Division of Insurance Division of Insurance en espanol State of Colorado DORA

Colorado Wellness Survey for Calender Year 2013 Data


Company Information
Company Name:
NAIC Code:
Address:
City:
State:
Zip Code:

Submitter Information
First Name:
Last Name:
Phone:
Email:

All questions should be answered for information as of 12-31-2013 and for wellness and prevention programs as defined in §10-16-136 C.R.S.
1. Did your company have any health benefit plans in 2013?
Yes – continue with survey
No – skip to question 5

1a. What types of health coverage plans did your company provide?
Individual
Small Group
Large Group
No Health coverage plans

1b. In which types of health coverage plans did your company offer wellness and prevention programs?
Individual
Small Group
Large Group
No wellness plans

1c. In which types of health coverage plans did policyholders/subscribers/members actually participate in wellness and prevention programs?
Individual
Small Group
Large Group
No wellness plans

2. What types of wellness and prevention programs did your company offer?
a. Health Screenings
b. Mental health and substance abuse screenings and prevention
c. Internet, telephonic, live coaching, or consultation-based wellness programs
d. Education and Training about dietary habits, including nutritional counseling
e. Online and in-person seminars or podcasts on health and wellness topics, wellness handouts, a wellness library, videos, or newsletters and a wellness intranet site
f. Wellness programs geared specifically for children, teens, or special populations
g. Stress management programs
h. Employee assistance programs for employees and their families
i. Disease Management
j. Diabetes care programs
k. Tobacco cessation programs
l. Prescription drug or carrier-approved nonprescription dietary supplement use that aids in overall health and wellness or which prevents disease
m. Patient-centered medical home programs
n. Nurse-on-call programs
o. Onsite or external health club or fitness center membership or facilities
p. Other (Please list) 

3. What incentives and/or rewards did your company provide for participation in a wellness and prevention program?
a. Premium discounts
b. Rebates
c. Modifications to co-payments
d. Modifications to deductibles
e. Modifications to coinsurance premiums
f. Product discounts or rebates
g. Other (please list) 

4. For each size category of small business group please provide the number of groups and the total covered lives in wellness and prevention programs and the total dollar value of discounts from wellness and prevention programs for calendar year 2013. For individual insurance please provide the total number of policies and the total number of covered lives in wellness and prevention programs, and the total dollar value of discounts from wellness and prevention programs for calendar year 2013.
Business Groups/ Individual Policies Covered Lives Total Dollar Value of Discounts
Small Business Groups of 1
Small Business Groups of 2-10
Small Business Groups of 11-25
Small Business Groups of 26-50
Individuals in participating programs

5. Please provide any clarifying remarks you may have relating to this survey here.



If you have any questions please contact Kelly Schultz at kelly.schultz@dora.state.co.us or 303-894-7481


Consumer Protection