Frequently Asked Questions
What is the purpose of the My Healthy Lifestyle wellness program?
The program was developed to help improve the health of our team members and their families by providing education, resources, and motivation to take action. We believe that team members who set and reach health goals will feel better, see long-term improvements in their health and quality of life and spend less on health-related costs.
Who can take advantage of My Healthy Lifestyle?
All team members are eligible and encouraged to participate in the My Healthy Lifestyle wellness program. Along with the health and lifestyle benefits of the program, any team member (and their covered spouse) who has health plan insurance benefits through Riverside Health System has the opportunity to receive a health insurance premium discount or other health-related incentive by meeting the requirements of the program.
How do I participate in order to receive the health insurance premium discount or other health-related incentive?
To earn health plan premium discounts or other incentives, you and your covered spouse, if applicable, need to complete four steps and meet healthy lifestyle targets.
My spouse is covered under my health insurance plan. Does he/she need to participate in the program?
Yes. If your spouse is covered under your health insurance plan, he or she must complete the same requirements as the team member in order to receive the reduced health insurance premium or other health-related incentive.
If only one of us meets the participation requirements, can we get a partial reduction on the health insurance premium?
To be eligible for My Healthy Lifestyle premium discounts, both you and your spouse need to complete all of the steps (wellness visit, lab tests, verification form/consent, wellness plan if appropriate). The number of healthy lifestyle points you earn, based on your risk factors, will determine the amount of your discount, or ‘tier.’
What about my children?
Dependent children will not be required to participate in the wellness exams in order to receive the reduced health insurance premium or other health-related incentive.
Can I get my annual wellness exam by a non-Riverside provider as well as a Riverside provider?
Yes. Your annual wellness exam may be provided by any Primary Care Physician. Please attach your exam results to the Physical Exam Verification Form / Patient Consent and Authorization form.
Am I responsible for any of the costs of the annual wellness visit?
No. Annual wellness exams, preventive screenings, and follow-up visits to develop a personal wellness plan are covered under Riverside health plans at 100%, with no co-payment when services are provided by a participating provider and appropriately billed with a preventive diagnosis. The preventive screenings include: Tobacco Use, Blood Pressure, TC:HDL Ratio or Total Cholesterol, Glucose, Body Mass Index.
I already had a recent annual wellness exam with my doctor. Can I use this information as part of the requirements for the My Healthy Lifestyle program?
If your annual wellness exam was within a year and included all of the necessary medical information, you may use the results to fulfill the wellness program requirements. However, you will need to have the medical provider complete the Physical Exam Verification Form / Patient Consent and Authorization and attach a copy of your lab results.
What should I do if I can’t get an appointment with my primary provider before November 30, 2013?
Please contact your primary provider’s office now to schedule your physical exam. You may want to consider a Riverside Medical Group (RMG) primary provider if your non-RMG provider is unable to provide an appointment before November 30, 2013. RMG primary providers are aware of the need for Riverside team members to have these exams. If you are a member of Riverside CareAdvantage PPO and have an RMG primary provider designated in Employee Self Service (ESS), you are also a member of Riverside CareAdvocate. You may call Riverside CareAdvocate at 866-799-2643 for assistance in scheduling your exam.
Is it possible to go to my doctor for both a “sick” visit and the wellness physical exam at the same visit?
If you go to your doctor for a “wellness” exam, the services and tests that are considered 100% covered preventive services will be at no out-of-pocket cost to you (Tobacco Use, Blood Pressure, TC:HDL Ratio or Total Cholesterol, Glucose, Body Mass Index). If other services or tests are performed that are not 100% covered preventive services, you may be charged for the office visit and the other services or tests. In addition, if you have a wellness visit scheduled and you happen to be sick that day, the doctor might not perform the wellness exam depending on the severity of your symptoms. If both wellness and “sick” services are performed, you will be charged for the “sick” office visit.
After I get my annual wellness exam do I submit my test results to Human Resources?
No. You will send your results to Health Advocate at the address on the Physical Exam Verification Form / Patient Consent and Authorization (Health Advocate Inc., Attn: Riverside Health Form, 3043 Walton Road, Suite 150, Plymouth Meeting, PA 19462). Health Advocate is a third-party (an organization independent from you and your physician/health plan) that maintains your medical information privately and confidentially.
What is the consent form and what do I do with it?
The completed Patient Consent and Authorization provides your consent to participate in the My Healthy Lifestyle wellness program including allowing Health Advocate to maintain your health results. The form acknowledges that Riverside will not receive individual health information from Health Advocate, but only the names of those team members who qualify for the cost-saving incentive. The form also provides personal consent for the use of health information for group reports and annual comparison of health risks that protect individual confidentiality. Note that you will also need to return the Physical Exam Verification Form / Patient Consent and Authorization and a copy of your lab results to Health Advocate at the address on the bottom of the form.
Will a follow-up appointment be required?
Not if your physician has the information—including lab results – that he or she needs at the time of your wellness exam. During the wellness exam, you and your physician will discuss your lab results (blood tests) along with the physical exam and develop a personal wellness plan. Evaluating your test results gives your physician an opportunity to suggest actions that could improve them. As an example, if you have an elevated blood pressure, your doctor might recommend you start a diet and exercise program. If your results are within the recommended range, you may work with your physician on maintaining your values or improving them further. Your wellness exam is covered 100% by your health plan. However, if non-preventive services (unrelated to your wellness exam and plan) are provided during your wellness visit, you may be billed accordingly.
Is there a certain document that I must use to verify that I have completed program requirements?
Yes. You should take the Physical Exam Verification Form / Patient Consent and Authorization to your physician annual wellness visit so that the physician can complete the form. If your Primary Care Physician is a Riverside Medical Group provider, the office can provide you with a printout of your test results. Remember – you have the responsibility to forward the completed Physical Exam Verification form, with lab results attached, and your Patient Consent and Authorization form to Health Advocate.
My Healthy Lifestyle is an Outcomes-Based program. What does that mean?
Your participation alone is not sufficient to qualify you for the incentives or rewards – reduced health insurance premiums – that are part of the program. You must also achieve measurable objectives for improved health. If it is unreasonably difficult for you to achieve the standards for the incentives under this program due to a medical condition, contact your Human Resources Representative, who will work with you to develop another way to qualify for the incentive.
What will be the requirements for this outcomes-based program?
Riverside is operating under a three-year strategy that started in 2012, to allow team members the opportunity to improve their health within a reasonable time frame in order to receive incentives.
How does the three-year strategy work?
It consists of a step progression designed to be reasonable for reaching defined health and wellness goals. Any changes will be communicated in advance.
Remember, if your spouse is covered under your health insurance plan, he or she must complete the same requirements as the team member in order to receive a reduced health insurance premium or other health-related incentive.
How will the points for the program be calculated beginning in 2014?
Team members and covered spouses accrue points based on health risk factors. The maximum number of points one can possibly score is 100.
How does the spouse’s score factor in?
If your spouse is covered under your health insurance plan, he or she must complete the same requirements as the team member in order to receive a reduced health insurance premium or other health-related incentive. Team members and spouses who do not participate in the program will not receive a health benefit incentive.
Premium reductions are calculated using a three-tier measurement:
- High-tier – The best health insurance premium reduction or other health-related incentive; a composite score that meets the baseline minimum requirement (30 points for plan year 2013, 50 points for plan year 2014) must be achieved by both the team member and the spouse.
- Mid-tier – The team member or the spouse meets the 30-point (50-point in 2014) baseline minimum, but the other person does not.
- Low-tier – The team member and the spouse participate but neither meets the baseline.
What if my test results are good and my health risks are not considerable and I don’t have any real health issues. How will the My Healthy Lifestyle wellness program benefit me?
Congratulations on your achievement! Your goal is to continue living an active and healthy lifestyle to ensure your test results stay within the recommended range and also benefit from the incentives.
What resources will be available to help me improve my health status and my test results?
Your primary care physician is your first resource to discuss your health status and to help you develop a personal wellness plan. Riverside also will provide activities and online resources to help team members improve their lifestyles. These will include specific programs identified to improve your test results, as well as programs recommended by your employee Wellness and Health Plan Advisory Council. Riverside health plan participants can also take advantage of Wellness Advocate, a variety of wellness support services available through Health Advocate.
Does Riverside have wellness center memberships or other resources that can help me with my personal wellness?
Team members are encouraged to explore the benefits of discounted membership and targeted programs offered by the Riverside Wellness & Fitness Centers (RWFC), as well as wellness center offerings described in our DollarSmart program on the Total Rewards intranet site. RWFC offers Smokeless®, the stop smoking program that will have you off of cigarettes in only five days, and Dietcise, an 8-week weight loss program that combines effective fat-burning exercise in a non-intimidating group setting with nutrition education emphasizing balance, variety and moderation. Riverside Medical & Surgical Weight Loss Center also offers options for weight management.
In addition, don’t forget Carebridge, Riverside’s work-life services partner. Carebridge offers 24-hour, 365-day access to wellness and EAP services plus a host of additional value-added services. These benefits are available, at no cost, to all Riverside team members (including Riverside School of Health Careers students) and their immediate family members. Carebridge is available 24 hours a day, 7 days per week by calling 1-800-437-0911. You can visit the Carebridge website at www.myliferesource.com. Our Riverside Access Code is: 8437M.
How long will the My Healthy Lifestyle program continue?
The My Healthy Lifestyle program will be an ongoing program at Riverside with incentives tied to the benefits package in years to come. While the overall goal of the program is to assist team and family members with improving their health, some of the initiatives and incentives might change from year to year.
Team members also can expect that Riverside Medical Group will continue to make your life easier through ongoing communication innovations. Look for myHealth eLink messages reminding you about Physical Examination Form completion, your wellness exam test results being available on your Electronic Medical Record, and the ability to complete, submit, and print your online Physical Examination form!
Where can I get more information?
Please access the My Healthy Lifestyle website, contact your Human Resources representative or call Total Rewards at (757) 534-5281.
What are the key dates for the wellness program requirements for team members and spouses covered by Riverside’s health insurance?
View the Steps to Healthy Savings, including key dates to mark on your calendar.