Bloom Health

exchange_bloomhealthCompany name: Bloom Health

Marketplace name: Bloom Health Private Exchange Platform®

CEO or Practice Leader: Simeon Schindelman, CEO and Chairman of the Board

Founded / Launched: Founded in 2009

Main Location / Headquarters: Minneapolis, MN

Website: Please click here.

Membership/number of lives currently on platform: Bloom currently works with more than 300 employers and over 100,000 members.

Segment size preference (“target business size”): The Bloom solution is designed to serve and currently has employers on the platform that range from 51 to 25,000+ across all industries including municipalities, union, and government groups. They are currently evaluating future solutions for the 2-50 small group segment as well as potential expansion of their retiree solution (currently offered on MA products in Michigan only).

States of operation (if available):  Their existing health plan partners have coverage in the following states: California, Colorado, Connecticut, Georgia, Illinois, Indiana, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, South Dakota, Texas, Virginia, Wisconsin. However, they can service employees residing in all 50 states.

Are employers required to use a defined contribution: No, employers can use either a defined contribution or defined benefit approach.

Carriers Offered: Currently, for medical Bloom works mainly with six (6) health plan partners that offer both fully insured and self-funded funding arrangements across nearly 25 states ( Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Michigan, Blue Cross and Blue Shield of Minnesota, Health Care Service Corporation (HCSC), Horizon Blue Cross and Blue Shield of New Jersey and Medica Health Plans)

For specialty products, Bloom offers products owned or manufactured by the health plans listed above as well  pre-packaged products for middle market clients – carriers include Davis Vision, EyeMed Vision Care, Guardian Life, Voya and VSP Vision Care. They expect this list to grow in 2015. Flexibility in carriers and plan designs is offered for national account clients.

Decision Support: A hallmark of the Bloom Health marketplace is its industry-leading consumer experience and decision support. Bloom offers 1:1 employee support through online tools, as well as unlimited phone access to licensed Advisors, to better understand their benefits options and make well-informed, confident decisions for their unique personal and family needs.

How does exchange get compensated: The Bloom compensation structure is based off fixed PEPM as well as commissions.

  • Depending on the medical carrier selected, Bloom’s client PEPM fees range from $3.75-$7.00 (Note: in this carrier-branded exchange approach, the carrier collects the market-set fees from the employer and Bloom and the carrier have a separate contractual financial arrangement).
  • Commissions are generally received from Bloom’s specialty carriers based off of product selection. Those commission schedules vary by carrier contractual arrangement.

Ownership of Company: Anthem Blue Cross Blue Shield/Wellpoint, BCBS Michigan, and Health Care Service Corporation (HCSC)

Standard or Custom Product Configuration: The health plan’s platform is single-carrier for medical products, but will allow for other specialty carriers to be offered. Flexibility in carriers and plan designs is offered for national account clients.

Do they Utilize Other Technology Company Solutions:  Bloom subcontracts overflow call center support to NOVO1 Contact Centers and SugarCRM is utilized to track and record service center operations. Bloom also partners with Empyrean Benefit Solutions for some back-end administration capabilities. All other functionality was built and is supported solely by Bloom Health.

Limits of Liability Insurance for Data Breach & HIPPA Violations: TBD

Single IX or Multi-carrier: Bloom primarily operates a single-carrier model for medical products, but will allow for other specialty carriers to be offered. However, Bloom does have the capabilities to also support a multi-carrier model. If an employer desires a fully insured multi-carrier approach, Bloom would recommend a best-in-class geographic approach. Note it is ultimately up to the carrier(s) to agree to participate on the Bloom product shelf.