2. Health and Lifestyle Benefits
Health Benefits
The Issue
One of the most challenging issues of our time is affordable and accessible
healthcare. More employers have been forced to restructure their benefit plans,
often reducing benefits, increasing deductibles or shifting to consumer-driven health
plan options. Many offer no insurance benefits at all. That leaves many individuals
uninsured, under insured or in the position of finding the right plan for themselves and
their families.
The Solution
Individuals: HealthPerx™ addresses this challenge by providing individuals and
their families with convenient access to physicians 24/7/365 and significant savings
on prescriptions, dental and vision care as well as access to health advocates,
telephonic counselors, medical travel assistance and much more. Regardless of
existing healthcare coverage, HealthPerx can easily save individuals and their families
thousands of dollars a year in time and money.
Employers: HealthPerx offers businesses an innovative and effective solution that
reduces absenteeism, increases productivity, promotes consumerism and decreases
overall healthcare costs. The high perceived-value can improve acquisition and
retention of employees for minimal cost.
Using telemedicine as the core benefit, studies are showing reductions in physician,
urgent care and emergency room visits,
while promoting wellness, prevention
• Everyone is accepted
and personal responsibility.
• Good for the immediate family
• Immediate availability–
Other Features, Packages
unlimited usage
and Pricing
• Easy to use–no paperwork
• Optional lifestyle benefits
• Satisfaction guaranteed
• List-bill capabilities
• Fulfillment kit and membership cards
• Website access to benefits and provider locations
•
Onsite member services call center staffed
with English- and Spanish-speaking
representatives who can help with enrollment,
verify discounts and assist with customer
service issues
One Card. Unlimited Savings.
Satisfaction 100% guaranteed.
If you are not completely satisfied,
simply contact us within 30 days
for a refund.
Packages can be configured to fit
client needs. To see core packages
and pricing, go to our website.
Group rates are available depending
on group size, benefit package and
other conditions.
Telemedicine*
Our telemedicine services meet the needs of busy professionals, business travelers
and active families by giving them immediate access to professional medical
advice, treatment and referrals. Consult with a national network of U.S. licensed,
board-certified physicians in minutes by phone or via video consult for personalized,
reliable medical advice and prescriptions (when necessary), wherever and whenever
needed, 24/7/365. Our network of physicians for pediatrics is the largest
in the country, consisting of practicing pediatricians, primary care and
urgent care physicians.
Get quality care when needed without any medical consult fees.
Members:
•
Save time and money by avoiding unnecessary visits to the doctor, urgent care
center or ER
• Prescriptions are phoned into your preferred pharmacy
• The physicians treat all ages—infants to seniors
• Great for college students
• HIPAA compliant and confidential
• Includes free Personal Health Record (PHR) storage, management and file sharing
*Telemedicine is not insurance and does not replace a primary care physician. The doctors do not prescribe
controlled medications.
“Telemedicine will play an increasingly
central role in getting the right care
at the right time to individuals…
particularly effective for acute,
routine, episodic, self-limited and
minor illnesses.”
– “Telephonic Medical Consults Answer the
Call for Accessible, Affordable and Convenient
Healthcare.” Position Paper. Center for Health
Transformation.
3. Health Benefits, Continued
Employers:
How it Works
Quick Facts and ROI
1. Set up your account and complete your health questionnaire online or by phone
Based on a recent analysis of 150,000 medical consults:
2. Request a medical consult
• 91% were successfully treated by phone or video consult
3. A doctor calls you (average wait time: 22 minutes) or schedules a video consult
• 53% of callers would have used PCP @ $100 per visit
4. he doctor discusses symptoms, diagnoses your condition and sends
T
a prescription to your pharmacy, if needed.
• 25% of callers would have used urgent care or specialists @ $153 per visit
• 9% of callers would have used an emergency room @ $900 per visit
• Medical visits would have cost 4 hours of productivity @ $25 an hour
Average Savings
Per Call = $272.25
Actual ROI will depend on cost of benefit package selected and utilization rate.
*This is an illustration of potential savings and does not represent actual savings figures. Savings vary by provider service and
geographical area.
Imagine the effect on your business if employees called
the doctor first!
“I was at work not feeling well but didn’t
want to leave work. So I decided to
call telemedicine. It was a wonderful
experience! The doctor called me back
within 30 minutes. I spoke with him
for about 15 minutes and he wrote me
a prescription that I was able to pick
up on my way home from work at my
local pharmacy! It was very convenient
Telemedicine saved me money and I
didn’t have to miss time from work.”
– Janice
Problem solved—
no medical consult fees
If a condition cannot be treated by
phone, the physician can advise what to
do and where to go—saving guesswork,
time and money.
Industry Facts
There is already a shortage of
physicians and medical personnel.
The future demand in the number of
yearly primary care physician consults
due to population increase and
expanded coverage will drive the need
for even more physicians, creating a
greater supply-demand gap for the
next 10 years.
What can be treated:
• Colds and flu
• Sore throat
• ronchitis and
B
respiratory infections
• Sinusitis
• Poison ivy and insect bites
• Headaches and migraines
• Stomach aches
• Allergies
• Urinary tract infections
• Ear infections
• Pink eye
• Pediatric care
• Prescription refills (short term)
“Projecting US Primary Care Physician Workforce Needs: 2010-2025”; Stephen M. Petterson, PhD, Winston R. Liaw, MD, MPH,
Robert L. Phillips Jr, MD, MSPH, David L. Rabin, MD, MPH, David S. Meyers and Andrew W. Bazemore, MD, MPH; November/
December 2012.
4. Health Benefits, Continued
Wait times for healthcare throughout the country as reported in the Merritt Hawkins
Survey (2010) for five specialties will continue to increase as well, driving more
people to urgent care and emergency rooms for non-urgent conditions.
Recent CDC and ACEP data about ERs:
•
85% of ER visits were the result of not being able to wait to see a patient’s
regular medical provider.1
• 20% of adults from age 18-64 have visited an ER in the past 12 months.2
• 80% of adult ER visits were due to lack of access to other providers.2
Pharmacy
• Save 10–85% (an average of 41%) on
prescription and drug purchases at more
than 60,000 pharmacies nationwide.
• Whether you have insurance or not,
many drugs are not covered and many
insurance plans require a deductible to
be met. Our card has no limits.
Medical Health AdvisorTM
helps patients:
• Navigate the healthcare and
insurance systems
• Find the best doctors, hospitals
and other providers
• Resolve insurance claims and billing issues
•
Schedule appointments with hard
to reach specialists
• 46% of ER visits were not classified an immediate emergent or urgent at triage.3
Dental Care
Telemedicine has the potential for restructuring medical care in ways that can solve
many of the problems in the medical industry while reducing costs and improving
quality of care.
• Save on everything from routine
cleanings, x-rays and fillings, to root
canals and crowns at thousands of
locations nationwide.
• Secure second opinions to provide
peace of mind
The HealthPerx Value Proposition
• Save on orthodontics, periodontics and
cosmetic procedures where available.
• Provides members access to a global
network of practicing physicians, travel
assistance personnel and emergency
evacuation benefits when traveling 100
miles from home and suffering a serious
injury or illness.
Telemedicine and other non-insurance benefits are playing an increasingly important
role as the healthcare industry evolves. HealthPerx is the only company offering
a complete solution and a turnkey strategy that provides both businesses and
individuals the solutions they seek.
•
Telemedicine with unlimited call features, NO medical consult fees and 24/7/365
availability—provides quality medical care anytime from anywhere!
Hearing Care
• Free hearing screenings and substantial
discounts on hearing aids and other
products and services at more than
3,300 locations nationwide.
•
Other health and lifestyle benefits using best-in-class provider networks
Vision Care
• Save 20–60% on prescription eyewear.
*All health benefits are good for member and all legal dependents
•
Complete implementation and marketing program that builds awareness
and drives utilization
• Call Center open 6 days a week to assist with member benefits
HealthPerx has developed a reputation built on quality,
flexibility, product performance, differentiation, reliability
and unparalleled customer service.
1 American College of Emergency Physicians Emergency Care Poll 2012
2 “Emergency Room Use Among Adults Aged 18-64: Early Release of Estimates From the National Health Interview Survey”,
Renee M. Gindi, Ph.D.; Robin A. Cohen, Ph.D.; and Whitney K. Kirzinger, M.P.H., Division of Health Interview Statistics, National
Center for Health Statistics, January-June 2011
3 National Hospital Ambulatory Care Survey published by the CDC 2009 Link: http://www.cdc.gov/nchs/data/ahcd/nhamcs_
emergency/2009_ed_web_tables.pdf
• ave 10–30% on eye exams and
S
40–50% on the national average on
LASIK surgery, from over 14,000
eye care professionals in our network.
Diagnostic Lab
Imaging Discounts
• iscounts of 50-75% on MRI and CT
D
scans and 10-80% on typical lab costs.
L
ab portion not available in MA, MD, ND, MI, NY, RI and SD.
Medical Bill SaverTM
• he Health Advocate™ Medical Bill Saver™
T
benefit can lower out-of-pocket costs on
medical bills not covered by insurance.
Medical Travel Assistance
Telephonic Counseling (EAP)–
24/7 access to counselors
who assist with problem
resolution for members with
issues such as:
• Depression, anxiety or stress
• Conflicts at work or home
• Reliance on alcohol, drugs,
tobacco or food
• Sexual, physical or emotional abuse
• Loss and grief
• Change and transition
5. Affordable access. Quality care. Substantial savings.
Here is an example of savings a family of four can expect using the HealthPerx Card.
Lifestyle Benefits
Emergency Roadside Assistance
Health Savings*
• to 15 miles towing (up to $80 retail value) per occurrence maximum
Up
for covered charges
Telemedicine
The family has high-deductible health insurance. Last year they
had 9 doctor visits but 6 of those were handled on the phone:
2 calls with the flu, 1 with bronchitis, 1 with a stomach ache and
2 with ear infections, saving 4 doctor office visits, 1 urgent care
and 1 ER visit.
•
Fuel, oil, fluid and water delivery service; lock-out, flat tire, battery and collision
assistance, available 24/7
$1,096
Pharmacy
One family member’s monthly drug was changed to “non-formulary”
and the price increased to $62. Using the savings card reduced the
price to $26, saving $36/month.
$432
(for member only)
•
Provides early notification whenever they detect your personal information is
being used to apply for many forms of credit or services
• Removal from pre-approved credit offers
•
24/7 access to live, domestic fraud resolution experts
• ID theft reimbursement insurance
Dental Care
3 family members do not have dental insurance. Using the
savings card, they saved on 3 cleanings and oral exams, and
saved 38% on a crown.
$523
Vision Care
The family needed 2 pairs of glasses. The cost with the card
was reduced from $504 to $311.
$193
Total Savings
Identity Theft Protection
• ID theft analytics–risk score
• Fraud databases, social networks and proprietary data monitoring
Legal Care
$2,244
•
Over 20,000 attorneys offering free services for consultations, new legal
matters, legal documents, small claims court representation, welfare, INS issues
and simple wills.
•
Capped fees on other commonly used legal services. For additional matters,
plan attorneys will either charge $125 per hour, or when appropriate, give
members a 40% discount off their usual and customary hourly rate.
Fitness Club
“As a pharmaceutical rep, if I get sick it could take hours out of my day. If
I’m out of town, it could result in packing it up and going home. Recently, an
allergy turned into a sinus infection and I thought I was going down for the
count, but I called telemedicine. Within 30 minutes, a doctor called, knew
exactly what was going on, and sent in a prescription that I picked up an
hour later. I couldn’t believe how well it worked. It’s the best value for the
dollar I have ever seen.”
– Frank
•
Guaranteed lowest membership rates at more than 8,500 fitness clubs
nationwide. Average annual savings are $207 per year. Receive a Week FREE
pass at all participating clubs.
Tax Help
• Unlimited advice on federal taxation
•
Free tax return preparation for forms 1040EZ, 1040A and standard 1040
•
Deep discounts on numerous other tax schedules
• audit assistance
IRS
•
Review of prior year’s tax return and tax planning
*This is an illustration of savings and does not represent an actual member experience. Savings vary by provider, service and
geographical location.
•
Member portal with tax tips, tax law changes, member advice and much more
6. Lifestyle Services
Here is an example of savings a family of four can expect using the HealthPerx Card.
Pet Care
•
Save 25% on all vet services–no exclusions, no forms to fill out, no deductibles.
All pets in the household are included (valid at participating veterinarians).
Optional Lifestyle Services
Lifestyle Savings*
Identity Theft Protection
Priceless
•
Save up to 25% at more than 5,500 home health or assisted living facilities.
Advisors available 24/7.
Golf Savings
•
Save up to 50% on greens fees at more than 2,000 courses throughout the
U.S., including Hilton Head, Myrtle Beach, Pinehurst and Palm Springs, plus
courses in Canada, Ireland and Scotland. Save on driving ranges, golf lessons,
stay-and-play packages and golf vacation packages.
“This is a fabulous benefit. I have had
two issues this year. One was related
to an issue with my dad’s Medicaid and
Veteran’s Benefits. I was connected
with an elder care attorney who was
so helpful. I would have had to pay
at least $500 for that much legal
advice on my own. The other issue
had to do with a contract I was asked
to sign for my business. The attorney
I got this time reviewed the contract
and got back to me in a day with his
recommendations, which were very
helpful. I was very impressed with
the service and professionalism from
Legal Club of America.”
Emergency Roadside Assistance
Service was provided to retrieve keys locked in the car, and to
change a flat tire. Towing services up to 15 miles ($80 value).
Eighty dollars will be applied toward the total bill for distances
greater than 15 miles.
$170
Legal Care
Issues were discussed with an attorney regarding veteran’s
benefits and Medicare eligibility. A family member talked with
an attorney specializing in elder care.
$500
Pet Care
The dog needed surgery and the family received
a $250 discount.
$250
Tax Help
The family received advice when filling out their tax returns.
Elder Care/Long Term Care
$100
Fitness Club
The family received a $50 discount on the enrollment fee
and a $5 per month discount.
$110
Total Savings
$1,130
Employers Note: Adding the Lifestyle Benefits is another opportunity for
you to use these offerings as employee incentives, perks, recognition
rewards, etc.
“ My wife and I tried out LA
Fitness on a free one-week
pass and then joined with our
discount. We saved $50 on
the enrollment fee and $10 a
month on the dues.”
– Bob
– William
*This is an illustration of savings and does not represent an
actual member experience. Savings vary by provider, service
and geographical location.
7. Disclosures
This plan is NOT insurance. This plan provides discounts at certain healthcare providers for medical services. This plan does not make payments directly
to the providers of medical services. The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers
who have contracted with the discount plan organization. This discount card program contains a 30 day cancellation period. FL, LA, MD, MS, ND, OK,
RI, SC, SD and TX residents: Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days
after the effective date. AR and TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days. MA residents: The plan is not
insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The range of discounts for
medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary services received. The discount medical
card program makes available, before purchase and upon request, a list of program providers, including the name, city, state, and specialty of each program
provider located in the cardholder’s service area. Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, P.O. Box 671309, Dallas,
TX 75367-1309, 800-800-7616. Website to obtain participating providers: www.locateproviders.com
Pharmacy Savings Card Disclosures: Pharmacy discounts are Not Insurance, and are Not Intended as a Substitute for insurance.
The discount is only available at participating pharmacies. The program administrator may obtain fees from pharmacies based on your prescription drug
purchases. These fees may be retained by the program administrator or shared with you and/or your pharmacy.
This program is not available in KS, UT, VT and WA. All other disclosures available on www.hperx.com.
For more information on individual and group plans,
benefit details and provider locations contact:
Thomas Hamilton
3440 Toringdon Way
Suite 205 Charlotte, NC 28277
P: 704-375-1112
thamilton@hamiltonedwards.com
