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Agent Sales News

Thanksgiving holiday schedule

Thanksgiving is almost here! In observance of the holiday, we’ll be pending publication of Agent News articles this week—and our offices will be closed Thursday and Friday, November 27 and 28.

See you next week and have a Happy Thanksgiving!

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November is National Epilepsy Month––take part

Epilepsy affects over two million Americans with 150,000 new cases detected each year. Perceived as a condition that affects young people, epilepsy can affect anyone at any age.

Take part in promoting awareness this November, which is National Epilepsy Awareness Month. The nation’s fourth most common neurological disorder after migraine, stroke and Alzheimer’s*, one in 26 people will develop epilepsy in their lifetime.1

While epilepsy is not uncommon, the public’s understanding of the disorder is limited.

Epilepsy is a brain disorder characterized by brief disturbances in the brain’s normal electrical functions, a kind of occasional glitch in the amazing electrical system, which controls everything we feel and do. These brief malfunctions (called seizures) may temporarily block awareness. They can also cause uncontrollable shaking, convulsions, confusion, or affect the senses.
Anyone, at any age, can have a seizure if the brain is stressed sufficiently by injury or disease. A single seizure isn't epilepsy, although the symptoms are the same. Epilepsy is the name given to seizures that occur more than once because of an underlying condition in the brain.

It’s important to be aware of seizures as people age, because they may have odd or strange experiences such as confusion, lost time, or suspended awareness. They, or their loved ones, may assume it’s just a part of the aging process––but it could be epilepsy, which can often be successfully treated.

To find out more about epilepsy, visit epilepsy.com or the Epilepsy Foundation’s Facebook and Twitter pages to get involved and help spread the word.

Sources: Epilepsy Foundation of Florida, National Academy of Sciences’ Institute of Medicine

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Care consultants help close the gap

The Florida Blue care consultant team (CCT) provides a wide range of services to assist our customers seeking care. This service strengthens relationships between Florida Blue and its diverse membership base.

The team recently added 12 bilingual benefit specialists, based in Miami, so Spanish-speaking members can access CCT services more easily. Because the service supports member satisfaction, retention and cost reduction, it’s a good idea to underscore the CCT team in discussions with your customers.

When members contact the CCT they can expect help in:

  • finding the lowest cost on prescription drugs—and comparing specific drug prices at individual pharmacies
  • accessing member discounts on selected everyday products and services
  • shopping around for the best value on medical and diagnostic procedures
  • navigating the self-service tools and other features on FloridaBlue.com
  • triaging chronic conditions with Florida Blue’s various care programs
  • tailoring benefits to their specific needs
  • locating and accessing wellness programs
  • making financial choices that align with their needs
  • accessing local resources for necessities

“The CCT bilingual team will help close a key gap for our company, providing guidance and care coordination for our Spanish members that will help them maximize the value of their health plan, and live happy and health lives,” explained Sherri Mikell, Vice President, Contact Services. “We are finally able to bring the value of the care coordination process to all our members.”

To access the CCT, members can call 1-888-476-2227 or visit any Florida Blue Center.

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Health care costs to rise in 2015; money-saving strategies

According to a recent report from the Health Research Institute (HRI), a division of PriceWaterhouseCooper, overall health care costs are expected to rise by 6.8 percent in 2015. Some of the factors driving the increase include:

  • greater use of medical resources as people seek care for previously untreated conditions
  • investments in new medical technology
  • cost of specialty drugs for conditions like multiple sclerosis and hepatitis C

Much of this increase will be reflected in higher premiums. In response, many employers are moving toward high-deductible plans that shift more of the cost to employees. In fact, the HRI report notes that high deductible health plan enrollment has tripled in the last five years; among employers not currently offering them, 44 percent are considering them.

These dynamics create opportunities for insurance professionals to add value and differentiate themselves from competitors. Employees and consumers will need counseling from experts on how to choose wisely among their options and save money.

Some money-saving strategies include:

  • Assess insurance needs next year. Younger, healthier consumers may prefer to purchase less coverage with higher out-of-pocket costs—especially with preventive services covered at 100 percent under the ACA. Consumers expecting to start families and those with chronic conditions might need more coverage.
  • Examine provider invoices carefully. Check for inadvertent double-billing, erroneous charges for appointments that were rescheduled, and other inaccuracies.
  • Consider employer contributions. Some companies contribute more toward the employee’s coverage, with a lower contribution (or none at all) for family members. Under some circumstances it may save money to enroll family members through the appropriate Marketplace.
  • Save on prescriptions by using generics whenever possible and asking physicians about lower-cost alternatives.
  • Consider opening a tax-deductible Health Savings Account. If they have a high deductible plan they should consider a HSA. It works like an IRA for medical expenses, and unused funds can roll over to the next year.
  • Shop wisely for health care services. Florida Blue has a team of Care Consultants who help members compare costs for procedures from different in-network providers.

Viewed in this light, the rise in health care costs can provide a perfect opening for you to earn trust and build your client base.

Source: U.S. News & World Report


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Give thanks at Thanksgiving

With the holidays approaching, remember that your cards and gifts will have to compete with others from the recipient’s friends and family members and might get overlooked.

Now is a perfect time to send year-end thank you cards to clients, customers and vendors. Enclose a gift card to a local bookstore or restaurant to keep the dollars spent in your community. If your clients are geographically widespread, gift cards to online gourmet gift shops are a great idea.

If you send an actual gift, it doesn't have to be expensive. Buy cookies shaped as turkeys or pumpkins, wrap each in a cellophane bag and then in bubble wrap. Then box them up to distribute to your most loyal customers.

Your thanks is sure to stand out when it’s before the Christmas gift-giving season.

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New Skillsoft eLearning courses for 2015

In preparation for 2015, Florida Blue will be releasing a variety of new eLearning courses to keep agents informed about critical health care topics that affect the Florida market.

Agents can access all available eLearning courses through Skillsoft, Florida Blue's learning management system. Find the Skillsoft link on the front page of accessBlue in the “Sales & Training Support” section, along with a Skillsoft External Job Aid that includes:

  • technical support;
  • troubleshooting information;
  • step-by-step log in instructions; and
  • a guide to help agents navigate the tool.

Skillsoft is available exclusively to agents; delegates do not have access. Future announcements will be made as new eLearning courses are released. For questions, email CommercialMarketsTrainingEvents2@floridablue.com. This information can also be found in Agent Bulletin #A14-235.

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Many uninsured remain unaware of the ACA

Although the Affordable Care Act (ACA) has reduced the number of people who lack health insurance, the remaining uninsured (13.4 percent of Americans, an all-time low) will prove harder to reach. That’s one of the conclusions in a Harris Poll survey for the nonprofit Transamerica Center for Health Studies.

Clearly, awareness is an issue. Almost half of the uninsured—46 percent—said they were unaware of the ACA’s mandate to purchase health insurance. Nearly the same number, 43 percent, said they were unaware of the federal and state Marketplace exchanges where they could have purchased coverage. Another 22 percent missed the deadline last year because they said they were unaware of it.

The report lists other reasons for remaining uninsured. Eleven percent of uninsured said insurance was too expensive, and 27 percent said they thought it would be less expensive to pay the penalty and the full amount of their health care costs. The penalty for failing to have a Qualified Health Plan, $995 or one percent of taxable income in the current fiscal year, will rise significantly in 2015.   

Among the other findings about currently uninsured Americans:

  • 44 percent are between ages 18 and 34
  • 33 percent are Latino
  • 40 percent have not gathered information about their personal health, health insurance and the health care system in the past 12 months
  • 42 percent could afford health monthly insurance premiums of $100
  • 22 percent can afford routine health expenses
  • 5 percent are currently saving for future health care expenses

The number of uninsured Americans has added relevance as the next Open Enrollment period for individuals under 65 begins November 15.

Source: BenefitsPro

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HHS report notes more issuers for 2015

A recent report from the U.S. Department of Health and Human Services (HHS) says consumers will have more choices in the Marketplace during the 2015 open enrollment period that begins November 15.

The report, dated Sept. 23, 2014, notes a net increase of 25 percent in the number of issuers offering Marketplace coverage in 2015. At the national level, 77 new issuers will offer Marketplace coverage; in Florida, one insurer is exiting the Marketplace, while four are entering, resulting in a net gain of three insurers.

The report examines preliminary data from 44 states: 36 that rely on the federally operated Marketplace plus eight that operate their own Marketplaces. Some of the report’s specific findings include:

  • Among the 44 states in the report, 77 issuers will be newly offering coverage in 2015.
  • Of these states, 36 will have at least one new issuer next year. 
  • The 36 federal Marketplace states alone will have 57 more issuers in 2015—a 30 percent net increase over 2014.
  • In four of these states, the number of participating issuers will be at least double the current number.
  • In the eight states that have their own Marketplaces, a total of six more issuers will be participating next year, a 10 percent net increase.
  • Some of the nation’s largest insurance companies will be offering coverage in more than a dozen new states, joining the hundreds of insurance companies already participating in the Marketplace.

The higher number of insurers doesn’t necessarily translate to a higher number of plans available to consumers. In some individual counties, if 2014 insurers either leave the market or reduce the number of plans available, then consumer choice may actually decrease.

View the full report.

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Electronic ID cards available for most dental PPO plans

Florida Blue has added convenient new servicing features that benefit members with most dental PPO plans. Now it’s possible for agents—and members themselves—to generate an electronic ID card and request a replacement card or benefit booklet.

The new capability applies to group and consumer members who have a Florida Blue/Florida Combined Life dental product. But it does not apply to those with prepaid and integrated health and dental products. Eligible plans include:

Group plans

  • BlueDental Choice, Choice Plus, Choice Copayment, Freedom

Individual qualified plans

  • BlueDental Choice Q and QF
  • BlueDental Copayment Q and QF

Individual consumer plans (no longer sold)

  • BlueDental Choice Plus
  • BlueDental Choice Copayment

Additional updates being made to accessBlue:

  • The ability to print and/or save eligible dental electronic IDs at an individual or group level.
  • Order replacement ID cards or benefit booklets for eligible dental products.
  • Find group and individual members by contract number, Social Security number and date of birth, or name and date of birth.
  • For groups: search by group number or group name.
  • To order at the group level, you must be the agent of record.

In addition, group benefit administrators can also generate an electronic dental ID card for members in groups with health and a PPO dental product. Benefit administrators of dental-only groups cannot access an electronic ID card in BlueBiz and should call Enrollment Membership & Billing to receive one. An email with details is being sent to group benefit administrators.

For details on these new capabilities, please refer to Agent Bulletin #A14-237, which also has a copy of the email to group benefits administrators and step-by-step instructions for accessing ID cards in BlueBiz.

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Study shows millennials lack insurance across the board

Despite the health insurance mandate contained in the Affordable Care Act (ACA), nearly a quarter of millennials (ages 18 to 29) lack health insurance, according to a survey conducted by Princeton Survey Research Associates International. That’s significantly more than the 16 percent of Americans overall—in all age groups—who lack health insurance.

Millennials usually enjoy lower premiums for health insurance and are often more likely to receive government subsidies than Americans in other age groups. Their choice to opt out of health insurance in greater numbers than the general population could be related to a sense of invincibility associated with their age group.

The trend is not limited to health insurance. The survey’s findings, based on responses from 1,003 adults in the continental U.S., reveals that millennials are foregoing other kinds of insurance, too. They appear to be underinsured across all insurance lines—including auto, life, homeowner’s, renter’s and disability. Still, the study notes, 60 percent of millennials are confident they are prepared for the financial consequences of being uninsured or underinsured.

What this translates to for agents? A selling opportunity. Prospects need to be informed about the ACA rules allowing coverage under parental policies until age 26. Those who don’t qualify under that ruling should be aware that going without insurance means they’ll pay their total cost of medical care, plus the government fee––2 percent of total household income for 2015 or $325 per adult and $162.50 per child––whichever is higher.

Source: Insurance Networking News

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Florida Blue e-News fall issue now available

Turn over a new leaf for fall. Test your flu I.Q, support national health awareness months, take part in the Great American Smokeout and much more. It’s all inside the new issue of the Florida Blue member newsletter.

The quarterly online member publication also features a special teen section: vaccinations to remember, unplugging from social media and cell phones, and getting involved in the community.

Individual and group members receive the newsletter via email (excluding ASO groups) and it’s accessible from the member page of the Florida Blue website.

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Overcoming 3 common objections in sales

In a sales-focused world, objections are a fact of life, a core feature of the environment. As insurance sales professionals, you’re trained to recognize and overcome objections, yet some are easier to handle than others. Consider these insights on handling three of the thorniest—the ones that sales people struggle with most often because they seem unassailable. Master these and you can boost your numbers significantly.

  • I’m too busy right now.” Ask when they’d like you to call back. If they give you a reasonable callback date and time, try going a little further: “Why is that a good time for you?” You just might gain some information you can use to your advantage. And it often opens the door for you to share some impressive results you’ve obtained by working with other clients.
  • I’m working with someone else.” If this tactic is true (a big if: it may just be a convenient excuse for getting rid of you), the prospect assumes your agency is too similar to the one they’re working with. Rather than probe for dissatisfaction with the competitor, try focusing on the prospect’s insurance coverage goals as a launch pad for your own expertise: “We use a “plan check-up” strategy that works well for my other clients. Perhaps we could discuss it further…”
  • I’m not interested.” This response is designed to shut you down, and you may be tempted to just move on. Before you do, though, try this parry: Ask the prospect to elaborate. “Why’s that? My agency will want to know why you said no, given your qualifications, our compelling offer and the benefits of working with our agency.” The prospect will hand you more concrete objections—the kind you can work with.

It’s really just a matter of persistence. Not every prospect will end up doing business with you. But by digging a little deeper, you can often turn the toughest objections into added relationships that benefit everyone.

Source: Globe and Mail

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October: National Breast Cancer Awareness Month

National Breast Cancer Awareness Month (NBCAM) is a chance to raise awareness about the importance of screening and the early detection of breast cancer.

  • About 1 in 8 women born today in the United States will get breast cancer at some point during her life.
  • After skin cancer, breast cancer is the most common kind of cancer in women.
  • Many women can survive breast cancer if it’s found and treated early.
  • A mammogram—the screening test for breast cancer—can help find breast cancer early.

Information to share with clients and members

American Cancer Society (ACS) guidelines for the early detection of breast cancer vary depending on a woman’s age, and include mammography and breast exam, plus an MRI for women at high risk.

According to the ACS in a 2012 report, about 2,140 cases of breast cancer were expected to occur among men, accounting for about one percent of all breast cancers; and approximately 450 men were expected to die from breast cancer.

Breast cancer doesn’t only affect women. Here are some known risk factors that can’t be changed:

  • age
  • family history
  • early menarche
  • late menopause

Risk factors that can be changed:

  • postmenopausal obesity
  • use of combined estrogen and progestin menopausal  hormones
  • alcohol consumption
  • physical inactivity

For more information and how you can help, visit: breastcancerwellness.org, breastcancer.org. nationalbreastcancer.org, ww5.komen.org.

Sources: Healthfinder.gov; Cancer.org

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Patient Centered Medical Home model raises patient satisfaction

A recent survey documents what Florida Blue has long believed: The Patient Centered Medical Home (PCMH) model is helping to produce higher rates of patient satisfaction than traditional care.

The difference is that PCMH physicians “focus on the patient as a whole,” according to Barbara Haasis, RN, CCRN, and senior clinical lead of Florida Blue’s Value-Based Programs. “Providing increased access, education and care coordination has increased our member satisfaction across the board for members utilizing our PCMH physicians.”

The survey sought feedback from 55,000 members who experienced care through one of Florida Blue’s 200-plus PCMHs. About 7,000 of these members responded, providing important data about access to care, communication provided by providers, support by the office staff, the overall rating of the health care provided, and the overall rating of the provider or physician(s).

Additional questions covered self-management and staying healthy, behavioral and mental health support, shared decision-making and other topics.

PCMHs provide comprehensive primary care that facilitates partnerships between individual patients, their personal doctors, and, when appropriate, the patient’s family. The PCMH program’s goal is to allow better access to health care, increase satisfaction with care and improve overall health. PCMHs put the patient at the center of a physician-led team that transforms the doctor's office into a safe and trusted “medical home.”

Florida Blue has the nation’s third largest PCMH program, with more than 2,400 physicians currently participating. The survey, named Consumer Assessment of Healthcare Providers and Systems (CAHPS), serves as an industry standard and is required by the National Committee for Quality Assurance (NCQA) for plan accreditation.

“Achieving the goals and principles of a PCMH model requires significant support and dedication throughout an entire practice,” Haasis said. “It is no longer business as usual.”

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Avoid superficial personalization in marketing

Straight out of Sales 101, insurance agents and other sales professionals are told, everyone likes to see and hear their name mentioned.

The technique works. Personalization has become so successful that sophisticated new database tools can insert a recipient’s name automatically into all kinds of communication. And that’s just the beginning. You can insert lots of other known data, too: the group’s name, or where the person works, their job title, purchase behavior, location, birthdate and much more.

Just because you can do something doesn’t mean you always should. Like any successful technique, this one is subject to overuse. In fact, two research projects suggest that superficial personalization has become stale—and possibly even counterproductive.

In one survey, the Economist Intelligence Unit (EIU) asked consumers about personalization. Their findings reveal:

  • More than 70 percent of respondents have noticed an increase in personalization by marketers.
  • A full 70 percent said over-personalizing was annoying because it’s seen as superficial.
  • Sixty three percent say they’ve grown numb to the technique.
  • Only 22 percent say personalization makes them more likely to respond to an offer.

The second study from the CEB Marketing Leadership Council, reached similar conclusions on various personalization elements:

  • Name: 34 percent say use of their name in a marketing piece makes no difference; another 13 percent prefer their names not be used at all.
  • Purchase history: 29 percent say it makes no difference; 22 percent prefer not to see it.
  • Birthdays and other life events: 35 percent say it makes no difference; 17 percent prefer not to see it.

The takeaway for insurance agents is clear: Use personalization sparingly in all your communication with prospects and existing clients. When you do, it should be contextually relevant—and never perceived as superficial.

Source: LinkedIn

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Not just any hospital: a Blue Distinction Center hospital

When quality is a priority, it’s smart to rely on data that’s accurate, objective and relevant. That’s the thinking behind the Blue Distinction Specialty Care Program. Started in 2006 by the Blue Cross and Blue Shield Association (BCBSA), the program uses an evidence-based approach to help people choose a medical facility for six key types of care:

  • bariatric surgery
  • cardiac care
  • complex and rare cancers
  • knee and hip replacement
  • spine surgery
  • transplants

Together, these types of care comprise more than 30 percent of today’s total inpatient hospital expenditures. The program is a significant differentiator for Florida Blue and serves as a positive example of the company’s commitment to help members and employers identify high-quality providers based on empirical data.

Blue Distinction designations rely on objective, nationally consistent selection criteria to identify high-performing specialty care facilities that can help support a smooth recovery for members to regain health and productivity. Facilities that earn the designations have a proven track record for delivering better results—including fewer complications and re-admissions—than hospitals without these recognitions.

There are two types of Blue Distinction Center designations:

  • Blue Distinction Centers (BDCs) demonstrate expertise in delivering specialty care.
  • Blue Distinction Centers+ (BDC+) demonstrate both expertise plus cost-efficiency in delivering specialty care.


BDC and BDC+ information is integrated into the existing BCBSA national provider directory. Florida Blue members can look for the distinctive icons next to the hospital facility name on the Florida Blue provider directory. The information is also available through the Blue Distinction Center Finder, a web tool that helps national consumers and their physicians find Blue Distinction Centers and Blue Distinction Centers+ nationwide.

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5 ways to improve sales perfomance

If you sell insurance products, chances are you’ve made your share of missteps—and learned from them. If you supervise salespeople, chances are they’ve done the same. Instead of everyone learning the same lessons the hard way for themselves, here are five of the most common learning opportunities that can be taken to heart without actually suffering the consequences. Learn these techniques now and you and your team can avoid confusing, alienating or losing customers.

  • Be authentic, always. Relationships are built on trust. If there’s a gap between your product’s features and your client’s needs, acknowledge it. Look for ways to work out the differences. If the gap is minor, find ways to illustrate how insignificant it is. But never ever sell dishonestly; take advantage of someone’s ignorance, or dismiss a prospect’s sincere or well-founded concerns.
  • Know when to move on: Nobody can sell everything to everybody. Not every prospect is a good fit. Learn to prioritize your sales effort. Recognize when you’re barking up the wrong tree, make the best of it and move on to the next prospect. That requires integrity, honesty and a positive attitude. That prospect who didn’t buy may be able to steer you toward someone who will.
  • Talk less, listen more: Lots of sales professionals spend 90 percent of their selling time talking. After all, you’ve got a great product to sell, with lots of advantages. Better to re-allocate that ratio in the client’s favor. Spend about 70 percent of your face time listening. And the 30 percent left over for talking should be focused on asking questions. This is especially true for first-time encounters with prospects whose priorities and businesses are unfamiliar to you.
  • Be the expert in the room: Prospects often enter problem-solving mode without knowing the landscape, the available options or the real reasons for their issues. They just want it fixed. As the sales person, you’re the expert. You’ve got the knowledge about the industry and the marketplace. You’re the one who can spot potential pitfalls and identify options the client may be unaware of. Deploy that expertise in ways that add value to your relationship. This technique is useful in any scenario, and particularly when interacting with existing clients who already have some degree of trust in you and your agency.
  • Leave consulting to consultants: You’re there to sell. Not consult. So temper the advice to be the expert with sensible limits. If you’ve got a prospect who clearly has no interest in buying, you’re under no obligation to keep sharing your hard-earned knowledge. Be selective about who’s allowed to pick your brain for free. That way you can focus your energy on prospects who are really prospects.

With a little reflection you can see these are common techniques that often get overlooked—by sales rookies and veterans alike. Keep them in mind, and encourage your team to do the same, and see if your numbers don’t improve.

Source: HubSpot

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Use BluesEnroll to benefit your group customers

Make the most of your experience with BluesEnroll, Florida Blue’s online enrollment tool. A few helpful tips:

  • Accuracy: Make sure the member’s information is correct. That goes for hire date, social security number, date of birth, and other critical details. Accurate member information helps avoid claims discrepancies, and other potential coverage issues. If you do catch a mistake after submitting information, contact the Agent Service Center at (800) 267-3156 as soon as possible to have it corrected.
  • Enable employee self-service by emailing BluesEnrollMigration@floridablue.com. This feature lets you keep all your administrative capabilities for a particular group while it reduces the pressure on open enrollment. With self-service enabled, employees can
    • use single sign-on from the Florida Blue member website
    • enroll for benefits
    • update personal information
    • obtain their own history tracking report or changes
    • view and print a list of current benefit elections
  • Training resources: Check out the training videos at the start page of the BluesEnroll website. Topics include adding new employees, initiating enrollment, adding life events, handling terminations and more. You can also sign up for online training courses.

Following these easy tips will ensure you get the most from BlueEnroll.

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3 ways agents can help with wellness

In today’s proactive health care economy, wellness programs stand front and center on the employee benefits stage. The programs have your clients’ attention because they’re cost-effective, and they can produce a wide range of beneficial results.

Your clients know two basic facts about wellness: chronic health conditions like diabetes and COPD can drive up costs, and wellness programs can play a key role in driving costs down by preventing and mitigating health risks. Those same clients look to benefit advisors like you to provide additional details and context. That creates a very real opportunity for you to add value and boost your own business. Here are some ways you can be a resource for your clients on the topic of employee wellness:

  • Help them get started: Like any first-time effort, clients who want to start a wellness program from scratch will lack understanding. Serve as a guide. Help them understand how a program can benefit their workforce. Help them develop a strategy that’s efficient and responsive to their specific needs. With your help the client can have a great foundation for a successful employee wellness program.
  • Decide on goals: You’ve had more experience with wellness programs than the client just starting out. So help them set goals that are measurable, realistic, attainable, and aligned with the company’s broader vision. With your guidance, the client can operate with reliable information that can help keep them competitive.
  • Be part of the feedback loop: Once the wellness program is up and running, help your client analyze the metrics. Help them figure out the ROI so they can tweak the program as needed. And keep them looped in on additional wellness education and training opportunities.

When you think about it, helping clients launch their own wellness program is a win-win scenario. Your clients (and their employees) get programs that are better designed. You get new business opportunities and a closer connection with your clients.

Florida Blue offers an award-winning wellness program, Better You from Blue. Just contact your Florida Blue representative for more information.

Source: BenefitsPro

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Top 10 employee questions about ACA

Questions abound about the Affordable Care Act (ACA) and inquiring minds want to know. The International Foundation of Employee Benefit Plans recently surveyed 600 employers to find out which questions employees ask most often.

Here’s a useful summary you can share with your group’s HR staff who field inquiries from their employees. It identifies the top 10 questions from employees—and basic answers that can help benefit professionals be prepared:

  1. How does a Health Insurance Exchange work? Most states, including Florida, use the federal Marketplace (healthcare.gov), and other states have their own. It lets employees shop for plans that have the features and benefits they like best, and all employees can use it. Some employees may qualify for a subsidy, depending on a variety of factors.
  2. How does the ACA affect individual employees? It requires individuals to have health insurance or pay a penalty. If the employer offers insurance that satisfies the ACA’s requirements, employees don’t have to take any further action to be compliant.
  3. What are the cost implications for employees? It depends on the premiums and cost-sharing details of the plans available and their location.
  4. Is the employer going to drop existing coverage? That’s a decision each employer makes. If they do, employees will be able to purchase it on the exchange and may qualify for a subsidy.
  5. Will the ACA result in different benefits? To comply with the law’s requirements, most plans did make changes in benefits in 2014—or will be modifying plans in 2015. This is different for every employer, and HR professionals will need to be prepared with the reasons.
  6. How long can children stay on employees’ plans? The ACA requires that coverage must be available for dependent children until age 26. This requirement went into effect in 2010 and has not changed.
  7. When is the next open enrollment period for the federal Marketplace? It starts Nov. 15, 2014 and ends Feb.15, 2015.
  8. What about the required 30 hours per week needed to qualify for coverage next year? An employee’s hours determined by management and the HR department. If an employee doesn’t qualify for employer-offered health insurance, he or she can still obtain it through the exchange starting in November and may qualify for a federal subsidy to help pay the premiums.
  9. Are spousal and dependent coverage still available under the employer plan? Spousal coverage is not required, but companies have the option to offer it. Employers are required to offer coverage for dependent children until the age of 26. 
  10. What will be the impact of ACA on the company? Employees should consult with management for a consistent answer to this question. If you know for sure that no immediate drastic changes are being considered, it’s a good idea to share that with employees.

Employers that will no longer be providing workplace coverage can help their employees by recommending an agent to provide assistance or by referring the employee to FloridaBlue.com for help finding an individual plan.

Source: HRMorning

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Florida Blue supports education on advance directives

As a service to members and all Floridians, Florida Blue participates in a state initiative to educate people on the need for health care advance directives. These important legal documents establish a person’s preferences about health care decisions if he or she becomes incapacitated and cannot make decisions for themselves.

With a health care directive in place, a person can alert family members, doctors and health care facilities about their health care desires ahead of time. Four types of advance directives are recognized in the state of Florida:

  • Living will: instructions that specify what actions should be taken if someone is no longer able to make decisions due to illness or incapacity
  • Health care surrogate designation: names a specific person to act as surrogate, empowered to make health care decisions on behalf of someone while they are incapacitated
  • Durable power of attorney: designates a specific person as attorney-in-fact, empowered make all decisions (including medical and financial) on behalf of someone who is incapacitated
  • Do-Not-Resuscitate (DNR) order: a legal order to respect the wishes of a patient who decides not to undergo life-support procedures

Members can access legal documents online at FloridaBlue.com under Member Forms, which also contains a link to the Florida Agency for Health Care Information for life planning information—or by accessing WebMD through the member website.

By supporting this statewide education initiative, Florida Blue encourages all Floridians to discuss their wishes with others, such as family members, friends, doctors and spiritual counselors. It’s a public service that reflects on Florida Blue’s commitment to health care throughout the state.



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Most Medicaid recipients transitioned to managed care

After experimenting since 2005 with managed care models for Medicaid recipients, Florida is transitioning nearly all its 3.6 million recipients into managed care plans. The effort, lawmakers believe, will cut costs. The rollout process, staggered across the state’s 11 Medicaid districts and managed by the Agency for Health Care Administration, is expected to be completed in August.

Some of you may receive questions about this, because over the last several months, state authorities have been mailing welcome letters informing Medicaid recipients about their choices. Recipients are matched with an available plan that appears to best meet their medical needs and can choose the plan suggested or may choose from a list of other plans available in his or her district. Specialty plans are available for patients with qualifying distinct diagnoses and/or chronic conditions.

Nearly all of Florida’s Medicaid recipients will be moved in phases to private insurers. Most recipients are required to choose from a list of available managed care organizations—generally HMOs and Provider Service Networks (PSNs)—that meet state-mandated minimum standards of coverage; many of the plans cover additional services.

The new system, called Statewide Medicaid Managed Care (SMMC) uses a capitation model in which managed care companies receive a flat fee for each participant enrolled. Medicaid recipients have 30 to 60 days to finalize their plan selection. There’s also a 90-day grace period in which recipients may revise their selection if they wish.

Choice counselors are available to guide Medicaid recipients through the plans available in each district. Recipients can receive guidance and make their selections by phone, in person or at the program’s counseling website.

For eligibility and participation requirements, covered benefits and provider details, click here. More information is available at the SMMC website.


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Important reminder about lab services

Florida Blue is on a quest to keep agents, employers and members informed about where to go for lab services. Please share this information with clients:

  • Within Florida: Quest Diagnostics is the preferred lab for members of Florida Blue and members of other Blue Plans who require lab services while in the state. Members who use a non-network lab will have higher out-of-pocket expenses.
  • Outside Florida: Members accessing lab services outside Florida may choose Quest Diagnostics if a local facility is available—or may choose a laboratory that participates in Florida Blue’s BlueCard National or BlueCard Worldwide network. It is the member’s responsibility to verify that the laboratory is in the BlueCard network before receiving services (except in an emergency). To find participating laboratories outside Florida, members can call the BlueCard Customer Service Center at 1-800-810-BLUE (2583). If calling from outside the U.S., Puerto Rico or the Virgin Islands, they may call collect 1-804-673-1177, 24 hours a day, seven days a week.

This information is also in Agent Bulletin #A14-158.

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Strategies for managing feedback on social media

One of the challenges to social media like Facebook and Twitter revolves around disgruntled users. If your agency has a following, sooner or later someone is going to say something negative—whether it’s warranted or not.

Since you can’t guarantee a total absence of negative comments, handling them requires planning, consistency and clear-headed thinking. Try these tips to improve your social media management:

  • Triage: Sort feedback into four basic groups: urgent, helpful, disgruntled and spam. Acknowledge the first three types promptly and appropriately, and resolve them in a reasonable timeframe.
  • Plan: The person who monitors your social media should be able to pass urgent and helpful issues (like tech problems or confusing language) along to the appropriate person so they can be addressed immediately. Identify the go-to people for resolving each type of drop-what-you-re-doing issue and prepare them.
  • Respond: Thank the people who identify a tech issue or suggest a better way to do things. For those who complain, it’s best to calibrate your response. If they have a legitimate complaint and present it reasonably, apologize, fix it and follow-up. If the person is unreasonable or clearly trying to pick a fight, it may be better to ignore than engage. If feedback is spam, ignore it.
  • Attitude: Be patient and helpful in your responses, looking for opportunities to improve your social media presence, turn a dissatisfied customer or prospect around, or cement an already productive relationship. Even when dealing with irrational people, keep it respectful and leave emotions out of it.
  • Remember your audience: When responding in a public forum to an individual issue, always remember that your entire following is watching. Use your responses to make allies and advocates of your readers. If feedback contains identifiable information, like a policy number or HIPAA-related data, take the conversation offline and explain why.

With the right attitude and procedures in place, you can master social media feedback and use it to your agency’s advantage.

Source: Simply Measured

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Employer groups can get onsite flu vaccinations

Here’s a major benefit for many of your employer groups: As a Florida Blue participating provider, Maxim Health will be available to conduct onsite flu vaccinations September 10 - January 31.

Program details:

  • Each employer location must have a minimum of 30 participants
  • Employees who are Florida Blue members present their member ID card at the vaccination event
  • Non-member employees and family members (age 4 and older) can participate at a cost of $25  (cash, check or money order accepted)
  • Flu vaccines are a covered benefit
  • No copay or deductible on preventive services
  • All claims are filed by Maxim Health through Availity. This eliminates the need for roster or invoice billing.

To arrange for an onsite vaccination event, refer to Agent Bulletin #A14-182, complete the Florida Clinic Request Form, and submit it as directed. The Bulletin also has helpful clinic scheduling guidelines.

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