Download - LGIT Annual Meeting
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LGIT Annual Meeting
LGIT Health Overview October 22, 2020
Tim Ailsworth - LGITFred Bean, Mark Kunkle, Kate Lobley – BeneconKen Huber – PSA Insurance & Financial Services
Andrew Belmear – CignaKyle Sanders – Kaiser Permanente
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What is LGIT Health?
Local Government Insurance Trust Health, known as LGIT Health, is a self-funded health insurance purchasing program established in 2010. The goal of LGIT Health is to provide
cost effective health insurance for municipal employees in the state of Maryland.
Today, 24 municipalities and/or authorities are members of LGIT Health.
LGIT Health members benefit by full transparency on costs, excellent employee benefits and surplus returns annually from
better than expected performance.
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Local Control is the Key to Success
LGIT Health is governed by the Board of Trustees of the Local Government
Insurance Trust. The LGIT Board makes sure that all profits (or surplus returns)
are returned to the members and not the insurance company. In addition, LGIT
staff acts as the treasurer for the Cooperative to assure financial accountability
with all funding. Benecon acts as the general administrator of the program for
all day-to-day activities.
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LGIT Health Partners
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Benecon is the leader in developing self-funded employee benefit
programs for both public and private sector employers.
14 Consortium/Cooperative programs nationwide
1280 employer groups / 122k covered employees
Member Retention exceeds 98%
Who is Benecon?
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Benecon’s Full Suite of Services for LGIT Health Members
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Day to Day Account
Management
Independent
Rate Development
DOL Compliance
Resources
Financial Services Data AnalyticsNurse Navigation &
Wellness Consulting
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How does LGIT Health benefit the members?
• Broad network of providers and
hospitals through Cigna and
Kaiser
• Benefits will match current plan
design or be slightly better in
certain cases
• Access to Benecon’s Nurse
Navigation & Wellness
Consulting services through
ConnectCare3
• Regular wellness initiatives
including online health coaching
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Current LGIT Health Membership
▪ Town of Berwyn Heights
▪ Boonsboro
▪ City of Brunswick
▪ Town of Centreville
▪ Town of Chesapeake Beach
▪ Chesapeake City*
▪ Town of Chestertown*
▪ Cheverly
▪ City of College Park
▪ City of Cumberland
▪ Gaithersburg
▪ Hampstead
▪ Kent County
▪ Kent County Public Library
▪ LGIT
▪ Town of Middletown
▪ Maryland Municipal League
▪ Mount Rainier
▪ City of New Carrollton
▪ Town of North East
▪ Town of Oakland
▪ Town of Poolesville
▪ Port Deposit
▪ Town of Riverdale Park
▪ Town of Sykesville
▪ City of Westminster
*Ancillary Benefits Only
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LGIT Health Model Overview
Claim Fund with Corridor
Member Surplus
Great Year Expected YearClaim Fund Exhausted
Aggregating Specific
Stop-Loss
Specific Stop-Loss
Administrative Fund
Cross Share Fund
Aggregate Stop-Loss
3%
18%
79%
1010
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PROPRIETARY AND CONFIDENTIAL
Historical Performance – Surplus
Plan Year Net Surplus Returned
2010-11 $77,511
2011-12 $646,194
2012-13 $451, 971
2013-14 $645,581
2014-15 $1,244,747
2015-16 $1,050,503
2016-17 $2,342,727
2017-18 $3,503,995
2018-19 $3,053,175
2019-20 *Not final $5,018,109
Cumulative Total $13,016,404
Over $13 million in surplus returned since inception!
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10 Years of Exceptional
Performance
• 99% Retention Rate
• Stable Rate Renewals
• Full Transparency on All Costs
• Local Control with LGIT Board of Trustees
• Key Partnerships with: MACO, MML, MCCMA, Mayors
Association
• Outstanding Customer Service & Account Management
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What the LGIT Health Members Are Saying…
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What the LGIT Health Members Are Saying…
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PSA Insurance & Financial Services
PSA has become a broker partner to market the LGIT Health program.
PSA is the Mid Atlantic region’s leading independent insurance
brokerage and risk management firm, providing employee benefits, risk
management and personal insurance solutions. PSA has been assisting
clients in growing and protecting their assets since 1928. With their vast
knowledge, experience and resources, they can provide national-caliber
capabilities with local service.
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#1 rated health plan for ease of doing business with health care professionals
#1 NCQA HEDIS clinical results for 14 consecutive years
#1 rated on overall trust index in national provider survey
#
Disease
Management
Program
Cigna Your
Health First
Digital
Innovation
• mycigna.com
• Cigna mobile
app
• Cigna One
Guide
24/7/365
Live
Customer
Service
Broad Network
Access
to meet access,
cost & quality
needs
Integrated
Experience
Medical, Rx,
Dental,
Behavioral,
Disability,
Vision
Employee
Assistance
Program
(EAP)
Improving
overall well-
being
80% of Cigna business is ASO
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Kaiser Permanente is now offered to new LGIT Health members
effective July 1, 2020.
Founded in 1945, Kaiser Permanente is recognized as one of
America’s leading health care providers and not-for-profit health plans.
Kaiser currently serves 12.4 million members in 8 states and the
District of Columbia.
Care for members and patients is focused on their total health and
guided by their personal Permanente Medical Group physicians,
specialists, and team of caregivers. Our expert and caring medical
teams are empowered and supported by industry-leading technology
advances and tools for health promotion, disease prevention, state-of-
the-art care delivery, and world-class chronic disease management.
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Fred Bean, VP Program Management
Questions?
Mark Kunkle, Director Program Management
Kate Lobley, Senior Account Manager
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Employee Benefits ▪ HR Consulting ▪ Commercial Insurance ▪ Risk Management ▪ Personal Insurance
PSA & LGIT HealthA New Partnership
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About PSA
Est 1928
Maryland Based Privately Held/Independent
One of the largest employee benefit practices in the region
National Caliber Capabilities with Local Service
98% Client Retention
165+ Employees
Locations
Hunt Valley
Rockville
Snow Hill
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Programs like LGIT Health Gaining in Popularity
Why?
Employers seeking more transparency than available in traditional insured programs
Fatigued with “trend” increases
Want opportunity to benefit from good plan performance
Seeking rate stability, predictability
Want fairness and insight into how rates are developed
LGIT Health provides these features!!!
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Our Process
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The Process
• Help you learn about the LGIT Health Program
• Information gathering
• PSA conducts an Overview & Analysis
• Presentation of LGIT Health proposal and findings of PSA’s analysis
• Comparison versus your current programs
• Review of additional services that come with the PSA relationship
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Making it clear what PSA does
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Our Capabilities
CUSTOMIZED COMMUNICATION & OPEN ENROLLMENT
SUPPORT
CLIENT ADVOCATE
TEAM
HEALTH RISK MANAGEMENT COMPLIANCE
EXPERTISE
HRIS CONSULTING
DISCIPLINED CONSULTING
PROCESS
OUTSOURCED HUMAN
RESOURCES
EXPERIENCED CLIENT
MANAGER
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Directing Our PerformanceYour Client Manager
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Your PSA Team
Executive Level
Management
An expert team of professionals becomes an extension of your
Human Resources team
Employees &
Dependents
LGIT Health Member Municipality
Regulatory Compliance
Dedicated Client
Advocate
Client Service
Benefit Consultant
Strategic Planning
Employee Benefits
Advisor
Relationship Mgr.
Benefit Analyst (BA)
Team
Financial Analysis
Client Advocate Team
Member Service
Employee
Communications Team Employee Education & Communication
Dedicated Nurse
Health Risk Management
Clinical Team
Clinical Support
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Ongoing Meetings
Stewardship
•Focusing on metrics and reporting for the plan year that just ended and a recap of historical performance
•Year in review plan history
•Identify/confirm strategic objectives
Claims Utilization & Compliance
•Review claims cost and utilization from prior year
•Plan documents
•Form 5500
•Strategic planning
•Management reporting update
Pre-Renewal
•Revisions to strategic plan
•Management reporting update
•Benchmarking
•RFP planning
•Renewal planning
Renewal
• Renewal results
•Open enrollment planning
•HRIS updates
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Sample Renewal Timeline & Calendar
Task Responsible PartyTarget Completion
Date
Stewardship and Strategic Planning Meeting PSA/Client 8/2/2018
Pre-Renewal Meeting PSA/Client 2/28/2019
Renewal Meeting - Present final proposal results & plan options to Group PSA/Client 3/25/2019
Finalize outstanding questions, rates, and plan designs PSA 4/1/2019
Finalize contribution structure/contribution rates - all plans PSA/Client 4/1/2019
Final decisions for benefit plans, carriers and contributions Client 4/4/2019
Notify awarded carrier/vendor(s) of final plans selected PSA 4/5/2019
Plan Implementation(s) Begin PSA/Client/Carrier(s) 4/5/2019
BenAdmin Implementation for 2019 PSA/Client/BL 4/12/2019
Open Enrollment Knovio & Benefit Guide draft(s) provided to Group for review PSA 4/17/2019
Open Enrollment Knovio & Benefit Guide draft(s) feedback provided Client 4/18/2019
Open Enrollment Knovio & Benefit Guide draft(s) provided to Group for 2nd review PSA 4/22/2019
BenAdmin rate template completed PSA 4/22/2019
Final approval of Brainshark and Benefit Guide from Group Client 4/22/2019
Benefit Guides printed PSA 4/24/2019
Benefit Guide delivered to the Group PSA 4/29/2019
Open Enrollment Begins Client 5/6/2019
Define Enrollment Meetings / Webinars PSA/Client TBD
Open Enrollment Ends Client 5/20/2019
Review/Audit of Open Enrollment election file(s) Client/Administrator 5/24/2019
Plan election files sent to carriers Client/TPA 6/3/2019
ID cards sent/received by all enrolled employees and members Carrier 7/1/2019
Effective Date of All Plans All Parties 7/1/2019
Contracts and Certificates of Coverage Carrier 7/31/2019
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Health Risk Management
Economic Result• Better insight on plan
performance = more targeted consulting strategies
• More high-risk members connected and engaged with carrier care management
Economic Result• Fewer high claims
• Lower increases
Health Risk Management
+DATA
ANALYTICSCLINICAL NURSEINTERVENTION
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Wellness Strategy Development
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Compliance Support
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Compliance Services
Dedicated Compliance Services Department
• Focused solely on Federal & State Laws that impact employee benefit plans
• Unlimited access to PSA’s team of Compliance Specialists
Supported by outside counsel
REVIEW AND DISCOVERY
ONGOING MAINTENANCE
• Compliance Review
• Contract Review
• Eligibility Rules
• Plan & Wrap Documents
• Required Notices
• Unlimited Research / Compliance Guidance
• Healthcare Reform
• Legislation & Regulatory
CHANGES
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Compliance Services
New legislation demands will require enhanced compliance oversight, and with all the changes brought on by health care reform, you may be feeling overwhelmed by the additional responsibilities. Take a deep breath—we can help.
We have the resources you need to keep you ahead of the curve.
• Compliance Services team (in-house)
• Annual Compliance Calendar
• ERISA Compliance Checklist
• ACA Checkup
• Seminars & Webinars
• “Benefit Minute”—monthly e-newsletter
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2018 Compliance Calendar
Ongoing for New Hires
• Exchange Notice (all new hires within 14 days)
• Ongoing measuring of new hires who are not FT
• SBC and required federal notices with enrollment materials to newly eligible employees
• Medicare Part D creditable/non-creditable notice to new enrollees
• Initial COBRA notice to new enrollees
• HIPAA privacy notice to new enrollees
• SPD (within 90 days of eligibility)
January Jan. 1 Benefits Plan Year Begins Jan. 31 Issue W-2s that include cost of health coverage
February Feb. 28 CMS online Creditable Coverage due Receipt/review of Plan Year contracts
March Mar. 1 Issue Form1095-C to Full Time Employees Mar. 31 1094-C transmittal due to IRS Review SPD, Update and Distribute
April Schedule A & employer information collected for Form 5500
May
June Prepare Form 5500 for submission
July July 31 File Form 5500 for welfare plan or extend July 31 File Form 720 & pay PCORI fee for prior plan year
August
September Sept. 14 SARs distributed to employees unless 5500 extended Confirm creditable/non-creditable status of all Rx plans for upcoming plan year
October Oct. 15 Medicare D Creditable Coverage Notice Due Oct. 15 Form 5500 due if extension filed
November Open Enrollment including distribution of SBCs and required federal notices
December Dec. 15 SAR distribution deadline to employees if 5500 extended Make sure all plan amendments completed for all plans
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Payroll, HRIS, and Benefits Platforms
• Seasoned team with exceptional depth of resources
• Platform agnostic
• Needs assessment and analysis of various solutionso Benefits Administration
o Integrated Payroll and Benefits Administration
o FSA, HSA, HRA, and COBRA
• Assist with set up & testing of enrollment portal
• Communicate annual plan changes to technology vendor
Helping our clients with the right solution
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Employee Advocacy Unit
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Client Advocate Support UnitThink of PSA as your benefits help desk. All employees and their dependents have access to our in-house Client Advocate Team (“Benefits Hotline”).
Employee & Dependents
• Open Enrollment
• Claims Disputes
• Coverage Issues
• Billing Payables
• Appeals
• Clinical Advocate
Human Resources Department
• Allows you to focus on strategic initiatives
HUMAN RESOURCES DEPARTMENT
EMPLOYEE & DEPENDENTSCustomized email address
Toll-free line
Dedicated Client Service & Employee Contact
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Sample Benefit Hotline ReportsQ4
Q2
Q1
Q3
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Employees drowning in a sea of
Insurance-eseCommunications Support
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Branded Employee Communication
Core Services include :
• Benefit Guide
• Benefits Overview Presentation
• Access to “Benefits 101” education
https://indd.adobe.com/view/8e6c8935-6950-44ce-841e-a4760e29f6f4
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“Benefits 101” EducationAdding more value to employee education
Short, educational videos on a variety of topics.
Links integrated into other printed/electronic communications.
Understanding Medical Termshttps://kvgo.com/psa/MedicalTerms101
Ways to Savehttps://kvgo.com/psa/WaystoSave101
What is Open Enrollment?https://kvgo.com/psa/OpenEnrollment101
Qualified Life Eventshttps://kvgo.com/psa/Change-in-Status101
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Open Enrollment Assistance
• Plan and coordinate open enrollment meetings
• Prepare open enrollment materials
• Develop Open enrollment presentation
• Conduct Open enrollment meetings via webinar or in person when safe
• Handle all employee calls, questions about open enrollment
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• Employee Disconnect
o Compensation includes much more than salary
o Without awareness, no appreciation
• Complete Picture
o Help employee understand value of non-cash compensation
o Improve retention by creating level playing field with competitors
Added fee for Outsourced HR Services*Data from Bureau of Labor Statistics. 3/10/16 release
Total Compensation Statements—The Purpose
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HRAssistLow Fixed Monthly Payment
Affordable option to alleviate the admin burden of understaffed HR teams.
• Dedicated HR Consultant/ Team Support• Needs Assessment and Project Plan• Monthly Calls• Block of HR Consultation• Access to Employment Attorney• Online Tools/ Templates/ Resources
Outsourced HR Support
We help our client’s existing “HR personnel” by providing the resources and expertise to fill gaps.
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• Innovative program for achieving costs control and stability
• High quality carrier partners Cigna and Kaiser
• Allows Kaiser offering with Cigna to members who would be unable to offer the choice
• Comprehensive scope of services provided by PSA
• Highly experienced team
• Extension of your HR department
• Focused on plan performance & utilizing all carrier resources
• Deep Health Care Reform & compliance capabilities
• National firm capabilities with local high touch delivery & accountability
• HR/Benefits Technology Support
Why LGIT Health & PSA
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Questions?
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CIGNA HEALTHY WAYS TO WORK
SM
Workplace Clearance Tool
946752
Offered by Cigna Health and Life Insurance Company or its affiliates
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WORKPLACE HEALTH AND SAFETY
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More than 85% of employers
are planning new workforce
health and office safety
measures, ranging from
new site entry policies to
supplying masks, testing and
(when ready) vaccinations1.
Address workplace readiness and employee concerns
Determine physical worksite entry procedures and screening protocol
Provide reliable COVID-19 related information
Monitor site-specific population health and geographic risk
Provide testing and, as available, vaccines
Support those who get ill through recovery
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
1. The Conference Board (2020), “From Immediate Responses to Planning for the Reimagined Workforce.”
https://conference-board.org/pdfdownload.cfm?masterProductID=20874
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ADDRESSING EMPLOYEE CONCERNS
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Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
SA
FE
70% of workers list concerns about returning to work,
with 51% citing fear of getting sick as their main worry.1
SIM
PL
E
3 in 4 people are willing to participate in daily health checks
but are worried about the extra time and effort required.2
CO
MP
LE
TE
Workers want expanded access to resources,
such as support managing stress, health coaching
and wellness services.2
1. Carucci, R. (6 June 2020). “How to prepare yourself for a return to the office.” Harvard Business Review.
2. M/A/R/C Research & Cigna Global Market Research and Insights (2020, May). COVID-19’s Impact on
Healthcare Attitudes and Practices Wave 2
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WHO IS BUOY HEALTH?
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Web-based, AI-powered health tools to help people figure out what to do when they get sick —and guide them to the right care.
Digital health company developed out of
the Harvard Innovation Labs by doctors
and data-scientists and dedicated to:
Providing personalized clinical support
through technology, the moment someone
has a healthcare concern
Helping to remove fear and complexity that often
confronts people entering the healthcare system
by helping them navigate care
Delivering triage at scale and with transparency,
connecting individuals with the right care endpoints
— at the right time
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
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One-time installation fee:
$5,000 one-time implementation fee
Monthly fee:
$450 monthly fee
(includes up to 360 users)
$1.25 per user per month
for each user over 360
PRICING AND FEE STRUCTURE
PER CLIENT
EXAMPLE
Client with 300 users per
month will pay $450/month
Client with 600 users per
month will pay $750/month
300users
600users
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
Optional service funds (such as wellness funds or communications funds) can be used.
Any customizations will be priced separately.
A “user” is one who completes a minimum of one complete flow through the Buoy product in a calendar month.
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DIGITAL CLEARANCE TOOLS FOR THE WORKPLACE
53
Powered by
Employee answers a brief questionnaire to assess symptoms and exposure.*
READY
Employee receives
a digital pass that
can be scanned or
shown for site entry.
NOT READYEmployee is
instructed
to stay home.
Within the tool,
she can find
resources to
understand her
risk profile and
easily search for a
nearby testing center
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
*Employees are evaluated on items such as exposure, symptoms, testing
results and/or occupational and activity risk amongst other criteria.
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MAKING INFORMED,
WORKPLACE-SPECIFIC DECISIONS
54
Get daily reporting to understand infection
rate shifts and make more informed decisions*
View employee status in real-time
Aggregated view of clearance by date,
time and location
Clearance status by risk category
*Data is aggregated and cannot be de-identified without the employee’s express and written consent.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
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MOVING FORWARD AS SAFELY
AND SECURELY AS POSSIBLE
55
A digital platform that gives employers:
An efficient, daily screener to automate site entry
A readily available marketing toolkit to educate
employees and reduce work for HR managers
Accurate, regularly updated clinical rules to ensure
you are using up-to-date CDC guidance
Real-time analytics to enable workplace- and
location-specific decisions
Targeted access, employee access for onsite workers only
REOPEN AND REMAIN OPEN.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
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FULL LAUNCH & OperationsSOFT LAUNCHEVANGELIST
TRAININGCREATION
56
IMPLEMENTATION
DISCOVERY
ROLLOUT ONGOING
• Employer
playbook
• Discovery
Checklist
• Back With CareTM
URL Delivery
• Client procedures
• Employee
communications
• Employer training
• Initial user feedback
• Updated procedures
and communications
if needed
• Launch with initial
work site!
• Access to Back With CareTM Real-Time
Dashboard
• Daily Back With CareTM trend reporting
via email
• Buoy Product and Feature Updates
• End User Helpdesk Support to
employees ([email protected])
Contact your Cigna sales representative to start a short set up process*.
Cigna will work with you to kick off the implementation process.
*In some cases a longer implementation timeline may be required if you would like to configure the care resources available
for your employees within the Back With CareTM experience.
IMPLEMENTATION MAP
Early adopters – Process begins early August
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
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57
All pictures are for illustrative purposes only.
Buoy is a trademark of Buoy Health, Inc. The Buoy website is operated by Buoy Health, Inc. Buoy Health’s services are not intended to be a substitute for professional
medical advice, diagnosis or treatment. Your use of the services is voluntary and subject to Buoy Health’s terms of service and privacy policy. In a true emergency, don't
wait. Call ahead to your nearest emergency room or call 911.
Product availability may vary by location and is subject to change.
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation including Cigna Health and Life Insurance Company
(CHLIC) or its affiliates.
946752 07/20 © 2020 Cigna. Some content provided under license.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna
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A BETTER WAY to take care of business
kp.org/choosebetter
LGIT Annual Meeting
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A BETTER WAY to take care of business
59
New Insurance Option for LGIT Health Plan
KP LGIT Health Plan
▪ Municipalities not currently enrolled in the LGIT program will have the opportunity to join LGIT Health Plan with Cigna and Kaiser Permanente.
▪ This opportunity is usually afforded to Counties and the State but is now available to all municipalities with over 50 FTEs
▪ Offers choice between four low cost Kaiser Permanente HMO options at preset rates combined with a self-funded option through LGIT with Cigna as the main insurer.
▪ The best of both worlds where it allows municipalities achieve maximum financial efficiency and offer choice to their employees.
▪ Members can switch plans and insurers during yearly open enrollment (Cigna to Kaiser, Kaiser to Cigna, Kaiser to Kaiser, Cigna to Cigna).
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A BETTER WAY to take care of business
60
New Insurance Option for LGIT Health Plan
KP LGIT Health Plan
▪ Quoting will be available through PSA Financial and Benecon (plan
administrator).
▪ Benecon will be responsible for the set up of the billing and enrollment
process (adding, deleting members, etc).
▪ Benecon will receive the enrollment file and forward Kaiser Permanente
its segment of membership.
▪ Over 150,000+ Government, Municipality, and County employees
already call Kaiser Permanente their Health Plan of Choice.
▪ Kaiser Permanente is the Ranked #1 HMO in the region. LGIT has a
proven track record of savings and service.
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A BETTER WAY to take care of business
61
Kaiser Permanente in the Mid-AtlanticKaiser Permanente offers our members superior quality, market-leading convenience, and highly coordinated care through an Integrated Care Delivery Model.
KP Medical Service Area
• Most US health care is fee for service
driven and disjointed
• KP care & coverage work cooperatively
• Medical data, workflows, population
mgmt. tools are fully integrated via the
world’s largest civilian EHR system:▪ Makes resources more accessible
▪ Engages patients in self care
▪ Identifies problems early
▪ Avoids care gaps
▪ Prevents medical errors
▪ Reduces waste
▪ Corrects inefficiencies
▪ Lowers costs
▪ Improves patient outcomes
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A BETTER WAY to take care of business
62
Kaiser Permanente in the Mid-AtlanticWith the largest multi-specialty physician group practice in the region, supported by state-of-the-art technology, Kaiser Permanente offers our members superior quality, market-leading convenience, and highly coordinated care.
Fast facts:
▪ Located in the District of Columbia, Maryland
and Virginia
▪ Over 785,000 members
▪ More than 1,700 Mid-Atlantic Permanente
Medical Group physicians
▪ Over 10,000 employees
▪ 34 medical facilities (Five Hubs)
▪ 24 hours / 7 days / 365 days care available
▪ Fully supported by Comprehensive EMR
KP Medical Service Area
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A BETTER WAY to take care of business
63
We Are #1 In Quality Patient Outcomes
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A BETTER WAY to take care of business
64
Chart Note: NCQA’s Private Health Insurance Plan Ratings 2017-2018; NCQA’s Medicare Health Insurance Plan Ratings 2017-2018
Highest in Healthcare Quality Rankings
What the Experts Say About KP
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A BETTER WAY to take care of business
65
Our Medical Group now covers over 52 medical and
surgical specialties
1,732 physicians
Over 1,100 board-eligible / board-certified physicians
have joined us since the beginning of 2009
Physicians recognized
in the November 2019
“Top Doctors” issue
Physicians recognized
in the February 2019
“Top Doctors” issue
Physicians recognized
in the November 2019
“Top Doctors” issue
169 199 37Northern Virginia Magazine Washingtonian Magazine Baltimore Magazine
How KP Physicians Measure Up
Hiring & Retaining Top Physicians
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A BETTER WAY to take care of business
66
Plan Options that Give Employers Choice
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A BETTER WAY to take care of business
HMO DHMO HDHP POS
Description
A plan that covers care
provided by in-network
physicians, with
predictable copays and
out-of-pocket
maximums.
An HMO plan that
shares costs between
the employer and
employees and offers
lower premiums.
A plan with a higher
deductible than a
traditional insurance
plan. The monthly
premium is usually
lower, but you pay more
health care costs before
the insurance company
starts to pay its share.
A plan that offers point-
of-service (POS) care,
with the option of
choosing physicians and
services from an
external provider
network.
Employee
Advantage
+ Lower out-of-pocket
costs
+ Care coordinated by a
primary care
physician
+ Lower premiums than
regular HMO plans
+ Care coordinated by a
primary care
physician
+ Lower premiums
+ Pre-tax funds can be
used for expenses when
combined with an HSA.
+ Broader choice of
primary care physicians
Out-of-network
coverage
No
(except for
emergencies)
No
(except for
emergencies)
Yes
But at a higher cost
Yes
But at a higher cost
Annual deductible
No Yes Yes No
(for in-network
coverage)
Copays
Yes
($0 copay child under 5)
Yes
($0 copay child under 5)
No
after deductible is meet
Yes
(for in-network
coverage)
($0 copay child under 5)
67
KP Product Categories
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A BETTER WAY to take care of business
Technology Turbocharges our Care
The Power of Technology
Every provider in the Kaiser
Permanente Medical Group is
connected to each other and
to the world’s largest
civilian electronic health
records system. This allows
our physicians up-to-date
information on members’ care,
the ability to study data from
more than 9 million records
to detect signs of emerging
chronic conditions, and access
innovative population health
management tools.
This connectivity means
faster, better-informed
decisions from physicians
and better treatment paths for
you.
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A BETTER WAY to take care of business
69
▪ From any computer with an internet connection, or Smartphone (via an iPhone or Android app), at any time of day or night, Kaiser Permanente members can:
• View their own medical record, all visits
• Securely email their Permanente Doctor
• Schedule appointments
• Fill prescriptions (free home delivery)
• View lab test results
• Print immunization records
• Review their list of medications
▪ Nationwide, millions of Kaiser Permanente members are using this convenient, time-saving technology.
Mobile and Virtual Care
KP Mobile Medicine
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A BETTER WAY to take care of business
70
Empowering Wellness as a Business Strategy
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A BETTER WAY to take care of business
Kaiser Permanente Workforce Health Value AddOur effective workforce health programs can help protect your business
from the rising costs of health care.
Workplace challenges
▪ Physical activity programs
▪ Other Team Challenge programs
Motivational tools
▪ Comprehensive Rewards Program
➢ Health Engagement Platform
▪ Custom communications
Measurement tools
▪ Reporting and analytics
▪ Assessments and evaluations
Consultative services
▪ Workforce Health consulting
▪ Team of health promotion professionals
Onsite services
▪ Health promotion classes
▪ Health screenings
▪ Flu clinics
▪ Healthy Picks vending machine program
▪ The FruitGuys delivery program
Digital and Telephonic
▪ Total Health Assessment
▪ Healthy Lifestyle Programs
▪ Wellness Coaching by Phone
▪ 24/7 access via KP.org
▪ 24/7 Access via video visits
Healthcare as a Business Strategy
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A BETTER WAY to take care of business
Tools and resources for members
kp.org: A hub for managing health
Total Health Assessment
Health and drug encyclopedias
Symptom checker
Healthy lifestyle programs
Health videos
Total Health Radio online radio show
and podcast
Healthcare as a Business Strategy
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A BETTER WAY to take care of business
kp.org/choosebetter © Kaiser Permanente 2014. All Rights Reserved.
Thank YouEnjoy the Remainder of the Meeting
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Mark Kunkle, Director Program Management
Questions?
Andrew Belmear, Senior Account Manager [email protected]
Michele Keplinger, Communications and Member Services Manager
Kenneth Huber, Executive Vice President,
Employee Benefit Group
Kyle Sanders, Senior Sales Executive