bluecross blueshield of western new york daemen college june 2013 open enrollment account executive:...
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BlueCross BlueShieldof Western New York
Daemen CollegeJune 2013 Open Enrollment
Account Executive:Denise Northrop
The Good Life℠
St. Bonaventure University POS 250D (Plans 1 and 2)
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Daemen CollegePOS 206 (Plans 1 and 2)
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Traditional Blue POS 206 - Current Plan Highlights
Plan Plan 1 Plan 2
In-Network Deductible N/A $500 Single $1,000 Family
Primary Care Copay $25 $25 after deductible
Specialist Copay $25 $25 after deductible
Emergency Room $50 $50 after deductible
Urgent Care Center $35 $35 after deductibleAmbulance $50 $50 after deductible
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 $10/$50/$100
Mail Order 2.5 Copays per 90 days 2.5 Copays per 90 days
Dependent Coverage To Age 26 To Age 26
Out Of Pocket Maximum N/A N/A
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
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Step 1: Health screening
Step 2:Health Assessment
Months 1-4 Months 5-7Months 1-4
Step 3:Health coaching
Good Life Timeline
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Complete a Health screening between June 1, 2013 - 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
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Complete the Health Assessment by September 30, 2013
• Complete your health screening first, need numbers for Health assessment
• Health survey that will take 15-20 minutes to complete
• Your Health Assessment results are confidential
Step 2: Health Assessment
Months 1-4
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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
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Good Life Scenario 1:Employee completes all steps
Step 1: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
June – September 2013
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Good Life Scenario 2:Employee completes step 1 but not 2
Phase Date Status Plan impact
Enrolled in POS 206 (Plan 1)
Not applicableRemain 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
June – September
2013
Not applicable
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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
June – September
2013
October – December
2013
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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
June – September
2013
October – December
2013
Enrolled in POS 206(Plan 1) through May 31, 2014
Phase Date Status Plan impact
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