Method of reducing employer health related costs while promoting employee wellness and health benefit plan strategy for same

• US 20060129436A1
• Filed: 01/06/2006
• Published: 06/15/2006
• Est. Priority Date: 07/11/2003
• Status: Abandoned Application

• Current Assignee: Douglas J. Short
• Original Assignee: Douglas J. Short
• Inventors: Short, Douglas J.
• Application Number:
  US11/326,763
• Publication Number:
  US 20060129436A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices

Abstract

In an effort to reduce employer health insurance related costs, at least one benefit under a health benefit plan is conditional on the employee voluntarily participating in a wellness program. The wellness program could include wellness categories such as a tobacco free category, normal blood pressure category, regular exercise category, a non-overweight category, a healthy cholesterol level category, a healthy blood glucose level category, and possibly even a category for participation in a health risk assessment. The invention may be implemented by an employer adopting a health plan with a higher deductible over a previous year, and providing credits against that deductible for employees who satisfy requirements regarding each of a variety of wellness categories. This should enable the employer to realize an immediate savings in the year that the invention is implemented, and future savings in years thereafter from healthier employees having lesser numbers of claims and smaller dollar claims.

Claims

1. A method of providing a health benefit plan to a group of employees, comprising the steps of:

covering employees under a group health benefit plan with a predetermined deductible;

providing a credit that reduces a deductible for an employee who satisfies a predetermined criteria associated with a wellness category.

2. The method of claim 1 including a step of conditioning the credit on the employee voluntarily permitting measurement of at least one biometric of the employee.

3. The method of claim 2 wherein the conditioning step includes the employee voluntarily providing a bodily fluid.

4. The method of claim 2 wherein the at least one biometric includes measurement of an indicator of tobacco usage, a cholesterol level, a blood glucose level, a body mass index and a blood pressure.

5. The method of claim 1 wherein the providing step is performed under a federally governed program.

6. The method of claim 1 wherein the credit is provided under a HIPAA compliant health benefit plan.

7. The method of claim 1 including a step of raising a deductible from a group health benefit plan for a previous year up to the predetermined deductible.

8. The method of claim 7 including a step of conditioning the credit on the employee voluntarily permitting measurement of at least one biometric of the employee.

9. The method of claim 8 wherein the conditioning step includes the employee voluntarily providing a bodily fluid.

10. The method of claim 9 wherein the biometric includes measurement of an indicator of tobacco usage.

11. The method of claim 9 wherein the biometric includes measurement of a cholesterol level.

12. The method of claim 9 wherein the biometric includes a blood glucose level.

13. The method of claim 9 wherein the biometric includes a body mass index.

14. The method of claim 9 wherein the biometric includes a blood pressure.

15. The method of claim 9 wherein the providing step is performed under a federally governed program.

16. The method of claim 9 wherein the providing step is performed under a HIPAA compliant health benefit plan.

17. The method of claim 2 including a step of rating the employee based on the biometric with respect to a non-health insurance policy.

18. The method of claim 17 wherein the biometric includes measurement of an indicator of tobacco usage.

19. The method of claim 18 wherein the non-health insurance policy includes at least of a motor vehicle insurance policy and a homeowners insurance policy.

20. The method of claim 2 wherein the biometric is based upon responses of an employee to a Health Risk Assessment.

21. The method of claim 20 wherein the conditioning step includes the employee voluntarily responding to a Health Risk Assessment questionnaire.

22. The method of claim 1 including a step of providing a partial credit that reduces the deductible for an employee who performs a predetermined employee action that tends to improve a biometric associated with a wellness category.

23. The method of claim 22 wherein the predetermined employee action includes taking medication prescribed based at least in part on the biometric.

24. The method of claim 23 wherein the predetermined employee action includes participation in a smoking cessation program.

25. The method of claim 23 wherein the predetermined employee action includes participation in a weight loss program.

26. The method of claim 23 wherein the predetermined employee action includes participation in an exercise program.

27. The method of claim 23 wherein the predetermined employee action includes participation in a wellness education program.

28. The method of claim 2 wherein the providing step and the voluntarily permitting step are performed annually.

29. The method of claim 28 including a step of displaying a trend in a biometric of the employee measured at different times.

30. The method of claim 3 wherein the at least one biometric includes testing the blood for a wellness category other than an indicator of tobacco usage, a cholesterol level, and a blood glucose level.

31. The method of claim 17 wherein the biometric includes body mass index.

32. The method of claim 31 wherein the non-health insurance policy includes at least one of a motor vehicle and homeowners insurance policy.

33. The method of claim 1 wherein the step of providing a credit that reduces a deductible for an employee who satisfies a predetermined criteria associated with a wellness category is applied in a non-linear manner in connection with applications of another credit relating to another predetermined criteria associated with another wellness category.

34. The method of claim 1 wherein the step of providing a credit that reduces a deductible for an employee who satisfies a predetermined criteria associated with a wellness category is applied in an additive manner in connection with applications of another credit relating to another predetermined criteria associated with another wellness category.