COTTINGHAM & BUTLER
HONKAMP KRUEGER & CO, P.C.
INNOVATIVE INSURANCE SOLUTIONS
1
Cottingham & Butler Introduction
• Privately held - established in 1887
• Headquarters in Dubuque, IA
• National provider of employee benefits and risk management solutions – clients in 48 states
• Over 3,500 customers
• 450+ employees
• 38th largest Insurance Broker in U.S.
• Recognized for excellence
• “Agency of the Year” National Underwriter
• “Agency of the Year” Rough Notes Magazine
• Professional services firm – focused on culture and growing organically
INNOVATIVE INSURANCE SOLUTIONS
22
Office Locations
• A number of larger offices, with some individual sales offices
• 95% of businesses outside of Dubuque, IA
• Clients in 48 states, ranging from Florida to Alaska, Maine to California
INNOVATIVE INSURANCE SOLUTIONS
33
Why We Are Different
• Depth and breadth of capabilities:
• Property & Casualty Insurance
• Casualty Claims Administration (TPA)
• Captives & Programs
• Safety & Loss Control Consulting Services
• Employee Benefits Brokerage & Consulting
• Benefit Claims Administration (TPA)
• Medical Management Services
• Wellness & Condition Management Solutions
• Personal Insurance Services
•
•
•
•
Relentless focus on outcomes and results
Willing to take risks and be innovative
Provide alternative financing strategies to reduce insurance costs
Exceedingly focused on metrics and analytics to get behind activity and
discern the real impact
• Constantly pushing ourselves to get better
INNOVATIVE INSURANCE SOLUTIONS
44
Brokerage Expertise & Accountability
Brokerage
•
We organize our traditional brokerage sales and service into practices –
Risk Management and Employee Benefits
•
Industry Expertise: Transportation, Tribal Nations, Agribusiness, Construction, Manufacturing
Claims Management
•
Casualty TPA that handles worker’s compensation & liability claims
•
•
99+% Retention Rate
Medical Claims TPA
• Pay claims for over 250 self-insured clients
• Over last 3 years, our average increase in cost per employee per year has
averaged less than 3% compared to the industry average of 10%
Onsite Clinical Expertise and Wellness Team
•
•
Full-time Medical Director, 24 Nurses, and team of Certified Health Coaches
Utilization review, case management, and condition management to over 100,000
individuals.
INNOVATIVE INSURANCE SOLUTIONS
5
Brokerage Expertise & Accountability
Safety Consulting
•
•
Eight full-time safety professionals
Service provided to our brokerage clients as well as a la carte
Captive & Program Management
•
•
Developed four trucking captives, including the largest member-owned group trucking
captive, and a heterogeneous captive for non-trucking clients.
Each captive has retention rates in the high 90% range.
INNOVATIVE INSURANCE SOLUTIONS
6
Today’s Agenda and Presenters
1. Pay As You Go Workers’ Compensation

Matt Murray, Risk Management Account Executive
2. P&C Overview and Risk Management Audit (RMA)

Jeff Bair, Risk Management Sales Executive
3. Benefits Consulting Services and Capabilities

Brad Plummer, Jane Mueller & Nicole Pfeiffer, Employee Benefits Vice
President/Sales Executives
4. HealthCheck360°

Michael Kelly, Director of HealthCheck360°
INNOVATIVE INSURANCE SOLUTIONS
7
Pay As You Go Workers’
Compensation
-Matt Murray
INNOVATIVE INSURANCE SOLUTIONS
8
What Is Workers’ Compensation?
• Coverage for an injured worker while in the course and scope of
employment.
• Mandatory coverage
• How is it priced?
– Each carrier has a different appetite. Pricing can be wildly different from
carrier to carrier.
– An experience modification factor (mod) is applied to each account. In
it’s simplest form a rating of an account based on “average”. 1.00 is
average; greater than one below average; less than one above
average.
– Carrier can apply discretionary credits/debits, dividends and other
pricing tools.
– Each class code and state has it’s own rate.
INNOVATIVE INSURANCE SOLUTIONS
9
Critical to Success in Workers’ Compensation
• Licensed insurance professionals
• Contracts with the key carriers offering pay as you go solutions and
significant volume with each carrier today
• Knowledge of states and negotiation
– As mentioned earlier, each state varies significantly on how workers’
compensation is priced.
• Iowa – State sets rate, carriers can deviate +/- 30%
• Illinois – Carriers can essentially charge whatever they want.
• Wisconsin – State sets rate, each carrier has the same premium. Only way
to change the premium is a dividend.
• Minnesota – A loss cost multiplier state. Large variance in what each carrier
would have for rates.
INNOVATIVE INSURANCE SOLUTIONS
10
Why Pay as You Go?
• Growing trend in companies wanting this option
• Payroll companies including ADP, Ceridian and Paychex are offering
this as a bundle with the payroll services
• If HK is not talking to clients about bundling the services together,
one of your competitors may be
INNOVATIVE INSURANCE SOLUTIONS
11
Why Use Pay as You Go?
Current Situation
Pay as you go Solution
•
•
•
•
•
25% down and 9 equal payments?
10 equals? Potentially monthly if
the carrier is willing to offer.
Premium is based off a best
“guess” on what the payroll will be
for the upcoming year
If the “guess” is not accurate,
there is opportunity for significant
additional premium or return
premium
Cash flow is based off your
estimates and available pay plans
•
•
•
•
•
•
No deposit or down payment
required for the client
Premium payments are based on
actual payroll
Less audit issues due to the
premium being calculated “real
time”
Improved cash flow
No checks to write or invoices to
pay for the insured
Integrates with Infinisource, once
the initial set up is complete, the
premium is determined when
payroll is run automatically
Simply put…a billing option.
INNOVATIVE INSURANCE SOLUTIONS
12
What Companies Fit?
All companies can fit for the pay as you go option. The following
categories have the greatest take up.
–
–
–
–
Under 100 employees
Contractors
Small businesses with cash flow issues
Companies that have had historical workers’ compensation audit issues
Will this work for every company?
– No, each company will still need to be individually reviewed by the
insurance carrier to determine if the carrier will released a workers’
compensation quote.
– If a carrier is setup for Pay as You Go quotes…it can be done.
INNOVATIVE INSURANCE SOLUTIONS
13
What Insurance Carriers Offer Coverage?
• Many companies you may know…
• More and more carriers are beginning to offer the option
INNOVATIVE INSURANCE SOLUTIONS
14
When Should C&B Get Involved?
• If a client is interested in the option, C&B will engage and gather the
needed information
• C&B will obtain competitive workers’ compensation options
• Provide Proposal to HK & client
• If they elect to go with the HK/C&B, we will immediately bind
coverage and start the process of getting the client set up for the
automatic payments
• Basic data needs to be included by HK in the data file to the pay as
you go software
Payroll Company ID
Payroll Period Start
Date
Employee Number
Check Date
Payroll Period End
Date
Subject Wages
Class Code
Policy Effective Date
Template
FEIN
Policy Expiration Date
State
INNOVATIVE INSURANCE SOLUTIONS
15
How Does the System Work?
• A net rate will be determined and automatically loaded into the
system.
• The client needs to assign a class code to each employee on initial
setup. This is only needed on intake and with any new hires.
• Once this is complete, each payroll period will automatically
generate the correct premium. An email will be sent to the client, HK
and C&B confirming the payment amount.
• A fee of $5-$9 will be charged to the client per pay period depending
upon premium size.
INNOVATIVE INSURANCE SOLUTIONS
16
The Workflow
HK
Payroll
• Provides a class code
per employee & verifies
in Payroll Software
• Provides new hire /
terminated employee
info throughout year,
needs to verify
employees class code.
• Payroll Data file collected with
needed info
• Software Interfaces with
PayGO to automatically send
payroll data
PayGo
Software
Client
C&B
• Develops net rate by
state & class code
• Automatically links rates
with payroll
• ACH set up to
withdrawal premium per
pay period.
• Negotiates and binds
quote with carriers
• Provides bound quote to
PayGo
INNOVATIVE INSURANCE SOLUTIONS
17
How Do We Get This in Front of Clients?
Ideas for Discussion
1. Introductory mailer, showing the partnership between
HK and C&B and ability to offer the payroll services
and pay as you go workers’ compensation
2. Quarterly webinars to provide knowledge and benefits
of the program to HK clients
3. Follow up by C&B or HK Payroll (to be agreed upon)
INNOVATIVE INSURANCE SOLUTIONS
18
Getting Started
• Several of you may have a clients/prospects in mind that this
option would work for
• C&B would run 2-3 pilot companies through the pay as you go
platform
• Integrate systems, work kinks out, and get a working
knowledge of how the process will go
INNOVATIVE INSURANCE SOLUTIONS
19
Your Resource
Who to contact at C&B for Pay as You Go Workers’ Comp:
Matt Murray| Risk Management Account Executive
563-587-5312 | mmurray@cottinghambutler.com
INNOVATIVE INSURANCE SOLUTIONS
20
Risk Management
-Jeff Bair
INNOVATIVE INSURANCE SOLUTIONS
21
Risk Management Practice Areas
• Everything But Trucking and Benefits
• Manufacturing
• Construction
• Food Related Companies
• Tribal / Casinos
• Target $100K Premium and Higher
• Midwest –
– 2nd Tier Cities – Under the Radar of Large National Brokers
– Iowa, Wisconsin, Illinois, Minnesota, Indiana, Michigan, South Dakota,
Nebraska, Missouri
INNOVATIVE INSURANCE SOLUTIONS
22
Business Model
<$100K Premium – Price Sensitive
 1.) Insurance Program Design
 2.) Brokerage Services
>$100K Premium – Service Sensitive





1.) Risk Management Program Design
2.) Brokerage Services
3.) Safety Services
4.) Claims Advocacy
5.) Third Party Claims Administration
INNOVATIVE INSURANCE SOLUTIONS
23
Consulting Competencies
Insurance Program Design
• Alternative Risk
– Captives
– Large Deductibles
– Self Insurance
• Risk Management Services
– Safety Programming and Consulting
– Claims Advocacy
• Third Party Claims Administration
– Unbundled Claims Administration
INNOVATIVE INSURANCE SOLUTIONS
24
Consulting Competencies
Insurance Program Design
• Risk Management Assessment
– Program Design
– Premium and Coverage Benchmarking
• Objective –
– Move away from price and develop conversation around program
design
– Develop consulting relationship rather than price shopping
INNOVATIVE INSURANCE SOLUTIONS
25
Consulting Competencies
Insurance Program Design
•
Risk Management Assessment
– Program Design
– Premium and Coverage Benchmarking
– Market Perception
•
Crazy Stuff
–
–
–
–
•
Fruit and Vegetable Distributor’s cargo policy excluded Fruits and Vegetables
Entire building schedules uninsured
Egg Producer Umbrella policy excluded salmonella outbreak
Every policy reviewed has had material findings
Outcome
– Properly Designed Program Tailored to Individual Exposure
– More informed underwriting
– More Coverage / Less Premium = VALUE
INNOVATIVE INSURANCE SOLUTIONS
26
Consulting Competencies
Alternative Risk
– Captives
– Large Deductibles
– Self Insurance
Significant percentage of clients participate in an alternative risk
program.
– Shift from an annual insurance renewal to an annuity corporate finance
project.
Lower Total Cost of Risk
– Insurance becomes less expensive as they take more risk.
– More operational focused since they have skin in the game.
INNOVATIVE INSURANCE SOLUTIONS
27
VIP - Personal Insurance
Unique Needs for VIP’s
– Large Property Holdings
– High Values
Features
–
–
–
–
Homeowner policy guarantees full replacement cost
Sewer and Water Backup to Full limits of the policy.
Auto Agreed Value with OEM replacement parts
Agreed Value for Jewelry, Furs, Art and other valuables
Exclusive access to top 5 affluent personal insurance markets
that cater exclusively to affluent clients
– Pure, AIG Private Client, Chubb, Ace
– Complete personal assessment – appraisals
Private Client Concierge Service
– Private Client Service Center
– Confidential
INNOVATIVE INSURANCE SOLUTIONS
28
Your Resource
Who to contact at C&B for Risk Management solutions:
Jeffrey Bair| Risk Management Sales Executive
563-587-5138 | jbair@cottinghambutler.com
What to expect:
– Respect that it is your relationship
– Work hand in hand with you
– Continued communication with you during process
INNOVATIVE INSURANCE SOLUTIONS
29
Benefits Consulting Services
and Capabilities
-Brad Plummer, Jane Mueller, and
Nicole Pfeiffer
INNOVATIVE INSURANCE SOLUTIONS
30
Example of Key Account Client Service Team Assignment
Krista Sigman
Linda Perry
Director of Group & Voluntary Benefits
Compliance & Human Resource Specialist
Phone: (563) 587-5578
Email: ksigman@cottinghambutler.com
Phone: (563) 587-5149
Email: lperry@cottinghambutler.com
Nicole Pfeiffer
Julie Harbaugh
Christine Storlie, MBA, PHR
Sales Executive
PPO Network Utilization Specialist
Manager of Client Human Resources
Phone: (563) 587-5208
Cell: (563) 580-3665
Email: npfeifferl@cottinghambutler.com
Phone: (563) 587-5346
Email: jharbaugh@cottinghambutler.com
Phone: (608) 467-0692
Email: cstorlie@cottinghambutler.com
Jane Mueller
Sales Executive
Phone: (563) 587-5263
Cell: (563) 590-4162
Email: jmueller@cottinghambutler.com
Melanie Kintzle
Benefit Services Unit Manager
Phone: (563) 587-5314
Cell: (563) 581-2917
Email: mkintzle@cottinghambutler.com
Devon Mullner
Benefits Services Representative
Phone: (563) 587-5237
Email: dmullner@cottinghambutler.com
Kathy Herting
Plan Document Specialist
Phone: (563) 587-5347
Email: kherting@cottinghambutler.com
Craig Herbst, CPA
Senior Business Analyst
Phone: (563) 587-5137
Email: cherbst@cottinghambutler.com
Adam Jensen, JD, CEDS, FLMI
Taylor Orton
Vice President and Director of Compliance
Benefits Analyst
Phone: (608) 467-5030
Email: ajensen@cottinghambutler.com
Phone: (563) 587-5366
Email: torton@cottinghambutler.com
INNOVATIVE INSURANCE SOLUTIONS
31
Evaluating Benefit Plans: How Are We Different?
1. Funding Methods – We have expertise in all funding methods: fully insured, splitfunded, minimum premium, self-funded. Most brokers specialize in one funding
method.
2. Geographic – We have benefits clients in 30+ states, and Assurex Partners in all
50 states and across the globe. Most brokers concentrate on a small geographic
area or one state.
3. Insurance Carrier Relationships – We place business for thousands of clients
annually with 50+ insured medical carriers, 25+ stop loss carriers and 30+ life &
disability carriers. Many brokers only have a handful of carriers they work with.
4. Strategic Approach – Our team uses a proprietary “3 C’s” approach to evaluating
benefit cost drivers and creates custom plans for each client based on company
culture, recruiting/retention objectives and budgetary goals. Our team of experts
provides creative solutions and outside the box ideas that our competitors don’t
think of.
5. Resources – We are truly unique, in that we can provide an integrated “one-stop
shop” solution.
INNOVATIVE INSURANCE SOLUTIONS
32
What We Do That is Different and Below the Surface…
Many
only
focus
here
Cost per Employee
Benchmark Plan Design
Dependent Eligibility
But what’s below
the surface?
Audit Metrics:
• Coverage
• Consumption
• Cost Sharing
Health Care Reform:
• Implications
• Exchanges
• Penalties
INNOVATIVE INSURANCE SOLUTIONS
33
Our “3 C’s” Framework for Evaluating Benefit Plans (on a High Level)
Metric
Calculation
What it tells you
Participation Rate
The number of employees who are
covered divided by the total number of
eligible employees
Whether you may be covering too many employees
relative to benchmark averages
Dependent Ratio
The total number of plan participants
divided by total number of covered
employees
Whether you may be covering too many
dependents
Metric
Calculation
What it tells you
Average claims per
Participant
Total claims costs (eligible Medical & RX
claims) before cost sharing divided by total
number of participants
The total amount of money spent on claims by an
average participant without regard to plan design
and contributions (absolute cost of benefits)
Demographic Index
Weighted average expected cost index
based on participant age and gender (1 is
average)
The impact of demographics on average costs
Admin Cost per
Participant
Total Plan admin costs divided by total
number of participants
The non-claims cost associated with the plan
Metric
Calculation
What it tells you
Plan Cost Sharing
percentage
The total amount paid by the plan divided
by the total eligible claims
The split between what the plan pays versus what
the employee pays when medical services are
purchased
ER Contribution
percentage
(Total plan costs minus employee
contributions) divided by total plan costs
The percentage of total plan costs that are paid for
by the employer
Coverage
Consumptio
n
Cost Sharing
INNOVATIVE INSURANCE SOLUTIONS
34
C&B Client Trend Line versus National Average
Cost Per Employee Per Year
National Average
$10,000
Cottingham & Butler
Per Employee Per Year
$9,500
$9,000
$8,500
$8,000
$7,500
$7,000
$6,500
2007
2008
2009
2010
2011
Since 2007, Cottingham & Butler’s clients have experienced
a trend of 2.8% increase in cost per employee per year
versus the national average of 7.4%.
INNOVATIVE INSURANCE SOLUTIONS
35
6 Primary Reasons Why We Perform Differently
1. We focus on strategic planning for long term cost containment. Most brokers
ride the renewal rollercoaster and don’t know how to effectively plan beyond the
current year.
2. We reach all over, not just locally which gives us a bigger view of the healthcare
marketplace and offers alternatives that other brokers may not have access to.
3. We excel with alternative and self-funding arrangements and believe that you
should find ways to buy less insurance over time and self-fund the claims that
are predictable and controllable.
4. Most brokers focus on off-the-shelf options and have market limitations. We
focus on principles and dig for the details below the surface that provide
opportunities for savings.
5. We provide wellness recommendations and deliver on our ROI estimates.
6. We focus and deliver on compliance and HR Services making our clients more
effective at managing their employees and benefit programs.
INNOVATIVE INSURANCE SOLUTIONS
36
Differentiators Between C&B and Other Brokers
Dedicated Employee Benefits Marketing Team with 100+ market relationships &
contracts
 Dedicated Analytics Team (including former BCBS Finance Manager in charge of
a 6 state region)
 ERISA Attorney on staff
 HR & Compliance Consultants on staff
 Proprietary TPA and PPO Networks
 Plan Document specialist
 Dedicated Non-Medical market and plan specialists
 ACA Experts on staff
 25+ Nurses and 4 Physicians on staff
 Wellness Consultants and proprietary programming/pricing with Healthcheck360°
 Transportation Industry Specific Benchmarking
 Exclusive HRIS/Payroll system capabilities and pricing
INNOVATIVE INSURANCE SOLUTIONS
37
Client Resources You Won’t Get With Other Brokers…
 3-Year Strategy Planning Guide
 Compliance CD & Quarterly Compliance Newsletter
 Health Plan Intelligence Suite (Reporting/Benchmarking Portal)
 MyWave HR Resources
 Plan Source Benefits Portal for Employees
 Online Benefit Enrollment Suite*
 Annual Compliance Manual
 5500 Filing*
 Full HR and Compliance Audit Services*
 Wellness/Benefits Resources on CD
 Proprietary HealthCheck360° programming/pricing*
 Transportation Industry Specific Benchmarking
 Health Care Reform Tool Kit
 Dependent Eligibility & Spousal Coverage Audits available through SISCO*
* Additional fees may apply
INNOVATIVE INSURANCE SOLUTIONS
38
Risk Management for Benefits
Benefit Compliance Audit
– Covers H&W benefit plan policies and processes that can put an employer at risk, including
the items covered in a DOL H&W plan audit
HR Compliance Audit
– Covers HR policies and procedures that can put an employer at risk
Employee Handbook Review
– Includes a review of the handbook with revisions to bring the handbook into compliance with
applicable law and desired corporate policies
HIPAA Title II Privacy and Security Consulting
– PHI mapping, HIPAA findings report, preparation of Privacy and Security policies and
procedures, forms, training materials and presentations for staff
Form 5500 Preparation/Delinquent Filer Voluntary Compliance Program
– Form 5500s, Schedules, and Summary Annual Report (SAR)
– DFVC: If your client has failed to file, would they prefer a penalty of:
A.
B.
$10/day capped at $4,000 max per plan, or
$1,100/day with no limit, going back as far as DOL wants
ERISA Wrap-around SPD Preparation
– Includes creation of Summary Plan Description containing all the ERISA-mandated
elements and required health notices
– Failure to provide SPDs and required notices can lead to fines and lawsuits
– Hint: fully-insured carriers don’t do this because it’s a Plan Sponsor duty and the certificate
booklets they do provide don’t contain the required items
INNOVATIVE INSURANCE SOLUTIONS
39
Best Practices
Compensation Review and Benchmarking
– Includes job description creation/review, marketing/benchmarking
positions
– Compensation structure analysis and linkage to performance
management
Benefit Issue Research & Analysis
Generic Benefit Form Preparation
– Includes eligibility, enrollment, plan administration, plan
amendments
Cafeteria Plan Preparation
– POP Plan, FSA, Dependent Care, Adoption Assistance
– COBRA Administration
– FMLA Administration
INNOVATIVE INSURANCE SOLUTIONS
40
Vendor Partnerships
• Insurance Carriers: We work with numerous fully insured carriers,
stop loss carriers, and voluntary benefit carriers
• TPAs: For our self-funded clients we work with a large number of
different TPA firms and understand the strength of their customer
service and claims adjudication processes
• PPO Networks: We have strong expertise in knowing network
geographic area strengths and we can plug in regional networks
for strong local discounts.
INNOVATIVE INSURANCE SOLUTIONS
41
Examples of Details Mattering in the Real World
•
Blue Card Fees
•
•
•
C&B engagement uncovered error in Blue Cross service delivery. Client received $550,000 retroactive
credit.
ACA Risk Management
•
Review of client on-boarding procedures reveals significant gap in ability to effectively demonstrate
offering coverage to 95% eligible. Exposure- Over $20 million in fines. Result: Significantly enhanced
recordkeeping and on-boarding process.
•
C&B engagement correctly calculates ACA fees saving client $109,000 versus carrier recommended
method.
Insurance Placement
•
•
Procurement of two year stop loss contract saves client exposure on seven figure claimant. Result: Cost
projections flat.
Performance Based Plan Design
•
Client implemented incentive-based plan design features to promote Wellness and Chronic Condition
Medical Compliance.
•
Care Plan Compliance Results:
•
Asthmatics 93%
•
Diabetics 73%
•
Hypertensive 87%
•
Costs are Down 7% over past five years, versus 7% compounded growth.
INNOVATIVE INSURANCE SOLUTIONS
42
Eligibility Audits
• On average, 4 - 8% of dependent
spouses and children on employer
sponsored benefit plans are not eligible
for the medical benefits they receive.
• The average cost to the employer for
each dependent is $3,500 (per year in
claims).
• A Plan with 1,000 covered employees
(1,200 dependents) is likely spending
between $150,000 - $200,000 per year
on members who do not qualify for
coverage.
• The simple fact is that employers can no
longer afford to overlook ineligible
dependents.
INNOVATIVE INSURANCE SOLUTIONS
43
Importance of Voluntary Benefits
•As employers consider their health care and total
rewards strategies in light of health care reform, nearly
half expect voluntary benefits and services (VBS) to
become more important over the next five years jumping
to 48% in 2018 from the current 21%.
•These supplements to core benefits are designed to fill
gaps in employees' security, health, wealth accumulation
and address unique personal needs.
•The most prevalent voluntary benefit offerings currently
provided by employers include life (94%), vision (84%),
disability (80%), dental (80%) and accident (68%)
insurance.
•Additionally, employers are considering adding a
number of voluntary benefits over the next two years.
The top offerings being considered include critical
illness, identity theft and financial counseling.
Towers Watson 2013 VBS Survey
INNOVATIVE INSURANCE SOLUTIONS
44
Additional Broker Resources
•
Educational Employee
Benefit Webinar and
Seminar Series
•
HR Communication Portal
which includes documents
for employers and
employees
•
Employee Benefits
Website to share benefit
plan information
•
Benefit Booklet Content
and Design Creation
INNOVATIVE INSURANCE SOLUTIONS
45
Your Resources
Contact Jane Mueller & Nicole Pfeiffer with employee benefit prospects:
Jane Mueller | Vice President Employee Benefits
563-587-5263 | jmueller@cottinghambutler.com
Nicole Pfeiffer | Vice President Employee Benefits
563-587-5208 | npfeiffer@cottinghambutler.com
INNOVATIVE INSURANCE SOLUTIONS
46
-Michael Kelly
INNOVATIVE INSURANCE SOLUTIONS
47
48
INNOVATIVE INSURANCE SOLUTIONS
48
About HealthCheck360°
•
Created in 2007 to change focus of wellness industry to
health risk management
•
Subsidiary of medical management firm HealthCorp
•
Natural evolution of 20+ years of experience in:
–
Health improvement and behavior change
–
Chronic condition management
–
Managing over 100,000+ employee lives
Proprietary & Confidential
INNOVATIVE INSURANCE SOLUTIONS
49
About Our Client Base
• Average group size – 300 employees
• Domiciled in 36 states
• Multiple Industries
–
–
–
–
Manufacturing
Professional Services
Health Care
Transportation/ Distribution
INNOVATIVE INSURANCE SOLUTIONS
50
5 Best Practices
INNOVATIVE INSURANCE SOLUTIONS
51
1. Biometric Screenings
Proprietary & Confidential
INNOVATIVE INSURANCE SOLUTIONS
52
2. Proprietary Objective Scoring System
• Our scoring algorithm is
directly correlated to present
and future cost drivers
• Balanced across all major
cost drivers
• Transparent to participant
• Designed to reward positive
change across health
spectrum
• Designed to integrate with
medical management
• Easily understood 0-100
scale
• Developed and reviewed by
physicians
Proprietary & Confidential
INNOVATIVE INSURANCE SOLUTIONS
53
3. Outcome Based Incentive Models
Incentive Rate
Preferred Rate
• Health score of 71+
• Repeat participants with <71
AND 5+ pt improvement
• All new participants
• Health score of 71+
• Repeat participants with <71
AND 5+ pt improvement
• All new participants
Standard Rate
Participation Rate
• Non-participants
• Participants who fail to meet
health goals
• Participants who fail to meet
health goals
Standard Rate
OR…
• Non-participants
INNOVATIVE INSURANCE SOLUTIONS
54
4. Data Driven Engagement and Programming
•
•
•
•
Biometrics
HRA responses
Demographics
Claims
Stratification
• Ideal, Low,
Moderate, High, &
Very High Risk
•
•
•
•
Communications
Technology
Health Coaching
Medical Mgmt
Data
Engagement
Proprietary & Confidential
INNOVATIVE INSURANCE SOLUTIONS
55
5. Client Specific Reporting
Individual Report
Executive & Aggregate Report
Claims analysis*
Health Coaching Reporting*
Risk Migration Analysis
Critical Value Reporting
Executive Review Presentation
– Provides synopsis of various reports
– Identifies key issues
– Compares company data to industry
cohorts
* If applicable
Proprietary & Confidential
INNOVATIVE INSURANCE SOLUTIONS
56
Importance of Participation
Participation Correlation to Claims
$4,967.48
$5,000.00
18% Increase in
non-participant
costs
$4,800.00
$4,600.00
$4,400.00
$4,194.13
$4,200.00
$4,000.00
$3,800.00
Biometric Participant
HC360 Sample Population Study, N=10262,
2012
Non-participant
Proprietary & Confidential
INNOVATIVE INSURANCE SOLUTIONS
57
Continued Positive Impact
Age vs. Total Score
90
1-Year Participants
85
2-Year Participants
3-Year Participants
HRA Total Score
4-Year Participants
80
Power (1-Year
Participants)
Power (2-Year
Participants)
75
R² = 0.6612
R² = 0.8504
70
R² = 0.9326
R² = 0.9663
65
20
25
30
35
40
45
50
55
60
65
Age
INNOVATIVE INSURANCE SOLUTIONS
58
Correlation to Health Score to Claims
Health Score Correlation to Claims
$6,000.00
Allowed Claims (Annual)
$5,500.00
$5,417.24
$5,000.00
y = 2978.7e0.1446x
R² = 0.987
$4,500.00
$4,460.83
$4,000.00
$3,980.86
$3,500.00
$3,474.83
$3,000.00
Ideal (85+)
Low Risk (71-84)
Moderate Risk (61-70)
HC360 Health Risk Level (Score)
High Risk (<=60)
HC360 Sample Population Study, N=10262,
2012
INNOVATIVE INSURANCE SOLUTIONS
59
HealthCheck360° Case Study
Average WC Cost by Health Level
$1,150.00
$1,050.00
y = 314.75e0.2959x
R² = 0.8591
$950.00
$952.22
$850.00
$750.00
$771.36
$703.24
$650.00
$550.00
$450.00
$350.00
$366.25
$250.00
Ideal Risk
Low Risk
Avg WC
Moderate Risk
High Risk
Expon. (Avg WC)
2000 EE manufacturing and distribution company – Significant correlation in
high health risk levels and workers compensation expense.
INNOVATIVE INSURANCE SOLUTIONS
60
Year 1 to Year 4 Migration
Health Risk Score Migration
1800
16921687
1602
1592
1600
1491
1355
Number of Participants
1400
1200
1000
1096
1015
928
969
857 827
800
619
600
566
475 464
452
375
400
283 283
200
0
Ideal
53% Increase
Low
Year 1
Moderate
Health Risk Score
Year 2
Year 3
High
Year 4 25% Decrease
Very High
37% Decrease
HealthCheck360 Population Study, N=19,301, 2012.
INNOVATIVE INSURANCE SOLUTIONS
61
Proposal Request Form
INNOVATIVE INSURANCE SOLUTIONS
62
Your Resource
Who to contact for HealthCheck360°:
Michael Kelly | Director of HealthCheck360°
563-587-5186 | Michael.Kelly@healthcheck360.com
www.healthcheck360.com
INNOVATIVE INSURANCE SOLUTIONS
63
INNOVATIVE INSURANCE SOLUTIONS
64