05/10/2017 BioNJ HR Forum-Discussion guide

May 10th, 2017
BioNJ HR Forum
New Directions in Employer-
Sponsored Plans
© 2017 Willis Towers Watson. All rights reserved.

Discussion Topics
© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only. 2
• Introduction and Forward Looking Statements
• Healthcare “Reform”: Where Do Things Stand?
• Current Trends in Employer-Sponsored Plans
• Using Technology to Enhance Benefit Offerings
• Worksite Wellness: Beyond Biometric Screening
• Q&A

40,000
colleagues
in 140+
countries
Scale, diversity and
financial strength
$8.2 billion
revenue
A deep history
dating back to
1828
Business Segments
Value to Clients
Corporate Risk and Broking
Exchange Solutions
Human Capital and Benefits
Investment, Risk
and Reinsurance
Client focus
Global team
Industry specialization
Proprietary analytics
Legal & Compliance Experts
4
5
Willis Towers Watson Overview
© 2016 Willis Towers Watson. All rights reserved. 3
HOW WE WILL
PARTNER WITH YOU
SUPPORTING YOUR
IDENTIFIED NEEDS
QUESTIONS AND
ANSWERS
WHY WILLIS TOWERS
WATSON
APPENDIX

05/10/2017
Healthcare “Reform”:
Where do things stand?

Basics of Insurance
• The premiums of the many pay the losses of the few
• Healthy insurance markets require low-risk participants to
counterbalance high risk
• Compulsory insurance, effectively enforced, will stop a “death spiral”
• Remember NJ Car insurance in the early 1990’s?
• License, registration and ???????
• Health insurance doesn’t have to be single-payer
• Private health insurance is compulsory in Switzerland
• Cantons strictly enforce individual mandate

Shortcomings of PPACA: What We’ve Heard
• Individual mandate was enforced via a tax penalty
• Essential benefits mandate; “one size does not fit all”
• Often cheaper to pay the penalty than buy health insurance; healthy
people stayed away
• Community rating mandate; rate actions applied to all policyholders
• Imposed taxes and fees in EXACTLY the wrong places
• Branded drugs
• Rich benefit plans (Cadillac Tax)
• Medical Devices

Example of a “Sin” Tax
Ballina NSW, Australia 03/23/2016

AHCA: What’s Wrong with this Picture?

American Health Care Act: First Version
 Employer-sponsored plans generally unaffected
 Convert Medicaid from defined benefit to defined contribution
 Individual and Employer mandates repealed: “Death spiral”?
 Repeals several ACA taxes and fees:
 Cadillac tax as of 2020; replaced by 90% tax
 ACA net investment income tax (immediate)
 Prescription drug tax (immediate)
 Medical device tax (immediate)
 Permit sale of insurance policies across state lines
 CBO: AHCA would leave 14 million uninsured in 2018, 24 million by
2026
9© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

The MacArthur Amendment: Possible Core of New
Legislation
Allow states to apply for waivers that would allow them to:
• Adopt an age-rating ratio greater than 5:1
• Apply state-defined EHBs
• Allow certain states to waive the continuous coverage and allow
issuers to rate based on health status
• "Pre-existing conditions are in the bill. And I mandate it.” President
Trump 04/30/2017
• Insurers can charger higher premiums if coverage lapses

AHCA: The Changing Support Landscape
Initial AHCA
All Democrats, some
Moderate Republicans
and Freedom Caucus
Opposed
AHCA pulled
from Vote
03/24/2017
04/25/2017:
MacArthur
Amendment to
AHCA
Freedom Caucus
Supports, some
Moderate
Republicans and all
Democrats oppose
AHCA again amended
05/02/2017; House vote
scheduled for 05/04/2017
Senate must
pass AHCA to
send bill on to
President.

The excise tax raises significant employer concerns
Pre-ACA
Unlimited tax exclusion on
employer-sponsored coverage
ACA
40% excise tax on cost over thresholds
Effective date: first 2018,
then delayed to 2020
AHCA
Early draft included a cap on employer
exclusion
Initial version: dropped employer cap, kept
the ACA excise tax for 2025
Effective date then delayed to 2026
AHCA scuttled March 24

Key considerations
Compliance and
administration
Existing ACA rules still apply
Timing
2018 enrollment planning and
longer-term considerations
Plan
management
Balance plan competitiveness
with cost management
Workforce
planning
Impact on recruiting and
retention by labor group
KEY CONSIDERATIONS

05/10/2017
Moving Forward: Current
Trends in Employer-
Sponsored Plans

Willis Towers Watson 2017 Emerging Trends in Employer-Sponsored Plans:
Executive Summary
Source: 2017 Willis Towers Watson Emerging Trends in Health Care Survey.
1
Employer confidence in offering health care benefits returns to pre-
ACA level despite uncertainty
2
Employers focus in 2017 on plan design changes, expanding their
ABHP strategy and adding value through vendor partnerships
3
Curbing pharmacy spend, especially the cost and delivery of
specialty drugs, is a top focus of employers over the next 3 years
4
Employers unlikely to take action in response to repeal of ACA with
the exception of the potential change to benefits tax treatment
5
Enhancing the employee experience is seen as key to boosting
health engagement
6
Employers emphasize greater choice, high-tech experiences,
personalized messages and enhanced navigation support

Employers are confident about continuing to sponsor health care
benefits
Sample: Employers with at least 200 employees.
2%
8%
36%
92%
62%
Five years
10 years
Not all confident Not very confident Somewhat confident Very confident
How confident are you that your organization will continue to sponsor health
care benefits to active employees in five years and in 10 years?

Most important changes in 2017
16%
of comments
12%
of comments
9%
of comments
Cost-sharing / OOP /
deductibles
Redesign medical
plan(s)
Added / promoted
high-deductible
Note: Identified as the top priority. n=600.
Cost-sharing
“Shift more cost sharing to employees by adjusting deductibles, OOP
max and employee contributions.”
Co-pays & Out-of-pocket
“Increased deductibles and out of pocket maximums.”
“Decreased out of network plan coinsurance.”
Prescription co-pays
“Added a list of generic prescriptions which by-pass the plan
deductible to the preventive care plan”
Expanded options
“Expanded Medical plan menu with more options for selection.”
“Moved to more expansive network of providers.”
Changing providers
“Changed healthcare providers for medical, dental, prescription and
flexible spending accounts.”
Changing coverages
“Replaced emergency room coverage with indemnity as a regular
benefit on the most popular plan.”
Expanded offering
“Offered CDHP and made it more desirable.”
“Collapsed several plan designs to one to potentially offer a high
deductible plan in 2018 with HSA.”
Full replacement
“Went full replacement high deductible health plan for 2017 - still
provide a choice of 2 plans.”
High-deductible with HSA
“Redesigned US medical plans to incentivize employees to enroll in
the Nationwide HDHP with HSA Plan.”

Relatively low health care cost trend
10.3%
14.7%
13.0%
11.3%
9.2%
8.3%
6.4%
5.3%
6.8% 6.8%
5.5% 5.5%
4.2%
4.9%
4.0%
5.0% 5.0%
9.0%
8.0% 8.0% 8.0% 8.0%
6.8%
6.0% 6.0%
5.0%
6.0% 6.0%
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017*
Health Care Trend After Plan Changes (Total Plan Costs) Health Care Trend Before Plan Changes CPI-U
*Projected.
But trend after plan changes
still well above inflation rate
Sample: Companies with at least 1,000 employees.
Source: 2016 Willis Towers Watson Best Practices in Health Care Employer Survey.
CURRENT STATE

Employers remain focused on controlling the cost of specialty
pharmacy
58%
17%
12%
10%
3%
22%
18%
22%
28%
11%
13%
25%
22%
21%
19%
4%
19%
29%
18%
29%
4%
21%
15%
22%
39%
Ranked 1 Ranked 2 Ranked 3 Ranked 4 Ranked 5
Please rank your pharmacy benefits strategy in priority order in terms of
potential areas of focus over the next year.
Specialty pharmacy cost management
Affordability for employee and their family members
Improvement in generic substitution
Vendor evaluation/accountability – Pharmacy Benefits Managers (PBM)
Vendor evaluation/accountability – Health Plan Pharmacy Coverage

Top areas of benefit modernization clients want to discuss
Source: Willis Towers Watson market experience, Summer/Fall 2016
Health care cost — especially pharmacy1
Differentiated benefits8
Benefits’ role in Total Rewards7
Financial well-being6
Voluntary benefits5
Leave policies4
The employee experience3
Leveraging new technologies2

Potential role of HSAs
Employer opportunities
 Offer High Deductible/Health Savings Account plan option (if not now offered)
 Consider shift to full replacement HD/HSA approach
 Drive consumerism and tax-free savings
 Linkage to retirement planning: pre-fund retiree medical cost
 Use any impending change in benefit taxation to reassess plans
Current caps = $3,400 single, $6,750 family, $1,000 catchup age 55 – 64
AHCA caps proposed = Statutory maximum out-of-pocket limits: $6,550 single,
$13,100 family, $2,000 catch up (if both spouses 55 – 64) (2017 figures)
BENEFIT TAXATION
Tax-free HSA contributions can help offset taxation on employer plans

Voluntary benefits: Powerful Attraction/Retention Tool
23
Critical illness
Accident
Hospital indemnity
 Pays a lump sum to participant based on diagnosis
 Pays participant on a schedule for accident/injuries
 Pays participant when hospitalized
Health
Permanent life (PL)
Perm life with LTC
LTC (limited options)
 ‘Buying’ life insurance (with cash value) vs. ‘renting’ term
 Access to LTC coverage through living benefit riders
 For nursing home, in-home and assisted facility care
Security
Employee purchase
Group auto/home
Pet insurance
 Purchases through 12 months of payroll deduction
 Discount auto/homeowners with payroll deduction
 Discount insurance for pet medical care
Discount access  Access to wide range of saving and discounts
Personal
Wealth
Legal plan
ID theft
 Range of legal services included or discounted
 Ongoing ID monitoring; remediation and restoration
Student loan  Provides student loan management and assistance
© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson client use only.

05/10/2017
Enhancing the Employee
Experience: Communications
and Technology

Enhancing the employee experience is a top priority of
employers
89%
Note: Percentage responding 4 or 5 on a 5-point agreement scale.
96%
Employers view enhancement of
the employee experience with
their health and well-being
programs as a priority over the
next three years
Improve
employee
engagement in
health care
decisions
Improve
employee
satisfaction with
the health care
program
Improve our
employee value
proposition or
Total Rewards
positions
Have a direct
impact on long-
term costs
Enhancing the member experience will:
81% 74%78%
58% 56% 64% 72% 64%
40% 38% 32% 25% 31%
200~999
employees
1,000 ~4,999
employees
5,000~9,999
employees
10,000~24,999
employees
25,000+
employeesExtremely important (4/5) Moderately important (3)
By employer size

40%
38%
35%
30%
27%
20%
15%
18%
14%
12%
23%
8%
23%
14%
17%
12%
10%
13%
15%
19%
16%
Provide employees with greater choice in health plan options and types of benefits
Have a high-touch process for health plan enrollment
Improve navigation of health care providers
Provide access to onsite/near-site wellness facilities and onsite health services
Customize communication to specific groups (e.g., segment population by generations, specific lifestyle risks)
Tailor programs to specific groups
Employers embrace high-tech processes, greater plan choice and
enhanced navigation
Action taken/Tactic used in 2017 Planning for 2018 Considering for 2019
Activities to enhance the member experience with the health care program
Have a high-tech process for health plan enrollment
(i.e., interactive online interface with decision-support around which plan is best suited)

Employers recognize the advantages of private exchanges
Note: Percentage responding 4 or 5 on a 5-point agreement scale.
To what extent do you agree with the following perspective about private health
insurance exchanges for active employees?
Offer more employee choice
Ease our administrative burden
Provide more robust decision support
Manage long-term cost trend
Improve our employee value proposition
or Total Rewards positioning
Improve employee satisfaction with the
health care program
83%
68%
56%
44%
76%
42%
74%
20%
56%
18%
60%
18%
Employers with a private exchange, n=44
Employers without a private exchange, n=612

A new benefit delivery model-OneExchange
THEIR
CHOICE
YOUR
GOALS
OUR
EXPERIENCE
THEIR
CHOICE
YOUR
GOALS
Technology
Platform
Why experience matters
What’s in it for you
IMPROVE
EFFICIENCY
PARTNER WITH
A TRUSTED
RESOURCE
ENGAGE AND
RETAIN
EMPLOYEES
CONTROL
COSTS
What’s in it for your employees
EXPANDED
CHOICE
PERSONALIZED
DECISION SUPPORT
VALUED
BENEFITS
INVESTMENT
IMPROVED
UNDERSTANDING
INSIGHTS
AND BEST
PRACTICES
ACCESS TO
PRE-BUILT
SOLUTIONS
LEADING
TECHNOLOGY
ONGOING
SUPPORT

EMPLOYEE INPUT
PERSONALITYHEALTH FINANCES
PUBLIC DATA
Expected
utilization
Health
status
Network
preferences
Risk
tolerance
Health and
financial
concerns
Health care
consumerism
Income
Savings
Health care costs
and utilization
STATISTICAL MODELING
A sophisticated algorithm
creates a benefit portfolio
recommendation personalized
to each employee’s
unique needs, risk and
financial situation
Recommendation engine
Helping Employees Make Informed Decisions

30
Why Communication Is Essential
Promote Your Benefits
 Educate employees
 Increase morale and
engagement
 Promote healthy behaviors,
reducing costs
 Improve retention
 Move your employees
to action
Employee Perceptions
 9% believe HR communicated
benefits effectively
 65% say employer
communicated about benefits
less than three times
 71% don’t know phrase
“consumer-driven health care”
Employer Challenges
 “Noise” in the workplace
 Communication frequency
 Communication length
 Delivery processes
 Lack of management support
Why employees may not
understand your benefits
Sources: Aflac and MetLife.
© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

Plan The Communication Strategy
31
One size does not fit all
Your company
 Goals and objectives
 Insights about culture
 Audiences
 Key messages
 Size and product stage
 Geographic Distribution (remote
Sales reps, several mfg plants etc.)
 Challenges
 Budget
Communications Consultant
 Audience analysis
 Recommendations
 Tools and resources
 Market insights
 Communication
channels
 Media
 Frequency
 Measurement
STRATEGY

A Variety Of Delivery Channels
Flipbooks
Print
Brainshark
Mobile
 Benefit Guides
 Posters
 Postcards
 Newsletters
 Email template
Vendor fees may apply.
Video postcards

Total Rewards Statements
 Custom print and online statements
 Variety of options and fees

New Directions in Workplace
Wellness

Revisiting Incentive Strategy
What is your current wellness incentive strategy?
Offer some type of wellness
incentive to encourage
participation
86%
Employees earn no
incentives in a year
40%
Companies plan to re-
evaluate incentive strategy
over the next 3 years
88%*
$880
Average
incentive
dollar
opportunity
$365
Average
dollar
pay-out
Note: * Based on companies using incentives in 2015. 75% for all companies.
Source: 2015/2016 Global Staying@Work Survey, United States.

Wellness programs are prevalent with low participation, and
little growth in program offering is expected
36
85%
73%
88%
32%
38%
77%
74%
3%
5%
1%
4%
5%
6%
7%
7%
8%
2%
12%
12%
5%
6%
Health risk assess
Onsite Biometrics
Onsite vaccines
On/near site clinic
Onsite coaching
Onsite diet/exercise
Well-Being Fairs
Worksite
Wellness
58%
72%
81%
89%
68%
37%
86%
58%
10%
6%
4%
2%
8%
9%
5%
10%
14%
9%
7%
3%
13%
18%
5%
14%
Web/Mobile coaching
Telephonic coaching
Weight Management
Tobacco Cessation
Stress or Resilience
Sleep
Disease Management
Maternity
Lifestyle Change and
Health Management
98%
81%
46%
31%
59%
1%
3%
24%
7%
11%
6%
20%
25%
18%
EAP
Telemedicine
Expert/ Second
Opinion
Transparency Tools
Online information
on demand
Provider Access and
Decision Support
2015 Planned 2016 Consider 2017-8
Median Participation Rate:
9% – 49%
3% – 7%
3% – 7%
Source: 2015/2016 Willis Towers Watson Global Staying@Work Survey, United States

The business impact of employee well-being
6.2
2.8
1.7
11.7
11.3
8.5
Poor
Good
Very good
Healthstatus
To absence To presenteeism
FTE days lost
Employees in poor health report more absence and are less engaged
Poor
health
Good
health
Very good
health
% highly
engaged
27% 38% 46%
% disengaged 25% 23% 19%
Employees in poor health are more likely to be stressed and financially struggling
Source: 2015/2016 Global Benefits Attitudes Survey, U.S.
Sample: Full-time employees with an employer health plan.
Poor
health
Good
health
Very good
health
% highly stress 65% 42% 30%
Financial worries
Very good healthGood healthPoor health
6%
30%
64%
11%
36%
53%
18%
44%
38%
Unworried Future worriesCurrent worries Struggling
4%
28%68%

WTW research findings on employer health incentives —
Incentives matter, but workplace experience drives engagement
Health Programs Commentary
Health Assessments &
Biometrics
 Higher incentive amounts  higher participation rates
 Penalties increase attention and participation, but can engender employee dissatisfaction
 Mature programs sometimes shift to HA and biometrics as a gateway, with no separate
financial incentive
 Employer value from these programs requires that the collected data be used to drive
program development and participant engagement
Wellness & Lifestyle  High value programs and group participation recognition can help create social norms to
increase program participation
 Financial incentives are less effective at driving participation
Worksite Activities Worksite activities can get high participation without incentives and can help develop
a culture of health
 Develop recognition program; e.g., most improved based on participation rates, healthy
measures and/or most creative and innovative programs, etc.
 Boost wellness champion programs to become more integral to local efforts
 Support local charities, local community priorities, etc.
 Consider raffles or group incentives
Chronic Condition
Management
Programs aimed at those with serious or chronic conditions have greater potential to
lower claims costs
 Clearly defined milestones
 Focus on behaviors that lower health care utilization
Tobacco  Tobacco penalties are common and can increase quit rates
Biometric Outcomes Outcome-based incentives are increasing, but impact on employee behavior is
unproven
 Reasonable alternative standards can drive improved health behaviors

Employees are becoming less comfortable with incentives designed as
penalties and outcome-based incentives
2010 2011 2013 2015
Rewards Premium reduction for program participation 67% 67% 65%
Nudges
Reminders for preventive care or prescription
refills
48% 51% 56%
Screening results to recommend a well-being
program
48% 54% 51%
Penalties
Premium increase for those who do not
participate in programs
47% 45% 43%
Outcome-
based
Higher premiums for tobacco users 53%
Higher premiums for elevated cholesterol,
blood pressure, or blood sugar (with
reasonable alternative standard)
27% 31%
Higher premiums for elevated BMI (with
reasonable alternative standard)
27%
I would be comfortable if my health care plan offered …
39
Source: 2015/2016 Global Benefits Attitudes Survey, U.S.
Sample: Full-time employees with an employer health plan.
59%
54%
43%
39%
57%
26%
27%

New, integrated approaches to well-being are emerging
On the Way Out
One size fits all
Programs designed and dictated
by the corporate office
Wellness programs that address
physical health only
Claims that traditional wellness programs
lower medical claims cost in year one
Outbound telephonic cold calls
Clunky delivery with excessive client focus on
incentive management
On the Way In
Including productivity, workforce engagement
and “employer of choice” in determination
of program value
Programs with ownership and accountability
at the local level, including champions
Well-being strategy that supports physical,
emotional and financial health
Programs tailored to employee cohorts,
generational groups, and/or individual
members
Face-to-face and pure digital coaching
Consumer-grade mobile experience
enhanced by social support and devices

Evaluating incentive options
© 2016 Willis Towers Watson. All rights reserved. 41
Ways to earn
incentive
Eligibility
Ways to
receive
incentive
Value
Now Potential Change
 Required activities – health
assessment, biometric screening,
health coaching and tobacco cessation
(if applicable)
 Two outcomes-based measures –
weight (BMI <25) and tobacco
cessation
 Premium reduction
 Gift cards or HSA contribution
 Employee requirement
 Premium reduction: $250
 Achievement rewards: $300 in gift cards
or HSA contribution
 Free medical coverage for 50 winners:
$2,500 (estimated at $125K per year)
 Choice of physical, emotional and
financial activities
 Change to BMI <30 to make more
achievable OR remove BMI altogether
 Use tobacco surcharge as part of plan
design with tobacco cessation program
as Reasonable Alternative Standard
(RAS)
 Employee and spouse requirement
 Redirect premium reduction – use
proceeds to invest in new programs
 Offer choice of cash, charity, goods, or
HSA funding
 Redirect free medical coverage to
smaller raffles throughout the year
 Total of $300/$300 (employee/spouse)
 Gift card/HSA funding broken down by
activity (e.g., $75/activity)
 Raffles - $500 each, 250 winners

05/10/2017
Behavioral Health: A New
Frontier in Wellness

The WTW Pulse Survey
Behavioral Health is a priority across industry segments and employer size
Employers depend on their medical carriers for behavioral health benefits and EAP
services. Integration across these services and with medical and disability programs is a
crucial opportunity.
Nearly 9 in 10 employers say behavioral health is an important priority over the next
three years.
Employers seek improvement in their behavioral health programs, particularly in access
and navigation.
The majority of employers have or will add coverage for behavioral telemedicine.
Many employers are adding workplace stress and resiliency programs and some
will consider new mobile apps for anxiety management and sleep habits.
1
2
3
5
4
Source: 2017 Willis Towers Watson Behavioral Health Survey
© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson internal use only. 43

Employers are showing increased interest in new technologies
Source: 2017 Willis Towers Watson Behavioral Health Survey
Question: Which specific mobile applications does your organization have in place or plan to have in place?
27%5%
Today Next 3
years
38%11%
Today Next 3
years
31%7%
Today Next 3
years
Apps for sleep
disorders
Apps for
anxiety
Apps to reduce stress
or increase resiliency
© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson internal use only. 44

05/10/2017
Telemedicine: A “New” Care
Delivery Method

Telemedicine: One component of telehealth spectrum
Telehealth goes far beyond Internet sites and telephone numbers
It can also encompass:
Data storage and review
Images, video, clinical data
Assessment
Scanners, “tricorders”
Communication/Education
Apps and portals
Telemedicine —
Real-time care delivery
Kiosks, video and virtual visits
Monitoring
Glucometers, scales
and wearables

Telemedicine: The opportunity
$45
$160
$930
Telemedicine
Urgent care
ER visit
Average CostAccess
Appropriate setting
Cost-effective
Consumer-oriented
Convenient

Telemedicine value proposition for employers
Access1 Enables easy access to medical care for employees and dependents
Employee
Productivity
2 Improves employee productivity by reducing time away from work
Cost-
Effectiveness
3 Redirects non-emergent and non-urgent care away from higher cost
venues, e.g., emergency rooms and urgent cares
Program Alignment4
Can be aligned with other health care program initiatives; serves as
an extension of a worksite health strategy
5
Reduces barriers to care, e.g., setting appointments, time off work,
wait times
Ease of Use
Counters Market
Forces
6
Avoids increased demand due to emergency room and other local
provider marketing campaigns

Potential: $6B yearly savings for employers
 Acute conditions appropriate for telemedicine,
in working-age people
 MarketScan data
 ICD-9-CM codes
 Average cost of traditional visits
 Assumptions
 $49/telemedicine visit
 No fixed PEPM charge
 Results
 Savings/person with employer-based insurance
 Multiplied by the number of people with
employer-based insurance*
*Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2013 Current Population Survey.
Employee Benefit Research Institute. Sept. 2013. No. 390. Table 1.
Savings
will increase as
better monitoring
devices are
developed
Question: If all employees and their dependents, with employer-based
health insurance, had access to telemedicine services via webcam or
smartphone, could health expenditure be decreased?
WTWAnalysis

Current telemedicine provider landscape
Vendor Characteristics Affiliations
Teladoc  Longest tenure
 11m lives and 500,000 consults in 2015
 Low upfront PEPM fixed cost
Aetna Microsoft Azure Trizetto
Health Partners
Advantec Blue Shield CA
MDLive  5m lives and 250,000 consults in 2015
 Low upfront PEPM fixed cost
 Acquired Breakout Behavioral
QuadMed Quest HealthNet
Surescripts Regence Humana
Labcorp Cigna Watermark
Premise Health HCSC
Now Clinic  No upfront PEPM
 Largely B2C. B2B in place 4th quarter 2013
 Uses UHC network doctors
Owned by Optum
Rite Aid
IT infrastructure from American Well
Doctor on Demand • No pepm. Per use charge is $40. Minimum yearly charge
• Do not offer performance guarantees
• Began operations in Dec. 2013
• 120,000 visits and/ or registrations in 2014
UHC
BCBSMN
American Well  Provides IT infrastructure for carriers and health systems
 AW provider network created in 2012
 Powers NowClinic , LiveHealth Online, and UHC
telemedicine
 New service allows choice of AW or health system provider
30 Blues plans, Wellpoint, UHC
Allscripts EMR
Behavioral health, oncology and
perioperative care for VA patients
Anthem partner for LiveHealth Online
50

05/10/2017
Summary & Next Steps

What Should Employers Do in the Meantime?
• Keep your Eye on the Ball: Continue to manage health care benefit design and delivery,
effective cost management, population health improvement, competitiveness and other
objectives.
• Ensure compliance with other laws that affect your health care plan. Some rules, such
as HIPAA, have received less attention in recent years.
• Consider the changes you’ve made under the ACA, and develop a list of provisions you
might need to revisit in the event of legislative changes. Think through scenarios
relevant to your benefit program, and conduct a cost/benefit analysis of the effects of
selected, potential changes.
• Update your benefit strategy; revalidate how your health and welfare benefits fit into
your broader Total Rewards offering. Consider the potential impact of changes to the
ACA on your employees and retirees.
• Communicate with employees and retirees to address their concerns.
52
What do employers do in the meantime?

05/10/2017 BioNJ HR Forum-Discussion guide

05/10/2017 BioNJ HR Forum-Discussion guide

Recommended

More Related Content

What's hot

What's hot(20)

Similar to 05/10/2017 BioNJ HR Forum-Discussion guide

Similar to 05/10/2017 BioNJ HR Forum-Discussion guide (20)

Recently uploaded

Recently uploaded(20)

05/10/2017 BioNJ HR Forum-Discussion guide