, 2014
Produced by The Institute for HealthCare Consumerism
Real-Time Analysis, Thought-Leadership and Solutions from Experts and Your Peers.
HealthCare Consumerism: The Solution for HealthCare Reform
WHERE EMPLOYERS AND THOSE WORKING WITH THEM COME TOGETHER TO COLLABORATE AND LEARN
May 7-9, 2014
ATLANTA
Cobb Galleria Centre
EARLYBIRD RATES Until March 31, 2014
WWW.THEIHCCFORUM.COM
LEARN. CONNECT. SHARE.
www.theihccforum.com Pre-Conference Events:
ATLANTA, MAY 7-9, 2014
The Only Conference 100% Dedicated to HealthCare Consumerism There’s no other event‌
‌where so much innovation is discussed and demonstrated around all aspects of health and benefit management’s current opportunities and challenges. ‌that attracts such a diverse group of stakeholders, both speaking and attending, and meets their needs with a wide range of rich, educational and interactive content. ‌where real-time collaboration and problem solving takes place, creating an energy that conference-goers continue to talk about long after returning to their companies to implement what they’ve learned. ‌that has been at the forefront of the health care consumerism mega-trend as we witness one of the most monumental shifts in our industry’s history.
Who Should Attend IHC FORUM? t t t t t t t
CEO’s, CFO’s and Presidents Corporate Wellness Directors Benefit Managers Health Plan Administrators Brokers Consultants Third Party Administrators
Participate in a longer, deeper dive into some of the most pressing issues in health and benefit management during our interactive Pre-conference Events. Space is limited, be sure to select and add these to your registration: t Making Health Care Consumerism Work: The Steps and Plan t Helping Employers Understand Defined Contribution and Private Exchanges t Pharmacy Benefit Management (PBM) – Employer Forum on Prescription Drugs: “Is transparency a myth?� t “A Dose of Reality� – A Panel of 8 Leading Physicians Report on the State of Healthcare in America t Lunch and Learn: The Power of Employee Choice: The Game Changing Combination of Private Exchanges and HSAs
LEARN. CONNECT. SHARE. WORKSHOPS. Choose four workshops to attend from among 32 interactive, trending topics. Read descriptions for each at www.theihccforum.com
Opening Keynote Address General Session Health Reform 2.0: The Great Debate John Goodman, PhD vs. Kenneth Thorpe, PhD Witness a rare face-to-face debate between two of the most influential health care experts as they battle with ideas regarding the future of health reform in the United States. John Goodman, PhD – President and CEO of the National Center for Policy Analysis and known as the Father of Health Savings Accounts – is a strong advocate of free-market patient-centered health reforms. Kenneth E. Thorpe, PhD – the Robert W. Woodruff Professor and Chair of the Department of Health Policy & Management at Emory University’s Rollins School of Public Health, also serving as the executive director of Emory’s Institute of Advanced Policy Solutions (IAPS) and director of the Institute’s Center for Entitlement Reform. — is a nationally known expert on foreign systems of healthcare and strong advocate of federal health reforms. These two policy influencers have had enormous political influence on their respective sides of the aisle. Dr. Goodman has been a key thought
leader for free market solutions and Dr. Thorpe worked in the Clinton administration on “HillaryCare,� has been an advisor to Congress, and has been key resource to most every Democratic presidential nominee during the last 20 years. The policy differences between these two heavy weights have been debated in the halls of Congress, national media, and industry journals. They have never squared off in public on the same platform. The Institute for Healthcare Consumerism is proud to bring to you a provocative debate on “Health Reform 2.0� — one you won’t want to miss.
Additional General Sessions: t
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SEE THE FULL 2014 IHC FORUM & EXPO AGENDA AT WWW.THEIHCCFORUM.COM
THE SOLUTION FOR HEALTHCARE REFORM Register Now and Save Don’t miss this opportunity to be at the forefront of the health and benefit management movement. Reserve your spot at IHC FORUM & Expo before March 31st, 2014 for the EARLY BIRD RATES.
*)$ '036. &YQP t .BZ t $PCC (BMMFSJB $FOUSF t "UMBOUB No industry event offers you more for your money. Join The Institute for HealthCare Consumerism for free and save even more. Already an IHC member? Check your inbox for our weekly e-blast and save using your exclusive member discount code. Visit www.theihccforum.com for details.
REGISTRATION RATES FOR FORUM & EXPO - MAY 7-9, 2014 Standard Rates (ends 5/04/14)
(starts 5/05/14)
Employer: Government & Non-Profit
$295
$395
$595
Employer: Private Sector
$395
$495
$795
Brokers/Advisors/Consultants
$395
$495
$795
TPAs/Health Plans
$395
$495
$795
Solution Providers
$595
$895
$1195
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Maintain your position as a forward-thinking professional within your organization and the health Complete your training at IHC FORUM & Expo 2014 to be eligible for online testing. -FBSO NPSF CZ WJTJUJOH UIF *)$ $FSUJmDBUJPO QSPHSBN POMJOF BU XXX UIFJIDD DPN VOJWFSTJUZ DFSUJmDBUJPO
2014 IHC FORUM & EXPO
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Snapshot of Attendee Takeaways: Here is what you will take back to your company and management teams after attending this conference: t Finalize 2015 open enrollment planning by comparing what peers of similar company sizes are doing, analyzing latest trends and adopting best and better practices. t Collaborate amongst all stakeholders while learning from a faculty of policy makers and legal experts speaking on general session panels, interactive “Learn�, “Connect� and “Share� workshops and pre-conference events. t Get the information you need to understand all the moving parts of healthcare consumerism, enabling you to advance your program to the next stage in order to keep up with a maturing industry without being left behind. t Understand how can you can retain the value and promise of the healthcare consumerism movement as you move toward implementing exchanges, compliance and more. t Collaborate on ideal benefit plans and models while learning about emerging innovations, technology, solutions and services. t Determine if Private Exchanges and Defined Contributions are working by participating in discussions that will determine ideal models for various employee populations. With over 90% of employers looking at these models, you’ll find out what employers are actually implementing in 2014 and 2015. t Now that employers can no longer “wait and see� when it comes to the ACA, you will leave with a firm understanding of where compliance is headed and what you need to know to satisfy regulations. t Read the full list of Attendee Takeaways at www.theihccforum.com
www.TheIHCCFORUM.com
HAVE A QUESTION? Contact us through the email form at www.theihccforum.com or call 404-671-9551 ext: 108
NEWS BRIEFS & INNOVATIONS
NEWS BRIEFS PlanSource Announces $12 Million Series B Investment to Expand its Private Exchange, Other Solutions 1MBO4PVSDF SFDFOUMZ BOOPVODFE UIBU JU IBT DPNQMFUFE B NJMMJPO 4FSJFT # *OWFTUNFOU 3PVOE XJUI JUT FYJTUJOH JOWFTUPST -FNIJ 7FOUVSFT BOE 5JNVDVBO "TTFU .BOBHFNFOU i"T B MFBEJOH QSPWJEFS PG IFBMUI DBSF UFDIOPMPHZ BOE FNQMPZFF CFOFmUT BENJOJTUSBUJPO PVS CVTJOFTT JT SBQJEMZ FWPMWJOH BOE FYQBOEJOH JO UIF BSFBT PG JOTVSBODF FYDIBOHFT BOE 4BB4 QMBUGPSN TPMVUJPOT GPS DBSSJFST QBZFST w TBJE %BZOF 8JMMJBNT $&0 PG 1MBO4PVSDF i)VOESFET PG CSPLFST BOE DBSSJFST JODMVEJOH TPNF PG UIF MBSHFTU IFBMUI QMBOT JO UIF 6 4 VTF 1MBO4PVSDF GPS PVS QSPWFO BCJMJUZ UP JODSFBTF EJTUSJCVUJPO BOE QSPEVDU QBSUJDJQBUJPO XJUI PVS TPQIJTUJDBUFE GVODUJPOBMJUZ w
HHS: Nearly 2.2 Million Selected Health Plans via Healthcare.gov from October to December /FBSMZ NJMMJPO QFPQMF IBWF TFMFDUFE QMBOT GSPN UIF TUBUF BOE GFEFSBM NBSLFUQMBDFT CZ %FDFNCFS UIF FOE PG UIJSE SFQPSUJOH QFSJPE GPS PQFO FOSPMMNFOU )FBMUI BOE )VNBO 4FSWJDFT 4FDSFUBSZ ,BUIMFFO 4FCFMJVT BOOPVODFE FBSMJFS JO +BOVBSZ " OFX ))4 SFQPSU QSPWJEFT UIF mSTU EFNPHSBQIJD JOGPSNBUJPO BCPVU FOSPMMFFT %FDFNCFS BMPOF BDDPVOUFE GPS OFBSMZ NJMMJPO FOSPMMFFT JO TUBUF BOE GFEFSBM NBSLFUQMBDFT &OSPMMNFOU JO UIF GFEFSBM NBSLFUQMBDF JO %FDFNCFS XBT TFWFO GPME HSFBUFS UIBO UIF DPNCJOFE UPUBM GPS 0DUPCFS BOE /PWFNCFS ‰ BOE FJHIU GPME HSFBUFS GPS ZPVOH BEVMUT BHFT UP
bswift Continues Growth and Extends Leadership in Benefits Technology and Exchanges in 2013 CTXJGU B MFBEFS JO DMPVE CBTFE UFDIOPMPHZ BOE TFSWJDFT GPS FNQMPZFF CFOFmUT IBT BOOPVODFE UIBU UIF DPNQBOZ BDIJFWFE TVCTUBOUJBM HSPXUI JO JODMVEJOH QFSDFOU JODSFBTF JO SFDVSSJOH SFWFOVF GSPN UP QFSDFOU DPNQPVOEFE BOOVBM HSPXUI SBUF JO SFDVSSJOH SFWFOVF GSPN UISPVHI QFSDFOU JODSFBTF JO FOSPMMNFOU WPMVNF ‰ UP NPSF UIBO NJMMJPO USBOTBDUJPOT ‰ GSPN UP BOE TZTUFN SFMFBTFT TJODF CTXJGU T GPVOEJOH BT B DMPVE CBTFE CFOFmUT UFDIOPMPHZ DPNQBOZ JO
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January/February 2014 I HealthCare Exchange Solutionsâ„¢ I www.TheIHCC.com I HealthCare Consumerism Solutionsâ„¢
GoHealth Launches Mobile Site, Making Health Insurance Shopping and Enrollment More Convenient (P)FBMUI B QSJWBUF POMJOF IFBMUI JOTVSBODF NBSLFUQMBDF IBT MBVODIFE JUT NPCJMF GSJFOEMZ XFCTJUF NBLJOH JU UIF POMZ MFBEJOH NBSLFUQMBDF GPS UBY DSFEJU FMJHJCMF IFBMUI JOTVSBODF QMBOT UIBU JT PQUJNJ[FE GPS NPCJMF EFWJDFT 8JUI ZPVOH QFPQMF B QSJNBSZ UBSHFU UP HFU FOSPMMFE VOEFS UIF "GGPSEBCMF $BSF "DU UIF MBVODI PG (P)FBMUI T NPCJMF TJUF HJWFT "NFSJDBOT B DPOWFOJFOU XBZ UP HFU DPWFSBHF EVSJOH PQFO FOSPMMNFOU XIJDI FOET .BSDI
PrivateHealthCareExchanges.com Reaches 90 Aggregated Solutions, Adds New Search Function 1SJWBUF)FBMUI$BSF&YDIBOHFT DPN 5IF *OTUJUVUF GPS )FBMUI$BSF $POTVNFSJTN T QSPKFDU BJNFE BU BHHSFHBUJOH BMM FYJTUJOH QSJWBUF FYDIBOHF TPMVUJPOT GPS UIF GSFF QVCMJD VTF PG FNQMPZFST IFBMUI QMBOT CSPLFST BOE PUIFST IBT BOOPVODFE UIBU JU OPX IBT PWFS TPMVUJPOT MJTUFE XJUI UIF FYQFDUBUJPO UP TVSQBTT CZ .BSDI 5IF XFCTJUF IBT BMTP BEEFE JUT TFBSDI GVODUJPO UP IFMQ CSPLFST IFBMUI QMBOT FNQMPZFST BOE PUIFS TFBSDI UIF EBUBCBTF XJUI DSJUFSJB TVDI BT HFPHSBQIZ NVMUJ DBSSJFS WT TJOHMF DBSSJFS BOE HSPVQ WT JOEJWJEVBM
NEW PRIVATE EXCHANGES
Visit PrivateHealthCareEXCHANGES.com for more information on these new private exchanges and many more
Diversified Insurance Solutions Announces Private Exchange Partnership with bswift %JWFSTJmFE *OTVSBODF 4PMVUJPOT POF PG 8JTDPOTJO T MFBEJOH JOTVSBODF CSPLFSBHF mSNT BOOPVODFE UIBU UIFZ IBWF TFMFDUFE CTXJGU B MFBEFS JO TPGUXBSF BOE TFSWJDFT GPS FNQMPZFF CFOFmUT BENJOJTUSBUJPO UP QSPWJEF UIF FYDIBOHF UFDIOPMPHZ QMBUGPSN GPS UIF %JWFSTJmFE *OTVSBODF .BSLFUQMBDF 5IF QSJWBUF FYDIBOHF JT EFTJHOFE UP NBOBHF DPTUT GPS FNQMPZFST BOE PGGFS DPNQFUJUJWF CFOFmU PQUJPOT GPS FNQMPZFFT CZ MFWFSBHJOH UIF SPCVTU UFDIOPMPHZ CTXJGU IBT EFWFMPQFE PWFS UIF MBTU ZFBST 5IF %JWFSTJmFE *OTVSBODF .BSLFUQMBDF XJMM mSTU DPODFOUSBUF PO CVTJOFTTFT JO TPVUIFBTUFSO 8JTDPOTJO BOE XJMM GFBUVSF GPVS NBKPS IFBMUI JOTVSBODF DBSSJFST 6OJUFE)FBMUIDBSF 814 )FBMUI *OTVSBODF "SJTF )FBMUI 1MBOT $PNNPO (SPVOE )FBMUIDBSF $PPQFSBUJWF BOE /FUXPSL )FBMUI 1MBO
Cigna Launches Private Health Care Exchange in Four Metro Areas $JHOB SFDFOUMZ BOOPVODFE UIF DPNQBOZ IBT FTUBCMJTIFE B QSJWBUF SFUBJM FYDIBOHF PGGFSJOH FNQMPZFST B OFX CFOFmU NBSLFUQMBDF BOE FNQMPZFFT NPSF PQUJPOT BOE DPOWFOJFODF GPS IFBMUI JNQSPWF NFOU $JHOB T QSJWBUF FYDIBOHF JT DVSSFOUMZ BWBJMBCMF UP TNBMMFS FNQMPZFST JO "UMBOUB %BMMBT 8BTIJOHUPO % $ NFUSP BSFB BOE 4BO 'SBODJTDP BOE XJMM CF FYQBOEFE UP PUIFS NBSLFUT BOE MBSHFS FNQMPZFS HSPVQT UISPVHIPVU 8JUI $JHOB T OFX PGGFSJOH FNQMPZFFT IBWF BDDFTT UP VTFS GSJFOEMZ iIFBMUI DBSF CFOFmU QMBO EFDJTJPO TVQQPSU UPPMTw UP TIPQ GPS BOE FOSPMM JO UIF QMBOT UIBU CFTU NFFU UIFJS VOJRVF OFFET 'PS FNQMPZFST UIF FYDIBOHF PGGFST B CFOFmUT BENJOJTUSBUJPO QMBUGPSN UIBU BMMPXT UIFN UP QSPWJEF UIFJS FNQMPZFFT XJUI B CSPBEFS DIPJDF PG QMBO PQUJPOT XIJMF TJNQMJGZJOH
FNQMPZFST BENJOJTUSBUJWF SFTQPOTJCJMJUJFT BOE DPOUSPMMJOH CFOFmU DPTUT *O BEEJUJPO $JHOB T CSPLFST DBO BMTP CFOFmU GSPN UIJT FBTZ UVSOLFZ QSJWBUF FYDIBOHF TPMVUJPO
DragonFly HIX Inc. Selects Q4 Health’s QHIX Platform For Their Private Health Exchange %SBHPO'MZ )*9 *OD BOOPVODFE UIBU UIFZ IBWF TFMFDUFE 2)*9 GPS UIFJS QSJWBUF IFBMUI DBSF FYDIBOHF 2)*9 CVJMU CZ 2 )FBMUI B EJWJTJPO PG 2 4ZTUFNT $PSQPSBUJPO JT BO JOEVTUSZ MFBEJOH DMPVE CBTFE QMBUGPSN GPS NBOBHJOH BMM FMFNFOUT PG B QSJWBUF FYDIBOHF PGGFSJOH 2)*9 NBOBHFT BMM FMFNFOUT PG B IFBMUI FYDIBOHF 8JUI JUT QSPQSJFUBSZ .BSLFUQMBDF JOEJWJEVBM DPOTVNFST PS FNQMPZFFT PG DPNQBOJFT PG BMM TJ[FT DBO DPNQBSF QVSDIBTF FOSPMM BOE NBOBHF DBQBCJMJUJFT GPS IFBMUI JOTVSBODF OFFET 2 JT MFBEJOH UIF DIBSHF GPS NBOBHJOH UIJT DPNQMFY BOE BMNPTU FWFS DIBOHJOH IFBMUI DBSF MBOETDBQF
PlanSource Announces Launch Of Barney & Barney ATLAS Employer Exchange On MyPlanSource Platform 1MBO4PVSDF UIF BMM JO POF DMPVE CBTFE CFOFmUT TPMVUJPO BOE PO EFNBOE UFDIOPMPHZ DPNQBOZ UIBU QSPWJEFT TUBUF PG UIF BSU CFOFmUT BENJOJTUSBUJPO JOTVSBODF FYDIBOHF QBZSPMM BOE )3*4 TPMVUJPOT UP FNQMPZFST UISPVHI JUT JOTVSBODF DBSSJFS BOE CSPLFS QBSUOFST BOOPVODFE UIF MBVODI PG UIF "5-"4 &NQMPZFS &YDIBOHF GPS #BSOFZ #BSOFZ --$ POF PG UIF UPQ QFSGPSNJOH JOTVSBODF CSPLFSBHFT JO UIF TUBUF PG $BMJGPSOJB 5IF "5-"4 &NQMPZFS &YDIBOHF B QSJWBUF JOTVSBODF FYDIBOHF GPS CVTJOFTTFT XJUI PS NPSF FNQMPZFFT XIP XBOU UP QSPWJEF IFBMUI CFOFmUT VOEFS UIF "GGPSEBCMF $BSF "DU "$" JT QPXFSFE CZ 1MBO4PVSDF T .Z1MBO4PVSDF &YDIBOHF .BSLFUQMBDF QMBUGPSN
EmSpring Announces New Private Exchange Solution &N4QSJOH $PSQPSBUJPO SFDFOUMZ BOOPVODFE UIF MBVODI PG UIF &N4QSJOH #FOFmUT .BSLFUQMBDF 5IJT POMJOF QSJWBUF FYDIBOHF TPMVUJPO DPNCJOFT TUBUF PG UIF BSU UFDIOPMPHZ XJUI JOTVSBODF DIPJDFT GSPN OBUJPOXJEF DBSSJFST &N4QSJOH #FOFmUT .BSLFUQMBDF JT CVJMU VQPO B QPXFSGVM BOE QSPWFO UFDIOPMPHZ GPVOEBUJPO BOE JODMVEFT B SPCVTU EFmOFE DPOUSJCVUJPO QMBUGPSN GPS FNQMPZFST BOE UIFJS FNQMPZFFT 5IF TZTUFN NBLFT JU FBTZ GPS FNQMPZFFT UP RVJDLMZ BOE FBTJMZ DPNQBSF QMBO PQUJPOT UP EFUFSNJOF UIF CFTU QMBO GPS UIFJS VOJRVF TJUVBUJPO BOE DJSDVNTUBODF 5P TJNQMJGZ UIF QSPDFTT FWFO NPSF VTFST IBWF UIF PQUJPO UP BDDFTT B EFDJTJPO TVQQPSU UPPM UP XBML UIFN UISPVHI BOE BTL UIFN RVFTUJPOT UP EFUFSNJOF UIF CFTU QMBO DIPJDFT
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bswift Announces Private Health and Benefits Exchange: Springboard Marketplace CTXJGU IBT BOOPVODFE UIF MBVODI PG 4QSJOHCPBSE .BSLFUQMBDF B QSJWBUF IFBMUI BOE CFOFmUT FYDIBOHF 'PS FNQMPZFFT UIF QMBUGPSN PGGFST B CSPBE TFMFDUJPO PG BUUSBDUJWF CFOFmUT BOE QFSLT SBOHJOH GSPN JOTVSBODF UP QSPEVDUT BOE TFSWJDFT UIBU DBO FMFWBUF UIFJS IFBMUI BOE XFMMOFTT 'PS FNQMPZFST UIF NBSLFUQMBDF QSPWJEFT B TUSFBNMJOFE XBZ UP QSPWJEF CFOFmUT BMM ZFBS SPVOE GPS CPUI USBEJUJPOBM CFOFmUT BT XFMM BT JOOPWBUJWF OFX PGGFSJOHT #FTU PG BMM JU FOBCMFT FNQMPZFFT BOE FNQMPZFST UP NBOBHF UIFJS CFOFmUT CVEHFUT WJB B EFmOFE DPOUSJCVUJPO NPEFM BJEFE CZ UIF i"TL &NNBw EFDJTJPO TVQQPSU UPPM UP IFMQ FNQMPZFFT NBLF FEVDBUFE BOE JOUFMMJHFOU DIPJDFT
PEOPLE ON THE MOVE Towers Watson Announces Expansion of Exchange Solutions Segment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
Mercer Appoints Sharon Cunninghis Leader of Mercer Marketplace Exchange Solutions 4IBSPO $VOOJOHIJT IBT CFFO BQQPJOUFE BT UIF MFBEFS PG .FSDFS .BSLFUQMBDF &YDIBOHF 4PMVUJPOT B OFX EJWJTJPO XJUIJO .FSDFS EFEJDBUFE UP EFMJWFSJOH DSFBUJWF TPMVUJPOT JO UIF FYDIBOHF TQBDF *O UIJT SPMF TIF XJMM SFQPSU UP +VMJP " 1PSUBMBUJO .FSDFS T 1SFTJEFOU BOE $IJFG &YFDVUJWF 0GmDFS .FSDFS BMTP BOOPVODFE UIBU #FSOBSE 8BMTI XJMM TVDDFFE .T $VOOJOHIJT BT UIF /PSUI "NFSJDB )FBMUI #FOFmUT 3FHJPO -FBEFS .S 8BMTI XJMM SFQPSU UP %BWF 3BIJMM (MPCBM )FBMUI #FOFmUT -FBEFS BOE 1BU .JMMJHBO /PSUI "NFSJDB 3FHJPO 1SFTJEFOU
PPI Benefit Solutions Launches Benesphere Employee Marketplace for End-to-End Private Exchange
Maxwell Health Names Bob Gaydos VP, Strategic Partnerships
11* #FOFmU 4PMVUJPOT 11* B MFBEJOH QSPWJEFS PG CFOFmUT BENJOJTUSBUJPO UFDIOPMPHZ BOE TFSWJDFT GPS TNBMMFS NJE TJ[FE FNQMPZFST IBT MBVODIFE B QSJWBUF FYDIBOHF TPMVUJPO 5IF #FOFTQIFSF &NQMPZFF .BSLFUQMBDF QSPWJEFT B XJEFS BSSBZ PG QMBO DIPJDFT BOE BO FOSJDIFE POMJOF FOSPMMNFOU FYQFSJFODF GPS FNQMPZFFT XIJMF BMMPXJOH FNQMPZFST B NPSF QSFEJDUBCMF GVOEJOH NFUIPE UISPVHI EFmOFE DPOUSJCVUJPO BOE QPXFSGVM XFC CBTFE UFDIOPMPHZ UP IBOEMF EBZ UP EBZ BENJOJTUSBUJPO 5IF #FOFTQIFSF &NQMPZFF .BSLFUQMBDF JT UIF OFYU HFOFSBUJPO PGGFSJOH GSPN 11* B DPNQBOZ UIBU IBT QSPWJEFE DPOTPMJEBUFE CFOFmUT BENJOJTUSBUJPO TFSWJDFT UISPVHI DBSSJFS BOE CSPLFS QBSUOFST GPS PWFS ZFBST BOE XIPTF NJTTJPO JT UP
.BYXFMM )FBMUI IBT BOOPVODFE #PC (BZEPT IBT CFFO OBNFE 71 4USBUFHJD 1BSUOFSTIJQT (BZEPT JT B OBUJPOBMMZ SFDPHOJ[FE FYQFSU JO UIF mFME PG FNQMPZFF CFOFmUT NBOBHFNFOU BOE CSJOHT UP .BYXFMM ZFBST PG JOEVTUSZ FYQFSJFODF GSPN TVDDFTTGVMMZ GPVOEJOH BOE HSPX JOH DPNQBOJFT JO UIF TQBDF UP IFMQJOH TIBQF IFBMUI JOTVSBODF QPMJDZ *O IJT SPMF BU .BYXFMM (BZEPT XJMM GPDVT PO CVJMEJOH OFX TUSBUFHJD QBSUOFSTIJQT BOE EFFQFOJOH FYJTUJOH POFT 1SJPS UP KPJOJOH .BYXFMM (BZEPT IFMQFE PWFSTFF UIF JOUSPEVDUJPO PG QSJWBUF CFOFmU FYDIBOHFT JOUP NVMUJQMF 6 4 NBSLFUT VOEFS UIF %JHJUBM #FOFmUT .BSLFUQMBDF CSBOE XIJDI JO BDRVJSFE IJT mSTU DPNQBOZ 5IF #FOFmU (SPVQ PG /FX &OHMBOE
HealthCare Consumerism Solutionsâ„¢ I www.TheIHCC.com I HealthCare Exchange Solutionsâ„¢ I January/February 2014
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Avoid The Cadillac Tax! Consumer’s Medical Resource® (CMR) helps your employees answer the five most important questions in healthcare while directly reducing healthcare costs: What do I have? What do I need? Where do I go? What will it cost? How do I connect?
“ CMR is a game-changer – offering it to our employees has been a huge win. On average, participating employees used the benefit twice in the first year. They avoided 26 unnecessary surgeries, saving approximately $500,000. It’s having an amazing impact on our employees’ lives and well-being, and not a week goes by when we don’t get a letter of appreciation.” Erin, VP Total Rewards – financial services company
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CMR delivers value by helping organizations take control of their healthcare costs. Find out what we can do for you. i ÞÊ7> >Vi]Ê ÀiVÌ ÀÊ vÊ >À iÌ }ÊUÊ Ü> >ViJV ÃÕ iÀà i` V> °V Ê Çn£ Çä £ÇÓÇÊUÊÜÜÜ°V ÃÕ iÀà i` V> °V
STATS & DATA BY RICH BIRHANZEL MANAGING DIRECTOR ACCENTURE HEALTH ADMINISTRATIVE SERVICES
Many Employees Will Choose Lower Benefit Levels on Private Health Insurance Exchanges
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nFYJCJMJUZ "MUIPVHI NBOZ JOTVSFST BSF UPVUJOH UIF )FBMUI *OTVSBODF &YDIBOHF $POTVNFS 3FTFBSDI TIPXT UIBU NPSF UIBO WBMVF PG OBSSPXFS OFUXPSLT UP SFEVDF QSFNJVNT JO BO FYDIBOHF POF JO GPVS FNQMPZFFT NBZ NBLF B CFOFmUT USBEFPGG PO UIFJS IFBMUI FOWJSPONFOU DPOTVNFS BQQFUJUFT GPS UIFTF QMBOT NBZ CF MJNJUFE JOTVSBODF QMBO XJUI VQ UP POF JO UISFF BDDFQUJOH UIJT USBEFPGG JO 4.0 Growing Discretionary UIF TNBMM FNQMPZFS NBSLFU Financial Tradeoff on billion Premium $ discount per month
% willing to increase their deductible
$75
83%
3.0 billion
Dollars
Emerging Health Choices for Employees Accenture estimates more than one in four employees are likely to select a lower priced health plan on a private exchange
Premium Dollars
Health Benefits Savings Sacrifice
1.9
billion 5SBEF PGG EFDJTJPOT IJTUPSJDBMMZ IBWF CFFO NBEF CZ FNQMPZFST ($900 annually) XIP IBWF TFMFDUFE CFOFmUT XJUI UIF JOUFOU UP QSPEVDF UIF CFTU 81% 900 SFTVMUT GPS UIF HSFBUFTU QPSUJPO PG UIFJS XPSLGPSDF 5PEBZ $50 ($600 annually) million QFSDFOU PG FNQMPZFST POMZ PGGFS POF UZQF PG QMBO TVDI BT B 110 72% PS ).0 "T QSJWBUF FYDIBOHFT FNFSHF FNQMPZFFT BSF NBLJOH $25 100 ($300 annually) million UIFJS PXO DPWFSBHF EFDJTJPOT GSPN B CSPBEFS BSSBZ PG DBSSJFST BOE QMBO PQUJPOT $IPPTJOH IFBMUI DBSF DPWFSBHF SFRVJSFT NBLJOH 2014 2015 2016 2017 2018 Source: Accenture’s Private Source: Accenture’s Private Exchange Research, Dec. 2013 Exchange Research, Dec. 2013 DPNQMFY mOBODJBM USBEFPGG EFDJTJPOT TVDI BT XFJHIJOH POF T PXO IFBMUI SJTLT BHBJOTU QFSTPOBM mOBODJBM DJSDVNTUBODFT "MUIPVHI FNQMPZFFT BSF FNQPXFSFE UP iDIPPTF XIBU T SJHIU GPS NF w JU T EJGmDVMU Growth of Ancillary Benefits UP QSFEJDU XIFUIFS UIFTF DIPJDFT XJMM XPSL PVU BT FYQFDUFE &NQMPZFFT Accenture forecasts ancillary benefits will grow XIP MPPL GPS JOJUJBM TBWJOHT PO IFBMUI JOTVSBODF XJMM OFFE UP CF as high as $4 billion by 2018 QSFQBSFE GPS IJHIFS DPTUT UIBU DPVME QPUFOUJBMMZ BSJTF GSPN VOFYQFDUFE 5IF JODPNF HBJOFE CZ TFMFDUJOH MPXFS QSJDFE IFBMUI JOTVSBODF IFBMUI JODJEFOUT 5P VOEFSTUBOE UIF QSFWBMFODF PG UIJT USBEFPGG FGGFDU DPVME CF VTFE PO BODJMMBSZ CFOFmUT "DDFOUVSF mOEJOHT TVHHFTU UIBU "DDFOUVSF FOHBHFE DPOTVNFST JO B NPDL QSJWBUF IFBMUI JOTVSBODF UIJT OFX QPPM PG iEJTDSFUJPOBSZ QSFNJVN EPMMBSTw DPVME HSPX BT IJHI BT FYDIBOHF FYQFSJFODF UP FYQMPSF UIF EFDJTJPOT FNQMPZFFT XPVME NBLF CJMMJPO CZ BT QSJWBUF FYDIBOHFT DPOUJOVF UP QJDL VQ NPNFO XIJMF FOSPMMJOH GPS CFOFmUT UVN )PXFWFS TPNF FNQMPZFST XJMM BMTP PGGFS UIF PQUJPO UP iDBTI PVUw B QPSUJPO PG UIFTF GVOET GPS FYBNQMF CZ DPOUSJCVUJOH UP TQFOEJOH Trends in Consumer Trade-off Decisions PS SFUJSFNFOU BDDPVOUT 0G UIPTF XJUI FNQMPZFS DPOUSJCVUJPO GVOET Survey shows 81 percent would be willing to increase their SFNBJOJOH BGUFS TFMFDUJOH IFBMUI DPWFSBHF QFSDFOU DPOUJOVFE UP deductible to save $50 a month/$600 a year TIPQ GPS PUIFS BODJMMBSZ CFOFmUT SBUIFS UIBO DBTI PVU "EEJUJPOBMMZ "DDFOUVSF T SFTFBSDI TIPXFE UIBU DPOTVNFST BSF XJMMJOH UP QFSDFOU PG UIPTF XIP IBE BMSFBEZ FYIBVTUFE UIFJS FNQMPZFS DPOUSJCV FNCSBDF TPNF USBEFPGGT JO SFUVSO GPS B MPXFS QSJDFE QMBO ZFU SFNBJO UJPO FYQSFTTFE B EFTJSF UP DPOUJOVF TIPQQJOH 5IFTF mOEJOHT QSFTFOU B XBSZ PG PUIFST "MUIPVHI FNQMPZFFT BSF XJMMJOH UP NBLF TPNF USBEFPGGT QSPNJTJOH HSPXUI PQQPSUVOJUZ GPS BODJMMBSZ CFOFmUT QSPWJEFST TP MPOH BT JO SFUVSO GPS MPXFS QSFNJVNT UIFJS XJMMJOHOFTT JT OPU VOMJNJUFE JU UIFZ DBO FGGFDUJWFMZ NBSLFU BOE TFMM UP DPOTVNFST UP HBJO TIBSF EFQFOET PO UIF BWBJMBCJMJUZ PG PUIFS PQUJPOT UP NBOBHF UIFJS SJTL 5BLF 'PS TVSWFZ NFUIPEPMPHZ OPUFT WJTJU XXX UIFJIDD DPN HealthCare Consumerism Solutions™ I www.TheIHCC.com I HealthCare Exchange Solutions™ I January/February 2014
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Help employees see their best. Learn more and find free vision savings calculators and employee education materials at HealthySightWorkingforYou.org.
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Š2014 Transitions Optical, Inc. All Rights Reserved. Transitions, the swirl, and Transitions Healthy Sight Working For You are registered trademarks of Transitions Optical, Inc. Photochromic performance is influenced by temperature, UV exposure and lens material.
VOLUNTARY BENEFITS BY RON FIELDS VICE PRESIDENT OF CORE BROKER SALES AFLAC
In An Era of Health Care Volatility, Supplemental Benefits Offer Security People Can Count On
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HealthCare Consumerism Solutionsâ„¢ I www.TheIHCC.com I HealthCare Exchange Solutionsâ„¢ I January/February 2014
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HealthCare Consumerism Radio Show Listeners will LEARN about the latest trends and best practices in health care consumerism, will CONNECT with healthcare industry thought leaders, and can SHARE their ideas by contacting the hosts of the shows afterwards. Archives of each show are also available. The HealthCare Consumerism Radio Show is co-hosted by The Institute for HealthCare Consumerism CEO and Founder, Doug Field along with Editorial Chairman, Ron Bachman and Produced in Conjunction with America’s Web Radio Join the Conversation by Sharing Your Thoughts and Questions:
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ASK THE BROKER
BY ANTHONY GLAUB PRESIDENT PROFESSIONAL INSURANCE ENROLLERS
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HealthCare Consumerism Solutionsâ„¢ I www.TheIHCC.com I HealthCare Exchange Solutionsâ„¢ I January/February 2014
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Wiser Health makes it easy to make the Wiser Health makes it easy to make the right healthcare decision. right healthcare decision. Explore a personalized and interactive web and mobile service designedand to help chooseweb treatments Explore a personalized interactive and that work. mobile service designed to help choose treatments that Makework. the best choice based on clinical evidence, personal popularity. Make thepreference best choiceand based on clinical evidence, personal preference and popularity. Learn about the treatments doctors choose when they sick.the treatments doctors choose when Learnare about they Find are outsick. what treatments are covered by insurance and are treatments FSA eligibleare covered by insurance Findwhich out what and which are FSA eligible
Choose Treatments That Work for You Choose Treatments That Work for You Come see us at Booth #18 Come see us at Booth #18 wisertogether.com 202.503.3700 info@wisertogether.com wisertogether.com
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info@wisertogether.com
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Brand Differentiation: More Important Than Ever in an Exchange Market BY SMITH WYCKOFF Âť KEY ACCOUNT MANAGER Âť MANAGED CARE/ONLINE RETAIL Âť TRANSITIONS OPTICAL, INC.
Brands are no stranger to the consumer marketplace. Companies invest in building brand awareness because they know that consumers value brands and find them an important reassurance of quality.
are tagging a portion of our new TransitionsÂŽ Signature™ lenses TV commercial with the message, “Check with your employer to make sure your vision plan covers TransitionsÂŽ brand lenses. Upgrade today and start living a life well lit.â€?
Medical insurance providers also recognize this and align with consumer-facing brands to reinforce the value of their offering. For example, they may make sure their provider networks include wellknown hospital brands and health facilities. Vision insurance providers have the additional ability to reinforce quality by focusing on brands within the materials side of the benefit — highlighting highend fashion frame brands and featuring well-known lens brands from companies who advertise directly to consumers.
Highlighting performance improvements in advertising is key, considering nine out of 10 employees want their vision benefit to cover the latest lens technologies.1
As insurance moves from a gateway product (sold almost exclusively to employers) to a direct-toconsumer one (offered through exchanges), the role of the brand comes into even sharper focus. As consumers browse their options, evaluating which brands are covered becomes an easy way to differentiate one offering from another. As the marketplace comes to this realization, consumer advertising may also see an interesting shift. At Transitions Optical, for example, we
While we, of course, do not anticipate changes overnight, as we enter an era of increasing consumerism highlighted by the exchange market, Transitions Optical and others in the optical industry will likely be looking for further opportunities to collaborate with vision plans to highlight products on the private exchanges and incorporate branded material in surrounding marketing to the consumer. The win-win for employers and employees is that this up-tick in communications will create greater awareness of the need for regular eye exams and quality vision wear, so more employees see and feel their best, and more employers save on medical costs and productivity.
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already moved their employee population into a private exchange, or are planning to in the highest adoption rates, according to recent research published by Alegeus Technologies.
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Submit your FREE Listing. Enhanced Listing and Premium Profile Opportunities Available.
www.PrivateHealthCareExchanges.com
DEFINED CONTRIBUTION
Defined Contribution: Learning from the Past, Looking to the Future BY DAVID URBANIAK » PRODUCT MANAGER » EVOLUTION1
With 2013 behind us, we can now look at what the year brought as related to the ever-changing world of defined contribution. Let’s first take a look at a couple key learnings and trends from 2013: Proven Solutions — and Public Rollout — Aren’t With 2014 under way, what change can we expect Necessarily Easy: 5IF FYQFSJFODFT BU CPUI UIF GFEFSBM BOE to see for defined contribution in the months TUBUF NBSLFUQMBDF MFWFMT JMMVTUSBUFE UIF OFFE UP MFWFSBHF QSPWFO ahead? QBSUOFST BOE TPMVUJPOT *OWFTUJOH JO UIF SJHIU UFDIOPMPHZ TFSWJDFT BOE QSPHSBN NBOBHFNFOU JT FTTFOUJBM " NBSLFUQMBDF XJMM GBJM Continued and Accelerated Shift in Model: &NQMPZFST JG ZPV EPO U GPDVT PO BMM UISFF 5IJT JT FRVBMMZ USVF GPS QSJWBUF XJMM LFFQ NPWJOH GSPN USBEJUJPOBM EFmOFE HSPVQ CFOFmU NPEFMT NBSLFUQMBDFT .BSLFUQMBDF QSPDFTTFT XFSF GBS GSPN IBTTMF GSFF UP EFmOFE DPOUSJCVUJPO NPEFMT XJUI DPOTVNFS EJSFDUFE IFBMUI BOE UIF OFFE GPS GPDVTJOH PO QMBOT 5IBU JT FNQMPZFST XJMM UIF DPOTVNFS FYQFSJFODF CFDBNF mY UIF BNPVOU UIFZ BSF XJMMJOH Plan selection in a DC/Exchange environment QBJOGVMMZ BQQBSFOU .BSLFUQMBDF UP DPOUSJCVUF CZ HJWJOH FBDI DPOTVNFS FYQFSJFODFT BSF UIF FNQMPZFF B EFmOFE DPOUSJCVUJPO On the Exchange UJQ PG UIF JDFCFSHT JO UFSNT PG BNPVOU "EEJUJPOBMMZ UIFZ Workers choices changed for 2013 when they used an exchange UIF PWFSBMM QSPHSBNT UIBU TJU XJMM QSPWJEF FNQMPZFFT XJUI 12% Consumer Directed Health Plan VOEFSOFBUI UIFN CVU UIF NPSF JOTVSBODF PQUJPOT UP (Higher deductible) 39% FYQFSJFODF JT UIF CFODINBSL CZ TFMFDU UISPVHI BO FYDIBOHF 18 IPX ZPVS NBSLFUQMBDF XJMM CF &YQFDU UP TFF B EFFQFS QSPEVDU Health Maintenance Organization 14 KVEHFE BOE XIFUIFS PS OPU ZPV FYUFOTJPO CFZPOE NFEJDBM BOE (HMC) XJMM CF TVDDFTTGVM BODJMMBSZ QMBOT BOE JOUP HZN 77 NFNCFSTIJQT QFU JOTVSBODF Preferred-Provider Organization 47 (PPO) Benefit Model Shift PSHBOJD GPPE EFMJWFSZ TFSWJDFT Gained Momentum, BOE NPSF Plan Selection Evolved: 2012 2013 Source: Aon Hewitt | The Wall Street Journal &NQMPZFST DPOUJOVFE UP NPWF " SFDFOU TUVEZ QVCMJTIFE CZ GSPN B DPOTVNFS ESJWFO IFBMUI "DDFOUVSF TIPXT UIBU CZ DBSF $%) NPEFM UP B EFmOFE DPOUSJCVUJPO NPEFM BOE BMM UIF OVNCFS PG FNQMPZFFT FYQFDUFE UP VTF B QSJWBUF NBSLFUQMBDF TJHOT JOEJDBUF UIBU XJMM DPOUJOVF JO +VTU XFFLT BHP 5BSHFU UP NBLF UIFJS JOTVSBODF QMBO EFDJTJPOT BOE QVSDIBTFT XJMM TVSQBTT $PSQPSBUJPO BOOPVODFE UIBU JU XBT NPWJOH JUT QBSU UJNF FNQMPZFFT UIF OVNCFS PG JOEJWJEVBMT FYQFDUFE UP VTF B QVCMJD FYDIBOHF CZ UP B EFmOFE DPOUSJCVUJPO QMBO PGGFSJOH OFBSMZ NJMMJPO DPOTVNFST 5IBU T BO JODSFEJCMF TIJGU BOE POF UIBU JT HPJOH UP JNQBDU FWFSZPOF JOWPMWFE JO TVQQPSUJOH BOE QSPWJEJOH 5IFSF BSF PQQPSUVOJUJFT UP QSPWJEF WBMVF UP UIF DPOTVNFST TPMVUJPOT SFMBUFE UP FNQMPZFF CFOFmUT $PNQBOJFT UIBU QSPWJEF JNQBDUFE CZ UIJT NPEFM DIBOHF /FXFS EBUB QVCMJTIFE CZ "PO TPMVUJPOT UP FNQMPZFST UPEBZ ‰ XIFUIFS EJSFDUMZ PS JOEJSFDUMZ BPO DPN GVSUIFS JMMVTUSBUFT UIF WBMVF PG VTJOH B UIJSE QBSUZ UISPVHI CSPLFST PS IFBMUI QMBOT ‰ OFFE UP TFSJPVTMZ DPOTJEFS BENJOJTUSBUPS 51" BT XFMM BT UIF OFFE UP PGGFS $%) BDDPVOUT PO UIJT TIJGU BOE EFUFSNJOF UIF SPMF UIFZ XBOU UP QMBZ JO UIJT FWPMWJOH UIF TBNF QMBUGPSN BT UIF EFmOFE DPOUSJCVUJPO BDDPVOUT FDPTZTUFN #VTJOFTTFT UIBU BSF QPTJUJPOFE UP QSPWJEF EFmOFE DPOUSJCVUJPO QSJWBUF FYDIBOHF TPMVUJPOT PS QBSUOFS XJUI BOPUIFS 5IF BNPVOU PG FNQMPZFFT XIP DIPTF UP FOSPMM JO B $%) QMBO XIFO PSHBOJ[BUJPO UP EP TP XJMM CF JO B HSFBU QPTJUJPO UP UBLF BEWBOUBHF HJWFO UIBU DIPJDF JO BO FYDIBOHF NPEFM USJQMFE GSPN QFSDFOU UP PG OFX PQQPSUVOJUJFT BOE QFSIBQT NPSF JNQPSUBOUMZ QSPUFDU UIFJS QFSDFOU 5IJT NFBOT UIBU OFBSMZ QFSDFOU PG FNQMPZFFT XJMM FYJTUJOH NBSLFU TIBSF CF MPPLJOH GPS BEEJUJPOBM TBWJOHT NFDIBOJTNT o XIFUIFS UISPVHI B nFYJCMF TQFOEJOH BDDPVOU '4" PS IFBMUI TBWJOHT BDDPVOU )4" o Continued — and Increasing — Employee Education UP IFMQ UIFN CVEHFU BOE TBWF GPS DVSSFOU BOE GVUVSF PVU PG QPDLFU and Communications: 5IF POHPJOH GSBDUVSJOH PG UIF HSPVQ IFBMUI DBSF FYQFOTFT 5IFSF JT USFNFOEPVT WBMVF UP UIF FNQMPZFF NBSLFU XJMM QSPWJEF OFX PQQPSUVOJUJFT GPS FNQMPZFFT UP QPUFOUJBMMZ BOE TBWJOHT UP UIF FNQMPZFS XIFO FNQMPZFFT BSF HJWFO UIF mOE CFOFmUT PVUTJEF PG UIFJS FNQMPZFS CVU UIF QSPDFTT XJMM PQQPSUVOJUZ UP FOSPMM JO $%) BDDPVOUT UISPVHI BO FYDIBOHF
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Dark garnet, new photo
PRIVATE EXCHANGES ‌ WHAT’S THE BUZZ?
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HEALTH SAVINGS ACCOUNTS
The Future of Health Savings Accounts: Exchange Opportunities and Challenges BY CYNTHIA PIAZZA » MARKETING COMMUNICATIONS MANAGER » CONNECTYOURCARE
Since their introduction a decade ago, forward-thinking employers have continued to aggressively adopt health savings accounts (HSAs) by making tax-advantaged health accounts a cornerstone of their benefits cost-savings strategy.
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VSJOH UIF "GGPSEBCMF $BSF "DU EFCBUFT NBOZ XFSF DPODFSOFE UIBU UIF OFX MFHJTMBUJPO XPVME EFTUSPZ )4"T #VU UIF PQQPTJUF PDDVSSFE ‰ EVF UP UIF DPNQFMMJOH mOBODJBM CFOFmUT UIF NBSLFU GPS )4"T IBT OFWFS CFFO TUSPOHFS 5IFTF BDDPVOUT FOBCMF DPOTVNFST UP LFFQ NPSF PG UIF NPOFZ UIFZ EPO U TQFOE PO NFEJDBM DPTUT GPS GVUVSF OFFET 1VCMJD BOE QSJWBUF FYDIBOHFT DPNQMJNFOU UIF JOIFSFOU DPTU TBWJOHT GPDVT PG )4"T QPJOUJOH UP FYQPOFOUJBM HSPXUI PQQPSUVOJUZ JO UIF NBSLFU *O UPEBZ T FDPOPNZ FTDBMBUJOH IFBMUI DBSF DPTUT BOE IFBMUI SFGPSN BSF GPSDJOH FNQMPZFST UP TFFL SFMJFG UISPVHI DPTU TBWJOHT TUSBUFHJFT JODMVEJOH )4" CBTFE QMBO EFTJHOT EFmOFE DPOUSJCVUJPO QMBOT BOE FYDIBOHFT "PO )FXJUU SFQPSUFE UIBU JO UIF BWFSBHF IFBMUI DBSF DPTU QFS FNQMPZFF KVNQFE QFSDFOU GSPN UP ‰ BCPVU QFSDFOU PG XIJDI XJMM CF BO JOEJWJEVBM T FYQFDUFE QSFNJVN DPOUSJCVUJPO 8JUI TVDI VOTVTUBJOBCMF HSPXUI JO IFBMUI DBSF DPTUT TPNF FNQMPZFST IBWF CFHVO TIJGUJOH GSPN B EFmOFE CFOFmU UP B EFmOFE DPOUSJCVUJPO TUSBUFHZ .BOZ NPSF BSF DPOTJEFSJOH UIF EFmOFE DPOUSJCVUJPO BQQSPBDI BT B XBZ UP TIBSF NPSF PG UIF DPTU PG IFBMUI DBSF XJUI FNQMPZFFT NFFU "$" DPNQMJBODF SFRVJSFNFOUT BOE FOHBHF FNQMPZFFT JO JNQSPWJOH UIFJS PXO IFBMUI 5IF BWFSBHF QSFNJVNT GPS BDDPVOU CBTFE )%)1T XFSF MPXFS UIBO UIF PWFSBMM BWFSBHF GPS BMM QMBO UZQFT GPS CPUI TJOHMF BOE GBNJMZ DPWFSBHF JO BDDPSEJOH UP UIF ,BJTFS 'BNJMZ 'PVOEBUJPO )4" CBTFE IJHI EFEVDUJCMF IFBMUI QMBOT )%)1T PGGFS CPUI FNQMPZFST BOE DPOTVNFST DPTU CFOFmUT UISPVHI UBY TBWJOHT BT XFMM BT MPXFS QSFNJVNT XIFO DPNQBSFE UP USBEJUJPOBM HSPVQ JOTVSBODF 6OMJLF HSPVQ IFBMUI QMBOT )%)1T UZQJDBMMZ EP OPU SFRVJSF MPOH UFSN DPOUSBDUT BOE UFOE UP CF TIJFMEFE GSPN CJH QSJDF IJLFT /BUJPOBMMZ FOSPMMNFOU JO BDDPVOU CBTFE IFBMUI QMBOT JT PO QBS XJUI ).0T BDDPSEJOH UP B SFDFOU .FSDFS SFQPSU JODSFBTJOH GSPN QFSDFOU PG DPWFSFE FNQMPZFFT JO UP QFSDFOU JO $POTFRVFOUMZ )4" BTTFUT BSF TIBSQMZ JODSFBTJOH BT XFMM 'JOBODJBM TFSWJDFT mSN %FWFOJS SFQPSUFE UIBU UIF OVNCFS PG )4" BDDPVOUT BQQSPBDIFE OFBSMZ NJMMJPO JO XJUI BTTFUT UPUBMJOH OFBSMZ CJMMJPO ‰ B QFSDFOU ZFBS PWFS ZFBS JODSFBTF GPS BDDPVOUT BOE BTTFUT CFUXFFO +VOF BOE +VOF
HSAs and Exchanges: A Perfect Pairing -JLF UIF FYDIBOHFT XIJDI BSF GPDVTFE PO QSPWJEJOH JOEJWJEVBM DIPJDF )4"T BDUJWFMZ FOHBHF DPOTVNFST JO NBOBHJOH UIFJS PXO IFBMUI BOE IFBMUI DBSF TQFOEJOH $POTDJFOUJPVT )4" PXOFST DPOTJTUFOUMZ FYIJCJU B QBUUFSO PG HSFBUFS DBSF BEIFSFODF BOE NPSF UIPVHIUGVM IFBMUIDBSF DPOTVNQUJPO 8JUI UIFJS TUSPOH JOnVFODF PO
UIF SBUF PG NFEJDBM TQFOEJOH )4" CBTFE )%)1T FODPVSBHF UIF UBY GSFF BDDVNVMBUJPO PG IFBMUI DBSF GVOET BOE UIFJS DVNVMBUJWF HSPXUI FOBCMFT DPOTVNFST UP FOHBHF JO JOWFTUNFOU PQQPSUVOJUJFT UP HSPX UIFJS TBWJOHT FWFO GVSUIFS 1VCMJD FYDIBOHFT HJWF UIF DPOTVNFS DPOUSPM PWFS UIF JOTVSBODF CVZJOH EFDJTJPO CZ UBLJOH UIF FNQMPZFS PVU PG UIF FRVBUJPO "MUIPVHI GFXFS PQUJPOT GPS DPWFSBHF BSF BWBJMBCMF )4"T BSF QVCMJD FYDIBOHF DPNQMJBOU " TUBOEBSEJ[FE )4" TFMFDUJPO XJMM CF B WJBCMF BOE BUUSBDUJWF PQUJPO GPS NBOZ DPOTVNFST FTQFDJBMMZ UIF TFMG FNQMPZFE *O TPNF DBTFT QVCMJD FYDIBOHF TVCTJEJFT NBZ NBLF QSFNJVNT NPSF DPTU FGGFDUJWF UIBO FNQMPZFS TQPOTPSFE QMBOT GVSUIFS ESJWJOH DPOTVNFST UP UIF BUUSBDUJWF QSJDJOH PG )4" CBTFE )%)1T 1SJWBUF FYDIBOHFT JO BEEJUJPO UP PGGFSJOH B NPSF SPCVTU NFOV PG PQUJPOT XJMM CF BCMF UP PGGFS FOIBODFE QFSLT UP NBLF DIPPTJOH )4" CBTFE BDDPVOUT FWFO FBTJFS JODMVEJOH DVTUPNFS TFSWJDF NPCJMF BQQMJDBUJPOT QBZNFOU DBSET POMJOF GVOET NBOBHFNFOU UPPMT BOE EFUBJMFE BDDPVOU FEVDBUJPO UPPMT 4PQIJTUJDBUFE UFDIOPMPHZ GPVOE JO QSJWBUF FYDIBOHFT XJMM CF B CPPTU GPS )4"T CZ BMMPXJOH JNNFEJBUF BDDPVOU PQFOJOH BU UIF UJNF PG QMBO FOSPMMNFOU BOE PUIFS XFC GBDJMJUBUFE TFSWJDFT TVDI BT $POOFDU:PVS$BSF T )4" 0O %FNBOE BOE )4" *OWFTUNFOU $FOUFS 5FDIOPMPHZ XJMM QMBZ B LFZ SPMF JO TIBQJOH UIF FYDIBOHFT JOUP B POF TUPQ TIPQQJOH FYQFSJFODF GPS NFEJDBM BOE WPMVOUBSZ CFOFmUT 5IF TUSVDUVSF PG UIF FYDIBOHFT BT B DPTU DPNQBSJTPO UPPM GBDJMJUBUFT DPOTVNFS EFDJTJPO NBLJOH BOE XJMM IFMQ ESJWF QSJDF DPOTDJPVT DPOTVNFST UP MPXFS DPTU PQUJPOT JODMVEJOH )4" CBTFE )%)1T $POTFRVFOUMZ FYDIBOHFT XJMM QSPWJEF OFX PVUMFUT JO XIJDI UP TIPXDBTF UIF WBMVF PG )4"T
Exchanges, HSAs and Consumerism #PUI QSJWBUF BOE QVCMJD FYDIBOHFT PGGFS UIF PQQPSUVOJUZ UP SFQPTJUJPO )4"T JO UIF DPOUFYU PG UIF CSPBEFS MJGF DZDMF PG UBY BEWBOUBHFE BDDPVOUT *OEVTUSJFT TVDI BT FEVDBUJPO USBOTQPSUBUJPO BOE IFBMUI DBSF XIJDI SFDFJWF TPNF NFBTVSF PG HPWFSONFOU TVQQPSU IBWF BMM TVDDFTTGVMMZ PGGFSFE DPOTVNFST B DIPJDF CFUXFFO QVCMJD BOE QSJWBUF PQUJPOT "T NPSF IFBMUI DBSF DIPJDF JT QMBDFE JO UIF IBOET PG DPOTVNFST JU XJMM CF VQ UP JOEJWJEVBMT UP NBLF UIF CFTU EFDJTJPO UP mOE PQUJPOT UIBU FOTVSF PWFSBMM TBWJOHT XIFUIFS UISPVHI QSJWBUF PS QVCMJD FYDIBOHFT )4" CBTFE )%)1T XJMM DFSUBJOMZ CF QBSU PG UIBU EFDJTJPO NBLJOH QSPDFTT 8IFO NBSLFUT NFFU DPOTVNFS EFNBOE CPUI TJEFT CFOFmU
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EXPERTS WEIGH IN:
Private Exchanges’ Past, Present and Future BY HEATHER LOVERIDGE » SENIOR EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM
At the beginning of 2013, questions swirled concerning private exchanges. Would employers actually transition to private exchanges? If they did, would they work? Would employers cut their health care contributions even more? Would employees want to utilize private exchanges? Would the many hiccups surrounding the public exchanges hurt or help adoption of private exchanges? Last fall’s open enrollment answered some of those questions and raised a few more. n one level, the challenges of the public marketplaces has become a psychological hurdle to overcome — marketplaces, public or private, now are held to a different standard based on the issues experienced in the Healthcare.gov and other public exchange implementations,” “On another level, the general awareness for marketplaces has been vastly advanced because of all of the attention paid to the launch of the public exchanges. “Whereas awareness was being driven primarily by payers, consultants and brokers (those who stood to gain or lose the most from marketplaces), now there is far more awareness among employers of all sizes as well as their employees. That increased awareness through media coverage could accelerate the expansion of private marketplaces not only as companies also as they look for alternatives to public marketplaces with dubious performance.” According to a study released by the Private Exchange Evaluation Collaborative in December 2013, of the 723 employers surveyed, 45 percent said they plan to consider or will be using
a private exchange for their full-time active employees before exchanges, employers were split on whether they would move “Most employers are still in the learning and exploring phase regarding private exchanges, and adoption into private exchanges will be incremental and at a measured pace,” said Don Garlitz, executive director of exchange solutions at bswift. “Initial enrollment into private exchanges has demonstrated that most employees opt for something different than what the employer had previously offered. Most corporations will explore this avenue mainly as a way to move culturally toward more personalization and personal responsibility. No doubt some will be looking for a palatable way to begin reducing future cash outlays, but labor demand will still be an important counterbalance in future budgeting decisions.” the past, present and future of private exchanges: John Young, CEO, Consumerdriven; Chris Condeluci, of counsel, Venable LLP; Bob Natt, executive chairman, Alegeus Technologies; Don Weber, managing director, PricewaterhouseCoopers; and
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IHC: What were the successes of fall’s open enrollment? Challenges? John Young: I would say that some of the consultant private exchange under the Aon Hewitt private exchange grew by six fold — notably the new client there was Walgreens. I think what’s interesting about Aon Hewitt’s model is that it’s all fully insured. It created its private exchange multi-source offering by working with insurers to create fully insured models. Chris Condeluci: One of the successes I saw was private exchange solution providers being able to engage employers and have a conversation respect to potential savings for the employers and expanded employee choice, decision support and interactive educational tools. The overall state of the health care industry has motivated more and more employers to look in the direction of a private exchange as a potential partner. One of the challenges for the private exchange industry is the belief among employers and investment analysts that private exchanges are only fully insured distribution channels and that self-insured employers cannot and should not utilize private exchanges. That is entirely false and shortsighted — it’s missing the fact that if
The delays in federal implementation of exchanges took away a little markets. The early challenges and implementation hiccups of some of the public exchanges have been well documented — in fact, most of the challenges have been technical in nature and have resulted from systemoverwhelming visitor volume. The result is a realization that technology requires careful planning, design and execution. Interest in online markets remains high, but employers want assurance that their exchange will work as expected. Don Weber: In preliminary discussions with some of the mature private active health exchanges, they did not indicate any issues during the recent enrollment period and indicated that their call centers were receiving positive comments. The results might be different for retirees and new negativity surrounding the public exchanges.
IHC: Were there any surprises employers weren’t expecting? John Young: The overwhelming percentage of people are self-selecting with an HSA, allowing them to maximize their take home pay. I think this is eye opening in one key area — the industry thought it did a pretty good
approach, usually you will likely see savings over the long term at the plan selection level. Bob Natt: The real challenge of the 2014 open enrollment period was
wildly different values on their own than what the employer has generally provided for them. So private exchanges have a very important and timely value proposition to the marketplace which is, give your employees,
approaches, introducing more wellness options and other accountability
…when it’s put in the hands of individuals to self select their own benefits, generally people are selecting wildly different values on their own than what the employer has generally provided for them.
IHC: What challenges are private exchanges currently facing (or may face)? John Young: I think the big opportunity, and sometimes a miss that happens within these exchanges, is the ongoing touch; the opportunity to help the employee understand the value of what they’ve self-selected. I technology enrollment. to really educate these individuals on what their options are and help them select the thing that is truly best for them and their family but will also provide a resource to help them become more prudent. I think that customer experience. The big opportunity today for all stakeholders is that there is such low literacy. A Carnegie Mellon study released in August said only 14 percent of the people they talked to could correctly identify the following: deductible, co-insurance, co-pay and out-of-pocket max. That means 86 percent of the people have a very low literacy level. Exchanges have to do more than facilitate enrollment; they have to be a partner in building literacy, understanding and giving people ideas and tools to help them be better health care consumers. Right now, for the most part we’re still supplying people with options. side as to what these options look like.
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EXPERTS WEIGH IN: Private Exchanges, Past, Present and Future
Exchanges have to do more than facilitate enrollment; they have to be a partner in building literacy, understanding and giving people ideas and tools to help them be better health care consumers. Chris Condeluci: From a regulatory standpoint , two things could potentially happen with private exchanges. One is the Department of retirement context. As more employers and private exchanges get more attention would regulators at the Department of Labor want to impose company or someone offering a private exchange solution? were to win the White House in 2016, they may stipulate that employers with 100 employees or below go through the ACA exchanges, therefore eliminating the outside market. The only reason I suggest that is there is eliminated the outside market and the individual as well as small group market in order to have more lives going through the ACA exchange — not because they wanted to push certain players out of the market. Shandon Fowler: The top three considerations for private exchange participation are the same as the consideration for any other kind of it save money – or does it at least slow down annual cost increases — and are competitors offering a “private exchange experience”? The primary driver now appears to be cost — several “private exchanges” are touting great cost savings by providing a different billing structure to employers while delivering a rudimentary shopping experience and incomplete data exchange solution. So reported cost savings in the short run may not translate to a competitive advantage in the long run due to a compromised user experience. As exchanges mature, the balance of costs and consumer experience should become much more clear for employers to understand.
IHC: What is the overall perception of private exchanges in HR departments today? Bob Natt: Today we’re seeing employers understanding and agreeing with the basic concept of private insurance exchanges. Many employers are beginning to evaluate the opportunity, with plans to implement during 2014/2015. A primary research study conducted by Alegeus Technologies in the fall of 2013 polled employers to gauge their understanding, opinions and attitudes regarding private exchanges. The results indicate more than half of employers claim to be highly familiar with the concept of private exchanges. Additionally, the research indicates 90 percent of employers
Based on the research, employers said 2015 will be the tipping point year for employers adopting and implementing private insurance exchanges. It remains to be seen if the delays and glitches in the rollout of health care reform will push that adoption curve out another year or so. Shandon Fowler: HR departments today still remain hesitant to adopt a full private exchange model simply because they don’t fully understand them. That’s not their fault because, as has been said by numerous industry insiders, “If you’ve seen one private exchange, you’ve private marketplaces starts to gain clarity, you will see HR administrators look to them more and more as a mechanism for addressing government
Don Weber: Because this concept is new for most large employers, many are both confused and skeptical. The confusion stems from the negative press on public exchanges and their lack of understanding the difference between public and private exchanges. The skepticism is related to the ability of exchanges to save money. HR has worked hard to provide different approach that may be counter-intuitive — hence the skepticism.
If the private exchanges perform well in 2014, my perception is that even greater interest will be generated in future years.
IHC: What should employers be wary of? Chris Condeluci: In the past there was a lot of talk, and I was one of those people talking about it, about non-taxable contributions being used to pay for an individual market plan. There were legal barriers in place prior to 2014 that prevented non-taxable contributions from being used. The ACA market reforms removed those legal barriers and so the question was raised. The answer is still no — according to IRS Notice 2013-54. What frustrates me as a practitioner is there are promoters out there — consultants, agents, brokers, etc. — continuing to promote using nontaxable contributions. Employers, be aware that the tax preferences for health insurance remain in a group market. If an employer were to offer that type of arrangement or allow employees to participate in that type of arrangement,
via private exchanges.
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DEFINING THE NEW NORMAL:
What are Private Exchanges and How Will They Change Employer-sponsored Health Insurance
BY JONATHAN FIELD » MANAGING EDITOR » THE INSTITUTE FOR HEALTHCARE CONSUMERISM
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What are Private Exchanges and How Will They Change Employer-sponsored Health Insurance Nearly every day now seems to bring the announcement of another chambers of commerce and other organizations are increasingly launching private exchange solutions for their members and clients.
At PrivateHealthCareExchanges.com — The Institute for HealthCare Consumerism’s attempt to aggregate all existing private exchange solutions for the free, public use of employers, health plans, brokers and others — we now have over 90 solutions listed with the expectation to surpass 100 by March 1. At PrivateHealthCareExchanges.com — The Institute for HealthCare Consumerism’s attempt to aggregate all existing private exchange solutions for the free, public use of employers, health plans, brokers and others — we now have over 90 solutions listed with the expectation to surpass 100 by March 1. offer a private exchange (or are planning to launch one in the future), employer adoption is still quite low, which raises the question, when will employers begin making the shift from traditional insurance to these online marketplaces? adoption have only increased following this past open enrollment period. Every top insurance agency in the country has already launched a private
Although the saying “If you’ve seen one exchange, you’ve one exchange” has become somewhat of an industry maxim, most exchanges — and arguably, the ones that will be successful — are touting several key features and will likely lead to some across-the-board industry changes.
Decision Support, Communication and Education: Enabling the Health Care Consumer Decision support tools will be a crucial and necessary component for private exchanges. Whether in a multi-carrier or single-carrier exchange consumers select the health plans that are better suited to their needs. While the era of health care consumerism is already well underway, private exchanges will only serve to magnify this trend over the years. innovative exchanges are utilizing cutting-edge communication tools tools — like those offered by Picwell, a startup founded at The University of Pennsylvania — have even now emerged that are specialized for integration into existing private exchanges.
Engaged, educated consumers of health care are the holy grail of the industry, and private exchanges can be a huge step in the right direction. Engaged, educated consumers of health care are the holy grail of the industry, and private exchanges can be a huge step in the right direction. When an employee knowledgeably selects the insurance products that best
of the market — was an early advocate of the technology, especially Towers not utilizing their private exchange platform at this point. A top concern is that many employers remain largely unaware of the variety of solutions available today under the “private exchange” label — or misunderstand the concept completely. Fully insured, self-funded.
Continuing the Strong Growth of HDHPs and Health Savings Accounts Although arguably the best exchanges will provide a wide variety of
are but a few of the characteristics employers need to examine when looking at private exchanges.
Fully insured, self-funded. Defined contribution, defined benefit. Single-carrier, multi-carrier. These are but a few of the characteristics employers need to examine when looking at private exchanges.
tied to a health savings accounts — with an increase in exchange adoption. This correlation can be seen in much of the early research on employee choice in private exchanges, including proprietary data from Bloom
contribution funding. In this model, Bloom founded that 66 percent of exchange participants were willing to choose a lower premium, higher deductible plan than they had prior to using the private exchange. Accenture’s data published elsewhere in this issue echoes this willingness from employees to select health plans with a lower premium
HealthCare Consumerism Solutions™ I www.TheIHCC.com I HealthCare Exchange Solutions™ I January/February 2014
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What are Private Exchanges and How Will They Change Employer-sponsored Health Insurance and a higher deductible. By placing survey participants in a mock private exchange to explore their decision making, the Accenture study found that one in four participants in a private exchange will select a lower priced health plan than what they had previously.
Institute (EBRI) indicated that the number of health savings accounts had grown from 6.6 million in 2012 to 7.2 million in 2013. In accordance with will continue to grow — possibly at an even higher rate — in the years to
The Rise in Voluntary Benefits: Brokers Take Note employees that select a higher deductible health plan will often have
Under the defined contribution model, employees that select a higher deductible health plan will often have sufficient funds remaining to select ancillary products that fit their lifestyle, including pet insurance and legal services in some exchanges like Mercer Marketplace.
Conclusion While private exchanges are not the panacea to solving health costs for employers, early indications show that they do work and can help employers of all sizes. Private exchanges will increase health savings account adoption, which alone has proven time and time again to reduce
lifestyle, including pet insurance and legal services in some exchanges like Mercer Marketplace.
their organization culture, but to reiterate, if you’ve seen one exchange,
contribution funding, decisions support tools and an overall better
funding. Not all are self-funded. Not all offer multiple carriers.
revenue in this market. Elsewhere in this issue, Anthony Glaub, president of Professsional Insurance Enrollers, discusses this opportunity at length.
lack of cohesion in even the basic terminology used. However, at this early stage, it is important to note that a private exchange is not one thing but a new class of solutions — all with their own sets of pros and cons for your organization.
Mercer, Towers Watson Name New Heads of Exchange Solutions Divisions BY JONATHAN FIELD Âť MANAGING EDITOR Âť THE INSTITUTE FOR HEALTHCARE CONSUMERISM
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Why Health Insurers are Leery of Playing in SHOP or Small Group Private Exchanges and Why Employer Demands Might Change Their Minds
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DEFINED CONTRIBUTION, CONT’D
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Conclusion *OEJWJEVBM BOE TNBMM HSPVQ QSPEVDUT BWBJMBCMF UISPVHI UIF HPWFSONFOU FYDIBOHFT BSF TJHOJmDBOUMZ EJGGFSFOU BOE MFTT JOOPWBUJWF UIBO UIPTF CFJOH EFWFMPQFE UISPVHI QSJWBUF FYDIBOHFT 1SJWBUF QMBOT XJMM GPDVT NPSF PO IFBMUI DBSF DPOTVNFSJTN 0OMZ QSJWBUF FYDIBOHFT DBO PGGFS TFMG JOTVSFE PQUJPOT 0OMZ QSJWBUF FYDIBOHFT DBO PGGFS UIF 42 January/February 2014 I HealthCare Exchange Solutions™ I www.TheIHCC.com
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EMPLOYEE BENEFITS CONSULTING
Intrepid goes beyond the typical expectations of the benefits consultant. We take the time to understand each client’s unique culture in order to implement the most progressive, creative solution to their benefits needs.
INTREPID
Liz Frayer, RHU 400 Interstate North Parkway, Suite 600, Atlanta, GA 30339 888-612-4644
“Our mission is to empower clients www.intrepid7.com to achieve a more sustainable health care policy; it’s about more than just giving the client a plan — it’s a process of educating the client and their employees to better understand the plan and ensure its success. When we see the shift that occurs when employees have their ‘aha’ moment is when we feel we have done our job. — Liz Frayer, RHU, Intrepid
PROFESSIONAL DEVELOPMENT
Health Insurance 101: An Orientation is a new, flexible online course offered by AHIP. It is designed to teach health insurance basics to those new to health care or individuals who wish to review the fundamentals. The course is formatted in short modules; you learn at your own pace and on your own time, moving through the materials as you choose. Plus, AHIP will customize the course to fit your organization’s specific learning requirements.
AMERICA’S HEALTH INSURANCE PLANS 601 Pennsylvania Ave., NW South Building, Suite 500 Washington, D.C. 20004 Lindsey Miranda Canaley Tel: 800.509.4422 Fax: 202.861.6354 lmirandacanaley@ahip.org www.ahip.org/courses
SOLUTION PROVIDER MEMBER PROFILES
HEALTH DECISION SUPPORT TOOLS
Castlight Health enables employers, their CASTLIGHT HEALTH 85 Market Street, Suite 300 employees, and health plans to take San Francisco, CA 94105 control of health care costs and improve care. Named #1 on The Wall Street 415.829.1400 Journal’s list of “The Top 50 Venturewww.castlighthealth.com Backed Companies” for 2011 and one of Dow Jones’ 50 Most Investment-Worthy Technology Start-Ups, Castlight Health helps the country’s self-insured employers and health plans empower consumers to shop for health care. Castlight Health is headquartered in San Francisco and backed by prominent investors including Allen & Company, Cleveland Clinic, Maverick Capital, Morgan Stanley Investment Management, Oak Investment Partners, Redmile Group, T. Rowe Price, U.S. Venture Partners, Venrock, Wellcome Trust and two unnamed mutual funds. — Giovanni Colella, M.D. CEO and Co-Founder, Castlight Health HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
A PRIVATE EXCHANGE THAT SIMPLIFIES HEALTH INSURANCE
INSUREXSOLUTIONS
10275 W. Higgins Road, Suite 500 Rosemont, IL 60018 855-563-6993 info@insurexsolutions.com www.insurexsolutions.com
The InsureXSolutions® private exchange offers employers a simplified role in the new health insurance marketplace. Employers with part-time workers or retirees, as well as small businesses can utilize this exchange to empower their employees to choose the health and dental insurance that best fits their personal and family needs. Employers can reduce costs and administrative tasks, while employees receive interactive support tools and personal guidance from our licensed insurance professionals. Available in select markets, InsureXSolutions is exclusively offered and operated by Flexible Benefit Service Corporation (Flex). Contact your broker or consultant, call us directly at 855-563-6993, or visit www.insurexsolutions.com to learn more. HealthCare Consumerism Solutions™ I www.TheIHCC.com I HealthCare Exchange Solutions™ I January/February 2014
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SOLUTION PROVIDER MEMBER PROFILES
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
MasterCard (NYSE: MA), is a global payments and technology company.
MASTERCARD WORLDWIDE 2000 Purchase St. Purchase, NY 10577-2509
It operates the world’s fastest payments processing network, connecting consumers, financial institutions, merchants, governments and businesses in more than 210 countries and territories. MasterCard’s products and solutions make everyday commerce activities—such as shopping, traveling, running a business and managing finances—easier, more secure and more efficient for everyone.
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HEALTH ACCESS ALTERNATIVES
Carena provides 24/7, on-demand access to CARENA, INC. health care by phone, webcam, and house 1525 4th Avenue, Suite 300 call. Seattle-based Carena is committed to Seattle, WA 98101 delivering the best health care experience 800.572.2103 possible. Its technology-enabled care delivery www.CarenaMD.com model provides on-demand access to health James.Taylor@CarenaMD.com care 24/7, via phone, secure video, and house call. Carena provides health care solutions to patients through employers, health systems and through its consumer service, CareSimple.
“People are paying more out of pocket for care than ever—through higher co-pays and deductibles, reduced benefits, and in the rising costs of goods and services. Taken together, health care has become more expensive and less accessible. Our goal is to make health care more affordable by providing the right care at the right time for the right cost; to help people live healthier lives by removing the barriers to people taking control of their health care.” — Ralph C. Derrickson, President & CEO, Carena
TOTAL POPULATION HEALTH MANAGEMENT
Orriant helps businesses produce a better, more profitable product by creating a workforce that is healthier, more productive, and less expensive to insure.
ORRIANT
9980 South 300 West Ste. 100 Sandy, Utah 84070 801.574.2306 www.orriant.com suzanne.viehweg@orriant.com
Orriant’s proven strategy is to hold people accountable for improving their health as an integral part of your benefit strategy in a way that is fair and compassionate to all.
“Employers can fight back to control rising health care costs. Orriant’s strategies have helped major employers from almost every industry cut the cost of health care, improve the health and productivity of their workforce, and push hundreds of thousands of dollars to their bottom lines.” — Darrell Moon, CEO, Orrian
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FSA/HRA/HSA/TRANSIT/COBRA: ADMINISTRATION & MANAGEMENT
January/February 2014 I HealthCare Exchange Solutions™ I www.TheIHCC.com I HealthCare Consumerism Solutions™
eflexgroup (eflex) is a nationwide eflexgroup administrator of pre-tax benefits 2740 Ski Lane and COBRA. Committed to providing Madison, WI 53713 fast answers, fast claims, and web 877.933.3539 ext 300 self-service, we set the industry www.eflexgroup.com standards for service. With a efgsales@eflexgroup.com customer focus and Lean Six Sigma methodology, we don’t talk about service, we prove it. See our metrics at eflexgroup.com.
“eflexgroup’s customer service department should be a model for ALL customer service departments. The courtesy, professionalism and knowledge surpass ANY customer service department I’ve encountered! I feel the outstanding, exemplary customer service of eflexgroup is simply the best!” — Kimberly Adams, Southeast Energy Assistance [testimonial]
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HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
TSYS Healthcare® provides end-toTSYS HEALTHCARE end strategic payment solutions for 706.649.5080 consumer directed healthcare. We www.tsys.com/healthcare partner with benefits administrators, healthcare@tsys.com financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.
“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. healthcare market, our customers rely on our option-driven system to prepare them for the future.” — Trey Jinks, Group Executive, TSYS Healthcare HSA / HRA / FSA ADMINISTRATION AND FINANCE
WageWorks helps employers support consumer directed pre-tax benefit programs, including health care (FSA, HSA, HRA), wellness programs, commuting and
WAGEWORKS 1100 Park Place, 4th Floor San Mateo, California 94403 United States of America 888-9905099 www.wageworks.com
child and elder care. Wage Works also offers retiree health care and COBRA Services. More than 100 of America’s Fortune 500 employers and millions of their employees use WageWorks.
SOLUTION PROVIDER MEMBER PROFILES
HSA ADMINISTRATION & FINANCE
At HSA Bank, we’ve been helping businesses HSA BANK optimize their health care spending for over 605 N. 8th Street Suite 320 15 years. We offer unmatched service and Sheboygan, Wisconsin 53081 expertise when it comes to health-based United States of America savings accounts. You can count on our 800.357.6246 dedicated business relations team for turnkey www.hsabank.com solutions and ongoing support that help your business and workforce save for a healthy future. To connect with your regional representative, call 866.357.5232 or visit hsabank.com.
“When implementing one of the first Medical Savings Account programs in the country, I had a belief that health care could be fixed with free-market principles. I still do. By adopting flexible and transparent practices that manifest core attributes of consumerism such as private exchanges, defined contributions, and self-funding; we will reform health care in our nation.” — Kirk Hoewisch, Co-Founder and President, HSA Bank, a division of Webster Bank, N.A. HSA / HRA / FSA ADMINISTRATION AND FINANCE
Evolution1 and our Partners serve more EVOLUTION1, INC. than 9 million consumers, making us 952.908.9056 the nation’s largest electronic payment, www.evolution1.com on-premise and cloud computing sales@evolution1.com healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.
“The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.” — Jeff Young Chairman and CEO, Evolution1
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SOLUTION PROVIDER MEMBER PROFILES
EMPLOYEE ENGAGEMENT TOOLS
Under the CIVA (CodeBaby Intelligent Virtual CODEBABY CIVA Assistant) brands of benefits and health 111 S. Tejon St. Suite 107 advisor, CodeBaby improves the healthcare Colorado Springs, CO 80903 consumer experience and optimizes online 877.334.3465 self-service on any web-based platform codebaby.com/online-solutions or device with absolutely no IT disruption. solutions@codebaby.com Benefits advisor offers guidance and selfservice options that help consumers and organizations alike to make better decisions about benefits selection. Health advisor engages new patient visitors on hospital or office websites or existing patients on wellness, prevention & disease management platforms.
“With the rapid changes in health care, our solutions provide organizations innovative ways to optimize their current platform while meeting the demand for an enhanced online experience. CIVA benefits and health advisor solutions are industryleading models that help consumers and organizations more efficiently navigate complex health benefit exchanges and patient portals. “ — Dennis McGuire, CEO, CodeBaby BENEFIT ENROLLMENT AND ELIGIBILITY
Totem Solutions is a boutique benefits TOTEM SOLUTIONS consulting and administration firm offering highly 11330 Lakefield Drive specialized services and products. We serve Bldg 1, Ste 150 benefit management and HR professionals as an Duluth, GA 30097 extension of their team, allowing them to focus on key initiatives and core strengths. Our services 770-295-1600 include Employee Benefits Consulting, Benefits Toll-free 866-481-4917 Administration, Enrollment, & Communication, www.totemsolutions.com Health Care Reform Education, Enrollment, Reporting & Compliance, Leave and Disability Management Administration.
“We are hands-on benefits advisors for public and private sector companies throughout the country. Totem delivers employer-centric service that simplifies benefits administration and enrollment in order to facilitate employee understanding and ensure the best possible employee experience. Our goal is also our great passion and commitment: to offer organizations clear and accurate counsel accompanied by services and solutions that are easy to access, seamlessly implemented and custom fit, while providing a worry-free outsourcing solution.” — Debbie Schultz, President, CEO, Totem Solutions
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HEALTH DECISION SUPPORT AND COST-SAVING TOOLS
WiserTogether Inc., helps patients choose the right care at the time. It
WISER TOGETHER Praveen Mooganur
offers an innovative online treatment
202.276.3074
selection & shared decision support
www.wisertogether.com praveen.mooganur@wisertogether.com
platform that helps patients make evidence-based, cost effective
treatment decisions across musculoskeletal, cardiovascular, mental health, diabetes, pregnancy and respiratory illnesses saving payers money. Currently 1.5 million members have access to the platform through employers and health plans in the country. WiserTogether was founded in 2008 and is based in Washington, DC. — Praveen Mooganur, COO, WiserTogether SUPPLEMENTAL HEALTH
Delta Dental leads the DELTA DENTAL industry in designing 1130 Sanctuary Pkwy, Suite 600 Alpharetta, GA 30009 innovative dental coverage programs that keep costs 770-641-5196 down and deliver quality care. Our diverse client list includes everyone from Fortune 100 companies to public agencies to individuals and families. Our customer’s satisfaction is based on our expansive dentist network, cost-saving mechanisms and superior customer service. We are part of the Delta Dental Plans Association that provides dental coverage to more than 56 million people in the US.
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HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
HEALTHCARE ACCESS
HealthPerx is a health and wellness marketing company specializing in creative non-insurance benefit solutions that reduce absenteeism, increase productivity and decrease healthcare costs. Consultants: These benefits differentiate you from competitors.
HEALTHPERX Jeff Marks, CEO Jmarks@hperx.com Direct: 205 222-4062 Toll Free: 888 417-6187 www.hperx.com
Corporations: These will give you a far greater ROI than your wellness program while saving your employees thousands of dollars a year. Differentiator: Telemedicine Services: offering the entire family unlimited calls with no consult fees 24/7/365—anytime from anywhere Additional Health Benefits: offering significant savings for pharmacy, dental, vision, medical advocacy, travel assistance, telephonic counseling (EAP) and more Turnkey Program: billing, administration, fulfillment, call center, marketing HealthPerx benefits complement any and all existing benefit plans. — Jeff Marks, CEO PRESCRIPTION BENEFITS MANAGEMENT
Provider of Prescription Benefits Management services to self-funded employee groups, TPA’s, Brokers, and Consultants. Phoenix also offers a prescription savings card, RxAdvantage, for individuals and groups alike.
SOLUTION PROVIDER MEMBER PROFILES
PHOENIX BENEFITS MANAGEMENT
410 Peachtree Parkway, Suite 4225 Cumming, Georgia 30041 888.532.3299 main office 678.208.6257 marketing & pr 678.208.6252 sales 678.208.6255 fax
Phoenix Benefits Management is a prescription benefit manager sales@phoenixpbm.com providing traditional PBM services marketing@phoenixpbm.com to Self-Funded companies, TPA’s, www.phoenixpbm.com Brokers, and Consultants. We also provide comprehensive 340B services as well as our very own prescription savings card known as the Phoenix RxAdvantage Prescription Savings Card. Though our approach is scalable, our solutions are individualized. It’s been our experience and it is our firm belief that prescription benefit plans are not a one-size-fits-all proposition so we create a plan that is customized to fit the unique needs of each and every one of our clients.
DataPath, Inc., is one of nation’s largest providers of CDH solutions specializing in account-based administration systems.
DATAPATH, INC.
1601 WestPark Drive, Suite 9 Little Rock, AR 72204
501.296.9990 www.dpath.com Since 1984, service providers using DataPath systems have provided administrative solutions for over 1 million participants of FSA, HRA, HSA, and COBRA. DataPath is the only solutions provider to design and deliver a full Suite of systems for handling 125, 105, 132, COBRA, HSAs, Credit and Debit Cards all delivered to account holders through a single Internet portal, myRSC.com.
“With the significant changes in healthcare today, our software solutions allow users to create custom plans for clients that benefit both the employer and employee. Not only have we created a single platform for all systems with myRSC.com, with the integration of our mySourceCard Debit Card at Wal-Mart and other retailers, our clients are able to offer a hassle-free solution with 100% compliance.” ®
HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT
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. HealthCare Consumerism Solutions™ I www.TheIHCC.com I HealthCare Exchange Solutions™ I January/February 2014
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SOLUTION PROVIDER MEMBER PROFILES
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BENEFIT ADMINISTRATION/PRIVATE EXCHANGES
Avoid the Cadillac Tax! Consumer’s Medical Resource® (CMR) helps your employees answer the five most important questions in healthcare: What do I have? What do I need? Where do I go? What will it cost? How do I connect? CMR helps leading Fortune 1,000 companies improve engagement, quality, and satisfaction through informed clinical decision-making with guaranteed savings. “10% of employees drive 70% of your cost. Our services not only help companies save money in areas such as reducing unnecessary elective surgeries, but also empower employees to make some of the most important decisions of their 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. i ÞÊ7> >Vi]Ê ÀiVÌ ÀÊ vÊ >À iÌ }ÊUÊ Ü> >ViJV ÃÕ iÀà i` V> °V Ê Çn£ Çä £ÇÓÇÊUÊÜÜÜ°V ÃÕ iÀà i` V> °V
TOTAL POPULATION HEALTH MANAGEMENT
Dr. tools Steven Level1Diagnostics uses new to M. Helschien LEVEL1DIAGNOSTICS Founderhealth and CC&BW evaluate employees’ cardiovascular 11722 Lightfall Court Heart disease is the number one killer Columbia, MD 21044 www.level1diagnostics.com in the U.S. and costs millions of dollars 410-707-5667 ◆ doc@level1diagnostics.com Dr. Steven Helschien, Founder in medical care and time lost from Sales: Penny Aleo, Executive VP work. Detection and prevention is the 443.878.3087 key to heart health. Level1Diagnostics pbaleo@gmail.com is an innovative program that, unlike conventional cardiology tests, provides new advanced technology testing and methods to detect and prevent the earliest signs of cardiovascular disease and encourage optimal health. “The biggest problem with traditional cardiology is that it is not preventive—there isn’t a testing program to evaluate people who don’t have any symptoms of heart disease, but may be at significant risk. Drugs and surgery are offered to patients instead of lifestyle change programs and supplements.” — Dr. Steven Helschien, Founder, Level1Diagnostics 48
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Since 1988, CieloStar (formerly OutsourceOne) CIELOSTAR has helped brokers, employers and employees 530 U.S. Trust Building navigate the ever-changing world of benefits. 730 Second Avenue South Now, with the dawn of “Defined Contribution Minneapolis, MN 55402 Health Care” we are again on the leading edge. With a team of industry thought leaders, CieloStar 612.436.2706 makes navigating healthand benefits choices john.reynolds@cielostar.com easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.
“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.” — John Reynolds, CEO, Cielostar HEALTH DECISION SUPPORT TOOLS
Truven Health Analytics, formerly Healthcare at Thomson Reuters, delivers unbiased information, analytic tools, benchmarks, and services to the health care industry.
TRUVEN HEALTH ANALYTICS 6200 S Syracuse Way, Suite 300 Greenwood Village, CO 80111 734.913.3000
Hospitals, government agencies, employers, health plans, clinicians, and life sciences companies have relied on us for more than 30 years. We combine deep clinical, financial, and health care management expertise with innovative technology platforms and information assets to make health care better by collaborating with our customers to uncover and realize opportunities for improving quality, efficiency, and outcomes.
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HEALTH INCENTIVES
MedEncentive offers a patented, web-based incentive system that’s been independently validated
MEDENCENTIVE
Cecily Hall Executive Vice President medencentive.com chall@medencentive.com
to control healthcare costs. Doctors and patients earn financial rewards for declaring adherence to best practices and healthy behaviors, provided they agree to be accountable to the other party for doing so. Easy to implement and
EMPLOYEE COMMUNICATION AND EDUCATION
ExperienceLab has created a breakthrough, CDHCENTRIC patented communication program that saves 507 S. 8th Ave. Bozeman, employers money by increasing adoption and Montana 59715 usage of consumer directed health (CDH) 617.224.6223 insurance plans among their employees. www.experiencelab.com CDHCentric, sold on a subscription basis, rtravis@experiencelab.com delivers regular, multi-media communications that are tailored based on seven unique attitudinal segments developed from proprietary research.
Traditional health plans protect employees from having to learn the basic skills for making cost-effective healthcare decisions. Our segmentation research, which is based on 20 years of behavioral marketing, found 7 unique personality types, and each makes healthcare decisions differently. The result is that, when employee messages are correctly tailored to their personalities, employees become health care consumers! — Roger Travis, President
embraced by users. SUPPLEMENTAL HEALTH
Transitions Optical, Inc. is the maker of Transitions® lenses, the #1-eyecare professional recommended photochromic lenses worldwide.
SOLUTION PROVIDER MEMBER PROFILES
TRANSITIONS OPTICAL 9251 Belcher Road Pinellas Park, FL 33782
800.533.2081 ext. 2262 www.healthysightworkingforyou.org
Transitions Healthy Sight Working for You® is an education initiative that helps HR professionals and benefits professionals communicate the value of the vision benefit to employees. More information and complimentary education tools are available at HealthySightWorkingForYou.org.
“Don’t overlook your employees’ healthy sight when thinking about your business goals. A vision benefit that includes an eye exam and sight-optimizing eyewear helps ensure that employees see their best, so they can do their best work, directly affecting your business.”
HEALTH ACCESS ALTERNATIVES
WeCare TLC is a medical risk management company that leverages onsite primary care clinics to provide solutions to rising healthcare costs while improving patient health and wellness.
WE CARE TLC
120 Crown Oak Centre Dr Longwood, FL 32750 800.941.0644 www.wecaretlc.com raegan.garber@wecaretlc.com
Our holistic approach to care empowers the clinic staff to act as patient advocates, which increases compliance and decreases unnecessary expensive services.
“Healthcare is now a right and employers are faced with the challenge of truly managing their healthcare costs. We have created a unique medical home clinic model that properly addresses quality of care and cost. This requires constant, aggressive, creative, and directed attention to accomplish but it can be done.” — Lynn Jennings, CEO, WeCare TLC
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RESOURCE GUIDE
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RADIO
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ADVERTISING INDEX AHIP ...................................................... 43
IHC FORUM & Expo 2014 ..................13-15
Allstate ................................................... I5
IHC Radio............................................... 22
Best Buy ........................Inside Back Cover
IHC Save the Date FORUM West 2014....39
Buck Consultants ................................... 34
insurexsolutions ..................................... 43
Carena ................................................... 44
Intrepid .................................................. 43
Castlight Health ..................................... 43
Level1Diagnostics .................................. 48
CDHCentric ............................................ 49
MasterCard ............................................ 44
CieloStar................................................ 48
MedEncentive ........................................ 49
ADVERTISING CONTACTS
CodeBaby............................................... 46
Mercer Marketplace............................... 28
Consumer’s Medical Resource..........18, 48
Orriant ................................................... 44
404.671.9551
ConnectYourCare ................................... 30
Phoenix Benefits Management................ 47
DataPath ................................................ 47
PrivateHealthCareExchange.com ............ 26
Delta Dental ........................................... 46
Redbrick Health ..................................... 12
eFlex Group............................................ 44
Totem Solutions ..................................... 46
Evolution1........................................36, 45
Transitions .......................................20, 49
Flexible Benefit Service Corporation........ 47
Truven Health Analytics ......................... 48
HealthPERX ............................................ 47
TSYS Healthcare ..............................10, 45
HealthStat ......................Inside Front Cover
UnitedHealthCare ..................... Back Cover
HSA Bank .............................................. 45
WageWorks ........................................... 45
IHC Call for Content................................ 40
WeCare TLC ........................................... 49
IHC Certification ....................................... 9
Wiser Together ................................24, 46
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January/February 2014 I HealthCare Exchange Solutions™ I www.TheIHCC.com I HealthCare Consumerism Solutions™
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myHealthcare Cost Estimator
TO TAKE CARE OF BUSINESS WITH INNOVATIVE TOOLS FOR THE JOB myClaims Manager UnitedHealthcare Health4MeTM
UHC.TVSM
The right health information can take you a long way. At UnitedHealthcare, we offer innovative tools that put members in touch with their information. myHealthcare Cost Estimator provides relevant information on care and estimated costs. myClaims Manager helps you understand, track and pay your medical bills online. UnitedHealthcare Health4Me is a mobile app that provides instant access to a family’s important health information. UHC.TV presents exciting, engaging online content about good health and living well. Empower your employees. It’s good for their health – and the health of your business. For more information, visit welcometomyuhc.com or call 1-866-438-5651.
uhc.com All UnitedHealthcare members can access a cost estimator online tool at myuhc.com. Depending on your specific benefit plan and the ZIP code that is entered, either the myHealthcare Cost Estimator or the Treatment Cost Estimator will be available. A mobile version of myHealthcare Cost Estimator is available in the Health4Me mobile app, and additional ZIP codes and procedures will be added soon. This tool is not intended to be a guarantee of your costs or benefits. Your actual costs and/or benefits may vary. When accessing the tool, please refer to the Terms and Conditions of Use and Why Your Costs May Vary sections for further information regarding cost estimates. Refer to your health plan coverage document for information regarding your specific benefits. ©2013 United HealthCare Services, Inc. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates. Health plan coverage provided by or through a UnitedHealthcare company. UHCEW506202-004