Blue Shield of California is seeking to develop a direct-to-consumer marketing strategy to drive organic growth of 500,000 new consumer memberships. The consultant's proposal provides a situation analysis noting a transitional healthcare marketplace with low product differentiation and Blue Shield's low share of voice. A planning overview includes a logical framework, competitive analysis, and SWOT matrix to develop the new strategy. The proposal outlines goals, opportunities, and a project schedule to create and deploy the direct-to-consumer campaign by the 2017 open enrollment season.

1. Marketing Consulting
Proposal
For Blue Shield of California
Trina V. Burton, Consultant November 24, 2015

2. Introduction
Copyright 2015 Trina Burton
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Blue Shield of California is seeking to develop a direct-to-consumer
mechanism to drive high organic growth of consumer membership in its individual, family, and
Medicare health plans. Several discussions with Senior VP of Consumer & Medicare Markets, Ken
Wood, and Internet research yielded significant information included in this document. Upon sorting
and categorizing the content, three very notable points—in the opinion of this consultant—will drive
program development.
 The marketplace is a transitional and dynamic environment where product differentiation is
virtually gray among all competitors for many reasons which are explored in this document.
 Share of voice is low in comparison to major competitors. The plan is not driving its own
“noise” in the marketplace.
 The ratio of members to the state’s population presents rich opportunity for growth.
This document sifts that information and pushes it through marketing structures at a high-level.
Immediately following this introduction is a brief Situation Analysis and Market Overview proposing a
strategic framework as a foundation to build a new and effective consumer strategy. The Planning
Overview presents architecture for further analysis including a Logical Framework, a Competitive
Analysis, and a SWOT Matrix. This consultant believes these marketing pillars are essential in leading
Blue Shield of California to greater clarity about its place and products in a shifting environment
lending itself to a firmer direction for consumer acquisition.

3. Situation
Analysis
“…one of our executives drove
from the airport to the office
and saw 13 competitive
billboards and nothing from us.
Our share of voice is quiet.”
(Paraphrased)
Sr. VP of Consumer & Medicare Markets
Blue Shield of California
Copyright 2015 Trina Burton
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4. is not news to any of us that competition in the US health care industry grew
even more variables into an already complex equation of member acquisition. The
Affordable Care Act, put in place by the Obama Administration, to enable health care
access for all Americans, rearranged the marketplace model for businesses, health
providers, and consumers alike. The tidal wave of change challenges those of us who
manage health care to rethink funding and costs, benefits, and the overwhelming
choices consumers must now wade through on their own. It’s a new marketplace with
new rules, new and emerging players, altered offerings and benefits with very active
Federal and state governance. Amidst the stormy marketplace, all entities whether
employers, health plans, or other providers, are working to find their brands’ sweet-
spot with consumers, gain dominant and “loud” share-of-voice, and exceed
subscriber/financial growth projections.
The Affordable Care
Act pushed the health
care industry into a
new era of reform and
rearranged the
marketplace
Copyright 2015 Trina Burton 4
It

5. Product similarity/parity is significant creating a “graying” of differentiation. This
also means that every like-product message is virtually the same. Blue Shield of California
is no different as it operates in a marketplace the size of the 7th largest country in the
world with a population of 38.9 million* citizens, that is growing at rate of 4.2% every 3-4
years.* The dominant consumer products cover individuals, families, and the segment of
each that is Medicare eligible. Blue Shield of California’s membership is 4 million, a 10.2%
population penetration rate. Achieving organic growth of one-half million additional
members within the next few years will require more aggressive approaches toward
eligible consumers, and partnerships with the new entities (The Exchanges and brokers)
influencing their choices. This proposal targets the 2017 open enrollment season to
rollout a new direct-to-consumer strategy that becomes scalable with increased
projections.
* Source: US Census Bureau 2010
Health care plans are
scrambling to find
their brands’ sweet-
spot with consumers
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6. Market
Overview
Exchanges funded by gov’t at 1B
Medicaid expanded 4M
50% drop in uninsured
4.5M selected coverage
Cigna, Aetna left mkt;
returning to CA for 2017
open enrollment*
1M pay penalty uninsured
State agencies manage
patient rights
Medicare is nearly free,
richer benefits, more gov’t
funding
Brokers expanded role
advising consumers
Employer market growth
limited
Consumers drive their own
plan selection
Low product differentiation
Digital individual plans
enter market, volume over
revenue
Estimated 600K/day turn 65
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* Re-entry of such big hitters will drive greater market dynamics.

7. Goals, Opportunities,
and Credibility
Grow organically 500K members by
direct-to-consumer mechanism
Position price from level offered by
Kaiser Permanente to low end of
market
Plan data management moving to
CRM level to steer members to
other plan products
Create investment stream for
emerging markets
Create message stream featuring
3rd party endorsements promoting
brand as top in state (i.e. ethics,
quality, best of blue); target brokers
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Target growing Medicare
Advantage market as 600K per day
celebrate age 65
Target large individual market
estimated at 2.7M
Target remaining 1M paying the
penalty as uninsured by choice
Reduced product differentiation,
opportunity to personally target
(CRM)
Strengthen Exchange
relationships, partner
Strengthen agency relationships -
DMHC, OPA-mitigating negative
consumer impacts
Deepen broker strategy, favorable
endorsement, “advise” consumers

8. California
Plans
6 million members
8 million members
4 million members
Re-entering CA market 2017
open enrollment season
Re-entering CA market 2017
open enrollment season
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California Health
Exchange offering 12*
plans to state citizens
* Number of competing plans will change as Aetna and Cigna re-enter market in 2017 enrollment season

9. Planning
Overview
Copyright 2015 Trina Burton
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10. Project
Logical
Framework
Approach
Copyright 2015 Trina Burton 10
LogFrame Approach brings clarity to diverse projects,
such as improving internal procedures, developing new systems,
streamlining operations, leveraging quality improvement, implementing
change initiatives, and other important topics that require a systematic
approach. It is built on answering four interrogative questions, that greatly
aid communication, collaboration, and consensus.
 What are we trying to accomplish and why?
 How will we measure success?
 What other conditions must exist?
 How do we get there?
The concepts scale and flex to accommodate one-person projects, team
efforts, or larger programs or functions. Originally created to help the
United States Agency for International Development (USAID) effectively
plan, implement, and evaluate the thousands of development projects in its
global multibillion-dollar foreign aid program.

11. Copyright 2015 Trina Burton
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DRAFT EXAMPLE
Logical Framework Approach*
Objectives Success Measures Verification Assumptions
Logical Hierarchy of If-Then Objectives Conditions When Objectives are Achieved Source of Evidence to Verify Measures Additional Factors Necessary for Success
Goal
What are we trying to accomplish and why?
Increase consumer plans' membership organically by 500K
accelerating new market growth across consumer products
How will we know we are successful?
Membership growth/numbers
Per product growth
Retention
How will we measure?
Month-end financial reports
3rd party reporting
Per product growth
What other conditions must exist?
Assumptions to reach goal
Greater share-of-voice
Deployed integrated marketing
See Situation Analysis in this deck
Improved relationships brokers, agencies
Activated investment stream
Purpose
Change or benefit expected from project.
Create direct-to-consumer strategy that is scalable by
product and market dynamics
Increased growth per product, by geography by
___% by ___date.
Per product month-end financials
Assumptions to achieve purpose
IT CRM focused technology in place supporting new
metrics reporting
Outcomes
Project deliverables. What happens?
New strategy becomes tactical plan
Execution occurs with in integrated consumer reach
vehicles
Best practices identified and shared
Challenges clearly identified with risk mitigation steps in
place
Outcomes date-completion included
Tactics deployed and presenting within targeted
mediums
Share-of-voice is higher or on par with largest
competitor
Evidence of deployment (cross-functional
presentations, kick-off showing final product, risk
plan approved, etc.)
Media reporting per vehicle used
Completed project framework approved
Assumptions to achieve Outcomes
Management supports
Marketing team supports
Plan execute community activity to heighten
outcome impact
Campaign is constant throughout the season to
12/15/16
Inputs How? Who? When?
IFP GM perspective/discussion Jeff Smith
Project Schedule by Week, Month
Medicare VP-GM perspective/discussion Cathy Campbell
Sr VP Consumer Markets/further discussion Ken Wood
EVP Markets/discussion David Fields
Other Stakeholders Name
Other Stakeholders Name
*This LogFrame Approach brings clarity to diverse projects, such as improving internal procedures, developing new systems, streamlining operations, leveraging quality improvement, implementing change
initiatives, and other important topics that require a systematic approach. The concepts scale and flex to accommodate one-person projects, team efforts, or larger programs or functions. Originally created in the
1960's to help the United States Agency for International Development (USAID) effectively plan, implement, and evaluate the thousands of development projects in its global multibillion-dollar foreign aid
program.

12. Copyright 2015 Trina Burton
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Returning to CA 2017 OE
Metric BS-CA Kaiser HealthNet United HC Stride Health Cigna Aetna
Size 4 million 8 million
Market Share 10.2%
3-yr growth rate
Segmentation Individuals, Families,
65+
Targeting Consumer
Positioning
Value propositions
Products Individual, Family,
Medicare, Medicaid
Product dev
Pricing
Promotion
Channels Exchange, Brokers
Technologies Digital plan
Resources
Service Delivery Group providers
Competitive Analysis

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SWOT Activity Notes Information Source Owner Completion
Strengths: Define the company's current mission statement. As a not-for-profit health plan, Blue Shield is guided by our mission and values, which encourage innovation
and enable us to be a catalyst for constructive change. Our mission and values are embodied in our proposal
to guarantee health coverage for all Californians, the first time a major health plan has called for universal
coverage.
Strengths: Identify market segments in which the company will
participate by conducting primary and secondary market research.
1-Individuals, 2-Families, 3-Medicare, 4-1M not choosing HP, 5-competitive plan members
Strengths: Identify the company's value proposition and how it will
differentiate itself within the marketplace.
General-we put the care of our members before profits
ID VP per product: 1-Individual, 2-Family, 3-Medicare
Marketing materials
Agency creative briefs
Weaknesses: Identify any barriers to market entry (for example,
capital requirements, technical barriers, patents, and process
barriers) that the company needs to overcome.
1-ACA changed Product, Price, Promotion, Place, Positioning
(i.e. Medicare is nearly FREE funded by the government, richer
product offering)
2-Broker-focused mkt; brokers advising consumers (was just
ERs)
Competitive creation of digital platforms reduces overhead,
makes nimble operations where volume is primary, not
monetization
3-CRM ready customer data to support Promotion, Place,
Positioning
4-Pricing-plans to be at Kaiser level or lower
5-Processes?
6-Needed capital for____________
7-Technical?
Weaknesses: Identify any risks inherent to the organization that
need to be mitigated so that the company can realize the business
plan.
1-Inability to segment customers for target mktg using CRM data
(maintaining sustained relationships with customers)
2-Not gaining greater broker endorsement toward consumers
3-No investment stream for emerging markets
4-Not having a robust direct-to-consumer model for acquisition
5-Maintaining silos of product org and marketing org
Opportunities: Identify areas where the current market is
underserved that provide an opportunity for the company.
1-Medicare: 1,000/month turning 65 in CA=30k consumers (5-600/day)
2-1 million folks paying penalty not choosing a HP, (why)
3-Medicare supplemental offerings, more available
4-Individual mkt?
6-Family plans group and non-group??
Opportunities: Identify any key processes, intellectual capital, or
other resources that the company can use to its advantage in the
marketplace.
1-ACA>consumer driven marketplace
Threats: Identify primary competitors, and then analyze competitor
performance by using all available data and additional data that can
be verified.
1-Kaiser, 8M members
2-Anthem Blue Cross (goal is margins)
3-The Exchange ACA, disables competitive differentiation
4-HealthNet
5-Covered CA
Threats: Identify secondary and potential future competitors that
might affect the business plan.
1- The Exchange, ACA, disables competitive differentiation
2-DMHC magnifies consumer issues with plan (i.e. directory issue); creates public platform of HC delivery +
and - (may not have been so PUBLIC before ACA)
Threats: Develop strategies for mitigating primary and secondary
competitive threats.
1-Create investment stream for emerging markets
2-CRM data, ability to target members for transition through plan products
3-Defined model, implemented for direct-to-consumer per IFP and Medicare products
4-Demolish product & mktg silos, merging strategies & tactics

14. Schedule
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Year Month Timeframe
Week 1 Week 2 Week 3 Week 4
2015 December
2016 January
February
March
April
May
June
July
August
September
October
November
December Ends Mid-Month
2017 Open Enrollment Season
Proposal Approval
Deploy Campaign
Create Project Plan
Building 2017 Open Enrollment Roadmap
Creative Development, Finalized, Media Purchased

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Tackling business challenges with her impeccable planning, nurtured
partnerships, and transparent communications, Trina is a results-driven career marketer. She brings
her vast business skillset drawn from combined global industry experiences in healthcare, technology,
wireless telecom, pet food, veterinary, credit cards, and the Internet.
Early in her career she quickly learned how to apply strategic concepts and tactical plans across
different types of business problems and issues regardless of industry. Though she’s worked in many
industries, health care is her favorite, as she has nearly 15 years experience (of her 30 years in
marketing) applying all marketing and communications components to managed care growth
(consumer, business, Medicare, Federal Employees, brokers, benefits managers). Her tenure includes
Humana and Blue Cross Blue Shield of Georgia where at the latter she was director of sales and
marketing administration. Her strategies smoothed Humana’s rocky entry into the Kansas City market
with the news media and brokers. An open enrollment advertising campaign developed just weeks
before the plan had permission to market to the target audience, doubled the subscriber base in 90
days to 200K. Her Medicare direct-to-consumer campaigns met a corporate mandate to the
executive director to quickly move monthly closed sales from 250K to 750K.
She was recruited to build a new communications department for an HMO and started by assessing
existing materials and messages and how they impacted the consumer brand experience. The market
was experiencing managed care growth and she determined the messages would not support the
necessary member education. A calculating risk taker, she discarded the information and started
from scratch using member focus groups, on-site visits to the plan’s 15 medical centers, and
meetings with department heads, learning the member experience first-hand.
Trina
Burton,
Consultant

16. Continued
Copyright 2015 Trina Burton
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Researching, writing, designing, and producing new member handbooks, provider directories,
monthly member magazine, and a showcase business/broker piece, she redefined the plans’
consumer messaging and tactical sales approaches. This work was recognized by Crain’s Modern
Healthcare and the Public Relations Society of America.
Her biggest successes are her integrated marketing programs for a new wireless carrier with no name
recognition, that derailed Sprint’s digital phone market introduction in its own home town.
Managing a national team of 80 project managers she installed the prepaid business unit into the T-
Mobile corporation amidst 3 dysfunctional mergers, separate operating platforms, 3 mixed brands
and multiple product denominations.
Trina has made big marketing impacts in 5 Fortune 500 companies generating combined gross
revenues upward of 1 billion. She has an MBA in business administration from Regis University in
Denver, and a BA degree in communications-journalism, public relations, and English from Drake
University in Des Moines, Iowa. She’s five classes away from her second MBA in health care
administration. Living in Redmond, WA near Microsoft world headquarters (also a client) she
supports and cares for her 86-year-old mother, enjoys the company and activities with her many
friends (she never meets a stranger) and is the favorite dog sitter to VIP clients Thumper, Jet and
Ziggy.
Linked In Profile

17. Copyright 2015 Trina Burton
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Health Care and
Community Honors
and Appointments
Washington State Alzheimer’s Community Board
Strategic planner supporting National Institutes of Health (NIH) ethnic trials at University of
Washington, event speaker sharing family story (4 years)
Missouri Board of Healing Arts
Appointed by late Missouri Governor as Public Member of the Commission for Physician Assistants;
also served as secretary (3 years)
Truman Medical Center
Missouri teaching hospital; Governors Board (2 years)
Visiting Nurses Association
Board of Directors, Marketing chair (2 years)
The Women’s Foundation for a Greater Memphis
Advisor to executive director: board strategy, creative fundraising, events, performance, assistance to
Hurricane Katrina (2000-present)
The Women’s Foundation of Kansas City
Board Director; committee chair: grants allocations, feasibility review, fund-raising, strategic planning;
philanthropist; as a consultant she developed the first strategy building donors relationships
attaching them to the organization in multiple ways (4 years)
Kansas City Business Journal/Junior Achievement
Up and Comer recognized for career long contributions to Kansas City business growth
Girl Scouts of USA
Lifetime commitment; Board Director (6 years); committee chair: fundraising, board nominations,
public relations, program development, scholarships; Wider Opportunities & United Way motivational
speaker throughout council, TV, radio talk shows; First Class recipient (Gold Award), philanthropist
(35 years)

18. Copyright 2015 Trina Burton
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“Trina’s greatest gift is her ability to strategically build and execute marketing campaigns that drive high brand
awareness/consideration and top line growth. She has a unique ability to courageously perceive the most compelling
story, identify the best target market for the solutions and design plans that showcase her strong expertise of marketing
channels. Tactically, collaboratively and cross-functionally she knows how to make things happen and constantly adds
to her base of knowledge.”
Rene Parson, GM Cricket Wireless (now owned by AT&T)
“Applying her excellent consumer marketing and general business skills, Trina lead a cross-functional business team that
evaluated and recommended a redesign of our unprofitable consumer prepay program. The integrated relaunch of
service became a significant contributor to Aerial’s growth and profitability. Trina is very intelligent, a hard worker, and
a self-starter. I have known her for over 20 years and watched her build brands, grow revenues and make permanent
positive changes in consumer business.”
Andy Fountaine, former VP Marketing, Aerial Communications (now T-Mobile)
“This was our largest and most complex event since taking control of building 25. Your contributions are numerous and
I want to thank you for all the hard work and dedication.” (reference to her project lead role in executing the world
conference for Microsoft Innovation Centers in Redmond, WA bringing 90 managers from 30 countries)
Andy Gammuto, Microsoft Director
Developer Experience team managing 4,000 events worldwide
Endorsements