Transcript Document

BeneFits Health Care Plans
Just the right fit.
For businesses
with 2 – 50 employees
Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance
Company. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensees of the Blue Cross
Association. ® ANTHEM is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue
Cross Association.
Agenda
• Why BeneFits, Why Now?
- The Uninsured
- Removing Small Business Roadblocks
• The Solution: BeneFits Product Portfolio
• Comparing BeneFits and EmployeeElect
• Target Market
• Sales Tips
7/17/2015
Slide 2
Why BeneFits, Why Now?
7/17/2015
Slide 3
The Uninsured
The math is compelling:
Small Group
Market (CA)
900,000
employers
Uninsured
55%
Opportunity
7/17/2015
500,000
employers
Slide 4
The Uninsured Opportunity
Number of
Employers
Percentage
Uninsured by
Size
Potential New
Customers for
You
2-9
739,047
61%
450,818
10-24
103,408
39%
40,329
25-50
38,777
19%
7,367
Source: AHRQ 2001 Medical Expenditure Panel Survey data
7/17/2015
Slide 5
Removing Small Business Roadblocks
We asked…and this is what we heard
• Cost
• Lack of insurance knowledge
• Complexity
7/17/2015
Slide 6
Removing Small Business Roadblocks
We listened…and removed the roadblocks!
• PPO rates from $81 to $225
• HMO Rates from $187 to $281
• We’ve cut our contribution requirements in half (only
25% or $50)!
• Free Premium Only Plans* (P.O.P.) for groups of 5 or
more for the first year
* Administrative services for the Premium Only Plan (P.O.P.) are provided by Ceridian Benefit Services, Inc.,
an independent company that is not affiliated with Anthem Blue Cross, its affiliates or parent organization.
7/17/2015
Slide 7
Removing Small Business Roadblocks
We listened…easier to understand
• Agent/Employer brochure
• Simple application
• Bi-lingual cut-out summaries
7/17/2015
Slide 8
Removing Small Business Roadblocks
We listened…easier to expand
• Dental
• Life
• Workers Compensation
7/17/2015
Slide 9
The Solution: BeneFits Product Portfolio
7/17/2015
Slide 10
The Solution
BeneFits…
500,000
By the
Prospects
1
Numbers
Portfolio
6
Plans
25% or $50
Employer
contribution
60%
Employee
participation
7/17/2015
Slide 11
BeneFits from
the Anthem Blue Cross Portfolio
6 Plans
1
Hospital BeneFits
2
Hospital BeneFits Plus
3
Hospital BeneFits Preferred
4
Comprehensive PPO BeneFits:
$35 Copay GenRx Plan
5
Comprehensive HMO BeneFits
Power SelectHMO Plan
6
Lumenos HSA 3000
(HSA-Compatible)
7/17/2015
Slide 12
The BeneFits Portfolio
Plans that builds with each step
Comprehensive coverage for eligible, in-network hospital
charges:
Annual
Deductible
Coinsurance
Annual
Out-of
Pocket
Plus modular benefit “steps” instead of comprehensive
coverage for other services:
Lifetime
Benefits
Generic
Only RX
Benefits
Prof
Services
1
Hospital
BeneFits
$1,250
30%
Deductible
Plus $2,500
$5,000,000
$15 copay
2
Hospital
BeneFits
Plus
$1,000
30%
Deductible
Plus $2,500
$5,000,000
$15 copay
50% of first
$1,000
3
Hospital
BeneFits
Preferred
30%
Deductible
Plus $2,500
$15 copay
50% of
first
$1,500
$750
7/17/2015
$5,000,000
Slide 13
Dental
2 free
cleanings +
up to $500
benefit innetwork
Vision
Blue View
Vision
The BeneFits Portfolio
To round out the BeneFits portfolio, three EmployeeElect plans
are included:
Annual
Deductible
Coinsurance
Annual
Out-of-Pocket
Office Visit
Copay
$4,000 includes
deductible*
$35 for 1st
$15 copay
12, then 45% Generic Only
4
$35 Copay
Plan BeneFits
$500 per
member*
35%
5
SelectHMO
Benefits
$500 per
member*
10% Inpatient
20% Outpatient
No charge for
professional
services
$2,250 includes
$25 PCP
deductible*
$35 Specialist
$3,000 per
member/
$6,000 per
family**
0% Inpatient
0% Outpatient
$3,000/ member
$6,000/ family**
6
Lumenos HSA
3000
(HSA-compatible)
* 2-member maximum
** Aggregate, medical/pharmacy combined
7/17/2015
Slide 14
0% after
deductible
Prescription
Drugs
$15 copay
Generic
$25 Brand
after $150
deductible
0% after
combined
deductible
BeneFits from Anthem Blue Cross
Adding Value
360° Health® gives employers a way to keep their employees as
healthy as they can be!
• Comprehensive suite of programs and services
- Online resources, including helpful decision-making tools
- Interactive health programs
- Discounts on health-related programs
- Personalized programs to help manage and coordinate
care for chronic conditions
7/17/2015
Slide 15
BeneFits from Anthem Blue Cross
Easy to add-on
Dental Options
• Dental BeneFits- PPO Dental Plan
• Dental Net- HMO Dental Plan
Life Benefits
• Choose a coverage amount… from
$15,000 to $50,000 (in $5,000 increments)
• Specify the employer contribution amount…25% or more
(in 5% increments)
7/17/2015
Slide 16
Easy to Save Money for Your Clients
Save More
• 1% savings on medical premiums with life
• 1% savings medical, 6% dental, 6% life – when packaged together
• 10% savings on Workers Compensation coverage from Employers
Compensation Insurance Company* when integrated with any of our
medical plans
• Additional savings on medical premium with Integrated Workers
Compensation
• First year of P.O.P. free with groups of 5 or more enrolling
* Employers Compensation Insurance Company is a separate entity that does not offer blue branded products or services.
7/17/2015
Slide 17
The BeneFits Portfolio
Let’s put it into perspective
 A 25 year-old living in Fresno can be covered on the
Hospital BeneFits plan for $81 a month.
– The Employer contribution: $20.25 a month
 A 38 year-old living in San Francisco can be covered
on the BeneFits Plus plan for $124 a month.
– The Employer contribution: $31.00 a month
 A 29 year-old living in Los Angeles can be covered on
the BeneFits Preferred plan for $150 a month.
– The Employer contribution: $37.50 a month
7/17/2015
Slide 18
Comparing BeneFits and EmployeeElect
7/17/2015
Slide 19
BeneFits vs. EmployeeElect
BeneFits
EmployeeElect
Target Audience
Uninsured or at risk groups
Full spectrum of small businesses
Min Participation
Requirements
60%
75%
Min Employer
Contributions
$50 or 25%
$100 or 50%
Medical Plan Choices
6 plans - target coverage options
17 plans –expansive range of options
Adding Dental
2 dental options
All dental plans
Dental BeneFits - Dental Net
8 PPO - 2 HMO - Voluntary dental
$15k-50K
All Schedules
Employer Cont: 25% or more
Employer Cont: 25% or more
Setting up a P.O.P.
$125/yr – FREE first year for
groups 5+ enrolled
$125/yr – FREE first year for groups
10+ enrolled
Integrated Workers’
Comp
10% discount on Workers Comp
portion of integrated bill. Possible
savings on Medical
10% discount on Workers Comp portion
of integrated bill. Possible savings on
Medical
Adding Life
7/17/2015
Slide 20
Qualifying and Enrolling
Existing Business
• For a group that wants to move from EmployeeElect to
BeneFits
– Benefit modification will be allowed once in a
12-month period
OR
– At focal/anniversary renewal
• Underwriting is required, and the entire group would
need to move to the BeneFits platform
7/17/2015
Slide 21
Target Market
7/17/2015
Slide 22
BeneFits a Powerful Sales Tool
Prospects
• Uninsured
• Retail and service industries
• Owners concerned with uneven cash flow
• Groups who have work-arounds
• Employers who think it is too expensive or too
complex
• Groups considering dropping coverage
7/17/2015
Slide 23
Sales Tips
7/17/2015
Slide 24
Great! Where Do I Start?
Review your book of missed opportunities
for easy leads……..
• Groups who were declined due to participation
• Groups who inquired but did not buy
• Groups previously quoted and did not qualify
• Targeted marketing based on service industries
7/17/2015
Slide 25
Thank you!