Young and Uninsured:
Closing the Gap for the Invincible
and the Ineligible
Steve Northrup
Vice President, Federal Affairs, WellPoint, Inc.
2008 National Health Policy Conference
Capital Hilton, Washington, D.C.
February 4, 2008
Agenda
Young Adult Characteristics
• Initial Perceptions and Misconceptions
• The Reality
• How They View Health Insurance
• Why They Aren’t Buying Health Insurance
Anthem Solutions for Young Adults
• Why TONIK®?
• TONIK Benefits
• The TONIK Experience
Consumer-Friendly Solutions
• Cost and Quality Transparency
• Innovative Consumer Tools
Our Uninsured Action Plan
Lessons Learned
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Young Adult Characteristics
Initial Perceptions and Misconceptions
• Young invincibles
• Don’t want and can’t afford health insurance
• Willing to live on the edge and take a chance
• Not worried about the future
• Indestructible
• Irresponsible
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Young Adult Characteristics
The Reality
• Men and women 19-29 years old - post college/pre-marriage
• Want to be seen as independent and responsible
• $30K+ annual income
• Heavy internet users
• Want a consumer-friendly product that is affordable and simple to apply
for, use, and manage
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Young Adult Characteristics
How They View Health Insurance
• Sign of being mature
• Offers security and peace of mind
Why They Aren’t Buying Health Insurance
• Too expensive
• Too confusing
• Insurance companies don’t offer products to fit their needs and lifestyle
• Procrastination
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Anthem Solutions for Young Adults
Why TONIK?
• Extensive market research led to products designed to provide what young
adults want
• Most plans under $100/month with some premiums as low as $69/month
• Plans cover medical, dental, vision, and pharmacy
• First-dollar coverage for preventive
benefits
• Automated payment option
• Straightforward, conversational
communication style
• 3 plans with only 2 variables
• Simplified online application,
20 minute process
• Instant, downloadable ID cards
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Anthem Solutions for Young Adults
Benefits
Thrill Seeker
Part-Time
Daredevil
Calculated Risk
Taker
Annual
Deductible/Out of
Pocket Max
$5,000
$3,000
$1,500
$20
4 visits/year
$30
4 visits/year
$40
Unlimited visits
Doctor Visit Copay
Deductible waived
Inclusive of all services received in office, including x-ray, lab,
etc.
In/Outpatient
Hospital
$0 after deductible
Prescription
Generic Only
$10
Dental
$25 Deductible
$0 Cleanings, Exams, X-rays
20% Fillings
Vision
$50 for Exam, Glasses, Contacts
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Anthem Solutions for Young Adults
The TONIK Experience
• More than 80,000 individual enrollees (most in California where TONIK
was introduced at end of 2004)
• 78% previously uninsured
• Majority of members are 19-29 years old
• Six current markets: CA, CO, NV, NH, CT, GA
• Planned expansion to all 14 states in which Anthem or one of its
affiliates is the Blue Cross or Blue Cross and Blue Shield licensee
• All plans purchased online
• Has expanded insured market by introducing the importance of
insurance to a new segment
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Consumer-Friendly Solutions
Cost and Quality Transparency Efforts
• Anthem Care Compare – Hospital and surgical center cost and volume
information
• Zagat Online Physician Rating Tool – Allows members to view other
members’ ratings of physicians, percentage of members who
recommend that physician, and member comments. Physicians rated
in four categories:
• Trust
• Communication
• Availability
• Environment
• Blue Precision
• Physician cost and quality information
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Consumer-Friendly Solutions
Innovative Consumer Tools
•
360° HEALTH® Program
• An integrated suite of resources and health programs designed to give members the
information and support they need to reach their highest possible level of wellness.
Includes web-based solutions like a health risk assessment, Daily Health Tips, Online
Preventive Guidelines. Also offers Healthy Newsletters, Wellness Materials, 24/7 Audio
Tape Library, 24/7 Nurse Line, Diet/Nutrition resources.
•
MyHealth RecordTM
• Secure internet access to self- and claims-populated health information, customized
health management tools, clinical alerts for medication safety and gaps in care, and a
Secure Message Center to allow consumers to communicate virtually with customer
service representatives.
•
E-Prescribing
• To enhance patient safety, quality of care
and health care affordability and spur more
widespread adoption of health information
technology tools. Combination of local
initiatives and sponsorship of the National
Electronic Prescribing Patient Safety
Initiative (NEPSI).
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Uninsured Action Plan
When $100/month is too much…
• Our plan to reduce the number of uninsured:
• Universal coverage for children
• Public programs for children in families up to 300% FPL
• Private products designed to appeal to families with previously
uninsured children
• Improving and expanding public programs for the most needy
• Public program coverage for parents up to 200% FPL and
childless adults up to 100% FPL
• Providing a bridge to self-sufficiency for the working poor
• Premium assistance programs for all individuals and families
up to 300% FPL
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Lessons Learned
Moving Forward
• Legislative and regulatory flexibility enable innovative, affordable
products
• Consumers can determine the type and benefits of health
insurance coverage best suited to their individual situations
• Third-party benefit review panels can provide insight into fiscal
impact of proposed or enacted mandates
• Educating consumers on the value of health insurance is a key
part of outreach
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