HOW TO SURVIVE AND THRIVE AFTER HCR:A Massachusetts Broker’s Perspective

August 19, 2014

HL1

Slide 1

HL1 Ha Le, 8/13/2014

Todays Agenda:

•A Possible Train Wreck

•This Years Legislation in California

•Your Future Success

Quick Reference

Participating Auto-Renew Groups Eligible Quoting

Aetna No ACA Plans N/A N/A

Anthem Blue Cross Yes 2013 Plans Oct, Nov, Dec In QuoteStar

Blue Shield of CA* Yes 2013 Plans Oct, Nov, Dec In QuoteStar

CaliforniaCHOICE® Decision Pending

Health Net Yes Sep: ACA Plans

Oct-Dec: 2013 Plans

Sep, Oct, Nov, Dec Carrier only

Kaiser Yes Sep-Oct: ACA Plans

Nov-Dec: 2013 Plans

Sep, Oct, Nov, Dec In QuoteStar**

SeeChange Yes 2013 Plans Oct, Nov, Dec In QuoteStar

UnitedHealthcare Yes Sep: ACA Plans

Oct-Dec: 2013 Plans

Sep, Oct, Nov, Dec Carrier only

* Non-Contracted Carrier

** Kaiser GF & GM Plans Combined

Resources:

LISI Website:

Tools & Resources > Sales Tools

• Grandmother Guidelines (SB 1446)

• Master Plan List Mapping (2013-2014)

How to Survive and Thrive

Under the ACA “A Massachusetts Perspective”

August 19, 2014

Presented by Mark S. Gaunya, GBA

What does healthcare reform look like in

?

Massachusetts Healthcare Reform

Sources: Kaiser Family Foundation, MA Division of Healthcare Finance and Policy, Wall Street Journal, March 2010, Steven Walsh (D),

Chair MA Healthcare Financing Committee, 2011

�Did MA insure the uninsured?

�National average insured rate is 83%

�MA has highest insured rate in country at 97%+

�Did MA reduce the cost of healthcare?

�In 2006, state healthcare budget was $12 billion

�State healthcare budget now exceeds $16.5 billion

�Healthcare costs in MA ($9,278) are 36% higher per capita than US average ($6,815)

“It has been a fiscal train wreck” – State Treasurer

YES

NO

Massachusetts Healthcare Reform

Success or Failure?

� 41% of state budget, by 2020 projected to be 50%

� 60% of small groups will receive increases from 10% to 97%

� $27 billion of unneeded care still in system

� Emergency room visits 13% higher than national average

� “Global Payments” (capitation) making a comeback� trend still accelerating by 5-8%

� 39 day waiting time for family physicians

� 50 day waiting time for internal medicine

� 50% of PCP not accepting new patients

Cost is up and access reduced by 1/5th over 7-9 years

Source: MA Medical Society, MA State Budget, Pioneer Institute, United Healthcare, Boston Globe

Massachusetts Healthcare Reform

What’s Happening Now?

� Un-insuring the insured

� Fully-subsidizing un-insured at cost of $10 million per month

� Fully-functioning Exchange website is no longer viable

� Exchange board creates parallel tracks for website fix

� 4 of top 10 health plans hemorrhaging red ink ($151M in Q1)

� State will spend $500m to comply with ACA regulations

The ACA is moving Massachusetts in the wrong direction

Source: Boston Herald

How can YOU

“Survive and Thrive”

Words are Powerful

Words are Powerful

� Broker or Strategic Advisor…there is a difference

� Licensed professional with continuing education requirements

� Help clients manage #2 or 3 expense (investment)

� Ensure compliance with federal and state laws and regulations

� Develop customized employee benefit risk management solutions

� Help clients create a culture of health and well-being

� Advocate for the employer, employees and their families

� Solve problems…definition of outstanding service

Advisors are an extension of their clients

Business Owner

or Producer?

Borislow Insurance

� Founded in 1982

� 42 employees in Boston, national network of 142 firms (UBA)

� Strategic Partner to 350+ clients

� Service over 40,000 employees and their families nationwide

� Thought leaders – published two books & created a mobile app

� Industry leaders – state, regional, national and international

participation (NAHU & MDRT)

� Policy Influence – advisory board members to major insurance

companies and government authorities

We are an innovative Benefits solutions,

HR and technology firm that partners

with our clients to build health and

welfare strategies that save them

Time and Money

How do we help?

�We are highly consultative and hyper-focused on relationships and delivering overall value

�We excel in risk management, program design, compliance, consumerism, health, well-being and client service with a personal touch

How do we help?

…Way Beyond Brokerage TM

Client

Designed to partner with our clients

Human Resource

Consulting

Risk Management and

Financial Reporting

Individual Insurance &

InvestmentsCompliance and

Regulatory Support

Health and Wellness

Health & Welfare

Strategy

Communication

and Education

Retiree

HealthcareInternational

Benefits

Culture of Gratitude

Charitable Giving MISSION STATEMENT

Borislow Insurance is committed

to supporting charitable causes

and organizations in our

community dedicated to

making a difference in the

lives of those less fortunate.

GIVING BACK to the Community

� Adopt-an-Island

� Adopt families duringthe holiday season

� YMCA- backpacks, pumpkins and wish lists

� Easter Baskets

� Habitat for Humanity

� Youth Summer Camp

Growth Strategies

&

Solutions

Succeeding in turbulent times

�Adversity is the breeding ground for opportunity

�Know your sweet spot and focus on it

�Know how you make a difference, keep doing it

�If it can’t be measured, it can’t be improved

�Interaction with clients is the top priority

�Being transformative is the highest level of value

Right strategy and right attitude = success

Growth Strategies

Focus on quality not quantity of prospects – BOR or bust

Focus on creating value vs. selling product

Create new structures and operating models

Partner with independent/small brokers who fit culturally

Build strategic partnerships with COI

Promote physical and financial well-being – whole person

Leverage intellectual capital

The currency of the future is creativity and innovation

Practical guide with client case studies

Featured In…a few publications

Employee Benefit Adviser

Employee Benefit News Health Insurance Underwriter

Magazine

Intellectual Capital – The BEST business card

Investing in developing technology

NEW Tools & Resources for our clients

CaptivatedHealth.com

When you need

answers or resources –

Captivated Health is

accessible 24/7

Brand New publication!

Living an attitude of gratitude

Closing Remarks

�MA healthcare reform IS a preview of things to come

� The Affordable Care Act (ACA) will NOT control costs

� Building healthcare confidence is the only way

� The currency of the future is creativity and innovation

� Survive and thrive by:1. Refining your vision

2. Investing in your people

3. Building a culture of health and wellness

4. Employing a flat, flexible operating model

5. Giving back to the industry and communities you serve

Success is only limited by your imagination

QUESTIONS?