January 7th Mesa Arizona

Wellness Program (building a culture of wellness)

Plan Design / Strategic planning Negotiations (The many pockets)

Plan Design Demographics of the group Utilization of the Benefits

Keep the chronically ill from getting

worse.

Early detection and prevention of disease Management of ongoing chronic illness

Weight High Blood Pressure Lack of Exercise High Cholesterol / Lipids Stress/depression Smoking / Chewing Tobacco

EARLY DETECTION IS KEY

Initially at a Renewal One to five percent of premium Presented as being proactive verses

reactive to increasing health care costs (Risk Management)

Investing in Wellness has a conservative ROI (return on investment) of 3 to 1

Incentives to participate in early detection initiatives with early detection testing and health questionnaires

Weight loss challenge Walking programs Mammogram Van Exercise incentives and programs Stop Smoking program Influenza vaccinations Health Fairs On Site Clinic Create a “Culture of Health”

Keep the chronically ill from getting

worse.

Organized teams in competition Pedometers Prizes - - ---everyone LOVES a prize Free food Education and participation is the key 10,000 steps a day

Ultimate goal is active participation and education - -- - -loosing weight is a bonus

Weekly guest speakers Discounted memberships to fitness

centers 100 start a ten week journey You are successful if 50 weigh in on the

last week and have attended at least 6 of the ten meetings

What is the cost? $20 to $30 per person for a ten week program

Cost is $20 to $25 per person You can set this up at a discount where the

employee pays $10 and the entity pays the balance

Done on site Total employee time takes 5 to 8 minutes

from the IN to the OUT

They come to YOU Cost is $100 total providing that your carrier

will cover the cost. (most will) They require at least 21 to participate, and

can accommodate up to 41 per day. Think in terms of 8 to 12 participants per

100 employees Professional service that only takes 20

minutes per each employee total

Health Risk Appraisals Cost of $50 to $65 per participant Includes; Health Questionnaire Full blood draw to test cholesterol, HDL,

LDL, triglycerides, glucose, kidney & liver function, nutrition, iron, bone, electrolytes, blood pressure, body fat, height and weight

15 to 25% of your employee population So - - -- you have 400 employees - - ---100

X $50 = $5,000 With incentives of $50 or more then 35 to

60% will participate With incentives of $100 or more then 75 to

80 percent will participate

Discounted Premiums Everyone pays 10 percent more Everyone who participates in one of the

diagnostic wellness initiatives will receive a 10% discount on their premium

Participation went to 99%

On site nurses performing finger prick blood tests

On line questionnaires. Some with incentives to employees

The costs vary but can be built into the renewal

Keep the chronically ill from getting

worse.

Free to employees Convenient Centrally located Free to Spouses And dependants

Budget $8,000 per weekly hour Staffing (PA, Nurse, Doctor oversight) Purpose Include (CDL exams, drug screenings,

Workers’ Compensation, Spouses and down the road Children)

Paying our employees not to take our coverage if they have coverage elsewhere

$150 (about 50% of our current employee only premium) to elect not to take our health care coverage

$15 (about 50% of our current employee only premium) not to elect to take our dental coverage

Tri Care eligible employees are excluded by federal law

Traditional with Co-pays and low deductibles

Higher deductibles with Health Reimbursement Accounts (H.R.A.) attached

High Deductibles ($1,250 or more) with Health Savings Accounts (H.S.A.) attached.

Doctor co-pays = .5 to 3 % E.R. & Urgent co-pays = .5 to 2.5 % Drug co-pay co-insurance = 1 to 5% In & out patient deductibles = 1 to 25%

Plan Design changes Cost shifting to employees Long term goals

Gradually increase Deductibles Higher Deductible w/HRA Dual plan / High Deductible w/HRA & High

Deductible w/ H.S.A Three tier – HRA and two H.S.A. $1250 and

$2500 Employees receive monies on all “high

deductible” and H.S.A. accounts

Keep the chronically ill from getting

worse.

Commission vary from 1% to 7% KNOW WHAT YOU ARE PAYING. What level

of service do you expect/demand Fee for service Utilize a hybrid compensation so that your

line items are not affected

Renewal pricing should never be a surprise Five months prior to the renewal date look

at trend Trend in losses reducing - -GO Trend for losses going up - -- WAIT Loss trend is flat - -- wait one month

Losses, + medical trend, + 20% Losses 84% + medical trend at 11%, + 20%

= 15% increase First pass at 25% increase with a reduction

to 16% with very little negotiating Broker / agent has little to do with this initial

decrease. You can do this easy. Target is; losses + medical trend + 10%

Carrier’s first number Second number Carrier’s Real number The Negotiated number (Both sides feel the

Pain) The Final DEAL (You are in Control)

Be (FACE TO FACE) with the “senior” underwriter. Everyone else is secondary to the discussion.

Do have the most senior carrier sales representative present

YOU are the best salesperson for your organization - -not your broker or agent

Be excited about your wellness initiatives and participation levels / Stress what is changing for the positive.

Ask the Underwriter to think outside of the box

When you are close to a deal ask for what is in the “other” pocket. (Wellness dollars)

If you are changing carriers, get a clear commitment on what the following year’s renewal will look like given the same losses and medical trend

The “NEW” business pocket

Managing the Monetary Risk of Health Care

Keeping the healthy, healthyCaring for our employees and their families

Questions?