Optum Health Financial Overview
Transcript of Optum Health Financial Overview
OptumHealth Financial Services – Carrier Neutral Solutions Dean KisselRegional Sales Director
Confidential property of OptumHealth. Do not distribute or reproduce without express permission from OptumHealth. 2
Our Organizational Structure
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Public and Senior Markets Group
Commercial Markets Group
Enterprise Services Group
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Short History of OptumHealth
HSAs, HRAs, FSAs, payables, cards, OptumHealth Bank, stop loss, COBRA
Health and well-being services, care management, networks, Web services
Mental health services, substance abuse treatment EAP, work/life
Old Brand Portfolio
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Our Services
Wellness Solutions
Health Portal
Decision support
Disease solutions
Complex medical conditions and specialty networks
Physical health
Behavioral Network
Behavioral disability solutions
Customizable online member portals
Employee Assistance Programs (EAP)
Medical/behavioral care coordination
Mental health and substance abuse
Psychotropic Rx management
WorkLife services
HSA accounts
FSA accounts
HRA accounts
Retiree accounts
COBRA administration
Transportation Administration
Consolidated and direct billing
Stop loss
Local care delivery
Collaborative technology
– Electronic Health Record (EHR)
– Health Information Exchange (HIE)
Connected care telehealth solutions
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Who is OptumHealth Financial Services?
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Focuses exclusively on health care financial services and benefits administration
Is one of the nation’s largest providers of health savings accounts
Offers health care financial accounts for both active employees and current and future retirees
Provides personalized service through a knowledgeable, professional benefits administration team
Manages over 2.1 million consumer health care accounts
Has over more than $1.3 billion in HSA assets under management
Serves Over 27,000 private and public sector employers nationwide
Has earned a 96% retention rate, supporting you every day, every step of the way
Health Accounts and Benefits Administration – All In One Place
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Our Unique Service Model
Our Service Model
Designated Implementation Managers start the transition
– Then, our seasoned Account Managers provide ongoing service to employers, brokers and consultants
– All calls and e-mails are responded to within 24 hours (one business day) maximum
– Assign a Senior Contact and Relationship Manager when appropriate
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HSAs - OptumHealth Bank SM
More than $1.3 Billion in HSA assets*
Almost 700,000 HSAs
*As of Dec 1, 2009
OptumHealth Bank, Member FDIC
Some of HSA differentiators are:
– Web tools:– - employer and – - employee videos– - calculators– - all forms and marketing – materials – Three account options– Three enrollment methods
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HSA Options
• Health eAccess HSA Generally designed for health care spenders who do not carry a large balance in their HSA Lower monthly maintenance fee, which is waived if you have a minimum balance of $500
• Health eSaver HSA Designed for health care spenders who carry higher balances in their HSA With the Health eSaver HSA, account holders earn interest on the funds in their HSA Interest rates are tiered and based on account balance This option offers free access to investments; there is a minimum investment balance
requirement of $2,000 and investments can be made in increments of $100
• Health eInvestor HSA Designed for account holders interested in maximizing long term savings potential of HSA The primary use of the Health eInvestor HSA is for investing purposes In regards to investments, this option has a lower minimum investment threshold of $500
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HSA Comparison
Health eAccess Health eSaver Health eInvestor
Monthly Maintenance Fee
$1 for balances less than $500 (Fee waived if balance is over $500)
$3 for balances less than $5,000 (Fee waived if balance is over $5,000)
$3 for balances less than $5,000 (Fee waived if balance is over $5,000)
Balance Required to Obtain APY 1,2
Annual Percentage Yield (APY) 1,2 Annual Percentage Yield (APY) 1,2 Annual Percentage Yield (APY) 1,2
$0-$499.99 0.00% 0.10% 0.10%
$500-$999.99 0.00% 0.10% 0.10%
$1,000-$1,999.99 0.00% 1.00% 1.00%
$2,000-$4,999.99 0.00% 1.40% 1.40%
$5,000-$14,999.99 0.00% 1.95% 1.95%
$15,000+ 0.00% 2.50% 2.50%
Investment Threshold3 $2,000 $2,000 $500
Monthly Investment Fee3 $3 $0 $2.50
1. Interest rates are variable and subject to change at any time based on market conditions2. Annual Percentage Yields (APY) as of 5/29/09, subject to change at any time. Required balance to obtain APY does not include investment balances3. Investment Fee (where applicable) is only assessed after the establishment of an investment
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HSA Highlights
• When an employee first enrolls with OptumHealth Bank, they will automatically be enrolled in the Health eSaver HSA
• 90 days after enrolling in an HSA, we will send the account holder a letter that explains the other HSA options available to them
• Once the HSA is open, account holders have the option of changing their HSA option by contacting Customer Service Account holders can change their account option at any time and as many times as they want
without incurring additional fees
• Account holders have access to their HSA funds via MasterCard Debit Card, Online Bill Payment or Checks
• OptumHealth Bank can customize HSA options by changing default or offering any combination of HSA options
• The Employer and Broker Support Team (BEST) is a dedicated resource for Employers and Brokers during HSA Implementation
• Effective June 1, 2009, OptumHealth Bank changed the following fees: Eliminated the Account Closure Fee Eliminated the Below Minimum Balance Fee Eliminated the Online Enrollment Fee (Paper Enrollment $25)
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Flexible Spending Accounts (FSA)
– Reimburse eligible participant expenses via check, automatic direct deposit, debit card, and claims rollover
– Online claims submission with easy-to-use interactive claim form
– E-mail notifications when claim is received and paid
– Flexible enrollment options
Some of our FSA differentiators include:
100% of the claims are adjudicated
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Health Reimbursement Arrangements (HRA)
– Easy-to-use employer and participant Web site
– HRA can be “notional” or funded– HRA can reimburse specific
expenses or all 213(d)– Special plan designs can be
administered – We will coordinate HRA with FSA– Special pricing for HRA with FSA (only $1 PPPM for second
account)
An independent SAS 70 Level II audit confirmed that OHFS has
a 99.95% claim accuracy.
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Funded Health Reimbursement Accounts (FHRAs)
– Eliminate health benefit liabilities– Use together with a VEBA or
Section 115 trust
Fund future medical expenses for retirees
Addresses GASB 45 mandates for public
employers
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Health Incentive Accounts (HIA)
– Creative ideas to engage employees
– Share our experience– Utilize our HRA experience and
platform
Wellness + Incentives to engage employees
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COBRA/HIPAA Administration (COBRA)
– Compliant plan administration– Meticulous documentation– Strict adherence to the law’s
eligibility requirements– In-house Compliance Department – ARRA Administration– Annual Standard Fees for
COBRA Services
Our SAS 70 Level II Certification assures high compliance standards
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Ongoing COBRA Administration Services
– We handle the tough situations– Employer terminates with carriers– Employer sends file to OHFS– OHFS sends QE Package – Receive premiums/track timelines– Carrier eligibility updates – Special separation agreements– ARRA Involuntary Terminations– Remit premiums – Provide employer with detailed monthly
reports– Open enrollment options
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Consolidated Billing
– The complicated and time consuming task of maintaining group health and welfare eligibility databases
– Disbursing payments to carriers
– Carrier reconciliation of enrollments, terminations and life event changes
– Leverage our experience
– Extension of your clients’ HR/Benefits team
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Retiree Billing/Direct Billing Administration
– Experienced Team with disciplined process
– Flexibility, based on client’s direction
– Mail coupons, collect premium payments, submit monthly report to employer, report changes to carrier(s) and employer
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Pre-Tax Transportation Administration
Wired Commute --Employees can order passes and/or pay for parking on-line
Card Method
Reimbursement Option
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Our commitment to You is to be the best partner at a competitive price. We pledge to:
– Make it simple
– Provide superior “high-touch” service
– Create and demonstrate value for you & your clients– One-stop shop - “All in One Place”
Why OptumHealth Financial Services?
OptumHealth Financial Services boasts a 96% client retention rate