Fall NY Broker Webinar

Transcription

1 Fall 2017 NY Broker Webinar October 5, 2017

2 Welcome Chuck Cerniglia VP, Small Business & Key Account Sales UnitedHealthcare, New York

3 Welcome Oxford Strong Stability Your Clients Need Network Strength Affordability Over 30 years of experience 96% member service satisfaction Freedom Network Liberty Network Metro Network Competitive rates New lower cost plan designs

4 Fall Ad Campaign Oxford Strong Look for our ads in the following places: Crain s Business New York, Westchester Business Journal, Long Island Business News WFAN Radio, NYC Elevators & Lobbies, LIRR & Metro North Digital & Key Word Search Advertising 1 UnitedHealthcare Service Statistics average for New York, New Jersey and Connecticut Oxford plan members from Jan. 1, 2016, t hrough Dec. 31, 2016, based upon United Experience Surveys. Source: Internal Consumer and Customer Call Center Metrics.

5 Today s Agenda Overview Agenda Product Update Small Group Update Specialty Benefits Broker Compensation

6 Small Business Product Update John Apuzzio Market Vice President, Product UnitedHealthcare, New York

7 Platinum and Gold Plan changes For AV compliance Platinum: Decreased OOPM to $2,500 from $3,000 Changed Tier 1 Rx deductible to $50 from $100 Reduced IP from $500 to $400 Gold: 2017 Gold Plan 2018 Change EPO $15/$30 $800 F NG OHI Increased Ded to $1,000 from $800 Increased Specialist to $35 from $30 PPO $25/$40 $1,000D F NG Increased OOPM to $4,500 from $4,000 Increased ER to $400 from $300 EPO $30/$60 $1,000D L G Increased ER to $300 from $200 EPO $25/$40 $1,250D M G Increased OOPM to $5,500 from $4,500 Note: No changes needed for G EPO $25/$40 $1,250D F NG Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

8 Silver Plan Changes For AV compliance 2017 Silver Plan 2018 Change S EPO $40/$70 $2,500D F NG OHI S EPO $40/$70 $2,500D L NG OHI S PPO $40/$70 $2,500D F NG OHI S EPO $30/$60 $2,500D M G OHI S EPO $25/$50 $3,000D L G OHI OOPM to $7,150 from $6,850 ER to $700 from $500 Lab to $20 from 100% Rx ded to $200 from $100 OOPM to $7,150 from $6,850 ER to $700 from $500 Lab to $20 from 100% Rx ded to $200 from $100 OOPM to $7,150 from $6,850 ER to $700 from $500 Lab to $20 from 100% Rx ded to $200 from $100 Deductible to $3,000 from $2,500 OOPM to $7,150 from $6,850 OOPM to $7,150 from $6,650 ER to $700 from $500 S EPO $30/$75 $3,000D L NG OHI OOPM to $7,150 from $6,850 S Prim Adv $25/$50 $2,000D L NG OHI OOPM to $6,000 from $5,500 S EPO HSA $2,000D $35/$50 M G OHI Decreased Deductible to $1,500 from $2,000 S EPO 30/60 $2,500D ME NG OHI OOPM to $7,150 from $6,850 No changes needed for S EPO HSA $2,000D 70% F NG or S PPO HSA $2,000D $30/$60 F NG

9 NYSG Plan Eliminations Effective 1/1/18 Plan Name G EPO $15/$30 $750D M G OHI B EPO HSA $3,200D 50% M G OHI Metal Gold Bronze Network Metro Metro Gatekeeper Gated Gated Rx Benefit $10/$65/50% to $800 D&C PCP $15 D&C Specialist $30 D&C INN Deductible $250 $1,500 INN Coinsurance 90% 80% INN OOPM $3,000 $6,000 Map Plan G EPO $25/$40 $1,250D M G B EPO HSA $5,500D 70% M G Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

10 NYSG New Plans Effective 1/1/18 Plan Name P FRDM NG 10/30/500/90/ EPO 18 G FRDM NG 30/60/2000/70/ EPO 18 G LBTY NG 30/60/2000/70/ EPO 18 G FRDM NG 30/60/2000/70/ PPO 18 S LBTY GT 20/60/4000/70/ EPO 18 B LBTY NG 25/75/3000/70/ EPO HSA 18 Metal Platinum Gold Gold Gold Silver Bronze Network Freedom Freedom Liberty Freedom Liberty Liberty Gatekeeper Non-Gated Non-Gated Non-Gated Non-Gated Gated Non-Gated Rx Benefit $50D non-t1 $5/$30/$60 $100D non-t1 $15/$45/$75 $100D non-t1 $15/$45/$75 $100D non-t1 $15/$45/$75 T1 = $10 T2/T3 = Ded then $65/50% to $800 D/70% PCP $10 $30 $30 $30 $20 D/$25 Specialist $30 $60 $60 $60 D/$60 D/$75 Urgent Care $50 $75 $75 $75 D/$60 D/70% Deductible $500 $2,000 $2,000 $2,000 $4,000 $3,000 INN Coinsurance 90% 70% 70% 70% 70% 70% INN OOPM $3,000 $6,850 $6,850 $6,850 $7,350 $6,550 OON Benefits N/A N/A N/A Yes N/A N/A Q1 18 Single Rate $ NYC / LI $ NYC / LI $ NYC / LI Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. $ NYC / LI $ NYC / LI $ NYC / LI

11 NYSG Liberty Advantage Effective 1/1/18 Plan Name P LBTY GT 15/35/250/90/EPO 18 G LBTY GT 25/45/1500/80/EPO 18 S LBTY GT 30/70/4000/60/EPO 18 Metal Platinum Gold Silver Network Liberty Liberty Liberty Gatekeeper Gated Gated Gated Rx Benefit $150D non-t1 $5/$30/$60 $150D non-t1 $5/$45/$75 $150D non-t1 $15/$50/$90 PCP $15 $25 $30 Specialist $35 $45 $70 Urgent Care $50 $75 $80 INN Deductible $250 $1,500 $4,000 INN Coinsurance 90% 80% 60% INN OOPM $3,000 $6,000 $7,350 OON Benefits N/A N/A N/A Q1 18 Single Rate $ NYC / LI $ NYC / LI $ NYC / LI Liberty Advantage plans include National Access for members that travel outside of the Oxford service area.

12 $0 PCP Copayments for all non HSA Plans CT Liberty Network Effective 1/1/18 Slightly smaller network, big on opportunity Effective January 1, 2018 for both Small Business and Key Accounts All 28 Oxford Connecticut network hospitals Easy access to19,810 physicians statewide Same 4-Tier pharmacy designs and formulary as Freedom plans with $250D on T3/T4 Variety of deductibles and coinsurance options Options available with HSA accounts Lower-cost, flexible plan options 14 plans that deliver some of the lowest priced Oxford options in CT portfolio PCP selection and referral required ValueRx network which includes major chains Walgreens, Rite Aid and Walmart No impact to NY and NJ Liberty members filling Rx prescriptions in CT Plans do not have national access New York and New Jersey access CT Liberty members will have access to 51,177 providers in New York and 24,900 providers in New Jersey NY and NJ Liberty members will have access to the CT Liberty Network and will no longer have in-network access to CT Freedom network providers

13 Small Group Update Greg Trotta Director, Small Business Sales & Account Management UnitedHealthcare, New York

14 Oxford Strengths We ve Got You Covered STABILITY Committed to the New York market amongst carrier turmoil Wide variety of options for all types of New York small businesses NETWORK ACCESS Freedom, Liberty, Metro PLAN DESIGNS 46 Plan Designs: EPO, PPO, HSAs FLEXIBILITY 1 st of the month new business submission deadlines Multiple plan offerings allowed Best-in-class online group & member enrollment Industry leading service model Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

15 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Oxford Plan Mapping CareConnect Plans

16 New York Small Group Oxford Competitive Position 8.1% Oxford overall approved rate increase Potential Increase Variations: AV Calculator & Network Factors: Will cause some plans to receive an increase of less than 8.1% Increased rate favorability vs Aetna & Empire Responsible rating with appropriate increases Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

17 Oxford Metro Network More enrolled groups than ever! Strong adoption in 2017 Highest Membership Concentration TODAY Launch Date: 1/1/16 60% Bronx, Kings, New York, & Richmond Counties 31% Nassau, Suffolk & Queens Counties All other counties = 9% Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

18 Oxford Metro Network Key Features Refresher OVERVIEW Group needs to be sitused in New York Subset of the Oxford Liberty Network New York and New Jersey access only Access to Metro Network (NY) and Garden State Network (NJ) Value Pharmacy Network Retail Chains In-network only EPO plans (no out-of-network benefits) Gated and non-gated options through our latest product addition, Metro Enhanced Major In-Network Hospitals: Memorial Sloan Kettering Long Island Health Network Hospital for Special Surgery New York Presbyterian Health System Mount Sinai Health System Westchester Medical Center In-Network Pharmacies: Walgreens Duane Reade Rite-Aid Walmart Out-of-Network Pharmacies (Not Covered): CVS Target Many non-chain pharmacies Check oxfordhealth.com for full listing of in-network hospitals & pharmacies Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

19 NYSG Underwriting Guidelines 2018 Update CHANGE FOR 2018 Oxford will begin accepting Parental Coverage as a valid waiver REMINDERS Federal Open Enrollment Period Groups must enroll between 11/15 12/15 Participation cannot be applied during this period Groups selecting 4 or more plan designs Must enroll or renew by the 15 th of the month prior to the requested effective date Must be submitted manually Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

20 UnitedHealthcare Health4Me Benefit Access at Your Fingertips Now your employees can get their health plan to go. The free UnitedHealthcare Health4Me mobile app helps members access their Oxford benefits and coverage information, manage their accounts and find a provider anywhere, anytime. Manage claims and pay providers. Estimate procedure costs. Locate and map directions to a clinic. View and share health plan ID card. Interface with Fitbit. Access personal health record. 2 Million Downloads* Talk with an advocate or nurse. *UnitedHealthcare internal usage reports, Results shown are not a guarantee of f uture perf ormance. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

21 Rally A Digital Health & Wellness Experience Help create a path toward better. Give your employees Rally. Build a culture of wellness and health ownership for your employees. Rally, a digital health and wellness experience, gives them: An intuitive health survey. Access via oxfordhealth.com or mobile device. Action plans called missions. Rally coin rewards. 96 of Rally experience users complete a health survey.* % experience rewards can help boost employee engagement.* 64 % of enrollees sign up for missions.* Potential benefits for you: Help increase engagement through health promotion and targeted Rally communications to promote health ownership. Track employee engagement and progress through integrated reporting (Key Accounts only). *Based on Rally experience results, Results shown are not a guarantee of future performance. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

22 Oxford Sweat Equity Fitness Reimbursement Program The only thing better than getting in shape is getting rewarded for it. The new Oxford Sweat Equity program offers members more types of qualifying exercises and the option to combine fitness facility visits with physical fitness classes to reach the required 50 workouts in a six-month period. Aerobics Boot camps Boxing/Kickboxing CrossFit Pilates Indoor rock climbing Also includes Citi Bike membership Martial arts Pure Barre Personal training Swimming TRX Tennis/Racquetball Zumba Yoga Weight/Resistance Standard gym (including YMCA & community centers where fitness services are offered) Most plans provide eligible Oxford members with reimbursement of: Up to $200 for subscribers Up to $100 for spouses Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

23 Specialty Benefits Chuck Cerniglia VP, Small Business & Key Account Sales UnitedHealthcare, New York

24 Specialty Benefits Oxford Benefit Management (OBM) OBM Package Dental (6 plan options) Vision (2 plan options) Employee assistance program with work and life services Health discounts 25k flat employee life insurance Easy Submissions & 60 Second Quoting Tool No census required; Simply enter the effective date, number eligible and zip code and in seconds you have an OBM quote Group Application, Employee apps & Quote No Binder Check & Tax Docs required if Oxford medical is in place Broker Commissions Flat 10% on all OBM plans Voluntary Products If TWO eligible, can write down to.. One enrolling in Vision Two enrolling for Dental Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

25 Specialty Benefits New NJ DHMO Product Our managed care product suite is innovative and convenient. UNIQUE NON-CAPITATED MODEL: COMPREHENSIVE BENEFITS: Hybrid fee-for-service / supplemental payment model (no capitation) No GD assignments required, no provider office rosters to verify eligibility Members can switch offices at any time with no wait open access to care Easily secure authorization to see a specialist or go direct on a discounted basis No closed offices No waiting periods No maximums CONSUMER FOCUSED DESIGN More than 450 procedures covered at a copayment level Pre Natal Benefits Oral Cancer Screening Cosmetic benefits at specific copayments / discounts Pediatric dentistry up to age 16 Discount on procedures not listed on the Schedule of Benefits Aligns with our wellness model and Bridge2Health

26 Specialty Benefits Myuhc.com & Health4Me app myuhc.com Information, assistance and transparency your way. Vision will be added to the Health4Me mobile application 10/31/17! Health4Me adding dental in Q Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

27 Specialty Benefits Warby Parker Eyewear Effective 1/1/18: Warby Parker doesn t accept. any other insurance Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

28 Specialty Benefits 2017 Broker Bonus Program Program Guidelines New Business Bonus: Qualification and bonus payment based on annualized premium for groups with effective dates from 1/1/17 through 1/1/18. Net Change in Premium: Full block of business (new business and renewal premium) net change in premium must be 90% to qualify for a new business and retention bonus. Retention Bonus: Must qualify for a new business bonus and meet the net change in premium requirements. Eligible Groups / Coverages Groups with 2+ eligible lives. Both employer-paid and voluntary lines of coverage are eligible Eligible coverages include dental, vision, base life, supp life, STD, LTD, critical illness, accident and hospital indemnity. New Business Net Change Coverages & Premium Bonus % 15 and $150K 2% 20 and $225K 3% 25 and $250K OR 10 and $750K 4% 30 and $300K or 10 and $1.125M 5% 35 and $350K OR 10 and $1.5M 6% Full BOB must meet premium net change of 90% Premium Net Change % Factor 100% % % 0.8 < 90.0% No Bonus Retention 25 Coverages & $750K Premium % premium persistency % premium persistency Bonus % 1% 3% 95.0%+ premium persistency 5% Must qualify for new business bonus to qualify for retention bonus. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

29 Medical Benefits 2018 NYSG (1-100) Broker Commission 3.75% Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Gro up.

30 Key Take-aways Oxford Strong 1. Brand new Liberty Advantage plans 2. Improved competitive position 3. Metro Network 4. UnitedHealthcare Specialty 5. Broker Compensation Stability Your Clients Need Network Strength Affordability Over 30 years of experience 96% member service satisfaction Freedom Network Liberty Network Metro Network Competitive rates New lower cost plan designs

31 Thank You We appreciate your business.

32 Disclaimer Oxford insurance products are underwritten by Oxford Health Insurance, Inc. UnitedHealthcare dental coverage underwritten by UnitedHealthcare Insurance Company, located in Hartford, Connecticut, UnitedHealthcare Insurance Company of New York, located in Islandia, New York, or their affiliates. Administrative services provided by Dental Benefit Providers, Inc., DBP Services (NY only), United HealthCare Services, Inc. or their affiliates. The policies may include exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. UnitedHealthcare vision coverage provided by or through UnitedHealthcare Insurance Company, located in Hartford, Connecticut, UnitedHealthcare Insurance Company of New York, located in Islandia, New York, or their affiliates. Administrative services provided by Spectera, Inc., United HealthCare Services, Inc. or their affiliates. The policies may include exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. UnitedHealthcare Life and Disability products are provided by UnitedHealthcare Insurance Company and in New York by Unimerica Life Insurance Company of New York. Life products are provided on policy forms LASD-POL (05/03) et al. and Disability products are provided on policy forms UHCLD-POL 2/2008 et al. In New York, the Life Insurance product is provided on Form LASD-POL-LIFE NY (05/03) and the Disability product on Form LASD-POL-ADD/DIS NY (05/03). UnitedHealthcare Insurance Company is located in Hartford, CT, and Unimerica Life Insurance Company of New York in New York, NY. Participation requirements for Life and Disability Insurance may be different than those stated. These policies may include exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. UnitedHealthcare Hospital Indemnity product is provided by UnitedHealthcare Insurance Company on policy forms UHIHIP-POL-TX, et al. and UHIHIP-CERT-TX, et al. in Texas and UHIHIP-POL-VA, et al. and UHIHIP-CERT-VA, et al. in Virginia. The product provides a limited benefit for certain hospital indemnity plan benefits. Please note: HOSPITAL INDEMNITY coverage is NOT considered minimum essential coverage under the Affordable Care Act and therefore does NOT satisfy the mandate to have health insurance coverage. Failure to have other healt h insurance coverage may be subject to a tax penalty. Please consult a tax advisor. The policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. This product is not available in all states. UnitedHealthcare Insurance Company is located in Hartford, CT.