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it looks like we're all here
few completely to your microphones are on
terry thank you
okay sounds like they're so i'm going to ask rather upset is long-term care
protest please begin your presentation of introductions to have ten minutes per
year initial presentation
this in front of you turn yellow when you have only two minutes left
turned red when the time has expired
and i lost it
keep an eye on it nineteen twenty minutes weakness
paints a preset begin your inspection
my name is paul what do you think your microphones on his account
condoning the morning
my name is paul ford
and c_e_o_ of long-term care partners
uh... on behalf of all of my colleagues in portsmouth and boston i'd like to
thank you for this opportunity to present
to file left through mcginnis director of
uh... care coordination
drama lance and director of program promotion and account executive
into roth
chief financial officer
kevin hill chief operating officer
and uh...
keith leader
director public ministration and claims
i've personally been in the long term care business since the late eighties
have followed the progress of calpers for years
calpers was a forerunner
of many logically our group uh... plans both public and private
that uh... uh... i actually was involved
and of course
it was the template for the federal long term care insurance program which we
administer
we are excited by the prospect
of working with the world class organization
on a program that occupy such an important place in long term care
finance
long term care packages established in two thousand to launch the federal
program for more than eight million active
and uh... active employees and then go to this
since that time we've undertake an increasingly complex
uh... it ministry challenges
setting new benchmarks
for service and enrollment in the process today were a major administrator
of large-scale benefit programs
catching more than three million persons
on mission
to provide lodge sponsors with complete administrative solutions
that generate a high degree of customer satisfaction
we realize
that this bid for calpers is among
the most important
in history the program
we believe that dole ccp
is right
is the right choice to administer calpers at this critical juncture
for the following reasons
we understand and manage important stakeholder relationships
the federal government
is large
complex with many distinct communities in cultures
these are some of them that we deal with
of course the congress
and its oversight committees and the regulatory agency the u_s_ house of
personnel or ***
h_h_s_
the g_a_o_ a wimpy treasure
but of course they're all those other groups
equally important the labor unions
the affinity groups the special uh... interest non-profits
consumer advocacy groups policymakers
providers
and last but not least insurers themselves
we must be accountable and responsible to teach
obvious parallels between the federal program
and the calpers program make us uniquely qualified
to understand what is at stake
what must be done
we provide an exceptional exceptionally high level
of customer service
we consistently exceed call center
many many other service level requirements
like speed of answering turnaround time
but alas service is not just be
it's also the quality of the response
the education how well the customer understands the program itself
accuracy of data
we work hard to train our people
to be expert on aspects of long-term care
and of course we have care
in capital letters to care system a system we built and host ourselves
care can be customized to calpers requirements such as eligibility
underwriting and plan design
and it's integrated across every function
marketing
underwriting
billing
claims finance
this means high quality data
calpers staff would have twenty-four by seven access reports
the calpers custom view
let me just mention our advanced process for rate increases
we can modify every major component of your plan
all plans
including inflation adjustment
to achieve premium neutral landing spots only fully automated basis
this is a factor in the success of our twenty ten rate increase
which we implemented for a hundred and fifty five thousand federal enrollees
more than half of whom
exercised options
other than paying
the rate increase
we realize customers want to do business online
we offer a powerful web sites
with interactive tools
wycombe online consult
the sites are up ninety nine ninety seven point ninety seven percent of the
time
visit is can obtain information
model they're wrong
uh... l t c brisk
few podcast signed up for webinars
and once they're once a actually control the program they can feel the coverage
details update contact information you claim to be invoices online
and select
of the appropriate landing spot if a rate increase is watkins taking place
isn't ulti cps specialty
we provide all the tools they need
by eligible persons to make informed decisions
and we do this continuously
without interruption
please note
fidelity c_p_
was the first
it among the first administrators
to take applications online
both abbreviated and fall
antoine cooperate into our site
auto adjudication
so that person's not able to meet
underwriting standards
can be addressed quickly
this exhibit shows how effective
the continuous model eyecandy
the yellow line indicates higher
enrollment growth
you notice
even during the time where we did not have
open seasons
we have manage to
uh... and rolled
more than fifty thousand people outside of an open season on annette basis
one we had an open season last spring
in twelve weeks of last spring
we brought in forty five thousand
new controls
this model shows how easily people can be led to an educational experience has
shown an application it features email blasts linking two points of interest
which lead
uh... to the application
this model has helped us to eliminate huge amounts of paper
reduce processing time reduce our carbon footprint
save money
in fact more than fifty percent
uh... under the approved budget
enrollment growth is a critical factor in long term care success
became law average h
he can mitigate wrist that is concentrating as people grow older
he can reduce your capital strain
it can reduce the frequency of rate increases
they can give you are watching baseball for which spread fixed costs
and of course all of that together will enhance
brand image
can't coordination
is the last
thing i would mention
although it's certainly not least with very proud of of this it's an undoubted
strength
all of our care coordinated scarf
registered nurses with clinical experience
uh... in uh... one troops here
uh... problems
up there is a four range of support that is available
and we have we develop very skillful plants to that are appropriate these us
some of the testimonials that we've received from
uh... berry
uh... gratified
customers
these are some of the reasons for which we believe long-term care
is the right choice we think our proposal offers the best overall
solution
at a competitive price we would be pondered department with calpers
in progressive long-term care insurance management now in in the future
thanks again for this opportunity to present we would be happy to take any
questions you might have
will now proceed to get more of your view
i'll begin by asking the first question
could you please share with us examples of innovation t-shirt one-year
applebee's game but it may be another one next innovations that you've
developed
uh... to better provide service or around
plan design for the benefit for but the cost savings and or camping trip
well there are many innovations so we could talk about
uh... in terms of a plan design
as you know uh... we have made use of informal care
uh... and in particular we have made family care
uh... an auction
now this is not something that every long term care insurance has done
but we recognize the importance of home and community-based care
it's uh... in great demand across the country and we realize that if properly
manage
it can be cost-effective but you've got to port
the correct structures in place
because there is additional risk
of abuse
and fraud
uh... we have provision that will allow family members should provide care
and the situation is working
uh... very well
uh...
third-party independent review
is another a feature we think that people like
because they know that if they have a dispute with the plane
they can always expect to sit down or have that the entire file reviewed by an
independent third-party uh... who is expert
uh... in the field uh... i don't know if anyone wants to add anything to this but
they're many examples of innovation
i think the other uh... one i would point out is the electronic service
model uh... obviously uh... webservices is something that is uh... that's
prevalent everywhere in financial services
probably less so in the church in particular long-term care
uh... seventy percent of our romance
take place on line and while that's uh... maybe an impressive statistic i
think probably the more important one
is that we have more people in the evening educating themselves you uh...
on the product prior to buy it's a direct sold product if you will so
people will go up there watch the videos
uh... ron different scenarios to find out what ah... might be affordable care
for them
anti-competitive trashing golan in over time that we think until purchase that
the one what area that that showed up poet mentioned we had done
sticking forty five thousand applications
during open season for the five weeks prior to the end of open season we
averaged over four thousand applications between midnight and five o'clock in the
morning so
it's where people have the ability to educate themselves and take advantage of
a model
i think you dispel quickly on year uh... informal care
howlett patio often catch for item what do you do we need
we do to determined that they're struggling
elect uh... marylou take that one she is art director of care coordination
we find that with informal care there certainly is a much higher risk of fraud
um... we kind of separate the terms of fraud and and when it comes to fl
informal care into soft raj
it seems to be no
along qualms with somebody about stretching the hours that the home care
was provided or even stating you were giving hours when it actually learn in
the whole on so we've had to act just and adapt around a fraud model
where we actually have on and quite innovative n
on getting in a telephonic check-in and check-out service um... by one of our
vendors we were the first in fact long-term care haha insurer that
uh... actually brought this plan and house
and at the provider then goes in jackson when they get their checks out when a
when they leave
has to be done on the home phone
and in the first year that we used to get this bus service we actually have
gone back to life two twelve percent savings on justin numbers of hours
billed cell
the answer your question is yes we see a lot of stretching of those hours in
informal care
and i believe that uh... what also involved
your home care by by on non agency provided nurses are or or actually home
health needs
i think you would would run into the same sort of things they're okay thank
you have a lot of questions the committee mislead
thank you very much
when looking at calpers long-term care program i'm sure you have seen some of
our challenges but what do you see is maybe one or two of our most important
challenges
and happy to have a just recommend reached you know we address that well as
i was indicating in my remarks and alma what kevin and others ah... abt
if they want
uh... but i think that the biggest challenges that you have p uh... mature
program
that is rising in claims
and uh... at the same time that you have an informant
that is falling off
this is not a good situation
uh... and one of the basic rules of insurance is to spread that risk and to
bring as many people end
uh... to be able to spread that risk as is consistent with sound underwriting
uh... i think the fact that aren't you are seeing of these claims which uh...
by the way constitute a very significant portion of total expenses for the
program
uh... at the same time that you've not held uh... and open application period
board made significant outreach efforts to bring anyone of uh... files ans of
the one point six million
uh... eligible s
uh... both state uh... and and how do you mean a simple
uh... retirees all those people
who are by the way buying policies
uh... other
uh... underwriters
in california
uh... i think is uh... something that definitely needs to be address that
disconnect between the rising claims
and falling on them
elegant o
that the other point i would make is out of hundred and fifty five thousand
release their their uh... it's important to proactively communicate what the
coverage actually does for those folks are not sure that uh... at least through
the due diligence process we're trying to identify the types of communications
that were sent out that illustrated to those people the value of the coverage
and how it could be used the types of care the world they're and that i would
extend that to
uh... as paul stated the group of people that have not had the ability to
actually purchase the coverage at least educate them about what long-term care
is
so they can understand it by either as some of the market or when the uh... the
program itself is open again
thank you thank you
thank you from
might question deals with the computer might toward internal coordination those
people who are members would you have any programs that try to keep people
elantra gt readiness to go to their health health care
uh... providers insurers
uh... to change you know
prove behavior health or something that what that would uh...
uh... with the media reported their needs for a long trip historically uh...
the long-term care insurance industry has not been
very aggressive in the area of wellness
that is starting to change has uh... we have quite a more experienced than we
realize that there is a great continuum between acute health care
and long-term care
uh... and uh... we are looking now at various uh... things that can be done
melinda lisa physically
uh... potential enrollees and actual enrollees uh... these things can include
lifelines type screening
for vascular uh... conditions a hot disease aneurysms kind of things that
can cause stroke
uh... as well as screens for cognitive impairment
how you can use uh... branded newsletters
that uh... are introduce a important subjects pertaining to nutrition
and longevity
exercise and longevity
uh... moderation and longevity small amounts and so forth and then uh...
finally you can have
interactive websites
and world so are looking at that i think uh... i think any of these things
all of these things arpan are components
in uh... a wellness program that uh... should be should be considered
and you're developing these things currently your these as i said we are
working on these now uh... our parent company john hancock has been actively
at work on uh... uh... using the usa screenings for some time
uh... there a number of uh... insurers who are doing this and we have looked at
all of the other components including about website management and services
where fidel could be included in whatever press uh... let's negotiate
correct
terrific thank you mister bilbrey
the camacho but would consider to be a three top different readers between
here
well kevin a mentioned the uh... the electronic service model i don't think
anybody's gone quite as far as we have to really make a long term care
insurance available on a direct basis
this long term care package has
uh... we've been very successful not only in terms of conventional paper
marketing
networking
field organization conventional standups seminars
meetings benefits all those things
uh... but we have really uh... pushed i think the envelope with respect to uh...
of a powerful web site that allows people to gain all kinds of uh...
uh... information from it
to interact with tools for planning and then
to uh... to be able to apply online
uh... window among the first to develop that capability
and uh... it's worked beautifully four s especially if you consider that would
doing this continuously another which we're not just opening up for open
season we have a shot down
and i submit that that is pol certainly talk what model but i think should be
considered so that's an important point differentiation
uh... acting
e uh... and of course implies a certain level of technology
we've also
push forward very high bp in the area of security
security management
we have uh... impressive security program
uh... that uh... uh... the destruction and that mrs
and allows us to be compliant with uh... with uh... system federal information
security management act yet but data privacy
we conducted with tests of surveys
uh... to make sure that uh... that uh... we uh... staying on top of what is
eighty stanley
moving target
because you can't be
first-rate
in terms of having electronic service model
and the slack and security
i don't have one other sir
uh... the special just no one ever embraces a rate increase and the method
that you used to actually communicate that very broadly very personally
to those people it's important and i think that we've had good success
uh... over what was the uh...
a significant rate increase and i think that on the heels of the way the we
designed the personalized communications when we had to take them about that
the trade-offs
and then secondly to follow that on within thirteen months with an open
season were forty five thousand came in
uh... we tried to be very objective about the complaints that we received
i think we did a fantastic job of executing that in nyc critic-at-large
into personalizing the communication
and the consummate occasion the lead up to that red ink recently understood what
the issues were
coelho that because you put a high emphasis on electronics in technology
what about our members that don't technology
what kind of service and a club have such a blacktown uh... john lansing who
has been extremely a successful with uh... paul of uh... what you might refer
to as the conventional
uh... support
uh... that i mentioned a moment ago john do want to talk a little bit about that
outreach
you're absolutely right line size doesn't
doesnt fit off and we apres ton a very high-tax to a high-tech environment what
that means is that we have so many options for people to follow so because
we thought emphasized our emphasis on down
uh... technology doesn't mean that we don't go out and talk to people
personally i think you can't discount that we do on
uh... hundreds of bob in-person meetings all over the country all the time and
for those people who want the technology we do webinars
uh... we go to conferences with other affinity groups we'd to health care is
when there is open season for other products even though we don't have an
open season where out there all the time
and we try to bob offer that we have a very um...
uh... gary could call center for people call in and these art calls and directs
that pick up the phone and and have to transfer the call picking yes to the
questions they're certified in long term care their uh... they've gone to two
different kinds of certification and they work with these individuals
providing a personalized uh...
uh... attach we have a database so that every time they call we know what
congress a simpson interactions that they've had before because the purchase
of long-term care isn't something that you care about once a nearby sick timing
issue if we had to kato's pali saying which we do all the time here in the
near route when you're ready to bite because you've had personal experience
your financial uh... plan exposure somebody says
and you feel that you want a bike in one of my so where there when they anita dot
i'd just like to add also that as far as claims goal we do not consider
our claim population highly technology ecological people some of them are a lot
of the family members that helped them out certainly have the technology and we
provide the website found the claim
piece of the website so that they do have access to things like invoices that
are being paid where are we at with them that sort of thing however we do not
depend on that website nor technology we deal more with um... on newsletters
clearly written written letter is on uh... uh... brochures that sort of thing
that the elderly population probably has more of a a contact with
and support yeltsin
so what bank through the process by and a seventy five seventy eight-year-old
woman highly anxious my husband
is to do all the pills i'd know that we have a long-term care policy and now he
has really dimension
and i'm understanding that something's going wrong
i call a number
what happens and how do you get me in the process and how long does that take
and i am not computer literate
what we use the term a one called those at all particularly for that in the
strange thing about long-term care issue paper ten or fifteen years
what upwards of twenty one hundred dollars and whether to or your
daughter's someone would call on that you place a call to us and we would do
two things we would all right there uh... to your point mister bilbrey other
email you package that explains everything or overnighted that's one of
the two depending upon your preference
the second thing we would do is we would set up an appointment with you right
there
we're registered nurse would call you and walk through that process the reason
we send the package on his to understood that you've got a day or two to pull the
information together
that every sugars would use to develop
number one are they eligible are proclaimed and number two to develop a
plan of care so the goal is that they would call in
we would do those two things in the next call that they would get
would be from a registered nurse
would walk them through that interview process which takes between forty five
minutes an hour
and and how long does it take to then do i sort of wait till i get to know
through my deductible period before i get any services earn do you
start sending separate wet it is specific to d type of policy that you
have been a package that would send a would explain
on what the waiting period is whether it's calendar days or interrogate
so uh... that could be a potentially depending upon uh... sixty days uh...
fine reference the calpers program correctly and uh... we walked in through
that on the first call so that they understood it
benefit sixty calendar days within you and you would start gaining uh... he
would start gathering up receipts and invoices
did you would submit
and then you would
deliver invoices to us for the payment process
is there anyone and the nurses working with you entire time because what we
feel is so important
is that somebody who has called in knows exactly where they are in the process
they know what they need to do in order to help us get the information we need
to determine benefit eligibility and they need to know what were doing in
uh... in the meantime for instance getting medical records not always a
quick process depending upon where the records are coming from and and that
sort of thing so we explain this to them we've put out a request for this record
were getting the assessment done benefit eligibility is being determined and at
the same time were working with them with whatever plan of care they
currently have in place so that in fact they know they don't wait for anything
to get the care they need that's ki
they need to have the appropriate care place and then we will walk them through
what they need to be collecting for for invoicing and that sort of thing
mary lou the um...
fee care coordinator who was assigned stays with that particular cardmember
uh... there's no there's no hand off because that's that's one of the big
problems that can sometimes see
with uh... alder
persons trying to deal with a number of different contacts with an organization
it i'd think kevin mentioned before the first call we try to give them as much
information as we can
and then that's right there d growing with a single person came as a document
in front of them of what has transpired already in the plane so they're not
constantly repeating themselves as as to what's going on
mr jones
thank in advance
southward to please comment on any litigation and or investigations uh...
car are pending at your organization is involved in the more changes of proposed
changes
have been the in your business practice as a result
investigations or
uh... litigation
we have been involved job
with several cases uh...
that had to do with that discrimination
uh... and our ability to operate
these were fairly complicated would take a while to explain them but they were
brought against
uh... the u_s_ office of personnel management
by certain persons who believes that because they would decline for coverage
in the program
uh... they he were actually discriminated against what this was a
probable toward for houston discriminating against them as employees
uh... a number of these cases for are tied up for a while
uh... and uh... we have assisted opie and in terms of of uh... working with
them
and with uh... attorneys um...
in one important portal case there has been a summary judgment given uh... very
much in favor of *** and i'm cells
uh... and there are several other
discrimination cases of the kind uh... pending i am not aware any other
uh... litigations that time we have fired up
and sorry we can't tell
and
could be clearly a lot of interest in asking questions and lemon thank you
very much for your time this morning
and at this time and ask you to see leads cleared reassigned insight in
unit the inspectors at sinking thank you very much thank you very much