One marketplace for public and private health and benefits exchanges

Transcription

1 One marketplace for public and private health and benefits exchanges

2 Your Sales and Distribution Supermarket Think of PlanSource OneMarket as your health and benefits supermarket with a goal of keeping sponsors and consumers happy. We only carry carefully selected products from leading insurance carriers and display them in our highly-configurable virtual shelves, providing employers and consumers with a complete benefits shopping, enrollment and billing experience.

3 Where Everybody Is Happy Employers Employees Sponsors Control Costs Realize lower and more predictable costs due to employees rightsizing their coverage and by switching to defined contribution. Give Choice and Flexibility With a defined contribution and more plan options, employees can choose the benefits that are right for their families. Go To Market Faster Sell more product through an established sales and distribution platform that directly and profitably reaches consumers. Ensure Compliance Lower your risk by moving to standard, ACA-compliant plans and using technology to control and enforce compliance. Empower The Employee Educational tools and personalized experience help employees become smarter and more satisfied consumers. Prescribe Your Products Recommend the right products that will fix coverage mismatches, reduce the cost of client acquisition and increase retention. Simplify Administration Reduce the burden on HR associated with benefits selection, annual enrollment and ongoing billing and administration. Maintain Employee Loyalty Satisfaction increases when employees understand the value of their benefits and enjoy convenient shopping and flexible options. Create Your Marketplace With a customizable marketplace and tailored consumer experience, your unique offer will stand apart and build your brand. 3

4 From Wholesale Model Traditional group-based benefits with limited options Custom Benefit Plans Unique and different plans and options by employer Defined Benefit Identifies the specific benefit that is payable to the employee Employer-Centric The customer is the employer Hands-On Approach The employer is responsible for benefits design and administration To Retail Model Individual products with greater product choice Standard Offerings Standard offerings determined by market segment Defined Contribution Money can be allocated across multiple benefits by the employee Consumer-Centric The customer is the consumer Hands-Off Approach The exchange is responsible for benefits design and administration Health Insurance Is Changing Health insurance is changing due to a fundamental shift in employer benefits strategy. The employer-driven structure is moving to a model in which pre-selected benefit tiers are offered to specific segments and shopping is aided with Amazon-like educational and decision-support tools. Private exchanges that use a defined contribution approach are catalyzing this change because they are flexible and can be customized to address the needs of any employer or sponsored group.

5 You Need Flexibility Today s diverse workforce has unique needs and a one-size-fits-all approach to benefits no longer works. The sponsors of a private exchange need flexible technology equipped with sophisticated business process workflows that facilitate partnerships with different insurance carriers who offer a wide range of products and services. PlanSource OneMarket delivers this flexibility with technical sophistication on the back-end and an intuitive consumer experience on the front-end. Features Standard Model Custom Model Complete Benefits Administration Engine Configurable User Experience Pre-Configured Offerings Data Exchange with Carriers Automated Quote-to-Card Process Co-Sourced Delivery Model Custom Branding and Configuration Sponsor-Influenced Offerings & Content Custom Product and Eligibility Rules Who Can Sponsor a Custom Model? Broker Employer Government Carriers Third Parties Custom Consumer Experience and Design Optional What Are The Types of Custom Models? Single-Carrier Stocked with products from a single insurance carrier with products that may be customized and priced for the employers or groups of employees Multi-Carrier Stocked with products from multiple insurance carriers whose products may be customized and priced for the employer 5

6 Health Insurance Is Changing Education and Consultative Sales Exchange sponsors need to educate employers and employees alike on defined contribution plans, the value they bring and how they differ from defined benefit plans. Flexible Offering Structures Ease of use and flexibility are critical, as carrier offerings with multiple products from multiple sources become more complex and employees demand a user-friendly experience. Consumer-Oriented Products Insurance carriers need to differentiate themselves by developing their own lowcost product offerings to compete sideby-side on a menu of comparable plans. Employee Advocacy Center Sponsors need to educate employees on defined contribution, offer robust enrollment and deliver unbiased and multi-channel decision support. Administrative Simplicity Capabilities including reporting, account management, data exchange, consolidated product billing and employee payroll deductions are critical. Established Data Exchange All exchanges require interfaces with existing systems to ensure the seamless transfer of product, member and group information. PlanSource OneMarket is more than just static shelves full of products and services - they are highly customizable storefronts in which both the administrative and buying experience are enabled by powerful, state-of-the-art technology. With complete built-in quote-to-card business processes that stock product from leading health and wellness product and service providers, PlanSource OneMarket delivers a flexible, consumer-friendly benefits marketplace. Source: ~Strategy& (Formerly Booz & Company)

7 Serves Functions Consumers Compliance Data Mining and Analytics Employer Shopping Employers Data Exchange Customer Onboarding Brokers Carriers Treasury Administration Plan Administration Consumer Shopping Partners R 7

8 A Friendly Employee Experience Insurance products are complex and confusing, so educating employees on the products and why they need them is a big challenge. With personalized content and intelligent plan recommendations woven into an easy-to-use and intuitive user experience, PlanSource helps consumers understand the benefits that are offered to them and make the right choices based upon their unique needs. It s Intuitive With customizable tools and educational content, employees easily understand the benefits that are offered, see the impacts on their paychecks, and become better informed consumers of healthcare. And Personalized Throughout the shopping experience, PlanSource asks relevant questions and surfaces meaningful information to provide personalized plan recommendations aligned to employee preferences. But Convenient With responsive, easy-to-use screens and a free smartphone app, employees can access their benefits, share their ID cards, store important healthcare contacts and receive notifications from their employers. 8

9 Employee Shopping We guide your employees through the process so that they can shop for benefits in the same consumer-friendly way they shop for other products online. Benefit Enrollment Employees enroll online with a userfriendly, one-thought-per-screen workflow, while HR professionals oversee the process and approve changes. Educational Content Personalize the videos, docs, tools and messages displayed to employees based on demographics, location, family status, employee type and more. Life Event Changes Automatically enforce your rules for life events as your employees get married, grow their families, or lose coverage throughout the year. Personalized Plan Recommendations Help your employees understand their best match plans based on their preferences and expected usage (doctors visits, prescriptions, etc.). PlanSource Mobile App Provide convenient access to benefits information, insurance cards, and announcements to your on-the-go employees. Defined Contribution Get control of your costs by fixing the amount you want to spend, and letting your employees choose the best way to allocate the funds. Spanish Language Support Engage with your Hispanic employee population by providing a userfriendly benefits shopping and enrollment experience in Spanish. Employee Communications Understand out-of-pocket responsibilities and payroll deductions, and receive notifications and electronic benefit confirmation statements. Wellness Programs & Incentives Base eligibility and/or rates on qualification towards a wellness credit and apply those credits to the employee and their qualifying dependents. 9

10 An Admin-Free Administrative Experience It s becoming increasingly costly and complex for employers to manage their benefit programs and ensure compliance. Companies need technology to monitor employee education and communication, manage eligibility, automate enrollment, manage carrier billing and adhere to ACA requirements. PlanSource provides HR teams with one technology platform to efficiently manage all aspects of their benefits programs. Maintain Control Benefits are a significant spend that PlanSource helps manage through eligibility, cost calculations and carrier billing and reconciliation, regardless of whether a defined-benefit or contribution approach is selected. Stay Compliant With government oversight and regulations increasing with the ACA, PlanSource has the requirements built into its features and workflow to ensure that processes and procedures are kept compliant from the start. And Be Engaging By giving employees technology tools like PlanSource that save them time, respect their circumstances and help them make the right decisions, team members will be happier and more productive. 10

11 ACA Compliance Automate the creation and distribution of Forms 1094-C and 1095-C and the complex measurements required for ACA compliance. Cost Calculations Calculate employee and employer contributions to premiums, and automatically transmit deductions to your payroll system. Eligibility Management Configure your employee groups and benefits, including business rules for waiting periods, coverage options, age restrictions and EOI. Employee Communications Provide custom communications to specific employees or employee groups during open enrollment or based upon events throughout the year. Standardize Benefits Plans Creating your benefits program is simple - select from a warehouse of standardized, ACA-compliant plans offered by leading insurance carriers. Bill Creation and Reconciliation Generate consolidated self-bills and reconcile carrier-provided bills based upon carrier-specific rules for billing and mid-month changes. Open Enrollment Oversee the open enrollment process for your employees for the new plan year, while continuing to manage changes in the current benefit year. Configurable Reporting Leverage a suite of built-in, best practice reports or create custom reports that can be generated automatically to meet your needs. COBRA Compliance Ensure COBRA compliance by managing the end-to-end process online from qualification to enrollment to termination. Customized Branding More than just colors and logo, the employee experience can be customized to include imagery, colors, messaging and content. 11

12 About PlanSource PlanSource provides the industry s most flexible and intuitive health exchange and benefits engagement platform in the cloud. Companies of all sizes use the PlanSource Platform for benefits shopping, enrollment, billing, ACA compliance and ongoing administration. PlanSource is based in Orlando, Florida with seven locations throughout the U.S. Established in 2008, PlanSource is a proven, SSAE16 SOC 2 Type 2 audited technology platform with an elaborate data exchange network composed of health and voluntary insurance carriers, HR and payroll systems, and TPAs. With a highly configurable system, an established network of health and ancillary benefit carriers, and a team of implementation experts, PlanSource achieves industry-leading implementation times for companies with even the most complex benefit programs, business rules and workforce configurations. PlanSource is a customer-focused company. We build our products and structure our service model with you in mind, which is evidenced by our industry-leading Net Promoter Score of 67 (compared to an average of 26 for other SaaS providers) and a customer retention rate of 99.8%. Together, we will provide a simple and enjoyable experience for HR teams and employees. sales@plansource.com (877) Copyright 2015 PlanSource, Inc. All rights reserved. PlanSource is a registered trademark of PlanSource, Inc., and PlanSource owns other registered and unregistered trademarks. Other names used herein may be trademarks of their respective owners.