Inside The Lumenos Plan

Health Assessment Incentives and why I am not OK with them and why you shouldn't be either!!

melonman — Thu, 29 Mar 2007 03:41:35 GMT

I personally am concerned that although the intent may be "well intentioned" my concern is that by doing so-would potentially open up being tagged with certain health issues consequentially causing a increase in my premium due to higher risk- potential liability etc. etc.. I have my annual check-up and I do realize that the info. that the Dr. has on me is avail. to my ins. carrier if they are footing the bill-(however-now that I think of that...with high deductible plans-I wonder how that affects the visibility of that information and whether I ought to have more confidentiality if they are only paying a relatively small % of the office visit via "discounted rate" or what.) Anyway, the point is that if I am tagged as having a chronic condition-whether I will be penalized and / or excluded and for me to volutarily subject myself to the potential of such is not worth the 100$ one time credit that my co. is offering as an incentive!

I realize that I don't have nearly as much privacy as I would hope and most certainly not as much as I would prefer however, just by the principal of the matter-I do't like offering anyone info. on my health condition. Genetics are already here people, and you are naive if you think that your offspring will not be able to have info. that you provide on yourself avail. for future uses which I see as potentially exclusionary and prohibitive. Health care costs are goin out of this world and if it's not obvious that big business and bean counters won't propose unethical much less morally reprehensible tactics and strategys to contain costs at any cost is-well, naive at best-ignorant at worst.

Is that enough or do you now understand a deeper meaning as to the nature of lack of compliance with the voluntary assessment rsood? The appraisal's that other companies are using in which physicians fill out-don't have numbers on them as far as lab results. If you voluntarily provide them-then I would think you open yourself up quite a bit as to how that data is used interpreted and analyzed as well as the resulting consquences-ie. change in structure of an employer's plan coverage due to high risk for certain people /conditions etc. etc. One could argue that the employer might see a need to increase coverage if alot of their employees had a need for certain services and the optimistic Pollyanna would say that this tool might be used in that way. I think we all know that unfortunately such is rarely ever the case and conversely-that if an employer were forewarned by such data that those types of costly services and coverage for chronic type diseases or conditions could be mitigated by reducing their liability via our benefit coverage in those specific areas.

How do most of the rest of you feel about the subject now?

melonman

Getting to know my pharmacist entirely too well

rgddn — Thu, 10 Jan 2008 01:14:45 GMT

Contrary to the "Blue" HMO plan I previously had, my pharmacist says Lumenos won't allow him to dispense more than thirty days worth of my maintenance medicines. As a result, rather than one trip to the pharmacist every ninety days I'm now forced to go there every month -- a costly and inconvenient irritation.

Why does Lumenos disallow 90-day refills of medications policy holders will obviously be on for the long term? How might we get Lumenos to re-consider this unhelpful policy?

How to view out-of-pocket dollar accumulations online?

markus678 — Mon, 23 Jul 2007 18:03:32 GMT

Does anyone know how we can view the dollar amount credited towards our annual coinsurance out-of-pocket maximums?

Looking for a doctor: How to get more information about the doctor in the "Doctors Plus Directory" search?

avocado — Mon, 23 Apr 2007 06:23:41 GMT

I'm trying to look for a dermatologist through the "Doctors Plus Directory" but I couldn't figure out a way to get more information on the doctors. For instance, the school they graduated from or where they did their residency. Any suggestions?

Thanks in adv! :)

Online member-submitted claim submission functionality

markus678 — Fri, 11 May 2007 15:46:49 GMT

Hi Rudi or associate Lumen:

The competition now has website functionality for members to submit out-of-network claims online. Will Lumenos also be providing this functionality to Lumenos members in the future?

Thanks,

Mark

High Blood Pressure

lexjan — Wed, 21 Mar 2007 18:00:01 GMT

I currently take several medications for high blood pressure. Recently, my blood pressure started to spike and I am unable to control it. I have been too the doctor, he has changed some of my medications and given me new medications. But, nothing seems to work to get my blood pressure under control. Does anyone have any suggestions?

Progress on the new national legislation re. one-time increase to max. annual HSA contributions?

melonman — Thu, 29 Mar 2007 04:01:44 GMT

I believe that congress passed leg. at the very end of last year or the beg. of this year that allows persons to increase the contributions to their HSA accounts (one time?) to an increased maximum from a qualified plan such as IRA or other. It also is law that health care providers must be able to accomodate for such rollovers / transfer of funds within 6mos. of said legislation.

Where is Lumenos with this and when can we expect that our employers willl be rolling out the announcement of this opportunity? OR will Lumenos provide such announcements? This is my first year with the Lumenos plan and I am getting nailed-I won't have any funds to rollover and may likely meet my out of pocket maximum so this is critical stuff for me. $5700 out of pocket is really gonna hurt however, if I can at least absorb 3K-$3500 of it with already saved-pre-tax dollars that would really help.

Anyone have any news or insight on this can of worms (for provider)? Or a contact to who might know anything and when?

melonman

"Redeem Your Incentives" function

rudi — Tue, 11 Apr 2006 15:37:09 GMT

We have been hearing for a while that no one likes the "Redeem Your Incentives" function. It doesn't actually make much sense, because who on earth would choose NOT to redeem incentives? It's free money after all.

Unfortunately, this annoyance is one of those IT problems that sounds easy to solve but isn't.

Our incentives program has grown a great deal since the early days, with different companies configuring different kinds of incentives, and it has become fairly cumbersome and manual for us to manage. Some of the data that results from going through the (apparently) vestigial Redeem process is actually required in order for us to successfully credit accounts.

The mildly good news, for those that are interested, is that we are rebuilding our incentives processes to make them far more automated, efficient, and relevant to operations. This will free up valuable people to do more effective work, and will reduce overall turn-around times and errors. It is quite a lot of effort, believe it or not, and touches a majority of our application teams. It's too early to estimate a release date, but following the project, we will be able to get rid of the pointless "Redeem" step, and just give you your money when you earn it.

- rudi

Suggestions for our web site?

rudi — Tue, 28 Nov 2006 17:55:27 GMT

We have various "official" methods of soliciting feedback on our web sites, service, and programs, but I thought I would ask here, unofficially.

What features would you be interested in seeing on the web site?
Is anything NOT working for you on our site? Broken? Stupid? Useless
And if you feel like being kind, what are your favorites?

I'd be happy to reply with info on some of our planned efforts, and take your new ideas back to the team.

thx
rudi

The Walking DVD

azhang — Tue, 15 Aug 2006 17:03:31 GMT

I found the walking DVDs by Leslie Sansone are really awesome. It is a combination of walking and upper body exercise and you can walk anytime at home.

http://www.amazon.com/s/ref=br_ss_hs/104-7060914-0748718?platform=gurupa&url=index%3Dblended&keywords=Leslie+Sansone&Go.x=14&Go.y=10

Hope this helps.

Andy

Back on Track

Oneluckyma — Fri, 12 Jan 2007 12:19:58 GMT

Hey there, I finally made it on here. and I found the perfect ticker for me. I love the Ivy leaves. Take care all.

GMaps Pedometer

cklasic — Fri, 28 Jul 2006 19:49:25 GMT

Lumens -

Our innovative friends at Google have done it again! They have a tool - GMaps Pedometer - that let's you map out walking/running routes whever you are. So now there is never an excuse to not walk at least 30 minutes a day.

It isn't the most intuitive to use, but once you master it, it comes in really handy.

Check it out - http://www.gmap-pedometer.com/

Sharing the Info

PrettyMonke03 — Sat, 16 Dec 2006 02:51:03 GMT

When my company first introduced Lumenos as an option, it was on a trial basis at a limited number of facilities to see whether there would be interest. I immediately jumped on it! Now, the trial period is over, and Lumenos is officially on the books. Recently, I convinced one of my friends to sign up for Lumenos because of the consumer driven aspect. It's such a great way to take control of your health! Thanks for existing.

Webcast success

country boy — Mon, 25 Sep 2006 23:38:36 GMT

I'm rather curious how successful the Lumenos webcasts have been. I'm sure it's hard to measure true success (e.g., how much it really improved people's health), but the number of people that participated and their feedback would be an early indication. Are there any of those results available?

Electronic EOB

talam — Fri, 14 Apr 2006 18:00:42 GMT

Your bank does it, so do the credit card companies, why not your health plan provider? I am talking about Electronic EOB (Explanation of Benefits). Well, bank and credit card companies doesn't provide EOB but they do give you option to go paperless on the monthly statements.

Soon you will be able to view your EOB (that you receive by mail) electronically; and if you wish you can opt-out from receiving paper EOB by mail. The great thing about electronic EOB is that, you can view, print and save at your convenience, thus reducing paper clutter and also you will have a digital record of the EOB in your computer.

Tahasin (Taz)

Vision care

bert5 — Thu, 02 Nov 2006 17:40:24 GMT

My lumenos plan mentions vision care through Cole Vision and PHCS. Does anyone have a similar plan and tried this? How do I go about to find providers for Cole Vision? Their website asks for a plan number.

San Francisco dinner and Health Incentives

rudi — Fri, 07 Apr 2006 18:46:42 GMT

Thanks to all who attended the Westin dinner in San Fran. It was quite an experience actually meeting so many of the people behind the data we process all day. Over the next few days I'll post some of my thoughts on the discussions I had with many guests.

One consumer mentioned that she thought it would be a good idea to provide additional financial incentives for maintaining a healthy lifestyle. In fact, we DO provide exactly this kind of incentive to many of our clients (although not all companies choose to include them all in the benefit design for their employees).

Here is a sample of the kinds of incentives some of our clients elect to provide to their employees:

E-Checkup Incentive
Healthy Weight Completion Incentive
Non-smoker Incentive
Personal Health Coach Graduation Incentive
Personal Health Coach Participation Incentive
Web Account Activation Incentive

The dollar amounts vary significantly, but range from, say, $50 to $200, and some of them are recurring every year, and can be earned by each person in a family. Most often, the company you work for pays these incentives.

Incentives serve everyone's interests: as consumers, they encourage you to be healthy, and that means fewer incidents, diseases, and therefore, less expensive premiums.

If you are a Lumenos consumer, you should check your plan design to see if incentives are available to you (you can see your plan design by logging into www.lumenos.com using your web account, and going to My Benefits | Benefit Details).

- rudi

Message from the moderator

rpeksens — Mon, 03 Apr 2006 19:35:30 GMT

My name is Rudi and I’ll be moderating Inside Lumenos. This is your Channel for access to all things Lumenos. For example, maybe you want to learn more about one of our online tools directly from our IT department. Or maybe you’d like to learn about how pharmacy claims work from an expert. Inside Lumenos is a great way to learn more about Lumenos and what we’re doing each day for our health care consumers.

Inside Lumenos is here for your information. All we ask is that you don’t give us too much information in return – personal information about yourself, especially health information – when you’re posting your question. And please keep your comments appropriate for a general audience.