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Insurance Marketing Resources


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Insurance Marketing Resources

  1. 1. Covenant Care – 25 to 250 employees A Competitive Alternative for Fully Insured Clients Covenant Advantage 200 Plus Employees Total Maximum Plan Cost Guarantee in Years 2 and 3
  2. 2. <ul><li>A competitive alternative for your clients who are fully insured </li></ul><ul><li>Protect your fully insured business with an alternative Fully Funded program </li></ul><ul><ul><li>An employer is only required to fund </li></ul></ul><ul><ul><ul><li>Administrative Fees, </li></ul></ul></ul><ul><ul><ul><li>Aggregate Premiums and </li></ul></ul></ul><ul><ul><ul><li>Aggregate Factors </li></ul></ul></ul><ul><li>Provides a unique strategy for managing the employee risk factors that drive employer costs </li></ul>The Covenant Care Program Introduction
  3. 3. <ul><li>Caps Employer’s Risk </li></ul><ul><li>Allows Profit Margins to remain with the Employer </li></ul><ul><li>Can lower maximum plan costs </li></ul><ul><li>No Lasers – at Issue or at Renewal- No Cash Calls </li></ul><ul><li>Potential for Reimbursement of unused claim $$$ </li></ul><ul><li>CAST – C ovenant A pplied S avings T echniques- Risk Management Solutions </li></ul>Covenant Care Program -Overview
  4. 4. CovenantCare Advantages Fully Insured CovenantCare Self-Funded Capped Funding Yes Yes No Lasers No No Yes Access to Claim Experience No (under 100 EE’s) Yes Yes Premiums Fixed Fixed Variable Cash Calls None None Weekly funding of claims up to specific per member Administration Higher Cost, Less Service Lower Cost, Great Service Lower Cost, Great Service Potential for year end savings No Yes Yes
  5. 5. The Health Care Dilemma
  6. 6. The Issue <ul><li>15% of all plan participants have acute or chronic health conditions </li></ul><ul><li>This group drives 80% of the claims </li></ul><ul><li>59% of next years acute chronic high risk population will come from this years low cost population </li></ul>35% At Risk 50% Healthy 15% Acute Chronic 59% of this years low cost population will be in next years high cost population. Low Cost Population
  7. 7. The Usual Approach <ul><li>Employers typically implement cost shifting strategies only to reduce healthcare costs </li></ul><ul><ul><li>Plan Design Changes </li></ul></ul><ul><ul><li>Plan Contribution Changes </li></ul></ul><ul><li>Positive impact of these changes are short lived. </li></ul><ul><li>Cost shifting will not provide a positive impact to the overall healthcare trend. </li></ul><ul><li>This strategy does not address the root cause of rising health care costs…lifestyle related conditions </li></ul>Reinsurance Premium Administrative Fees
  8. 8. The Solution <ul><li>Discover the root cause of escalating health care costs </li></ul><ul><li>Employer implements a strategy focusing on risk management not on cost shifting </li></ul><ul><li>This strategy motivates employees to take a more active role in managing their lifestyle and health care expenses </li></ul>
  9. 9. Risk Management Strategy <ul><li>Case Study 1 – Precept Ministries </li></ul><ul><li>A faith based ministry needed to control their rising health care costs </li></ul><ul><li>Implemented our strategy in 2006 and have experienced a reduction in actual claims costs by as much as 62% </li></ul><ul><li>The ministry has saved $811,576 over past two years </li></ul>Claim Savings
  10. 10. Risk Management Strategy <ul><li>Case Study 2 – </li></ul><ul><li>Benton County, AR </li></ul><ul><li>2006 Health plan $500K in the red </li></ul><ul><li>2006 implemented The Covenant Risk Strategy </li></ul><ul><li>2008 Results </li></ul><ul><ul><li>Paid back $500K </li></ul></ul><ul><ul><li>Plan $2.3M in the black </li></ul></ul><ul><li>Success brought to the attention of the national media </li></ul>Claim Savings
  11. 11. Covenant Applied Savings Techniques and Risk Management Strategies <ul><ul><li>Covenant Pharmacy Initiatives </li></ul></ul><ul><ul><li>MEDInnovations TC3 </li></ul></ul><ul><ul><li>MEDai Predictive Modeling </li></ul></ul><ul><ul><li>TelaDoc </li></ul></ul><ul><ul><li>MAP Program </li></ul></ul><ul><ul><li>Lab Card Benefit Program </li></ul></ul><ul><ul><li>BRAVO Wellness – Optional </li></ul></ul>
  12. 12. Incentive and Results Based Wellness Initiatives <ul><ul><li>Employers achieve immediate cost savings by linking incentives and penalties to participation and results of biometric screenings : BMI, Smoking, Blood Pressure, Cholesterol and Glucose </li></ul></ul><ul><ul><li>Bravo coordinates the screening process, appeals and the HIPAA compliant wellness requirements </li></ul></ul><ul><ul><li>HRA and Biometric results are sent to the employees & employer receives aggregate report </li></ul></ul><ul><ul><li>Employer is able to implement cost savings strategies using payroll contributions , multiple health plan designs, and HRA deposit </li></ul></ul><ul><ul><li>Results drive design and implementation of targeted wellness solutions to improved employee health and achieve long tern savings </li></ul></ul>
  13. 13. CovenantCare Plan Features <ul><li>Immediate Advance Funding </li></ul><ul><ul><li>The plan allows for a fixed budget each month. If claims exceed the cumulative monthly attachment point, then claims are immediately advanced by Pan American Life. The employer is only responsible for funding monthly factors and premiums on the first of each month </li></ul></ul><ul><li>Terminal Liability Option </li></ul><ul><ul><li>Three months of paid run out costs 1.5 months of premium and factors </li></ul></ul><ul><ul><li>Six months of run out costs 2 months of premium and factors </li></ul></ul><ul><ul><li>Can be elected and paid for any time prior to the contract end date </li></ul></ul><ul><li>Unlimited Aggregate Maximum </li></ul><ul><ul><li>LTM - Lifetime Maximum per individuals apply, but unlimited for the group </li></ul></ul>
  14. 14. Covenant Care Plan Design Comparison Premier Plan Plus Plan Access Plan Plan Maximum $5,000,000 $5,000,000 $250,000 Deductible $500 $1,500 $1,000 Coinsurance 80/20 to $12,500 100% after deductible 50/50 to $10,000 Office Visit $20 / $40 100% after deductible $20 / $40 RX Benefit $10 / $25 / $50 100% after deductible $10 (Generic Only) Maximum OOP $3,000 $1,500 $6,000
  15. 15. <ul><li>Covenant Advantage – Multi Year Rate Cap </li></ul><ul><li>The Covenant Advantage Plan has a total maximum Plan Cost Guaranteed for years 2 and 3, but the program must include the following: </li></ul><ul><li>Medical Advocacy Plan (MAP) </li></ul><ul><li>BRAVO Wellness </li></ul><ul><li>CareHere – Onsite Clinic with 200+ employees per location </li></ul>