AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT...

26

Transcript of AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT...

Page 1: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.
Page 2: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

AGENDA

HEALTH PLAN

•Customizable benefit design

•Funding options

•Comprehensive network options

CLIENT SERVICES

•Customer service

•Core administrative services

•Reporting

CARE DELIVERY

•Patient-centered care

•Care management

•Wellness Solution

•Occupational Health Services

2

Page 3: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Contain your total cost of care byintegrating a customized health planwith our unique care delivery systemand exceptional client services.

3

Page 4: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

4

Page 5: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Achieve optimal coverage for your companywith our flexible options.

5

Page 6: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Customize your benefits to meet the needs of your employees.

• Defined network

• Point-of-service plans (POS)

• Preferred provider organizations (PPO)

• Consumer-directed health plans (CDHP)

– Health savings account (HSA)

– Health reimbursement arrangement (HRA)

– Integrated HSA and HRA administration through HealthEquity®

– High deductible health plans (HDHP)

6

Page 7: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Manage your risk with our full-spectrum of funding options.

7

Page 8: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Your employees can get the care they need wherever they live.

8

Page 9: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Care at Group Health Medical Centers

• It offers our greatest

competitive advantage.

• It’s where care and coverage

work together to create more

value for patients and employers.

9

Page 10: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Empower your employees to improve their health and the result can be a more productive workforce and lower overallhealth care costs.

10

Page 11: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

No one else brings it all together in one package like we do.

11

Page 12: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Experience something different with patient-centered care at Group Health Medical Centers.

• Patients can spend more time with their doctors*

• Doctors with Group Health Physicians partner with patients

in health care decisions

• Primary and specialty care physicians can focus

more attention on patient care

• Each clinic features a variety of services, including doctor visits,

X-rays, lab, and pharmacy services

* Group Health Research Institute study published in Health Advisor, Vol. 29, May 2010. * Group Health Research Institute is the research division of Group Health Cooperative.

12

Page 13: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Employees can save time and money with online services at ghc.org.*

• Appointment scheduling

• Prescription refill ordering

• Electronic medical records, including lab and test results

• Secure e-mail exchanges with their doctor

• An award-winning** app for iPhone® and AndroidTM

smartphones to access care on the go

** Some services only available with care at Group Health Medical Centers** Source: Best Mobile App of 2011, TechFlash Newsmakers Award

13

Page 14: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

14

Page 15: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Manage your medication costs with our safe, competitive pharmacy solution.

• Extensive pharmacy network includes 25 Group Health

pharmacies, contracted network pharmacies, and the

MedImpact pharmacy network.*

• 2013 Medicare 5-star quality rating for prescription drug coverage

for Group Health Cooperative Clear Care® (HMO) plans.

• Market leader in prescribing generic drugs.

• Competitive formulary based on rigorous review of

new drugs for safety and effectiveness.

• Online and mail-order refills.

* Available for some plans 15

Page 16: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Care management beyond the exam room helps patients get the care they need, and reduces unnecessary services.

• 24/7 Consulting Nurse Service

• Complex case management

• Transition management between care settings

• Utilization review

• Disease management coaching

16

Page 17: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Keep employees healthier with our Wellness Solution.

17

Page 18: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Make wellness an integral part of the workplace.

We provide wellness consulting to help you build multi-year

programs and for an additional fee, we offer:

•Wellness challenges

•Worksite biometric screening events

•Worksite flu shot events

18

Page 19: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

For help with workplace injury care and safety, there’s our Occupational Health Services.

• Injured worker care at Group Health Medical Centers

• For an additional fee, we offer the following:

– Industry-specific physicals and employment exams

– Screening

– Drug and alcohol testing

– Prevention services

19

Page 20: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Published research demonstrates that our model of care boosts quality and curbs costs.

20

Page 21: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

You don’t just get a plan.You get advice every step of the way.

21

Page 22: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Exceptional customer service you can rely on.

• Local designated account management

and customer service teams

• Win-win relationships where everyone benefits—

employees, employers, and providers

22

Page 23: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Core administrative services

• Claims administration

– Subrogation

– Coordination of benefits

• Eligibility maintenance

• Appeals

• Summary of benefits

and coverage

23

Page 24: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Ongoing data-driven consultation helps you understand both health plan and care delivery cost and utilization.

24

Page 25: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.

Let’s talk about how your company canbenefit from the Group Health difference.

25

Page 26: AGENDA HEALTH PLAN Customizable benefit design Funding options Comprehensive network options CLIENT SERVICES Customer service Core administrative services.