October 29, 2012

So one of the questions I get asked frequently is ‘What can I do to lower my health care costs?’ So often it’s been a matter of taking a step back on benefits, either by including or increasing a deductible on a company health plan. Recently though, August in fact, Blue Cross Blue Shield of MA came up with something new.

BIBSMA has come out with a wellness program that can actually impact cost. What’s the catch? Well, here’s the broad scope version of how it works. You need to have 10 enrollees on a plan, so if you have a company of less than 10 employees, or a company where less than 10 employees enroll in the coverage, it won’t work. The gist of this plan is to engage employees to go to the doctor and get a clean bill of health, and if not start working toward better health.

What’s the bottom line? If you are a business owner in MA, and you have 10 enrollees on a plan, you’ve passed the first criteria. How much you can potentially save falls to enrollee engagement as a function of those that engage and complete the program. By completion, the enrollees doctor deems them healthy per key health measures (height, weight, blood pressure, smoking status, etc..). The graph below illustrates the percentage of enrollees that complete the program vis a vis the percentage of premium that can be rebated at the end of a plan year.

20-49% 1.25% of current year’s premium
50-79% 2.50% of current year’s premium
80-100% 5.00% of current year’s premium

There is also an incentive to drive engagement of the program at the employee level in the form of debit cards. Employees can receive as much as $300 in a debit card by completing the program and be deemed healthy per the program parameters. This helps the whole thing become a win/win for the employer and employee.

If you’d like to find out more. feel free to reach out by emailing me at [email protected] .

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