2016 Small Group Incentive Wellness For Metallic Plans Employer Q & A

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1 2016 Small Group Incentive Wellness For Metallic Plans Employer Q & A 2016 SGIWQA-CC General Program Information Q. What is the Small Group Incentive Wellness program? A. The Small Group Incentive Wellness program is included in 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 2016 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. Employee Reward Q. How do employees 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. Set up their account and complete their General Health Assessment (GHA) on regence.com. 2. Complete a biometric screening at an in-network provider s office, a Patient Service Center or by using a home test kit. 3. Obtain their gift card code in their Rewards Tracker on regence.com within 30 days of the end of the wellness program campaign. 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 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 and have completed the online General Health Assessment (GHA). Then employees need to obtain 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 get their gift card code in their Rewards Tracker on regence.com. Employer Premium Discount A. How will employers know if employees have participated in the program for them to receive a premium discount? A. We have developed internal reporting to identify which employees have qualified for the premium discount. Employers will not have access to individual employee information. The only reporting employers will receive is the aggregate premium discount credit found when applicable, on their monthly billing statement. Q. When will I begin to see the premium discount on my billing statement? A. The premium discount adjustment is applied in an aggregate credit for qualified employees on the applicable next month s billing for eligible employees retroactive to the beginning of the current plan year and continues throughout the plan year as long as the eligible employee remains enrolled. Q. Who do contact for questions regarding my monthly billing statement and premium discount credit? A. Your Membership Ambassador is prepared to answer questions you may have regarding your monthly billing and the premium discount credit for eligible employees. 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 Guide Template Member Flyer Poster Payroll stuffer The toolkit is available to employers on the Employer and Producer Wellness Programs pages on regence.com. Biometric Screening and GHA Q. How does the employee complete the GHA? 2

3 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 their Rewards Tracker. Biometric screening results cannot be uploaded until the GHA has been completed. Q. How does an employee complete a biometric screening? A. Employees can complete a biometric screening several ways including: 1. Obtaining a biometric screening at an in-network providers office by scheduling a preventive care exam and having their results faxed in using the Physician Results Form 2. Completing a biometric screening 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 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. If employees utilize an out-of-network provider, regular plan benefits will apply. Q. How do employees obtain the Physician Results Form? A. Prior to visiting a participating physician for a biometric screening employees must register at: and download the Physician Results Form by clicking on Register Now in the Not yet registered? field as shown below. 3

4 Then enter the Registration Key: Metallic2016 under the Registration Key field as shown below. Eligibility information is determined by the member name (not employer group name) and the program; Metallic Employees must register using the first name, last name and date of birth that was provided to the Plan at the time of enrollment to assist with verification. Their name (Johnathan vs. John) and member ID number (numbers only e.g ) must be entered exactly as it appears on their member ID card. Q. What do employees do if they get an error message when entering the Registration Key when registering for a Physician Results Form? A. If employees receive an error message when registering they should verify that they are using the Registration Key Metallic2016 and also verify that their first name, last name, date of birth and member ID number match what was provided at the time of enrollment. If the problem persists, employees can call the customer service number found on the back of their member ID card. Q. Where do Physicians fax the results when using the Physician Results fax form? 4

5 A. Physicians should fax preventive screening results to: Summit Health at using the Physician Results Form. Physicians or employees cannot fax biometric screening results directly to Regence. Q. How do employees confirm that their Physician Results form was received by Summit Health? A. First employees should confirm that their physician has submitted the Physician Referral Fax form to Summit Health. Once confirmed employees can login to to view and download their screening results. If participants still have questions regarding the status of their fax, they can call the Summit call center at ten business days after results have been faxed. Eligibility information is determined by the member name (not employer group name) and the program; Metallic Q. How do employees access a Patient Service Center? A. Employees can register for a screening at a participating Patient Service Centers by registering at and clicking on the Not yet registered? box as shown below. Employees must register in advance of going to a walk in center. To register employees need enter the Registration Key: Metallic2016 under the Registration Key field as shown below. 5

6 Eligibility information is determined by the member name (not employer group name) and the program; Metallic Employees must register using the first name, last name and date of birth that was provided to the Plan at the time of enrollment to assist with verification. Their name (Johnathan vs. John) and member ID number (enter numbers only e.g ) must be entered exactly as it appears on their member ID card. Q. How do employees request a home test kit? A. Employees can request a home test kit at: or by calling the Summit customer service team at They will need to enter their User access code: Metallic2016 in the field Get Started Here as shown below. Eligibility information is determined by the member name (not employer group name) and the program; Metallic Employees must register using the name that was provided to the Plan at the time of enrollment to assist with verification. Their name must be entered exactly as it appears on their member card (Johnathan vs. John). Home 6

7 test kits must be ordered by the end of the second month after plan enrollment. They must be returned and processed by the three-month deadline in order to qualify. If employees find that they need additional assistance they should contact customer service at the number located on the back of their member card. 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 Enrollment in this wellness program is restricted. Please contact your wellness administrator? when ordering a home test kit or scheduling at a Patient Service Center they should call the customer service number found on the back of their member 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 Physician Results 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 Results Form. Employees can view and download their screening result by logging in to Preventive care exams must take place during the wellness campaign period to be eligible. Exams taken prior to the group s current effective/renewal date will not apply. 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? 7

8 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 code once they complete their biometric screening and GHA? A. Employees will obtain their gift card code in their Rewards Tracker after completing the GHA in regence.com and once we receive their biometric screening results. Screening results will be provided by our vendor and uploaded to regence.com. Once these activities are confirmed, employees will receive an that their biometric screening results have been uploaded and the redeem gift card code indicator will be displayed on the member dashboard in their Rewards Tracker. The Redeem gift card code indicator only remains in Rewards Tracker for 30 days following the end of the wellness campaign. Employees can print the Rewards Tracker page showing their gift card code, the code to themselves or write down the code to use later. Once a gift card code has been redeemed members can view it later by navigating to the incentive summary page; from the Wellness Tools Dashboard > Reward > Rewards Summary > select the correct campaign then scroll to the bottom of the page and look under Claimed Gift Cards. 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. 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. 8