Health Plan Cigna broker selection

1. Selecting the Right Agent/Broker/Health Plan
Employee Education Ensuring Enrollment Success
Employee Tools and Access to Information
Presented By:
John Young, Vice President
CIGNA Healthcare

2. Myth – My consultant will take me there.
•90% of employers rely on brokers to help with
insurance
•Nearly 70% of employers shopped for a different
arrangement, yet 90% made no change to benefit
providers.
•BROKERS - 39% said they spoke of/introduced
CDHP to at least some of their clients. Less than
10% think CDHC won’t happen, but a majority -
60% - think it will take at least three years to catch
on. Only 12% are actively recommending CDHPs.

4. The New Role of the Broker
• More Strategic
• Less support of overrides
• Leadership into the future vs. renewal orientation
• Shift from “fixed costs” and “discounts”
orientation to utilization reduction and employee
engagement focus.
• HRA only, HSA only, HRA and HSA strategy.
• Advisor who become experts in CDHP will own
the market.

5. CIGNA experience shows enrollment drivers

6. Ensuring A Successful Implementation
Environment
• Corporate Priority
• Active Enrollment
• Executive/Leadership Commitment
Benefit Design
• Contribution Strategy
• OOP Maximums
HR Support & Incentive
• Extensive Training – Consumer-Driven Health School
• Online Toolkit
• Goal/Reward System
Customized Communications
• Implementation and Year-Round
• Multi-media to Address Learning Styles,
• Meeting Strategy
• Frequency, Duration
Importance to Meet Enrollment Goal
• Plan Disruption
• Establishing the Business Case
• Coinsurance Level
• Account Funding Level

7. Establish
business case &
build awareness
among
employees and
confidence
among
benefits/HR staff
Understand
audiences and
objectives;
develop custom
communications
program
AWARENESS
Provide
increasing levels
of program
detail through a
customized,
multi-media
campaign
PLANNING INFORM ACTIVATE SUSTAIN
Build a
consumer
marketplace
Identify
opportunities,
and provide
member-specific
support
Support and
reinforce
behaviors with
ongoing
coaching and
service
excellence
Pre-enrollment Post-enrollment
Passive Interested Engaged Discerning Value-conscious
Consumer
States Employee Education Begins
The Process Of Consumer Development
Phases Behind A Successful Introduction

8. CIGNA Choice FundSM communications timeline
Actively engage members throughout the year
1 – 2 Weeks 1 – 4 Weeks
EDUCATE employees, and build
confidence among benefits staff
Present communications
program, build custom plan
PRE-ENROLLMENT
Communications timeline
Implementation plan
Train the Trainer
Letter
from CEO/
President/HR
E-mail
series
Intranet
series
Newsletter
articles
4 – 8 Weeks
EDUCATE benefits staff on additional
product details, tips
Presentation script
Access to CIGNA Client Managers
Orange = Employer Pieces
Purple = Consumer Pieces

9. CIGNA Choice FundSM communications
timeline Education and information to drive
behavior change
4 – 8 Weeks, Cont’d. 2 – 4 Weeks
EMPOWER with decision tools;
reinforce overall wellness choices.
ENGAGE employees on product details,
features and benefits. Build comfort.
OPEN ENROLLMENT POST-ENROLLMENTPRE-ENROLLMENT
EFFECTIV
E
DATE
Customized plan of weekly
consumer touches
CEO/President/HR letter
E-mail
Intranet
Newsletter articles
Posters
Payroll stuffers
Educational brochures
Multiple consumer touches
per week
Enrollment support web site
Pre-enrollment kit
Toll-free help line
Benefit fair
Kiosk
In-person enrollers
ID card
Handbook
Monthly e-mail
Intranet
myCIGNA.com
customization
12 Months
ENGAGE employees on use of tools.
Enable purchase decision.

10. Using Communications to Build Active,
Engaged Members
4 – 8 Weeks, Cont’d. 2 – 4 Weeks
OPEN ENROLLMENT POST-ENROLLMENTPRE-ENROLLMENT
12 Months

11. CIGNA’s Health Advisor Program
Helping
individuals
achieve personal
health through an
experience of
comprehensive
health
coaching
Preference
Sensitive Decision
Support
Treatment decision
support that understands
and respects personal
preferences.
Gaps in Care
Appropriate/evidence-
based support and
guidance for members
and providers
Health and
Wellness Outreach
Proactive coaching
services to the
at-risk member.
Lifestyle Coaching
Effective behavior and
health enhancement
through multi-session
coaching
Referral and
Education
Program guidance
and easy-to-
understand
information to
members.

12. L UNIT FREQUENCY H
H
L
Rx
PCP/SCP
Outpatient
Inpatient
Diagnostic
ER
LikelihoodofUsingInformationforDecisions
Additional Factors of Influence
1 – Level of emotional commitment
2 – Amount of price variance
Low High
Amount of price variance
Cost Information Must Be Actionable

13. • Members select
pharmacy and drug
• Receive actual
price they’ll pay
Prescription Pricing Tool

14. Outpatient Surgical Procedure Cost

15. High Tech Radiology Cost

16. Inpatient Procedure
Cost and Quality

17. Inpatient Procedure
Cost and Quality

18. Targeted Member MessagingMonthly Health Statements
Personalized Member Outreach

19. CIGNA’s Plan Comparison Tool
for Choice FundSM
Customers
Powered by
• Allows members to
compare the potential
out-of-pocket costs of
various CIGNA health
plans offered by their
employer
• Supports pre-
enrollment decisions
and educates the
member about the plan
• Establishes online
relationship (versus
phone)

20. Online Enrollment – Decision Support

21. Online Enrollment – Plan Personalization

22. 15-minute questionnaire
helps determine
accurate personal
health status
Employs 5,000+
calculations that screen
for over 21 clinical risk
factors
Results are integrated
with CIGNA’s Disease
Management Programs
Can be customized
with client-specific
questions
Health Risk Assessment
22

23. Health Savings Account (HSA)/Qualified
High Deductible Plan (QHDP) –
Effective Sales & Implementation
By: Scott M. Stevens, RHU
S.M. Stevens and Associates
dba NP Dodge Insurance

24. My 5 Step Selling Approach
1) Assess prospect’s needs and obtain a solid
understanding of their particular situation
2) Search our markets for the best solutions to meet
their needs (e.g., insurance carriers, administrators,
vendors)
3) Implement the plans and services agreed to
4) Communicate to their employees, all of the
particulars relating to the plans implemented,
providing a thorough understanding of the features
and benefits
5) Support the client on an ongoing basis, essentially
becoming an extension of their employee benefits
department

25. Anticipate Objections & Provide
Counters
1) The amount of the deductible
(“what if I get hit by a truck on the
1st day?”)
Counter:
Show them that in most cases,
they’re actually better off with the
account based plans (show side by
side comparison; also consider
supplemental coverage)

26. Anticipate Objections & Provide
Counters2) Paying full price for health care prior to
satisfaction of the deductible
A. “you mean I have to pay the full price of
my medication, and not a copay?”
B. “I have to pay the entire cost of the
office visit?”
Counter:
A. Show them that in time, they’ll pay
nothing for their care, once the HSA is
funded (also consider teaming up with a
pharmacy)
B. Explain that after the PPO discount, the
actual cost of an office visit is about $75
Note: The more the employer funds, the less the “pain” to the employee;
also, look for carrier and or bank incentives

27. Anticipate Objections & Provide
Counters
3) Tracking eligible expenses
(“you mean I have to save all
my receipts, and keep track of
all my medical expenses?”)
Counter:
The insurance company will
track expenses via the EOB
(save receipts if expenses are
not run through the health plan)

28. Anticipate Objections & Provide
Counters
4) Confusion between HSAs,
HRAs, and FSAs (“if I don’t
use up the funds by end of year,
I lose them?”)
Counter:
Explain the difference between
HSAs and FSAs, and point to
the many benefits of the HSA

29. Anticipate Objections & Provide
Counters
5) What’s it going to cost to set up
and maintain my spending
account?
Counter:
Create relationships/alliances
with banks/credit unions that
agree to waive set up and
administrative fees

30. Spending Account/HDHP Advantages for
Employees
• Reduces employee out of pocket
costs
• Rewards health conscience
employees with cash
• Reduces income tax, increases take
home pay
• Provides additional long term
savings plan
• Offers more freedom of healthcare
provider choice
• Can be reimbursed for a wide range
of medical expenses including
dental, vision, and certain premiums

31. Out of Pocket Health Ins. Costs
• Premiums (What comes out of
your paycheck)
• Copays (Office visit, facility, Rx)
• Deductibles (Ind., Family, Per
confinement)
• Coinsurance (20%, etc.)
• Plan Penalties (Precertification,
PPO, etc.)

32. Is the “traditional” plan really better on a larger claim?
Family Coverage
$6,225-$500=$5,725$7,663Actual Out Of Pocket Expense
$79.32x52=$4,125$93.52x52=$4,863Premium Contribution
$0$25x2x12=$600Rx Copays (2 per mo. For 12
mos.)
$0$20x10=$200Office Copays (10 office visits)
$2100 - HSA$2,000Maximum out of pocket
100% =$020%=$1,000Coinsurance
$2,100$1,000Deductible
$50,000$50,000Example: By-pass surgery-total
cost
HDHP/HSATraditional Plan

33. The Role of The Broker or
Agent
Chris Lokken
Employee Benefits Account Executive
Johnson Insurance Services, LLC

34. Healthcare Experience
• Employee Benefit Consultant, Blue Cross & Blue Shield
of Wisconsin ( now Anthem).
• Independent Agent in Northwest Wisconsin for the past 4
years.
• Current President of the North Central Chapter of the
Wisconsin Association of Health Underwriters.
• Assisted numerous clients in developing Consumer-
Directed Healthcare strategies.

35. Positioning/Vision Statement
In the world of Consumer Directed Health
Care, the agent is a key component to the
success or failure of any Consumer
Directed Health Care Program.

36. Today’s Goals
• Understand the Role of The Agent/Broker
– What do agents need to do?
– What do clients need from their relationship?
– How critical is this to our collective success?

37. “Insurance is only as good as your Agent”
-Anonymous Client of Chris Lokken
• Nothing in insurance happens without the help of
the agent.
• Most consumers use an agent to learn and make
healthcare financing decisions.
• Consumer-Directed Health Care is a new area to
learn about and advise clients.
• CDHC also presents unique challenges to agents.

38. What Can Agents Do?
• Educate, Educate, Educate.
• Ask the right questions.
• Cost savings are nice, but this is a shift in
thinking.
• Have a “sense of the moment”.
• Don’t just do it to keep the business.

39. What Kind of Relationship?
• What kind of vision is being created?
• What is the commitment level?
• What technical knowledge?
• What resources are available?
• What are their thought on education?

40. This is Critical to Our Success
• There are two pathways
- The Right Pathway
- The Wrong Pathway