Bravo Wellness Webinar

Welcome to today’s webinar

“Why Many Company Wellness Programs Fail --- and What To Do About It”

Sponsored by:Waldo Agencies, Inc.

Bravo Wellness

Today’s Presenters:

Tony KahmannBenefits & Utilization Consultant

Waldo Agencies, Inc.

David McGlennenRegional Sales Director

Bravo Wellness

Live Well. Pay Less.

Percentage of Chronic Diseases Thatare Caused by Poor Lifestyle

Cancers Stroke Heart Disease Diabetes0%

10%20%30%40%50%60%70%80%90%

100%

71% 70%82%

91%

Sources: Stampfer, 2000; Platz, 2000; Hu, 2001

• Chronic diseases related to lifestyle account for 75% of national medical costs. Eleven separate studies by the Centers for Disease Control suggest that worksite wellness programs can produce significant improvements in employee health.—Centers for Disease Control,2006

Why Results-Based Wellness?

• 53% of U.S. Adults think its fair to ask those with unhealthy lifestyles to pay more for their health insurance. (Up from 37% only three years ago.) —Wall Street Journal/Harris Interactive Poll

• 56% of employers plan to hold employees more responsible for the cost of health benefits

–Washington Post, March 12, 2010

Common Wellness Roadblocks

• “What’s our return on investment for all this wellness stuff anyway…?”

• “Is anyone really changing their lifestyle and getting healthy?”

• “Are we risking a discrimination lawsuit or a massive employee revolt?”

• “Who has time to manage all of this event planning and activity tracking?”

• “How do we increase our participation?”

“Perhaps the ‘best’ approach in increasing wellness participation levels is formally linking your benefit program

to your wellness plan design.” Mr. David Hunnicutt, President of WELCOA

Bravo Wellness:• Exists to support your wellness initiative• Helps employers navigate non-discrimination

laws• Can provide compliance and technology

and/or coordinates the biometric screening process, the appeals process and the need for alternatives for individuals who have medical issues that prevent them from achieving a goal

Healthy

Employees

Cost Savings

Productivity Gains

Quality of Life

Positive Message

Quality Health

Assessments

Tools for Healthy

Living

Meaningful

Incentives

Bravo

Legal/

Compliant

Administration

Bravo

Your Partner for Results!

Federal Wellness Rules• Federal legislation allows employer sponsored health

plans to give rewards or assess penalties based on the results of a health assessment– Premium Contribution Differentials– Benefit Plan Differentials (deductibles, co-pays,

co-insurance levels)

• Regulations are complex but achievable. Savings to health plans can be significant (short and long term)

• 2010 National Healthcare Law preserves and expands the model

History1996 • HIPAA requires uniform coverage and non-

discrimination

2001 • Interim “bona-fide wellness rules” introduce exceptions for wellness plans – very restrictive

2007

• Final Wellness Rules issued • Distinction between incentives for participation and

incentives “contingent upon the satisfaction of a health standard”

• Rules clarified in February, 2008 Checklist for Wellness Program

2010• National Health Reform solidifies regulation as Law and

provides for expanded incentives/penalties tied to health lifestyle results

HIPAA Final Wellness Rules: We Can Help!

If an incentive is “contingent upon the satisfaction of a health standard”:

It must be re-assessed at least once per year

It must be designed to promote health and wellness

It may not exceed 20% of the total cost of coverage offered (Raised to 30% effective January 1, 2014)

It must be available to all “similarly situated individuals”, appeals and “reasonable alternatives” must be offered

The availability of the appeal must be disclosed in all plan materials

Your One StopReward wellness with a reduced payroll contribution, a better

health plan, a deductible credit or HRA deposit or an HSA contribution —expect 92% participation!

Bravo Wellness

coordinates

program including

screenings, appeals and

alternatives

Payroll

Vendor

Eligibility

Manager

TPA or

CarrierHealth Savings Account

(125 Plans only)

What Makes Bravo Wellness Different?

One-Stop Shop or a la Carte?

• If needed, Bravo Wellness can offer your organization a screening network, wellness program vendors, healthy lifestyle coaching programs, etc. from our list of national partners

• We can customize the Bravo Wellness offering to meet your specific needs … from coordinating all of the elements or handling just certain components, such as the screening or appeals process

© 2009 Bravo Wellness

What Makes Bravo Wellness Different

Administration of Appeals

• Appeals can be an overwhelming, time-consuming process, especially for those who are unfamiliar with the rules• Bravo Wellness has extensive experience with both types of appeals:

• Type 1: Disputing the accuracy of results• Type 2: Exceptions due to medical issues

Medical Issues

• We also work with individuals and their physicians to set alternative goals and complete healthy lifestyle coaching programs when appropriate

© 2009 Bravo Wellness

Use Your Wellness Provider or One of Our Preferred Partners

Each Employer May Design Goals for Their Culture and Budget

Sample Design:

NOTE: Bravo Wellness manages appeals and gives alternatives if these goals are medically inadvisable or unreasonably difficult due to a medical condition.

Participation and Result Requirements

Measurements: “Gentle” Result Requirements Points

Tobacco/Nicotine: Negative 1

Blood Pressure: <140/90 1

Cholesterol: <160(LDL) 1

Body Mass Index:(Body Fat % and Waist Measurements are also considered – automatically!)

<30 1

Bravo Wellness arranges biometric screenings for all employees

© 2009 Bravo Wellness

Sample Design: Employee Earns Contribution Reduction or Penalty

Choose Plan(s) from Any Carrier or TPA

Total Monthly Premium

Current Employee

Contribution 20%

“Gentle” Contribution Adjustments Based on Wellness Results

Adjust based

on points earned

Non-Participation Pass 0 Pass 1 Pass 2 Pass 3 Pass 4

Single $515 $103 +$200 +$75 +$50 +$25 +$0 -$25

Family $1,212 $242 +$400 +$150 +$100 +$50 +$0 -$50

© 2009 Bravo Wellness

Employer Can Save More By Adjusting Goals and Penalties

Financial Impact to Sample Group

Savings Analysis

CensusTotal Annual

Premium Cost

Savings From Incentives and

PenaltiesEntire Cost of Program***

Immediate Net Savings

Gentle Implementation

(as shown) 500 $4,762,800 $125,000 $100,000 $25,000

Moderate* Implementation 500 $4,762,800 $415,000 $100,000 $315,000

Aggressive** Implementation 500 $4,762,800 $600,000 $100,000 $500,000

© 2009 Bravo Wellness

* Moderate assumes Medium criteria, 50% non-participation penalty and 20,15,10,5 or 0% of premium for goals ** Aggressive assumes NIH criteria, 70% non-participation penalty and 20,15,10,5 or 0% of premium for goals*** Entire Cost includes set up, screenings, labs, appeals, fulfillment, Know Your Number and Move It. Lose It. Live Healthy. program

Balance Savings with Culture

2011• Health Goals: Easy• Employee Impact: -$10 to +

$50/month• Employer Impact: Break Even

2012• Health Goals: Moderate• Employee Impact: $0 to +

20% of premium• Employer Impact: 6–8% net

savings

2013• Health Goals: Aggressive• Employee Impact: $0 to +

20% of premium• Financial Impact: 10–15% net

savings© 2009 Bravo Wellness

PARTICIPATION GOALS

Component Success Measure Premium Reduction

Participation Based GoalsParticipate in:

HRABiometric Test Health Coach Session

Participate by completing:1. Complete Health Risk Appraisal2. Annual Biometric test: (Onsite events available)3. Health Coaching Session; 1-time session with Health Coaches to review results 4. Complete any on-going health coaching sessions or disease management

programs (1 session/quarter): if identified based on risk factors or claims utilization

$520 Year ($20/per pay)

RESULT BASED GOALS

Healthy Measures Reward results for healthy biometric levels; 3 levels ($130-$520/yr) Alternative Standards and Re-qualify procedures in place See Below

Up to $520 Year

Level LDL Cholesterol Blood Pressure Glucose BMI Tobacco Use IncentiveGold < 100 < 120/80 < 100 < 25

No $20 pay period ($520/yr)

Silver < 130 < 130/85 < 110 25.1 - 27.4 $10 pay period ($260/yr)Bronze < 160 < 140/90 < 126 27.5 - 30 $5 pay period ($130/yr)

Not Qualify Participate HRA & Biometric Testing but not meet healthy measures $0 payperiod

Biometric Testing Colleagues that do not meet the healthy measure biometric standards during the company-provided annual assessment period may retest quarterly at their own expense and submit results to Bravo Wellness for validation. If the healthy measure level is met, incentive will begin in the subsequent calendar quarter.

Participation Alternative Standard

Colleague may have personal physician complete affidavit annually that states colleague's condition is being treated by

physician with medication.Complete Healthy

Weight Course annuallyComplete Tobacco

Cessation Program annually Colleagues that do not qualify for

any level but complete Participation Alternative Standard; Bronze Incentive will be awarded.

Medical Alternative Standard

If it is medically inadvisable or unreasonably difficult due to a medical condition for a participant to attempt to achieve a goal, they may file an appeal.

Colleagues that do not qualify for any level but complete Medical

Alternative Standard; Gold Incentive will be awarded.

Alternative Custom Design

Case Study #1

1890 Employee Manufacturing Company – One Year Summary

• 1883 Participated (99.6%)• Every incentive category improved

− Improved BP from 28.8% desirable to 45%− Reduced BMI from 54.3% obese to 44%− Improved LDL from 57% desirable to 68%− Decreased Tobacco use from 49% to 47%

• “Hard-Dollar” (cost-shift) net savings: $202,000• “Soft-Dollar” (reduced risk) savings: $329,000• Non-Incentives measures (i.e. glucose) did not improve; everything tied to $$ did!

Sample Timeline

Ongoing ReinforcementHealth Coach ProgramsScreening

Results SentScreening

Event

Actual timeline depends on the customer, but the sooner employee communication begins the better the success of the program.

Planning Enrollment Meeting/Screening Communication

Select Bravo Wellness Goals Educate/Inform/Engage Reinforce/Encourage

Implementation• Compliance

Checklist• Communications • Final Design• Screening Logistics

Enrollment Meeting• Enrollment Presentation• Medical Plan Materials• Registration/Sign Ups

REWARD EFFECTIVE DATE

Results Mailed• Administer Appeals• Administer Alternatives

45-60 Days Prior to Effective Date120- 180 Days Prior to Effective Date

30 Days After Effective Date

A Growing TrendBravo Wellness now has over 100 diverse clients and has coordinated over 60,000 screenings. Clients include: