Speakers:  Kathy Woods, Director, Business Continuity, Premera  Jennie Clinton, Program Manager, Crisis Management & Personal Preparedness, Premera Our presentation will provide a case study on our approach to overall preparedness the personal aspect being a large component; b. Program component; c. How we engage execs, employees, and community partners. In this presentation we will: 1. Share how we are getting our employee base more prepared to support keeping the company in business; 2. How to motivate and provide incentives for employees to take action; and, 3. Demonstrate how we partner and engage the public sector to do this.

1. Premera and Personal Preparedness
April 27, 2011
Kathy Woods, Director, Business Continuity
Jennie Clinton, Program Manager, Business Continuity
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2. Agenda
• Premera Overview
• Business Continuity Framework
• Where Personal Preparedness Fits
• Why the focus
• Our approach
• SharePoint site
• Open Discussion/Questions
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3. About Premera
Premera Blue Cross
• Premera Blue Cross is headquartered in Mountlake Terrace, Wash.,
with operations in Seattle and Spokane, Wash., and Anchorage,
Alaska. The company and its predecessors have operated in
Washington since 1933 and in Alaska since 1952.
• More than 1.5 million members in Washington and Alaska
• Fiscal Year 2009 revenues in Washington and Alaska of $2.9 billion
• A network of 27,000 healthcare professionals in Washington and
Alaska
• More than 2,800 employees in Washington and Alaska
The Premera Family of Companies
• LifeWise Health Plan of Oregon; LifeWise Health Plan of Washington;
LifeWise Assurance Company; Calypso Healthcare Solutions;
Ucentris Insured Solutions and Vivacity
• Consolidated 2009 revenues: $3.1 billion
• Nearly 3,000 employees
• A network of more than 35,000 healthcare providers
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4. Business Continuity Program
Our Business Continuity Vision: “We will ensure the company is prepared to continue critical services during a major disruption, and to
restore suspended services after a disruption, by operationalizing Systemic Business Continuity Management Practices throughout the
organization.”
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5. Role of Health Plans
The healthcare industry is part of our nation’s critical infrastructure…. Each of us plays
a key role in crisis response situations.
As a health plan, the actions we take in
responding to any disaster situation
are guided by these over-arching
principles:
• Ensure our members have
access to care which includes
both medical care and
prescription drug availability.
• Ensure our providers
continue to receive payment
Earthquake for services rendered and
covered by plan
• Ensure compliance with
disaster-specific guidance
from all regulatory agencies.
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6. Our Cornerstones for Recovery
Associate Support Unless and until you recover your people, we will not recover your business.
- Family/personal preparedness is the right thing to do and improves our responsiveness when it’s
We can’t needed as well.
recover without - The first we need to consider is our associate situation following a major disaster. If the family is
our people. in need, get them stabilized. Once associates know their families are safe, they are good to go for
incredible hours/days. This requires preparation work up front with associates and families.
- Plan for potential associate absenteeism of 30-50%, or more. Business Operations will be
impeded.
Member Support Focus on not putting members in the middle for situations outside of their control.
- Allow early refill of prescriptions to replace lost drugs or assist if members are forced to
evacuate.
- Guide members to network provider.
- Ensure access to care for our members.
Employer Group - Review data to identify employer groups with members in disaster areas.
Support - Self-funded customers bear financial risk and provide guidance that we take for their members.
- As the event unfolds, we analyze and document guidance we receive and determine how we will
implement for our fully insured groups.
- Share our approach with Self-funded groups and ask if they want to enact the same guidance to
their members.
- our proactive approach helps employers maintain a consistent approach for members who are
impacted by disaster events.
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7. Our Cornerstones for Recovery
Provider Support - Active outreach to our market contacts to determine impacts to providers and support we can
provide.
- We publish information gathered about provider status in documentation our Customer Care
Specialists use when assisting members.
- Extend timeliness for claims submission and/or documentation to support pended claims.
- We have internal business continuity plans and processes in place to continue execution of
service within our operational areas.
Regulatory - We operate in a highly regulated industry; federal and state guidelines drive actions
Agencies - States’ Departments of Insurance provide guidance in many disaster situations requiring action
- The Centers for Medicare & Medicaid Services (CMS) provides standing guidance related to
Medicare members.
- In the event of FEMA disaster and/or Department of Health and Human Services Public Health
Emergency, includes:
- Typical in large-scale disasters for CMS to provide additional guidance requiring action.
- New guidance from CMS (currently in draft) suggest plans should do what they need to do in
order to support Medicare members.
Challenges Health - Visibility to disasters that have occurred and subsequent CMS and/or DOI guidance issued.
Plans Face - Must be in compliance with federal regulations as well as those in all 50 states.
- All decisions are not our own.
- Disasters appear to be occurring more frequently and with greater impact.
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8. Our Approach to Planning
• Should you be onsite at work, Premera has an Incident Response
Immediate Team (IRT) managed by the Facilities Department. This team is
Response made up of volunteers trained to evacuation, provide search and
rescue efforts and conduct basic first aid and medical triage for
(Facilities) associates.
• The CMT is comprised of executives within Premera that manage
Crisis the response of crisis situations. If we needed to address policy
Management issues, or a major crisis situation that could be created as the result
of an earthquake, this team meets to handle the issues that would
(Business Continuity) arise.
• Business Continuity is currently working with business areas to refine,
Business Unit maintain and develop plans around what the critical areas of the
business could do to maintain the most time-sensitive activities (e.g.
Response customer service). Business Continuity works with IT Disaster
(Business Continuity) recovery, to ensure infrastructure recovery is aligned with business
requirements.
• While we have pieces in place to manage an earthquake-type of
Personal event on campus, it is the associates responsibility to ensure they are
personally prepared. Business Continuity strives to create an
Preparedness awareness and provide tools for our associates that will help them
(Business Continuity) with that planning. This includes a very basic emergency/hygiene kit
provided to associates when they start employment.
• Ensures the Resiliency, Restoration, availability and Recovery of
IT Disaster Premera’s Critical Technology Services, as identified by the Business
Recovery Units . Involves plans, procedures, and technical measures that
enable the recovery of information systems, IT operations, and
(IT) critical data after a disruption.
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9. The Need For Readiness
Premera must be ready to very immediately coordinate and
communicate following an event:
– Disasters appear to be occurring more frequently and with greater
impact.
– Customer expectations higher; less tolerance for downtime
The Danger: “Out of 5 businesses
experiencing a major disaster or extended
outage, 2 will never reopen their doors. Of
the 3 remaining, 1 will close their doors
within 2 years. 60% of businesses
experiencing a disaster will cease
operations within 2 years. Business
continuity plans and disaster recovery
services ensure continuing viability.”
Gartner (Roberta Witty, Donna Scott)
Gartner
Disaster Recovery Plans and Systems Are Essential
12 September 2001
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10. Why We Do It
Premera is concerned about associates and recognizes a higher level of personal
preparedness is generally correlated to a faster and more effective response.
Even with the ability to respond, if families and homes aren’t ok, there is a lack of
willingness to respond. If our associates have the awareness and resources to help
them prepare at home, they are likely to be willing and able to report to work.
In short – we cannot recover without our people, our people can’t recover without a
job to come back to.
• 91% of Americans live in places at moderate to high risk of earthquakes, volcanoes,
tornadoes, wildfires, hurricanes, flooding, high-wind damage or terrorism.
• Dept. of Homeland Security researched several studies in different parts of the US, as
well as other countries revealing that between 44-66% of first responders and
healthcare workers surveyed, would not report to work if they had concerns about
safety for their families or homes.
• A study of the Medical Reserve Corps volunteers found the assurance that their
family would be cared for/be ok was identified as the most important factor in enabling
them to respond.
• Sister company in Florida needed to restart response and recovery after a
hurricane .While business recovery was up and running according to plan,
there were not enough people to maintain operations because they were
taking care of personal impacts. Until the employees were settled at home,
they could not follow the recovery plan.
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11. Approach
Keys to our success:
• Obtain executive support
• Determine preparedness baseline
• Create and maintain awareness
• Provide the “how”
• Develop Personal Preparedness SharePoint Site
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12. Obtaining Support
Personal Preparedness is not a clear-cut revenue
generating department, nor is it a regulatory requirement –
so how did we do it?
• Focused on creating awareness with leadership – Crisis Management
Team and Business Continuity Council, key executive champions
• Education with leadership: examples and statistics, particularly with
other like organizations, guest speakers
• Worked into exercise scenarios with
top executives
• Provided program outline with a
phased approach
• Leveraged momentum and feedback
from associates
• General culture of the company
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13. Determine baseline
• Developed a Preparedness Survey
– Released September of 2010
– All associates asked to complete
– Additional question sets for response/recovery associates
– Used to determine specific aspects of preparedness
• Overall knowledge
• What steps they had taken
• Overall comfort with readiness for self and home
– Approximately 25% of population felt prepared
– Conduct annually to measure progress
• Next steps
– Voluntary program, recognize 100% participation unlikely
– Develop phased approach
• 2011- Target management & recovery teams
• 80% those teams begin activities in 2011
• End of 2012-2013 80% completed
• 25% general employee base start program
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14. Awareness
• Quarterly sessions on our campuses with guest speakers
– Focus on one aspect of preparedness
– General sessions for all associates, closed sessions for executives
– Speakers have included State and Local EMD; Snohomish County
Dept. of Health; National Weather Service
– Prizes and giveaways – focused on preparedness items
• Internal communication
– News articles
– Monthly preparedness tips
– Staff Meetings
– New employee orientation
• Monthly “lunch-n-learn” course
– Focus on one or two elements
– How to build kits
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15. Provide the “how”
• “Path to Preparedness”
– Breaks into 12 specific steps to help associates prepare (aligned
with WA State EMD)
– Incentives for each step completed
– Looking for our critical workers to complete these
– Formal launch Q2 2011
– Easy access to 3-day kits, supplies (vendor discounts, Premera
Perks) for our associates
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16. Preparedness SharePoint
• Developed mascots – Preparedness Patty & Disaster Dave
• Logo to use for all program communication/events
• Personal Preparedness SharePoint Site
– Path to Preparedness
program details and
participation tracking
– Incentives
– Upcoming events
– Resources, Videos
– Blogs
– Information sharing
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17. The SharePoint Site
Premera Personal Preparedness Site
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18. In Summary
• Obtained executive support
• Multiple communication channels and
visible communications from the top
• Session topics/company articles are
relevant and were ready to seize opportunity
– H1N1 and Snohomish County Dept. of Health
– Chile/Haiti Earthquakes and UW Risk/Seismology
– Japan Earthquake/Tsunami and Tim Serban
• Incentives for attending and participating
• Building momentum and leveraging interested parties
• Continuous feedback (surveys, focus groups)
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19. Questions?
Kathy Woods
425-918-5010; kathy.woods@premera.com
Jennie Clinton
425-918-6533; jennifer.clinton@premera.com
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