Michigan recently enacted legislation intended to "promote the availability of health behavior wellness, maintenance, and improvement programs" in private insurance. [1] The insurance code was amended to allow group health plans and insurance carriers to give premium rebates of up to 10 percent if workers or members participate in group wellness programs. Individuals and families are also eligible for reduced cost-sharing if they commit to healthier lifestyles.
Michigan joins Vermont and Rhode Island in leading state efforts to encourage private health plans to emphasize prevention and wellness. Vermont allows insurers to offer "Healthy Lifestyles" discounts of up to 15 percent of premium for compliance with a health promotion program. Rhode Island is promoting healthy lifestyles in private insurance through its wellness health benefit plan. And California Governor Schwarzenegger's health reform proposal features incentive and reward programs, including premium reduction, for engaging in healthy activities (see Profile in this issue).
Michigan's Blue Care Network (BCN), a subsidiary of Blue Cross Blue Shield of Michigan, recently began offering a wellness plan to small and large businesses across the state. For example, the plan is being offered through the Detroit Regional Chamber.[2] Under the rationale that responsible behaviors should cost less, "Healthy Blue Living" rewards members who commit to healthier lifestyles with lower out-of-pocket costs. Employers choosing this option pay reduced premiums (by about 10 percent), and members face lower copayments and deductibles during the first 90 days of coverage. The reduced cost-sharing continues if a member:
- completes a health risk appraisal, after which BCN sends a detailed profile with tips on how to minimize risks;
- meets with his or her primary care physician to complete and submit a qualification form, which involves developing a wellness plan whereby the member and physician set targets and monitor progress; and
- adopts a healthy lifestyle by focusing on six high-impact health measures for which the member has some control (alcohol use, blood pressure, blood sugar, cholesterol, smoking, and weight).
To help reach their health goals, members have access to a health coach, smoking cessation programs, YMCAs, Weight Watchers' discounts, and other benefits.
References
[1] Michigan Senate Bill 848.
[2] For more information see Michigan Blue Network Web site and Detroit Regional Chamber Web site.
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