Company medical plan to include new option and Healthy for Life premium rate in 2016

Transcription

1 Company medical plan to include new option and Healthy for Life premium rate in 2016 Dear employees: We are all aware that health care costs and wellness are major issues throughout the country. Companies affected by the Affordable Care Act (ACA) have been making a range of choices, including moving to a new approach where employees secure medical coverage exclusively through independent market exchanges. I am pleased to inform you, following a careful review of the issues, LG&E and KU plan to continue to offer affordable, highquality employer-provided health insurance benefits. However, to do so we must make adjustments over time to avoid the ACA s 40 percent excise tax, popularly known as the Cadillac tax, on the value of benefits over certain levels. We have developed changes in both our medical insurance and wellness offerings that, with your help, will allow us to avoid this tax while at the same time affording you the opportunity to save money on premiums. Throughout the year, HR will conduct educational sessions around these exciting changes, which are summarized below. New medical option for 2016 As you know, we currently offer an EPO and three PPO medical plan options. In 2016, we will keep the EPO and two of the three PPOs. The one to be eliminated PPO High Deductible is used by only 4 percent of employees. It will be replaced by a similar option known as a High Deductible Healthcare Plan (HDHP) that includes a key enhancement, a Health Savings Account (HSA). New 2016 Healthy for Life premium rate for participants in the LG&E and KU medical plan As a self-insured employer, our medical premiums are determined annually by our collective level of health care expenses. In 2016, the amount you pay for companysponsored medical coverage will be impacted by whether you qualify for the Healthy for Life premium rate; this rate requires completion of three actions. By Aug. 31, 2015, both employees and spouses enrolled in an LG&E and KU medical plan must complete all three of the following steps to qualify for the Healthy for Life premium rate. 1. Obtain and submit your biometric screening results from a 2015 company health fair, your primary care physician or through another convenient option (details inside) to a new Healthy for Life ( HFL ) portal; and 2. Complete an online Well-Being Assessment on the HFL portal; and 3. Indicate your tobacco status in the HFL portal and, if you are a tobacco user, complete the Quit for Life tobaccocessation program by Aug. 31, The details of these changes and wellness offerings are being explained in employee meetings and in this packet. If you haven t already done so, we encourage you to complete biometric screenings at a company health fair between February and June Like last year, employees who attend an on-site company health fair in 2015 will receive a $75 gift card as an extra incentive. In 2015, we hope to exceed our excellent 2014 rate of 80 percent participation in health fairs. I encourage you to read the enclosed information thoroughly so you can plan appropriately to take advantage of these enhanced wellness offerings. Sincerely, Paula Pottinger Senior Vice President, Human Resources

2 Required steps to qualify for new Healthy for Life premium in 2016 To qualify for the new Healthy for Life (HFL) premium rate in 2016, employees and their spouses (if on the company s medical plan) must complete these steps by Aug. 31, If individuals choose not to complete the steps below, they will pay a higher premium in 2016 through the base rate. Step 1: Obtain and submit your biometric screening results. Employees and spouses have various options to submit biometric screenings to the HFL portal, as shown in Table 1 below. Results must be submitted by Aug. 31. Step 2: Complete an online Well-Being Assessment. Employees and spouses should create individual accounts on the HFL portal to complete their online Well-Being Assessment. See page 5 for more details about creating an account. To qualify for the HFL rate in 2016, both employees and spouses (if on the company s medical plan) must complete the assessment by Aug. 31. Step 3: Indicate your tobacco status in the HFL portal and, if you are a tobacco user, complete the Quit for Life tobacco-cessation program. While on the HFL portal, users must indicate their tobacco status in the Tobacco Status Verification section. If you and your spouse (on the company medical plan) indicate you are not tobacco users, then no further action is required on your part. However, if you and/or your spouse indicate tobacco use, the tobacco user(s) must complete the Quit for Life program (four mandatory phone calls) by Aug. 31. Please note: 2015 marks the first year that the Quit for Life program must be completed before Open Enrollment. Tobacco users should begin the process early to ensure they have enough time to complete the program before Aug. 31. Completion typically takes approximately six weeks. Table 1. Options for Submitting Screening Results Employees Spouses Action LTD employees only Page 2 Free: Attend a 2015 company health fair, and employees can earn an instant $75 gift card. The results will be loaded automatically onto the HFL portal one month after the health fair. Health fair dates are available at lge-ku.com/2015healthfairschedule. Co-pay may apply: Complete a physical with your primary care physician and submit your annual screening results by: 1. Logging into the HFL portal. 2. Clicking the Complete a Health Screening tile under My Plan. 3. Downloading and printing the Physician Fax Form. 4. Taking the form to your annual screening visit with your primary care physician. 5. Asking the physician s office to return the form by following the instructions on the form. Employees can confirm the biometric screening results were submitted by visiting the portal 7 10 business days after the physician submits the form. Co-pay may apply: Women who visit their OB-GYN as part of their annual yearly physical (not for exams during pregnancy) can print out a Physician Fax Form on the portal (see instructions above), take it to their OB-GYN and have the doctor return it by following the instructions on the form. Individuals can confirm receipt of the faxed form by visiting the portal 7 10 business days after the physician submits the form. Free: Visit a LabCorp facility and submit your screening results by: 1. Logging into the HFL portal. 2. Clicking the Complete a Health Screening tile under My Plan. 3. Downloading and printing the LabCorp form. 4. Taking the form to a LabCorp facility. LabCorp will perform all of the tests on the form and submit the screening results. Individuals can confirm receipt of the information by visiting the portal 7 10 business days after the submission. Free: Self-testing and mail-in option allows spouses and employees on long-term disability to request a home test kit from the portal by: 1. Logging into the HFL portal. 2. Clicking the Complete a Health Screening tile under My Plan. 3. Selecting Click to order a Home Test Kit and following on-screen instructions. The kit enables individuals to provide a small blood sample for the lab and includes a self-addressed, postage-paid mailer to return the sample. The kit will be received 3 5 business days after submitting the request. The kit will include specific instructions on how to perform the test, and a nurse line is available for those who need additional help. Users will receive an letting them know when the results are available for viewing on the portal (typically within days after the kit is mailed back to the lab).

3 Healthy for Life premium rate FAQs Q1. Why is this new rate structure being offered? A. It is designed to encourage employees and spouses to take charge of their health and to reduce health care costs. Due to the Affordable Care Act, the company s health care costs will increase. With LG&E and KU s decision to maintain its self-insured status, rather than engaging in the public health care exchange market, the company has a long-term wellness strategy with three primary objectives: 1. Ensure our employees have access to high-quality health care. 2. Provide tools such as a new HFL portal, NurseLine, LiveHealth Online, health coaching, etc. to help the LG&E and KU work family stay healthy and prevent disease. 3. Monitor the needs of employees and spouses to ensure our wellness program meets a variety of needs including gym memberships, weight-loss and nutrition classes, access to screenings, education on health topics and more so those who want to get healthier have access to the resources they need. Our long-term strategy to address health care costs is to provide the appropriate tools and resources to help our employees be healthier. If individuals engage in their own health and wellness, they will pay a lower premium in Q2. How much financial difference will there be between the HFL medical premium and the base rate for the medical plan options? A. The HFL premium will be $1,200 ($100 per month) less than the base rate premium in Please note that since 2016 medical premium rates are undetermined at this time, it is unknown how 2016 medical premiums will compare to current monthly premiums. Our premiums are largely determined by our claims experience. Q3. Do the three steps have to be completed in the order listed on page 2? A. No. These activities can occur simultaneously. Want to complete your Well-Being Assessment before your health fair is scheduled? No problem. Want to get started on the Quit for Life program before completing your Well-Being Assessment? No problem in fact, we encourage it! Healthy for Life online portal login page. Q4. Why is my spouse being included? A. Spouses are an integral part of the LG&E and KU work family and those spouses enrolled in the company s medical plan account for a portion of our medical expenses. More importantly, the company wants its employees to live happy, healthy lives with their families. Q5. My spouse/i recently had biometric screenings completed by my primary care physician. Can I submit these results? A. Employees and/or spouses who had their biometric screenings completed by their primary care physician on Aug. 1, 2014, or later, may submit these results by Aug. 31, Employees/spouses will need to have their doctor complete the Physican Fax Form. The form (including instructions) is available on the HFL portal (lke.mywellmetrics.com). While the doctor must complete and sign the form, the doctor or employee/ spouse can fax the information to the HIPAA-secure fax line listed on the form. Q6. How does this HFL rate impact the tobacco-user premium? A. The steps required to avoid the tobacco-user premium will now be a part of the steps necessary to qualify for the HFL rate. On the HFL portal, users will see a Tobacco Status Verification tile. Employees and spouses (if on the company s medical plan) will be required to verify whether they are tobacco users. A tobacco user is defined as someone who has used any tobacco or smoking-related product (cigarette, cigar, pipe, chewing tobacco, snuf, snus, hookah or e-cigarette) within the last three months, regardless of frequency or location. If the employee or spouse indicates they use tobacco, each tobacco user will be required to complete the Quit for Life program as Page 3

4 Page 4 they have in previous years under the tobacco-user premium. This year, however, tobacco users will need to complete Quit for Life by Aug. 31, 2015 before Open Enrollment. Remember, failure to report tobacco use is a violation under LG&E and KU's Fraud Policy. Q7. How do I complete the Quit for Life program? A. To complete the program, tobacco users must participate in four phone calls. Call 1: Employees/spouses work with the tobaccocessation vendor to create a quitting plan based on various factors (forms of tobacco use, usage amount, etc.). Once the quitting plan is created and the participant is registered, he/she is transferred to a cessation coach to complete Call 1. Call 2 occurs on the participant s scheduled quit date. Call 3 occurs approximately one week later. Call 4 occurs two to three weeks after Call 3. During calls 2, 3 and 4, the cessation coach discusses issues such as: Challenges the participant is experiencing. Any triggers and possible alternatives to help replace those triggers. How to replace a negative view (on why he/she should quit) with a positive one. Tools to help create a new routine to replace habitual behavior. For example, if a participant would smoke a cigarette immediately after eating, the coach will provide suggestions on how to alter that habit. Nicotine replacement therapy, including patches, gum or prescription medications. Tobacco users must make the initial call to the Quit for Life program ( ) and are encouraged to begin immediately to complete the program in time. Representatives from Quit for Life are available from 8 a.m. to 9 p.m., seven days a week. After the initial call, a cessation coach will reach out to the employee/spouse. A coach will make three attempts per call to interact with a participant. After the third attempt, a letter will be mailed to the participant s home to encourage them to contact Quit for Life for a coaching call. Q8. What if I just completed Quit for Life during our recent Open Enrollment (between August and Dec. 1, 2014)? Do I have to enroll again? A. If you and/or your spouse successfully completed the Quit for Life program in 2014 and have remained tobacco-free, you do not need to complete the program again in However, if you and/or your spouse have used tobacco within the last three months, even after completing Quit for Life in 2014, the tobacco user(s) must complete the program again by Aug. 31, You are strongly encouraged to begin immediately to complete the program in time. Q9. My spouse and I are both on the company s medical plan. If I complete the three requirements and my spouse doesn t (or vice-versa), will I qualify for the HFL premium rate? A. No. If both you and your spouse are enrolled in the company s medical plan, both of you must complete each of the steps to qualify for the HFL rate in 2016.

5 Q10. My spouse has secondary coverage through LG&E and KU. Does he/she still have to meet the three requirements despite having only secondary coverage through the company? A. Yes, all spouses who are on the company s medical plan whether for primary or secondary coverage are required to complete the three steps. Healthy for Life Online Portal FAQs Q11. How will this apply to new hires or employees who have a change in status? A. New hires (and their spouses, if on the company s medical plan) will have 60 days to complete the online Well-Being Assessment and Tobacco Status Verification (and, if a tobacco user, complete the Quit for Life tobacco-cessation program). Due to the timeframe required to complete the Quit for Life program (approximately six weeks), new hires are advised to immediately start the process. New hires and spouses new to the medical plan will have 12 months to complete the biometric screenings. Managers are strongly encouraged to reinforce the HFL rate with their new employees, who will have learned of it during the onboarding process. For an employee who is impacted by a change in status (for example, if a spouse loses a job or medical coverage through his/her employer and wants to be added to the company s medical plan), their spouse will follow the same process as a new hire detailed above. The 60 days conforms to other required changein-status documentation (marriage certificate, birth certificate, etc.). If you have any questions about new hires or change in status, please contact the Benefits Department at benefits@lge-ku.com. Q12. How does this impact employees on long-term disability and survivors on the medical plan? A. Both employees on long-term disability (and their spouses, if on the company s medical plan) and survivors on the medical plan must take the same steps listed on page 2 as active employees. Q13. How does this impact retirees? A. Retirees are on a separate medical plan and are not eligible for the HFL rate. Q14. Does the HFL rate require action from any dependent children? A. No, to qualify for the rate, only the employee and spouse (if covered by LG&E and KU s medical plan) need to take action. Additional dependents such as children are not affected. Q15. What is the HFL portal? A. The HFL portal is an online tool which employees and spouses must use to complete their Well-Being Assessment and Tobacco Status Verification the second and third requirements to qualify for the HFL premium rate in The portal will provide personalized health recommendations based on an individual s responses to the site s online Well-Being Assessment. Individual biometric screening numbers will be available on the site. The site also will include wellness challenges and other opportunities for employees/spouses to earn wellness points. Silver Level status is reached when a user submits their biometric screenings, completes the online Well-Being Assessment and submits their Tobacco Status Verification form. Please remember, tobacco users must also complete the Quit for Life tobacco-cessation program by Aug. 31, 2015, to qualify for the HFL premium in If an employee/spouse reaches Gold Level status for their earned points by Dec. 31, they will receive an additional $100 incentive. See pages 7 8 for more details about incentives. Q16. How do employees access the site? A. On Feb. 11, employees received an from LG&E and KU Support (via support@adurolife.com) to their work address. The provided a link to the website along with a personalized activation code. Do not share this code with anyone. It is your individual access code for your personal information. After signing in for the first time, employees should change their password. Afterward, employees can sign in by visiting lke.mywellmetrics.com and entering their newly created user name and password. Future communications will come from Healthy for Life (via support@adurolife.com). Q17. What does the portal look like? A. A screenshot of the portal is shown on the next page. Each user will see tiles for the three required steps to earn the HFL premium rate in 2016; however, other suggested actions may vary based on an individual s response to their Well-Being Assessment, overall health goals, etc. Page 5

6 Healthy for Life online portal s tiles for wellness activities. Page 6 Q18. If I verify I m a tobacco user in the Tobacco Status Verification tile, where will I see the tile for the Quit for Life tobacco-cessation program (required to qualify for the HFL premium in 2016)? A. Everyone regardless of their response to the tobacco status verification will see the Quit for Life tile in the portal throughout the year. Tobacco users can confirm they have completed Quit for Life by logging into the portal, clicking My Points at the top of the screen and look for Quit for Life under Points History. Please note it may take several weeks for your completion to be uploaded to the portal. Q19. Do my spouse and I have to create two separate accounts on the portal? A. Yes. In order for your information to be specific to your health experience (including results from your Well-Being Assessment and personalized recommendations), each user should have a separate login account. In addition, to qualify for the HFL rate in 2016, both the employee and spouse (if on the company s medical plan) must complete the steps outlined on page 2 by Aug. 31, To create an account, spouses should visit the website lke.mywellmetrics.com and click the Get Started button. They will need to enter an address, their date of birth and their employed spouse s employee ID number (E + six digits) with an s at the end. For example, if the employee s ID number is E012345, the spouse will need to enter E012345s. Q20. My spouse is not on the company s medical plan. May he/she take advantage of the HFL portal and the company health fairs? A. All spouses regardless of whether they are on the company s medical plan may attend a health fair and earn incentives (see Table 2 on the next page). All spouses also can enroll in the HFL portal. Vendor ADURO will receive spouse information from the company via information obtained in PeopleSoft. If your spouse s information is not in PeopleSoft, you can update it by ing benefits@lge-ku.com.

7 Table 2. Wellness Incentives Healthy for Life online portal levels Actions to receive incentives Employee incentive Spouse incentive Silver Level (3,000 points) Gold Level (Silver Level completion + 2,000 extra points = 5,000 total points) $75 Visa gift card (only Step 1: Obtain and submit biometric screenings if participating in a company health fair) Step 2: Complete online Well-Being Assessment (via HFL portal) $50 Amazon e-gift card Step 3: Complete Tobacco Status Verification (via HFL portal) Complete other wellness actions (via HFL portal) for 2,000 extra points $100 Amazon e-gift card $100 Amazon e-gift card after completing steps 1 3. Spouses may obtain biometric screenings through one of five options listed on page 2. $100 Amazon e-gift card Q21. I m an employee, but I m not on the company s medical plan. Can I still create an online account and access the HFL portal? A. Employees who are not on the company s medical plan are encouraged to create an online account on the portal, complete the Well-Being Assessment and earn wellness points to receive incentives. Q22. Do my results from my biometric screenings and the online Well-Being Assessment remain private? A. LG&E and KU will not receive any clinical health information regarding specific participants. Our third-party wellness vendor ADURO is prohibited from disclosing any personal health information to anyone, including LG&E and KU. Q23. Do I have to wait until my Silver Level status is 100 percent complete before starting the Gold Level challenges to earn extra points? A. No. You can start completing challenges on the portal to earn extra points even while you re working on achieving Silver Level status. Please note, however, that you cannot officially qualify for Gold Level until Silver Level is completed. For example, you can talk to a wellness coach to earn points toward Gold Level at any time, but you cannot earn the Gold Level incentive until all items from the Silver Level are completed. Q24. I m having technical issues with the HFL portal. Whom should I contact? A. Technical support issues can be resolved by calling ADURO support at from 9 a.m. to 9 p.m. (Eastern time) or by ing support@adurolife.com. Q25. Whom should I contact if I have questions about the HFL medical premium or the portal? A. If you have questions related to the medical premium, non-technical questions about the portal, or any additional questions, wellness@lge-ku.com. Incentives FAQs Q26. What incentives are available? A. Employees and spouses regardless of medical plan participation will receive incentives for completing various wellness actions, some of which are already required to qualify for the HFL premium. The portal will be a key tool in helping you complete HFL premium requirements and earn additional incentives. Employees and spouses can attain two status levels on the site, based on activities completed: Silver Level status: Achieved when a user submits biometric screenings, and completes both the online Well-Being Assessment and Tobacco Status Verification. Each activity is worth 1,000 points on the portal. Completion of these three activities (in addition to completing Quit for Life, if you are a tobacco user) by Aug. 31, 2015, is required to qualify for the HFL premium in Completion of these activities by Dec. 31, 2015, will earn additional wellness incentives; however, you would not be eligible for the HFL premium if completed after Aug. 31. Gold Level status: Earned after a user achieves Silver Level status and completes additional wellness challenges worth 2,000 points on the portal by Dec. 31, Gold Level participants will earn an extra $100 Amazon e-gift card. Table 2 (above) outlines the wellness incentives available. Q27. I m an employee on the company s medical plan. What happens if I miss the Aug. 31 deadline for completing all three HFL premium requirements? A. You would not qualify for the 2016 HFL premium rate because you missed the deadline of Aug. 31, However, if you complete those actions by Dec. 31, 2015, you would still be able to earn the additional wellness incentives being offered for Silver and Gold level participants. Page 7

8 Q29. I m an employee and received biometric screenings but not at a company health fair. Will I receive the $75 gift card? A. No. Employees must attend an on-site company health fair to receive the $75 gift card. However, once the biometric results are submitted to the HFL portal, 1,000 points will be earned in the Silver Level. Obtaining and submitting your biometric results is the first step toward earning the additional incentives, which requires Silver Level completion (3,000 points). Q30. How/when will I receive the incentives? Q28. How do I earn the Gold Level incentive? A. Users must first earn 3,000 points by completing the three Silver Level requirements (see Table 2 on page 7) before officially progressing to the Gold Level. While individuals can simultaneously work on Silver and Gold level requirements on the HFL portal, you cannot earn the $100 Gold Level incentive until all three Silver Level requirements are complete. The Gold Level incentive is achieved when a user reaches a total of 5,000 points (3,000 of which must be earned on the Silver Level). The additional 2,000 points can be achieved by participating in coaching or challenges such as a vision exam, logging fitness activity, etc. Log in to your HFL portal to view all available challenges. A. Employees who attend a health fair will receive the $75 Visa gift card at the event, as they did in The additional incentives Amazon e-gift cards will be sent to the address listed on the portal account after the employee/spouse completes Silver Level status or Gold Level status. Q31. I m an employee, but I m not on the company s medical plan. Can I still earn incentives? Can my spouse? A. Yes. Employees who are not on the company s medical plan are encouraged to create an online account on the HFL portal, complete the Well-Being Assessment and participate in challenges to receive these incentives. All spouses regardless of whether they are on the company s medical plan are eligible to receive these incentives, too. Friend us on Facebook If you haven t already friended us on Facebook during a previous Open Enrollment, you and your spouse are encouraged to do so now. The company s private Facebook site Your Benefits. Your Way. will send messages directly to employees and dependents providing links, updates and reminders about company benefits and wellness offerings. It also allows employees and spouses to post questions and share feedback. To friend the page, log in to Facebook and visit (The acronym is short for Open Enrollment. Your Benefits. Your Way. ) Then click +1 Add Friend, as shown below. Page 8 Your friends request will be sent to the Open Enrollment Facebook administrator for confirmation, and you ll then be added to the site s friends list. Then, you ll begin receiving Facebook posts about other friends being added, as well as any posts about Healthy for Life or Open Enrollment. As a special incentive, friend us from now until April 30 and you will be entered in a random drawing to win one of nine $10 Subway gift cards.