WELCOME TO GROUP - Medica...EMPLOYEE ASSISTANCE PROGRAM (EAP) MEDICA | Medica Business Confidential...

WELCOME TO GROUPADMINISTRATOR TRAINING

CLIENT MANAGEMENTJOY SHELBY

MEDICA | Medica Business Confidential 3

AGENDA

• Welcome

• Account Management

• Service Center

• Group Administration

• Enrollment Procedures

• Billing Procedures

• Employer eServices

• Communications Support

• Medica CallLink®

• Employee Assistance Program

• Wellness Programs and Resources

• My Health Rewards by Medica®

• Healthy Savings

• Fit Choices® by Medica

• Take Action Calendar and Onsite Resources

• ROC Tour or My Health Rewards Demonstration

ACCOUNT MANAGEMENT

Group set-up

Pre- and post-enrollment meetings

Health and wellness events

Broker assistance

Account Managers

SERVICE CENTER TOTAL SERVICE TEAM

SERVICE CENTER

One Call Does It All!!

Phone Numbers

952-992-2200

1-800-936-6880

SERVICE CENTER

My Plan Total Service Team – One Stop Shop

Phone Numbers

1-855-2MY-PLAN

1-855-269-7526

SERVICE TEAM AND TOTAL SERVICE TEAM

Clarify benefit information

Address enrollment and eligibility concerns

Check billing, claims and provider status

Check on the status of an enrollment

Order materials for you on behalf of your customers

Answer questions about mymedica.com and the My Plan portal

Capabilities

SERVICE TEAM AND TOTAL SERVICE TEAM

Dedicated team

Committed to quality

Extensive plan knowledge

−All representatives have customer service experience

−Core competency assessments completed annually; refresher training provided weekly

−Monthly quality audit average score: 98%

Excellence

GROUP ADMINISTRATIONBRENT PETERSON

GROUP ADMINISTRATION

Enrollment Procedures

Billing Procedures

Employer eServices

Communications Support

Topics

ENROLLMENT PROCEDURES

When Can Employees Enroll?

EMPLOYEES CAN ENROLL… FORM TO USE…

WHEN NEWLY HIRED

THE MEDICA ENROLLMENT/

CHANGE/CANCELLATION FORM

FOLLOWING A CHANGE IN FAMILY

STATUS:

a) LOSS OF OTHER COVERAGE

b) BIRTH

c) ADOPTION

d) MARRIAGE

e) DIVORCE

DURING OPEN ENROLLMENT

Enrollment / Change / Cancellation Form

Submit within 31 days of event

Use to:− Add employee

− Add dependent (i.e. spouse, child)

− Waive coverage

− Change information (i.e. name and address)

− Remove employee from plan (termination date: end of month)

Plan Selection Change Form

Submit within 31 days of event or plan change

Use to:− Move already enrolled employee from one plan

to another

Continuation Eligibility

To Determine Eligibility:

COBRA/Continuation laws and requirements are the responsibility of the employer (contact your legal counsel)

For more information on Minnesota State Continuation:

• MN Department of Commerce 651-539-1500 or 1-800-657-3602 https://mn.gov/commerce

• MN Department of Health651-201-5000 or 888-345-0823 http://www.health.state.mn.us/

Federal COBRA questions: US Department of Labor at 1-866-487-2365 or www.dol.gov

Continuation Eligibility

To Re-enroll Members Who Have Elected Continuation

Terminate coverage using the Enrollment/Change/Cancellation Form

Notify members of continuation rights

Re-enroll using the Enrollment/Change/Cancellation Form

Employee Enrollment Information or Changes

Send Enrollment Information or Changes to:

Medica

PO Box 30986

Salt Lake City, UT 84130-0986

Fax# 248-733-6064

Material Orders

Forms may be found online at Medica.com or requested from the Medica Service Center at 952-992-2200

Master Group Contract

Many questions can be answered by referring to your Master Group Contract (MGC). The MGC is a legal contract between your company and Medica that lists the following:

- Term of contract

- Grace Period

- Acceptance of contract

- Eligibility

- Rates

BILLING PROCEDURES

Billing

Pay as billed, wait for adjustments

Payment due by first of the month

Bills run on or around 11th of the month

Do not terminate employees on billing statement

Changes are due a full 30 days prior to reflect on billing statement

Automatic Clearing House (ACH), an automated payment option, is available upon request

Questions? Call Service Center at 952-992-2200

BILLING PROCEDURES

Invoices

Invoice reflects:

Account’s summary

Current invoice summary

Invoice detail at subscribers level

Applicable adjustments

EMPLOYER eSERVICES®

Employer eServices®

Real time online administration

Secure internet connection 24/7

EMPLOYERESERVICES.COM

Features

Manage access

Enrollment

ID Cards

Billing

Pay online

Manage Access with Registered CMA

Client Master Administrator (CMA)- Manages access of users

- Activate or inactivate access

- Assign functional permissions, such as enrollment or billing

IF YOU... CONTACT…

Want to register for

Employer eServices®

Medica Service Center at

952-992-2200 or 1-800-936-6880

Email the Service Center at

medicaservicecenter@medica.com

Have a general question about Employer

eServices® or experience a technical

issue while using eServices®

Employer eServices® customer

support at 1-800-651-5465

QUESTIONS

COMMUNICATIONS SUPPORT

Member Newsletters

Biannual distribution

Mailed to all enrolled employees

HEALTHY ATTITUDES

Monthly distribution

Emailed to members registered on mymedica.com; available as PDF for employers to distribute

4MEMBERS

Employer Update E-Newsletter

Monthly employer newsletter

Employer events

Policy changes

Product, network and service changes

Ideas for helping you manage your health care costs and engage your employees in healthy lifestyles

If you aren’t receiving it, visit medica.com/employer and provide your email address

Medica.com Employers

Plan information

Employer and member information resources

Valuable health and wellness programs and resources for employers and members

Find A Doctor

Online versions of our publications

Recent Medica news

EMPLOYEE ASSISTANCE PROGRAM

EMPLOYEE ASSISTANCE PROGRAM (EAP)

Services and Resources

Adult/elder services

Child/parenting services

Chronic condition support services

Convenience services

Life learning

Legal mediation services

Communication resources

Financial services

Management critical incident

response preparation and response

Management consultation

Training services

CATEGORIES CORE SERVICES AND BENEFITS

Masters-Level Associates 24/7 to talk

about personal, financial or legal

worries

Three in-person counseling sessions

covered at 100%

Critical Incident Response and Worksite

Trainings: 150 onsite hours

30-minute legal consultation at no cost

(in person or over the phone)

Promotional postcard mailings to

employees’ homes

EMPLOYEE ASSISTANCE PROGRAM (EAP)

Offering Help with Life Events

Buying a

new homeGetting married

or divorced

Financial

stress

stressHaving

children

Childcare or

eldercare issues

Retirement

issues

Moving or

relocation

Starting

a new job

Returning

to work

FOR 24/7 ASSISTANCE: 1-800-626-7944

MEDICA CallLink® NURSE LINE

MEDICA CallLINK®

Nurse Line

Answer health questions and help with decisions

Educate on treatment options and condition management

Guide to appropriate level of care and advice on provider selection

Locate network physicians and pharmacies

Available 24-7

Call 1.800.962.9497 to talk to a registered nurseChat live with a nurse online at mymedica.com

MEDICA HEALTH AND WELLNESS OVERVIEW

WHY THE NEED?

Reasons for Developing a Healthy, Supportive Culture

A culture will assist to help change behavior and risk. Costs follow risks!

Healthy culture happens by design! Find ways to make your culture healthier.

Habits are influenced by environment.

Goal: Create a culture where the healthy choice becomes the easy choice.

WHY IMPORTANT?

AGENDA

2019 My Health Rewards

Healthy Savings

Health Club Reimbursement

2019 Take Action Calendar & Onsite Resources

Weaving Wellness into Your Workshop/Partnership

MY HEALTH REWARDS®

MY HEALTH REWARDS BY MEDICA®

Online Health and Wellness Programs

MY HEALTH REWARDS BY MEDICA® │ 2019

MEMBERS 18 YEARS OLD + CAN EARN UP TO $100 IN GIFT CARDS FUNDED BY MEDICA

POINTS EARNED 100 200 300 400 500

REWARDFirst

$20 gift-cardSecond

$20 gift-cardThird

$20 gift-cardFourth

$20 gift-cardFifth

$20 gift-card

MY HEALTH REWARDS(STANDARD)

ENHANCED ADDS:

RESULTS ADDS:

ACTIONHealth

Assessment

Next Steps

ConsultT

JourneysTM TrackTMVirtual

Care Education

MonjCare

SupportBiometric Screening

Biometric Result*

POINTS PER

ACTION100 25 50 each 1 per day 25

25 for access,

1 per day 200 onceper year

(ifidentified)

100 25 per Result*

HEALTH ACTION

Once per year

Up to 300 per year

Up to 200 per year

Once per year

Up to 200 per year

Once per year

Up to 100 per year

*RESULTS INCLUDE:

BMI non HDL cholesterol blood pressure blood sugar

Personalized Homepage

Compass Health Assessment Examples

Compass Health Assessment Results

Next-Steps Consult

Health guides provide education on compass health assessment and biometric screening results:

− Personalized phone consultation

− Raise health awareness and reinforce positive results

− Identify small steps toward healthier changes

− Recommend programs

Journey

Journey Example

My health rewards wellness member portal will feature enhancements to track

− A more intuitive and easy identification of activities

Track Options

Gift Card Redemption

NEW FOR 2019

Virtual Care Education

Virtual Care Education: Awards

25 My Health Rewards points for

reviewing virtual care options

VIRTUAL CARE OPTIONS®

Convenient and Cost Effective Online Treatment

CLINIC-BASED AMWELL VIRTUWELL CallLink NurseLine

Many clinics offer virtual care, online care or e-visits

24/7 online clinic available in every state

Includes coverage for medical and behavioral health care services

24/7 online clinic available in select states

Available 24/7

Prices varyMedical: Each visit is $49 or less

Behavioral health: Price varies by type of service

Medical: Each visit is $49 or less

Check with your clinic to see if they offer virtual care and how you can connect with

your provider online

Mobile, web and phone visits with a board-certified doctor

Online visits with a certified nurse practitioner

Phone visits with a certified nurse practitioner

Clinic’s website Amwell.com Virtuwell.comhttps://www.medica.com/we

llness/nurse-line

*Virtual care options can vary by your plan’s network. Check care options at medica.com/findadoctor.

Treatment of Common Medical Conditions

Allergies

Bladder infections

Cold & Flu

Ear infections

Fevers

Migraines

Pinkeye

Stomach pain

Other, non-urgent common health conditions

Behavioral Health Services

Some virtual care providers offer behavioral health services, including treatment for:

− Depression

− Anxiety

− Stress

− Mood disorders

− Insomnia

− Eating disorders

− Family (marriage, children)

− Grief and loss

− Coping with illness

Cost per visit varies by type of service. Eligible services are covered as a behavioral health office visit.

Mobile, Web & Phone

Three easy options:

− Smartphone/tablet: Download the free Amwell app from the Apple Store or on Google Play

− Computer: Go to amwell.com

− Phone: Call 844-733-3627

Mobile Phone

Overview

Introducing Monj

Monj is a company on a mission to reverse the obesity trend in America by addressing the largest cause of lifestyle-related diseases - people’s relationship to food.

They offer a skills-based behavioral curriculum centered on food, key lifestyle factors and social determinants including stress, social connection, mindset and movement.

Introducing Monj

Monj Rewards members 25 points for accessing the site, and 1 point per day up to 200 max for completion of daily missions.

Monj – Helpful Tools and ResourcesDaily Missions: Learn-by-doing missions are aimed at building healthy behaviors in small daily steps.

Power ups: Quick meals made by adding fresh ingredients that boost flavor (and nutrition). Great when eating out too.

Cooking Lessons: Monj cooking lessons vary in ingredient variety, skill level, and complexity.

Essentials: Content covering topics from how to store produce, to eating on the road, to hacking delicious snacks.

Shopping tools: Our smart shopping list enables members to buy the right amounts, avoiding waste by reducing extras bought in the store.

Team Ups: Connecting colleagues, friends and family for collaboration.

The Good Bite: Monj weekly emailed content addresses the whole person.

Monj – Helpful Tools and Resources

HEALTHY SAVINGS OVERVIEW

Healthy Savings makes eating healthier

easier and more affordable.

The program is easy-to-use, members simply

shop, scan and save instantly!

Discounts on healthy foods of up to $250 per month

Foods qualified by a third party based on nutrient

density – only healthiest 1/3 qualify

No clipping or downloading coupons needed; all

promotions are automatically loaded onto barcode

Available to members within 30 miles of

participating retailer

HEALTHY SAVINGS | Discounts on Healthy Foods

Coming Soon:

Participating Retailers:

HEALTHY SAVINGS

Branded Savings

200+ participating brands

Over $50 in member value

each week

Pre-qualified as healthy

Stackable with coupons

…and 195 more brands!

HEALTHY SAVINGS

200+ Participating Brands

FRUITS VEGETABLES GRAINS PROTEIN DAIRY WHOLE PLATE

HEALTHY SAVINGS

How it WorksMember accounts are pre-loaded with discounts each week

Shop for promoted items

Scan card or mobile app at checkout

Save instantly

HEALTHY SAVINGS

Weekly Emails

Trending (Sundays)

Announces new benefit week & lists the top trending offers for the week with link to the full list.

Featured (Tuesdays)

Highlights four popular featured promotions and shows them as prepared foods.

Expiring (Thursdays) Opt-in

Reminds members of the promotions that are three days from expiration.

HEALTHY SAVINGS

Mobile App & Website Portal

Members have two options to access their savings – the Healthy Savings mobile app and the website portal.

HEALTHY SAVINGS

Mobile App & Website Portal

App users engage at a 150% higher rate and save 250% versus non-app users.

View Savings

Find Store Browse Offers Scan Products Scan Barcode

MY HEALTHY

SAVINGS:

$150.00

HEALTHY SAVINGS

Available Offers

Members can use the Healthy Savings website portal or mobile app to view their available savings and browse all offers.

Members can also favorite promotions by tapping on the open heart. ♥ They will get notified when the favorite offer is promoted.

HEALTHY SAVINGS

Farmers Market

Members can save up to $3.00 on produce at participating Farmers Markets

HEALTHY SAVINGS

Program FAQs - Card

How Do I Activate My Card?

− With your card, go to medica.com/healthysavings and click “Register” to access your weekly savings and manage your account.

Where Can I Use My Card?

− Any Healthy Savings retailer. Find stores nearest you on the “Store Finder” page or on the “Store” tab on the mobile app.

How Do I Use the Card in the Store?

1. We suggest using the app to help you locate products eligible for discounts

2. Present your card to the clerk before payment to scan the barcode

3. See “HS” discounts noted on the sales receipt

HEALTHY SAVINGS

Program Awareness

Member Flyer

Member Video

Member Poster

FIT CHOICES BY MEDICASM

$20 8,000+ 2xCREDIT TOWARD MONTHLY DUES

HEALTH CLUBS TO CHOOSE FROM

THE FIT CHOICES BENEFIT CAN BE PAID

TWICE IN 2019

NationalMany fitness facilities have locations nationwide, however not all locations may participate in the Fit Choices program. Contact the location you wish to visit to ensure they participate in the program

RegionalMany regional and local facilities in Minnesota, North Dakota, South Dakota, and western Wisconsin are in the Fit Choices program.

Check medica.com for more information

WELLNESS PARTNERSHIPS

Medica’s Online Wellness Resources – Medica.com

WELLNESS PARTNERSHIPS

2019 Take Action Calendar

WEAVING WELLNESS INTO YOUR WORKSITE

GUIDING PRINCIPLES

The wellness vision and strategy is grounded in the organization’s core vision and mission statement.

The formation of the wellness foundation is designed to offer support, motivation and engagement for employees to live a healthy lifestyle and to fulfill their passion and purpose.

The partnership will create a sustainable and supportive environment.

The partnership will create a cohesive wellness team.

Medica will collect and leverage data that matter most to your organization.

Medica’s partnership offers best practice consultation in building a sustainable wellness culture with a customized strategy that meets the needs and interests of each unique employee population. It is based upon the following guiding principles:

WHY – DEVELOP A WORKSITE STRATEGY

What gets measured gets done!

Builds the business case

It connects the dots with your wants

Makes engagement leaps

YOUR VISION IS THE GAS TANK

IT’S ALL ABOUT BABY STEPS!

STEP ONE STEP TWO STEP THREE

Well-being framework Well-being strategy & action plan

Well-being engagement dashboard

MEDICA’S HEALTH CONSULTATION MODEL | Best Practice

Goal: Create a sustainable, results-oriented worksite wellness approach that provides

awareness, motivation and support in addressing the unique health risks and interests of each

employer towards living a thriving lifestyle.

STEP ONE | Well-being Framework

Goal: Identify the uniqueness of each employer’s culture to assist with development of a wellness strategy that best meets the needs and interests of their employee population.

MEDICA’S DATA ANALYSIS SCOPE OF WELL-BEING CULTURE ANALYSIS

Demographics Population risk My Health Rewards by Medica® Preventive care utilization Chronic conditions – claims Employee engagement survey

Resources: Refer to Well-Being Framework Binder Section

Identify well-being pillars Identify existing programs/resources Cultivate supportive health promoting

environments, policies and practices

Resources: Refer to Well-Being Strategy & Action Plan Binder Section

Achieve leadership support Review environment structure related

to supportive health promoting environment, policies and practices

Effective communication channels Wellness Culture Champions

Resources: Refer to Well-Being Framework & Strategy & Action Plan Binder Sections

WHY IMPORTANT?

MEDICA | Medica Business Confidential

QUESTIONS & ANSWERS

THANK YOU

WELCOME TO GROUP - Medica...EMPLOYEE ASSISTANCE PROGRAM (EAP) MEDICA | Medica Business Confidential...

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