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INSIDE: SHEDDING LIGHT ON ANNUITIES • UNDERSTANDING MEDICARE PRESCRIPTION DRUGS • DEI & VOLUNTARY BENEFITS M VOLUME 39, NUMBER 8 Serving California’s Life/Health Professionals & Financial Planners MAY 2021 LIKE EVERYONE ELSE, WE’RE OBSESSED WITH
Brighter PREPARE FOR Days Ahead. Did you know 85% or more of seniors are eligible for our competitive CSNP and DSNP Plans? Now you can help brighten the lives of those 65+ with low cost/no cost benefits that will help you enroll more clients. So get ready for sunnier days with year-round enrollment. Offer more with a Medicare Advantage Health Plan from Brand New Day. Contact Broker Support to find out how to get certified or for an upcoming training. Call 1-866-255-4795 Ext. 2018 or visit bndhmo.com/brokers 2 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
CALIFORNIA DIFFERENT We do things a little different at CHOICE Administrators. We give employees the freedom to select the health and benefit plan that’s right for them. And our vast selection of health and ancillary options means there’s something for everyone with CaliforniaChoice and ChoiceBuilder - now, that’s pretty cool. CHOICE Administrators. A California Different way to do health care. Quote Different CaliforniaChoice 800.542.4218 calchoice.com | ChoiceBuilder 866.412.9254 choicebuilder.com
Contents M AY 2 0 2 1 12 24 MENTAL HEALTH 28 Deepak Chopra featured at MEDICARE INSIDER NAHU’s Capital Conference Is Protecting Mental Helping Your Medicare BY NAAMA O. POZNIAK Health Possible During the Clients Understand and COVID-19 Pandemic? Utilize their Prescription This unique appearance and sharing is BY DR. TYLER AMELL Drug Benefits certain to have a ripple effect, especially BY MARGARET STEDT with those of us who write the policies, Researchers are diving into how the lobby for and deliver the American pandemic impacted our mental well The most challenging part of coverage healthcare system. being and they warn that the real for Medicare beneficiaries is their 32 mental health burden is usually felt after prescription drug coverage. disasters. 14 26 ANNUITIES LONG TERM CARE An insider offers an update MENTAL HEALTH on the California LTC 2021 Mental Health Benefits Shedding Some Light on Insurance Task Force Survey Annuities BY LOUIS H. BROWNSTONE Why are fixed annuity sales surpassing There’s never been a time where mental variable annuity sales? There’s a new momentum in California health services were more important. BY ALVIN PARRA to solve the many social and financial Find out what industry pros have to say problems of long-term care services and about these important benefits. Get some light shed on the different support. types of annuities and how you might use them in your practice. 4 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
Health plan options that fit your small business clients. With Covered California for Small Business, we help tailor health plan options so employers and employees can get the coverage they want at a price that fits their budget. Our flexible coverage options work with businesses as they grow to offer coverage that will adapt to their needs as well as care for and retain quality employees. CoveredCA.com/ForSmallBusiness | 844.332.8384 Insurance companies vary by region. MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 5
PUBLISHER Ric Madden publisher@calbrokermag.com ASSOCIATE PUBLISHER Naama O. Pozniak naama@calbrokermag.com EDITOR Victoria Alexander editor@calbrokermag.com ART DIRECTOR Randy Dunbar 34 40 randy@calbrokermag.com VP MARKETING Devon Hunter devon@calbrokermag.com ASSISTANT EDITOR/MARKETING Linda Hubbard Lalande HEALTH EQUITY MARKETING linda@calbrokermag.com A Q&A with Kaiser’s Head Digital Marketing Strategies ASSOCIATE EDITOR Thora Madden of Equity Every Insurance Company thora@calbrokermag.com Kaiser Permanente has a deeply rooted Should Implement in 2021 CIRCULATION commitment to diversity. BY KAITLYN WILCOXSON calbrokermag@calbrokermag.com BUSINESS MANAGER Dr. Ronald L. Copeland, MD, F.A.C.S., According to marketing experts at Lexena Kool lex@calbrokermag.com senior vice president of National Equity, CoSchedule, companies that document LEGAL EDITOR Inclusion and Diversity strategy and their marketing strategy are 313% more Paul Glad policy for Kaiser, explains what this likely to report success. But what should means to the organization. be included in your marketing strategy? 36 EDITORIAL AND PRODUCTION: McGee Publishers, Inc. What type of content should you create? 3727 W. Magnolia Blvd.,#828 Burbank, CA 91505 And what platforms are worth the investment? 42 Phone No.: 818-848-2957 calbrokermag@calbrokermag.com. VOLUNTARY BENEFITS Subscriptions and advertising rates, U.S. one year: Fostering DEI with Voluntary $42. Send change of address notification at least Benefits 20 days prior to effective date; include old/new BY DENNIS HEALY Voluntary Benefits address to: McGee Publishers, 3727 W. Magnolia Blvd.,#828, Burbank, CA 91505. To subscribe on- Time to Be Flexible line: calbrokermag.com or call (800) 675-7563. More companies are elevating Diversity What to expect in VB as a pandemic- California Broker (ISSN #0883-6159) is published Equity & Inclusion (DEI) programs to weary workforce faces new realities monthly. Periodicals Postage Rates Paid at Bur- critical business strategies. How do BY MIKE WILBERT bank, CA and additional entry offices (USPS #744- voluntary benefits fit into this? 38 450). POSTMASTER: Send address changes to California Broker, 3727 W. Magnolia Blvd.,#828, Employees have different priorities Burbank, CA 91505. as a result of the pandemic and their ©2021 by McGee Publishers, Inc. All rights re- perspective on benefit choices has served. No part of this publication should be repro- shifted. duced without consent of the publisher. INSURTECH No responsibility will be assumed for unsolicited editorial contributions. Manuscripts or other mate- Benefits Technology rial to be returned should be accompanied by a self- Solutions for Today’s addressed stamped envelope adequate to return Workforce the material. The publishers of this magazine do not BY SARAH OLIVER assume responsibility for statements made by their advertisers or contributors. IN EVERY ISSUE Printed and mailed by Southwest Offset Printing, One year later and there is no question Gardena, CA. that the pandemic has not only changed Industry News 8 how we work remotely, but how we can Classified Advertising 46 do so seamlessly and smarter as a result Ad Index 46 of the technology that’s available to us. 6 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
LIFE SETTLEMENTS OFFER ONE SIMPLE IDEA. CHOICE. The secondary market for life insurance gives policyowners powerful options for managing their life insurance policies. Through transactions like a life settlement or a , you and your clients now have the tools to tap into the market value of policies that are underperforming or are simply no longer needed. The result is new estate planning strategies that maximize value. coventry.com 800.877.4179 ©2021 Coventry First. All rights reserved. CALBR052021
INDUSTRY/NEWS Insight on Life Settlements Market Cal Broker contributor Lisa Rehburg of Rehburg Life Insurance Settlements recently attended the Institutional Investor Conference organized by the Life Insurance Settle- The United States ments Association (LISA). Rehburg says the bottomline for life settlements is that reported a record-high 4.6 the market is great for investors, which means it is great for clients. A few of her key takeaways from the conference: million doses of COVID vaccines administered in Investor Perspective: one day, according to data • The market is good with projected growth in the next 3 - 7 years, and the published by the Centers future is bright. for Disease Control and • Coming out of the COVID-19 crisis, capital influx into the market will Prevention. However, increase. vaccination hesitancy • According to new research commissioned by Managing Partners Group haunts us: more than (MPG), more than half (51%) of institutional investors globally plan to 75% of the US population reduce their exposure to bonds this year. The research shows that, of isn't fully vaccinated, those planning to switch, 52% plan to redirect their investments into life according to CDC data. settlements. Because of this, new cases Client Perspective: and hospitalizations are • Clients put the sale of their life insurance policies on hold during the increasing, according to COVID-19 virus spikes, creating pent up transaction volume. That changed CDC Director Dr. Rochelle during the 2nd half of 2020 and continues to increase in 2021. Walenky. Young people • The face value of policies sold was down in 2020 v. 2019, meaning and those not vaccinated investors are buying lower face value policies. account for most of these • Increased consumer demand for new life insurance policies - up over 7% new COVID cases. in 2020 v. 2019 - results in an increased future life settlement pool. MediKeeper Launches COVID Navigator H ere's an interesting twist as we tracking, documentation and reporting of contemplate our brave, new post- cleared and not cleared employees," says COVID-19 world. MediKeeper David Ashworth, CEO of MediKeeper. announced a major upgrade to its COVID "It's a quick and easy way for employees Navigator mobile app. The app now to submit their vaccination status and for enables employers to digitally identify and HR administrators to be notified when an track which employees are vaccinated. employee has been cleared or enters vaccine Once info is input, a report is sent to information." The COVID Navigator is the employer to show an individual's integrated with a case management solution. vaccination status. "MediKeeper's The app is both HIPAA compliant and COVID Navigator reduces the HiTrust certified in order to protect privacy administrative burden of reporting and and security. COVID Navigator is available follow-up and makes it easier for HR for companies to access from the Apple to manage the vaccination, screening, Store or Google Play. 8 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
High Limit Disability Individuals annually earning in excess of $500,000 need disability benefits that can keep pace with their affluent lifestyle - they need High Limit Disability. The benefits of a recently-insured surgeon, making $1,100,000 consisted of: ⌂ $10,000/month Group LTD ⌂ $15,000/month Individual DI ⌂ $32,000/month High Limit DI Call (800) 345-8816 Occupation: Surgeon or Age: 51 visit www.piu.org for more information. Income: $1,100,000 Total Benefit: $57,000/month
INDUSTRY/NEWS Take Our Survey & You Might Win $ Vālenz Announces Acquisition of you haven't had a chance to Kozani Health answer the super Vālenz announced it has quick Cal Broker acquired Kozani Health, a survey, there's still time! company that provides a You can find the survey comprehensive bill review at https://tinyurl.com/ solution primarily for self- CalBrokerSurvey. And funded employers and the self- guess what? Answer the insured community. Kozani Health joins the ever-expanding survey and you can enter Vālenz ecosystem of data and to win a $500 Visa gift solutions as Valenz ProteKHt. card. The gift card drawing The new solution offers detailed will coincide with Cal line-by-line bill reviews Broker's 40th anniversary performed by nurses, certified issue later this year. coders and practicing specialists to uncover inappropriate billing. NAHU Power Hour 4th Wednesday of the month from 4-5p.m. Pacific. Members and nonmembers welcome. Register at NAHU.org. LAAHU DEI Book Club, discussing Miles McPherson’s book, The Third Option, goes through September, Register at LAAHU.org. CAHU Women’s Leadership Summit POSTPONED Email questions to info@cahu.org. San Diego Association of Health Underwriters Sales Expo Virtual, May 6. More at SDAHU.org. Los Angeles Association of Health Underwriters Annual Symposium, Virtual, May 13-14. More at LAAHU.org. IICF International Inclusion in Insurance Forum June 15-17, This action-oriented program will have a focus on an inclusive future for the industry. Register at IICF.org. BenefitsPro Broker Expo virtual one day May 18 AND in person in San Diego, August 16-18. Save 15% off with promo code RIGHTPLAN. Info at BenefitsPro.com. American Association for Medicare Supplement Insurance National Medicare Supplement Insurance Industry Summit, Sept 8-10, Schaumburg Convention Center, Chicago area, info at medicaresupp.org. 10 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
GOOD READ: The Full Body Yes by Scott Shute W e recently received "The Full Body Yes: Change Your Work and Your World from the Inside Out" by LinkedIn's Scott Shute. Shute is a a source of happiness and meaning. Sounds good, right? The book offers a four-step plan to make that happen, yet it’s couched in a memoir-like read. If you know any highschool or college kid from a wheat farm in Kansas grads, this is an ideal book to give as a who eventually snagged a job as gift. But it’s also really great read for head of mindfulness and compassion those who want to know more about at LinkedIn. In itself that seems an how meditation and mindfulness work epic feat. Which segues nicely to the for business and tech-oriented people. premise of the book. The concept Have anything good you’re of the book is that work shouldn't reading? Drop us a line and tell us be a burden that takes place outside of your what you’re reading and what you love about it! "real life." Furthermore, Shute says work can be Editor@calbrokermag.com WLS Offering Refund Options CAHU Women’s Leadership Summit (WLS) was Cigna + Oscar postponed to an undetermined date in 2022. If you Expands Small registered and need to request a refund or discuss Businesses’ Access other options, please contact Natalie Sinclair at natalie@caladmanagement.com. to Affordable Health Plans in California There's a new collaboration between Cigna and Oscar for small business health insurance in the Bay Area, SM Central Coast, Greater Sacramento, Inland Empire, Voluntary Product Listing Los Angeles, Orange County, • Accident • Disability • Legal • AD&D • TruHearing • Whole Life Insurance North Bay and San Diego • Critical Illness • Identity Theft • 10, 15 and 20 Year regions. The companies will Renewable Term Life share risk equally under a reinsurance agreement for solutions offered through this strategic partnership and plan Amalgamated Life Insurance Company 333 Westchester Avenue, White Plains, NY 10604 to expand the partnership Brian Italia CA License # 0D87644 646.599.7338 over time. bitalia@amalgamatedbenefits.com www.amalgamatedbenefits.com MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 11
Agent's Voice Deepak Chopra Shares Wisdom at CapCon BY NAAMA O. POZNIAK “In the midst of movement and chaos, keep stillness inside of you.” — Deepak Chopra F or over ten years, I When peace is found, so is had the pleasure of meaning and purpose. attending the Capital “Directly or indirectly, Conference (CapCon) in stress is the number one Washington, D.C. Last year, killer in our society. By the last flight I took before itself, stress produces the pandemic began was to loss of immune function. CapCon. This is the National Stress is the number one Association of Health pandemic of our civilization. Underwriter's (NAHU) annual COVID-19 doesn’t even conference and one of the come close. Many people largest and most influential have chronic illnesses, healthcare industry events. anxiety, depression and Beyond hosting it virtually inflammation. Ninety- for the first time, this year five percent of all chronic we were honored to have diseases are related Dr. Deepak Chopra as the to lifestyle. We can keynote speaker. foresee these illnesses, The manifestation of this and therefore they are collaboration with Chopra preventable.” and his team was weaving Chopra sees the future of for more than 10 years. His wellbeing as “personalized vision, knowledge, energy, and predictive — we can and expertise are critical predict what’s going to in our industry. This unique happen.” But it is a process, appearance and sharing not an overnight cure. is certain to have a ripple effect, especially with those of us Most people don’t give much importance to sleep, but who write the policies, lobby for and deliver the American lack of sleep is considered to be one of the most significant healthcare system. contributors to premature death because of the inflammatory Here is a recap of Dr. Chopra’s CapCon presentation: consequences. Sleep is the window to our soul and spiritual Excitement crackled across cyberspace as the session was experiences. Humans need seven to eight hours of sleep broadcast through Zoom to many corners of the country. to minimize risk of Alzheimer’s disease, inflammation, Chopra invited the audience to “connect from the heart” cardiovascular disease, anxiety and depression. When you when he spoke of the challenges brought forth by the wake up after a good night’s sleep, you should feel refreshed, coronavirus pandemic. “We all, including me, observed joyful and energetic. Toxins have been released, and the first-hand the pain, anger, grief, and fear experienced by body has had a chance to self-regulate. You have returned to the populace. So much taken for granted — friends, family, homeostasis. employment, good health — lost instantly. People felt Meditation is the best way to manage stress through self- helpless in the throes of the disease and, tragically, many inquiry, reflection and mindfulness. Incorporating art into our people died and continue to die still. lives in the form of music and poetry is very healing. Never “But notwithstanding variants, it is the usual course of underestimate the power of laughter. Laughter brings joy, and viruses to become less contagious and virulent eventually. joy illuminates our lives. It may take time, but this too shall pass, and 2021 will be The body must move, and movement links to good health. the year of recovery. We must ask ourselves what we have Any form of exercise that coordinates the mind and body learned and gained from this experience. It is essential is beneficial and healing. Recommended practices include to let go of the past to change our future and find peace. strength-building yoga combined with breathing techniques 12 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
or other mind-body integrative adequate healthcare or nutrition. shines a light on the purity of your techniques, such as Tai Chi, Chi Gong or Financial distress, whether you are rich true nature and, in turn, affects your martial arts. Data shows that exercise or poor, can cause significant stress emotions, behavior and life. incorporating mind-body coordination, and biological havoc. The extremely In the next few years, we will deep breathing, meditation, singing poor and the extremely rich worry about see technical expertise extended to and chanting stimulates the vagus money all the time and often confuse handheld devices, like Fitbit, with whom nerve, calms the body, and decreases their self-worth with their net worth. Chopra is working, allowing a person to inflammation, allowing the body to self- Net worth is not self-worth. Financial reap the benefits of meditation. Such heal. security doesn’t come from the amount technology aims to enable the user to How we fuel our bodies makes a of money you have, but how you feel experience a joyful, energetic body, a clear difference. Avoiding processed about money. What is your relationship compassionate heart and lightness of chemicals, hormones and steroids with money? How do you use it? Do being — and to inspire us all to walk the in our food is a key to wellness. you have enough money to retire? If pathway to total health. Cardiovascular disease and so many you get sick, do you have insurance? We can minimize disease and illness others can be avoided by following Do you spend money on experiences, as we get older, but we do age. Nothing a plant-based diet with maximum or do you spend it on possessions? Do is going to prevent old age or death. diversity. Damage can be reversed you have default systems? Do you pay Everybody gets old if they are healthy. quickly by a change of diet and your taxes? Do you know how to give? However, we can mitigate the suffering nutritional intake. All of these factors make up a person’s that comes from old age and the fear Our bodies have a biological rhythm. financial well-being. of death. With a sense of spiritual We are affected by circadian rhythms Spiritual wellbeing is being in connection, we can learn not to fear — the internal processes that control touch with the true self. When we get death but embrace it as a natural part our sleep cycles and seasonal rhythms, in touch with our true self through of life. lunar rhythms and gravitational meditation, we access a field of infinite Every spiritual tradition teaches rhythms. Our bodies are part of the possibilities, incorporating values like that the soul is timeless, immortal symphony of the whole universe. When truth, goodness, beauty, harmony, and boundless, and infinite. If we your feet touch grass, dirt, or sand, or love, compassion and joy. Once you can assume that, we embrace self- when you touch a tree, you get what are in touch with your spiritual core, realization, and fear evaporates. is called “grounded.” You can return it influences everything else in your to self-regulation, self-healing, and life positively. Spiritual enlightenment equilibrium. Career wellbeing is fundamental as our work gives us purpose in life. Ask DIGITAL TECHNOLOGY yourself: are you happy at your job? Are your talents being recognized? Are you part of a team that complements + THE HUMAN FACTOR each other’s strengths? Ideally, a work environment incorporates a shared vision where there is an emotional and spiritual bonding and where each person brings an added benefit to the team, as in sports. It’s essential to find a career that fulfills your spirit. It is a critical factor in long-term happiness. Social wellbeing means having people in your life who care about you. It would help if you strived to surround yourself with friends and family who support you and that you support in return. You are available to them and them to you through attention, affection and acceptance. Community wellbeing refers to your home. Ideally, this should be a space of comfort and safety. During the quarantine, people found BenefitMall leverages innovative technology backed by our themselves at home more than ever before. Therefore, it became critical to human expertise to provide the best in broker services. live in a comfortable home “in which solace could be found, day after day.” Financial wellbeing refers to feeling safe about your money. The pandemic has thrown many people into financial distress. Suddenly, many cannot afford 800.350.0500 BenefitMall.com MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 13
Mental Health M e ntal H ealth Be n e fits California Broker reached out to several industry experts to weigh in on mental health benefits. There’s never been a time where mental health services were more important. Find out what these industry pros had to say... COMPILED BY THORA MADDEN By Paula Allen 14 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
DESCRIBE YOUR COMPANY’S ROLE Jennifer As part of our commitment to OR PRODUCTS IN THE BEHAVIORAL Christian- transforming health care, we offer a HEALTH SPACE. Herman, comprehensive program of industry- Ph.D., leading behavioral health services. Stephanie executive Blue Shield health plans provide a Shields, SVP director, sophisticated approach to managing of Broker Mind Body both inpatient and outpatient Sales at Aflac: Medicine – behavioral health services, employing Mental and Behavioral Health, Blue Shield specially trained behavioral health emotional health of California: clinicians to assess members’ has long been an We are living in unprecedented situations and direct them to the most important topic, times, the likes of which our society appropriate care setting. We ensure but employers has not experienced in more than a seamless coordination process for got a closer look 100 years. For more than a year now, the care of members with significant at how employees are doing and the COVID-19 has caused worldwide behavioral health needs through challenges they face in light of the disruptions in our work lives, family co-located care managers and a pandemic. As a result, they want to relations, job security and economic collaborative approach that promotes enhance their benefits offerings to activity. In integrated care support wellness in this area. In fact, addition, social coordination. This the 2020-2021 Aflac WorkForces Report showed that 26% of employers distancing has led to feelings of We have enhanced simplifies the member experience said employee mental health issues separation, loss of our products to make and enables had an effect on their company in the past year, and 26% of employees said community, stress sure we not only personalized, relevant and and anxiety. they expect their employer to offer Now, more than react to an event like responsive care, mental health assistance benefits to ever, Blue Shield hospitalization or while still leveraging make them feel more comfortable going recognizes the cutting-edge to a physical worksite. need to address disability by providing technology to Aflac examined the journey an the behavioral cash to help with expand access to employee experiences when seeking health needs of these services. We treatment for mental health symptoms. our members, expenses health provide additional As a result, we have enhanced our including the insurance doesn’t flexibility through a products to make sure we not only biological, variety of member react to an event like hospitalization psychological cover, but also to focus access points (e.g., or disability by providing cash to and social factors on well-being. telebehavioral help with expenses health insurance that impact their health and tech- doesn’t cover, but also to focus on — Stephanie Shields, Aflac enabled hybrid behavioral health. well-being. Our group short-term Our whole-person applications). disability product provides mental approach to health In addition illness coverage, and as a means and well-being, collaborative-care to our legacy partnership with our to help support early diagnosis and philosophy, and relentless innovation behavioral health partner, Magellan treatment. Aflac considers a mental are what set us apart. These are the Health® (Magellan), we have expanded health screening a covered condition drivers that enable us to deliver a high- our network with innovative provider for group supplemental wellness or quality, personalized experience to our partners and solutions. health screening benefits. In addition, members. Telebehavioral health services. we provide employers with access Together with our behavioral health BlueShield offers 24/7/365 to value-added services such as an partners, Blue Shield is scaling an telemedicine and telebehavioral employee assistance program and integrated medical and behavioral health services to members through telehealth, including meeting with a health program that seeks to ensure Teladoc. This includes a national counselor or psychiatrist virtually. This coordination between primary care network of physicians and experienced can help provide support for treatment physicians, specialty medical practice psychiatrists, psychologists, therapists and round out their strategy to support clinicians, and behavioral health and social workers to address a mental health, stress management and professionals with the goal of providing broad range of common illnesses and overall wellness. a more holistic care experience. We provide relief for issues like addiction, aspire to ensure members have timely depression, stress or anxiety, domestic access to behavioral health care and abuse, grief counseling and more. that their cultural, ethnic, gender and Telebehavioral health sessions language preferences are taken into conducted during the COVID-19 period consideration when finding the right are covered in the same way in-person provider. visits are covered. All credentialed MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 15
and contracted behavioral healthcare video conferencing via phone, tablet, or members who may be at risk for opioid providers are now permitted to computer. Bright Heart works with over overuse or substance abuse. Various conduct telehealth video sessions 150 hospitals, specializing in opioid outreach strategies are leveraged for all routine services and certain disorders, substance abuse treatment, to prevent unnecessary surgery, advanced behavioral analysis, intensive chronic pain/opioid dependency and inappropriate medication use, and outpatient treatment programs, eating disorders. Bright Heart Health is expensive emergency-room visits. and partial hospitalization program equipped to complete intakes within 24 Strategies include telephonic coaching services. If a member is unable to hours of receiving a patient self-referral by medical and behavioral health participate in a face-to-face telehealth or provider referral, offering members clinicians, medication reconciliation by video session, outpatient providers may on-demand care and minimal wait a licensed pharmacist, 24/7 access also conduct sessions via telephone. times. to tailored, evidence-based digital So, if members need care, they can programming, and self-guided modules. call their provider to see how to receive Value-added services: Blue services via their phone or video Shield’s value-added services provide Complex case management conference. our clients with game-changing services: Magellan’s complex case opportunities that offer a broader management services expedite and Wellvolution: Blue Shield’s award- clinical value story through seamless support access to treatment facilities winning lifestyle medicine program, integration and improved competitive and care for more acute behavioral Wellvolution®, positioning through health conditions. We partner with combines best- innovation and Magellan to offer an integrated medical in-class digital improved costs. and behavioral health model that helps therapeutics, Our newest cutting- ensure coordination between primary evidence-based Blue Shield has extensive edge solutions care physicians (PCPs), specialty therapies, and experience supporting focus on technology, medical practice clinicians, and member-centric medical/behavioral behavioral health professionals, with design to ensure transgender benefits integration, early the goal of providing a more holistic members have and providing patient intervention. We care experience. access to work to break personalized, advocacy services for down the stigma of Autism and applied behavior flexible tools that members diagnosed with mental health needs analysis services: The Magellan work within their while promoting Autism Connections® program existing routines gender dysphoria through awareness, through helps families navigate the complex and address their our integrated care these behavioral healthcare system, obtain access unique problems. To help management model. health programs and services: to quality providers, and receive support within their communities. The members with program combines the expertise of social distancing — Jennifer Christian-Herman, Behavioral fully credentialed providers who meet Blue Shield of CA during the health condition applied behavior analysis requirements current COVID-19 management with targeted efforts to engage and outbreak, services: Our serve children diagnosed with autism we adapted integrated care and their caregivers to ensure everyone our Wellvolution diet and lifestyle management model leverages impacted receives the care, guidance, programs to support members during a behavioral health condition and support they need. this uncertain time. These 100% management component designed to virtual programs are customized to help members overcome depression Maternal mental health meet current challenges, supporting so they can effectively manage their services: Members experiencing members to take better care of their chronic conditions. Behavioral health maternal behavioral health conditions physical and emotional health while coaches, who are master’s-level such as depression (including they remain at home. We also expanded clinicians, engage members using postpartum) and anxiety either before, the platform to include on-demand motivational coaching techniques and during, or after pregnancy receive exercise videos and a recipe library of cognitive skill-building exercises, and an additional layer of support via healthy recipes for all dietary needs they support members in developing our Prenatal Program. Members are to increase well-being support for our their own self-management plans. provided access to behavioral health members during the pandemic. specialists who can offer help and Bright Heart Health. We are also Pain management services: We guidance with stress management, employing technology to address also offer, as part of our integrated care coping mechanisms, managing behavioral health concerns through management model, a comprehensive depression or anxiety, and more. our partnership with Bright Heart and collaborative approach to Health. They provide expert care and pain management, including pain LifeReferrals 24/7: Members can support to adults through two-way interventions that provide support for get in-person and telephonic support 16 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
for all areas of their lives — from to ensure services are done in and coverage relationships and child and elder care, accordance with a client’s human together—is to financial and legal issues — with resources and legal policies. uniquely built LifeReferrals 24/7™. This employee- to meet our assistance-program-like offering Unum members’ needs includes three face-to-face counseling Spokesperson during this difficult sessions with licensed therapists in Pam Jenkins, moment in time. each six-month period at no extra Assistant Vice We draw from charge. President, a full spectrum Product of proven care. Transgender patient advocacy & Market From primary care to specialty mental services: Blue Shield has extensive Development, health care to emergency care and experience supporting transgender Colonial Life: everything in between, our providers benefits and providing patient advocacy Various coordinate and manage care delivery services for members diagnosed programs proved their value last year across an expansive mental health care with gender dysphoria through our during the pandemic. Colonial Life ecosystem. That gives our members integrated care management model. provides an Employee Assistance many options—including options for We offer personalized advocacy and Program (EAP) within our Group getting care remotely—and they can health education services by dedicated Term Life product. Workers have free work with their provider to select the nurse case managers to address the access to confidential counseling care that’s right for them. complex medical and psychosocial and resources such as securing At the center of all of this is our implications of gender transition, and local childcare options and finding electronic health record system, which our comprehensive medical policy alternative elder care solutions. In most allows members to manage their follows internationally recognized states, employers may choose to offer care online and gives us the ability standards of care from the World our disability plans with psychiatric or to coordinate their care. Our doctors Professional Association of Transgender psychological condition benefits. know what they need to do, and the Health. ecosystem enables us to provide care based on what works and helps us Community health advocates: Brian T. make sure the patient experience is As part of our Health Reimagined Sullivan, RHU, as seamless as possible. The ability to program, we are piloting the use REBC, FLMI, maintain clear communication across of community health advocates in MHP, CHRS, our care teams is particularly critical select regions to work directly with, Market Vice during a crisis, which can affect how or on behalf of, patients to navigate President, and where care is delivered. the health system and connect Humana: We also always try to spot concerns them with community resources that Humana’s early, which is why providers across our address their behavioral health and wellness network have the knowledge, training, social needs while aiming to reduce programs, and resources to address mental health inequities. Community health Humana Employee Assistance Program health concerns. Patients and their advocates act as navigators and (EAP) and Go365, offer a variety of providers develop care plans tailored liaisons with local stakeholders and resources to provide mental health to their challenges and goals, including provide the empathetic support and support. With Humana EAP, employers frequency and duration of visits. real-time problem solving necessary have the option to offer the traditional Adjustments are made as needed. to enable whole-person health and EAP offerings, including professionals Ongoing feedback from members helps wellness. who can connect employees to a us understand what tools, therapies, network of licensed counselors. But it and self-care techniques are helping, Workplace support services: also offers other components, such as identify additional things to work on, Managers and supervisors receive life coaching, a legal/financial benefit, and decide on a path forward after telephonic support to assist with and a website. Go365 offers digital achieving treatment goals. employee issues, such as substance mental health resources, Unwinding The result is a fluid care experience abuse or personal and family Anxiety and MyLife, as well as a that evolves with our members’ needs. problems, that could be impacting SelfHelpWork’s stress course called job performance. Workplace Support Living Easy: Stress & Resiliency. consultants are master’s level, Mary trained clinicians who assist with Yener Balan, M.D., DFAPA, Kaiser Langowski, the development of corrective action Permanente: CEO, Solera plans and a proper return to work, Along with our expansive mental Health: as appropriate, for the employee. health offerings, collaborative We have Workplace Support consultants approach, and responsive care, our several partner with managers and supervisors integrated system—which offers care programs that MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 17
serve behavioral health through our pandemic. We continually work on ways specialty requests to meet appointment all-encompassing Solera Connect we can better respond to customer standards due to increased telehealth platform. This matches consumers to needs by being easier to use, to obtain utilization. their best-fit, health community-based and to be more accessible to a greater This decrease was partially offset and digital solutions while creating a number of consumers. by the need to accommodate social- single touchpoint Aflac has digital distancing restrictions and heightened for condition tools in place to safety measures for members and management All credentialed and provide solutions employees, increasing wait times for and streamlined engagement. contracted behavioral for businesses that have had to some patients and facilities. Some specialized in-person services have Moreover, people healthcare providers are shift to operating also been limited due to the pandemic, are matched to their level of acuity by now permitted to conduct remotely. We partner with many third- resulting in the need to utilize out-of- network services. condition with the telehealth video sessions party platforms ability to move up for all routine services that offer benefits PANDEMIC ADAPTATIONS or down as needed administration The following list outlines various based upon ongoing and certain advanced solutions to program adaptations Blue Shield data monitoring of behavioral analysis, employers and a and Magellan have implemented or how consumers are seamless digital supported providers in implementing progressing. This intensive outpatient experience for over the course of the pandemic: ensures that people treatment programs, and their employees. In We adopted the best practice to are getting the right addition, we have allow providers the freedom to select level of support that partial hospitalization updated customer- the Health Insurance Portability and they need. With program services. facing technology Accountability Act (HIPAA) compliant the platform and a capabilities, telehealth platform of their choice for single agreement, — Jennifer Christian-Herman, changing the way we delivering care. we simplify the Blue Shield of CA engage and service We expanded support for providers, difficult tasks in our customers and making it easy for them to onboard for getting programs support brokers. telehealth. Through Blue Shield and launched, including claims processing, MagellanProvider.com, we offer a free consumer engagement, eligibility Jennifer Christian-Herman, Ph.D., webinar, “Telehealth 101: What You screening and vendor management, Blue Shield of CA: Need to Know and How to Get Started”; thereby speeding up rollout of solutions A silver lining to the COVID-19 lists of telehealth payable services and and saving costs. Specifically, we pandemic crisis has been the capacity billing instructions; “10 Steps to Getting offer both a Diabetes Prevention and to rapidly expand telebehavioral health Started as a Telehealth Provider”; and Weight Management Program and have services. Blue Shield, in partnership answers to frequently asked questions recently launched a bundled suite of with Magellan and Teladoc Health, about telehealth. programs called Solera True Strength Inc. has dramatically expanded Some partial hospital programs which combines Stress, Sleep & these services, and as a result, (PHP) moved to a telehealth format, Resilience with Tobacco Cessation and provider/member utilization has risen offering group and individual therapy, Social Isolation. significantly. psycho-pharmacological management, During the COVID-19 public health and assessment via two-way video. HOW HAS COVID CHANGED emergency, telehealth services have Patients have participated in these WHAT YOU DO? FOR EXAMPLE, expanded to ensure patients continue programs from home or other suitable ARE PEOPLE ACCESSING YOUR receiving care in a timely fashion in a locations outside the traditional SERVICE IN A DIFFERENT WAY? safe manner that mitigates risks to both structured PHP setting. HAVE YOU SEEN AN UPTICK IN members and providers. We have made For intensive outpatient program USE? several adaptations to our telehealth (IOP) services, we have seen two approach to support this expansion, models emerge that incorporate Stephanie Shields, AFLAC: including temporary changes to our telehealth modalities: Many changes have taken place levels of care. (1) video visits or telehealth-based in the insurance industry because of IOP, during which the member attends COVID-19, especially the acceleration PANDEMIC OBSERVATIONS only from an offsite/home setting via a of digital initiatives for American Members have exhibited a greater telehealth connection businesses. Aflac is constantly evolving willingness to access treatment through (2) a hybrid model that combines in- to enhance the customer experience, telehealth modalities. For the periods of person and video visit–based care and from benefits enrollment and education April to September, 2020, Blue Shield requires evaluation of the treatment to policy management and filing a and Magellan experienced a reduced plan and therapeutic program claim. Our efforts to expand and reach need to look outside the network to components to ensure clinical validity. more people were in place before the accommodate geographic needs and 18 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
Prior to COVID-19, Applied Behavior circumstances. For some levels of care, like Classpass or Echelon. They also Analysis (ABA) historically allowed very we do not believe telehealth to be a have the ability to submit a selfie to limited telehealth opportunities. As of best practice and will likely revert to our Go365 app as proof for working March 2020, in response to requests pre-pandemic policies. In other cases, out. We also expanded our eligible by state regulatory bodies, Blue Shield through adapting our policies, we have activities for earning points to make and Magellan began allowing telehealth determined that defining a new level of it easier for members to be rewarded accessibility for all ABA codes. This was care to account for telehealth access for being healthy. In addition, we warmly received by the ABA provider may be appropriate. offered webinars, new content and community, as it enabled them to see communications to help members with their members and remain compliant Pam Jenkins, Colonial Life: stress, exercise and prevention. With with shelter-in-place directives. Early The pandemic increased the risk of EAP, we added text-based and video feedback from providers has indicated mental and behavioral health issues counseling options to our network, to patient satisfaction scores have and made people more financially make it easier to get help virtually, as remained the same fragile. In this well as adding new website content and for both types of environment, promotional flyers addressing mental visits. benefits to help health issues related to the pandemic. Blue Shield People who already protect people and Magellan struggled with addiction from the financial Dr. Balan, Kaiser Permanente: have continued costs of illness, The toll the pandemic is taking on to receive and are suffering in isolation, injury or loss us all is undeniable, and there’s no review requests for creating dangerous and of life are more question that COVID-19 will continue psychological and neuropsychological potentially life-threatening important than ever. Unfortunately, to affect people’s mental health around the world. Early on, the Journal testing throughout situations. the pandemic has of the American Medical Association the pandemic. made benefits projected a nationwide increase in — Dr. Balan, Kaiser Permanente Some providers enrollment — and depression, anxiety and post-traumatic have been using learning which stress due to COVID-19. (This is telehealth in benefits are best according to Sandro Galea, M.D., et their testing, for you — harder, al., “The Mental Health Consequences and our internal too. of COVID-19 and Physical Distancing: psychological testing team has We’ve always focused on meeting The Need for Prevention and Early compiled a list of testing measures that our customers where they are — making Intervention,” Journal of the American are conducive to telehealth services. sure they understand and choose the Medical Association Internal Medicine, We use this list, as well as the American right benefits — regardless of whether April 10, 2020.) Psychological Association’s principles, it’s in-person or virtual. When offices Sadly, that is proving true with more as guidelines for telehealth testing began to close in the U.S. last year, we recent data suggesting that signs and during the COVID-19 crisis. already had a virtual meeting platform symptoms of mental health conditions for benefit counselors, but we expanded continue to rise, particularly among POST-PANDEMIC PLANS our number of virtual counselors. Our young people and caregivers. As While Blue Shield specifically and Employee Assistance Program (EAP) people search for ways to cope with the nation in general have made great also provides phone and online chat increasing stress and anxiety, we’re strides in combating the COVID-19 solutions for a variety of personal and seeing startling increases in substance pandemic, the crisis is far from over. work issues. use and addiction. Unfortunately, the Together with our partner Magellan, we The ability for customers to connect national opioid crisis has only worsened have quickly responded to the public with benefits counselors during off- during the coronavirus pandemic. health emergency, making needed hours is also paramount. If 10 p.m. on In June, four out of 10 adults said changes to support timely access to a Wednesday is the best time, Colonial they’ve dealt with mental health or care and patient safety. We recognize, Life can make it happen. Virtual makes substance use issues, while more however, that the changes we’ve made it possible. than one out of 10 said they’ve either during this critical time require further started using substances or increased evaluation before we commit to making Brian Sullivan, Humana: their use. (Mark E. Czeisler et al., them permanent. We are currently Go365 rewards points to members “Mental Health, Substance Use, and documenting specific plans for this for working out, but we verify their Suicidal Ideation During the COVID-19 evaluation and recommended actions activities before doing so. Since gyms Pandemic—United States, June 24–30, based on observations during the and other fitness facilities had shut 2020,” Morbidity and Mortality Weekly pandemic period. down or otherwise experienced a drop Report, August 14, 2020.) We expect to assess whether some in attendance, we added functions People who already struggled with of our expanded telehealth services to our program where members addiction are suffering in isolation, deliver an optimal level and quality could earn points for exercising creating dangerous and potentially of care outside of these extenuating along with virtual fitness programs life-threatening situations. A recent MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 19
study (“June Brings Some Mental This could include helping employers to 741741 are connected to trained Health Relief for U.S. Workers, but Risk construct a benefits education strategy counselors who provide support in for Mental Health Conditions Remains to help workers learn about and take dealing with issues such as anxiety, High,” Total Brain, accessed Sept. 23, advantage of all the offerings available stress, fear, and isolation and help 2020) found that: to them. With employees continuing them identify coping strategies and • 54% of employees are at to operate remotely, it’s important for other resources. increased risk of a depressive employers to see how their workers disorder, 49% have a higher risk are dealing with the extraordinary Jennifer Christian-Herman, Ph.D., of post-traumatic stress disorder challenges of pandemic conditions. Blue Shield of CA: • 41% have a higher risk of a Aside from a mental health To help ensure employers, general anxiety disorder issue, many people are struggling employees and individuals have • 11% have a higher risk for with extended periods of isolation, comprehensive knowledge of Blue addiction. facing stress and anxiety about Shield’s behavioral health benefits health concerns, or juggling a variety and know how to access them, we This confluence of problems of responsibilities personally and encourage brokers and benefits contributes heavily to deaths due to professionally while working from professionals to partner with their Blue drugs, alcohol, or suicide, also known home. In particular, women are a Shield sales representatives, who can as “deaths of despair.” These deaths demographic bearing many burdens. provide them with the current layout of have been on the rise the last decade Research shows that, compared with Blue Shield’s offerings. and projections for the coming months men, they complete more household At Blue Shield, we know that are grim. However, we know they’re chores and provide more child care and behavioral health is more than just a preventable. caregiving for older adults. Yet, they provider network, covered benefits, and have less leisure time, which can affect tech-enabled care. Our members need Mary Langowski, Solera Health: their ability to get much-needed rest to: With COVID-19 we have seen and self-care. And that data predates more demand for all of our programs. COVID-19, which put many women in • Recognize early signs and A recent American Psychological a position to have to choose between symptoms Association survey showed 42% of work and child care. Brokers have an • Understand what programs are respondents reporting undesired weight opportunity to lend a listening ear and available and appropriate for gain, due to the pandemic, which is a offer solutions to help workers set their them high contributing factor for the onset of employees up for • Quickly diabetes, so both payers and employers success. access care across all are moving to help consumers stem the On the topic of COVID-19 has brought acuity levels tide. Moreover, COVID-19 has brought emotional health, increased stress upon Americans, a non-benefits increased stress upon By realizing our with a Gallup poll showing that 55% of consideration Americans, with a vision of an improved people are experiencing stress “a lot of is informing healthcare delivery the day”, which is why we launched the businesses about Gallup poll showing system, we believe True Strength Bundle to help address national programs that 55% of people are that future members this combination of conditions. they can promote will actually have less Our programs are traditionally to employees experiencing stress “a need for behavioral accessed both in-person and digitally. such as Crisis lot of the day”, which healthcare services, To adapt for COVID-19, our community- Text Line, which because problems based organizations successfully and Aflac supported is why we launched that lie in social quickly moved to offer virtual classes, during COVID-19 the True Strength and behavioral but digital options continue to remain with a $1 million circumstances—which extremely popular. donation to assist Bundle to help address can progress into frontline workers. this combination of medical issues—will WHAT SHOULD BROKERS AND The not-for-profit be lessened. BENEFITS PEOPLE KNOW AND organization conditions. This is key to DO TO HELP CLIENTS BETTER responds to — Mary Langowski, emphasizing not UNDERSTAND AND UTILIZE THEIR thousands of Solera Health only Blue Shield’s BEHAVIORAL HEALTH BENEFITS? texts each day behavioral health and from individuals wellness benefits, but Stephanie Shields, AFLAC: experiencing mental or emotional to communicating the importance of Maintaining ongoing, authentic distress. They reported an increase in addressing mental health and helping relationships with clients is vital. communication with frontline workers members find clinicians they can trust. Check in with them regularly to listen and their family members impacted and provide counsel, both generally by the pandemic. Individuals seeking Pam Jenkins, Colonial Life: and about emotional health benefits. crisis counseling who text FRONTLINE Brokers should: 20 | CALIFORNIA BROKER CalBrokerMag.com MAY 2021
• Continue to talk about the at kp.org/getcare. In addition, our position, align our workforce, and importance of dealing with any emotional wellness support resources reinforce and accelerate our digital mental concern as a health issue. have been essential during the roadmap. Looking ahead to 2022, Aflac • Contribute to the process of pandemic. Whether it’s to help with will hone in on our growth initiatives, destigmatizing mental health. sleep, stress, or relationships, we including building a coordinated • Recognize the impact to an offer many digital resources for our value proposition and experience for employer’s bottom line if members’ mental health and wellness, our newly acquired businesses and employees are struggling to find including popular expanding our help with personal issues. This wellness apps distribution through can result in higher absenteeism, like myStrength Our goal is to always new channels. In poor job performance, and impact and Calm. The addition, we are coworkers. myStrength app be available for our also continuing (a wholly owned members, especially to look at how Brian Sullivan, Humana: subsidiary of Livongo we can leverage We believe that intervening early Health, Inc.) offers a when they need us automation and can help reduce the rate at which personalized program most. We moved fast to digital solutions to employees present with more advanced with interactive create efficiencies complications, such as depression activities, in-the- shift delivery of nearly for our customers. and chronic stress. Behavioral health moment coping 100% of our scheduled solutions should address a wide range tools, inspirational mental health services Jennifer of severity and diversity of mental resources, and Christian- health issues. Humana EAP, for community support. to telehealth options, Herman, Ph.D., example, could be seen as an offering Calm is a meditation including group visits. Blue Shield of only for “serious” situations like fitness and sleep app CA: for duty evaluations, but they can designed to help — Dr. Balan, We are also offer more preventive, everyday lower stress and Kaiser Permanente focused on further resources to help people cope. Those reduce anxiety. integration of under-utilized aspects of EAPs should medical and be explored and promoted more. And Mary Langowski, behavioral health wellness programs should be more Solera Health: care. Together with our behavioral holistic in nature, not just addressing Both brokers and benefits health partners, Blue Shield offers nutrition and exercise, but also stress professionals should know that the two an integrated medical and behavioral and anxiety—two major drivers of poor keys to maximizing behavioral health health program that seeks to ensure health in general. benefits for consumers are awareness coordination between PCPs, specialty and choice. Many people do not even medical practice clinicians, and Dr. Balan, Kaiser Permanente: know that there are behavioral health behavioral health professionals, with Our goal is to always be available benefits available to them, so clients the goal of providing a more holistic for our members, especially when should be encouraged to outreach care experience. they need us most. We moved fast to to their member population. More Our behavioral health vision for shift delivery of nearly 100% of our importantly, clients need to understand 2021–2024 is focused on further scheduled mental health services to that different people learn differently, integrating medical and behavioral telehealth options, including group so offering just a single point solution health care by leveraging the visits. This helped ensure our members provider for a behavioral health collaborative care model and existing could receive high-quality mental health condition will not work for everyone. accountable care organization (ACO) care without delay and without risking This is not a case where one size fits all, partnerships to: exposure to COVID-19. We were able to which is why Solera curates networks quickly ramp up our telehealth offerings of providers offering a range of learning • Implement a value-based care because we already had a robust, methodologies and algorithmically model highly efficient telehealth system. We matches members to the best fitting • Integrate primary care behavioral also accelerated investments that have solution for them. health enabled us to collect reported patient • Base decisions on data-driven outcomes remotely, without patients WHAT IS YOUR COMPANY'S MAJOR stratified medical behavioral having to come into the office. FOCUS OR CONCERN IN THE NEXT integration These things make it easy for YEAR OR TWO? members to get care remotely through Members and providers will also video visits, phone appointments, Stephanie Shields, AFLAC: have improved access to digital self- e-visits, email consultations, mail- Aflac, along with the world, will help tools that provide evidence-based order pharmacy, and a host of other continue to navigate the global treatment options and care navigation. virtual support options on kp.org and pandemic’s effects in 2021. This year In-flight initiatives to improve medical/ the Kaiser Permanente app found we continue to secure our financial behavioral health integration include: MAY 2021 CalBrokerMag.com CALIFORNIA BROKER | 21
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