Trinity Health Healthy Blue Solutions SM Plan Year. January 1 December 31. Benefit Plan Coverage Comparison Guide

Transcription

1 Trinity Health Healthy Blue Solutions SM 2013 Plan Year January 1 December 31 Benefit Plan Coverage Comparison Guide

2 Contents The Trinity Health Healthy Blue Solutions Program...2 How to take your BlueHealthConnection online health assessment...3 Frequently asked questions...4

3 1

4 The Trinity Health Program Healthy Blue Solutions Lower your out-of-pocket costs with the Trinity Health Healthy Blue Solutions program. Healthy Blue Solutions rewards your decision to actively adopt a healthier lifestyle by reducing your copayments and deductibles. It combines quality PPO health care benefits with effective wellness and care management features. Healthy Blue Solutions provides you with incentives, support and choices so you can reach your optimal level of health. How Trinity Health Healthy Blue Solutions Works There are two levels of Healthy Blue Solutions benefits, Enhanced and Standard. Enhanced benefits offer you lower copayments and deductibles than Standard benefits. If you and your covered spouse complete the BlueHealthConnection health assessment by January 31, 2013 and complete the first one of four possible coaching sessions with a BCBSM health coach by April 15, 2013, you will remain in the Enhanced benefit level. The Enhanced benefit plan has lower copayments and deductibles for covered health benefits. Your benefit level will be determined based on your participation. After you and your covered spouse complete the online health assessment, you will receive a letter indicating if you or your covered spouse are required to call a BCBSM health coach and schedule the first of four coaching sessions. If any of the deadline dates fall on a weekend or holiday, the deadline is automatically extended to the next business day. To continue receiving Enhanced benefits, you and your spouse need to: 1. Go online to bcbsm.com and complete a BlueHealthConnection health assessment by January 31, 2013 (see health assessment instructions on page 3) 2. Based on your health assessment results, speak with a BCBSM health coach by April 15, 2013 That s it. Just two simple steps are all you need to do to remain in the Enhanced benefit level. Note: An incomplete health assessment will result in all members covered on the contract moving to the Standard benefit level. Please complete all of the questions. The more detail you provide the more comprehensive your health action plan will be. What are the steps to qualify for Enhanced benefits? You and your covered spouse must complete the online health assessment by January 31, (Current BCBSM members who have taken the health assessment from July 1, 2012 to January 31, 2013 will meet the requirement). New BCBSM members will have from January 1, 2013 to January 31, 2013 to complete the health assessment to meet the requirement. Based on your health assessment results, you or your covered spouse must also complete the first of four possible wellness coaching sessions by April 15,

5 How to take your BlueHealthConnection health assessment Remember, to remain in the Enhanced benefit, you and your covered spouse need to go online to BlueHealthConnection, take a health assessment by January 31, 2013, and, if required, speak with a BCBSM health coach by April 15, Log in to Member Secured Services at bcbsm.com. In the BlueHealthConnection column, click on the Health and Wellness tab at the top of the page. Click on Health Assessment. Click Start Now. You can start the questionnaire. Information that will be helpful when you take the health assessment: Your blood pressure Your height, weight and waist circumference Your cholesterol levels (total and HDL) The approximate date of your last checkup When, approximately, you had your most recent vaccinations, such as for flu and tetanus When, approximately, you had your most recent screenings for various Members are encouraged to take the online health assessment as early as possible during the month of January recommendations to you more focused. cancers and other conditions If you include this information when you fill out the questionnaire, your results will be more accurate and Think about your lifestyle too. For example, how often do you do the following things? Drink alcohol Smoke cigarettes, cigars or a pipe Exercise, or perform tasks like yard work or washing the car by hand Eat fruits and vegetables Drive faster than the speed limit Feel tense or depressed Make plans to improve your health Work with a BCBSM health coach After you complete your health assessment, BCBSM will review your assessment results, along with any claims history, to determine if you will benefit from working with a health coach. If you are identified as being at-risk, BCBSM will send you a letter asking you to call a BCBSM health coach. Your health coach will help you work toward managing your risks or chronic conditions to lead a healthier lifestyle. Staying healthy is easy with BCBSM wellness programs We offer a number of programs and services to help you achieve your optimal wellness: A health assessment that provides a comprehensive picture of your current health status and risks. It shows what health areas need attention and provides recommendations for minimizing health risks. A health coach who will work with you if you have certain health risks or chronic conditions. BlueHealthConnection, which offers you an array of Web-based resources, including tools you can use to manage and understand your health, and a 24/7 nurse phone line. Healthcare Advisor TM, an online decision-making support resource that provides information to help you manage your health and make better health care decisions. Blue365, which offers you discounts on fitness centers, vitamins, alternative medicine options, nutrition counseling, health and wellness magazine subscriptions and more. You can find out more about these programs and services by visiting bcbsm.com. If you take the health assessment before January 1, 2013, you won t be able to take it again for six months. It will count toward your health assessment requirement. Call a BCBSM health coach at BLUE (2583) if you have questions. 3

6 Frequently asked questions What is a health assessment and why should I fill one out? The health assessment is no ordinary questionnaire. After answering approximately 50 questions you will get a health assessment profile, including your wellness score and analysis of your health. It takes only about 20 minutes to complete, but afterward you can spend as much time as you like reviewing your results. Your answers generate a report that identifies your potential health risks for conditions such as heart disease or diabetes. The report then tells you what you can do to improve your health. When must my health assessment be completed? You must complete a health assessment online by January 31, I don t have access to a computer at work or at home. How can I take my health assessment? Your employer may be able to provide you access to a computer to take your health assessment. Also, most public libraries have computers with Internet access available. What if I don t have time to take my health assessment within the required timeframe? Can I get an extension? No. You must complete your health assessment by January 31, 2013, in order to qualify for the Enhanced benefit plan. It takes about 20 minutes to complete the health assessment online and does not have to be completed in one sitting. If you re unable to finish the questionnaire in one sitting, do not click the SUBMIT button. You can visit the site later and finish the questionnaire. Does my spouse need to take the health assessment? What about my children? Yes, your covered spouse is required to take the health assessment. Your children do not have to take the it. I took my health assessment. Now what? Your health assessment, along with any claims history, will be analyzed to determine if you have health risks or a chronic condition. If you are at risk, BCBSM will mail you a letter asking you to make an appointment with a BCBSM health coach. You will need to speak with a health coach by April 15, 2013 to remain in the Enhanced benefit level. The toll-free number is BLUE (2583). 4 How can I make sure I keep the Enhanced benefit level after the first 120 days? It s easy just participate. You and your covered spouse need to take the health assessment by January 31, 2013, and, based on your health assessment results, speak with a BCBSM health coach by April 15, If a member is required to speak with a health coach, the member must schedule and complete the health coach call prior to April 15, If my spouse or I am a smoker, will we automatically have higher copayments and deductibles? No. As long as you and your spouse complete the health assessment by January 31, 2013, and speak with a BCBSM health coach by April 15, 2013, you will remain in the Enhanced benefit level. If my spouse or I have a chronic condition such as diabetes or asthma, will we automatically have higher copayments and deductibles? No. You automatically are enrolled in the Enhanced benefit level. What happens if I (or my covered spouse) do not take the health assessment? The health assessment is required. If you or your covered spouse don t take it by January 31, 2013, and speak with a BCBSM health coach, if needed, by April 15, 2013, you will be moved to the Standard benefit level, effective May 1, 2013, and will have a higher deductible and copayments. Please note that speaking with a BCBSM health coach is only required if it is determined that you have a health risk. I have no or low risk factors. What resources are available to me? Congratulations for maintaining a healthy lifestyle. You can take advantage of the Blues wellness resources to help you stay healthy, including online tools and a 24/7 nurse phone line. Our goal is to help you continue to lead a healthy lifestyle and minimize your risk of developing health problems in the future. What s the difference between the Enhanced and Standard versions of my PPO plan? The copay and deductible for the Enhanced plan are lower than for the Standard plan. Who can I contact if I have other questions? For general questions, please call Customer Service at If you have questions accessing the health assessment, call a BCBSM health coach at BLUE (2583).

7 5

8 bcbsm.com R008268