Hardin County Schools Consortium Benefits Comparison & Wellness Updates August, 2006.

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Presentation transcript:

Hardin County Schools Consortium Benefits Comparison & Wellness Updates August, 2006

Hardin County Schools Consortium SuperMed Plus (PPO Program) –Hospital and Physician based PPO Program –Wellness Benefits at 100% - NO DEDUCTIBLE Up to $500 per year maximum –Well Child Care at 100% - NO DECUCTIBLE –Up to $500 maximum to 12 months –Up to $150 maximum ages 1-9 years old –Mammograms –Pap Tests

Hardin County School Consortium–CLASSIC PLAN NETWORKNON-NETWORK Deductible: $100/$200$100/$200 Coinsurance: $400/$800$900/$1,800 Out-of-Pocket Maximum: $500/$1,000$1,000/$2,000

Hardin County Schools Consortium-Plus Program NETWORK NON-NETWORK Deductible: $250/$500 $500/$1,000 Coinsurance: $750/$1,250 $1,500/$2,500 Out-of-Pocket Maximum: $1,000/$1,750 $2,000/$3,500

Hardin County Schools Consortium – Plus Program $15 Office Visit Co-pay MMO Network of Professional Providers Wellness Benefits at 100% Access

Identify Health Risks Health Risk MeasureHigh Risk Criteria AlcoholMore than 14 drinks/week Blood PressureSystolic >139 mmHg or Diastolic > 89 mmHg Body WeightBMI ≥27.5 CholesterolGreater than 239 mg/dl Existing Medical ProblemHeart, Cancer, Diabetes, Stroke Illness Days>5 days last year Job SatisfactionPartly or not satisfied Life SatisfactionPartly or not satisfied Perception of HealthFair or poor Physical ActivityLess than one time/week Safety Belt UsageSafety belt use less than 100% of time SmokingCurrent smoker StressHigh Use of Drugs for RelaxationFew times a month or more Overall Risk Levels Low Risk0 to 2 high risks Medium Risk3 to 4 high risks High Risk5 or more high risks University of Michigan Health Management Research Center

Health Risk Assessment Medical Mutual partners with WebMD to offer our HRA –Accessible through My Health Plan on MedMutual.com Assess current health risks based on past health history, current medical information and daily habits Provide guidance on how to actually change behavior and improve health Aggregate reporting helps identify opportunities for implementing Medical Mutual’s SuperWell programs

HealthQuotient Health Quotient Score Comparison to Peer Group

Quit Line (Smoking Cessation) Quit Line Medical Mutual has partnered with the Ohio Tobacco Use Prevention and Control Foundation to offer the Ohio Tobacco Quit Line, a smoking cessation program Includes telephonic counseling services and the option to receive free over-the-counter (OTC) nicotine replacement therapy (NRT), in the form of the patch, Nicoderm® CQ, at no out-of-pocket expense

SuperWell Nurse Line Advice is a phone call away, available 24 hours a day, 7 days a week Serves as an “early warning system” for emerging health conditions Prepares members for doctors visits, including knowing what questions to ask Learn how to make better decisions about healthcare Provides education on various health topics Group-specific reporting available.