Employee Health Plan – Healthy Choice Guidelines

Personalized Information

In early January caregivers and spouses covered by the health plan receive personalized instructions outlining the information the plan has on record and if additional information is required. To access this information members can access their Healthy Choice Portal account.  The portal describes what the plan member needs to do during the first nine months of the year to earn the best premium for the following year.

2018 health status (chronic condition, healthy, or unknown) is displayed in your Healthy Choice portal account (click here to login)
                                                                                                    
Please also keep in mind: If your spouse is enrolled in the health plan, he or she also will need to fully meet Healthy Choice requirements in 2018 for you to qualify for the best premium in 2019. So please help them create an account on the Healthy Choice Portal and review the steps needed to participate.

New: Click here for 2018 program guidelines and how to achieve each level of premium discount.


Below are the steps to take, depending on the information you (employee Caregiver or spouse) receive and what your portal dashboard states:


Unknown / Missing Information

What it says:  You need to submit more health information.
What you need to do: 
  • Schedule a health visit to have the Health Visit form completed and submitted to the health plan
  • After your visit, if you are healthy or receive one of the 6 diagnoses, follow the steps below
Note:  All new hires must submit a health visit form in order to determine which program they need to participate in.


Chronic Condition

What it says:  You’ve been identified with one or more of the following:  high cholesterol, high blood pressure, weight management, diabetes, asthma or tobacco use*
What you need to do:  Join the appropriate Coordinated Care program and meet the requirements for six months


Healthy

What it says:  You are healthy
What you need to do: 
  • Join an EHP Physical Activity program and go 10 times a month for 6 months by Sept. 30  OR
  • Participate with an approved activity monitor to track at least 150,000 steps or 900 physical activity minutes a month for six months by Sept. 30
  • IMPORTANT: If you are newly diagnosed with one or more of these chronic conditions - asthma, diabetes, high blood pressure, high cholesterol, tobacco use, or weight management - please call Health Plan Customer Service at 216-448-2247 or toll-free at 877-688-2247 to have your records updated. You will need to join a Coordinated Care program(s) and meet program requirement to be eligible for a premium discount in the future.

What to Do:

  • To qualify for the most discounted  (Diamond) Health Plan premium for the following year, you and your spouse if applicable will need to fully meet your Healthy Choice goals by Sept. 30 of the current year.