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CBIA Health Connections

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 Jan. 1, 1995 4 Health Plan choices

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CBIA Health Connections

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  1. CBIA Health Connections April 26, 2007

  2. Presentation Overview • CBIA Health Connections – Who we are • Choice, Choice, Choice • Rating • What we do - Administration / Technology • Challenges and Considerations

  3. CBIA Health Connections • Introduced Jan. 1, 1995 • 4 Health Plan choices • 6000 companies • 88,000 members • Agent / Broker distributed

  4. CBIA Health Connections • Employee Choice Model Purchasing Group

  5. CBIA Health Connections • Standard Benefits with Health Plans • Employee Chooses the Insurer • Price • Network • Formularies

  6. 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

  7. 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

  8. Pricing • CT - Small case reform laws • Age Rating (5 year) • Gender • Area • Family Tiers • No Rating Bands / underwriting • Reinsurance Pool

  9. 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

  10. CBIA Health Connections • Shift by Plan Type • Shift by Benefit Level

  11. Administration / Technology • CBIA Health Connections looks like one large employer but there are a lot of details……

  12. Administration • Distribution • Materials – Web & Print • Proposal (benchmark plan) • Decision Tools - CDHP Plans • Training • Website • Information • Employee, Employer & Broker • Online transaction • Wellness / Lifestyle

  13. Employer Global Pricing • Ability to benchmark the most cost effective option of a plan design • Set employer contribution based on that plan

  14. Specify a Contribution Strategy

  15. The Employee Specific Illustration shows choices based on the contribution strategy

  16. Administration • Administration • Billing (consolidated) • Collection / Late Notice • Reconciliation (receivable at EE level) • Remittance • Eligibility • Customer Service / CRM • Data Sync • Commissions / 1099’s

  17. CBIA HC Administration CBIA BusinessPartners &Customers Request Coordination RequestMediums Carriers Billing &Admin ContactManagemt Web Agents Health Plans E-Mail Workflow Employers Phone AncillaryCarriers Fax Employees CustomerService AgentReps DataEntry Paper Action & Follow-up

  18. Administration • Proposal presentation • Meet market practices • Information must be in Health Plan systems • Financial integrity

  19. The Changing Market • Cost Pressures • Legislative Challenges • Healthcare Cost Pressures • Consolidation of Health Plans • Consumer Driven Options • Wellness / Lifestyle

  20. 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

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