Corporate WellnessAnd Health

Improvement Programs

Presented by Physicians Health Plan

AGENDA

• PHP Preventive Benefits• MyNurse 24/7• PHP Website• Treatment Cost Calculator• MyHealth 24/7• Keeping You Healthy• Member Discounts• Member Handbook• Customer Service

Information

A sample of services covered at 100%:• Routine well child visits

• Routine childhood immunization up to age 19

• Routine annual physical exam office visit 

PHP’s Preventive Guidelines: Based on the “A” or “B” list by the U.S. Preventive Services Task Force; immunizations as recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and preventive care and screenings for children and women as recommended by the Health Resources and Services Administration.

A complete list of preventive services can be found online at www.phpni.com.

PREVENTIVE BENEFITS

Eye exam benefit: One eye exam is covered per calendar year when you see a PHP network Ophthalmologist or Optometrist (Office visit copay or deductible would still apply.)

ImmunizationsThe following vaccinations are covered and available at retail pharmacies:• Influenza

• Pneumococcal (pneumonia)

• Zoster (shingles)

• TDAP (Tetanus, Diphtheria, Acellular Pertussis) 

Please refer to your current schedule of benefits for coverage details

PREVENTIVE BENEFITS

• 24/7 Call Center• 1-800-931-4714• Speak with experienced,

knowledgeable nurses about specific health concerns

• Help line for non-critical situations

What is MyNurse 24/7?

MYNURSE 24/7

www.phpni.com

PHP WEBSITE

Members Portal

Member Login• First time users must register• Enter User Name• Enter password

PHP WEBSITE

First Time Users, click here

Member Registration• Enter your Member ID Number or

Social Security Number– Your ID number can be found on your PHP Member ID Card

• Enter Username & password. Confirm password.• Enter your date

of birth• Enter your

email address• Choose Security Question & Answer

PHP WEBSITE

TREATMENT COST CALCULATOR

• New online tool available for members with over 200 procedures and services.

• Based on your benefit and coverage information.

TREATMENT COST CALCULATOR

• Search over 200 procedures and services by health topic, diseases and conditions, or by name.

• Find & compare providers based on your geographic location.

TREATMENT COST CALCULATOR

Provides:• Total Cost• Your Share• Plan Share• Costs in

Relevant Categories

Reminder – This tool is based on your plan benefits and coverage information.

Treatment Cost Calculator

TREATMENT COST CALCULATOR

Additional Information

• Costs related to chronic conditions

• Cost savings tips

Reminder – This tool is based on your plan benefits and coverage information.

QUALITY INFORMATION

• HealthGrades

• Quality ratings for area providers & hospitals

• Health & Human Services Comparison Tools

• Hospital Compare

• Dialysis Facility Compare

Click here to access MyHealth 24/7

MYHEALTH 24/7

Click on Wellness and Disease Management

Select MyHealth 24/7

Interactive Web Services: • Health & Symptom Evaluation• Medical Library• Health Helpers Calculators

What is MyHealth 24/7?

MYHEALTH 24/7

• Pharmacy• My Health Files• News and

Communication

MYHEALTH 24/7

• Health & Symptom Evaluation– Personal Evaluation System (PES) – evaluates

your symptoms and find possible causes– Assessments – create report cards detailing your

risk factors in key areas, such as general health, diabetes, congestive heart failure and more.

• Medical Library– The medical library is an extensive collection of

physician-authored medical articles. You can find relevant texts through typing in a key word in the search engine box on the right, or by browsing the chapters of topics displayed in alphabetical order.

Online Health Risk Assessment• Who should

complete an Assessment

• Who will see My Assessment

• Changing health conditions

MYHEALTH 24/7

MYHEALTH 24/7

• Health Helpers– Quizzes– Calculators

• Pharmacy– Contains information to help you

compare and learn more about medications.

– Enter your zip code for the national average cost of a particular drug. Note: This will not include any PHP discounts.

MYHEALTH 24/7

• My Health Files– My Medications– Personal Profiles– My Chart

• News & Communications– Health news articles– Care Navigator transcripts– Forms and more…

• Quarterly newsletter• Mailed to your home • Health and wellness

information• Participating Provider

updates• Member discount

updates• Special

announcements

HealthNews Member Newsletter

KEEPING YOU HEALTHY

Sweet PHP Rewards

KEEPING YOU HEALTHY

Designed to help individuals manage their diabetes and improve their overall health.

• Participants must submit test scores and activity logs, using the care plan from their doctor

• A diabetes care manager will provide one-on-one, phone-based personal coaching

• Copays will be waived for diabetes supplies/medications as progress continues through the program (not to

exceed $599 in reimbursement or gift cards to local retail stores* in a calendar year)

Certain reimbursements may be taxable

*VISA gift cards are only given to HDHP members

Weight Loss Programs

KEEPING YOU HEALTHY

• Inches Away Incentive Program– $1,500 lifetime maximum– Initial payment of $500 paid after

participant loses 10% of body weight; $1,000 paid if loss is maintained for one year after initial payment

– Adults must have BMI of at least 27– Measurements must be recorded &

reported through a physician– Adolescents must be referred by

physician into a PHP approved program

– Must be an active PHP member with group coverage throughout the entire process

Smoking Cessation

KEEPING YOU HEALTHY

• Pharmacy benefit includes coverage for CHANTIX– Covered 100% under preventive services,

30 day supply, 6 months in a 12 month time period.

– Includes “GetQuit” online support plan

Certain reimbursements may be taxable

• A call to action that evokes active, year-round participation in walking and reducing the risk of heart disease and stroke by supporting the AHA.

• Online tool offers physical activity, nutrition and other health information integrated within a single online resource.

• PHP is a AHA Cause Sponsor for Northeast Indiana.

AHA My Heart. My Life. Program

• VSP Vision Care– Point-of-service savings– Nationwide access– Provider locator at:

www.vsp.com/choice

MEMBER DISCOUNTS

Vision DiscountProgram brochure with discount and provider information can be found at www.phpni.com, on the Member and Employer portals.

VALUE-ADDED PROGRAMS

Discounts at Health Clubs and Community Classes• PHP members receive

special discounts when they present their PHP Member ID card

• Complete list of participating local organizations at: www.phpni.com under Member Discounts in the Individuals & Families section

• Discounts vary with each organization

PHP Card Nights

VALUE-ADDED PROGRAMS

• Supports local sports teams • PHP members enjoy special

discount off ticket price when they present their PHP ID Card on PHP Card Nights

• Discounts vary by team• Game nights are listed in the

quarterly newsletter or also online at www.phpni.com, Individuals & Families section, Member Discounts

• Mailed to all new members’ home address

• Valuable resource helps members make the most of their benefit plan

• Provides Customer Service contact numbers, online account access, pharmacy and provider information

MEMBER HANDBOOK

Comprehensive Member Resource

• MyNurse 24/7:1-800-931-4714

• My Health 24/7: www.phpni.com

• PHP Customer Service:260-432-6690, ext. 111-800-982-6257, ext. 11email: custsvc@phpni.com

CUSTOMER SERVICE