Blue Cross’ ‘Lifestyle Blue’ Plan a Great Fit for Small Business

Monday, April 16, 2012

 

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Blue Cross Blue Shield of RI's new Lifestyle Blue plan has great upside for small business.

Lifestyle Blue is BCBSRI’s newest medical plan designed for small businesses. The first of its kind in Rhode Island, the plan is for employers with 50 or less employees who seek affordability and choice in their coverage selections.

The 3-in-1 plan gives employees a choice of three unique benefit designs to match their lifestyle. Each plan is geared toward a different stage of life, and varies slightly to fit the needs of that demographic.

The plans offer varying deductibles, urgent care and emergency room copays as well as differences in prescription costs. But no matter which of the three plans they select, employees all pay the same rate. And none of the plans require copays for primary care visits as long as the members visit physician practices that are designated as patient-centered medical homes (PCMHs).

What are PCMHs?

PCMHs are physician practices designed to provide an improved patient experience and better outcomes – hopefully at lower costs.  PCMHs must:

  • Use electronic medical records for better care coordination

  • Include Nurse Case Managers who work to triage same-day care

  • Provide one-on-one support and in-home follow up

  • Include weekend office hours and co-located behavioral health/pharmacists programs.

Even if an employee’s physician is not part of a PCMH, they can still receive care from that physician, but for a copay.

A Step Toward Wellness

With all three plans, employees earn an incentive in the form of a deductible reduction of $250 ($500 for family) for completing an online health assessment, having an annual well visit and participating in a personalized wellness step designed to help improve health.  Employees also get reimbursed up to $200 ($400 for family) for taking part in a wide range of wellness activities, including gym membership, sport leagues, golfing, weight loss programs, yoga, and more. 

BCBSRI further supports employers with wellness program resources such as workshops, seminars and health fairs that focus on a variety of health topics.

Regardless of which plan option employees choose, Lifestyle Blue may be just what the doctor ordered.

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Amy Gallagher has over 19 years of healthcare industry experience.  As Vice President at Cornerstone Group, she advises large employers on long-term cost-containment strategies, consumer-driven solutions and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, is a member of local organizations like the Rhode Island Business Group on Health, HRM-RI, SHRM, WELCOA, and the Rhode Island Business Healthcare Advisory Council, and participates in the Lieutenant Governor’s Health Benefits Exchange work group of the Health Care Reform Commission.

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