Achieve Frequently Asked QuestionsProgram
What do I need to do to qualify for the money-saving Enhanced plan?
Both you and your covered spouse (if applicable) will have to complete these three easy steps by the end of your qualification period*:
- Have your personal care physician (PCP) complete the Member Qualification Form (MQF)
- Demonstrate your commitment to good health with a score of at least 85 on your MQF; and we can help you meet your goals
- Log in at hap.org and complete the Health Risk Assessment
What are the differences between the Enhanced and Standard plans?
Both the Enhanced plan and Standard plan provide you and your covered dependents access to the same quality care and doctors.
The Enhanced plan has lower copays and out-of-pocket costs. You and your covered spouse (if applicable) must qualify for the Enhanced plan by meeting the program requirements before the end of your qualification period. The Standard plan has higher copays and out-of-pocket costs.
What if my spouse does not want to work toward health goals?
Both enrolled adults on your HAP contract must meet the program requirements to qualify for the Enhanced plan. If you and your covered spouse (if applicable) meet the program requirements, everyone covered on the contract, including dependent children, will be eligible for the Enhanced plan.
If you are already in the Enhanced plan, you will remain in the Enhanced plan as long as you meet the program requirements. If you and/or your covered spouse do not meet the program requirements, everyone on the contract will be transferred to the Standard plan after the qualification period ends.
If you are currently in the Standard plan and meet the program requirements, you will be moved to the Enhanced plan after the qualification period ends.MQF and Qualification Period
When can I turn in my Member Qualification Form (MQF)?
If you are a current Health Engagement member, HAP will accept your MQF up to three months before your qualification period begins. For example, if you are a returning member and your HAP contract is effective January 1, you may turn in your MQF beginning October 1. If you are joining the program for the first time, you must wait until your qualification period begins. All members must turn in their MQF by the end of the 90-day qualification period.
When can I access the Health Risk Assessment (HRA)?
You can access the HRA anytime within your qualification period. If you are a returning Health Engagement member, you can access the HRA early (up to three months before your qualification period begins).
How often can I see my doctor for preventive care, such as a meeting to complete the MQF?
HAP will cover those preventive services that are recommended once a calendar year (January 1 through December 31), without any cost-sharing to you. If your HAP health plan has cost-sharing, such as a copay or coinsurance, you may have to pay out-of-pocket if you receive preventive services more often than once in a calendar year.
I recently went to my doctor for a physical. Do I have to go back to get the MQF filled out?
Please contact your personal care physician’s (PCP) office to determine if there is enough information on file for the doctor to complete your MQF without the need for a return visit. Your recent physical must be within nine months of your plan’s qualification period start date.
What happens if I complete the HRA and I visit my PCP by the end of my group's qualification period, but my PCP does not submit the MQF before the deadline?
It is your responsibility to ensure your PCP completes and submits the MQF to HAP. If preferred, during your visit you can ask your PCP for a copy of the completed MQF and submit it according to the instructions on the form.
Can I get an extension if I am unable to schedule an appointment with my PCP in the first 90 days of the qualification period?
No. Both the HRA and the MQF are due before the end of the qualification period. If you have any difficulty in getting an appointment with your PCP, call HAP Customer Service at (888) 819-2540 for assistance.
Should I keep a copy of my MQF?
Yes. Please keep a copy of your MQF for your records. It is your responsibility to ensure that your doctor completes the form and that it’s returned to HAP within the 90-day qualification period.
Can I print a MQF?
Yes. After you register and log in at hap.org, select Health Engagement from the My Plan tab to print a personalized form.
How can I find the HRA on hap.org?
After you register and log in at hap.org, click on Health Risk Assessment in the Quick Links section.
How will I know if my HRA and MQF are complete?
To view the status of your HRA and MQF, register and login at hap.org using your HAP ID number and password. Then select Health Engagement from the My Plan tab.
How much will I save by qualifying for the Enhanced plan?
The Enhanced plan has lower copays and a lower deductible, if applicable. To find the Enhanced and Standard plan copays and deductibles for your plan, contact your employer's Human Resources department or HAP Customer Service at (888) 819-2540.
Why did I get moved to the Standard plan?
Any member who did not meet the program requirements to remain in the Enhanced plan after the 90-day qualification period is moved to the Standard plan. You will have an opportunity to re-qualify for the Enhanced plan next year during the 90-day qualification period.
If I am in the Standard plan this year, will I remain in the Standard plan for the first 90 days of the next year?
Yes. For the first 90 days, your copays and deductible will be at the Standard plan level. If you qualify for the Enhanced plan during the 90-day qualification period, your benefits will be transferred to the Enhanced Plan after the end of the qualification period.
If I follow all program rules and adopt a healthy lifestyle, do I need to complete the same requirements again at my group's renewal?
Yes. In order to qualify for the Enhanced plan you and/or your covered spouse (if applicable) must complete the program requirements every year.
If either my covered spouse or I do not currently meet one or more of the Lifestyle Behavior targets, will we automatically have higher copays or be exempt from the program?
No. As long as you and your covered spouse score a minimum of 85 points on your MQF, you can qualify for the Enhanced plan. Your score will be based on target requirements for your specific level.
If there are circumstances that make it difficult for you to complete any of the steps for the Enhanced plan requirements, please call Customer Service at (888) 819-2540. We’ll work with you confidentially to find the best solution for your situation. Please also see the Notice of Reasonable Alternative in the back of your Member Kit.
If either my covered spouse or I do not meet the criteria for BMI, or lose five percent of our body weight, will I lose those points on the MQF?
No. As long as you/your spouse commit to another option such as a weight management program, you will receive those points on your MQF.
What if my covered spouse or I have dual medical coverage (more than one type of coverage)? Can we still receive the Enhanced plan?
Yes. You and your covered spouse (if applicable) will need to visit a HAP-affiliated doctor and complete all the steps to qualify for the Enhanced plan.
Will COBRA participants have to qualify for the Enhanced level?
Yes. COBRA participants will have the same requirements for qualifying.
What if I leave the plan for a portion of the plan year (due to a lay-off for example) and decide to come back? Can I be reinstated?
Members who are reinstated within 180 days (six months) or less from the date their coverage lapsed will be placed into their former benefit plan. If the lapse is more than 180 days (six months), members will automatically be placed into the Enhanced plan for the remainder of the benefit year.
To stay in the Enhanced plan, you and your covered spouse (if applicable) will need to complete the needed steps at your next qualification period.
What if I have Medicare, do I have to meet the Health Engagement program requirements?
If you are actively working and you and/or your covered spouse have Medicare, you both need to meet the Health Engagement program requirements to stay in the Enhanced plan.
If you are retired and age 65 or older, and you or your covered spouse has Medicare, the person with Medicare does not have to meet the program requirements. However, the non-Medicare member does need to meet the Health Engagement program requirements.
If you are retired and under age 65, or have a non-Medicare spouse, both of you must meet the Health Engagement program requirements to stay in the Enhanced plan.
What happens if I add my spouse to my health plan after the group's effective date? Does he/she have to meet the same 90-day requirements?
No. Any spouse added to your plan after the group's effective date will be placed in the same benefit plan as the contract holder.
What information will be shared with my employer?
Your privacy is important to us. No information from your HRA or MQF will be shared with your employer. HAP's commitment to members includes ensuring the confidentiality of your personal and medical information by adhering to strict internal and external safeguards.
*“Covered spouse” would also include “same sex domestic partner” if your health plan has such benefits.