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Item H4 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Time approx. 10:00 a.m. Meeting Date:_ October 16,2013 Division: Employee Services Bulk Item: Yes _ No X Department: Employee Benefits Staff Contact Person/Phone#: Teresa Aguiar X4458 AGENDA ITEM WORDING: Discussion and approval to implement a Wellness Program to become effective January 1, 2014 which will affect County Commissioners, Constitutional Officers and employees who participate in the Group Health Plan. ITEM BACKGROUND: On February 16, 2011,the BOCC approved to advertise a Request for Proposals for Medical Plan Administration on a Self-Funded or Fully Insured Basis, including: Claims Administration, Utilization Review, Large Case Management, Disease Management,Network Management,Pharmacy Benefit Management, Wellness Programs and/or Stop Loss Insurance. On October 19, 2011, The BOCC approved a three year contract to begin November 1, 2011 with Blue Cross Blue Shield of Florida(BCBSFL) for Medical Plan Administration on a Self-Funded Basis. Early last year, a Wellness Committee was formed which consisted of a Representative from each Constitutional Office and BOCC representative employees in the lower, middle and upper keys. Earlier this year,the team convened in order to work together to develop the Wellness Program. BCBSFL assisted staff in finalizing the product for implementation. PREVIOUS RELEVANT BOCC ACTION: On October 19, 2011, the BOCC approved the contract with BCBSFL which includes Wellness Program assistance. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval. TOTAL COST INDIRECT COST: BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes_ No X AMOUNT PER MONTH Year , VV ° APPROVED BY: County Atty * OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM# Revised 7/09 BOARD OF COUNTY COMMISSIONERS County of Monroe Mayor George Neugent,District 2 Mayor Pro Tern,Heather Carruthers,District 3 The Florida Keys Danny L.Kolhage,District 1 David Rice,District 4 Sylvia J.Murphy,District 5 Office of the Employee Services Division Director The Historic Gato Cigar Factory 1100 Simonton Street,Suite 268 Key West,FL 33040 (305)292-4458—Phone (305)292-4.564-Fax TO: Board of County Commissioners DATE: September 20,2013 FROM: Teresa E.Aguiar, Employee Services Director SUBJ: Approval of Wellness Progr This item requests your approval to implement a formal Wellness Program to cover Monroe County BOCC employees, Commissioners, Constitutional Officers and their employees. As you know, in the past we have been offering wellness activities for employee participation such as Lunch&Learns and reimbursements for participating in walk/bike/triathlon events in the community to encourage wellness behavior. We also coordinate annual health fairs for group health plan participants in the lower, middle and upper keys. These events have yielded approximately 5-10% annual participation. Early last year Blue Cross Blue Shield of Florida(BCBSFL)representatives met with staff and the Wellness Committee members to educate us on worksite wellness and offer guidance and assistance in the County's future wellness initiatives. The Wellness Committee members consist of a representative from each Constitutional Office and BOCC representatives from the lower, middle and upper keys. Earlier this year the Committee members met to assist in creating a Wellness Program that would encourage consistent participation in wellness activities. The members' role was to represent their peer group by sharing ideas, needs, concerns and feedback from their work areas and colleagues in regards to wellness activities. Staff then gathered the information and worked with BCBSFL to develop a formalized worksite wellness program. The Program requires all participants to complete onsite health screenings at the County organized health fairs or online personal health assessment with doctor labs. If approved,the program will be effective January 1, 2014 and the individual will have until September 30,2014 to obtain 500 points of the various activities offered in the program. Individuals will be provided access to a webinar that will train them on how the program will work and help them navigate the website. It is believed that this program will help our efforts in encouraging sustained improvement in healthy behaviors. Healthy living and exercise increases one's health and the more participation the greater chance that we will see a moderation in our health care costs. The fact is that health care costs are going to continue to go up no matter what we do—Wellness programs help to mitigate those increases. It is recommended that you approve this recommendation with the effective date of January 1, 2014. If you have any questions, please do not hesitate to contact me at X4458. lllueRewards—Proposed Program Design with Monroe County BOCC �„rye Group#: B0611 Year I Activity Name Activity Points Activity Activity Recurrence Period Reported by . . Get Asses sed! Complete Group-Hosted Personal Health Assessment (onsite health screenings or online PHA with doctor labs) Description: 'Biometric'-Blood pressure, cholesterol ratio, total cholesterol, high-density lipoprotein(HDL) body weight(BMI),blood glucose levels. Measurements: Individuals at risk track throughout the Once 7S Health Fair BCBSF program as part of their personalized health care plan,(Nursing Health Care Coaches are assigned)and monitor numbers.BcBs can provide a report at any time. Orul:r:ome.s:Analytical data to determine health improvements and cost controls provided by BcBs. w Get Tools! Viewed Navigating Health Care Video Dry;sc:ript:io n:15 min video that can be viewed anytime that explains all of the options available to participants such as Once 10 Throughout Health Care Coaches to control diabetes or prenatal health. BCBSF irMperrruremrrrri:,:r: Number of participants that view. program Outcome: Participants become aware of the many options and share information with others. View Making Most of your Health Care Dollars Video Desc:ri tion:3 min video explaining plan coverage:in- network v. out-network,cost-share v.deductibles etc. Once 10 Throughout BCBSF �rc:rNuierrrentar:Amount of money saved. program Outcomes:Members use less expensive services saving the plan money. Personal Health Record Video Description:2 min video introduces the importance of creating a health record and identifies the benefits. Once 10 Throughout BCBSF Measurements:Number of participants that view. program Outcomes:Data tracked. Sign Up for Online Member Health Statement Description:Members register to receive their Explanation of Benefits on-line and access plan information. Claim Once 10 Throughout processing greatly increased with opportunities to catch BCBSF mistakes/errors sooner. program Measurements:Number of participants that register. ()uftorr°ce5: Potential less costfor employee and plan. 9/20/2013 Page 1 of 10 D UV An Wependent Licensee of 0e Rue Cross and Rur S hfWd Arauos;'oaflomn IIIII I «y, Uses Estimate Costs for Medical Services/Know Before You Go Tool Description:Members compare cost of medical services before they schedule appointments, and tests. ix per 10 Throughout M sera=��°�entsm Number of participants that view. quarter WebMD Outcomes:Potential to greatly reduce employee and plan program cost. (We plan to emphasize health care cost comparison shopping in our newsletters and trainings). Uses Personal Health Record De scri Linn Electronic documentation provides data for future analysis without violating confidentiality. ix per Measurements:Number of records created. 10 Throughout utc a��i�ws Analytical data. Close monitoring of high risk quarter program WebMD o participants...are they utilizing the tools available to manage health?If not, why.If so, what works best? b Get Moving! Enters Data in Exercise Tracker Description:ion:Electronic documentation provides data for 1x per week 10 Throughout future analysis without violating confidentiality. WebMD Measurements:Number of records created. program Outcomes:Analytical data. Enter Data in Weight Tracker Desctip ion Electronic documentation provides data for 1x per week 10 Throughout future analysis without violating confidentiality. WebMD Measurements:Number of records created. program Outcomes:Analytical data. Get Informed! Select an Exercise Goal with the Digital Health Assistant Descti Lion On-line tools to identify establish and monitor goals.Provides relative information with encouraging tips alongthe way. Throughout Y Once 10 WebMD Measurements:Number of records created. program Outcomes: Number of goals achieved Select a Maintain Positive Mood Goal with the Digital Health Assistant Mood being soft approach to the management of emotional health. Description:On-line tools to identify establish and monitor Once 10 ThroughoutWebMD goals.Provides relative information with encouraging tips Program along the way. Measurements:Number of records created. 0encornes: Number of goals achieved. 9/20/2013 Page 2 of 10 0 UV An Ilindnp en ent Lkensne of the he 0guns and Bhe Sin eld Asnaidafion No M Select a Nutrition Goal with the Digital Health Assistant BcBs provides great coaching tools too. (Sugar Busters) Description:On-line tools to identify establish and monitor Throughout goals.Provides relative information with encouraging tips Once 10 WebMD along the way. program 4eawrsura r ents,Number of records created. ,iutrornes: Number of goals achieved Select a Quit Tobacco Goal with the Digital Health Assistant Remember we have AHEC program as great resource. Description: On-line tools to identify establish and monitor Throughout goals.Provides relative information with Once 10 WebMD 9 encouraging f 9� 9 tips P program along the way. Measurements:Number of records created. a,rla.vmesa Number of goals achieved Select a Stress reduction Goal with the Digital Health Assistant es(.,rip pion:On-line tools to identify establish and monitor Throughout goals.Provides relative information with encouraging tips Once 10 WebMD along the way. program Measurements:ts:Number of records created. Outcomes,. Number of goals achieved Select a Weight Loss Goal with the Digital Health Assistant Da sciiprtion On-line tools to identify establish and monitor goals.Provides relative information with encouraging tips Once 10 Throughout WebMD along the way. program Measurements:Number of records created. i:"pawp.a,rrmesm Number of goals achieved Achieve an Exercise Goal with the Digital Health Assistant Description:pion:Each goal achieved is highly rewarded to motive and encourage continual participations. Once 50 Throughout WebMD i amasurerraer ts:Number of pounds and inches lost. program Out:armesm Reduced BMI numbers=Improved health for participants and reduced cost for plan. Achieve a Maintain Positive Mood Goal with the Digital Health Assistant Desctiprpion Each goal achieved is highly rewarded to Throughout motive and encourage continual participation. Once SO WebMD iearsarrarrrserrp°sm Number of records created. program Outcomes: Number of goals achieved(data will indicate self-reporting improvements) Achieve a Nutrition Goal with the Digital Health Assistant Throughout Description:Each goal achieved is highly rewarded to Once SO WebMD motive and encourage continual participations. program 9/20/2013 Page 3 of 10 *Aia l0111" 9, Arr IIrdrrpr.rtideira Il.icensee d tl e BLe Ci msc and CB6 9ie@d Assndarfloiru Asa Pti�H t asur,,meats:Number of pounds and inches lost. Outcomes: Reduced BMI numbers=Improved health for participants and reduced cost for plan. Achieve a Quit Tobacco Goal with the Digital Health Assistant Description: We may considering sending out the KWHS Throughout marching band for this one O Once 50 WebMD Measurements:Not smoking—eliminate tobacco use. program Outcomes: Reduction in number of smokers improves participant health and reduced cost for plan. Achieve a Stress Goal with the Digital Health Assistant Description Each goal achieved is highly rewarded to motive and encourage continual participations. Once 50 Throughout WebMD Measurements:Data self-reported. program Outcomes:s. Reduced stressors =Improved health for participants and reduced cost for plan. Achieve a Weight Loss Goal with the Digital Health Assistant Description:Each goal achieved is highly rewarded to Throughout motive and encourage continual participations. Once 50 WebMD Measur nientsm Number of pounds and inches lost. program Outcomes: Reduced BMI numbers=Improved health for participants and reduced cost for plan. Make Progress toward your Weekly Plan Description:To encourage members to participate at any 5ptseach Throughout level and post data into the system. 1x per week WebMD Measurements:Data self-reported. /180max program Outcomes: Data available for analysis. Complete a Weekly Plan Description:To encourage members to participate at any 10pts Throughout level and post data into the system. 1x a week each/100max program WebMD Measurements:Data self-reported. Outcomes: Data available for analysis. !% Group Sponsored onsored Activities Healthy Cookbook Event D srtipt n:To encourage members participation and share practical cooking tips to improve daily nutrition. Throughout Measurements:Number of participants. Once 5 program Group Reports Outcomes: Improved nutrition and program participation will reduce plan cost. Healthy Cookbook Event Cheerleader points A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level o Throughout Y f Once 50 program Group Reports participating by scheduling the event,securing the location, organizing the event,leading the activities, 9/20/2013 Page 4 of 10 F�r4&Ae ®ruv, An Vndepemndent:fiicensee of the Bbe Cross and BLe slh'iM Associstuen i I m � conducting the registration,and providing the activity reports for BcBs to award the individual points. 5k walk/run/bike challenge/Hula-hoop Challenge/jump rope challenge or Triathlon DescripI`1cm:Team events to improve physical fitness in a fun and competitive manner. 6x a year 25 Throughout Group Reports �� o�a.�r�;^�� enBs°a Number of participants. Program Outcomes:Improved health for individuals and reduced cost for the plan. 5k walk/run/bike challenge/Hula-hoop Challenge/jump rope challenge or Triathlon Cheerleader A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the a year 50 Program Group Report location,organizing the event, leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. 7 Inning Stretch Description:Similar to activity at baseball games. The team cheerleader calls for the 7th inning stretch around 3:00 pm in the afternoon.Participants stand up from their desk and complete the four minute desk exercises that were identified in the Lunch&Learn exercise session.Physical stretching increases circulation and energy levels while Throughout avoiding the need for a snack or soda ix year 5 Program Group Reports Measurements:Number of participants. Outcomes:Fun physical activities help to overcome the stigma of exercise being punitive. Improved physical conditioning reduces health care cost for individual and plan. 7` inning Stretch Cheerleader Points A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the 1x year 50 Self-Report location,organizing the event, leading the activities, Program conducting the registration,and providing the activity reports for BcBs to award the individual points. AHEC Tobacco Cessation The FL Keys Area Health Education Center provides 1x a year 10 Throughout Group Reports participants with a FREE program that includes Rx patches, Program support groups and more. AHEC Tobacco Cessation Cheerleader A 'Cheerleader'is the person responsible for coordinating 1x a year 50 Throughout Group Reports the group activity. They go above and beyond the level of Program participating by scheduling the event,securing the 9/20/2013 Page 5 of 10 auw 4 mum �I� VII An Oubdepeirwde nt I.censesn of 6e Mue Gross and Due Sfdeld Assodafion .mwp m, �I�lil J ,fj� location, organizing the event, leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. Thpaughems R62 400 PFG§FaFn GF9UP RePGA Annual Flu Shot Throughout Description:On site clinic's provided in collaboration with Program Visiting Nurses Association. Measurements:Number of participants. ix a year 10 Self-Report Outcomes:Reduced health care cost associated with upper respiratory infections and reduced absenteeism for individuals and co-workers. Annual Flu Shot Clinic Cheerleader A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the 1x a year 50 Program Group Report location,organizing the event,leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. Go to Farmers Market scd iption Participants take afield trip to a Farmers Market to identity healthy food choices/alternatives. Throughout P' ' ��,�tar�t��entsm Number of participants. ix a week 5 Program Self-Report Outcomes::Improved nutrition for participants and lower health care cost for plan. Farmers Market Cheerleader A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the 1x a year 50 Program Group Report location,organizing the event,leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. Sport Tournaments(flag football,softball,tennis,beach 5x a year 10 Throughout Self-Report volleyball) Program Sport Tournaments(flag football,softball,tennis,beach volleyball)Cheerleader A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the ix a year 50 Program Group Report location,organizing the event,leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. Healthy Recipe Contest Throughout Description: A fun activity to encourage the consideration 2x a year 10 Group Report .fir reparation of nutritional meals and support Program 9/20/2013 Page 6 of 10 01.11, 9 An Independent Licensee of tl'ie Blue Cross and Bhe Shlkdd Association rl, participation in the program. asurvinent n Number of participants. Oute,,,'om 5,'Program participation,improved nutrition and lower health care cost. Healthy Recipe Contest Cheerleader A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the 2x a year SO Group Report location,organizing the event,leading the activities, Program conducting the registration,and providing the activity reports for BcBs to award the individual points. Weight loss Program(weight watchers,Jenny Craig, Throughout Nutrisystem,BIue36S discounts,TSFL) Program k esrripdon:Individual and group activities to encourage weight loss. Measurements:Weight loss numbers. 1x a year 5 Group Reports Outcome Improved health for individuals and lower health care cost for the plan. Weight loss Program(weight watchers,Jenny Craig, Throughout Nutrisystem,BIue36S discounts,TSFL)Cheerleader Program A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of ix a year SO Group Reports participating by scheduling the event,securing the location,organizing the event,leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. Biggest Loser Challenge Di.rva cription:A fun weight loss competition modeled after popular television program. Measurements: Weight loss numbers. 2x a year S Throughout Group Reports Outcomes:es Improved health for individuals and lower Program health care cost for the plan. Biggest Loser Challenge Cheerleader A 'Cheerleader'is the person responsible for coordinating the group activity. They go above and beyond the level of Throughout participating by scheduling the event,securing the 2x a year SO Program Group Reports location,organizing the event,leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. Create a wellness bulletin board in break room Throughout Cheerleader Program The person responsible for coordinating a Wellness Bulletin 2x a year SO Group Report board to share information about activities and program events. 10 minute stretch breaks Throughout Dscfiption r Similar to the 7`n inning stretch but targeting 3x a week S Self-report 9/20/2013 Page 7 of 10 R. ) 0 An Vuude uruurodent Liceruuueun of tau Blue Cross and Mu e prelhie'd A=Oatioin less active participants at any time during the work day in Program an effort to overcome resistance to physical activities and improve program participation. Measurements:Number of participants. Outroa m Improved health for participants and reduced cost for plan. 10 minute stretch breaks Cheerleader Throughout A 'Cheerleader'is the person responsible for coordinating Program the group activity. They go above and beyond the level of participating by scheduling the event,securing the 1x a year 50 Group Report location, organizing the event,leading the activities, conducting the registration,and providing the activity reports for BcBs to award the individual points. BCBS Lunch and Learns Throughout Description:Psycho-educational seminars provided by BcBs Program during lunch that focus on health improvement topics. 2x a year 2S Group Report Measuar merit:Number of participants. Outcomes:Improved health for participants,increased program participation and reduced health plan cost. Nutritional Assessment with RD Throughout Description:tion: One on One services with registered dietician Program primarily targeting those diagnosed with diabetes. Measurements:nts:Number of participants. 4x a year 2S Self-Report Outcomes:es:Improved health for participants,increased program participation and reduced health plan cost. EAP/Aetna Webinar Lifestyle topics Throughout Description:30-40 min Psycho-educational lifestyle Program Webinars on topics like managing elder care,adolescent behavior,child development and many more. Once a aaa+�.sur ra�r nts: Number of participants. month 10 Group Report im)a.aia:omesm Reduced stressors for participants and reduced health plan cost. Individual Physical Activities(Swimming laps,walking Throughout fitness,weightlifting,exercise classes,bicycling,racquet Program ball,water aerobics,spin classes,tai chi classes) Descii lion:Targeting those that are already active to participate in the program and document their activities. 3x a week 5 Self-Report Measurements:Data entered. (hilt"urns:Healthy data will increase the overall health of the group and continue to keep health care cost low. Walking/Cycle to work Throughout Description:To encourage and reward healthy lifestyles. 3x a week 5 Program Mea�stira�rraa:�nts:Data entered. Self-report Outcomes:Healthy data will increase the overall health of 9/20/2013 Page 8 of 10 Ain k d'eiaecua ent Licensee of the the group and continue to keep health care cost low. Q:Why is the company so interested in my health? A: Promoting better health for employees is a win-win for employees and the company. When employees are healthier,we can enjoy a better quality of life,have more energy for the things we love and reduce out-of-pocket health care costs. Almost three-quarters of what the United States spends every year on health care is on chronic diseases—and most of these can be prevented or controlled by changing behaviors and making better health care choices. We want to encourage employees to take the steps they can to improve their health. Q:Why wellness now? A:In the past,we—along with the rest of the industry—focused on efficiently treating the symptoms of health issues. As health care costs continue to rise rapidly,we are focusing on prevention and intervention activities to encourage healthy lifestyles and reduce future costs. Q: Who can participate in the program? A: All employees can—and should—participate. Each Employee has an opportunity to earn Blue Reward"Points". Earn enough points and be rewarded with reduced health care premiums. Q: How does the program work? A: Employees earn points for participating in certain health and wellness activities that are part of the BOCC Group wellness program. Q: How many points do I need? A: Employees must complete the health assessment/biometric screenings and earn at least 500 points between January 1St and September 301h each year. We will add the online Personal Health Assessments instructions here and dates for the on-site health fairs Q: How do I earn points? A: Employees earn points by participating in the on-site personal health assessment,using online retail tools and learning programs through Member Account at floridablue.com and WebMD,tracking physical activity with online tracking tools,completing learning modules and participating in company-sponsored wellness events and even 9/20/2013 Page 9 of 10 ON An hdepeu dent V.kwnee of tyre hJJF. ag �l getting a seasonal flu shotl Q: How do I track my points? A: For Florida Blue health plan members, you can track your points through the WebMD "Earn BlueRewards" tab. Through a series of weekly and monthly updates, points will be added to your account for completed activities. Please note that your points are awarded as soon as possible. However, it may take 30 calendar days to post your points from the previous month's activities. Q.What is my reward?(may be modified) Employees are rewarded with reduced premiums. Employees that don't participate(or meet the minimum level of points)will be assessed a monthly fee of$100.00 (hired before 5/01/12). For those currently xontributing$50.00 per month toward the monthly premium(hired on or after 5/01/12),the assessment will be an additional$50 for a total of$100.00 per month. Q: When does the program start and end? A: The program starts at midnight on January 1st and ends at midnight on September 30th,2013.There will be opportunities throughout the year to earn points,with new components added as they become available. Q: How do I find the tools on the Member Website and WebMD? A: We've created a navigation chart to help you find the tools easily. Q: How do I get started? A: ® If you're a Florida Blue health plan member,log into or register for Member Account at floridablue.com and then navigate to WebMD "Earn BlueRewards". This is where you will find many of the Program tools and activities. As you complete activities,points will be added to your WebMD"Earn BlueRewards"account. 30/1/2013 Page 10 of 10 An hdgenndent Uceinsee of tlie B ue Cross and INu e SNdd Association