To the Participants:

• The phone lines have been muted• You may type you questions in the GoToWebinar box on the right• Q & A will be sent in a follow up email• Recorded webinar will be posted at www.TheBrokerageInc.com

Are you ready for the 2016 ACA OEP?

Medicare OEP – October 15, 2015 through December 7, 2015Affordable Care Act OEP – November 1, 2014 through January 31, 2016

Agenda for 10-23-15• ACA updates• 2016 OEP Enrollment Expectations• 2016 Certification

• ACA – FFM & CMS Enterprise portal• Carriers specific info

• ACA Qualified Health Plan Options from The Brokerage• BCBSTX• Baylor Scott and White• Humana One• Memorial Hermann• Oscar Health• UnitedHealth One

Agenda 10-23-15 continued

• Marketing• Retail• Lead Programs

• Where to get info at www.TheBrokerageInc.com• Quotes and Enrollments with RabbittApp

What’s going on today?

From the “ACA Observation Deck” at The Brokerage

Key findings from KFF

• Beginning in FY 2014, policy changes introduced by the ACA have been driving Medicaid enrollment and spending growth.• Medicaid enrollment and spending increased substantially in FY 2015• the first full year of implementation of the major ACA coverage expansions.

• Total Medicaid enrollment and spending growth is projected to slow in FY 2016• looking ahead, states will monitor the effects of the ACA and other payment

and delivery system reforms on spending. 

Findings from Deloitte Survey: Employers and Private Exchanges• Potential for decreasing costs• Simplifying the employer’s role in benefit administration• Providing employees with comparable, higher-quality coverage at a

lower cost• It appears that the trend of employers embracing the shift to private

exchanges may be growing• Since there is an expressed willingness to move, understanding

employers’ preferences and concerns will likely be crucial for health plans and other stakeholders in the private exchange business

In a recent healthinsurance.org article:• Charles Gaba estimates enrollment on the public Marketplaces will

swell to 14.7 million in 2016• 25% increase from 2015.

• According to Gaba: “The CBO seems to think that this is the Big One. They’re betting that an additional 5 million people will be dropped from their ESI coverage next year. It looks to me like the CBO strongly believes that most of those folks will be shifted over to the individual exchanges.”

5 Reasons For Continued Marketplace Enrollment Growth in 2016

1. Technical and feature improvements (of exchanges).2. Increasing Individual Shared Responsibility penalty for not being

covered.3. Dwindling transitional/grandfathered plan enrollees.4. Loss of employer-sponsored insurance (ESI) coverage.5. Increased consumer outreach.

Individual Shared Responsibility Fee

5 Reasons Not to Hold Our Breath

1. Premiums will be going up for many people.2. High deductibles and co-pays are going to be an issue for others.3. The penalty for not having coverage may still not be a big enough

incentive.4. There is no more low-hanging fruit - meaning many of the

uninsured who were previously uninsurable now have coverage. The remaining uninsured are harder to reach or incentivize.

5. Competition from other forms of coverage.

2016 Agent Certification

Medicare and ACA certification instructions are online at www.TheBrokerageInc.com

You will receive this memo in our follow up message to this

webinar.

2016 Qualified Health Plan Updates

BCBSTX

• Today is the last day to submit POR forms. We will shut them down on 10/24 for Open Enrollment. • Update on CMS Window Shopping: CMS notified us that the

Marketplace window shopping is targeted to go live on Sunday, 10/25; however the provider and formulary search features will not be available until 11/1. • BCBS Window Shopping is still available on our website and the

Express Link. Our 2016 Provider Finder will be updated on 11/1.

BCBSTX Updates

• 2016 Materials: Plan Comparison Charts and the BlueCare Dental Flyer are currently available in the Supply Portal in both English and Spanish. Paper rates will be released on 11/1. • Paper Apps: If you need to submit an SEP more than 45 days in the future, you will

need to complete a paper app. (We identified a system issue and are working to correct this.) Also, remember that if you want to submit 11/1 or 12/1 apps, those also need to be done by paper. Please make sure your agents save the fax confirmation or the Portal upload tracking number in case they experience app processing issues. • BCBS Product Training (click here): This was emailed to producers in the 10/19 News

Alert email and has now been posted to BAP (under Individual > Training & Admin). We will not be posting this on ComplianceWire this year. This training is not required for selling either On or Off Exchange, but is strongly recommended since the products are changing.

Blue Access for Producer (BAP) Enhancements

• Seeing your production made easier• Commissions• Quotes• Online apps – with subsidies via HealthCare.gov • Status

Regional plan: Memorial Hermann

ACA and Medicare plans…

Humana

• H1• Individual and Family coverage

• Medicare• Medicare Advantage• Medicare Supplements• Prescription Drug Plans

Marketing and Leads

Shared Same Day Internet Leads*Batch Size Cost per lead

25+ $6.00

100+ $5.50

500+ $5.00

1000+ $4.50

Orders are taken over the phone… EM Insurance Leads

Call (800) 439-5095

Retail, Provider, Community Based Marketing• Contact Kristina at 800-442-4915 for store assignments• Kristina’s direct line is 469-635-6785

• H.E.B. (over 70 stores assigned to The Brokerage)• Houston, Corpus, South TX (RGV), Waco, Austin, San Antonio

• Walmart (over 100 stores assigned to The Brokerage)• Ridgmar Mall in Ft Worth (UHC One opportunities)

H.E.B. for ACA and Medicare MarketingThe Brokerage

has been awarded over

70 H.E.B. locations in

2016

DirectHealth.com (new Walmart opportunity)

• New rules, strict protocols!• $500 buy in• May be reimbursed up to 100% by

TBI with production

• Branded shirts to be purchased by participants

Online ACA Quote and Enrollment Tools

Online ACA Quote and Enrollment Tools

Features RabbittApp HealthSherpa

Per exchange app charge $6 $10

On and Off Exchange Apps On and Off-Exchange Off-Exchange only

CRM Yes Yes

Physician Finder Yes Yes

Licensed to enroll without an agent No Yes

Commission Tracker Yes No

Comprehensive, Real Time Reporting Yes No

Add on Ancillary Sales Yes No

Ability to upload documents to HealthCare.gov

Yes Yes

Enroll to use RabbittApp

You will need your NPN, FFM

User Name and

Password to register!

RabbittApp Confirmation

Daily RabbittApp Training Webinars

Wrap up and observations…

ACA Customer Enrollment Tips

1. Review: Plans change, people change – review your coverage and look for a letter from your plan about how your benefits and costs may change next year, 2. Update: Starting November 1, log in and update your 2016 application - make sure your household income and other information is up-to-date for next year, 3. Compare: Compare your current plan with other plans that are available in your area4. Choose: Select the health plan that best fits your budget and health needs 5. Enroll: The marketplace opens on November 1, make sure to review, update, compare and choose by December 15 to have any changes take effect on 1-1-16. Contact your agent after you’ve enrolled and make sure you pay your first month’s premium.

What to expect moving in the 2016 OEP• Encourage your clients to re-determine their subsidies for 2016• If subsidized, encourage your clients to shop their current plan to

make sure they are getting the second lowest Silver plan • IRS reconciliation in April 15, 2016• CMS prefers to keep the disruption to a minimum and focus on

getting more people insured

Questions and Comments

Please type your questions or comments in the Q&A box to the right of your screen. We will answer all questions and send a follow up email to all participants. This

webinar has been recorded and posted at www.ThebrokerageInc.com