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