welcome to the 2021 small business broker
TRANSCRIPT
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Welcome to the 2021 Small Business Broker Roadshow!
Our presentation will begin in just a
few moments.
During the presentation, all lines will
be muted. Please also refrain from
using the raise hand feature.
Please submit any questions you
have using the Q&A button at the
bottom of your screen.
We will address questions at the end
of our presentation. We will follow up
via email to answer any questions we
can’t cover on this call.
Presenters
Jason Bleau
Vice President & GM
Tom Marshall
Area Vice President of Sales
Berylnn Bell
Area Vice President of Account Management
Mark Zeedik
Sales Manager, Specialty
2
Deana Perrin
Senior Director, Operations
Katherine Hast ings-Sierze
Small Business Account Executive
Sandi Eber
Senior Sales Manager – GA Channel - Statewide
Agenda
New Business Updates01.
Renewal & OE02.
Specialty benefits03.
Digital enhancements04.
Q&A05.
© 2021 Blue Shield of California. All Rights Reserved.
Closing remarks06.
Welcome from Jason Bleau
© 2021 Blue Shield of California. All Rights Reserved.
© 2021 Blue Shield of California. All Rights Reserved.
New business updates
Tom Marshall
Q4 Rating Action
6
• Consistent and sustainably affordable
Average HMO Rate Actions
Jan Apr Jul Oct YEAR
1.7% 1.8% 1.2% -1.8% 2.9%
0.7% 0.0% 4.0% 4.4% 9.3%
0.6% 0.0% 0.0% 2.8% 3.4%
0.0% 4.3% 0.0% -0.9% 3.4%
2.3% 1.0% 0.0% -2.1% 1.2%
0.9% 1.6% 3.8% 1.8% 8.3%
0.9% 0.0% 0.9% -1.2% 0.6%
0.0% 1.0% 1.2% 1.4% 3.6%
1.3%
Average PPO Rate Actions
Jan Apr Jul Oct YEAR
6.5% 2.3% 2.5% -7.7% 3.1%
2.4% 0.0% 2.2% 0.0% 4.7%
1.1% 0.0% 0.0% 5.0% 6.2%
-0.2% 0.8% 0.0% 0.5% 1.1%
1.1% 1.9% 0.0% 0.7% 3.7%
1.3% 1.5% 3.3% 1.8% 8.1%
0.9% 0.0% 0.9% -1.2% 0.6%
0.0% 1.0% 1.2% 1.4% 3.6%
1.2%
Average Rate Actions for all plans
Jan Apr Jul Oct YEAR
6.0% 2.2% 2.2% -6.3% 3.7%
1.9% 0.0% 2.8% 1.1% 5.9%
1.0% 0.0% 0.0% 4.5% 5.5%
-0.2% 1.6% 0.0% 0.2% 1.6%
1.4% 1.7% 0.0% 0.0% 3.1%
1.2% 1.5% 3.4% 1.8% 8.1%
0.9% 0.0% 0.9% -1.2% 0.6%
0.0% 1.0% 1.2% 1.4% 3.6%
2014
2015
2016
2017
2018
2019
2020
2021
2022
PPO Plans with rich benefit designs Continue to be the most popular; Demand varies regionally
#1 #2 #3
Rural North/Sierra Silver Full PPO 180/55 Bronze Full PPO 6850/65 Silver Full PPO Savings 2500/35%
Wine Country Platinum Full PPO 250/15 CCSB Gold 80 PPO 250/25 Platinum Full PPO 250/10
Greater Sacramento Bronze Full PPO Savings 6900 Gold Full PPO Savings 1750/15% Platinum Full PPO 250/15
San Francisco CCSB Gold 80 PPO 250/25 Platinum Full PPO 250/10 Platinum Full PPO 0/10
Contra Costa Platinum Full PPO 250/10 CCSB Gold 80 PPO 250/25 Gold Full PPO 1200/35
Alameda Platinum Full PPO 0/10 CCSB Gold 80 PPO 250/25 Bronze Full PPO Savings 6900
Santa Clara CCSB Gold 80 PPO 250/25 Platinum Full PPO 0/10 CCSB Platinum 90 PPO 0/15
San Mateo Platinum Full PPO 0/10 CCSB Gold 80 PPO 250/25 CCSB Platinum 90 PPO 0/15
Monterey Bay Gold Full PPO Savings 1750/15% Platinum Full PPO 250/10 Silver Full PPO 2300/45
Central Valley North Silver Full PPO 1800/55 Gold Full PPO 1200/35 Platinum Full PPO 250/10
Central Valley South Gold Full PPO 0/20 Silver Full PPO 1800/55 Gold Full PPO 750/30
South Coast Silver Full PPO 1800/55 Gold Access+ HMO 500/35 Gold Full PPO 750/30
Southern Desert Gold Access+ HMO 1000/35 Silver Full PPO 1800/55 Gold Full PPO 500/30
Kern Bronze Full PPO 6500/50% Silver Full PPO 1800/55 Gold Full PPO Savings 1750/15%
Los Angeles North CCSB Gold 80 PPO 250/25 Gold Full PPO 0/20 Gold Full PPO 500/30
Los Angeles South Gold Full PPO 500/30 Gold Full PPO 0/20 Platinum Full PPO 0/10
Inland Empire Silver Trio HMO 2350/65 Platinum Trio HMO 0/20 Silver Full PPO 1800/55
Orange Platinum Full PPO 0/10 Gold Trio HMO 0/30 Silver Trio HMO 2350/65
San Diego Silver Trio HMO 2350/65 Platinum Trio HMO 0/20 Gold Trio HMO 0/30
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© 2020 Blue Shield of California. All Rights Reserved.
Coming soon!New PPO & HMO plan offerings
• One Silver HMO offering
• One Bronze HMO offering
Two HMO plans
Two new Bronze PPO plans
New plans
Off exchange portfolio updates
• AV changes minimal
• Minor benefit changes to several plans
Underwriting updates 2022
© 2021 Blue Shield of California. All Rights Reserved.
Relaxed
participation
extended through
2022
Mirror plans can
now be sold
alongside
another carrier
Mirror plans can
now take
advantage of the
Relaxed
participation
promotion
Trio ACO HMO network expansion
City Zip Code
Carpinteria 93013
Carpinteria 93014
Goleta 93116
Goleta 93199
Goleta 93118
Goleta 93117
Santa Barbara 93110
Santa Barbara 93130
Santa Barbara 93160
Santa Barbara 93111
Santa Barbara 93103
Santa Barbara 93190
City Zip Code
Santa Barbara 93109
Santa Barbara 93102
Santa Barbara 93120
Santa Barbara 93121
Santa Barbara 93101
Santa Barbara 93140
Santa Barbara 93108
Santa Barbara 93107
Santa Barbara 93106
Santa Barbara 93150
Santa Barbara 93105
Santa Ynez 93460
Solvang 93463
Solvang 93464
Summerland 93067
Santa Barbara (partial county)
© 2021 Blue Shield of California. All Rights Reserved.
The following medical group will be
added to the Trio ACO network:
• Sansum Medical Clinic
The following hospital partner will be added to the Trio ACO network:
• Santa Barbara Cottage Hospital
• Santa Ynez Valley Cottage Hospital
• Goleta Valley Cottage Hospital
Trio ACO HMO network expansion
© 2021 Blue Shield of California. All Rights Reserved.
City Zip Code
Marina 93933
Monterey 93940
Monterey 93942
Monterey 93943
Monterey 93944
Pacific Grove 93950
Pebble Beach 93953
Seaside 93955
Monterey (partial county)The following medical group will be added to the Trio ACO network:
• Aspire Health plan
With network medical groups consisting of:
• Montage
• Salinas Valley Health System
The following hospital partner will be added to the Trio ACO network:
• Community Hospital of the Monterey Peninsula (CHOMP)
• Salinas Medical Center
Wellvolution
Largest digital therapeutics network
of any U.S. health plan, including 7
stress management programs.
myStrength
Self-service tools that can help with
stress, anxiety, depression, sleep
disorders, and mild substance
abuse.
Teladoc Mental Health
Nationwide virtual (phone or video)
coaching with a behavioral health
provider for members living in the U.S.
and while traveling.
Nurse help 24/7
Online chat or phone assistance. Can
give referrals to providers or county
mental health resources, and help
members access care.
Continual network enhancement
Our network continually evolves to
address the needs of members.
Inside California
Fully insured members have access to
Magellan’s provider network of over
15,000 behavioral health clinicians &
facilities (in person & virtual options).
Outside of California
Fully insured members have access to
over 34,000 behavioral health providers
through the national BlueCard network
(in person & virtual options).
Digital programs Virtual care and coaching In person
LifeReferrals 24/7
Confidential program of behavioral
health coaches, providing access to
financial & legal coaches, for
stressful circumstances (divorce,
adoption, budgeting, etc.)
Behavioral health
Mandates: No surprises
© 2021 Blue Shield of California. All Rights Reserved.
Consolidated Appropriation Act / Transparency in Coverage Final Rule
Blue Shield of California expects to meet compliance with all provisions by enforcement dates.
• No notifications regarding broker compensation to small business customers.
• Health plans already meet mental health parity requirements.
• Enhanced Continuity of Care policies in 2022.
• All members that meet the mandate specifications will receive new ID cards in 2022
• Updated federal guidance in August extended deadlines for several prov isions, however, Blue Shield teams continue to work on developing solutions for implementation and we will keep you informed.
Celebrating successful submissions with the Employer Enrollment Tool
Over the last year:
• You have submitted over 4,000 groups
and 34,000 members through the tool
• 9,500 quotes have been run to help your clients pick the coverage that’s right for
them
• The median average from when you start
an application to when you receive
member ID numbers is 2 hours
• We have accelerated processing time by
more than 41x
© 2021 Blue Shield of California. All Rights Reserved.
Broker bonus calculator
One sale, two reward systems to award your efforts, and a handy tool to help predict your bonus earnings!
• Sell more, earn more with our Small Group Incentive Program
• Get cash with Direct Elite Rewards
Earn more with our Small Business Incentive Program
© 2021 Blue Shield of California. All Rights Reserved.
Direct Elite Rewards
© 2021 Blue Shield of California. All Rights Reserved.
Renewal and open enrollment
© 2021 Blue Shield of California. All Rights Reserved.
Berylnn Bell
Coming 2022! Maintenance & renewal on the Employer Enrollment Tool
Spring 2022
• Group maintenance
• Member maintenance
• Book of business reporting
• Invoice and delinquency
visibility
• New profiles for agency sharing
& visibility
Summer 2022
• Renewal
• Recertifications
© 2021 Blue Shield of California. All Rights Reserved.
Changes Overview
What:
• IT design is enabling both digital and paper communications for ALL members* until they
register an account and opt-in to (or out of) paperless.
• Digital communications sent to members will include email notifications that members have letters or EOBs waiting for them in their online account, as well as an email encouraging
members to register online.*ALL members with an e-mail address on file, regardless of their communication preferences
Why:
• Enabling automatic digital communications introduces members to the ease and
convenience of online communications and prov ides members easier access to register their online account.
• Members today expect a digital experience!
When: • Digital communications have been enabled for Small Group on September 12.
What this means for you!
• We need your support to collect email addresses during the enrollment process and help
members receive the best experience available to them. • Please encourage your employer groups and their employees to register online accounts
and take control of their health care!
Auto digital opt-in at enrollment
© 2021 Blue Shield of California. All Rights Reserved.
Digital change is on the horizon!
New renewal microsite
• New download renewal PDF kit function
• Improved user experience
• New specialty page
• Updated the site’s look and feel
Making it easier for your group to renew!
© 2021 Blue Shield of California. All Rights Reserved.
Specialty benefits
© 2021 Blue Shield of California. All Rights Reserved.
Mark Zeedik
Introducing 22 new dental PPO plans
22 new dental PPO plans based on benefit levels
• Five DPPO categories to choose from
• DPPO Bronze / Bronze Voluntary
• DPPO Silver
• DPPO Gold
• DPPO Platinum
• DPPO Diamond
NEW FOR 2022
Simplified Portfolio
• Offer competitive benefit offering
• Streamlined naming conventions
• Ability to show buy-up / buy-downoptions with clear hierarchy
• Fewer plans with range of benefit options; voluntary, plan names that align with Medical
PRIMARY GOALS
© 2021 Blue Shield of California. All Rights Reserved.
Introducing 22 new DPPO plans
Existing "Marketed" DPPO plans will change to
"Non-Marketed" status
Renewing groups may continue to renew into their
same plan
New for 2022
Dental PPO plan status change
© 2021 Blue Shield of California. All Rights Reserved.
Dental HMO –Orthodontic in Progress
Takeover
• Available for eligible members
receiving “active orthodontic treatment” that will not be finished until
after BSC DHMO plan takes effect
• Available for new groups moving from
prior carrier’s DHMO plan to new BSC DHMO plan
• Takeover process is handled between member and provider. Provider will
submit required documents to dental claims team
Grid of orthodontic in progress takeover
by plans:
Dental benefit changes
© 2021 Blue Shield of California. All Rights Reserved.
Dental HMO – Enhanced Dental Cleaning
for Pregnant Women
• Allow third cleaning for pregnant
women to maintain good oral hygiene as shown in the sample summary of
benefit illustration below
Dental HMO/PPO/DINO –Dental Cleaning Frequency Change
• Benefit enhancement to allow dental cleaning frequency to twice per consecutive 12-month period vs. once every
6-months (current cleaning frequency)
• Value-added benefit to allow more member flexibility to maintain good dental hygiene
© 2021 Blue Shield of California. All Rights Reserved.
Dental benefit changes
Specialty benefit changes - Vision
© 2021 Blue Shield of California. All Rights Reserved.
This change will increase the elective contact lens benefit allowances to match the frame allowances.
In-scope:
• Vision plans with contact lens benefit
• Vision plans with frame allowance of $150
• Enhancement available for both new and renewing groups in 2022
MATCH ELECTIVE CONTACT LENS ALLOWANCE TO FRAME
ALLOWANCE
Benefit enhancement to include standard progressive lenses on plans without premium progressive lenses. These are a type of progressive lens with plenty of room at the bottom for your near vision.
In-scope:
• Offer competitive benefit offering
• Streamlined naming conventions
• Ability to show buy-up / buy-down options with clear hierarchy
• Fewer plans with range of benefit options; voluntary,
plan names that align with Medical
ADD STANDARD PROGRESSIVE LENSES
Digital enhancements
© 2021 Blue Shield of California. All Rights Reserved.
Deana Perrin
• Shop, quote and enroll using our employer
enrollment tool
• Check new group submission status and view your online client list
• Administer member level changes
• Order sales and marketing collateral
• Update your demographics, banking
information and manage email subscriptions
• Broker compensation, rewards and
commission
• Stay up to date on broker communications
• Group related questions
• Broker of record changes and book of
business transfers
• Billing inquiries
• Commissions questions
• New Small Group receipt verification
that requires escalation
• Questions regarding claims.
• Help you navigate our online tools and
resources
• Assists with renewal planning and
strategy
• Attends renewal open enrollment meetings to employees understand their
plan benefits
• Provides staff education including
specialty products
• Help you navigate our online tools and resources
• Unresolved escalated issues
Securely manage your BSC
book of business 24/7
(800) 559-5905
7:30am - 6:30pm M-F
For contact information, visit
blueshieldca.com/SMBcontact
SELF SERVICE PORTAL PRODUCER SERVICES ACCOUNT EXECUTIVE
© 2021 Blue Shield of California. All Rights Reserved.
Small business service supportThe Producer Services team and Sales/Account Management team are here to support you.
Exciting initiatives to improve the experience for you
• Addition of ~120 broker service agents for
quicker response
• Updated IVR aligning reason for call to a high skilled agent on that topic
• Simplified validation process on voice and digital channels to better protect your
information
• Agents empowered to handle your servicing needs reducing the amount of time taken to
address critical items
RECENTLY IMPLEMENTED
• End to end rev iew of all current processes for streamlining
• Expanded capabilities on digital including live chat with cobrowse, updated online client list, dynamic search, and notifications for key client information
• Enhanced content to help you service your clients easier
• Commissions transformation to simplify your payout and
associated reporting
COMING SOON
© 2021 Blue Shield of California. All Rights Reserved.
We are making changes to improve our service. Producer Serv ices has updated our phone
Interactive Voice Response (IVR) to make choosing your options easier. Once you enter your Tax ID as validation, you will be given 4 main options to get quickly to a representative skilled on your call type.
Self-serv ice options include member eligibility, benefits, PCP info, application status, ID cards,
billing information, or ordering forms. Just press 1.
If your questions are more complex and require a broker serv ices specialist, continue in the
menu. You will be asked to select your line of business and choose from the following options:
Press 1 for application support, benefits, eligibility, and broker eligibility.
Press 2 for billing, payments, PCP changes, plan changes, or to order ID cards and supplies.
Press 3 for commissions, bonuses, digital web support, or claims and appeals.
Press 4 for specialty benefits like- dental, v ision, or life.
Getting you the right answers fasterOur Producer Services menu options are improving.
Self service capabilitiesSimplifying the digital experience for ease of servicing
© 2021 Blue Shield of California. All Rights Reserved.
Questions & Answers
© 2021 Blue Shield of California. All Rights Reserved.
Closing remarksfrom Jason Bleau and the Small Business Team!
© 2021 Blue Shield of California. All Rights Reserved.
Thank you