HealthbyChoice Incentives explained
Information to guide you through your HealthbyChoice IncentivesSM plan.
Choice vs. Standard benefit levels
Employees begin at the Choice level of copays, deductibles and coinsurance. To keep this level, they must meet their plan requirements in 90 days or a date set by you.
If they don't meet requirements, they move to the Standard level, which has higher copays, deductibles and coinsurance.
Spouse benefits
Both the employee and their spouse must meet the requirements in order to receive Choice benefits.
Premium rates
Your premium rates are based on a combined rate, not on how many employees are at each benefit level. Your rates will remain the same, regardless of who achieves Choice benefits and who stays at Standard benefits.
Requirements for Choice benefits
Employees must meet these requirements:
-
Online health risk appraisal: Complete the online health risk appraisal, which is available through their Member Center here on priorityhealth.com. Learn more about the appraisal below.
-
Meet 3 wellness criteria: Visit their doctor and have them document the employee meets these criteria:
| Three key wellness criteria |
|---|
| Wellness criteria* |
Qualification requirements |
| Tobacco use |
Non-tobacco user |
| Body mass index (BMI) |
Below 30 |
| Blood pressure |
Below 140/90 |
Employees who don't meet the 3 criteria can still maintain Choice level of benefits if they:
- Complete a fasting cholesterol test
- Complete a fasting blood sugar test
- Agree to follow their doctor's treatment recommendations
Online health risk appraisal
Our online health risk appraisal is a fast and easy way for your employees to gauge their health. In addition:
- Employees can easily identify health issues they need to work on and receive recommendations for improving their health.
- Employees can update their health risk appraisal any time to track their progress toward health goals and wellness criteria.
- You will never see an individual employee's results.
Watch a short video about the health risk appraisal- 3 min.
All employees must create an online account to get to online health risk appraisal.
See how to create an online account and how to log in.
Keeping Choice benefits
After 90 days, participants who met the wellness criteria will maintain Choice benefits for the remainder of the plan year. Those who didn't are automatically transferred to the Standard level.
At the next enrollment date, employees' benefit statuses carry over for the first 90 days of the new plan year. During this 90-day period, employees and their spouses have the opportunity to qualify, or requalify, for the Choice level of out-of-pocket costs.
