Wellness Premium Incentive (WPI)

The Wellness Premium Incentive (WPI) Program is designed to encourage ongoing health awareness and a relationship with your medical provider. Through this ongoing incentive, employees and/or spouses who undergo an annual physical/wellness exam will be eligible for the wellness premium rate (lower premium). The annual exam is to be completed by September 30 of each year. This program is a voluntary offering.

If you or your spouse are enrolled in a St. Johns County medical plan at the time you undergo the qualifying exam, a form does not need to be submitted by you or your doctor.
If you or your spouse are not enrolled in a St. Johns County medical plan at the time you undergo the qualifying exam, you should request the Wellness Premium Incentive Verification Form from your benefits department. Forms should be returned to the contact listed at the bottom.

There are no specific tests that are required to earn the credit. Your physician should determine which tests to administer based on your age, gender, and physical condition. While physicals and wellness exams often include such things as a blood pressure check, cholesterol test, glucose test, and/or a height and weight checks, no specific tests are required.

All employees and dependent spouses enrolled in the St. Johns County medical plan are eligible to participate and receive the incentive.

If you are enrolled in the St. Johns County medical plan at the time you complete the exam and your provider codes the exam with a routine/preventive primary code there should be no cost to you. If your provider includes one or more diagnostic codes when filing the claim to FloridaBlue, you may be assessed a charge for the exam. Please reach out to your provider with any further questions about codes.

The Wellness Premium Incentive Program reporting period will begin October 1 of the prior year and end on September 30 of the current year. Completion of your exam during this time period will provide a premium credit for the upcoming benefit year; e.g., program opens on 10/1/2021 and ends on 9/30/2022 for a credit during the 2023 plan year.

The wellness exam routine code needs to appear as the primary code on the insurance claim in order for the office visit to be covered at 100%. This is both for purposes of processing the claim as a preventive service (with no charge assessed to the member) and to earn the premium credit for the following plan year.

Privacy is understandably a great concern for many of us. As part of the Wellness Premium Incentive Program, FloridaBlue will only report individual completion status (as indicated by yes/no) back to System Benefits Administration to be used for assigning the lowest premium rate. No individual medical information such as test results, doctor information, diagnosis, etc. will be provided.

Participants who complete their wellness exam in September will not be reflected in the Plan Source portal due to the reporting lag. Once the program has ended on September 30, all participants who have completed their wellness exam within the program dates will be uploaded and reflected correctly in the system at that time.

Questions can be directed to The Bailey Group at StJohnsWell@mbaileygroup.com. Employees should also feel free to reach out to their benefits department with any questions.