2015 Small Group Incentive Wellness For Metallic Plans Employer Q&A

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1 2015 Small Group Incentive Wellness For Metallic Plans Employer Q&A SGIWQA-WA General Program Information Q. What is the Small Group Incentive Wellness program? A. The Small Group Incentive Wellness program is being added to our metallic products for The program rewards employees with a $100 gift card for completing certain wellness activities and rewards employers with a 4% discount on their monthly premium for eligible employees who participate in the program. Q. What products is the Small Group Incentive Wellness program available on? A. Small Group Incentive Wellness is embedded in the 2015 Small Group metallic plans. Q. Which employees are eligible to participate in the Small Group Incentive Wellness Program? A. Active employees are eligible to participate if they complete the wellness activities within the first three months of the plan s effective/renewal date. Q. Are all enrolled dependents also eligible to participate in the Small Group Incentive Wellness program? A. No, the program applies to eligible enrolled employees and not their dependents. Dependents on these plans will be eligible for the standard $25 gift card incentive program available on regence.com. Q. How will employers know if employees have participated in the program for them to receive a premium discount? A. We are developing reporting to identify which employees have qualified for the premium discount. The discount will be applied in an aggregate credit reflected in the employer s monthly billing for eligible employees back to the plans effective/renewal date. Employers will not have access to individual employee information. Q. How does the employee earn the Incentive Wellness program reward? A. Eligible employees must complete their wellness activities within the first three months of the group s plan effective/renewal date. To qualify for the reward employees must: 1. Complete a biometric screening at an in-network provider s office, a Patient Service Center or by using a home test kit. 2. Complete their General Health Assessment (GHA) on regence.com 3. Obtain their reward redemption code on regence.com within the first three months of the group s effective date. Q. What do employees need to do to participate in the Small Group Incentive Wellness program? - 1 -

2 A. Employees need to make sure that they have registered on regence.com. Then they need to complete a biometric screening via a preventive care exam at an in-network provider s office, at a Patient Service Center or with a home test kit. Finally they need to complete the General Health Assessment (GHA) on regence.com and get their gift card code. Q. How are preventive care exams covered on metallic health plans? A. Preventive care exam health screenings from an in-network provider are covered at 100% not subject to deductible. Employees may refer to the Preventive Care Coverage brochure found on regence.com for more information about which services are covered under Preventive Care Coverage. They can learn more details about these services at healthcare.gov. Biometric Screening and GHA Q. How does the employee complete the GHA? A. After setting up their account on regence.com members can complete the online GHA from their member Dashboard by clicking on Wellness Tools and then clicking on General Health Assessment from Rewards Tracker. Q. How does an employee complete a biometric screening? A. Employees can complete a biometric screening several ways including: 1. Obtain a biometric screening at an in-network providers office by scheduling a preventive care exam 2. At a Patient Service Center 3. By using a home test kit Q. What is included in a biometric screening? A. Biometric screening simply includes performing the preventive care screenings to measure cholesterol, blood sugar, body mass index (BMI) and blood pressure (Systolic/Diastolic) levels. It can be done during your preventive care exam or annual exam. Q. What specific preventive screenings or measures does the provider need to perform? A. The provider will need to complete preventive screening for the following measurements: Height Weight Body mass index Blood pressure (systolic and diastolic) Total cholesterol (HDL, LDL, TC/HDL ratio, Triglycerides) Glucose fasting/non-fasting - 2 -

3 Q. How do employees access a Patient Service Center? A. Employees can register for a visit at participating Patient Service Centers by registering at They need enter the Registration Key: Metallic2015 under the New Participant field as shown below. Q. How do employees request a home test kit? A. Employees can request a home test kit at: They will need to enter their User access code: Metallic2015 in the field Get Started Here as shown below. Q. What do employees do if they get an error message when entering the Access Code for a home test kit or the Registration Key when registering for a Patient Service Center? A. If employees receive the error message your project is completed and is no longer active when ordering a home test kit or the error message, Thank you for participating in the home screening program. We are unable to accept your Access Code at this time as your program has ended. If you have any questions regarding this, please contact - 3 -

4 your Employer. We are sorry for any inconvenience caused. when scheduling at a Patient Service Center they should call the customer service number found on the back of their member ID card. Q. How do employees obtain doctor/physician biometric screening results? A. If the member has had a preventive care exam at in-network provider s office, they can request that the provider submit the results using our health screening form. If they have not had a preventive exam, they can schedule a preventive care exam with an innetwork provider and the provider will fax in the results using our Physician Referral Fax form. Q. Where do employees obtain the Physician Referral Fax form? A. The Physician Referral Fax form is available on regence.com. Q. Where do Physicians fax the results when using the Physician Referral Fax form? A. Physicians should fax preventive screening results to: Summit Health at using the Physician Referral Fax Form. Q. If employees use a Patient Service Center or home test kit for biometric screening, will Regence provide their screening results to their physician? A. No. We will not be providing biometric screening results to the employee s physician. However, if specific health risks are identified, we encourage employees to consult with their health care provider. Q. Will GHA and biometric screening results be communicated to employers? A. No. Biometric screening results will be uploaded to the employee s GHA on regence.com to give them information on their numbers and for gift card fulfillment. Employers will only receive aggregate participation results to determine eligible employees that qualify for the premium discount. Q. Will Regence be assigning case management and/or health coaching based on the GHA and biometric screening results? A. Case management is not integrated into the Small Group Incentive program at this time. However, as part of the completing the online GHA, employees will have the option to have a health coach reach out to them for coaching and support. The wellness portal will also generate a personal risk assessment and recommend online workshops relevant to the employees health status. Gift Cards Q. How do employees obtain a gift card once they complete their biometric screening and GHA? A. Members will receive their gift card code once we receive their biometric screening results and after completing the GHA in regence.com. Screening results will be provided by our vendor and uploaded to regence.com. Once these activities are confirmed, the - 4 -

5 gift card code is displayed on the member dashboard in Rewards Tracker. The gift card code only remains in Rewards Tracker through the end of the wellness campaign. Employees will need to print the Rewards Tracker page showing their gift card code or write down the code to use later to redeem their gift card. Employees should target completion of their online GHA and biometric screening in the first one to two months of their plan effective/renewal date to allow for processing of their lab results and the upload of biometric data to regence.com which could take up to 45 days. Q. What if employees are not able to complete their wellness activities and receive their gift card code within the three month time limit? A. If employees do not complete their wellness activities within the three month program time frame, they are not eligible to receive the gift card. If they complete their wellness activities and do not obtain their gift card code within the three month time frame, we will not be able to provide them with the code. Q. Are employee $100 gift cards subject to tax withholdings and reporting? A. As indicated on our program flyers disclaimers, the $100 gift cards may be subject to tax withholding and reporting. Reporting is the employee s responsibility. Q. Will Regence be sending a 1099 to employees for receiving their $100 gift card? A. No, 1099 reporting is not required on rewards below $600 per year. Employer Program Promotion Tools Q. What tools do you have to help employers promote the Small Group Incentive Wellness program in their work place? A. We have developed an Employer Toolkit for the Small Group Wellness Incentive Program. The toolkit includes: Employer Flyer Employer Brochure Template Member Flyer Poster Payroll stuffer The toolkit is available to employers on the Employer page on regence.com