Individuals and families will need assistance from brokers like you as they shop for a health plan that fits their needs.

Transcription

1 Individuals and families will need assistance from brokers like you as they shop for a health plan that fits their needs. Today, we ll talk about 2016 UnitedHealthcare health plans available in your state, and related information that can help you prepare for Open Enrollment. Let s begin. 1

2 First, we ll review some basic Marketplace facts to help consumers choose a plan Then, we ll take a closer look at 2016 UnitedHealthcare health insurance plans available in your state, the network, and review plan benefits. We will review tools available to UnitedHealthcare members to help them to manage their health care and costs whether at home or on the go We ll also let you know what other resources and materials are available and where to find them Finally, we ll talk about UnitedHealthcare to help you know what sets us apart from the rest. 2

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4 Here are key facts about the Health Insurance Marketplace to share with interested individuals: 1. Individuals may qualify for federal financial assistance, called a subsidy, to help them pay for a plan. This subsidy may come in the form of a premium tax credit, which reduces premium payment. 2. Subsidies are only available through the Individual Marketplace. Individuals who qualify for a subsidy must buy a plan from the Individual Marketplace to receive it. 3. Individuals who qualify for a subsidy must be sure to submit the required information to keep their subsidy. If they don t, they can lose coverage percent of people saved an average of $263 a month with a Marketplace plan.* Visit uhc.com/tax-calculator for more information 5. The open enrollment period starts November 1, 2015, and ends January 31, Know the date when the first premium payment is due and when health coverage begins. 7. To keep coverage, individuals must pay the monthly premium when it s due. If coverage is lost, the individual will have to wait until the next open enrollment period to sign up again. 4

5 Talk to interested individuals about basic details to help them choose a plan that best suits their needs. To understand their different plan options, individuals will need to understand: How much does it cost? The premium (monthly cost of the health plan) The deductible (amount that must be met before the health plan begins to pay) The copay (amount they can expect to pay each time they receive health care services or fill a prescription) Is their doctor in the network? Ask if the individual has any doctors or clinics they already use. Check the online provider directory to see if those doctors or clinics provide services in the selected health plan. Does the plan cover what they need? Do they need a certain prescription drug? Is it covered? What is the co-pay? 5

6 All Marketplaces offer metal levels of insurance plans. Individuals need to consider how often you go to the doctor and your budget for monthly premium, deductible and co-pays. Thinking about their medical needs may affect their choice. These questions help individuals to walk through what to consider when choosing a plan: How often do they visit a doctor? How many prescription medications do they take each month? How do they want to manage healthcare costs? Would they rather pay more for their premium or their deductible? Add up the points and go to the next slide to see the recommendations. 6

7 The Bronze plan is the least expensive plan option because it has the lowest premium and the highest cost when they visit a doctor. The Silver plan has a lower premium and a higher cost when they visit a doctor. The Gold plan has a higher premium and lower cost when they visit a doctor. Help them get the most for their money. If an individual qualifies for cost-share reduction, it may be the best value to choose a silver plan to maximize the reduction of the deductible and lower copays. In essence, it boosts it to a higher metallic level plan. 7

8 If they have internet access, share the Choosing A Plan video with individuals and let them know they can access from uhc.com. This video will step them through the three main considerations when they choose a plan. 8

9 Let s take a look at UnitedHealthcare health insurance plans available for

10 The three plan types for our Individual Marketplace health plans include: Co-pay plans provide the convenience of set co-pays for physician visits and prescriptions. HSA plans include the option of a tax advantaged health savings account for individuals who want greater control over their health care spending Catastrophic Plans are a low cost option available for customers who are either under age 30 or for those individuals who cannot obtain affordable coverage in the Exchange. 10

11 When your client purchases one of the qualified health savings account plans, he or she may set up a tax-advantaged health savings account. The money deposited into the health savings account, within legal limits, can be used to pay for qualified medical expenses that may or may not be covered by the health plan. For 2016, clients with self-only coverage can deposit up to $3,350 into their HSA. Clients with family plans (that is plans with two or more individuals covered on the plan), may deposit up to $6,750 for the year. Individuals age 55 and over can take advantage of the Catch Up Provision and deposit an additional $1,000 annually. Deposits to the HSA can be made anytime, subject to the IRS rules. 11

12 We are offering Individual Marketplace plans in the counties shaded in blue. 12

13 Here are the Compass Traditional and Copay plans we are offering in your area. 13

14 Here are the Compass HAS plans we are offering in your area. 14

15 Here are the Compass Catastrophic plans we are offering in your area. 15

16 All plans must provide coverage for the 10 categories of Essential Health Benefits defined by each state so coverage details can vary from state to state. Just because a benefit is considered an essential health benefit doesn t mean that it s covered at 100%. It simply means that this coverage has to be included in the state s plans. Preventive care is always covered 100 percent in our network. This includes immunizations and preventive health screenings. Be sure to review plan details with consumers to ensure they understand what preventive services are included in benefit plans. To see a list of preventive care guideline recommendations, visit uhcpreventivecare.com 16

17 Here is information about getting care in our network. 17

18 When individuals sign up for UnitedHealthcare health coverage, here s what they can expect. About 24 hours after we are notified of enrollment, they ll receive a welcome . Around 3 5 business days after welcome is sent, a temporary ID card will be mailed with instructions on how to activate the policy, similar to how you activate a new credit card. Member will call us through a toll-free number to activate. We will verify contact information including and that the PCP has been selected or we will help them select a PCP. We will attempt to collect the first month s payment during this activation process. They should check the ID card to make sure the information is correct. This is the card they should bring with them every time they go to the doctor or pick up a prescription. About 5 7 days after they pay their first premium bill, they ll receive a health plan kit outlining all benefits and provisions. that contains important documents. Shortly after they receive the health plan 18

19 kit, they ll receive the final ID card reflecting the PCP they selected during the activation process. It s important to remind individuals to continue paying the bills for the premium otherwise coverage will end and they won t be able to sign up for coverage until the next open enrollment period. 18

20 The initial premium is not due at the time of application however an invoice will be sent once we receive the file from the state. The plan can be activated once the payment is received. UnitedHealthcare makes it easy to pay. Individuals will have several payment options: They can Pay by Phone by checking account. They can access the web portal to pay with either a credit card or by utilizing their checking account, by automatic withdrawal Or, they can mail their payment We make it easy for them to choose whichever payment method is most convenient for them. 19

21 Now we ll show you tools that are available to UnitedHealthcare members to help them manage health care and costs whether at home or on the go 20

22 When members register at myuhc.com, they can choose how they want to get information and also have 24/7 access to many helpful health resources and cost decision tools so they can get the most from their health plan. Myuhc.com is also available in Spanish. These tools include: Health4Me mobile app NurseLine myhealthcare Cost Estimator myclaims manager Healthy Savings Let s explore these tools further on the next few slides. 21

23 UnitedHealthcare Health4Me helps members manage their health no mater where they are. They can Find a doctor as well as show and share ID card with doctors Find and price care: Search using cost estimates & quality ratings Check claims, deductibles, health savings accounts and health records onthe-go Manage OptumRx prescriptions, look up pharmacies and costs Build a Better Me trackers and rewards with connectivity to FitBit Additional Note: Although Health4Me is not available in Spanish, however, all of the information needed can be accessed by calling Customer Service. 22

24 NurseLine is the largest, most experienced nurse information service in the country with a proven track record for delivering results and offers decision support and health and medication information and education through a variety of channels. Registered nurses, with an average 15 years of experience are available 24 hours a day, 365 days a year. Members can call the number on the back of their ID card. There are Spanish-speaking nurses, as well as more than140 other languages available through interpretation. Services for the hearing impaired are also provided. 23

25 myhealthcare Cost Estimator helps members estimate costs before getting care. Located on myuhc.com, members can calculate their estimated out-ofpocket expenses for many treatments and procedures based on their specific plan: Cost estimates are based on actual contracted rates for more accurate cost calculations. Provides members with the information they need to understand treatment options such as Emergency Care vs Urgent Care. Fully integrated with Customer Care and clinical support allowing access to a wide range of resources. 24

26 With myclaims Manager, UnitedHealthcare s online claims tracking, management and payment tool, members can view, manage and pay their providers from one location. Easy-to-read visuals help members better understand their health care benefits, explain what their plan paid, what they owe and why. Simple and easy to navigate. View claim status, identify claims to watch, mark claims paid and add personalized notes. Colorful visuals show how each claim was processed, including what the member owes. Pay health care providers online or for out-of-pocket expenses, view payment history and store payment method for future use. Seamless access to Health Statements and Explanation of Benefits Also available in Spanish 25

27 On the next few slides, we ll show you where you can find more information. 26

28 Materials are available by visiting uhc.com/assisters. 27

29 Here are some examples of collateral to educate and inform consumers and business partners of UnitedHealthcare Marketplace products and services. Materials are available in English and Spanish.

30 There are two ways individuals can find more information on choosing plans available to them and also how to enroll. They can visit: uhc.com or healthcare.gov 29

31 The Hispanic and Latino community continues to grow and has specific preferences, especially when it comes to medical attention and health care. Let s take a moment to review the resources for Spanish-preference individuals. Personalized enrollment support is available at our fully-staffed bilingual direct sales and enrollment Call Center Members can search for participating providers and find those providers where Spanish is spoken. Latino Health Solutions bilingual website myuhc.com is in Spanish, including myclaims Manager Once a member has enrolled, Customer Service is available in Spanish with full member support. Friendly, bilingual customer care professionals are trained to understand common doubts and hesitations that some Hispanics have about enrolling in and using their health care coverage. 30

32 Latino Health Solutions is dedicated to providing bilingual health and wellness resources, information and services in both Spanish and English to help meet the health care needs of Hispanic/Latino families. Our award-winning uhclatino.com includes an Information Center with medical terms and descriptions of laboratory tests and common illnesses as well as a variety of bilingual health education fliers, brochures, and other health maintenance materials that address common health issues of the Hispanic community. Educational videos are available in both Spanish and English at uhclatino.com such as: How insurance works, what are HSAs, What are Life Events?, What are the Penalties for not enrolling? And more There are also many health and fitness topics and recipes Award-winning fotonovelas focus on how Hispanic families deal with common health concerns. 31

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34 Consumers choose UnitedHealthcare based on the stability of our national size, our focus on quality improvement, and the value of our approach to health engagement. 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 care. 33

35 Here are awards UnitedHealthcare has received for best-in-class performance as an organization but most importantly, for our clients. 34

36 Across each major decision a consumer will encounter picking the best benefit plan, making informed choices, managing their health and wellness, and completing daily health and insurance tasks - there are many strategies and assets we are leveraging and building to engage consumers more successfully: Brand recognition and broad product offering that meet their expectations on cost and access Simplicity to enroll Access to comprehensive network of medical professionals and hospitals, and a primary care provider to help individuals manage their care With innovative tools such as consumer transparency tool, as well as other technology, information and resources that empower them to make informed, confident decisions Latino Health solutions offering bilingual support Providing integrated care and benefit advocacy such as 24/7 telephonic nurse support for a simpler, more personal experience; and Enabling them with the support they need, when they need it - meeting them where they are 35

37 We are working to create a better consumer experience through: Direct links to critical information as individual is picking a plan Improving on-boarding experience focused on simple messages and clear actions 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

38 Thank you for taking the time to learn more about UnitedHealthcare. If you have questions, you can call the navigator hotline or visit uhc.com/assisters 37