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Available Benefits
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Innovative Strategies to
Reduce Healthcare Costsand other
Value Added Benefits
Managing Healthcare Costs
• Employers continue to seek creative solutions to
reduce healthcare costs, decrease absenteeism
and increase productivity
• They have been forced to restructure their
benefit plans, often reducing benefits and raising
deductibles and co-pays
• This leaves some gaps in coverage and more
exposure for employees
• This also leaves some strategic opportunities
Proprietary and Confidential
Managing Healthcare Costs
• One creative solution that can fill in these gaps
and minimize exposure for employees is the
HealthPerx™ Card, which offers a range of
affordable healthcare benefits.
• These benefits offer the entire family thousands
of dollars in savings.
• At the same time it offers the employer those
creative solutions they seek - reduced
absenteeism, increased productivity and
decreased overall healthcare costs.
Proprietary and Confidential
Disclosures
• This plan is NOT insurance.
• Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department,
• PO Box 671309, Dallas, TX. 75367-1309
• This plan provides discounts at certain healthcare providers for medical services.
• This plan does not make payments directly to the providers of medical services.
• The plan member is obligated to pay for all healthcare services but will receive a discount
from those healthcare providers who have contracted with the discount plan organization.
• This discount card program contains a 30 day cancellation period.
• Member shall receive a full refund of membership fees, excluding registration fee, if
membership is cancelled within the first 30 days after the effective date.
• The range of discounts for medical or ancillary services provided under the plan will vary
depending on the type of provider and medical or ancillary service received.
Proprietary and Confidential
Benefit Choices
Proprietary and Confidential
Health BenefitsTelemedicine
Pharmacy Savings
Vision Care
Dental Care
Hearing Care
Physician & Hospital Discounts
Medical Health Advisor
Telephone Counseling (EAP)
Lab, X-ray & Imaging
Complete benefit information, provider locators, FAQs and links to Rx price finder and Lab discounts can be found by
visiting www.hlperx.com
Health Care Reform and TeleHealth
Proprietary and Confidential
With over 22 million consumers entering the system,
healthcare demand will be high.
There is already a shortage of primary care
physicians.
The Consequences:
Individuals ignore symptoms and delay
treatment which can lead to more serious medical
complications
Individuals often leave work for minor issues
which results in loss of productivity and
unnecessary costs
Individuals overuse Urgent Care and ERs
TeleHealth can provide immediate access to
healthcare to every individual wherever they are,
whenever they need it, without any added cost.
The most efficient and cost effective method to deliver telemedicine is by phone.
Studies Show
Proprietary and Confidential
Physician telephone consults … have been proven to replace
45%-64% of doctor office visits and 15%-35% of hospital ER
visits. Source: TelaDoc 2007 Survey and Consult A Doctor Survey Results 2010
Costs can be reduced as the healthcare system moves from in-
person physical exams to virtual visits. The average ER visit is
$1024 and primary care office visit is $140. Source: BCBS 2007: Health
Cost Estimator
Patient satisfaction with telemedicine is high…due to
convenience, comfort , privacy…and the security of having 24-
hour access. Source: Us Department of Commerce, Office of Technology
The Challenge: Most telemedicine services require a co-pay.
This represents a significant barrier resulting in low usage
rates.
We have eliminated that barrier.
Featured Telemedicine Partner
Proprietary and Confidential
Consult A Doctor™ provides a network of licensed, board certified physicians
24/7, available by phone or secure email, who can diagnose and treat non-
emergency, routine medical conditions. They can prescribe medications when
appropriate.
Call Consult a Doctor™:• When your physician is not available
• For non-emergent medical conditions or questions
• After normal business hours, nights, weekends
• When on vacation or in the field
• Requesting prescriptions or refills
Survey Results (Jan.-Jun. 2010)
• Patient calls for Consult a Doctor™ services
are diagnosed and treated successfully over
94% of the time (the other 6% cannot be
treated by phone) with 98% satisfaction rating.
• 64% of callers would have gone to physician
and 15% to the ER—a significant savings of
time and money.
DisclosuresConsult A DoctorTM physicians do not prescribe controlled medications. Consult A DoctorTM is not insurance.Consult A DoctorTM does not replace your primary care physician.
Consult A Doctor factsPhysicians:
Experienced—over 10 years experience
Progressive—trained in telemedicine
Quality Care—board certified and state licensed
US Based—available anytime, anywhere, for anyone
Compassionate—professional and knowledgeable
Quality Assurance—consultations peer reviewed
Common Conditions Treated:
Cold/flu
Bronchitis
Allergies
Sinus and respiratory infections
Headaches, stomach aches, diarrhea
Urinary tract infections
Prescription refills
Second Opinions
Proprietary and Confidential
Consult A Doctor Summary
On-demand healthcare – wherever and whenever you need, as
often as you need.– by phone or email 24/7/365
Diagnosis, treatment and prescriptions when appropriate
Never wait for a doctor again
All physicians U.S.-based, licensed, board-certified, rigorously
credentialed and experienced
Saves Employers: Can reduce absenteeism, increase
productivity and decrease overall healthcare costs
Saves Employees: Can save thousands of dollars a year
Proprietary and Confidential
Return on Investment
Proprietary and Confidential
Expected ROI for this program ONLY calculates the Consult A Doctor benefit.
All other benefits are simply considered
value-added in this example.
Assumptions:
Company Contribution of $7.95 PEPM
Usage based on 2.4 members per family
Average office visits 3.07 per person per year
Average ER visits .405 per person per year
Productivity value measured on employees
With 20% participation: Receive $1.86 for every $1 invested
With 33% participation: Receive $3.07 for every $1 invested
With 50% participation: Receive $4.65 for every $1 invested
Disclosures:Office and ER visits taken from CDC Nat’l. Center for Health Statistics.Costs per office and ER visit based on BCBS negotiated rates.Reductions in office and ER visits based on actual survey results.
Imagine if every corporation strongly encouraged a “call first” policy
Pharmacy Savings Card
Proprietary and Confidential
Even though employees may have a pharmacy benefit, many prescriptions aren’t covered.
Ex: cosmetic drugs, appetite suppressants, smoking cessation prescriptions, prenatal vitamins or nutritional supplies, inject-able supplies, contraceptive devices, immunizations and vaccines and many more
Our card covers them all.
The Pharmacy Savings Card is NOT Insurance.
The prescription drug benefit network delivers significant discounts on both
brand-name and generic drugs at over 60,000 pharmacies across the United
States.
Members save between 15% and 75% on prescription drug purchases, with
an average of 52% off the retail price of most Rx purchases.
Pharmacy Savings Card
Proprietary and Confidential
Other Features:
• RxPrice Retriever - look up the discounted price of a
prescription drug and see average savings available on the
drug within the discount network.
• Generic Navigator - find generic equivalents of a
brand name drug and compare prices of the brand
drug and generic equivalents available within the discount
network.
The Pharmacy Savings Card is NOT Insurance.
Pharmacy Savings Card
Proprietary and Confidential
Example of Generic Navigator • How it helps families save money • How it promotes consumerism
Drug Selected
LIPITOR 40 MG Tablet QTY 30 =$133.18 (discounted price)
Generic Alternative
GENERIC PRODUCT NOT AVAILABLE N/A
Optional Drugs within this Therapeutic Class
Speak to your Physician about a therapeutic alternative.
SIMVASTATIN 40 MG Tablet QTY 30 =$10.66
PRAVASTATIN SODIUM 40 MG QTY 30 =$13.67
LOVASTATIN 40 MG Tablet QTY 30 =$26.76
LESCOL 40 MG Capsule QTY 30 =$90.81
MEVACOR 40 MG Tablet QTY 30 =$124.02
CRESTOR 40 MG Tablet QTY 30 =$127.01
Physician & Hospital—Galaxy Health™
Save 10-40% at over 300,000 specialty physicians
and thousands of hospitals and urgent care
centers nationwide.
Save on cosmetic surgery procedures, including
skin resurfacing, acne scars, liposuction, and
more.
One of the largest physician and hospital networks
in the nation.
No age or health restrictions.
Other Health Benefits
Proprietary and Confidential
Medical Health Advisor—Helps members:
Navigate the healthcare and insurance systems
Find the best doctors, hospitals and other providers
Resolve insurance claims and billing issues
Save time and money on healthcare bills
Locate and research current treatments for a medical condition
Help members make informed medical decisions
Schedule appointments with hard to reach specialists
Secure second opinions to provide peace of mind
Identify renowned "best in class" medical institutions
Other Health Benefits
Proprietary and Confidential
Telephone Counseling (EAP)
Our telephone counselors assist with problem resolution and suggest options to help members with personal issues of any size.
Highlights
Counselors work with a multitude of issues including:
Depression, anxiety or stress
Conflicts at work or home
Reliance on alcohol, drugs, tobacco or food
Sexual, physical or emotional abuse
Loss and grief
Change and transition
Members receive free unlimited telephone counseling services 24 /7.
All Counselor have a master's degree and five years of postgraduate experience
Counselors follow up and monitor progress until member is satisfied
Services are confidential
Other Health Benefits
Proprietary and Confidential
Other Health Benefits
Dental Discounts not available to Vermont residents
Dental Care
Members save 15% to 50% on everything
from general dentistry and cleanings to
root canals, crowns and cosmetic
dentistry where available.
Over 76,000 dental practice locations.
Save on specialty care, orthodontics,
endodontics and periodontics where
available.
No limit on number of visits
*Actual costs and savings vary by provider and geographical area.
** According to the Aetna Enterprise Provider Database as of
October 1, 2008.
.
Proprietary and Confidential
Savings Examples
Service Cost* Aetna Cost Savings
Adult Cleaning $96 $56 $40 42%
Child Cleaning $69 $39 $30 43%
Routine Checkup $49 $29 $20 41%
Four Bitewing X-rays $61 $34 $27 44%
Composite Filling $163 $84 $79 48%
Crown $889 $597 $292 33%
(porcelain fused to noble metal)
Complete Upper Denture $1207 $800 $407 34%
Molar Root Canal $1005 $678 $327 33%
* This represents average fees for procedures done in Los
Angeles, Orlando, Chicago and New York in 2009.
Other Health Benefits
Vision Discounts not available to Vermont Residents
Vision Care
Save an average of 20%-60% on prescription
eyeglasses, frames, lenses, tints, coatings,
UV protection and specialty items
Savings on eye exams and 40-50% off the
national average on LASIK surgery and PRK
(where available)
Savings of 10%-30% on contacts
Over 12,000 locations including national
chains and independent providers
Pearle •Sears • JC Penny •Target • LensCrafters • Sterling •EyeMasters• QualSight LASIK
Vision Care Savings
Proprietary and Confidential
Example 1 - New York, NY
Regular Exam (Ophthalmologist) $150.00
CTC Member pays: $120.00
Savings: $30.00 20%
Conventional Lasik: $5,500.00
CTC Member Pays: $3,600.00
Savings: $1,900.00 35%
Example 2 - Dallas, TXRegular Exam (Ophthalmologist) $190.00
CTC Member pays: $133.00
Savings: $57.00 30%
Frames (Regular) $89.95
CTC Member Pays: $54.47
Savings: $31.48 35%
Progressive / Polycarbonate $209.00
CTC Member pays: $156.75
Savings: $52.25 25%
Other Health Benefits
Proprietary and Confidential
Hearing Care-
Beltone Hearing Centers—1350 locations
Free hearing screening and substantial discounts on
hearing aids and other products and services.
Newport Audiology Centers
35% discount off hearing aid prices at over 2,000 locations 100% Service Satisfaction during the first 60 days
Mail Order Hearing Aids
Save 40% to 60% off average National Retail Pricing on
over 100 models of name brand hearing instruments.
Receive the lowest price available.
45-day in-home trial period and 1year factory warranty
Other Health Benefits
Proprietary and Confidential
Diagnostic Lab, X-Ray and Imaging
Affordable: Deeply Discounted Rates – 40-70%.
Never have to pay full price for any lab work, x-rays or imaging again.
Savings are bigger than any PPO or insurance company offers.
Convenient: Choose the lab location that's best for you…near home, work, or
even while traveling.
Quality: We use only federally and state certified clinics, including such
names as LabCorp. Over 2900 radiology centers in the US.
Easy Laboratory Testing: Order your tests online or call us. Have the test(s)
performed at the lab and generally within 48 - 72 hours, you will be notified of
your test results. It's that easy.
No co-pays
No deductibles
Confidential: Results sent only to you. See how easy it is to order a lab test:
http://hlperx.prepaidlab.com/
Other Benefits
Proprietary and Confidential
Lifestyle Benefits
Emergency Roadside Assistance
Identity Theft Protection
Legal Services Direct
Tax Help Line
Pet Care
Fitness Club Discounts
Complete benefit information, provider locators and
FAQs can be found by visiting www.hlperx.com
Lifestyle Benefits
Proprietary and Confidential
Emergency Roadside Assistance –
Up to 15 miles towing (up to $80 retail value) per occurrence maximum for
covered charges.
Flat tire assistance, fuel, oil, fluid and water delivery service, lock-out
assistance, battery assistance, & collision assistance.
LifeLock™ ID Theft Protection * (for member only—family is extra)
Identity Alert™ System – provides early notification whenever they detect your
personal information being used to apply for many forms of credit or services
WalletLock™ helps cancel and replace the contents of a lost or stolen wallet
eRecon™ patrols the web and notifies you of illegal selling or trading of your
information
TrueAddress™ notifies you when a change of address is requested in your
name
Free annual credit reports from the three major credit-reporting agencies
24-hour customer service
$1 million total service guarantee –if you become a victim of identity theft
because of a failure in their service, they will help you fix it at their expense, up
to $1,000,000
Lifestyle Benefits
Proprietary and Confidential
Legal Services Direct
Nine free services which include: Unlimited initial phone consultations for new legal matters
Initial one-on-one consultations for new legal matters
Document review (6 pages or less)
Letters written on the member’s behalf
Phone calls made on member’s behalf
Assistance with governmental programs
Assistance with small claims court representation
Free simple will with free annual updates
Free living will—state specific
Eight commonly used legal services deeply discounted, such as traffic ticket defense,
name change, simple divorce, simple trust and more.
Plan attorneys will either charge $125.00 per hour, or 40% off their usual and
customary hourly rate, whichever is greater.
Lifestyle Benefits
Proprietary and Confidential
Tax Help Line
• Unlimited advice on federal taxation
• Free tax return preparation for forms 1040 EZ, 1040A and standard 1040
• Deep discounts on numerous other tax schedules
• IRS audit assistance
• Tax planning
• Review of prior year's tax return
• Member portal with tax tips, tax law changes, member advice and much
more
Pet Care- Receive 25% off all services at participating vets. Free pet tag and
24/7 location service. Receive 10-30% off at participating providers on pet
services, such as boarding, doggie day care, training, pet sitting and grooming.
Fitness Club Discounts-International Fitness Club Network--Guaranteed
lowest rates at over 8,500 quality fitness centers nationwide. Introductory Free
Week Trial to all clubs. All meet ACSM guidelines.
Other Features
Proprietary and Confidential
List-bill capabilities
Fulfillment Kit and Membership Cards
Website Access to benefits and provider locators
Onsite member services call center staffed with English
and Spanish speaking representatives who can help with
enrollment, verify discounts and assist with customer service
issues.
Compliance Department monitoring state legislative
requirements
Marketing assistance and brochures
Money Back Guarantee
All benefits are good for the entire family*
*LifeLock™ benefit covers cardholder only
Target Applications
Proprietary and Confidential
Self-funded corporations
Fully insured companies with high deductible
plans
Limited-liability plans
Schools, Government, Associations
These low cost benefits complement any insurance
plan by offering innovative strategies for reducing
absenteeism, increasing productivity, and
decreasing overall healthcare costs for the
employer while encouraging employees to take
more responsibility for their healthcare costs.
Value Proposition
Proprietary and Confidential
Employers Employees
• Ability to add a benefit with a high perceived value
• A program that will decrease absenteeism, increase productivity and reduce overall healthcare costs
• Ability to ensure that every employee has access to healthcare when they need it wherever they are
• Ability to promote health and wellness and encourage personal responsibility
• A program that can help with acquisition and retention of employees
• Access to medical consultations 24/7 as well as savings on pharmacy, vision, dental, hearing and more
• A benefit that can fill in many gaps in insurance coverage, particularly with high-deductible and consumer-driven healthcare plans
• A program that eliminates unnecessary visits to the doctor or ER
• A benefit that can save the family thousands of dollars a year
• Lifestyle benefits that can save the family additional money on everyday needs
Standard Benefits Package
Proprietary and Confidential
Benefits Health Lifestyle
Health &
Lifestyle
COMBO
HEALTH BENEFITSTeleHealth
Pharmacy Savings Card
Dental Care
Vision Care
Hearing Care
Lab, X-ray & Imaging
LIFESTYLE BENEFITSFitness Center Discounts
LifeLock™ Identity Theft Protection
Emergency Roadside Assistance
Legal Services Direct
Pet Care
Monthly Investment $15.99 $16.99 $26.99Enrollment and Fulfillment costs included
Health BenefitsStand-alone
Monthly Price
HPA Package
Price
Consult A Doctor™ 48.65 Incl
Pharmacy Savings Card n/c Incl
Physician & Hospital Discounts 12 Incl
Medical Health Advisor 9 Incl
Telephonic Counseling (EAP) 10 Incl
Vision Care 10 Incl
Dental Care 10 Incl
Hearing Care n/c Incl
Lab, X-ray and Imaging Discounts 11 incl
Total Cost/Value $110.65 $24.99
.lllllllllllllllllllll
Health Package Using All SelectionsCan create any combination the client wants
Packages and Pricing
Proprietary and Confidential
Voluntary BenefitsSelect benefits to include and we will develop wholesale pricing.
We can bundle any combinations as long as we have 3 or
more paid benefits in a package.
Standard Health Benefits package includes Consult A Doc,
Pharmacy, Vision, Dental, Hearing, Lab and Fitness @ $15.99
PEPM
Involuntary or Embedded BenefitsBased upon group size and projections or guarantees, we will
develop involuntary pricing package.
Fulfillment Kits can be provided by client and reduce cost.
Contact:
Proprietary and Confidential
Sample HealthPerx™ Card Website
www.hlperx.com