A BETTER WAY to take care of business 2015 Fall Broker Forum Rockville, MD September 25 kp.org/choosebetter
A BETTER WAY to invest in employee health Welcome Larry Gross Executive Director Market Development kp.org/choosebetter
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Agenda Welcome State of the Region Virtual Tour Video Baltimore Region Expansion Small Group Expansion Bonuses & Commissions 2016 Product and Rate Highlights Broker Tool Kit Refresh Annual Awards and Raffle Q&A Don’t forget to visit our Mobile Health Unit and get your complimentary flu shot! 4
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville State of the Region Membership Update Market Momentum Unrivalled Excellence Care Delivery System Update Working with KP 5
A BETTER WAY to invest in employee health Virtual Tour Kaiser Permanente Capitol Hill Medical Center kp.org/choosebetter
A BETTER WAY to build the future KP’s Baltimore Expansion C ourt ney Campbell Executive Director of Sales – Mid/Large, Labor & Trust kp.org/choosebetter
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Baltimore Harbor Medical Center Opening November 9, 2015 • 19,000 square feet • Family practice • Internal Medicine • Laboratory • Mammography • Ob/Gyn • Pharmacy • Radiology 815 E. Pratt Street 8
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Severna Park Medical Center Q1 2017 → Moving to Quarterfield Road in Glen Burnie (approximately 3 miles west of the current location) • 25,000 square feet (largest in Anne Arundel County) • 23 exam rooms; 11 provider offices • Family practice • Internal Medicine • Laboratory • Mammography • Ob/Gyn • Opthalmology • Optometry/Optical Shop • Pediatrics • Pharmacy • Radiology 9
A BETTER WAY to invest in employee health Small Group Expansion Matt Chubb Senior Sales Manager Mid/Large Group kp.org/choosebetter
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Our small group expansion goals Comply with Affordable Care Act (ACA) to incorporate groups with 51-100 employees into the small group line of business Ensure a positive broker, employer, and member experience 11
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Small group expansion overview What does it mean? The ACA requires all states to include employers with no more than 100 full-time-equivalent employees in the small group market for health coverage by January 1, 2016. This means groups with 51 – 100 full-time-equivalent employees will now be considered small groups. 12
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Timeline for new business New 51-100 business will be enrolled in small business effective January 1, 2016. 13
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Timeline for existing business Existing 51-100 groups in Maryland will have to move to small business plans at renewal in 2016 if there are no federal or state transition delays and current benefit plans are not grandfathered. Both Virginia and the District of Columbia have adopted the Keep Your Plan transition policy, announced by CMS, through October 2016 renewals. 14
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 new business options New groups can get coverage directly from Kaiser Permanente or through the Small Business Health Options Program (SHOP), or other private exchanges. 15
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 renewal options Groups with grandfathered plans: Transition may be voluntary. Groups with nongrandfathered plans: Transition may be required but could be delayed by early renewal, “Keep Your Plan,” or implementation delay at the federal level. Groups with grandfathered and nongrandfathered plans (hybrids): Transition may or may not be required, but could be delayed by early renewal, “Keep Your Plan,” or implementation delay at the federal level. 16
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville What’s changing for brokers Streamlined sales and renewal processes with standardized plans and rates Faster turnaround using Kaiser Permanente online self-service quoting tool for new business Demographic data for dependents is needed to generate a quote 17
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville What’s changing for your clients Rating methodology Member level rating Rates are calculated individually for each employee, using certain factors “Composite premium” member level rating methodology (available in Maryland and Virginia only) An aggregate (or average) premium is allocated per employee, based on a 4-tier rating structure Only available with a single plan-offering 18
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Have questions? Contact me Visit us on the Web: account.kp.org 19
A BETTER WAY to take care of business Bonuses & Commissions Karen Binder Senior Director Sales Operations kp.org/choosebetter
A BETTER WAY to take care of business A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville Special Group Sales Bonus Effective: November 1, 2015 – January 31, 2016 (Incentive Paid to New Subscribers) # of Eligible 1-50 51-79 80-100 Employees in Group: $50 $75 $100 Commission Rate: per subscriber per subscriber per subscriber Example: On December 15, 2015 you sell a new group with 70 eligible employees effective for January 1, 2016. The new group enrolls 67 new subscribers. Your one-time Group Sales Bonus payout will be 67 subscribers X $75 = $5,025. * Program applies to new groups sold with 1-100 eligibles. Payouts based on new active subscribers enrolled in the sold group plan 21
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 Individual Broker Commissions Effective: January 1, 2016 $200 PMPY for each new member you enroll to a Kaiser Permanente plan for 2016. $200 PMPY for every existing member you renew to a Kaiser Permanente plan for 2016. Example 1: Renew 3 individual contracts and your compensation will be 3 x $200 = $600 Example 2: Sell 10 new family contracts in 2016 (4 members per family) and your compensation will be 40 x $200 = $8,000 Commissions will be paid after the first month of coverage, with no charge backs. Commissions are for On & Off exchange. 22
A BETTER WAY to take care of business A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 Group Broker Commissions Effective: January 1, 2016 Incentive: Per Subscriber Per Month Eligible 1-100 101-250 251+ Employees $35 $30 Commission Rate Negotiable as a per subscriber per subscriber % of premium per month per month Example: Your Kaiser Permanente 1-100 eligible employee group has 65 subscribers enrolled at the end of the month, your compensation will be 65 x $35 = $2,275 23
A BETTER WAY to take care of business A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 Broker BOB Bonus Program Effective: January 1, 2016 Incentive: Paid on Net Growth Qualifying 100% - 105% - 110% - level of 90-94.99% 95% - 99.99% 115% + 104.99% 109.99% 114.99% subscribers $15 $25 $30 $83 $90 $98 1400+ per per per per per per Diamond Elite subscriber subscriber subscriber subscriber subscriber subscriber $12 $20 $25 $58 $67 $70 900-1399 per per per per per per Platinum Elite subscriber subscriber subscriber subscriber subscriber subscriber $8 $15 $20 $25 $35 $40 350-899 per per per per per per Gold subscriber subscriber subscriber subscriber subscriber subscriber $4 $10 $15 $20 $30 $35 200-349 per per per per per per Silver subscriber subscriber subscriber subscriber subscriber subscriber * Group cap of $75,000 per group, effective 1/1/2016 24
A BETTER WAY to take care of business A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 Broker BOB Bonus Program Effective: January 1, 2016 Incentive: Paid on Net Growth Example: • On 12/31/2015, your book of business includes 930 Kaiser Permanente subscribers, thus placing you in the “Platinum Elite” tier • On 12/31/2016, your KP book of business has grown by 74 subscribers, or 108% growth • Your 2016 bonus payout is 1,004 subscribers x $58 = $58,232 25
A BETTER WAY to take care of business 2015 Fall Broker Forum | Rockville 2016 Broker In-Group Growth Bonus Effective: January 1, 2016 Incentive: Paid quarterly based on net subscriber growth Growth within Existing Groups Total Bonus Earned Additional 100-199 Subscribers $2,500 bonus payment Additional 200-249 Subscribers $5,000 bonus payment Additional 250+ Subscribers $7,500 bonus payment Example 1: The number of subscribers for your current group increases by 146 in January 2016 (1 st Quarter), you will earn a one time bonus of $2,500 . Example 2: In July (3 rd Quarter), of the 2016 year, the subscriber level increases again by 100 subscribers, you will receive a one time bonus of $2,500 . 26
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