Hello, we’re Oscar! - TN.govOscar will be available in Davidson, Cheatham, Montgomery, Robertson,...
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Hello, we’re Oscar!
Transcript of Hello, we’re Oscar! - TN.govOscar will be available in Davidson, Cheatham, Montgomery, Robertson,...
Hello, we’re Oscar !
TODAY’ S TEAM
Tr ipp Girdler Sales Executive, TN tr ipp@hioscar .com
(615) 305- 2644
Kyle Estep Market Director ,
kestep@hioscar .com
Presenter
Presentation Notes
This my favorite part of the job being here with you today. I literally get so much energy from this because it is great to the see the broker enthusiasm when we come into the markets. Let me take a second now to let the team introduce themselves
WHAT WE’ LL COVER TODAY
01 — Who is Oscar? 02 — What makes Oscar different? 03 — 2020 Product Portfolio 04 — Questions?
Presenter
Presentation Notes
01: Who is Oscar? (10min) 02: What makes us different (10-15min) 03: Product portfolio (10-15min) 04: How to work with us / Q&A (20min)
— 0 1 —
Who is Oscar?
Presenter
Presentation Notes
01: Who is Oscar? (10min) 02: What makes us different (10-15min) 03: Product portfolio (10-15min) 04: How to work with us / Q&A (20min)
It all star ted with a bill.
Really.
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If y’all have time to go through the Oscar origin story.
Oscar is the fi r st health insurance company bui l t to make health care easy.
We were built to make health care easy for consumers...
…using our own insurance technology...
…to provide members great and affor dable cover age.
Presenter
Presentation Notes
We were built to make health care easy for consumers... Our focus on simplifying health care for the consumer is driving record levels of member engagement—and customer satisfaction—in the industry. …using our own insurance technology... We have built our own insurance and delivery functions from the ground up. That means everything gets done faster and better—from claims processing to telemedicine. …to provide members great and affordable coverage. We partner with the top health systems in the country to provide members access to the best possible care. And we use technology to keep that coverage affordable.
TOP TALENT
$1.2B Raised to Date
One of our biggest investors is Google’s parent company, Alphabet.
.
1,000+ Employees
Improving health care from our New York HQ and teams across Los
Angeles, Dallas, Tempe, and Nashville.
Sophisticated Par tners
Including a co-branded product with Cleveland Clinic: their first-ever
health plan.
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We attract top talent from the most prestigious names in tech and health care.
Seven years since our founding...
Source: Oscar 2018 financial report
Improved financials have val idated our business model, dr iving top l ine growth and bottom l ine stabi l ization.
>3x $1B+
OUR FI NANCI ALS
...the expansion continues.
15 total states 26 total mar kets 3 pr oduct lines 1000+ employees $1Bn+ annual r evenue Backed by Alphabet, Google C apital, and Ber kshir e Hathaway
Oscar Today
Presenter
Presentation Notes
Speak to the Google investment/partnership.
— 0 2 —
What makes Oscar di fferent?
Presenter
Presentation Notes
01: Who is Oscar? (10min) 02: What makes us different (10-15min) 03: Product portfolio (10-15min) 04: How to work with us / Q&A (20min)
The Oscar approach
By making health care easy, we make it more affordable.
Through industry- leading tools and customer ser vice, Oscar makes it easy for member s
to navigate their healthcar e.
* Get $$$ just for walking*
An app with ever ything you need.
T alk to a doctor For fr ee, 24/7.
Message your dedicated health team.
*Step tracking rewards are an incentive that is part of our voluntary wellness program (available to all members).
APPROACH
Presenter
Presentation Notes
This is where we talk about our unique “only with Oscar” features.
Source: Periscope Membership: Product adoption dashboard as of Dec ‘18, subscribers ages 18 - 55, Industry average from National Business Group on Health survey of employee usage of telemedicine when offered by employer.
We make it easy to talk to a doctor with our Doctor on Call feature. That’s why our members use telemedicine 7x more than industr y average.
Industry avg.
And now for the first time, it’s easy for members to renew prescriptions for free over the phone through Doctor on Call.
Not available in NY, CA, NJ and not available for Small Group or Catastrophic plans.
HOW
$3 Preferred drugs with almost* every plan.
A Fr iendly Welcome Members feel the Oscar difference from Day 1.
Presenter
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When the Garcia family first joined Oscar, they got their Welcome Kit in the mail. It was easy to find all of the important information they needed, like how to use our free telemedicine service, ‘Doctor on Call,’ as well as how to find a doctor in our app. q
Prompt answers Personal Advice Problems solved Better service 90% of members
recommend doctors introduced by Oscar
Source: Internal Oscar Concierge dashboard as of August 2019
Care guide Care guide Care guide Nurse Social worker
< 1 minute average
response time
75% of issues resolved on
first call to Oscar
4.5 score for member satisfaction
Concierge. A dedicated team for every member
Presenter
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Concierge strategy: Personalized engagement builds trust and relationships with members. Members come to us about their healthcare decisions. Oscar guides member’s care capturing symbiotic value and improving health outcomes.
Including ● Member Welcome Kits ● Concierge Teams ● SOBs & SBCs
RECURSOS DI SPONI BLE EN ESPAÑOL
— 0 3 —
Oscar 2020
Presenter
Presentation Notes
01: Who is Oscar? (10min) 02: What makes us different (10-15min) 03: Product portfolio (10-15min) 04: How to work with us / Q&A (20min)
No gatekeepers. No r efer r als r equir ed.
Top 3 things to know about our Oscar plans
Oscar never requires a referral to see a specialist.
Oscar members get full and direct access to our network.
Free prescription renewals
over the phone.
$3 Preferred prescriptions from day 1 with most* plans.
Every client gets a dedicated Concierge Team of care guides
and a nurse.
Help with questions, getting care, paperwork, and more.
Not available in NY, CA, NJ and not available for Small Group or Catastrophic plans.
PRODUCT
Talk to a doctor for free, 24/7
Dedicated, personalized care
teams.
What’s new this year
Prescription Renewal available through Doctor on Call
$3 Preferred drug copays available from day 1 on most* IFP plans
Introducing Next plans - Bronze & Silver Fully Oscar contracted network
Not available in NY, CA, NJ and not available for Small Group or Catastrophic plans.
PRODUCT
Our Nashville Network
Members have ful l , unrestr icted access in Nashvi l le & Memphis Oscar wi l l be avai lable in Davidson, Cheatham, Montgomery, Rober tson, Trousdale,
Ruther ford, Sumner , Wil l iamson, and Wilson Counties
Updated as of: October 2019
● Children’s Hospital at TriStar Centennial
● Saint Thomas Hospital for Specialty Surgery
● Saint Thomas Midtown Hospital ● Saint Thomas West Hospital ● TriStar Centennial Medical Center ● TriStar Skyline Medical Center ● TriStar Southern Hills Medical Center ● TriStar Summit Medical Center ● TriStar Ashland City Medical Center ● Tennova Healthcare - Clarksville ● Trousdale Medical Center ● Saint Thomas Rutherford Hospital ● TriStar StoneCrest Medical Center ● TriStar Hendersonville Medical Center ● Sumner Regional Medical Center
Presenter
Presentation Notes
But we want to make clear that our lower cost point does not mean compromising on network. We’ve constructed an extremely strong network, both from a coverage and quality perspective. SPECIALTY COVERAGE: Our data scientists work closely with our network team to analyze provider specialty data--they actually divvy up the medical world into 500 different types of care that member might need -- down to the level of congenital cardiothoracic surgery and neurotology. (For context, most health insurers define only 40-50 types of care, which can lead to coverage gaps for less common medical specialities.) They also defined common provider pairings, like anesthesiologists and surgeons, to ensure the network contracted all of the key players for specific types of care. PROVIDER QUALITY: And beyond making sure that absolutely every type of care is covered in network, we are also uncompromising about quality of care, which is why we are partnering with top provider systems in the region. For example, we worked hard to include what has been ranked as the #1 ranked hospital in the Los Angeles metro area* -- UCLA’s medical system. Other similar plans (e.g., TRIO), do not include UCLA or USC. Source: US News Best Hospitals rankings, 2017-2018 (https://health.usnews.com/best-hospitals/area/ca/ucla-medical-center-6931755)
Our Memphis Network
Members have ful l , unrestr icted access in Nashvi l le & Memphis Oscar wi l l be avai lable in Fayette, Haywood, Lauderdale, Shelby, and Tipton Counties
Updated as of: October 2019
● Baptist Memorial Hospital - Collierville ● Baptist Memorial Hospital - Memphis ● Spence and Becky Wilson Baptist
Children’s Hospital ● Baptist Memorial Hospital for Women ● Saint Francis Bartlett Medical Center ● Baptist Memorial Hospital - Tipton ● Baptist Memorial Hospital - DeSoto
Presenter
Presentation Notes
But we want to make clear that our lower cost point does not mean compromising on network. We’ve constructed an extremely strong network, both from a coverage and quality perspective. SPECIALTY COVERAGE: Our data scientists work closely with our network team to analyze provider specialty data--they actually divvy up the medical world into 500 different types of care that member might need -- down to the level of congenital cardiothoracic surgery and neurotology. (For context, most health insurers define only 40-50 types of care, which can lead to coverage gaps for less common medical specialities.) They also defined common provider pairings, like anesthesiologists and surgeons, to ensure the network contracted all of the key players for specific types of care. PROVIDER QUALITY: And beyond making sure that absolutely every type of care is covered in network, we are also uncompromising about quality of care, which is why we are partnering with top provider systems in the region. For example, we worked hard to include what has been ranked as the #1 ranked hospital in the Los Angeles metro area* -- UCLA’s medical system. Other similar plans (e.g., TRIO), do not include UCLA or USC. Source: US News Best Hospitals rankings, 2017-2018 (https://health.usnews.com/best-hospitals/area/ca/ucla-medical-center-6931755)
We par tner with the highest- qual i ty providers to bui ld a connected patient exper ience.
● CVS Advanced Choice is our exclusive pharmacy vendor ● Quest is our preferred lab partner ● Liberty is used for pediatric dental ● Davis takes care of pediatric vision ● Optum manages our mental health benefits
Plan Designs
Presenter
Presentation Notes
Magic login to [email protected] to walk through: Requesting appointments Viewing book of business - click into policies and explain statuses Click into billing history to show if they’ve paid Run quote for SEP enrollment Show how to email plan and then select plan to enroll in
11 plans across all metal tiers, available on and off-exchange Catastrophic: 1 • Bronze: 4 • Silver: 5 • Gold: 1 All plans include free, unlimited Doctor on Call— now with prescription renewal! Our telemedicine feature reduces out-of-pocket expenses including prescription renewals and routine diagnosis, especially valuable for price sensitive clients. $3 Generic Preferred drug benefits from day 1 Our $3 Generic Preferred drug list will help minimize prescription costs for your clients. All plans include Oscar’s unique perks Including a personal Concierge Team for each member, Step Tracking rewards*, and an award-winning mobile app.
*Step tracking rewards are an incentive that is part of our voluntary wellness program (available to all members).
Oscar 2020 Individual & Family Plans
Detailed plan gr ids available on the Oscar website
Oscar 2020 Individual & Family Plans
● Only $0 Deductible Bronze plan in market
● Alternative to high-deductible, coinsurance plans
Deductible $0
Out-of-pocket Max $8,150
Primary Care Office Visits $50
Specialist Office Visits $90
Urgent Care $100
Generic Drug Prescriptions $3
Key Benefits & Cost Shares Why We Love It?!
● People who love copays ;)
● Clients who qualify for APTC subsidy only (no CSR)
Who It’s Best For...
Spot l i ght : Cl assi c Next Br onze
● $0 Deductible / $0 PCP Visits / Low Copays
● Alternative to high-deductible, coinsurance plans
Key Benefits & Cost Shares Why We Love It?!
● Highly subsidized on-exchange clients
Who It’s Best For...
Spot l i ght : Cl assi c Si l ver Next CSR 150
Deductible $0
Out-of-pocket Max $1,800
Primary Care Office Visits $0
Specialist Office Visits $5
Urgent Care $15
Generic Drug Prescriptions $3
● Priced much lower than on-exchange Silver plans
● Alternative to high-deductible, coinsurance plans
Key Benefits & Cost Shares Why We Love It?!
● People who do not receive subsidies
● Clients who want a silver plan
Who It’s Best For...
Spot l i ght : Cl assi c Si l ver Of f - Exchange Onl y
Deductible $7,000
Out-of-pocket Max $8,150
Primary Care Office Visits $25
Specialist Office Visits Ded Applies
Urgent Care $100
Generic Drug Prescriptions $3
Search for doctors & drugs
Plan grids, rate tables,
network details, forms, SOBs,
and more
One-pagers on Oscar’s perks
LI NKS, COLLATERAL + MORE AT HI OSCAR. COM/ BROKERS
Things to Remember | Tennessee 2020 Individual Market Plans
Oscar is available to consumers in two metro areas for 2020 ● Nashville: Davidson, Cheatham, Montgomery, Robertson, Trousdale, Rutherford,
Sumner and Williamson counties ● Memphis: Shelby, Fayette, Tipton, Haywood and Lauderdale counties
Oscar’s plans are EPO - no referrals required and no out-of-network benefits All of Oscar’s plans include:
● Free and unlimited telemedicine - “Doctor on Call” ● Dedicated concierge teams ● Step tracking rewards (up to $100 / year in Amazon credit) ● Free preventive care
Things to Remember | Tennessee 2020 Individual Market Plans
For full plan grids and collateral, go to www.hioscar.com/brokers ● Scroll down and click the link below “Everything you need to sell”
For SOBs / SBCs, go to: www.hioscar.com/forms For Consumers:
● Enrollment Questions: 1-855-OSCAR-55 ● Easy Quote & Enrollment: www.hioscar.com/quote
Questions?
Presenter
Presentation Notes
01: Who is Oscar? (10min) 02: What makes us different (10-15min) 03: Product portfolio (10-15min) 04: How to work with us / Q&A (20min)
QUESTI ONS?
Tr ipp Girdler Sales Executive, TN tr ipp@hioscar .com
(615) 305- 2644
Kyle Estep Market Director ,
kestep@hioscar .com
Chr is Gardner Sr . Sales Executive, TN cgardner@hioscar .com
(615) 732- 9945
Presenter
Presentation Notes
This my favorite part of the job being here with you today. I literally get so much energy from this because it is great to the see the broker enthusiasm when we come into the markets. Let me take a second now to let the team introduce themselves
