HEP compliance

STATE PARTNERSHIP PLAN 2.0 (insurance) – HEP compliance deadline 12/31/19 Check your status

Physician Notification Form email completed form to: HEPQuestions@connect2yourhealth.com

The State Partnership Plan 2.0 (the district’s medical and Rx plan) has a Health Enhancement Program (HEP) requirement.  Earlier this year, UnitedHealthcare sent a postcard mailer to all covered employees announcing the HEP requirements.  The HEP requirements are age-banded and cover the following services:
– Preventive Visit (physical)
– Vision Exam
-Dental Cleanings *
-Cholesterol Screening
– Breast Cancer Screening (Mammogram)
– Cervical Cancer Screening (Pap Smear)
– Colorectal Cancer Screening/Colonoscopy

*Dental insurance is contracted with Delta Dental.  Delta Dental has agreed to share dental cleaning service dates with UnitedHealthcare in order to assist with the HEP requirements.  

Email to district Nov 18, 2019: The following information is from CTHEP for all employees to review.

Attached is a new document created to address “Frequently Asked Questions” related to the Health Enhancement Program. The document is located on the Health Enhancement website, CTHEP.com. This can be forwarded to your employees or posted on your internal website for a great employee resource.

Below is a link that goes over the Health Enhancement Program and can be a great source for new hires or a refresher for existing employees.

As a reminder for the employees/group d held to 2019 compliance, reminder letters are going out to employees and their dependents that are still missing requirements for 2019. All requirements will need to be completed by December 31, 2019.

*If the group/employee started after January 1st 2019, the first compliance year will be 2020.

We encourage all employees and covered dependents to visit the HEP portal to find out what requirements need to be completed by Dec. 31, 2019 and schedule any appointments as soon as possible to avoid the late-year rush.

Participants can log onto the HEP portal – www.cthep.com – to see what requirements are due. 

Participants can also contact us toll free at (877) 687-1448. We have HEP representatives available Monday through Thursday from 8 am to 6 pm and Friday from 8 am to 5 pm.

Attached is a copy of the physician notification form for those who completed a requirement, such as mammogram or colonoscopy, with prior insurance coverage, and would like credit for completing it.

HEP Chronic Conditions:

If you have one or more of the chronic conditions listed below, for each condition you must either take an online survey, read a fact sheet about your condition(s), or speak to a HEP nurse before December 31, 2019 to be compliant with the HEP program.  Remember to also complete your required preventive screenings.

You can log in to your account to complete the survey(s) or read a fact sheet online or you can print the appropriate fact sheet(s) from the list below and follow the return instructions.

You may also complete your requirements by calling a HEP customer service associate at 877-687-1448, Monday through Thursday 8:00 a.m. to 6:00 p.m. and Friday 8:00 a.m. to 5:00 p.m. to take your survey. During the call, you will also have the option to speak to a nurse who will conduct a full assessment, and if appropriate, engage you in further case management.

HEP Chronic Conditions include:

Note:Please remember, if a HEP nurse should call you, you are required to accept the call to remain compliant with HEP requirements

HEP compliance is based on your age as of January 1 of the compliance year. 
Please follow the appropriate age band (for this calendar year, your age on 01/01/19) for requirements.

All employees and covered dependents enrolled in the SPP2.0 must meet the individual requirements by 12/31/2019

Failure to meet one or more requirements by 12/31/19 will result in a higher rate penalty for the employee.  In such a case, the employee will be charged (via payroll deduction) 100% of the difference between the higher penalty rate and the district contract rate, including any penalties assessed to dependents.

Next Steps…1) If you haven’t done so already, consider creating an account with the State of CT HEP.  By doing so, you can track your services history and see what needs to be completed by December 31, 2019.  To enroll, please visit WWW.CTHEP.COM.
2) A registered account holder can access summary information on all insured household dependents age 18 and older (ie., dependent has met 2 of 5 requirements).  Detailed information is available for the registered account holder and all dependents under age 18.  Dependents age 18 and over may create their own HEP account, or call CTHEP at 877-687-1448 and request that their HEP information be shared with the covered member.

There are two attachments to this email.
The first attachment is the 2019 HEP Requirements.  The chart can also be found on WWW.CTHEP.COM.

The second attachment is the Physician Notification Form (can also be found on the CT HEP website).  Employees will use this form to report any medical service they received in 2019 that has not been reported to CT HEP.  When using this form you may leave the employee id and department id sections sections blank.
Should you have any compliance questions please contact CT HEP at 877-687-1448.
Best regards,Elio