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James ReidPresident Aetna Voluntary Plans
September 2011
Supporting Employees in a New Economy
Voluntary FinancialProtection Plans
Providing your employees and their loved ones with financial
protection for health events and other life events
AetnaVoluntary Plans
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AETNA VOLUNTARY PLANS
TheAetnaWay
Putting you and your employees in the centerof everything we do
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Areas of focus
Market forces impacting health care costs
Employer benefits cost strategies to prepare for Health Care Reform
Financial challenges leaving consumers ill-prepared for health events
The value of voluntary financial protection solutions for employers and employees
AETNA VOLUNTARY PLANS
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Market forces impacting your employee benefits costs
AETNA VOLUNTARY PLANS
1 “2011 Employee Benefits: A Research Report by SHRM,” June 2011.2 “Employer Costs for Employee Compensation – December 2010,” United States Department of Labor.3 “Large Employers’ 2012 Health Plan Design Changes,” National Business Group on Health, August 2011.4 “Health Care Reform: How Companies Need To Worry,” Forbes.com, November 29, 2010.
ECONOMY
of employers report their employee benefits have been negatively affected1
77%
RISING HEALTH CARE COSTS
Benefits now account for
Employers expect health care costs to increase by more than
7% in 20123
compensation costs2
30% of employee
HEALTH CARE REFORM
of employers expect Health Care Reform to lead to higher health costs4
70%
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What employers are doing to ease increased cost expected from Health Care Reform
AETNA VOLUNTARY PLANS
1 “2011 Employee Benefits: A Research Report by SHRM,” June 2011.2 “Health Care Reform: Employer Actions One Year Later,”The International Foundation of Employee Benefit Plans, June 8, 2011.
PLAN DESIGN
More employers will be offering consumer-directed health plans in 20121
29% are raising in-network deductibles2
COST SHIFTING
40% of employers are increasing employees’ share of premium2
28% are increasing employees' proportion of dependent coverage cost2
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Consumers shouldering more benefit costs and not financially prepared for emergencies
AETNA VOLUNTARY PLANS
Hardship withdrawals from 401(k) plans have risen to the highest level in 10 years3
1 “HSBC Survey: Americans Saving More But Still Not Enough,” September 2009.2 2011 Employee Benefits Research Institute Study.3 “401(k) Withdrawals Spike,” CNNMoney.com, August 2010.
of Americans lack the savings to cover
61%
3 monthsof expenses1
38%of Americans lack the savings to cover
1 monthof expenses2
29%of Americans lack the savings to cover
$1,000in expenses3
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Potential financial gaps as the result of a critical illness
AETNA VOLUNTARY PLANS
Long-term disability benefits
Short-term disability benefits
Salary
Acute phase of disability Ongoing support
SOU
RC
ES O
F IN
CO
ME
ILLNESSSTRIKESExpenses GAP
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Keeping up with everyday expenses when an unexpected illness or accident prevents you from working
Not everyone thinks about additional expenses and the loss of income associated with a health event
Traditional health insurance plans are designed to provide coverage for health care but not everyday expenses
An unexpected illness or accident can take a toll on employees – both emotionally and financially
78% of those that declared bankruptcy as a result of a critical illness1:
– Had medical insurance at the time of illness
– Owed close to $18,000
AETNA VOLUNTARY PLANS
1“Medical Bankruptcy in the United States, 2007: Results of a National Study,”August 2009, The American Journal of Medicine.
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How voluntary plans can fill the need
Solutions for you & your employees
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The value of voluntary plans to your company
Improvement in worker morale/satisfaction 77%
No added direct cost to the company 75%
The ability to attract and retain employees 71%
Less expensive options than employees could buy on their own 69%
A wider array of benefits for workers 66%
1“The Voluntary Benefits Report Card,” LIMRA International, 2007.
Employers believe that voluntary benefits offer:1
SOLUTIONS FOR YOU AND YOUR EMPLOYEES
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Employees’ perspective on benefits
identify benefits as“very important”among a list of the
most important factors in satisfaction and
retention1
60%say that the ability
to match their benefit choices to their individual needs
is an overall important plan characteristic2
90%feel it is important to have choices in their
benefits package2
89%
1“2008 Workplace Forecast,” Society for Human Resource Management.2“Brazzell, Bonnie, and Lowerre, Gil, Eastbridge Consulting, “Goldilocks and the Voluntary Benefits,”BenefitsSellingMag.com, December 2009.
SOLUTIONS FOR YOU AND YOUR EMPLOYEES
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How voluntary financial protection plans can help your employees
SOLUTIONS FOR YOU AND YOUR EMPLOYEES
Cash benefits paid directly for specific health events
Benefits can be used in any way the employee wants
Peace of mind knowing that they have financial protection from an unexpected hospitalization, illness or injury
Ability to focus on getting better and back to work
Examples of plans: critical illness, accident and hospital indemnity
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Hospital indemnity, critical illness and accident plans provide financial protection beyond core benefits*
SOLUTIONS FOR YOU AND YOUR EMPLOYEES
Loss of comprehensive coverageDeductibles/copaysOut-of-network careHigher-tier drugsNon-traditional and experimental treatments
Travel expensesDaycare/elder careHome health careHospice careLoss of incomeMortgage/loansDebt payoffSavings/asset protection
* This list does not refer to covered policy benefits.
Commonuses of benefits proceeds
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Managing the cost of a health plan with a hospital indemnity plan
CASE STUDY:
Challenge
SGD North America, a premier manufacturer specializing in glass fragrance, cosmetic and pharmacy bottles; glass bricks; insulators and jars
Needed to reduce the monthly employee benefits contribution while still providing quality health care coverage options
Solution
Offered a core medical plan that consolidated several $0 deductible plans into a single $1,000 deductible plan
Offset the medical deductible by offering an Aetna Voluntary Hospital Plan (employee-paid plan)
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Managing the cost of a health plan with a hospital indemnity plan
CASE STUDY:
Results
Members’ monthly medical premium costs reduced by $25
Onsite enrollment meetings better educated SGD employees about plan benefits
Aetna Voluntary Hospital Plan received over 36% participation
Members hospitalized receive a lump sum payment of $1,000 and a daily benefit of $100 for up to 100 days
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Benefits of combining voluntary financial protection and core medical plans
Additional Protection
Provide coverage for incidents beyond the scope of traditional benefits
Simplified Administration
Single point of contact Simplified enrollment with a single eligibility file
Accelerate benefits payments through automated transfer of medical claims data
Data Integration Care Management
Ensure that members are receiving appropriate case/disease management services
SOLUTIONS FOR YOU AND YOUR EMPLOYEES
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Member receives cash benefits payment
Hospital receives payment for medical services
Offering a hospital indemnity plan with a medical plan
PLAN INTEGRATION EXAMPLE:
Qualifying inpatient hospital stay
Hospital submits claims
Aetna processes medical claim and hospital indemnity benefits*
* Members who have medical coverage from a carrier other than Aetna must send an Aetna claim form to receive benefits under the Aetna Voluntary Hospital Plan.
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Examples of voluntary financial protection plans and how they work
Solutions to prepare your employees for health events
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Financial protection plans are affordable; some cost less than $10 per week
Plan General overviewOffers financial protection for…
on- and off-the-job accidents
major illnesses such as heart attack, cancer or stroke
out-of-pocket expenses related to a hospitalization
Pays a lump sum benefit upon diagnosis Coverage is portable and complements existing medical benefits
Pays a lump sum for one hospital stay and a daily cash benefit per inpatient day
Benefits include hospitalization, emergency treatment, intensive care, fractures and moreCoverage is portable and typically guaranteed at initial enrollment; no medical exams or tests
Group Accident Plan
Group Critical Illness Plan
Hospital Indemnity Plan
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Questions?
For more information:
Contact James Reid at [email protected] send an email to [email protected]
Visit www.AetnaVoluntary.com
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Aetna Voluntary insurance plans are offered and/or underwritten by Aetna Life Insurance Company (Aetna).
The Group Accident and Critical Illness Plans are limited benefit insurance policies and are underwritten by American Heritage Life Insurance Company (headquarters: Jacksonville, Florida). Eligible claims for this plan are the sole financial responsibility of American Heritage Life Insurance Company. The plans have exclusions and limitations and may not be available in all states. The Aetna Voluntary Hospital Plan is offered and/or underwritten by Aetna Life Insurance Company (Aetna).
This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage. Not all health services are covered. Health insurance plans contain exclusions and limitations. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change.
Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetna.com.
Policy form numbers for Oklahoma residents include: GR23 and/or GR-29/GR-29N and/or GR-96172 and/or GR-96173.
Aetna Voluntary Hospital Plan is not available in all states and specific rules apply. Please contact your Aetna representative for more information.
©2011 Aetna Inc.
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