Health Engagement Program
January 12, 2017
Consumer-Directed Health Plan
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The Consumer-Directed Health Plan (CDHP)
• High Deductible Health Plan
• Health Reimbursement Account (HRA) helps offset the deductible
• No copays
• Wellness Premium Credits available during Open Enrollment
• Wellness Incentives add funds to HRA for visiting certain providers
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How Your HRA Works
• HRA funding is based on the number of family members covered
• HRA funds are used to cover a portion of the member’s deductible
and coinsurance
• If HRA funds are depleted, the member must pay the remaining
deductible and coinsurance
• If funds remain in the HRA at the end of the benefit year, they will roll
over to the following year if the member re-enrolls in the CDHP
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State Health Plan contributions to HRA account
• Additional State Health Plan contributions to your HRA:
• See your selected Primary Care Provider (PCP) – $25
• See a Blue Options Designated Specialist – $20
• Use a Blue Options Designated Hospital – $200
• Participate in the Health Engagement Program
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Health Engagement Program
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Health Engagement Program for CDHP Members
• The Health Engagement Program offers additional Health Reimbursement
Account (HRA) funds for Consumer-Directed Health Plan (CDHP)
members who engage in healthy activities. There are two components:
• Healthy Lifestyles: Members can earn incentives for completing
healthy behaviors such as tracking physical activity and nutrition.
• Positive Pursuits: Members with identified conditions can earn even
more in their HRA for actively managing their condition.
• To participate, you must be on the Consumer-Directed Health Plan and
over the age of 18
• Each qualifying member can earn HRA incentives for participating
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Healthy Lifestyles
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Healthy Lifestyles Activity Options
Activity Options
HRA Funds
Complete 3 Lifestyle Coach
sessions
$25/year
Track physical activity
-OR-
$25/quarter
2017 Earning Potential
Funds Per
Eligible Participant:
calories consumed
$175
NEW Earn 500 RivalPoints
$50/year
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$350
$525
Lifestyle Coaching
• A Lifestyle Coach is able to guide you on
topics such as weight management, nutrition,
physical activity, stress management and
more. Together you can create goals and a
plan to achieve them!
• Complete 3 sessions to earn an incentive of
$25 into your HRA
• Calls must be completed at least 2 weeks
apart
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Tracking Physical Activity or Calories Consumed
• Choose a tracking goal of physical activity or calories consumed
• To meet your tracking goal, record at least 60 days/quarter (an
average 5 days a week) of:
30 minutes of activity or take
5,000 steps each day
-OR-
Calories consumed each day
• Meet your tracking goal and earn $25/quarter
• You can track manually and through a connected device or health
application—for a full list, visit your portal
• While you can track both, you will only receive an incentive for the
first tracking goal you meet in a calendar quarter
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Healthy Lifestyles Enrollment
• Visit shpnc.org, click on your Personal Health Portal, and follow the
instructions under the Healthy Lifestyles Enrollment tab
• If you enrolled in 2016, you do not need to re-enroll in 2017 to earn
incentives
• HRA funds can only be earned for the activities completed after
enrollment—so the earlier you enroll the more incentives you can earn!
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Heath Engagement Program Rewards
• The Health Engagement
Program Rewards tab will
display after you enroll
• Here you can see:
• All your options for
earning incentives
• Your progress towards
earning incentives
• Information on registering
for RivalHealth
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NEW RivalHealth
RivalHealth has been added to Healthy Lifestyles to:
• Provide you with more options to
participate in Healthy Lifestyles
• Encourage a team-based approach
to health improvement
• Help you measure your
improvement over time
• Provide additional options for
earning HRA funds
500 RivalPoints = $50 in your HRA
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RivalPoints: Creating Buzz
• Buzz is an interaction with other participants within RivalHealth
• Through Buzz, you can:
• Connect with others who have similar health goals
• Find new ideas for staying healthy
• Get the motivation you need to stay on track
• Help you celebrate your successes
Points Awarded
Frequency Points Can Be Earned
5 RivalPoints per Buzz
Once every 18 days
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RivalPoints: Taking A FitIn
• A FitIn is an assessment of your fitness level that
provides you with a fitness score, or RivalRating
• By taking your FitIn you can:
• Understand your current fitness level
• Measure your success over time
Points Awarded
Frequency Points Can Be Earned
100 RivalPoints per FitIn Taken
Once every 90 days
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RivalPoints: Increasing Your RivalRating by 5%
• Improving your RivalRating will take work-- if you improve your
fitness, we want to reward you!
Points Awarded
Frequency Points Can Be Earned
100 RivalPoints
Once per year
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RivalPoints: Meeting Quarterly Challenges
• Each quarter, we will launch a
challenge to focus on a health habit
• By meeting the challenge
requirements, you can earn 100
RivalPoints
• Recognize which challenges are
worth points by the ribbon in the left
corner
Points Awarded
Frequency Points Can Be Earned
100 RivalPoints per Challenge Met
Once every 90 days
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Register for RivalHealth
• Register for RivalHealth to earn more in your HRA
• You’ll need your health benefits card to get started
• During registration, you’ll be asked a few questions to help customize
your account
• If you’re already registered, you’re ready to start earning RivalPoints
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Viewing RivalPoints
• Visit your RivalPoints page to see:
o Your total RivalPoints earned
o Activities to earn points
o Time frame for activity options
• Make sure to visit your Personal
Health Portal to view all activity
options and your progress
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Positive Pursuits
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Positive Pursuits
• Positive Pursuits is only available to CDHP members with the following
diagnosed medical conditions:
• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Congestive Heart Failure (CHF)
• Coronary Artery Disease (CAD)
• Diabetes
• Hypertension
• High cholesterol
• If eligible, you can earn additional HRA funds to help pay for necessary
health services, which will help you stay as healthy as possible and avoid
complications of your condition.
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Positive Pursuits Activity Options
• Incentivized activities are diagnosis-specific and may include:
 Visit(s) to Primary Care Provider
 Completion of lab tests or education
 Taking medications as prescribed
 Calls with Nurse Coach
• Activities are awarded based on claims and Nurse Coach interaction
• If you have more than one condition, you can earn funds for each
condition, with the exception of overlapping activities
• Example: A member with both CHF and CAD will only receive an
incentive once for receiving a CBC lab test, even though it is an activity
under both conditions.
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Positive Pursuits Enrollment
• If you are eligible for Positive Pursuits, call 800-817-7044 to enroll today
• After you enroll, you will receive a welcome letter and be able to see
addition information in your Personal Health Portal outlining your conditionspecific activity options to earn funds into your HRA
• Members participating in Positive Pursuits are also encouraged to
participate in Healthy Lifestyles, so make sure to sign up for both to earn
even more
• HRA funds can only be earned for the activities completed after
enrollment—so the earlier you enroll the more incentives you can earn!
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Health Reimbursement Account
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HRA Incentive Timing
Type of Activity
Timeframe HRA Funds Will Be Applied
Claims-based Activities
Up to 4 months
Non-Claims Activities
Up to 2 weeks
Check the balance of your HRA through Blue Connect by:
• Visiting shpnc.org
• Selecting
• Clicking
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Reviewing HRA Funds Earned
$525.00
0
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Reviewing HRA Funds Earned
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Getting Started
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Thank You!
www.shpnc.org
www.nctreasurer.com