Public & Private Health Insurance Exchange to Provide Controlled Access for Non-Group- Eligible Employees HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR Innovation Office: 219-662-0201 Cell: 630-240-2583 Fax: 219-661-0236 e-mail: [email protected]Website: www.hrmdco.com
Transcript
Individual Policy Type, Public & Private Health Insurance
Exchange to Provide Controlled Access for Non-Group-Eligible Employees
The Problem • Part-time employees, contractors, COBRA eligibles and pre-65 retirees all
need to purchase health insurance coverage or pay penalty
• The Health Insurance Exchanges (HIX’s) employers have been seeing thus far from their traditional benefit advisors have largely been group-based thereby offering no solution for these cohorts
• Some individual policy-based HIX’s have been “open access” types via the internet with no employer controls thereby subjecting employees to the vagaries of multiple and unknown retail level insurance agents or employer must pay heavily to protect employees
• These other HIX models do not provide a viable / optimal solution for those employer’s wanting to show these cohort populations that the employer is working on their behalf to find a solution to the ‘get insured or get penalized “ dilemma under ACA.
The Solution • This SaaS-Based system deploys a proprietary “Choice Architecture” that
was developed by award winning software developers who applied their 10+ years of experience with transformative, consumer-driven solutions
• The Choice Architecture delivers an award winning, consumer-level shopping platform containing personalized-to-the individual recommendations for individual-policy-type health insurance coverage
• The Choice Architecture risk adjusts the consumer’s desire to pay more or less fixed monthly insurance premiums vs. having less or more out-of-pocket cost exposure at time of incident
• The coverage comes from within a large portfolio of the nation’s leading national and regional health plans plus the federal and state HIX’s.
• The system also assesses eligibility for federal and state subsidies, and it can accommodate any employer-made Defined Contributions thereby allowing the individual to optimize coverage by procuring the best health insurance coverage at the lowest cost.
• Given the complexity involved, the shopping experience is supported by a customer call center that is :
- US based 24 X7 telephonic or on-line
- staffed with duly licensed but salaried-only professionals
- quality controlled to result in an average enrollment time of
12 minutes or less
• The system can also accommodate traditional group plan enrollments so as to provide a total cohort enrollment experience
The Solution
Personalized Health Plan Recommendations
Plan Cost Comparison
Checkout & Apply
Next Steps• This product/service is contained in the HR Specialty
Products & Services Catalogue™ • Operational level details about this particular service
provider can be obtained in conference with the vendor• The HR Mining &Distribution Co. is an independent and
contracted representative of the vendor• Upon your request, we will arrange for an introduction
that can range from a simple, quick conference call to a services overview / system demo
