WINONA AREA PUBLIC SCHOOLS INSURANCE COMMITTEE MEETING - BOARDDOCS
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October 6th, 2020
Winona Area Public Schools
Insurance Committee Meeting
Executive Summary
January 2021
Medical Proposals:
For the January 2021 HITA Best/Final Proposals, Winona Area Public Schools sought bids from
their incumbent carrier, Blue Cross and Blue Shield of Minnesota (BCBS), HealthPartners,
Medica and United Health Care (UHC).
Based on the current member count and projected cost per member, the BCBS renewal, as well
as Medica were the most competitive. Health Partners and United Health Care (UHC) both
showed rate increases from the BCBS final proposals. Please see the following rate comparisons
for detailed outcome of the bids.
Health Partners:
Declined to offer a rate change from their initial HITA Proposal. However, they did reduce their
second-year rate cap from 12% to 9%.
Rates show a -0.2% Decrease from Current.
*Varied Disruption in Provider and Pharmacy Networks.
United Health Care:
A Best/Final Proposal was received. A rate reduction from Initial Bid of 1% increase to a -3.3%
decrease from current was offered. In addition, a second-year rate cap is now offered at 9.9%.
Broad Network only available. Unable to provide a cost savings network. EAP Included
This proposal represents a 5.2% Increase from Blue Cross final proposal.
*Varied Disruption in Provider and Pharmacy Networks.
Blue Cross and Blue Shield of Minnesota:
A Best/Final Proposal was received. A rate reduction from the Initial Bid of -7% from current to
-8% from current was offered. In addition, BCBS lowered their rate cap from 9.9% to 8.5%.
No Disruption in Provider and Pharmacy Networks. Two additional Premium Providers are now
offered in the High Value Network which includes Children’s Hospital and Allina Health System.
Effective January 1, 2021, HealthPartners Health System and Park Nicollet will no longer be
included in the High Value Network. No EAP
Wellness Program – Share Care – OMADA – Blue 365-Learn to Live-Tobacco Cessation-Discount
Marketplace
Medica:
A Best/Final Proposal was received. A rate reduction from the Initial Bid of -2.5% from current
to -6.3% from Current was received. In addition, a second-year rate cap is now offered at 12.5%.
This represents a 1.8% increase from Blue Cross final proposal.
*Varied Disruption in Provider and Pharmacy Networks. EAP Included
Wellness Program Credit - $60,000 (No Requirements)
Invest Fitness Program – Free Tracking Devices, up to $75 month toward HSA Accounts, Web-ex
Training, Health Club Reimbursements $20, Health Savings Program.
*Varied Disruption in Provider and Pharmacy Networks.
Winona Area Public Schools
Final Bid Comparisons
January 1, 2021 ‐ December 31, 2021
BCBS BCBS
HealthPartners Medica UHC
Current Renewal
Effective Until 12/31/2020 Effective Until 12/31/2021 Effective until 12/31/2021 Effective until 12/31/2021 Effective Until 12/31/2021
Total Monthly Premium $ 389,213.47 $ 358,076.92 $ 390,092.22 $ 364,637.82 $ 376,539.31
Total Annual Premium $ 4,670,561.64 $ 4,296,923.04 $ 4,681,106.64 $ 4,375,653.84 $ 4,518,471.72
$ (373,638.60) $ 10,545.00 $ (294,907.80) $ (152,089.92)
Difference from Current
‐8.0% 0.2% ‐6.3% ‐3.3%
$ 384,183.60 $ 78,730.80 $ 221,548.68
Difference from Renewal
8.9% 1.8% 5.2%
Final Bid 10.6.20 Released Final Bid 10.6.20 Released Final Bid 10.6.20 Released with Final Bid 10.6.20 Released
with Second Year Rate Cap of with Second Year Rate Cap of Second Year Rate Cap of with Second Year Rate Cap of
8.5%. 9%. 12.5%. 9.9%.
Two Year Rate Comparison
BCBS HealthPartners Medica UHC
Rates @ Max Renewal for Year 2 $ 4,662,161.50 $ 5,102,406.24 $ 4,922,610.57 $ 4,965,800.42
Sum of 2 Years Premium Costs $ 8,959,084.54 $ 9,783,512.88 $ 9,298,264.41 $ 9,484,272.14
Difference from 2 Year Blue
$ 824,428.34 $ 339,179.87 $ 525,187.60
Cross Cost
Year 2 cap of 8.5% Year 2 cap of 9% Year 2 cap of 12.5% Year 2 cap of 9.9%
Two Year Comparison is Based on Enrollment Information as of Renewal from Blue Cross
This is a general plan comparison only. For exact terms and conditions, please refer to the contract.
Winona Area Public Schools
BCBS Current & Renewal Rates
Current Rates Effective: January 1, 2020 through December 31, 2020 Renewal Rates Effective: January 1, 2021 through December 31, 2021
Former $2,200 HDHP ‐ Non Embedded
Former $2,200 HDHP ‐ Non Embedded $3,000 HDHP ‐ HSA Plan Embedded Deductible
Former $100 Deductible Plan Former $500 Deductible Plan $1,000 Deductible Plan HSA Plan $3,000 HDHP ‐ HSA Plan Embedded Deductible
HSA Plan High Value Network
Aware Network Aware Network Aware Network High Value Network Aware Network
Aware Network (Mayo & Satellites Out of Network)
(Mayo & Satellites Out of Network)
In Network Benefits
Calendar Year $100 per person $500 per person $1,000 per person $2,200 per single contract $2,200 per single contract $3,000 per person $3,000 per person
Deductible $300 per family $1,000 per family $2,000 per family $4,400 per family contract $4,400 per family contract $6,000 per family $6,000 per family
Annual Medical $500 per person $1,000 per person $2,000 per person $2,200 per single contract $2,200 per single contract $3,000 per person $3,000 per person
Out of Pocket Max $1,000 per family $2,000 per family $4,000 per family $4,400 per family contract $4,400 per family contract $6,000 per family $6,000 per family
Pharmacy Out of $150 per person $300 per person $300 per person
Combined with Medical OOP Combined with Medical OOP Combined with Medical OOP Combined with Medical OOP
Pocket Max $250 per family $500 per family $500 per family
Preventive Health Care 100% Coverage 100% Coverage 100% Coverage 100% Coverage 100% Coverage 100% Coverage 100% Coverage
Office Visits 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Hospital ‐ Inpatient
80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Care
Hospital ‐ Outpatient
80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Care
Urgent Care 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Emergency Care 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Ambulance 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
$10 Generic, $25 Brand, $10 Generic, $25 Brand, $10 Generic, $25 Brand,
$40 Non‐Preferred Brand $40 Non‐Preferred Brand $40 Non‐Preferred Brand
Prescription Drugs 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Specialty Drugs: 80% after Deductible to Max Specialty Drugs: 80% after Deductible to Max of Specialty Drugs: 80% after Deductible to Max of
of $200/prescription $200/prescription $200/prescription
Classic Network w/ Open FlexRx Formulary (Excludes Classic Network w/ Open FlexRx Formulary (Excludes Classic Network w/ Open FlexRx Formulary (Excludes Classic Network w/ Open FlexRx Formulary (Excludes
Classic Network w/ Open FlexRx Formulary Classic Network w/ Open FlexRx Formulary Classic Network w/ Open FlexRx Formulary (Excludes
Pharmacy Network CVS/Target) CVS/Target) CVS/Target) CVS/Target)
(Excludes CVS/Target) (Excludes CVS/Target) CVS/Target)
Includes Preventive Rx Includes Preventive Rx Includes Preventive Rx Includes Preventive Rx
Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐Pocket Separate Out of network Deductible / Out‐of‐Pocket Separate Out of network Deductible / Out‐of‐Pocket Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐
Out of Network Benefits
Pocket maximum Pocket maximum maximum maximum maximum Pocket maximum Pocket maximum
Calendar Year $300 per person $750 per person $2,000 per person $3,000 per single contract $3,000 per single contract $5,000 per person $5,000 per person
Deductible $900 per family $1,500 per family $4,000 per family $6,000 per family contract $6,000 per family contract $10,000 per family $10,000 per family
Annual Medical $1,000 per person $2,000 per person $2,700 per person $6,000 per single contract $6,000 per single contract $8,000 per person $8,000 per person
Out of Pocket Max $2,000 per family $4,000 per family $5,400 per family $12,000 per family contract $12,000 per family contract $16,000 per family $16,000 per family
Coinsurance 65% after Deductible 65% after Deductible 65% after Deductible 80% after Deductible 80% after Deductible 80% after Deductible 80% after Deductible
Prescription Drugs No Coverage No Coverage No Coverage No Coverage No Coverage No Coverage No Coverage
Rates Current Rates Renewal Rates Current Rates Renewal Rates Current Rates Renewal Rates Current Rates Renewal Rates Current Rates Renewal Rates Current Rates Renewal Rates Current Rates Renewal Rates
Single 3 $ 1,086.47 3 $ 1,007.17 12 $ 1,022.63 12 $ 941.52 10 $ 949.72 10 $ 868.28 94 $ 849.60 94 $ 818.82 146 $ 711.44 146 $ 631.83 36 $ 800.84 36 $ 770.26 16 $ 670.56 16 $ 596.63
Family 0 $ 2,716.48 0 $ 2,518.19 1 $ 2,556.86 1 $ 2,354.04 0 $ 2,374.57 0 $ 2,170.94 17 $ 2,124.24 17 $ 2,047.27 36 $ 1,778.79 36 $ 1,579.74 4 $ 2,002.32 4 $ 1,925.86 18 $ 1,676.60 18 $ 1,491.72
Monthly Total $ 3,259.41 $ 3,021.51 $ 14,828.42 $ 13,652.28 $ 9,497.20 $ 8,682.80 $ 115,974.48 $ 111,772.67 $ 167,906.68 $ 149,117.82 $ 36,839.52 $ 35,432.80 $ 40,907.76 $ 36,397.04
Annual Total $ 39,112.92 $ 36,258.12 $ 177,941.04 $ 163,827.36 $ 113,966.40 $ 104,193.60 $ 1,391,693.76 $ 1,341,272.04 $ 2,014,880.16 $ 1,789,413.84 $ 442,074.24 $ 425,193.60 $ 490,893.12 $ 436,764.48
Difference from $ (2,854.80) $ (14,113.68) $ (9,772.80) $ (50,421.72) $ (225,466.32) $ (16,880.64) $ (54,128.64)
Current ‐7.3% ‐7.9% ‐8.6% ‐3.6% ‐11.2% ‐3.8% ‐11.0%
Blue Cross Blue Shield Proposed rates for 2021 are guaranteed for 12 months, with a rate cap of +8.5% for the 2022 service year.
Note: Enrollment reflects census provided with RFP.
This is a general plan comparison only. For exact terms and conditions, please refer to the contract.
Winona Area Public Schools
Medica Proposed Rates
Rates Effective: January 1, 2021 through December 31, 2021
$2,200 HDHP ‐ Non Embedded
$2,200 HDHP ‐ Non Embedded $3,000 HDHP ‐ HSA Plan Embedded Deductible
$100 Deductible Plan $500 Deductible Plan $1,000 Deductible Plan HSA Plan $3,000 HDHP ‐ HSA Plan Embedded Deductible
HSA Plan Medica Elect Network
Medica Choice Passport Network Medica Choice Passport Network Medica Choice Passport Network Medica Elect Network Medica Choice Passport Network
Medica Choice Passport Network (Mayo & Satellites Out of Network)
(Mayo & Satellites Out of Network)
In Network Benefits
Calendar Year $100 per person $500 per person $1,000 per person $2,200 per single contract $2,200 per single contract $3,000 per person $3,000 per person
Deductible $300 per family $1,000 per family $2,000 per family $4,400 per family contract $4,400 per family contract $6,000 per family $6,000 per family
Annual Medical $500 per person $1,000 per person $2,000 per person $2,200 per single contract $2,200 per single contract $3,000 per person $3,000 per person
Out of Pocket Max $1,000 per family $2,000 per family $4,000 per family $4,400 per family contract $4,400 per family contract $6,000 per family $6,000 per family
Pharmacy Out of $150 per person $300 per person $300 per person
Combined with Medical OOP Combined with Medical OOP Combined with Medical OOP Combined with Medical OOP
Pocket Max $250 per family $500 per family $500 per family
Preventive Health Care 100% Coverage 100% Coverage 100% Coverage 100% Coverage 100% Coverage 100% Coverage 100% Coverage
Office Visits 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Hospital ‐ Inpatient
80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Care
Hospital ‐ Outpatient
80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Care
Urgent Care 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Emergency Care 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Ambulance 80% after Deductible 80% after Deductible 80% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
$10 Generic, $25 Brand, $10 Generic, $25 Brand, $10 Generic, $25 Brand,
$40 Non‐Preferred Brand $40 Non‐Preferred Brand $40 Non‐Preferred Brand
Prescription Drugs 100% after Deductible 100% after Deductible 100% after Deductible 100% after Deductible
Specialty Drugs: 80% after Deductible to Max of Specialty Drugs: 80% after Deductible to Max of Specialty Drugs: 80% after Deductible to Max of
$200/prescription $200/prescription $200/prescription
Pharmacy Network Express Scripts Express Scripts Express Scripts Express Scripts Express Scripts Express Scripts Express Scripts
Out of Network Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐ Separate Out of network Deductible / Out‐of‐
Benefits Pocket maximum Pocket maximum Pocket maximum Pocket maximum Pocket maximum Pocket maximum Pocket maximum
Calendar Year $300 per person $750 per person $2,000 per person $3,000 per single contract $4,400 per single contract $5,000 per person $6,000 per person
Deductible $900 per family $1,500 per family $4,000 per family $6,000 per family contract $8,800 per family contract $10,000 per family $12,000 per family
Annual Medical $1,000 per person $2,000 per person $2,700 per person $6,000 per single contract $6,600 per single contract $8,000 per person $10,000 per person
Out of Pocket Max $2,000 per family $4,000 per family $5,400 per family $12,000 per family contract $13,200 per family contract $16,000 per family $20,000 per family
Coinsurance 65% after Deductible 65% after Deductible 65% after Deductible 80% after Deductible 80% after Deductible 80% after Deductible 80% after Deductible
$11.50 Generic, $28.75 Brand, $11.50 Generic, $28.75 Brand,
Prescription Drugs $46 Non‐Preferred Brand $46 Non‐Preferred Brand 65% after Deductible 80% after Deductible 80% after Deductible 80% after Deductible 80% after Deductible
No Coverage for Specialty Drugs No Coverage for Specialty Drugs
Rates Renewal Rates Medica Rates Renewal Rates Medica Rates Renewal Rates Medica Rates Renewal Rates Medica Rates Renewal Rates Medica Rates Renewal Rates Medica Rates Renewal Rates Medica Rates
Single 3 $ 1,018.11 3 $ 934.97 12 $ 951.75 12 $ 878.52 10 $ 877.72 10 $ 799.02 94 $ 827.72 94 $ 752.59 146 $ 638.70 146 $ 699.91 36 $ 778.63 36 $ 712.37 16 $ 603.11 16 $ 662.50
Family 0 $ 2,545.56 0 $ 2,337.70 1 $ 2,379.63 1 $ 2,196.56 0 $ 2,194.54 0 $ 1,997.79 17 $ 2,069.52 17 $ 1,881.69 36 $ 1,596.91 36 $ 1,749.97 4 $ 1,946.79 4 $ 1,781.13 18 $ 1,507.94 18 $ 1,656.45
Monthly Total $ 3,054.33 $ 2,804.91 $ 13,800.63 $ 12,738.80 $ 8,777.20 $ 7,990.20 $ 112,987.52 $ 102,732.19 $ 150,738.96 $ 165,185.78 $ 35,817.84 $ 32,769.84 $ 36,792.68 $ 40,416.10
Annual Total $ 36,651.96 $ 33,658.92 $ 165,607.56 $ 152,865.60 $ 105,326.40 $ 95,882.40 $ 1,355,850.24 $ 1,232,786.28 $ 1,808,867.52 $ 1,982,229.36 $ 429,814.08 $ 393,238.08 $ 441,512.16 $ 484,993.20
Difference from $ (2,993.04) $ (12,741.96) $ (9,444.00) $ (123,063.96) $ 173,361.84 $ (36,576.00) $ 43,481.04
Current ‐8.2% ‐7.7% ‐9.0% ‐9.1% 9.6% ‐8.5% 9.8%
Medica Proposed rates for 2021 are guaranteed for 12 months, with 12.5% rate cap for the 2022 service year.
This is a general plan comparison only. For exact terms and conditions, please refer to the contract.
Medica Value Added Benefits
HEALTH PLAN RESOURCES
FOR A HEALTHIER YOU
Your plan includes some nice “extras” that can help you stay healthy, get support and make the most of your plan, at no extra cost to you.
STAY HEALTHY
Health Club Reimbursement Program
Motivation to hit the gym. Meet a monthly workout requirement at a participating fitness club and you can earn
SM
up to a $20 credit toward your dues. That’s up to $240 a year. To learn more about Fit Choices or to find a
health club near you, go to medica.com/fitchoices.
Health Rewards Program
Get inspired to make positive changes. Taking steps to improve your health might be easier than you think.
Whether you want to stress less, quit smoking or eat more fruits and veggies, My Health Rewards by Medica®
makes it fun — and rewarding. You’ll earn rewards as you complete activities personalized just for you. To get
started with My Health Rewards, download the Virgin Pulse app, free in the App Store and on Google Play.
Healthy Pregnancy & Parenting Program
Get support during your parenthood journey. Tap into personalized guidance, support, and coaching for your
entire parenthood journey with the Ovia Health apps. They give you on-demand support and clinically backed
guidance to help you achieve your health goals, whether that’s tracking your period, getting pregnant, or
navigating pregnancy, postpartum and parental wellness. Download Ovia Parenting, Ovia Pregnancy or Ovia
Fertility for free from the App Store or Google Play. Enter your employer and health plan information to access
all the unique tools and features.
Healthy Savings Program
Eating healthier just got easier. Save money on a variety of foods with the Healthy Savings program. It’s almost
like getting a free trip to the grocery store every month. If you live near a participating store, you’ll be enrolled
automatically in the program. Just watch your mailbox for more information and your Healthy Savings card. Learn
more at medica.com/healthysavings or download the Healthy Savings app in the App Store or on Google Play.
Preventive Care
Care you need to help stay healthy. Few things are more important than your health, and you can help protect it by
getting regular preventive care. Routine checkups, screenings and immunizations can help you avoid health problems
or catch them early. Learn about what kind of preventive care you need at medica.com/prevention.
Virtual Care
Save time and connect with a provider online. Virtual care visits, also known as online care or e-visits, are a
quick and easy way to care for common conditions, including allergies, bladder infections, sinus infections and
pink eye. Connect with a provider from your computer or mobile device to get a diagnosis, treatment plan and
prescription (if needed). You can access virtual care through providers in your plan’s network. Check with your
clinic to find out if they provide options for getting care online. Or log on to mymedica.com, click on Find a Doctor
and select Virtual Care Providers to find your virtual care options.
GET SUPPORT
24-Hour Health Support
Trusted answers any time of day or night. Worried that your stomach bug could be serious? Wondering what to
do about that cough that won’t go away? The advisors and nurses at Medica CallLink® can help. They’re available
24 hours a day, 365 days a year to answer your questions and help you make smart decisions about your health.
Just call 800-962-9497 (TTY users, call 711).
Employee Assistance Program
When you need help with life’s changes. Sometimes life throws you a curveball. Whether it’s financial troubles,
personal issues or family problems, we can help. Just call 800-626-7944 any time of day or night, any day of
the year to talk with a counselor. They’ll help you find the resources you need to get back on track.
FIND INFORMATION
Mymedica.com
Manage your plan online. Mymedica.com is your one-stop resource for all kinds of information to help you
manage your health plan benefits. Register at mymedica.com to:
Find out what’s covered by your plan
Manage your prescriptions
Order ID cards
Receive the 4members e-newsletter to get information about health topics and your benefits
Search for providers and compare cost and quality information
Track your claims
View your Explanation of Benefits (EOB)
Pharmacy Resources
Manage your prescriptions online. Looking for information about prescriptions? Use the online pharmacy
resources to see what drugs are covered under your plan, check drug costs, find a network pharmacy, manage
mail order prescriptions and more. Log on to mymedica.com or download the Express Scripts®* app from the
App Store or Google Play.
* Express Scripts® administers Medica's pharmacy program.
Have a question?
Call Customer Service at the number on the
back of your Medica ID card.
© 2019 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica Health
Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management,
LLC and the Medica Foundation.
COM5486-1-00919
MY HEALTH REWARDS
BY MEDICA®
ESTABLISH & MAINTAIN HEALTHY GOALS
Whether you want to eat healthier, sleep more, stress less or get fit, My Health Rewards
TAKE A JOURNEY
is an online tool that helps you reach your health goals at your own pace. Earn points for
completing activities and get rewarded on your own personal path to health. 1. Pick a topic.
Health Assessment – Helping you understand your health status
Earn 100 points per year when you complete the health assessment.
2. Customize your Journey.
Your first step to living a healthier life begins with an online health assessment. Results and
recommendations are provided to you immediately and you can return to your assessment at
any time to modify or update it with new information–just hit the Retake button.
Next-Steps Consult® – Helping you understand your health assessment
Earn 25 points per year when you complete a Next-Steps Consult.
After you complete your health assessment, have a Next-Steps Consult. Talk to a Health
Guide to review your results, learn about your health risks and identify steps toward healthy
3. Complete steps and
changes. Schedule your consult from the My Health Rewards site. Remember to include your
log progress.
phone number in your request so we can call you for the consult.
Journeys* – Helping you develop healthy new behaviors
Earn 50 points for every Journey you complete. Complete six Journeys to earn up to 300
points per year.
Take a Journey to better health! Journeys are designed to last a few weeks, depending on your
4. Reach a goal to unlock
unique path. You pick a healthy topic and as you succeed in completing the steps in your Journey
you’ll earn points to unlock small celebrations such as challenges and badges. the next level.
Track* – Helping you reinforce and maintain healthy habits
Earn points for tracking your activities. Achieve a minimum of 500 on your Daily Wellness
Meter to earn one reward point for that day. Earn up to 200 reward points per year.
Track gives you credit for daily activities. You can log your healthy activities such as physical
activity, healthy eating and life balance. A Daily Wellness Meter encourages you to set, and beat,
5. Complete a Journey,
your personal best every day.
start another.
§§ Tracking can be done on your My Health Rewards site and by syncing with select personal
devices including Fitbit® and Garmin , or popular apps such as RunKeeper and MapMyFitness.
TM
Virtual Care – Helping you understand your care options
Earn 25 points for understanding your virtual care provider options.
Virtual care visits, also known as online care or e-visits, are a quick and easy way to get care for common medical conditions.
Connect with a provider using your computer or mobile device to get a diagnosis and treatment - even a prescription if you need
one. Virtual care can save you time - and you’ll earn points just for learning more about your options.
Monj – Helping you improve the way you eat
Earn 25 points for visiting the Monj site and completing your profile and 1 point per day (up to 200 points per year) for
completion of daily missions.
Monj is an online food and lifestyle program that can help you increase your overall wellness, while learning important skills. You’ll
be guided through Monj’s lessons—the blueprints for building healthy eating skills—and learn in an interactive and enjoyable way.
Rewards for Healthy Behaviors
Rewards encourage and motivate you to complete healthy programs and 500 POINTS
activities. We offer a points-based incentive program with built in rewards every Earns fifth $20 gift card
step of the way: 400 POINTS
§ Five incentive levels Earns fourth $20 gift card
§ Each level has a value of 100 points (500 points is maximum accumulation)
300 POINTS
§ $20 gift card tied to each level Earns third $20 gift card
§ Points are cumulative throughout the plan year
200 POINTS
Earns second $20 gift card
When you earn a reward, we’ll automatically notify you. To get notifications by email,
be sure your email address is listed correctly in your profile. 100 POINTS
Earns first $20 gift card
Improving your health. Improving your life. UP TO $100 IN REWARDS!
Go to your member website, mymedica.com, and click on the
Health and Wellness tab to get started.
My Health Rewards is not available with all Medica plans. Medica reserves the right to modify the program requirements and devices at any time. Participation in a wellness program is optional. Rewards are
available to all eligible employees that participate. If you think you might be unable to meet a standard for a reward under this wellness program, you may qualify for an opportunity to earn the same reward
by different means. Submit a question to medica.com/healthandwellnessquestions or call Medica Customer Service at 952-945-8000 for information on available reasonable alternative standards and we will
work with you (and, if you wish your physician) to find a wellness activity with the same reward that is right for you in light of your health status.
© 2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica Health Plans, Medica Health Plans of Wisconsin,
Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management, LLC and the Medica Foundation.
*RedBrick Journeys and Track are registered trademarks of RedBrick Health Corporation.
My Health Rewards member
COM10185-1-00918
MYMEDICA.COM
YOUR ONE-STOP SOURCE FOR HEALTH PLAN INFORMATION
If you haven’t checked out your Medica member website, now’s the time! Mymedica.com is your one-
stop resource for all kinds of information to help you manage your health plan benefits and improve
your health. Here are just a few of the many things you can do on mymedica.com:
SEE which drugs are covered and how
ORDER ID cards
much they cost
FIND out what’s covered by your plan CHAT with a nurse online
LEARN about and participate in fun and
TRACK your claims
effective health and wellness programs
CHECK to see if a doctor or other
health care provider is in your plan’s
network
After registering on mymedica.com, smartphone users can access a mobile version of the site.
QUESTIONS?
If you have any questions about mymedica.com or your benefits, call Customer Service at the number on
the back of your Medica ID card.
© 2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes
Medica Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions,
Medica Health Management, LLC and the Medica Foundation.
COM5854-1-01018YOUR DOCTOR.
YOUR CHOICE.
PREMIUM DESIGNATION PROGRAM Premium Care Physician
The physician meets the Premium program
Get the information you need to choose a doctor that’s right for you quality and cost-efficient care criteria.
Looking for a doctor? Our Premium Designation program can help you make
informed decisions about the doctors you choose. Quality Care Physician
The physician meets the Premium program
Premium doctors have met standards for quality and cost-efficient care. quality care criteria but does not meet the
program’s cost-efficient care criteria or is
The Premium program evaluates doctors in various specialties using evidence-
not evaluated for cost-efficient care.
based medicine and national standardized measures to help you find quality and
cost-efficient providers.
Not Evaluated For Premium Care
To see how doctors are rated for quality and cost-efficient care, simply look for The physician’s specialty is not evaluated
the hearts after their names when you use our online provider search tool at in the Premium program, the physician
medica.com/FindaDoctor. does not have enough claims data for
program evaluation or the physician’s
program evaluation is in process.
To learn more about the program, visit
medica.com/Premium Designation. Does Not Meet Premium Quality Criteria
The physician does not meet the Premium
program quality criteria so the physician is
The Premium program is a resource for informational purposes only. The fact that a not eligible for Premium designation.
doctor has a Not Evaluated For Premium Care or a Does Not Meet Premium Quality
Criteria designation doesn’t mean that the doctor doesn’t provide quality health care
services. All doctors in Medica’s networks have met certain minimum credentialing
requirements (separate from the Premium program).
©2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health plan businesses that includes Medica
Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-Insured, Medica Health Management, LLC and MMSI, Inc.
COM5879-1-00618HEALTHY SAVINGS
Eating healthier just got easier! Save money on a variety of foods with the Medica Healthy Savings program. Healthy
Savings allows you to save on foods that help you take charge of your health and achieve your wellness goals.
How it works
If you live near a participating store, you’ll be enrolled automatically in the program. Just watch your mailbox
for more information and your Healthy Savings card. There’s no extra cost for Healthy Savings; it’s just another
benefit of being a Medica member!
Each week, featured healthy promotions are pre-loaded onto your Healthy Savings account. You can shop for the
promotions at any of our participating grocery stores. You can customize grocery lists, and even use a smartphone
in the store to find the specials you want.
*
Scan your Healthy Savings card or mobile app at checkout and save instantly on healthy foods in every food
group —dairy, fruit, vegetables, proteins, and grains. During the summer months, you can even save on healthy
produce at participating farmers markets.
Get the mobile app
Download the Healthy Savings mobile app from the App Store or Google Play to get savings on your
smartphone. The app features customized messages, personalized lists, store locations and a mobile barcode to
use at checkout.
Visit medica.com/healthysavings for more information.
Buy healthy. Eat healthy. Be healthy.
*Healthy Savings currently available at Knowlan's Festival Foods Minnesota locations only.
© 2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services
companies that includes Medica Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-
Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management, LLC and the Medica Foundation.
COM10603-1-00319HEALTH CLUB
REIMBURSEMENT
240 MORE REASONS TO GET FIT
Looking for reasons to go to the gym? Join Fit ChoicesSM by Medica and earn up to a $20 credit each month toward your health
club dues when you meet your monthly visit requirement. That’s up to $240 a year.
Getting started is simple:
Find a participating health club near you and learn more about Fit Choices at medica.com/fitchoices.
The program includes many national, regional and local health clubs.
Visit the health club and present your Medica ID card.
Work out at your club. The club tracks your visits and notifies Medica.
Meet your monthly visit requirement and receive up to a $20 credit toward your monthly health club dues.*
To make sure you are eligible or to learn about your monthly visit requirement and credit, call Customer Service.
The number is on the back of your ID card.
Go to medica.com/fitchoices for more
information about Fit Choices.
*If your monthly dues are less than $20, you’ll receive credit for the amount of your dues. Up to two members per eligible Medica policy can earn the $20 credit
per month with a single or family health club membership. A maximum of two $20 credits per month. Eligible members must be 18 years of age or older to
receive the credit.
©2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica
Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica
Health Management, LLC and the Medica Foundation.
COM5455-1-0918MEDICA
CALLLINK®
GET SUPPORT FOR YOUR HEALTH CONCERNS 24/7
Medica CallLink connects you with advisors and nurses around the clock.
When you call, you’ll receive trusted answers, information and support for a
wide range of health concerns. More good news? This service is available at no
additional cost to you, as part of your health plan.
Connect with CallLink to get answers to your health-related questions: MEMBER TIPS
§ Learn more about a diagnosis. Talk with an advisor or nurse at
800-962-9497.
§ Decide what type of care meets your needs.
§ Understand symptoms and treatment options. TTY users call 711.
§ Create a plan for adding healthy habits to your routine. You can also chat live online
with an advisor or nurse by
§ Understand how to take medications safely and effectively.
logging on to mymedica.com.
§ Find a doctor or hospital and schedule an appointment.
§ Get information about preventive screening services like health
screenings and immunizations.
Advisors and nurses are available anytime, 24 hours a day, 365 days a year.
© 2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes
Medica Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions,
Medica Health Management, LLC and the Medica Foundation.
COM5450-1-01018EMPLOYEE ASSISTANCE
PROGRAM
GET SUPPORT 24/7
When you need help with life’s challenges — whether it’s personal, financial or legal
concerns — call the Medica® Optum® Employee Assistance Program (EAP). Master’s-
level specialists can help you find answers and resources to tackle the tough issues
you and your family face. This service is available at no additional cost to you, as part of
your benefit plan. Your call and conversations with EAP specialists are kept confidential,
in accordance with the law.
With EAP, you have access to:
MEMBER TIPS
§ Five counseling sessions per issue per year covered at 100%. Talk with an EAP specialist
§ Legal and mediation services to help with will and trust preparation, child support at 800-626-7944.
or custody concerns, divorce, adoption and more. You receive a 30-minute legal
consultation at no cost (in person or over the phone). If you decide to hire an
TTY users call 711.
attorney, you’ll get a 25% discount.
§ Financial advisor support to help with debt, financial planning, foreclosure and more.
§ Child care referrals and support to help take care of elderly parents.
§ Community resources, like support groups.
§ An online resource, LiveAndWorkWell.com. Access a robust collection of interactive
resources and information that will help you with the everyday challenges of work
and life. Enter the access code “MEDICA” when you visit the site.
§ Help with dependency issues, like alcohol, tobacco, gambling or drugs.
§ Education resources and career consulting.
EAP specialists are available anytime, 24 hours a day,
365 days a year at 800-626-7944.
This program should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. This program is not a
substitute for a doctor’s or professional’s care. Due to the potential for a conflict of interest, legal consultation will not be provided on issues that may involve legal
action against Optum or its affiliates, or any entity through which the caller is receiving these services directly or indirectly (e.g., employer or health plan). This
program and its components may not be available in all states or for all group sizes and is subject to change. Coverage exclusions and limitations may apply.
© 2019 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes
Medica Health Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions,
Medica Health Management, LLC and the Medica Foundation.
COM5461-1-00919YOUR PHARMACY
BENEFITS
NEW PHARMACY BENEFITS IN 2020
Beginning Jan. 1, 2020, Medica will work with Express Scripts® to manage your pharmacy benefits.
GO MOBILE!
Your plan covers a variety of prescription drugs and includes options for filling your
You have access to a
prescriptions. Read more to learn how your pharmacy benefits work.
mobile app that helps you
save money and manage
What Drugs Are Covered And How Much Will My Prescriptions Cost? your prescription benefits
Covered drugs are shown on the Medica drug list. This list includes both brand-name on the go. With the app
and generic drugs, and is reviewed and updated regularly by a group of independent you can:
physicians and pharmacists. Your doctor can use this list to choose the medications
that are right for you, while helping you get a good value. Check drug costs and
learn how to save on
The drug list is divided into three groups, which determine your share of the costs your prescriptions
(generic, preferred brand and non-preferred brand). Generic drugs have the lowest
copayment or coinsurance. To see your costs, log on to mymedica.com and choose Find a network
the Pharmacies & Prescriptions tab, then navigate to the Price a Medication tool. pharmacy
With the Price a Medication tool you can: View a temporary
prescription ID card
See what drugs are covered
Look up how much a drug will cost Manage mail order
Check whether there’s a lower-cost generic option for your drug prescriptions
You can download the
How Do I Fill My Prescriptions? free Express Scripts® app
from the App Store or on
You can fill your prescriptions at a retail pharmacy in Medica’s large pharmacy Google Play.
network. To find a network pharmacy near you, log on to mymedica.com.
Many plans also offer options for filling ongoing prescriptions. Check your coverage
document on mymedica.com to see if your plan offers:
90-day refills
You can pick up a three-month supply of medication at one time from certain retail
pharmacies. To find a pharmacy near you, log on to mymedica.com.
Mail Order
With mail order, you can have ongoing medications mailed right to your home. Learn
more on mymedica.com, or contact Medica’s designated mail order vendor, Express
Scripts Pharmacy, at 800-263-2398.
*Express Scripts® administers Medica’s pharmacy program.When Can I Get Refills?
You can refill your prescription when you’ve used 85% of your medication. The pharmacy calculates this amount based on your
prescription’s quantity and the date you last had it filled. As an example, say your prescription is for a 31-day supply:
Days’ supply of medication 31
Multiplied by 85% x .85
26
In this example, you can refill your prescription 26 days after you fill it. These refill guidelines help ensure safe use of
medications and minimize waste. If there’s a reason you would need to refill sooner (for example, you are leaving on a vacation)
call Customer Service.
Are There Any Restrictions On My Medications?
Some drugs have special requirements or limitations, which are noted on the drug list and in the Price a Medication tool
on mymedica.com.
Prior Authorization (PA): To receive coverage, your doctor must first request approval from Medica.
Step Therapy (ST): Step therapy is sometimes used when there are several drug options for treating the same condition.
Before receiving coverage for a drug requiring step therapy, you must first try one or more preferred drugs.
Quantity Limit (QL): The maximum amount allowed for a specific period of time or per prescription.
For example, 60 tablets per month.
What Is A Specialty Drug, And How Do I Get A Specialty Prescription Filled?
Some medications are considered specialty drugs. These drugs are used to treat certain complex health problems. Specialty
drugs tend to be very expensive and may need special handling. The Specialty Drug List is divided into two groups, preferred
and non-preferred. Preferred specialty drugs have the lowest copayment or coinsurance. To see your share of the costs and a
list of medications that are considered specialty drugs, log on to mymedica.com. You’ll fill most specialty drug prescriptions
through Medica’s designated specialty pharmacy, Accredo Specialty Pharmacy. Contact them at 866-544-6817.
What If I Have A Health Savings Account (HSA)?
With an HSA, you generally pay the full cost of your prescriptions until you meet your deductible. Some HSA plans cover certain
preventive maintenance drugs before you meet your deductible. To see if yours does, check your coverage document on
mymedica.com. Or you can use the Price a Medication tool to look up your cost for a particular drug. The tool takes into account
your specific coverage and whether you’ve met your deductible.
©2019 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica Health
Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management,
LLC and the Medica Foundation.
COM6841-1-00919Medica Choice Passport ®
LET’S GET STARTED
Medica Choice Passport gives you access to a large, national network and the freedom to
see any provider at any time. You’ll benefit from network discounts and a plan that’s easy
to use — no matter where you live.
Plan Features MEMBER TIPS
Get the information you need at
§§ Choose from any doctor, clinic or facility in the large Medica Choice Passport network. medica.com/members.
To get the highest level of benefits, see network providers.
§§ Find out what your plan
§§ While you don’t need a referral to see a specialist, it’s a good idea to work closely with
covers, track claims, order
your primary care doctor to coordinate your health care needs.
extra ID cards and more.
§§ If you’re considering out-of-network care, check out the tip sheet first at medica.com/
members. Your share of the costs is likely to be significantly more if you receive care §§ See who’s in your plan’s
outside the network. The good news is that the network is very large, so it’s easy to network.
find a network provider that meets your needs.
§§ Get answers to questions
§§ You’re covered when you travel. Passport’s nationwide network means you have about preventive care;
access to in-network care when you’re away from home. health savings accounts;
deductibles, copayments
and coinsurance; and
more in our tip sheets.
Want to learn more? Go to medica.com/members, where you can get
all the information you need about your plan.
©2018 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that
includes Medica Health Plans, Medica Health Plans of Wisconsin, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health
Plan Solutions, Medica Health Management, LLC and the Medica Foundation.
COM5940-1-00918Medica Elect ®
LET’S GET STARTED
With Medica Elect, you choose a primary care clinic. This clinic coordinates your overall care and
will direct you to a specialist if you need one. When you need care, you’ll always start at your
primary care clinic (unless it’s an emergency). Each family member on your plan can choose their
own primary care clinic. MEMBER TIPS
Your primary care clinic is affiliated with a care system. A care system is a group of primary care Get the information you need at
clinics, specialists and hospitals that work together to give you care. Each family member on your medica.com/members.
plan can choose a different care system, or they can choose different primary care clinics within
§§ Find out what your plan
one care system. Whatever you decide, be sure you see providers in your primary care clinic’s covers, track claims, order
care system. Care systems you can choose from are listed on the back of this page. extra ID cards and more.
§§ See who’s in your plan’s
How Do I Change My Primary Care Clinic? network.
You can use the online form (see Member Tips to the right) or call Customer Service at the
number on the back of your Medica ID card. Remember that your clinic is affiliated with a care §§ Get answers to questions
system, so you can pick a new clinic in a different care system if you’d like. You can change your about preventive care;
health savings accounts;
primary care clinic as often as once a month. If you request your change by the 20th of the month,
deductibles, copayments
your clinic will change the first day of the month after you make your request.
and coinsurance; and
more in our tip sheets.
Want to learn more? Go to medica.com/members, where you can get
all the information you need about your plan.Do I Need A Referral?
Getting a referral when you need one ensures you receive your highest level of benefits. Here’s what you need to know about referrals:
§ When you see a specialist within your care system, you don’t need a referral.
§ If you need to see a doctor who’s in the Medica Elect network but isn’t in your care system,
you’ll need a referral from your primary care clinic.
§ If you need to see a provider outside the Medica Elect network, you’ll need a referral from
your primary care clinic and pre-approval (called “prior authorization”) from Medica.
To learn more about referrals, see the tip sheet in your welcome packet or at medica.com/members.
Who’s In The Network?
The following care systems are in the Medica Elect Network.
Twin Cities Metro Greater Minnesota
All Metro Duluth
§ Allina Medical Clinics § St. Luke’s Care System
§ Children’s Health Network Northern Minnesota
§ Hennepin Healthcare § Integrity Health Network
North Metro
§ RiverWay/North Suburban Clinics Wisconsin
East Metro Northwestern Wisconsin
§ Lakeview Medical Care System § Integrity Health Network
§ St. Luke’s Care System
West Metro
§ Park Nicollet Health Services
To find a provider in your care system or in the network, use
Greater Metro
the online search tool. Just go to medica.com/findadoctor
§ Minnesota Healthcare Network
and choose Medica Elect.
What Information Do I Need to Enroll In Or Change My Primary Care Clinic?
When you choose or change your primary care clinic, you’ll need the clinic’s PCC ID. You can find this number in the online
search tool. Go to medica.com/findadoctor and choose Medica Elect. Then:
1. Choose Physicians and Facilities, then Find a Network Provider.
2. Choose Facilities and Services, then Clinic - Primary Care.
3. Narrow your results by entering your ZIP code or choosing a care system, specialty or other criteria.
4. In your results, look for the clinic’s Care System listing. That’s where you’ll find the clinic’s PCC ID, which looks
like this: PCCID: 0000000123. If no PCC ID is displayed, you can’t choose the clinic as a primary care clinic.
© 2019 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica Health
Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management,
LLC and the Medica Foundation.
COM5381-1-00919MY HEALTH REWARDS
BY MEDICA INVEST
®
ENCOURAGING AND MOTIVATING YOUR EMPLOYEES
TO REACH THEIR WELLNESS GOALS
My Health Rewards by Medica helps employees build healthy habits and live their best life. In 2020, a new program, My Health
Rewards Invest, will go a step further to motivate your employees to reach specific health goals. When you invest in the health of
your employees, you invest in their future.
My Health Rewards Invest Program Strategy
My Health Rewards Invest is a buy-up program and is available to employees enrolled in a health savings account (HSA).*
Employees that meet monthly wellness goals will earn up to $75 per month (up to $900 per calendar year). Funds are
deposited quarterly by the employer into the employee’s HSA.**
WELLNESS GOAL DETAILS MONTHLY REWARD
Sleep Sleep more than 7 hours a night for 20 days in a calendar month. $25
Nutrition Track calories with MyFitnessPal for 20 days in a calendar month. $25
Activity Take 10,000 steps for 20 days in a calendar month. $25
Up to $75 per month
(up to $900 per year)
How it Works
Employees track their calories with MyFitnessPal. It’s free in the App Store or Google Play. Sleep and steps can be tracked with a
compatible fitness tracker including the Max BuzzTM, a fitness tracker offered through the My Health Rewards Invest program.
Employees sync their nutrition, sleep and steps with their My Health Rewards mobile app powered by Virgin Pulse, making it easy
to watch the progress toward their monthly goals.
* Employees with an HSA can earn the My Health Rewards Invest rewards. Spouses and dependents over age 18
are eligible for the standard My Health Rewards program. Employees not enrolled in an HSA will have continued
access to the standard My Health Rewards program.
**Medica will send a quarterly member detail report reflecting the HSA dollars earned along with a check for the
total HSA dollars earned for the quarter. The report and check will be sent approximately one month following
the end of the quarter. The employer deposits and distributes funds to their employees' HSA using their chosen
HSA vendor. Medica will not be responsible for tracking IRS HSA contribution limits. It is the responsibility of the
member to know the IRS HSA contribution limits and plan accordingly.1. Eligible employees 2. Employees use a 3. Employees track 4. Employees sync 5. Every month,
download the Virgin compatible fitness their daily calories their fitness tracker employees can earn
Pulse mobile app and tracker to track sleep with MyFitnessPal. and MyFitnessPal to up to $75, deposited
create an account and steps. log daily progress. quarterly by the
with My Health employer into the
Rewards Invest. employee’s HSA.
Incentive Strategy
The key to our health and wellness strategy is a rewards program that encourages and motivates employees to achieve their
wellness goals. Pairing incentive strategies with digital technologies and daily engagement can drive improvements in the way
employees engage in their health.
Small Steps, Big Changes
With My Health Rewards Invest, we’ll help your employees make small, everyday improvements in their nutrition, sleep and
activity. When your employees stick to our program, they’ll build healthy habits, have fun and experience the lifelong rewards of
better health.
To learn more about this program, contact your broker
or Medica sales at 952-992-3055 or 800-371-1613.
© 2019 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica Health
Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management,
LLC and the Medica Foundation.
COM20329-4-01119MY HEALTH REWARDS
BY MEDICA INVEST
®
INVEST IN YOUR HEALTH. INVEST IN YOUR FUTURE.
My Health Rewards by Medica is powered by Virgin Pulse, a pioneer in digital health and wellness solutions that help you build
healthy habits and live your best life. Whether you want to eat healthier, sleep more, stress less or get fit, My Health Rewards is an
online tool that helps you take small steps to reach your health goals. Complete activities and get rewarded on your own personal
path to health.
Program Features
Welcome to My Health Rewards Invest. When you meet three wellness goals for sleep, activity and nutrition, you’ll get
rewarded!* Each month, you can earn up to $75, deposited quarterly into your Health Savings Account (HSA).
WELLNESS GOAL DETAILS MONTHLY REWARD
Sleep Sleep more than 7 hours a night for 20 days in a calendar month. $25
Nutrition Track calories with MyFitnessPal for 20 days in a calendar month. $25
Activity Take 10,000 steps each day for 20 days in a calendar month. $25
Up to $75 per month
(up to $900 per year)
Assess Your Health
Get started with the health assessment. The confidential, short survey will give you a
snapshot of your health across seven factors, from mental health to fitness. You’ll get
a personalized report with recommended actions.
Track Your Steps, Calories and Sleep
Track your activities to make steady progress toward health improvements and
earn rewards. Connect your personal fitness tracker and log in at least weekly to
get credit for your steps and sleep. You can sync with a variety of devices and apps.
TM
Don’t have a fitness tracker? Ask your employer about the Max Buzz , a Virgin
Pulse fitness tracker that can be used to track activity and sleep.
Want to build better sleep habits? Check out the Sleep Guide for helpful tips.
Track your calories with MyFitnessPal. It’s free in the App Store or Google Play.
Connect your account and track calories at least 20 days per calendar month.
*Only subscribers with an HSA can earn the My Health Rewards Invest rewards. Your spouse and dependents over
age 18 are eligible for the standard My Health Rewards program. Ask your employer for more information.Personalize Your Health Journey Choose to work on the areas that matter the most to you, whether it’s eating habits, sleep, physical activity, relationships, finances or something else. You’ll receive Daily Learning Cards on your areas of interest. Review these daily tips and get inspired! Build Healthy Habits » Choose a Healthy Habit you’d like to work on. » Work on it, little by little, every day. » Experience the rewards of better health and well-being. With My Health Rewards, we’ll help you make small, everyday changes to your well-being that are focused on the areas you want to improve the most. When you stick to our program, you’ll build healthy habits, have fun and experience the lifelong rewards of better health and well-being. Watch for more information on how to get started with My Health Rewards Invest. *My Health Rewards is not available with all Medica plans. Medica reserves the right to modify the program requirements and devices at any time. Participation in a wellness program is optional. Rewards are available to all eligible employees that participate. If you think you might be unable to meet a standard for a reward under this wellness program, you may qualify for an opportunity to earn the same reward by different means. Email medica.support@virginpulse.com or call Virgin Pulse at 833-450- 4074 for information on available reasonable alternative standards and we will work with you (and, if you wish your physician) to find a wellness activity with the same reward that is right for you in light of your health status. © 2020 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to the family of health services companies that includes Medica Health Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management, LLC and the Medica Foundation. COM20488-1-00420 My Health Rewards Member
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