Q. What is the Culture of Health Program?
A. Culture of Health is a set of programs and resources to support the overall health of our workforce. The Culture of Health tools and resources include a Health Portal, Personal Health Assessment, and Lifestyle Health Coaching Program. These programs are available to all employees and family members (age 18 and older) eligible to enroll in the ExxonMobil Medical Plan.
Additional Culture of Health programs are available to participants in the EMMP POS II "A" or "B", as well as EMMP Cigna Open Access Plus – In Network, or EMMP Aetna Select options, and they are designed to help you improve your health and to assist you in obtaining good health care when care is needed. These programs reflect a commitment by you and the company to good health and quality care. The Culture of Health tools and resources include a 24 Hour Nurse Line, Health Advocates, Health Management Program, Cancer Management Program, and Centers of Excellence.
The tools and resources offered through Culture of Health are available to you free of charge. However, health care claims (e.g., doctor's fees or facilities charges) are processed according to the Plan provisions discussed earlier. See the sections How to file claims, Covered expenses, and Exclusions.
The Health Portal is an Internet Web gateway to reliable health care information written, reviewed, and approved by Healthyroads®. This Internet site is filled with useful health and health care information, including the following:
- Exercise and Nutrition Planners
- Test and Procedures Resource – Short articles providing the latest information about tests and procedures for finding, preventing, and treating health conditions.
- Wellness Topics – Provides articles about health and prevention topics at each stage of your life.
- Tools and Videos – Easy to use tools and videos to learn more about your health and healthy lifestyle choices.
Personal health assessment
This online questionnaire, available on the Health Portal, is a quick and easy way to:
- Assess your health status;
- Learn how to maintain your health; and
- Put together a plan to address health risks.
The Healthyroads Personal Health Assessment can help identify conditions you and your doctor may need to monitor and manage. The assessment is completely confidential, and you may choose to have your results sent to a Health Advocate for review, if you participate in either EMMP POS II option.
Lifestyle health coaching
Everyone who completes the Personal Health Assessment will be eligible to enroll in the Healthyroads Lifestyle Health Coaching Program. The coaching program is personalized one-on-one support to help you make healthy behavior changes, or to help you maintain the healthy habits you already have. You can work with qualified health coaches on the telephone and use online tools and self-help materials.
24-Hour nurse line
Highly trained, licensed nurses are available by telephone at 1-800-556-1555, 24-hours a day, 7 days a week to answer routine questions about your health, or questions about a specific medical situation, condition, or concern. However, these nurses cannot diagnose medical conditions/ailments, prescribe medication or give specific medical instruction. Topics discussed during your call may include services and expenses not covered under the Plan. See Exclusions for more information.
Health Advocate Program
The Health Advocate Program provides direct support to you, your family, and your treating physician(s) in the management of specific health care needs. The Health Advocate staff consists of registered nurses, supported by a medical director. Once you begin working with a Health Advocate, the nurse will work personally with you as long as you need support.
Health Advocates will assist you to coordinate a wide array of health care-related support and educational services. As situations require, your Health Advocate will assist you with admission, counseling, inpatient advocacy, discharge planning and home counseling. The nurse will also act as your proactive partner, working directly with you to help you navigate the health care delivery system by assisting with the coordination and management of your health care needs and collaborating with others involved in your treatment.
If you or a family member is identified as having an illness or disease or if you have signs or symptoms that indicate that you are at risk for contracting a serious illness or disease and you have primary coverage under the ExxonMobil Medical Plan, the Health Advocates may contact you to provide support, information, and guidance. In addition, you may contact Aetna Member Services to reach a Health Advocate if you have any questions.
Health Management Program
If you have certain chronic illnesses and meet eligibility criteria, you may be contacted by a licensed registered nurse through the Health Management Program offered by Optum (formerly Alere) or you can contact Optum directly at 1-800-557-5519. These specially trained nurses focus on helping participants with conditions in which education, daily choices, and lifestyle decisions can have a significant effect on health and the progression of the condition. If you elect to work with your health management nurse, you will receive educational materials, assistance in managing your condition, and personal support.
Health management services are provided for the following primary disease conditions:
- Congestive heart failure
- Coronary artery disease
- Diabetes (adult and pediatric)
- Musculoskeletal and Chronic pain
- Chronic Obstructive Pulmonary Disease (COPD)
Cancer Management Program
If you are newly diagnosed with cancer, undergoing active treatment for cancer, or are experiencing a recurrence, you may be referred to a specifically trained Cancer Management nurse through your Health Advocate or Health Management nurse. Referrals will be made to Optum (formerly Alere) for support to those undergoing treatment or you can call Optum directly at 1-800-557-5519.
Centers of Excellence and Institutes of Excellence
Centers of Excellence (COE) and Institutes of Excellence (IOEs) are nationally recognized facilities for the treatment of certain conditions or the delivery of certain procedures where high-level knowledge and expertise provide better care and more likely positive outcomes.
COEs/IOEs are not available for all diseases and all conditions or procedures relevant to a disease state. For instance, at this time there are COEs/IOEs for pancreatic cancer, but there is insufficient information available to select COEs/IOEs for lung cancer. Changes to identified COEs/IOEs may occur in the future.
Participation in a COE/IOE program is voluntary, and designed to direct participants to nationally recognized facilities with more positive outcomes. A COE/IOE-recommended treatment plan, however, must meet the Medical Plan provisions for medically necessary care in order for claims to be eligible for reimbursement.
Whenever clinically appropriate, you will be referred to a local COE/IOE. If access to a clinically appropriate COE/IOE requires the patient to travel 100 or more miles, the Medical Plan will reimburse reasonable transportation costs for you and a caregiver. The Plan will also provide a per diem for you and a caregiver to cover lodging and other expenses. If you become hospitalized, only your caregiver will receive the per diem, because food and lodging are already provided as part of the hospital charge. The per diem amounts are established by the Administrator-Benefits.
If you decide not to use a COE/IOE, you will not incur additional out-of-pocket costs for choosing another hospital in the Plan's network. However, you must obtain Comprehensive Infertility Services and Advanced Reproductive Technologies at an Aetna-designated Institute of Excellence in order for the services to be covered.