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Frequently Asked QuestionsYour Plan for Health (YPFH)
2008 Health Plan Options
2008 Faculty and Staff Incentive Program
Points Tracking Privacy and SecurityHealth Coach and Care Coordination
Personal Health Assessment (PHA)
Privacy, Flow, and Uses of Personal Health Information
Wellness
Your Plan for Health (YPFH)What is Your Plan for Health (YPFH)?YPFH is a new, multi-phase approach to how the university thinks about health care. The focus is on helping faculty, staff, and the university reach the healthiest state possible by offering programs, tools, and incentives for identifying and acting on health care risks, promoting smart, cost-efficient choices based on individual needs, and taking control of health care spending. How do I benefit from YPFH?YPFH can help you reach your highest potential for health. You’ll have new programs, tools, and incentives to help you address potential health risks, manage an illness or chronic condition, and live as healthy as you can. Being healthy isn’t your only reward—as the OSU community gets healthier, Your Plan for Health can help control and minimize the cost of your future medical premiums. Why does OSU need YPFH?Nationally, health care costs continue to rise at unaffordable rates for employers and their employees. The Ohio State University is also affected by this problem, since our health care cost increases are already outpacing salaries and inflation. By introducing YPFH now and putting new emphasis on preventing and better managing illness, we can get more value for our health care dollars over the longer term. Plus, OSU as a community will be more productive when we are all healthier. What changes have already been made as part of YPFH?The initial stages of YPFH—including enhanced coverage for weight management and tobacco cessation programs, alternative treatment options such as medical massage therapy and acupuncture, and easier, more affordable compliance options through the prescription drug plan—were effective on January 1, 2006. The university also introduced the PHA and offered free biometric health data screenings at the beginning of the 2006 plan year. In July 2006, the university introduced health coaching and care coordination programs. What changes can I expect in the future?The university is committed to providing the best medical outcomes and care for you and your family. To maintain this focus, we will continually evaluate and refine plan offerings based on program results and member feedback. You can expect to see additional plan and process enhancements through YPFH in the future.
2008 Health Plan OptionsWhy are the health plans changing for 2008?The university is making changes to its health plans to align their design with the Your Plan for Health initiative’s long-term goals of reducing health care cost inflation while maintaining high-quality health care benefits for faculty and staff. The new plans are designed to give you more flexibility, so you can balance your monthly premiums and potential out-of-pocket costs for health care services. Where can I find information on the new health plan options?Click here for an overview of health plan
options. More detailed information, including premiums,
copayments, and coinsurance, is available on the Open Enrollment web site 2008 Faculty and Staff Incentive ProgramHow does the Incentive Program work?The program runs from January 1 to December 31, 2008. Refer to the activity chart for eligibility dates to earn points. Participants must report all completed activities on the points-tracking account at www.yp4hpoints.com
What are the eligibility requirements for the Incentive Program?
Will taking the Personal Health Assessment (PHA) count for points in the Incentive Program this year?No, in 2008, the PHA is no longer a points-eligible activity since taking the PHA entitles you to an annual medical premium deduction of up to $120. However, you must complete the PHA to be eligible to participate in the Incentive Program. How are the points for the incentive activities tracked?Points are tracked by participants on their points-tracking account at www.yp4hpoints.com How do I log on to my points-tracking account?First log on to www.yp4hpoints.com First-Time Participants: Participants With Existing Accounts: Once you log on, click on the “Points-Tracking Program” link on the left to confidentially track incentive points online. For technical assistance, refer to Frequently Asked Questions (FAQs) or contact corpfeedback@matria.com. Be sure to include your name, date of birth, Employee ID number, and zip code. You will receive a reply within 24 to 48 hours. If I didn’t complete the PHA prior to January 1, 2008, can I still participate in the Incentive Program?Yes, however if you complete your PHA after January 1, 2008, access to the Incentive Program may be delayed for up to three weeks in order to process eligibility. How much is the incentive?The maximum that can be achieved is 125 points. Accumulated points will be assigned a dollar value, less tax, and paid directly to you. Am I required to participate in the Incentive Program?No, the Incentive Program is completely voluntary. You decide whether or not you wish to participate. Are dependents of faculty and staff eligible for the Incentive Program?Dependents are not eligible for the 2008 Incentive Program unless they work for the university and are also benefit-eligible. What activities can I participate in to qualify for points?Click here for the complete list of activities. Why did the point value for care coordination decrease in the Incentive Program this year?Beginning in 2008, if you are participating in care coordination to manage chronic conditions such as asthma, chronic obstructive pulmonary disease (COPD), diabetes, and heart disease (coronary artery disease or congestive heart failure), you are now eligible for the Value-Based Drug Plan. Through this plan, care coordination participants can get the copay on generic drugs waived or a 50% reduction in the cost of formulary brand-name drugs taken for any of these chronic conditions. Does the Incentive Program apply to me if I am already engaging in healthy activities and behaviors?Yes, all eligible faculty and staff are able to participate and receive the same point values—no matter what their health status. Healthy behaviors and activities will be given a point value depending on potential impact of an individual’s health and the personal effort required to participate. Why is participation in the 2008 Incentive Program important to me?Understanding the value of good health and engaging in healthy activities are a win-win opportunity for you and the university. You will be rewarded—both financially and with better health. The university will benefit by having a more productive, healthier workforce. Why is the university investing in the 2008 Incentive Program?Research shows providing incentives to employees for engaging in healthy behaviors and managing chronic conditions increases overall health and well-being, and decreases overall health care costs. Health care cost inflation is one of the biggest obstacles to increasing salaries. Reducing this rate of inflation from 10.5% to 7% over the next few years, while still maintaining high-quality health care benefits, will save millions of dollars that could be used for salaries and other priorities. Will there be additional activities added to the Incentive Program?Additional activities may be announced throughout the incentive period. What is a Community Challenge?It is an event sponsored by a community organization that promotes a physical activity, such as Race for the Cure, the American Heart Walk, Swim for Diabetes, Relay for Life, etc. To qualify for points for this activity, you will have to participate in the physical-activity portion of the event. How do I qualify for being tobacco free?Being tobacco free means absolutely no use of any tobacco products (cigars, cigarettes, chewing tobacco, pipe). This means that you 1) have smoked less than 100 cigarettes in your lifetime; or 2) used to use tobacco products, but no longer do (ex-smoker).¹ What if I’m trying to quit smoking?You will receive points for participating in a tobacco cessation program offered through the OSU Faculty and Staff Health Plan or through CareAllies. How is participating in CareAllies health coaching or care coordination programs tracked?Participation in these programs will be reported by the health plan to Matria Healthcare. The Office of Human Resources will not receive any information from CareAllies. Do activities count if they are completed before or after the incentive period?The eligibility window to complete and track most activities is January 1–December 31, 2008. The activities listed under Prevention and Health Management programs can be counted if completed within the period of October 1, 2007–December 31, 2008. How much do I have to exercise?Participants need to average 12 “physical activity sessions” per month. General guidance for what constitutes a “physical activity session” is listed below¹:
What health-related workshops are eligible for incentive points?You can earn points for attending or viewing a health-related workshop
sponsored by the OSU
Faculty and Staff Wellness Program What type of nutrition counseling qualifies for the Incentive Program?A nutrition counseling session with a registered dietician is points-eligible. Participants enrolled in a university-sponsored medical plan can use the nutritional counseling benefit in the health plan, or OSU employees may access the Faculty and Staff Wellness Program to schedule a session free of charge. What are preventive screenings?Preventive screenings and exams (vision, dental, physical, mammogram,
colonoscopy, etc.) are recommended based on established guidelines What weight management programs qualify for incentive points?You may earn points for participating in weight management programs offered by the OSU Faculty and Staff Health Plan or through CareAllies. Does stress management count as an activity in the Incentive Program?Yes, if you are enrolled in a stress management program offered by the OSU Faculty and Staff Health Plan or through CareAllies. ¹Centers for Disease Control (CDC) Points-Tracking Privacy and SecurityIs the information that I am submitting confidential?Absolutely! The points-tracking web site is maintained by Matria Healthcare, a third-party vendor; therefore, the Office of Human Resources (OHR) will only receive information on the TOTAL number of points earned in order to issue the incentive payment. Individual activities and/or points will not be received by OHR. The Ohio State University and its third-party vendors are committed to maintaining the privacy and confidentiality of your personal health information. They are subject to federal privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA). Click here to see the complete Confidentiality of Personal Health Information statement or see “Privacy, Flow, and Uses of Personal Health Information.” Why is it important to log out?Many people share computers. In order to protect your personal information, employees should always click on the Logout button at the top right of the web site when they are done using the web site. This will log you out of the web site and the next person to visit the web site will log in with his or her information. If you visit the web site and there is someone else’s name in the upper left-hand corner of the screen, please click on the Logout button and log in as yourself. This simple step will ensure that your personal information is kept personal and that Your Plan for Health credits are entered on your profile and not on another employee’s profile. All of the personal health information you provide on the Your Plan for Health points-tracking web site is completely confidential. This information is stored on the secure servers at Matria Healthcare. No one at OSU has access to your personal health information, username, or password without your permission. How do I disable my pop-up blocker?The use of a pop-up blocker may cause problems with the functionality of the web site. Though useful in preventing unwanted advertising windows from popping up on your browser screen, a pop-up blocker can also prevent a new browser window from opening when you want it to. In order to connect to other providers’ web sites, the site opens a new browser window to enable you to access the new site. Some pop-up blockers cause what appears to be a problem with functionality, by preventing a new window from being opened. If you are experiencing this problem, try opening your pop-up blocker’s settings or preferences (usually by right-clicking on the icon in your system tray in the lower right-hand corner of your screen or by clicking on the appropriate button on your toolbar, depending on which pop-up blocker you may be using). You can now disable the pop-up blocker while you are using the web site. You may re-enable the pop-up blocker when you are finished. Health Coach and Care CoordinationWhat are Health Coaches and Care Coordinators? What do they do?Health Coaches and Care Coordinators will supplement the care provided by your health care team. A Health Coach focuses on health promotion and education, which involves helping healthy people stay healthy and helping those with health risks avert them through information and lifestyle strategies. A Care Coordinator focuses on chronic condition management—helping people with asthma, diabetes, and other chronic conditions understand the plan of care developed by their health care providers and get the information and supporting resources they need to succeed in that plan. CareAllies administers both of these programs for the university. Will my health status affect my health care premiums, benefit eligibility, or employment?Any indications of your health status, whether through health care claims or your responses to questions in the PHA, will not have any effect on premiums, eligibility for benefits, or employment decisions. Are these programs voluntary?Yes, these programs are designed to help you live as healthy as possible, but participation is your choice. You may decline to take part at any time. Will my information remain private?The university is committed to safeguarding your personal health information, and abides by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), which protects the privacy of personal health information. The disclosure of PHA data and medical and pharmacy claims from Ohio State’s health plan to CareAllies is allowable under HIPAA because it is considered necessary for specific health care operations. However, no university entity outside of the health care setting will have access to CareAllies program enrollment information or any personal health information that CareAllies maintains when working with individuals through these programs. The contract OSU has with CareAllies requires it to adhere to the same stringent HIPAA regulations to keep your information private and secure. How will CareAllies identify eligible participants for health coaching or care coordination?Based on CareAllies’ analysis of the PHA, an individual whose results indicate certain health risk factors—such as poor nutrition, lack of physical activity, stress, smoking, being overweight, or having high blood pressure, cholesterol, or blood sugar—will automatically be invited to participate in its health coaching program. For care coordination, CareAllies reviews medical and prescription drug claims or PHA results of individuals who already have or are at high risk for asthma, chronic obstructive pulmonary disease (COPD), diabetes, or heart disease (coronary artery disease and congestive heart failure). Are CareAllies services available only for those with identified health risks or a chronic condition?No, any benefit-eligible faculty and staff and their enrolled adult dependents who have completed a PHA and authorized the release of those results to the health plan can benefit from the CareAllies health coaching program. They can join the program by being invited to participate by CareAllies or through physician referral, or they can contact CareAllies directly. In addition, any benefit-eligible faculty and staff and their dependents may call the CareAllies 24-Hour Nurse Line to get free around-the-clock answers to routine questions about health or a specific medical situation or concern from highly trained, licensed nurses. Is a Care Coordinator or Health Coach meant to replace my physician?No. Health Coaches and Care Coordinators are intended only to supplement the care provided by your health care team. Personal Health Assessment (PHA)What is the Personal Health Assessment (PHA)?The PHA is an online questionnaire about your well-being and lifestyle that is designed to provide a more complete picture of your health. Developed by The Ohio State University Medical Center (OSUMC), it can help you and your health care provider(s) optimize the good habits you already have and identify risks that you need to know about and manage. Why should I take the PHA?The PHA will provide you with information you need to begin living a healthier lifestyle. You’ll receive an online report that you can use to improve the quality of your life and potentially reduce your risks for certain health conditions. How do I take the PHA?There are three steps required to take the PHA. (1) Set up a PatientLink
account at http://patientlink.osumc.edu Still have questions about taking the PHA? The online “how to” presentations make it easy by taking you through the process step by step. Click here to view. How long does it take to complete the PHA?On average, the PHA questionnaire takes about 15–20 minutes to complete. Who is eligible to take the PHA?Anyone over the age of 18 can take the PHA. However, only benefit-eligible faculty and staff, as well as employees of OSU Affiliated Groups who are health plan members, are eligible to receive an incentive for completing the PHA in 2007. How do I get a PatientLink e-mail account?You can set up a PatientLink account at http://patientlink.osumc.edu Follow the prompts to create your PatientLink account. You will be asked to provide an e-mail address that will become the login for your account. This can be either a personal e-mail address or your university e-mail address (e.g., name.#@osu.edu). Note: OSU Medical Center employees cannot use a medical center e-mail address (e.g., firstname.lastname@osumc.edu). Each individual must provide a unique e-mail address. If you use a personal e-mail address, your spouse or dependents cannot use the same e-mail address to establish PatientLink accounts for themselves. In most cases, you’ll receive a message that you have immediate access to the PHA once you set up your PatientLink account. In a limited number of cases, you may have to wait a day or two so that your information can be matched to your OSU Medical Center records or so that a medical record number can be assigned to you. If you need help setting up your PatientLink account or have technical difficulties, call 877-293-1701 (toll free) or (614) 293-1701 between noon and 9 p.m. Monday–Friday and 9 a.m. and noon Saturday. What is the health plan premium reduction for taking the Personal Health Assessment?Complete the Personal Health Assessment (PHA) by December 14, and save $10 each month, which totals $120 for the year, on your health plan premiums in 2008. Do I have to take the PHA?No, the PHA is not required. However, by completing the PHA, you’ll gain valuable insight on your health risks that can help you live healthier. Also, making healthy changes in your life can ultimately help you reduce your health care costs. Who has access to my PHA data?Please see “Privacy, Flow, and Uses of Personal Health Information” below. How often should I take the PHA?To get a complete and accurate picture of your health, it is recommended that you take the PHA annually. PHA ScreeningsWhy is a PHA screening important?This health screening measures vital health statistics, including blood pressure, glucose and cholesterol levels, weight, and height. These numbers can provide a quick glimpse of your health status and highlight your risk for certain health conditions. You must have this information to complete the Personal Health Assessment (PHA) or your risks for certain diseases cannot be calculated. Faculty and staff can get a free biometric health screening in about 20 minutes through the OSU Faculty and Staff Wellness Program. However, 12 hours of fasting prior to the screening is required to get the most valid results. How do I schedule my health screening? Visit www.osumhcs.org/hra/register Why am I asked about follow-up at the screening?A Wellness nurse wants your permission to contact you if any of your numbers were outside the normal range to determine whether you have made contact with your Primary Care Physician or to assist you in finding appropriate resources. A nurse will not contact you unless you give him or her permission, and will only contact you at the phone number you provide. If you would rather give a home or cell phone number, that is fine. Why am I asked about authorization?One of the enhancements to the PHA this year is for individuals who have completed a screening to have their results entered directly into the PHA. This means that you won’t need your results form in front of you when completing the online questionnaire. The authorization gives the OSU Faculty and Staff Wellness Program permission to take your screening results and enter them into your medical record at the OSU Medical Center. This will allow your results to pre-populate the PHA. The results may also be available to any of your health care providers who practice within OSU Medical Center. If I go to my doctor and get numbers that are different from my screening results, can I use those in my PHA?When you go to take the PHA, you will be offered the opportunity to “over-write” any numbers that are more recent. You will be asked to indicate where you obtained the numbers and a date as well. Why do I want my numbers entered into OSU Medical Center records?This is a convenience for you. First, your screening results will pre-populate the PHA, so you will not have to enter the 10 values, where you obtained them, and a date. Second, you will not have to worry about having your screening results in front of you when you are ready to complete the PHA. Who will have access to my screening information?If you allow us to enter your results in your lifetime electronic medical record at OSU Medical Center, they will be available to your OSUMC medical care providers and care team. Additionally, your results will be maintained by the Faculty and Staff Wellness Program at the Health Plan (MHCS) for program reporting and effectiveness. Why do I need an employee ID?Your employee ID helps us to verify your identity to ensure that we attach screening results to the right person. This is very important if the results are being entered into your electronic medical record. Your employee ID number can be found on previous pay stubs, a Medical Center ID Badge, or BUCKID issued after 2002, or by contacting your department Human Resources Professional. Why do I need a PatientLink e-mail address?Your PatientLink e-mail address is used as a verification of your identity. It is the primary identification for you to complete your PHA and matches you to your electronic medical record at OSU Medical Center. My numbers don’t match what I have seen before in my physician’s office. Why?First, remember this is a screening and not a definitive diagnosis. Results may differ due to the type of equipment used; a change in lifestyle, such as increased and/or decreased physical activity; time of day of blood draw; increase in fat and/or alcohol intake several days before the test; hydration level; and if suggested 12-hour fast was followed. How can I reschedule a screening appointment?You will receive two automated e-mail reminders of your screening appointment. Each reminder message will include a link for you to follow should you need to cancel an existing appointment, or cancel and reschedule a new appointment. You may call 292-1894 (select option 3), and leave a voicemail message to cancel your appointment. After the current appointment is canceled, a new appointment can be scheduled via the online system. (Please allow two business days after leaving a message about canceling an appointment.) Can I come back for a screening next month?Individuals are only eligible to complete one PHA screening per year (January through December). This is to ensure that we offer a broad range of access to the screenings for eligible individuals. Can my spouse get a free screening?At this time, only benefit-eligible faculty and staff, as well as employees of OSU Affiliated Groups who are health plan members, are eligible to get a free screening. Privacy, Flow, and Uses of Personal Health InformationWill my responses to the Personal Health Assessment (PHA) or my health status affect my health care premiums, benefit eligibility, or employment?No. Any indications of your health status, whether through health care claims or your responses to questions in the PHA, will never have any effect on premiums, eligibility for benefits, or employment decisions. However, if you release information to The Ohio State University Faculty and Staff Health Plans (health plan), it may qualify you for participation in certain health management programs. Where is my PHA data stored?Your PHA data becomes part of your electronic medical record at The Ohio State University Medical Center (OSUMC) and is protected in the same manner as any record created at the medical center. Personal health information, including your patient records and PHA data, is securely stored behind the OSUMC firewall, an electronic “barrier” restricting access to your data to authorized physicians or medical center personnel. How can I be sure that my health information is safe?The university is committed to safeguarding your personal health information. We abide by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA protects the privacy of personal health information, such as PHA data and health care claims, and specifies that personal health information can only be used and disclosed for purposes of treatment, payment, and health care operations. Health plans and health care providers are required to follow HIPAA regulations and must keep patient information private through appropriate and reasonable steps specified in the law. HIPAA imposes criminal and civil penalties on violations of these regulations, and both the university and medical center have internal sanctioning policies in place. Who has access to my PHA data?Your OSU physician(s) and health care team will have access to your PHA through the electronic medical record at the medical center. It will be housed in the same location as lab data and other important patient information that physicians review to ensure the most up-to-date information. How is my PHA data used?When completing the PHA, you’ll be asked whether you would like to release your PHA data to the health plans in order to gain access to the health coach program. If you authorize releasing your PHA information, your participation in health coaching is optional. Your authorization is required before any other entity outside of OSUMC receives your PHA data. Is my PHA data released to the Office of Human Resources (OHR)?Individual PHA data is never shared with OHR. Your PHA data (without any of your personal identifying information) is aggregated with all other PHA results and used for measurement and benefit program design. Under federal privacy regulations, the medical center must obtain your authorization before releasing your information. Why does a third-party vendor receive my data?OSU has contracted with CareAllies and Matria Healthcare, vendors outside the university, to administer Your Plan for Health programs. OSU has a contract with both vendors that requires them to adhere to the same stringent regulations that the health plan does to keep your information private and secure. These programs are designed to help you live as healthy as possible, but participation is your choice. What if I don’t authorize releasing my PHA data?If you do not authorize releasing your PHA data to the health plan, you will not be able to participate in the health coaching program. You could still be invited to work with a Care Coordinator, based on analysis of your health care claims, but participation in this program is also your decision. Also, to qualify for the maximum amount of points under the 2007 Faculty and Staff Incentive Plan, it is necessary to complete the PHA and release the results to the health plan. What is HIPAA?HIPAA stands for Health Insurance Portability and Accountability Act of 1996. The Privacy Rule and Security Rule adopted by the United States Department of Health and Human Services, as required by HIPAA, created national standards to determine what kind of protected health information (PHI) can be disclosed and how it can be disclosed. Where can I get more information about HIPAA? The U.S. Department of Health and Human Services
(HHS) provides detailed information on its web site regarding
HIPAA. The following is a link to HHS's HIPAA Fact Sheet: http://www.hhs.gov/news/facts/privacy.html WellnessWhat weight management benefits are available as part of Your Plan for Health?The weight management benefits include nutrition counseling, weight-loss programs (including Weight Watchers), and fitness center discounts. The benefits can help you lose weight, get fit, and maintain a healthy weight. What is the nutrition services benefit?You can meet with a licensed registered dietician for general meal and diet planning. Your first three visits per plan year are paid at 100% of fee schedule or UCR (usual, customary, and reasonable). Three additional visits are permitted but require prior authorization and are subject to a $15 copay (network plans) or a deductible and applicable coinsurance (non-network plans). All dollars are reimbursed subject to the plan’s fee schedule or UCR (usual, customary, and reasonable) and are applied to the $2 million lifetime maximum. Do I need prior authorization to see a licensed registered dietician?No. You do not need prior authorization
for your first three visits. However, some licensed registered
dieticians require physician referrals before an appointment
is made. We encourage you to work with your physician when seeking
nutrition services. Prior authorization is required only after
your first three visits per plan year. Your physician must
provide sufficient documentation based on the criteria. Contact
OSU Managed Health Care Systems, Inc. at Do I need to submit a claim to NGS?If you visit a network licensed registered dietician, they should submit the claim on your behalf. If you visit a non-network licensed registered dietician, you may have to pay up front and then submit a claim for reimbursement. What is the benefit I can receive for enrolling in a hospital-based/physician-directed weight management program?The university reimburses 50% of your cost, with payouts made at no shorter than 6-session intervals or at program end if fewer than 6 sessions are remaining. Payment will not be greater than the amount paid to date, and the total reimbursement is subject to a $1,000 plan year weight management maximum and $25,000 weight management lifetime maximum. Do I need prior authorization to join a hospital-based/physician-directed weight management program? Yes. Prior authorization is required to receive the reimbursement.
Contact OSU Managed Health Care Systems, Inc. at How do I find a hospital-based/physician-directed weight management program?Contact OSU Managed Health Care Systems, Inc. at How do I receive the reimbursement for a hospital-based/physician-directed weight management program?Reimbursement is based on proof of attendance and payment. You must fill out and submit a reimbursement form to NGS in order to receive the reimbursement. The reimbursement form is available on the Lose Weight/Get Fit page. What is the benefit I can receive for enrolling in a Weight Watchers program?The university reimburses 50% of the program’s cost (including the registration and weekly meeting fee), with payouts made at no shorter than 5-meeting intervals or at program end if less than 5 meetings are remaining. Payment will not be greater than the amount paid to date, and the total reimbursement is subject to $1,000 plan year weight management maximum and $25,000 weight management lifetime maximum. Food supplements, meals, books, and scales are not covered. What Weight Watchers program can I attend?Only attendance-tracking meetings (including Weight Watchers At-Work) are eligible for coverage. The At-Home or Online programs are not covered. Do I need prior authorization to join a Weight Watchers program?No, prior authorization is not required to join a program or receive the reimbursement. How do I find a Weight Watchers program?Visit www.weightwatchers.com How do I receive the reimbursement for a Weight Watchers program?Reimbursement is based on proof of attendance and payment. You must fill out and submit a reimbursement form to NGS in order to receive the reimbursement. Weight Watchers will not bill on your behalf. The reimbursement form is available on the Lose Weight/Get Fit page. What fitness incentives are available?The university has negotiated discounts with a number of fitness centers and health clubs. For a complete list of discounts, click on Lose Weight/Get Fit, and view the fitness center discounts chart. Discounts are for single membership for faculty and staff unless otherwise noted; check with the fitness center for family membership pricing. How do I obtain the fitness center discount?Proof of employment must be provided onsite at the fitness center to obtain the discount. Depending on the fitness center, this may be in the form of a recent pay stub or BUCKID. Contact the fitness center to inquire about the proof of employment required. How long will the discounts be effective?The discounts are effective through 2006. Contract agreements with each fitness center will be reviewed at the end of the year and evaluated for 2007 renewal. What tobacco cessation benefits are available?You can receive a total of $120 in reimbursements for participating in tobacco cessation treatments. A maximum of $60 will be reimbursed for program costs, and a maximum of $60 will be reimbursed for over-the-counter nicotine replacement supplements (when used in conjunction with an approved tobacco cessation program). The tobacco cessation benefit includes coverage for tobacco cessation treatment medications: generic medication (Bupropion SR) with a $5 retail/$10 mail-order copay, and non-preferred medication (Zyban, Wellbutrin SR) with a 50% coinsurance for both retail and mail order. What tobacco cessation programs can I join?There are a number of programs that can help you kick the habit for good. The university provides reimbursement for tobacco cessation programs from leading sponsors, including American Cancer Society, American Lung Association, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Clinical Partners Program, and OSU College of Dentistry Tobacco Cessation Clinic. For a complete list of approved program providers, click on Quit Tobacco Use. How do I receive the tobacco cessation reimbursements?You must submit the tobacco cessation reimbursement form (signed by the program manager) to NGS in order to receive the reimbursement. To get a reimbursement for an over-the-counter item, the receipt must be attached to the form. The reimbursement form is available on the Quit Tobacco Use page. What are the new alternative therapy options?The university now provides health plan coverage for alternative therapy options that can work in tandem with traditional medical care or in place of traditional physical or occupational therapy. The coverage changes consist of combined physical, occupational, and massage therapy benefit options; combined chiropractic care and acupuncture benefit options; and expanded alternative therapy providers. This coverage is designed to help you and your health care providers find the therapy that works for you. What medical massage therapy benefits are available?Medical massage therapy is a new covered service that is combined with outpatient physical therapy and outpatient occupational therapy. There is a combined limit of 45 visits per plan year for physical, occupational, and physical therapy visits. Network plan participants will have a $15 copayment, and non-network plans are subject to a deductible and applicable coinsurance for office visits. Do I need prior authorization for medical massage therapy?Yes. Prior authorization with a medical diagnosis and physician prescription are required before your first medical massage therapy visit. Also, after 15 visits for either physical or occupational therapy, prior authorization is required for additional visits. What acupuncture benefits are available?Acupuncture provided by a licensed acupuncturist is a new covered service combined with the chiropractic benefit. There is a combined limit of 30 visits per plan year for acupuncture and chiropractic visits. Network plan participants will have a $15 copayment, and non-network plans are subject to a deductible and applicable coinsurance for office visits. Do I need prior authorization for acupuncture?No, but a medical diagnosis and physician prescription are required before your first acupuncture visit. After 5 acupuncture visits, prior authorization is required for additional visits. How do I get prior authorization for acupuncture or medical massage therapy?Your provider should contact OSU Managed Health Care Systems,
Inc. at How do I find an acupuncturist or licensed massage therapist?Visit the OSU Managed Health Care Systems, Inc. web site at www.osumhcs.com What are the signs of stress?Stress affects people in different ways. Some can tolerate a lot of stress before they show any symptoms; others can tolerate very little stress before it alters their behavior and health. Prolonged chronic stress can affect almost everyone. Common symptoms of someone under stress include any or all of the following: Irritability, inability to sleep, fatigue, lack of concentration, physical tension, headaches, and moodiness. What if someone else in my family is stressed?The services of both CareAllies and the University Faculty and Staff Assistance Program (UFSAP) extend to family members. The CareAllies stress management program is available to adult dependents who have taken the PHA and authorized its release to the university health plan. Do I need to call my doctor before I ask CareAllies or UFSAP for help with stress?No, these services can be accessed without a referral from your doctor.
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