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© 2009 Regence. Private and Confidential.
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ActivateSM – Healthy Living RewardedActivateSM – Healthy Living Rewarded
• Rewards employees for healthy choices
• Employees pay their doctors online
• Encourages healthy competition
• Supports loyalty through growing rewards
• Simple to administer
Key Attributes:
© 2009 Regence. Private and Confidential.
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Regence ActivateSM Coverage
Health Plan• Simple benefit design• Affordable coverage• Options to choose from
Member Choice Account• $ rewards for healthy choices• Pays deductible & coinsurance• Provides up-front coverage• Funds roll over each year
Activate brings together a simple health plan with financial incentives for making healthy lifestyle choices
© 2009 Regence. Private and Confidential.
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Member Choice Account
Save!• Use MCA to pay deductible & coinsurance
• Pay providers directly online
• Unused funds roll over each year
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Log On• Sign up on myRegence.com
• Health assessment activates MCA
• $200 goes into MCA
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Get Moving• 5,000 points = $10
• Earn up to $100 each quarter
• Members can earn $600 per year
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Activate Home Page
© 2009 Regence. Private and Confidential.
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Reward PointsReward PointsExamplesExamplesActivityActivity
Stress Management
Physical Activities
Preventive Health
Nutrition & Weight Loss
Online Activities
Activities Designed To Fit Any Lifestyle
250 points eachGo biking or walking; participate in team sports, take an exercise class
5000 points per year500 points per year
Get an annual women’s or men’s exam; Get a flu shot
500 points eachIncrease fiber intake;Eat fruits and vegetables
600 points per year500 points per month
Get help with child care; get a massage
100 points each500 points per use
Read health-related articlesUse the Health Cost Estimator Tool
Over 100 activities available to choose from!
© 2009 Regence. Private and Confidential.
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Typical Copay PlanActivateHealthy Living Rewarded
Member Choice AccountUp-front Benefits
Activate offers a unique option for pre-deductible benefits
$600 Member Choice Account $20 copay / Upfront Lab & X-ray
• 100%coverage – no copays
• Benefits are member’s choice
• Accumulates toward deductible
• Funds roll over each year to build equity over time
• Pay your doctor online
Advantages Advantages• Provides cost predictability
• Full benefit is available day one
• Doesn’t require engagement
Considerations• Full benefit is achieved
throughout the year
• Requires engagement
Considerations• Always have to pay cost share
• Benefits are specified
• Does not accumulate toward deductible
• Use it or lose it benefits
© 2009 Regence. Private and Confidential.
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Member Choice AccountWhat’s it Worth?
Nearly ½ of insured consumers spend less than $600 on medical expenses each year
Common Services MCA Benefit
A $600 MCA will pay for… 1 wellness exam, a mammogram, 2
doctor visits, a cholesterol screening and an allergy shot
or…
1 wellness exam, a doctor visit, a specialist visit and two x-rays
or…
5 doctor visits
…it is all up to the member
And it all counts toward the deductible!
Adult wellness exam $150 - $190
Well-child/baby exam $100 - $135
Doctor visit $100 - $120
Specialist visit $215 - $280
Immunizations $10 - $15
Cholesterol screening $20 - $50
X-ray $25 - $80
Mammogram $85 - $150
PSA Test $30 - $60
Allergy injection $50 - $60
Source: RBS 2008-2009 network discount costs
Why $600? ][
© 2009 Regence. Private and Confidential.
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Member Choice AccountThe Employee Perspective
Let’s look at the spending habits of 100 typical consumers.See how a $600 MCA creates value for all employees.
Source: Regence 2007-2008 claims data
Member Claims
These members
will have no costs, so all funds are retained(15%)
Covers most costs
(20%)
Buys down deductible by
$600(35%)
Covers all costs (30%)
$5,000+$0 $600 $1,500
© 2009 Regence. Private and Confidential.
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Couple
Family of 4
Year 1 Year 2 Year 3 and Beyond
Single
Building Loyalty Through Rewards
Earned Account Rollover Total RolloverDeductible is max. amount
$600
$1,200
$2,400
$1,200
$2,400
$4,800
$1,800
$4,800
$7,200
Each family member's MCA remains separate
Total sum value is displayed
© 2009 Regence. Private and Confidential.
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Keeping Employees
Engaged
Keeping Employers
Informed
Supporting Program Success
• Online scorecard to track and improve participation
• Communications triggered by low activity levels
• Superior interactive reporting
• Employee activity participation
• MCA earnings, expenditures, and rollover
Elizabeth
Heather
Richard
Account Overview Activity Graph
Activated Members
50%
35%
85%
© 2009 Regence. Private and Confidential.
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A Solution That Strikes at Health Care Dysfunction
• Creates a direct connection between behavior and cost at the employee level
• Encourages loyalty through growing rewards
• Gets the entire family involved
• Offers a seamless web-based experience
Regence Activate…
© 2009 Regence. Private and Confidential.
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You Choose From Three Categories of Providers
Employees can select the Provider(s) they want, depending on the portion of the cost they wish to pay - providers fall into one of three categories:
Category 1 90% of doctors
Lowest patient cost
Category 2 3% of doctors
Moderate patient cost
Category 3 7% of doctors
Highest patient cost
© 2009 Regence. Private and Confidential.
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ActivateSM Snapshot
*Deductible
*Coinsurance
Coinsurance Maximum
Lifetime Maximum
Member Choice Account
Riders
$1,500, $2,000, $3,000
80/60/60
$3,000 $4,000 $6,000
$2 million
Up to $600 per member
4 options - Vision, EAP, Spinal Manipulations, Complementary Care
Medical
* Can be paid with MCA funds
© 2009 Regence. Private and Confidential.
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ActivateSM Snapshot
Generics
Brand Formulary
Brand Non-Formulary
Deductible Options
Annual OOP Max (Per member)
$5 $7 $10 10%
75% 70% $35 70%
50% 50% $75 50%
$250, $500, $1,000
NA
Rx
© 2009 Regence. Private and Confidential.
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What is a Value-Based Benefit Design?
• Value in healthcare depends on Improving health Reducing financial barriers to
effective treatments
• Future treatment costs tend to be more manageable for those actively involved in their own health
• Financial incentives drive improved health status:
Reduced financial barriers for medication therapies of higher clinical value
Goal is to improve medication adherence
© 2009 Regence. Private and Confidential.
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Providing Value to Everyone
EmployerEmployer EmployeeEmployee
• Incentives to take personal responsibility to improve/maintain health
• Aligns preventive benefits with better access to high value medications
• Decreases financial barriers to medication adherence
• Employees who are healthier, engaged and productive
• Drive reduced absenteeism
• Better medication adherence may reduce treatment costs
Example
Untreated high cholesterol can lead to atherosclerosis, causing restricted blood flow that could lead to heart attack or stroke.
ER costs or other medical care could potentially be avoided by following a medication regimen.
© 2009 Regence. Private and Confidential.
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Activate Rx: Transformational Pharmacy Product
• Integration of wellness and prevention
• Not subject to deductible are Generics and Formulary Brands frequently used for:
High cholesterol
High blood pressure
Asthma
Diabetes
• Diabetic patients can receive a generic medication for high cholesterol for $0 copay
Smoking cessation
© 2009 Regence. Private and Confidential.
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[Insert Customer Name Here][Insert Customer Name Here]
Helping You Plan for a Healthier FutureHelping You Plan for a Healthier Future
Thank you for your time!Questions?