High Option Plan

Wellness and Other Special Features

 Refer to the 2019 NALC Health Benefit Plan brochure (RI 71-009) for complete details.

Wellness and Other Special feature

 

24-hour help line for mental health and substance abuse

You may call 877-468-1016, 24 hours a day, 7 days a week, to access in-person support for a wide range of concerns, including depression, eating disorders, coping with grief and loss, alcohol or drug dependency, physical abuse and managing stress.

24-hour nurse line

Call CareAllies 24-Hour Nurse Line at 877-220-NALC (6252) to access a registered nurse 24 hours a day, 7 days a week. This nurse line seeks to influence consumer behavior by providing tools, education, counseling and support to help members make decisions with respect to their health and use of healthcare services.

Childhood Weight Management Resource Center

 

Visit our Web site for information and tips on weight management and overcoming childhood obesity. You can access numerous articles on food, nutrition, exercise and fitness specifically geared for children of all ages. You can also find recipes, meal suggestions, and a BMI chart designed for children from age 2 through 20.

Through this on-line tool, parents can sign up for a free OptumHealth Live and Work Well monthly email newsletter that can be tailored to their child’s age and special interests.

Disease management programs

- Your Health First

Through a clinical identification process, individuals are identified who have a chronic medical conditions uch as asthma, COPD, depression, diabetes, heart disease, and musculosketletal disorders. Health advocates trained as nurses, coaches, nutritionists and clinicians use a one-on-one approach to help individuals:

  • Recognize worsening symptoms and know when to see a doctor
  • Establish questions to discuss with their doctor
  • Understand the importance of following doctors' orders
  • Develop health habits related to nutrition, sleep, exercise, weight, tobacco, and stress
  • Prepare for a hospital admission or recover after a hospital stay
  • Make educated decisions about treatment options

Enhanced Caremark Direct Retail Program

In 2016, we are introducing our Enhanced Caremark Direct Retail Program (previously the Caremark Direct Program).  This enhanced program brings this service to your local CVS network pharmacies which include all major chains.  This program is no longer available through CVS Caremark®’s mail order program.

As with the Caremark Direct Program, our enhanced Caremark Direct Retail Program allows you to purchase non-covered drugs and prescribed over-the-counter medicines through our network pharmacies and receive the convenience, safety and confidentiality you already benefit from with covered prescriptions. Caremark Direct Retail is offered at no additional charge to you.

Caremark Direct Retail is a value-added program that provides you with safe and convenient access to competitively priced, non-covered prescriptions and certain over-the-counter medications.

You may call 800-933-NALC (6252), 24 hours a day, 7 days a week, for a complete listing of available medications and their cost.

Health Assessment

The Health Assessment is an online program that analyzes your health related responses and gives you a personalized plan to achieve specific health goals. Your Health Assessment profile provides information to put you on a path to good physical and mental health.

  • When one covered member completes the HRA, you may choose one of the following:
    • Self only CignaPlus SavingsSM discount dental program;
    • Waiver of two $20 PPO medical office visit copayments (when the Plan is the primary payor) incurred in the same year as the Health Assessment is completed; or
    • a wearable actifity tracking device.
  • When two or more covered family members (including the member) complete the HRA, you may choose one of the following:
    • Family CignaPlus SavingsSM discount dental program,
    • Waiver of two $20 PPO medical office visit copayments (when the Plan is the primary payor) incurred in the same year as the Health Assessment is completed; or
    • a wearable activity tracking device (limit 2 devices per enrollment  

Note: You must be 18 years or older to be eligible to complete the Health Assessment. Individuals age 13 and older can access other services offered by CareAllies/Cigna.

CignaPlus SavingsSM is a discount dental program that provides members access to discounted fees with participating dental providers. For more information on this program, call 877-521-0244 or visit www.cignaplussavings.com.

Healthy Rewards Program

A program available to all members that provides discounts on services that are not usually covered by the Plan. You will receive discounts on weight management and nutrition services, fitness clubs, vision and hearing care, magazine subscriptions, and healthy lifestyle products. This program promotes wellness, good health, and healthy behaviors. For more information call 800-558-9443 or visit our Web site.

Personal Health Record

Our Personal Health Record allows you to create and maintain a complete, comprehensive, and confidential medical record containing information on allergies, immunizations, medical providers, medications, past medical procedures, and more. Participation is voluntary and access is secured. Access this tool from our home page.

Solutions for Caregivers

For members or spouses that are caring for an elderly relative or disabled dependent, this program provides expert assistance from a Care Advocate, a registered nurse with geriatric, disability and community health experience. Your benefit gives you a bank of six free hours per calendar year, which may be used for any combination of the following services:

•  Evaluating the elder’s/dependent’s living situation

•  Identifying medical, social and home needs (present and future)

•  Recommending a personalized service plan for support, safety and care

•  Finding and arranging all necessary services

•  Monitoring care and adjusting the service plan when necessary

You also have the option to purchase continuing services beyond the six hours offered. You must call 877-468-1016, 24 hours a day, 7 days a week, to access the services of Solutions for Caregivers. Hours of operation are 8:00 a.m. to 8:30 p.m. (Pacific time), with a Care Advocate on call after hours and on weekends.

Substance Use Disorder (SUD)

This program offers assistance in finding In-Network providers and treatment options in the area and provides education about the SUD condition. Call OptumTM at 855-780-5955 to speak with a licensed clinician who can help guide you to an In-Network treatment provider or treatment center. Better treatment outcomes occur when you have a lear individualized treatment plan within your community.

Weight Management Program

The Weight Talk® Program through Optum® is a personal coaching program designed to achieve measurable, sustainable weight loss. It is delivered through regular phone-based coaching sessions with a dedicated coach. Participants set realistic weight goals and through small multiple behavior changes learn how to achieve and maintain a healthy weight for the rest of their lives.

Participants receive scheduled telephone coaching sessions with a dedicated coach or registered dietitian. Participants also have lifetime access to weight loss tools, educational resources and community support on the Weight Talk® Web site.  Each participant receives a Welcome Kit containing a weight loss workbook, food journal, tape measure and a wireless activity monitor that tracks and uploads steps, calories burned, distance traveled, and activity duration wirelessly to the Weight Talk® Web site. This allows participants to track their activity history on the Web site and allows coaches to see the participants’ progress throughout the course of the program.

Individuals can enroll in the Weight Talk® Program online or by calling the toll-free number at 844-305-0758. A personal dedicated coach is available Sunday through Friday 7:00 a.m. through 3:00 a.m. and Saturday 9:00 a.m. through 12:00 a.m. Eastern Time.

Non-FEHB benefits

CignaPlus Savings® (discount dental program)

CignaPlus Savings® (discount dental program) – Non-FEHB benefit

CignaPlus Savings® is a discount dental program that provides members access to discounted fees with participating dental providers. This program is available only to members, and their dependents, of the NALC Health Benefit Plan. The monthly Self Only premium is $3.00 and $5.00 for Self and Family. This is a discount program and not insurance, and the member must pay the entire discounted charge for dental services.  For additional information or to join call 877-521-0244 or visit our Web site.