#whccic The Convergence of Group and Individual markets

Real time notes from WHCC – Innovation Congress

Rob Panepinto, Managing Director, Client Practice Group at Connextions Health

A tactical look at the transformation from B-to-B to a B-to-C model.

“Reform will just be an accelerator – the market will reform regardless.” Employment-based coverage will continue to decline.
Triggers to change:
1. Job or Benefit Loss
2. Aged out ( >18 >65)
3. Group Plan opt-out
4. Early Retirement

Member Transition Best Practices:
1. Develop Right product, at right time to right members
2. Targeted outreach campaigns
3. Multi-channel web buying support for consumers (web, chat, text)

If you develop pre-approved products as part of retention efforts how do you handle brokers in that context.

[Editor’s Note:] what do the Cell Companies do with brokers when they upsell?

What can be implemented today:
<65 Perspective – 
– Timing of access to disenrolling members
– Target the Right customers (pre-screening and auto or rapid underwriting)
– COBRA (Provide consulting support to help members make the right selection)
– Provide support and education

With Aging Up Dependents: 
– You sell to both Kids and Parents
– These invincibles are underwritten by the parents in event of a catastrophe

In small business sector where Group coverage is declined:
– Offer individual products

Michael Cho, Founder and Chief Strategist at DestinationRx

Group Retirees needs are different. They are angry at loss of coverage. 
This group is typically in the higher income bracket and are active Internet users.

The Plan knows what the retiree has used on the group plan. This puts you in the position to be able to tailor a plan to meet their needs very effectively. These are savvy buyers. Don’t sell on Premium. They understand total Cost of Ownership. They look for lowest overall cost.

The upcoming reform legislation will impose a similar buying experience on the proposed exchanges. People will be able to see estimated total annual costs and not just the premium.

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