1 / 11

CBIA Health Connections an example of a successful exchange for 15+ years

Explore the success story of CBIA Health Connections since its introduction in 1995. Learn about the reasons behind its longevity, the rating rules in Connecticut, lessons learned, and future opportunities for growth and innovation in the healthcare market.

jgrear
Download Presentation

CBIA Health Connections an example of a successful exchange for 15+ years

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CBIA Health Connectionsan example of a successful exchange for 15+ years January 8, 2010

  2. Presentation Overview • CBIA Health Connections • Who we are • Why we are successful • Rating rules in Connecticut • What we do • Lessons learned and opportunities

  3. CBIA Health Connections • Introduced Jan. 1, 1995 • Employee choice model • 4 Health Plan choices • 5000+ companies • 75,000+ members

  4. CBIA Health Connections • Standardized Benefits across Health Plans • Employer Chooses CBIA Health Connections • Employee Chooses the Insurer • Price • Network • Formularies • Satisfaction

  5. Why CBIA has been Successful • Deliver value to: • Market, Employer, Employees, Insurers • Engaged with and understand our customers • Stay true to core mission – small employers • Private sector status allows for: • Innovation and adaptation to market changes • Efficient operations • Avoid selection issues

  6. Rating Rules in CT • Small Case Reform Laws – under 50 full time employees • Adjusted Community Rating – no rate bands for claim experience • Guarantee issue • Guaranteed renewability • Rating factors allowed: • Age, family tier, gender, area, case size, SIC, plan design • Reinsurance pool (CSEHRP)

  7. Exchange & Administration CBIA Health Connections administered like one large plan to the insurers but there are a lot of details……

  8. Lessons Learned in the Market • Potential Pitfalls • Rates based on claims & health status • Adverse selection • Looking to save administrative costs only • Operating outside of regular market practices • Broker compensation variances

  9. Things to Think About • Unintended consequences of rating changes • Coordination of multiple funding sources • Subsidies • Part-time employees • Risk adjustment (premium redistribution) • Minimal focus on wellness and behavior change

  10. Opportunities • Bring culture of wellness to the small business market • Has worked in large company market • Currently no financial incentive • Plan design with incentives / disincentives for wellness, prevention and care of chronic illness • Decision support tools to help employees / patients make informed decisions about their health • More transparency of quality and costs from providers • Promote competition, innovation and quality – subsidy should follow the customer

  11. CBIA Health Connectionsan example of a successful exchange for 15+ years January 8, 2010

More Related