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Agent Sales News

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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Geraghty pleased with first-year ACA enrollment despite challenges

Florida Blue CEO, Patrick Geraghty, expressed his satisfaction with the results of the ACA’s first-year enrollment numbers, which added 339,000 Florida Blue customers through the Marketplace, according to a Kaiser Health News article.

Geraghty said the surge in membership produced fewer young, healthy enrollees along with a higher than expected demand for expensive health care services. About 23 percent of Florida Blue’s exchange buyers were young adults in the 18-to-34 category. While that figure was expected to be lower than the national average (28 percent) because of Florida’s older population, it was still below the company’s projections.

“It’s a concern certainly, as any market would want lower-age healthier individuals … because it balances the risk pool,” Geraghty said.

Overall, Florida Blue, noted as one of the most fiscally stable health insurers in the country, has about a 40 percent share of the total individual state insurance market (On and Off Marketplace).

Although one-third of Florida consumers––nearly one million people––chose Florida Blue when shopping on the exchange, several factors could still exert upward pressure on rates next year.

While proposed 2015 rates are not yet revealed, several factors could drive up rates next year—including the law’s requirement for younger adults: that the oldest person buying coverage pay no more than three times the rate paid by the youngest enrollee.

“We will be under tremendous financial pressure initially given the age, risk profile and high utilization of the new membership,” Geraghty said. “It is far from clear that large enrollment in the marketplace is a financially beneficial place to be.”

Read the full article.

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5 client service traits you’ll want more of

In any insurance agency, your most reliable source of growth is referrals from existing clients. The best route to achieving a high rate of referrals is by delivering consistently excellent client service. And for that commodity your agency depends on the key players on your team.

Fortunately, the industry’s top client service performers have certain things in common—attributes you can either look for when interviewing job candidates or instill in your team members once they’re onboard. Either way, these are the qualities you want more of. Because the more client service people you have with these qualities, the better your agency will do:

  • They never judge: Client service stars take people as they are, on their own terms, without trying to change them. They leave their personal opinions at the door and avoid discussing their own personal views with others. And when a client or prospect crosses the line, the real rock stars know never to react.
  • They hold themselves accountable: Consistently excellent client service depends on self-knowledge—on leading with your strengths and resolving to improve in other critical areas. A star performer avoids making excuses when things don’t go as hoped and will never blame a client, even when others might. Taking responsibility for mistakes—and fixing them thoroughly and promptly—sits much better with a client than finger-pointing.
  • They manage their emotions well: The best client service people stay focused on their clients’ needs—not their own. They stay positive and composed, without getting defensive in the face of negativity or taking a client’s foul mood as a personal affront. And they have the smarts to realize that they have the power to turn any unpleasant client situation around, simply by controlling their own emotions.
  • They focus on solutions: When presented with a challenge from a client or prospect, great client service people keep their eyes on finding a solution, even if it takes some hard work and creativity. This is distinctly different from simply making the problem (or the problem client) disappear. Instead, they use every resource at their disposal to find a way to meet the challenge—even if it means re-framing the problem or focusing on alternatives the client hadn’t considered before.
  • They take responsibility for doing good work: When top performers commit to doing something for a client, they make a priority of following through. They meet deadlines they’ve agreed to, and they supply all the information a client needs to move to the next step—even if the information isn’t what the client hoped for. The best people take responsibility for delivering less-than-ideal news gracefully and in the best possible light.

By focusing on these five proven indicators of top client service performers, you can help your agency get to the next level, and the ones after that.

Source: Think Advisor

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Florida Blue Health Care Reform site

With all the nuances of the Affordable Care Act (ACA), you or your clients may have questions at one point or another. Save time researching and add value for your clients. Florida Blue has the answers you need on floridabluehealthcarereform.com.

Do your group or individual clients have ACA questions? They can submit them directly to Florida Blue ACA team experts by clicking on Ask a Question at the bottom of the page on along with answers to frequently asked questions, videos, resources and a subsidy estimator.

All agents should continue to call (800) 267-3156 to speak with a representative in the Agent Service Center with any questions.

Under the Resources for professionals tab, you will find the “For agents” and “For employers” sections. The agent section provides information on Medical Loss Ratio, Summary of Benefits and Coverage and more.

Florida Blue is here for you.

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2015 Marketplace rates released

Following up on CEO Patrick Geraghty’s recent interview with Kaiser Health News (KHN), Florida Blue has released 2015 rates for plans available through the federal Marketplace. In his original interview, Geraghty discussed a number of factors pointing to the possibility of higher rates.  

Part two of the interview, published on August 1 indicates rates will go up by an average of 17.6 percent, an increase Geraghty characterized as “typical” and “not aberrant.”  We informed you of this directly and provided you with talking points on Aug. 1 in Agent Bulletin #A14-193.

The increase is largely driven by demographics of the insurance pool, including older adults who previously lacked coverage and are using more services than expected. In addition, nearly 90 percent of Floridians who bought coverage on the Marketplace get a federal subsidy to lower their share of the premium.

“No one can claim in good conscience that a 10 percent rate increase or more would signal the advent of something new and unprecedented,” said Greg Mellowe, policy director of consumer group Florida CHAIN. “For years, this was standard practice in Florida.”

Geraghty said he’s unsure if the latest round of price increases will lead people to drop coverage. “It depends on how much value they place in what they are receiving,” he said.

About a dozen carriers will be competing in the individual health insurance market next year in Florida. Currently, Florida Blue is the only carrier to offer insurance plans in all 67 counties. Another advantage is its 18 walk-in Florida Blue Centers, which will host enrollment seminars and offer face-to-face service for members and potential new customers. This year, the retail locations hosted over 3,000 seminars during the open enrollment period.

But rates are not the whole story. A person’s individual situation will be the key driver of price. Simply looking at the average premiums will not show the wide-ranging prices members could potentially pay based on what products they choose to purchase as well as their current personal health care needs.

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Tips to get your emails opened

In 2013, the number of emails sent and received worldwide averaged 180 billion per day. Unlike a traditional mailbox, an email inbox can hold a virtually limitless number of these files.


As a receiver of emails, you face the daunting task of sorting through your share of those 180 billion attempts to touch your world. You’ll probably separate them, possibly with the help of a filtering system, into three groups: junk, non-urgent emails you’ll want to read later, and those that require your immediate attention.


As a sender of emails, your agency must cope with this ritual—and take steps to raise the chance that your outgoing email will get opened, read and acted on.


Even if you’re just sending out a newsletter that recipients have already opted to receive, bear in mind that those same recipients have probably opted to receive lots of other newsletters. If email in any form is part of your marketing plan, making the content relevant and useful is obviously a top priority. But getting it opened is a prerequisite.


That’s the job of the subject line.


Put yourself in the recipient’s shoes—because you often are. You’re scanning a whole inbox full of unopened emails, looking first for reasons to delete, with nothing more than the subject line to base your decision on. So as a marketer, it pays to write subject lines that scream “Open Me!” Here are a few tips:

  • Arouse curiosity: Phrase your subject line in a way that grabs attention. Include a how-to. Or a numbered list (5 reasons to…). If you deploy this tactic, be sure the actual email pays off on the implied promise. Otherwise, you’ll lose credibility—and readership.
  • Add urgency: If the content is time-sensitive in any way, capitalize on it. Don’t use this technique too often or you’ll turn readers off. But if an honest and meaningful deadline is coming up, lead with that.
  • Be unique: Study the subject lines of your competitors—not so you can copy them but so you can differentiate yourself from them. Tease or excite the reader with something the other guys don’t use. An offer, or maybe a different spin on your agency’s service.
  • Try some humor: People don’t expect to be entertained while engaged in an activity as mundane as sorting through emails. Funny or clever subject lines, maybe with a twist on words or a turn-of-phrase, get opened because they’re unexpected. And a good chuckle is always appreciated.
  • Focus on one compelling element: Your email content has lots of elements. Don’t try to cover them all in a single subject line. Pick the one aspect of your email that’s most compelling and easiest to state, and make that the hero. Simple is better. With a large enough database, you could pick two or three areas of focus to test against each other, so you can see what works best.
  • Connect with the recipient: You and your client or prospect are similar in many ways. You’re both concerned with insurance benefits, you both follow the same industries and keep an eye out for ways to deliver quality and value. Acknowledge your alike-ness in the subject line.
  • Write like you talk: To connect with your clients and prospects, speak their language. Write subject lines that sound engaging and conversational, not stodgy or jargon-y.
  • Always be truthful: People know when they’ve been snookered or misled—even inadvertently. So be sure your content delivers what your subject line says it will.
  • Skip the hard sell: Remember, the job of the subject line is to get the recipient to open the email. If the subject line sounds sales-y, it’ll get deleted instantly.


Do you need to use all these tips in every outgoing email? Of course not. But keep them in mind next time you engage your email marketing machine. And get ready for a measurable boost in response.


Source: Slideshare

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ICD-10 work continues

Despite federal legislation last April requiring a delay in implementation, Florida Blue is still preparing to adopt ICD-10 (the tenth revision of the standard medical diagnosis and inpatient procedure codes). With all the work accomplished so far, Florida Blue is maintaining its forward momentum and working with providers and other external stakeholders to ensure they do the same.

As a result, Florida Blue remains on track to be ICD-10 ready this year, even though implementation will be delayed until at least October 1, 2015. External testing with willing providers is continuing as they submit their ICD-10-coded claims for processing in a test environment. 

To ensure a smooth transition and avoid business disruptions once ICD-10 is implemented, Florida Blue is continuing to collaborate with providers, other payers and stakeholders and keeping them informed through several channels, including:

  • organized medicine events and activities
  • monthly teleconferences and podcasts
  • social media
  • ongoing ICD-10 end-to-end testing with participating providers

We will keep you informed.

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Providing your groups with wellness programs

The results are in: Selling wellness is no cakewalk for benefit advisers. Employee Benefit Advisor (EBA) surveyed 150 industry professionals, mostly agents and consultants, earlier this year to come up with its first-ever benchmark study on workplace wellness programs. One striking fact: Nearly a third of respondents (32 percent) don’t even offer wellness programs to their clients or don’t know if their clients are working with a program vendor.

Broadly speaking, the survey found that large employers demand innovation and a custom-tailored approach to wellness programs; smaller employers still require convincing that the programs are a good investment. The most important wellness plan issues for employers, according to the respondents, include:

  • educational tools that are easy for employees to use
  • significant return on investment
  • program cost overall
  • tools for maximizing employee engagement
  • creating a wellness culture
  • availability of health coaching resources

The nationwide survey listed the most popular plan vendors chosen by advisors; these included WebMD Health Services, along with several others. Choosing a quality program is critical. According to one respondent, any well-designed wellness program should include these key features:

  • a web-based platform with a secure portal for members
  • a solid communication and roll-out plan with management buy-in
  • a suite of tools for administrative management
  • capability for reporting individual risk
  • tools to educate employees and help them set goals
  • structured incentives to maximize enrollment
  • a health risk assessment (HRA) tool that’s accredited
  • tools for program management
  • suggestions for team challenges
  • tools to track employee participation in activities and events
  • capability for tracking group progress

Florida Blue has partnered with WebMD Health Services to provide tools focused on improving the health and wellness of groups’ employees. With WebMD, employees will have the tools they need to make better health and benefits decisions, positively change their health behavior, and live a healthier life.

What to do about the 32 percent of survey respondents that stand outside the wellness space? The survey results included some insights and possible explanations. Some brokers that don’t offer wellness programs:

  • might be reluctant to invest the time needed to become wellness experts
  • might assume it’s unprofitable to offer wellness programs
  • might not realize that competitors could gain an advantage by offering a quality wellness program

To help agents stay ahead of the competition, Florida Blue offers Better You from Blue, an award winning, interactive, incentive based, wellness program available to qualifying large groups.  Later this year, Better You from Blue will expand to include small groups and we will keep you informed when it becomes available.

Source: Employee Benefit News

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