PriorityWell Choice Benefits turns wellness activity into lower out-of-pocket costs, which makes it a compliance question as much as a benefit.
Priority Health added PriorityWell Choice Benefits in 2023 as an incentive option. Members earn lower out-of-pocket expenses by completing activities that match their interests and goals.
What the program is and what members do.
What Choice Benefits is
Priority Health announced PriorityWell Choice Benefits in August 2023 as an incentive program for large-group employers that purchase PriorityWell. It offers members lower out-of-pocket expenses when they complete activities based on their own interests and goals. It sits on top of the PriorityWell platform.
How members earn
Priority Health says activities and points are tracked on the Priority Health Wellbeing Hub, a digital platform managed by Virgin Pulse. Members choose activities that fit their goals rather than following one fixed list. Reaching the activity targets is what moves the out-of-pocket reduction.
Pulse Cash
Priority Health says members may also earn Pulse Cash. It can be redeemed for gift cards to retailers and restaurants, exchanged for fitness accessories or turned into a charitable donation. This is a separate reward from the lower out-of-pocket costs, so ask how the two are counted.
Eligibility, funding and plan design.
Funding types
Priority Health describes PriorityWell Choice Benefits as available for self-funded and fully funded employer groups. That is broader than some carrier incentive programs, which are limited to self-funded plans. It is still an employer purchase, and availability depends on what the group has bought.
Size
The 2023 announcement frames the program for large-group employers that purchase PriorityWell. We did not find a published minimum headcount. Confirm the size threshold with Priority Health before building employee communications around it. Ask for the current threshold and whether it is measured by enrolled employees or covered lives.
Plan design
Because the reward is lower out-of-pocket cost, the incentive touches the benefit design itself. Two employees on the same plan may pay different amounts depending on activity. That can be a strong motivator, but it needs clear rules and a fair alternative for people who cannot take part.
What to settle before relying on it.
How does the out-of-pocket reduction actually work?
Ask Priority Health for the exact mechanics: which cost-sharing amounts drop, by how much, and when the reduction starts. Ask what happens mid-year if a member stops earning points. The marketing description does not answer these questions, and employees will.
Has employment counsel reviewed the incentive?
Incentives tied to health outcomes fall under HIPAA and ACA wellness rules, and programs that collect health data can raise ADA and GINA questions. Activity-only rewards are treated differently from outcome-based ones. We would want employment counsel to review the design and the notices before launch.
Who funds the reward, and what does it cost us?
Lower member cost sharing has to be paid for somewhere. Ask whether it is built into the premium or rate, or charged to a self-funded employer through claims. Get the cost assumption in writing so you can compare it with the engagement you realistically expect.
Common questions about this program.
Is Choice Benefits the same as PriorityWell?
No. PriorityWell is the digital platform. Priority Health describes Choice Benefits as one of the incentive options available to employers that purchase PriorityWell, added in 2023.
Can a fully insured group use it?
Priority Health describes it as available to self-funded and fully funded employer groups. Whether a specific group can add it depends on what the employer has purchased, so confirm with Priority Health.
Could this support a Michigan premium rebate?
Possibly, but not automatically. Michigan law (MCL 500.3426) lets insurers offer premium rebates for employer wellness programs that show results, with a 30% cap, or 50% for tobacco cessation. Ask Priority Health whether it offers such a rebate and what evidence it would require.
Programs and vendors named on this page
Official pages for the services mentioned above. Availability, cost and eligibility vary by plan and employer group, so confirm what applies to your group with the carrier.
Personify Health (formerly Virgin Pulse)
Well-being platform and incentive administration.
Where these details come from.
This page summarizes what Priority Health publishes. Programs change, so confirm current details with the carrier before relying on them.
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