THANK YOU!. A super-hero is defined as an individual with "extraordinary or superhuman powers” and dedicated to protecting the public. By most definitions,

THANK YOU!

A super-hero is defined as an individual with "extraordinary or superhuman powers” and dedicated to protecting the public.

By most definitions, characters do not strictly require actual superhuman powers to be deemed superheroes.

Why We Need H.E.R.O.s

• Up to 75% of what the Untied states spends on Health

care is directly

related to what

we have chosen to

eat, drink and

smoke.


• Depression is estimated to be the number three health care cost driver

THE CONCEPT

Healthier Employee Reimbursement Option

• Available as a stand-alone program, or• Integrated with an HRA, or• Integrated with a HSA

H.R.A.

H.S.A.STAND-ALONEH.E.R.O.


• For an HRA, employees can earn points based upon traceable activities that are converted into dollar values for employer HRA contributions.

• The wellness plan can be added as a “no cost” component through restructuring the HRA. One option is to rollback the HRA benefit and let employees earn back the full HRA through active Participation in the wellness plan.


•On average, carrier based and embedded wellness plans attract 4% of an employer’s population.

•We have partnered with Trotter Wellness to offer multiple solutions that can either be integrated with your HRA or HSA or offered as a standalone option.

•Trotter participation averages 88%


•How many of us today have been on a diet?•How many of us today on a diet lost weight?•And how many of us today were on a diet a second time?•And a third time?

Putting The Pieces Together

HEALTHIER

EMPLOYEE

REIMBURSEMENT

OPTION

Wellness That Works®

Gain the Trotter Wellness Advantage

and get ahead of rising healthcare costs.

Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved

About Trotter Wellness®

Comprehensive wellness program management Serving individuals and organizations nationwide Specializes in health risk related behavior change

through Health Risk Assessments (HRA’s), Health Coaching and comprehensive program management


About Trotter Wellness® Our success is demonstrated by a documented return

on investment obtained by both our clients and members

Our programs are supplemented by a robust online suite of online modules, tools and customized resources

Our integrated delivery platforms provides a seamless system of logistics, behavior change, tracking and reporting

Results Driven Structure

88% program participation for employees and spouses

93% satisfaction with Optimal Health Coaching™ (3rd party survey results)

98% retention rate of clients after the 1st year

5.2 Average ROI for those who measure

• High participation

• High satisfaction

• Program planning

• Effective behavior change

• Outcome measurement



Why Wellness

Healthier Workforce

Reduced Health Claim Costs

Reduced Workers’ Compensation Costs

Increased Productivity & Morale

Reduced Sick Time


Why Wellness

Source: Health Affairs 2012: Ten Modifiable Health Risk Factors Are Linked to More than One-Fifth of Employer-Employee Health Care Spending, Goetzel et al. Based on 2009 data.

Additional yearly health costs of an employee with key risk factors


Program Options

Optimal Health™ - Full service corporate wellness program

Wellness That Works® - Performance based wellness program

Corporate Wellness Essentials™ - Small business and self-service corporate wellness program

Well Nation® - Individual wellness programs

Golden Health® - Individual wellness programs for seniors


Optimal Health™ Program

Full service, corporate wellness program Improves participant’s health through health coaching Focuses on prevention, health risk reduction, goal

setting, targeted programming Based on a ROI model Includes incentive planning, participatory or

standards/progress based incentive programs Corporate aggregate reports, health coaching reports,

and corporate action planning


Our Model

Biometrics HRAsCoaching

Assessments Goals Set Behaviors Changed

Claims Reduced


Our Platforms

Behavior Change

• Biometrics• HRAs• Health Coaching• Web Tools &

Resources

Logistics

• Timeline planning• Communications• Environmental

assessment• Incentives• Implementation

planning• Year-long support

Tracking / Reporting

• Personal reports• Aggregate data• Health Coaching

reports• Action planning• ROI metrics


The Key to Results: Optimal Health Coaching™ The catalyst for long-term sustainable behavior change

Awareness is only the 1st step; and it is not enough Professional, full-time Trotter Wellness health coaching

staff certified by the American College of Health Coaches™

Optimized utilization of other available services and resources for the company

One-on-one, private, confidential, personalized and convenient telephonic model


The Key to Results: Optimal Health Coaching™ Support and guidance enables each member to have an

opportunity to set realistic, personal and sustainable health goals

Health coaching support to participants is available year-long, Monday-Friday, 8am to 8pm CST

Access to comprehensive targeted educational resources through their Health Coach and emailed or mailed to participant

Wellness That Works® Performance based program

for qualified companies

No up-front program fees

We are not paid unless we deliver measurable results

• Available to most large companies

• Full service, corporate program

• Delivers reductions in health, workers’ compensation and disability claims

• Increases productivity


Corporate Wellness Essentials™

Self-service wellness program Designed for small businesses Good fit for organizations

looking for basic wellness tools

Use as a foundation for a more robust wellness program

• Online purchase & setup

• Comprehensive implementation guide

• Monthly wellness activities and challenges

• Customer service support available


Well Nation® Healthy living programs for

individuals Focus on a participant’s

unique needs Support from a professional

wellness coach Programs are concentrated

over 90-days for quick results• Weight management• Smoking / Tobacco Cessation• Nutrition• Fitness• Total Wellness


Golden Health® Healthy living programs for

individuals 50 years + Identify health risks and

create a plan to address them On-going support from a

professional Health Coach Programs are 90-days in

length• Professional wellness coach

support• Personal wellness report• Five focused program

available



Sample Results: Waupaca Foundry

Largest producer of gray, ductile, and compacted graphite iron in the world

Leadership backed wellness initiative Implemented in all sites, spouses and retirees, over

5,000 eligible members Alignment of benefit plan design, health risk reduction

strategies and health coaching support



$75 per month incentive ($900 per year) benefit credit towards medical premium

Program Requirements:Biometric ScreeningHealth Risk Assessment2 Health Coaching SessionsChoice: Annual Physical or 3rd Health Coaching

Session



Year 5 Results89% Participation9 Point improvement on Overall Wellness Score37% improvement in fitness-related risk34% improvement in cancer-related risk17% improvement in nutrition-related risk

16 : 1 ROI




Why Trotter Wellness® 10 years of wellness program experience with a national

reach Led by an experienced, knowledgeable and professional

team A reputation built on delivering consistent results Prefers long-term partnerships based on mutual trust,

open communication and the unified goals of increasing health, reducing costs and transforming lives


Questions

Thank You!!!!

First there was the Pam Anderson tape…………..

Then there was the Kim Kardashian tape………..

And now we bring you the following tape……….

Health Care Reform: The Legal Landscape (and other

fun stuff)

Ashley Gillihan, [email protected]

© 2013, Alston & Bird, LLP

mailto:[email protected]

Steps You Should Be Taking Now in 2013

• Market Place Notice

– Do I have to send it to COBRA beneficiaries?

– Do I have to send to employees in the territories?

• Annual enrollment for 2014-send revised SBCs

– Can I include the new language on a cover sheet?

– Do I have to send on behalf of an EAP?

• Mid-October--Begin standard measurement period for 2015

• Address impact of Windsor

– Do I have to cover same sex spouse’s?

– How do the new rules affect Health FSAs, HRAs, and HSAs?

2014 • 2nd wave of health insurance reforms (effective for plan years beginning on or

after January 1, 2014)

– Essential health benefits• Do I have to provide EHBs?• How do I identify EHBs?

– Deductible limits• Can I use an HRA to satisfy the deductible?

– OOP Limit• What is included in the OOP?• Are multiple network tiers considered a single network?

– Provider nondiscrimination• Do I have to allow all providers to participate in my network?

2014• Health Insurance Reforms (cont’)

– Wellness rules• Who is entitled to a reasonable alternative?• What is an activity based program?

– Clinical trials?• Do I have to cover all clinical trials?

– 90 day waiting period limitation• If our waiting period was longer than 90 days, and someone is still in a

waiting period when the plan year in 2014 begins, do we have to cover them?

– No pre-existing condition exclusions• What is a pre-existing condition exclusion?

– End to annual limit waivers

2014

• Amend Health FSAs to comply with 2500 limit (which was effective for plan years beginning on or after January 1, 2014)

• W-2 reporting for 2013 by January 31, 2014

• Send Certificate of creditable coverage through December 31, 2014

Other Fun Stuff

• Technical Release 2013-03– Can an employer pay premiums for a major medical policy

issued in the individual market?

– Can an employee pay for major medical IM premiums through a cafeteria plan?

– Can I still have a stand alone defined contribution arrangement?

– What does “integrated” mean?

THANK YOU

• 12:19:17 pm]: Thanks for contacting Health Insurance Marketplace Live Chat. Please wait while we connect you to someone who can help.

• [12:32:13 pm]: Please be patient while we're helping other people.






































• [12:51:21 pm]: Welcome! You're now connected to Health Insurance Marketplace Live Chat.

Thanks for contacting us. My name is Adriana. To protect your privacy, please don't provide any personal information, like Social Security Number, or any other sensitive medical or personal information.

• [12:51:40 pm]: Adriana • Hello, how may I help you? • [12:53:32 pm]: Adriana • Are you looking for information about

health insurance in the state you live in, or a different state?

• [12:53:32 pm]: Steve • I can't even type and send you something

as the send button is disabled. This is useless.

• [12:53:32 pm]: Steve • wow • [12:53:33 pm]: Steve • are you there • [12:53:33 pm]: Steve • Hello? • [12:53:52 pm]: Adriana • Yes, what state do you live in? • [12:55:19 pm]: Steve • Confusion! • [12:55:19 pm]: Steve • NJ • [12:55:49 pm]: Adriana •

Thank you. I’m required to inform you of specific details regarding your state. This is essential information for your future reference. After I give you this information, I will address your initial question. Thank you for your patience.”

• [12:57:21 pm]: Adriana • I can answer your questions about the

Marketplace and how you can enroll. You can also use HealthCare.gov to find this information and what programs you may qualify for, as well as find and apply for coverage, compare plans, and enroll in a health insurance plan. You can apply now through the end of open enrollment. Open enrollment for health coverage in 2014 closes on March 31, 2014.

• [12:57:21 pm]: Steve • Why does it take so long for my message

to go through? It seems like there is a 2 minute delay

• [12:57:21 pm]: Adriana • I apologize for the inconvenience. • [12:57:21 pm]: Adriana • I'll gladly assist you with information on

creating and managing your HealthCare.gov account. It will take me just a moment to review and respond to your question.

• [12:57:21 pm]: Steve • ok • [12:57:21 pm]: Adriana • We have a lot of visitors trying to use our

website right now. That is causing some glitches for some people trying to create accounts or log in. Keep trying and thanks for your patience. You might have better success during off-peak hours, like later at night or early in the morning. We’ll continue working to improve the site so you can get covered!”

• [12:57:21 pm]: Steve • Busy day today? • [12:58:45 pm]: Steve • Is the delay a systemic system issue or

just the amount of traffic going through today?

• [1:00:28 pm]: Adriana • We have a lot of visitors trying to use our

website right now. • [1:02:01 pm]: Steve • Will I be able to get more affordable

healthcare or simply more accessible care?

• [1:05:31 pm]: Adriana • You can enroll in a Health Insurance

Marketplace plan from October 1, 2013, until the end of open enrollment. Open enrollment closes on March 31, 2014. You have plenty of time to enroll.

• [1:09:35 pm]: Adriana • Do you have any other questions that I

can help you with? • [1:11:07 pm]: Your chat session is over.

Thanks for contacting us, and we hope we've answered your questions. Have a great day.

• [1:11:07 pm]: 10/1/2013

Documents

THANK YOU!. A super-hero is defined as an individual with "extraordinary or superhuman powers” and dedicated to protecting the public. By most definitions,