Transcript CBIA Health Connections April 26, 2007 Presentation Overview  CBIA Health Connections – Who we are  Choice, Choice, Choice  Rating  What we do - Administration / Technology  Challenges.

CBIA Health
Connections
April 26, 2007
Presentation Overview

CBIA Health Connections – Who we are

Choice, Choice, Choice

Rating

What we do - Administration / Technology

Challenges and Considerations
CBIA Health
Connections
 Introduced
4
Jan. 1, 1995
Health Plan choices
 6000
companies
 88,000
 Agent
members
/ Broker distributed
CBIA Health
Connections
 Employee
Choice Model
Purchasing Group
CBIA Health
Connections

Standard Benefits with Health Plans

Employee Chooses the Insurer
• Price
• Network
• Formularies
CBIA Health
Connections

Plan of choice for the owner

Business loves competition

Never have to “switch”

Consolidated administration / bill

Global budgeting for the employer

Employee gets choice
CBIA Health
Connections

Employers eligible (3-100)

Multi Vendor (4 Health Plans)
• CIGNA, ConnectiCare, Health
Net, United Healthcare

Employee Choice (38 options)

Standard Plan design
Pricing

CT - Small case reform laws
• Age Rating (5 year)
• Gender
• Area
• Family Tiers
• No Rating Bands / underwriting
• Reinsurance Pool
CBIA Health Connections

2 Suites of Plan Design Options
• HC - 24 options
• HMO $10, $20, $30
• POS $10, $20, $30
• HC2 - 38 options
• HMO $20, $20/40, $30/45
• POS $20, $20/40, $30/45
• HSA’s, HRA’s
CBIA Health Connections
 Shift
by Plan Type
 Shift
by Benefit Level
Administration /
Technology

CBIA Health Connections
looks like one large
employer but there are a lot
of details……
Administration

Distribution
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•
•
•
•
Materials – Web & Print
Proposal (benchmark plan)
Decision Tools - CDHP Plans
Training
Website
• Information
• Employee, Employer & Broker
• Online transaction
• Wellness / Lifestyle
Employer Global Pricing

Ability to benchmark the most cost
effective option of a plan design

Set employer contribution based
on that plan
Specify a Contribution Strategy
The Employee Specific Illustration shows
choices based on the contribution strategy
Administration

Administration
•
•
•
•
•
•
•
•
Billing (consolidated)
Collection / Late Notice
Reconciliation (receivable at EE level)
Remittance
Eligibility
Customer Service / CRM
Data Sync
Commissions / 1099’s
CBIA HC Administration
Business
Partners &
Customers
Agents
CBIA
Request
Mediums
Web
Request Coordination
Contact
Managemt
Billing &
Admin
E-Mail
Employers
Employees
Phone
Fax
Paper
Workflow
Customer Agent
Service
Reps
Data
Entry
Action & Follow-up
Carriers
Health
Plans
Ancillary
Carriers
Administration

Proposal presentation

Meet market practices

Information must be in Health
Plan systems

Financial integrity
The Changing Market

Cost Pressures

Legislative Challenges

Healthcare Cost Pressures

Consolidation of Health Plans

Consumer Driven Options

Wellness / Lifestyle
CBIA Health
Connections

Why HC works in the Private Sector:
• Company’s wary of government involvement
• Common benefits (standardized but not exact)
• Other services i.e Life, STD, LTD, Dental, COBRA,
Section 125, HRA’s, HSA’s
• Ability to change and adapt quickly
• Utilization management and reporting
• Wellness initiatives
• Communications