Open enrollment 2012 is long wrapped up, but carriers are already preparing for 2013. As the health care market is in a constant state of change, EBA spoke with the major medical providers for their views of trends and what to expect in the future. Providing answers are:

* Aetna: Timothy G. Kelly, market vice president - national accounts, Metro New York / Northern New Jersey

* CareFirst BlueCross BlueShield: Michael Sullivan, corporate spokesperson

* Cigna: Jackie Aube, vice president in charge of product development

* UnitedHealthcare: Yasmine Winkler, chief marketing and product officer

* Unum: Jim Hettenbach, director of market development


What trends did you see in last year's open enrollment season?

Aetna: Large employers are looking for ways to maintain robust benefits while encouraging member engagement and containing total costs. We also saw increased interest in wellness programs as a way to help improve health and lower total costs.

There also has been an increasing trend toward incentive- and disincentive-based initiatives that are tied directly to member cost and require participation in engagement-based programs. Communications and activities for these initiatives begin during open enrollment - biometric screening, metabolic syndrome testing, member health engagement plans, etc. There is a growing trend toward making it mandatory to engage in understanding one's baseline state through financial reward (or disincentives).

As employee cost share increases, employers are making programs available to members to encourage them to participate in their health and understand their risk factors so that they can do something before a catastrophic event occurs.


Cigna: We saw continued increasing popularity of our Choice Fund customer-driven health plans. Key to their popularity is design: our plans are designed to improve costs rather than shifting them or compromising care. We have seen that consumer-driven health plans have consistently reduced costs, maintained or improved customers' levels of care and enrollees have become smarter consumers of health care, for example, choosing generic medications over brand name drugs.

We are also seeing increased interest from employers in health and wellness programs that help employees be healthy and productive. Cigna's proprietary research shows 66% of high-risk individuals and 31% of all individuals reduced their health risks after completing the company's health assessment and using its health coaching programs. By reducing their health risks, individuals are less likely to face future health problems and higher health care costs.


UnitedHealthcare: There was increased interest in our incentive-based wellness programs that reward employees for making healthy choices. Through wellness programs, employees can earn financial incentives for lowering their cholesterol, losing weight, or even signing up for a health coaching program or visiting a fitness center. We believe wellness offerings are part of the reason why UnitedHealthcare's total membership grew by more than a 1.5 million members last year.


CareFirst: For 2010, enrollment was 3,378,700; and in 2011, it was 3,364,600, - stable membership figures given the significant changes in the health care industry.

Overall, CareFirst's enrollment has remained largely stable from year to year. There have been some shifts in those markets with the greatest price sensitivity leading up to 2012, but from 2012 to 2013, we expect modest growth in enrollment.


Unum: While Unum doesn't sell major medical, we do closely follow the trends in major medical because they directly affect ancillary benefits - which is what we sell. Unfortunately, 2012 will see the continuation of trends that have vexed the industry for a while now.

Costs of health coverage will continue to increase, putting pressure on employers to balance their budgets without sacrificing benefits coverage for their employees. A result is that more employers are adopting higher deductible health plans or shifting to consumer-driven options.

We're seeing steady growth in the market for supplemental benefits - coverage that will help employees cover the financial gaps these new [consumer-driven] medical plan designs create.


What are you developing for 2013 open enrollment?

UnitedHealthcare: In addition to wellness offerings, we are excited about our new mobile health apps like Health4Me and online tools such as the UnitedHealthcare Health Care Cost Estimator.

Health4Me is a mobile application that helps members manage their health care easier and faster by enabling them to find physicians near them, check the status of a claim or speak directly with a nurse 24/7 for medical advice.

Our Health Care Cost Estimator has been popular for many years, and this year we are making enhancements to the tool. We are very excited and encourage by the feedback we've already received from employers.


Cigna: We continually seek feedback and continue to improve and refine the language in our enrollment materials and are adding new decision support tools and information to help our customers better understand and get the most benefit from their plans. Our Let's Be Clear initiative is focused around helping people during enrollment and all year round In addition, prior to the 2012 enrollment season, we dramatically improved the personalization and consumer-friendly navigation of our website for our health plans.


CareFirst: CareFirst is in the early stages of two major initiatives that we expect to significantly improve the affordability of coverage and how patient care is delivered in our service region. HealthyBlue is a family of products that encourage members to work in partnership with their primary care providers to plan for the best possible care outcomes and savings, while rewarding healthy behaviors. Our Patient-Centered Medical Home program incentivizes primary care providers to ensure the best possible care planning and coordination of care when specialists are brought into the care plan.


Unum: As medical options change in response to cost pressures or to health care reform, there will be a lot of decisions that shift to the employee, particularly as supplemental benefits are added into the mix. As employees take on more of the buying decisions and costs, it becomes critical that employees receive the information they need to make informed benefits decisions.

We're investing in tools and technology that will help brokers and employers guide employees through this decision-making process. The enrollment experience needs to be simple and straightforward, but chockfull of information to help employees make a properly informed decision.

Aetna: We are putting even greater focus on our engagement and wellness strategies, and ways to connect with members to help them manage their health. We continue to find that integrated solutions, including our Aetna One choices, bring real results, in health and savings, and we will continue to encourage customers to choose integrated solutions that make it even easier to keep members connected and engaged.

We also continue to enhance and expand our technologies that make it easier for members to interact with us and guide their health care choices, including Aetna Mobile, mobile apps such as iTriage, online personal health records that members can share with their providers, and our virtual online assistant "Ask Ann" that helps more than 20,000 members a day with personalized guidance to find health benefits information.


Where are group benefits heading and what are you doing to get there?

Aetna: Consumer engagement will be key for group benefits as well as individual. We will continue to build easy-to-understand options and ways to enhance the consumer experience, so our members become fully engaged in their own health and health care decisions.

We're also helping our customers navigate the complex, far-reaching and still-evolving changes of health care reform that demand re-evaluation of benefit strategies. New taxes, fees, benefit mandates and administrative requirements add to benefit costs, while employers face coverage mandates and restrictions on employee cost-sharing. Employers need a trusted adviser and advocate to help them navigate successfully through the reform-driven market.We are focused on transforming the system to make quality health care more affordable and accessible, and to help people lead healthier lives.


UnitedHealthcare: As you may have seen from UnitedHealthcare's presence at the Consumer Electronics Show, we are working on some fun, innovative projects. One new area we are looking into is fitness gaming. Our company is currently exploring the use of the play, psychology, mechanics and technology of games in a health context as it applies to care management, condition management, proactive wellness and performance fitness. By using these game elements to drive greater engagement, we aim to promote greater health and well-being of our members and the general public.

Also, consumers have changed how they prefer to receive information. Many people now use smart phones or even iPads and prefer to watch online videos for news or other information. Therefore businesses must adapt. That is a key reason why we just created UHC.TV, a new online site that provides health- and wellness-related programming.

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