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PRIVATE EXCHANGES: Are they right for you?. Small Group Premiums Increasing Copyright 2013, Health Partners America. All Rights Reserved. No duplication,

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Presentation on theme: "PRIVATE EXCHANGES: Are they right for you?. Small Group Premiums Increasing Copyright 2013, Health Partners America. All Rights Reserved. No duplication,"— Presentation transcript:

1 PRIVATE EXCHANGES: Are they right for you?

2 Small Group Premiums Increasing Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent. 3 types of cost sharing limits: Actuarial value requirements (metallic levels) Out-of-pocket limits Under the ACA, out-of-pocket limits for health plans are subject to the limit that currently applies to health savings account qualified health plans, which is $6,250 for single coverage and $12,500 for family coverage in 2013, and we estimate it to be $6,350 for single coverage and $12,700 for family coverage in Deductible limits $2,000 single / $4,000 family deductible maximum Applies to small group market only

3 Small Group Premiums Increasing Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent. Other contributing factors: Minimum Essential Benefits Modified Adjusted Community Rating –Premium variations only allowed for: Age (3 to 1) Tobacco use (1.5 to 1) Family composition Geographic regions Wellness discounts are allowed for groups in specific circumstances

4 Add it up… " Well you can take a swag at it by adding up the values: 4% premium taxes 4-11% product increase 25% rating rules increase for healthiest groups Add another 12% for just the regular trend increase So you get 25-50% rate increase in the small group market." - Anonymous Carrier Executive Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

5 Regulatory Burden on Employers Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

6 THINGS ARE CHANGING Offering group health benefits could soon repel employees. Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent. The poles are shifting

7 ACA’S IMPACT ON INDIVIDUALS Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

8 Example: Family of 4 making $55k a year premium of $14,556. Single premium $5,400 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

9 Example: Family of 4 making $55k a year premium of $14,556. Single premium $5,400 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

10 Example: Family of 4 making $55k a year premium of $14,556. Single premium $5,400 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

11 Example: Family of 4 making $55k a year premium of $14,556. Single premium $5,400 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

12 Example: Family of 4 making $55k a year premium of $14,556. Single premium $5,400 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

13 Bottom Line 1.Small group is getting more expensive –Cost sharing increased –Essential Benefits –Rating changing 2.Regulations are burdensome 3.Value to employees is decreasing –Subsidies cannot be accessed if employer offers insurance Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

14 CHANGE WAVES OF

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17 Shifting Roles - Employer Health plan important component in attracting and retaining employees Selecting plan for employees Collecting money and paying carrier Concern over funding and participation requirements No plan or Defined Contribution platform important component in attracting and retaining employees Choosing contribution and platform to offer Reimbursing premiums in coordination with payroll No minimum contribution or participation requirements Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

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19 Shifting Roles - Employee No say in Employer plan – take it or leave it Employer deducts premium contributions and pays carrier Few Consumer Driven options Health plan not always paired with ancillary and supplemental for optimal planning Choice of any plan from any carrier available in state Pay the carrier directly – Employer reimburses Education and guidance on HDHPs Complete insurance planning to maximize every dollar Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

20 Majority of time spent on product specific issues: Quoting, Comparing, Communicating, Servicing Commissions from one product make up majority of revenue Limit to how many clients before capacity is reached Focus can be shifted to sharpening sales and relational skills, bring new strategies to attract and retain employees Multiple revenue sources from every case Scalability achieved through efficiencies in system remove all limits to what you can handle Shifting Roles - Broker Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

21 EXCHANGES 101

22 Private Exchanges Aren’t New Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

23 Different Exchange Types Less ComplexMore Complex Consumer-based and Funded Employer-based and Funded (at least partially) Single CarrierMultiple Carriers Health Insurance Only Multiple Benefits (i.e., Dental/Vision, Life, Accident, Critical Illness, DI, LTC) Defined Benefits (employer choice)Defined Contribution (employee choice) One-time Upfront Purchase OnlyYear-round, Ongoing Administration Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

24 Private ExchangePublic Exchange Single Carrier Group Multi Carrier Group, employer chooses carrier Multi Carrier Group, employer chooses carrier Multi Carrier Group, consumer chooses carrier Multi Carrier Group, consumer chooses carrier Small Group SHOP Exchange Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

25 Group Major MedicalSingle Carrier Single Carrier Group ABC Health Plan 1 ABC Health Plan 2 ABC Health Plan 3 ABC Health Plan 4 ABC Health Plan 5 ABC Health Plan 6 ABC Health Plan 7 ABC Health Plan 8 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

26 Group Major MedicalMultiple Carriers Single Carrier Group Multi Carrier Group, employer chooses carrier Multi Carrier Group, employer chooses carrier ABC Health Plan 1 ABC Health Plan 2 XYZ Health Plan 1 XYZ Health Plan 2 XYZ Health Plan 3 ACME Health Plan 1 ACME Health Plan 2 Vandalay Health Plan 8 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

27 Group Major MedicalMultiple Carriers Single Carrier Group Multi Carrier Group, employer chooses carrier Multi Carrier Group, employer chooses carrier ABC Health Plan 1 ABC Health Plan 2 XYZ Health Plan 1 XYZ Health Plan 2 XYZ Health Plan 3 ACME Health Plan 1 ACME Health Plan 2 Vandalay Health Plan 8 Multi Carrier Group, consumer chooses carrier Multi Carrier Group, consumer chooses carrier Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

28 Private ExchangePublic Exchange Single Carrier Group Multi Carrier Group, employer chooses carrier Multi Carrier Group, employer chooses carrier Multi Carrier Group, consumer chooses carrier Multi Carrier Group, consumer chooses carrier Single Carrier Individual Multi Carrier Individual Small Group SHOP Exchange Individual State/Federal Exchange (FFE in SC) Individual State/Federal Exchange (FFE in SC) Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

29 Individual Major MedicalSingle Carrier Single Carrier, based on zip code Single Carrier, based on zip code ABC Health Plan 1 ABC Health Plan 2 ABC Health Plan 3 ABC Health Plan 4 ABC Health Plan 5 ABC Health Plan 6 ABC Health Plan 7 ABC Health Plan 8 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

30 Individual Major MedicalMultiple Carriers Single Carrier, based on zip code Single Carrier, based on zip code Multi Carrier, Based on zip code Multi Carrier, Based on zip code ABC Health Plan 1 ABC Health Plan 2 XYZ Health Plan 1 XYZ Health Plan 2 XYZ Health Plan 3 ACME Health Plan 1 ACME Health Plan 2 Vandalay Health Plan 8 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

31 Individual Major Medical Pending state-level guidance regarding Web Based Entities (WBE) Single Carrier, based on zip code Single Carrier, based on zip code Multi Carrier, Based on zip code Multi Carrier, Based on zip code Qualified Health Plans (QHP) for that state Qualified Health Plans (QHP) for that state Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

32 Private ExchangePublic Exchange Single Carrier Group Multi Carrier Group, employer chooses carrier Multi Carrier Group, employer chooses carrier Multi Carrier Group, consumer chooses carrier Multi Carrier Group, consumer chooses carrier Single Carrier Individual Multi Carrier Individual Web Based Entities (WBE) Small Group SHOP Exchange Individual State/Federal Exchange (FFE in SC) Individual State/Federal Exchange (FFE in SC) Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

33 Exchange Solutions Description Drivers Keys to Success Limited and targeted plan designs Expanding Market Simplification, Great servicing Comprehensive suite of group plans from one carrier or a few carriers Health Plans, Large Brokers Health Plan Success Regional individual Health plans based on the consumer’s location Reform, GI individual plans WBE status Large inventory, DC/PRA, Employers leaving group Limited products (health + dental) Reform, Subsidies Default for uninformed Government Retiree Exchanges Group Plan Private Exchange Individual Plan Private Exchange Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

34 THE MULTI BILLION DOLLAR EXCHANGE OPPORTUNITY Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

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36 Private ExchangePublic Exchange Single Carrier Group Multi Carrier Group, employer chooses carrier Multi Carrier Group, employer chooses carrier Multi Carrier Group, consumer chooses carrier Multi Carrier Group, consumer chooses carrier Single Carrier Individual Multi Carrier Individual Web Based Entities (WBE) Small Group SHOP Exchange Individual State/Federal Exchange (FFE in SC) Individual State/Federal Exchange (FFE in SC) Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

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39 Source: Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

40 Government Subsidies through Private Exchanges Cindy Gillespie, a former advisor to Mitt Romney: "the bottom line of this new model is that consumers never have to go near the state or federally-facilitated exchange website to buy a product and access the refundable tax credit. All of the information transfers between the private broker site and the ACA exchange and the insurance carriers are invisible to the consumer." Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

41 HPA’s Private Exchange Broker Blueprint An Exchange is not just a website – it is the whole fulfillment process 2 ways to facilitate government subsidies 1.Qualify as a WBE 2.Have subsidy calculator on exchange site, when prospect enters information call center expert makes call and walks them through the enrollment process on the appropriate government exchange (state or federal) Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

42 TypeBroker Sells?Cafeteria PlanACA Self fundedYesOOP accounts Fewer design requirements. If meets <9.5% req. no penalty Traditional groupYesOOP accounts Design requirements. If meets <9.5% req. no penalty DC groupYesOOP accounts, HRA,PRA Design requirements. If meets <9.5% req. no penalty DC individual (MM, LBM, STM, Subsidized plans) YesOOP accounts, HRA,PRA ER would plan to pay penalty where applicable Individual (MM, LBM, STM, Subsidized plans) YesNo ER would plan to pay penalty where applicable Subsidized individualYesOOP accounts ER would plan to pay penalty where applicable Medicaid (SC not expanding)NoOOP accounts ER would plan to pay penalty where applicable Medicare/ Med Supp YesOOP accounts ER would plan to pay penalty where applicable All Products Will Be Available Through An Exchange In 2014 – And YOU Can Sell Them Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

43 Private Exchange Meets Employers Needs Attract and retain good employees Offer flexible and affordable benefit plans that all of your employees will qualify for Maximize on tax savings without administrative headaches Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

44 Private Exchange Meets Employees Needs Make the most of their money Easy and informative shopping experience Live support by professional, licensed consultants Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

45 How a Private Exchange works Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

46 THE DOUBLE THREAT: PRIVATE EXCHANGES AND DEFINED CONTRIBUTION PLANS Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

47 Defined Contribution Health Plans Defined Contribution = »Tax Savings for Employers »Tax savings for Employees Defined contribution plans »Group and Individual plan designs »Relationship to exchanges Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

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49 How to use a private exchange HOW TO OFFER BENEFITS IN 2014 Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

50 Employer Involvement LOW HIGH Employer Plan -> Government subsidies Exchange Involvement Reimbursement/ Spending Accounts Employer Sponsored Plan Options Offer nothing ACA Implications Private Exchange with Individual Products Private Exchange with Individual Products and Cafeteria Plan Private Exchange with Individual Products and Group Products Private Exchange with Individual Products, Group Products, and Cafeteria Plan Available to EEs making less than 400% FPL Available to EEs making less than 400% FPL – if group health doesn’t meet requirements Not offered Cafeteria plan ER contributions an option Employer sponsored products: health, dental, vision, life, DI, accident, CI Cafeteria plan Employer sponsored products: health, dental, vision, life, DI, accident, CI < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 Government exchange HPA exchange branded for ER, Agency or Organization HPA exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings HPA exchange branded for ER, Agency or Organization. Links to Bswift for group offerings HPA exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings. Links to Bswift for group offerings None Ind. MM premium reimbursement – HRA/PRA OOP med expenses – FSA/HSA/DCA Ind. MM premium reimbursement – HRA/PRA OOP med expenses – HRA/FSA/HSA/DCA None Available to EEs making less than 400% FPL – if group health doesn’t meet requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30

51 Employer Involvement LOW HIGH Employer Plan -> Government subsidies Exchange Involvement Reimbursement/ Spending Accounts Employer Sponsored Plan Options Offer nothing ACA Implications Private Exchange with Individual Products Private Exchange with Individual Products and Cafeteria Plan Private Exchange with Individual Products and Group Products Private Exchange with Individual Products, Group Products, and Cafeteria Plan Available to EEs making less than 400% FPL Available to EEs making less than 400% FPL – if group health doesn’t meet requirements Not offered Cafeteria plan ER contributions an option Employer sponsored products: health, dental, vision, life, DI, accident, CI Cafeteria plan Employer sponsored products: health, dental, vision, life, DI, accident, CI < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 Government exchange Private exchange branded for ER, Agency or Organization HPA exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings HPA exchange branded for ER, Agency or Organization. Links to Bswift for group offerings HPA exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings. Links to Bswift for group offerings None Ind. MM premium reimbursement – HRA/PRA OOP med expenses – FSA/HSA/DCA Ind. MM premium reimbursement – HRA/PRA OOP med expenses – HRA/FSA/HSA/DCA None Available to EEs making less than 400% FPL – if group health doesn’t meet requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30

52 Employer Involvement LOW HIGH Employer Plan -> Government subsidies Exchange Involvement Reimbursement/ Spending Accounts Employer Sponsored Plan Options Offer nothing ACA Implications Private Exchange with Individual Products Private Exchange with Individual Products and Cafeteria Plan Private Exchange with Individual Products and Group Products Private Exchange with Individual Products, Group Products, and Cafeteria Plan Available to EEs making less than 400% FPL Available to EEs making less than 400% FPL – if group health doesn’t meet requirements Not offered Cafeteria plan ER contributions an option Employer sponsored products: health, dental, vision, life, DI, accident, CI Cafeteria plan Employer sponsored products: health, dental, vision, life, DI, accident, CI < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 Government exchange Private exchange branded for ER, Agency or Organization Private exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings HPA exchange branded for ER, Agency or Organization. Links to Bswift for group offerings HPA exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings. Links to Bswift for group offerings None Ind. MM premium reimbursement – HRA/PRA OOP med expenses – FSA/HSA/DCA Ind. MM premium reimbursement – HRA/PRA OOP med expenses – HRA/FSA/HSA/DCA None Available to EEs making less than 400% FPL – if group health doesn’t meet requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30

53 Employer Involvement LOW HIGH Employer Plan -> Government subsidies Exchange Involvement Reimbursement/ Spending Accounts Employer Sponsored Plan Options Offer nothing ACA Implications Private Exchange with Individual Products Private Exchange with Individual Products and Cafeteria Plan Private Exchange with Individual Products and Group Products Private Exchange with Individual Products, Group Products, and Cafeteria Plan Available to EEs making less than 400% FPL Available to EEs making less than 400% FPL – if group health doesn’t meet requirements Not offered Cafeteria plan ER contributions an option Employer sponsored products: health, dental, vision, life, DI, accident, CI Cafeteria plan Employer sponsored products: health, dental, vision, life, DI, accident, CI < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 Government exchange Private exchange branded for ER, Agency or Organization Private exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings Private exchange branded for ER, Agency or Organization. Links to Bswift for group offerings HPA exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings. Links to Bswift for group offerings None Ind. MM premium reimbursement – HRA/PRA OOP med expenses – FSA/HSA/DCA Ind. MM premium reimbursement – HRA/PRA OOP med expenses – HRA/FSA/HSA/DCA None Available to EEs making less than 400% FPL – if group health doesn’t meet requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30

54 Employer Involvement LOW HIGH Employer Plan -> Government subsidies Exchange Involvement Reimbursement/ Spending Accounts Employer Sponsored Plan Options Offer nothing ACA Implications Private Exchange with Individual Products Private Exchange with Individual Products and Cafeteria Plan Private Exchange with Individual Products and Group Products Private Exchange with Individual Products, Group Products, and Cafeteria Plan Available to EEs making less than 400% FPL Available to EEs making less than 400% FPL – if group health doesn’t meet requirements Not offered Cafeteria plan ER contributions an option Employer sponsored products: health, dental, vision, life, DI, accident, CI Cafeteria plan Employer sponsored products: health, dental, vision, life, DI, accident, CI < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 Government exchange Private exchange branded for ER, Agency or Organization Private exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings Private exchange branded for ER, Agency or Organization. Links to Bswift for group offerings Private exchange branded for ER, Agency or Organization. Specific instructions, forms, links for TPA offerings. Links to Bswift for group offerings None Ind. MM premium reimbursement – HRA/PRA OOP med expenses – FSA/HSA/DCA Ind. MM premium reimbursement – HRA/PRA OOP med expenses – HRA/FSA/HSA/DCA None Available to EEs making less than 400% FPL – if group health doesn’t meet requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30 If group health is option no penalty applies if it meets requirements < 50 FTE -No penalty > 50 FTE Penalty of $2k per full time EE minus first 30

55 Marketplace Analogy Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

56 Customer Service Group Products Individual Products Account Based Products Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

57 INDIVIDUAL PRODUCTS No additional fees for standard customizations. Revenue share on leads sent to call center based on subscription level. You keep 100% of commissions for leads you handle yourself. Template Quote Engine Call center fulfillment CRM tracking of leads sent to call center Education and decision support tools Custom Incorporate enrollment links/forms/brochures from your own carrier relationships Back Office Inventory Template Health (MM, LBM, STM) Medicare Supp Life, Dental, Vision, Accident, Critical Illness, P& C Government Subsidies Custom Incorporate enrollment links/forms/brochures from your own carrier relationships Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

58 ACCOUNT BASED PRODUCTS (including section 125 and 105 plans) No additional fees for site integration. Set up and monthly fees to Employer based on TPA. Set up and Admin fees may be shared. Template Evolution 1 Integration Evolution 1 partner relationships Custom Incorporate enrollment links/forms from your own TPA or Admin platform relationships Back Office Premium Reimbursement : PRA, HRA OOP Expenses: H.S.A., Health FSA, Limited Health FSA, Integrated HRA, Dependent Care, Transit Inventory Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

59 GROUP PRODUCTS Leads for group products can be generate through Agency/Association template. PEPM fee for group enrollment and admin platform applies- can be paid by broker Employer, or carrier Template Bswift reseller partnership Our service experts support the system for you Custom Incorporate your own group enrollment/admin relationship Back Office Inventory Template 140+ Product templates -Medical, Dental, Vision, Life 100+ Carrier (Electronic Data Integration) EDIs established *Can add any needed Custom Incorporate your own group enrollment/admin relationship Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

60 CUSTOMER SERVICE Service for products can be handled by the carrier, the producer or the fulfillment center depending on how leads were routed. Service for the website and online tools managed by our team of onshore exchange specialists. Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

61 Customer Service Group Products Individual Products Account Based Products Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

62 STORE MARKETINGPRIVATE EXCHANGE ADVERTISING In-store Coupon Packs Flyers Billboards Radio/TV Flyers for Employers General flyers Forms Press Release Prospecting Letters Call Scripts Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

63 SIMPLE PROCESS 1. Build your marketplace 2. Choose your inventory 3. Grand opening Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

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65 Key Take-Aways Huge Shift to individual coverage driven by PPACA Roll of HRA, PRA and OOP spending accounts will increase Group products still offer advantages Exchanges will be crucial for communicating and enrolling all of these types of benefits Talk to us after the meeting to see how HPA’s Private Exchange Broker Blueprint gives you a turnkey solution that pulls it all together Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.

66 Copyright No part of this presentation may be reproduced or transmitted in any form without the written permission of the author. Disclaimer This presentation was diligently researched and compiled with the intent to provide information for persons wishing to learn about the landscape of health insurance reform and the opportunities they present. Throughout the making of this consumer presentation, every effort has been made to ensure the highest amount of accuracy and effectiveness for the techniques suggested by the author. The presentation may contain contextual as well as typographical mistakes. No information provided in this presentation constitutes a warranty of any kind; nor shall readers of this presentation rely solely on any such information or advice. All content, products, and services are not to be considered as legal, medical, or professional advice and are to be used for personal use and information purposes only. This presentation makes no warranties or guarantees express or implied, as to the results provided by the strategies, techniques, and advice presented in this presentation. The publishers of this presentation expressly disclaim any liability arising from any strategies, techniques, and advice presented in this presentation. The purpose of this consumer presentation is to educate and guide. Neither the publisher nor the author warrant that the information contained within this consumer presentation is free of omissions or errors and is fully complete. Furthermore, neither the publisher nor the author shall have responsibility or liability to any entity or person as a result of any damage or loss alleged to be caused or caused indirectly or directly by this presentation. Safe Harbor Notice Certain statements in this presentation relate to future results that are forward-looking statements as defined in the Private Securities Litigation Reform Act of This presentation contains statements involving risks and uncertainties, including statements relating market opportunity and future business prospects. Actual results may differ materially and presentation results should not be considered as an indication of future performance. Factors that could cause actual results to differ are not included. Copyright 2013, Health Partners America. All Rights Reserved. No duplication, in whole or in part, permitted without expressed written consent.


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