Tag Archives: Wellness

My thoughts on the status of Wellness Programs

With a bit a research you will find that nearly every report, from bloggers to Rand, clearly report that Wellness Programs that have a Disease Management program AND effectively communicates with the employees, will see the most return for their investment.

Spending a lot of money on Healthy Lifestyles is warm and fuzzy and may help the country out in the long run, but there isn’t so much of a bang for a buck.  Especially for the average 100 employee group.

True wellness companies just aren’t in that small employer (<500) market any longer and the costs associated with putting one together just don’t make sense.   

In a time where the competition lies in the bells and whistles, most carriers have built in a wellness program for their clients.   Anthem Blue Cross of California has one of the best I have seen.  Their Wellness Program is called “Time Well Spent” is turnkey.   It provides the employer and the employee with the following:

  • Wellness calendar with links to print or download 3 different flyers on the topic of the month.  This allows for quick distribution to employees.
  • Provides an introductory brochure to let employees know that it is time to get online and create an account for their health plan.
  • They are reminded to get their annual exam so they know their numbers.  Risk Assessments require current cholesterol, blood pressure and sugar
  • Provides a free Health Risk Assessment.
  • Employees with identified risks will be contacted in some manner by the carrier to jump into their disease management program.

I cannot detail the cornucopia of information that is available through this program.  I can say that Anthem of California’s is very impressive and user friendly.

Frankly, most carriers have these program.   In order to stand out to our clients, I try to pass the information on to both employer and employees.  Although, without the commitment from the employers, they won’t get much traction.   In the case of Anthem Blue Cross, it is VERY simple for an employer to decide if this effort will work for them.   I only need print out the calendar, a few sample brochures, some of the reports backing up the efficacy of this particular route and get them going.    

During this time of national change, employees are a bit worried about hearing from HR departments and Benefit Agents on their health plans.  Employers looking for ways to bring some sunshine into their benefit program should consider this opportunity to spread a little positive action.


Autism Coverage for California – A New Day starts July 1, 2012

It’s hard to find a family that has not been touched by the diagnosis of Autism.   It’s epidemic spread not only causes devastating concern for families but the financial implications are extreme.   Federal and State educational programs are only spread so thin before resources run dry for many.   Even with Federal and State Mental Health Parity Laws, the insured public continues to fight on a daily basis for therapies to help their children.

As insurance agents engaged in this daily fight, we welcome this clarity of coverage.  Our agency has always worked as an advocate for our clients to get the most out of their policies and to provide as much covered care as possible.   Help is arriving in California on July 1, 2012 in the form of SB946.  SB946 (aka. Mental Illness: Pervasive Developmental Disorder) will add coverage for Behavioral Health Treatment (BHT).

The technical definition of BHT is “professional sevices and treatment programs, including applied behavior analysis and evidence-based intervention programs that develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive development disorder or autism.”   Coverage must be prescribed by a licensed physician and pre-authorized by the health plan.  It will cover treatment in non-institutional and home settings as well as in-office services.

In addition to mandating coverage for autism treatment, the bill requires the creation of the Autism Advisory Task force.   Advocates for Autism issues will be well represented on this board.  “Autism Speaks” Vice President, Lorri Unumb was named as a member of this important task force.  “I am honored to serve on this task force and to contribute to making California’s autism insurance reform law one of the most effective in the nation,” said Unumb. “Autism Speaks welcomes this opportunity to work with the DMHC.”

California insurers will begin mailing notices to all policyholders over the next month to provide information on this important July 1, 2012 amendment.   The bill also mandates that insurers provide adequate access to providers that will be able to provide these services.  This will help to assure policyholders that covered services will also be made more available.

When an employee is dealing with this family issue they are very often pulled away from work.   They may spend hours on the phone fighting for coverage approvals and provider access.   Employers are paying the price for this lack of “presenteeism” in these employees.  We look forward to educating employers and employees on the benefits of this new law and how proper Wellness and Employee Assistance Programs can work together to provide the best outcome when dealing with the issues affected by this new law.

Paula L. Wilson, RHU, REBC is principal of Paula L. Wilson, Inc., an Employee Benefits Firm.    Employers are encouraged to contact Paula at 888-447-2852.