Transcript BlueCross BlueShield of Western New York

BlueCross BlueShield
of Western New York
Daemen College
June 2013 Open Enrollment
Account Executive:
Denise Northrop
The Good Life℠
Daemen
College University
St.
Bonaventure
POS 250D
206 (Plans
(Plans1 1and
and2)2)
Register Online at bcbswny.com
3
Find a Provider at bcbswny.com
4
Traditional Blue POS 206 - Current Plan Highlights
Plan
Plan 1
Plan 2
In-Network Deductible
N/A
$500 Single
$1,000 Family
Primary Care Copay
$25
$25 after deductible
Specialist Copay
$25
$25 after deductible
Emergency Room
$50
$50 after deductible
Urgent Care Center
$35
$35 after deductible
Ambulance
$50
$50 after deductible
$500/$1,000
$500/$1,000 after
deductible
Outpatient Surgery
$75
$75 after deductible
Prescription Drugs
$10/$50/$100
$10/$50/$100
2.5 Copays per 90 days
2.5 Copays per 90 days
To Age 26
To Age 26
N/A
N/A
Inpatient Hospital –
maternity covered in full after
deductible
Mail Order
Dependent Coverage
Out Of Pocket Maximum
5
POS 206 - $250 Wellness Card
6
Benefit Differential Program Basics
• Employee-specific; your personal health information is
kept private
• Your Employer will not know if you completed the steps
of Good Life – BlueCross handles this behind the scenes
• Participation-based, not outcome-based
• Participation is optional, but your out-of-pocket
expenses will change if you choose
not to participate
• At the start of the program, you are automatically
enrolled in POS 206 (Plan 1), which has lower out-ofpocket costs
• Eligible for the program on an annual basis
7
Good Life Timeline
8
Step 1:
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching
Months 1-4
Months 1-4
Months 5-7
Step 1:
Health screening
Complete a Health screening
between June 1, 2013 September 30, 2013
• Blood pressure, blood sugar, and
cholesterol checks
• Weight, waist, and height
measurements
Months 1-4
Two options to complete this step:
• Worksite screening – Dates TBD
• Physician Verification Form (look
back 6 months 1/1/13)
9
Step 2:
Health Assessment
Complete the Health Assessment
by September 30, 2013
• Complete your health screening
first, need numbers for Health
assessment
• Health survey that will take 15-20
minutes to complete
Months 1-4
10
• Your Health Assessment results
are confidential
Step 3:
Health coaching
Complete the Health Coaching
between October 1 – December 31, 2013
• Health coaching phone calls to help
you reduce lifestyle-related risks such
as obesity, smoking, high cholesterol,
and hypertension.
Months 5-7
11
• You will receive two to three calls
during the four-month program.
Scenarios
Good Life Scenario 1:
Employee completes all steps
Phase
Step 1:
Health screening
Step 2:
Health Assessment
Date
13
Plan impact
June – September 2013
June – September 2013
Step 3:
Health coaching
(if applicable)
Status
October – December 2013
Enrolled in POS 206
(Plan 1) through
May 31, 2014
Good Life Scenario 2:
Employee completes step 1 but not 2
Phase
Date
Step 1:
June –
September
2013
Enrolled in
POS 206 (Plan 1)
June –
September
2013
Moved to POS 206
(Plan 2) with an
additional $500/$1000
medical deductible as of
October 1, 2013
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching (if
applicable)
14
Not applicable
Status
Plan impact
Remain in POS 206
Not applicable (Plan 2) with the additional
$500/$1000 deductible
Good Life Scenario 3:
Employee completes steps 1 and 2, but not step 3
Phase
Date
Step 1:
June –
September
2013
Enrolled in
POS 206 (Plan 1)
June –
September
2013
Enrolled in POS 206
(Plan 1) through
December 31, 2013
October –
December
2013
Moved to POS 206
(Plan 2) with additional
$500/$1,000 deductible as
of January 1, 2014
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching
15
Status
Plan impact
Good Life Scenario 4:
Employee completes steps 1, 2, and 3
Phase
Step 1:
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching
16
Date
Status
Plan impact
June –
September
2013
Enrolled in
POS 206 (Plan 1)
June –
September
2013
Enrolled in
POS 206 (Plan 1)
through May 31, 2014
October –
December
2013
Enrolled in
POS 206(Plan 1)
through May 31, 2014
Questions?