Blue Cross and Blue Shield of North Carolina

Minutes of Meeting BCBS NC Jan 17, 2012 Summary of Discussion 1. BCBSNC covers 350K individual members and is the market leader in the state. It is expected that 200-250K might not be grandfathered after Healthcare Reforms. Majority of the members are not eligible for subsidy. 2. With 80% market share , the emphasis is on Customer Retention through focused segmentation 3. BCBSA (Blue Cross Blue Shield Association) has created 7 segments of market 4. BCBSNC uses a Typing Tool for segmenting its customers along with external scores 5. Fulfillment Cycle a. 60-70% of applications are auto-approved. 4-5 days taken for mailing the kit. b. For remaining 30%, the Underwriting takes additional time of 7 days.

Profile Blue Cross and Blue Shield of North Carolina (BCBSNC) is a not-for-profit, fully taxed company with headquarters in Chapel Hill and major operations centers in Durham and Winston-Salem. They are the largest health insurer in the state, with over 4,000 employees serving more than 3.7 million customers.

Customer Service Number of claims paid in 2010 Value of claims paid Customer service calls received in 2010 Product PPO BlueCard Indemnity HMO TOTAL

: : :

48.1 million $11.5 billion more than 3.9 million

Membership 2,471,106 887,340 281,214 78,695 3,718,355

Network Overview Our network of health care providers includes 92% of medical doctors and 99% of hospitals in the state. Provider Primary Care Specialists Hospitals Health maintenance organization (HMO) 5,215 19,145 113 Preferred provider organization (PPO) 5,234 20,045 113

Membership Engagement 1. MEMBERS AREA AT OFFICIAL WEBSITE-http://www.bcbsnc.com/members/public/ Registered members can Find details of their benefits Create personalized wellness programs Get exclusive online discounts

2. SOCIAL MEDIA

BCBSNC launched an online community platform to encourage members to share their thoughts and ideas regarding medical costs. LetsTalkCost.com is dedicated to fostering an open discussion about rising medical costs. Users post comments, questions, or frustrations in one of six categories: attorneys, doctors, hospitals, individuals, insurers, pharmaceuticals. They have the opportunity to comment on thoughts posted by others as well. Community members include company leaders, who monitor and respond to the conversations. 3. MOBILITY Apps for Android and IPhone are available for download. Functionality provided Urgent Care finder locates the nearest in-network center using GPS position Find a Drug helps find lower-cost drug options, average drug costs and even gives the ability to save drug information

Technology Stack CRM : EHR : Analytics: Oracle Siebel Allscripts Intelimedix

Additional Info: 1. Blue Cross and Blue Shield of North Carolina and Allscripts will invest a combined $23 million to help physicians and clinics statewide upgrade their technology an effort to allow doctors to access patient medical records more quickly. The Chapel Hill-based health insurance provider announced the collaboration with Chicagobased Allscripts (Nasdaq: MDRX). The initiative will cover the entire cost of upgrades for eligible free clinics and 85 percent of the cost for some independent practices.(Sep 2011) 2. Blue Cross and Blue Shield of North Carolina and its counterpart in Kansas City have joined forces to invest in new technology that is designed to help improve the electronic claims process. The two health insurance groups have formed Topaz Shared Services LLC and will buy software and information technology services from The TriZetto Group Inc , which works primarily with health care organizations.

BCBSNC-Product Lines
BCBSNC offers a variety of product lines to meet the health care coverage needs of our customers. The following health care benefit plans are available product offerings by BCBSNC: HMO product Blue Care(Health Maintenance Organization [HMO] plan)

PPO products Blue Options(Preferred Provider Organization [PPO] plan) Blue Options (PPO plan with deductible and coinsurance only) Blue Options (PPO plan with in-network benefits only) Blue Options 1-2-3 (PPO plan with three benefit levels) Blue Options HSA (high-deductible PPO plan paired with a health savings account) Blue Options HRA (high-deductible PPO plan paired with a health reimbursement account) Blue Options FC (PPO plan with fixed contributions) Blue Advantage(PPO plan purchased by individuals) State Health Plan (PPO plan for State Health Plan membership)

CMM products Indemnity Product Classic Blue (comprehensive major medical CMM plan) Blue Assurance (CMM plan for individuals)

BlueCard BlueCard is a national program that enables members of one Blue Cross and/or Blue Shield (Blue) Plan to obtain health care service benefits while traveling or living in another Blue Plans service area. The program links participating health care providers with the independent Blue Plans across the country and in many foreign countries and territories worldwide, through a single electronic network for claims processing and reimbursement.

Health Care Coverage Solutions Plans for Employers: Blue Options PPO plan Blue Options 1-2-3 Lower cost PPO plan with tiered benefits Blue Options HSA High-deductible health plan with Health Savings Account Blue Options HRA PPO with health reimbursement arrangement Blue Care Open-access HMO plan Classic Blue Comprehensive major medical plan Dental Blue Ancillary dental plan Dental Blue Select Voluntary dental plan Plans for Individuals: Blue Advantage PPO plan Blue Options HSA High-deductible health plan with Health Savings Account Blue Medicare Supplement and Blue Medicare Rx Blue Medicare HMO and Blue Medicare PPO Medicare plans Dental Blue for Individuals Individual dental plan Discount Programs: BCBSNC customers can receive discounts for health-related services including chiropractic services, hearing aids, laser eye surgery and vision care.