Low Income Subsidy Plans Special Health Care Plans

Low Income Subsidy Plans Special Health Care Plans for the Working Uninsured

Public Law 08 -33 CGS The High Risk Pool is the sole issuer of more affordable comprehensive coverage for uninsured small businesses with 10 or fewer employees half of whom earn less than 300% of FPL The Premium is expected to be 40% below the market primarily from Medicare Reimbursement Rate but also web based enrollment and administration and moderate “finders fee” for brokers with No Profit for the Pool Employers transition to unsubsidized market in 3 years

Benefits and Rates Develop Managed Indemnity and PPO Plans with all of the 40 small group mandates in CT Calculate initial premium rates Develop 3 year premium stabilization options utilizing line of credit or reinsurance to fund claims for first three years and If profitable, retain profits to fund future losses then assess if there is a net loss after three years

Marketing and Communications Build awareness and successfully market these special plans to our pool’s various audiences through brokers and agents, small business people and other “influencers” in the state such as CPAs, financial advisors, Chambers, etc. Survey to understand the market Cost is the primary reason for not purchasing a plan Flexibility and ease of administration is almost as important

Marketing and Communications Observations There is no typical small business Many are new and many are well established but small Many have employees but many are self-employed or are a family business There are some predictable practices in employer sponsored group insurance Less than half of the owners of groups of less than ten have offered insurance to them If an employer offers and contributes then the employees will enroll

Marketing and Communications Strategy Focus on and engage product “evangelists” to successfully drive people to the website and sign up. Stress Key Attributes: Affordability, Comprehensive Benefits and “Web Easy” or simple paper eligibility, enrollment and billing Develop integrated web based system that reduces agent effort and pool administrative costs

Name & Tagline

Message Simplification Problem Many small business employers simply can’t afford to provide health insurance for their employees. Solution We offer more affordable coverage for the working uninsured.

Inspiration before information You had an idea. You’re making it work. Now it’s time to focus on health insurance for you and your employees.

The New Website About the Plan Provide all the information that “evangelists” (agents, brokers, CPAs, financial advisors, Chambers of Commerce) will need for their clients Quick and Easy Eligibility Determination Simple questions to self determine eligibility of the business Quick Quote Model quoted premium based on various employer contribution and employee participation rates

The New Website Agent Compensation and Registration Area Explanation of “Finders Fee” basis of compensation Quick and easy registration of the agency or the individual that will receive compensation if a group applies and qualifies Quick print or quick mail marketing packets Easy Employer Administration Area Option of doing web based administration or to print selfadministration packet Quick tour of the affordable, comprehensive healthcare plan and the advantages of group insurance to employers Structured walk through with web input of forms for entire application, enrollment and ongoing administration process

The New System for Application, Quoting, Enrollment Processes Receive marketing communications Learn about plans (MI, PPO), Determine eligibility, Get a quote, Apply, Web access at hospitals, Enroll the group physician offices, colleges, Email communications community centers, etc. Spousal waiver forms Small Agents & Brokers Employer Groups & Individuals Receive marketing communications Learn about plans (MI, PPO), Determine group’s eligibility, Get a quote, Submit group’s application, Enroll group, Receive finders fee payments Email communications Employees & Individuals Web-Based and Printed paper Application, Quoting, Enrollment System Pre-populated group and employee info, Plan info, FAQ’s, application and waiver forms Online quoting and application tools Review & approve applications Review enrollments Electronic Approval and mailing Call center and customer service Reporting and Control Pool Administrator Learn about the plans (MI, PPO), Enroll self, family when group approved Optional: Provide confidential health Information for self, family members to UHC Applications, Email and phone calls, Enrolled Groups, Members Claims Processing, Medical Management Web Based Administration System Eligibility feed: Enrolled Groups, Members Claims Administrator

Questions?