Integrating Health & Wellness INTO EVERYDAY LIFE

Integrating

wellness

into

everyday life

BlueCross BlueShield of Tennessee –

we aren’t just your insurance provider.

We’re your partner for health.

At BlueCross BlueShield of Tennessee, we are dedicated to providing affordable, innovative and flexible health solutions to companies like yours. We offer unmatched flexibility as we partner with you to integrate health and wellness into your employees’ daily lives. A collaborative relationship with you and your employees is critical to the success of our partnership. To provide the most effective programs, we must work together so that we can fully recognize the health and wellness needs of each of your employees. We base our BlueHealth Solutions on the overall health status, lifestyles and current health care behaviors of everyone within your workforce.

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Data-Driven Methodology

The secret to our success is embedded in everything we do, every day. We apply a behavioral science-based methodology that combines our best-in-class medical informatics, feedback from doctoral-level consultants, custom care management and proactive outreach methods. This allows us to get to know you and your employees, and address your health needs. We access a broad spectrum of data to get a comprehensive look at your employees’ health. This includes:

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Medical claims

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Biometric screenings

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Pharmacy claims

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Lifestyle information

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Health-risk assessments

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Data from other benefit partners

Based on our cumulative and comprehensive review of data, we determine the most appropriate program and outreach mechanism for each member based on their current or predicted health needs. We look at the full continuum of care, from simple preventive reminders to catastrophic case management needs. Our priority is to provide support and guidance for individuals regardless of their situation.

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Holistic Approach to Care

Our comprehensive menu of health and wellness programs is all-inclusive and spans the entire continuum of care. We have the capability to meet the most diverse health needs of your employees while still helping you manage your costs. And with the extensive support of our national networks, we can customize your health care solutions locally or across America.

As a society, we have to begin to change our habits one healthy choice at a time. Change starts with the individual choices we as Americans make each day for ourselves and those around us. SOURCE: THE SURGEON GENERAL’S VISION FOR A HEALTHY AND FIT NATION

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The Buck Consultants Working Well Survey found that 78 percent of employers are strongly committed to creating a workplace culture of health. Why? To boost employee engagement in their health and organizational performance.

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Partners in Wellness: Collaborating to build a worksite culture focused on health 6

Health Promotion Consulting Merely offering a wellness program is no guarantee that you will engage your employees or improve your population’s health. We have decades of health care expertise, so let us partner with you to ensure your success in starting a new wellness program or enhancing an existing one. We offer complimentary services with standard deliverables, or you can purchase more extensive packages that have resulted in significant success for our clients. In 2014, our consultants saw a 95 percent improvement in member participation and they increased member engagement by 88 percent*.

Custom Communications Site We don’t believe your program should be standard, and neither should your marketing materials. This site, available via Employer and Broker BlueAccess, allows you to access and customize BlueHealth Solutions fliers, brochures, posters and other materials. You have the ability to select images, add company-specific incentive language, add your company logo and more. Digital and printed copies are available at no cost.** SM

Stand Alone Wellness for the whole population, regardless of insurance coverage Wellness services have become a part of the employee value proposition. Now you can give your whole population access to our wellness programs, regardless of their medical coverage. This means that if your company offers medical insurance from several carriers or employs a workforce with members who don’t have BlueCross medical coverage, they can still participate in our health and wellness programs.

InSpire

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Building a culture of health is no easy task, but our social network, InSpire, is your connection to an online community that encourages your employees to live healthier lives and support each other on their wellness journey. Through device and mobile app integration, InSpire fuels your culture of health, bringing positive behavioral change to the forefront of every workforce. Expanded product options are available for purchase and can help make the entire experience more customized. We can even design a private InSpire community specifically for your company.

BlueHealth Rewards

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Our flexible, customizable incentive program is designed to help you encourage your employees to improve their health through participation-based, health-contingent and clinically measured activities. Our program is unique in that we can incorporate detailed feedback from our consulting behavioral scientists into an engaging, datadriven program that meets the diverse needs of your population. * These results are above average.

** Charges will be incurred for expedited shipping

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Wellness: Helping the Healthy Stay Healthy

Wellness Portal BlueAccess at bcbst.com is a convenient, easily accessible way to help members reach their health goals. The secure online portal offers wellness resources like our self-directed coaching, health trackers, food and exercise diary, and more. SM

Personal Health Assessment (PHA) This interactive member experience helps identify health risk factors based on current lifestyle habits, dietary behavior and exercise levels. The PHA helps establish the baseline for a member’s health status and provides you with health-risk population reporting merged into your claims data.

Self-Directed Coaching Our online educational coaching sessions offer an easy, fun way to make lifestyle choices for better health. Available 24/7, the coaching modules help with selfmanagement and motivation as your employees integrate wellness into their lives.

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Financial Planning Tools Our Financial Planning Tools on BlueAccess help members make smart decisions about health care costs. They can use these innovative online tools to search for estimates on more than 1,400 non-emergent procedures, project expenses in relation to their benefits, compare rates for providers and facilities, and more.

BluePerks

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Created exclusively for BlueCross members, this program features discounts up to 50 percent on complementary and alternative medical services not usually covered by health plans. This includes massage therapy, acupuncture, nutritionist consultations and more. BluePerks also offers savings on health and wellness products intended to help members lead a healthy, balanced lifestyle.

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Nurseline Our patient-centered nurse triage program is available 24/7 through online chat or by telephone. Our nurses can provide symptom assessment and answer any healthrelated questions. They also provide support for members facing surgery or other major health decisions regarding appropriate levels of care.

Telehealth Telehealth powered by BlueHealth Solutions provides access to board-certified doctors anywhere, anytime – 24/7. Consultations are available via phone or secure video for most non-emergency medical conditions. MDLIVE telehealth doctors can diagnose symptoms, prescribe medication* and send prescriptions to your pharmacy of choice.

Precious Cargo® Personal education and pregnancy support are imperative for a healthy pregnancy and baby. Our program includes 24/7 telephone support during pregnancy and delivery, information on prenatal planning, exercise and nutrition, and more.

Worksite Wellness Ongoing promotional support for worksite wellness initiatives like Lunch and Learn sessions, wellness challenges and motivational speaking services helps engage your population and build a culture of health on site. We also provide implementation guidance for all value-add and buy-up products.

Biometric Screenings This screening measures height, weight, BMI, blood pressure, blood sugar and cholesterol (total, LDL and HDL). Through biometric data integration with the PHA and your claims experience, we are able to also identify potential engagement opportunities for each individual and your overall population.

* Please note: Some state laws require that only a doctor can only prescribe medication in certain situations and may be subject to certain limitations. BlueCross members should have their prescriptions filled at a network pharmacy in compliance with the BlueCross drug formulary. 11

Lifestyle: Making Smarter Choices

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Lunch & Learns Health and wellness presentations are performed by our health management consultants on site at your Tennessee location or via WebEx. Designed to promote healthier living, the presentations focus on a wide variety of topics that range from weight loss to lifestyle habits to chronic condition prevention.

Motivational Speaking Services Invite BlueHealth Solutions to your next Tennessee-located employee conference, training session or business event. Our on-staff experts will deliver a keynote speaking opportunity for your organization, covering wellness, health, motivation, team building or any topic of your choice. All you have to do is provide us with the subject matter and we will tailor our address to your needs.

FitnessBlue

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Our flexible, low-cost fitness program gives you access to more than 9,000 fitness locations nationwide. The price is right, with a one-time enrollment fee of $29 and a $29 monthly membership fee (per member). No long-term contract is required, only a three-month initial commitment and unlimited use of any participating facility.

Targeted Preventive Reminders When life gets busy, we are here to help. Our proactive reminders about preventive care are sent via the employee’s preferred method of communication (e.g., email, mail, phone or text) to help keep them on track.

Behavioral Health Management Support for early identification and intervention with behavioral health care is offered if Behavioral Health is part of an employer’s contracted benefits.

Lifestyle Health Coaching Our coaches are available to motivate, educate and provide guidance on setting and reaching goals for situations like tobacco cessation, weight loss and stress management. Outreach is based on the employee’s PHA and biometric screenings. Members have unlimited interactions with coaches via telephone, secure messaging and, in 2015, our mobile app. * Healthways, Inc. is an independent contractor that administers the Prime Network of fitness centers. The Prime Network is made up of independently owned and managed fitness centers. Healthways, Inc. does not provide BlueCross BlueShield of Tennessee products or services and is solely responsible for any products or services the company provides.

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Total Population Health: Managing Ongoing Conditions and Supporting Members with the Care and Guidance They Need

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Total Population Health Each person approaches their health differently, and our BlueHealth Solutions program is a complete total population health management approach based on a whole-person, member-centric model of care. With a focus on “Every Member, Every Day,” we provide a personal level of support to each member wherever they are on the health continuum. BlueHealth Solutions offers a myriad of flexible strategies that will help your employees manage conditions, overcome barriers to health and wellness, and provide support for all health needs – from members who just need help making healthier choices to those facing complex, catastrophic illnesses.

Targeted Care Campaigns

High-Risk Maternity Management

Outreach encourages closing gaps in care for your employees’ chronic conditions with interaction through their preferred method of communication (e.g., email, mail, phone or text).

We offer support for pregnant women who need special care for complicated pregnancies.

Pharmacy Care Management Prescriptions can assist members, but they can also be a huge cost. We offer programs to help improve safety, drug compliance and health outcomes while reducing overall health care costs.

Utilization Management We ensure that your staff gets timely, cost-effective care when and where it’s needed.

Transition of Care Your employees have our support if they need to move from an acute care facility to another appropriate setting.

NICU Babies Management This program promotes healthy outcomes for your employees with premature and medically complex newborns through the baby’s first birthday.

Rare Disease Management Support and guidance are available upon diagnosis of a rare disease. Employees with our pharmacy benefit have access to our preferred specialty pharmacy network that offers additional support and guidance from nurses and pharmacists specially trained in medication therapy management for patients diagnosed with rare diseases.

Transplant Management We provide assistance and coordination of quality care for organ transplant recipients.

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Effective, Engaged, Empowered

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Mobile and Self-Service Tools BlueCross is the right partner for you. Our ultimate goal is to motivate your employees and keep them engaged for peace of mind through better health. Together, we can achieve success by launching and implementing effective initiatives that will engage your employees and empower them to make meaningful changes in their lives. BlueAccess and our smartphone app, myBlue TNSM, support your employees with personalized online and mobile resources, information, health plan details and more:

Overview of benefits, claims and account balances Help with finding a doctor Details about BluePerks discounts Connection to MDLIVE, InSpire, BlueHealth Rewards or Lifestyle Coaching if these benefits are part of your plan Targeted care campaigns, preventive screening reminders and messages about gaps in care based on employee preference Any time an employee calls our Member Service line, our representatives are able to see all communications and program opportunities, so our staff can remind them of programs that will help them stay engaged with their health goals.

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Checks and Balances: Measurement and Reporting

We provide your company with a variety of reporting options through BlueInsightsSM. It includes an integrated reporting package, a custom scorecard to track your goals, and a dashboard for guided analytics on key performance indicators. This allows you to track your plan performance against the prior year and benchmarks.

The BlueInsights dashboard is also available through our myBlue TN mobile app, literally putting your plan’s performance at your fingertips.

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The reason we’ve stayed with BlueCross BlueShield of Tennessee since 2000 is because of their ability to help us integrate and identify opportunities with our employees. The integration and the analysis they’ve been able to do for us helped us identify gaps, other illnesses and trends…and ultimately reduced our overall health care costs. BOB RAVENER, EXECUTIVE VICE PRESIDENT AND CHIEF PEOPLE OFFICER, DOLLAR GENERAL

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Living by Example We realize it’s not easy to integrate health and wellness into your employees’ everyday life because we’ve faced this challenge ourselves. This is how we know BlueHealth Solutions works. The approach is simple but effective, and focuses on understanding, measuring and influencing human behavior. Our success measures speak for themselves. 20

BlueCross Employee Wellness Results Program Highlights from 2013

49%

Overall, 49 percent of our members participated in our programs while 30 percent actively engaged with a coach or nurse.

92%

Of the members who interacted with a coach or nurse, 92 percent became more engaged as a result of that outreach.

RISK

At the end of the year, our coached employees had lower risk,

PMPM’s, and inpatient and ER visits. They also participated in more preventive services than the non-coached employees. Of the members who participated in our campaigns during the last year:

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36 percent closed a hypertension gap

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31 percent closed a wellness gap

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28 percent closed a diabetic gap

Health Plan Highlights from 2013

-14%

For 2013, we experienced a medical trend decrease and came in at 14 percent below our book of business benchmark.

-2%

Our member ER visits declined 2 percent over the past 12 months.

The success and popularity of incentive programs are not unique to the BlueCross employee population. According to the 2014 National Survey of Employer-Sponsored Health Plans conducted by Mercer, the number of large employers offering wellness programs with financial incentives increased from 52 to 56 percent from 2013. The Mercer survey also maintained that while incentives for employees participating in wellness programs are the most common, last year 23 percent of large employers used outcomes-based incentives for achieving or showing progress toward specific health status targets, up from 20 percent in 2013.

Source: BlueCross BlueShield of Tennessee, 2013

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If your company is ready for a new approach to health care, contact your BlueCross BlueShield of Tennessee representative to see how we can create customized health solutions for your company.

1 Cameron Hill Circle | Chattanooga, TN 37402 | bcbst.com BlueCross does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association

For TDD/TTY help call 1-800-848-0299. Spanish: Para obtener asistencia en Español, llame al 1-800-565-9140 Tagalog: Kung kailangan ninyo ang tulong sa Tagalog tumawag sa 1-800-565-9140 Chinese: 如果需要中文的帮助,请拨打这个号码 1-800-565-9140 Navajo: Dinek’ehgo shika at’ohwol ninisingo, kwiijigo holne’ 1-800-565-9140

MDLIVE is an independent company and does not provide BlueCross BlueShield of Tennessee products or services. MDLIVE is solely responsible for the products and services they provide. MDLIVE does not replace the primary care physician. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE operates subject to state regulation and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services. MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc.and may not be used without written permission. For complete terms of use visit http://www.mdlive.com/pages/terms.html BHS-1 (5/15) BlueHealth Solutions Overview - Self-Funded