lgit annual meeting

LGIT Annual Meeting

LGIT Health Overview October 22, 2020

Tim Ailsworth - LGITFred Bean, Mark Kunkle, Kate Lobley – BeneconKen Huber – PSA Insurance & Financial Services

Andrew Belmear – CignaKyle Sanders – Kaiser Permanente

What is LGIT Health?

Local Government Insurance Trust Health, known as LGIT Health, is a self-funded health insurance purchasing program established in 2010. The goal of LGIT Health is to provide

cost effective health insurance for municipal employees in the state of Maryland.

Today, 24 municipalities and/or authorities are members of LGIT Health.

LGIT Health members benefit by full transparency on costs, excellent employee benefits and surplus returns annually from

better than expected performance.

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Local Control is the Key to Success

LGIT Health is governed by the Board of Trustees of the Local Government

Insurance Trust. The LGIT Board makes sure that all profits (or surplus returns)

are returned to the members and not the insurance company. In addition, LGIT

staff acts as the treasurer for the Cooperative to assure financial accountability

with all funding. Benecon acts as the general administrator of the program for

all day-to-day activities.

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4

LGIT Health Partners

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Benecon is the leader in developing self-funded employee benefit

programs for both public and private sector employers.

14 Consortium/Cooperative programs nationwide

1280 employer groups / 122k covered employees

Member Retention exceeds 98%

Who is Benecon?

Benecon’s Full Suite of Services for LGIT Health Members

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Day to Day Account

Management

Independent

Rate Development

DOL Compliance

Resources

Financial Services Data AnalyticsNurse Navigation &

Wellness Consulting

How does LGIT Health benefit the members?

• Broad network of providers and

hospitals through Cigna and

Kaiser

• Benefits will match current plan

design or be slightly better in

certain cases

• Access to Benecon’s Nurse

Navigation & Wellness

Consulting services through

ConnectCare3

• Regular wellness initiatives

including online health coaching

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Current LGIT Health Membership

▪ Town of Berwyn Heights

▪ Boonsboro

▪ City of Brunswick

▪ Town of Centreville

▪ Town of Chesapeake Beach

▪ Chesapeake City*

▪ Town of Chestertown*

▪ Cheverly

▪ City of College Park

▪ City of Cumberland

▪ Gaithersburg

▪ Hampstead

▪ Kent County

▪ Kent County Public Library

▪ LGIT

▪ Town of Middletown

▪ Maryland Municipal League

▪ Mount Rainier

▪ City of New Carrollton

▪ Town of North East

▪ Town of Oakland

▪ Town of Poolesville

▪ Port Deposit

▪ Town of Riverdale Park

▪ Town of Sykesville

▪ City of Westminster

*Ancillary Benefits Only

9

LGIT Health Model Overview

Claim Fund with Corridor

Member Surplus

Great Year Expected YearClaim Fund Exhausted

Aggregating Specific

Stop-Loss

Specific Stop-Loss

Administrative Fund

Cross Share Fund

Aggregate Stop-Loss

3%

18%

79%

1010

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PROPRIETARY AND CONFIDENTIAL

Historical Performance – Surplus

Plan Year Net Surplus Returned

2010-11 $77,511

2011-12 $646,194

2012-13 $451, 971

2013-14 $645,581

2014-15 $1,244,747

2015-16 $1,050,503

2016-17 $2,342,727

2017-18 $3,503,995

2018-19 $3,053,175

2019-20 *Not final $5,018,109

Cumulative Total $13,016,404

Over $13 million in surplus returned since inception!

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10 Years of Exceptional

Performance

• 99% Retention Rate

• Stable Rate Renewals

• Full Transparency on All Costs

• Local Control with LGIT Board of Trustees

• Key Partnerships with: MACO, MML, MCCMA, Mayors

Association

• Outstanding Customer Service & Account Management

12

What the LGIT Health Members Are Saying…

1313

What the LGIT Health Members Are Saying…

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PSA Insurance & Financial Services

PSA has become a broker partner to market the LGIT Health program.

PSA is the Mid Atlantic region’s leading independent insurance

brokerage and risk management firm, providing employee benefits, risk

management and personal insurance solutions. PSA has been assisting

clients in growing and protecting their assets since 1928. With their vast

knowledge, experience and resources, they can provide national-caliber

capabilities with local service.

#1 rated health plan for ease of doing business with health care professionals

#1 NCQA HEDIS clinical results for 14 consecutive years

#1 rated on overall trust index in national provider survey

#

Disease

Management

Program

Cigna Your

Health First

Digital

Innovation

• mycigna.com

• Cigna mobile

app

• Cigna One

Guide

24/7/365

Live

Customer

Service

Broad Network

Access

to meet access,

cost & quality

needs

Integrated

Experience

Medical, Rx,

Dental,

Behavioral,

Disability,

Vision

Employee

Assistance

Program

(EAP)

Improving

overall well-

being

80% of Cigna business is ASO

1616

1717

Kaiser Permanente is now offered to new LGIT Health members

effective July 1, 2020.

Founded in 1945, Kaiser Permanente is recognized as one of

America’s leading health care providers and not-for-profit health plans.

Kaiser currently serves 12.4 million members in 8 states and the

District of Columbia.

Care for members and patients is focused on their total health and

guided by their personal Permanente Medical Group physicians,

specialists, and team of caregivers. Our expert and caring medical

teams are empowered and supported by industry-leading technology

advances and tools for health promotion, disease prevention, state-of-

the-art care delivery, and world-class chronic disease management.

Fred Bean, VP Program Management

[email protected]

Questions?

Mark Kunkle, Director Program Management

[email protected]

Kate Lobley, Senior Account Manager

[email protected]

mailto:[email protected]



Employee Benefits ▪ HR Consulting ▪ Commercial Insurance ▪ Risk Management ▪ Personal Insurance

PSA & LGIT HealthA New Partnership

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About PSA

Est 1928

Maryland Based Privately Held/Independent

One of the largest employee benefit practices in the region

National Caliber Capabilities with Local Service

98% Client Retention

165+ Employees

Locations

Hunt Valley

Rockville

Snow Hill

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Programs like LGIT Health Gaining in Popularity

Why?

Employers seeking more transparency than available in traditional insured programs

Fatigued with “trend” increases

Want opportunity to benefit from good plan performance

Seeking rate stability, predictability

Want fairness and insight into how rates are developed

LGIT Health provides these features!!!

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Our Process

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The Process

• Help you learn about the LGIT Health Program

• Information gathering

• PSA conducts an Overview & Analysis

• Presentation of LGIT Health proposal and findings of PSA’s analysis

• Comparison versus your current programs

• Review of additional services that come with the PSA relationship

2323

Making it clear what PSA does

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Our Capabilities

CUSTOMIZED COMMUNICATION & OPEN ENROLLMENT

SUPPORT

CLIENT ADVOCATE

TEAM

HEALTH RISK MANAGEMENT COMPLIANCE

EXPERTISE

HRIS CONSULTING

DISCIPLINED CONSULTING

PROCESS

OUTSOURCED HUMAN

RESOURCES

EXPERIENCED CLIENT

MANAGER

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Directing Our PerformanceYour Client Manager

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Your PSA Team

Executive Level

Management

An expert team of professionals becomes an extension of your

Human Resources team

Employees &

Dependents

LGIT Health Member Municipality

Regulatory Compliance

Dedicated Client

Advocate

Client Service

Benefit Consultant

Strategic Planning

Employee Benefits

Advisor

Relationship Mgr.

Benefit Analyst (BA)

Team

Financial Analysis

Client Advocate Team

Member Service

Employee

Communications Team Employee Education & Communication

Dedicated Nurse

Health Risk Management

Clinical Team

Clinical Support

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Ongoing Meetings

Stewardship

•Focusing on metrics and reporting for the plan year that just ended and a recap of historical performance

•Year in review plan history

•Identify/confirm strategic objectives

Claims Utilization & Compliance

•Review claims cost and utilization from prior year

•Plan documents

•Form 5500

•Strategic planning

•Management reporting update

Pre-Renewal

•Revisions to strategic plan

•Management reporting update

•Benchmarking

•RFP planning

•Renewal planning

Renewal

• Renewal results

•Open enrollment planning

•HRIS updates

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Sample Renewal Timeline & Calendar

Task Responsible PartyTarget Completion

Date

Stewardship and Strategic Planning Meeting PSA/Client 8/2/2018

Pre-Renewal Meeting PSA/Client 2/28/2019

Renewal Meeting - Present final proposal results & plan options to Group PSA/Client 3/25/2019

Finalize outstanding questions, rates, and plan designs PSA 4/1/2019

Finalize contribution structure/contribution rates - all plans PSA/Client 4/1/2019

Final decisions for benefit plans, carriers and contributions Client 4/4/2019

Notify awarded carrier/vendor(s) of final plans selected PSA 4/5/2019

Plan Implementation(s) Begin PSA/Client/Carrier(s) 4/5/2019

BenAdmin Implementation for 2019 PSA/Client/BL 4/12/2019

Open Enrollment Knovio & Benefit Guide draft(s) provided to Group for review PSA 4/17/2019

Open Enrollment Knovio & Benefit Guide draft(s) feedback provided Client 4/18/2019

Open Enrollment Knovio & Benefit Guide draft(s) provided to Group for 2nd review PSA 4/22/2019

BenAdmin rate template completed PSA 4/22/2019

Final approval of Brainshark and Benefit Guide from Group Client 4/22/2019

Benefit Guides printed PSA 4/24/2019

Benefit Guide delivered to the Group PSA 4/29/2019

Open Enrollment Begins Client 5/6/2019

Define Enrollment Meetings / Webinars PSA/Client TBD

Open Enrollment Ends Client 5/20/2019

Review/Audit of Open Enrollment election file(s) Client/Administrator 5/24/2019

Plan election files sent to carriers Client/TPA 6/3/2019

ID cards sent/received by all enrolled employees and members Carrier 7/1/2019

Effective Date of All Plans All Parties 7/1/2019

Contracts and Certificates of Coverage Carrier 7/31/2019

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Economic Result• Better insight on plan

performance = more targeted consulting strategies

• More high-risk members connected and engaged with carrier care management

Economic Result• Fewer high claims

• Lower increases


+DATA

ANALYTICSCLINICAL NURSEINTERVENTION

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Wellness Strategy Development

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Compliance Support

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Compliance Services

Dedicated Compliance Services Department

• Focused solely on Federal & State Laws that impact employee benefit plans

• Unlimited access to PSA’s team of Compliance Specialists

Supported by outside counsel

REVIEW AND DISCOVERY

ONGOING MAINTENANCE

• Compliance Review

• Contract Review

• Eligibility Rules

• Plan & Wrap Documents

• Required Notices

• Unlimited Research / Compliance Guidance

• Healthcare Reform

• Legislation & Regulatory

CHANGES

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Compliance Services

New legislation demands will require enhanced compliance oversight, and with all the changes brought on by health care reform, you may be feeling overwhelmed by the additional responsibilities. Take a deep breath—we can help.

We have the resources you need to keep you ahead of the curve.

• Compliance Services team (in-house)

• Annual Compliance Calendar

• ERISA Compliance Checklist

• ACA Checkup

• Seminars & Webinars

• “Benefit Minute”—monthly e-newsletter

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2018 Compliance Calendar

Ongoing for New Hires

• Exchange Notice (all new hires within 14 days)

• Ongoing measuring of new hires who are not FT

• SBC and required federal notices with enrollment materials to newly eligible employees

• Medicare Part D creditable/non-creditable notice to new enrollees

• Initial COBRA notice to new enrollees

• HIPAA privacy notice to new enrollees

• SPD (within 90 days of eligibility)

January Jan. 1 Benefits Plan Year Begins Jan. 31 Issue W-2s that include cost of health coverage

February Feb. 28 CMS online Creditable Coverage due Receipt/review of Plan Year contracts

March Mar. 1 Issue Form1095-C to Full Time Employees Mar. 31 1094-C transmittal due to IRS Review SPD, Update and Distribute

April Schedule A & employer information collected for Form 5500

May

June Prepare Form 5500 for submission

July July 31 File Form 5500 for welfare plan or extend July 31 File Form 720 & pay PCORI fee for prior plan year

August

September Sept. 14 SARs distributed to employees unless 5500 extended Confirm creditable/non-creditable status of all Rx plans for upcoming plan year

October Oct. 15 Medicare D Creditable Coverage Notice Due Oct. 15 Form 5500 due if extension filed

November Open Enrollment including distribution of SBCs and required federal notices

December Dec. 15 SAR distribution deadline to employees if 5500 extended Make sure all plan amendments completed for all plans

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Payroll, HRIS, and Benefits Platforms

• Seasoned team with exceptional depth of resources

• Platform agnostic

• Needs assessment and analysis of various solutionso Benefits Administration

o Integrated Payroll and Benefits Administration

o FSA, HSA, HRA, and COBRA

• Assist with set up & testing of enrollment portal

• Communicate annual plan changes to technology vendor

Helping our clients with the right solution

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Employee Advocacy Unit

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Client Advocate Support UnitThink of PSA as your benefits help desk. All employees and their dependents have access to our in-house Client Advocate Team (“Benefits Hotline”).

Employee & Dependents

• Open Enrollment

• Claims Disputes

• Coverage Issues

• Billing Payables

• Appeals

• Clinical Advocate

Human Resources Department

• Allows you to focus on strategic initiatives

HUMAN RESOURCES DEPARTMENT

EMPLOYEE & DEPENDENTSCustomized email address

Toll-free line

Dedicated Client Service & Employee Contact

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Sample Benefit Hotline ReportsQ4

Q2

Q1

Q3

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Employees drowning in a sea of

Insurance-eseCommunications Support

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Branded Employee Communication

Core Services include :

• Benefit Guide

• Benefits Overview Presentation

• Access to “Benefits 101” education

https://indd.adobe.com/view/8e6c8935-6950-44ce-841e-a4760e29f6f4

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https://indd.adobe.com/view/bf0d935b-38dd-42fe-ab85-93640f89da5e

http://www.brainshark.com/HRTechnologies/HSA101

https://indd.adobe.com/view/8e6c8935-6950-44ce-841e-a4760e29f6f4

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“Benefits 101” EducationAdding more value to employee education

Short, educational videos on a variety of topics.

Links integrated into other printed/electronic communications.

Understanding Medical Termshttps://kvgo.com/psa/MedicalTerms101

Ways to Savehttps://kvgo.com/psa/WaystoSave101

What is Open Enrollment?https://kvgo.com/psa/OpenEnrollment101

Qualified Life Eventshttps://kvgo.com/psa/Change-in-Status101

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http://bit.ly/Medical_Terms

https://kvgo.com/psa/MedicalTerms101

http://bit.ly/Ways_to_Save

https://kvgo.com/psa/WaystoSave101

http://bit.ly/Annual_Open_Enrollment

https://kvgo.com/psa/OpenEnrollment101

http://bit.ly/Change-in-Status

https://kvgo.com/psa/Change-in-Status101

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Open Enrollment Assistance

• Plan and coordinate open enrollment meetings

• Prepare open enrollment materials

• Develop Open enrollment presentation

• Conduct Open enrollment meetings via webinar or in person when safe

• Handle all employee calls, questions about open enrollment

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• Employee Disconnect

o Compensation includes much more than salary

o Without awareness, no appreciation

• Complete Picture

o Help employee understand value of non-cash compensation

o Improve retention by creating level playing field with competitors

Added fee for Outsourced HR Services*Data from Bureau of Labor Statistics. 3/10/16 release

Total Compensation Statements—The Purpose

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HRAssistLow Fixed Monthly Payment

Affordable option to alleviate the admin burden of understaffed HR teams.

• Dedicated HR Consultant/ Team Support• Needs Assessment and Project Plan• Monthly Calls• Block of HR Consultation• Access to Employment Attorney• Online Tools/ Templates/ Resources

Outsourced HR Support

We help our client’s existing “HR personnel” by providing the resources and expertise to fill gaps.

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• Innovative program for achieving costs control and stability

• High quality carrier partners Cigna and Kaiser

• Allows Kaiser offering with Cigna to members who would be unable to offer the choice

• Comprehensive scope of services provided by PSA

• Highly experienced team

• Extension of your HR department

• Focused on plan performance & utilizing all carrier resources

• Deep Health Care Reform & compliance capabilities

• National firm capabilities with local high touch delivery & accountability

• HR/Benefits Technology Support

Why LGIT Health & PSA

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Questions?

47

CIGNA HEALTHY WAYS TO WORK

SM

Workplace Clearance Tool

946752

Offered by Cigna Health and Life Insurance Company or its affiliates

WORKPLACE HEALTH AND SAFETY

49

More than 85% of employers

are planning new workforce

health and office safety

measures, ranging from

new site entry policies to

supplying masks, testing and

(when ready) vaccinations1.

Address workplace readiness and employee concerns

Determine physical worksite entry procedures and screening protocol

Provide reliable COVID-19 related information

Monitor site-specific population health and geographic risk

Provide testing and, as available, vaccines

Support those who get ill through recovery

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2020 Cigna

1. The Conference Board (2020), “From Immediate Responses to Planning for the Reimagined Workforce.”

https://conference-board.org/pdfdownload.cfm?masterProductID=20874

ADDRESSING EMPLOYEE CONCERNS

50


SA

FE

70% of workers list concerns about returning to work,

with 51% citing fear of getting sick as their main worry.1

SIM

PL

E

3 in 4 people are willing to participate in daily health checks

but are worried about the extra time and effort required.2

CO

MP

LE

TE

Workers want expanded access to resources,

such as support managing stress, health coaching

and wellness services.2

1. Carucci, R. (6 June 2020). “How to prepare yourself for a return to the office.” Harvard Business Review.

2. M/A/R/C Research & Cigna Global Market Research and Insights (2020, May). COVID-19’s Impact on

Healthcare Attitudes and Practices Wave 2

WHO IS BUOY HEALTH?

51

Web-based, AI-powered health tools to help people figure out what to do when they get sick —and guide them to the right care.

Digital health company developed out of

the Harvard Innovation Labs by doctors

and data-scientists and dedicated to:

Providing personalized clinical support

through technology, the moment someone

has a healthcare concern

Helping to remove fear and complexity that often

confronts people entering the healthcare system

by helping them navigate care

Delivering triage at scale and with transparency,

connecting individuals with the right care endpoints

— at the right time


52

One-time installation fee:

$5,000 one-time implementation fee

Monthly fee:

$450 monthly fee

(includes up to 360 users)

$1.25 per user per month

for each user over 360

PRICING AND FEE STRUCTURE

PER CLIENT

EXAMPLE

Client with 300 users per

month will pay $450/month

Client with 600 users per

month will pay $750/month

300users

600users


Optional service funds (such as wellness funds or communications funds) can be used.

Any customizations will be priced separately.

A “user” is one who completes a minimum of one complete flow through the Buoy product in a calendar month.

DIGITAL CLEARANCE TOOLS FOR THE WORKPLACE

53

Powered by

Employee answers a brief questionnaire to assess symptoms and exposure.*

READY

Employee receives

a digital pass that

can be scanned or

shown for site entry.

NOT READYEmployee is

instructed

to stay home.

Within the tool,

she can find

resources to

understand her

risk profile and

easily search for a

nearby testing center


*Employees are evaluated on items such as exposure, symptoms, testing

results and/or occupational and activity risk amongst other criteria.

MAKING INFORMED,

WORKPLACE-SPECIFIC DECISIONS

54

Get daily reporting to understand infection

rate shifts and make more informed decisions*

View employee status in real-time

Aggregated view of clearance by date,

time and location

Clearance status by risk category

*Data is aggregated and cannot be de-identified without the employee’s express and written consent.


MOVING FORWARD AS SAFELY

AND SECURELY AS POSSIBLE

55

A digital platform that gives employers:

An efficient, daily screener to automate site entry

A readily available marketing toolkit to educate

employees and reduce work for HR managers

Accurate, regularly updated clinical rules to ensure

you are using up-to-date CDC guidance

Real-time analytics to enable workplace- and

location-specific decisions

Targeted access, employee access for onsite workers only

REOPEN AND REMAIN OPEN.


FULL LAUNCH & OperationsSOFT LAUNCHEVANGELIST

TRAININGCREATION

56

IMPLEMENTATION

DISCOVERY

ROLLOUT ONGOING

• Employer

playbook

• Discovery

Checklist

• Back With CareTM

URL Delivery

• Client procedures

• Employee

communications

• Employer training

• Initial user feedback

• Updated procedures

and communications

if needed

• Launch with initial

work site!

• Access to Back With CareTM Real-Time

Dashboard

• Daily Back With CareTM trend reporting

via email

• Buoy Product and Feature Updates

• End User Helpdesk Support to

employees ([email protected])

Contact your Cigna sales representative to start a short set up process*.

Cigna will work with you to kick off the implementation process.

*In some cases a longer implementation timeline may be required if you would like to configure the care resources available

for your employees within the Back With CareTM experience.

IMPLEMENTATION MAP

Early adopters – Process begins early August



57

All pictures are for illustrative purposes only.

Buoy is a trademark of Buoy Health, Inc. The Buoy website is operated by Buoy Health, Inc. Buoy Health’s services are not intended to be a substitute for professional

medical advice, diagnosis or treatment. Your use of the services is voluntary and subject to Buoy Health’s terms of service and privacy policy. In a true emergency, don't

wait. Call ahead to your nearest emergency room or call 911.

Product availability may vary by location and is subject to change.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation including Cigna Health and Life Insurance Company

(CHLIC) or its affiliates.

946752 07/20 © 2020 Cigna. Some content provided under license.


A BETTER WAY to take care of business

kp.org/choosebetter

LGIT Annual Meeting


59

New Insurance Option for LGIT Health Plan

KP LGIT Health Plan

▪ Municipalities not currently enrolled in the LGIT program will have the opportunity to join LGIT Health Plan with Cigna and Kaiser Permanente.

▪ This opportunity is usually afforded to Counties and the State but is now available to all municipalities with over 50 FTEs

▪ Offers choice between four low cost Kaiser Permanente HMO options at preset rates combined with a self-funded option through LGIT with Cigna as the main insurer.

▪ The best of both worlds where it allows municipalities achieve maximum financial efficiency and offer choice to their employees.

▪ Members can switch plans and insurers during yearly open enrollment (Cigna to Kaiser, Kaiser to Cigna, Kaiser to Kaiser, Cigna to Cigna).


60

New Insurance Option for LGIT Health Plan

KP LGIT Health Plan

▪ Quoting will be available through PSA Financial and Benecon (plan

administrator).

▪ Benecon will be responsible for the set up of the billing and enrollment

process (adding, deleting members, etc).

▪ Benecon will receive the enrollment file and forward Kaiser Permanente

its segment of membership.

▪ Over 150,000+ Government, Municipality, and County employees

already call Kaiser Permanente their Health Plan of Choice.

▪ Kaiser Permanente is the Ranked #1 HMO in the region. LGIT has a

proven track record of savings and service.


61

Kaiser Permanente in the Mid-AtlanticKaiser Permanente offers our members superior quality, market-leading convenience, and highly coordinated care through an Integrated Care Delivery Model.

KP Medical Service Area

• Most US health care is fee for service

driven and disjointed

• KP care & coverage work cooperatively

• Medical data, workflows, population

mgmt. tools are fully integrated via the

world’s largest civilian EHR system:▪ Makes resources more accessible

▪ Engages patients in self care

▪ Identifies problems early

▪ Avoids care gaps

▪ Prevents medical errors

▪ Reduces waste

▪ Corrects inefficiencies

▪ Lowers costs

▪ Improves patient outcomes


62

Kaiser Permanente in the Mid-AtlanticWith the largest multi-specialty physician group practice in the region, supported by state-of-the-art technology, Kaiser Permanente offers our members superior quality, market-leading convenience, and highly coordinated care.

Fast facts:

▪ Located in the District of Columbia, Maryland

and Virginia

▪ Over 785,000 members

▪ More than 1,700 Mid-Atlantic Permanente

Medical Group physicians

▪ Over 10,000 employees

▪ 34 medical facilities (Five Hubs)

▪ 24 hours / 7 days / 365 days care available

▪ Fully supported by Comprehensive EMR

KP Medical Service Area


63

We Are #1 In Quality Patient Outcomes


64

Chart Note: NCQA’s Private Health Insurance Plan Ratings 2017-2018; NCQA’s Medicare Health Insurance Plan Ratings 2017-2018

Highest in Healthcare Quality Rankings

What the Experts Say About KP


65

Our Medical Group now covers over 52 medical and

surgical specialties

1,732 physicians

Over 1,100 board-eligible / board-certified physicians

have joined us since the beginning of 2009

Physicians recognized

in the November 2019

“Top Doctors” issue


in the February 2019



in the November 2019


169 199 37Northern Virginia Magazine Washingtonian Magazine Baltimore Magazine

How KP Physicians Measure Up

Hiring & Retaining Top Physicians


66

Plan Options that Give Employers Choice


HMO DHMO HDHP POS

Description

A plan that covers care

provided by in-network

physicians, with

predictable copays and

out-of-pocket

maximums.

An HMO plan that

shares costs between

the employer and

employees and offers

lower premiums.

A plan with a higher

deductible than a

traditional insurance

plan. The monthly

premium is usually

lower, but you pay more

health care costs before

the insurance company

starts to pay its share.

A plan that offers point-

of-service (POS) care,

with the option of

choosing physicians and

services from an

external provider

network.

Employee

Advantage

+ Lower out-of-pocket

costs

+ Care coordinated by a

primary care

physician

+ Lower premiums than

regular HMO plans

+ Care coordinated by a

primary care

physician

+ Lower premiums

+ Pre-tax funds can be

used for expenses when

combined with an HSA.

+ Broader choice of

primary care physicians

Out-of-network

coverage

No

(except for

emergencies)

No

(except for

emergencies)

Yes

But at a higher cost

Yes

But at a higher cost

Annual deductible

No Yes Yes No

(for in-network

coverage)

Copays

Yes

($0 copay child under 5)

Yes


No

after deductible is meet

Yes

(for in-network

coverage)


67

KP Product Categories


Technology Turbocharges our Care

The Power of Technology

Every provider in the Kaiser

Permanente Medical Group is

connected to each other and

to the world’s largest

civilian electronic health

records system. This allows

our physicians up-to-date

information on members’ care,

the ability to study data from

more than 9 million records

to detect signs of emerging

chronic conditions, and access

innovative population health

management tools.

This connectivity means

faster, better-informed

decisions from physicians

and better treatment paths for

you.


69

▪ From any computer with an internet connection, or Smartphone (via an iPhone or Android app), at any time of day or night, Kaiser Permanente members can:

• View their own medical record, all visits

• Securely email their Permanente Doctor

• Schedule appointments

• Fill prescriptions (free home delivery)

• View lab test results

• Print immunization records

• Review their list of medications

▪ Nationwide, millions of Kaiser Permanente members are using this convenient, time-saving technology.

Mobile and Virtual Care

KP Mobile Medicine


70

Empowering Wellness as a Business Strategy


Kaiser Permanente Workforce Health Value AddOur effective workforce health programs can help protect your business

from the rising costs of health care.

Workplace challenges

▪ Physical activity programs

▪ Other Team Challenge programs

Motivational tools

▪ Comprehensive Rewards Program

➢ Health Engagement Platform

▪ Custom communications

Measurement tools

▪ Reporting and analytics

▪ Assessments and evaluations

Consultative services

▪ Workforce Health consulting

▪ Team of health promotion professionals

Onsite services

▪ Health promotion classes

▪ Health screenings

▪ Flu clinics

▪ Healthy Picks vending machine program

▪ The FruitGuys delivery program

Digital and Telephonic

▪ Total Health Assessment

▪ Healthy Lifestyle Programs

▪ Wellness Coaching by Phone

▪ 24/7 access via KP.org

▪ 24/7 Access via video visits

Healthcare as a Business Strategy


Tools and resources for members

kp.org: A hub for managing health

Total Health Assessment

Health and drug encyclopedias

Symptom checker

Healthy lifestyle programs

Health videos

Total Health Radio online radio show

and podcast

Healthcare as a Business Strategy

Mark Kunkle, Director Program Management

[email protected]

Questions?

Andrew Belmear, Senior Account Manager [email protected]

Michele Keplinger, Communications and Member Services Manager

[email protected]

Kenneth Huber, Executive Vice President,

Employee Benefit Group

[email protected]

Kyle Sanders, Senior Sales Executive

[email protected]




