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Annual Benefit Changes (ABCs). Ohio. Agenda. Back ground on changes Review of portfolio changes Selling Strategy Communication dates Consultative Selling Questions. Background on Changes. Changes .
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Agenda • Back ground on • changes • Review of portfolio • changes • Selling Strategy • Communication • dates • Consultative • Selling • Questions
Changes • As a result of complying with healthcare reform – from an admin • Lean but still attractive to groups and members – we made some reductions, we had some gaps – we created new plans to fill the gaps. Price points • Added some additional plans to meet cost shares • Stay competitive – managing portfolios = address gaps that were present – competitors – simplify portfolio Options that groups are going to have
ABC Objectives 2012 ABCs will focus more on portfolio management and less on benefit modifications • Simplified 2-99 portfolio with new cost share options to fill price point • gaps and offering different Rx options special enhancements to 2-50 • Pharmacy portfolio standardization and modification • Benefit enhancements for Lumenos
Health Care Reform • Anthem will comply with the HHS recommendations for Women’s Preventive effective 8/1/12. Several of these services will not require additional services, because the services are already covered based on other recommendations. The guidelines are listed below.
Future Lumenos Enhancement List date TBD • Physician home and office • Specialist office • Urgent care • Emergency room • Rx
What is the competition doing? • Observations and Opportunities • We are leaner than UHC in portfolio size in the Key market. Humana is • larger due to 2-99 single portfolio • We offer fewer 0% plans than either competitor • Humana now offering plans with $300-$350 copays. UHC $250 ER on all. • We offer $250 ER on select plans • We are the richest with a $200 and $250 deductible (on Key portfolio) verses • $500 as the richest with top two competitors • We offer fewer HAS 100% plans than UHC who offers 10; Humana offers 3 • UHC offers an HRA product with Rx copays day on and an embedded • deductible resulting in challenges and group loss for sales • We offer the richest 4 tier Rx option • Gaps identified on SG and Key that must be addressed with new portfolio
Selling Strategies Market Segments: Funding Arrangements: