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Wellness Scoring and Premium Reward

The VNS Wellness program is designed to identify and assist our employees with known and unknown chronic illnesses.

The purpose is to 1) promote employee participation in building healthier lifestyles as well as provide education and management of chronic medical conditions and 2) reassign some risk from VNS to us as employees who are unwilling to manage our health which creates a financial cost to employees who are taking care of managing their health.

I. Tobacco Use
To everyone’s knowledge tobacco use represents an historic illness and healthcare cost citing at least one source by researchers the average excess health care costs of smokers – who have higher rates of lung disease, heart disease and other illnesses, is $2,055 annually.

Tobacco use will have an additional surcharge of $50 per month. This surcharge is similar to the spousal surcharge that is currently being assessed for spouses who have an opportunity to utilize their employer’s health insurance program but elect to use VNS’ instead.

If you smoke, dip or use tobacco products and are insured by VNS’ health insurance program you can avoid the surcharge by 1) enrolling in the plan’s tobacco cessation program and 2) sign an affidavit that you agree not to smoke during the plan year.

II.Introduction to Scorecard
The VNS Wellness program focuses on five defined health benchmarks: blood pressure, body mass index (BMI), cholesterol, triglycerides, and diabetes management. Any five of these categories, if unmanaged, could result in significant health issues and extensive health costs.

III. How it will Effect an Employee Directly
Basically, everyone’s premium insurance will be increasing with the start of the new policy year January 1, 2014, by $1,300,yet everyone also has the ability to eliminate the premium increase up to 100% by participating in the Wellness program and improving your health.

For each benchmark met, a $10 credit per pay period will be applied to individual’s premium up to (5 categories x 26 pay periods) or $1,300 in premium reduction. We will also allow where borderline results are achieved a $5 premium reduction.

IV. Review Scorecard
Scorecard will be completed and reviewed with you by your CHP (Community Health Partners) coach. These scorecards will not be shared with anyone from VNS. This information is strictly confidential. The only information that will be transmitted to VNS is the premium reduction credit amount that will be used to reduce an employee’s payroll contribution withheld for health insurance coverage. The premium reduction credit amounts will be submitted to Human Resources.

If anyone exceeding their BMI achieves a 10% weight reduction during the program year, you will be eligible for the 10 points and $10 premium reward in the BMI category.

If your point score is 50 or less CHN will enroll you in a continuing education and coaching  session such as they have done this past year. If you score higher than this, you can also request more frequent coaching if there is a goal you would like to achieve with respect to your health.

V. Reasonable Alternative Standard (RAS)
An employee can contact their CHN health coach, request an RAS form and take the form to their own physician to develop a plan to achieve an improved target within a six-month period. The plan must be approved by the employee’s physician and CHP. If approved, the employee can qualify for the reward upon successful completion of the RAS program.

VI. Contested Results
For any contested biometric result that the employee feels is incorrect such as “White Coat Syndrome”, etc., the employee will be allowed to retake the contested test with their own physician at the employees cost. The test taken with the employee’s physician must be subsequent to the date the employee took the CHP test they are contesting.

VII. Improved Health Status
Every employee will be allowed to take a re-test once a year if they feel they have improved their health conditions and can now attain a reward level that they could not meet from the annual tests taken in October/ November. The re-test must be scheduled with CHP and can be taken from March through September of the plan year to qualify for the premium reward.

Wellness Program Requirements and Incentives