New SMU health program pays incentives for wellness, prevention

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New SMU health program pays incentives for wellness, prevention

Benefits U logoIn an effort to improve the health of SMU’s faculty and staff, while helping to control rising medical costs, the University is offering a voluntary health and wellness program with a $300 cash incentive for those who successfully complete the program.

Healthy Outcomes, a voluntary pilot program, is designed to reward healthy behavior and to acknowledge the crucial role of prevention in reducing the cost of health care, says Jeff Strese, executive director of SMU Human Resources. “We want to encourage employees to be aware of their health status and to take action, if needed.”

The program is a response to significant portions of the Affordable Care Act that go into effect Jan. 1, 2014. The healthcare reform law encourages better outcomes and lower costs by permitting employers to offer incentives to employees who take steps to become more aware of their health issues and reduce their known risk factors.

A key component of the program is a baseline check-up designed to identify specific health risks and help participants take steps to maintain good health or improve risk factors.

Catapult Health logoSMU has contracted with Catapult Health to administer the check-ups on campus. The 45-minute Baseline Check-up will measure blood pressure, height, weight, and waist circumference. The Check-up includes a finger-prick blood screening which will identify any risk factors associated with HDL cholesterol, triglycerides and blood glucose. You will also have a private consultation with a nurse practitioner to help you establish your health goals.

The Check-up meets the screening requirements for those participating in Wellpower and for those who wish to participate in the 2014 Deductible Discount Program.

The Healthy Outcomes Program is open to all SMU faculty and staff members enrolled in a SMU medical plan on January 1, 2014.

There are three steps to completing the pilot successfully and earning a $300 Healthy Outcomes Achievement Award:

  1. Complete a Baseline Check-up before Friday, Nov. 25, 2013 using Catapult Health or your primary care physician. During the Baseline Check-up, you will complete a Commitment Form to officially join the program.
  2. After your Baseline Check-up, your Achievement Period begins. You will have until Thursday, May 15, 2014 to meet your health goals based on your screening results:
    1. If you have no risk factors, your goal will be to maintain your good health by keeping your lab values in the normal range.
    2. If you have one or more risk factors, your goal will be to improve your lab values for each risk factor identified.
    3. Catapult will provide information about SMU’s wellness resources that may help you achieve your goals, or you may select a program of your choice and/or work directly with your primary care physician.
    4. If you are pregnant, you may download and complete a maternity waiver form found on the appointment scheduler website.
    5. If you have a medical condition that would impede your ability to meet the program goals, Catapult and your physician can work with you to develop an alternative program. Email Catapult to request a medical condition form to be completed by your physician.
  3. Complete the Results Check-up before Thursday, May 15, 2014 using Catapult Health or your primary care physician. The Results Check-up will include another finger-prick blood screening that will determine if you met your health goals during the Achievement Period.

Check-up results and information are protected by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). SMU will not have access to your individually identifiable health information.

SMU will receive a list of names along with the Check-up date in order to properly credit participants with completing a screening for Wellpower and the 2014 Deductible Discount. If you volunteer to participate in the Healthy Outcomes program, your name will be released to SMU only if you qualify for the $300 cash incentive. SMU will not know if you volunteered for the program, but did not complete it successfully.

The on-campus Baseline Check-ups will begin Tuesday, Oct. 29 and continue through Friday, Nov. 15 on the main campus. The SMU-in-Plano campus will host the final day of Check-ups on Tuesday, Nov. 19, 2013. Make an appointment online at www.timeconfirm.com/smu or by calling (214) 269-1513 and following the automated instructions. The online and phone schedulers are both available 24/7.

The Check-up is open to all benefit-eligible staff and faculty. Spouses and family members are not eligible to participate at this time.

Additional information about how to use results from your own physician, screening/check-up locations, directions to schedule your appointment and more may be found on the SMU HR website.

Watch your mailbox for more information from SMU Human Resources.

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SMU to use new pharmacy network in 2014

Benefits U logoImportant changes to SMU’s Health and Wellness Plan pharmacy network are coming in 2014 – “changes that should help the University group health plan and its faculty and staff members save more than $1 million on their prescriptions over the next three years,” says Jeff Strese, executive director of human resources.

Participating pharmacies have agreed to offer greater prescription discounts to remain in the SMU network, which serves all of the University’s medical plans. They include Costco, Kroger, Sam’s Club, Target, Tom Thumb and Wal-Mart, as well as several independently owned stores.

CVS and Walgreens pharmacies will no longer be part of Express Scripts’ SMU network. If you have recently filled a prescription at a CVS or Walgreens, you will receive a letter from plan administrator Express Scripts providing the locations of three network pharmacies closest to the pharmacy last visited.

Express Scripts logoExpress Scripts has created a web portal, Express-Scripts.com/SMU, that will allow faculty and staff members to compare prescription prices at more than 450 Dallas-Fort Worth area retailers. The site will be open during the University’s 2014 open-enrollment period, Oct. 12-31, 2013.

If you currently use CVS or Walgreens but want to take advantage of the new prescription discounts, you must transfer your prescriptions to a network pharmacy by Jan. 1, 2014. You can complete a transfer in one of three ways:

  • Take your prescription container to the new network pharmacy of your choice; they will contact your current pharmacy to transfer the prescription.
  • Call your new pharmacy and ask them to contact your current pharmacy for your prescription information.
  • Ask your doctor to call your new pharmacy with your prescription information.
  • Ask SMU’s Compass Health Pro, Jeremy Garrett, to do the work for you. He can research Express Scripts’ contracted rates at pharmacies near you after Jan. 1, when Express Scripts loads its online database of 2014 prescription pricing. Call after Jan. 1 with your Rx information at (800) 513-1667, ext. 726.

If you currently use a CVS or Walgreens pharmacy to fill prescriptions, you can continue to do so. However, you will pay the full retail cost without plan discounts, and the costs will not apply toward your medical plan deductible or out-of-pocket maximum.

After extensive analysis with Express Scripts, SMU’s Department of Human Resources learned that 99 percent of faculty and staff members currently filling prescriptions at a CVS or Walgreens pharmacy have access to an alternative network pharmacy within less than three miles of their current pharmacy location, says Sheri Starkey, director of total compensation and senior associate director of human resources.

“By asking some faculty and staff members to move to our new retail pharmacy network, all faculty and staff will benefit from the savings our plan will experience over the next three years,” she adds. “This change is one step we’re taking to ensure the continuation of a comprehensive and affordable benefit plan.”

The University’s mail-order prescription plan will remain unchanged.

More information on the new SMU pharmacy plan will be included in the 2014 open-enrollment packages, scheduled for delivery in early October 2013.

> Learn more about 2014 open enrollment at smu.edu/hr

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