Healthy Incentives SM Program Details Joint Labor Management Insurance Committee negotiated benefits

Today’s objectives Review Healthy Incentives SM program framework and goals Describe out-of-pocket expense levels Explain how to earn lowest out-of-pocket expense level in 2007 Provide 2006 deadlines Answer questions

Healthy Incentives SM program goals Help us get healthy Encourage us to stay healthy Slow rising health care costs

Three out-of-pocket expense levels Gold: lowest, Silver: medium, Bronze: highest Determined by participation, not results Current health status not a factor Same covered services/treatments Applies to KingCare SM and Group Health

Out-of-pocket expenses Prescription co-pays remain the same KingCare SM –Annual deductible –Co-insurance Group Health –Office visit co-pays

Plan changes for 2007 Benefit access fee –$35.00 per month –To cover spouse/domestic partner Emergency room co-pay increase –$100 (waived if admitted) –To encourage appropriate ER use

GoldSilverBronze Annual deductible $100 individual $300 family $300 individual $900 family $500 individual $1500 family Co- insurance (in-network provider) 10% (King County pays 90%) 20% (King County pays 80%) 20% (King County pays 80%) gold Go for the gold! Three out-of-pocket expense levels: – KingCare SM

GoldSilverBronze Office visit co-pays $20$35$50 Inpatient hospital co-pay $200 per stay $400 per stay $600 per stay Three out-of-pocket expense levels: Group Health old Go for the gold!

KingCare SM example $1,000 medical bill Gold Total bill $1000 Annual deductible (individual) $100 Co-insurance (% of remaining bill for in-network providers) $90 (10% of remaining) You pay $190 Silver $1000 $300 $140 (20% of remaining) $440 Bronze $1000 $500 $100 (20% of remaining) $600

How Healthy Incentives SM works Complete annual wellness assessment by June 30 Silver level Complete annual wellness assessment by Jan 31 —PLUS— Complete your individual action plan by June 30 Gold level OR

Questions?

What is the wellness assessment? Private and confidential health survey Will ask health and lifestyle questions Will take minutes to complete Key to earning gold and silver out-of-pocket expense levels

How to take the wellness assessment Available Jan. 1 Letter from Benefits and Retirement Operations Section (BROS) provides instructions and your access code Take it online or call BROS to request a paper copy Useful info to have on hand includes: Blood pressure, cholesterol levels, weight, height, waist measurement, fasting blood glucose levels Call your provider for these numbers

Can I take the wellness assessment at work? Yes, employees can use county equipment Employees must take the wellness assessment on their own time, such as during lunch or breaks Be aware of privacy concerns

Wellness assessment process Take the wellness assessment Get your wellness assessment summary Keep printed copy with your important personal records Earns the silver out-of-pocket expense level

“I agree” to earn gold Harris HealthTrends, Inc. & HealthMedia ® administer wellness assessment Harris HealthTrends supports your individual action plan Provide consent for them to share information Checking “I agree” is required to earn gold

gold How to earn the gold out-of-pocket expense level You and your covered spouse/domestic partner : 1)Complete wellness assessment by Jan. 31 2)Keep a printed copy of your wellness assessment summary 3)Enroll in your individual action plan by Mar. 15 4)Participate in your individual action plan by June 30

Enroll in your individual action plan Harris HealthTrends will: –Contact employees by phone or letter –Explain individual action plan options –And enroll you in the plan you choose Official participation in your individual action plan does not begin until you are enrolled in the program

Individual action plan: Low risk Participation is required to earn gold out-of- pocket expense level Focus on maintaining and building healthy habits Active participation will require completion of a log (paper or online) for 8 weeks Return log to Harris HealthTrends

Individual action plan: Moderate and high risk Participation is required to earn gold out-of- pocket expense level Focus on reducing health risk factors, making healthy lifestyle choices, and preventing/ managing disease Accept at least 3 phone calls from a health coach over 90 days

Spouse/domestic partner participation reminder For both you and your covered spouse/domestic partner to be covered at the same level, you must participate at the same level If you earn gold, but your spouse/domestic partner does not participate = bronze Children do not participate

2006 deadlines Gold out-of-pocket expense level By Jan 18 – request paper copy of wellness assessment By Jan 31- Complete wellness assessment By March 15 - Begin individual action plan By June 30- Complete individual action plan

Summary Three out-of-pocket expense levels –Gold, silver, and bronze –Same covered services –Applies to KingCare SM and Group Health Out-of-pocket expenses: annual deductible, co-insurance, and co-pay Participation, not health status, earns lower out-of-pocket expense levels

Summary The wellness assessment is key to earning gold or silver out-of-pocket expense levels for 2007 Look for a letter from Benefits and Retirement Operations Section by Dec 31, 2005 with instructions for taking wellness assessment Complete wellness assessment by Jan 31, 2006 if you want to go for the gold out-of-pocket expense level

Summary Keep printed copy of your wellness assessment summary Enroll in individual action plan with Harris HealthTrends by March 15 Complete your individual action plan by June 30, 2006 to earn gold out-of-pocket expense level

Questions?