Health Connector for Business (HCB) CY 2019 ReviewHEATHER CLORAN DILORENZO Director of Health Plans and Operations

CASEY ALEXANDERHealth Plans and Operations Manager

Health Connector Board of Directors MeetingFebruary 13, 2020

2

System change to make

experience faster and

simpler

ENHANCEMENTS

76% of new members are the result of a

broker sale

BROKERS

59% of new members are in a choice model

CHOICE

127% more membership

growth compared to

2018

GROWTH

Health Connector for Business experienced significant membership growth, continued market interest in choice models, improved broker partnerships, and developed tools to enhance the customer experience.

Health Connector for Business:Year in Review - 2019

Membership Growth

4

Through January of 2020, Health Connector for Business membership grew by 36 percent since January of 2019.

Health Membership Growth

5

This slide compares 2018 to 2019 sales, reflecting a 127 percent increase in sales year to year.

HCB new medical sales for CY2019 reflect 372 groups and 2,135 members, reflecting a 127 percent increase compared to CY2018 new sales.

Health New Sales: CY 2018 vs. CY2019

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Source: Aggregate Health Connector for Business Monthly Welcome Survey Data, January 2018-January 2020, reflecting 61 groups.

(48%)

(52%)

0

5

10

15

20

25

30

35

No Yes

Did you offer coverage before signing up with the Health Connector for Business?

Results reflect aggregate data from the HCB welcome surveys

A robust employer survey is planned for 2020

Nearly half of new groups indicate they did not offer coverage to their employees prior to enrolling through HCB.

New Groups: Offer of Prior Coverage

7

0

10

20

30

40

50

60

Top 10 IndustriesNew Sales by the Choice Model Year 2019

One Plan

One Carrier

One Level

5550

3125 24 24

19 1715 13

Although the platform serves a wide array of industries, construction and business services are the highest share of new groups.

Top 10 Industries: New Group Sales 2019

8*Tufts Premier joined the HCB platform for new sales beginning in April 2019.

AllWays Health Partners17%

BCBSMA8%

BMC HealthNet Plan6%

Fallon Health3%

Harvard Pilgrim Health Care14%

Health New England3%

Tufts Direct42%

Tufts Premier7% UnitedHealthcare

0%

Overall Membership by Carrier

AllWays Health Partners7%

BCBSMA8%

BMC HealthNet Plan6%

Fallon Health2%

Harvard Pilgrim Health Care3%

Health New England3%

Tufts Direct56%

Tufts Premier14%

UnitedHealthcare1%

2019 New Sales Membership by Carrier

Carrier enrollment on the HCB platform differs from the dynamics seen on the off-Exchange small group market and varies between new and existing groups.

Carrier Enrollment CY 2019

9

Source: CHIA Enrollment Trends August 2019 Databook. Data from March 2019. http://www.chiamass.gov/enrollment-in-health-insurance/. Excludes carriers with negligible enrollment.

37%

24%

15%

9%6%

4% 4%0% 0%

4%

9% 9%

55%

0%2%

5%2%

13%

0%

10%

20%

30%

40%

50%

60%

Tufts Direct AllWays HPHC BCBSMA BMCHP Fallon HNE United TuftsPremier

2019 Small Group Enrollment On- and Off-Exchange

Health Connector for Business Non-Health Connector for Business

Tufts Direct and AllWaysHealth Partners are the most popular small group options on-Exchange (36.5% and 24.3%, respectively)

BCBSMA is the most popular small group option off-Exchange (55%)

BMCHP almost exclusively sells small group coverage on-Exchange

On-Exchange shoppers are more likely to select a Tufts Direct plan than off-Exchange shoppers

On-Exchange small group enrollees’ plan selections differ substantially from those chosen by off-Exchange shoppers.

Small Group 2019 Plan Choices

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Source: HPC Cost Trends Report (2019), Kaiser Family Foundation analysis of premium data from healthcare.gov (marketplace premiums 2014-2019); Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey (MEPS), (commercial premiums 2013-2018), Health Connector enrollment data.Notes: U.S. data includes Massachusetts. Employer premiums are averages based on a large sample of employers within each state. Exchange data represent the weighted average annual premium for the second-lowest silver (Benchmark) plan based on county-level data in each state as well as a measure for all CCA non-group premium average. Exchange premiums grew in 2018 partly due to the discontinuation of cost-sharing reduction subsidies by the federal government. Health Connector for Business data represents average premiums for single coverage sold on-exchange.

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

2013 2014 2015 2016 2017 2018 2019

MA Small Groups

US Small Groups

MA Exchange Benchmark Plan

US Exchange Benchmark Plan

HCB, All Groups

HCB New Groups

CCA Non-Group Average

Annual Average Premiums for Single Coverage in the Employer Market and Average Premiums in the ACA Exchanges, MA and the U.S., 2013-2019 The Health Connector offers

the lowest average premiums of any Exchange in the nation

Still, Massachusetts has among the highest premiums in employer markets, particularly for small employers

Employers shopping through the Health Connector realize savings by enrolling in plans historically more popular with non-group members

The Health Connector’s low premiums are available to small employers who shop through the Health Connector for Business platform.

Health Connector Premiums vs. State and National Insurance Market Premiums

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84%

12%

4%

Existing Groups

Group Size 1-5

Group Size 6-10

Group Size 11+60%

24%

16%

2019 New Sales Groups

Group Size 1-5

Group Size 6-10

Group Size 11+

Although “micro-groups” continue to be the majority of sales, newer groups are larger than existing groups, demonstrating a wider penetration across the entire small group market.

Average Group Size: New Sales vs. Renewals

12

Health Connector for Business dental plans are now all on the same online platform with health plans. HCB dental membership has grown throughout CY2019 by 30 percent.

Dental Membership Growth

Value of Choice Models

14

One Carrier18%

One Level19%

One Plan63%

Overall Membership by Plan Offering

One Carrier26%

One Level33%

One Plan41%

2019 New Sales Membership by Plan Offering

59 percent of new members are enrolled in a Choice Model, while 37 percent of total membership is in a choice model.

Choice Models: Enrollment CY2019

15

57%

43%

Overall Employee Plan Selection - CY2019

Reference Plan Other Plan

Of the members enrolled in a Choice Model, a significant portion of members selected a plan that differed from the plan chosen by the employer.

Choice Models: Reference Plan CY2019

Broker Engagement

17Brokered

76%

Non-Brokered24%

2019 New Sale Members by Broker Status

259

433

0

100

200

300

400

500

Jan 19 Dec 19

Grou

ps

Total Brokered Groups CY 2019

67% increase47% increase

220

323

0

50

100

150

200

250

300

350

Jan 19 Dec 19

Brok

ers

Certified Brokers CY 2019

Brokers continue to be a leading partner in driving new membership. Broker certifications and sales increased significantly in 2019. By the end of 2019, 43 percent of total membership and 76 percent of new sales membership was a result of a broker sale.

HCB Broker Engagement

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Broker Appreciation Breakfasts

• Two events held in June and November

• First event held in eastern Massachusetts, Newton, and the second event was in central Massachusetts, Westborough

• Events focused on policy, HCB updates, and broker partner presentations

• Approximately 80 brokers attended

Certification/Refresher Trainings

• 49 in-person trainings and 88 webinar trainings

Broker Partnered Presentations

• Facilitated eight local Chamber of Commerce focused presentations held across the state in collaboration with certified broker and HCB team

Broker Trade Associations

• Sponsored MassAhu’s (Massachusetts Association of Health Underwriters) annual Benefest and participated in NEEBC’s (New England Employee Benefits Council) annual Health Insurance Market Outlook event

HCB Broker Engagement

19

LOW COST CARRIER OPTIONS35%

CONNECTWELL70%

FLEXIBLE CHOICE 75%

In the Summer of 2019, in-depth interviews were conducted with 20 registered brokers for feedback on the platform. Brokers provided an array of feedback including the reasons why they choose to use the Health Connector compared to other distribution channels.

HCB Broker Engagement

System Enhancements

21

CY 2018: 29 Paid Out Rebates

CY 2019: 107 Paid Out Rebates

System and program enhancements:

• Groups are automatically enrolled in the program

• Targeted awareness campaign to employers, employees, and brokers aimed to increase participation

• No account creation for employees

• Redesigned incentive program requiring employee completion of an activity focused on mental, physical, and financial health

In January 2019, the Health Connector relaunched a streamlined wellness program aimed to increase participation.

Improved Wellness Platform: ConnectWell

22

Launched in November 2019, a new anonymous quoting tool allows employers and brokers to get quick, easy quotes. By entering minimal information, employers can see quotes from all health and dental plans.

Employer Quick Quote

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In December 2019, Health Connector for Business launched an improved payment portal for employers to make automatic monthly payments, easily monitor balances owed, and review enrollment changes directly from their online account.

Employer Payment Portal

What’s Next?

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“I can just go in, select a base plan, and my employees can go in and select whatever plan they want.”

Alex JongOwner, Levend Bagelry

Conduct formal small group surveys Develop creative outreach campaigns

to promote awareness Explore further system enhancements

for members and carriers Deepen relationships within in the

broker community Continue to draw attention to HCB’s

opportunities for savings and affordability for Massachusetts small employers Continue to strengthen partnerships

with community and small business organizations

What’s next for 2020?

Appendix

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* Groups size is defined by number of enrolled employees/subscribers

Choice Model by Group Size: CY 2019

28

* Groups size is defined by number of enrolled employees/subscribers

Carrier Choice by Group Size: CY 2019

29*there is a large number of “other” because the system functionality to capture referred by status was deployed to the platform post go-live. Any business that created an accounted prior to the functionality were assigned to “other”

Referred By Status: 2019 New Sales

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Organizations and Event Partners

A Maven's WorldCorridor 9/495 Regional Chamber of Commerce

Massachusetts Association of Chamber of Commerce Executives SCORE Woostapreneurs Forum

Assabet Valley Chamber Enterprise BankMassachusetts Small Business Development Center Network

Small Biz Helper / Community Collaborative Course Worcester Business Journal

Associated Subcontractors of MAEnterprise Center at Salem State University MASSAHU Small Business Administration

Worcester Regional Chamber of Commerce

Auburn Chamber of CommerceGreater Boston Chamber of Commerce Melrose Chamber of Commerce SPACES Newbury Worcester SCORE

Black Economic Council of MA Greater Gardner and North Quabbin Chambers of Commerce

Merrimack Valley Chamber of Commerce

Sustainable Business Network of Massachusetts Workbar

Blackstone Valley Chamber of Commerce

Greater Holyoke Chamber of Commerce Metro South Chamber of Commerce

The Greater Merrimack Valley Human Resource Association

Cambridge Innovation CenterGreater Hyannis Chamber of Commerce

Nashoba Valley Chamber of Commerce

The Massachusetts Conference for Women

Cape Ann Chamber of Commerce

Greater Lowell Chamber Commerce and Nashoba Valley Chamber of Commerce New England Business Association The Small Business Expo

Center for Women & Enterprise Greentown LabsNew England Employee Benefits Council Tri-Town Chamber of Commerce

Center for Women and Enterprise Inner City Capital Connections NGIN Workspace Union Square Main Streets

Chamber of Central MA SouthLawyer's Committee for Civil Rights and Economic Justice North Shore Chamber of Commerce

United Regional Chamber of Commerce

CIC Boston Lowell Chamber of CommerceNorthampton Chamber of Commerce US Haitian Chamber of Commerce

City Councilor-at-Large Annisa Essaibi George MA Office of Business Development Northeast HR Association Venture Café Wellness Night

City of SommervilleMarlborough Chamber of Commerce Plymouth Chamber of Commerce Wakefield Chamber

Community Health Center of Franklin County Mass Nonprofit Network Roslindale Business Group Western MA SCORE Chapter

We have participated in or hosted a minimum of at least one event with the following organizations across the Commonwealth.

Community and Business Collaborations