CBIA Health Connections

1
CBIA Health Connections

• April 26, 2007

2
Presentation Overview

• CBIA Health Connections Who we are
• Choice, Choice, Choice
• Rating
• What we do - Administration / Technology
• Challenges and Considerations

3
CBIA Health Connections

• Introduced Jan. 1, 1995
• 4 Health Plan choices
• 6000 companies
• 88,000 members
• Agent / Broker distributed

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CBIA Health Connections

• Employee Choice Model Purchasing Group

5
CBIA Health Connections

• Standard Benefits with Health Plans
• Employee Chooses the Insurer
• Price
• Network
• Formularies

6
CBIA Health Connections

• Plan of choice for the owner
• Business loves competition
• Never have to switch
• Consolidated administration / bill
• Global budgeting for the employer
• Employee gets choice

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CBIA Health Connections

• Employers eligible (3-100)
• Multi Vendor (4 Health Plans)
• CIGNA, ConnectiCare, Health Net, United
  Healthcare
• Employee Choice (38 options)
• Standard Plan design

8
Pricing

• CT - Small case reform laws
• Age Rating (5 year)
• Gender
• Area
• Family Tiers
• No Rating Bands / underwriting
• Reinsurance Pool

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CBIA Health Connections

• 2 Suites of Plan Design Options
• HC - 24 options
• HMO 10, 20, 30
• POS 10, 20, 30
• HC2 - 38 options
• HMO 20, 20/40, 30/45
• POS 20, 20/40, 30/45
• HSAs, HRAs

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CBIA Health Connections

• Shift by Plan Type
• Shift by Benefit Level

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Administration / Technology

• CBIA Health Connections looks like one large
  employer but there are a lot of details

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Administration

• Distribution
• Materials Web Print
• Proposal (benchmark plan)
• Decision Tools - CDHP Plans
• Training
• Website
• Information
• Employee, Employer Broker
• Online transaction
• Wellness / Lifestyle

13
Employer Global Pricing

• Ability to benchmark the most cost effective
  option of a plan design
• Set employer contribution based on that plan

14
Specify a Contribution Strategy
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The Employee Specific Illustration shows choices
based on the contribution strategy
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Administration

• Administration
• Billing (consolidated)
• Collection / Late Notice
• Reconciliation (receivable at EE level)
• Remittance
• Eligibility
• Customer Service / CRM
• Data Sync
• Commissions / 1099s

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CBIA HC Administration
CBIA
BusinessPartners Customers
Request Coordination
RequestMediums
Carriers
ContactManagemt
Billing Admin
Web
Agents
Health Plans
E-Mail
Workflow
Employers
Phone
AncillaryCarriers
Fax
Employees
CustomerService
Data Entry
AgentReps
Paper
Action Follow-up
18
Administration

• Proposal presentation
• Meet market practices
• Information must be in Health Plan systems
• Financial integrity

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The Changing Market

• Cost Pressures
• Legislative Challenges
• Healthcare Cost Pressures
• Consolidation of Health Plans
• Consumer Driven Options
• Wellness / Lifestyle

20
CBIA Health Connections

• Why HC works in the Private Sector
• Companys wary of government involvement
• Common benefits (standardized but not exact)
• Other services i.e Life, STD, LTD, Dental, COBRA,
  Section 125, HRAs, HSAs
• Ability to change and adapt quickly
• Utilization management and reporting
• Wellness initiatives
• Communications