1. Independent | Local | Not-for-Profit | Community-Focused The Path Forward BCBSVT’s Response to Extraordinary Times

2. Independent | Local | Not-for-Profit | Community-Focused Introduction Catherine Hamilton, Ph. D. Vice President of Planning

3. Independent | Local | Not-for-Profit | Community-Focused To discuss: How the Exchange impacts Vermonters How to help Vermonters through the transition Q & A Overview: 3

4. Independent | Local | Not-for-Profit | Community-Focused Information about: Why BCBSVT is launching a retail campaign Introduction to the changes in Vermont’s health care landscape as the result of the Affordable Care Act Information about what BCBSVT will provide to businesses and consumers o Information o Decision support o Timing of activities and how to stay connected o New and improved offerings for large groups Today’s Objectives 4

5. Independent | Local | Not-for-Profit | Community-Focused Extraordinary times and the unprecedented changes facing Vermonters o Largest transition of consumers and businesses in our history o Vermont’s Exchange only model Our Mission o To always put members’ experience first The Challenge o Guide Vermonters’ understanding of changes and impacts o Successfully transition thousands of Vermonters to new products and the Exchange o Respond to our customers –who asked for help Why Are We Here? 5

6. Independent | Local | Not-for-Profit | Community-Focused Extraordinary Times for Small Businesses and Individuals Direct to consumer o Consumer choice Standardized products and benefits Online portal administered by state Mandatory for individuals 6

7. Independent | Local | Not-for-Profit | Community-Focused Extraordinary Times for Small Businesses and Individuals 89% of Consumers Will Be New to Purchasing Three in four Vermonters unaware of the Exchange 7

8. Independent | Local | Not-for-Profit | Community-Focused Extraordinary Times for Small Businesses and Individuals 8

9. Independent | Local | Not-for-Profit | Community-Focused BCBSVT customers asked us to help build understanding and guide transition Comprehensive retail campaign 17 different operating plans --- repurposing staff o New media campaign o Comprehensive outreach, phone support, new website o New product offerings Responding to the Challenge 9

10. Independent | Local | Not-for-Profit | Community-Focused Why are we here today? How the Exchange impacts Vermonters Helping Vermonters through the Transition Q & A Closing Thoughts 10

11. Independent | Local | Not-for-Profit | Community-Focused What Change is Coming and Who’s Affected? What: An online Exchange marketplace for comparing and purchasing health insurance Who: All individual consumers and small businesses under 51 employees 11

12. Independent | Local | Not-for-Profit | Community-Focused When Does this Change Happen? October 1, 2013 January 1, 2014 March 31, 2014 Open enrollment begins Policy year begins (upon renewal for groups) Open enrollment ends (individuals ) 12

13. Independent | Local | Not-for-Profit | Community-Focused Deductibles/cost sharing: 9 standard product designs Covered Benefits: Essential Health Benefits o State recommended BCBSVT benefits as basis o Pediatric, dental and vision What Are the Product Choices? 13

14. Independent | Local | Not-for-Profit | Community-Focused Small Business(<51) Impacts What Stays the Same: Voluntary to offer insurance o No Penalties Health plans issue products Select contribution level Small business tax credits available Can hire a broker What Changes: Employees face tax penalties if uninsured Employees can choose among health plans Products are standardized Use the Exchange website to enroll and pay premium Broker fees cannot be part of the premium 14

15. Independent | Local | Not-for-Profit | Community-Focused Small Group Employer Decisions Keep my coverage? Drop my coverage? 1.Plan design/contribution level? 2.Small business tax credit? 3.Employee plan/product choices? 4.Broker? 1.What options do my employees have? 2.Increase wages? 3.Tax implications? 4.HR implications? 15

16. Independent | Local | Not-for-Profit | Community-Focused Individual Consumer Impacts (not covered by employer) What stays the same: Health plans issue products Premiums not tax deductible expense What changes: Uninsured face tax penalties Subsidies available if income eligible Products are standardized Use the Exchange website to enroll and pay premium Catamount goes away 16

17. Independent | Local | Not-for-Profit | Community-Focused Large Employer Impacts What stays the same:  Can purchase from a health plan  Enroll with health plans  Pay premium directly to health plans  Brokers fees part of the premium  Premium still tax deductible expense What changes: Will face tax penalties if they don’t offer insurance Coverage must be credible 17

18. Independent | Local | Not-for-Profit | Community-Focused Why are we here today? How Exchange impacts Vermonters Helping Vermonters through the Transition Q & A Closing Thoughts Overview 18

19. Independent | Local | Not-for-Profit | Community-Focused Guide Vermonters through the transition to the Exchange Be there when you need us Deepen relationships with consumers Optimize the member experience Comprehensive outreach campaign Best products at the best price Great member experience Our Commitment 19

20. Independent | Local | Not-for-Profit | Community-Focused BCBSVT outreach campaign Media Community events Community meetings Business meetings Webinars Phone support Website Satellite office How Will We Carry Out our Commitment? 20

21. Independent | Local | Not-for-Profit | Community-Focused BCBSVT coverage consultants will work face to face, by phone or web Brochures, videos and webinars A toolkit for decision-making On site information sessions HRA/HSA packages that provide an easy way for employers to continue to fund health coverage Outreach to individual employees of companies that are dropping coverage What Services We Will Provide to Small Businesses 21

22. Independent | Local | Not-for-Profit | Community-Focused Timeline for Supporting Businesses March – June 2013 July – Sept 2013 Oct 2013 – March 2014 Assist Employer/ Employees o Plan choice o Enrollment Assist with decision Educate on change Options Timing 22

23. Independent | Local | Not-for-Profit | Community-Focused Pre-Campaign Build Awareness Campaign Engage Vermonters Ongoing Continuous improvement in consumer experience How Will We Will Reach Vermonters? January 2013 – August Outreach and education about the changes September 2013 – March 2014 Transition groups and individuals Open enrollment Offer products to market Decision-support 2014-2016 and beyond Ongoing optimization of consumer experience 23

24. Independent | Local | Not-for-Profit | Community-Focused New and Improved Offerings for Large Groups Joanne Reynolds Senior Sales Executive

25. Independent | Local | Not-for-Profit | Community-Focused Objectives of Client Partnership Program 25  The objective of the Client Partnership Strategy is to create strong lasting relationships with clients. We achieve this by understanding each client’s unique health, wellness, condition management needs and by developing customized solutions to address these needs. The long-term result is a more engaged, healthier, and more productive workforce and highly satisfied employer customers.

26. Independent | Local | Not-for-Profit | Community-Focused Client Partnership Program 26  Benefit Design and Financing Consultation  Custom Reporting and Data Analytics  Advisory Experts  Health Advocacy and Clinical Solutions  Health Care Reform  Worksite Health and Wellness  Consumer Engagement

27. Independent | Local | Not-for-Profit | Community-Focused 27 Accountable Blue  New health and wellness product  Team-oriented approach – shared incentives among the health plan, employer, member and provider  Goal is to keep members healthy and manage illness FLEXIBLE BENEFIT DESIGN A customized benefit design to support your health and wellness goals INTEGRATED HEALTH AND WELLNESS SERVICES A suite of customized health, wellness, and care management programs EMPLOYEE INCENTIVES Incentives to encourage and reward healthy behaviors

28. Independent | Local | Not-for-Profit | Community-Focused Team Oriented Approach 28 Employer Group Employee incentives Health & Wellness programs Clinical and Participation Performance targets Workplace environment BCBSVT Flexible benefit design Worksite health, wellness, care management programs Custom analytics Custom consumer engagement campaigns Concierge health & wellness services Providers Quality-focused guideline based care Patient-Centered Affordable and fiscally responsible Evidence-based care  Emphasizes well-being, condition management and healthy outcomes  Everyone is accountable o Consumer o Provider o Employer o Health plan o Community  Two levels of engagement o Worksite o Population  Aligned incentives

29. Independent | Local | Not-for-Profit | Community-Focused 29 How Accountable Blue Works Identify benefits and incentives of value to Employer Identify benefits and incentives of value to Employer Health Assessment Health Interest Survey Clinical Data Organizational Health Evaluation Demographics  Flexible benefit design  Integrated health & wellness services  Employee incentives A customized benefit design to support your health and wellness goals A suite of customized health, wellness, and care management programs Incentives for healthy behaviors Claims ©2012 Blue Cross and Blue Shield of Vermont

30. Independent | Local | Not-for-Profit | Community-Focused Why are we here today? How the Exchange impacts Vermonters Helping Vermonters through the Transition Q & A Closing Thoughts Overview 30

31. Independent | Local | Not-for-Profit | Community-Focused Are We On the Right Track? 31