FAQ's
Questions are organized into the categories shown below. You can read all of the FAQs by scrolling through this document or you may click on the category that interests you and be taken directly to that section.
General Information
Eligibility
Health and Wellness Assessment
Online Health Resources
Health Coaching
Condition Management
Health and Wellness Assessment Reports
Confidentiality and Consent
General Information
1. Question: What is Health Smarts?
Answer: Health Smarts is SISC's comprehensive health improvement program for SISC PPO Plan participants. Through Health Smarts, SISC and our health partners, Blue Cross of California and Blue Shield of California, both supported by WebMD, provide a wide choice of online resources to help you take charge of your health – everything you need in the areas of preventive care, health improvement, condition management and decision support.
Although most SISC PPO plans provide coverage for preventive care, it is always a good idea to check your plan benefits before scheduling a preventive care appointment with your doctor.
2. Question: Why is SISC introducing this program?
Answer: We all know that increases in health care costs are a national concern and are expected to continue for the foreseeable future. However, there are actions that each of us can take to slow the increases.
Research has shown that 70% of disease is preventable if health risks are reduced. When people are healthier, they are happier and more productive. So, if we can help district employees and their families reduce their health risks, we can slow the rate at which our health care costs increase, reduce absenteeism, and model healthy living in the workplace and the classroom. Health Smarts is designed to do all of those things.
3. Question: Why is Health Smarts only for PPO Plan participants?
Answer: SISC offers our members the choice of medical coverage under a health maintenance organization (HMO) or preferred provider organization (PPO).
HMOs have more typically been focused on keeping their members healthy, and in helping them improve their health. Participants in SISC HMOs already have health and wellness assessments and health improvement programs available to them directly through their HMOs.
The traditional focus of PPOs has been on providing coverage for medical care, including prevention. However, until recently there has been less emphasis on efforts aimed at helping participants improve their health to avoid preventable medical conditions. Programs such as Health Smarts represent a new focus on health and prevention for SISC's PPO participants.
Eligibility
1. Question: Are all SISC members eligible for Health Smarts programs?
Answer: Health Smarts is generally available only to participants in the SISC PPO medical plans - SISC members, including retirees and COBRA participants, and their covered dependents. SISC members who are enrolled in HMOs have health assessments and health improvement programs available directly through their HMO.
There are some limitations on the availability of Health Smarts for dependent children and retirees.
- Dependent children under age 18
- Blue Cross – not eligible for health coaching; ConditionCare is available only for those with asthma and diabetes
- Blue Shield – can only participate in Health Management Programs; no other portion of Health Smarts is available
- Both – not eligible to participate in the prize drawing for completing the health and wellness assessment by May 1, 2008.
- Members in CompanionCare Medicare Supplement (Blue Cross)
- Health coaching is not available.
2. Question: I declined SISC medical coverage but did take dental. Can I participate in Health Smarts?
Answer: At this time, Health Smarts is available only to participants in one of SISC's PPO plans.
3. Question: Are all of my covered dependents eligible for Health Smarts?
Answer: In general, the answer is yes. Anyone who is covered under a SISC PPO Plan can access online health-related information and tools.
Eligibility to take the online health and wellness assessment depends on the plan: all Blue Cross PPO participants can take it; Blue Shield PPO participants who are age 18 or older can take it.
Health coaching is limited to the SISC member and his or her covered spouse/domestic partner.
Under the Blue Cross ConditionCare program, covered dependent children can participate in the pediatric asthma and pediatric diabetes programs.
Blue Shield's Health Management Programs are available to any PPO plan participant who is diagnosed with one of the conditions, regardless of age.
4. Question: If I am on an approved leave of absence, am I eligible to participate in Health Smarts?
Answer: Yes, as long as you are enrolled in a SISC PPO Plan during your leave.
Health and Wellness Assessment
1. Question: What is the health and wellness assessment?
Answer: The health and wellness assessment is an online tool that asks you a series of health-related questions. Based on your answers, it offers you a personalized assessment of your current health status and lifestyle practices. It includes a report that rates your health on a 100-point scale and compares your health status to others your age. The report also provides suggested activities to improve your health, and targeted health information.
The assessment will take between 15 and 20 minutes to complete. It is helpful - but not required - to have your most recent height and weight, waist size, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, blood pressure and blood sugar measurements available when you complete the health assessment. These measurements are typically part of an annual physical exam which is covered under most SISC PPO plans. (While most SISC PPO plans cover preventive care, be sure to check your plan's benefits before scheduling your physical.)
2. Question: Who is responsible for the health and wellness assessment?
Answer: SISC's health partners for Health Smarts are our health plan administrators, Blue Cross of California and Blue Shield of California, each of which is supported by WebMD. The health and wellness assessment is powered by WebMD, one of the pioneers in the field of online health improvement programs. WebMD worked with each of our health plan administrators to develop a health and wellness assessment tool that would meet your needs.
3. Question: When can I take the health and wellness assessment?
Answer: You can take the health and wellness assessment anytime. If you take it before May 1, 2008, and you are age 18 or over, you will be entered into a drawing for one of 30 gifts valued at up to $500 each. If you are one of the winners, you'll have your choice of a(n):
- iPod Touch, so you can work out to the music you love
- bodybugg, an armband that tracks calories in and calories burned
- $500 gift certificate for sports/fitness equipment.
To maintain the confidentiality of your information, Blue Cross and Blue Shield will each conduct a random drawing from people in their plans who completed the assessment by May 1.
4. Question: How do I access the online health and wellness assessment?
Answer: The health and wellness assessment is available through SISC's web site, www.sisc.kern.org. Click the Health Smarts link on the left navigation and, from the upper right corner of the Health Smarts page, click the button for your plan's assessment: Either:
- Blue Cross Health Assessment or
- Blue Shield Wellness Assessment.
If it's your first visit to the Blue Cross or Blue Shield site, you'll be asked to register. Registering is easy and quick - just be sure to have your medical plan ID card with you because you'll be asked for your ID number.
If you have already registered, just log into the site using your user name and password and click on the health and wellness assessment link.
The first time you take the health and wellness assessment, WebMD will ask you to accept the terms and conditions of the site and complete a profile indicating areas of interest. Once you have completed this, you will be ready to take the assessment.
5. Question: What if I get my "numbers" after I complete the health and wellness assessment?
Answer: No problem. If you want to see whether your assessment results are different when you enter your "numbers", just go to www.sisc.kern.org, click Health Smarts, and on the upper right corner of the Health Smarts page, click the button for your plan's assessment.
When you reach the health and wellness assessment, fill in your numbers in the spaces provided and click submit. On the next page of the assessment, if you don't want to change any of your answers, just click submit: You don't have to complete the rest of the assessment a second time. The system will take you to the results page where you will see a new report.
6. Question: What are my "numbers"?
Answer: Your "numbers" are measurements that provide one indicator of your health status. They include your:
- Height
- Weight (without clothes, pre-pregnancy)
- Waist measurement
- Normal resting pulse rate
- Percent of body fat
- Blood sugar level
- Total cholesterol
- LDL (bad) cholesterol
- HDL (good) cholesterol
- Triglyceride levels
- Blood pressure reading - systolic (upper number) and diastolic (lower number).
If you know your "numbers" when you complete the health and wellness assessment, the results will be more meaningful. However, you can take the assessment even if you don't know your "numbers."
Online Health Resources
1. Question: What are Health Smarts' online health resources?
Answer: Your first stop for online health resources is the SISC website at www.sisc.kern.org. From there, click on Health Smarts for an overview of all the programs, information and tools available to you through Health Smarts. If you want details, just click on your health plan administrator's name or logo (Blue Cross or Blue Shield).
On your plan administrator's website, you will find a library of health-related information. In addition, your health and wellness assessment report will contain links to information and programs that might help you reduce any risks revealed by your answers to the assessment questionnaire. The links will be to information and programs offered through either your health plan administrator or WebMD.
2. Question: I completed the Blue Cross Health Assessment and the report suggested I visit a Lifestyle Center. What's that?
Answer: Lifestyle Centers are online tools and programs that Blue Cross offers to SISC PPO plan participants through WebMD. Lifestyle Centers are targeted to specific risk factors, such as weight, fitness, stress, cholesterol, etc., that are revealed by a member's health and wellness assessment results.
3. Question: I completed the Blue Shield Wellness Assessment and the report suggested some Health Programs and Information Centers. What are they?
Answer: Health Programs are online tools and programs with 10-12 phases that Blue Shield offers SISC PPO plans who have specific risk factors, such as weight, fitness, stress, cholesterol, etc. that are revealed by their health and wellness assessment results. Health Programs are powered by WebMD.
Information Centers are online resources and tools addressing specific health topics that Blue Shield makes available to SISC PPO plan participants; Information Centers do not offer guided programs.
Health Coaching
1. Question: Who is eligible to receive health coaching?
Answer: Based on your health and wellness assessment results, you may be eligible for a follow-up health coaching program—paid for by Health Smarts. If your health and wellness assessment shows elevated risk in areas such as blood pressure, cholesterol or tobacco use, your health plan administrator will mail you information about the health coaching program and will follow up with a phone call inviting you to participate. Blue Cross PPO plan participants will also receive an email about health coaching.
Please note that if you are a dependent child under age 18 or you are in the Companioncare Medicare supplement through Blue Cross, health coaching is not available to you.
2. Question: How will I know if I am recommended for health coaching?
Answer: After you take the health and wellness assessment, if you are eligible for health coaching your health plan administrator will mail you information about one or more health coaching programs and will follow up with a phone call inviting you to participate. Blue Cross PPO participants will also receive an email about health coaching options.
If you're a Blue Cross PPO plan participant and want to get started before your mailed invitation arrives, you may call 1-800-670-4316, Option 3, and speak to a health coach about enrolling. Please be sure to take your health and wellness assessment before you call so your results will be available to the health coach. It may take some time for your assessment results to be available to a health coach.
3. Question: How much will it cost me to participate in a health coaching program?
Answer: You do not have to pay anything to participate in health coaching programs. They are all paid by Health Smarts.
4. Question: What qualifies someone to be a health coach?
Answer: The program's health coaches have degrees in a range of health-related areas, including health education, nutrition, exercise physiology, mental health counseling, and diabetes management. Typically, they are Certified Health Education Specialists or have similar certification in their specialty (e.g., Certified Exercise Physiologist, Registered Dietitian, etc.)
5. Question: What is the Health Smarts health coaching program?
Answer: The Health Smarts health coaching programs are designed to support individuals with certain health risks in making positive lifestyle changes that can manage, reduce or eliminate those risks.
If your health and wellness assessment indicates that you would benefit, your health plan administrator will mail you an invitation to participate in a health coaching program designed to help you in areas such as:
- Managing your blood pressure
- Controlling cholesterol
- Staying physically active
- Quitting smoking
- Managing stress
- Managing your weight.
If you don't respond, your health plan administrator will follow up by phone and/or email to determine if you want to participate.
If you enroll, you and your health coach will set up a regular telephone call to check in. Blue Cross also offers the option of connecting with your coach through email or on the health coaching web site.
When you and your health coach connect, your coach will listen to your concerns, give you specific suggestions for improving your health and suggest other health improvement programs, if they are appropriate. Your coach will help inspire and reinforce positive behavior change and, by focusing on positive actions, will enable you to reduce or eliminate your health risks.
6. Question: Do I have to participate in a health coaching program if it is recommended?
Answer: You are under no obligation to participate in a health coaching program; it is completely voluntary. However, since it is confidential, supportive and offered at no cost to you, you want to be sure to really consider the opportunity if you are invited to participate.
7. Question: If I don't receive an invitation, can I participate in a health coaching program anyway?
Answer: If you are in a Blue Cross PPO as a SISC member or a covered spouse or domestic partner, you may elect to participate in a health coaching program even if your health and wellness assessment does not indicate a risk. (Please note that health coaching is not available to anyone covered under the Blue Cross CompanionCare Medicare supplement.)
Blue Shield limits health coaching to plan participants whose health and wellness assessment results indicate a specific risk that would benefit from health coaching.
To find out more about health coaching programs, go to www.sisc.kern.org, and click on Health Smarts. On the Health Smarts page, click on "Health Improvement" for general information. If you want specifics about what your health plan administrator offers, click on the link to your administrator's web site.
8. Question: Can my spouse and children participate in health coaching?
Answer: Your spouse or domestic partner can participate in health coaching, as long as he or she is covered under a SISC PPO medical plan. Blue Cross PPO participants can choose to participate in a health coaching program even if their health and wellness assessment results do not indicate a risk. Blue Shield limits health coaching to plan participants whose health and wellness assessment results indicate a specific risk that would benefit from health coaching.
There is one exception: Health coaching is not available to anyone covered under the Blue Cross CompanionCare Medicare supplement.
At this time dependent children under age 18 are not eligible to participate in health coaching.
Condition Management
1. Question: What is condition management?
Answer: SISC introduced condition management in the fall of 2007. It helps people with specific conditions manage the condition and stay as healthy as possible.
Although the name of the program will vary depending on your plan administrator (ConditionCare for Blue Cross; Health Management Program for Blue Shield), the program works in essentially the same manner for both. Condition management nurses who are knowledgeable about the condition will work over the telephone with PPO plan participants who are living with asthma, diabetes, heart failure (HF), coronary artery disease (CAD), or chronic pulmonary obstructive disease (COPD).
This voluntary, confidential program extends - but does not replace - your relationship with your doctor. It is offered at no additional cost to PPO plan participants who are diagnosed with any of the above conditions.
2. Question: What's the difference between health coaching and condition management?
Answer: Health coaching is offered to those whose health and wellness assessment results show that they are at risk of developing certain health conditions. Health coaching is designed to help those individuals make changes that will reduce or eliminate their health risks.
Condition management is offered to those who have been diagnosed with asthma, diabetes, heart failure (HF), coronary artery disease (CAD), or chronic obstructive pulmonary disease (COPD). Our condition management programs pair these individuals with a nurse who is knowledgeable about the condition and who will work with them over the phone to help them fully understand their condition and stay as healthy as possible regardless of their health status.
3. Question: I was recently diagnosed with diabetes. How will I know if I'm eligible for condition management?
Answer: Your medical claims will alert your health plan administrator (Blue Cross or Blue Shield) of your condition. Shortly afterward, a representative from your health plan administrator will call to invite you to participate in the condition management program for diabetes. If you choose to participate, you will be given a number to call to set up an initial telephone meeting with a nurse who is knowledgeable about diabetes.
4. Question: How much will it cost me to be in the condition management program?
Answer: Nothing. The cost of the condition management program is paid by Health Smarts.
5. Question: What will happen to my medical coverage if I don't participate in condition management?
Answer: Nothing. Participation in condition management is completely voluntary. Condition management can be a valuable addition to the care your doctor already provides; and many doctors are pleased when their patients participate in supplemental care programs like this. So, if you're invited to participate, we ask that you seriously consider it. However, you are never under any obligation to participate.
6. Question: Can my spouse and children participate in the condition management program?
Answer: If your spouse or domestic partner is covered under a SISC PPO medical plan and has been diagnosed with asthma, diabetes, heart failure (HF), coronary artery disease (CAD), or chronic obstructive pulmonary disease (COPD), he or she can participate in condition management.
If you're a Blue Cross PPO plan participant, your covered dependent children can participate in the pediatric asthma and pediatric diabetes programs.
7. Question: Will my doctor be involved with my condition management program?
Answer: The condition management nurse will notify your doctor about your participation in the condition management program. Condition management nurses don't replace your doctor; they will work with your doctor to develop your individual goals. The condition management nurse may ask your doctor to complete a questionnaire to help ensure they are aware of your doctor's treatment plan for you.
Health and Wellness Assessment Reports
1. Question: When will I get my health and wellness assessment report and what will it contain?
Answer: Within seconds of taking the online health and wellness assessment, you will receive an online report that highlights health issues you can modify and provides links to information and resources that can help reduce your health risks. The report also assesses your health on a 100-point scale and compares your health status to that of your peers. You can print this information to take to your next doctor visit. This action plan doesn't replace your relationship with your doctor, but it gives you some things to think about, explore, and act upon.
2. Question: What will SISC, my district and my school site do with the data?
Answer: No one at SISC, your school district or your school site will ever see your data. We realize that the security of your personal health information is of great concern to you and SISC takes it very seriously. Your personal health information is protected by law. SISC does not receive individual participant data. We only receive aggregate reports, which help us to determine how to improve the program in the future.
No one at SISC, your school district or your school site will ever see your health and wellness assessment results or any other personal health information because all program components are offered by third-party vendors—not SISC.
3. Question: Can I get a copy of the report for my doctor?
Answer: Yes. You can print your health and wellness assessment report from the site and take it with you to your next doctor visit.
Confidentiality and Consent
1. Question: How is my data protected?
Answer: We realize that the security of your personal health information is of great concern to you and SISC takes it very seriusly. Your personal health information is protected by law. Any personal health information collected on the site is governed by WebMD's HIPAA privacy policy.
Through your user name and password, you will be the only one with access to your personal health information. If the results of your health and wellness assessment reveal an opportunity for you to improve your health, that information may be shared with Blue Cross or Blue Shield health coaches or condition management nurses. However, any personal health information you provide within the site will not be shared with SISC, your school district or your school site. SISC only receives aggregate data to help determine how to improve the Health Smarts program in the future.
No one at SISC will ever see your health and wellness assessment results or any other personal health information, because third-party vendors offer all program components—not SISC.