2016 Individual Exchange
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1 2016 Individual Exchange Alabama Not for Consumer Use
2 Agenda We are with you every step of the way Marketplace facts and helping consumers choose a plan UnitedHealthcare health insurance plans: 2016 overview UnitedHealthcare tools to manage health care and costs at home, work or on the go Where to find more information About UnitedHealthcare 2 Not for Consumer Use
3 3 The Marketplace and helping consumers choose a plan
4 Key Marketplace facts About 85% of people qualify for a subsidy Qualified individuals must buy a plan from the Individual Marketplace to receive a subsidy Individuals may lose coverage and/or the subsidy if they do not submit required information 87% of people saved an average of $263 a month with a Marketplace plan.* Visit uhc.com/tax-calculator Open enrollment is November 1, 2015, through January 31, 2016 Know the date when health coverage begins To keep coverage, pay the monthly premium when it s due *Projected savings based on qualification for a tax credit subject to verification upon filing an individual s federal tax return. Approximately 87 percent of individuals in Federally-facilitated Marketplace selected plans with tax credits and these individual have post-tax credit premiums that were 76% (an average of $264) less than full premium, on average. See Premium Affordability, Competition and Choice in the Health Insurance Marketplace, 2014, June 18, 2014, Department of Health and Human Services. Actual savings may vary. 4
5 What interested individuals want to know How much does it all cost? The premium: (monthly cost of the health plan) The deductible: (amount that must be met before the health plan begins to pay) The co-pay: (amount they can expect to pay each time they receive health care services or fill a prescription) Is my doctor in the network? Check the provider directory to confirm their doctors or clinics are in the network What prescription drugs does the plan cover? Check drugs and costs 5
6 Help individuals to choose a plan Ask individuals the three questions below to help find the plan that might be right for them Add up the points and go to the next page to see the results: pts. 6
7 Metallic plan recommendations* Based on total points, they might like: *Every metallic level plan includes access to the same doctors and medications. 7
8 Video to support plan choice Help individuals learn more about choosing a health plan Share the Choosing a Plan video from uhc.com Video steps consumers through the three main considerations when choosing a plan Available in English now and Spanish in November 8
9 9 UnitedHealthcare health insurance plans: 2016 overview
10 Plan types we offer in your state s Marketplace Co-pay Convenience of set co-pays for doctor visits and prescriptions HSA Plans that include the option of a tax-advantaged health savings account. If member qualifies for cost-share reduction that brings the deductible below the required level, the member will not be able to put money in the HSA. The member may continue to use any dollars in the HSA. Catastrophic Low-cost option for people under 30 or for those who are exempt from the ACA mandate 10
11 Facts about 2016 HSA contributions An HSA bank account lets people with certain plans put money aside, tax-free, to save and pay for health care expenses. Here are the maximum contribution amounts for 2016 Single plan: $3,350 Family plan: $6, and over: an additional $1,000 annually Required deductible to contribute: $1,300 single and $2,600 family 11
12 Here s where to find our plans in your state Our company name in your Marketplace: UnitedHealthcare of Alabama, Inc. On Exchange plan availability 12
13 Plans at a glance Compass Copay Plans Compass HSA Plans Compass Catastrophic Plans 13
14 Plans at a glance Compass Copay Plans Compass HSA Plans Compass Catastrophic Plans 14
15 Plans at a glance Compass Traditional & Copay Plans Compass HSA Plans Compass Catastrophic Plans 15
16 What s included with all our plans Essential Health Benefits Ambulatory patient services Emergency services Hospitalization Maternity & newborn care Mental health and substance abuse Prescription drugs Rehabilitative & habilitative Laboratory services Preventive, wellness services and chronic disease management Pediatric dental & vision Preventive care at no cost* Immunizations Routine physical exams Routine health screenings Routine cancer screenings Women s preventive services Contraceptives Tier 1 Rx Prenatal care if service qualifies as preventive care * As specified by USPTF and our UnitedHealthcare coverage guidelines; diagnostic services are not considered preventive in most circumstances 16
17 Getting care in our network Network Name: UnitedHealthcare Compass Provider Search Choose a primary care provider (PCP) in the service area. Have a referral from PCP to see a network specialist. In-network coverage only except for emergency care. uhc.com/docfind Note Provider search can be done in Spanish 17
18 What to expect when they sign up Welcome 24 hours Health plan kit 5 to 7 days after bill paid Activation letter/ ID card 3-5 days Final ID card 5 to 7 days 18
19 We make it easy to pay First premium payment Plan becomes active once payment is received Ways to pay first and ongoing premium payments Phone: Checking account payment Web portal: Credit card Checking account payment Automatic withdrawal Mail payment 19
20 20 UnitedHealthcare tools to help manage health care and costs
21 24/7 access anytime or anywhere when members register at myuhc.com Choose how they want to get information online, mail, , text Available in Spanish Access health resources and cost decision tools UnitedHealthcare Health4Me mobile app NurseLine SM myhealthcare Cost Estimator myclaims Manager 21
22 Health4Me app helps you where you are From home, work or on the go, members can easily: Share their ID card Find and price care Check claim status Manage OptumRx prescriptions Connect to FitBit There s a convenience clinic nearby Doctor, can I get the MRI at the clinic instead of the hospital? Note Although Health4Me is not available in Spanish, information can be accessed by calling Customer Service 22
23 Tools to help manage health care NurseLine 24/7 nurse support Decide if you should see a doctor, go to an urgent care center or emergency room, or treat yourself at home Find a doctor or hospital Answer questions about an illness or injury Give you support on caring for a chronic health problem, like diabetes Registered nurses, with an average 15 years of experience, are available 24 hours a day, 365 days a year Call the number on the back of the ID card Nurses are supported by Spanish language interpreters Understand your medications PLAN TIPS Call a nurse wherever you are. This 24/7 service is part of your health plan at no additional cost. 23
24 Tools to help manage costs myhealthcare Cost Estimator Estimate costs before getting care Calculate estimated out-of-pocket expenses Estimates based on contracted rates Understand treatment options Integrated with Customer Care and clinical support 24
25 Tools to help manage costs myclaims Manager Easy to use View claim status See what is owed Pay providers for out-ofpocket expenses View payment history Access health statements and explanation of benefits Available in Spanish 25
26 26 Where to find more information
27 Assister resources on dedicated website Materials are on the Assister Resources site: uhc.com/assisters Slides Assister newsletter Hotline
28 Material available on your website Collateral to provide information on UnitedHealthcare Marketplace products and services Mini Brochure Marketplace FAQ Network Flier Consumer Guide Subsidy Chart uhc.com/assisters Hotline
29 Enrollment websites UnitedHealthcare For more information on how to enroll, consumers can visit uhc.com HealthCare.gov Members visit healthcare.gov/ for enrollment (plan selection), plan shopping eligibility, plan compare (and issuer links and 1-800#s) 29
30 Summary of resources in Spanish Personalized enrollment support is available at our fully-staffed bilingual (Spanish-English) direct sales and enrollment Call Center ( ) Provider search with Spanish language indicator Latino Health Solutions bilingual website at uhclatino.com myuhc.com is in Spanish, including myclaims Manager Once a member has enrolled, Customer Service is available in Spanish with full member support 30
31 Latino Health Solutions uhclatino.com Spanish website Bilingual health information center with medical terms and descriptions of laboratory tests and common illnesses Bilingual health education fliers, brochures, and other health maintenance materials Valuable educational videos in both Spanish and English at uhclatino.com How insurance works, What are HSAs, What are Life Events, What are the Penalties for not enrolling, etc. Health and fitness topics and recipes Award-winning fotonovelas 31
32 32 About UnitedHealthcare
33 About UnitedHealthcare Why UnitedHealthcare? Consumers choose UnitedHealthcare based on the stability of our national size, our focus on quality improvement, and the value of our better approach to health engagement Our Quality Our Value Our Tools Our market leadership is a result of the unmatched quality for our members, customers, and providers Using better analytics, we provide a better approach to members that leads them to better health engagement With innovative tools we provide members help to better manage their health care 33
34 About UnitedHealthcare Our Awards BEST-IN-CLASS PERFORMANCE for our clients and as an organization Claims- Processing Accuracy since 2012 Insurance & Managed Care since 2010 Community- Minded Health Company 34
35 About UnitedHealthcare Brand recognition Broad product offering Simplicity to enroll Access to comprehensive network Innovative tools, technology, information and resources Latino Health Solutions bilingual (English/Spanish) resources available Integrated care and benefit advocacy Offering support consumers need, meeting them where they are 35
36 Creating a better consumer experience Direct links to critical information Improving on-boarding experience Improving our service model Adding more staff to handle calls Adding more Spanish lines and providing collateral in Spanish Focusing on more soft transfers 36
37 Thank you! Thank you for taking the time to learn more about UnitedHealthcare! Questions: Hotline Assister website: uhc.com/assisters 37 Not for Consumer Use
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State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:
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Health Care Reform Update
Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in
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RIT Blue Point2 POS B Coverage Period: 01/01/2016-12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs
This is only a summary. If you want more detail about your medical coverage and costs, you can get the complete terms in the policy or plan document at www.excellusbcbs.com or by calling 1-800-499-1275/V;