Facilitating Individual Coverage Options for Part-time ... · RightOpt® From Hire through Retire®...

RightOpt® From Hire through Retire® Facilitating Individual Coverage Options for

Part-time, COBRA, and Pre-Medicare Retirees,

with Special Guest from Panera Bread

Today’s Objectives

Help you better understand: • How public and private exchange offerings can work in tandem to provide a breadth of

insured products

• Why employers are interested in supporting ineligible populations in shopping for insurance

• What the members would experience when shopping through a combination public and

private exchange

Sherri Bockhorst National Practice Leader

Health Exchange Solutions

Buck Consultants at Xerox

David Foster Market Leader

Health & Productivity


Misi Holmberg Sr. Manager

Benefit Operations

Panera, LLC

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Employer Interest is High and Growing

Percentage of large employers considering a private exchange by population.

*Source: NBGH Large Employers’ 2014 Health Plan Design Survey, August 2013; Percentage considering private exchanges in 2015 or after.

30%

15%

20%

41%

26%

40%

0%

10%

20%

30%

40%

50%

Full Time Actives Spouses Part Time Actives COBRA Pre-65 Retirees Medicare Retirees

3

Uninsured Rates Among Actives is High

Critical opportunities for

individual coverage:

• Approximately 1/3 of those

eligible but not enrolled, and

1/3 of those not eligible, are

uninsured…that’s 9.2M

uninsured employees

working for large employers

• Approximately 2%, or nearly

1M individuals are covered

under COBRA

41.3M

11.7M

5.4M

2.2M

2.9M

7.7M

FT PT

Coverage through employer

Eligible, not enrolled

Not eligible

Insurance Coverage For Workers

Source: Health Insurance Coverage Bulletin; Abstract of Auxiliary Data for the March 2013 Annual Social and Economic Supplement to the Current Population Survey

Employers with over 500 employees.

4

Help people avoid penalties

related to ACA’s individual

mandate

Provide personalized and

more consistent shopping

experience across the public

and private marketplace

Create affinity to the

organization by providing

support and access to

additional ancillary benefits

Notify COBRA participants of

additional options available

in the individual market,

potentially with a government

subsidy

Support access to federal tax

credits that may save

employees money on health

care expenses

Offers a combination of

website and call center

concierge support

Why Employers Facilitate Access

Supporting members through a low to no-cost solution helps

you and your employees.

5

Medical Insurance Support for 2015

Phone + RightOpt Portal

• Licensed agents will help customers claim tax credits, compare plans and enroll – via phone and Internet co-browsing.

• Customers can self-serve through RightOpt portal, where they can compare plans using the GetInsured Plan Score, claim tax credits and enroll.

Phone + State Exchange Site

• Licensed agents will help customers claim tax credits, compare plans and enroll on the state’s marketplace site – via phone and Internet co-browsing.

Referral Only

• Following subsidy eligibility, customers will be referred to state marketplace for enrollment assistance.

FFM States:

Phone + RightOpt portal

State-Based Marketplaces:

Phone + state website

Referral States

Referral States (2) Enrollment States (49)

Fully integrated solution leveraging

certified Web Based Entity, GetInsured,

for eligibility, shopping and enrollment

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Of those who completed pre-enrollment

information were eligible for a premium tax

credit

Key Stats from 2014 Enrollment (RightOpt)

77%

Of those who looked at plans on-line enrolled

with us 21%

Of those interacting with us chose web only /

co-browsing / telephonic only support 11/80/9%

7

Making it Easy

With Xerox + GetInsured, our clients empower individuals to…

Determine if they are eligible for premium tax credits, Medicaid or an employer subsidy.

Return to the site for additional support regarding health care utilization and improvement.

Shop for a best fit health insurance (medical, dental and vision) through phone and online support leveraging available subsidies.

1 2 3

8

Employer toolkit of template

language for announcement

letter, FAQs, employee

presentation and new hire

letter; plus RightOpt

branded poster and

postcards

Health

Reimbursement

Account

management

Telephonic health

advocacy

A Turnkey Solution

In-person or

webinar

meetings for

eligible

populations Outreach call

introducing

RightOpt

Public subsidy

calculation, plan

compare & selection

Telephonic and

on-line plan

enrollment support

Client-branded

portal, custom

URL and toll-

free number

Fully branded

custom

communication

campaign

RightOpt branded

member

engagement portal

Plan renewal and

qualifying life

event enrollment

support

Pre-enrollment

Engagement, Education & Eligibility

Enrollment

Plan Comparison & Enrollment

Post-Enrollment

Renewals & Support

Above the line = no cost

Below the line = additional fees

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Panera Bread, Special Guest Presenter

September 30, 2014

Our Road to RightOpt

Supporting the Various Needs of our Associates Post-ACA

Company Background

• Panera Bread began in 1981 as Au Bon Pain, Co., Inc. founded by Louis Kane and Ron Shaich, the company prospered along the east coast of the United States and internationally.

• In 1993, Au Bon Pain Co., Inc. purchased Saint Louis Bread Company® and underwent a comprehensive re-staging between 1993 and 1997 during which average unit volumes increased 75% and the concept’s name was changed to Panera Bread.

• Now, Panera has 1,838 bakery-cafes in 45 states and in Ontario Canada operating under the Panera Bread®, Saint Louis Bread Co.®, and Paradise Bakery & Café® names.

The Challenges and Opportunities

• Simplify

• Easily distinguishable plan offerings

• Continue to offer cafe hourly associates meaningful benefit coverages

• ACA impacts

– ACA regulations required a change to cafe hourly associates existing benefit offerings

– The calculation of full-time status among variable hour associates adds a great deal of workplace management difficulty

– Communicating and educating associates about the private exchange opportunities

– Create competitive advantage where possible

• Need for a new approach to health care to mitigate cost increases and reform changes

• Fall 2013 enrollment

– Implement RightOpt‘s individual market channel to support education and enrollment in the Public Marketplace

– Implement Preventive MEC plan to replace Limited Medical Plan offerings

• Summer 2014

– Move to Xerox benefit administration platform

• Fall 2014 enrollment

– Implement RightOpt’s full exchange capabilities for the 1/1/15 effective date

Phased Implementation

1. Manage the complexity

http://www.mypanerabenefits.com/

2. Understand individual options…

…and enroll through RightOpt’s PT solution

3. Or enroll in Panera’s plan

Retail Hourly Experience • 2014 enrollment results

– 10% of retail hourly enrolled in benefits, continued concern for the 90% not enrolled in Panera offerings

– Just under 5% reviewed options on the public marketplace, with nearly 80% qualifying for a tax credit

– Yet 85% of enrollees still chose the preventive only plan

• 2015 enrollment expectations

– Access to public marketplace continues to be important to Panera

– Enrollment in the public marketplace expected to be higher with increased confidence and reliability in shopping experience

– As uninsured penalties increase, we anticipate growth in public option enrollment

Thank You!

Enhancing the members’ experience through their entire work/life cycle,

while reducing delivery costs and administrative burden

Eligible Actives

• Group plans

• Self-funded

• “Quilted” network

• Honeycomb of

partners to

service Choose-

Use-Improve

Ineligible Actives

& COBRA

• Individual insured

plans

• Public subsidy

access through

WBE

• Voluntary benefit

portfolio

Early

Retirees

• Individual

insured plans

• Public subsidy

access through

WBE, plus HRA

• Voluntary benefit

portfolio

• Health Advocacy

Medicare

Retirees

• Individual

insured plans

• Account

administration

• Medicare

transition

support

• Health Advocacy

RightOpt® A single experience from hire through retire®

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Implementation Timing

For coverage starting in 2015, the Open Enrollment Period is November

15, 2014–February 15, 2015

Available for 1/1/15 open enrollment or ongoing support:

• Non client-branded solution is a turnkey no-cost solution with a 3-5 week implementation

requirement

• Additional customization available with timing, scope and fees to be determined based

upon needs

37

Contact Us

Sherri Bockhorst National Practice Leader

Health Exchange Solutions


[email protected]

David Foster Market Leader

Health & Productivity


[email protected]

Misi Holmberg Sr. Manager

Benefit Operations

Panera, LLC

[email protected]

38

©2014 Xerox Corporation and Buck Consultants, LLC. All rights reserved. Xerox® and Xerox and Design® are registered trademarks of Xerox Corporation in the United States and/or other countries.

Buck Consultants® and RightOpt® are registered trademarks of Buck Consultants, LLC in the United States and/or other countries. BR11887

Buck Consultants, LLC is the broker of record regarding insurance placed through RightOpt

Facilitating Individual Coverage Options for Part-time ... · RightOpt® From Hire through Retire®...

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