1. BlueCross BlueShield of Western New York
Daemen College
June 2013 Open Enrollment
Account Executive:
Denise Northrop

2. Daemen College
POS 206 (Plans 1 and 2)

3. Register Online at bcbswny.com

4. Find a Provider at bcbswny.com

5. Traditional Blue POS 206 - Current Plan Highlights
In-Network Deductible
N/A
$500 Single $1,000 Family
Primary Care Copay
$25
$25 after deductible
Specialist Copay
Emergency Room
$50
$50 after deductible
Urgent Care Center
$35
$35 after deductible
Ambulance
Inpatient Hospital –
maternity covered in full after deductible
$500/$1,000
$500/$1,000 after deductible
Outpatient Surgery
$75
$75 after deductible
Prescription Drugs
$10/$50/$100
Mail Order
2.5 Copays per 90 days
Dependent Coverage
To Age 26
Out Of Pocket Maximum

6. POS $250 Wellness Card

7. 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-of- pocket costs
Eligible for the program on an annual basis 7 7

8. Good Life Timeline Months 1-4 Months 1-4 Months 5-7
Step 1: Health screening
Step 2: Health Assessment
Step 3: Health coaching
Months 1-4
Months 1-4
Months 5-7
Complete health screening by March 21, 2011
Complete Blue Lifestyle Survey by March 31, 2011
Complete health or lifestyle management program by October 31, 2011

9. Step 1: Health screening
Complete a Health screening between June 1, September 30, 2013
Blood pressure, blood sugar, and cholesterol checks
Weight, waist, and height measurements
Worksite screening – Dates TBD
Physician Verification Form (look back 6 months 1/1/13)
Two options to complete this step:
Step 1: Health screening
Months 1-4
Find out your height, weight, waist measurement, blood pressure, blood sugar and cholesterol levels.
Worksite access will be performed free of charge, by an external vendor, in a private setting.
Results will be provided at the time of the screening & should be noted on Know Your Numbers card.
A schedule will be provided & reservations can be made after January 1st.
See iConnect for further details.
Screening done by 3/31
If you choose the personal physician out, the Physician Certification form is due by 3/21
After you do this, you move on to Step 2.
If, however, you do not complete Step 1, you will lose The Good Life advantages and your benefit level will change for the remainder of the year.

10. 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 minutes to complete
Your Health Assessment results are confidential
Step 2: Health Assessment
Months 1-4
Complete the Blue Lifestyle Survey by March 31, 2011
Even if you completed survey in 2010, you need to complete it again in 2011.
Get your screenings done first.
Take the and input your screening results
Confidential health and wellness assessment
If you do not complete Step 1 and Step 2, you will lose The Good Life advantages and your benefit level will change for the remainder of your plan year.

11. Step 3: Health coaching Months 5-7
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.
You will receive two to three calls during the four-month program.
Step 3: Health coaching
Months 5-7
Depending on your health screening, claims history and survey results, you MAY have to complete a lifestyle or health management program.
If it’s determined that you do not qualify for a lifestyle or health management program – you’re all set. You can enjoy the health benefits associated with the Good Life program.
For those that qualify for a lifestyle management or health management program, here is what they are …

12. Scenarios

13. Good Life Scenario 1: Employee completes all steps
Health screening
Phase
Date
Status
Plan impact
Enrolled in POS 206
(Plan 1) through May 31, 2014
Step 2:
Health Assessment
Step 3:
Health coaching
(if applicable)
October – December 2013
June – September 2013

14. Health coaching (if applicable)
Good Life Scenario 2: Employee completes step 1 but not 2
Phase
Date
Status
Plan impact
Enrolled in POS 206 (Plan 1)
Not applicable
Remain in POS 206
(Plan 2) with the additional
$500/$1000 deductible
Moved to POS 206 (Plan 2) with an additional $500/$1000 medical deductible as of October 1, 2013
Step 1:
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching (if applicable)
June – September 2013

15. Good Life Scenario 3: Employee completes steps 1 and 2, but not step 3
Phase
Date
Status
Plan impact
Enrolled in POS 206 (Plan 1)
Enrolled in POS 206 (Plan 1) through December 31, 2013
Moved to POS 206 (Plan 2) with additional $500/$1,000 deductible as of January 1, 2014
Step 1:
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching
June – September 2013
October – December 2013

16. Good Life Scenario 4: Employee completes steps 1, 2, and 3
Enrolled in POS 206 (Plan 1)
Enrolled in POS 206 (Plan 1) through May 31, 2014
Step 1:
Health screening
Step 2:
Health Assessment
Step 3:
Health coaching
June – September 2013
October – December 2013
Enrolled in POS 206(Plan 1) through May 31, 2014
Phase
Date
Status
Plan impact

17. Questions?