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Wellness Program (building a culture of wellness)
Plan Design / Strategic planning Negotiations (The many pockets)
Weight High Blood Pressure Lack of Exercise High Cholesterol / Lipids Stress/depression Smoking / Chewing Tobacco
EARLY DETECTION IS KEY
Initially at a Renewal One to five percent of premium Presented as being proactive verses
reactive to increasing health care costs (Risk Management)
Investing in Wellness has a conservative ROI (return on investment) of 3 to 1
Incentives to participate in early detection initiatives with early detection testing and health questionnaires
Weight loss challenge Walking programs Mammogram Van Exercise incentives and programs Stop Smoking program Influenza vaccinations Health Fairs On Site Clinic Create a “Culture of Health”
Organized teams in competition Pedometers Prizes - - ---everyone LOVES a prize Free food Education and participation is the key 10,000 steps a day
Ultimate goal is active participation and education - -- - -loosing weight is a bonus
Weekly guest speakers Discounted memberships to fitness
centers 100 start a ten week journey You are successful if 50 weigh in on the
last week and have attended at least 6 of the ten meetings
What is the cost? $20 to $30 per person for a ten week program
Cost is $20 to $25 per person You can set this up at a discount where the
employee pays $10 and the entity pays the balance
Done on site Total employee time takes 5 to 8 minutes
from the IN to the OUT
They come to YOU Cost is $100 total providing that your carrier
will cover the cost. (most will) They require at least 21 to participate, and
can accommodate up to 41 per day. Think in terms of 8 to 12 participants per
100 employees Professional service that only takes 20
minutes per each employee total
Health Risk Appraisals Cost of $50 to $65 per participant Includes; Health Questionnaire Full blood draw to test cholesterol, HDL,
LDL, triglycerides, glucose, kidney & liver function, nutrition, iron, bone, electrolytes, blood pressure, body fat, height and weight
15 to 25% of your employee population So - - -- you have 400 employees - - ---100
X $50 = $5,000 With incentives of $50 or more then 35 to
60% will participate With incentives of $100 or more then 75 to
80 percent will participate
Discounted Premiums Everyone pays 10 percent more Everyone who participates in one of the
diagnostic wellness initiatives will receive a 10% discount on their premium
Participation went to 99%
On site nurses performing finger prick blood tests
On line questionnaires. Some with incentives to employees
The costs vary but can be built into the renewal
Budget $8,000 per weekly hour Staffing (PA, Nurse, Doctor oversight) Purpose Include (CDL exams, drug screenings,
Workers’ Compensation, Spouses and down the road Children)
Paying our employees not to take our coverage if they have coverage elsewhere
$150 (about 50% of our current employee only premium) to elect not to take our health care coverage
$15 (about 50% of our current employee only premium) not to elect to take our dental coverage
Tri Care eligible employees are excluded by federal law
Traditional with Co-pays and low deductibles
Higher deductibles with Health Reimbursement Accounts (H.R.A.) attached
High Deductibles ($1,250 or more) with Health Savings Accounts (H.S.A.) attached.
Doctor co-pays = .5 to 3 % E.R. & Urgent co-pays = .5 to 2.5 % Drug co-pay co-insurance = 1 to 5% In & out patient deductibles = 1 to 25%
Gradually increase Deductibles Higher Deductible w/HRA Dual plan / High Deductible w/HRA & High
Deductible w/ H.S.A Three tier – HRA and two H.S.A. $1250 and
$2500 Employees receive monies on all “high
deductible” and H.S.A. accounts
Commission vary from 1% to 7% KNOW WHAT YOU ARE PAYING. What level
of service do you expect/demand Fee for service Utilize a hybrid compensation so that your
line items are not affected
Renewal pricing should never be a surprise Five months prior to the renewal date look
at trend Trend in losses reducing - -GO Trend for losses going up - -- WAIT Loss trend is flat - -- wait one month
Losses, + medical trend, + 20% Losses 84% + medical trend at 11%, + 20%
= 15% increase First pass at 25% increase with a reduction
to 16% with very little negotiating Broker / agent has little to do with this initial
decrease. You can do this easy. Target is; losses + medical trend + 10%
Carrier’s first number Second number Carrier’s Real number The Negotiated number (Both sides feel the
Pain) The Final DEAL (You are in Control)
Be (FACE TO FACE) with the “senior” underwriter. Everyone else is secondary to the discussion.
Do have the most senior carrier sales representative present
YOU are the best salesperson for your organization - -not your broker or agent
Be excited about your wellness initiatives and participation levels / Stress what is changing for the positive.
Ask the Underwriter to think outside of the box
When you are close to a deal ask for what is in the “other” pocket. (Wellness dollars)
If you are changing carriers, get a clear commitment on what the following year’s renewal will look like given the same losses and medical trend
The “NEW” business pocket
Managing the Monetary Risk of Health Care
Keeping the healthy, healthyCaring for our employees and their families