What are the differences in the 2006 Plan options?

The premium you pay differs with each plan; http://www.whoi.edu/services/HR/benefits/OE/printablerates.htm

• The service area differs for each plan
• Some of the plan design features differ; see the chart below highlighting the major differences

2005 Programs 2006 Programs

To obtain more information, please review the summary of benefits brochure at http://www.whoi.edu/services/HR/benefits/OE/index.htm

*BCBSMA has updated the Access Blue Plan to Access Blue Enhanced Value Plan with the Department of Insurance (DOI).

What are considered Inpatient and Outpatient services?

An inpatient service is an overnight stay in a hospital. Outpatient services are day surgery in a surgical day care unit, ambulatory surgical facility, or hospital outpatient department. For more detailed information, please contact your primary care physician or BCBSMA Customer Service at 1-800-737-8982.

Why is WHOI moving in the direction of wellness programs?

• The Institution is trying to manage its increasing health care costs. Since our health care costs are based on WHOI's employees and their families' medical claims, the actions we take in improving the overall health of the WHOI community will directly effect the Institution's and employees' health care cost.

• Many studies indicate that a group can change the health risk characteristics by acting on health and health behaviors. The facts are that 40-50% of all claim costs are due to modifiable or preventable conditions/behaviors.

What is a Personal Health Assessment (PHA)?

• The PHA is a confidential questionnaire designed to show how your lifestyle choices affect your overall quality of life.

• The PHA helps to identify any risk factors you might have for developing future health problems and, if necessary, will help Blue Cross Blue Shield of Massachusetts (BCBSMA) get you the assistance you need.

Why should I take the Personal Health Assessment (PHA)?

• When you complete the PHA and opt-in to share your information with BCBSMA, you will receive a 12.7% premium reduction in 2006.  

• Upon completion of the PHA, you'll receive a confidential, customized Health Assessment Report.  

• When you complete the PHA and opt-in, you may be eligible to participate in one of BCBSMA's Health and Wellness Management Programs such as the Blue Health Coach, Diabetes, Congestive Heart Failure, Coronary Artery Disease, or Chronic Kidney Disease Management programs.

• It only takes 10-20 minutes to complete and you'll be on your way to a more active and healthy life.

I have been having difficulty in accessing the PHA; who do I call for assistance?

BCBS Personal Health Assessment web site is fully supported using Internet Explorer 5.01 or higher or Netscape 7.1 or higher.  If you are using Internet Explorer or Netscape and have difficulty accessing the PHA, then please contact Hilary Davis at ext. 3716 or Ken Friend at ext. 3537, and they will assist you.  BCBS does not recommend accessing the PHA using Mozilla Firefox, Safari, Opera or other web browsers.  If you are using a browser not supported by BCBS you may experience problems navigating the web site.  If you do not have access to a computer with Internet Explorer or Netscape installed, please call Human Resources at ext. 2253 so that an alternative solution can be provided.  

For other issues please contact BCBSMA Customer Service at 1-866-822-0570.

Who actually does the PHA evaluation?

BCBSMA has contracted with WebMD to administer the PHA.

Will WHOI and/or BCBSMA see the results of the PHA?  

WHOI will only see PHA results on an aggregate level; no individual results will be shared. BCBSMA will see your individual results to allow them to identify people who may benefit from their Health and Wellness Management Programs mentioned above.

Is BCBSMA going to "check up" on people who complete the PHA?

If you opt-in to share your data with BCBSMA, you may be considered for participation in one of their Health and Wellness Management Programs mentioned above. You can decline participation in these programs at any time.

What potential is there for the information gathered in the PHA to be used against employees?  

From a WHOI perspective, there is no potential (or desire, for that matter) for the Institution to use PHA information against employees. As stated previously, information will only be provided to WHOI on an aggregate level and no individual information will be shared. From a BCBSMA perspective, again, they will see your individual results to help identify those who may benefit from their Health and Wellness Management Programs.

Is the premium saving for taking the PHA tied with the results of the PHA? 

No, your responses and results have no effect on the premium savings.

I have a philosophical problem with sharing my health information. Although I understand that the Institution is trying to manage the rising cost of health care, I am afraid that, at some point in the future, this may lead to coverage or even employment decisions. Why is the Institution making such a large financial incentive for employees to take the PHA?

Emerging trends are for 13% to 15% medical premium increases each year for the foreseeable future. To continue to increase the Institution's overhead rate and/or pass on cost increases to employees does not address primary drivers of soaring health care costs. Therefore, the Institution has embraced "Wellness with a Passion" and created a significant incentive to engage employees in this effort.

This is a voluntary program and you can certainly elect not to participate. The only effect is that you would not be eligible to receive the premium credit.

When I opt-in (which one does by checking the box stating I have read and agree with WebMD's Terms and Conditions and Privacy Policy), how do I know what vendors they may release information to and how is my information protected?

Your Personal Health Assessment information, as well as your usage on www.bluecrossma.com is kept confidential, as detailed in the Blue Cross Blue Shield of Massachusetts (BCBSMA) and WebMD strict policies regarding privacy and confidentiality of personal health information.

When you agree to share your data with BCBSMA and WebMD (by opting in), your data will only be used as part of BCBSMA's Health and Wellness Programs. It won't affect your insured status. The data is sent to the Health and Wellness Management system at BCBSMA and handled in strict compliance with their privacy policies. The data is analyzed and, if you could benefit from one of their health management programs, you will be provided with further information about that program and invited to participate.

Who is paying for the savings I will get if I complete the PHA and opt-in?

The increase in our rates if no changes were made to our plans was 12.7%. Plan design changes were made to decrease the cost of the plans by shifting cost to employees at the point of service (as the survey indicated). These changes resulted in lower costs for the Institution and no increase in employee premium rates if one completed the PHA and opted in.

In addition, we are embracing and encouraging participation in our Health and Wellness Program, commencing with the PHA. To continue to support wellness participation, and in line with the community's majority feedback, we are sharing the net zero increase with employees who also embrace the Health and Wellness Program.  For those that choose not to, we are applying the original rate of increase to their medical contribution, which equates to our original renewal increase had no changes been made.

How will WHOI know if a person has filled out a PHA so they can be assessed the right premium?  

• BCBSMA will give the Human Resources Office a list of the names of employees who completed the PHA and opted-in. No additional information will be shared.

• We will e-mail each employee a confirmation that his/her name was received and his/her credit processed.

• Likewise, we will e-mail those employees whose names were not received to confirm that and to confirm their 2006 premium.

Who does BCBSMA use as part of their wellness programs?

The current outside health and wellness vendors associated with WHOI's Personal Health Assessment are WebMD and Lifestyle Management Resources. BCBSMA also internally administers programs such as Disease Management, Cardiac Healthways, and Blue Care Connection for a Healthy Heart, to name a few.

All of BCBSMA's vendors are contractually bound to conform to the strictest level of security to protect BCBSMA's members' personal information. Each vendor is in compliance with HIPAA regulations, as well as BCBSMA's own security standards. In every case, BCBSMA only passes the minimum amount of personal information necessary to properly implement each program. BCBSMA realizes that, above the HIPAA regulations, they could not maintain a successful wellness program to meet their goal of helping their members reach their optimal health without employing the highest standards to protect their members' privacy. This is not only important from a security standpoint but to foster trust in their programs and increase participation.