CarePlus Prospect Presentation Deck BBT 082313
S LI DE 1
[Name of Employer, Entity]
Health Benefits and Administration
Cost Predictability, Improved Health and Productivity
S LI DE 2
CarePlus logo
BB&T Logo
S LI DE 3
Today’s Objective – Tomorrow’s Promise
Objective – today
 To confirm your objectives for 2013
 Provide an overview of the exclusive CarePlus solution
 Confirm your interest in receiving a proposal
 Initiate our APPtm unique assessment and profiling process
Our Promise – to be completed within two weeks
 Complete a detailed analysis of your current plan designs and costs
 Identify a solution to meet your needs or recommend another firm
 Construct a written proposal and confirm initial agreement
 Present a detailed presentation to your decision committee
 Confirm details and establish implementation plan
S LI DE 4
[Employer Problem identified on this slide]
S LI DE 5
CarePlus Works with Employers with similar Challenges
Manage the rising costs of health care coverage
Improve employee health to increase productivity & profitability
Continue offering high-quality health plans for employee retention & recruitment
Slide 6
Success Story: CLIENT NAME
 Include information about their previous programs and problems
 Include how CarePlus fit for them, and how it helped solve their problems
 INSERT CLIENT LOGO
S LI DE 7
Employers Can Break Away From the Pack
 CarePlus is only available through BB&T Insurance Services Inc.
Page 1 of 14
CarePlus Prospect Presentation Deck BBT 082313
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Careplus underwriting practices are recognized by insurance carriers as detailed,
comprehensive and accurate – insurance companies like what we do – so do our
clients.
Clients achieve their financial, and health and wellness goals.
CarePlus plan designs focus on all employer population segments so the right funds
are used for the right risks.
We converge medical data for 100 million Americans with current medical best
practices to deliver engaging communications and rewards to employees through
print, internet and mobile technology.
CarePlus offers several activities and outcomes based incentives and rewards.
A Fully insured medical plan featuring Anthem Blue Cross in California is available.
Self Insured models are available.
S LI DE 8
How is CarePlus Different from other plans?
Other Plans
Defined Benefit
Carrier renewal – Client budget
Procurement options – Reaction-based management
Plan Design
Contributions
Vendors
Funding
Basic
Strategies
CarePlus
Defined Contribution
Business & HR priorities – Health improvement focus
Integrated solutions – Metrics-based management
Promote
Consumer
Accountability
Make
Better
Decisions
Integrate
Systems and
Data Management
Change
Employee
Behavior
Advanced
Strategies
CarePlus works proactively while the other plans work reactively.
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 9
Comparative Results
Engagement
Market Norm
Health Assessment
20%
CarePlus 2012
Results
65%
Biometric Screening
10%
60%
Health Coaching
2%
25%
Condition
Management
Case Management
5%
35%
20%
55%
Health
US Population
CarePlus 2009
CarePlus 2012
Total Cholesterol
34%
35%
31%
HDL
37%
36%
33%
Blood Pressure
31%
31%
26%
BMI
66%
65%
59%
Key Factor
Market Norm
Cost Management
Carrier focused
CarePlus 2012
Results
ER and EE focused
Cost Trends
9-12%
4-5%
Reporting Metrics
Limited
Extensive
Communication
Strategy
Plan usage
Behavior and
lifestyle change
Health Management
Carrier driven
ER sponsored and EE
incentive focused
S LI DE 1 0
CarePlus Strategies for Success
• Control medical claims through fewer medical services and better outcomes.
• Improve the health of employees.
• Engage members in improving their health and getting better results.
• Improve productivity and reduce absenteeism and presenteeism.
• Reduce disability, workers comp and safety claims.
• Support HR recruitment and retention strategies.
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 1 1
Savings Opportunities by Category
Value-based Rx Design
1-2%
When employees are in full compliance with their treatment plan for managing an ongoing
condition like diabetes, high blood pressure, high cholesterol, their cost for Rx is reduced
High-Quality Hospitals
1-2%
High-cost procedures will be covered at a higher percentage if members use centers of
excellence for treatment.
Business Procedures
2-3%
Allowable amounts will be set for major procedures and the member will be engaged in
confirming costs at or below that allowable level amount at the facility they choose for their
procedure.
S LI DE 1 2
Savings Opportunities by Category
Move from High to Low Cost Plans
3-4%
Offering non-capitalization consumer-driven, lower-cost plans to allow low users savings on
premium costs and additional benefits from lower utilization.
Pooled Successes
2-3%
By combining multiple clients into one pool, the fixed retention costs will be less per district with
larger volume discounts.
Health as Primary Goal
3-4%
Reducing claims through an incentive management program that rewards employees’ wellness
activities and health improvement behaviors
S LI DE 1 3
The Potential Return On Investment
• 4 – 7% first year premium savings
• Trends at 35 – 50% less than market norms
• Reduced absenteeism and presenteeism
• HR teams spend 36% less time managing benefit programs
• Accuracy and timeliness of administrative functions reduce overall costs by 2%
• CarePlus members demonstrate commitment to improving their health, and driving
down costs
 58% are committed to cardiovascular exercise
 67% to losing weight
 45% to improving blood pressure
 67% to improving cholesterol
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 14
Plan Design - Selection Philosophy
System Focus
Process Focus
1
2
3
4
5
6
7
Health Plan
Health and Wellness
Buyer
Acceptor
Budget
Have to offer
to employees
Want to see value and
satisfied employees
Plan Use
As needed
Used to the maximum
benefit levels
Adoption
We offer benefits
We encourage use
Outcome Focus
8
9
10
Health and Wellness Adopter
Establish a
Culture of
Health with skin in
the game
Integrated into the
business function as
a core efficiency
We lead by example
and reinforce
at all levels
Purchasers traditionally focus on health benefits programs in a consistent way and, from time to
time, may shift their focus as budgets, income streams and employee populations change.
Where is [name of employer or entity]?
S LI DE 1 5
System Focus
1
Plan
Designs
2
Process Focus
3
4
5
Outcome Focus
6
7
8
9
10
Basic offerings
HMO / PPO / HSA
Basic offerings with buy-ups
ancillary / richer Benefits
Custom plan design with
integrated wellness
Enrollment
Levels
Enrollees use what is
offered
Introduction of incentives for
healthy behaviors
Participation or loss
of eligibility
Empower
Investment
Market price
lowest contribution
Involved
2% of premium
Committed
5% of premium
Renewal
Price
Reduction
Market trend
≈ 10% – 15%
40% savings
≈ 6% – 9%
75% Savings
≈ 2% – 4%
Purchasers’ outcomes are based on the complexity of their health plan design, the level of
healthy activities and rewards implemented, and their investment.
Purchasers of a basic system-focused plan sustain annual rate increases consistent with the
market norm, whereas a process-focused plan can save up to 40% of trend, and an outcomesfocused plan up to 75% of trend.
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 16
CarePlus Areas of Excellence that Improve Results
• Employer pool of like minded companies
• Enrollment / on-boarding services
• Wellness / health promotion
• Incentive management programs
• Online enrollment and administration
• Employee portal access and management
• Employee resource center
• Condition management / disease management
• Claims analytics
• Activity and behavior reporting
S LI DE 1 7
Unhealthy Behaviors Drive 70% of Illnesses & Medical Claims
Risk Factors
Stress
Obesity
Tobacco
Inactivity
Poor diet
Chronic Disease
Diabetes
Depression
High cholesterol
Chronic bronchitis
High blood pressure
Complications
Stroke
Cancer
Lung disease
Heart disease
Premature birth
If we can change unhealthy behaviors in any of our employees or retirees, we reduce the
annual amount of medical claims – reducing our annual expenses and rate increases.
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 1 8
Reduce Health Risks - Reduce Medical Claims
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 1 9
Employee / Member Participation
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 2 0
Allocate the Right Funds to the Right Risks
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 2 1
We Use Big Data and Analytics to Transfer decisions about Health Benefits from Employer to
Employees
S LI DE 2 2
CarePlus Fully Insured – California
CarePlus Logo
Medical
Cigna
 3 PPO selections
 2 HAS selections
Dental
Cigna
 High / Low PPO
 HMO
Vision
VSP
 PPO plan
Life
Cigna, Unum or Hartford
 1X salary & $50k flat
 Buy up and buy down option
LTD / STD
Cigna, Unum or Hartford
 60% base
 Buy up and buy down option
Voluntary
Unum
 Accident
 Sickness
 Critical Illness
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CarePlus Prospect Presentation Deck BBT 082313
S LI DE 2 4
Rate Factors
First Year
 Clients enter CarePlus pool at current pricing level
 Discounts available for pooling risk and health improvement activity
 Total cost influenced by employee migration
 Employee cost share drives election choice
 Claims utilization moves to plan design mean
Second and Subsequent Years
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Pool renewed as total block
Client rates adjusted up or down based upon
Change in demographics
Employee participation in wellness activity
o Employee participation in coaching / management programs
o Claims loss ratio
S LI DE 2 5
CarePlus Implementation Process
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We do an assessment and audit of a company’s programs, population, claims, providers
(about 30 to 45 days)
We assess the strength of the existing structure to meet the stated company goals
We examine the marketplace and make recommendations of plans, carriers, vendors,
etc.
We agree on implementation timeframes and enrollments are scheduled
We brand enrollments, employee materials, online portal, call center responses and
more to reflect the company’s culture
We provide quarterly reports to show progress toward goals
S LI DE 2 6
Enrollment and Eligibility
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Monitor new employee compliance
Default employee coverage
Collect and manage EOI forms
Manage life events/qualified status changes
Manage new hire and term data
Process enrollment data
Manage over-age dependents
Manage data loads
Manage escalated eligibility issues
FSA Administration
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Compliance
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CarePlus Prospect Presentation Deck BBT 082313
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Participant support
Reimbursement processing
Banking and funding
Debit cards
Payroll contribution reconciliation
Reports and statements
Premium Billing & Reconciliation
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Reconcile monthly carrier invoices
Calculate actual premium due
Prepare one consolidated invoice for client
Monitor premium credits for retroactive adjustments
Timely dissemination of payments to all carriers
COBRA Administration
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New hire participant notification
Qualifying event letter generation
Qualifying event processing
Election form processing
Premium billing
Reporting
Annual enrollment
Customer Care Center
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Employee resource/Call center
Respond to all employee benefit questions
Toll-free, dedicated phone numbers
Customized scripts and protocols
Bilingual agents and translators in 130 languages
Data Management
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Manage monthly scheduled data transmissions with HRIS, payroll
and carriers/vendors
Apply data validation filters on
all files
Review and resolve discrepancies identified on carrier load error reports
Manage system-programming updates due to changes in benefit plans, carriers,
acquisitions, etc.
Online Enrollment
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Access personalization benefit plan options and see current coverage
Preview personal and employer H&W contributions
Enroll for benefits 24/7
Update personal and dependent information
Receive online and/or live customer service support
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CarePlus Prospect Presentation Deck BBT 082313
Benefits Portal
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Secure, online portal – Single-point of access to benefit information
Integration with enrollment system via secure single sign-on
Integration with health management tools
Direction to core programs
Monthly health promotion updates
S LI DE 2 7
Additional Capabilities – Benefits Outsourcing
Benefits Consulting Services
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Strategic plans
Program audits
Benefits, compensation,
HMS and 401(k) focus
Retirement Plan Services
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Plan design consulting
Vendor search, management
Employee communication
Cost analysis and industry benchmarking
Compliance advisement
Brokerage Services
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Underwriting and procurement
Communications programs
Vendor management
Plan and participant-level service
Compliance services
Health Management Services
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Wellness and health promotion programs
Condition management
Medical plan audits
Employee assistance programs
Employee advocacy programs
Administrative Services
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Employee resource/Call center
Benefit administration
Enrollment processing
Billing reconciliation
COBRA/FSA administration
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CarePlus Prospect Presentation Deck BBT 082313
Technology Solutions
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Online system management
Payroll and HRIS integration
Electronic connectivity
Data management
Benefit portal development and management
S LI DE 2 8
Next Steps
Our recommendation:
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Complete a detailed analysis of your current plan designs and costs through our
profiling process
Identify a solution to meet your needs or recommend another firm
Construct a written proposal and confirm initial agreement
Present a detailed presentation to your decision committee
Confirm details, agreement and establish an implementation plan
S LI DE 29
CarePlus Logo
BB&T Logo
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