2012 Healthy Tigers Wellness Initiative
Frequently Asked Questions
What is the Healthy Tigers Wellness Program?
The Healthy Tigers Wellness Program provides an opportunity for employees to "earn" an insurance premium discount by completing a voluntary, free health and wellness screening. This screening will include evaluation of several health risk factors including:
- Blood pressure
- Cholesterol
- Glucose (or blood sugar)
Employees will also be asked to complete a short health risk assessment questionnaire and will have the option of having their height, weight, body mass index and percent body fat measured during the wellness screening. The results of the screenings will be available immediately during the appointment, and the employee will receive personalized counseling from a pharmacist concerning the results.
What is the last day to qualify for the 2012 Healthy Tigers program?
Forms must be received no later than noon on 12/19/2012. This paperwork includes Healthcare Provider Screening forms and Office visit referral forms completed by your physician. Forms received after the 12/19/12 noon deadline will not be accepted for the discount in 2013.
How often is screening required?
Only one screening (with any required follow up) between January 1 - December 19, 2012 is required to qualify for the discount in 2013. If your spouse is covered by your AUBCBS policy, he/she must also be screened once between January 1 and December 19, 2012.
Can I be screened more than once a year?
If more than one screening (not counting the required follow-up) is performed between January 1 and December 19, 2012, you will be responsible for paying out of pocket for the office visit, lab work and/or screening charges. The AUBCBS insurance plan only allows one wellness visit with your physician in a calendar year. If screening is performed by your physician and you visit a physician for an additional wellness visit or if you are screened twice by the AUPCC, you will incur costs for the second visit. It is important to note that certain lab tests associated with the Healthy Tigers Program performed by your doctor are only covered by the AUBCBS insurance plan one time in a 5 year period. Lab costs associated with this program may be billable to you if conducted by your physician.
If my spouse is covered under my AU BCBS policy, must he/she be screened between January 1 and December 19, 2012?
Yes. For those with family coverage or employee + spouse coverage, both the subscriber (employee) and the covered spouse must be screened in order to qualify for the 2013 benefit year.
NOTE- THE AUPCC WILL NOT PROVIDE SCREENINGS DURING
THE MONTH OF DECEMBER. APPOINTMENTS FILL UP CLOSE TO YEAR END, SO DO NOT WAIT UNTIL THE LAST MINUTE TO SCHEDULE YOUR SCREENING.
FOR EMPLOYEES AND/OR SPOUSES WHO CHOOSE TO SUBMIT A HEALTHCARE PROVIDER SCREENING FORM, THE VISIT MUST HAVE OCCURRED BETWEEN JANUARY 1 AND DECEMBER 19, 2012 AND FORMS MUST BE RECEIVED NO LATER THAN NOON ON 12/19/12.
I am a new hire or had a status change or qualifying event and am newly eligible for insurance coverage. Can I qualify for the discount for the current year? What are the deadlines for screening?
New hires and employees with a status change or qualifying event who elect AU BCBS as their insurance coverage will have 90 days from the date insurance coverage is effective to be screened in order for the discount to be applied in the current year. For those with family coverage or employee+spouse coverage, the covered spouse must also be screened within the 90 day time period. Upon completion of the required screening(s), the discount will begin the following month. Screenings performed within that 90 day period will qualify the employee for the current year's discount and the following year's discount. If the screening is performed more than 90 days after the effective date of insurance coverage, the discount will not be applied until the following benefit year.
New hires and employees with a status change or qualifying event who elect AU BCBS may submit the applicable Healthcare Provider Screening form(s) within the 90 day period. The tests documented on the form must have been performed by the physician in either the most recent past or the current calendar year (eg- for 2012, the tests must have been performed either in calendar year 2011 or in 2012 prior to the end of the 90 day window). The form must be received in the AUPCC no more than 90 days after coverage is effective. Healthcare provider forms with tests performed in the most recent past calendar year (2011) will only qualify the employee and spouse, if applicable, for the current benefit year (2012). Additional screening will be required during the current calendar year by December 19, 2012 in order to qualify for the 2013 benefit.
Examples:
An employee is hired on October 1st 2011 and enrolls in coverage. They can either 1) go to the AUPCC within 90 days of coverage date, or 2) submit a Healthcare Provider Screening Form which documents that the required tests were conducted during 2011. In both cases, they would be eligible for the discount in the remaining months of the current year assuming they were screened before the end of December 2011 and for 2012. They must be screened in 2012 in order to qualify for the 2013.
In that same scenario if an employee is hired on October 15, 2011 and screened on January 10, 2012 (within the 90 days), the screening would be effective for the remainder of that calendar year (January 10 - December 31, 2012) and the following calendar year, 2013.
For those newly enrolling (who were not previously enrolled) in coverage during open enrollment, insurance coverage begins January 1, 2012. The employee and spouse, if applicable, may be screened through the AUPCC within 90 days of the effective date. This screening will qualify them for the 2012 and 2013 calendar year.
If preferred, a Healthcare Provider Screening Form (HPSF) documenting tests done between January 1, 2011 - December 31, 2011 is acceptable for eligibility for the discount in 2012. A Healthcare Provider Screening form with tests performed between January 1 and December 19, 2012 or a screening performed through the AUPCC during from January 1 through November 30, 2012 would be required to qualify for the 2013 calendar year.
If I or my spouse was enrolled in the BCBS coverage in the previous year but were not screened before year end, and then our election changed during Open Enrollment for the current year, can we have screenings 90 days from our coverage change date to qualify for the current year discount?
Any employee and/or spouse who was enrolled in the BCBS coverage during the previous year was eligible and should have been screened in that year in order to qualify for the current year's discount. The Open Enrollment provision allows for screenings in the first 90 days of the year to accommodate employees/spouses who are NEWLY enrolled in the coverage and who were NOT ELIGIBLE to be screened in the previous year. If both spouses work for the University, switching the subscriber from one spouse to another, if both were covered in the previous year, will not qualify you for the Open Enrollment screening provision and current year discount. Any screenings completed between January 1 and December 19, 2012 will only affect your eligibility for the discount in the next calendar year.
Can I "fail" the screening tests or fail to qualify for the Healthy Tigers program?
No, the tests are not pass/fail. The only way not to qualify for the discount is to not be screened or to fail to follow up with a physician if your test results require physician follow up. If physician follow up is required, the referral form must be returned to the AUPCC within 120 days or within the calendar year, whichever is shorter. Verification of receipt of your form is strongly encouraged.
You can fail to qualify for the 2013 insurance discount by not returning all required forms no later than noon on 12/19/12.
When is physician follow up required?
If the screening results are above established thresholds, then the employee will be required to follow up with a physician before the discount will be activated. The screening thresholds are:
- A systolic blood pressure (top number) equal to or greater than 160 mmHg
- A diastolic blood pressure (bottom number) equal to or greater than 100 mmHg
- A total cholesterol level equal to or greater than 250 mg/dL
- A blood glucose equal to or greater than 200 mg/dL
If the employee opts to have his or her height, weight, body mass index and body fat measured, the pharmacist will provide counseling on the results, but these values will not be used to make decisions concerning physician referral. However, if any of the four values above is high, then the AU employee will be required to go to a physician for follow up.
The physician co-pay for the first follow up visit will be waived. The employee will receive a Healthy Tigers referral form to take to the physician and the physician's office will be instructed to waive the physician co-pay for this initial follow up visit (a $25.00 value).
After the employee completes the follow up appointment, the physician may fax the completed referral form to the Auburn University Pharmaceutical Care Center (AUPCC) or the employee may mail, fax or email it back to the AUPCC him/herself. The fax number and address for the AUPCC is noted on the referral form. All forms must be received no later than noon on 12/19/12.
in order to qualify for the 2013 premium discount.
Who is eligible for the benefit?
This benefit is being offered to any employee who subscribes to the Auburn University BlueCross/BlueShield (BCBS) health insurance plan. To qualify for the $25 premium discount for the 2013 benefit year, both the subscriber and spouse must be screened if the subscriber has AU BCBS family coverage or employee + spouse coverage.
What if an Auburn University employee does not subscribe to the Auburn University BCBS health insurance plan? Can he/she participate in the Healthy Tigers Wellness initiative? How about student workers, temporary employee services (TES) employees and contractors?
Employees who are not eligible for or elect not to subscribe to Auburn University's BCBS health insurance plan will not be eligible for the Healthy Tigers Wellness program. They will not be eligible for free health screenings, a waived co-pay for follow up physician care or the $25.00 health insurance premium discount.
However, Auburn University is committed to encouraging a health and wellness culture on campus and providing access to health and wellness resources to the Auburn University family. Therefore, employees in these categories can schedule a health and wellness screening at the AUPCC for a fee of $30.00 (which reflects an employee discount for the testing). A pharmacist will provide individualized counseling on the results.
How can an employee or his/her spouse schedule an appointment for a Healthy Tigers wellness assessment?
Go to the Healthy Tigers website and click "Schedule Appointment Online". Click "Register Now" below the location and date in which you would like to register to be screened. Complete the required information. Be sure to click the "ENTER" button in order to continue. You will receive an email and you MUST follow the confirmation instructions to complete your registration. Please confirm your registration as soon as receiving the email. If you do not confirm the appointment, it will not save the appointment. Separate appointments must be made for each person (ie- your spouse). Be sure to return to the Healthy Tigers main page and click "Schedule Appointment Online" prior to scheduling a separate appointment for your spouse.
What if I would like to get the Healthy Tigers testing done at my physician's office?
That is perfectly fine; you simply need to print the Healthcare Provider Screening Form from the Healthy Tigers website and take it with you to your physician's office. Verification of receipt of forms in the AUPCC is strongly encouraged.
Please note: Lab, office visit and other screening costs associated with the some of the Healthy Tigers screening procedures, if conducted by your physician, may be billable to you unless they are deemed to be medically necessary.
The AU BCBS insurance plan only allows one wellness visit from your physician in a calendar year. If screening is performed by your physician and you visit a physician for an additional wellness visit, you will incur costs for the second visit. See your BCBS Summary of Benefits (http://www.auburn.edu/administration/business_office/pdf/national-bluecard-ppo-matrix.pdf) for more information and consult with your doctor or his/her office staff to determine how this might affect you and if you may be responsible to pay for the full amount of the testing.
What if an employee or his/her spouse who is covered by the AU BCBS plan already has an established relationship with a physician and has had this testing performed recently? Do they have to repeat the testing in order to receive the premium discount?
If an employee or his/her covered spouse has visited a physician and had lab work completed between January 1 and December 19, 2012, those results can be used. The employee will need to print the Healthcare Provider Screening Form and follow the instructions. The employee or spouse must complete and sign Section 1 of the form including all contact information and AU BCBS contract number. Forms received without all identifying information (name, date of birth, contract #, banner id # if applicable, etc.) will not be accepted and therefore will not qualify you for the 2013 insurance premium discount.
The physician will need to complete, sign and date Section 2 of the form and return it to the AUPCC. Forms received without the required screening data (cholesterol, blood sugar and blood pressure) will not be accepted and therefore will not qualify you for the 2013 insurance premium discount. The address, phone number, e-mail address and FAX number for the AUPCC are provided at the bottom of the form. All Healthcare Provider Screening forms must be received in the AUPCC by close of business on December 19, 2012.
If I have my physician submit the Healthcare Provider Screening form to the AUPCC, how will I know when the AUPCC has received it?
Verification of receipt of forms in the AUPCC is strongly encouraged.
What if an employee or his/her covered spouse already knows that he/she had high blood pressure, diabetes or high cholesterol and is receiving medical care from a physician for these conditions? Does he/she have to repeat the testing in order to receive the premium discount?
Yes. The employee and, if applicable, his/her spouse who is covered by AU BCBS must either participate in the health screening program or get a physician to complete the Healthcare Provider Screening Form. Data reported by the physician must have been collected between 1/1/2012 and 12/19/2012.
For screenings completed by the AUPCC, if the laboratory results are higher than the threshold values described above, then the employee will still receive a waived co-pay for a physician office visit for further follow up in order to facilitate improved disease control.
How will the AUPCC be offering screenings (timing, frequency and location)?
The AUPCC faculty, post doctoral residents, student pharmacists and staff work very hard to facilitate the process of enrolling employees in the Healthy Tigers Wellness Initiative. Employees have an opportunity to obtain a health and wellness screening by:
- Scheduling on line an AUPCC appointment time slot for a health and wellness screening. The AUPCC is located on the main campus in the Harrison School of Pharmacy. The address is 2155 Walker Building, West Thach Avenue. It is located diagonally across from the Haley Center and across the street from the stadium and Petrie Hall.
- Scheduling an appointment slot on line for one of the "roving" health and wellness screenings at locations throughout the main campus, at AU Montgomery and at key locations throughout the state. The AUPCC holds monthly screenings on the campus of AUM and also provides screenings at numerous locations across the state throughout the year
- The AUPCC provides appointment times after hours and at locations that are accessible to employees who work second and third shifts.
- ACES and AAES employees can also download the Healthcare Provider Screening Form and obtain their test results from their physician and return the results to the AUPCC or schedule an appointment on line if there is a screening in your area.
- ACES and AAES and other off campus employees are encouraged to make suggestions for off-site screening locations throughout the state. If you have a suggestion, please e-mail Emily Mann, Director of Operations in the AUPCC at mannemi@auburn.edu. Please include the suggested location, number of AU employees interested in participating and the name of a contact person at the site. A minimum of 20 scheduled appointments are required in order to hold the screening.
How long will appointments take?
The AUPCC is reserving 15 minutes per employee to provide all testing, interpretation of results and appropriate counseling. If coordination of follow up care with a physician is needed, then this might add up to 30 additional minutes to the time required for the appointment.
Do I need to fast before my appointment?
No, fasting is not required.
Will AU supervisors allow employees to complete these screenings during the work day?
Maybe. All supervisors are encouraged to provide support for the AU Healthy Tigers Initiative and facilitate employee participation. However, due to the varying responsibilities of AU employees, this may not be possible in every situation. Supervisors are encouraged to be as accommodating as possible for screenings offered by the AUPCC (without disrupting or adversely impacting job responsibilities). If the employee chooses to go to a physician for testing, the employee will be required to take sick leave for these appointments as outlined by AU Human Resources' policies and procedures.
Will this benefit be continued after 2013?
Currently, Auburn University plans to continue the Healthy Tigers Wellness Initiative. However, the Healthy Tigers Wellness requirements, health and wellness interventions and the participant incentive may change in future years. The rules will be updated each year.
What happens if an employee forgets to get a Healthy Tigers Wellness Program screening completed before December 19, 2012? What if an employee completes the screening but does not complete the physician follow up by December 19, 2012?
If an employee and spouse, if applicable, do not complete the screening process along with any required follow up by December 19, 2012, the employee will not be eligible for the premium discount for 2013 . For example, if an employee has single coverage and did not get screened in 2011, the employee will not qualify for the discount during 2012. The employee may be screened by 12/19/2012, but the discount will not begin until calendar year 2013.
For AU employees with AU BCBS family or employee + spouse coverage, both the employee and spouse must be screened and any required follow up completed and turned in by noon on 12/19/2012 in order to qualify for the $25 premium discount.
Will the employee be required to reach any specific clinical goals in order to be eligible for the discount (i.e., get his/her total cholesterol below 250 mg/dL, etc.)?
No. If the employee's results are above range, he/she must consult a physician for follow up care. The physician co-pay for the initial follow up visit will be waived. Hopefully, this will result in an increased awareness of health risks, behavioral change and treatment as needed. The goal is to decrease the employee's health risks. However, the employee does not have to reach specific goals in order to be eligible for the premium discount.
Does the employee have to consult a specific physician for follow up?
No. The employee is free to schedule an appointment with his/her own physician for follow up. However, if an employee does not have a physician and is not able to obtain an appointment for follow up, an AUPCC representative will assist the employee with scheduling the follow up appointment.
Are the screenings being offered at the Auburn University Medical Clinic (AUMC) on the main campus?
No. The healthcare screenings are being coordinated through the Auburn University Pharmaceutical Care Center (AUPCC). However, the AUPCC is working very closely with the AUMC medical group to facilitate follow up care for employees with abnormal laboratory values. The AUMC will be a referral source for employees who do not have an established relationship with a physician in the area and need assistance with coordinating follow up care.
What are the goals of the Healthy Tigers Wellness Initiative?
The goals of the Healthy Tigers Wellness Initiative are that AU employees:
- Will have an increased interest in health and wellness.
- Will have an increased health-related quality of life.
- Will have increased energy and productivity.
- Will establish a "medical home" with a physician.
- Will address health risks as early as possible in order to prevent disease progression and possible health complications.
- Will engage in wellness activities.
- Will commit to risk factor reduction through lifestyle changes and self-management of overall health risks.And many more...
What are the potential benefits of the Healthy Tigers Wellness Initiative for Auburn University?
Studies have shown that fostering a work environment that encourages health and wellness can lead to:
- Improved employee health
- Increased productivity
- Decreased absenteeism
- Stabilization of healthcare and pharmacy costs
- Stabilization of health insurance premium costs (for employees out-of-pocket costs and the employers' fringe benefit costs)
Auburn University is a self-insured employer, so these potential benefits are significant.
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