THANK YOU!
A super-hero is defined as an individual
with "extraordinary or superhuman
powers” and dedicated to protecting
the public.
By most definitions, characters do not
strictly require actual superhuman
powers to be deemed superheroes.
Why We Need H.E.R.O.s
• Up to 75% of what the Untied states
spends on Health
care is directly
related to what
we have chosen to
eat, drink and
smoke.
Why We Need H.E.R.O.s
• Depression is estimated to be the number
three health care cost driver
THE CONCEPT
Healthier Employee
Reimbursement Option
• Available as a stand-alone program, or
• Integrated with an HRA, or
• Integrated with a HSA
Why We Need H.E.R.O.s
• For an HRA, employees can earn points based
upon traceable activities that are converted into
dollar values for employer HRA contributions.
• The wellness plan can be added as a “no cost”
component through restructuring the HRA. One
option is to rollback the HRA benefit and let
employees earn back the full HRA through active
Participation in the wellness plan.
Why We Need H.E.R.O.s
•On average, carrier based and embedded
wellness plans attract 4% of an employer’s
population.
•We have partnered with Trotter Wellness to offer
multiple solutions that can either be integrated with
your HRA or HSA or offered as a standalone
option.
•Trotter participation averages 88%
Why We Need H.E.R.O.s
•How many of us today have been on a diet?
•How many of us today on a diet lost
weight?
•And how many of us today were on a diet a
second time?
•And a third time?
Putting The Pieces Together
Wellness That Works®
Gain the Trotter Wellness
Advantage and get ahead
of rising healthcare costs.
About Trotter Wellness®
 Comprehensive wellness program management
 Serving individuals and organizations nationwide
 Specializes in health risk related behavior change
through Health Risk Assessments (HRA’s), Health
Coaching and comprehensive program management
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
About Trotter Wellness®
 Our success is demonstrated by a documented return
on investment obtained by both our clients and
members
 Our programs are supplemented by a robust online
suite of online modules, tools and customized
resources
 Our integrated delivery platforms provides a seamless
system of logistics, behavior change, tracking and
reporting
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Results Driven Structure
 88% program participation
for employees and spouses
 93% satisfaction with
Optimal Health Coaching™
(3rd party survey results)
 98% retention rate of clients
after the 1st year
 5.2 Average ROI for those
who measure
• High participation
• High satisfaction
• Program planning
• Effective behavior change
• Outcome measurement
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Why Wellness
 Healthier Workforce
 Reduced Health Claim Costs
 Reduced Workers’ Compensation Costs
 Increased Productivity & Morale
 Reduced Sick Time
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Why Wellness
Additional yearly health costs of an employee
with key risk factors
Source: Health Affairs 2012: Ten Modifiable Health Risk Factors Are Linked to More than One-Fifth of EmployerEmployee Health Care Spending, Goetzel et al. Based on 2009 data.
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Program Options
 Optimal Health™ - Full service corporate wellness program
 Wellness That Works® - Performance based wellness
program
 Corporate Wellness Essentials™ - Small business and selfservice corporate wellness program
 Well Nation® - Individual wellness programs
 Golden Health® - Individual wellness programs for seniors
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Optimal Health™ Program
 Full service, corporate wellness program
 Improves participant’s health through health coaching
 Focuses on prevention, health risk reduction, goal
setting, targeted programming
 Based on a ROI model
 Includes incentive planning, participatory or
standards/progress based incentive programs
 Corporate aggregate reports, health coaching reports,
and corporate action planning
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Our Model
Biometrics
HRAs
Coaching
Assessments
Goals Set
Behaviors
Changed
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Claims
Reduced
Our Platforms
Behavior Change
Logistics
• Timeline planning
• Communications
• Environmental
assessment
• Incentives
• Implementation
planning
• Year-long support
•
•
•
•
Biometrics
HRAs
Health Coaching
Web Tools &
Resources
Tracking / Reporting
• Personal reports
• Aggregate data
• Health Coaching
reports
• Action planning
• ROI metrics
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
The Key to Results: Optimal Health Coaching™
 The catalyst for long-term sustainable behavior change
 Awareness is only the 1st step; and it is not enough
 Professional, full-time Trotter Wellness health coaching
staff certified by the American College of Health
Coaches™
 Optimized utilization of other available services and
resources for the company
 One-on-one, private, confidential, personalized and
convenient telephonic model
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
The Key to Results: Optimal Health Coaching™
 Support and guidance enables each member to have an
opportunity to set realistic, personal and sustainable
health goals
 Health coaching support to participants is available
year-long, Monday-Friday, 8am to 8pm CST
 Access to comprehensive targeted educational resources
through their Health Coach and emailed or mailed to
participant
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Wellness That Works®
 Performance based program
for qualified companies
 No up-front program fees
 We are not paid unless we
deliver measurable results
• Available to most large
companies
• Full service, corporate
program
• Delivers reductions in health,
workers’ compensation and
disability claims
• Increases productivity
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Corporate Wellness Essentials™
 Self-service wellness program
 Designed for small businesses
 Good fit for organizations
looking for basic wellness
tools
 Use as a foundation for a
more robust wellness program
• Online purchase & setup
• Comprehensive
implementation guide
• Monthly wellness
activities and challenges
• Customer service support
available
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Well Nation®
 Healthy living programs for
individuals
 Focus on a participant’s
unique needs
 Support from a professional
wellness coach
 Programs are concentrated
over 90-days for quick results
•
•
•
•
•
Weight management
Smoking / Tobacco Cessation
Nutrition
Fitness
Total Wellness
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Golden Health®
 Healthy living programs for
individuals 50 years +
 Identify health risks and
create a plan to address them
 On-going support from a
professional Health Coach
• Professional wellness coach
 Programs are 90-days in
support
length
• Personal wellness report
• Five focused program
available
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Sample Results: Waupaca Foundry
 Largest producer of gray, ductile, and compacted
graphite iron in the world
 Leadership backed wellness initiative
 Implemented in all sites, spouses and retirees, over
5,000 eligible members
 Alignment of benefit plan design, health risk reduction
strategies and health coaching support
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Sample Results: Waupaca Foundry
 $75 per month incentive ($900 per year) benefit credit
towards medical premium
 Program Requirements:
 Biometric Screening
 Health Risk Assessment
 2 Health Coaching Sessions
 Choice: Annual Physical or 3rd Health Coaching
Session
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Sample Results: Waupaca Foundry
 Year 5 Results
 89% Participation
 9 Point improvement on Overall Wellness Score
 37% improvement in fitness-related risk
 34% improvement in cancer-related risk
 17% improvement in nutrition-related risk
 16 : 1 ROI
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Sample Results: Waupaca Foundry
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Why Trotter Wellness®
 10 years of wellness program experience with a national
reach
 Led by an experienced, knowledgeable and professional
team
 A reputation built on delivering consistent results
 Prefers long-term partnerships based on mutual trust,
open communication and the unified goals of increasing
health, reducing costs and transforming lives
Proprietary & Confidential Trotter Wellness® Copyright ©2013 All Rights Reserved
Questions
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Thank You!!!!
First there was the Pam Anderson tape…………..
Then there was the Kim Kardashian tape………..
And now we bring you the following tape……….
Health Care Reform: The
Legal Landscape (and other
fun stuff)
Ashley Gillihan, Esq.
ashley.gillihan@alston.com
© 2013, Alston & Bird, LLP
•
Steps You Should Be Taking
Now
in
2013
Market Place Notice
– Do I have to send it to COBRA beneficiaries?
– Do I have to send to employees in the territories?
•
Annual enrollment for 2014-send revised SBCs
– Can I include the new language on a cover sheet?
– Do I have to send on behalf of an EAP?
•
Mid-October--Begin standard measurement period for 2015
•
Address impact of Windsor
– Do I have to cover same sex spouse’s?
– How do the new rules affect Health FSAs, HRAs, and HSAs?
2014
•
2nd wave of health insurance reforms (effective for plan years beginning on or
after January 1, 2014)
– Essential health benefits
• Do I have to provide EHBs?
• How do I identify EHBs?
– Deductible limits
• Can I use an HRA to satisfy the deductible?
– OOP Limit
• What is included in the OOP?
• Are multiple network tiers considered a single network?
– Provider nondiscrimination
• Do I have to allow all providers to participate in my network?
2014
•
Health Insurance Reforms (cont’)
– Wellness rules
• Who is entitled to a reasonable alternative?
• What is an activity based program?
– Clinical trials?
• Do I have to cover all clinical trials?
– 90 day waiting period limitation
• If our waiting period was longer than 90 days, and someone is still in a
waiting period when the plan year in 2014 begins, do we have to cover
them?
– No pre-existing condition exclusions
• What is a pre-existing condition exclusion?
– End to annual limit waivers
2014
• Amend Health FSAs to comply with 2500 limit
(which was effective for plan years beginning on
or after January 1, 2014)
• W-2 reporting for 2013 by January 31, 2014
• Send Certificate of creditable coverage through
December 31, 2014
Other Fun Stuff
• Technical Release 2013-03
– Can an employer pay premiums for a major medical policy
issued in the individual market?
– Can an employee pay for major medical IM premiums through a
cafeteria plan?
– Can I still have a stand alone defined contribution arrangement?
– What does “integrated” mean?
THANK YOU
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