The Georgia Pulse
A Message from Brian Fetherston
Account Management has overall responsibility for the client relationship and ensuring BCBSGa meets its client commitments. Account Managers act as the primary liaison between brokers, clients and BCBSGa.
One of the primary responsibilities of the Account Manager is to renew our clients policies and contracts. This involves proposing cost increases, offering creative alternatives in plan design and programs, and negotiating the final package of benefits and cost. A renewal is not a one-time event, but rather an ongoing process of being proactive, strategic and responsive to our client needs. In January, the Account managers will handle over 400 medical client renewals. Our current membership retention rate for January is 94.5%.
Our Account Managers also provide consultative analysis of our clients benefit programs to make recommendations on benefits and cost containment opportunities.
The Account Managers are also responsible for adding additional Specialty business to existing medical accounts. Account Managers capitalize on their relationship and in partnership with the Specialty Sales team drive significant contributions to our Specialty goals. Year to date 2014, our Account Managers have added over $1.4 million in Life & Disability premium, 5,700 new dental members and 5,500 new vision members.
We have a team of 14 Large Group Account Managers that serve our 1,250 medical clients. Our teams are structured into three segments based on the size of the client.
50-250 Segment (servicing 1,040 clients)
Jae Marie Fry
250-1,000 Segment (servicing 180 clients)
Special Account 1,000+ Segment (servicing 30 clients)
Director, Large Group Account Management
Meet Damon Cain
Damon recently joined us as an Account Manger serving our clients in the 250-1000 segment. Damon hails from Marshall, Texas (home of boxing champ George Foreman and historical Wiley College). His professional experience consists of serving ten years as a Military Intelligence officer in the Army (rank of Major) where he served in Korea, Afghanistan, Iraq, Kuwait and various posts in the U.S.
Prior to joining the BCBS GA team Damon worked as a Large Group Account Executive for Humana (6 years) managing a book of business comprised of medical, dental, vision, life, disability, worksite voluntary benefits as well as turn-key wellness solutions for clients having 100-3000 employees.
Damon enjoys being active with hobbies such as spending time with his wife (Dominique) and sons (Dylan and Dallas), running, working out and playing soccer.
Damon’s StrengthsFinder* attributes are:
*The Clifton StrengthsFinder™ measures the presence of 34 talent themes. Talents are people's naturally recurring patterns of thought, feeling, or behavior that can be productively applied. The more dominant a theme is in a person, the greater the theme's impact on that person's behavior and performance.
Individual and Small Group
As most of you know, 2014 brought many challenges for the Individual and Small Group (ISG) segments. The first year of Health Care Reform (HCR) was interesting to say the least.
For over 5 years, Small Group has been in an undesirable position from a price perspective. This is a highly commoditized product in that there are very few levers to pull in order to make our products more competitive. Prior to the Affordable Care Act (ACA), we could not create non-standard benefits nor did we have a great deal of room to negotiate on price. In our current post ACA environment, we are further restricted by the law. Medical Underwriting is no longer allowed and all rates are based upon the age of the members within the group. We cannot even use gender to help determine price or predict potential risk.
In an effort to retain as much pre-ACA business as possible, we offered groups the opportunity to remain on their pre-ACA plans for an additional year. We were able to do this based on an extension provided by the government. Every small group was given the opportunity to change their anniversary date to December. This would allow them to remain on their pre- ACA plans for as long as possible. We also allowed new business to enroll with 12/31 effective dates. This gave those new groups the chance to stay in a pre-ACA world for an extended period. For many groups, the medically underwritten rates were better than the age banded rates required by HCR.
This December strategy was very successful! We attracted new business and retained a great deal as well. Even though this helped for a short time, our price position in 2014 remains uncompetitive. Additionally, one of the biggest challenges we face in Small Group today is that a large number of Small Business owners have decided to stop offering group benefits to their employees. This phenomenon has resulted in a shrinking small group market across the country, not just at Blue Cross and Blue Shield of Georgia.
As we continue to focus on growth and retention, we introduced the down market ASO product, Balance Funding, to the market. This is proving to be a great option for many of our groups. This product allows them to stay on the pre-ACA products which is the best option for many.
We are encouraging Small Businesses and Small Group Brokers to continue to offer group insurance when it makes sense for them. We have been doing this by educating our brokers and partnering with them during this difficult time. We have held 16 Broker Road Shows across the state this year. In total, we saw well over 1000 brokers. This show of partnership during hard times has proven to be a great way to foster and grow our relationships across the state.
We are now looking at the second year of HCR. Our 2015 price position looks better than it has in years. We are already beginning to sell new business for January 1 and we are getting great feedback from our agents on our renewals as well. The whole team is energized and looking forward to the coming year!
The Individual Market has also experienced an interesting first year of HCR. In April of 2013, we had to file our rates for 2014. Once the rates were filed, we were not allowed to change them. This may not sound that difficult, but you must consider that we could no longer medically underwrite in the Individual market just like in Small Group. This meant no rating up for medical conditions nor could we decline coverage for anyone.
We created a product portfolio offering only HMO products in order to mitigate as much risk as possible. These products are on the narrow provider network called Pathway and also include our Select Formulary. We offered the same products on and off exchange. Our price position was not terribly competitive but we still managed to win about 14% or the market share. We attribute this to brand loyalty and recognition. The low cost leader in 2014 was Humana. We suspect that they won the majority of the market share.
In preparation for 2015,we again had to file our rates with the Department of Insurance in Q2 of 2014 . We had a lot more information this year but it was still a challenge because so much is strictly prescribed. There will be 9 carriers on the Exchange in 2015 compared with just 5 participating in 2014.
Although there are more carriers competing on the Exchange in 2015, our position looks very good. We were able to file a rate decrease where other carriers filed big increases.
We changed our strategy Off Exchange to include 8 Open Access POS plans. On Exchange, for the subsidy eligible individuals, we maintained our HMO portfolio with the Pathway network as well as the narrow formulary.
Coventry seems to be the low cost leader in 2015, but we are already getting great feedback from our broker community. Open Enrollment officially started on November 15th. It will end on February 15th with the last available effective date being March 1, 2015. We will be sure to keep everyone informed of our sales as we begin to see our enrollment numbers.
One of the new initiatives we launched in Individual this year is a focus on education. The law states that every American must have insurance, yet many do not understand the first thing about it. We are partnering with hospitals in communities around the state conducting educational meetings for residents of the local areas. The focus of these meetings is to provide information and explain the importance of being insured on January 1, 2015. Each Sales Representative is reaching out to a broker in each area so that they understand we continue to remain true to the broker channel.
The ISG team is doing a great job keeping up with our new and ever changing landscape! We will continue to report out on new developments throughout the year so that we can all stay informed.
Director, ISG & Small Group
This fourth quarter open enrollment season has been an extremely busy time of year, as always, for the Sales Account Representatives. With the tremendous success in new business sales and retention, the team has been traveling all across the State promoting and educating clients on the suite of services offered to our Blue Cross Blue Shield members. The collective efforts of the SAR team to ensure that we are illustrating service excellence to our business partners have not gone unnoticed.
“Noreen has been extraordinarily professional and the level of support she provides exceeded my expectations. Working with her is a pleasure.” – Director of Human Resources, CAFI, Inc.
“Leigh has been a tremendous help in implementation and ongoing service of KaMin's plans. She is a fun, positive, extremely willing, team player and an absolute asset to the BCBSGA family.” – Sr. Account Executive, Sterling Risk Advisors
“My company has gone through a rough transition and Alberta was instrumental in helping us implement our employee’s coverage. Thank you very much for providing this quality of assistance to your customers.” – The Blood and Marrow Transplant Group of Georgia
“Mary, your diligence and caring is rare and VERY MUCH appreciated! “ - Broker
“A quick note to let you know just how pleased we are to have Brandell as our account rep. His knowledge of your service and his response to any issues are exceptional.” – GC&E Systems Group, Inc.
“I just wanted to provide some much deserved feedback to you about Tina. She has been so very helpful, professional and responsive to our client and my needs. She is a refreshing breath of fresh air.” – Sr. Account Manager, Benefit Controls of the Carolinas
“Wanted to send you an email to let you know that Suwanna does a FANTASTIC job always! She did wonderful OE meetings at Oversight Systems and is always very helpful. We really appreciate her.” – Account Executive, Wells Fargo Insurance Services
Thanks you to all of the Sales Account Representatives for your hard work and for putting our Values in Action!
Director, Client Services