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2022 Annual Benefit Changes: Enhancements in Ohio's Portfolio and Selling Strategies

The 2022 Annual Benefit Changes (ABCs) in Ohio introduce significant updates in healthcare offerings, focusing on portfolio management and compliance with healthcare reform. Key changes include the simplification of the 2-99 portfolio, new cost share options, and various enhancements to the pharmacy portfolio. Strategic efforts have been made to address market gaps and to remain competitive against notable players like UHC and Humana. Essential communication dates and strategies to navigate these changes will be covered to ensure effective client engagement and successful implementation.

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2022 Annual Benefit Changes: Enhancements in Ohio's Portfolio and Selling Strategies

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Presentation Transcript

  1. Annual Benefit Changes (ABCs) Ohio

  2. Agenda • Back ground on • changes • Review of portfolio • changes • Selling Strategy • Communication • dates • Consultative • Selling • Questions

  3. Background on Changes

  4. Changes • As a result of complying with healthcare reform – from an admin • Lean but still attractive to groups and members – we made some reductions, we had some gaps – we created new plans to fill the gaps. Price points • Added some additional plans to meet cost shares • Stay competitive – managing portfolios = address gaps that were present – competitors – simplify portfolio Options that groups are going to have

  5. Objectives of ABC Changes

  6. ABC Objectives 2012 ABCs will focus more on portfolio management and less on benefit modifications • Simplified 2-99 portfolio with new cost share options to fill price point • gaps and offering different Rx options special enhancements to 2-50 • Pharmacy portfolio standardization and modification • Benefit enhancements for Lumenos

  7. What are the changes?

  8. Portfolio Changes

  9. Pharmacy Changes

  10. Health Care Reform • Anthem will comply with the HHS recommendations for Women’s Preventive effective 8/1/12. Several of these services will not require additional services, because the services are already covered based on other recommendations. The guidelines are listed below.

  11. Future Lumenos Enhancement List date TBD • Physician home and office • Specialist office • Urgent care • Emergency room • Rx

  12. Future Lumenos Enhancement List date TBD

  13. Selling Strategy, Competition and Processes

  14. What is the competition doing? • Observations and Opportunities • We are leaner than UHC in portfolio size in the Key market. Humana is • larger due to 2-99 single portfolio • We offer fewer 0% plans than either competitor • Humana now offering plans with $300-$350 copays. UHC $250 ER on all. • We offer $250 ER on select plans • We are the richest with a $200 and $250 deductible (on Key portfolio) verses • $500 as the richest with top two competitors • We offer fewer HAS 100% plans than UHC who offers 10; Humana offers 3 • UHC offers an HRA product with Rx copays day on and an embedded • deductible resulting in challenges and group loss for sales • We offer the richest 4 tier Rx option • Gaps identified on SG and Key that must be addressed with new portfolio

  15. Selling Strategies Market Segments: Funding Arrangements:

  16. Updated SQFs and SOBs

  17. Important Dates

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