King County HRI Toolkit

 

Benefit Plan Design

Healthy Incentives℠ is an innovative benefits program that encourages employees and their covered spouse/domestic partners to take ownership of their health.  Employees and their covered family members continue to receive the same high level of medical coverage they are used to receiving, but the participation of employees and their spouse/domestic partners in Healthy Incentives℠ affects their level of out-of-pocket expenses for medical coverage in the following year.

1. Participation begins with taking a wellness assessment that identifies behaviors that put someone at higher risk for developing a chronic disease such as diabetes, heart disease or coronary artery disease.
2. After taking the wellness assessment, employees and their spouse/domestic partners are given the opportunity to participate in an individual action plan tailored to their risk of developing a chronic disease. A company independent of King County administers the wellness assessment and analyzes it to determine each individual's risk for developing a chronic disease.
3. When individuals are determined to be low risk, they keep a diary of regular exercise or nutrition as their individual action plan.
4. When individuals are determined to be moderate or high risk, they work with a health coach over the phone to engage in activities that can improve their health.

Healthy Incentives℠ has three levels of out-of-pocket expense levels that are determined by participation: gold (lowest level), silver (moderate level) and bronze (highest level). Employees and their spouse/domestic partners who:

• take the wellness assessment in January earn silver
• who take the wellness assessment in January and complete an individual action plan by June 30 earn gold
• who take only the wellness assessment by June 30 earn silver
• do nothing, earn bronze.

Each year, employees and their spouse/domestic partners have the opportunity to take the wellness assessment and complete an individual action plan to receive the lowest out-of-pocket expense level for the following year.

The higher the participation in the Healthy Incentives℠ program, the more likely employees and their spouse/domestic partners will make healthy lifestyle choices and prevent chronic medical conditions. That translates into a longer, better quality of life for employees and their spouses/domestic partners and reduced medical costs for King County.

• Healthy Incentives program
• Wellness Assessment
• Individual action plan
• Out of pocket expense level

Care Management Programs

• Enhanced member outreach
• Case management
• Nurse line
• Medquery