Healthy Blue
Living HMO
SM
every card.
Confidence comes with
®
The plan that creates a
healthier workplace
Join the wellness revolution
BCN Healthy Blue LivingSM HMO is a wellness incentive plan from Blue Care Network of Michigan that
rewards your employees for making better health choices.
10 years ago, it blazed a new managed care trail. It was Michigan’s first HMO product to tie personal wellness to
financial rewards. There are many competitors now — but none with our experience.
Success in meeting your business needs
Having a healthy workforce is not only good for your employees, but it can benefit your business as well. Businesses
save on premiums versus traditional HMO products when they select Healthy Blue Living for their employees.
We focus on making your health care costs manageable and optimizing the value delivered. Healthy Blue Living rates
compare favorably to traditional health care plans with similar coverage because:
• Employees who are accountable for their well-being and make a commitment to healthy living have lower outof-pocket costs.
• Better health can lead to a drop in absenteeism, an increase in productivity and a decrease in long-term costs.
Healthy Blue Living results
Healthy Blue Living employers have witnessed real results. They’ve seen health scores for members in
the plan since 2009 move from unhealthy to healthy for:
57%
59%
60%
of members with
of members with
of members with
high cholesterol
high blood pressure
high blood sugar
Reward better health choices
Healthy Blue Living motivates employees to live healthier and make wellness a priority. All of your employees in this
plan will have the same great benefits package as one another. However, each employee will have the opportunity to
lower his or her out-of-pocket costs by achieving or maintaining the enhanced benefits level.
Benefit levels
Enhanced: Lower copayments and deductible
Standard: Higher copayments and deductible
To learn how your employees can earn the enhanced level, refer to the next page.
Doesn’t use (confirmed by primary
care physician through blood or
urine cotinine testing)*
ssur
e
Body mass index
below 30
pre
d
a
ug
r
At the heart of Healthy Blue Living are
health measures that focus on six key
areas your employees can control that
significantly affect their health. If these
health measures aren’t within wellness
targets, they can affect health care
costs and increase the likelihood that
an employee will develop a chronic or
disabling condition.
oo
sio
Dep
res
s
od
Blo
At or below target (fasting
blood sugar or A1C)
6 measures for
healthy living
ht
eig
W
Any depression
is in full remission
n
Tobacco
Bl
Below 140/90
Cholesterol
LDL-C below target (based on
risk factors: <100, <130 or <160)
*After one negative test, no testing is needed again.
Self-reported tobacco users don’t need the test.
Change lives by leading change
New employees who select Healthy Blue Living begin the plan year with enhanced benefits. Renewing employees start
at the level of benefits they had in the previous plan year. Help your employees keep or earn enhanced benefits by
telling them to:
✓ Visit their primary care physician who will complete and electronically submit
their Blue Care Network Qualification Form
Within the first
90 DAYS
of plan year
✓ Meet the six health measures or work toward meeting wellness targets
✓ Complete the online health assessment at bcbsm.com
✓ Participate (if tobacco user) in our tobacco-cessation program until they quit
Within the first
120 DAYS
of plan year
✓ Participate (with a BMI of 30 or more) in a BCN-sponsored weightmanagement program
If an employee doesn’t meet the above Healthy Blue Living
requirements, then everyone on his or her contract will have
standard benefits for the rest of the plan year.
Every member must have a primary care physician to provide
care or refer them to a specialist.
Blue Care Network is committed to helping members achieve their best health status. Rewards for participating in our wellness program, Healthy Blue
Living, are available to all contract holders who meet all qualification requirements. If any contract holder thinks they might be unable to meet a standard or
requirement for a reward under this wellness program, they might qualify for an opportunity to earn the same reward by different means. They can work with
their BCN primary care physician to find an alternative that’s right for them in light of their health status.
Lead the way to better health
Offering Healthy Blue Living to your employees comes with tasks for you. Here are your responsibilities:
Give your employees instructions for taking the online health assessment at bcbsm.com
Tell your employees to complete the health assessment and qualification form within 90 days of enrollment
in order to earn enhanced benefits with lower out-of-pocket costs
Institute and maintain a smoke-free workplace
Encourage employees to participate in wellness programs
Remind employees that they must select a primary care physician to coordinate their care
Required
program
Employer requirements by group size
1–50 enrolled
employees
51–300 enrolled
employees
301–1000 enrolled
employees
1001+ enrolled
employees
Select at least one of
the optional programs
Select at least two of
the optional programs
Select at least three of
the optional programs
Select at least four of
the optional programs
Required
Required
Required
Required
Not required
1 time per year
2 times per year
2 times per year
Distribute healthrelated articles for
employees (brochures,
newsletter, posters)
2 times per year
2 times per year
2 times per year
3 times per year
Provide on-site class
or discounts for
weight loss
1 time per year
1 time per year
2 times per year
2 times per year
Provide healthy
foods in cafeteria and
vending machines
Ongoing
Ongoing
Ongoing
Ongoing
1 time per year
1 time per year
2 times per year
2 times per year
Ongoing
Ongoing
Ongoing
Ongoing
Provide smoke-free
environment
Optional programs
Health fair
Provide stress-relief
class
Provide discounts
to exercise facilities,
or exercise classes
2 times per year, or
exercise facility on site
Give employees a great start
Here’s a snapshot of what can happen during the plan year:
Beginning of plan year
Day 91
During the plan year
New employees start with
enhanced benefits.
Qualified employees earn or keep
enhanced benefits. Nonqualified
employees move to standard
benefits for the rest of the plan year.
Employees who don’t follow the
recommended program or treatment
plan move everyone on his or her
contract to standard benefits.
Renewing employees start at
the level of benefits they had
in the previous plan year.
Employees over 65 are eligible
Active employees and retirees over age 65 are eligible for Healthy Blue Living. However, if Medicare is the primary
health care coverage for an employee, retiree or covered spouse, that person cannot enroll in Healthy Blue Living.
Individuals eligible for Medicare may be able to enroll in a Medicare product.
Helping your employees on the path to a healthier lifestyle
It can be a challenge to achieve a healthy lifestyle. That’s why we offer some valuable resources to help employees
not only reach their wellness goals, but achieve lower copayments and deductible at the enhanced benefits level.
Tobacco use
Our effective tobacco-cessation program helps members quit at no additional cost.
Weight management
For employees with a body mass index of 30 or more — confirmed by their qualification form —
we provide access to programs that help them better manage their weight.
Once enrolled in a BCN-sponsored weight-management program, the employee must actively
participate until his or her body mass index falls below 30. We cover the cost of one program
per plan year. At renewal each year, employees with a BMI of 30 or more may move to a different
BCN-sponsored program. Employees should consult with their primary care physician before starting
any regular exercise or weight-management program.
Let our health plan work for your employees
Member discounts
Members have access to exclusive discounts on a variety of healthy products and services from groceries and
fitness gear to travel and gym memberships.
Publications
Employees who select Healthy Blue Living receive a special issue of our award-winning Good Health magazine
twice a year. It’s loaded with health tips and lifestyle advice.
Health and wellness information is also online at facebook.com/MiBCN.
And everyone may sign up for our free monthly e-newsletter at bcbsm.com/enewsletters. Readers learn to improve
their health with articles, videos, tips and recipes.
Healthy activities and programs
We have a variety of care and disease management programs to help members stay healthy, get better or improve
their quality of life while living with a chronic illness.
24-Hour Nurse Advice Line
For no extra cost, members can call a registered nurse 24 hours a day, seven days a week. A registered nurse can
answer health care questions, assess symptoms and provide self-care tips, and give advice on making decisions
about treatment options for a condition or disease.
Industry-leading network
Blue Care Network has the largest HMO network of physicians and hospitals in the state, with more than 5,700
primary care physicians and 21,000 specialists and most of the state’s leading hospitals. And members are always
covered for emergency care — in Michigan, across the country and around the world.
Exceptional customer service
Members can call the Customer Service number on the back of their Blue Care Network ID card for expert help with
claims and benefits. Translation services are available for non-English speakers in more than 140 languages.
bcbsm.com gives members the power to make smart health choices.
When adult members sign up for a member account, it gives them:
An easier search: See what’s covered, and look up doctors, hospitals and treatments in one spot.
The complete picture: Plan for surgery by knowing all services involved, each of their estimated costs,
and overall timing — from initial visit through therapy.
Healthy choices: Manage goals and fitness with Blue Cross® Health & Wellness, powered by WebMD®.
WebMD Health Services is an independent company supporting Blue Care Network by providing health and wellness services.
Find us online:
bcbsm.com | news.bcbsm.com | facebook.com/MiBCN
ahealthiermichigan.org | twitter.com/bcbsm | youtube.com/bcbsmnews
CB 9446 JUN 16
Blue Care Network is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association.
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