Presentation Transcript

1. CIGNA Consumer-Driven Health Care HSA-qualified HDHP Program Overview For employers with 50 or fewer employees

2. Today’s Discussion • Growth of Consumer-Driven Health Plans • The CIGNA Approach To Consumer-Driven Health Care • HSA Overview • Engagement and Advocacy • Service Experience and Employee Education

3. Optional Slide Consumer-Driven Health Momentum Has Reached All Segments * end of 2004 Forrester Research. Employers Sound Off on CDHPs, May 2005.

4. Approach To Consumer-Driven Health Care

5. Optional Slide What We Stand For Improvehealth. It’s our single focus. It means we stand for care that is effective and personal choices that matter. It means we connect the health of your employees to the health of your business.

6. Our Approach Improve Health – Control Costs Consumerism: personal choices that matter • Enabling informed healthcare decisions Health Advocacy: care that’s effective • Delivering integrated care for superior clinical outcomes Actionable Information: connecting employee health to the health of your business • Providing consumers with the tools they need to make informed decisions about their health

7. HSA Overview

8. Definitions Health Savings Account • A tax-exempt trust or custodial account created exclusively to pay for the qualified medical expenses of the account holder and his or her spouse or dependents. • Covers all medical expenses listed in IRC section 213(d) • Can be used only in conjunction with a qualified high-deductible health plan • Funded with actual dollars • Remains the property of the account holder; no “use it or lose it” rules High-Deductible Health Plan • A medical plan that meets certain criteria set by the federal government * These are 2007 limits. Limits for future years will be set by the IRS.

9. The Health Plan 100%Coverage $ High-Deductible Health Plan (coinsurance) Health Savings Account 100% Preventive Care Deductible Working Together A high deductible health plan (HDHP) is required for an HSA • Minimum Deductible*: • $1,100 Single / $2,200 Family • Maximum Out of Pocket*: • $5,500 Single / $11,000 Family • Deductible and covered expenses apply to out-of-pocket maximum • 100% Preventive coverage recommended • One deductible amount for Medical and Pharmacy *2007 Federal Limits

10. HSA Overview • CIGNA Advantages • HSA banking option powered by JPMorgan Chase • Industry-leading consumer decision support tools, including WebMD® suite of tools • Leading clinical resources • …Helping create more engaged consumers and lower medical costs.

11. CIGNA Plan Design Options

12. Tax Advantages of an HSA* • Tax-Free Contributions • Employee contributions: income tax-free • Employer contributions (optional): Deductible for employer; not taxable for employee • Tax-Free Interest and Investment Gains • Interest and gains accrue tax free while they remain in the HSA • Tax-Free Withdrawals • Withdrawals for a qualified medical expense are not taxed • Other withdrawals incur income taxes plus 10% penalty (<65) *In Alabama, California, New Jersey, and Wisconsin, contributions are prior to federal taxes but after state income taxes. Employer contributions, earned interest and investment income are taxable as gross income for state income tax purposes.

13. Engagement and Advocacy

14. Health Promotion Lifestyle Management Disease Management Care Management Number of members impacted Cost of medical care per member Goal:Keep everyone well Healthy 7% of cost; 43% of members Goal: Prevent from migrating to more chronic/acute condition At Risk 10% of cost; 22% of members Goal: Minimize impact of illness Chronic 35% of cost; 18% of members Goal: Resolve acute illness impact as quickly and effectively as possible Acute 48% of cost; 17% of members • Cardiac • Depression • Diabetes • Obesity • Asthma • Low Back Pain • COPD • 10 Secondary “targeted conditions” • Tobacco Cessation • Weight Loss • Stress Management • Substance Abuse • Cancer • High Risk Maternity • Neonatal Intensive Care • Transplant • Extended care • Musculoskeletal • Inpatient Management • Intensive Behavioral • Health Risk Assessment • Physician report card and member reminder mailings • Prenatal/Maternal Care • Work/Life Balance • Preventative Care Programs • Discounts on Health & Wellness services CIGNA Programs CIGNA Resources Address the Continuum of Consumer Health Needs Help  Assess  Target Health advocacy services to engage, navigate and facilitate services across the continuum of care

15. Consumers, Armed With The Right Information, Can Take Action

16. The Key: myCIGNA.com • Review benefit coverage levels • Track account balance, claims and payments • Support important health decisions • Cost and quality information • Read personalized messages 16

17. Health Risk Assessment • 15-minute questionnaire helps determine accurate personal health status • Employs 5,000+ calculations that screen for over 21 clinical risk factors • Results are integrated with CIGNA’s Disease Management Programs 17

18. Procedure Pricing Tool Saint Hospital Community Hospital

19. Prescription Pricing Tool • Members select pharmacy and drug • Receive actual price they’ll pay LOCAL PHARMACY 123 MAIN STREETHOMETOWN, ST 00000(555) 123-4567

20. Hospital Quality Information Saint Hospital 123 Main StreetHometown, ST 00000(123) 555-1234 Community Central Hospital 123 Center StreetHometown, ST 00000(123) 555-5678

21. Hospital information tool allows members to compare hospitals based on data for 164 surgical and medical procedures Personalized with In/Out of Network indicators to help members understand financial implications of decisions Physician Surgical Volume results will be included in limited areas Hospital Quality Information

22. Service Experience and Employee Education

23. CIGNA HSA-qualified HDHPwhenpowered by JPMorgan Chase We have capitalized on the strengths of both organizations to deliver an empowered HSA • CIGNA • HDHP claim adjudication • JD Power certified customer service • Large National Network • Medical management • Decision support tools • Enrollment and communication support • JPMorgan Chase • Debit card/checkbook processing • Financial service specialists • Interest crediting • Scheduled and unscheduled deposits • Investment options CIGNA Advantages • Consumer • One toll-free member services number • Combined web experience via myCIGNA.com and link to JPMC • Online bank application and signature • 100% Preventive Care coverage • Employer • An affordable alternative to health care • Provides employees with savings opportunity • Potential for reduced claim costs

24. Two Ways to Access HSA Dollarsif account is established through JPMorgan Chase… • HSA Debit Card • Visa® branded, issued by Chase • Can be used at ATM as well • Checkbook Two Ways to Track Utilization if account is established through JPMorgan Chase… • myCIGNA.com • Access to claim transactions and history • Link to JPMC member website • JPMorgan Chase Member Website • Access to Health Savings Account transaction and balance information • General Information (including investment options) available

25. 24-Hour Nurse Line Clinical guidance and care support Behavior ChangeLifestyleManagement Improve Health – The CIGNA Advantage A more aware health care consumer Member Education Open Enrollment Personalized Media Provider Outreach Member activities myCIGNA.com, WebMD, 800.CIGNA24 Education • Clinical Programs: • Health promotion • Disease Management • Care Management • Outreach triggers: • Health risk assessment • Predictive model • Integrated data • Referrals CIGNA activities CIGNA Health Advocacy & Clinical Resources

26. Simplifying Your Communication Needs • Access to communication materials • Newsletters • Business activities

27. Using Communications To Build Active, Engaged Members ENROLLMENT POST-ENROLLMENT

28. 2005 Health Plan/Managed Care Organization Disease Management Leadership Award • Disease Management Association of America Top 100 IT Innovators 2005for technology Awards And Recognition Demonstrate CIGNA’s Commitment To The Consumer Optional Slide • “CIGNA has catapulted itself into the top ranks” • - Consumer Driven Market Report, September 2004 • #1 in Health Sector IT • - 2006 InformationWeek 500 America’s Best Health Plans NCQA • Best Technology & Communications Introduced by a Health Plan Organization for Employee/Consumer Choice • 2005Consumer Directed Health Care Conference & Expo • 2005 CIGNA Plans Recognized NCQA Highest Effectiveness of Care Measures 5 years in a row (2001 – 2005)