healthcare consumerism solutions nov/dec 2013

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ISSUE || November/December 2013

IHC FORUM West Official Show Issue December 5-6, 2013

www.theihcc.com

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INSIDE:

The History of Health Savings

AccountsCommemorating the

10th Anniversary

Looking to the Future of HSAsWith Roy Ramthun, Bill Sweetnam,

Mike Parkinson, Kirk Hoewisch, John Young and Others

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Feature

COMING UP NEXT:

www.TheIHCC.com I HealthCare Consumerism Solutions™ I November/December 2013 3

I N S I D EFEATURES

I N S I D E

The Institute for HealthCare Consumerism Launches Magazine SupplementHealthCare Exchange Solutions

HealthCare Exchange Solutions helps you understand the choices in the health and benefit marketplace and make the best decisions

among a complicated array of exchange solutions options.

COMING UP NEXT: January 1, 2014 is the next major milestone for the implementation of the Affordable Care Act. Although the employer mandate has been delayed until 2015 and the individual mandate appears to have been pushed back to April 2014, many provisions will still go into effect on January 1. In the January/February issue of HealthCare Consumerism Solutions, we will review the recently passed compliance deadline and look forward to future milestones in 2015 and beyond.

35 The History of Health Savings Accounts: Commemorating the 10th Anniversary and Looking to the Future

December 8, 2013 will mark the 10th anniversary of health savings accounts (HSAs). In telling the story of health savings accounts, decades-long arguments on solutions to our broken health system inevitably arise. With current debates swirling around the chaotic implementation of the Affordable Care Act, the history of HSAs (and their precursor, medical savings accounts) sits at the heart of the free-market solution to health care reform.

To commemorate the 10th anniversary of HSAs, I’ve connected with many influential figures in the history of health savings accounts and asked them to tell their part of the story. Special thanks to Roy Ramthun, Ron Bachman, Bill Sweetnam, Beverly Gossage, Mike Parkinson, Kirk Hoewisch and John Young for their assistance in telling this history of health savings accounts.

By Jonathan Field, Managing Editor, The Institute for HealthCare Consumerism

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6 Publisher’s Letter

9 Briefs & InnovationsIntroducing Virgin Pulse: Virgin HealthMiles Rebrands with New MissionAflac Updates Lump Sum Critical Illness PlanWellero Launches Mobile Payment ApplicationWiserTogether Names Steven Eno as Vice President of Marketing

11 FORUM West Preview

14 What’s Happening at the Institute?

15 Stats & DataBenchmarking Data Crucial as Employers Re-Examine HRAs and HSAs

By Thomas Mangan, CEO, United Benefit Advisors

43 Solution Provider Member Profiles

50 Resource Guide/Ad Index

8 Bachman’s BanterNew Guidelines for Individual MandateBy Ronald E. Bachman, FSA, MAAA, Chairman, Editorial

Advisory Board, The Institute for HealthCare Consumerism

33 EngagementHealth Care Consumerism and the Chief Engagement Officer: A Powerful Combination

By Frank Hone, Managing Director, Healthcentric Partners, Inc.

41 WellnessTrending in 2014: Making Wellness a Strategic Initiative

By Joseph O’Brien, President & Chief Executive Officer, Interactive Health

42 Health Reform ComplianceSmall and Mid-sized Business Take Note: Five Things Not to Do Regarding Health Reform

By Sheryl Southwick, Director of Compliance, TriNet

Do Less to Win in WellnessWellness is not working. Let’s be honest — despite more than 30 years of effort at improving population health and thousands of wellness companies offering all sorts of solutions, an honest look at the health of the average U.S. citizen reveals that it is tragically poor compared with what it could be. So the obvious conclusion must be that “We need to do more!”

By Russell Benaroya, Co-Founder and CEO, EveryMove, and Andrew Sykes, Chairman, Health at Work

Wellness Programs Tick the “Caring Box” for Today’s WorkersCompanies and employees are at an impasse when it comes to health care expenses. Businesses continue to chip away at their bottom lines by reducing benefits options and passing costs on to workers. Workers, meanwhile, are not pleased to see benefits-driven reductions continually impacting their take-home pay. As the economy improves and the job market opens up, many companies may be surprised to find fed-up workers heading for the exits. A Right Management survey revealed that 86 percent of employees planned to actively look for new jobs in 2013. And it wasn’t just rank-and-file workers eyeing other opportunities. In 2012, 32 percent of employers lost their top performers to other organizations, and 39 percent of companies worry the trend will continue.

By Tom Giddens, Executive Vice President, Director of Sales, Aflac

I N S I D E DEPARTMENTS

ONLINE EXCLUSIVES

EventsThe IHC FORUM WestDec. 5-6, 2013Red Rock Resort & Casino – Las Vegaswww.theihccforum.com IHC FORUM & Expo

Cobb Galleria Centre - Atlanta IHC FORUM West

Red Rock Resort & Casino – Las Vegas

Come LEARN, CONNECT and SHARE with the top thought-leaders in the rapidly growing health care consumerism megatrend: www.theihccforum.com

The Institute for HealthCare Consumerism’s IHC FORUM Conferences are the only national events 100% dedicated to health care consumerism. HR professionals, wellness program directors, brokers, consultants, TPA’s and regional health plan administrators attend IHC FORUM events for cutting-edge workshops, general sessions, pre-conference events and networking opportunities. FORUM-goers learn from peers who have successfully adopted health care consumerism programs, and gain insights from industry thought leaders and policymakers on how to navigate the marketplace, cut costs, engage employees and comply with current health care laws share leading practices. In addition, attendees are eligible for IHC University’s Certified HealthCare Consumerism Specialist (CHCS) designation as well as HR CEU credits.

MembershipBecome a Member, Reap the RewardsHave you become a member of The Institute for HealthCare Consumerism (IHC) at www.theihcc.com? Why wait? Visit the website today and sign up for a premium membership. Got a story to tell about an innovative health and benefit program or best practice in health care consumerism? Share it with fellow members of The IHC. Share a case study, white paper, article or post a blog at www.theihcc.com. Members also receive special discounts to attend IHC events, such as the IHC FORUM conference series.

4 November/December 2013 I HealthCare Consumerism Solutions™ I www.TheIHCC.com

http://www.theihccforum.com

© 2013 Total System Services, Inc.® All rights reserved worldwide.

TSYS® is a federally registered service mark of Total System Services, Inc.

Provide employees the right tools to make the most of their healthcare choices.

At TSYS Healthcare®, our approach to client-driven innovation allows you to define and shape flexible, integrated payment solutions that meet your unique needs. Our independent industry partnerships and elite platform functionality help our clients build solutions that make sense.

Our solutions include:

Integrity | Relationships | Excellence | Innovation | Growth

Learn more at www.tsyshealthcare.com or call us at +1.706.649.5080

Get to know us. [email protected]

&HOHEUDWLQJ�WKH��WK�$QQLYHUVDU\�RI�+HDOWK�6DYLQJV�$FFRXQWV�DQG�0RYLQJ�7RZDUG�WKH�)XWXUH�RI�+HDOWK�&DUH�&RQVXPHULVPThis December 8th will mark ten years from the day President George W. Bush signed the Medicare Modernization Act into law, creating health savings accounts based on the template and legacy of medical savings accounts. Through the dedication and passion of a number of key individuals, health savings accounts have grown from essentially a footnote to the 2003 Medicare act to a thriving segment of the health insurance market with a trajectory that shows increasing growth moving forward.

While many initially believed that the Affordable Care Act had the potential to end or seriously hinder the growth of health savings accounts, the opposite has been proven to be true. Ironically, the Affordable Care Act has provided significant space for the growth of health savings accounts. In this issue’s cover feature, we take a look back at the last two decades of health savings accounts — back to the days when Pat Rooney and John Goodman were proselytizing for the little known medical savings accounts.

For the feature, Jonathan Field, Managing Editor, interviewed key figures in the history of health savings accounts, including Roy Ramthun, Bill Sweetnam, Mike Parkinson, John Young, Kirk Hoewisch and others. The article delves into the history of health savings accounts — but also looks to the future. While we want to recognize the leadership of the fathers of health savings accounts, it is crucial that we collectively look forward to the future and the innovations necessary to continue the growth of health savings accounts.

In addition to the editorial coverage in this publication, we are on the heels of our FORUM West conference in Las Vegas, and we are excited to be hosting several health savings accounts-related sessions and workshops with Kevin McKechnie, HSA Council; Bill West, HealthEquity; Roy Ramthun, HSA Consulting Services; and others.

As this fall’s open enrollment comes to an end, and we tip our hats to the individuals who worked for the advancement of health savings accounts and greater consumerism in health care, it is necessary that we at the same time look to the next decade and beyond. At FORUM West, the industry will gather to collaboratively analyze the efficacy of private exchanges and other advancements in consumerism. We hope to see you there.

Sincerely,

Doug FieldCEO/[email protected]

L E T T E R PUBLISHER

www.theihcc.comVOLUME 9 NO. 7 | NOVEMBER/DECEMBER 2013

Published by FieldMedia LLC292 South Main Street, Suite 400

Alpharetta, GA 30009 7HO��Fax: 770.663.4409

CEODoug Field

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MANAGING DIRECTOR Brent Macy

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ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS

Dusty Rhodes

CHAIRMAN OF IHC ADVISORY BOARDRonald E. Bachman, CEO, Healthcare Visions

EDITORIAL ADVISORY BOARD

Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River

Group; John Hickman, Alston+Bird LLP; Tony Holmes, 0HUFHU�+HDOWK��%HQH¿WV��0DUF�.XWWHU��$ÀDF��

Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC

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BUSINESS MANAGERKaren Raudabaugh

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+HDOWK&DUH�&RQVXPHULVP�6ROXWLRQV™ Volume 9 Issue 7Copyright ©2013 by FieldMedia LLC. All rights reserved.

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TO SUBSCRIBE: Make checks and money orders payable to +HDOWK&DUH�&RQVXPHULVP�6ROXWLRQV™ magazine 292 S. Main Street, Suite 400, Alpharetta, *$� �� RU� YLVLW� ZZZ�WKHLKFF�FRP�� 1RQ�TXDOL¿HG� SHUVRQV� PD\� VXEVFULEH�at the following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 RU�VXEVFULEHUVHUYLFH#¿HOGPHGLD�FRP�IRU�QDPH�DGGUHVV�FKDQJHV�

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The Right Choice at the Right Time

WHO: All persons who are required to purchase health insurance under the Affordable Care Act.

WHEN: Effective January 1, 2014. [Editor’s note: At press time, information regarding a potential delay in the Individual Mandate was circulating via national news media outlets.]

WHAT: The IRS final rule (August 27, 2013) specifies requirements, responsibilities, exemptions, administration and income tax penalties for individuals if they do not obtain health care coverage in 2014.

EXECUTIVE SUMMARY: Below are the key questions and answers each person should know:

1. WHO IS RESPONSIBLE FOR COVERAGE? Each “taxpayer” is individually responsible for ensuring they have the minimum essential coverage for themselves and any persons who qualify as their tax dependent. (A “taxpayer” is one who is required to file a tax form not one who actually owes or pays taxes.)

2. WHAT IS MINIMUM COVERAGE? Government-sponsored coverage, an employer-sponsored plan, individual coverage, grandfathered coverage, Medicare, Medicaid (although some existing limited Medicaid programs will not qualify) and other coverage expressly defined as Minimum Essential Coverage.

3. WHO QUALIFIES FOR EXEMPTIONS? Taxpayers are exempt who cannot purchase an eligible plan for 8 percent or less of their modified adjusted household income. Household income

includes (a) Employer contributions, (b) tax credits, and (c) premium amounts paid through salary reduction. If an employee is determined exempt because employer coverage is unaffordable, the employee is exempt from the individual mandate regardless even if individual coverage is affordable through an exchange using premium tax credits. Taxpayers are exemption if they are without coverage for a continuous period of less than three months.

ADDITIONAL EXEMPTIONS: (a) Taxpayers whose family income falls

below the tax filing threshold; (b) Members of federally recognized Indian tribes; (c) Members of faiths qualifying for the religious conscience exemption; (d) Participants in “Shared Ministries;” (e) Individuals not lawfully present in the United States; and (f) Individuals who are incarcerated after final disposition of charges.

4. HOW MUCH ARE THE PENALTIES? The greater of a flat dollar amount or a percentage of income. The flat dollar amounts phase in over three years from $95 in 2014 to $695 in 2016 for adults and half that amount for children up to a maximum of three. The income percentage increases from one percent in 2014 to 2.5 percent for years after 2015. Taxpayers will not be additionally penalized for under-withholding or underpaying estimated taxes.

5. HOW WILL PENALTIES BE ADMINISTERED AND COLLECTED? The IRS can collect the penalty by offsetting it against refunds due the taxpayer for overpayments. A taxpayer that fails to pay the penalty is not subject to criminal penalties or to liens and levies.

ACTIONS: Individuals should talk to their agent, broker, accountant or tax advisor to determine if they are meeting the individual coverage mandate or have an exemption. Spouses should determine if the mandate applies to them individually and who may be required to carry dependent children under their insurance plan. Employers may be helpful in providing information for those not selecting employer offered coverage. Public and private insurance exchanges available in your area may also be able to answer questions and assist with any needed coverage.

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BY RONALD E. BACHMAN FSA, MAAACHAIRMAN, EDITORIAL ADVISORY BOARDTHE INSTITUTE FOR HEALTHCARE CONSUMERISM

BACHMAN’S BANTER

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Change Healthcare Engages Comparion to Further Enhance its Health Care Quality Data OfferingConsumer engagement and cost transparency leader Change Healthcare recently announced a new partner in quality reporting: Comparion. One of the nation’s largest sources of health care information, Comparion will provide Change Healthcare clients with access to physician HI¿FLHQF\�PHDVXUHV�QRW�DYDLODEOH�IURP�DQ\�SXEOLF�LQIRUPDWLRQ�VRXUFH��Comparion measures physician utilization performance across all care settings on a per-patient basis, including departmental charges per episode and procedure and prescription drug detail. In addition, &RPSDULRQ�PHDVXUHV�FKDUJH�SHU�HSLVRGH�E\�SK\VLFLDQ��PDMRU�SUDFWLFH�category, episode of illness, health plan/employer and hospital.

Introducing Virgin Pulse: Virgin HealthMiles Rebrands with New MissionVirgin HealthMiles recently unveiled a new brand for the world’s leading employee health engagement platform, as the company will now be known as Virgin Pulse. The new brand and brand identity represent its evolution from a primary focus on corporate wellness programs to one squarely targeted on employee engagement and improving employees’ Total Quality of Life.

Tango Health and eflexgroup Partner to Launch Suite of CDHC Accounts and Compliance ServicesTango Health, a leading provider of health savings account management DQG� $&$� FRPSOLDQFH� VRIWZDUH� DQG� VHUYLFHV�� DQG� HÀH[JURXS�� WKH�industry leader in account-based plans, have announced an agreement WR� GHOLYHU� DQ� LQWHJUDWHG� VXLWH� RI� KHDOWK� VDYLQJV� DFFRXQWV�� ÀH[LEOH�spending arrangements, health reimbursement accounts, COBRA administration and ACA compliance services for employers. The combined solution delivers on the exact needs of employers and human resource professionals as they prepare for complying with the ACA, ZRUN� WR� FRQWDLQ� KHDOWK� EHQH¿W� FRVWV� DQG� GHOLYHU� KHDOWK� EHQH¿WV� WKDW�employees actually want.

Aflac Updates Lump Sum Critical Illness Plan$ÀDF�� D� OHDGLQJ� SURYLGHU� RI� YROXQWDU\� DQG� JXDUDQWHHG�UHQHZDEOH�insurance, announced that it has enhanced its Lump Sum Critical Illness insurance policy to offer more options such as guaranteed-issue, dependent child coverage and an HSA-compatible policy. The new SODQ�SD\V�FDVK�EHQH¿WV�WR�KHOS�HPSOR\HHV�ZLWK�FRVWV�DVVRFLDWHG�ZLWK�DQ�XQH[SHFWHG�KHDOWK�HYHQW�WKDW�PLJKW�QRW�EH�FRYHUHG�E\�PDMRU�PHGLFDO�LQVXUDQFH�� 7KHVH� FDVK� EHQH¿WV� FDQ� EH� XVHG� IRU� PHGLFDO� WUHDWPHQW��living expenses and other out-of-pocket expenses for a covered critical LOOQHVV� HYHQW� LQFOXGLQJ� KHDUW� DWWDFN�� VWURNH�� SDUDO\VLV�� FRPD�� PDMRU�human organ transplant and end-stage renal failure.

Wellero Launches Mobile Payment ApplicationCambia Health Solutions, a total health solutions company, is proud to announce the launch of Wellero, a company that is revolutionizing the health care payment system. Wellero offers consumers a mobile application that allows them to pay for their health care services before WKH\� OHDYH�WKHLU�SURYLGHU¶V�RI¿FH��:HOOHUR�DOORZV�FRQVXPHUV�WR�SD\�DW�WKH� WLPH� RI� VHUYLFH� EDVHG� RQ� WKHLU� KHDOWK� LQVXUDQFH� EHQH¿WV� RU� FDVK�prices for the uninsured.

UMB Releases New HSA Reporting ToolUMB Healthcare Services, a division of UMB Financial Corporation, introduces HSAWorks™, the industry’s most-advanced reporting and ¿UVW�HYHU�DQDO\WLFV�WRRO�WKDW�DOORZV�EURNHUV��WKLUG�SDUW\�DGPLQLVWUDWRUV��health plans and employers to analyze health savings account (HSA) data to achieve desired plan results. The time for better reporting capabilities has never been greater, as AHIP recently reported nearly 15.5 million Americans are enrolled in HSAs and the growth trend continues upward. In the nearly 10 years since the introduction of HSAs, traditional reporting, when available, has given visibility to average DFFRXQW�EDODQFHV�DQG�FRQ¿UPDWLRQ�LI�LQGLYLGXDOV�ZHUH�LQYHVWLQJ�RU�QRW�

1Pay by Evolution1 Sets the Standard in Prepaid Benefits Card Industry1Pay by Evolution1® continues to receive industry recognition, most UHFHQWO\�ZLQQLQJ�D��3D\EHIRUH�$ZDUG�IRU�EHQH¿WV�FDUG�LQQRYDWLRQ�IRU� LWV� %HQQ\�� 3UHSDLG� %HQH¿WV� &DUG�� 3D\� LV� D� VXLWH� RI� SD\PHQW�solutions offered by Evolution1, the nation’s leading provider of innovative health care software and payment solutions that administer and manage CDHC accounts. Leading with the revolutionary Benny Prepaid Card, 1Pay innovation ranges from patented card processes to ÀH[LEOH� DXWRPDWHG� SURYLGHU� SD\PHQWV� DQG� UHLPEXUVHPHQWV� WKDW� XVH�best-in-class web, virtual payment, printing and mobile technologies.

Cobb County Selects Healthstat to Manage Employee Health ProgramThe Cobb County (Ga.) Board of Commissioners has unanimously selected Healthstat, Inc. to administer and manage an on-site health SURJUDP� IRU� HPSOR\HHV� FRYHUHG� XQGHU� LWV� KHDOWK� EHQH¿WV� SODQ�� 7KH�goal is to operate a comprehensive employee health program that will continue to improve employee health and further reduce costs associated with the county’s health plan.

New CieloStar Card Debits Accounts, Adds RewardsCieloStar announces the deployment of its new CieloStar Card which will allow consumers to settle co-pay health care costs and receive rewards DQG�EHQH¿WV� DOO� RQ�RQH� FRQYHQLHQW��PXOWL�SXUSRVH� FDUG��7KH�&LHOR6WDU�&DUG� ZLOO� SHUPLW� FRQVXPHUV� WR� WUDFN� WKHLU� KHDOWK� EHQH¿WV�� GLVFRXQWV��rewards and health savings dollars in one easy-to-access place.

WiserTogether Names Steven Eno as Vice President of MarketingWiserTogether, Inc., a pioneer in online shared decision support solutions, has appointed Steven Eno as its Vice President of Marketing. Steve is an experienced marketing executive with a background in

KHDOWK� FDUH� DQG� ¿QDQFLDO� VHUYLFHV�� +H� KDV� OHG�PDUNHWLQJ� WHDPV� DW�GE, American Express, Citigroup and UnitedHealthcare. In his most UHFHQW�SRVLWLRQ��KH�ZDV�UHVSRQVLEOH�IRU�KHDOWK�DQG�ZHOOQHVV�EHQH¿WV�for GE Capital’s U.S. employees and led company-wide marketing initiatives.

HEALTHCARE CONSUMERISM NEWS BRIEFS

HEALTHCARE CONSUMERISM PEOPLE ON THE MOVE


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visit us at booth #8 and check out our learn session on Thursday at 2:30 PM

FieldMedia LLC is the parent company to HealthCare Consumerism Solutions magazine, EmployersWeb.com, IHC FORUM and The Institute for HealthCare Consumerism. 292 South Main St., Ste 400, Alpharetta, GA 30009

2014 FORUM & EXPO IS

RIGHT AROUND THE CORNER

May 7-9, 2014ATLANTACobb Galleria Centre

LEARN. CONNECT. SHARE.Join The Institute for HealthCare Consumerism and Get a

Discount on IHC FORUM Registration www.theihccforum.com

ATLANTA, MAY 7-9, 20143URGXFHG�E\�7KH�,QVWLWXWH�IRU�+HDOWK&DUH�&RQVXPHULVP

Growth for IHC FORUM & EXPO May 7-9, 2014:

Larger Exhibitor Floor

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Only Event Focused Exclusively on HealthCare Consumerism

The Fastest Growing Event in the Health, HR, Benefit Industry

REGISTER EARLY — SUPER SAVER RATES START AT $99!ADDITIONAL WAYS ATTENDEES CAN PARTICIPATE Submit Your Speaking Credentials Now — Be a part of IHC FORUM & Expo panels or general sessions!

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HEALTHCARE CONSUMERISM: THE SOLUTION FOR A CHANGING WORLDwww.theihccforum.com

The Only Conference 100% Dedicated to Innovative Health and Benefit ManagementLEARN. CONNECT. SHARE.FORUM & Expo 2014 puts you in the right place at the right time. Get hard stats and real-time feedback from peers, industry experts and thought-leaders on how the new marketplaces are performing during 2014 open enrollment. Through cutting-edge general sessions, workshops, intimate roundtable discussions and unlimited networking opportunities, the IHC FORUM, produced by The Institute for HealthCare Consumerism, is the ONLY place you can attend to be part of this valuable collaboration experience.

LEARN from peers successfully implementing healthcare consumerism initiatives. CONNECT with forward-thinking experts and industry professionals on

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latest topics and current trends.

Who Should Attend IHC FORUM?CEOs/Presidents/CFOsHR and Benefit ExecutivesHealth Plan AdministratorsCorporate Wellness DirectorsBenefit Brokers and ConsultantsThird Party Administrators

Plan to attend a day early for CEU-eligible pre-conference sessions on “Making HealthCare Consumerism Work: The Steps and Plan” or “The Institute for HealthCare Consumerism: Continuing Education Course for Brokers — HealthCare Consumerism in PPACA (includes updates on Health Care Reform Law) for Brokers, Advisors and Consultants.” Additional fees apply. Visit www.theihccforum.com for details.

ATLANTA, MAY 7-9, 2014

Produced by The Institute for HealthCare ConsumerismVisit www.theihccforum.com to preview the agenda and register for the conference.

Maintain your position as a forward-thinking professional within your organization and the health

HUK�ILULÄ[�THUHNLTLU[�PUK\Z[Y`�H[�SHYNL��

Complete your training at IHC FORUM & Expo 2014 to be eligible for online testing.

Learn more by visiting the IHC Certification program online at www.theihcc.com/university/certification or call 404.671.9551

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Take your career to the next level by adding *LY[PÄLK�/LHS[O*HYL�

Consumerism Specialist (CHCS)

designation to your credentials.

Register Now and SaveDon’t miss this opportunity to be at the forefront of the health and benefit management movement. Reserve your spot at the FORUM & Expo before January 10th for $99 SUPER SAVER RATES.

FORUMNo industry event offers you more for your money. Join The Institute for HealthCare Consumerism as a Premium Member and save even more. Already an IHC member? Check your inbox for our weekly e-blast and save using your exclusive member discount code. Visit www.theihcc.com for details or call 404.671.9551.

SAVE THE

DATE

December 4-5, 2014LAS VEGASRed Rock Resort & Casino

SUBMIT YOUR SPEAKING CREDENTIALS NOW!Be a part of IHC FORUM West panels or general sessions!

Submit Presentation Topics — Lead an interactive workshop!

Claim Your Space as a Sponsor and/or Exhibitor!

WWW.THEIHCCFORUM.COM

F O R U M W E S TLAS VEGAS, DEC 4-5, 20143URGXFHG�E\�7KH�,QVWLWXWH�IRU�+HDOWK&DUH�&RQVXPHULVP

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LEARN. CONNECT. SHARE.Join The Institute for HealthCare Consumerism and Get a

Discount on IHC FORUM Registration www.theihccforum.com

LEARN.CONNECT.SHARE.

Editor’s Note: With FORUM West right around the corner and an industry in the heart of a historically important open enrollment period, things are moving a feverish pace at the Institute for HealthCare Consumerism. On the heels of our annual Superstars issue, FORUM West, the introduction of our certification program and much more, Dusty Rhodes once again runs down the list of what’s happening at the Institute.

Become a Certified HealthCare Consumerism Specialist (CHCS)

At FORUM West in Las Vegas, we are excited to be rolling out our first professional certification, Certified HealthCare Consumerism Specialist (CHCS). By attending FORUM West conference and pre-conference certification courses, attendees will qualify for Certified HealthCare Consumerism Specialist (CHCS) online testing, scheduled for January 2014. By passing the certification testing, professionals will receive the Certified HealthCare Consumerism Specialist (CHCS) designation from The Institute for HealthCare Consumerism (IHC). Certification class seats are limited; get started with your registration process today.

2013 HealthCare Consumerism Superstars Issue

Every fall, The Institute for HealthCare Consumerism recognizes the leaders in human resources, health care, wellness and employee benefits through its HealthCare Consumerism Superstars issue. This year, we are highlighting the hard work and innovation of over 60 companies, including Cummins, Life Technologies, Activision

Blizzard, Proctor & Gamble and Darden Restaurants. This year’s issue will also include a completely re-worked Industry Innovator awards. Following an unprecedented number of nominations, we have selected 25 Industry Innovator for this year’s publication, including a new Top Five category, which includes Benefitfocus, Alegeus Technologies, Towers Watson’s Exchange Solutions, Keas and Catamaran.

PrivateHealthCareExchanges.com Beta Now Online The health benefits landscape is rapidly changing, and moving forward, private health insurance exchanges will play

a significant role in this space. To satisfy the industry’s need for a guide to the various private exchanges and defined contribution solutions, The Institute for HealthCare Consumerism has launched PrivateHealthCareExchanges.com. This website is designed to assist any employers, brokers, health plans or other organizations that are looking to implement a private exchanges. We are now in the beta phase and are currently aggregating exchanges and looking for industry feedback.

Save the Date for the 2014 FORUM & Expo

We are excited to announce the dates for our 2014 FORUM & Expo in Atlanta. We will be back at

the Cobb Galleria Centre from May 7 to 9 – yet with a slightly different name. We have dropped the “East” and changed to FORUM & Expo for our May event in Atlanta. The 2013 FORUM East was our largest event yet with over 700 attendees and over 50 sponsors. Due to the attendee growth, increased sponsor participation and overall success of the 2013 FORUM East, FORUM & Expo will feature expanded content and a larger exhibitor floor for three days instead of two. Get an early jump on the 2014 FORUM & Expo by visiting the FORUM website and signing up for email updates. Early sponsors are already lining up, including Castlight Health, Towers Watson, Delta.

What’s Happening at the InstituteBY DUSTY RHODES » ASSOCIATE DIRECTOR OF EDUCATION » THE INSTITUTE FOR HEALTHCARE CONSUMERISM


CER

TIFIED SPECIALIST

HEA

LTHCARE CONSUMERIS

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ATLANTA, MAY 7-9, 2014


STATS & DATABY THOMAS MANGAN

CHIEF EXECUTIVE OFFICERUNITED BENEFIT ADVISORS

As employers continue to grapple with the impact of the Patient Protection and Affordable Care Act (PPACA) on their benefit offerings, many will be taking a closer look at medical plans with

attached health reimbursement arrangements (HRAs) and heath savings accounts (HSAs).

For those who do, accurate and timely benchmarking data will be critical in making informed decisions relevant to an employer’s industry, geographic location, and size. United Benefit Advisors’ (UBA) 2013 Health Plan Survey, the nation’s largest and most comprehensive annual survey of health plans, allows employers to compare several points regarding medical plans accompanied by HRAs and HSAs that illustrate the importance of benchmarking.

Following are a few of those high-level data points:There was a very slight uptick

in the percentage of U.S. employers offering plans with HRAs in 2013 (8.6 percent) compared to 2012 (8.3 percent). And employee participation in these plans dropped very slightly from 8.8 percent in 2012 to 8.6 percent in 2013. These minor shifts could signal early reactions to PPACA, which jeopardizes high deductible plans funded with HRAs. In fact, insurance carriers in many states no longer sell plans with high deductibles, thus forcing employers to purchase plans with lower deductibles. Hence, a significant portion of the extremely significant renewal increases on group health plans can be attributed to these changes in out-of-pocket costs, especially in states such as Arizona, Arkansas, Georgia, Idaho, Iowa, Kentucky, Missouri, Ohio, Oklahoma, Tennessee, Utah, Wyoming and Virginia.

In contrast to plans with attached HRAs, those with HSAs attached saw a slight rise in both employer adoption and employee participation rates in 2013. 15.1 percent of employers offer plans with HSAs, compared to 14.7 percent in 2012. And employee participation in these plans rose from 7.1 percent in 2012 to 8.8 percent in 2013. This upward trend might continue, as HSAs have a long shelf life as they comply with the maximum allowable out-of-pocket costs under PPACA of $6,350 for individual and $12,700 for family coverage (which goes into effect January 1, 2015).

95.1 percent of plans with HSAs provide coverage for recommended preventive services without requiring enrollees to first meet plan deductibles, as allowed under IRS rules. 86.9 percent of plans with HRAs cover first dollar preventive coverage, largely due to the fact that these plans often use funds in the HRA primarily to pay a portion of the premium (making the deductible appear lower to employees).

On average, funding levels

of plans with HRAs have increased significantly for singles (from $1,605 in 2012 to $1,766 in 2013) and for families ($3,075 in 2012 to $3,506 in 2013). Under PPACA, it seems unlikely that small employers will be able to use HRA contributions to get deductibles to the $2,000/4,000 level. As a result, there will likely be a dramatic shift in funding strategies in the near future. For example, many of these employers may opt to partially self-insure their medical plans to significantly lower their premiums, versus having to buy a plan with more coverage than they need.

On average, funding levels for plans with HSAs have remained constant for singles (approx. $574 for both 2012 and 2013) while average funding for families has increased from $928 in 2012 to $958. Since employers are generally increasing family premiums and out-of-pocket costs, plans with HSAs attached may become increasingly attractive to employees seeking family coverage.

Regional benchmarking is extremely valuable to employers who are assessing funding levels for plans with HRAs and HSAs attached. Below, for example, are average regional funding levels for plans with HRAs and HSAs—data that can dramatically change an employer’s strategy:

Consumer-directed health plans (CDHPs) continue to offer the best option to lower a health plan’s cost with average rates on par with the tight staff model of HMO plans offered in California. HSAs affiliated with these plans are driving this cost trend due to their emphasis on patient awareness of the cost of care.

Obviously, benchmarking data represents only one tool that should be used by employers, HR and benefits professionals, and other decision-makers as they strategize on health care plans and the impacts of PPACA. Consulting the expertise of a skilled benefits advisor is the best way to fully understand the myriad of options available, taking into consideration the complexities of PPACA compliance, cost reduction strategies and employee retention. $��\HDU�YHWHUDQ�LQ�WKH�¿HOG�RI�HPSOR\HH�EHQH¿WV��7KRPDV�0DQJDQ�LV�WKH�&KLHI�([HFXWLYH�2I¿FHU�RI�8QLWHG�%HQH¿W�$GYLVRUV�DQG�D�PHPEHU�RI�LWV�ERDUG�RI�WUXVWHHV��+H�KDV�EHHQ�QDPHG�RQH�RI�WKH�WRS��PRVW�LQÀXHQWLDO�LQGLYLGXDOV�LQ�WKH�KHDOWK�FDUH�LQGXVWU\�E\�(PSOR\HH�%HQH¿WV�1HZV�DQG�LV�ZLGHO\�UHFRJQL]HG�DV�RQH�RI�WKH�LQGXVWU\¶V�PRVW�SURJUHVVLYH�WKRXJKW�OHDGHUV��+LV�H[WHQVLYH�EDFNJURXQG�LQ�HPSOR\HH�EHQH¿WV�VSDQV�VDOHV��VHUYLFHV�DQG�RSHUDWLRQV��DQG�KLV�DUHDV�RI�H[SHUWLVH�LQFOXGH�LQVXUDQFH�FDUULHU�DQG�EURNHU�PDQDJHPHQW��FDUULHU�UHODWLRQV��ZHOOQHVV��KHDOWK�LQVXUDQFH�FRQVXOWLQJ��&2%5$��+,33$��DQG�SHQVLRQ�PDQDJHPHQW�

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Region HRA - Single HRA - Family HSA - Single HSA - FamilyNortheast $1,668 $3,302 $632 $1,118

Southeast $1,680 $3,261 $543 $826North Central $1,895 $3,872 $463 $821Central $1,755 $3,694 $535 $928West $1,976 $3,493 $815 $1,194

S I M P L I F Y I N G T H E B U S I N E S S O F H E A L T H C A R E

©2013 Evolution1, Inc. All rights reserved.

W hether you’re a broker wanting to recommend the best solution to your clients, a financial institution expanding your product offerings, a health plan provider seeking greater efficiency gains, a software developer providing payment solutions

or a benefits administrator driving greater profitability, we can help address your needs.

Our advantages:

The nation’s largest electronic payment, on-premise and cloud computing healthcare solutions

Solutions administer HSAs, HRAs, FSAs, Defined Contribution, VEBAs, Wellness and Transit Plans

Serving over 75,000 companies and 9 million consumers Industry-leading prepaid benefits card with innovative auto-substantiation technologies

PARTNER WITH THE MARKET LEADER IN CONSUMER-DRIVEN HEALTHCARE TECHNOLOGY AND SERVICES.

Exchange

www.theihcc.com

November/December 2013

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What to Expect this Year and Beyond

Panel of Leading Experts Looks at Emergence of Private Exchanges

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ANNOUNCING

Private Exchanges and Open Enrollment:

In today’s economic climate, properly managing your health care plans helps both your people and your bottom line. But finding the time and the resources can be a challenge.

Buck can help. Together with Xerox, we:

• Touch two out of every three insured Americans who use health care annually

• Process 900 million health care claims every year

• Have contracts with 36 state Medicaid organizations

• Provide RightOpt™, our private health

insurance exchange, to manage costs for both you and your employees

• Supply Accountable Care Organization technology to 2000+ hospitals

• Support every major insurance carrier

www.buckconsultants.com

By leveraging our experience across the health care industry — from providers and payers to employers and government agencies — you can make your health care plans more accessible, affordable, and efficient.

To learn more, visit www.buckconsultants.com

FEATURE

11 Private Exchanges and Open Enrollment: What to Expect this Year and Beyond

How will the emergence of private exchanges impact the health benefits landscape? That’s the question we posed to eight industry leaders. Each gave his opinion on why private exchanges will succeed and what tools, technologies or components will be crucial for their success.

With Eric Grossman, Mercer; Jeff Bakke, Evolution1; Scott Carver, PlanSource; Ken Sperling, Aon Hewitt; Ron Goldstein, Choice Administrators; Dennis McGuire, CodeBaby; Sanjay Singh, hCentive; and David Lindgren (left to right).

INSIDE

4 Publisher’s LetterCEO/Publisher Doug Field covers the latest in the private exchange and defined contribution industry and what’s happening at the Institute around exchanges

5 Briefs & InnovationsKeeping you up-to-date with the latest news, research and innovations in defined contribution and health insurance exchanges

7 Health Care Reform: Private Exchanges and Voluntary

Health care reform, PPACA, ACA — the federally mandated changes that are coming have many different names and will be implemented whether the nation is ready or not. At the heart of this change is the formation of health care exchanges both public and private. For the benefits industry — and the voluntary market in particular — the question is not whether change will occur, but how? And will insurance carriers be ready? In what way will voluntary products fit into this new landscape? What are voluntary

providers doing to prepare for these changes?

By Ginger Bates, Director of Research, Eastbridge Consulting Group, Inc.

8 Exchange Profile: America’s Most Broker-Friendly Private Exchange

The Affordable Care Act is going to make individual health insurance more attractive than group health insurance for millions of Americans. For the first time, many employers who have been using group major medical coverage to attract and retain employees may find that offering those same benefits may actually repel those same employees.

By Joshua Hilgers, President & Founder,

Health Partners America

9 Employee Benefits in a Post-Exchange World

I’m sure you have read the forecasts, market predictions and statistics about health care’s movement to state and federal exchanges. The preliminary enrollment data is starting to trickle in, and there are about 100,000 people enrolled in products purchased from public

exchanges. This number is grossly off from the projections.

By Carlos Ferrara, Chief Operating Officer,

Solstice Benefits

10 Don’t Panic: Four Tips for Employers as January 1 Approaches

October 1 has come and gone. Now what? Although there is much debate about whether the initial launch of the public exchanges was successful, one thing is certain: launching a massive health care transformation across the U.S. was never going to be easy. As an employer, you have a lot to think about when it comes to implementing an effective benefits strategy, especially as health reform continues to unfold. Here are four tips that will help as we work our way toward the next health reform milestone: January 1.

By Joe Donlan, President, ConnectedHealth

15 Exchange Soution Provider Member Profiles

www.TheIHCC.com I HealthCare Exchange Solutions™ I November/December 2013 3

DEPARTMENTS

Private Exchange Panel Discussion

Amid Healthcare.gov Struggles,

Private Exchanges Show Promising Future

The Obama administration’s initial struggles with Healthcare.gov have been widely reported. While many predicted the federal health insurance marketplace would get off to a slow start, not many could have anticipated that the technological errors would be so widespread and persistent. As a result, some Democrats are now joining their Republican colleagues in calling for the delay of the ACA’s individual mandate.

As the federal marketplace continues to experience glitches, many of the other health insurance exchanges — including several state-based exchanges — are having rather successful open enrollment periods. hCentive, a leading exchange software provider and contributor to this issue, is reporting that all of their state exchanges performed well out of the gate. Other private exchange platform providers, such as Aon Hewitt, Mercer, Liazon and CieloStar, are continuing to announce more and more clients and partnerships as employers, brokers, health plans and others discover the benefits offered by a private exchange.

In this issue of HealthCare Exchange Solutions, we are excited to be featuring a number of articles focusing on private exchanges and this year’s open enrollment period. For the cover feature, we gathered a select group of business leaders and posed to them one question: how will the emergence of private exchanges impact the health benefits landscape? The responses, covering topics like defined contribution, decision-support tools, technology and broker accessibility, will provide a wealth of knowledge for any organization looking to implement a private exchange solution.

Other articles from Solstice Benefits, Eastbridge Consulting, Health Partners America and ConnectedHealth look at additional topics that will be crucial to the private exchange market, including implementation, health care reform and voluntary insurance.

In addition, The Institute for HealthCare Consumerism is proud to announce the launch of PrivateHealthCareExchanges.com, the only online guide for employers, health plans, brokers and other organizations looking to navigate the industry’s various private exchange and defined contribution solutions. With the beta launch, we are aggregating private exchanges and looking for constructive feedback from the industry on what criteria they would like to see us showcase.

Finally, our FORUM West conference is rapidly approaching and will feature many exchange-related general sessions and workshops. We hope to see you there.

Sincerely,

Doug FieldCEO/[email protected]

www.theihcc.comVOLUME 1 NO. 5 | NOVEMBER/DECEMBER 2013

Published by FieldMedia LLC292 South Main Street, Suite 400

Alpharetta, GA 30009 7HO��Fax: 770.663.4409

CEODoug Field

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MANAGING DIRECTOR Brent Macy

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MANAGING EDITORJonathan Field

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SENIOR EDITORHeather Loveridge

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ACCOUNT MANAGERJoni Lipson

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MARKETING COMMUNICATIONS MANAGERLana Perry

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ART DIRECTORKellie Frissell

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ASSOCIATE DIRECTOR OF EDUCATION SERVICES AND PROGRAMS

Dusty Rhodes

CHAIRMAN OF IHC ADVISORY BOARDRonald E. Bachman, CEO, Healthcare Visions

EDITORIAL ADVISORY BOARD

Kim Adler, Allstate; Diana Andersen, Zions Bancorporation; Bill Bennett; Doug Bulleit, DCS Health; Jon Comola, Wye River

Group; John Hickman, Alston+Bird LLP; Tony Holmes, 0HUFHU�+HDOWK��%HQH¿WV��0DUF�.XWWHU��$ÀDF��

Sanders McConnell, TSYS Healthcare; Roy Ramthun, HSA Consulting Services LLC; John Young, Consumerdriven LLC

WEBMASTERS Kevin Carnegie

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Tom BecherZHEPDVWHU#¿HOGPHGLD�FRP�

ASSOCIATE WEB ADMINISTRATOR Tim HemendingerWLPK#¿HOGPHGLD�FRP

DIRECTOR OF CONFERENCE SPONSORSHIP/ CORPORATE MEMBERSHIP/REPRINTS

Rogers Beasley ��ā�UEHDVOH\#¿HOGPHGLD�FRP

BUSINESS MANAGERKaren Raudabaugh

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+HDOWK&DUH�([FKDQJH�6ROXWLRQV™ Volume 1 Issue 5Copyright ©2013 by FieldMedia LLC. All rights reserved.

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TO SUBSCRIBE: Make checks and money orders payable to +HDOWK&DUH�([FKDQJH�6ROXWLRQV™ magazine 292 S. Main Street, Suite 400, Alpharetta, GA ��RU�YLVLW�ZZZ�WKHLKFF�FRP��1RQ�TXDOL¿HG�SHUVRQV�PD\�VXEVFULEH�DW�WKH�following rates: single copy $7.50; $75.00/yr in the U.S., $105/yr in Canada and $170/yr international. Please contact FieldMedia at 404.671.9551 or VXEVFULEHUVHUYLFH#¿HOGPHGLD�FRP�IRU�QDPH�DGGUHVV�FKDQJHV�

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+HDOWK&DUH� ([FKDQJH� 6ROXWLRQV™ is designed to provide both accurate and authoritative information with regard to the understanding that the publisher LV� QRW� HQJDJHG� LQ� UHQGHULQJ� OHJDO�� ¿QDQFLDO� RU� RWKHU� SURIHVVLRQDO� VHUYLFH�� ,I�legal advice is required, the services of a professional adviser should be sought.

The magazine is not responsible for unsolicited manuscripts or photographs. Send letters to the editor and editorial inquiries to the above address or to M¿HOG#¿HOGPHGLD�FRP��3HUPLVVLRQ� WR�UHXVH�FRQWHQW� VKRXOG�EH� VHQW� WR�� M¿HOG#¿HOGPHGLD�FRP�

PUBLISHERExchange

4 November/December 2013 I HealthCare Exchange Solutions™ I www.TheIHCC.com

NEWS BRIEFSNew Employer Participation in Aon Hewitt’s Corporate Health Exchange Five Times Higher in 2014Aon Hewitt has announced that 18 large employers, including Walgreens and 2013 participants Sears Holdings, Darden Restaurants and Aon plc, will offer health benefits this fall through the Aon Hewitt Corporate Health Exchange, the nation’s largest multi-carrier private health care exchange. The number of new employers joining Aon Hewitt’s exchange in 2014 is five times the number that participated in 2013. Enrollment is expected to triple to more than 330,000 U.S. employees. In total, Aon Hewitt anticipates more than 600,000 U.S. employees and their families will be covered under plans in the Aon Hewitt Corporate Health Exchange in 2014.

Array Health Launches Next Generation Private Exchange MarketplaceArray Health has announced the next generation of its Array Spectrum™ Member Marketplace, the consumer-facing module of its private exchange solution. The new Marketplace features Array SmartFit™ decision support technology designed to simplify and humanize the process of buying benefits. With this solution consumers provide feedback to simple statements to indicate their preferences around financial risk, access to providers, prescription needs and more. The Array SmartFit technology uses proprietary algorithms to suggest plans that best map to each individual’s values. In addition to simplifying the decision-making process, health plan details are presented using everyday language, not insurance terms, further facilitating the shopping experience.

Frenkel Benefits Launches Frenkel Benefits Marketplace, a Private Exchange in Partnership with bswiftFrenkel Benefits, an employee benefits broker and consulting firm, has unveiled the Frenkel Benefits Marketplace, a private exchange powered by bswift’s technology platform. Designed to take advantage of private health care opportunities in light of Affordable Care Act requirements, the exchange will manage costs for employers and offer competitive benefit options for employees. Within the next 12 months, Frenkel Benefits Marketplace is expected to support 20,000+ consumers and provide shopping tools, decision support and enrollment for employees. Frenkel Benefits chose to partner with bswift, a leader in cloud-based technology and services for employee benefits and health exchanges, because of its proven technology including a robust defined contribution platform for employers and employees, and bswift’s new “Ask Emma” interactive benefits advisor.

PlanSource Announces Its Selection As Technology Platform For Utah’s Public Exchange, Avenue HPlanSource has announced that after a thorough competitive evaluation process, it has been selected as the shopping and administration technology platform for Avenue H, the State of Utah’s public health insurance marketplace. PlanSource will provide the technology through which Avenue H offers its easy-to-use online health insurance marketplace and benefits shopping experience for small businesses throughout Utah, under the Small Business Health Options Program (SHOP) outlined in the Affordable Care Act. The PlanSource platform will cover plan quoting, employer shopping,

employee shopping, plan recommendation, enrollment, eligibility data management and data distribution to carriers for Avenue H.

Mercer Signs Up 52 Employers to its Private Exchange Platforms, Including Petco and Kinder MorganMercer has signed up 52 employers to offer a comprehensive range of benefits through Mercer’s private exchanges for the 2014 plan year. These employers include Petco and Kinder Morgan. Mercer anticipates that the exchanges will cover 200,000 employees, retirees, and family members next year. The 52 employers range in size from 100 to 30,000 employees and represent more than 15 industries. Thirty-three early adopters have chosen Mercer Marketplace, Mercer’s private exchange for active employees, to offer in 2014 a range of medical, dental, life, disability, and other voluntary benefit choices. In addition to Petco, some of the employers that will also offer Mercer Marketplace to their active employees include DineEquity (parent company of Applebee’s Neighborhood Grill & Bar® and IHOP® restaurants), Addison Group LLC, Cosentry, PAS Technologies Inc., Sanborn Map Company, Surgical Specialties Corporation, Kraus Flooring, and Vistronix.

CieloStar Selects My Health and Money Transparency Solution for its Private ExchangeMy Health and Money LLC, a unique, cost-saving solution for employ-ees and consumers managing high-deductible health coverage, has been selected as an integral component of CieloStar’s new CieloChoice Fully Integrated Health and Benefits System. My Health and Money was created as a customizable, online portal to promote money-saving health care decisions that don’t compromise quality. CieloChoice is CieloStar’s proprietary web-based health and benefits solution that allows employers, affinity groups, brokers, third-party administrators, and associations to offer private exchanges and defined contribution benefit solutions to their employees, clients and member organizations.

Ascension Benefits & Insurance Solutions to Offer Private Exchange with Bloom HealthAscension Benefits & Insurance Solutions, partnering with Minneapolis-based Bloom Health, announces BenXchange by Ascension. BenXchange by Ascension is a private exchange model that gives clients the ability to offer employees an online benefits marketplace, providing a new solution for personalized benefits. Employees can choose from a variety of insurance carriers and ancillary products. To assist consumers with their purchasing decisions, Bloom Health’s user-friendly decision-support tools offer a unique way to communicate with and educate individuals to increase satisfaction for both employees and Ascension’s employer clients. BenXchange by Ascension allows employers to implement a defined contribution solution to provide personalized benefits in a group market setting.

USI Helps Clients Manage Employee Benefits Through Launch of Private Insurance ExchangeUSI Insurance Services has announced the launch of a private exchange to help clients manage their employee benefits. As a leading national benefits broker and consultant, USI has developed a broad and deep set of solutions to help employers control the costs of their benefits plans. This private exchange will be integrated with USI’s existing solutions.

BRIEFS


Mercer is a global consulting leader in talent, health, retirement, and investments. We help clients around the world advance the health, wealth, and performance of their most vital asset — their people.

PRIVATE EXCHANGES … WHAT’S THE BUZZ?

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Mercer Marketplace enables employers to:

through choice.

Mercer Marketplace provides employees with:

convenient buying.

Visit us at www.mercer.com/private-health-exchanges, or contact us at [email protected].

Dark garnet, new photo

BY GINGER BATES » DIRECTOR OF RESEARCHEASTBRIDGE CONSULTING GROUP, INC.

VOLUNTARY

Health care reform, PPACA, ACA — the federally mandated changes that are coming have many different names and will be implemented whether the nation is ready or not. At

the heart of this change is the formation of health care exchanges both public and private. For the benefits industry – and the voluntary market in particular — the question is not whether change will occur, but how? And will insurance carriers be ready? In what way will voluntary products fit into this new landscape? What are voluntary providers doing to prepare for these changes?

A recent Frontline Report™ from Eastbridge Consulting Group, Inc., Health Care Reform: Private Exchanges & Voluntary, attempts to answer those questions and others to get a better picture of voluntary carriers’ current strategy for addressing health care reform particular to the private exchange environment.

Exchange Participation and TypeOf the 18 carriers participating in the study, all but two plan to offer

their voluntary products via a private exchange. The majority of these, however, said they are still in the exploratory phase of planning their strategies or plan to partner with medical carriers, brokers/consultants or technology vendors to craft their solution.

For those that already know their strategy or approach, the carriers were evenly split among building a single-company private exchange either internally or via a vendor, adding their products to a multi-company private exchange set up by others, or using both the single-company and multi-company private exchange approach. Whatever their private exchange plan, almost all carriers are busy creating alliances with various technology and administration companies to help them navigate the exchange set-up and implementation process.

Product Offerings and Modifications Voluntary life, critical illness, accident and short-term disability

products are the most frequently mentioned planned offerings for the private exchanges. Although some product modifications, such as changing the definition of a dependent to age 26 and offering

pediatric dental plans, have already been made by many of the carriers, whether more substantial modifications will need to be made to the voluntary products offered remains a bit murky. Questions around what constitutes an “excepted benefit” and how that will affect existing indemnity plans, as well as potential underwriting changes

to help manage risk tolerances and anti-selection concerns, are just a few of the unknowns right now. Regardless of which products are offered on private exchanges, most of the carriers believe that the products will be generally more standardized and pre-packaged in terms of the benefits offered than those offered outside of the exchange environment.

Broker RolesMany carriers believe that

the broker role will change in the future, becoming more consultative in nature. This will involve offering a broader

repertoire of products and more communication with less focus on cost comparisons and more on regulatory, compliance and tax issues. Most also believe that brokers across the market will be involved in private exchanges. However, many agree that larger, more sophisticated brokers will be the earlier adopters of technology and change.

Impact to Voluntary Despite the evolving nature of most carriers’ exchange strategies,

all of the carriers interviewed believe that private exchanges will have mostly a positive impact on the voluntary/worksite business, especially in the initial years that the exchanges are available. These include increased knowledge and awareness of voluntary benefits overall by employers and employees, as well as the addition of a new distribution channel for voluntary that will generate revenue growth for the carriers. Other positives include the packaging of voluntary products with other products such as high-deductible health plans and HSAs along with a continued shift towards consumer choice versus the employer as the primary decision-maker. (DVWEULGJH�&RQVXOWLQJ�*URXS��,QF��LV�D�FRQVXOWLQJ�ILUP�EDVHG�LQ�$YRQ��&7��VHUYLQJ�WKH�ILQDQFLDO� VHUYLFHV� LQGXVWU\��*LQJHU�%DWHV� LV� WKH�'LUHFWRU�RI�5HVHDUFK�DW�(DVWEULGJH��6KH�FDQ�EH�UHDFKHG�DW�JEDWHV#HDVWEULGJH�FRP

Health Care Reform: Private Exchanges and Voluntary


About the Study: Health Care Reform: Private Exchanges & Voluntary is an

Eastbridge Frontline Report™. These

reports provide timely data on hot or

new topics where the facts are often

still emerging or are in transition. A total

of 18 voluntary carriers provided their

thoughts and feedback for this study.

mailto:[email protected]

PRIVATE EXCHANGE PROFILE

Individual insurance is now guaranteed issue. This has not been the case in 45 of 50 states for the last 30 to 40 years. Many small businesses have been offering coverage because it was the only place for their employees to find coverage.

Mandated benefits and coverage levels are the same in the individual and small group markets.Individual insurance is owned by the employee, and they can take it with them regardless of their job situation.Individual coverage premiums are lower than group premiums for most consumers.Federal subsidies will help pay the premiums for millions of Americans.Cost-sharing subsidies will help make health care more affordable for millions of Americans by reducing deductible, co-pays and co-insurance.

Why the Private Exchange Broker BlueprintUnderstanding the new dynamics that are going to be at play is more important than ever. Unfortunately, many insurance producers do not have the time or resources to stay on top of the rapidly changing market. That’s why Health Partners America is here. We provide the training, tools, technology and fulfillment of individual health insurance (including facilitating federal subsidies) that a producer needs to not only keep their block of business but to grow it as well.

The Private Exchange Broker Blueprint is made up of four key components that are all focused on helping the insurance producer meet their business needs while maximizing their profits. The flexibility in product selection, lead routing and fulfillment gives a producer broad capabilities, while the training, marketing tools, account management and business development teams help bring about focused execution.

The Four Key ComponentsTraining – Knowledge equals success. Our award-winning training team provides our broker community with the most up to date information on federal health reform, strategies for employers and other organizations and the latest marketing strategies. We provide on-demand training videos, weekly coaching webinars, open office

hour webinars and business development teams to insure the brokers’ success.

Tools – Having the right marketing materials to communicate your message is vital and can be expensive to develop. HPA has developed them for you. We have professional marketing pieces to communicate the concept to employers and other organizations and marketing pieces to brand with the employer to communicate to their employees. Marketing in the form of one-pagers, PowerPoint presentations, infographics and more.

Technology – Health Partners America has built the most flexible and broker-friendly private exchange/marketplace platform available. The platform can be customized for the broker, their agency or even their client. The product lines and messaging can all be customized as well. That is not the end of the technology though. The leads generated in the online marketplace are tracked and managed by an industry-leading Client Relationship Management (CRM) system. Those leads can be routed to the broker to fulfill or to a fulfillment center licensed in all 50 states with a revenue share set up for the broker generating the lead. Leads sent to the fulfillment center are also tracked by the CRM and gives full transparency to the broker on exactly what is happening with the leads they generate.

Team – We have experts to help you in two ways. First, our Account Management and Business Development teams will help you get off to a fast start and close employers on the concept of a private exchange. Second, our fulfillment team partner can provide a broker unprecedented leverage by enabling the broker to market multiple lines of insurance in all 50 states and even facilitate the eligibility and application of the federal subsidies. The fulfillment center agents are experts in cross-selling and actually average 2.5 policies per sale.

Who Needs the Private Exchange Broker Blueprint?There is a new reality facing America. The rise of individual insurance is being embraced by employers but, will brokers lead the way? It will certainly not replace all employer-sponsored group insurance — but it is a strategy that brokers need to be prepared for. Health Partners America provides a turn-key solution for brokers at an affordable price. To learn more visit www.healthpartnersamerica.com.

America’s Most Broker-Friendly Private Exchange

BY JOSHUA HILGERS » PRESIDENT & FOUNDER » HEALTH PARTNERS AMERICA


Individual Insurance Takes on a Role in Employee BenefitsThe Affordable Care Act is going to make individual health insurance more attractive than group health insurance for millions of Americans. For the first time, many employers who have been using group major medical coverage to attract and retain employees may find that offering those same benefits may actually repel those same employees. There are several key reasons for this shift:

I’m sure you have read the forecasts, market predictions and statistics about health care’s movement to state and federal exchanges. The preliminary enrollment data is starting to trickle in, and there are about 100,000 people enrolled in products purchased from public exchanges. This number is grossly off from the projections.

So what do we do as business owners, brokers, insurance professionals and those who are making benefit decisions for their organization? How can we make balanced, informed, sound choices regarding health care in this new landscape, especially when there is little data to guide, validate and substantiate our vetting process?

This is when I turn an ear toward the consumer, in our case, our employees. I stop listening to the noise in the news and listen to those who are impacted the most. I sat down with our Director of HR, Ellen deClaire, to discuss the voice of the employee and the mindset of those making the ultimate, and often difficult, choice for group benefits.

Carlos: Do you think benefit enrollment in smaller groups will be affected by the emergence of exchanges?

Ellen: In some cases, absolutely. Some employees will opt out of their employer-sponsored benefits and go to the exchange because it will be more reasonably priced than their current benefits. In the small group market, they can age band the pricing of benefits, so it’s possible that older employees could pay more, which would make them want to consider shopping on exchanges.

C: What about the Essential Health Benefits (EHB) provision; must employers now offer group benefits that include the EHB stipulations, such as pre-existing conditions?

E: Yes. Once it’s time for a group’s open enrollment, the new plans that are offered cannot have a pre-existing

conditions clause or lifetime max.

C: Rumor has it that an increased number of employers will try to renew in December, so they can prolong including those EHBs in 2014, as well as avoid increased premiums. What do you see trending in the human resources field?

E: That’s a tough one. I think the decision to renew early as a cost-savings tool is really dependent on the organization. One that offers products on a voluntary basis — or perhaps has a significant portion of its workforce eligible for subsidies on exchanges — will view this through a different lens than a group that pays for 100 percent of insurance costs for its employees.

C: What steps should groups take to educate their employees about their benefits options?

E: Of course, offering cost-saving solutions and information is important. There will be an occasional employee who asks about dependent care and how to find a less ex-pensive alternative. They can be advised to shop elsewhere, such as exchanges, to compare costs and benefits.

Education is important as well. At Solstice, we have created an internal training course on the Affordable Care Act. There is so much information out there — and so much misinformation — that we wanted our employees to know the facts. When they are faced with making benefit decisions, they will know the nuances of reform, what certain terminology means and feel confident making benefit decisions. Our goal is to demystify this very complex topic and empower our workforce with knowledge. And of course, employer groups should be sending out their ACA-required notice to employees informing them of insurance options.

C: Based on what you hear and read in the news about wait times to shop on the exchange, the cost, the reported

system glitches — would you be apt to move your employees to public or private exchanges?

E: I would be more inclined to move to a private exchange. We have more control of the products, of the communication to our employees and, ultimately, to their satisfaction with their benefits.

C: What do you see as the future for health and ancillary benefits? What will you do in the long term as far as benefits are concerned?

E: We are shifting our benefit’s spotlight from medical-only to a big-picture approach. The data is evident: health is no longer just about medical concerns. Oral health impacts overall health from heart disease, to diabetes and more. It’s no longer about just medical as so many aspects of one’s health are impacted by areas not traditionally covered under medial.

Wellness, stress and nutrition tools help lower medical premiums and provide for a more engaged, happy workforce. We are broadening our scope of health. Our focus moving forward is on wellness and overall health. It’s about focusing on the whole body, about a healthier lifestyle overall.

Times are changing with uncertainty ahead. Employer groups will want to continue to be involved in their employees’ benefits. After all, that’s one of the key ways to recruit the best talent and retain employees. Private exchanges provide cost-savings coupled with a positive online shopping experience, and I expect to see more and more groups moving in that direction. Full-suite offerings that include wellness, ancillary benefits and medical together will be the next generation of employer benefits. And, we look forward to that. Because when it comes to health, we really shouldn’t separate out each aspect of the benefits we offer—or leave any out altogether. They are all intercon-nected and critical for the well-being of our workforce.

CONVERSATIONS

Employee Benefits in a Post-Exchange WorldBY CARLOS FERRARA » CHIEF OPERATING OFFICER » SOLSTICE BENEFITS

A candid conversation with Ellen deClaire, Director of Human Resources, Solstice Benefits


��7KLQN�%H\RQG�+HDOWK�5HIRUPConsider how providing health care benefits will promote

your company’s goals and vision — apart from the requirements of the Affordable Care Act (ACA). Most businesses have four goals: lower costs, engage employees, improve productivity and strengthen competitiveness. The right benefits strategy can do all of those things. Putting the priorities of the business first makes it easier to integrate the relevant portions of the health-care law into an overall benefits program that supports your company’s goals.

��&RQVLGHU�1HZ�%HQH¿W�2SWLRQVAs employers feel the margin crunch, they increasingly seek

answers to help moderate costs but also keep employees engaged, healthy and productive. One way to do this is through defined contribution, where the employer determines whether and how much they want to contribute toward employees’ benefits. This approach lets you avoid the open-ended health care costs that typically come with a defined benefit plan. Instead, you set a budget you can afford. Your employees can use that amount to help cover the cost of a plan that meets their particular needs.

Ultimately, the defined contribution model helps control costs and can be adapted to almost any sized workforce and various employee populations — full-time employees, part-timers and 1099 contractors. Remember, in the long run, it’s about allowing employees to tailor their coverage and meet their needs across a range of health and ancillary benefits, taking into account who they are, their attitudes about benefits and how they intend to use their coverage.

��&RPPXQLFDWH��&RPPXQLFDWH�� &RPPXQLFDWH�

Employees want to know if they should expect any drastic changes as a result of the ACA. Create clear and consistent communication materials and training for your employees that highlight any changes for your company. Everyone — from millennials to retirees — needs to

hear the basics and learn how the ACA may impact them specifically. Each employee population has different needs and interests when it comes to health care, so try to cater to those characteristics the best you can. And think beyond open enrollment. A good strategy engages people throughout the year.

��&UHDWH�D�)OH[LEOH�3ODQHaving a plan that is responsive to your organization’s growing

needs is always a good idea – albeit, easier said than done. In a nutshell, your plan should identify: ACA deadlines and requirements; a list of employees and hours they work; your benefits budget; planned communication around your implementation strategy; how employees might interact with the federal or state-based exchanges; and the tax implications for your employees. If you have a benefits advisor, meet with them regularly to ensure your progress aligns with your goals. And collect feedback from your employees (via surveys, etc.) to help determine if you are hitting those goals.

The tens of millions of people who visited the public exchanges during the first week of October taught us this: consumers nationwide want to find affordable health coverage. As an employer, you are a trusted resource, and you play a critical role in helping your workforce understand their options: where to go, what to do and how to navigate the system. It’s a huge responsibility, but, if done well, it’s one that can reap huge benefits for your staff, your business and your bottom line. $V� 3UHVLGHQW� DQG� &R�)RXQGHU�� -RH� 'RQODQ� VHWV� WKH� VWUDWHJ\� IRU�&RQQHFWHG+HDOWK�� EULQJLQJ� KLV� H[SHULHQFH� LQ� SURYLGLQJ� VROXWLRQV� IRU�HPSOR\HUV� DQG� LQVXUDQFH� SODQV� DORQJ� ZLWK� KLV� SDVVLRQ� DQG� HQHUJ\� IRU�GHSOR\LQJ� WHFKQRORJ\� DQG� QHZ� DSSURDFKHV� LQ� LPSURYLQJ� WKH� KHDOWK� V\VWHP�IRU�FRQVXPHUV��-RH�EHJDQ�KLV�FDUHHU�LQ�VDOHV�WR�KRVSLWDO�V\VWHPV�DQG�FDUULHUV�DQG� UHFRJQL]HG� HDUO\� RQ� WKH� YDOXH� RI� XVLQJ� WHFKQRORJ\�DQG� GDWD� WR� KHOS� VROYH� EXVLQHVV� SUREOHPV�� 3ULRU� WR�&RQQHFWHG+HDOWK�� -RH� ZDV� D� FR�IRXQGHU� RI� 6XELPR�� D�UHFRJQL]HG�PDUNHW�OHDGHU�LQ�FRQVXPHU�GULYHQ�KHDOWK�FDUH��-RH� ZDV� 9LFH� 3UHVLGHQW� RI� :HE0'� +HDOWK� 6HUYLFHV� XQWLO�� +H� ZDV� DZDUGHG� KLV� %DFKHORU� RI� $UWV� 'HJUHH� LQ�%XVLQHVV�IURP�/DNH�)RUHVW�&ROOHJH�

Don’t Panic: Four Tips for Employers as January 1 Approaches

BY JOE DONLAN » PRESIDENT » CONNECTEDHEALTH


HEALTH CARE REFORM

October 1 has come and gone. Now what? Although there is much debate about whether the initial launch of the public exchanges was successful, one thing is certain: launching a massive health care transformation across the U.S. was never going to be easy. As an employer, you

have a lot to think about when it comes to implementing an effective benefits strategy, especially as health reform continues to unfold. Here are four tips that will help as we work our way toward the next health reform milestone: January 1.

As the implementation of health reform continues, the key aspects of the ACA have become well known to most employers. Thus, this year’s open enrollment season is a logical time for taking strategic aim at the future of KHDOWK�EHQH¿WV�DQG�KRZ�SULYDWH�H[FKDQJHV�FDQ�KHOS�EXVLQHVVHV�JRLQJ�IRUZDUG�

)RU�PDQ\�HPSOR\HUV��LW¶V�WLPH�WR�UHWKLQN�KRZ�EHQH¿WV�DUH�GHOLYHUHG��Mercer’s research and interviews with HR executives have a revealed D� VLJQL¿FDQW� LQWHUHVW� LQ� FDSLWDOL]LQJ� RQ� WKH� RSSRUWXQLWLHV� WKDW� SULYDWH�exchanges offer to both employers and their employees. Private exchanges FDQ�DGYDQFH�WKH�PDMRU�WUHQG�LQ�UHFHQW�\HDUV�WR�UHTXLUH�JUHDWHU�HPSOR\HH�DFFRXQWDELOLW\� IRU� EHQH¿W� GHFLVLRQV� DQG� VKDUHG� HPSOR\HU�HPSOR\HH�responsibility for health care cost and utilization.

Employee accountability and shared responsibility have emerged

through three fundamental and inter-related strategies:�� The widespread adoption of consumer-driven

health plans. These plans will be available on private exchanges, and employees will have resources to help determine whether such a plan is their best choice.

�� A focus on health and wellness with incentives and disincentives tied to healthy behaviors and outcomes. This focus should continue with a private exchange.

�� Narrowing of provider networks to drive improvement in cost and quality. Private exchanges will support alternative network products.Overlay the above three trends with the ability for a private


PRIVATE EXCHANGES AND OPEN ENROLLMENT:

What to Expect this Year and Beyond

+RZ�ZLOO�WKH�HPHUJHQFH�RI�SULYDWH�H[FKDQJHV�LPSDFW�WKH�KHDOWK�EHQH¿WV�ODQGVFDSH"�7KDW¶V�WKH�TXHVWLRQ�ZH�SRVHG�WR�HLJKW�LQGXVWU\�OHDGHUV��LQFOXGLQJ�

H[HFXWLYHV�IURP�0HUFHU��$RQ�+HZLWW��(YROXWLRQ��DQG�RWKHUV�� (DFK�JDYH�KLV�RSLQLRQ�RQ�ZK\�SULYDWH�H[FKDQJHV�ZLOO�VXFFHHG�DQG�

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Strategic Change and the Private Exchange Advantage BY ERIC GROSSMAN » SENIOR PARTNER AND EXCHANGE BUSINESS LEADER » MERCER

H[FKDQJH� WR� IDFLOLWDWH� WKH�PRYH� WR�GH¿QHG� FRQWULEXWLRQ�� VWUHDPOLQH�SODQ�management, and expand choice for employees, and the high interest becomes clear. Private exchanges offer many advantages, which is why so many employers are interested. Now is the time to determine whether this is the right approach for you and your employees.

Defined Contribution Strategies Simplify Health Care Experience

for EmployersBY JEFF BAKKE » CHIEF STRATEGY OFFICER » EVOLUTION1

We’re in a time of unprecedented change for the health care industry — the biggest change since Medicare was introduced in 1965. The numbers tell the story:�� 6LQFH� 2FWREHU� �� WKH� ¿UVW� GD\� WKDW� LQVXUDQFH� H[FKDQJHV� EHJDQ�

accepting enrollees, more than 20 million people have visited +HDOWKFDUH�JRY��'HVSLWH�VLJQL¿FDQW�WHFKQLFDO�FKDOOHQJHV��WKDW�QXPEHU�continues to climb. According to a May 2013 report from the &RQJUHVVLRQDO�%XGJHW�2I¿FH�DQG�WKH�-RLQW�&RPPLWWHH�RQ�7D[DWLRQ��PLOOLRQ� LQGLYLGXDOV�ZLOO� ¿QG� FRYHUDJH� WKURXJK�SXEOLF� H[FKDQJHV�by 2023.

�� $ERXW� RQH� LQ� ¿YH� SHRSOH� ZLOO� EX\� WKHLU� LQVXUDQFH� IURP� D� SXEOLF� RU�private health insurance exchange in the next three years, and private exchanges will ultimately surpass federal and state-run versions by 2018, according to a June 2013 report by Accenture. Although only one million individuals are expected to enroll in private exchanges this year, Accenture predicts nearly 40 million people will be buying their health plans from private exchanges by 2018, topping the 31 million individuals who are forecast to enroll in publicly-funded exchanges. Accenture also estimated 56 percent of the total exchange market ZLOO� FRPH� IURP� SULYDWH� PDUNHWSODFHV� LQ� RQO\� ¿YH� \HDUV�� DQG� DERXW�27 percent of consumers currently insured through employer-based FRYHUDJH�ZLOO�UHFHLYH�WKHLU�EHQH¿WV�WKURXJK�D�SULYDWH�H[FKDQJH�E\��6SHFL¿F�WR�SULYDWH�H[FKDQJHV�� WKH\�RIIHU�HPSOR\HUV�D�QHZ�DSSURDFK�

in providing health care coverage for employees. In order to both protect H[LVWLQJ� KHDOWK� SODQ� JURXS� FXVWRPHUV� DQG� WR� FDSLWDOL]H� RQ� WKH� GH¿QHG�contribution private insurance exchange opportunities in 2014, we need solutions that go well beyond rudimentary enrollment platforms and legacy consumer-directed health account solutions.

To be successful, it is imperative that health plans, third-party DGPLQLVWUDWRUV�� ¿QDQFLDO� LQVWLWXWLRQV� ±� DQG� DOO� KHDOWK� FDUH� SDUWQHUV�� IRU�WKDW�PDWWHU�±�GHFLGH�ZKDW�WKHLU�UROH�LV�JRLQJ�WR�EH�DQG�KRZ�WKH\�DUH�JRLQJ�to participate in insurance marketplaces, and provide solutions that deepen the relationship with customers and members.

Key to success is choosing the right solution. 1Plan by Evolution1® — RXU�FRPSOHWH�GH¿QHG�FRQWULEXWLRQ�VROXWLRQ�²�GHOLYHUV�WKH�QH[W�JHQHUDWLRQ�RI�FRQVXPHU�GLUHFWHG�KHDOWK�LQ�D�FRPSOHWH�PXOWL�DFFRXQW�GH¿QHG�FRQWULEXWLRQ�solution. 1Plan supercharges both private and public insurance exchanges with a solution for employers and employees to EXGJHW� IRU� DQG� VHOHFW� EHQH¿WV�� VKRS� IRU� LQVXUDQFH� DQG�manage premiums and out-of-pocket expenses in a comprehensive, easy-to-use experience. In short, 1Plan VLPSOL¿HV�WKH�EXVLQHVV�RI�KHDOWK�FDUH��

Private Exchanges Bring New Power to Health Benefits Delivery

BY KENNETH L. SPERLING, CEBS » NATIONAL HEALTH EXCHANGE STRATEGY LEADER » EXCHANGE SOLUTIONS OF AON HEWITT

With the emergence of private health care exchanges, this open enrollment season stands poised to be a turning point in the evolution RI�HPSOR\HU�VSRQVRUHG�KHDOWK�FDUH�EHQH¿WV��,Q�WKH�VDPH�ZD\�WKDW�YLUWXDO�marketplaces like Amazon, Travelocity, and Orbitz connect buyers and

The Influence of Private Exchanges on Health Benefits: The Two Things

That Will Shift the MarketplaceBY SCOTT CARVER » PRESIDENT » PLANSOURCE

At PlanSource, we have a unique perspective on the impact that H[FKDQJHV�ZLOO�KDYH�LQ�WKH�KHDOWK�FDUH�EHQH¿WV�ODQGVFDSH��2XU�0\3ODQ6RXUFH�technology is a complete health insurance exchange platform — one that spans both private and public exchanges (which are very different), one that includes both single- and multi-carrier installations, and one that also LQFOXGHV�ERWK�FDUULHU�VSHFL¿F�DQG�EURNHU�VSHFL¿F�H[FKDQJHV��

We speak daily with all of the parties involved in the exchange equation — carriers, employers, the employees who act as buyers and end users, and third-party brokers who are actively involved in the decision-PDNLQJ� DQG�RU� RQJRLQJ� DGPLQLVWUDWLRQ� SURFHVV� ²� DQG� WKH� PDMRULW\� RI�these discussions center on the private exchange model. We’ve found that there are two common threads that have enough groundswell of interest and appeal that they are inevitable.

7KH�¿UVW�SRLQW�LV�DOVR�WKH�PRVW�REYLRXV��WKDW�PLJUDWLQJ�WR�DQ�RQOLQH�technology solution is imperative for employers of all types and sizes. The growing workload for compliance with the Affordable Care Act — much of which can be automated through system reporting — is a compelling reason for that change. The second point is the opportunity for employers WR�VHW�XS�GH¿QHG�FRQWULEXWLRQ�SDUDPHWHUV��ZKLFK�SURYLGHV�D�PHDQV�IRU�FRVW�FRQWURO�� VLPSOL¿HG� FRPSOLDQFH�� DQG�D�ZD\� WR� FRPPXQLFDWH� WR� HPSOR\HHV�the full value of their total compensation package.

Beyond these two points we see little substantive difference in the ZD\�KHDOWK�EHQH¿WV�DUH�EHLQJ�DGGUHVVHG�ZKHQ�FRPSDUHG�WR�WKH�WLPH�EHIRUH�health care reform and exchanges. Before ACA an employer would engage carriers, shop/compare rates and plans, and then offer those choices to their employees. Now they’re engaging in the same process, but simply XVLQJ� DQ� RQOLQH� V\VWHP� �ZKLFK� DOVR� KDSSHQV� WR� EH� PRUH� HI¿FLHQW� IRU�FDUULHUV�DQG�EURNHUV�DV�ZHOO��(PSOR\HHV�JHW�WKRVH�VDPH�EHQH¿WV��DQG�WKH�experience is both familiar and in line with expectations from other areas such as online retail — with comparison tools, advanced decision support, and even cost modeling and plan recommendation options available (for example, all of these are integrated directly in our platform).

The private exchange model, and these two points in particular, use the power of technology to empower everyone involved in the process. Empowerment increases overall VDWLVIDFWLRQ� DQG� LPSURYHV� WKH� ¿QDO� UHVXOWV�� ZKLFK� LV�one of the main goals of health care reform, a primary mission of our company, and overall a good thing for HYHU\RQH�LQYROYHG�LQ�KHDOWK�EHQH¿WV�


PRIVATE EXCHANGES AND OPEN ENROLLMENT: What to Expect this Year and Beyond


sellers, a health care exchange is a competitive marketplace that connects insurance companies with individuals who are shopping for health insurance. In a private exchange, consumers are empowered to select health care coverage that best meets their health needs from a variety of plans, insurance carriers and price points.

This fall, over 600,000 employees and their dependents will use Aon +HZLWW¶V� SURSULHWDU\� &RUSRUDWH� +HDOWK� ([FKDQJH� ZHE� SRUWDO�� VSHFL¿FDOO\�designed as a retail shopping experience. Consumer feedback from the Corporate Health Exchange 2012 open enrollment was overwhelmingly positive: 93 percent of employees appreciated having a choice of insurance companies, 79 percent of employees believed they had chosen the best plan for them and their families, and 75 percent reported a greater understanding of what their employer contributes for their health care coverage.

An exchange isn’t right for every company, but our clients that have MRLQHG�WKH�H[FKDQJH�FRQFHSW�IRXQG�D�VWUDWHJLF�¿W�ZLWK�WKHLU�RUJDQL]DWLRQ¶V�total rewards strategy. They are comfortable giving up control of elements like plan design and claims management in exchange for more options and an improved employee selection and enrollment experience, based on a standard set of plan designs. By focusing on improving the health DQG� ZHOOQHVV� RI� WKHLU� HPSOR\HHV�� WKH\� H[SHFW� WR� UHDS� EHQH¿WV� DEVHQFH�management, disability incidence and duration, and employee productivity.

This year’s open enrollment promises to be a time of great transformation, as private exchanges bring the SRZHU�RI�WKH�FRPSHWLWLYH�PDUNHWSODFH�WR�KHDOWK�EHQH¿WV�delivery, ultimately helping to change the health care ODQGVFDSH�IRU�WKH�EHQH¿W�RI�DOO�VWDNHKROGHUV��

Education and Engagement: Crucial for Private Exchange Success

BY DENNIS MCGUIRE » CHIEF EXECUTIVE OFFICER » CODEBABY

The intense public attention on health plan selection has highlighted the process as a complex and emotional undertaking with wide-ranging ¿QDQFLDO� DQG� KHDOWK� LPSOLFDWLRQV�� (PSOR\HU� SULYDWH� H[FKDQJHV� DUH� RQH�RI� WKH� PDQ\� EHQH¿WV� RIIHUHG� WR� WKH� WDOHQW�� GULYLQJ� WKH� VXFFHVV� RI� \RXU�FRPSDQ\��,W¶V�D�UHÀHFWLRQ�RI�WKH�FRPSDQ\�FXOWXUH��DQG�HLWKHU�HQKDQFHV�RU�detracts from employee commitment and loyalty. The success of private exchanges depends on employee education, engagement and ease of use.

Not surprisingly, in a ConsumersUnion study participants had GLI¿FXOW\�¿QGLQJ�D�SODQ�WKDW�UHSUHVHQWHG�WKH�EHVW�YDOXH��DQG�WKH\�KDG�OLWWOH�ability to assess the overall coverage they would receive. This confusion DURXQG�FRYHUDJH�� FRVWV�DQG�VLWXDWLRQ�VSHFL¿F�QHHGV�KDV� FDXVHG� IRUZDUG�thinking employers to adopt a range of interactive and educational tools to guide and assist employees during open enrollment. Smartly, they are borrowing online retailer practices such as product comparison tools, behavioral analytics, chat, video, and intelligent virtual assistants to create a superior customer experience. Statistics show that these tools are already expected by employees due to the prevalence of consumer-based technology in daily life. As consumer engagement becomes the adopted PRGHO�IRU�EHQH¿WV�HQUROOPHQW��\RX¶UH�OLNHO\�WR�VHH�RSWLRQV�IRU�RQ�GHPDQG�contextual information, video tutorials, cost-at-time-of-care calculators, click-to-chat and click-to-call to name a few.

A unique and highly effective way employers are facilitating enrollment while lowering costs is through the use of an intelligent virtual

assistant. Not to be confused with traditional virtual assistants that comprise simpler knowledge base solutions and don’t meet the needs of WRGD\¶V� FRQVXPHU��+RZHYHU� ¿IWK� DQG� VL[WK� JHQHUDWLRQ� YLUWXDO� DVVLVWDQWV��as described by Gartner, do. They are 3D avatars that have natural language response, emotional expressions, human movements, and the ability to guide users through the enrollment process, yet escalate to live help when necessary. These features speak volumes to employers who want to provide 24/7 access to their employees without relying on the HR team, allowing them to self-pace their enrollment and IHHO�FRQ¿GHQW�DQG�SUHSDUHG�WR�PDNH�HGXFDWHG�FKRLFHV��

Broker Guidance is Key Influence in Employer Health Care Decisions

BY RON GOLDSTEIN » PRESIDENT AND CEO » CHOICE ADMINISTRATORS

:KHQ� LW� FRPHV� WR� SXUFKDVLQJ� KHDOWK� EHQH¿WV� IRU� HPSOR\HHV�� VPDOO�businesses now have three options to choose from: the government PDUNHWSODFH�� D� VLQJOH� FDUULHU�RU� D�SULYDWH� H[FKDQJH��(PSOR\HUV�ZLOO� ¿QG�UDWHV� DQG�EHQH¿WV� IRU� DOO� WKUHH� RSWLRQV� DUH� YHU\� VLPLODU��ZKLFK�EHJV� WKH�question: :LWK�SDULW\�EHWZHHQ�UDWHV�DQG�EHQH¿WV��ZKDW�ZLOO�XOWLPDWHO\�EH�WKH�GULYLQJ�IRUFH�LQ�D�EXVLQHVV�RZQHU¶V�GHFLVLRQ�PDNLQJ�SURFHVV"�

7KH� DQVZHU�� DFFHVV� WR� FDUULHU� QHWZRUNV�� YDOXH�DGGHG� EHQH¿WV� DQG�guidance from brokers.

The most successful exchanges will offer a variety of carriers and EHQH¿WV� �+02�� (32�� 332�� DQG� SULFH� SRLQWV� WKDW� PDNH� KHDOWK� FDUH�accessible and affordable for everyone. We know from the past 30 years of health plan evolution that provider networks are fundamental to consumer decision-making.

*RLQJ�IRUZDUG��FDUULHUV�ZLOO�EDVH�¿QDO�SULFLQJ��LQ�SDUW��RQ�WKH�GHSWK�RI� WKHLU� SURYLGHU� QHWZRUNV�� $V� FDUULHUV� SDLU� QHWZRUNV� DQG� EHQH¿W� SODQ�options, employers considering how important networks are will be key in the decision-making process.

Secondly, programs offering additional products and services — whether they’re available to buy-up, offered on a voluntary basis or at no additional employer cost — will quickly differentiate themselves from SURJUDPV� WKDW�GR�QRW��7KHVH�EHQH¿WV�PD\� LQFOXGH�DQFLOODU\�RSWLRQV� OLNH�dental, vision or chiropractic, and could extend to services such as online human resources support or employee discount programs. Offering HPSOR\HUV�WKHVH�W\SHV�RI�EHQH¿WV�DW�OLWWOH�RU�QR�FRVW�ZLOO�DOORZ�RQH�SURJUDP�to stand apart from others — while also empowering employers to offer more robust products and services to employees.

And lastly, programs that work with independent brokers will provide a greater service to employers. In an era of change and confusion, brokers are best equipped to provide unbiased recommendations necessary to help employers make well-informed decisions.

Government and market forces have prompted a shift in how EXVLQHVVHV� FRQVLGHU� ZKHUH� WKH\� SXUFKDVH� HPSOR\HH� EHQH¿WV�� 5DWH� DQG�EHQH¿W�GLIIHUHQWLDWLRQ� LV�QR� ORQJHU�D�SRLQW�RI�FRQWHQWLRQ�� VR� WKH�ZD\V� LQ�which carriers and exchanges compete will be vital to their success. Those programs offering multiple provider networks, products and services that add real YDOXH��DQG�EHQH¿WV�FRXQVHOLQJ�FDQ�KHOS�EXVLQHVV�RZQHUV�make smart decisions. They are the options you’ll see succeed in 2014.


At hCentive, we have built our business on exchange technology. When I co-founded the company in 2009, it was for the explicit goal to enable states, payers and consumers be successful in the post-ACA world. Since then, we have been hard at work building state exchange, private exchange and exchange connectivity solutions. As October 1 has passed, we are happy to report all of our state exchanges performed well the day of the launch and they are continuing to succeed with increasing number of enrollments. In fact, one of our exchanges has received recognition from multiple media sources as being one of the most successful exchanges out of the gate.

While it takes more than technology to make an exchange successful, we are proud that we provided a solid foundation allowing the states to concentrate on the other components — marketing, outreach, etc. In addition, all of the health plans relying on our exchange connectivity solution went live on October and have been receiving enrollments with WUDI¿F�VWHDGLO\�LQFUHDVLQJ��

While a lot of attention is focused on the Federally Facilitated Marketplace and state-based exchanges, the adoption and use of private exchanges is growing. 2014 is predicted to be a watershed year for private exchanges, with studies predicting that over one million active employees will participate in a private exchange, up from about 100,000 in 2013. By

2017, the number of employees is predicted to surge to between 10 and 20 million. Companies who are seeking new ways to reduce their exposure to rising health care costs are mainly driving these employee numbers.

The needs in the private exchange market are vast and diverse. While the concept of private exchanges has been around for a number of years, market demand has completely changed the game requiring plans to implement new private exchange technology to meet the new UHTXLUHPHQWV��,W�LVQ¶W�HQRXJK�WR�RIIHU�WKH�WUDGLWLRQDO�EHQH¿WV�ZLWK�VWDQGDUG�SULFLQJ��(PSOR\HUV�DUH�H[SHFWLQJ�WUDGLWLRQDO�EHQH¿WV�SOXV�DQFLOODU\�VHUYLFHV�ZLWK� WKH� DELOLW\� WR� XWLOL]H� GH¿QHG� FRQWULEXWLRQ� SOXV� D� ORW� PRUH��:H� VHH�private exchanges morphing into consumer engagement platforms, which ZLOO�GHOLYHU�DXWRPDWLRQ��HI¿FLHQF\�DQG�HIIHFWLYHQHVV�LQ�ERWK�LQWHUPHGLDU\�and dis-intermediary sales and distribution channels.

:H�DUH� H[FLWHG� E\� WKH� IXWXUH��:H� NQRZ� WKDW�PDUNHW� FKDQJH� LV� MXVW�starting. We pride ourselves — and our products — on EHLQJ� ÀH[LEOH��:H�ZLOO� UHPDLQ� QLPEOH� WR�PHHW� WRGD\¶V�challenges while equipping our clients to address future requirements as needed. Being an active member of this convergence is exciting, we are belted in and ready for the ride.

Let’s face the reality. Many small businesses with less than 50 employees either have given strong consideration to terminating their HPSOR\HH� EHQH¿W� SODQ� RU� QR� ORQJHU� RIIHULQJ� RQH��:K\"� ,W¶V� QR� VXUSULVH��High costs are the driving force. I don’t think I’m going too far out on a limb to assume most of you agree.

Now we have a wave of new regulations and plan changes forthcoming with the ACA that will likely increase group health plan premiums even further for many small businesses. But the ACA appears to have given VPDOO�EXVLQHVVHV�D�QHZ�ZD\�WR�KHOS�HPSOR\HHV��+RZ�\RX�PLJKW�DVN"�*LYH�employees a raise and call it a day. It’s that simple.

Let employees shop freely for an individual plan. They choose the price, insurance company, network, deductible, co-pays, etc. All an employer has to do, if they are willing and able, is provide some after-tax dollars to help employees enroll in coverage.

$IWHU�DOO��VPDOO�EXVLQHVVHV�ZRQ¶W�EH�VXEMHFW�WR�WKH�HPSOR\HU�PDQGDWH��and if they do offer a group health plan, then most employees won’t be able to qualify for a subsidy. Plus individual plans are upwards of 15-20 percent less expensive than the same exact group health plans. That’s right, individual plans are cheaper than small group plans. So, why would

a small group continue to offer more expensive plans and take on the DGPLQLVWUDWLYH� WDVNV� DVVRFLDWHG�ZLWK� JURXS�KHDOWK� SODQV"� 6RPH�PD\� VD\�WKH\�ZDQW�WR�RIIHU�D�FRPSHWLWLYH�EHQH¿WV�SDFNDJH��EXW�WKDW¶V�LQVDQLW\�

Giving employees the ability to choose a health insurance plan they want and at a cost they can afford is ideal — especially if you believe in the overall consumer-driven model. You know the belief in letting employees be true health care consumers.

While there are still some rules small businesses will need to follow to avoid ERISA plan status, the private exchange can assist with the proper set-up and execution of the program for the employer and employees. %XW� WKLQN� DERXW� DOO� RI� WKH� EHQH¿WV�� ¿[HG� FRVWV��PLQLPDO� DGPLQLVWUDWLRQ��employee choice, access to subsidies — and most of all happy employers and employees.

This business model alleviates the employer burdens of dealing with group health plan renewals and reduces many of their administrative tasks. It also empowers employees to get the coverage they are now required to have.

Technology Drives Future of Private ExchangesBY SANJAY SINGH » CHIEF EXECUTIVE OFFICER » HCENTIVE

Simplify Small Business Health Insurance, Empower EmployeesBY DAVID LINDGREN » COMPLIANCE OFFICER » INSUREXSOLUTIONS PRIVATE EXCHANGE

PRIVATE EXCHANGES AND OPEN ENROLLMENT: What to Expect this Year and Beyond

We see private exchanges morphing into consumer engagement platforms, which will deliver automation, efficiency and effectiveness in both intermediary

and dis-intermediary sales and distribution channels.²�6DQMD\�6LQJK��&(2��+&HQWLYH

EXCHANGE SOLUTION PROVIDER MEMBER PROFILES

HSA/HRA/FSA TECHNOLOGY: ADMINISTRATION & MANAGEMENT

TSYS Healthcare® provides end-to-end strategic payment solutions for consumer directed healthcare. We partner with benefits administrators, financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.

“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. healthcare market, our customers rely on our option-driven system to prepare them for the future.”

! Trey Jinks, Group Executive, TSYS Healthcare

TSYS HEALTHCARE706.649.5080www.tsys.com/[email protected]

Evolution1 and our Partners serve more than 9 million consumers, making us the nation’s largest electronic payment, on-premise and cloud computing healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

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HSA / HRA / FSA ADMINISTRATION AND FINANCE

EVOLUTION1, [email protected]

BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

Since 1988, CieloStar (formerly OutsourceOne) has helped brokers, employers and employees navigate the ever-changing world of benefits. Now, with the dawn of “Defined Contribution Health Care” we are again on the leading edge. With a team of industry thought leaders, CieloStar makes navigating healthand benefits choices easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.

“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.”

! John Reynolds, CEO, Cielostar

CIELOSTAR530 U.S. Trust Building730 Second Avenue SouthMinneapolis, MN 55402

612.436.2706 [email protected]

$FFHVV�WKHVH�SUR¿OHV�RQOLQH�DW�ZZZ�7KH,+&&�FRP�


A PRIVATE EXCHANGE THAT SIMPLIFIES HEALTH INSURANCE

The InsureXSolutions® private exchange offers employers a simplified role in the new health insurance marketplace. Employers with part-time workers or retirees, as well as small businesses can utilize this exchange to empower their employees to choose the health and dental insurance that best fits their personal and family needs. Employers can reduce costs and administrative tasks, while employees receive interactive support tools and personal guidance from our licensed insurance professionals. Available in select markets, InsureXSolutions is exclusively offered and operated by Flexible Benefit Service Corporation (Flex). Contact your broker or consultant, call us directly at 855-563-6993, or visit www.insurexsolutions.com to learn more.


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The Only Online Guide Where Employers,

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already moved their employee population into a private exchange, or are planning to in the ��EHQH¿WV�\HDU��WKH�WUHQG�ZLOO�FRQWLQXH�WR�JURZ�ZLWK�WKH��EHQH¿W�\HDU�VHHLQJ�WKH�

highest adoption rates, according to recent research published by Alegeus Technologies.

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Despite many positive advances over the past decade, the opportunity for consumerism in health care still remains largely untapped. Consumer power has been the engine of growth for a wide array of

product categories from electronics to automobiles to fashion. It has fueled our nation’s economic boom for more than half a century, but it has been virtually dormant in health care.

We are now, however, beginning to see signs of real change. Market forces are emerging to help start shifting the balance of power from the sup-ply side toward the demand side. The supply side — health care providers, hospitals, health plans and drug companies — have had little historical moti-vation to truly engage the consumer. One notable exception is the experience of direct-to-consumer advertising for pharmaceuticals, which did drive demand for some brands, but didn’t do much to broadly activate patients.

We view the unfolding realities of health reform — with all of its intend-ed and unintended consequences — as an important milestone that will lead to swifter expansion of health care consumerism. Even as government inter-vention is seen as negative — even evil, maybe — by those supporting market-based solutions, the Affordable Care Act will open many doors to greater innovation and smarter approaches. It will help awaken the sleeping giant.

Health Care ConsumerismTen years ago, many observers viewed the initiation of consumer-

directed health plans (CDHPs) as the cornerstone of health care consumer-ism and anticipated a transformation toward individual accountability and greater market power. It was slow to materialize and is still far short of expec-tations. Employers were slow to adopt and promote CDHPs; individuals GLGQ¶W�UHFHLYH�VXI¿FLHQW�LQIRUPDWLRQ�DQG�JXLGDQFH��DQG�WKH�SODQV�WKHPVHOYHV�didn’t provide enough relevant tools and support.

Now, however, we’re seeing greater availability of resources for price transparency and comparative quality ratings, wellness-related tiered pre-miums and more patient-oriented uses of relevant data feeds. These are important steps, but the consumer must be engaged for these resources to be properly and effectively utilized.

Consumer Engagement�� Engagement holds the promise of truly connecting consumers to

realistic health and well-being improvement and more effective and HI¿FLHQW�XVDJH�RI�WKH�KHDOWK�FDUH�V\VWHP��%XW�HQJDJHPHQW�LV�QRW�ZHOO�understood, properly resourced or organizationally supported. This discipline is still in its formative phase.

�� Providers have a long way to go to really capture the essence of patient engagement and begin to shift their business practices to fully address individuals as partners in their own health.

�� Health plans are moving in a good direction to be more consumer-FHQWULF��EXW�LW¶V�D�GLI¿FXOW�WUDQVLWLRQ�IRU�PDQ\�ZKR�KDYH�GHHS�URRWV�LQ�

the legacy business-to-business model of health insurance. �� Employers are still searching for the right strategic combination of

program design and participant incentives to activate the workforce, promote accountability and deliver results.

Most believe that it has extraordinary potential to help change many facets of health care. And as we all know, patient engagement has been dubbed “the blockbuster drug of the century.”

Chief Engagement OfficerWe believe in the importance of engagement as a game changer.

To achieve its potential, it deserves stronger recognition in terms of organizational structure. This is why we advocate the designation of the Chief (QJDJHPHQW�2I¿FHU�UROH�ZLWKLQ�KHDOWK�FDUH�FRPSDQLHV�WKDW�UHO\�RQ�FUHDWLQJ�consumer relationships to succeed.

Engagement needs specialized expertise and a dedicated budget. Consumer insight related to health behavior is missing or underutilized in many organizations. Many companies do have teams of people intending to uncover interesting angles and different perspectives, but it’s rarely applied to its full value. The overall aim of engagement in health care is to drive behavior change and personal accountability. This is different from marketing, which is generally intended to sway individuals toward a single purchase decision or action – not sustained involvement.

Engagement is geared to move people through their individual decision pathways. It needs to address the rational and emotional barriers to change and articulate the consumer value proposition that will result from shifts in attitudes and behavior. It has to embrace the process of behavior change, disrupt inertia and reinforce positive actions.

,Q�GH¿QLQJ�WKH�VFRSH�IRU�WKH�&KLHI�(QJDJHPHQW�2I¿FHU�UROH��ZH�VHH�LW�encompassing several key areas:1. 6WUDWHJLF�,QWHQW�±�2ZQLQJ�DQG�GH¿QLQJ�WKH�RYHUDUFKLQJ�DSSURDFK�WR�

DFKLHYLQJ�WKH�VSHFL¿F�EXVLQHVV�REMHFWLYHV�IRU�EHKDYLRU�FKDQJH�DQG�having the authority to execute against these goals

2. Behavioral Science – Understanding and applying the knowledge of how people make choices, including consumer insights and behavioral economics

3. 6HJPHQWDWLRQ�DQG�7DLORULQJ�±�'H¿QLQJ�EURDG�DXGLHQFH�VHJPHQWV�at the macro level and providing individualized communications tailoring at the micro level

4. Targeting and Delivery of Effective Messaging – Leading the design, development and delivery of communication stimuli that inform, educate, encourage and reinforce

To view the complete article, visit www.theihcc.com.

Health Care Consumerism and the Chief Engagement Officer: A Powerful Combination

ENGAGEMENTBY FRANK HONE

MANAGING DIRECTORHEALTHCENTRIC PARTNERS, INC.

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The Fathers of Health Savings Accounts

6SHDN�ZLWK� HQRXJK� H[SHUWV� LQ� FRQVXPHU�GLUHFWHG� KHDOWK� FDUH� DQG� D� JHQHUDO� FRQVHQVXV�IRUPV�UHJDUGLQJ�WKH�IDWKHUV�RI�PHGLFDO�VDYLQJV�DFFRXQWV�� -RKQ� *RRGPDQ� DQG� 3DW� 5RRQH\��$OWKRXJK�WKH�LGHD�RI�PHGLFDO�VDYLQJV�DFFRXQWV�VHHPV�WR�KDYH�DULVHQ�LQGHSHQGHQWO\�IURP�PDQ\�EULOOLDQW� HFRQRPLF� DQG� KHDOWK� SROLF\� PLQGV�GDWLQJ�EDFN� WR� WKH� ��V�� LW� LV� LQDUJXDEOH� WKDW�WKHVH�WZR�¿JXUHV�ORRP�ODUJH�RYHU�WKH�KLVWRU\�RI�KHDOWK�VDYLQJV�DFFRXQWV�

7KURXJKRXW� WKH� ��V� DQG� HDUO\� ��V��-RKQ� *RRGPDQ�� 1DWLRQDO� &HQWHU� IRU� 3ROLF\�$QDO\VLV�� DQG� 3DW� 5RRQH\�� *ROGHQ� 5XOH�,QVXUDQFH�&RPSDQ\��EHFDPH�QDWLRQDOO\�NQRZQ�IRU�WKHLU�DGYRFDF\�RI�D�ODZ�WKDW�ZRXOG�DOORZ�IRU�WD[�IUHH� FRQWULEXWLRQV� LQWR� D� PHGLFDO� VDYLQJV�DFFRXQW�� 7KHLU� FRPELQHG� HIIRUWV� LQFOXGHG�DUWLFOHV� LQ� SURPLQHQW� MRXUQDOV� DQG� PHHWLQJV�ZLWK�NH\�JRYHUQPHQW�RI¿FLDOV�

Roy Ramthun�� )RXQGHU�� +6$� &RQVXOWLQJ�6HUYLFHV�� //&�� )RUPHU� 6HQLRU� +HDOWK� 3ROLF\�$GYLVRU� WR� 3UHVLGHQW� *HRUJH� :�� %XVK�� ³0U��+6$´� I served on the GOP staff of the Senate Finance Committee from 1990 to 1995. During

1992, “health reform” became part of the presidential election debate with then-governor Bill Clinton and sitting President George H.W. Bush offering plans to reform health care. Our committee held a series of hearings on the VXEMHFW� WR� EHJLQ� WR� HGXFDWH� 0HPEHUV� RI� WKH�Committee on the topic. One of our hearings included Pat Rooney, CEO of Golden Rule Insurance Company, as a witness. I remember him being dressed in a blue seersucker suit and bow tie with a fashionable hat, which drew snickers from some of the Members on the dais. He struck me as a stereotypical Southern JHQWOHPDQ��VR�,�ZDV�D�OLWWOH�VXUSULVHG�WR�¿QG�KH�hailed from Indianapolis.

He was the last witness, and he talked about a completely different concept than the previous witnesses — none of whom I remember, only Mr. Rooney. He described an “experiment” that he had tried with his own employees: WKH� FRQFHSW� RI� UDLVLQJ� WKHLU� LQVXUDQFH� EHQH¿W�deductibles and giving them cash (which came from premium savings) to offset at least some of the higher deductible. He put the cash he gave to employees in a “medical savings account” that each employee could access. He said the change in employee behavior was truly amazing.

However, the cash was taxable, while the insurance premiums were not. So he described the distortion in tax policy that he felt was sending the wrong message to employers and employees. I remember being struck by such a simple concept — equalizing treatment of health care tax policy for health care expenses paid out-of-pocket with health care expenses paid through health insurance. I later learned that Mr. Rooney convinced six Senators — four Democrats and two Republicans — to introduce a bill to change the tax policy.

The Health Security Act — or Clintoncare — and Failed Attempts at Federal Health Reform

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THE HISTORY OF HEALTH SAVINGS ACCOUNTS:Commemorating the 10th Anniversary

and Looking to the Future


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Happy 10th Anniversary HSAs!

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Flexible Benefit Service Corporation (Flex) also o!ers FSAs, HRAs, Transit/Parking, COBRA and the InsureXSolutions private insurance exchange. Learn more by visiting flexiblebenefit.com.


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Roy Ramthun: The elections of 1992 brought the Clintons to the White House and the ensuing development of and debate over Clintoncare (also known as the Health Security Act). Medical savings accounts were never considered for a place in the bill but did appear prominently in GOP alternatives. As history records it, Clintoncare led to a stalemate (even with Democrat control of both House and Senate). And there wasn’t much more debate or discussion over MSAs. By 1996, I had left Capitol Hill and was now working as a lobbyist for an insurance company in the private sector. It was not an issue I was following at the time. But I HYHQWXDOO\�OHDUQHG�WKDW�D�GHPRQVWUDWLRQ�SURMHFW�that would allow self-employed individuals and small businesses to purchase MSA plans was included in the HIPAA law of 1996. I later heard that Sen. Ted Kennedy did not want MSAs included in the HIPAA law but eventually agreed WR�LQFOXGH�WKHP�DV�D�³GHPRQVWUDWLRQ�SURMHFW�´

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The Seven Year’s Test: Medical Savings Accounts

$IWHU�WKH�SDVVDJH�RI�WKH�+HDOWK�,QVXUDQFH�3RUWDELOLW\� DQG� $FFRXQWDELOLW\� $FW� RI� ��PHGLFDO�VDYLQJV�DFFRXQWV�EHFDPH�ODZ�²�EXW�LQ�D�VHYHUHO\�VWXQWHG�YHUVLRQ�IURP�ZKDW�PDQ\�KDG�ZDQWHG�� )ROORZLQJ� GHEDWH� RQ� ZKHWKHU� 06$V�VKRXOG�EH�LQFOXGHG�LQ�WKH�+,3$$�ODZ��WKH�¿QDO�YHUVLRQ�OLPLWHG�06$V�WR�D�WHVW�SURJUDP�IRU�RQO\�VPDOO�EXVLQHVVHV�DQG�WKH�VHOI�HPSOR\HG��'HVSLWH�WKHVH� UHVWULFWLRQV�� PHGLFDO� VDYLQJV� DFFRXQWV�GLG� EHJLQ� WR�PDNH� VRPH� JURXQG� LQ� WKH� KHDOWK�LQVXUDQFH�LQGXVWU\�

Kirk Hoewisch�� 6HQLRU� 9LFH� 3UHVLGHQW��6DOHV�� +6$� %DQN� �IRUPHUO\� 06$� %DQN�� HDUO\�

SURSRQHQW� RI� 06$V� “[In the 1990s], there ZDV� JUHDW� GLI¿FXOW\� LQ� JHWWLQJ� RWKHUV� WR� VHH� WKH�advantages of the HDHP/MSA concept. However, WKHUH�ZHUH�GH¿QLWHO\�RWKHU�³EHOLHYHUV´�OLNH�P\VHOI��who were very excited about MSAs. For example, in those early years, I attended the National $VVRFLDWLRQ� RI� $OWHUQDWLYH� %HQH¿W� &RQVXOWDQWV�(NAABC) in Chicago and met with the pioneers of CDHC: Rooney, [Harv] Randecker, [Greg] Scandlen and others. In those early years, there were only a handful of players besides ourselves (called State Bank of Howards Grove at the time). There was Norwest, Merrill Lynch and American Health Value. We all shared the vision and passion for the CDHC revolution.

Beverly Gossage�� FXUUHQW� *23� FDQGLGDWH� IRU�.DQVDV�,QVXUDQFH�&RPPLVVLRQHU��OHDGLQJ�+6$�+5$�FRQVXOWDQW� My family owns Kastl Plumbing in Lawrence, Kansas, which they started 43 years ago. About 11 years ago, my sister asked if I could KHOS�KHU�ZLWK�¿QGLQJ�VROXWLRQV�IRU�WKH�FRPSDQ\¶V�health insurance, which was experiencing another annual increase of 27 percent. I began doing research for them and discovered medical savings accounts. We agreed that raising the deductible, lowering premiums and putting savings aside for the employees made sense. After my call to the Department of Insurance to ask which carriers offered these plans resulted in a list of carriers who merely offered group plans in Kansas, I began to call all of the carriers. I found two willing to consider an MSA for a group, but they were no help in locating an agent who was a specialist in these plans. I left my position as District Manager of Sylvan Learning Centers, got my agent’s license and embarked on this new mission WR�DVVLVW�EXVLQHVVHV�DQG�LQGLYLGXDOV�ZLWK�¿QGLQJ�consumer-driven health plans. I later discovered that Kastl Plumbing — to my knowledge — was WKH�¿UVW��IXOO�UHSODFHPHQW�06$�JURXS�SODQ�LQ�WKH�country.

Health Reimbursement Arrangements and the Rise of the Start-ups

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FDUH� ZDV� DGYDQFHG� ZLWK� WKH� HYROXWLRQ� RI�KHDOWK�UHLPEXUVHPHQW�DFFRXQWV��+5$V��+5$V��UHYLYHG� E\� WKH� 7UHDVXU\� 'HSDUWPHQW¶V� UXOLQJ�WKDW� IXQGV� FRXOG� EH� UROOHG� RYHU� IURP� \HDU�WR� \HDU�� ZHUH� D� KXJH� ERRQ� WR� WKH� HPHUJLQJ�FRQVXPHU�GLUHFWHG� KHDOWK� FDUH� PDUNHW��+RZHYHU�� WKHUH� LV� D� NH\� GLVWLQFWLRQ�� KHDOWK�UHLPEXUVHPHQW�DUUDQJHPHQWV�ZHUH�QRW�VDYLQJV�DFFRXQWV� IRU� KHDOWK� FDUH� H[SHQVHV�� 7KURXJK�7UHDVXU\�UHJXODWLRQV��WKH\�ZHUH�GHVLJQDWHG�DV�KHDOWK�LQVXUDQFH�SROLFLHV�

8OWLPDWHO\�� DQ� HPHUJLQJ� JURXS� RI� VWDUW�XSV�� QDPHO\� /XPHQRV� DQG� 'H¿QLW\� +HDOWK��FRPSDQLHV� WKDW� ZRXOG� IRUHYHU� FKDQJH� WKH�ODQGVFDSH� RI� KHDOWK� LQVXUDQFH�� EHJDQ� WR� FDWFK�WKH� LQGXVWU\¶V�DWWHQWLRQ��,QLWLDOO\�� WKHVH�JURXSV�ZHUH�EDVHG�DURXQG�WKH�+5$�PRGHO�

Ron Bachman�� (GLWRULDO� &KDLUPDQ�� 7KH�,QVWLWXWH� IRU� +HDOWK&DUH� &RQVXPHULVP��3UHVLGHQW� � &(2�� +HDOWKFDUH� 9LVLRQV�� ,QF��IRUPHU�3DUWQHU��3ULFHZDWHUKRXVH&RRSHUV� The recession beginning in 2000 encouraged some companies to move ahead without the Treasury approval to establish health reimbursement arrangements. At the time, they were simply referred to as Personal Care Accounts (PCAs). Medtronics, a durable medical equipment FRPSDQ\��ZDV�LQ�¿QDQFLDO�WURXEOH�DQG�PDGH�WKH�bold decision to lower their health care costs with a PCA plan design and force the Treasury into a decision.

In early September 2001, Speaker Newt Gingrich set up a meeting with Mark McClellan M.D., Ph.D., President Bush’s Chief Health Policy Advisor, and myself, then at PricewaterhouseCoopers. Also at the meeting were Joe Walsh, J.D., Principle, PwC, and Jon Comola, Chairman, The Wye River Group on Health.

PwC had been working with Medtronics DQG� 'H¿QLW\� +HDOWK�� D� QHZ� FRPSDQ\� IRXQGHG�by Tony Miller that was offering the PCA plan design. The concept of HRAs was presented as QRW�QHHGLQJ�DQ\� OHJLVODWLRQ�EXW� MXVW�JHWWLQJ� WKH�Treasury Department to make a declaration that Sections 105 and 106 of the IRS code could be interpreted to allow for accumulating health

1980s and early 1990s, John Goodman, National Center for Policy Analysis,

and Pat Rooney, Golden Rule Insurance Company, became nationally known for

their advocacy of a law that would allow for tax-free contributions into a medical

savings account.

In 1996, Mr. Rooney convinced six Senators — four Democrats and two Republicans — to

introduce a bill to change the tax policy.

In 1992, Pat Rooney described an “experiment” that he had tried with his own employees: the concept of

raising their insurance benefit deductibles and giving them cash (which came from premium savings) to

offset at least some of the higher deductible.

A “demonstration project” that would allow self-employed

individuals and small businesses to purchase MSA

plans was included in the HIPAA law of 1996.

Timeline of HSA History


accounts. Dr. McClellan immediately saw the value of the approach as it would be a more consumer-centric approach than the use-it-or-lose-it requirements of the then popular but OLPLWLQJ�ÀH[LEOH�VSHQGLQJ�DUUDQJHPHQWV��

Mark saw the potential for a sea change in the insurance market. He stated that the Treasury could do this before the end of 2001.

Unfortunately, the tragedy of September 11 happened the next week and the administration’s efforts were sidetracked. But, after resolving VRPH� WHFKQLFDO� UHJXODWRU\� LVVXHV�� LQ� MXVW� QLQH�months the Treasury on June 22, 2002 declared approval of HRAs. Many kudos go to William 6ZHHWQDP�� WKH� 7UHDVXU\� RI¿FLDO� LQ� FKDUJH� RI�getting the HRA regulations completed. In :DVKLQJWRQ�� JHWWLQJ� VRPHWKLQJ� WKLV� VLJQL¿FDQW�in nine months is the equivalent of moving at the speed of light. The success and growth of HRAs set the stage for HSAs to be passed in December 2003.

Mike Parkinson, Principal�� 3�� +HDOWK�//&�� 3DVW� 3UHVLGHQW�� 7KH� $PHULFDQ� &ROOHJH� RI�3UHYHQWLYH� 0HGLFLQH�� IRUPHUO\� ([HFXWLYH� 9LFH�3UHVLGHQW�� &KLHI� +HDOWK� DQG� 0HGLFDO� 2I¿FHU��/XPHQRV� I had known of “Archer” Medical Savings Accounts — sponsored by Congressman Bill Archer — through my work with the American Medical Association. MSAs were in the market, but constrained in number by federal legislation. MSAs promoted the ability of consumers to use tax-advantaged monies (recall that employers had a tax-advantage for providing coverage already) directly from SURYLGHUV�� 'H¿QLW\� DQG� /XPHQRV� LQLWLDOO\� XVHG�health reimbursement arrangements to provide account-based plans. Our Lumenos team ZRUNHG� FORVHO\� ZLWK� NH\� ,56� RI¿FLDOV� WR� DVVLVW�them in crafting the health savings account regulations, which were released in 2004. I was privileged to be with Secretary Snow on the IRS’s release to discuss how health savings accounts, particularly if properly designed and supported with information, could be “good medicine.”

Health Savings Accounts Become Law

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Roy Ramthun: When I was asked to take a position at the U.S. Treasury Department in the fall of 2003, HSAs were not yet being considered as a provision of the 2003 Medicare Modernization Act which created the Part D prescription drug program. But I later learned that including HSAs, which no longer had most RI�WKH�06$�³GHPRQVWUDWLRQ�SURMHFW´�UHVWULFWLRQV��was a key provision that helped persuade some more conservative Republican members of the House to vote in favor of the legislation. When I heard they were included, I realized immediately what HSAs were and how they might be able to change the debate on health care generally and for the upcoming presidential election cycle in 2004.

When I was told by Treasury Secretary John Snow’s chief of staff that HSAs were to be my new number one priority, I immediately recognized the opportunity to apply my health care experi-ence to the development and implementation of the rules for HSAs, as well as the need for com-municating those rules to insurance companies, banks, employers, and others who might have an interest. We decided to create some initial guidance about the basic details of HSAs which was published in less than a month after enact-ment. We also decided to host a meeting of inter-ested stakeholders at the Treasury Department to answer questions about the guidance and to request input on which areas needed the most urgent attention to help stakeholders understand the rules and take advantage of the opportunity to create HSA products.

Bill Sweetnam��3ULQFLSDO��*URRP�/DZ�*URXS��IRUPHU�%HQH¿WV�7D[�&RXQVHO��2I¿FH�RI� WKH�7D[�3ROLF\�� 8�6�� 'HSDUWPHQW� RI� WKH� 7UHDVXU\�� NH\�OHJDO�¿JXUH�LQ�WKH�IRUPDWLYH�\HDUV�RI�ERWK�+5$V�DQG� +6$V�� There was a short period of time from the enactment of the MMA in December of 2003 and the effective date for HSA provision in January 1, 2004. So, our biggest problem was determining what questions needed to be answered by guidance and when the guidance was required in order for there to be a successful roll-out of HSAs. We talked with the interested groups about those issues shortly after the MMA was passed and continued to have a dialogue with all interested parties about what guidance was needed to offer HSAs and high-deductible health plans. With the help of my staff at the 2I¿FH�RI�7D[�3ROLF\��PRVW�QRWDEO\��.HYLQ�.QRSI��and the IRS attorneys at the IRS Chief Counsel’s 2I¿FH�� ZH� ZHUH� DEOH� WR� LVVXH� HLJKW� SLHFHV� RI�guidance by July 2004 that addressed many of the important issues surrounding HSAs and high-deductible health plans. Those government attorneys determined whether there were problems in administering the new law, and they proposed smart, effective solutions to those problems. Without the excellent lawyers at the 2I¿FH�RI�7D[�3ROLF\�DW�7UHDVXU\�DQG�DW� WKH� ,56�&KLHI�&RXQVHO¶V�RI¿FH��ZH�ZRXOG�QRW�KDYH�EHHQ�able to provide the needed guidance that helped get HSAs off the ground.

Beverly Gossage: Before long the local and state Chambers of Commerce, the NFIB and other business groups asked me to do seminars for their members. I tried to research for articles DQG�DQ\� LQIRUPDWLRQ� WKDW� ,� FRXOG�¿QG�RQ� WKHVH�plans. I read Regina Herzlinger’s book, Michael Cannon’s articles, John Goodman’s blogs and visited Lumenos. I was so excited about the HSA legislation and couldn’t wait for all my clients DQG�SRWHQWLDO� FOLHQWV� WR�KDYH� WKH�EHQH¿WV�RI� DQ�HSA since MSAs were restricted to small groups and the self employed. On January 1, 2004, I submitted multiple applications for clients and converted Kastl Plumbing and current clients to an HSA.

2000 brought on the evolution of health reimbursement

accounts (HRAs)

Sometime in 2002, Kastl Plumbing becomes the first,

full-replacement MSA group plan in the country.

After the passage of the Health Insurance Portability and

Accountability Act of 1996, medical savings accounts became law.

Thanks to William Sweetnam, approval of HRAs was declared

June 22, 2002.

HRA legislation was sidetracked by September 11,

2001



In March 2004, I received a fax from Assurant Health asking me to seize writing HSAs because they were not approved in Kansas. When I called the Department of Insurance to ask why this federal law was not approved in Kansas, they said legislators had to write a law that would allow HSAs to be tax deductible since the current law at the time said MSAs were tax deductible, and they asked me if I would be willing to testify in favor of this change and WR� H[SODLQ� WKHVH� SODQV�� 7KDW� ZDV� WKH� ¿UVW� RI�many testimonies on behalf of consumer-driven solutions. The law was passed, and they agreed to make it retroactive on behalf of my clients and others who may have set up these accounts prior to the law being written.

Consumer-directed Health Care Takes Off

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Mike Parkinson: But rather than accelerate &'+3V�LQ�VRPH�ZD\V��LQ�VRPH�PRUH�VLJQL¿FDQW�ways, the CDHP movement was blunted under the national carriers. First what was a transformational strategy for health insurance with a drive for healthy behaviors, patient care engagement, cost transparency and paradigm shift — it was the consumer’s/patient’s money, not the plan’s — became a plan option. Some PDMRU� UHYHQXH� VWUHDPV� IRU� WKH� QDWLRQDOV� ²�for example, pharmacy “rebates” — were threatened. If consultants were challenging — brokers were even more so in the small to mid-sized employer market distribution channel. It became clear that the broker was the customer

— not the employer. And the compensation models didn’t promote brokers selling CDHPs. 7KH� GHSDUWXUH� RI� WKH� JUHDW� PDMRULW\� RI� VHQLRU�leaders from the acquirers at the end of their VSHFL¿HG� FRQWUDFWV� ZDV� WHVWDPHQW� ,� EHOLHYH� WR�the fact that CDHPs weren’t embraced fully.

PPACA and the Future of Health Savings Accounts

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Roy Ramthun: 2YHU� WKH� QH[W� ¿YH� \HDUV�� ,�anticipate additional strong adoption of HSAs by employers and the private market generally. HSAs have demonstrated their staying power as a game changer that truly helps bend the “cost curve” in health care. Obamacare (especially the Cadillac plan tax provision) will only accelerate this adoption — even though that was not its intent. As the market grows, HSA administrators and insurance carriers will need to respond to the demand for more transparency, user-friendly tools, and programs that help support consumers as they take more responsibility for maintaining their health. I think it is too early to know what the response to HSAs will be within the state-based insurance exchanges. For many, it might be the only plan they can afford. I remain hopeful in this part of the market as well.

Mike Parkinson: Employers who choose to continue to offer health insurance will only be offering health savings accounts “done right”, viz. with funding to the account and additional incentives for improving health and medical care. Using consumer-driven health plans to power and integrated health and productivity strategy — involving EAP services, disability and leave management, worker’s compensation and on-site services — makes the most economic sense. And its frankly what we’re doing now with an incentivized health management program at UPMC and integrated approach. Leveraging the use of new technologies with transparent pricing, comprehensive shared decision-making support and even incentives for their use will further drive savings and better care. And it goes without saying, individuals purchasing health savings accounts — if we support the most vulnerable with economic support to make care affordable — can work as well.

John Young�� /HDGLQJ� &'+&� &RQVXOWDQW��IRUPHUO\�6HQLRU�9LFH�3UHVLGHQW��&RQVXPHULVP��&LJQD�� )RXQGHU�� &RQVXPHU�'ULYHQ�0DUNHWLQJ��WKH� PLG�PDUNHW� GLVWULEXWLRQ� V\VWHP� IRU�'H¿QLW\� +HDOWK�� The future of health savings accounts and consumerism strategies has never been brighter. Today, we see mass adoption of HSAs and other account-based strategies in every employer segment, notably the middle market, which has been the slowest to adopt. Adding to this increased employer sponsored DGRSWLRQ��WKH�H[SHULHQFH�RI�GH¿QHG�FRQWULEXWLRQ�health strategies is setting a very interesting new H[SHFWDWLRQ�� WKH� PDMRULW\� RI� HPSOR\HHV� ZKHQ�IDFHG�ZLWK�D�GH¿QHG�¿QDQFLDO�FRQWULEXWLRQ�DQG�H[SDQGHG�EHQH¿W�FKRLFHV�DUH�IDU�DQG�DZD\�VHOI�VHOHFWLQJ�ORZHU�YDOXH�EHQH¿WV��

More than half of these employees are VHOHFWLQJ�+6$�TXDOL¿HG�PHGLFDO� SODQV��1RUPDO�participation when offered as an option is 10 SHUFHQW�� 'H¿QHG� FRQWULEXWLRQ� VWUDWHJLHV� DUH�seeing 50 percent HSA enrollment. This gives us insight to the exchange environment around WKH� FRUQHU�� 7DNLQJ� GH¿QHG� FRQWULEXWLRQ� DV� D�preview, health reform and the Affordable Care Act will create many more participants in HSAs. 7KH�PDQ\� GLIIHUHQW� LQÀXHQFHV� KHUH� DUH� SDYLQJ�the way for HSAs: the elimination of Limited Coverage Plans and the looming Cadillac plan tax, to name a couple. But behavioral economics are powerfully in play — health savings accounts will succeed when you give people choice, make them spend their own money and offer them lower value options.

The success and growth of HRAs set the

stage for HSAs to be passed in December 2003.

In the mid-2000s, health savings accounts and

consumer-directed health care were given an opportunity to compete in the health insurance market without significant restrictions.

Eight pieces of guidance were issued by July 2004

that addressed many of the important issues

surrounding HSAs and high-deductible health plans.

The many different influences here are paving the way for

HSAs: the elimination of Limited Coverage

Plans and the looming Cadillac plan tax, to

name a couple.



AV��DSSURDFKHV��HPSOR\HUV�DQG�HPSOR\HHV�¿QG� WKHPVHOYHV� LQ�D�period of uncomfortable and exciting change. The implementation of the Affordable Care Act (ACA) — and particularly the roll-out

of public and private exchanges — has greatly expanded an employer’s FKRLFHV� IRU� SURYLGLQJ� KHDOWK� FDUH� EHQH¿WV� WR� WKHLU� HPSOR\HHV�� 7KLV�expansion in choice has led to some employer confusion in evaluating the many new options available and how best to manage and communicate the complexity for their employees. Despite these changes, one thing is certain — the health of an organization’s employees should not become an afterthought.

Wellness is becoming a key driver of corporate strategy for organizations, yielding increased productivity and business performance. Best-in-class organizations are recognizing this and decoupling ZHOOQHVV� IURP� WKH� EHQH¿W� VHOHFWLRQ� SURFHVV�� :LWK� D� ZLGH� UDQJH� RI�organizations seeking to implement wellness programs, the need for program customization continues to grow. Further, the diverse needs of employees will drive increased demand for personalized wellness solutions, particularly because of the alternative standard requirements outlined by the ACA. In light of this evolving landscape, independent wellness programs offer a distinctive value proposition to organizations intending to make wellness a priority.

TREND: Wellness as a strategic business initiative beyond cost reduction

Organizations are recognizing that improving the health, and therefore increasing productivity, of their workforce can do more than cut costs. Increased productivity leads to an improved bottom line and sustained competitive advantage. Successful outcomes-based wellness programs measure productivity in addition to focusing on medical cost savings. For example, an independent study found that participants of Interactive Health’s programs returned to work sooner than claimants who did not participate — 11 days sooner from worker’s compensation and 17 days sooner from short-term disability. The implication is simple: by taking a strategic approach to wellness, an organization develops a workforce that is healthier, more productive and more likely to drive value.

TREND: The role of independent wellness programsIndependent wellness programs are optimally positioned to aid

organizations in identifying and achieving its strategic wellness goals while offering the necessary customization and personalization. Since these same programs are separate from health plan carriers — and the new public and private health insurance exchanges — employers can also IHHO�FRQ¿GHQW�LQ�WKH�FRQWLQXLW\��SRUWDELOLW\�DQG�FRQVLVWHQF\�RI�WKH�ZHOOQHVV�program across an organization, no matter where they obtain health insurance for their employees or how many health plan carriers are used.

TREND: Continued rise in customization and personalization

$V� ZLWK� PRVW� SURGXFWV� DQG� VHUYLFHV� WRGD\�� D� ³RQH� VL]H� ¿WV� DOO´�approach no longer works for wellness programs. The culture, needs and JRDOV�RI�RUJDQL]DWLRQV�YDU\�VLJQL¿FDQWO\��VR�LW¶V�YLWDO�WKDW�ZHOOQHVV�SURJUDPV�factor this into the program design. These variables may include size of workforce, demographics, geographic distribution, employee satisfaction, engagement and motivation, organizational communication style, and VSHFL¿F� SRSXODWLRQ� KHDOWK� ULVNV�� WR� QDPH� D� IHZ�� ,Q� ,QWHUDFWLYH� +HDOWK¶V�experience, the most effective wellness programs have been developed based on the unique needs of the organization and more effectively positions it to generate results that will create a competitive advantage.

With varying health risks, needs and readiness to change among participants, a successful program treats each participant as an individual. To achieve improved health outcomes, well-designed programs should provide a personalized course of action, with goals and rewards for progress toward health improvement. This is important for individual engagement, especially among participants at high risk for addressable conditions like diabetes, pre-diabetes, hypertension and metabolic syndrome. By personalizing health recommendations to individual circumstances, rather than an idealized notion of what is “healthy,” these programs encourage greater levels of participation and continuing engagement amongst employees.

TREND: Meeting alternative standard requirements under the ACA

Outcomes-based (or health-contingent) wellness programs will be required under the ACA to offer participants an alternate course of action to earn an incentive if they are unable to meet program requirements. Alternatives may vary by organization — examples could include an DOWHUQDWH� KHDOWK� RXWFRPH�� D� VSHFL¿F� DFWLRQ� WR� WDNH�� RU� D� YDULDEOH� WLPH�period to achieve the incentive. Ultimately, these alternative standards need to be incorporated into the wellness program design that is based on the organization and/or employee’s circumstances – customization and personalization can be an effective means for doing so.

Heading into 2014The year ahead will be a critical one for organizational adoption and

expansion of strategic wellness programs. Designing programs to account for the unique circumstances facing organizations and employees will be a key determinant of their success. Organizations that are looking to maximize the potential of these programs and drive competitive advantage will do well to consider partnering with independent wellness program providers like Interactive Health to help them navigate the wellness landscape. After all, the health of your organization is what’s at stake.

Trending in 2014: Making Wellness a Strategic Initiative

WELLNESSBY JOSEPH O’BRIENPRESIDENT & CEO

INTERACTIVE HEALTH


BY SHERYL SOUTHWICKDIRECTOR OF COMPLIANCETRINET

HEALTH REFORM COMPLIANCE

There are millions of articles and web pages that describe the Affordable Care Act (ACA). At least the same amount of articles DQG� ZHEVLWHV� SURYLGH� LQVLJKW� DQG� RSLQLRQV� RQ� WKLV� PDMRU� SLHFH� RI�

U.S. legislation. At TriNet, we serve over 7,000 small and medium-sized businesses throughout the U.S. as a strategic partner for payroll, HR, EHQH¿WV�DQG�HPSOR\PHQW�ODZ�FRPSOLDQFH�DQG�ULVN�UHGXFWLRQ��DQG�ZH�KDYH�noticed a growing — and wrong — notion that not all small businesses need to take action on the ACA. Some also believe there are clever workarounds — however, there are not.

ACA myths and legends abound, some of which have been mistaken for fact. With so much misinformation about the ACA, some businesses PD\�¿QG�LW�KDUGHU�WR�XQGHUVWDQG�WKH�$&$�ZLWK�HDFK�GD\�WKDW�SDVVHV��%XW��three things are crystal clear: the ACA is complex; its roll out will not be without headaches; and small businesses — of all sizes — will have to understand ACA requirements and take action.

Even though the government recently announced that two ACA provisions—the employer mandate and reporting requirements – will not be implemented until 2015, there are processes and compliance requirements that you need to act on now or in the very near future. Failure to do so could be costly.

In order to help businesses stay on the right side of the ACA, here are ¿YH�VLPSOH�ZKDW�QRW�WR�GRV�

Don’t think there is nothing to do: All businesses, no matter the size, have an action to take. For instance, even if a small business does not offer health care, it still has to make all employees aware of the health care marketplaces

where they can purchase their own plans. Failure to do so equals QRQ�FRPSOLDQFH�±�ZLWK�WKH�SRWHQWLDO�RI�KHIW\�¿QHV��

Don’t try to morph your employees into something they are not: Changing employees to independent contractor status to reduce your FTE count is not advised. There are several criteria involved in determining

HPSOR\HH�FODVVL¿FDWLRQ��6LPSO\�FKDQJLQJ�HPSOR\HH�FODVVL¿FDWLRQ�ZLWKRXW�FRQIRUPLQJ�WR�GH¿QHG�OHJDO�FULWHULD�PLJKW�SXVK�\RX�LQWR�non-compliance on multiple fronts, including the ACA, the IRS, and the wage and hour laws and regulations regarding overtime, exempt status, and the like. This would expose you to lawsuits and myriad non-compliance penalties.

Don’t create a dual business model: Several criteria of the ACA become relevant to businesses with over 50 FTEs. We have heard several small businesses suggest that they can circumvent the rules by splitting their

business into two and setting up a separate business each hiring under 50 employees — each with different Federal Employer Identify Number (FEIN). This is not advisable as the government assesses headcount based on overall business ownership. So, if you own two businesses, the total headcount of both will most likely be tallied up. This ill-conceived work-around could work up some pretty big non-compliance penalties.

Don’t believe it will be easy for employees to get health insurance from the government: There will be marketplaces where everyone will be able to buy healthcare without the exclusion clauses of the past.

However, employees will have to navigate these market places. The application process is likely going to be pretty arduous and premium costs are still unknown. Your employees may have a negative experience with the process.

Don’t wait: Don’t think you can wait until 2015! Most of the ACA’s regulations have not been delayed and you need to get started now. Once all elements of the ACA become effective, employer penalties will be

assessed and managed with a retroactive point of view, so you need to pay attention and start planning to comply now.

Even without the ACA, a national survey* purported the average small business owner spends 25 percent of time on HR paperwork. Yet, the silver bullet of business success, particularly with small and entrepreneurially-driven businesses, is being able to stay laser focused on the vision, mission, and the core competency of the business. How do you maintain focus on the business without being over-burdened by complex employment laws and compliance with new laws such as ACA? Seek help from experts. The sooner you get smart — the sooner you mitigate risk of non-compliance. 6RXUFH�� 8�6�� 6PDOO� %XVLQHVV� $GPLQLVWUDWLRQ� KWWS��ZZZ�VRXUFHSRLQWH�FRP�VWDUWOLQJ�VWDWLVWLFV�

Small and Mid-sized Business Take Note:Five Things Not to Do Regarding Health Reform

6ROXWLRQV�WR�KHOS�\RXU�LQQRYDWLYH�KHDOWK�DQG�EHQH¿W�SURJUDPV��HEALTH DECISION SUPPORT TOOLS

Castlight Health enables employers, their employees, and health plans to take control of health care costs and improve care. Named #1 on The Wall Street Journal’s list of “The Top 50 Venture-Backed Companies” for 2011 and one of Dow Jones’ 50 Most Investment-Worthy Technology Start-Ups, Castlight Health helps the country’s self-insured employers and health plans empower consumers to shop for health care. Castlight Health is headquartered in San Francisco and backed by prominent investors including Allen & Company, Cleveland Clinic, Maverick Capital, Morgan Stanley Investment Management, Oak Investment Partners, Redmile Group, T. Rowe Price, U.S. Venture Partners, Venrock, Wellcome Trust and two unnamed mutual funds.

— Giovanni Colella, M.D.CEO and Co-Founder, Castlight Health

CASTLIGHT HEALTH85 Market Street, Suite 300San Francisco, CA 94105

415.829.1400www.castlighthealth.com

PROFESSIONAL DEVELOPMENT

Health Insurance 101: An Orientation is a new, flexible online course offered by AHIP.

It is designed to teach health insurance basics to those new to health care or individuals who wish to review the fundamentals. The course is formatted in short modules; you learn at your own pace and on your own time, moving through the materials as you choose. Plus, AHIP will customize the course to fit your organization’s specific learning requirements.

AMERICA’S HEALTH INSURANCE PLANS 601 Pennsylvania Ave., NWSouth Building, Suite 500Washington, D.C. 20004Lindsey Miranda Canaley

Tel: 800.509.4422Fax: 202.861.6354 [email protected] www.ahip.org/courses

HEALTHCARE DATA ANALYTICS

Med-Vision delivers health-plan risk management and wellness strategies to help employer groups achieve optimal employee health. Med-Vision’s healthcare data analysis tool, Med-View, guides employers in mitigating health risks. With Med-Vision’s help, self-funded employers, healthcare facilities, municipalities, and school districts have reversed trends and decreased healthcare costs while enhancing care.

“You can’t change what you can’t measure. That’s why Med-Vision leverages Med-View’s analytics tool to investigate employee-health data and determine actionable solutions for employers. Med-Vision uses the data to implement innovative and customized plans for strategic wellness and disease management. Results include healthier employees, greater productivity, and drastically lower healthcare costs.”

— Connie Gee, Vice President, Wellness Strategist & Health Data Analyst

MED-VISION LLCConnie Gee, Vice President [email protected]

813-205-1577www.med-vision.comwww.med-view.net

Intrepid goes beyond the typical expectations of the benefits consultant. We take the time to understand each client’s unique culture in order to implement the most progressive, creative solution to their benefits needs.

“Our mission is to empower clients to achieve a more sustainable health care policy; it’s about more than just giving the client a plan — it’s a process of educating the client and their employees to better understand the plan and ensure its success. When we see the shift that occurs when employees have their ‘aha’ moment is when we feel we have done our job.

— Liz Frayer, RHU, Intrepid

INTREPIDLiz Frayer, RHU400 Interstate North Parkway, Suite 600,Atlanta, GA 30339

888-612-4644 www.intrepid7.com

EMPLOYEE BENEFITS CONSULTING


WWW.THEIHCC.COM SOLUTION PROVIDER MEMBER PROFILES

http://www.castlighthealth.com/

http://www.healthysightworkingforyou.org/

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MasterCard (NYSE: MA),

is a global payments and

technology company.

It operates the world’s fastest payments processing network,

connecting consumers, financial institutions, merchants,

governments and businesses in more than 210 countries and

territories. MasterCard’s products and solutions make everyday

commerce activities—such as shopping, traveling, running a

business and managing finances—easier, more secure and more

efficient for everyone.

MASTERCARD WORLDWIDE2000 Purchase St.Purchase, NY 10577-2509

HEALTH ACCESS ALTERNATIVES

Carena provides 24/7, on-demand access to health care by phone, webcam, and house call. Seattle-based Carena is committed to delivering the best health care experience possible. Its technology-enabled care delivery model provides on-demand access to health care 24/7, via phone, secure video, and house call. Carena provides health care solutions to patients through employers, health systems and through its consumer service, CareSimple.

“People are paying more out of pocket for care than ever—through higher co-pays and deductibles, reduced benefits, and in the rising costs of goods and services. Taken together, health care has become more expensive and less accessible. Our goal is to make health care more affordable by providing the right care at the right time for the right cost; to help people live healthier lives by removing the barriers to people taking control of their health care.”

— Ralph C. Derrickson, President & CEO, Carena

CARENA, INC.1525 4th Avenue, Suite 300Seattle, WA 98101

800.572.2103www.CarenaMD.com [email protected]

TOTAL POPULATION HEALTH MANAGEMENT

Orriant helps businesses produce a better, more profitable product by creating a workforce that is healthier, more productive, and less expensive to insure.

Orriant’s proven strategy is to hold people accountable for improving their health as an integral part of your benefit strategy in a way that is fair and compassionate to all. “Employers can fight back to control rising health care costs. Orriant’s strategies have helped major employers from almost every industry cut the cost of health care, improve the health and productivity of their workforce, and push hundreds of thousands of dollars to their bottom lines.”

— Darrell Moon, CEO, Orrian

ORRIANT9980 South 300 West Ste. 100Sandy, Utah 84070

801.574.2306 www.orriant.com [email protected]

FSA/HRA/HSA/TRANSIT/COBRA: ADMINISTRATION & MANAGEMENT

eflexgroup (eflex) is a nationwide administrator of pre-tax benefits and COBRA. Committed to providing fast answers, fast claims, and web self-service, we set the industry standards for service. With a customer focus and Lean Six Sigma methodology, we don’t talk about service, we prove it. See our metrics at eflexgroup.com.

“eflexgroup’s customer service department should be a model for ALL customer service departments. The courtesy, professionalism and knowledge surpass ANY customer service department I’ve encountered! I feel the outstanding, exemplary customer service of eflexgroup is simply the best!”

— Kimberly Adams, Southeast Energy Assistance [testimonial]

eflexgroup2740 Ski LaneMadison, WI 53713

877.933.3539 ext 300 [email protected]

WWW.THEIHCC.COMSOLUTION PROVIDER MEMBER PROFILES

http://eflexgroup.com/

http://www.eflexgroup.com/





TSYS Healthcare® provides end-to-end strategic payment solutions for consumer directed healthcare. We partner with benefits administrators, financial institutions, health plans, and software providers to navigate all aspects of HSAs, HRAs, FSAs, transportation accounts, cash reimbursements, and lines of credit. TSYS Healthcare cards offer participants the security they expect along with the ability to conveniently access funds from multiple accounts and manage their benefits payments with simplified single-card access. Clients and partners benefit from simplified processes, reduced paperwork and cost savings that can contribute to improved return on investment.

“We built the TSYS Healthcare platform to meet the market demand for reliable, configurable and intelligent solutions. Understanding the dynamic U.S. healthcare market, our customers rely on our option-driven system to prepare them for the future.”

— Trey Jinks, Group Executive, TSYS Healthcare

TSYS HEALTHCARE706.649.5080www.tsys.com/[email protected]

Evolution1 and our Partners serve more than 9 million consumers, making us the nation’s largest electronic payment, on-premise and cloud computing healthcare solution that administers reimbursement accounts, including HSAs, HRAs, FSAs, VEBAs, Wellness and Transit Plans. It is the only solution that offers a single end-to-end user experience, provides innovative auto-substantiation technologies, and automates workflow for Partners, employers, and consumers. It does all this on one technology platform comprised of 1Cloud™, 1Direct™, 1Pay™, 1View™, 1Plan™, and 1Mobile™. Evolution1 and our Partners are dedicated to delivering value, reducing costs and simplifying the business of healthcare.

“The combination of our innovative products will further our leadership position in a rapidly changing healthcare market. Together with our Partners we are committed to reducing costs and simplifying the business of healthcare.”

— Jeff Young Chairman and CEO, Evolution1


EVOLUTION1, [email protected]

HSA ADMINISTRATION & FINANCE

At HSA Bank, we’ve been helping businesses optimize their health care spending for over 15 years. We offer unmatched service and expertise when it comes to health-based savings accounts. You can count on our dedicated business relations team for turnkey solutions and ongoing support that help your business and workforce save for a healthy future. To connect with your regional representative, call 866.357.5232 or visit hsabank.com.

“When implementing one of the first Medical Savings Account programs in the country, I had a belief that health care could be fixed with free-market principles. I still do. By adopting flexible and transparent practices that manifest core attributes of consumerism such as private exchanges, defined contributions, and self-funding; we will reform health care in our nation.”

— Kirk Hoewisch, Co-Founder and President, HSA Bank, a division of Webster Bank, N.A.

HSA BANK605 N. 8th Street Suite 320Sheboygan, Wisconsin 53081United States of America

800.357.6246www.hsabank.com

WageWorks helps employers

support consumer directed

pre-tax benefit programs,

including health care

(FSA, HSA, HRA), wellness

programs, commuting and

child and elder care. Wage

Works also offers retiree health care and COBRA Services.

More than 100 of America’s Fortune 500 employers and

millions of their employees use WageWorks.


WAGEWORKS

1100 Park Place, 4th Floor San Mateo, California 94403United States of America

888-9905099www.wageworks.com




EMPLOYEE ENGAGEMENT TOOLS

Under the CIVA (CodeBaby Intelligent Virtual Assistant) brands of benefits and health advisor, CodeBaby improves the healthcare consumer experience and optimizes online self-service on any web-based platform or device with absolutely no IT disruption. Benefits advisor offers guidance and self-service options that help consumers and organizations alike to make better decisions about benefits selection. Health advisor engages new patient visitors on hospital or office websites or existing patients on wellness, prevention & disease management platforms.

“With the rapid changes in health care, our solutions provide organizations innovative ways to optimize their current platform while meeting the demand for an enhanced online experience. CIVA benefits and health advisor solutions are industry-leading models that help consumers and organizations more efficiently navigate complex health benefit exchanges and patient portals. “

— Dennis McGuire, CEO, CodeBaby

CODEBABY CIVA111 S. Tejon St. Suite 107Colorado Springs, CO 80903877.334.3465codebaby.com/[email protected]

HEALTH DECISION SUPPORT AND COST-SAVING TOOLS

WiserTogether Inc., helps patients

choose the right care at the time. It

offers an innovative online treatment

selection & shared decision support

platform that helps patients make

evidence-based, cost effective

treatment decisions across musculoskeletal, cardiovascular, mental health,

diabetes, pregnancy and respiratory illnesses saving payers money. Currently

1.5 million members have access to the platform through employers and health

plans in the country.

WiserTogether was founded in 2008 and is based in

Washington, DC.

— Praveen Mooganur, COO, WiserTogether

WISER TOGETHERPraveen Mooganur

202.276.3074

[email protected]

BENEFIT ENROLLMENT AND ELIGIBILITY

Totem Solutions is a boutique benefits consulting and administration firm offering highly specialized services and products. We serve benefit management and HR professionals as an extension of their team, allowing them to focus on key initiatives and core strengths. Our services include Employee Benefits Consulting, Benefits Administration, Enrollment, & Communication, Health Care Reform Education, Enrollment, Reporting & Compliance, Leave and Disability Management Administration.

“We are hands-on benefits advisors for public and private sector companies throughout the country. Totem delivers employer-centric service that simplifies benefits administration and enrollment in order to facilitate employee understanding and ensure the best possible employee experience. Our goal is also our great passion and commitment: to offer organizations clear and accurate counsel accompanied by services and solutions that are easy to access, seamlessly implemented and custom fit, while providing a worry-free outsourcing solution.”

— Debbie Schultz, President, CEO, Totem Solutions

TOTEM SOLUTIONS11330 Lakefield DriveBldg 1, Ste 150Duluth, GA 30097

770-295-1600Toll-free 866-481-4917www.totemsolutions.com

SUPPLEMENTAL HEALTH

Delta Dental leads the industry in designing innovative dental coverage programs that keep costs down and deliver quality care. Our diverse client list includes everyone from Fortune 100 companies to public agencies to individuals and families. Our customer’s satisfaction is based on our expansive dentist network, cost-saving mechanisms and superior customer service. We are part of the Delta Dental Plans Association that provides dental coverage to more than 56 million people in the US.

DELTA DENTAL1130 Sanctuary Pkwy, Suite 600Alpharetta, GA 30009

770-641-5196


http://www.totemsolutions.com/



DataPath, Inc., is one of nation’s largest providers of CDH solutions specializing in account-based administration systems.

Since 1984, service providers using DataPath systems have provided administrative solutions for over 1 million participants of FSA, HRA, HSA, and COBRA. DataPath is the only solutions provider to design and deliver a full Suite of systems for handling 125, 105, 132, COBRA, HSAs, Credit and Debit Cards all delivered to account holders through a single Internet portal, myRSC.com.

“With the significant changes in healthcare today, our software solutions allow users to create custom plans for clients that benefit both the employer and employee. Not only have we created a single platform for all systems with myRSC.com, with the integration of our mySourceCard® Debit Card at Wal-Mart and other retailers, our clients are able to offer a hassle-free solution with 100% compliance.”

DATAPATH, INC.1601 WestPark Drive, Suite 9Little Rock, AR 72204

501.296.9990www.dpath.com



HEALTHCARE ACCESS

HealthPerx is a health and wellness marketing company specializing in creative non-insurance benefit solutions that reduce absenteeism, increase productivity and decrease healthcare costs. Consultants: These benefits differentiate you from competitors. Corporations: These will give you a far greater ROI than your wellness program while saving your employees thousands of dollars a year. Differentiator: Q Telemedicine Services: offering the entire family unlimited calls with no consult fees

24/7/365—anytime from anywhereQ Additional Health Benefits: offering significant savings for pharmacy, dental, vision,

medical advocacy, travel assistance, telephonic counseling (EAP) and moreQ Turnkey Program: billing, administration, fulfillment, call center,

marketing HealthPerx benefits complement any and all existing benefit plans.

— Je" Marks, CEO

HEALTHPERXJeff Marks, [email protected]

Direct: 205 222-4062Toll Free: 888 417-6187www.hperx.com

PRESCRIPTION BENEFITS MANAGEMENT

Provider of Prescription Benefits Management services to self-funded employee groups, TPA’s, Brokers, and Consultants. Phoenix also offers a prescription savings card, RxAdvantage, for individuals and groups alike.

Phoenix Benefits Management is a prescription benefit manager providing traditional PBM services to Self-Funded companies, TPA’s, Brokers, and Consultants. We also provide comprehensive 340B services as well as our very own prescription savings card known as the Phoenix RxAdvantage Prescription Savings Card. Though our approach is scalable, our solutions are individualized. It’s been our experience and it is our firm belief that prescription benefit plans are not a one-size-fits-all proposition so we create a plan that is customized to fit the unique needs of each and every one of our clients.

PHOENIX BENEFITS MANAGEMENT410 Peachtree Parkway, Suite 4225 Cumming, Georgia 30041

888.532.3299 main office 678.208.6257 marketing & pr 678.208.6252 sales 678.208.6255 fax

[email protected] [email protected] www.phoenixpbm.com

LOOKING FORWARD TO A CONSUMER DRIVEN FUTUREIt has been an exciting year at Flexible Benefit Service Corporation (Flex). We celebrated our 25th anniversary along with a decade of increasingly popular HSAs. We have been a trusted benefits administrator of these consumer-driven plans since day one and also offer FSAs, HRAs, Transit and COBRA Administration. In fact, we now offer the InsureXSolutions® private exchange to employers with part-time workers or retirees, as well as small businesses. At Flex, we look towards the future and leverage our consumer-driven experience as a way to help our clients move forward in the changing marketplace. Contact your broker or consultant, call us directly at 888-353-9178 or visit www.flexiblebenefit.com to learn more.

FLEXIBLE BENEFIT SERVICE CORPORATION (FLEX)10275 W. Higgins Road, Suite 500 Rosemont, IL 60018

888-353-9178 [email protected] www.flexiblebenefit.com



http://www.hperx.com



http://www.flexiblebenefit.com

BENEFIT ADMINISTRATION/PRIVATE EXCHANGES

Since 1988, CieloStar (formerly OutsourceOne) has helped brokers, employers and employees navigate the ever-changing world of benefits. Now, with the dawn of “Defined Contribution Health Care” we are again on the leading edge. With a team of industry thought leaders, CieloStar makes navigating healthand benefits choices easy for employers and employees by offering comprehensive benefits administration solutions with a high-touch, high technology model—most recently launching a proprietary private health insurance exchange.

“Fueled by the far-reaching impact and complexities of health care reform taking effect in 2013 and 2014, employers and employees increasingly find themselves in a ‘farmer’s market’ of benefits choices. Cielostar is uniquely positioned with enabling technology that helps purchasers and consumers make the best possible decisions and create a best-in-class benefits administration process. Our unique comprehensive approach to benefits offers everything from back room technology for enrollment, data, billing and call centers to complete solutions for COBRA, CDHP and health insurance exchanges.”

— John Reynolds, CEO, Cielostar

CIELOSTAR530 U.S. Trust Building730 Second Avenue SouthMinneapolis, MN 55402


HEALTH DECISION SUPPORT TOOLS

FSAstore.com is the only one-stop-shop exclusively stocked with FSA eligible products and services. At FSAstore.com, consumers have access to more than 4,000 FSA eligible products, a national database of FSA eligible services, and much-needed information through the FSA Learning Center. FSAstore accepts all FSA and major credit cards, offers 24/7 customer service, one-to-two-day turnaround for all orders, and free shipping on orders over $50.

“Each year consumers lose hundreds of millions of dollars simply because they do not deplete all of the pre-tax funds available to them in their FSA. But this year, more consumers than ever are realizing that they can use that money to buy many of the daily health products they need, and without a prescription. FSAstore.com strives to make it easy for participants to use and understand their FSAs.”

— Jeremy Miller, Founder and President, FSAstore.com

FSASTORE.COM244 5th Avenue, Suite J-257New York, NY 10001

888.FSA.1450 (372-1450)

HEALTH DECISION SUPPORT TOOLS

Truven Health Analytics, formerly Healthcare at Thomson Reuters, delivers unbiased information, analytic tools, benchmarks, and services to the health care industry.

Hospitals, government agencies, employers, health plans, clinicians, and life sciences companies have relied on us for more than 30 years. We combine deep clinical, financial, and health care management expertise with innovative technology platforms and information assets to make health care better by collaborating with our customers to uncover and realize opportunities for improving quality, efficiency, and outcomes.

TRUVEN HEALTH ANALYTICS6200 S Syracuse Way, Suite 300Greenwood Village, CO 80111

734.913.3000

TOTAL POPULATION HEALTH MANAGEMENT

Level1Diagnostics uses new tools to evaluate employees’ cardiovascular healthHeart disease is the number one killer in the U.S. and costs millions of dollars in medical care and time lost from work. Detection and prevention is the key to heart health. Level1Diagnostics is an innovative program that, unlike conventional cardiology tests, provides new advanced technology testing and methods to detect and prevent the earliest signs of cardiovascular disease and encourage optimal health.

“The biggest problem with traditional cardiology is that it is not preventive—there isn’t a testing program to evaluate people who don’t have any symptoms of heart disease, but may be at significant risk. Drugs and surgery are offered to patients instead of lifestyle change programs and supplements.”

— Dr. Steven Helschien, Founder, Level1Diagnostics

LEVEL1DIAGNOSTICS11722 Lightfall CourtColumbia, MD 21044

Dr. Steven Helschien, FounderSales: Penny Aleo, Executive [email protected]

Dr. Steven M. HelschienFounder and CC&BW

www.level1diagnostics.com410-707-5667 ◆ [email protected]








HEALTH INCENTIVES

MedEncentive offers a

patented, web-based

incentive system that’s been

independently validated

to control healthcare

costs. Doctors and patients earn financial rewards for

declaring adherence to best practices and healthy

behaviors, provided they agree to be accountable to

the other party for doing so. Easy to implement and

embraced by users.

MEDENCENTIVECecily HallExecutive Vice President

[email protected]

WeCare TLC is a medical risk management company that leverages onsite primary care clinics to provide solutions to rising healthcare costs while improving patient health and wellness.

Our holistic approach to care empowers the clinic staff to act as patient advocates, which increases compliance and decreases unnecessary expensive services.

“Healthcare is now a right and employers are faced with the challenge of truly managing their healthcare costs. We have created a unique medical home clinic model that properly addresses quality of care and cost. This requires constant, aggressive, creative, and directed attention to accomplish but it can be done.”

— Lynn Jennings, CEO, WeCare TLC

HEALTH ACCESS ALTERNATIVES

WE CARE TLC120 Crown Oak Centre DrLongwood, FL 32750


ExperienceLab has created a breakthrough, patented communication program that saves employers money by increasing adoption and usage of consumer directed health (CDH) insurance plans among their employees. CDHCentric, sold on a subscription basis, delivers regular, multi-media communications that are tailored based on seven unique attitudinal segments developed from proprietary research.

Traditional health plans protect employees from having to learn the basic skills for making cost-effective healthcare decisions. Our segmentation research, which is based on 20 years of behavioral marketing, found 7 unique personality types, and each makes healthcare decisions differently. The result is that, when employee messages are correctly tailored to their personalities, employees become health care consumers!

— Roger Travis, President

CDHCENTRIC507 S. 8th Ave. Bozeman, Montana 59715


EMPLOYEE COMMUNICATION AND EDUCATION

Transitions Optical, Inc. is the maker of Transitions® lenses, the #1-eyecare professional recommended photochromic lenses worldwide.

Transitions Healthy Sight Working for You® is an education initiative that helps HR professionals and benefits professionals communicate the value of the vision benefit to employees. More information and complimentary education tools are available at HealthySightWorkingForYou.org.

“Don’t overlook your employees’ healthy sight when thinking about your business goals. A vision benefit that includes an eye exam and sight-optimizing eyewear helps ensure that employees see their best, so they can do their best work, directly affecting your business.”

TRANSITIONS OPTICAL9251 Belcher RoadPinellas Park, FL 33782

800.533.2081 ext. 2262www.healthysightworkingforyou.org

SUPPLEMENTAL HEALTH

http://medencentive.com/


http://www.wecaretlc.com/

http://www.wecaretlc.com/


http://www.experiencelab.com/


http://HealthySightWorkingForYou.org/

http://www.healthysightworkingforyou.org/

WWW.THEIHCC.COMRESOURCE GUIDE



If you use the services of our solutions providers, please tell them you saw their ad in +HDOWK&DUH�&RQVXPHULVP�Solutions™.5HTXHVWV�IRU�3HUPLVVLRQV�WR�UHXVH�FRQWHQW��FRQWDFW� &RS\ULJKW�&OHDUDQFH�&HQWHU�DW�LQIR#FRS\ULJKW�FRP�

ADVERTISING CONTACTS

AHIP ...................................................... 43

Best Buy ........................Inside Back Cover

Buck Consultants ............................. HXS 2

Carena ................................................... 44

Castlight Health ..................................... 43

CDHCentric ............................................ 49

CieloStar ..................................HXS 15, 48

CodeBaby ............................................... 46

DataPath ................................................ 47

Delta Dental ........................................... 46

eFlex Group ............................................ 44

Evolution1 ..........................16, HXS 15, 45

Flexible Benefit Service Corporation ..36, 47

FSA Store ............................................... 48

HealthPERX ............................................ 47

HealthStat ......................Inside Front Cover

HSA Bank .............................................. 45

hubbub .................................................. 10

IHC FORUM & Expo 2014 ..................11-12

IHC Radio............................................... 50

IHC Save the Date FORUM West 2014....13

insurexsolutions ............................. HXS 15

Intrepid .................................................. 43

Level1Diagnostics .................................. 48

MasterCard ............................................ 44

MedEncentive ........................................ 49

MedVision .............................................. 43

Mercer Marketplace ......................... HXS 6

Orriant ................................................... 44

Phoenix Benefits Management ................ 47

PrivateHealthCareExchange.com .... HXS 16

SelectAccount ........................................ 34

Tango Health ......................................... 38

Totem Solutions ..................................... 46

Transitions ............................................. 49

Truven Health Analytics ......................... 48

TSYS Healthcare ..................5, HXS 15, 45

UnitedHealthCare ..................... Back Cover

WageWorks ........................................... 45

WeCare TLC ........................................... 49

Wiser Together ..................................7, 46

ADVERTISING INDEX

CEO/PUBLISHER

Doug Field G¿HOG@¿HOGPHGLD�FRP�ā�H[W��

MANAGING DIRECTOR

Brent Macy�EPDF\#WKHLKFF�FRP�ā�H[W��

ACCOUNT MANAGER

Joni Lipson�MOLSVRQ#¿HOGPHGLD�FRP

DIRECTOR OF CONFERENCE SPONSORSHIP/CORPORATE MEMBERSHIP/REPRINTS

Rogers Beasley [email protected]�ā�H[W��

404.671.9551

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REWARD THEM WITH A HEALTHYDOSE OF FUNStaying healthy feels better with Best Buy® gift cards.

GIFT CARD INCENTIVESAs powerful incentives, Best Buy gift cards energize your health and wellness program by motivating people with the things they want most, from TVs to tablets to smart phones. They’re hard to resist and easy to redeem online or in store. For instant e-mail delivery and easy personalization, choose our popular e-gift cards. Make your wellness program even more rewarding. Visit us online today.

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© 2013 BBY Solutions, Inc. All rights reserved.

All UnitedHealthcare members can access a cost estimator online tool at myuhc.com. Depending on your specifi c benefi t plan and the ZIP code that is entered, either the myHealthcare Cost Estimator or the Treatment Cost Estimator will be available. A mobile version of myHealthcare Cost Estimator is available in the Health4Me mobile app, and additional ZIP codes and procedures will be added soon. This tool is not intended to be a guarantee of your costs or benefi ts. Your actual costs and/or benefi ts may vary. When accessing the tool, please refer to the Terms and Conditions of Use and Why Your Costs May Vary sections for further information regarding cost estimates. Refer to your health plan coverage document for information regarding your specifi c benefi ts.

©2013 United HealthCare Services, Inc. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affi liates. Administrative services provided by United HealthCare Services, Inc. or their affi liates. Health plan coverage provided by or through a UnitedHealthcare company.

UHCEW506202-004

uhc.com

TO TAKE CARE OF BUSINESSWITH INNOVATIVE TOOLS FOR THE JOB

The right health information can take you a long way.

At UnitedHealthcare, we offer innovative tools that put members in touch with their information.

myHealthcare Cost Estimator provides relevant information on care and estimated costs. myClaims Manager helps you understand, track and pay your medical bills online. UnitedHealthcare Health4Me is a mobile app that provides instant access to a family’s important health information. UHC.TV presents exciting, engaging online content about good health and living well.

Empower your employees. It’s good for their health – and the health of your business.

For more information, visit welcometomyuhc.com or call 1-866-438-5651.

myHealthcare Cost Estimator

myClaims Manager

UnitedHealthcareHealth4MeTM

UHC.TVSM

healthcare consumerism solutions nov/dec 2013

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