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Optum Health Financial Overview
- 1. OptumHealth Financial Services– Carrier Neutral Solutions Dean Kissel Regional Sales Director
- 2. Our Organizational StructurePublic and Senior Markets Group Commercial Markets Group Enterprise Services Group
- 3. Short History ofOptumHealth HSAs, HRAs, FSAs, payables, cards, OptumHealth Bank, stop loss, COBRA Health and well-being services, care management, networks, Web services Mental health services, substance abuse treatment EAP, work/life Old Brand Portfolio
- 4. Our Services WellnessSolutions Health Portal Decision support Disease solutions Complex medical conditions and specialty networks Physical health Behavioral Network Behavioral disability solutions Customizable online member portals Employee Assistance Programs (EAP) Medical/behavioral care coordination Mental health and substance abuse Psychotropic Rx management WorkLife services HSA accounts FSA accounts HRA accounts Retiree accounts COBRA administration Transportation Administration Consolidated and direct billing Stop loss Local care delivery Collaborative technology Electronic Health Record (EHR) Health Information Exchange (HIE) Connected care telehealth solutions
- 5. Who is OptumHealthFinancial Services? Focuses exclusively on health care financial services and benefits administration Is one of the nation’s largest providers of health savings accounts Offers health care financial accounts for both active employees and current and future retirees Provides personalized service through a knowledgeable, professional benefits administration team Manages over 2.1 million consumer health care accounts Has over more than $1.3 billion in HSA assets under management Serves Over 27,000 private and public sector employers nationwide Has earned a 96% retention rate, supporting you every day, every step of the way Health Accounts and Benefits Administration – All In One Place
- 6. Our Unique ServiceModel Our Service Model Designated Implementation Managers start the transition Then, our seasoned Account Managers provide ongoing service to employers, brokers and consultants All calls and e-mails are responded to within 24 hours (one business day) maximum Assign a Senior Contact and Relationship Manager when appropriate
- 7. Web tools: -employer and - employee videos - calculators - all forms and marketing materials Three account options Three enrollment methods HSAs - OptumHealth Bank SM More than $1.3 Billion in HSA assets* Almost 700,000 HSAs *As of Dec 1, 2009 OptumHealth Bank, Member FDIC Some of HSA differentiators are:
- 8. HSA Options HealtheAccess HSA Generally designed for health care spenders who do not carry a large balance in their HSA Lower monthly maintenance fee, which is waived if you have a minimum balance of $500 Health eSaver HSA Designed for health care spenders who carry higher balances in their HSA With the Health eSaver HSA, account holders earn interest on the funds in their HSA Interest rates are tiered and based on account balance This option offers free access to investments; there is a minimum investment balance requirement of $2,000 and investments can be made in increments of $100 Health eInvestor HSA Designed for account holders interested in maximizing long term savings potential of HSA The primary use of the Health eInvestor HSA is for investing purposes In regards to investments, this option has a lower minimum investment threshold of $500
- 9. HSA Comparison Interestrates are variable and subject to change at any time based on market conditions Annual Percentage Yields (APY) as of 5/29/09, subject to change at any time. Required balance to obtain APY does not include investment balances Investment Fee (where applicable) is only assessed after the establishment of an investment Health eAccess Health eSaver Health eInvestor Monthly Maintenance Fee $1 for balances less than $500 (Fee waived if balance is over $500) $3 for balances less than $5,000 (Fee waived if balance is over $5,000) $3 for balances less than $5,000 (Fee waived if balance is over $5,000) Balance Required to Obtain APY 1,2 Annual Percentage Yield (APY) 1,2 Annual Percentage Yield (APY) 1,2 Annual Percentage Yield (APY) 1,2 $0-$499.99 0.00% 0.10% 0.10% $500-$999.99 0.00% 0.10% 0.10% $1,000-$1,999.99 0.00% 1.00% 1.00% $2,000-$4,999.99 0.00% 1.40% 1.40% $5,000-$14,999.99 0.00% 1.95% 1.95% $15,000+ 0.00% 2.50% 2.50% Investment Threshold 3 $2,000 $2,000 $500 Monthly Investment Fee 3 $3 $0 $2.50
- 10. HSA Highlights Whenan employee first enrolls with OptumHealth Bank , they will automatically be enrolled in the Health eSaver HSA 90 days after enrolling in an HSA, we will send the account holder a letter that explains the other HSA options available to them Once the HSA is open, account holders have the option of changing their HSA option by contacting Customer Service Account holders can change their account option at any time and as many times as they want without incurring additional fees Account holders have access to their HSA funds via MasterCard Debit Card, Online Bill Payment or Checks OptumHealth Bank can customize HSA options by changing default or offering any combination of HSA options The Employer and Broker Support Team (BEST) is a dedicated resource for Employers and Brokers during HSA Implementation Effective June 1, 2009, OptumHealth Bank changed the following fees: Eliminated the Account Closure Fee Eliminated the Below Minimum Balance Fee Eliminated the Online Enrollment Fee (Paper Enrollment $25)
- 11. Flexible Spending Accounts(FSA) Reimburse eligible participant expenses via check, automatic direct deposit, debit card, and claims rollover Online claims submission with easy-to-use interactive claim form E-mail notifications when claim is received and paid Flexible enrollment options Some of our FSA differentiators include: 100% of the claims are adjudicated
- 12. Health Reimbursement Arrangements(HRA) Easy-to-use employer and participant Web site HRA can be “notional” or funded HRA can reimburse specific expenses or all 213(d) Special plan designs can be administered We will coordinate HRA with FSA Special pricing for HRA with FSA (only $1 PPPM for second account) An independent SAS 70 Level II audit confirmed that OHFS has a 99.95% claim accuracy.
- 13. Funded Health ReimbursementAccounts (FHRAs) Eliminate health benefit liabilities Use together with a VEBA or Section 115 trust Fund future medical expenses for retirees Addresses GASB 45 mandates for public employers
- 14. Health Incentive Accounts(HIA) Creative ideas to engage employees Share our experience Utilize our HRA experience and platform Wellness + Incentives to engage employees
- 15. COBRA/HIPAA Administration (COBRA)Compliant plan administration Meticulous documentation Strict adherence to the law’s eligibility requirements In-house Compliance Department ARRA Administration Annual Standard Fees for COBRA Services Our SAS 70 Level II Certification assures high compliance standards
- 16. Ongoing COBRA AdministrationServices We handle the tough situations Employer terminates with carriers Employer sends file to OHFS OHFS sends QE Package Receive premiums/track timelines Carrier eligibility updates Special separation agreements ARRA Involuntary Terminations Remit premiums Provide employer with detailed monthly reports Open enrollment options
- 17. Consolidated Billing Thecomplicated and time consuming task of maintaining group health and welfare eligibility databases Disbursing payments to carriers Carrier reconciliation of enrollments, terminations and life event changes Leverage our experience Extension of your clients’ HR/Benefits team
- 18. Retiree Billing/Direct BillingAdministration Experienced Team with disciplined process Flexibility, based on client’s direction Mail coupons, collect premium payments, submit monthly report to employer, report changes to carrier(s) and employer
- 19. Pre-Tax Transportation AdministrationWired Commute --Employees can order passes and/or pay for parking on-line Card Method Reimbursement Option
- 20. Our commitment to You is to be the best partner at a competitive price. We pledge to: Make it simple Provide superior “high-touch” service Create and demonstrate value for you & your clients One-stop shop - “All in One Place” Why OptumHealth Financial Services? OptumHealth Financial Services boasts a 96% client retention rate
Editor's Notes
- #2 Hello. Thank you for taking time to meet with me today. I’m here to help you explore a benefit option that (your employer / specify employer) is offering for next year’s enrollment. It’s a health savings account, or what I’ll call an HSA during my presentation.
- #3 Story – we are part of the bigger family of UHG
- #4 In 2007 we took a broad look at our portfolio of specialized care and financial services products. We realized that to make this story a compelling one in the marketplace, we needed to simplify and unite these services. (We have weaved all these into one brand – this is the suite of service that I bring to you - As you can see here, we reduced the brand portfolio from 10+ independent specialty brands into one consolidated brand. OptumHealth helps people navigate the health care system, finance their current and future health care needs and achieve their goals for health and well-being. We do this thruogh: Technology Clinical and financial expertise Compassion and understanding We work with: Employers Brokers and benefits consultants Public sector – as employers and benefits providers (e.g. Medicaid) Health plans – to expand their product set We help: Individuals Families Retirees Government benefits recipients
- #5 All of these are part of the suite of services: What does the brand Optum mean to you?
- #6 Key Points – we are ‘solely’ focused on
- #7 As an employer, you will benefit from: Regardless of the size of the business you get a dedicated account manager (except HAS) HAS will have the BEST team – Broker and employer team Significant savings on defined contribution accounts. Tax advantages
- #8 As I said, it’s important to make a smart choice when considering which company will hold your account. OptumHealth Bank focuses on health care banking. Because of this focus, OptumHealth Bank, Member FDIC, is a leading HSA administrator. Account holders and employers across the country count on OptumHealth Bank for their health care banking needs. OptumHealth Bank has more than $800 million in HSA savings and investments in nearly 500,000 accounts. Thousands of employers have elected to offer OptumHealth Bank HSAs to their employees. HSA deposit accounts in OptumHealth Bank are insured by the Federal Deposit Insurance Corporation to at least $250,000 for each depositor.
- #12 Ask the question - Do you have these in this market? Need flexibility; we are very flexible! Flexible Spending Accounts are set up by employers to provide their employees with tax-free savings to be used toward qualified medical or dependent care expenses. They offer the advantage of reduced FICA taxes for both parties. Employees decide on their contribution based on what they believe their qualified, annual expenses will be. This contribution can be made easily through payroll deductions. The full amount of the annual contribution is available from the first day the Flexible Spending Account goes into effect for the medical FSA. For the dependent care FSA, however, only funds that have been contributed by the employees can be used for expense reimbursement. IRS regulations no longer mandate that funds not used by the end of the year be forfeited. Employers can now provide employees with time extensions before funds are forfeited, if they elect to do so. The extension period can be applied to both the medical and dependent care FSA. The IRS regulates that the dependent care FSA annual limit be capped at $5,000.
- #13 Flexible Spending Accounts are set up by employers to provide their employees with tax-free savings to be used toward qualified medical or dependent care expenses. They offer the advantage of reduced FICA taxes for both parties. Employees decide on their contribution based on what they believe their qualified, annual expenses will be. This contribution can be made easily through payroll deductions. The full amount of the annual contribution is available from the first day the Flexible Spending Account goes into effect for the medical FSA. For the dependent care FSA, however, only funds that have been contributed by the employees can be used for expense reimbursement. IRS regulations no longer mandate that funds not used by the end of the year be forfeited. Employers can now provide employees with time extensions before funds are forfeited, if they elect to do so. The extension period can be applied to both the medical and dependent care FSA. The IRS regulates that the dependent care FSA annual limit be capped at $5,000. Stand-alone or bundled – HRA plan designs are unique. HRA and FSA – together – more people are usually the HRA and then the FSA is the second account you are charged just $1 on. An HRA if someone is 25 – we give you $1,000 –$800 would toll into retirement if you only used $200 that year; so this does roll-over. Keeps building just like HSA. When you are young this is great. – move to a consumer driven system like and HSA? HRA – health reimbursement ‘arrangement’ not ‘account’ if the employer changes the HRA / you can have – both HSA. If you want a lot of control – the HRA is all ‘employer’ money and more defined. The FSA allows the employer to participate. FSA – flexibility AND Engagement – ER can do some seeding as well. Packaging an LPFSA with the other – Whether HRA, HSA, FSA we have the expertise to administer one, both or all – we are the industry source; Our participant call center
- #14 Same idea but is unique to a ‘retire’ account for a ‘public’ sector. HRAOur Funded Health Reimbursement Account (FHRA) is an employer funded defined contribution retiree health care plan designed specifically to help public sector employers gain control over their plan costs and take advantage of GASB 45’s more favorable accounting treatment of funded liabilities. Key Benefits for Employers: Tax-free — Your contributions to an FHRA grow tax-free and are never subject to taxation if funds are used to reimburse participants’ future qualified health care premiums and/or out-of-pocket health care expenses. Manage OPEB liabilities — Reduce or eliminate reported health care benefit liabilities (OPEB) for future retirees. An FHRA offers a tax-effective method to pre-fund some or all of the costs associated with providing a retiree health care plan. Full service and easy administration — An FHRA may be structured as part of a fully integrated health care program for your employees with minimum administrative effort required by you. Plan design flexibility — Design an FHRA plan to best fi t the needs of your employee groups, including collective bargaining units. Inflation protection — Your financial exposure to future medical inflation is significantly reduced or eliminated by moving to a defined contribution or hybrid plan design. Protection & security — Assets are sheltered in a Trust and may only be used by qualified persons for qualified medical expenses. FICA savings — Contributions made to an FHRA are exempt from FICA taxation. Unused sick and vacation — An FHRA provides you with additional flexibility in the payout of accrued vacation, sick or other leave. You may structure an FHRA to reward the responsible use of a sick and vacation leave program and discourage its abuse. Debt rating — An FHRA can reduce or eliminate the impact of retiree health benefits on your debt rating. Retention — An FHRA can help you attract and retain valued employees.
- #15 HRA in disguise to reward someone for the proper behavior.
- #17 Tax deductible – Contributions to the HSA are tax deductible (up to the legal limit), similar to an IRA. Tax-free – Distributions used to pay for qualified medical expenses are never taxed. Tax-deferred – Interest earnings accumulate tax-deferred. If used to pay qualified medical expenses, they are tax free. With our Health Savings Account, funds are tax-deductible and can earn tax-free interest and investment income. • No “use it or lose it” policy. The money is always there for your employees, year after year. • Flexible funding allows anyone to fund the account: employers, accountholders, and/or any other person, through tax-deductible contributions. Contributions made by others can be claimed as an “above-the-line deduction” to reduce the account holder’s taxable income.
- #21 Jake