FAQs

Expand All

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.

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.
  • 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.
  • 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.

Member Services

  • How do I change or update my account/profile information?

    You can change or update your single sign-on account profile information by:
    1.  clicking here to go straight to your account page or by clicking on the pink “Login” button in the top right-hand corner of the site and logging in.
    2. Then click on the pink “My Account” button and select “Change Settings.” Your Account Details page will display with options to change your account information in the left-hand column menu.
    You can change or update your home phone number, mobile phone number, email address/username, password, and secret questions.
     
  • 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. The number to call for claim and benefit specific questions is listed on your healthcare identification card. 
  • How do I delete my account?

    Deleting your login information will remove your access to your health care information through an online portal. This includes services such as the Wellness Portal and your Claims Management portal. This will impact your ability to meet your points requirements for future open enrollment periods and could result in you not being eligible for the Accelerate Plan.

    We take your privacy and confidentiality seriously. The Ascend to Wholeness Healthcare Plans partners adhere to all HIPAA privacy regulations. If at any time you would like your single sign-on account removed from our data base, click here and our healthcare support team will email you about next steps for completing account deletion.
     
  • How do I log out?

    You can log out by clicking on the pink “My Account” button in the top right-hand corner of the site and selecting “Log out.”
     
  • How do I reset my password?

    You can reset your password by
    1. clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and logging in.
    2. Then click on the pink “My Account” button in the top right-hand corner of the site and select “Change Settings.”
    3. Then in the left-hand column menu select “Change Password.” The site will then guide you through the process to reset your password.
    If you have forgotten your password you can reset your password by clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and selecting “Forgot password.” The site will then guide you through the process to change your password and log in.
     
  • How do I reset my username?

    Your username is the full email address you used to register on AscendtoWholeness.org. You can reset your username by 
    1. clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and logging in.
    2. Then click on the pink “My Account” button in the top right-hand corner of the site and select “Change Settings.”
    3. Then in the left-hand column menu select “Change Email.” The site will then guide you through the process to change your username.
    If you have forgotten your username you can reset your username by clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and selecting “Forgot Username.” The site will then guide you through the process to change your username and log in.
     
  • I forgot my password, how do I log in?

    If you have forgotten your password you can reset your password by clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and selecting “Forgot password.” The site will then guide you through the process to change your password and log in.
     
  • I forgot my username, how do I log in?

    Your username is the full email address you used to register on AscendtoWholeness.org. If you have forgotten your username you can reset your username by clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and selecting “Forgot Username.” The site will then guide you through the process to change your username and log in.
     
  • What is my username?

    Your username is the full email address you used to register on AscendtoWholeness.org. If you have forgotten your username you can reset your username by clicking here or by clicking on the pink “Login” button in the top right-hand corner of the site and selecting “Forgot Username.” The site will then guide you through the process to change your username and log in.
     
  • Where can I find form 1095-C?

    Form 1095-C is used by the federal government to establish proof of employer-provided healthcare coverage. Employers are responsible for providing this form to eligible employees.

    If you have not received your 1095-C form, please contact your employer directly, or you may be able to download the form from AscendToWholeness.org if your employer contracts with Adventist Risk Management, Inc. to produce the form on their behalf. Please follow the instructions below: 
    1. Start by clicking here or click on the pink "Benefits Management" button in the top right-hand corner of this site to log into your Benefits Management account.
    2.  Once logged in, select "My Profile" from the menu bar.
    3.  In the left-hand menu column, click on "Employee File." Scroll down and find the most recent version of your 1095C form.
    4.  Download this form by clicking the "View" link located in the same line as the form you want to download. 

Telehealth

  • How do I access medical records related to my visit?

    You can request a copy of your medical records from your visit with the Telehealth doctor.
  • How do I add a dependent child to my account?

    Parents and guardians can add their children who are under age 18 to their account and have doctor visits on their behalf.  Enroll yourself first and then add then add your child or dependent to your account. 
  • How do I add my dependent spouse?

    Your spouse should create a separate account to enroll.
  • How do I contact support?

    • Login Assistance – 855-635-1393.
    • Benefits – 888-276-4732
  • How do I enroll?

    1. Download the iOS or Android mobile app OR visit http://webtpa.amwell.com
    2. Fill in the contact information form
    3. Set up your username and password
    4. In the "Do you have insurance?" drop down please select WebTPA
    5. Enter Service Key: WebTPA4
    Login Assistance – 855-635-1393
    Benefits – 888-276-4732
  • What can doctors treat on Telehealth?

    Examples you can meet with a doctor to receive treatment for are:
    • Colds
    • Flu
    • Fever
    • Rash
    • Abdominal pain
    • Sinusitis
    • Pinkeye
    • Ear infection
    • Lactation counseling
    • Migraines
    • Depression
    • Anxiety
    • Stress
    • Insomnia
  • What is Telehealth (Amwell)?

    Telehealth is a faster, easier way to see a doctor. You can have video visits anytime on your smartphone, tablet, or computer. It's easy to use, private, and secure. Telehelath can be used any time, day or night. It’s perfect when your doctor’s office is closed, you’re too sick or busy to see someone in person, or even when you’re traveling.
    Telehealth offers:
    • Your choice of trusted, U.S. board-certified doctors and therapists
    • Peace of mind with a doctor “on call” 24/7 to provide quality care
    • Consultation, diagnosis, and prescriptions 
  • What is the cost?

    Members will be responsible for copays as noted below for each Doctor visit.
    •  $15 for Accelerate Plan members per visit
    •  $30 for Access Plan members per visit.
    The copay is assessed at the time of the telehealth visit and can be paid via credit card.
  • What should I do if I have a child over 18 who is still on my health insurance?

    They should enroll as an adult and create their own separate account.
  • When Would I Use Telehealth?

    • I should probably see a doctor, but can’t fit it into my schedule
    • My doctor’s office is closed
    • I feel too sick to drive
    • I have children at home and don’t want to bring them with me
    • It's difficult for me to get a doctor's appointment
    • I'm on business travel and stuck in a hotel room
    • When traveling in the United States
  • Who Are The Doctors?

    Clinical services on Amwell are provided by Online Care Group – the nation’s first and largest primary care group devoted to telehealth. Doctors on Amwell:
    • Have an average of 15-years of experience in primary and urgent care.
    • Are US Board Certified, licensed, and credentialed.
    • Have profiles, so you can see their education and practice experience.
    • Are rated by other patients, so you can review and select the doctor that meets your needs. 
  • Who Is eligible?

    Covered Employees or Covered Dependents on the Ascend to Wholeness Healthcare Plan.

Plans

  • 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

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.

© 2019 Adventist Risk Management,® Inc.