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Wellness Health Solutions
Market OpportunitiesThe State of Healthcare
Suite of BenefitsPricing & Commission Structure
How We Support You
Wellness Health Solutions
Built a program to support brokers with a one-stop business modelOffers a suite of benefit plans to help employers control healthcare costBrokers are supported 24/7 and compensated above industry standards
The Market Opportunity
Healthcare costs has more than doubled the past decadeEmployers are reducing benefitsEmployees are being hit with first dollar exposuresCost sharing of health premiums increasing
Milliman (MMI) Index
MMI: Cost By Source of Payment
MMI: Components of Spending
Healthcare Reform: What It Means
Government regulation and mandatesCommission reduced or eliminated altogetherBrokers forced to expand their offerings into other product lines to protect revenue30+ million more consumers into an already overburdened system
Healthcare Reform Issues
Shortage of physiciansLonger delays Increased absenteeismDecreased productivityIgnored symptoms will result in more expensive care which will increase premiums
Employer Problems
Healthcare out-pacing inflation 2:1Premiums increasing without any controlClaim filings increasing causing higher premiumsEmployee benefits being cutHealthcare reform limiting benefits
• We help control costs and premiums by focusing on the two key healthcare cost drivers:– Doctor/Urgent Care/ER visits – Prescription drugs
• By utilizing Telemedicine and our Pharmacy Savings Card we can help control costs
There is a Solution
The Game Changer: Telemedicine
Members have access to a board certified U.S. based physician 24/7/365 who can
diagnose and treat non-emergency, routine medical conditions. Physicians can
prescribe medication and access the service via phone, email, or bi-directional
video.
The Benefits of Telemedicine
Controls claim lossReduces absenteeismIncreases productivityBenefit options to employersMore benefits to employeesControls premiums
Telemedicine Facts
Common Conditions treated: Cold/flu Sore Throat Sinus and Respiratory Fever
• Experienced in Primary Care, Internal Medicine or Emergency Room Practices• Fully Credentialed by the NCQA• 80% of doctor visits are for non-emergency conditions• 15% of emergency room visits are for non-emergency conditions
Telemedicine can significantly reduce non-emergency visits resulting in huge savings!
Doctor Visit: Current Situation
Missed multiple days of workSpent time in doctor’s officeCo-paysClaim against insurance
Set up appointmentMiss two days of workWait at doctor’s office with other sick peopleSee doctor for five minutesPrescribes medicationPay co-pay (claim against insurance) or $120 bill if you don’t have insurancePick up medicationMiss additional day of workReturn for follow-up visit
Telemedicine: The Alternative
• Miss one day of work• No exposure to sick
people• No cost for visit• No insurance claim to
file
• Call Consult A Doctor• Medication prescribed• Pick up medication• Miss one day of work
Consult a Doctor ROINUMBER OF EMPLOYEES
100UTILIZATION
25% 33% 50% 75%REDUCED OFFICE VISITS 118 156 236 354
MONTHLY INVESTMENT REDUCED ER VISITS 4 5 7 11$1,000
OFFICE VISIT SAVINGS $11,789 $15,561 $23,578 $35,366ER VISIT SAVINGS $3,645 $4,811 $7,290 $10,935PRODUCTIVITY SAVINGS $5,013 $6,617 $10,026 $15,040
ANNUAL INVESTMENT TOTAL SAVINGS $20,447 $26,990 $40,894 $61,341
$12,000 TOTAL RETURN ON INVESTMENT $8,447 $14,990 $28,894 $49,341
Consult a Doctor ROI
Pharmacy FactsIn the U.S. in 2008 spending for prescription drugs was more that doubled what was spent in 1999Over the last decade the percentage of Americans who took at least one prescription drug in the past month increased by 10%The use of multiple prescription drugs increase by 20% and the use of five or more drugs increased by 70%One out of every five children used at least one or more prescription drugs compared with nine of every 10 adults aged 60 and over.More than 30 million individuals in the US do not have access to PBM wholesale pricingThe trend in the healthcare industry shows fewer drugs being covered by insurance and more individuals required to pay a high deductibles
dataRx: Our Pharmacy Partner• Founded in 1998• Owned by independent pharmacists• Processes more than three million prescriptions a month• Available for use in all 50 states, Guam, and Puerto Rico• More than 25 million pharmacy savings cards in
circulation
The Pharmacy Savings Card is not Insurance.
Comparison of Rx Cards
The Pharmacy Savings Card is not Insurance.
Our Pharmacy CardCovers all prescriptions except controlled substancesOffers an interactive Price Look-up Tool No claims to fileOnly card that pass on the rebates to the consumerSave 11-75% on prescription drug purchases, with an average saving of 53%More than 33,000 prescriptions under $7Accepted at more than 65,000 pharmacies
The Pharmacy Savings Card is not Insurance.
Participating Pharmacies
The Pharmacy Savings Card is not Insurance.
Price Look-up Tool
Price Control is Our Bottom-line
Promoting consumerism by adding look-up tools to lower prescription costCovering all prescriptionsNo claims to file against insurance which helps control premiumsDirect rebates to consumer
Controlling Utilization
Implementing a program to control usage of benefits Call First Policy™Interactive return-on-investment (ROI) calculators for employersYear-end reports showing annual savings
Call First Policy™
Call First Copy.
Health Savings Promotion
Other Healthcare BenefitsDentalVision HearingLab and X-rayGalaxy NetworkMedical Health AdvisorEAP
These benefits are built into our Benefits Packages to help control preventive care cost. These benefits use best in class networks and promote consumerism. We have included
a Provider Look-up Tool on our Website for members to easily locate a doctor in the network.
Commission Structure
One Stop Business SolutionSales CenterCall center with LiveChatLive training WebinarsOn-demand sales collateral printingMailing and fulfillmentWebsite and email marketing supportBack office/workflow integration
Wellness Sales Center