For HR Leaders
At the request of the North American Division (NAD) employers, Adventist Risk Management (ARM) is implementing a redesign of the NAD health plans. The 2018 health plans include a more robust whole-person care program designed to support health plan members by:
- Enhancing mind, body and spirit
- Encouraging positive life choices
- Investing in them
Partnering with Adventist Health
The redesign of this important employee benefit is in line with our distinctive Seventh-day Adventist health message. ARM has partnered with Adventist Health, the church’s health system on the west coast, which is uniquely positioned to support the NAD because it:
- Is culturally aligned with Seventh-day Adventist heritage and values
- Underwent a similar and very successful redesign in 2013 of its health plans for more than 32,000 covered lives
- Has recently received multiple, national workplace wellness awards
- Engages a dedicated, fully-integrated care coordination team with the expertise that benefits the NAD health plan members
2018 FAQs for Employers
Ascend To Wholeness Healthcare Plans
For questions about eligibility issues, billing or to appeal a claim, please continue to email .
Large groups (100+ employees) We will try to coordinate a team of presenters such as those at the NAD HR Conference (as schedules permit).
Mid-sized groups (50-100 employees) We will coordinate with one key presenter.
Smaller groups (Less than 50) We are happy to arrange a personalized webinar/video conference meeting. We also will be recording a webinar version of this presentation which can be shared via web.
During open enrollment the members/spouses will choose either the Accelerate Plan or Access Plan for 2018. If they choose the Accelerate Plan, they are agreeing to participate in care coordination. Adventist Health will provide coaching and information to address specific health concerns, based on data from the biometrics screening and wellness assessment. When health plan members sign up on the Ascend to Wholeness portal (a requirement for those on the Accelerate Plan), they will be asked to provide an email addresses and phone number to be used to contact them about additional free resources such as exercise challenges, newsletters, etc.
It is critical that you allow enough time for processing of the claims that are eligible to earn 2017 Healthy for Life Rewards points such as an annual physical exam or dental cleaning. These type of visits need to be completed before the final quarter of 2017. We do not want to discourage you from getting these essential preventive exams in the final quarter of 2017 if you were unable to do so previously. However, please understand that if these visits are done within the last there months of the year, we cannot guarantee the claims adjudication process will be completed in time for you to be awarded points.
Listed below are the deadlines for redeeming 2017 and 2017 points:
- 2016 points deadline – June 30, 2017
- 2017 points deadline – January 31, 2018
Achieving the necessary amount of activity points may be a new concept for some health plan members and they will need clear instructions. However, during ARM’s due diligence which included studying other employer-offered health plans, this approach not only helps members to be more aware of their own health status but also drives member satisfaction.
Tracking points will be much easier for members as we move to the Ascend to Wholeness portal. This new version is mobile friendly and will be available as an app. Ease of use for health plan members has been a constant focus of the re-design process.
In addition, it will be possible to track steps or other activities using a variety of wearable devices. These can be set to synchronize with the portal to automatically post activities that accrue points.
During 2018, the first year of the Ascend to Wholeness wellness program and redesigned health plans, the covered employee and spouse will have the opportunity to complete the biometrics screening and wellness assessment, earning 60 points for each, for a total of 120 points. The remaining 80 points can be earned through activities such as preventive care (a dental exam, annual physical, or vaccinations for instance) healthy lifestyle habits (examples include logging exercise, fruit/vegetable intake and water intake) and wellness webinars. Earning the activity points can vary each year and be selected to suit a health plan member’s personal goals. This is an example of empowering employees to manage their own whole person health.
Therefore, it is critical we collectively communicate the advantages of the Accelerate Plan to employees and their families. They would be missing out on the best value if they chose the Access Plan. This is particularly true for 2018 where members will be automatically enrolled in the Accelerate Plan without having to meet any points requirements.
It would be unfortunate for some to choose the Access Plan out of fear of change or misperceptions about the activity points and care coordination. This is another reason why ARM would like to have permission to reach out directly to health plan members in order to augment the communication by each employer.
The Adventist Health team has a medical director on staff who will be advocating as needed with the doctors and other providers in our network on the best treatments for the best outcomes for our health plan members.
Ascend to Wholeness is an activity-based wellness program as opposed to a results-based program. This means that we as employees/spouses must agree to engage with the Adventist Health team. If for example, the results of my biometrics screening reveal that I’m 40lbs overweight, the Adventist Health team will discuss with me lifestyle changes to lose weight. If at the end of the year, I have not lost 40lbs, that does not prevent me from remaining in the program the next year. The key is that I’m participating in the program.
NOTE: The results from other Adventist health care employers across the country show that employees/spouses choose to be engaged once they have these kinds of resources made available to them. By participating in the wellness programs and care coordination, they have enjoyed positive lifestyle changes and improved health.