Carrier – UnitedHealthcare / AllSavers

Jason Powers: I’m Jason Powers and I’m joined here by Michael Margherio, executive director of sales and account management with UnitedHealthcare. Welcome to our carrier product update series. This is a special one. This is our Q4 kickoff summit. And everything that we do with UnitedHealthcare to have you here live in the studio is a real treat. So thank you for being here today. It’s a hot one outside. 

Michael Margher…: It’s very hot out there, but thanks for having me. I appreciate it.

Jason Powers: So we’ll get right into it. You got a lot to cover. 

Michael Margher…: We do. 

Jason Powers: There’s a lot of really exciting stuff going on with UnitedHealthcare.

Michael Margher…: Yeah, there’s some cool stuff happening.

Jason Powers: So we’ll jump right into it. 

Michael Margher…: All right. Well, the first thing that we are talking about these days is our ancillary product portfolio. So we have a whole range of all of the … If you want to go forward one, but we have a whole range of everything that you might need to give to an employer. So if you go forward one, you’ll see on the left side dental and vision, both of whom have broad national networks to … I think we’re in the top three of largest national networks for both of those products. Vision is especially cool. It’s half retail and half private. So you get a pretty good mix for your employees. And then of course basic life and a ADD, we do both short and long term disability contracts. And we have a whole suite of work site products. You see there on the right side critical illness, accident, hospital indemnity. Those creep up into some of the larger group, but if you have a big group, we’ll sell you  group pet insurance.

Jason Powers: United’s in the pet insurance industry?

Michael Margher…: We have a partner in that space. And the only unique thing there is it requires a PNC license because life and health doesn’t cover your pets.

Jason Powers: Did not know that.

Michael Margher…: But it’s been very popular.

Jason Powers: Makes sense.

Michael Margher…: In the last couple years, as you’ve seen, a lot of employers looking for an extra benefit to throw in there and pet insurance has been very popular.

Jason Powers: I’m just curious, is that 100 plus eligibles?

Michael Margher…: Eligibles. Yeah.

Jason Powers: Got it. 

Michael Margher…: That’s right. 

Jason Powers: Got it. All right. 

Michael Margher…: Yeah. 

Jason Powers: Good to know. 

Michael Margher…: Yeah. And then of course with those, if you move forward, one of the things that we do is we do bundling and packaging. So put your medical and your dental together, put your vision with us and you get some benefits of both simplified administration, one bill, one point of contact service teams, but also some savings like you would expect when you put two or three lines together. We do that both in a credit that you can see there and then, if you move forward one, there’s some bundling that will last into perpetuity, as long as those lines remain in for us. And so that what you’re seeing there is for two to 50 size groups. For 51 and above there’s a similar but slightly different package of bundling. It’s been very positive [inaudible]

Jason Powers: Is that the difference, you bundle and active savings?

Michael Margher…: That’s right. Yeah, you bundle. That’s right.

Jason Powers: Got it.

Michael Margher…: Exactly.

Jason Powers: Makes sense.

Michael Margher…: Yeah.

Jason Powers: And so then I saw this slide and I went so I know groups in the past have had some challenges with the integration with navigator, but you have this coming now.

Michael Margher…: This is coming. I think this is exciting. Any agent within employee navigator license, we’re running some pilots in different parts of the country and expanded that to any agent that has an employee navigator license. So what we’ve done is, if you move forward one, Bo, today we’ve got the data exchange. So it’s back and forth. You don’t need to send file feeds. You don’t need to do any of that. Makes it way simpler. And then launching here shortly our full API integration, which eliminates all of the interplay. Everything goes real time into our systems. Couple of unique things with that, of course. When you think employee navigator and EDI feeds, you’re talking about backend systems. So things that we probably don’t talk to you a lot about, the name of the platform and those sorts of things, now we’re getting exposed, which is a little bit weird.

People don’t know what prime and some of those other platforms mean. So on the next page you see some of the list of that. I think it’s in the middle of the page. Prime, USP, Facets, maybe nobody knows what that is, but those are the underlying systems that are medical and ancillary programs are built on. The other thing that I think it’s intuitive once you understand it, but it’s counterintuitive at the beginning, that last bullet point there, we can’t do this for new business because the way navigator system works. It has to be built in our system, it has to be built in their system and then everything connects. So for a new business we still have to install the group and then the automation happens. Where we’ve had this in place, it’s been spectacular. Saves a lot of time and effort and energy for the agent and for the employer and avoids all of those hassle phone calls four months later. We forgot to add this dependent. Can you make an exception? And just makes it a lot smoother.

Jason Powers: If it’s in your native system and in your navigator, it’s going to be in the system in UnitedHealthcare. So they’re just reconciling?

Michael Margher…: They’re reconciling. Right. And there’s some build out work inside of navigator, but if you have a license there they have people that can help support that, too.

Jason Powers: Yeah, for sure.

Michael Margher…: Super excited about that. Mostly I think navigator’s business is 92% under 100. So that’s where we’re focused as well. We can do EDI feeds with a lot of vendors for 100 plus business, but this is exclusive to that under 100 space.

Jason Powers: Yeah, so it helps fill in some gaps for me because this year we actually ran into a group with an agent that the group really wanted to have some sort of integration. And in the past they were always told no and this explains a lot of that well. I mean, there’s no way United’s going to do this for this size of the group, but you did.

Michael Margher…: Yeah.

Jason Powers: It totally changes their habits as a group and where they go and how they integrate with UnitedHealthcare.

Michael Margher…: Yeah, navigator’s been a good partner and I think nationally they’re our biggest partner in that space, which is how we decided to start with them. There’s probably some more coming down the pike, too.

Jason Powers: That’s great. 

Michael Margher…: Yeah. 

Jason Powers: So then moving on to UnitedHealthcare level funding.  So I can’t say All Savers anymore.

Michael Margher…: You can say it because the change was as of March of ’21. 

Jason Powers: So we still have a …

Michael Margher…: Right. We started writing everything level funded into the new, I call it, a front door. It’s a new entry point into our system. And so you can see on the next page that everything that exists today on All Savers will stay there until next spring, waiting until after January, of course. Next spring we will start taking those All Savers cases and they’ll renew to UnitedHealthcare level funded. This has been by far and away our best selling product in the under 100 market. It’s been competitive across the country. We’ve got a great size book of business going into it. A couple things that I think are unique about ours is it’s a 12-60 contract. So a long run out, really hard to get a claim outside of 60 months hopefully, but we see a lot of them that are 12-24 and you can get some exposure and some gaps there. So really like that feature. The move to the level funding has also then brought us … Those members have the same experience.

So not just the same portal for the broker and the employer, but the same portal for the members. They get the same tools, the phone app and the transparency tools and all the things that people have come to expect. So been very exciting. The other thing that you see in the middle of that page, we’re rolling it out down to two.

Jason Powers: Do you see that?

Michael Margher…: Yeah. How about that?

Jason Powers: Down to two.

Michael Margher…: Down to two. And there’s some pretty detailed caveats on the participation rules for that two to five space, but that’s listed out there. And then it stays at that 50% for anything nine plus. The other thing that I didn’t remember to get on the page, right now we’re doing GRA or GRX underwriting down to 10. In Missouri, that’s going down to five.

Jason Powers: Five. I saw the announcement.

Michael Margher…: So that will be exciting, too. I think that makes that space just that much easier to [inaudible]

Jason Powers: I think it’s just going to make it hard for anybody else to really compete in that space with UnitedHealthcare.

Michael Margher…: Yeah, been very happy with that. And then last thing to point out there that has also been exceedingly popular is the 15 month contracts that we’ve been putting in place. A lot of times the goal of that was just for all of us to get the volume off of January 1st. And it’s worked great, but [00:09:00] now also we spread the volume out to three one and four one [inaudible 00:09:05]

Jason Powers: So you were the guy who complained, too, that I don’t get a break after Q4?

Michael Margher…: Correct. It doesn’t end anymore. That’s correct. 

Jason Powers: The one thing I think that is important for brokers to know on a 15 month contract is that it does move that open enrollment period to whatever that 15 month is. You can’t open enroll at the original …

Michael Margher…: Correct. It moves the whole thing. That’s exactly right. Good point.

Jason Powers: Yeah. That’s exciting and I think it’s exciting on the two to four. I know that it’s hard to get excited in that two to four space, but there’s a lot of groups that are not being served in that space. It’s with a competitive product and the repricing. And some of the ACA plans for families has gone up to a really high number. That’s about a mortgage payment for a really nice house [inaudible]

Michael Margher…: I think that’s right. And unfortunately I think some of that’s still going to exist. Our funding isn’t right for every employer and there’s an underwriting process to go through. Try to make that as easy as possible. And I think that down to five will help there, but it can be a really good solution for a lot of folks.

Jason Powers: Yeah, for sure. 

Michael Margher…: Yeah, very excited about that. 

Jason Powers: And Mark brought this up in one of our conversations and he acted like I should have read it in a broker blast. What’s Mineral?

Michael Margher…: Yeah, Mineral used to be called ThinkHR.

Jason Powers: Okay.

Michael Margher…: And so one of the things that we’ve been getting questions on as we move fully insured employers into level funded is I need help with some of this HR stuff, the compliance stuff. So on the next couple of pages, Mineral, we’ve embedded it in our two to 100 level funded groups. And it’s at no cost to the employer, so truly embedded in that. It’s starting October 1st and they get a bunch of support, including dedicated call center support. They can call a certified HR representative. The booklets have been exceedingly popular, build your employee handbook. And a compliant fashion, especially, think about it, if you got 15 employees in four states and you got to have compliant handbooks in multiple states. Mineral helps with all of that.

And we built a suite on the next page. We built a suite with them that is a little bit different than what they offer out in the market. So there’s a couple of things there. That living handbook there towards the bottom is really the one that has been getting the most eyebrows raised because there’s a lot of support for employers that didn’t have probably … Not only do they not have the resources, probably weren’t compliant in certain circumstances. And we’re trying to bring that to that space.

Jason Powers: Not just the builder, but with the United offering they get in multiple states and Spanish available. Yeah.

Michael Margher…: So this is rolling out October 1st inside of anything new level funded, anything renewing All Savers under 100. This will be embedded. Yeah.

Jason Powers: Wow.

Michael Margher…: And Mineral has a team. They will reach out to the employer. There are certain circumstances that they already have Mineral. It doesn’t change anything. They won’t get a new login. We’re not duplicating anything, so trying to make it easy for folks.

Jason Powers: Sure. That’s great.

Michael Margher…: Yeah, pretty excited about that. That’s been well received as well. 

Jason Powers: And then I saw this one, too. Care Cash, talk to me. I’ve seen some similar programs standalone, but this is now integrated with the UnitedHealthcare deal.

Michael Margher…: Yeah, the first thing to say here is we’ve had this for a couple years. It was 100 plus. And so we’ve moved the threshold down to 50 plus. So I think that’s exciting. It’s worked pretty well. The way I like to tell people to think about this is it’s a HR limited use HRA on a card. It’s designed for specific needs. And what we’re trying to do is remove hurdles for people who are not going to get their care because of that $40 copay or $80 Urgent Care copay or whatever it is. So driving them to quality providers, using our premium designation, so it’s for use at premium designated primary care docs and specialists only can use it at urgent care and then virtual visits. It doesn’t cover your deductible. It doesn’t cover your emergency room and it’s really designed to drive people to get to the right provider in that moment.

Where we’ve seen success, if you move forward, you can see some of the places that people have started using it on their primary care office visits primarily is what’s been happening and then virtual visits and urgent care. There’s some data that shows, if you get people to the right place up front, I think we all know this, go get your preventive screen, go to the urgent care, you save going to the emergency room and you save that $5,000 or $10,000 or $20,000 claim. So I think if you go forward a couple, you can see where people are using it mostly. Premium care physicians, behavioral health, virtual visits and then urgent cares last, but this has been really well received. The people who have it, love it. They get to use it. There’s not necessarily a target client, but where we’ve seen the most success, the most uptake is if you got an employer that has some lower paid employees. They really would struggle with the [00:14:30] doctor’s office copay or the Urgent Care copay. We’ve seen school districts, teachers [inaudible]

Jason Powers: Where’s the funding come from on the back? You mentioned it’s kind of like an HR based. 

Michael Margher…: Yeah, so it’s prebuilt into the plan. It’s a buy up in 51 to 100. We’re embedding it in 100 plus. It’s a buy up, so it’s got a little premium increment. It’s under 1% and it’s the $200 for an individual, $500 for a family. And that rolls over. If they don’t use it in a year, I think there’s a max of 2,000. But as long as you stay on that Care Cash compliant plan, can’t use it with an HSA of course because it’s a first dollar benefit, but as long as you stay on that Care Cash compliant plan the dollars in that can roll over year to year and helps prevent that upfront sticker shock of people not wanting to go [inaudible]

Jason Powers: So UnitedHealthcare is funding that?

Michael Margher…: That’s right.

Jason Powers: I mean, through premium.

Michael Margher…: It’s funded through your premium, but it doesn’t result in any taxable consequence or anything like that. And it’s limited at the point of sale. You can’t go swipe it for a pack of cigarettes or whatever. It’s limited those two 13D expenses. So it’s worked really well.

Jason Powers: That’s interesting, the 51 plus market, for sure. All right, so then talk to us about zero out-of-pocket on certain preferred drugs. That’s something new, too.

Michael Margher…: This is something new. This is January 1st and it’s inside of our fully insured business and it has to be approved by insurance regulators. So be interested to see if any state department of insurance don’t want us doing this. Stranger things have happened, but assuming it’s approved everywhere. Well, a similar story, trying to eliminate hurdles for people to get the drugs where we all know paying for the drug is much cheaper and much healthier than not being compliant. And now you’re in the emergency room, so preferred insulins. The cue to this is they’re on a preferred list. Preferred insulins, both short acting and long acting, and then you see a list there of a couple of emergency use type drugs for hypoglycemia, super low blood sugar, those sorts of things.

And some of the other ones in the overdose, Naloxone, a lot of police departments keeping that on hand, a lot of use there. So trying to remove barriers for the things that we all know, if you don’t stay compliant, it ends in a health disaster and a much larger cost, right.

Jason Powers: Yeah. 

Michael Margher…: Yeah, we all talk about it in terms of cost, but a better outcome for the individual as well. And that’s everything two plus, everything fully insured started January.

Jason Powers: Wow. 

Michael Margher…: Yeah.

Jason Powers: All right, and then the next one I’ve seen, I’ve seen this pop up on Facebook., I think I’ve seen it pop up in LinkedIn, but this is probably the first time I think I’ve actually talked about it. What’s the partnership with Peloton?

Michael Margher…: Yeah, so we have an actual partnership with Peloton in addition to their famous bike, which you don’t need to have to use that app. They’ve got a membership where you can access their workout instructors. So I think partially they’re famous for their bike, partially they’re famous for their classes. This gives you access to their online classes and their coaches. You can either access them live as they go or access the recordings. They’ve got a bunch of different channels. And so it’s a one year membership. It’s built into our fully insured business. It’s not in level funded yet and it’s a buyout for self-funded groups. And, again, you don’t need the bike, but you can go do the workout. So I’ve seen people that they have their own equipment, but now they got a coach. And the old line, if you want to go fast, go alone. If you want to go far, go with somebody else. You surround yourself with other people doing the workout and your outcome is better.

Jason Powers: Yeah. That’s absolutely true in my household.

Michael Margher…: Right. Yeah, for sure. No doubt about it. 

Jason Powers: And then Apple Fitness. 

Michael Margher…: Yeah, similar. So some people like Peloton, some people, like me, have an Apple Watch. And for Apple Fitness, you do need the watch because that’s how it connects to the tracking, of course. But, again, it’s the same thing. It’s a one year membership and we’ve been doing this for a little while. So this is an extension. If you already have that one year, you can add another year. 

Jason Powers: And, again, this is on the fully insured?

Michael Margher…: This is in everything fully insured two plus.

Jason Powers: Two plus. Not on the level funded?

Michael Margher…: Not a level funded today.

Jason Powers: But a buy up on the buy self-funded large group. 

Michael Margher…: That’s right. 

Jason Powers: Got it. 

Michael Margher…: Yeah. Those are the fun, easy ones to talk about. People like to see that. And I actually think all of our clients, all of the employers, we go into open enrollment meetings and we tell people to get healthier, but we don’t give them the tools to do that. And we tell them their rates are going up and they don’t see any value in it. I mean, this a nice to have, but can help support that, too.

Jason Powers: Yeah, for sure. So then My ScriptRewards, your next one, what’s that?

Michael Margher…: This one is hyperfocused. This has been in place for a few years, also focused on HIV medications. What we’ve seen is people can get on a medication and those prices can go through the roof and we’re constantly negotiating to get a preferred price on a specific drug that’s effective. And what we’ve found of course is you give people an incentive you can change their behavior. So this is the same thing. Really, you see that three very narrow focus, but giving them up to $500 if they switch to a preferred medication. So they get $250 upfront, they stay on it for six months, they get another $250. That comes in one or two different forms. If they have an HSA with us with Optum Bank, it goes straight into their HSA. If they don’t have that, they get a debit card that looks a lot like that cash card we talked about. It’s a limited use 213D debit card.

Jason Powers: Got it. And then, again, this is …

Michael Margher…: This is everything fully insured.

Jason Powers: Everything fully insured?

Michael Margher…: That’s right. 

Jason Powers: Wow. 

Michael Margher…: Yeah, I like this one and I’m trying to support people who have high cost drugs and remove barriers.

Jason Powers: Well, I know the MS drugs one we keep running into the growth hormone one. That’s another one we keep running into. So this is expanding into those now.

Michael Margher…: It’s been in HIV for a while. Yeah, three or four years in that space.

Jason Powers: Man, you guys are just cranking out new stuff.

Michael Margher…: Yeah, a lot of cool stuff. I think we all realize, you do the math, getting people healthy costs less than paying for their claims. We all know that. It’s not as easy to do as that, but it’s the right thing to do.

Jason Powers: Yeah. So then point of care assist.

Michael Margher…: Yeah, I like this one. This is something that you would never see happen. This is a behind the scenes. It’s something we’ve been working with our network providers for a long time. They want more information so that they can support their patients in making better decisions. We started this with pharmacy. So if you move forward, you see a bunch of bubbles on there and one of them is called pre-check my script. And it basically puts into the provider’s electronic medical record all of the information we have on their patient. So think of the average provider. They may not know if their patient went and filled that script. They don’t know if they were compliant with the doctor’s orders, so to speak. And this tries to give them some line of sight into that.

And I’ll show you some data in a second, but that pre-check my script, if you move forward, if it’s one of those bubbles that you see there, it was so successful. Then providers said we want more, so we’re trying to expand it to other prior auths and other eligibility stuff. They can see other claims. Think about a doctor’s group and the primary doc sends their patient to see a specialist. Well, what if they went to a specialist outside of that system’s four walls? The doctor doesn’t know if they ever went to the specialist and this attempts to close that gap a little bit. It’s been very well received. Again, you would never see it. I would never see it. The doctors, we’ve been telling them for years, you can get this and go log into the UnitedHealthcare portal. And they said, “Yeah, cool. Thanks, United. I’m pretty busy over here. Can’t you put it in my daily workflow?”

So that’s what we did. We started with the two big EMRs, Epic and Cerner and we integrated our data into their daily workflow. So when they’re sitting there talking to you as a patient, they now see more information about you. And hopefully you and them together can make a better decision. Think about your doctor gives you a prescription. You have no idea if it’s on the preferred drug list. You have no idea what the copay is. And maybe you had your phone app and you did some of that work while your doctor was talking to you, but now they get to see it, too.  And it just makes it much more powerful.

Jason Powers: Wow. Yeah, because that’s one of those concerns in a doctor’s office, is that it depends on your insurance.

Michael Margher…: Yeah, that’s right. And that tier three copay can be prohibitive for people. And so if in the moment they can prescribe something else, it saves everybody that trouble. The other thing it does, if you move forward one, you give a little bit of a view of what it looks like to the provider. They see we throw in modules. They can see more data.  In this case, that patient, they went to the ER and the doctor didn’t know it, but now the doctor sees that in the morning when they’re reviewing their patient for the day. So it empowers them to give better care. And then the last detail on this is some of the outcomes on the next page, which that one that I think is most interesting, frankly, is that fourth one down. 50 minutes. We can save the providers and the pharmacists all time and the patients when they can …

Still drugs need prior auth, but you can do it there through the system and it’ll either go through or not. So you know in the moment, saves the patient from going to the pharmacy. The pharmacist saying, “Well, we got to call your doc. They have to fax in this paperwork.” That takes a day or two. It doesn’t come through, it doesn’t get approved. Now the person’s not taking their med. The doctor is annoyed. The 50 minutes saved, that’s before there’s even a complaint to HR and they call you and me. So it’s been really fantastic. And then I think the last one there, too, $415, that’s a big number and that’s what we’ve found so far using this system. If they switch from tier three or a non-preferred drug to a preferred drug, it saves the plan the $415. So this is one of those things, like I said, works in the background.

Jason Powers: But this isn’t a plan specific. This is [inaudible]

Michael Margher…: No, it’s not plan specific. It’s any UnitedHealthcare patient, any of our TPA business through UMR. For those providers, they can see all of our data for that patient and it just makes their experience better. And it makes the patient experience better, even though they don’t know what’s happening. 

Jason Powers: Wow. 

Michael Margher…: Yeah, I love that one. 

Jason Powers: Wow. And we’ll put, just so agents know, we’ve got new product grids on the small group side. We’ve got product grids for level funded. We’ve got some other marketing materials that we’ll put out on the site so that they’ve got downloadable content, but this is probably … I mean, I’ve been through a lot of different 1-1 cycles with UnitedHealthcare and this there’s so much going on.

Michael Margher…: There’s a lot to keep track of, but I think it’s all good stuff. We’ve got more coming out and sometimes hard to keep up. Got to get a fire hose to control it. 

Jason Powers: Well, Michael, I appreciate you being on. Any final parting words for brokers that are getting ready to the close up shop for the day and head out to sell tomorrow?

Michael Margher…: Head out to the heat that is Kansas City. No, I think we want your feedback. What else do you want from us? I always want to hear that. We think we’ve got great solutions and great products and that generally proves out to be true, but I always want to see what else is out there that people are interested in.

Jason Powers: You heard it from Michael. If you’ve got ideas, he’ll take them.

Michael Margher…: For sure. 

Jason Powers: He’ll take them and he’ll take as many cases as you can write for UnitedHealthcare and 2-4. Same here. Well, for the agents out there, this closes up our carrier product updates for today. We appreciate you being on today. Get out there, sell some in Q4 and we’ll see you next time.