2019 Broker Summit
Hometown Health
Today’s Agenda
• Hometown Health Staff Introductions• Lunch• Ritz-Carlton Memorable Customer Service Presentation• Renown Health Update• Legislation Update• 2020 Products & Benefits• Southern Nevada Update• Online Provider Directory Sneak Peak• Healthy Tracks & Health Fairs• Broker Recognition• Questions & Answers
Hometown Health Leadership
Hometown Health
Ty WindfeldtCOO Health Services Division
Renown Health
Sam KingCFO & Interim CEOHometown Health
Previous Structure
Overview Acute CareDivision
Network Services Division
Transitional Care Division
Health Insurances Division
Shared ServicesDivision
Focus
Provide acute care services and
Renown financial sustainability.
Improve the health of consumers by offering care and coverage that is high-quality &
affordable.
Provide health services that are neither hospital
care nor traditional medical group
services.
Provide health insurance products for Medicare and
Commercial populations.
Provide corporate/shared services,
population health services and
operating division oversight.
New Structure
OverviewAcute Care
DivisionHealth Services
Division
Focus
Provide acute care services with high quality, efficiency, reliability, & experience.
Improve the health of consumers by offering care and coverage that is high-quality, affordable.
Support ServicesDeliver solutions to operating divisions based on their requestedspecifications.
Legislative Update – AB469
Hometown Health
Balance Billing:A practice in which a Non-Participating Provider bills you for amounts in excess of the allowed amount.
AB469:Prohibits an Out-of-Netowrk (OON) Provider from balance billing for medically necessary emergency services. OON hospitals are required to provide notification.
*Does not apply to:• Persons covered by policies outside of Nevada,• Services provided more than 24 hours after stabilization,• Services provided at critical care hospitals• Self-funded plans (unless the plan opts-in)
Legislative Update
SB87: Guaranty Assocations
SB88: No longer required to take course to be a licensed producer- just the test
SB262:Asthma Medications
SB370:Fetal alcohol spectrum disorder
SCR10: PEBP to provide health insurance to public
AB472:Surrogate Coverage
AB254:Provisions to Sickle Cell Disease
SB447: Durable Medical Equipment
Legislative Update
SB481:Commissioner may regulate self-funded MEWAs;
Short term policies can't be renewed within a 365 day period;
Off-exchange carriers required to notify members of on-exchange options
SB482: Allows reciprocal licensure with surrounding states;
Allows the Commissioner to apply for an ACA innovation waiver;
Eliminates 90 day waiting period on-going enrollment
2020 Product Differences
Market Individual and Family Small Group Large Group
Product HMO PPO HMO PPO HMO PPO
Hometown Network Signature PPO Signature PPO Sig Stndrd PPO
Referral Required Yes No Yes No Yes No No
OneHealth Network No* Yes No* Yes No* Yes Yes
National Network No* No* No* Available* No* Available*
Access Outside of Network No Yes No Yes No Yes
Formulary Standard EHB Standard EHB Standard EHB Standard EHB Enhanced Enhanced
Pediatric Vision Covered Covered Covered Covered Supplemental Supplemental
Dental Supplemental Supplemental Supplemental Supplemental Supplemental Supplemental
Hearing Aids Covered Covered Covered Covered Not Covered Not Covered
2020 IFP Enrollment Period Changes
Hometown Health
90-day waiting period for year-round enrollment. Beginning 1/1/2020, we will no longer allow year-round enrollment with a 90-day waiting period for IFP. The ONLY ways you can enroll to become an IFP member is through Open Enrollment (11/1 – 12/15) or with a QLE. The 2020 IFP EOCs will be changed as follows:
Current Language:3. Selection Outside of Open or Special Enrollment Periods
This policy is available for enrollment outside of the Open Enrollment and Special Enrollment Periods. For applicants seeking to enroll in the plan during this period, there will be a 90 day waiting period for coverage to begin after your completed application and first month’s premium has been received. You may change your plan selection during the waiting period if the revised application has been received on or before the 15th of the month immediately preceding the first date of coverage. Coverage is effective upon the first day of the month immediately succeeding the month in which the waiting period expires. Coverage is not retroactive to the date on which the application for coverage was received.
New Language:This policy is not available for enrollment outside of the Open Enrollment and Special Enrollment Periods.
Teladoc
Hometown Health
Highlights of the Teladoc benefit:
• $0 copay for covered members (including specialty visits)• Both telephone and video consults are available• Teladoc is available in all 50 states • Teladoc can diagnosis and treat wide variety of
general health issues• Teladoc offers dermatology diagnosis and treatment• HDHP copays are $45 or $75 for Dermatology until
you satisfy your annual deductible – after that, the cost will be $0.
Teladoc
Hometown Health
Frequently Asked Questions:
Q: Does Teladoc include Renown providers?A: No, only Teladoc physicians are available.
Q: Will Teladoc providers have access to EPIC?A: Not in real time. Post visit notes will be uploaded to EPIC at a later date.
Q: Is payment required at time of service?A: Yes. Debit or credit card can be used.
Nevada Behavioral Health Systems
Hometown Health
Hometown Health has partnered with Nevada Behavioral Health Systems to provide timely and effective behavioral health care to our members.
Including:• Same Day Behavioral Health Evaluations• Medication Management • Care Coordination
Hometown Health Comprehensive Provider Networks
Provider Type
Hometown Health
OneHealth
Family Practice 357 743
Internal Medicine
101 560
Pediatrics 71 224
OB/GYN 92 223
Orthopedists 122 151
Cardiology 70 125
All Others 2,552 2,552
Total 3,277 4,578
As of January, 2019
Hometown Health Comprehensive Provider Networks
Provider Type
Hometown HealthNorth
Hometown HealthSouth
Family Practice 357 743
Internal Medicine
101 560
Pediatrics 71 224
OB/GYN 92 223
Orthopedists 122 151
Cardiology 70 125
All Others 2,552 2,552
Total 3,277 4,578As of January, 2019
Southern Nevada
Market Overview• Available in Clark & Nye County – P3 Health Partners• Broker Driven Sales – Partner with Medicare Brokers• Everything is FREE! Including Extra Benefits• FY20 Focus: Maintain Membership, Grow by Supporting Broker
Sales – Southern Nevada Broker Summit 8/27
2019 Broker Summit
Hometown Health
Ed JaquetteManager, Information Technology
Renown Health
Provider Directory Demo
Healthy Tracks
Hometown Health
Web-based, customizable wellness portal with self-management tools aimed at reducing health risks.
• Incentive Campaigns• Health Risk Assessment• Personal Health Profile• “University” of Health & Wellness Courses• Wellness Challenges • Fitness Tracker Syncing• Mobile App
Healthy Tracks
Hometown Health
HEALTHY TRACKS UPDATES
• 100 New Challenges!– Loaded in portal, ready to use
• Peer-to-Peer Challenges– Challenge your co-workers or family!
Healthy Tracks
Hometown Health
PROGRAM ENHANCEMENTS
Health Coaching
• Drive behavior change• Create accountability• Set goals• Biometric screening results review• Conveniently done over the phone or online• Certified, graduate level health educators• Data driven outreach (coach initiated)
Healthy Tracks
Hometown Health
HEALTHY TRACKS MEMBER ACCESS
• IFP, Small Group– Mygymbenefit.myhealthytracks.com
• SCP– Seniorcareplus.myhealthytracks.com
• Large Group, Self Funded Groups– Custom Portal
Healthy Tracks
Hometown Health
LARGE GROUP WELLNESS• Custom portal with company logo• Employer access to health assessment and screening reports• Data analysis
Health Fairs
Hometown Health
Data driven approach to engage employee participation to create and maintain a culture of wellness.
CUSTOMIZED WELLNESS EXPERIENCES: Introducing ACT by Healthy Tracks
• Customized stations focused on dimensions of wellness
• Personalized tools and solutions to members to encourage them along their wellness journey
• Drive members to PCP and other preventive health appointments
• Multi-event approach to provide the most support toward attaining health goals
• Integrate with Healthy Tracks for total wellness solution
Wellness
Hometown Health
BENEFITS
• Member benefits• Employer benefits• Health plan benefits• Community benefits
Flu Shots
Hometown Health
FLU SHOT PROGRAM
• Corporate flu shot events– Please have your corporate groups call Mary Bristol at 775-982-4148 to
schedule onsite flu shots.
– No charge for groups of 20 or more Hometown Health members
• Community flu shot events– No cost to Hometown Health members; $40 charge for non-members
~No cost when included in the benefit plan under preventive care(ACA).
Motivate U
Hometown Health
MOTIVATE U 2019 REDESIGN
Program Enhancements•30 participants per session•New session every month•6 months of health coaching•Registered dieticians• Local gym partners•Over 85% completion rate!
– Applications open to all HTH fully-insured members– Exclusive Motivate U sessions available!
Motivate U
Hometown Health
MOTIVATE U STATS!
Session 1 2019, 20 participants:• 103.5 total pounds lost!• 2.34% body fat lost per person• 23.9 pounds of skeletal muscle mass gained • 3.8 inches waist circumference lost per person• 88% program completion rate
Monthly Wellness Luncheons
Hometown Health
TAKE A BITE OUT OF WELLNESS 3RD TUESDAY OF EVERY MONTH
• Trending wellness topics • Free to Hometown Health members!• Option to purchase lunch for $15 • RSVP Required• Raffle Prize!
September 17th – Live your Best Life! October 15th – How Oral Health affects the Body November 19th – The Role of a Plant-Based DietDecember 17th – Stress Management
Broker Recognition
Hometown Health
Pete Gilbert, Employer Benefits
Julie Ann EvansJewels Benefits
Bronze Broker Partners
Broker Recognition
Hometown Health
Mark Lehmann, ASG
Chris CarothersCarothers Insurance
Silver Broker Partners
Broker Recognition
Hometown Health
Alex SampsonJT Sampson
Kevin SampsonMatt Law
Grant DodgeHealth Benefits Associates
Gold Broker Partners
Broker Recognition
Diamond Broker Partners
Memorable Experiences start with Memorable Service.
Select your team’s favorite experience option.
Schedule a day and time for Spring 2020 with your Account Executive.
Broker Recognition
Hometown Health
LP Insurance Lloyd Barnes
Kevin MonaghanTim Holland
Nate Kerr
Dillon Health Mike Dillon
Diamond Broker Partners
Assured Partners Consulting Lauren Yurick
Deanna DehartTodd Wilson
Health Benefits Associates
Alex SampsonKevin Sampson
JT SampsonMatt Law
Grant Dodge