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Track B: Sales Magic Channel Mix Formula: Identifying the Best Distribution Combination for Your Plan Ali Hall, Vice President of Sales AgentCubed, LLC Margaret Dziedzic‐Mood, Director, Medicare Sales and Marketing Harvard Pilgrim Health Care

Track B: Sales - Financial Conferences · Track B: Sales Magic Channel ... Harvard Pilgrim Health Care ... How can you create more synergy for more sales? 3. Which strategies are

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Track B: Sales 

Magic Channel Mix Formula: Identifying the Best Distribution Combination for Your Plan 

Ali Hall, Vice President of Sales AgentCubed, LLC 

Margaret Dziedzic‐Mood, Director, Medicare Sales and Marketing Harvard Pilgrim Health Care 

 

 

 

 

 

 

 

Ali Hall comes with 10 years of professional experience in Business Performance Improvement, Project 

Management, Client Retention and Sales. Primary focus is individual insurance with subject matter 

expertise in Medicare sales.  Her experience is with both telephonic and feet on the street distribution 

channels.    

Margaret Dziedzic-Mood is the Director of Sales and Marketing at Harvard Pilgrim HealthCare, Wellesley, Massachusetts. She has been involved with direct selling to the senior population since 1994, working for Fallon Health in Worcester Massachusetts, before joining Harvard Pilgrim Health Care in 1997. Since 2001 she has been one of the major contributors in the development and implementation of sales and marketing strategies for Harvard Pilgrim’s Medicare Products’ Options (Group and NonGroup). Ms. Mood is a graduate of Assumption College, Worcester, MA and received her MBA from Anna Maria College, Paxton MA.

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Magic Channel Mix Formula: Identifying the Best Distribution Combination for Your Plan

Discussion Topics

1. What are you doing with your distribution and channel mix to get additional sales?

2. How can you create more synergy for more sales?

3. Which strategies are most cost effective?

4. Scrutinizing the role of CRMs

5. Internal vs. external advantages and limitations

6. Making the biggest splash with a limited budget

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Call CenterCall Center

BrokersBrokers

Sales Channel MixLE

AD

S

CaptiveAgentsCaptiveAgents

Private Exchanges

Private Exchanges

Unassisted Sales

Unassisted Sales

MM1

Sales Synergy

Definition of Synergy?? – “synergia” a Greek word which means “working together”

Keys to success:• Defined, jointly developed goals

• Communication

• Education/setting expectations

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Scrutinizing the Role of CRMsAdvantages

Accurate campaign tracking. Turn theories into data driven results

Real-time visibility to lead and agent performance

Ability to automate lead distribution and re-assign leads

Provides your field agents a tool to manage leads, quote and enroll

Improve customer experience

CRM can raise conversion by 30%

Increases cross-selling capabilities

Challenges/Disadvantages

• Cost/requires an investment

• Buy-in from stakeholders

• Administration and training

• Customization surprises

Internal vs. external advantages and limitations

External• No employee cost• Finding hard to reach

clients/minimal dependency on the plan to provide leads

• Scalability• Competing with other plans when

presented options• Who owns the members?• If new to market – ramp up time

quicker• Cost of commissions (6 years, 10?,

evergreen?)• Increased oversight/ potentially

more compliance risk • May require initial technology

investment (EDIs, online tracking tools)

Internal• Increased control over lead distribution

and ongoing management/compliance• Better stats (measures) of marketing

efforts• Lower/fixed cost per sale• Interacting online• Keeping busy year round • Takes time to find the right individuals• Cost of building sales force• Targeting more remote areas may be

difficult (phone/digital not always the option)

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Additional food for thought (making the biggest splash with limited $$s)Distribution should align not only with your membership and financial goals but also your corporate culture. Additional distribution is an extension of YOU and goes beyond compliance… it’s about TRUST and PARTNERSHIP

Direct Field Sales force can’t compete with other channels; focused on commercial conversions, community and provider relationships

– Call Center can help cover a wide territory, lead conversions much lower in costs; assess insourced vs. outsourced and find experienced partners. Structure contract around your goals. Potentially will deliver the highest number of sales but it cant be your only solution

Necessary to engage external partners:

– brokers, engage in lead distribution and measure performance. Excel in broker service, institute tight broker oversight. Utilize broker advisory groups and act upon advice.

– The business of Medicare Private Exchanges is going strong. Must assess how your plan options are positioned on each exchange, upfront technology investment required t can yield long term savings on marketing and sales dollars as well as resources; unfound leads.

As part of your forecasting process, engage your partners/distribution channels and get input on projected membership by channel

Keep up with technology… your future members like their computers, tablets and smart phones. Many will interact with your plan without any help from you.

Don’t just trust your gut… ongoing must run analytics to determine ROIs, cost per lead, cost per sale and make decisions on where to invest and where to reduce spend, may consider segmenting your analytics by enrollment area and sales channels to get the truepicture

Don’t forget Marketing….Measure, measure, measure! Direct mail and direct response tactics integral part of launch and agein strategy, but do analytics and be very targeted by demographics. Know where opportunities are best; provider marketing most cost effective

QUESTIONS?

Ali HallVP of Sales, [email protected](208) 904-0902

Margaret Dziedzic-MoodDirector, Medicare Sales and Marketing [email protected](617) 509-3436

AH [2]1

       

        

How to Train a High‐Performing Sales Force 

 Moderator: 

Scott Levine, Senior Vice President Strategy, Healthcare Practice Lead Kern Health 

 Panelists: 

Phyllis Cain, Director, Sales Individual Lines SummaCare 

 Margaret Dziedzic‐Mood, Director, Medicare Sales and Marketing 

Harvard Pilgrim Health Care    

Scott Levine Senior Vice President Strategy, Healthcare Practice Lead KERN ‐ an Omnicom Agency  KERN Health is an insurance marketing agency with a specialty focus on Medicare member acquisition of the Baby Boomer Generation. Backed by a proven foundation of experience in healthcare and multiple competitive acquisition industries, KERN provides exceptional value to health insurance marketers. As a member of the Omnicom Group Network, we are also able to offer healthcare insurers a powerful partnership that includes unique access to hundreds of the world’s top agencies.  Leading KERN's Healthcare Practice, Scott is a seasoned expert in health insurance marketing, having developed the strategic plan that helped to enable Blue Cross and Blue Shield of Arizona to successfully prepare and thrive within the uncharted waters of the ACA. In addition, he developed the successful two‐year launch plan for Merck’s foray into the non‐pharmaceutical weight management arena.  As Senior Vice President of Strategy, Scott guides and facilitates the development of a holistic view of all clients’ and prospective clients’ business, creating innovative strategic communications solutions to a diverse array of business and marketing challenges. Scott leads strategic initiatives across Digital and Traditional methodologies directing internal and external resources for KERN, An Omnicom Agency.  Scott has developed strategic plans for some of the worlds’ largest and well‐known brands, including several Fortune 500 clients as KERN is the agency to 5 of Advertising Age’s 2015 Top 100 Advertisers. Scott is a strategic leader with a strong business acumen who understands the changing media landscape, shifts in consumption patterns, and how to translate quantitative, qualitative and trend data into compelling brand stories and unique selling propositions.  As part of KERN’s Executive Leadership Team, Scott works directly with all discipline heads and related client counterparts and plays an integral part as the lead in New Business acquisition.  Scott consistently partners with the account service/client strategy leads to develop marketing and communication strategies that are fueled by technology, media, and cultural insight while collaborating with KERN’s analytics group to target behaviors and understand motivational drivers of behavior that will result in more effective communication strategies as evidenced by Scott’s development of Progressive Persona Profiling, now a proprietary KERN audience intelligence tool.  As a seasoned, experienced marketer with over 25 years of professional practice, Scott is fluent in market research techniques, both quantitative and qualitative as well as new methodologies that combine both approaches with a solid understanding of media theory, media history and well versed in new media channels. Scott possesses a deep knowledge of Technology with the ability to understand how technology can evolve into media. 

Bio: Phyllis Cain, Sales Director for Individual Product Lines, SummaCare Phyllis began her insurance career by starting her own agency for a multi-line company in Littleton Colorado. After building an agency from scratch, she became a Corporate Sales Trainer, and then moved into Sales Agency Recruitment/Management. In 2005 she joined SummaCare, a provider owned health plan as the the Sales Director for both the Medicare and Marketplace product lines. Phyllis has a degree in Social Work from Colorado State University. She is married and has two grown children and four grandchildren.

Margaret Dziedzic-Mood is the Director of Sales and Marketing at Harvard Pilgrim HealthCare, Wellesley, Massachusetts. She has been involved with direct selling to the senior population since 1994, working for Fallon Health in Worcester Massachusetts, before joining Harvard Pilgrim Health Care in 1997. Since 2001 she has been one of the major contributors in the development and implementation of sales and marketing strategies for Harvard Pilgrim’s Medicare Products’ Options (Group and NonGroup). Ms. Mood is a graduate of Assumption College, Worcester, MA and received her MBA from Anna Maria College, Paxton MA.

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How to Train a High Performing Sales ForceMargaret Dziedzic-Mood Director, Medicare Sales and Marketing – Harvard Pilgrim Health Care

Phyllis CainDirector, Sales Individual Plans – SummaCare

Background – SummaCare SummaCare Integrated Delivery System and Provider Owned

Not Exclusive – compete with all the other payers Started 30 years – Goodyear first client

Local – Regional Health Plan

Sales Director over both Medicare and Marketplace Products

Composition of Sales Team Direct Employed Agents

Avg. tenure is 15 years

Internal Seasonal Call Center 50% return rate

Use retired SummaCare employees and current overtime

Group to Individual Broker

Broker Referral Bonus

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Background – Harvard Pilgrim Not-for-profit health plan, based in Wellesley, MA

1100 employees across 7 locations Over 1.2 million members in MA, NH, ME, CT Full range of health insurance choices and funding options

Offering Group (Indemnity) and Non Group (Med Supp and Med Advantage) Medicare Options

Sales Channels (Medicare Options) Internal

Licensed Field Sales Agents (avg. tenure 15 years)

Call Center (in house and outsourced)

External Independent Brokers

Commissions

Referral Program

Medicare Private Exchanges

Getting Results from Proven Strategies/Management

Sales by Method – How Telephonic – 63% of business

Paper – 31% of business

Targeted Seminars

Sales by Method – Who 59% Employed Reps

28% House

12% Group to MC Broker

We promote a culture of appreciation, respect, purpose, belonging and collaboration. This results in longevity and loyalty – going above and beyond, which creates better performance and productivity.

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Getting Results from Proven Strategies/Management (cont.) Majority of sales are a result of our internal call center

Staffed with employed and seasonal representatives

Seasonal Mature workforce staffing agency

Interspersed among the (employed staff – avg. 15 year tenure)

50% seasonal staff return every year

Retired dedicated work force

Relates to our audience because of similar needs

Know the area

Early to work and stays late – will work weekends and holidays

Deliver packages to homes

Host seminars

Enrollment patterns are stable from last year: 75% enrolled through a human assistance channel for 2016 and 2017, while just under one in five did so online in each year.

2017 Medicare Shopping and Switching Study

75%

34%

30%

7%

4%

17%

6% 10%

2%

3%

2%

4%

4%7%

72%

41%

23%

7%

15%

4%

4%

1%

7%

Net: Human assistance

Agent

In‐bound call

Seminiar

Other: Human assistance

Net: Online

Insurer's online enrollment tool

Medicare.gov

Some other way online

Private exchange

Paper application

Other

ENROLLMENT CHANNELBase: Post AEP 66+ Plan or insurer switcher, n=205

2017, n=181 2016, n=231

2017:Which of the following methods did you use to sign up with your 2017Medicare health insurer?

Going Back to Basics – How Do You Sell Effectively

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Sales Management 101 – Finding the Right Star Makers Attributes Required:

High EQ, pick up on cues, adapt to people and situations

Common customer service sense

Conscientious – hard working, not on cell phones

Impeccable follow up – permission to call back and call until there is a decision

Strong sense of duty – show up on time to the events, phone coverage awareness

Positive personality – lack of discouragement, resilience

Great listener – hears what people are not asking

Enjoys being a problem solver

Desire to improve to better serve the next Medicare eligible

Sales Management 101 – Finding the Right Star Makers (cont.) Curiosity – ask great questions and really listen to help the prospect with the

reason they called in

Anticipate the next question or reason

Time efficient Sets time by priorities

Hottest leads worked first and often

Birthday driven leads for those aging in and others leaving employer coverage

Use of technology – automated emails

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Sales Management 101 – Finding the Right Star Makers (cont.) Not only finding the star makers, but developing the STAR MAKERS

Tap into each unique sales representative’s motive and encourage action steps to achieve their desired goal

The two root words of the word Motivation are:

MOTIVE and ACTION The MOTIVE, or goal, provides the needed desire;

But nothing ever actually happens without ACTION

Optimal Training ProgramsTell me and I forget. Teach me and I remember. Involve me and I learn.- Benjamin Franklin

We spend 3 weeks in training using a combination of text book and hands on/simulation 1 week overview and resource training 2 weeks hands on/simulation

Screen Casts Visual Kinesthetic Auditory Simulation Repetitive One on one coaching from seasoned seasonal staff trainer and employed

rep lead

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Motivating Strategies

“People often say that motivation doesn’t last. Well, neither does bathing –that’s why we recommend it daily.” – Zig Ziglar

“Motivation is the art of getting people to do what you want them to do because they want to do it.” – Dwight D. Eisenhower

Motivating Strategies (cont.) Mutual trust and respect

“I always have your back”

“Walk the walk” management Working alongside your sales force

Taking calls/making presentations

Taking on more challenging situations

Upper management involvement Attending sales presentations

Seeking feedback from sales reps to understand challenges

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Motivating Strategies (cont.) Staff engagement

Recruit and hire the right people

Get them involved early on Product development

Marketing materials development

Clear understanding of goals and strategy approach Full engagement in development of the sales and marketing plan

Flexibility Every possible telecommuting tool implemented

Work hard in busy selling season, more ‘play time’ in the summer

Staff development

Compensation Solutions The “Secret Sauce”

Commissions motivate employees to sell harder, while salaries create loyal employees.

Happy “marriage” of company’s goals and sales staff’s goals

Company’s compensation goals: Competitive and economical (not an easy task)

Attract and retain the right talent

Track and control sales activities

Flexibility to modify based on market condition

Sales Staff goals: Fairness

Simplicity and easy to understand

Balance between fixed and variable compensation

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Compensation Solutions (cont.) Designing your Compensation Plan

Evaluate your tools available to measure sales activities

Compensation Mix (salaries, commissions, bonuses)

Straight Salary (works if introducing new products or entering new markets, full confidence in sales staff performance).

Combination: salary and commission (works to improve sales performance and activities)

Combination: salary and bonus (works very well if rewarding team performance)

When paying commissions…

Paid on sales volume

Fixed Rate Commission (regardless of volume the payout is the same per sale)

Progressive (tiered) Commission (ability to earn more as each threshold quota is achieved)

Can reset each month

Cumulative

Compensation Solutions (cont.) Administering Your Compensation Plan

Socialize with a subset of sales staff to anticipate questions and additional explanation

Communicate in advance

Explain how it works and how it ties to sales goals

Ensure process in place to measure and pay timely

Final Thought…. Sales compensation is a tricky business

Finding the balance between salary and commission may be your ticket to loyal, motivated sales employees.

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Questions?

Using Technology, Online Sales, Social Media, and Apps to Close the Sale 

Christopher Neuharth, Vice President, Product Design & User Experience Connecture 

Christopher Neuharth As Vice President of Product Design and User Experience for Connecture, Christopher manages product design and implementation, including client consultation, consumer research, content strategy, user testing, and analytics insights. Christopher also leads an internal innovation group, ConnectureLabs, to design and test new market innovations. 

               

Case Study: Cross Walking Members into a New Plan 

 Sarah Fernandes, Medicare Sales Manager 

Health New England  

Jonathan S. Cummins, Director, Government Programs Sales and Marketing Geisinger Health Plan 

   

 

 

Sarah A. Fernandes Medicare Sales Manager Health New England  Sarah Fernandes has been in the health insurance industry for almost 20 years—the last 18 with Health New England. She currently serves as the Medicare Sales Manager responsible for  oversight of Health New England’s internal and external agents. She also does recruitment, training, compliance, compensation and reporting for all Health New England agents and Medicare sales staff.    Sarah is responsible for all aspects of Medicare sales, from creating a sales plan, to writing sales presentations and educational material, to ensuring compliance with all Medicare rules and regulations. Sarah is also responsible for community engagement and member retention and has been successful in achieving over a 94 percent retention rate for the past five years.   Prior to her current position, Sarah spent 11 years with the Health New England customer service team, working her way up to customer service manager.   Based in Springfield, Massachusetts, Health New England is a non‐profit health plan serving members in Massachusetts and Connecticut. Health New England offers a range of health care plans in the commercial, Medicaid and Medicare Markets.   Sarah resides in Belchertown, MA with her husband Armand and their two children: Hailey (14) 

and Ryan (11). In her free time, she is a “sports mom”; supporting her son in his love for 

hockey, soccer and lacrosse and her daughter at baton twirling competitions.    

 

Jonathan Cummins Director of Medicare Sales Geisinger Health Plan Jonathan has served in marketing, sales and product development during the past 16 years within the fields of health insurance and financial services. Jonathan spent several years in marketing and product management with Excellus BlueCross BlueShield based in upstate New York where he managed the company’s first suite of branded/un-branded Medicare Advantage PPO products and $0 premium plans. Jonathan has also served with Coventry Healthcare in the capacity of Director of Medicare Marketing. He worked closely with national distribution to implement a national Medicare Advantage product and was responsible for marketing at the local health plan level to grow their HMO and local PPO enrollment. Currently, Jonathan acts as the Director of Medicare Sales in Government Programs for Geisinger Health Plan, a nationally ranked health plan that is part of one of the largest rural integrated delivery systems in the United States. At Geisinger Health Plan, he works closely with all functional areas to ensure that the organization’s Medicare products are appropriately developed and brought to market. Jonathan oversees the distribution team (call center, captive field agents and contracted sales entities) managing them to meet enrollment, compliance, and product knowledge expectations.

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Cross Walking Members into

a New Plan

Agenda

• Cross-walking: What, Why and When

• Potential Reasons for Cross Walking

• Strategies from Start to Finish

• Communications (Messaging)

• Case Study Health New England and Geisinger

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3

Cross-walking: What, Why and When

• What– The transfer of members involuntarily from their current plan to a new

plan (technical definition) a.k.a. “member mapping” or–The internal strategic “landing zone” for members involuntarily

disenrolled

• Why– CMS mandate– Internal organizational strategy

• When–Crosswalks must be filed with the MAO’s bid

• June 5th is the date this must be filed for the 2018 bid.• Not filing a crosswalk = an incomplete bid.

–June 6th – June 9th: Window for submitting first round of crosswalk exception requests through HPMS.

–Mid – late July: Second window for submitting HPMS crosswalk exceptions.

Reasons

•Plan termination due to life cycle planning (part of the health plan’s

strategy)

•Plan failed to meet filed business plans in more than 5 years

•Plan reaches Total Beneficiary Cost (TBC) limits and/or fails CMS

meaningful difference requirements

•PBP reduction as part of bid negotiation

•Low enrollment plans forced to terminate per the bid instructions

•MAO has duplicate plan ID’s under the same contract

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Requirements

• If cross-walking into a new plan is needed, it’s important to remember a few simple rules:– Members can only be cross-walked to a plan within the contract;

they can only be cross-walked from one plan type to another (e.g. HMO to HMO)

– Members can only be cross-walked from an MAPD to another MAPD within the contract or MA to another MA

– SNP members can only be cross-walked to another SNP within the MAO that is of the same type

Considerations• Key considerations, before you jump into cross-walking members into a new plan:

– Number of members being disrupted– Potential benefits of cross-walking – Execution (plan communication, budget, buy-in from key-

stakeholders, training, materials)– Plan compliance standings– Distribution – how did the disrupted members come to the health

plan originally?– Timing of cross-walk (if strategic and not CMS required)– Plan’s definition of success with the effort

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Strategies (things to think about)

Active

• Capable of providing extensive plan outreach (budget)

• Volatile membership (e.g. new members)

• PPO, POS, PFFS, MSA

• Market leader

• Moderate or severe network disruption

Passive

• Little outreach

• ‘Sticky’/Older membership

• HMO

• Third position or lower in market

• Little or no network disruption

8

Communication Tactics

•Message– Balance: too much or too little can be damaging– Key: Provide enough information to make a decision; don’t highlight reasons

for members to shop

• Tactical Communications Strategy– Depends on budget, available resources– Combined Direct Mail/Web/Outbound Call program most successful

– DM – ‘pre’ ANOC to include PURL– PURL points to prefilled online enrollment application– Outbound call program to include scripted re-enrollment strategy (3 – 5

attempts)

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Geisinger Case Study

10

Geisinger Case Study

•Situation: •$0 MA only/$41 MAPD HMO members cross-walked (mapped) from their plan to a plan ranging from ~$70 - $149 per month

•14,000 members impacted•A new, $0 premium HMO plan was introduced

•Goal:•Retain 70% of membership in either plan

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11

Geisinger Case Study

•Results•Retained ~60%of members (8,400)•50% remained as originally mapped•50% selected the $0 premium plan

12

Geisinger Case Study

•Situation: •PPO Members terminated due to financial performance

•~13,000 members impacted

•Goal:•Re-enroll 70% of impacted members into the most similar Geisinger Gold plan

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13

Geisinger Case Study

Results•76% member re-enrollment into an alternative plan

“Have it your way” re-enrollment

Health New England Case

Study

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15

Health New England Case Study

• HNE offered 4 HMO plans: Premium (high), Plus (mid), Basic (mid), and Value (low)

• 2016 “Bid Process” Health New England (HNE) was bumping up against total beneficiary cost (TBC) and meaningful difference between our products

• We had to make a business decision on whether to:• Significantly increase our plan premiums,• Dramatically change benefits/structure, • Consolidate plans, i.e., eliminate one

• Risk in all options…what would be best for our members and HNE•What would have the least impact (total members/financially)

16

Health New England Case Study

•Decision: close the Basic (mid) plan for 1/1/2017

•Over 1,500 members impacted

•Consolidate into the most “like plan which = $40 per month/$480 per year premium increase

•Retain 80% of membership

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17

Health New England Case Study

• Cross functional team was established: •Senior leadership, Marketing, Communication, Sales, Customer Service, Operations, Enrollment, Complaints and Appeals

• CMS said: No communication to members (outside the ANOC/EOC) until 10/01/2016”

• Tasked with:•Developing a multi-facet communication plan

•Developing materials for outreach•Deliver the message•Training of key staff

18

Health New England Case Study

What did we do?•Created marketing piece to go out 10/1

•Set up community meetings throughout AEP specific to this population (face to face)

•Outbound call from sales manager (someone they know and trust)

•Training, training and more training (consistent message)• SHIP counselors, Senior Center leaders,

Internal call center, External Sales, Enrollment Representatives, Accounting etc.

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19

Health New England Case Study

20

Health New England Case Study

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21

Health New England Case Study

How’d we Do?•Goal was to retain 80% of members

Success: • HNE retained 89% of the Basic membership

Questions?

Sarah Fernandes, Medicare Sales ManagerHealth New England [email protected]

Jonathan S. Cummins, Director, Government Programs Sales and MarketingGeisinger Health [email protected]

               

Case Study: Broker Management & Oversight of Internal & External Staff 

 Brent Hess, Director, Medicare Sales 

SelectHealth  

Mark Lee, Broker Account Manager SelectHealth 

   

Brent Hess, born and raised in Southern California, earned his bachelor’s degree in 

Business Administration with a minor in Human Resource Management from 

California State University of Fullerton. Twelve years ago, he began his sales career as 

a Health and Life Insurance Agent. Beginning with Humana®, he worked as a Market 

Manager for the Senior Products Division for Utah, Idaho, and Nevada. In 2012, Brent 

joined Intermountain Healthcare® and started a Medicare Advantage program for 

Utah and Idaho. He is now the Director of Sales and Marketing for SelectHealth® with 

responsibilities including sales, marketing, advertising, product distribution, product 

development, sales compliance, and Medicare product operations. Brent has had opportunities to 

represent himself on the radio, television, and other media venues to educate the community on 

Medicare options and healthcare questions in general.  Through his transparent approach to this 

business, Brent has brought unprecedented membership growth and retention to SelectHealth® and 

their clinical providers. He has done this by meeting and exceeding customer expectations, developing 

sustainable products, communicating appropriately, and helping people navigate the challenges of 

healthcare options.   

Promoting collaboration between SelectHealth and our External Sales partners.  

Mark Lee started as the Broker Manager for SelectHealth five years ago when the Advantage product from SelectHealth was introduced.  Mark built a robust and engaged broker sales force in Utah and Idaho that took the plan from creation to over 40,000 members today.  Mark earned a bachelor’s degree from California State in Business and Entrepreneurship, then began his career as a B2B Sales Executive in the telecommunications industry.  He later transitioned to individual health products as an independent producer.  Mark entered the Medicare Advantage industry as a captive agent for Humana in Utah and Nevada.   Mark’s background as an individual producer, entrepreneur and sales professional helps him forge strong, productive relationships that last.   

3/9/2017

1

Broker Engagement, Management, & Oversight

Brent Hess – Director, Medicare SalesMark Lee – Manager, Broker Distribution

3/9/2017

2

3

• Monitoring and oversight 

• Risk Assessment 

• Policies and procedures 

• Effective management

• Timeliness of paying commissions

• Recent changes and solutions

Our Discussion

4

Our Model• Non‐Profit / Hospital Sponsored & Mission Driven

• Direct Contract / Concierge Broker Support 

• Initial In‐Person Training

• Co‐op Marketing Partnerships

• FMV Commission (Prorated)

• Broker Advisory Council

• Multi‐Channel Distribution

• Shared decision making

3/9/2017

3

5

How did we do in 2016?

• 8,800 Enrollments

• Over 41,000 active members

• 78% Broker via the channel

• 4 Sales Complaints

• 0 CTMs

• 95% Retention Rate

6

Concierge Approach

• Careful vetting process

• Personal relationship 

• Cell, Text, Email, Etc. (Oh Yeah, we are local)

• After Hours

• Doesn’t matter what plan is being sold

• Kitchen Table Calls

• Proactive and supportive

• Their opinion counts

3/9/2017

4

7

Monitoring & OversightGoogles Definition: 

To watch or organize to make certain it is being done.

CMS’ Definition:

• Accountable to CMS or the State for performance of the delegated function

• Responsible for ensuring the function is performed in accordance with applicable federal and state standards

• Sponsor remains wholly accountable for the activities of its subcontractors

Our Definition:

• Inspect what you expect

• Being Proactive… Not Reactive

• Remain Accessible – We become the subject matter expert

8

Oversight…Relationships & Partnering

• Call it something different… 

• Build Trust not CYA Procedures

• Trust but Verify Procedures

• Direct Contracting

• Direct Oversight

• Frequent Communication

• Access to Benefits Coalition

XXXXX

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How do you Engage Brokers?

3/9/2017 9

• Lunch/Dinner Meetings 

• Co‐Op Marketing

• Turn Service calls into Sales calls

• Remove operational / procedural hurdles

• Be a resource

• Give them a fishing pole… not just a fish

10

Risk Assessment• Impact 

• Policies & Procedures

• Audits

• Resources

• Training

• Documentation & Recordkeeping

• Compliance Team Partnership

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11

Effective Management

• Broker visits

• Support

• Newsletter / e‐blasts

• One‐on‐one relationship (Concierge)

• Keeping cool

• Buffer the agent and the company

• Crafting message

12

Commissions 

• What does the market pay?

• Getting it right… the first time

• How do you pay initial?

• How do you pay renewals?  

• How long do you pay renewals?

• Internal commissions?

• Application type

3/9/2017

7

Commissions ‐ Case Study

3/9/2017 13

SelectHealth decided to reduce initial commissions and prorate renewals. At the exact same time… United went where SelectHealth came from.

• Marketability Implications

• Budget Challenges

• How did SelectHealth rebound?

• Lessons Learned

14

Changes• Loss or Gain of STAR Ratings

• Coverage Gap Reduction

• Distribution Channel Conflict

• Private Exchanges

• AOR Changes 

• New agents vs. Seasoned Agents

• Demographic changes

3/9/2017

8

15

Changes… Continued

• Regulatory

• Funding

• Acquisitions / Mergers

• Channel Conflict

• Competitive changes

• Network Changes

POS Removal ‐ Case Study

16

• 95% Retention

• Market Conditions

• Network differentials

• Broker reactions

• Value vs. Marketability

• Perceived vs. Actual Savings

• Lessons Learned

3/9/2017

9

Idaho Distribution Change – Case Study

17

• Launched with Broker only model

• Introduced Employed Agent after 2 Years

• Perceptions

• Realities

• Lessons Learned

Wrap Up

18

• Importance of Monitoring and Engaging

• Effective and Operational Policies and procedures 

• Concierge Approach

• Timeliness and Marketability of Paying Commissions

• Distribution Strategies

• Recent changes and solutions

• Always finding application to our lessons learned

3/9/2017

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Questions?

3/9/2017 19

Seminars and Successful Outreach Programs 

Lesley Quick, Medicare Sales Represenative, Spokane Premera Blue Cross 

Chris York, Vice President of Business Development Dialog Direct 

Lesley Quick is a Sales Executive for Premera Blue Cross Medicare Advantage products. Lesley has 

presented to thousands of Medicare beneficiaries and acquired the education, knowledge and skills to 

deliver a powerful, compliant and results driven presentation.  With a multi‐disciplinary role in the 

community, she is also called on to conduct activities that foster achievement of star rating performance 

measures as well as successful member retention. 

Lesley has spent over 28 years in the insurance industry, beginning at a regional Blue Shield.  Being both 

highly analytical and personable, she became an employee benefits broker with one of the largest 

international brokerage firms in the country, managing and serving over 200 business clients. With a 

passion for connection to the client and an emphasis on excellent customer service, Lesley eventually 

started her own agency and spent 5 years specializing in Medicare health coverage options.  Her 

expertise has provided the opportunity to work with several Medicare Advantage plan launches in the 

Eastern Washington Spokane market as well as established products and carriers.  In 2013 Lesley came 

full circle to re‐join her Blue Cross / Blue Shield origins and works at Premera Blue Cross, based out of 

the Seattle area of Washington State. 

 

Chris A. York Vice President of Sales and Operations 

a division of 

Mr. York is currently Vice President of Sales and Operations of South Shore Venture, LLC, and Kramer Direct, both part of the new Dialog Direct, a company specializing in marketing to seniors for Medicare Supplement and Medicare Advantage Companies and 35 has years of experience in the life and health insurance industry.    

Beginning as an insurance agent in the field, he went on to hold a variety of executive management positions with several Insurance Holding Companies, was elected to the Board and named Secretary of one life company, and was the Chief Marketing Officer for three national insurance companies. He also was a key executive in the nation’s largest senior life and health insurance marketing company.  He has been extensively involved in sales and marketing, hiring and training agents and managers, product design and development, negotiations with large marketing organizations, regulatory compliance and as a key liaison with state insurance departments and agencies. 

Mr. York received a Bachelor of Science in Advertising from the University of Texas in Austin. 

3/16/2017

1

Data Analytics

Direct Marketing Contact Center

Social eCommerce Fulfillment Creative Services

Event Management

Seminar StrategiesThat Increase Attendance

Chris YorkVice President of Business Development

• Coordinate your strategies:• Lead Generation for Agency Force• Seminars• Direct to Consumer

Start Now!

Identify Your Goals

3/16/2017

2

Use The RightData

• Do you need modeled data?• Credit bureau, head of household• Household, 5 individuals• Use multiple data files (15%-20%

increase in numbers)

• Direct Mail• Social Media• TV/Radio• Newspapers

Incorporate Multi-Channel Media

3/16/2017

3

Break through Mail Box Clutter

6

3/16/2017

4

• Zip Code Analysis• Number of potential members eligible

by zip code• Number of seminars required• Keep events within 5 miles of target

audience. In rural areas no more than 15 miles.

Pre-PlanningIs Key

Site Selection

Take Reservations

• RSVP and Reminder • Record authorization to remind,

call after event• Scope of appointment

• Script set-up for hot transfer• Downloads

• Download events into excel or entire file to update CRM

3/16/2017

5

Offer Premiums

Impact of Gift Cards – Case Study

• With Gift cards the Response rate was 25% higher than the mailings without Gift Cards

• Conversion rate was 20% higher.

• Including gift cards in either one or both mailings gave similar response rates.

               

Case Study: Running a Successful Telesales Team 

 Jonathan S. Cummins, Director, Government Programs Sales and Marketing 

Geisinger Health Plan    

Jonathan Cummins Director of Medicare Sales Geisinger Health Plan Jonathan has served in marketing, sales and product development during the past 16 years within the fields of health insurance and financial services. Jonathan spent several years in marketing and product management with Excellus BlueCross BlueShield based in upstate New York where he managed the company’s first suite of branded/un-branded Medicare Advantage PPO products and $0 premium plans. Jonathan has also served with Coventry Healthcare in the capacity of Director of Medicare Marketing. He worked closely with national distribution to implement a national Medicare Advantage product and was responsible for marketing at the local health plan level to grow their HMO and local PPO enrollment. Currently, Jonathan acts as the Director of Medicare Sales in Government Programs for Geisinger Health Plan, a nationally ranked health plan that is part of one of the largest rural integrated delivery systems in the United States. At Geisinger Health Plan, he works closely with all functional areas to ensure that the organization’s Medicare products are appropriately developed and brought to market. Jonathan oversees the distribution team (call center, captive field agents and contracted sales entities) managing them to meet enrollment, compliance, and product knowledge expectations.

3/29/2017

1

Case Study: Running a Successful

Telesales Team

2

Pop Quiz

Before we get started here is some Modern Management vocabulary. Can you guess their meaning?

1. Prairie Digging

3/29/2017

2

3

Prairie Digging

When something happens in a Call Centre with Cubicles, where peoples heads pop up over the walls to see what’s going on

4

Pop Quiz

Can you guess the meaning?

2. Open-Collar Workers

3/29/2017

3

5

Open-Collar Workers

People who work from home or telecommute

6

Pop Quiz

Can you guess the meaning?

3. Adminisphere

3/29/2017

4

7

Adminisphere

The rarified organization layers beginning just above the rank of call center manager. Decisions made from the Adminisphere are often irrelevant to the problems they were designed to solve.

8

Pop Quiz

Can you guess the meaning?

4. Blamestorming

3/29/2017

5

9

Blamestorming

Sitting around in a group discussing why a deadline was missed or the project failed and who was responsible.

10

Pop Quiz

Can you guess the meaning?

5. Under Mouse arrest

3/29/2017

6

11

Under Mouse Arrest

Getting busted for violating the company’s web browsing rule of conduct.

12

Agenda

• Your Strategy and Process

• Management of the Center

• Case Study: Running a Successful Call Center

3/29/2017

7

13

Definition of a Successful Call Center

• Expenses are at or below budget

• Exceed sales targets for your market environment (i.e. conversion)

• At or above required operations benchmarks– Abandonment

– Service level and hours of operation

– Quality

– Hold times

• Culture of compliance with disciplined leadership

• Real time reporting for optimal management decisions

• Engaged agents and supervisors

14

What is your telesales strategy?

Supportive Majority

Sales oriented

Direct to consumer focused

Customer service oriented

Brand focused

Organizational Culture; Leadership’s Definition of Success

3/29/2017

8

15

Employed or Vendor?

• Employed, contracted vendor or hybrid?

• Considerations– Legal/regulatory (e.g. FDR audits)

– Compliance environment

– IT capabilities (CRM and/or telephonic connectivity to external vendor)

– Budget

– Management of contact center operations

16

Employed or Vendor?

• Why Employed?– Higher close ratios, especially with less competitive plans

– Control over employees (full or part time)

– Staff available to focus on other initiatives outside of AEP

– Less turnover = less continuous initial trainings

3/29/2017

9

17

Employed or Vendor?

• Why a vendor?– Business seasonality

– Buy vs. build (e.g. IT lift to implement)

– Health insurance co’s are not in the call center business

– Better reporting

– Business continuity/disaster recovery

– Performance guarantees

• RFP process

18

A Sound Structure

Actuarial

(profitability by plan/LOB)

Product Development/

Management (market environment and

product positioning)

Marketing (messaging,

audience response by channel)

Provider Network (areas of

stronger/weaker access)

Sales Operations (resource

constraints/excess capacity)

Sales Leadership

Information Technology (CRM

and telephonic capabilities)

Sales Management (seasonality, sales

forecasts, etc.)

• Don’t develop the structure in a vacuum. Consider:

3/29/2017

10

19

Successful Contact Center Management

Workforce Management

system

• Accurate forecasts• Vetted software• Trained staff• Robust Reporting• Reference site

Focused Local

leadership

• Training focused• Analytic• Agile• Empowered• Hands-on

20

Determine Your Process

3/29/2017

11

21

Determine Your Process

• Your call process flow may differ depending on your strategy– Licensed vs. non-licensed

– Inbound and outbound

– Retention (current members) vs. new

– Product

22

Scripting

Do’s

• Develop with ‘human design’ principles (member experience)

• Include CMS requirements-privacy/confidentiality, etc.

• Build flexibility into script and treat as a living doc

• Coach agents to read naturally vs. robotic

• Include sales cues script

• Emphasize listening and recommending

• Build in metrics to measure script performance

Don’ts

• Skip CMS required steps

• Develop script as ‘once and done’

3/29/2017

12

23

Training and Agent Development

• Whether employed or vendor, sales training is key– Curriculum to include technical training on CRM

– Product – tested and certified

– Selling skills

– Compliance – tested and certified

– Quality Assurance

• Culture of compliance must exist balanced with consultative sales processes

24

Scope of Appointment

• Scope of Appointment – CMS Requirement

• What are carriers doing for SOA?– SOA used for all walk ins and scheduling future appointments

– Recorded on all calls for appointments, with field redundancy

– Check with your compliance department

• What is the latest on the Scope of Appointment for telephonic sales?– New guidance issued for 2017 marketing guidelines

• How does SOA affect other channels of distribution?– All channels are subject to the same guidance

3/29/2017

13

25

A Disciplined Management Approach

• Measuring Performance– Establish goals and Key Performance Indicators, manage to

them daily• CMS call performance indicators by agent

• Sales conversion by agent (different methodologies)

• Call quality outcomes and dispositions via QA evaluations (sales and compliance)

– QA calibration • Training management to identify areas of improvement

• Daily during AEP

– Script management

26

Case Study: Running a Successful Team

• Evolution of a sales Contact Center

• New vs. Retained Member Call Forecasts (AEP vs. Lock-in)– Strategy should determine contact center budget, not the

other way around

– Enrollments by Channel• TM = lower acquisition costs and higher member retention

– Product Development (plan competitiveness) • If you are not positioned strongly in the market, TM sales can

overcome some of the product weaknesses

• TM sales can improve retention with effective outbound strategy

3/29/2017

14

27

Case Study: Running a Successful Team

• New vs. Retained Member Call Forecasts (AEP vs. Lock-in) continued…– Budget

• Determine staff in-house or 3rd party

• If in-house, separate sales dept or combined with member svcs?

• Staffing levels– Marketing inbound lead forecasts - BRC, inbound calls, web, etc.

– Historical call volumes

– Outbound call lists

– Average handle time

– Expected service levels and abandonment rate

28

Case Study: Running a Successful Team

• Total Enrollments expected through telesales– Depends on strategy

– Depends on how a ‘sale’ is defined

• Geisinger telesales accounts for– 30% of gross enrollments during lock-in

– 22% of gross enrollments during AEP

– 95% of home visits

– 95% of group meetings

               

Implementing an Effective Certification Process for Your Sales Force 

 Craig Hayden, Chief Marketing Executive 

Vibra Health Plan

 

Craig Hayden, Vice President & Chief Marketing Executive 

Vibra Health Plan  

Craig has over 16 years of Medicare Advantage sales, product management, and marketing experience 

in leading teams of professionals to meet or exceed plans’ goals.  

 

Prior to joining Vibra Health Plan, Craig served as the assistant vice president of Medicare sales for 

Affinity Health Plan (greater New York City).  Craig has served in a variety of sales, marketing and 

product management positions with Capital District Physicians’ Health Plan (Capital & Hudson Valley 

regions of NY), UPMC Health Plan (Greater Pittsburgh region), and Excellus Blue Cross Blue Shield 

(Upstate regions of NY).  

3/15/2017

1

Implementing An Effective Certification Process for Your Sales ForceCraig HaydenVP, Chief Marketing ExecutiveVibra Health PlanHarrisburg, PA 

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY1

Implementing An Effective Certification Process for Your Sales Force

Presentation topics

➢How can you streamline the process and make it easier for agents?

➢Learning from recent mistakes

➢How can you make business easier? 

➢What should you do and what should you avoid? 

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

2

3/15/2017

2

Vibra Health Plan implementation of sales, broker and 

marketing infrastructure

Affinity Health Plan  Implemented Broker commission & 

certification along with CRM software plus broker training

Capital District Physicians Health Plan  Implemented broker commission and 

new CRM software plus manual broker certification & training

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

Craig Hayden

3

About Vibra Health Plan  March 2017 – 3rd Month of Membership 

& Operations

Serving 17 PA Counties with 780K Beneficiaries in the service area

Mission ‐ Vibra Health Plan will provide a superior member experience through relentless member support and through improvements in Health care coordination, quality and affordability. Need the support of independent 

insurance brokers to fulfill this mission and deliver the product

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

4

3/15/2017

3

2015 2016

➢ Initial Network recruited ➢ PA certificate of authority ➢ Notice of Intent to File Medicare 

Advantage PPO Plans

➢ Recruited, Certified & Appointed ~300 independent agents

➢ UAT & Implemented Broker Certification 

➢ UAT & Implemented Learning Management System

➢ UAT & Implemented CRM ➢ UAT Broker Commission

Timeline – Vibra Health Plan Startup

5

2017

➢ Surpassed three established plans’ net enrollment 

➢ Nearly tripled the 1st year sales of recent Medicare only startup plans

➢ Implemented & Paying Broker Commissions

How can you streamline the process and make it easier for agents?

24/7 Online Access Support Line Short Process Time

6

3/15/2017

4

How can you streamline the process and make it easier for agents?

Eliminate Paper Payment to FMOs and GAs

Testing

7

Learning From Recent Mistakes

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

Don’t do a paper &/or manual process

Difficult to report results from paper process

Accountability difficult with paper process

8

3/15/2017

5

Learning From Recent Mistakes

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

Non-Tech Savvy brokersLeave Time to Develop &

Get Sign OffMonitor service uptime

and reliability

9

Learning From Recent Mistakes

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

User Acceptance Testing Project Management

10

3/15/2017

6

How can you make business easier? 

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

➢Design process for real brokers facing limited time to complete six to ten separate plan certifications

➢Reduce the levels of payees (if possible)

➢Use agent’s National Producer Number (NPN) as their writing number in your system(s)

11

How can you make business easier? 

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

➢Automatic/systematic appointment of brokers once certification/training process is completed

➢Communicate status of completion to brokers on a regular basis

➢System integration of onboarding process to your plan

12

3/15/2017

7

What should you do and what should you avoid? 

➢Online 24/7 process

➢Process opened to brokers as early as possible

➢Broker Support to help them complete process

➢Keep your product training & testing simple

➢System integration

➢Use National Producer Numbers

➢Paper process

➢Don’t test on memory – allow use of  reference materials (i.e. training material &/or collateral)

13

VHP Company Goals

Easy for Brokers to Complete

Integration of the Certification

Process

Easy Reporting and Monitoring Brokers as they

complete the process

Low Implementation &

Hosting Costs

14

3/15/2017

8

VHP Team Goals

• Captive and independent broker cooperation & participation are paramount

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

15

Project Goals

Projected ~ 60% of sales to be accomplished by

independent insurance brokers

Callidus Work Flow/LITMOS system provided solution to

certify & appoint brokers• VHP still working toward

SI with CRM, Broekr Payment System and Enrollment System (EAM/QNXT)

Callidus ICM (Incentive Compensation Manager)

system provided platform to pay and track broker

commissions

16

3/15/2017

9

Challenges

Remote vendor implementation

vs. onsite vendor

!

System integration

!

Vendor contracting &

oversight

!

Project/Time Management

!

17

Technology Partner ‐ CallidusCloud

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

LEAD TO MONEY SUITE

LEAD TO MONEY SUITE

Solid foundation for aggressive growth targets

Rapid implementation methodology

Proven Medicare partner and solution suite

Health insurance professionals

Pre-built third party integrations (NIPR, background checks, e-sign)

Complete integrated solution (Onboard, ICM, Learning)

18

3/15/2017

10

How can you streamline the process and make it easier for agents?

Broker appointment workflow system is

easy to use for brokers with typical

technical savvy

Processed ~300 broker appointments

during initial AEP season

ICM (Incentive Compensation

Manager) payment system extremely

helpful with efficiency and accuracy of

broker commissions

19

Key Take‐Aways

Time spent on your statement of work (SOW) is well spent

Discuss the product with the end user as thoroughly as possible

Test your system as much as possible during UAT (user acceptance testing)

Achieving all implementation goals during the allotted timeline is critical.

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3/15/2017

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Thank You for Your AttentionQuestions???

ALL CONTENTS OF THIS PRESENTATION ARE CONFIDENTIAL AND PROPRIETARY

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