Health Option Plan for Employees

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1 Health Option Plan for Employees IBG BENEFITS MANAGEMENT CO., INC. PRESENTED BY: A comprehensive health care plan that is helping Employers and Employees save 15-40% on health care costs.

2 Health Option Plan for Employees Traditionally, when businesses provide employee medical insurance benefits, employees receive little more than an insurance policy issued by a particular insurance company which pays certain medical expenses in the event of illness or injury. The created health plan becomes nothing more than a process of treatment, claims, and payments. Medical insurance is not a health plan. ehope sm is not simply another insurance product, although insurance products are used. It is a multi-disciplinary, comprehensive and integrated health care strategy that provides employees and employers with comparable or better health care benefits. By understanding insurance companies and how they price risks, the innovative design of ehope sm typically reduces health care benefit costs by 15-40% and helps keep those costs low year after year. You know what you pay, but do you know what you pay for? a whole new way to think of health care... Uses specially structured consumer driven high deductible health plans (HDHP) to reduce premiums while providing comprehensive coverage; Incorporates a second health insurance company to insure the deductible including first dollar coverage; Includes a comprehensive health, wellness, disease management and prevention program to assist employees and families in maintaining and improving their health, directly reducing health claims and costs; Adds a vision benefit to promote eye health for all employees which is essential to general health, job site effectiveness and safety; Provides telephone access to medical doctors, RNs and other health care providers 24/7/365 from the convenience of home, workplace or vacation; Harnesses technology through the web, smartphone and other devices to help all employees, especially high risk individuals, access treatment and monitor chronic conditions; Incorporates comprehensive individual health status and utilization reporting with electronic medical records to allow for more effective medical treatment without duplicating services and increasing costs; Provides employers with comprehensive aggregate utilization reporting which is essential to negotiating appropriate health care pricing in future years; Provides employees with a Personal Health Care Advocate and pharmacy benefit consultant to coordinate treatment, maximize utilization of services and secure cost effective medications; IBG s Health Benefits Consultants continually monitor changes and trends in health care and health care reform legislation to assist employers in maintaining the most comprehensive and cost effective health care available.

3 designed to reverse health care cost trends In the wake of rising health care costs and health care reform, now more than ever employers need more than health insurance agents and health insurance products. Businesses need health care consultants who can help them navigate the ever changing waters of employer sponsored health benefits. At IBG Benefits Management Co. we know health care benefits, where they are today and monitoring where they will be tomorrow. Working through a multidisciplinary team of actuaries, underwriters, benefits attorneys and other health care professionals, IBG helps employers reverse the trend of rising health care costs by designing integrated health benefit solutions and helping businesses adapt to the changes of tomorrow. IBG adheres to three principles of health care benefit design: Exhibit 2: Average Annual Premiums for Single and Family Coverage, * Estimate is statistically different from estimate for the previous year shown (p<.05). Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, Single Coverage Family Coverage 1. Health Insurance is Not Health Assurance Health care is more than health insurance - it is about actually maintaining the health and health consciousness of employees and their families. 2. You Can t Fix What You Don t Know Health consciousness requires education, engagement and empowerment of employers, employees and families. 3. Efficient and Effective Coordination of Benefits Health benefit costs can be controlled through a better understanding of and realignment of health benefit services and providers.

4 designed to lower costs and increase care Comprehensive Major Medical Coverage The ehope sm solution starts with a High Deductible Health Plan (HDHP). Clearly, we understand that employees do not want, and frequently cannot afford, healthcare under a HDHP and they won t. The HDHP is used to create significant premium cost savings. The reduction in cost is from this first step alone is frequently as high as 50-70%. COMPREHENSIVE COVERAGE Major Medical Insurance Insurance to Cover Deductibles, Co-Pays and Co-Insurance Health, Wellness and Prevention Program Disease & Chronic Condition Management Telephone Access to Physicians 24/7/ HR Registered Nurse Hotline Personal Health Care Advocate Prescription Drug Coverage Dental & Vision Coverage Annual Biometric Blood Test Personalized 30+ page Health Plan Health Assessment Report Online Health Information Resources Medical Service / Bill Negotiation Service Online Medical Record Storage Smartphone Accessibility & Monitoring Insuring the Deductible The ehope sm Plan then incorporates a second health insurance company to insure the higher deductible. We refer to this second insurance company s product as a wrap. In other words, ehope sm wraps a second insurance policy around the major medical policy. By understanding insurance company pricing models, and separating these risks so that they are assumed by two different insurance companies, a net cost savings is created. Thus, even after paying the premium for a HDHP major medical policy and a premium to a second insurance company to cover the deductible, there remains about a 30-40% net premium savings. designed to improve health and productivity Wellness, Prevention and Disease Management ehope sm incorporates a comprehensive health, wellness, disease management and prevention program which is clinically designed and proven to improve employee health, reduce health care costs, decrease absenteeism and presenteeism (in attendance but not focused) and increase productivity. The wellness and prevention program is the backbone of the ehope sm Plan since it is designed to assist employees and their families in maintaining and improving their health, which has the indirect benefit of reducing health care costs for both employees and employers. Spouses and Children Health issues affecting family members, particularly children, is a major cause of work related stress, anxiety, errors and time off. Thus, an employee s overall health and productivity is directly related to the health and well-being of their spouse and children. For this reason ehope sm offers a comprehensive health, wellness, prevention and disease management program for the entire family with features specifically designed for children. The Children s program has been clinically designed to encourage and engage children to participate in their own health consciousness through interactive education and games that are age appropriate. Employees and their families will benefit from: Included - Biometric blood test Included - Personalized Health Care Plan Included - Online health information resources Included - Online medical information storage Included - Smartphone accessibility Included - Access to RNs, Physical Therapists, Nutritionists and other health care professionals

5 CUSTOM SOLUTIONS designed to increase access to care 24 / 7 / 365 Access One of the most fundamental needs of employees and families is access to health care providers, particularly physicians. However, access should not be confused with a $20 co-pay. A $20 co-pay for an employee is a $60 - $120 expense for the insurance company and for this service, premiums are significantly increased. ehopesm incorporates alternative delivery and pricing models to more appropriately align utilization and costs while providing all employees and their families with 24/7/365 access to Physicians, RNs and other health care providers in a more cost effective manner. Access is available either in a doctor s office, via telephone, or even through internet and smartphone conferencing. Vision, Dental and Other Essential Benefits Vision and eye health are essential for general health, job site effectiveness and safety. For this reason vision benefits are available for all employees and dependents. Recognizing that each employee has unique needs, ehopesm also makes Dental, Disability, Long Term Care, Life and other essential benefits an option for employees and their families. designed to empower employees Personal Health Care Advocate Under most employer sponsored health insurance plans, an employee has a relationship with his/her physician for services, with a pharmacist for products and with an insurance company for payment. As long as the payments are made, the relationship works. However, what happens when the situation becomes more complex IBG s Health Benefits Consultants work with employers to assist them in customizing health care programs that really work. Their expertise in both traditional and non-traditional health care delivery models provide employers with the tools they need to navigate the health care waters through the 21st century. TECHNOLOGY SOLUTIONS Health care today is more than just medical insurance, doctor visits and bill payment. It is about integrating technology to improve healthy outcomes through web based administration, smartphone access to providers, online medical records retrieval and more. IBG s technology solutions help reduce costs while providing more efficient and effective health care benefits. A medical course of action is recommended and a second opinion is desired; An employee must make an informed decision among various treatment alternatives; Complications develop following a course of treatment or prescription regime; Care must be coordinated among various service providers (e.g. primary care, specialist, occupational therapist, physical therapist, mental health etc.); Claims are denied or employees are unable to pay their medical bills. The costs associated with these and other complications is measured not only in terms of dollars and cents but in terms of on the job anxiety, depression, tardiness, absenteeism and presenteeism. The ehopesm Plan provides employees with their own personal Health Care Advocate. This individual is not simply an insurance company s customer service department, this is a non-biased independent individual whose primary objective is to assist employees in navigating the complexities of the health care delivery industry. The Advocate is available to assist with processing benefit denial appeals, selecting appropriate specialists, coordinating care and treatment. In general, the Advocate is responsible for assisting employees in maximizing the benefits and services available under the ehopesm Plan and all of its constituent elements.

6 Examples of how HDHP and Wrap... work together! In Network Hospital Stay & Surgery = $18,000 Typical Plan* $2,500 Employee Coinsurance $2,500 Major Medical Payment $13,000 $13,000 Total Payments $18,000 $18,000 Employee Out-of-Pocket ER $244 EE $131 ER $198 EE $107 Typical per EE Premium Cost (ER 65% / EE 35%) Annual Premium Savings per EE (Based on 18.65% savings. Typical savings 15-40%) ER $552 EE $288 Wrap In-Patient Limit *Typical Plan Assumptions (In Network): EE Only Premium Deductible Coinsurance Annual Maximum Typical ehopesm Individual Premium EMPLOYEE PAYMENT ehopesm Employee Deductible Wrap Policy Payment Out-Patient Services = $7,240 Typical Plan* Employee s MRI $1,100 ehopesm $1,100 Child s Stitches $640 $640 Spouse s X-Ray $800 $800 Employee s Lab Work $800 $800 Child s Broken Leg $3,900 $2,108 Major Medical Policy Pays $1,792 Wrap Policy Pays Accident Indemnity Policy Pays $4,540 $5,448 ($2,300) Employee Out-of-Pocket Annual Premium Savings per EE ER $1,450 EE $782 (Based on 65%/35% ER/EE Cost Sharing and 18.65% savings. Typical savings 15-40%) $375 $2,500 80% / 20% $305 Wrap Out-Patient Limit $2,500 (x2) *Typical Plan Assumptions (In Network): Family Premium Deductible (individual/family) Coinsurance Annual Out-of-Pocket Maximum (individual/family) $1,000 $2,500 / 80% / 20% / $10,000 Typical ehopesm Family Premium $814 Note: The Accident Indemnity policy pays benefits without requiring coordination with other insurance coverage. Thus, in some situations, an insured person may receive payment in excess of out-of-pocket medical expenses as indicated above. "Increased Benefits... at a Reduced Cost.

7

8 IBG Benefits Management Co. is a national employee benefits and risk management firm serving professional practices, businesses, governments, labor organizations and not-for-profit organizations. The firm s founders had a simple vision to provide America s small to mid-size clients with the same high quality employee benefits, executive compensation and risk management solutions previously only available to the largest of corporations. Utilizing a multi-disciplinary approach, IBG brings together under one roof a talented team of attorneys, accountants, actuaries, financial planners, health plan administrators, IT professionals, insurance and benefits professionals to work cooperatively with clients in solving critical issues affecting their futures. IBG is a task oriented and solutions driven firm which blends tradition with innovation to help clients meet their objectives. This full facet approach allows IBG to design and implement integrated solutions that address all of a client s tax, legal and financial considerations. IBG is... Solutions. Delivered. Health Option Plan for Employees #5 Strand Street Frederiksted, VI BENEFITS MANAGEMENT COMPANY IBG Benefits Management Co., Inc. 501 S. Towanda Barnes Rd. Suite #3 Bloomington, IL TOLL FREE: (877) Old Roswell Place Suite A500 Roswell, GA 30076

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