Hispanic and Millennials have enrolled in the ACA Exchange at half the rate of all Non-Hispanics. That means substantial opportunity exists behind some cultural and generational barriers. As these newly insured take a journey through your brand’s experience and touchpoints, they will be reassessing their original brand perceptions, forming and sharing new brand opinions with circles of influence that include exchange eligibles for the open enrollment six months ahead.

1. ACA 2.0: New Eligibles,
New Opportunity,
New Demands
Critical Steps to seize & retain the untapped
Hispanic & Millennial ACA Exchange Potential
1. 2014 Opportunity, progress & gaps
2. Main barriers to adoption critical to
address
3. An efficient targeting technique to
advance conventional age/language
engagement approaches
4. New customer experience demands
for insurers and hospitals
5. Immediate & Long-Term Tips to
maximize growth and retain share

2. About Santiago Solutions Group
SSG is a growth consulting leader driven by
management P&L experience, Big Data and
predictive analytics.
•
We develop fact-based business models,
insights, customer experiences and roadmaps
that profitably segment distinct customer groups
and drive revenue.
•
We help clients focus their resources where the
highest ROI opportunities exist and customize
strategies advancing efficient Total Market
growth.
© 2012 Santiago Solutions Group Inc.
 2014 Santiago Solutions Group Inc.
•
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3. About the Presenters
Carlos Santiago has been guiding strategic
growth rooted on predictive analytics for leading
marketers in health & wellness for 13 years. Prior
to SSG, Carlos headed segment marketing
business units in telecom.
Derene Allen specializes in insights & analytics
Bessie Ramírez brings healthcare brand
management and product development best
practices for the development of strategic plans and
implementation roadmaps.
 2014 Santiago Solutions Group Inc.
identifying actionable levers with the highest
potential impact for customer experience and brand
advocacy.
3

4. Realistic Opportunity Assessment
 2014 Santiago Solutions Group Inc.
The opportunity gap for 2014.
4

5. Currently, 1 in 4 Uninsured Hispanics & Millennials
have price expectations aligned with actual
Exchange plans options; it’s a good start!
Readiest
Potential
Uninsured eligibles
Millennials and Hispanics are
willing to pay above $100*
monthly premium to avoid
1% penalty vs. 42% of NH
*Univision Study on ACA participation, Spring 2013.
Q22: If you had to pay a monthly penalty of $[1% of income/12] for not buying health insurance, how much would you be willing to pay
each month to have the health insurance coverage for you and your family to avoid paying the penalty? Margin of Error of +/- 4%
 2014 Santiago Solutions Group Inc.
1 in 4
5

6. Of CA’s 1.6M potential (among willing to pay >$100),
Hispanics represent 33% & Millennials 43%
Huge Potential willing to pay still to be realized:
44-50% of the ready opportunity comes from Hisp & Mill
Hispanic & Millennials pace of enrollment is 1/2 of NH pace
Uninsured >$100*
+ IFP (000)
NH IFP
650K
42%
Hisp IFP
278K
18%
HUnIns>$
100
240K
NHUnIns
15%
>$100
395K
25%
CA Enrollment Progress &
Upside Potential**
Opp’y Ahead = 696K
= 434K
= 563K
67%
a/o 12/31
84%
33%
Attained
83%
17%
16%
= 349K
= 84K
NH
= 106K
Hispanic Millennial
Proj Oppty = 1,563K
*“Individuals Enrolled in October, November and December, with Subsidy Status, Across Ethnicity” www.coveredca.com, calibrated to
current proportions 19.7% Hispanic and 80.3% NH.
*Univision Study on ACA participation, Spring 2013, n=520
Eligible uninsured + IFP 18-64 FPL 139-400 (IFP=Individual & Family Plans)
SSG Opportunity Sizing: Scarborough 2013 Double Base USA + n=281,221
 2014 Santiago Solutions Group Inc.
CA Exch Subsidy Eligibles
FPL 139-400 Documented:
6

7. Of Texas ~1M in potential, 36% are Hispanic and
42% are Millennial; of C/So FL’s ~800K ‘ready’
potential, 20% are Hispanic & 35% are Millennial
Eligible FPL Documented 139-400
UnIns>$100K + IFP*1 (000)
Central-So2
Share of Exchange
Eligibles In 3
Sample States
TX
FL
H
NH
UnIns>$
100
356K
36%
NH
UnIns>$1
00
278K
28%
Projected
Oppty=985K
Hisp IFP
99K
13%
H
UnIns>$
100
121K
12%
NH IFP
355K
46%
NH
UnIns>$100
266K
34%
UnIns>$100
57K
7%
41%
Mill
31%
Hisp
Projected
Oppty=777K
SSG Analyses of Scarborough 2013 Double Base USA+
*Univision Study on ACA participation, Spring 2013, n=520
1UnIns>$100 refers to people that are willing to pay more than $100/month; IFP = Individual & Family Plans
2Central-So = Central and South Florida only (excludes Tallahassee DMA)
 2014 Santiago Solutions Group Inc.
Hisp
IFP
230K
24%
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8. Opportunity for savvy Hospitals that master Patient
Experience and apply to grab competitors’ share
H-CAHPS standardizes customers
perspectives of care experience1
culminating in Advocacy
Patients Who Would Definitely
Recommend the Hospital to
Friends & Family
92%
SFSH
SD Avg.
79%
71%
National
Avg.
1Includes:
•
•
•
•
Trust In System
New Currency
Increased Freedom of Choice
Cultural Competence To
Forefront As Potential
Differentiator
78%
Rewards Hospitals with
Local
Local
Alternative1 Alternative2
• Loyalty
• Higher ROI
 2014 Santiago Solutions Group Inc.
78%
Brings Consumers
Communication - Responsiveness – Cleanliness - Customer Advocacy
8

9. Mindset, Cultural Barriers Standing
Between Eligibles and Adoption
 2014 Santiago Solutions Group Inc.
The main barriers to adoption and
which ones to address
9

10. Complex
System
New Concepts
& Subsidies
Subsidies
Metal Program
Plan Names
Multiple Brands
Multiple stakeholders
Complex Enrollment
Fragmented
process
 2014 Santiago Solutions Group Inc.
Federal, state,
County
government.
10

11. Cultural/
Generational
Nuances
Customer
Experience
Relevant
Comm.
Perceived
Value
 2014 Santiago Solutions Group Inc.
Hispanics & Millennials
face Additional,
Interdependent
Barriers to Adoption
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12. Hispanic’s Distinct Cultural Nuances
I feel healthier
than ever
I have a degree but work
2 part-time service jobs
I watch Drop Dead Diva
after my “novela”
Not many
doctors
understand me!
I love the web, but
prefer transactions in
person
I’m
slow to
trust…
I’m on my
smartphone
24hrs/day
I didn’t have
health insurance
growing up
Cash is
king!
 2014 Santiago Solutions Group Inc.
I’m a 27 year old proud Latina Mom…
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13. Millennials:
Digital & On-the-go
Among the uninsured eligible for subsidies,
Millennials are more likely than Total to:
 Often under-employed, living
with parents
 Afraid costs will increase1
 Be hyper-connected, hyperinformed, hyper-influenced by
SM/video clips
 Engage in physical activities,
often for socializing2
Sources:
1. Harvard Public Opinion Poll, Dec 2013
2. 2. SSG analyses of 2013 Doublebase GfK-MRI 2013 , N= 50,764
 2014 Santiago Solutions Group Inc.
 Believe “I am my own doctor” and
only go to doctor when ill2
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14. Relevant Communications are Key in the
Exchange
The ACA has overlooked
main cultural
communication challenges
and in-lingual needs of
Hispanics.
Lackluster in-culture &
in-language offering,
devoid of consumer
insights
Suboptimal
use of
marketing
tools
Sources: 1 MRI 2013. 2 The US Department of Health & Human Services. 3
 2014 Santiago Solutions Group Inc.
Limited in-cultural
communication
channels
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15. Millennials & Hispanics are Facing Value
Choices
San Antonio, fa. of two,~$36K/yr
 Basic plans from $1–4K/yr with
fa. deductibles from $4.5–13K/yr
 Healthcare expenses last year
~$1,200
 Penalty of $360 is better for us!
Los Perez… an Upscale, FPL 250-400
and fully Bicultural/Bilingual
Los Angeles, fa. of 5, ~$65K/yr
 Basic plans from $4–6K/yr with
fa. deductibles from $3–10K/yr
 Healthcare expenses last year
~$4,000
 We’ll deal with the Penalty of $650
 2014 Santiago Solutions Group Inc.
The Moya-Baum’s, a typical eligible
Millennial couple in their early 30’s
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16. Value & Effective Prospecting
 2014 Santiago Solutions Group Inc.
An efficient targeting technique to advance conventional
age/language engagement approaches
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17. The stated 2014 stated potential will expand
3x
Opportunity
as insurers effectively recalibrate messages, reinforce offering for the
untapped potential, grab competitive share, and create loyalty with base
It’s a
marathon,
not a sprint!
3 Key Factors Will Play A Role In Expanding The Initial Pool Of Enrollees
• Value Perception will improve with prospects
• Tax Penalties will decrease consumers value threshold
• Competitive Pressures
•
Cost-savvy competitors will drive down prices
• Effective offering, messaging, targeting, and delivery will lead to
share shifts
 2014 Santiago Solutions Group Inc.
Time
17

18. The Challenge:
How to acquire & retain new
entrants in a smarter way?
 2014 Santiago Solutions Group Inc.
Is there a better mousetrap
that leads to increased ROI?
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19. Targeting Healthy Lifestyle individuals can yield
base that increases competitive edge
Directly resonating and connecting with Healthy Lifestyle individuals enhances
marketing effectiveness over Generational approaches yielding a pool that is
8-20% less likely* to have PCDs relative to age
Index of Preventable Chronic Diseases (PCD)
Among Healthy & Unhealthy Lifestyles by Generational Segment
Healthy Lifestyle
108
100 =
Millennial
Avg
Individual Healthy Scores
104
103
95
8%
100 =
GenX
Avg
19%
100 =
Boomer
Avg
94
10%
87
Millennial
Gen X*
Boomer*
 2014 Santiago Solutions Group Inc.
Health Unaware
* Statistical
2 SSG
significant at 95% confident level
Wellness Segmentation™ (powered by GfK MRI) GfK MRI 2013 Double Base , N= 49,970
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20. Building Customer Intimacy with the
Newly Insured
 2014 Santiago Solutions Group Inc.
2013 Santiago Solutions Group Inc.
New customer experience demands for insurers
and hospitals
20

21. At each Touch-point of Adoption & Engagement,
any “stumbling block” can be disruptive & “scary”
Opinion
Consideration
Validation
ACA/
Covered CA
Complexity
Preference
Validation
Search for
Information
Distrust
Communication Tools
Purchase
(Advocates)
Validation
Application &
Eligibility
Determination
Perceived Value
Enrollment
Cultural Nuances
Brand Promises
 2014 Santiago Solutions Group Inc.
Awareness/
Interest
21

22. WHAT do I need to do to ensure a more
positive customer experience?
Increased Customer Intimacy ensures healthier business growth
 2014 Santiago Solutions Group Inc.
KNOW THY CUSTOMER
22

23. Focus on 2 key fundamentals to ease journey of
Hispanic & Millennial eligibles and new enrollees
• Reduce customer effort
& channel switching by
ensuring all links work
and explanations are
short & to the point
• Understand key drivers
of ongoing
satisfaction/monitor
always
SIMPLE
CLEAR
COMMUNICATIONS
SMOOTH
JOURNEY
 2014 Santiago Solutions Group Inc.
• Simple & clear
communications in the
language of preference
• Relate terms, look &
content to something
more familiar (ie. car
insurance)
• Create empathy
23

24. Strategic Implications
 2014 Santiago Solutions Group Inc.
2014 Santiago Solutions Group Inc.
Tips to focus on right now to
maximize growth and retain share
24

25. Overarching sustainable growth strategies to win
the ‘Exchange marathon’ as opportunities intensify
Experience & Advocacy
Accelerate Customer
Centric Transformation
Ease ACA + your own gaps, by
delighting and creating Hispanic
& Millennial brand advocates
Shift From Thinking Of Patient
Pools to Customers while
applying Best Practices
 2014 Santiago Solutions Group Inc.
Integrate Strategies
Fully understand Total Market
similarities & nuances and
address them from the outset
across functional areas
25

26. 5 Tips/2 Foundations to improve efficacy of
Hispanic & Millennial efforts ‘Here & Now’
Simplicity
Revisit network design
to ensure culturally
competent access
Secure in-culture and
in-language medical
and support staff
Enable face-to-face,
where Hisp & Mill are
Relevance
Create identity
reflecting community
Bolster pertinent
disease maintenance &
prevention programs
Bring mobile solutions
Leverage personal
circles of influence-SM
In-person and mobile
Go way beyond
H-CAHPS
 2014 Santiago Solutions Group Inc.
Create relevant &
relatable identity
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27.  2014 Santiago Solutions Group Inc.
TIME FOR
YOUR
QUESTIONS
27

28. Subscribe to the SSG
monthly Newsletter
Thank You
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@Santiago_Group
@Carlos_SSG
Follow Santiago Solutions Group
+1 818.736.5661
We’d like to extend special thanks
to Univision for sharing their study
on ACA participation, conducted
during Spring 2013.
 2014 Santiago Solutions Group Inc.
www.SantiagoSolutionsGroup.com
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