2017 BravoWell Program
Welcome You have the power to improve your healthcare costs! The City of Cocoa Beach has partnered with Bravo, a company that works with employers like yours to administer engaging wellness programs that produce real results. Participation in the BravoWell program is voluntary, but by taking part you will have the opportunity to earn significant rewards while making strides towards a healthier you. BRAVOWELL PROGRAM GUIDE 2
Table of Contents Program Overview 4 How it Works 6 Health Screening Details 9 Screening Results & Support 12 BRAVOWELL PROGRAM GUIDE 3
Program Overview How you save. Your employer has created a plan with you in mind! The participation requirements listed below are part of your 2017 wellness program. The BravoWell program is voluntary. However, if you enroll in the health plan but choose not to participate, you may miss out on significant financial rewards. Your participation in this plan will generate a financial savings if you are covered on the health plan. However, if you enroll in the plan but choose not to participate, you will be responsible for a portion of health care cost increases. Your covered spouse is also invited to participate. Non-participation from a spouse may result in a financial impact for your health care cost. 2017 Plan Design Goals for 2017 Incentives Credit Earned if Goal Met Future 2018 Employer Goals Credit Earned if Goal Met Employee Spouse Complete the Online Health Risk Assessment Rates and Financial impact will be communicated prior to registration closing. Online Health Risk Assessment Body Mass Index Or waist measurement (Female < 35 inches; Male < 40 inches) Participate 29.9 Participate in a Screening Blood Pressure 130/85 Complete the Online Health Risk Assessment LDL Cholesterol Or HDL Cholesterol Female: > 50 Male: > 40 130 Fasting Glucose 115 Participant in a Screening Tobacco Negative Rates and Financial impact will be communicated prior to registration closing. Not sure if you can meet one or more of the goals? We can work with you, and if you wish, your doctor, to find an alternative way to qualify for the full reward. Contact Bravo at 877.662.7286 or visit your company portal at: www.bravowell.com/cocb. BRAVOWELL PROGRAM GUIDE 4
Do It for Those Who Matter. BRAVOWELL PROGRAM GUIDE 5
How it works. 1 2 3 Complete the steps below, before October 21, 2016, to enroll in your wellness program. Each step is necessary for your success. Registration Opens June 8, 2016. Visit : www.bravowell.com/cocb. 1. Register Visit the URL above and follow the step-by-step instructions to create an account or login. Complete the registration step by providing Bravo with your updated information, ensuring your results are delivered quickly and accurately. 2. Complete a Health Risk Assessment The health risk assessment (HRA) is an added feature that provides you with additional information in your results letter about your current health status, areas of risk and suggestions on how to improve your health. It covers demographic data, medical history, medications, measured biometrics and actual lab values, resulting in more valuable and telling data. 3. Schedule a Screening Appointment with your Provider You can download an approved form to visit your own provider or an approved clinic. Submit your signed provider form back to Bravo by November 11 th, 2016. The web portal will be closed on 10/22/16 and you will no longer be able to access the HRA or physician form after that date! BRAVOWELL PROGRAM GUIDE 6
Program Overview Registration is open June 8 October 21, 2016 To begin registration, visit: www.bravowell.com/cocb. If this is your first time registering, select Create an Account to begin the registration process. Enter your details Complete the required criteria to begin. (First name, last name, date of birth, and SSN) and select continue. Last 4 digits of SSN Choose a username and security question Create a username, select and answer the security question and select continue. Finish creating your account Enter your email, create a password and click submit. If you give your email address, you will receive a verification link. You must click the link in your email in order to verify your account. You must verify your account in order to review your results online. BRAVOWELL PROGRAM GUIDE 7
Don t forget. Keep these important dates & deadlines in mind. Starts Ends Register For The BravoWell Program June 8, 2016 October 21, 2016 Complete Your HRA June 8, 2016 October 21, 2016 Submit Provider Screening Form June 8, 2016 November 11, 2016 Receive Your Incentive January 1, 2017 December 31, 2017 BRAVOWELL PROGRAM GUIDE 8
Health Screening Details BRAVOWELL PROGRAM GUIDE 9
Health Screening Details Screening with your provider. When scheduling your screening appointment, it s important to provide your healthcare provider s office with the correct information for a successful visit. I recently had a preventative health screening. Can I submit those results? Bravo will accept results from health screenings that took place on or after January 1, 2016. What type of appointment am I scheduling? When calling your healthcare provider s office to schedule your appointment tell them you would like to schedule, preventative screening visit or annual wellness visit. These are the frequently used industry terms and your healthcare provider s office should be able to easily accommodate your request. If a blood test is required, what type should I request? Your healthcare provider s office should perform a standard lipid panel blood test for you. For the most accurate results, fasting 10-12 hours prior to your health screening is recommended. What should I bring with me to the appointment? Do not forget to bring your screening form with you to your appointment. Your healthcare provider is required to fill out this form and sign it. This form can be obtained through your web portal. Who is permitted to sign the form or complete the appointment? If your provider is an M.D., N.P., P.A., or D.O., their signature is acceptable to process the form. Please remember that a participant signature is also required to process the form. If you are filing an appeal due to pregnancy, a midwife (CNM) is also considered an approved provider. Once completed & signed, can my healthcare provider submit my form? Your healthcare provider can fax the form and lab work results to Bravo on your behalf. As the participant, it is ultimately your responsibility to ensure the completed form is sent to Bravo on or before your complete by deadline. How to submit your provider screening form to Bravo Submit your form, along with supporting documentation, to your company portal by clicking on the upload document button on your dashboard. BRAVOWELL PROGRAM GUIDE 10
Health Screening Tests The following tests will be graded as part of the BravoWell program. Body Mass Index Body mass index (BMI) is a measurement of your weight distribution compared to your height. Many health conditions, including cholesterol levels and total heart health, are related to your body mass. Elevated BMI can result in health problems associated with heart and kidney disease. Blood Pressure Blood pressure is the force of blood against the walls of the arteries. It is recorded in two numbers: the systolic/top number (pressure as the heart beats) and diastolic/bottom number (pressure as the heart relaxes between beats). LDL Cholesterol Cholesterol is a waxy substance in the blood stream and the body s cells which aids in forming some hormones and other body functions. Specifically, LDL cholesterol is labeled as the bad cholesterol and if too much is circulating, it can build up in the walls of arteries that serve the heart and brain and increase an individual s risk of heart disease and stroke. HDL Cholesterol Cholesterol is a waxy substance in the blood stream and the body s cells which aids in forming some hormones and other body functions. Cholesterol is broken down into HDL and LDL. HDL is labeled the good cholesterol as it may protect against heart attack - but low levels may actually be harmful. Glucose Most of the food you eat is broken down into glucose, a form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. Uncontrolled glucose levels increase risk for diabetes. Tobacco/Nicotine Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately one of every five deaths in the United States each year. Cigarettes, cigars, e-cigarettes, other tobacco products (such as chewing tobacco and snuff), and tobacco smoke contain nicotine. BRAVOWELL PROGRAM GUIDE 11
Screening Results & Support BRAVOWELL PROGRAM GUIDE 12
Screening Results & Support As a participant in the BravoWell program, your results will be posted to your company portal. You will receive a results letter mailed to your home as well. Incentive results Program feature reminders Your screening results and status related to your program goals Participant details and important deadlines Also included in your results letter (based on your program features): Additional Lab Test Results Health Engagement Resources Appeal and Alternative Information BRAVOWELL PROGRAM GUIDE 13
Frequently Asked Questions Does everyone have to participate? No, participation in this program is voluntary. However, if you choose not to participate, you may miss out on significant financial impacts, and may be responsible for contributing an additional amount towards your health insurance premium if you enroll in the health plan. How will I receive my results? Results will be posted to your secure account on the portal you registered on. You will receive an email notification to alert you when they are available. You will also receive a results letter mailed to your home. What if I don t meet my program goal? If your program requires the achievement of a goal, there may be alternative ways to qualify. If we have results from your last Bravo screening, your improvement will be automatically considered. If Bravo does not have prior results, you will be provided the information you need to request an alternative goal in your results letter. Alternatives are typically based on improvement from prior results or on completion of a program that is related to health improvement within a certain biometric. Contact Bravo and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status. Will my employer see my results? No, Bravo will not share your individual results with your employer. They will be given a summary of the number of wellness points each employee received as a result of the health screening, but will not know which category or any specific laboratory results. Your employer may request that your results be sent to an approved third party for coaching or to be included in your health assessment. Do spouses and adult dependent children need to be screened? Since studies show that engaging spouses can help improve the health of the employee, your company is allowing spouses to be screened this year. This year, adult dependent children will not be screened. Is this program legal? Can my employer really base my premium on my health results? Bravo administers programs in compliance with the Affordable Care Act s (ACA) Incentives for Non- Discriminatory Wellness Programs in Group Health Plans. This allows employers to adjust healthcare cost for those on the health plan who meet certain health goals. At Bravo, we also adhere to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Protected Health Information (PHI) protocols. This ensures that your personal information, including your results, will not be shared with any unauthorized parties, including your employer. What if my results are not consistent with recent tests? In the event that the screening results differ significantly from recent medical results, a Type 1 (dispute of accuracy) appeal may be submitted with supporting documentation within 30 days of the date displayed on your original results letter. Any retesting may be at the expense of the participant. What if I have a medical condition and I cannot meet the goal or the alternative goal (if applicable)? If your employer s goal(s) or reasonable alternative goal(s) are considered unreasonably difficult due to a medical condition or medically inadvisable (Type 2 Appeal), Bravo manages appeals and coordinates personalized alternatives for these goals. Any retesting may be at the expense of the participant. Contact Bravo for more information. For more information about the appeal process, see the next page. What tools and resources are available to me? Included on your web portal are great resources to prepare for your next screening event. Simply login to get started! BRAVOWELL PROGRAM GUIDE 14
Screening Results & Support Filing an Appeal For Type 1 & Type 2 Appeals Why would I file an appeal? You would file an appeal if you dispute the accuracy of your results (Type 1) or your healthcare provider feels it is unreasonably difficult due to a medical condition or it s medically inadvisable for you to meet the employer s goals or alternative (Type 2). How soon should I file an appeal? Appeals must be filed by the deadline date listed on your results letter, which is typically 30 days. Submit your appeal and supporting documentation via fax, by mail or by email. Contact information is located on your appeal form. What paperwork is needed to file an appeal? 1. A completed appeal form with documentation and signature by an approved provider is required. Approved providers include: doctor of medicine (M.D.), doctor of osteopathy (D.O.), physician assistant (P.A.), or nurse practitioner (N.P.). If you are filing an appeal due to pregnancy, a midwife (CNM) is also considered an approved provider. AND 2. Copies of any additional testing results and supporting documentation may be required. The details for following an appeal are outlined on your appeal form. Where do I obtain an appeal form? An appeal form may be printed from your web portal at www.bravowell.com/cocb or by calling Bravo toll-free at 877.662.7286. Who pays for the re-testing when an appeal is submitted? Any re-testing will be at your expense. When will I be notified of the decision of my appeal? A notification will be sent within 3-7 business days that your appeal has been received and is being processed. Typical appeals can be resolved within 10-15 business days unless additional documentation or results are required. When will the financial adjustment be made? If the appeal is approved, it will be as if you passed the category originally. BRAVOWELL PROGRAM GUIDE 15
Additional Tools and Resources Active.com, and other resources, are available at www.bravowell.com/cocb for nutrition information, training tips and nearby activities. Also, follow the links below for more information about specific biometric measures. Your Online Health Risk Assessment: By completing your online health risk assessment, you will receive a comprehensive risk stratification report. Cholesterol http://www.heart.org/heartorg/conditions/cholesterol/cholesterol_ucm_001089_subhomepage.jsp http://www.webmd.com/cholesterol-management/lowering-triglyceride-levels?page=2 http://www.mayoclinic.org/reduce-cholesterol/art-20045935 Blood Pressure http://www.heart.org/heartorg/conditions/highbloodpressure/abouthighbloodpressure/about-high- Blood-Pressure_UCM_002050_Article.jsp#.VyJG3Xp3Upk Body Mass Index http://www.bmicalculator.org/how-can-i-lower-my-bmi/ Glucose http://www.diabetes.org/are-you-at-risk/ Tobacco http://betobaccofree.hhs.gov/ Low Blood Sugar http://www.cdc.gov/healthyweight/assessing/index.html A1c http://www.everydayhealth.com/hs/type-2-diabetes/lower-a1c-for-diabetes-control/ Triglycerides http://www.webmd.com/cholesterol management/lowering-triglyceride-levels?page=2 BRAVOWELL PROGRAM GUIDE 16
Welcome How it works. Registration Create an account and/or login to the Bravo portal. Complete the necessary steps on your personal dashboard. Screening Visit your doctor or an approved clinic. Review Review your results, including alternative options and resources to continue your journey towards better health. Receive Your incentive will be applied January 1, 2017. If you have questions pertaining to your 2017 insurance contributions, you can contact your HR department. Ongoing Support There are a number of resources available to you throughout the year. Take advantage of the year-round support on the Bravo Portal. BRAVOWELL PROGRAM GUIDE 17
Additional Tests As an added feature of your health screening, your employer has chosen to provide you with a number of additional tests Albumin - Albumin is one part of serum proteins and a component of total protein. Low values may be a result of hepatic (liver) or renal (kidney) disorders. Higher values may indicate dehydration. ALB/GLO Ratio - Albumin/Globulin Ratio is an indicator test. A low A/G ratio may be an indicator of autoimmune disease or kidney condition. A high A/G ratio may be an indicator of a genetic condition, and in some situations leukemia. More specific tests, such as albumin, liver enzyme tests, and serum protein electrophoresis must be performed to make an accurate diagnosis. ALP - Alkaline Phosphate is an enzyme found primarily in the liver and bones. These levels are usually higher in pregnant women and children due to its role in the bone making process. Elevated levels may be an indication of bone, kidney, or liver disorders. ALT - Alanine Aminotransferase (ALT) is an enzyme involved in the metabolism of the amino acid alkaline. ALT is found in a number of tissues, but in higher concentration in the liver. Elevated levels can be due to certain medications or extensive exercise, but can also be a sign of liver disorders. AST - Aspartate Aminotransferase (AST) is an enzyme found in high concentration in heart muscle, liver cells, skeletal muscle cells and to a lesser degree in other tissues. Elevated levels of AST can indicate muscle trauma, heart damage or damage to the liver. Bilirubin - This is a byproduct of the breakdown of red blood cells and is made into a water-soluble form in the liver. Elevations can indicate chronic liver disease, gall bladder disease, or anemia (a red blood cell disorder). BUN - Blood Urea Nitrogen (BUN) is an end product of protein metabolism, which is cleared by the kidneys. Elevated levels may be an indication of kidney disorders or diuretics. Total Cholesterol - Cholesterol is a normal body component that is used in the structure of cell membranes and the synthesis of bile acids and steroid hormones. It is one of the major lipids (fats) in the body. Excess cholesterol in the blood has been correlated with cardiovascular disease. Chol/HDL Ratio - Cholesterol/High Density Lipoproteins (HDL) ratio is obtained by dividing the total cholesterol by the HDL cholesterol. This test is a comparison of the good cholesterol vs. total cholesterol. The lower the ratio the better. Values above 5.0 may be an at risk indicator for Cardio Vascular Disease. Total Cholesterol and HDL levels are more useful than this ratio in determining what, if any, treatment options are needed. Calcium - Calcium testing is typically ordered to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. Blood calcium levels do not directly tell how much calcium is in the bones, but rather, how much calcium is circulating in the blood. Creatinine - Creatinine is a byproduct of muscle tissue metabolism. Elevations might suggest kidney or vascular diseases. High protein diets may cause mild elevations. Fructosamine/GSP - This test shows the time averaged indicators of blood glucose levels over the previous two to three weeks. Glycated Serum Protein (GSP) is used to assess the glycemic status of diabetics. BRAVOWELL PROGRAM GUIDE 18
Additional Tests Continued GGT - Gamma Glutamyl Transpeptidase (GGT) is an enzyme found in the liver, bile ducts and kidneys. Greater than normal levels may indicate hepatitis, heavy alcohol use, or the use of certain medications. Globulin - Globulin is a component of total serum protein, which shows the total amount of proteins in the blood. Abnormal levels have been found in individuals with immune disorders, infections, and other diseases. Glucose - Glucose is a type of sugar found in the body that is used as a diabetic marker to measure blood sugar levels. This test is for glucose levels and is very sensitive to food intake. To achieve the most accurate results it requires a period of fasting before testing. High levels may indicate a diabetic condition. HDL Cholesterol - High Density Lipoproteins (HDL). High levels have shown to provide a protective effect against coronary heart disease. It is sometimes referred to as the good cholesterol. LDL Cholesterol - Low Density Lipoproteins (LDL). Elevated levels can be related to coronary heart disease. It is sometimes referred to as the bad cholesterol. LDL/HDL Ratio - Low Density Lipoproteins (LDL)/High Density Lipoproteins (HDL) are sometimes used to help predict chances of developing heart disease. It looks at the ratio between bad cholesterol (LDL) and good cholesterol (HDL). Total Protein - Results of a total protein test will give your doctor information on your general health status with regard to your nutrition and/or conditions involving major organs, such as the kidney and liver. High values may be an indicator of dehydration, chronic inflammation, or infection. Extremely low values may be associated liver or kidney disorder, or difficulty with protein digestion or absorption; however, if results are abnormal, further testing is usually required to help diagnose the disease affecting protein levels in the blood. Triglycerides - Triglycerides comprise the largest portion of fat in the blood. In higher elevations it can be an indication of diabetes, acute alcoholism, liver disease or renal failure. Triglycerides may also be elevated in non-fasting samples. BRAVOWELL PROGRAM GUIDE 19
One International Place 20445 Emerald Parkway Dr. SW Suite 400 Cleveland, OH 44135 Toll Free 877.662.7286 Support/Help support@bravowell.com www.bravowell.com BRAVOWELL PROGRAM GUIDE 20