P.R.E.P. Prevention Reward Employee Program

Transcription

1 P.R.E.P. Prevention Reward Employee Program Plan Document

2 ii Table of Contents Table of Contents 1 Welcome to P.R.E.P. 1 Introduction & Overview 1 Eligibility 1 Requirements 1 2 Completing your P.R.E.P. Options 2 Wellness Visit 2-3 Health Assessment 3 Additional P.R.E.P. Options 4-5 Rewards 6 3 Program Alternatives 7 4 Additional Resources 8-15 Glossary & Contact Information 8 HA Alternate Request Form 9 DPCA Verification Form 10 Preventive Communication 11 How do I get my EOB? 12 Rally Informational Flyer 13-15

3 1 P. R. E. P. Be REWARDED for taking steps to Get Health and Stay Healthy. Program Plan Period April 1, 2015 through March 31, 2016 INTRODUCTION P.R.E.P. (Prevention Reward Employee Program) is a Voluntary program administered by Valley Schools Employee Benefit Trust for SUSD Health Plan members and focuses on key practices of good health. Participation is easy, requires no special registration, and it encourages you to take important preventative steps to get health and stay healthy. Scottsdale Unified School District believes in proactively focusing on the wellness needs of its employees. The District is committed to supporting optimum health and wellness for staff. P.R.E.P. (Prevention Reward Employee Program) promotes disease prevention, health improvement and maintenance of good health. Members are encouraged to read this P.R.E.P. guide to gain an understanding of the program specifics, requirements and available options. More program details are contained on the following pages. There are THREE Primary Components, or Requirements to the P.R.E.P. program. To receive rewards, you must provide specific documentation to the Valley Schools P.R.E.P. Coordinator upon completion of certain requirements. Only ONE activity per component is permitted. ELIGIBILITY REQUIREMENTS For Program Participation Employees must be enrolled on one of the SUSD Health Insurance Plans to be eligible and participate in P.R.E.P. If employment or benefits are terminated prior to the end of the P.R.E.P. plan period, rewards are forfeited. For the Type of Reward Your Health Insurance Plan determines which reward you are eligible to receive. The two rewards are as follows: UHC HDHP UP TO $150 HSA Contribution UHC Core / PPO $50 Whole Foods Gift Card PRIMARY P.R.E.P. REQUIREMENTS 1. Annual Wellness Exam 2. RALLY Health Survey 3. Additional Options See pages 4-5 for detailed instructions on completing your selected option Flu Vaccination Preventive Cancer Screening as recommended based upon age & gender (Mammography, Colonoscopy, Prostate Screening, Skin Cancer Screening). For more information about preventive care, visit Please see page 8 for P.R.E.P. coordinator contact information. Complete a Smoking Cessation Program (State, county, or district sponsored) Enroll in DPCA Program if applicable (Diabetes Prevention & Control Alliance)

4 Completing Your P.R.E.P. Items P. R. E. P. 2 #1 Annual Wellness Visit (Documentation necessary from employee. To facilitate physician communication on preventive care, you may wish to print a copy of the physician letter on page 10 to accompany you on your wellness visit). It is important to establish a relationship with your primary care physician. Seeing your primary care doctor at least once a year for your annual Wellness Visit is essential in providing you and your doctor an overall snapshot of your current state of health. For SUSD benefited employees, your annual wellness visit in most situations is at no cost to the member (see page 11 for more details) and typically only takes about ten to fifteen minutes to complete. What can you expect at your visit?1 Patient History: Your doctor will ask you some questions to determine how you are currently feeling and if you have any con-cerns. Typically he or she will also ask you questions that relate to your habits (diet, exercise, smoking etc.) as well as your vaccination status. Vital Signs: Your doctor will check your blood pressure, heart rate, respiration & temperature. Heart & Lung Exam: Your doctor will listen to your heart and lungs. Physical Examination: This would include checking your throat, mouth, tonsils, nose, sinuses, eyes, lymph nodes and thyroid Neurological Exam: This includes testing your nerves, strength, balance and reflexes. Dermatological Exam: Some doctors will check the condition of your skin and nails. Men: Depending on your age, most doctors will check for hernia, testicular cancer and prostate health during your annual exam. Women: If you do not see your OBGYN for your annual cervical and breast exam, your primary care doctor can perform these exams at the time of your annual physical. Lab Tests: Doctors will sometimes order a metabolic blood panel to include glucose (blood sugar) levels, cholesterol and lipids, etc. as well as a urinalysis....continued on page 3 P.R.E.P. Be REWARDED for taking steps to Get Health and Stay Healthy. Program Plan Period April 1, 2015 through March 31, 2016

5 3 P. R. E. P. #1 Annual Wellness Visit continued... (Documentation necessary from employee) The primary purpose of obtaining your annual wellness exam is to discover potential risk factors or conditions that require attention, management and/or treatment. If caught early, many diseases or conditions can be successfully treated, controlled or eliminated by following your doctors recommendations. Remember, with Health Care Reform preventative care changes, your annual wellness visit is at no cost to the member. To complete your P.R.E.P. Wellness Visit, you will need to contact your primary care physician and schedule your visit. If you do not have a primary care doctor, you can search for an in-network physician at Use the Provider Search Tool at to find a doctor conveniently located in your area, call, make your appointment and be certain to inform the office that your visit is for your Annual Wellness Exam. You can also call United Healthcare s customer service at: 1(866) for assistance in finding a physician. For more information regarding preventative care, visit #2 Rally Health Survey (No documentation necessary from employee) Take your first step towards a healthier life by taking a personalized health survey at By taking the Rally Health Survey, you can learn your Rally Health Age, engage in personal health missions, and use gaming and social media to support your health journey. The survey takes approximately minutes to complete and you will be provided with immediate feedback on the current state of your health. To get started, visit Once you are logged in on the home page, click on the Rally Health Survey link on the right side, or, on the rotating RALLY banner. See pages of this guide for detailed flyers and instructions for taking your Rally Health Survey. You do not need to send in proof of completion. Your P.R.E.P. Coordinator receives a quarterly report from UHC with the names only of those who have completed the survey. No scores or survey details are shared with the P.R.E.P. Coordinator or your employer. If you are physically unable to complete the Health Survey, you can fill out the alternate request form (located on page 9) and choose one of the alternate P.R.E.P. options to complete in lieu of the survey. You will need to provide a copy of your EOB (explanation of benefits) via mail, or fax to the P.R.E.P. Coordinator as proof of completion. Please see page 8 for contact information. Your EOB can be located online at

6 #3 Additional P.R.E.P. Options P. R. E. P. 4 Choose any one of the items below to meet your final goal of Documentation IS REQUIRED for ALL Additional Options. Flu Vaccinations (Documentation necessary from employee) It s more important than ever to take care of your health. By getting a single flu shot you can protect yourself against the seasonal flu, H1N1, and other forms of the flu virus. There are several ways you can obtain a flu vaccine: Visit your physician or call the member number on your health plan ID card to find a provider near you. EOB (explanation of benefits) is required for proof of completion. Visit myuhc.com to locate your EOB. Fax, , or mail to P.R.E.P. Coordinator. Visit a network Convenience Care Clinic or one of the participating national United Healthcare network. EOB (explanation of benefits) or receipt of service is required for proof of completion. Fax, , or mail to P.R.E.P. Coordinator. Complete a Smoking Cessation Program (Documentation necessary from employee) One out of five deaths in America can be attributed to cigarette smoking. Now is the perfect time to make the decision to quit and get paid for making a lifelong commitment to your health! Complete a state, county, or district sponsored cessation program to meet your additional P.R.E.P. requirement. Visit the links below to find a program option that is right for you. Arizona Smoker s Helpline (800) Maricopa Tobacco Use Prevention Program (602) You can also speak directly to your doctor about smoking cessation options such as medications and other support tools. Please fax, , or mail your proof of program completion to P.R.E.P. Coordinator. Visit a school site within your district when notified vaccinations are available on site. EOB (explanation of benefits) is required for proof of completion. Visit to locate your EOB. Fax, , or mail to the P.R.E.P. Coordinator. Preventive Cancer Screenings (Documentation necessary from employee) Screening means checking your body for cancer before you have symptoms. Getting screening tests regularly may find breast, cervical, skin, and colon cancers early when treatment is likely to work best. EOB (explanation of benefits) is required for proof of completion. (See page 12 for details on how to obtain your EOB.) Fax, , or mail to P.R.E.P. Coordinator. DPCA Program (Documentation necessary from employee) Diabetes is one of the fastest growing diseases in the country. More than one in four adults is pre-diabetic and one in ten adults is diabetic. Fortunately, there are actions that can be taken to reduce the prevalence of prediabetes, the clinical complications associated with diabetes, and the financial burden the epidemic places on employers. The Diabetes Prevention and Control Alliance, an innovative new program from United HealthCare, is at the center of the solution. Continued on page 6...

7 5 P. R. E. P. DPCA Program Additional P.R.E.P. Options continued... Members of United Healthcare who are diabetic or prediabetic are invited to participate in a free program aimed at lowering patient costs and complications related to diabetes. If you have been diagnosed with diabetes or pre-diabetes, call the appropriate number below to find out if you qualify to enroll. 1(800) for diabetics 1(800) for pre-diabetics If it is determined that you are a qualified candidate for the DPCA program and enroll, please print the DPCA enrollment form verification on page 10 and have your DPCA counselor/advisor sign and return the form via , fax, or mail to your P.R.E.P. Coordinator.

8 REWARDS P. R. E. P. 6 Congratulations for completing your P.R.E.P.! The District Medical Plan you are enrolled in determines which reward you are eligible to receive. UHC HDHP with HSA Members Reward: Up to $150 HSA deposit Well Visit = $100 Rally Health Assessment = $25 Additional Option = $25 Only ONE activity per Component is permitted Once verification of completion of the P.R.E.P. requirements (or participation) has been received by the P.R.E.P. Coordinator at the end of the program, members enrolled in the High Deductible Health Plan with a Health Savings Account will receive an additional deposit of up to $150 in their active Optum HealthBank Savings Account in June or July UHC CORE / PPO Plan Members Reward: $50 Whole Foods Gift Card Once verification of completion in ALL THREE components of the P.R.E.P. program has been received by the P.R.E.P. Coordinator at the end of the program, members enrolled in the PPO Traditional Plan or HDHP without Health Savings Account will receive a $50 gift card to Whole Foods. 2 Gift cards will be mailed via USPS to participants in July Please be certain your address on file with the District Office is current. Valley Schools and Scottsdale Unified School District are not responsible for misdirected, lost, or stolen mail. All Required Components, Activities and Options must have been completed during the P.R.E.P. plan year, April 1, 2015, through March 31, All Documentation must have been submitted by the Final Deadline of April 15, 2016, to the P.R.E.P. Coordinator at Valley Schools Employee Benefit Trust. 1 Valley Schools and SUSD reserve the right to alter reward date(s) if necessary. 2 Valley Schools and SUSD reserve the right to substitute a gift card of equal value to an alternate retail provider.

9 7 P. R. E. P. Program Alternatives* 1. Wellness Exam If a member is unable to complete an Annual Wellness Visit, a physician s note is required confirming the member s inability to complete the visit. A detailed explanation is not necessary. The physician s note can be mailed or faxed to: Fax: 1(877) Mail: Valley Schools P.R.E.P. Coordinator (Confidential) PO Box Phoenix, AZ Health Survey If a member is physically unable to complete the Health Survey online, the member can fill out the alternate request form at the back of this guide and choose one of the alternate P.R.E.P. options to complete in place of the survey. 3. DPCA Program The DPCA Program is open only to members who are diabetic or pre-diabetic. If a member does not qualify for the DPCA program, they can elect to complete one of the other alternate P.R.E.P. options. 4. Smoking Cessation If a member does not smoke, they may choose to complete one of the other alternate P.R.E.P. options. 5. Flu Vaccinations If a member is physically unable to receive a flu vaccination, they may choose to complete one of the other alternate P.R.E.P. options. 6. Cancer Screenings If a preventive cancer screening is not recommended based upon the person s age and gender, the member may choose to complete one of the other alternate P.R.E.P. options.

10 Glossary & Contact 8 Glossary and Contact Information Annual Wellness Visit Physical examination conducted by your physician to detect possible disease states or risk factors. Some examples of a wellness visit would be: annual physical, well woman exam, well man exam. HDHP High Deductible Health Plan District Sponsored Health Plan Option that focuses on consumerism and is often paired with a health savings account. DPCA Diabetes Prevention and Control Alliance United Healthcare special program to assist and educate diabetics and pre-diabetics. Health Survey Health Assessment An online survey which provides members a score representing their current state of health & alerting members of possible areas for improvement. HSA Health Savings Account Tax free savings account associated with members who are enrolled in a high deductible health plan or consumer driven health plan. EOB Explanation of Benefits* A statement provided by a health insurance company to covered individuals explaining what medical treatment and/or services were paid for on their behalf. P.R.E.P. Coordinator wellnesscoordinator@myprepaz.org Fax: 1(877) Mail: Valley Schools P.R.E.P. Coordinator (Confidential) P.O. Box Phoenix, AZ *All EOBs and claims summaries can be found online at: (See page 15 for instructions on how to obtain EOBs.)

11 Rally Health Survey Alternate Request Form P. R. E. P. 9 Dear P.R.E.P. Coordinator: I certify that I am unable to complete the Health Assessment online at myuhc.com. I choose the following P.R.E.P. option below to complete in place of the Health Assessment. Smoking Cessation DPCA Program Flu Vaccination Cancer Screenings Name: District: Signature: Date:

12 P. R. E. P. 10 DPCA Verification Form Name of PREP member/employee Dear DPCA Counselor/Advisor, The above employee is participating in a district wellness program called PREP. Our employees, who qualify, receive an incentive for enrolling in the DPCA program for either pre-diabetics or diabetics. They are required to provide proof of enrollment between May 1, 2015 through April 30, Please verify by signing this form that the employee listed has enrolled in the DPCA program. Date Employee Name DPCA Counselor/Advisor Signature (Form will not be accepted without counselor/advisor signature) PREP MEMBER: Please fax, or mail this completed form to: Fax: (877) wellnesscoordinator@myprepaz.org Mail: PO Box Phoenix, AZ Thank you. Sincerely, Valley Schools Employee Benefits Trust P.R.E.P. Coordinator

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14 How do I get my EOB??? P. R. E. P. 12 Log on to Enter your username and password OR Register, if you haven t done so already Click on Manage My Claims Scroll down your claim summary to find the exam you are looking for Once you find it, click on View Claim Click on Explanation of Benefits Not sure if this is the right EOB? Scroll down to the At a Glance portion of the screen for a detailed description of the claim