Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This rule establishes the policy of the
board of trustees in regards to the Strive for Wellness® Partnership Incentive
and the method and timeframes in which the requirements of the incentive must
be completed and submitted.
(1) Strive for
Wellness® Partnership Incentive-The Partnership
Incentive is a voluntary program that eligible members may elect to participate
in to earn a reduction in premium. Eligible members are responsible for
completing requirements.
(2)
Partnership Incentive-The Strive for Wellness®
Partnership Incentive is a reduction in premium of twenty-five dollars ($25)
per month per eligible member who is compliant with this rule.
(3) Eligibility-The following members
enrolled in a Missouri Consolidated Health Care Plan (MCHCP), Preferred
Provider Organization (PPO), or Health Savings Account (HSA) Plan are eligible
to participate in the Partnership Incentive:
(A) Active employee subscribers;
and
(B) Non-Medicare
subscribers.
(4)
Limitations and exclusions-The following members are not eligible to
participate in the Partnership Incentive:
(A)
Subscribers under the age of eighteen (18) years;
(B) Dependents;
(C) TRICARE Supplement Plan
subscribers;
(D) Subscriber (with
the exception of active employee subscriber) who has Medicare as primary
coverage; and
(E) When Medicare
becomes a subscriber's primary insurance payer, the subscriber (with the
exception of active employee subscriber) is no longer eligible to participate
and will lose the Partnership Incentive the first day of the month in which
Medicare becomes primary.
(5) Participation.
(A) In order to receive the Partnership
Incentive, eligible members must complete all of the following every plan year
for the incentive to be effective the first day of the second month after the
requirements are completed:
1. The Partnership
Promise;
2. The Health Assessment;
and
3. The Health Education Quiz. A
series of questions administered by MCHCP designed to measure understanding of
MCHCP benefits and/or general health knowledge.
(B) The requirements must be completed
through the member's myMCHCP account.
(C) Eligible members adding medical coverage
must complete all of the following within thirty-one (31) days of his/her
medical coverage effective date (unless otherwise specified) for the incentive
to be effective the first day his/her medical coverage is effective:
1. The Partnership Promise;
2. The Health Assessment; and
3. The Health Education
Quiz.
(D) An employee
earning the Partnership Incentive who then terminates all employment with the
state and is rehired as a new state employee with medical coverage effective in
the same plan year, will receive the Partnership Incentive effective the first
day his/her medical coverage is effective after s/he is rehired.
(E) An eligible member completing the
Partnership Incentive requirements in October of a plan year, who is eligible
for but not currently receiving the Partnership Incentive, will receive the
incentive for December of the current plan year, in addition to the next plan
year.
(F) Eligible members who have
earned the incentive may earn a
de minimis gift for completing
one (1) or more of the following MCHCP-approved health actions. An eligible
member must report the completion of the health action to MCHCP by December 31
of each plan year, and may receive only one (1) gift per year. MCHCP-approved
health actions are as follows:
1. Receiving a
preventive lab screening such as cholesterol and blood sugar;
2. Receiving an annual preventive
exam;
3. Attending three (3) Strive
for Wellness® sponsored health education or physical
activity events;
4. Participating in
physical activity such as walking, jogging, Zumba, yoga, or weight-training for
one hundred fifty (150) minutes each week for three (3) months;
5. Standing for at least two (2) hours during
each workday for three (3) months; or
6. Walking one (1) million
steps.
(G) The Partnership
Incentive shall begin January 1 and end December 31 of each plan
year.
(6) A waiver may be
granted, in whole or in part, for the applicable plan year if a member requests
a waiver of a requirement(s) in writing along with a provider's written
certification that it is medically inadvisable for the member to participate in
the applicable require-ment(s).
(7)
MCHCP and/or its vendor may audit participation information for accuracy.
Misrepresentation or fraud could lead to loss of the Partnership Incentive
and/or prosecution.
(8) MCHCP and/or
its vendor may utilize participation data for purposes of offering additional
programs in accordance with MCHCP's privacy policy.
*Original authority: 103.059, RSMo
1992.
