health & lifestyle perx presentation
DESCRIPTION
TRANSCRIPT
Managing Healthcare Costs• Employers continue to seek creative
solutions to reduce healthcare costs, decrease absenteeism and increase productivity
• They have been forced to restructure their benefit plans, often reducing benefits and raising deductibles and co-pays
• This leaves some gaps in coverage and more exposure for employees
• This also leaves some strategic opportunities
Managing Healthcare Costs
• One creative solution is the HEALTH PERx™ Card, which offers a range of affordable healthcare benefits.
• These benefits offer the entire family thousands of dollars in savings.
• At the same time it offers the employer those creative solutions they seek
Disclosures• This plan is NOT insurance.
• This plan provides discounts at certain healthcare providers for medical services.
• This plan does not make payments directly to the providers of medical services.
• The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers who have contracted with the discount plan organization.
• This discount card program contains a 30 day cancellation period.
• Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after the effective date.
• The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received.
Benefit ChoicesHealth BenefitsPharmacy Savings Card
Telemedicine
Vision Care
Dental Care
Hearing Care
Physician & Hospital Discounts
Medical Health Advisor
Telephone Counseling (EAP)
Lab, X-ray & Imaging
Complete benefit information, provider locators, FAQs and links to Rx price finder and Lab discounts can be found by
visiting www.wellnesshealthsolutions.com.
Health Care Reform 20-30 million consumers entering the system
A shortage of primary care physicians
What Will Happen? Individuals will ignore symptoms and delay
treatment which can lead to more serious medical complications
Individuals will leave work for minor issues which results in loss of productivity and unnecessary costs
Individuals will overuse Urgent Care and ERs
Telemedicine can eliminate
most of these problems
Health Care Reform and Telemedicine Access Points for Healthcare
Medical Offices—physician assistants and nurse practitioners
Walk-in Clinics–-Grocery Stores and Pharmacies
Urgent Care and ER Clinics
Telemedicine—Doctors by phone or secure email
Telemedicine can provide immediate access to healthcare to every individual wherever they are, whenever they need it.
The most efficient and cost effective method to deliver telemedicine is by phone.
“Telemedicine has the potential for restructuringmedical care in ways that can solve many of
the problems, while reducing costs and improving quality of care.”
National Center for Policy AnalysisConvenient Care and Telemedicine White Paper, November 2007
National Center for Policy Analysis
Studies Show
Physician telephone consults … have been proven to replace 45%-64% of doctor office visits and 15%-35% of hospital ER visits. Source: TelaDoc 2007 Survey and Consult A Doctor Survey Results 2010
Costs can be reduced as the healthcare system moves from in-person physical exams to virtual visits. The average ER visit is $1024 and primary care office visit is $140. Source: BCBS 2007: Health Cost Estimator
Patient satisfaction with telemedicine is high…due to convenience, comfort , privacy…and the security of having 24-hour access. Source: Us Department of Commerce, Office of Technology
The Challenge: Most telemedicine services require a co-pay. This represents a significant barrier resulting in low usage rates.
We have eliminated that barrier.
TelemedicineWe partner with a network of licensed, board certified physicians, available 24/7/365 by phone or secure email, who can diagnose and treat non-emergency, routine medical conditions. They can prescribe medications when appropriate.
Call :
• When your physician is not available • For non-emergent medical conditions or
questions• After normal business hours, nights,
weekends• When on vacation or in the field• Requesting prescriptions or refills
Survey Results
• Patient calls are diagnosed and treated successfully more than 94% of the time (the other 6% cannot be treated by phone) with 98% satisfaction rating.
• 64% of callers would have gone to physician and 15% to the ER—a significant savings of time and money.
Disclosures:Physicians do not prescribe controlled medications. Telemedicine is not insurance.Telemedicine does not replace your primary care physician.
FactsPhysicians: Experienced in Primary Care, Internal Medicine or
Emergency Room practices Fully credentialed by the NCQA
Common Conditions Treated: Cold/flu Sore Throat Bronchitis Allergies Sinus and Respiratory Infections Headaches and Migraines Stomach aches and Diarrhea Urinary tract Infections Minor Burns Sprains Insect Bites Prescription Refills Second Opinions
Return on Investment
Based on typical investment in this benefit program (results vary according to number of variables)
With 25% participation: Receive $1.86 for every $1 investedWith 33% participation: Receive $3.07 for every $1 investedWith 50% participation: Receive $4.65 for every $1 invested
Disclosures:Office and ER visits taken from CDC Nat’l. Center for Health Statistics.Costs per office and ER visit based on BCBS negotiated rates.Reductions in office and ER visits based on actual survey results.
Imagine if every corporation strongly encouraged a “call first” policyTelemedicine is a game-changer!
Pharmacy Savings Card
Wellness Health Solutions has direct contracts for discounts on both brand-name and generic drugs at more than 67,000 pharmacies.
Savings of 11% to 75% with an average of 53% off the retail price of most Rx purchases.
Pharmacy Savings Card
Even though some individuals may have a pharmacy benefit, many prescriptions aren’t covered.
Ex: cosmetic drugs, appetite
suppressants, smoking cessation prescriptions, prenatal vitamins or nutritional supplies, inject-able supplies, contraceptive devices, immunizations and vaccines and many more
Our card covers them all.
Pharmacy Savings Card
Other Features that promote consumerism:
• RxPrice Retriever
• Generic Navigator
The Rebate Program
The only Pharmacy Savings Card in the country to offer rebates from more than 30 pharmaceutical manufacturers on over 1,000 branded drugs.
When consumer purchases a drug on rebate list, they will receive a preloaded MasterCard in the mail with their rebate amount. Many drugs offer $12-$20 rebates.
Subsequent rebates will be loaded onto that same card.
Every time a rebate is processed, card holder will be notified by email.
Mail Order Price Guarantee
Our Clients are eligible for additional programs:
• Smoking Cessation programs at big savings
• Diagnostic Lab, X-ray and Imaging Discounts
• Access to “Health & Wellness Focus” portal
Wellness Health Solutions can provide client with a desktop monitoring tool allowing you to monitor all pharmacy transactions in “real time.”
Additional Benefits
Smoking Cessation Program
Additional Benefits
Present Pharmacy Savings Card and receive significant discount on Chantix™ prescription
After 90 day program, receive additional $30 via Rebate Card
Take advantage of educational materials and complete support program available through Pfizer “The Get Quit” Plan
Additional BenefitsDiagnostic Lab, X-Ray and Imaging
Affordable: Deeply Discounted Rates: 10-60%.
Convenient: Choose the lab location that's best for you
Quality: Federally and state certified clinics. More than 2,900 radiology centers
Easy Laboratory Testing: Order your tests online or call us. Results within 48-72 hours. It's that easy.
No co-paysNo deductibles
Confidential: Results sent only to you.
People who do not currently have medication coverage
Many drugs on PBM plan cost more than discount card
People who are taking a drug not covered by their medication coverage
Those with a high co-pay or deductible
Those using another discount card
There are more than 33,000 prescriptions below $7
Who Can Benefit
Wellness Health Solutions will collaborate with and assist as needed in producing marketing materials, printing , website development and distributing cards.
Other Issues
• We own our own network—more than 67,000 pharmacies
• We offer excellent discounts to the consumer (11-75%)• We offer cash rebates on many brand drugs• We collect and pay out on 93% of all prescriptions• We provide “real time” monitoring capabilities• We provide smoking cessation discounts and
educational tools• We provide discounts on Lab, X-ray and Imaging• We provide a comprehensive, user friendly, wellness
portal• Everything can be branded to your firm• We operate a “transparent” pass-through business
model so there are no hidden features
SUMMARY
This can be a stand-alone benefit
This card is now being offered to Associations, Non-profits, Municipalities and other groups for distribution to their members and communities.
Every time a prescription is filled, they earn revenue
We can design website tools for pharmacy cards online or print cards for our distribution partners.
Generate Revenue with a Free Pharmacy Savings Card
Other Health Benefits
Dental Care
Members save 15% to 50% on everything from general dentistry and cleanings to root canals, crowns and cosmetic dentistry where available.
More than 92,500 dental practice locations.
Save on specialty care, orthodontics,
endodontics and periodontics where available.
No limit on number of visits
*Actual costs and savings vary by provider and geographical area.** According to the Aetna Enterprise Provider Database as of October 1, 2008. .
Other Health BenefitsVision Care
Save an average of 20%-60% on prescription eyeglasses, frames, lenses, tints, coatings, UV protection and specialty items
Savings on eye exams and 40-50% off the national average on LASIK surgery and PRK (where available)
Savings of 10%-30% on contacts
More than 12,000 locations including national chains and independent providers
Pearle •Sears • JC Penny •Target • LensCrafters • Sterling •EyeMasters• QualSight LASIK
Other Health BenefitsHearing Care-
Beltone Hearing Centers—1,350 locations Free hearing screening and substantial discounts
on hearing aids and other products and services.
Newport Audiology Centers 35% discount off hearing aid prices at more than
2,000 locations 100% Service Satisfaction during the first 60 days
Mail Order Hearing Aids Save 40% to 60% off average National Retail Pricing on more than 100 models of name brand hearing instruments. Receive the lowest price available. 45-day in-home trial period and 1year factory warranty
Other Health BenefitsDiagnostic Lab, X-Ray and Imaging
Affordable: Deeply Discounted Rates – 10-60%.
Convenient: Choose the lab location that's best for you
Quality: Federally and state certified clinics. More than 2,900 radiology centers
Easy Laboratory Testing: Order your tests online or call us. Results within 48 - 72 hours. It's that easy.
No co-paysNo deductibles
Confidential: Results sent only to you.
Physician & Hospital—Galaxy Health™
Save 10-40% at more than 300,000 specialty physicians and thousands of hospitals and urgent care centers nationwide.
Save on cosmetic surgery procedures
One of the largest physician and hospital networks in the nation.
No age or health restrictions.
Optional Health Benefits
Medical Health Advisor—Helps members:
Navigate the healthcare and insurance systems Find the best doctors, hospitals and other providers Resolve insurance claims and billing issues Save time and money on healthcare bills Locate and research current treatments for a
medical condition Help members make informed medical decisions Schedule appointments with hard to reach
specialists Secure second opinions to provide peace of mind Identify renowned "best in class" medical institutions
Optional Health Benefits
Telephone Counseling (EAP)
Our telephone counselors assist with problem resolution and suggest options to help members with personal issues of any size.
Highlights
Counselors work with a multitude of issues including: Depression, anxiety or stress Conflicts at work or home Reliance on alcohol, drugs, tobacco or food Sexual, physical or emotional abuse Loss and grief Change and transition
Members receive free unlimited telephone counseling 24/7. All Counselor have a master's degree and five years of
postgraduate experience
Optional Health Benefits
Other BenefitsLifestyle Benefits
Emergency Roadside Assistance
Identity Theft Protection
Legal Services Direct
Tax Help Line
Pet Care
Fitness Club Discounts
Complete benefit information, provider locators and FAQs can be found by visiting
www.wellnesshealthsolutions.com.
Lifestyle BenefitsEmergency Roadside Assistance – Up to 15 miles towing (up to $80 retail value) per occurrence maximum for covered charges. Flat tire assistance, fuel, oil, fluid and water delivery service, lock-out assistance, battery assistance, & collision assistance.
LifeLock ID Theft Protection * (for member only—family is extra) Identity Alert™ System – provides early notification whenever they detect your
personal information being used to apply for many forms of credit or services WalletLock™ helps cancel and replace the contents of a lost or stolen wallet eRecon™ patrols the web and notifies you of illegal selling or trading of your
information TrueAddress™ notifies you when a change of address is requested in your
name Free annual credit reports from the three major credit-reporting agencies 24-hour customer service $1 million total service guarantee –if you become a victim of identity theft
because of a failure in their service, they will help you fix it at their expense, up to $1,000,000
Lifestyle BenefitsLegal Services Direct
Nine free services which include: Unlimited initial phone consultations for new legal matters Initial one-on-one consultations for new legal matters Document review (6 pages or less) Letters written on the member’s behalf Phone calls made on member’s behalf Assistance with governmental programs Assistance with small claims court representation Free simple will with free annual updates Free living will—state specific
Eight commonly used legal services deeply discounted, such as traffic ticket defense, name change, simple divorce, simple trust and more.
Plan attorneys will either charge $125 per hour, or 40% off their usual and customary hourly rate, whichever is greater.
Lifestyle BenefitsTax Help Line• Unlimited advice on federal taxation • Free tax return preparation for forms 1040 EZ, 1040A and standard 1040 • Deep discounts on numerous other tax schedules • IRS audit assistance • Tax planning • Review of prior year's tax return • Member portal with tax tips, tax law changes, member advice and much
more
Pet Care- Receive 25% off all services at participating vets. Free pet tag and 24/7 location service. Receive 10-30% off at participating providers on pet services, such as boarding, doggie day care, training, pet sitting and grooming.
Fitness Club Discounts-International Fitness Club Network--Guaranteed lowest rates at over 8,500 quality fitness centers nationwide. Introductory Free Week Trial to all clubs. All meet ACSM guidelines.
Other Features List-bill capabilities
Fulfillment Kit and Membership Cards
Website Access to benefits and provider locators
Onsite member services call center staffed with English and Spanish speaking representatives who can help with enrollment, verify discounts and assist with customer service issues. Compliance Department monitoring state legislative
requirements
Marketing assistance and brochures
Money Back Guarantee
All benefits are good for the entire family*
*LifeLock benefit covers cardholder only
Target Applications Self-funded corporations
Fully insured companies with high deductible
plans
Limited-liability plans
Schools, Government, Associations
These low cost benefits complement any insurance plan by offering innovative strategies for reducing absenteeism, increasing productivity, and decreasing overall healthcare costs for the employer while encouraging employees to take more responsibility for their healthcare costs.
Value Proposition
Employers Employees
• Ability to add a benefit with a high perceived value
• A program that will decrease absenteeism, increase productivity and reduce overall healthcare costs
• Ability to ensure that every employee has access to healthcare when they need it wherever they are
• Ability to promote health and wellness and encourage personal responsibility
• A program that can help with acquisition and retention of employees
• Access to medical consultations 24/7 as well as savings on pharmacy, vision, dental, hearing and more
• A benefit that can fill in many gaps in insurance coverage, particularly with high-deductible and consumer-driven healthcare plans
• A program that eliminates unnecessary visits to the doctor or ER
• A benefit that can save the family thousands of dollars a year
• Lifestyle benefits that can save the family additional money on everyday needs
Packages and Pricing
Voluntary Benefits
Select benefits to include and we will develop wholesale pricing.
Involuntary or Embedded Benefits
Based upon group size and projections or guarantees, we will develop involuntary pricing package.
Fulfillment Kits can be provided by client and reduce cost.
What we Have
We have a transformative product
We have the power to change the system
We need to reinvent our business value-propositions
We need to persuade others to see this vision
We will help them see themselves as visionaries