Managing Healthcare Costs
• Employers continue to seek creative
solutions to reduce healthcare costs,
decrease absenteeism and increase
productivity
• They have been forced to restructure their
benefit plans, often reducing benefits and
raising deductibles and co-pays
• This leaves some gaps in coverage and
more exposure for employees
• This also leaves some strategic
opportunities
Managing Healthcare Costs
• One creative solution is the HEALTH
PERX™ Card, which offers a range of
affordable healthcare benefits.
• These benefits offer the entire family
thousands of dollars in savings.
• At the same time it offers the employer
those creative solutions they seek
Disclosures
• This plan is NOT insurance.
• This plan provides discounts at certain healthcare providers for medical services.
• This plan does not make payments directly to the providers of medical services.
• The plan member is obligated to pay for all healthcare services but will receive a discount
from those healthcare providers who have contracted with the discount plan organization.
• This discount card program contains a 30 day cancellation period.
• Member shall receive a full refund of membership fees, excluding registration fee, if
membership is cancelled within the first 30 days after the effective date.
• The range of discounts for medical or ancillary services provided under the plan will vary
depending on the type of provider and medical or ancillary service received.
Benefit Choices
Health Benefits
Pharmacy Savings Card
Telemedicine
Vision Care
Dental Care
Hearing Care
Lab, X-ray & Imaging
Complete benefit information, provider locators, FAQs and
links to Rx price finder and Lab discounts can be found by
visiting www.wellnesshealthsolutions.com.
Health Care Reform
20-30 million consumers entering the system
A shortage of primary care physicians
What Will Happen?
Individuals will ignore symptoms and delay
treatment which can lead to more serious
medical complications
Individuals will leave work for minor issues
which results in loss of productivity and
unnecessary costs
Individuals will overuse Urgent Care and ERs
Telemedicine can eliminate
most of these problems
Health Care Reform and Telemedicine
Access Points for Healthcare
Medical Offices—physician assistants and
nurse practitioners
Walk-in Clinics–-Grocery Stores and
Pharmacies
Urgent Care and ER Clinics
Telemedicine—Doctors by phone or secure
email
Telemedicine can provide immediate access to healthcare to every individual
wherever they are, whenever they need it.
The most efficient and cost effective method to deliver telemedicine is by phone.
National Center for Policy Analysis
“Telemedicine has the potential for restructuring
medical care in ways that can solve many of
the problems, while reducing costs and
improving quality of care.”
National Center for Policy Analysis
Convenient Care and Telemedicine White Paper, November 2007
Studies Show
Physician telephone consults … have been proven to replace 45%-64%
of doctor office visits and 15%-35% of hospital ER visits. Source: TelaDoc 2007
Survey and Consult A Doctor Survey Results 2010
Costs can be reduced as the healthcare system moves from in-person
physical exams to virtual visits. The average ER visit is $1024 and
primary care office visit is $140. Source: BCBS 2007: Health Cost Estimator
Patient satisfaction with telemedicine is high…due to convenience,
comfort , privacy…and the security of having 24-hour access.
Source: Us Department of Commerce, Office of Technology
The Challenge: Most telemedicine services require a co-pay. This
represents a significant barrier resulting in low usage rates.
We have eliminated that barrier.
Telemedicine
We partner with a network of licensed, board certified physicians, available
24/7/365 by phone or secure email, who can diagnose and treat non-emergency,
routine medical conditions. They can prescribe medications when appropriate.
Call :
Survey Results
• When your physician is not available
• For non-emergent medical conditions or • Patient calls are diagnosed and treated
questions successfully more than 94% of the time (the
other 6% cannot be treated by phone) with 98%
• After normal business hours, nights,
satisfaction rating.
weekends
• When on vacation or in the field • 64% of callers would have gone to physician and
15% to the ER—a significant savings of time and
• Requesting prescriptions or refills
money.
Disclosures:
Physicians do not prescribe controlled medications.
Telemedicine is not insurance.
Telemedicine does not replace your primary care physician.
Proprietary and Confidential
Facts Physicians:
Experienced in Primary Care, Internal Medicine or
Emergency Room practices
Fully credentialed by the NCQA
Common Conditions Treated:
Cold/flu
Sore Throat
Bronchitis
Allergies
Sinus and Respiratory Infections
Headaches and Migraines
Stomach aches and Diarrhea
Urinary tract Infections
Minor Burns
Sprains
Insect Bites
Prescription Refills
Second Opinions
Return on Investment
Based on typical investment in this
benefit program (results vary according to
number of variables)
With 25% participation: Receive $1.86 for every $1 invested
With 33% participation: Receive $3.07 for every $1 invested
With 50% participation: Receive $4.65 for every $1 invested
Imagine if every corporation strongly encouraged a “call first” policy
Telemedicine is a game-changer!
Disclosures:
Office and ER visits taken from CDC Nat’l. Center for Health Statistics.
Costs per office and ER visit based on BCBS negotiated rates.
Reductions in office and ER visits based on actual survey results.
Pharmacy Savings Card
Wellness Health Solutions has direct
contracts for discounts on both brand-
name and generic drugs at more than
67,000 pharmacies.
Savings of 11% to 75% with an average of
53% off the retail price of most Rx
purchases.
Pharmacy Savings Card
Even though some individuals may
have a pharmacy benefit, many
prescriptions aren’t covered.
Ex: cosmetic drugs, appetite suppressants,
smoking cessation prescriptions, prenatal
vitamins or nutritional supplies, inject-able
supplies, contraceptive devices,
immunizations and vaccines and many
more
Our card covers them all.
Pharmacy Savings Card
Other Features that promote
consumerism:
• RxPrice Retriever.
• Generic Navigator
Proprietary and Confidential The Pharmacy Savings Card is NOT Insurance.
Pharmacy Savings Card
Drug Selected
LIPITOR 40 MG Tablet QTY 30 =$133.18 (discounted price)
Generic Alternative
GENERIC PRODUCT NOT AVAILABLE N/A
Optional Drugs within this Therapeutic Class
Speak to your Physician about a therapeutic alternative.
SIMVASTATIN 40 MG Tablet QTY 30 =$10.66
PRAVASTATIN SODIUM 40 MG QTY 30 =$13.67
LOVASTATIN 40 MG Tablet QTY 30 =$26.76
LESCOL 40 MG Capsule QTY 30 =$90.81
MEVACOR 40 MG Tablet QTY 30 =$124.02
CRESTOR 40 MG Tablet QTY 30 =$127.01
Proprietary and Confidential
The Rebate Program
The only Pharmacy Savings Card in the
country to offer rebates from over 30
pharmaceutical manufacturers on over
1000 branded drugs.
When consumer purchases a drug on
rebate list, they will receive a preloaded
MasterCard in the mail with their rebate
amount. Many drugs offer $12-$20 rebates.
Subsequent rebates will be loaded onto
that same card.
Every time a rebate is processed, card
holder will be notified by email.
Proprietary and Confidential The Pharmacy Savings Card is NOT Insurance.
Additional Benefits
Mail Order Price Guarantee
Our Clients are eligible for additional programs:
• Smoking Cessation programs at big savings
• Diagnostic Lab, X-ray and Imaging Discounts
• Access to ―Health & Wellness Focus‖ portal
Additional Benefits
Smoking Cessation Program
Present Pharmacy Savings Card and
receive significant discount on Chantix™
prescription
After 90 day program, receive additional
$30 via Rebate Card
Take advantage of educational materials
and complete support program available
through Pfizer ―The Get Quit‖ Plan
Additional Benefits
Diagnostic Lab, X-Ray and Imaging
Affordable: Deeply Discounted Rates – 10-60%.
Convenient: Choose the lab location that's best for you
Quality: Federally and state certified clinics. Over 2900 radiology
centers
Easy Laboratory Testing: Order your tests online or call us. Results
within 48 - 72 hours. It's that easy.
No co-pays
No deductibles
Confidential: Results sent only to you.
Who Can Benefit
People who do not currently have medication
coverage
Many drugs on PBM plan cost more than
discount card
People who are taking a drug not covered by
their medication coverage
Those with a high co-pay or deductible
Those using another discount card
There are 33,000 prescriptions below $7
SUMMARY
• We own our own network—over 65,000
pharmacies
• We offer excellent discounts to the consumer
(11-75%)
• We offer cash rebates on many brand drugs
• We provide smoking cessation discounts and
educational tools
• We provide discounts on Lab, X-ray and Imaging
• We provide a comprehensive, user friendly,
wellness portal
• Everything can be branded
This can be a stand-alone benefit
Generate Revenue with a Free Pharmacy Savings Card
This card is now being offered to
Associations, Non-profits, Municipalities
and other groups for distribution to their
members and communities.
Every time a prescription is filled, they earn
revenue
We can design website tools for pharmacy
cards online or print cards for our
distribution partners.
Proprietary and Confidential The Pharmacy Savings Card is NOT Insurance.
Other Health Benefits
Dental Care
Members save 15% to 50% on everything
from general dentistry and cleanings to
root canals, crowns and cosmetic
dentistry where available.
Over 92,500 dental practice locations.
Save on specialty care, orthodontics,
endodontics and periodontics where
available.
*Actual costs and savings vary by provider and geographical area.
No limit on number of visits ** According to the Aetna Enterprise Provider Database as of
October 1, 2008.
.
Dental Discounts not available to Vermont residents
Other Health Benefits
Vision Care
Save an average of 20%-60% on prescription
eyeglasses, frames, lenses, tints, coatings,
UV protection and specialty items
Savings on eye exams and 40-50% off the
national average on LASIK surgery and PRK
(where available)
Savings of 10%-30% on contacts
More than 12,000 locations including national
chains and independent providers
Pearle •Sears • JC Penny •Target • LensCrafters • Sterling •EyeMasters• QualSight LASIK
Other Health Benefits
Hearing Care-
Beltone Hearing Centers—1350 locations
Free hearing screening and substantial discounts
on hearing aids and other products and services.
Newport Audiology Centers
35% discount off hearing aid prices at over 2,000
locations
100% Service Satisfaction during the first 60 days
Mail Order Hearing Aids
Save 40% to 60% off average National Retail Pricing on
over 100 models of name brand hearing instruments.
Receive the lowest price available.
45-day in-home trial period and 1year factory warranty
Proprietary and Confidential
Other Benefits
Lifestyle Benefits
Emergency Roadside Assistance
Identity Theft Protection
Legal Services Direct
Pet Care
Fitness Club Discounts
Complete benefit information, provider locators and
FAQs can be found by visiting
www.wellnesshealthsolutions.com.
Proprietary and Confidential
Lifestyle Benefits
Emergency Roadside Assistance –
Up to 15 miles towing (up to $80 retail value) per occurrence maximum for
covered charges.
Flat tire assistance, fuel, oil, fluid and water delivery service, lock-out
assistance, battery assistance, & collision assistance.
LifeLock ID Theft Protection * (for member only—family is extra)
Identity Alert™ System – provides early notification whenever they detect your
personal information being used to apply for many forms of credit or services
WalletLock™ helps cancel and replace the contents of a lost or stolen wallet
eRecon™ patrols the web and notifies you of illegal selling or trading of your
information
TrueAddress™ notifies you when a change of address is requested in your
name
Free annual credit reports from the three major credit-reporting agencies
24-hour customer service
$1 million total service guarantee –if you become a victim of identity theft
because of a failure in their service, they will help you fix it at their expense, up
to $1,000,000
Lifestyle Benefits
Legal Services Direct
Nine free services which include:
Unlimited initial phone consultations for new legal matters
Initial one-on-one consultations for new legal matters
Document review (6 pages or less)
Letters written on the member’s behalf
Phone calls made on member’s behalf
Assistance with governmental programs
Assistance with small claims court representation
Free simple will with free annual updates
Free living will—state specific
Eight commonly used legal services deeply discounted, such as traffic ticket defense,
name change, simple divorce, simple trust and more.
Plan attorneys will either charge $125.00 per hour, or 40% off their usual and
customary hourly rate, whichever is greater.
Lifestyle Benefits
Pet Care- Receive 25% off all services at participating vets. Free pet
tag and 24/7 location service. Receive 10-30% off at participating
providers on pet services, such as boarding, doggie day care, training,
pet sitting and grooming.
Fitness Club Discounts-International Fitness Club Network--
Guaranteed lowest rates at over 8,500 quality fitness centers
nationwide. Introductory Free Week Trial to all clubs. All meet ACSM
guidelines.
Other Features
List-bill capabilities
Fulfillment Kit and Membership Cards
Website Access to benefits and provider locators
Onsite member services call center staffed with English
and Spanish speaking representatives who can help with
enrollment, verify discounts and assist with customer service
issues.
Compliance Department monitoring state legislative
requirements
Marketing assistance and brochures
Money Back Guarantee
All benefits are good for the entire family*
*LifeLock benefit covers cardholder only
Target Applications
Self-funded corporations
Fully insured companies with high deductible
plans
Limited-liability plans
Schools, Government, Associations
These low cost benefits complement any insurance
plan by offering innovative strategies for reducing
absenteeism, increasing productivity, and
decreasing overall healthcare costs for the
employer while encouraging employees to take
more responsibility for their healthcare costs.
Value Proposition
Employers Employees
• Ability to add a benefit with a high perceived • Access to medical consultations 24/7 as well as
value savings on pharmacy, vision, dental, hearing
and more
• A program that will decrease absenteeism,
increase productivity and reduce overall • A benefit that can fill in many gaps in insurance
healthcare costs coverage, particularly with high-deductible and
consumer-driven healthcare plans
• Ability to ensure that every employee has
access to healthcare when they need it • A program that eliminates unnecessary visits to
wherever they are the doctor or ER
• Ability to promote health and wellness and • A benefit that can save the family thousands of
encourage personal responsibility dollars a year
• A program that can help with acquisition and • Lifestyle benefits that can save the family
retention of employees additional money on everyday needs
Packages and Pricing
Voluntary Benefits
Select benefits to include and we will develop wholesale pricing.
Involuntary or Embedded Benefits
Based upon group size and projections or guarantees, we will
develop involuntary pricing package.
Fulfillment Kits can be provided by client and reduce cost.