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RightOpt® From Hire through Retire® Facilitating Individual Coverage Options for
Part-time, COBRA, and Pre-Medicare Retirees,
with Special Guest from Panera Bread
Today’s Objectives
Help you better understand: • How public and private exchange offerings can work in tandem to provide a breadth of
insured products
• Why employers are interested in supporting ineligible populations in shopping for insurance
• What the members would experience when shopping through a combination public and
private exchange
Sherri Bockhorst National Practice Leader
Health Exchange Solutions
Buck Consultants at Xerox
David Foster Market Leader
Health & Productivity
Buck Consultants at Xerox
Misi Holmberg Sr. Manager
Benefit Operations
Panera, LLC
2
Employer Interest is High and Growing
Percentage of large employers considering a private exchange by population.
*Source: NBGH Large Employers’ 2014 Health Plan Design Survey, August 2013; Percentage considering private exchanges in 2015 or after.
30%
15%
20%
41%
26%
40%
0%
10%
20%
30%
40%
50%
Full Time Actives Spouses Part Time Actives COBRA Pre-65 Retirees Medicare Retirees
3
Uninsured Rates Among Actives is High
Critical opportunities for
individual coverage:
• Approximately 1/3 of those
eligible but not enrolled, and
1/3 of those not eligible, are
uninsured…that’s 9.2M
uninsured employees
working for large employers
• Approximately 2%, or nearly
1M individuals are covered
under COBRA
41.3M
11.7M
5.4M
2.2M
2.9M
7.7M
FT PT
Coverage through employer
Eligible, not enrolled
Not eligible
Insurance Coverage For Workers
Source: Health Insurance Coverage Bulletin; Abstract of Auxiliary Data for the March 2013 Annual Social and Economic Supplement to the Current Population Survey
Employers with over 500 employees.
4
Help people avoid penalties
related to ACA’s individual
mandate
Provide personalized and
more consistent shopping
experience across the public
and private marketplace
Create affinity to the
organization by providing
support and access to
additional ancillary benefits
Notify COBRA participants of
additional options available
in the individual market,
potentially with a government
subsidy
Support access to federal tax
credits that may save
employees money on health
care expenses
Offers a combination of
website and call center
concierge support
Why Employers Facilitate Access
Supporting members through a low to no-cost solution helps
you and your employees.
5
Medical Insurance Support for 2015
Phone + RightOpt Portal
• Licensed agents will help customers claim tax credits, compare plans and enroll – via phone and Internet co-browsing.
• Customers can self-serve through RightOpt portal, where they can compare plans using the GetInsured Plan Score, claim tax credits and enroll.
Phone + State Exchange Site
• Licensed agents will help customers claim tax credits, compare plans and enroll on the state’s marketplace site – via phone and Internet co-browsing.
Referral Only
• Following subsidy eligibility, customers will be referred to state marketplace for enrollment assistance.
FFM States:
Phone + RightOpt portal
State-Based Marketplaces:
Phone + state website
Referral States
Referral States (2) Enrollment States (49)
Fully integrated solution leveraging
certified Web Based Entity, GetInsured,
for eligibility, shopping and enrollment
6
Of those who completed pre-enrollment
information were eligible for a premium tax
credit
Key Stats from 2014 Enrollment (RightOpt)
77%
Of those who looked at plans on-line enrolled
with us 21%
Of those interacting with us chose web only /
co-browsing / telephonic only support 11/80/9%
7
Making it Easy
With Xerox + GetInsured, our clients empower individuals to…
Determine if they are eligible for premium tax credits, Medicaid or an employer subsidy.
Return to the site for additional support regarding health care utilization and improvement.
Shop for a best fit health insurance (medical, dental and vision) through phone and online support leveraging available subsidies.
1 2 3
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Employer toolkit of template
language for announcement
letter, FAQs, employee
presentation and new hire
letter; plus RightOpt
branded poster and
postcards
Health
Reimbursement
Account
management
Telephonic health
advocacy
A Turnkey Solution
In-person or
webinar
meetings for
eligible
populations Outreach call
introducing
RightOpt
Public subsidy
calculation, plan
compare & selection
Telephonic and
on-line plan
enrollment support
Client-branded
portal, custom
URL and toll-
free number
Fully branded
custom
communication
campaign
RightOpt branded
member
engagement portal
Plan renewal and
qualifying life
event enrollment
support
Pre-enrollment
Engagement, Education & Eligibility
Enrollment
Plan Comparison & Enrollment
Post-Enrollment
Renewals & Support
Above the line = no cost
Below the line = additional fees
24
Panera Bread, Special Guest Presenter
PAGE 26
September 30, 2014
Our Road to RightOpt
Supporting the Various Needs of our Associates Post-ACA
PAGE 27
Company Background
• Panera Bread began in 1981 as Au Bon Pain, Co., Inc. founded by Louis Kane and Ron Shaich, the company prospered along the east coast of the United States and internationally.
• In 1993, Au Bon Pain Co., Inc. purchased Saint Louis Bread Company® and underwent a comprehensive re-staging between 1993 and 1997 during which average unit volumes increased 75% and the concept’s name was changed to Panera Bread.
• Now, Panera has 1,838 bakery-cafes in 45 states and in Ontario Canada operating under the Panera Bread®, Saint Louis Bread Co.®, and Paradise Bakery & Café® names.
PAGE 28
The Challenges and Opportunities
• Simplify
• Easily distinguishable plan offerings
• Continue to offer cafe hourly associates meaningful benefit coverages
• ACA impacts
– ACA regulations required a change to cafe hourly associates existing benefit offerings
– The calculation of full-time status among variable hour associates adds a great deal of workplace management difficulty
– Communicating and educating associates about the private exchange opportunities
– Create competitive advantage where possible
• Need for a new approach to health care to mitigate cost increases and reform changes
PAGE 29
• Fall 2013 enrollment
– Implement RightOpt‘s individual market channel to support education and enrollment in the Public Marketplace
– Implement Preventive MEC plan to replace Limited Medical Plan offerings
• Summer 2014
– Move to Xerox benefit administration platform
• Fall 2014 enrollment
– Implement RightOpt’s full exchange capabilities for the 1/1/15 effective date
Phased Implementation
PAGE 31
2. Understand individual options…
PAGE 32
…and enroll through RightOpt’s PT solution
PAGE 33
3. Or enroll in Panera’s plan
PAGE 34
Retail Hourly Experience • 2014 enrollment results
– 10% of retail hourly enrolled in benefits, continued concern for the 90% not enrolled in Panera offerings
– Just under 5% reviewed options on the public marketplace, with nearly 80% qualifying for a tax credit
– Yet 85% of enrollees still chose the preventive only plan
• 2015 enrollment expectations
– Access to public marketplace continues to be important to Panera
– Enrollment in the public marketplace expected to be higher with increased confidence and reliability in shopping experience
– As uninsured penalties increase, we anticipate growth in public option enrollment
PAGE 35
Thank You!
Enhancing the members’ experience through their entire work/life cycle,
while reducing delivery costs and administrative burden
Eligible Actives
• Group plans
• Self-funded
• “Quilted” network
• Honeycomb of
partners to
service Choose-
Use-Improve
Ineligible Actives
& COBRA
• Individual insured
plans
• Public subsidy
access through
WBE
• Voluntary benefit
portfolio
Early
Retirees
• Individual
insured plans
• Public subsidy
access through
WBE, plus HRA
• Voluntary benefit
portfolio
• Health Advocacy
Medicare
Retirees
• Individual
insured plans
• Account
administration
• Medicare
transition
support
• Health Advocacy
RightOpt® A single experience from hire through retire®
36
Implementation Timing
For coverage starting in 2015, the Open Enrollment Period is November
15, 2014–February 15, 2015
Available for 1/1/15 open enrollment or ongoing support:
• Non client-branded solution is a turnkey no-cost solution with a 3-5 week implementation
requirement
• Additional customization available with timing, scope and fees to be determined based
upon needs
37
Contact Us
Sherri Bockhorst National Practice Leader
Health Exchange Solutions
Buck Consultants at Xerox
David Foster Market Leader
Health & Productivity
Buck Consultants at Xerox
Misi Holmberg Sr. Manager
Benefit Operations
Panera, LLC
38
©2014 Xerox Corporation and Buck Consultants, LLC. All rights reserved. Xerox® and Xerox and Design® are registered trademarks of Xerox Corporation in the United States and/or other countries.
Buck Consultants® and RightOpt® are registered trademarks of Buck Consultants, LLC in the United States and/or other countries. BR11887
Buck Consultants, LLC is the broker of record regarding insurance placed through RightOpt