independent | local | not-for-profit | community-focused the path forward bcbsvt’s response to...

Independent | Local | Not-for-Profit | Community-Focused

The Path ForwardBCBSVT’s Response to Extraordinary Times


Introduction

Catherine Hamilton, Ph. D.Vice President of Planning


To discuss:

How the Exchange impacts

Vermonters

How to help Vermonters through the

transition

Q & A

Overview:

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Information about:• Why BCBSVT is launching a retail campaign• Introduction to the changes in Vermont’s health care landscape as the

result of the Affordable Care Act • Information about what BCBSVT will provide to businesses and consumers

o Information o Decision supporto Timing of activities and how to stay connected

o New and improved offerings for large groups

Today’s Objectives

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• Extraordinary times and the unprecedented changes facing Vermonterso Largest transition of consumers and businesses in our historyo Vermont’s Exchange only model

• Our Missiono To always put members’ experience first

• The Challengeo Guide Vermonters’ understanding of changes and impactso Successfully transition thousands of Vermonters to new products and

the Exchangeo Respond to our customers –who asked for help

Why Are We Here?

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Extraordinary Times for Small Businesses and Individuals

• Direct to consumeroConsumer choice

• Standardized products and benefits• Online portal administered by state• Mandatory for individuals

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89% of Consumers Will Be New to Purchasing

Three in four Vermonters unaware of the Exchange

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• BCBSVT customers asked us to help build understanding and guide transition

• Comprehensive retail campaign• 17 different operating plans --- repurposing staff

o New media campaigno Comprehensive outreach, phone support, new websiteo New product offerings

Responding to the Challenge

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Why are we here today?


Vermonters

Helping Vermonters through the Transition

Q & AClosing

Thoughts

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What Change is Coming and Who’s Affected?

What:• An online Exchange marketplace

for comparing and purchasing health insurance

Who:• All individual consumers and small

businesses under 51 employees

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When Does this Change Happen?

October 1, 2013

January 1, 2014

March 31, 2014

Open enrollment

begins

Policy year begins (upon renewal for

groups)

Open enrollment

ends (individuals)

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• Deductibles/cost sharing: 9 standard product designs• Covered Benefits: Essential Health Benefits

o State recommended BCBSVT benefits as basiso Pediatric, dental and vision

What Are the Product Choices?

0%

20%

40%

60%

80%

100%

Bronze Silver Gold Platinum

$ out of pocket

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Small Business(<51) Impacts

What Stays the Same:

• Voluntary to offer insuranceo No Penalties

• Health plans issue products• Select contribution level• Small business tax credits available• Can hire a broker

What Changes:

• Employees face tax penalties if uninsured

• Employees can choose among health plans

• Products are standardized• Use the Exchange website to enroll

and pay premium• Broker fees cannot be part of

the premium

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Small Group Employer Decisions

Keep

my

cove

rage

? Drop m

y coverage?

1. Plan design/contribution level? 2. Small business tax credit?3. Employee plan/product

choices?4. Broker?

1. What options do my employees have?

2. Increase wages?3. Tax implications? 4. HR implications?

15


Individual Consumer Impacts (not covered by employer)

What stays the same:

• Health plans issue products• Premiums not tax deductible

expense

What changes:

• Uninsured face tax penalties• Subsidies available if

income eligible• Products are standardized• Use the Exchange website to

enroll and pay premium• Catamount goes away

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Large Employer Impacts

What stays the same:

Can purchase from a health plan Enroll with health plans Pay premium directly to

health plans Brokers fees part of the premium Premium still tax deductible

expense

What changes:

• Will face tax penalties if they don’t offer insurance

• Coverage must be credible

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How Exchange impacts

Vermonters


Q & AClosing

Thoughts

Overview

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• Guide Vermonters through the transition to the Exchange

• Be there when you need us• Deepen relationships with

consumers• Optimize the member experience

Comprehensive outreach campaign

Best products at the best price

Great member experience

Our Commitment

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BCBSVT outreach campaign

Media

Community events

Community meetings

Business meetings

Webinars

Phone support

Website

Satellite office

How Will We Carry Out our Commitment?

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• BCBSVT coverage consultants will work face to face, by phone or web

• Brochures, videos and webinars• A toolkit for decision-making• On site information sessions• HRA/HSA packages that provide an easy way for employers to

continue to fund health coverage• Outreach to individual employees of companies that are

dropping coverage

What Services We Will Provide to Small Businesses

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Timeline for Supporting Businesses

March – June 2013 July – Sept 2013 Oct 2013 – March 2014

• Assist Employer/ Employeeso Plan choiceo Enrollment

• Assist with decision

• Educate on change• Options • Timing

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Pre-Campaign

Build AwarenessCampaign

Engage Vermonters

Ongoing

Continuous improvement in

consumer experience

How Will We Will Reach Vermonters?

January 2013 – August

• Outreach and education about the

changes

September 2013 – March 2014

• Transition groups and individuals• Open enrollment

• Offer products to market• Decision-support

2014-2016 and beyond

• Ongoing optimization of

consumer experience 23


New and Improved Offerings for Large Groups

Joanne ReynoldsSenior Sales Executive


Objectives of Client Partnership Program

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The objective of the Client Partnership Strategy is to create strong lasting relationships with clients. We achieve this by understanding each client’s unique health, wellness, condition management needs and by developing customized solutions to address these needs. The long-term result is a more engaged, healthier, and more productive workforce and highly satisfied employer customers.


Client Partnership Program

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Benefit Design and Financing Consultation Custom Reporting and Data Analytics Advisory Experts Health Advocacy and Clinical Solutions Health Care Reform Worksite Health and Wellness Consumer Engagement


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Accountable Blue

New health and wellness product Team-oriented approach – shared incentives among the health plan,

employer, member and provider Goal is to keep members healthy and manage illness

FLEXIBLE BENEFIT DESIGN

A customized benefit design to support your health and wellness goals

INTEGRATED HEALTH AND WELLNESS

SERVICES

A suite of customized health, wellness, and

care management programs

EMPLOYEE INCENTIVES

Incentives to encourage and reward healthy

behaviors


Team Oriented Approach

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Employer Group• Employee incentives• Health & Wellness programs• Clinical and Participation

Performance targets• Workplace environment

BCBSVT• Flexible benefit design• Worksite health, wellness,

care management programs• Custom analytics • Custom consumer

engagement campaigns • Concierge health &

wellness services

Providers• Quality-focused

guideline based care• Patient-Centered• Affordable and fiscally

responsible• Evidence-based care

Emphasizes well-being, condition management and healthy outcomes

Everyone is accountable o Consumero Providero Employer o Health plano Community

Two levels of engagemento Worksite o Population

Aligned incentives


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How Accountable Blue Works

Identify benefits and incentives of

value to Employer

Health Assessment

Health Interest Survey

Clinical Data

Organizational Health Evaluation

Demographics

Flexible benefit design

Integrated health & wellness services

Employee incentives

• A customized benefit design to support your health and wellness goals

• A suite of customized health, wellness, and care management programs

• Incentives for healthy behaviors

Claims

©2012 Blue Cross and Blue Shield of Vermont




Vermonters


Q & AClosing

Thoughts

Overview

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Are We On the Right Track?

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independent | local | not-for-profit | community-focused the path forward bcbsvt’s response to...

Documents

exchange o

impacts o

mission o

connected o new

extraordinary times

challenge o guide vermonters

history o vermonts exchange

basis o pediatric