FAQs

About

  • What are the new plans?

    New 2018 health plans include a robust whole-person care program, Ascend to Wholeness, designed to support health plan members by:

    • enhancing a balanced well-being in mind, body and spirit,
    • encouraging positive life choices,
    • and investing in you through valuable new services.

  • What is Ascend to Wholeness?

    Ascend to Wholeness is an activity-based lifestyle and wellness program, focusing on whole-person health. It provides comprehensive care coordination, biometrics screenings, wellness assessments, personalized health coaching, a wellness portal and many educational opportunities.
  • What prompted the new plans?

    Employers in the North American Division (NAD) asked Adventist Risk Management, Inc. (ARM) to re-design our health plans. ARM conducted an extensive two-year study to find ideal solutions. This comprehensive redesign not only gives you choices and invests in your long-term health, but also has the potential to save money for both you and your employer. Controlling costs while providing health care benefits to more than 26,000 NAD plan members requires a bold, new approach. Your employer is making enhanced benefits available to you, including tools to augment your lifestyle to get or stay healthy, and enjoy your life to the fullest.
  • Who is providing these new services?

    ARM has partnered with Adventist Health, the church’s health system on the west coast, to provide these services. Adventist Health is uniquely positioned to support your wellness lifestyle because they:

    • are culturally aligned with Seventh-day Adventist heritage and values,
    • underwent a similar and very successful health plan redesign in 2013 for more than 32,000 members,
    • have recently received multiple national workplace wellness awards,
    • and engage a dedicated, fully-integrated confidential care coordination team.

Plans

  • What do biometrics screenings involve?

    Biometrics screenings are free confidential screenings for all Access and Accelerate plan members and their spouses. Screenings include total cholesterol, HDL cholesterol, glucose, blood pressure, height and weight, and BMI (Body Mass Index). You will receive further information regarding how and when to complete your biometrics screening.
  • What points are required in 2018 to enroll in the Accelerate Plan for 2019?

    To be eligible for the 2019 Accelerate Plan you must earn points in 2018 based on the following points structure:

     

    TOTAL POINTS Biometrics Screening/Wellness Assessment (required) Activities Points Date Eligible for Health Plans
    200 120 80 Jan 1 – Mar 31, 2018
    160 120 40 Apr 1 – Jun 30, 2018
    0 0 0 Jul 1 – Dec 31, 2018

Biometric Screenings

  • Do I have to fast?

    Fasting is encouraged, but not required. A fast is not required for accurate results for total cholesterol, HDL cholesterol and glucose measurement. If you would like LDL and triglycerides measured, you will need to fast for 8-12 hours before your appointment. Fasting means no food or drink other than water, and no chewing gum. Participants should continue to take their medications as prescribed.” Be sure to DRINK PLENTY OF WATER and arrive fully hydrated.
  • Can I talk to someone about my results?

    Yes. You’ll have the opportunity to meet with a health coach to review your results and receive some suggestions for prospective next steps to improve your health, and to prevent illness and disease. The purpose of the screening is not to provide a medical diagnosis, but rather an overview of your results as well as to offer some tips to improve your health. The biometric screening is an opportunity to Know Your Numbers, build awareness, and help you determine if a follow-up visit with your personal care provider to further discuss your results is necessary.
  • Do I have to participate?

    Yes, if you want to qualify for the 2019 Accelerate Plan.
  • Does it cost me anything?

    No. Your employer is funding the cost of this program and your participation is free. This is part of our commitment to your health.
  • How is a fingerstick performed?

    A small puncture is made in the 2nd or 3rd finger, and approximately four drops of blood are withdrawn. The blood from the capillary tube is then placed in a cassette, which is inserted into the reading instrument. The reading instrument requires less than six minutes to process the specimen.
  • How long will the screening take?

    The entire screening process typically lasts 15-25 minutes. This includes completing your registration form and the option to discuss your results with a health coach. Scheduling your appointment online will help your screening process run smoothly.
  • I just had my annual physical or am scheduled to have one soon; should I still participate?

    Yes, we encourage you to complete the screening and share your results with your doctor. Completing the screening is one of the requirements for eligibility for the 2019 Accelerate Plan. You’ll also need to complete a wellness assessment on the Wellness portal in the Ascend To Wholeness website. Employees and spouses enrolled in the Access Plan are also encouraged, but not required, to participate.
  • On the day of the screening, what do I need to do?

    Bring your health plan ID card with you and wear sleeves easy to roll up for blood pressure measurement. If you’ve chosen the optional LDL/triglycerides screening, you will need to fast.

  • What if I am not at a location where screenings are being held or I work remotely? Or what if my spouse cannot attend an on-site screening?

    If you work remotely or at a location where screenings are not offered, or your spouse is unable to attend an on-site screening, please contact your HR department to discuss your options for completing a health screening.
  • What tests will be performed?

    The screening measures height and weight, blood pressure, glucose, total and HDL cholesterol (finger stick) and calculates body mass index and body composition LDL cholesterol and triglycerides will be measured for those who fast.
  • Who administers the screening?

    Ascend To Wholeness has contracted with an independent biometric screening company to offer onsite screening services for eligible employees. Interactive Health is a professional health screening company that provides highly skilled, trained and certified professionals to perform the screenings.
  • Will my individual results be shared with my employer?

    No. Personal health information (PHI) is not shared with the participant’s employer. In conjunction with claims and demographic information, biometric screening data is used to determine general health status. A small percentage of individuals will be identified as candidates for care management. Those identified will be contacted by a care manager. Individual biometric data is not shared with anyone at Adventist Health outside of the care management team. All information is kept confidential and complies with the requirements of HIPAA.
  • Will this worksite preventive screening replace going to my doctor for an annual physical?

    No. Worksite screenings do not replace a complete preventive annual exam with a physician. It is meant to alert you to potential risk factors and you are encouraged to follow-up with your personal physician.

Privacy

  • Will my employer have access to my health information?

    No personally-identifiable information will be shared with your employer (including Human Resources, your manager or supervisor). NAD employers receive only aggregated data stripped of personally-identifiable information. The NAD takes your privacy and confidentiality seriously.

     

    As your health plan administrator, ARM and all partners adhere to all HIPAA privacy regulations.

Important Deadlines

  • When do benefit changes take effect?

    These changes take effect January 1, 2018.
  • What if I forget to enroll or miss the deadline? Will I end up having no health coverage?

    You must take action! Enrolling is required for coverage under the 2018 Ascend to Wholeness Healthcare Plans.

     

    Changes in plans can only occur during open enrollment, unless you have a qualifying life event such as marriage, divorce, birth or adoption of a child, or a spouse losing or gaining other coverage. As you are accustomed, your employer will send out clear communications on the open enrollment process.

Families

  • Can my spouse be on a different plan? For example, may I choose the Accelerate Plan, while my spouse enrolls in the Access Plan?

    No, all participants in the same family must be on the same plan.

     

    The one exception to this rule is if you and your spouse are both NAD employees enrolled individually under your own coverage.

  • Do my children need to meet the wellness requirements for the Accelerate Plan?

    No, only you and your covered spouse are required to complete the Accelerate Plan requirements outlined in the open enrollment materials.

Cost Coverage and OUT-OF-POCKET

  • Are my out-of-pocket costs for medical coverage going up?

    A positive change for 2018 is that the OOP will include your deductible, coinsurance and copays.

     

    OOP limits will decrease for the Accelerate Plan and increase for the Access Plan. Both plans will accrue your co-pays, coinsurance, and deductible toward your OOP, which means you will reach your OOP quicker.

    On the Accelerate Plan, your individual OOP will decrease by $50, and the family OOP will decrease by $100.

    On the Access Plan, your individual OOP will increase by $400, and your family OOP will increase by $800.

  • Can I change my coverage after open enrollment?

    If you experience a life change during the plan year — such as marriage, divorce, birth or adoption of a child, or a spouse losing or gaining other coverage — you could qualify to make changes to your benefit plan.

    You are required to notify HR within 30 days of the date of the event to make benefit plan changes. Failure to notify HR within 30 days may disqualify you and require you to wait until the next open enrollment to make plan changes.
  • Can I go to any hospital I want?

    Our health plans only cover hospitals that are in our PPO.

     

    There are two exceptions:
    1) emergency/urgent care, and/or
    2) unavailable care.
    If specialized care is unavailable at a PPO facility, the health plan’s member services will help you complete an Unavailable Service request which, upon approval, would allow payment at a non-PPO facility.

  • How much will my monthly contribution rate be?

    Contribution rates vary depending on the NAD employer. Please check directly with your human resources representative regarding your contribution rates.
  • What is an out-of-pocket maximum?

    An out-of-pocket maximum (OOP) is the most you’ll pay during a policy period (usually a year) for health care services.

     

    Once you’ve reached your OOP, your plan begins to pay 100 percent of the allowed amount for covered services.

  • Will there still be a vision and dental benefit?

    Yes, the dental and vision benefits will remain unchanged.

Additional Information

  • How do I find details of what is covered under each plan in order to make an informed decision?

    This information will be provided to you prior to open enrollment. Also, you may always visit your new, member-friendly website, www.AscendToWholeness.org.
  • Is this focus on plan redesign and wellness about saving money?

    Not directly, although we believe both NAD employers and health plan members enrolled in the Ascend to Wholeness program will save money in the long run. Collectively, we are best able to fulfill our church’s mission when we start with ourselves.

     

    Goals for the 2018 employee health plans and Ascend to Wholeness are to actively empower us to manage our own wellbeing and to implement major tenets of our Seventh-day Adventist health message.

Member Services

  • Will my HR representative still be able to help me when I have questions about my benefits or will I have to call a centralized number?

    HR representatives will continue to offer assistance with benefits and there will continue to be an 800-number available for claim and benefit specific questions.

© 2018 Adventist Risk Management,® Inc.

2019 Open Enrollment

Looking for Open Enrollment information? Find everything you need to know right here!