These wellness programs are too narrowly focused. We had “screenings” in late 2007 for heart disease. I had high cholesterol and high triglicerides, and was overweight. But I didn’t smoke and pledged to try to follow the guidelines. In early 2008 I was diagnosed with fatal cancer and kidney failure. The screenings were so narrow that none of this was even hinted at. Maybe it’s just as well... it might have been treated as a pre-existing condition. But the point is there were strong markers something was seriously wrong and these screenings missed all of it.
I am sure that somewhere in the policy terms and conditions it would preclude coverage for conditions based upon providing false information. Similar to life insurance policies (ie lying about cigarette use to get a non-smoker rate for coverage). Is this a backdoor way for insurers to avoid or deny coverage in select circumstances?
Don't get me wrong, I wouldn't blame them for doing so, there should be no benefit to providing false or misleading information. Those with the highest risk based upon personal choices, rightfully, shoulder a higher expense. I don't think I blame you for opting out - in the interest of privacy. It is amazing to me that with HIPPA regulations so many people can "justifiably" gain access to medical information - the more layers involved in care, the less privacy is afforded.
SEIU coaching lies? I am shocked!
Well, if you participate, then you do not have to lie.
My company has 2 or 3 wellness programs offered to you They are voluntary to participate. If you choose to participate, they give you a $150 bonus per wellness program you volunteer to take.
I volunteer for 2 of them as I am not qualified for the 3rd one (I am a nonsmoker). It is not so hard to do. In fact, I have actually learned quite a bit from them. I am glad they are offered. I have done this for at least the past 4 or 5 years, since first offered.
If I would be forced to join, or pay 20% of my monthly insurance premium, I would join.
I'm guessing a lot of people are fearful of losing their job or seeing an increase in their insurance premium if they are overweight or have something else that hurts them medically, therefore they do not want to participate.
My insurance carrier, BC/BS, sent me a statement with an additional $10 added to the premium to participate in THEIR wellness program...whether I opted out of it or not. That began on January 1 of this year, WHEN they also sent me a notice that since I qualified for Medicare that they could no longer be my primary carrier, and only my supplemental carrier. I had no intention of filing yet for Medicare as I had taken a lost cost hospital care policy that covers 100% with a $5,000 deductible. Since I am very healthy and can afford to pay for my own checkups and visits for prescriptions for the sniffles. Now I have been FORCED into Medicare which covers 80/20 for anything and my supplemental costs more than the well patient/hospital care policy.
You talk about one hacked off individual.
They told us they had contracted with an outside vendor to manage this “program”.
This is a large part of the health care “problem” today. Too many entities with their collective fingers in the pie. What percentage is this outside vendor getting per member per month? What are his incentives from the payor source? I know, they’ll provide bogus data, collected from cooked information back to an insurance company who says that they want this data but don’t really cuz they don’t know what to do with it.
While in local government, my boss, the H.R. Manager, ORDERED me to lie once. And not just lie, but commit perjury during voir dire for a court case. So when I was asked the question, I told the judge, “My boss told me to tell you (blank), but that’s not true. This is true.” Then I provided a copy of the MOU addressing that issue.
These things are a sham and encourage lying - like education encourages 'grading on the curve' and 'dumbing down' to boost their school ratings.
If everyone gets a 4.0 and everyone becomes "Wellness" - we'll all be wicked smart and live forever....layers and layers of people will be paid in these looped farces. It makes the wheels on the buses go 'round n 'round.
"Eat a Book ~Read your Vegetables ~ Get a Free IPod" :>)
...and give the carrier the legal right to deny payment for any and all medical costs on behalf of an individual found to have provided false information.
It’s not about whether you tell the truth or not. It’s not even about Obamacare.
The insurance company has set up the hoops to jump through specifically so they can offer a lower priced product but in fact charge a higher price. They know a significant portion of the insured will either refuse to participate or forget to complete the participation which lets them charge more money. It is no more complicated that that.
Out of curiosity, last year I gained and lost about 1000 pounds and at several points my vital signs were not consistent with human life. I never got a call or email from the insurer concerned about my responses. Nobody was looking at the information other than whether I participated or not.
If you lie, then later on when they are obliged to cover and expensive medical charge, they will deny it saying you lied and therefore coverage is forfeited.
how Shariah compliant. Unfortunately this corruptive philosophy is one reflected in what I was told decades ago
by an agent of the State-when seeking help at the employment office—and what I was told by agents of the VA on benefits.
Like that golden oldie “Money for nothin—and your checks for free.” (oops in Freudian slip I substituted an e for an i and now hasten to escape the iou.... or ei ei o
There is already precedence on this. You lie and you’re benefits can be reduced. Example would be a smoker with life insurance. If you lie and get a premium discount and it is later found out you lied - the payout won’t be null and void, but rather adjusted downwards to what you paid and the actuaries considered with the new found facts.
Why would *all* employees be required to join a wellness program?
Well this sure as hell isn’t Overlake Hospital thats for sure........
(1) "Insurance fraud" means an act or omission committed by a person who, knowingly, and with intent to defraud, commits, or conceals any material information concerning, one or more of the following:
(a) Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, insurance producer, or surplus line broker, false information as part of, in support of, or concerning a fact material to one or more of the following:
(i) An application for the issuance or renewal of an insurance policy;
(ii) The rating of an insurance policy or contract;
(iii) A claim for payment or benefit pursuant to an insurance policy;
(iv) Premiums paid on an insurance policy;
(v) Payments made in accordance with the terms of an insurance policy; or
(vi) The reinstatement of an insurance policy;