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On the Way to WellnessYear Two – Year of Action

Fall 2014

Year Two of the Wellness Program for Indiana State University Faculty,

Staff and Early Retirees

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National Health Care Crisis . . .• According to the CDC, 1/3 of American’s are obese.• By the year 2030, it is estimated that almost 50% of adults will be

obese.• Obesity among young children has doubled in the past 20 years • Chronic health conditions account for approximately 75% of the

nation’s $2 trillion of medical care costs – more than 15% of the US gross domestic product

• The majority of chronic diseases can be prevented through lifestyle changes

• It is estimated that 7 million people do not know they are diabetic.• More than 1/4th of all Americans – 2 out of 3 – have multiple

chronic conditions.

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In Indiana, Grade F for FATSource: Trust for America’s Health, and the Robert Wood Johnson Foundation

• Indiana’s obesity rank is still 8th in the nation• Two thirds of Hoosiers are classified obese or

overweight• 30% are physically inactive; one in four adults • More than half of a million adults are diabetic• Obesity related cancers are on the rise.• Indiana has one of the highest prevalence of

smoking in the nation – more than 1.1 million adults still smoke

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Indiana Savings by 2030 For a 5% reduction in BMI now

• Diabetes – $5.16 Billion• Obesity related cancer – $256 Million• Coronary heart disease and stroke -- $5.92

Billion• Hypertension – $864 Million• Arthritis -- $1.2 BillionObesity threatens our State Financially

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Our Situation in 2014

• Average age of employees covered by the health plan is 52+ (does not include retirees over age 65)

• Employees in age categories of 45 to 54 and 55 to 64 produce higher claims than other age categories

• We cover approximately 1,400 employees plus dependents; 3,000 total lives.

• Health claims increases are double digits thus far compared with the same time period in 2013.

• Total spend is over $20 million per year and increases annually due to medical inflation, utilization and large claims.

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On the positive side,• The University’s health plan is self-insured.– we pay our claims processed by third party

administration (CIGNA, Delta and Express Scripts)– we do not pay insurance taxes that insured groups pay– we save the built-in profits that insurance companies

charge– We purchase a Reinsurance policy (excess coverage)

for any individual’s claims over $250,000 per year– We are not subject to State mandated coverage– We choose what we want covered.– Savings with self-insured plan is ± $2 million/yr

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However, we must comply withHealth Care Reform and the Affordable Care Act• We cover adult children to age 26 (Dec 31)• In 2014, we have no pre-existing condition clause for

anyone now and in the future,• We cover women’s preventative care and other

preventative services at 100%,• We must offer health coverage to employees working

more than an average of 30 hours per week (includes part-time employees and students),

• The coverage must be affordable for 95% of employees,• The Act imposes taxes, fees and severe penalties.

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Multi-Year Wellness PlanFirst three years

• Year One: Discovery • Year Two: Action• Year Three: ResultsThe University may not see any reductions in claim costs for several years; in fact, our claims could increase due to employees seeking health care that they did not before.

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Goals

• Help faculty/staff live happier, healthier and more productive lives.

• Emphasize the importance of wellness to faculty/staff and future affordability of health benefits.

• Reduce future health costs with targeted programs to improve health conditions.

• Maximize use of on-campus resources.

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Wellness ProcessUnion Health System will again provide Wellness services.• Health Risk Assessment -the employee’s assessment of

his/her own health (online)• Biometric Testing – finger stick results• On campus health screenings –

September 9 thru October 22• One Community.com -- My Health Score• Programs on Wellness Topics• Coaching – individual help with health issues• All services performed are confidential.

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To be screened, employees and spouse/partner in 2014 – Total Cholesterol

• HDL• LDL

– Triglycerides– Blood Glucose– Blood Pressure– Height/Weight and BMI– Cheek swab for nicotine (only in individuals who sign tobacco free

affidavit) New for 2015

Each participant receives almost immediate results of the testing and information before they leave the screeningAlso, results will be posted on One Community for the employee to review along with other information

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Employee Incentives/Surcharge2015

• Participating employees will receive a discount on health coverage rates.• For employee only or employee child coverage: $30 less per month ($15 per pay

for non-exempt staff) • For employee/spouse and employee/dependent coverage: $50 per month; $25 per pay for non exempt staff. ONLY IF BOTH EMPLOYEE AND SPOUSE PARTICIPATE.• Employees who use tobacco products and are on our health plan will have a $50

surcharge/month on their health coverage rates ($25/pay for non-exempt staff) • To avoid tobacco surcharge, both the employee and spouse must be tobacco

free or agree to a cessation program in 2015.• Employees not on our health plan may participate in any of the services but will

not have an incentive/surcharge.

Note: 2015 Rates have yet to be determined. However, with double digit claims increases, there will be changes in coverage and rate increases in 2015.

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Tobacco Use Affidavit• Employees can sign affidavit indicating they do not use tobacco

products and avoid the surcharge• Employee can participate in tobacco cessation during 2015 and sign

the affidavit to avoid the surcharge—this can occur for only two years• Attendance/progress in cessation efforts will be monitored• Many different cessation programs are offered• Prescription cessation will be covered at 100%. (Chantix, Nicotrol NS, Nicotrol Inhaler and Zyban)• We reserve the right to perform random tobacco testing (saliva cheek

swab) • We reserve the right to retroactively charge employees the surcharge

(to January 1) should an employee sign the affidavit fraudulently

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Health Coverage Rate Subsidy

Individuals may voluntarily apply for a subsidy:• If total household income is lower than 200% of the 2014

Poverty Guidelines• The subsidy application must be completed no later than

October 31, 2014, and• A 2013 tax transcript must be provided on all family members

indicated on the Subsidy form before the reduced rates are applied.

• Late information will be accepted, but the subsidy will not be retroactive. Subsidy rates will begin the month after receipt of the tax transcripts.

• On line form will be available.

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200% of 2014 Poverty Guidelines48 Contiguous States & DC

Persons in Family/Household 100% of Poverty Guidelines 200% of Poverty Guidelines1 $11,670 $23,3402 15,730 31,4603 19,790 39,5804 23,850 47,7005 27,910 55,8206 31,970 63,9407 36,030 72,0608 40,090 80,180

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Assessment

One Community allows employees to see how their results have improved from one year to the next.Aggregate reports will be provided to ISU with how the group has improved over from one year to the next in various areas.Individual results are all confidential. No one will have access to individual results except their own.

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Communication

• Wellness Instructions• Wellness Newsletters • Reminders / Posters• Web Page / email announcements• Group meetings across campus• Individual meetings

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Questions/Comments