OPEN ENROLLMENT
Effective 1/1/2015
Highlights
Please review ALL documents in this packet.
All open enrollment forms (white – waiver or orange – enrollment) are due
to the Office of Human Resources by December 1, 2014.
The following list highlights items to consider as you complete the forms:
1) Monthly premium changes
Effective 1/1/2015 the monthly premium rates will have increased when compared to the 2014 premium
rates. Please be sure to review each plan carefully before selecting your plan for the upcoming 2015
coverage year to take these increases into account.
2) Affordable Care Act (ACA)
Please note that ONU meets the minimum value standard for benefit plan coverage and the cost of
coverage to you is intended to be affordable, based on employee wage. The Marketplace can help you
evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost.
Please visit HealthCare.gov for more information.
3) Flexible Spending Account (FSA)
If you wish to elect flexible spending in 2015, you MUST submit a new Anthem flexible spending form each
year, an FSA enrollment form is included in this packet.
4) Health Savings Account (HSA)
Contributing to a HSA is for participants of Plan B only. If you wish to continue or start a contribution to a
HSA, as an enrollee on Plan B, please complete the HSA form included in this packet.
5) Healthy Campus Program
Please log onto the HR Moodle course, Healthy Campus Program, https://lms.onu.edu, for an updated look
at your total healthy campus points. If you have not reached the 40 point goal to receive your 2015
discount, please join us at the upcoming health screenings for an opportunity to receive points. Information
regarding the health screenings and possible healthy campus points to be earned are included in this packet.
Coverage Waiver
WAIVING COVERAGE: By providing my signature below, I hereby acknowledge that I was offered the
opportunity to elect and participate in my employer’s healthcare plan and have decided not to enroll myself, or
dependents, for such coverage.
Employee Signature: __________________________________________ Date: _____________________
ANTHEM
SDC
OFFICE OF HUMAN RESOURCES ONLY:
BANNER
MEDICAL
DENTAL
PAYROLL
LEHR MEMORIAL BUILDING • PHONE: (419) 772-2013 • FAX: (419) 772-3510 • www.onu.edu/hr • [email protected]
OHIO NORTHERN UNIVERSITY HEALTH BENEFITS
Premium Information
Eligibility for Benefits
Coverage, if elected, becomes effective the first day of
employment and terminates contingent with University
policy. Employees choosing not to enroll in this plan at the
time of initial employment are requested to sign a waiver of
insurance. Employees may change or enroll in the plan at a
subsequent date as explained in the Medical Insurance
Summary Plan Description (SPD) located on the Office of
Human Resources website, benefits page.
The total monthly premium to be paid by the employee is listed below and is
based on plan choice and salary at January 1, 2015. This salary amount will
be based on actual annual contracted hours, not including overtime or
summer pay. Premium adjustments may be made in the case of a
professional move within the employees current position.
The 2015 Healthy Campus Program launch will be announced in the
upcoming weeks. Information regarding this program will be sent from
the Office of Human Resources soon.
Dependent coverage shall be made available for spouse and
children up to 26 years of age, pursuant to the terms of the
SPD.
Open enrollment for health insurance begins in October of each year
for coverage effective January 1 of the following year.
2015 Anthem Blue Access Medical and Rx Plans
2015 ONU Plan Options
Deductible
(includes deductible)
Plan B
Non-network
Network
Non-network
Network
Non-network
Single:
$400.00
$500.00
$500.00
$750.00
$1,250.00
$1,500.00
Family:
$800.00
$1,000.00
$1,000.00
$1,500.00
$2,500.00
$3,000.00
90%
60%
80%
50%
90%
60%
Single:
$2,000.00
$4,000.00
$2,500.00
$5,000.00
$3,250.00
$6,500.00
Family:
$4,000.00
$8,000.00
$5,000.00
$10,000
$6,500.00
$13,000.00
$20.00
Ded. & Coins.
$25.00
Ded. & Coins.
Deductible & Coinsurance
$100.00 copay (waived if admitted)
Deductible & Coinsurance
Office visit copays:
Emergency room visit:
Wellness:
Core Plan
Network
Then paid at:
Max out of pocket
Plan A
$100.00 copay (waived if admitted)
100%, unlimited benefit deductible & copays waived
Rx Drug Card Plan
Maximum Out of Pocket
$1,200 Single, $2,400 family
Prescriptions:
Retail: 10% Generic/30% Formulary/40% Non-Formulary Mail
Order: 5% Generic/%25 Formulary/35% Non-Formulary
Mandatory Generic Drugs Provision
Pretax savings plans:
Flexible Spending Account available
with a $2,500 per year maximum contribution for health care and
$5,000 maximum for dependent day care per year
100%, unlimited Benefit
Deductible & Copays waived
Prescriptions accumulate to the
medical deductible & coinsurance
Member pays 100% of discounted
cost of Rx at pharmacy. Submitted
claims are applied to deductible and
reimbursed at 75% after deductible
is satisfied
*100% Preventative tier included
Flexible Spending Account (FSA)
available with $2,500 healthcare
(limited access)/$5,000 dependent care
maximum per year
Health Savings Account (HSA)
available $3,350 single/ $6,650
family maximum annual
contribution
NOTE: All plans include Anthem Vision Plan and Superior Dental Preventative Plan
Office of Human Resources
Lehr Memorial Building • Phone: (419) 772-2013 • Fax: (419) 772-3510 • www.onu.edu/hr • [email protected]
2015 Employee Medical/Rx/Vision & Preventative Dental Monthly Contribution Rates
Salary Range
Employee annual
salary or wage is
≤ $35,000
Employee annual
salary or wage is
$35,001 - $90,000
Employee annual
salary or wage is
$90,001+
Coverage Level
Plan A
Core Plan
Plan B
Employee Only
$99.00
$80.00
$36.00
Employee + Spouse/Partner
$354.00
$282.00
$128.00
Employee + 1 Child
$294.00
$234.00
$106.00
Employee + Family
$580.00
$461.00
$209.00
Dual Employee Family
$343.00
$275.25
$124.25
*Healthy Campus monthly discount
$15.00
$15.00
$15.00
Employee Only
$137.00
$110.00
$46.00
Employee + Spouse/Partner
$491.00
$392.00
$160.00
Employee + 1 Child
$407.00
$324.00
$131.00
Employee + Family
$804.00
$641.00
$261.00
Dual Employee Family
$475.00
$380.25
$157.25
*Healthy Campus monthly discount
$20.00
$20.00
$20.00
Employee Only
$200.00
$160.00
$83.00
Employee + Spouse/Partner
$712.00
$568.00
$291.00
Employee + 1 Child
$590.00
$469.00
$239.00
Employee + Family
$1,166.00
$930.00
$448.00
Dual Employee Family
$691.50
$552.50
$278.00
*Healthy Campus monthly discount
$25.00
$25.00
$25.00
Anthem Blue View Vision Plan
Type of Service
In-Network
Out-of-Network
Routine eye exam
Eyeglass frames (once every 12 months)
Eyeglass lenses (standard, one pair every 12 months)
• Standard plastic single vision lenses
• Standard plastic bifocal lenses
• Standard plastic trifocal lenses
• Standard plastic lenticular lenses
Contact lenses (once every 12 months)
• Elective conventional lenses
• Elective disposable lenses
• Non-elective contact lenses
$10.00 copay, then covered in full
$130.00 allowance, then 20% off remaining
$35.00 allowance
$45.00 allowance
$25.00 copay, then covered in full
$25.00 copay, then covered in full
$25.00 copay, then covered in full
$25.00 copay, then covered in full
$25.00 allowance
$40.00 allowance
$55.00 allowance
$80.00 allowance
$130.00 allowance, then 15% off remaining
$130.00 allowance, no additional discount
Covered in full
$105.00 allowance
$105.00 allowance
$210.00 allowance
Superior Dental Plan Coverage Options and Monthly Rates
Coverage Level & Benefit
Preventative care inclusions: 2 oral exams & 2 cleanings per year, fluoride,
bitewing x-rays, intraoral periapical x-rays, & minor emergency treatment
Basic care inclusions: Some oral surgery, endodontics, restoratives, space
maintainers, & repair of crowns, bridges, & partials
Major care inclusions: Periodontics/surgical periodontics, oral surgeries,
sealants, prosthodontics, crowns & onlays
Maximum payment per member per year (including preventative care)
RATES:
Employee Only
Employee + 1 Dependent
Employee + multiple dependents (Family)
Basic Plan
(Preventative)
Buy-up Plan
(Enhanced)
100%
100%
50%
90%
0%
50%
$750.00
With Med
Dental Only
Included
$15.60
Included
$32.67
Included
$46.98
$1000.00
With Med
Dental Only
$22.25
$37.85
$46.83
$79.50
$66.60
$113.58
[Empl full name], [DOB], [A #], [class]
OPEN ENROLLMENT - EFFECTIVE 1/1/2015
Each employee MUST complete the form below and return it
to the Office of Human Resources by December 1, 2014, unless waiving coverage.
The annual open enrollment period for Ohio Northern University allows eligible employees to enroll, add, or remove eligible family members to, and/or
change your current healthcare selections.
BUY-UP
DENTAL
BASIC
DENTAL
PLAN B
(High Deduct.)
HEALTHCARE
CORE
PLAN
PLAN A
Please check mark the coverage in which you would like to enroll.
EMPLOYEE ONLY
EMPLOYEE + SPOUSE/PARTNER
EMPLOYEE + CHILD
EMPLOYEE + FAMILY
VOLUNTARY
(employee pays 100% of cost)
*The Office of Human Resources will contact you directly if a
voluntary benefit is selected.
AFLAC
LONG TERM CARE (LTC)
LIFE INSURANCE
FLEXIBLE SPENDING ACCOUNT (FSA)
DEPENDENT INFORMATION:
Child
Partner
Dependent’s Full Name
Spouse
Please list all dependents who will be covered under your ONU healthcare plans
Date of Birth
Social Security #
Check mark coverage
desired for dependents
Medical
Dental
ADDITIONAL INFORMATION
HEALTH SAVINGS ACCOUNT (HSA): Contributing to a HSA is for participants of Plan B only. If you wish to continue or start a contribution to a
HSA, please complete the attached HSA form.
FLEXIBLE SPENDING ACCOUNT (FSA): If you wish to elect flexible spending in 2015, you MUST submit a new Anthem flexible spending form each
year (enclosed).
COVERAGE ELECTED: I hereby apply for group coverage for which I am or may become eligible under the above group programs, except those
waived as indicated above. I authorize deductions, if any, from my compensation for my share of the cost of coverages to which I am entitled and
have elected. I understand that I must meet the eligibility requirements of the Plan and that completion of this form does not guarantee coverage
under the Plan. I affirm that the information contained herein is correct and true.
Employee Signature: __________________________________________ Date: _____________________
ANTHEM
SDC
OFFICE OF HUMAN RESOURCES ONLY:
BANNER
MEDICAL
DENTAL
PAYROLL
FSA Reimbursement Account
Enrollment Form
Complete this form and return it to your human resources representative
Employee Information
Employer
Name
Employee Name
Account Number
/
Street Address
SSN
Daytime Phone
City
State
Date of Birth
Number
Zip
Date of Hire
Code
Gender (M or F)
Do you want to know if Anthem Blue Cross and Blue Shield received and processed your claim? Please provide your e-mail address:
E-mail Address
Section 125 Elections
Health Care Flexible Spending Account (contact your administrator for the maximum allowed contribution)
I elect to participate $
I elect to waive coverage
per pay period x
remaining pay periods = $
Plan Year Total
remaining pay periods = $
Plan Year Total
Dependent Care Flexible Spending Account
Annual maximum allowable is:
•
$5,000 for married filing jointly or single
•
$2,500 if married filing separately
I elect to participate $
I elect to waive coverage
per pay period x
Employee Certification
•
•
•
•
•
•
•
I understand I may elect coverage under any or all of the above components;
I understand completion of this form does not guarantee insurance coverage will be initiated and, in most cases, an application for
insurance must also be completed;
I understand the terms of eligibility of this plan do not override the terms of eligibility of each of the available benefit plan options;
I understand my election is irrevocable for the plan year unless I have a change in status or other qualified even as a defined in the IRS
Regulations, and the requested change is on account of and consistent with the event;
I understand any unused contributions will be forfeited to my employer at the end of the plan year;
I understand participation in this plan reduces my Social Security withholdings and could reduce my Social Security benefits;
I certify I have read and agree to the terms of participation.
Employee Signature
Date
For Employer Use Only
Company Name
Division
Effective Date
Pay Cycle
Entered in Payroll
Initial
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross and Blue
Shield of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30
counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer nonHMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite
benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia
(serving Virginia excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.): Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin
("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare
and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association. ® ANTHEM is a registered trademark. The Blue Cross and Blue
Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
TO BE
COMPLETED BY
PLAN B
PARTICIPANTS
ONLY
BANK NAME
MM/DD/YY
If this is a new account or any banking information has been changed,
please attach a voided check or letter from your banking institution.
Return this form to the Office of Human Resources.
PreventiveRx Drug List:
Expanded Plan
SM
PreventiveRx covers drugs that help keep you healthy because they prevent illness and other
health conditions. You can get the products on this list at low or no cost to you.
This list includes only prescription products. Brand-name drugs are listed with a first capital letter. Non-brand drugs (generics)
are in lowercase letters.
Brand-name drugs that have a generic equivalent available are not covered under this Preventive Rx benefit.
Not all drugs on this list may be covered by your plan. Some drugs, such as those used for cosmetic purposes, may be
excluded from your benefits. Please refer to your Certificate or Evidence of Coverage for coverage limitations and exclusions.
Birth control
All generic versions are
included:
Beyaz
Generess-FE
Lomedia 24 FE
medroxyprogesterone
150mg/ml
Minastrin 24 Fe
Natazia
Nuvaring
Quartette
Skyla
Blood clots
Brilinta
Coumadin
Eliquis
enoxaparin
fondaparinux
Fragmin
heparin
Innohep
Pradaxa
warfarin
Xarelto
Bowel prep (laxatives)
Colyte
Golytely
Halflytely
Moviprep
OCL
Osmoprep
peg 3350/electrolytes
Prepopik
Suclear
Suprep
Trilyte
Visicol
Breast cancer
anastrozole
13017ANMENABS Rev. 8/14
exemestane
Fareston
letrozole
tamoxifen citrate
Diabetes
Diabetic supplies,
including blood sugar
meters, test strips and
lancets require a
prescription to be
covered by this plan.
acarbose
ActoPlusMet XR
Apidra
Avandamet
Avandaryl
Avandia
Bydureon
Byetta
chlorpropamide
Cycloset
Farxiga
glimepiride
glipizide
glipizide er/xl
glipizide with metformin
hcl
Glumetza
glyburide
glyburide with
metformin hcl
glyburide, micronized
Glyset
Humalog
Humulin
Invokana
Janumet
Janumet XR
Januvia
Jardiance
Jentadueto
Juvisync
Kazano
Kombiglyze XR
Korlym
Lantus
Levemir
metformin hcl
metformin hcl er
nateglinide
Nesina
Novolin
Novolog
Onglyza
Oseni
pioglitazone
pioglitazone-glimepiride
pioglitazone-metformin
Prandimet
repaglinide
Riomet
Symlin
Tanzeum
tolazamide
tolbutamide
Tradjenta
Victoza
Flu
Relenza
Tamiflu
Gout
allopurinol
Colcrys
probenecid
probenecid/colchicine
Uloric
Heart health and high
blood pressure
acebutolol hcl
acetazolamide
afeditab cr
Aldactazide 50-50mg
amiloride hcl
amiloride/hctz
amlodipine besylate
amlodipine/benazepril
Amturnide
atenolol
atenolol/chlorthalidone
Avalide 300/25mg
Azor
benazepril hcl
benazepril hcl/hctz
Benicar
Benicar HCT
betaxolol hcl
Bidil
bisoprolol fumarate
bisoprolol fumarate/
hctz
bumetanide
Bystolic
candesartan
candesartan/hctz
captopril
captopril/hctz
Cardene SR
Cardizem LA 120mg
cartia xt
carvedilol
chlorothiazide
chlorthalidone
clonidine hcl
Clorpres
Coreg CR
Covera-HS
digoxin
Dilatrate SR
dilt-cd
diltiazem hcl
diltiazem hcl er
Diuril
doxazosin mesylate
Dutoprol
Dynacirc CR
Dyrenium
Edarbi
Edarbyclor
Edecrin
enalapril maleate
enalapril/hctz
Epaned
eplerenone
eprosartan
Exforge
Exforge HCT
felodipine er
fosinopril sodium
fosinopril/hctz
furosemide
guanabenz acetate
guanfacine hcl
Hemangeol
hydralazine hcl
hydralazine/hctz
hydrochlorothiazide
indapamide
Inderal XL
Innopran XL
irbesartan
irbesartan/hctz
Isordil 40mg
isosorbide dinitrate
isosorbide dinitrate er
isosorbide mononitrate
isosorbide mononitrate
er
isradipine
labetalol hcl
Lanoxin
levatol
lisinopril
lisinopril/hctz
losartan
losartan/hctz
Matzim LA
PreventiveRx Drug List:
Expanded Plan
SM
methazolamide
methyclothiazide
methyldopa
methyldopa/hctz
metolazone
metoprolol succinate er
metoprolol tartrate
metoprolol/hctz
minoxidil
moexipril hcl
moexipril/hctz
nadolol
nadolol/
bendroflumethiazide
Nexiclon XR
nicardipine hcl
nifedipine
nifedipine er
nimodipine
nisoldipine
Nitro-Bid
Nitro-Dur 0.3, 0.8mg/hr
nitroglycerin
Nitroglycerin 400mcg
Spray
nitroglycerin er
Nitroglycerin Lingual
nitroglycerin spray
Nitrostat
Nymalize
perindopril
pindolol
prazosin hcl
propranolol hcl
propranolol hcl er
propranolol/hctz
quinapril hcl
quinapril/hctz
ramipril
Ranexa
sotalol hcl
sotalol hcl af
spironolactone
spironolactone/hctz
Tarka
Taztia XT
Tekamlo
Tekturna
Tekturna HCT
telmisartan
telmisartan/amlodipine
telmisartan/hctz
13017ANMENABS Rev. 8/14
terazosin hcl
Teveten 400mg
Teveten HCT
thalitone
timolol maleate
torsemide
trandolapril
triamterene/hctz
Tribenzor
valsartan
valsartan/hctz
Vecamyl
verapamil hcl
verapamil hcl er
High cholesterol
Advicor
Altoprev
Antara 30, 90mg
atorvastatin
atorvastatin/amlodipine
cholestyramine
cholestyramine light
colestipol hcl
Crestor
fenofibrate
fenofibric acid, dr
Fenoglide
fluvastatin
gemfibrozil
Lescol XL
Lipofen
Liptruzet
Livalo
lovastatin
niacin ER
Niacor
omega-3 ethyl ester 1
gram capsule
pravastatin
Prevalite
Simcor
simvastatin
Triglide
Vascepa
Vytorin
Welchol
Zetia
Malaria
atovaquone/proguanil
chloroquine
Daraprim
hydroxychloroquine
mefloquine hcl
primaquine
quinine sulfate capsule
Nausea, vomiting
Aloxi
Antivert 50mg
Anzemet
Cesamet
chlorpromazine hcl
Diclegis
dimenhydrinate
dronabinol
Emend
granisetron hcl
ondansetron hcl
ondansetron odt
prochlorperazine
promethazine hcl
Scopace
Transderm-Scop
trimethobenzamide hcl
Zuplenz
Osteoporosis
alendronate sodium
Alora
Angeliq
Atelvia
Binosto
Cenestin
Climara Pro
Combipatch
Duavee
Enjuvia
est. estrogens with
methyltestosterone
Estraderm
estradiol
estradiol/norethindrone
acetate
estropipate
FemHRT 0.5mg/2.5mcg
Femtrace
Forteo
fortical
Fosamax Plus D
ibandronate
medroxyprogesterone
acetate
Menest
Menostar
Miacalcin
Minivelle
Ogen
Prefest
Premarin tablets
Premphase
Prempro
Prolia
raloxifene
risedronate
Vivelle-Dot
zoledronic acid (generic
Reclast)
RSV (respiratory
syncytial virus)
Synagis
Stopping smoking
bupropion hcl sr
(generic Zyban only)
Chantix
Nicotrol inhaler
Nicotrol NS
Stroke
Aggrenox
cilostazol
clopidogrel bisulfate
dipyridamole
Effient
ticlopidine hcl
Zontivity
Vaccines
All brand and generic
versions are included.
Vitamins
All generic versions are
included:
Prenatal vitamins (taken
during pregnancy)
Prescription
multivitamins with
fluoride
Prescription
multivitamins with
fluoride and iron
Weight loss
benzphetamine hcl
diethylpropion hcl
diethylpropion hcl er
phendimetrazine
phentermine hcl
Qsymia
Regimex
Suprenza ODT
Xenical
FALL 2014 HEALTH SCREENING INFORMATION
What is the ONU Annual
Health Screening Program?
The Health Screening program is being held in
collaboration with Ohio Northern University and
Lima Memorial Health System Laboratories. This
program is designed to provide important
laboratory data to you and your physician at no
cost.
Are these tests important to me?
Early detection and treatment/control of chronic
diseases is one of the best ways to prolong your
life and to increase your quality of life.
Who may participate?
The University is offering voluntary health
screenings for ALL campus employees, retirees
and their spouses (including Sodexo, Barnes and
Noble, and The Inn) regardless of whether the
employee is enrolled in our health insurance plan
at no cost.
*Children are not eligible to participate.
IMPORTANT
All medical information and blood test
results are confidential and will be
provided to you and your personal
physician (it is no longer necessary to
provide an envelope).
The screenings require a 12-hour period of
fasting. Please do not eat for 12 hours
prior to testing with the exception of water
and black coffee.
ONU Annual Health
Screenings:
Saturday, October 25th
6:30-9:30am
Activities Room, McIntosh Center
Wednesday, October 29th
6:30-9:30am
Activities Room, McIntosh Center
To ensure good health, participation is not
enough. To fully understand your results, please
contact your physician or a HealthWise clinician
for review. HealthWise will be available the day
of the screening to schedule appointments. The
review will be held on campus and will be free of
charge.
Getting Healthy and Giving Back:
Once again, screenings will be
performed by Lima Memorial
Health System Laboratories
through a non-profit program. Lima Memorial
will be donating $1 for every screening to the
West Central Ohio Medical Laboratory Science
Program which is an ONU degreed program
within the Department of Biology.
Preregistration information:
Please follow the link below and enter your name,
gender, and the date you plan to attend the
screening. You will then “submit” your basic
information and print the downloadable form.
www.onuhealthfair.squarespace.com
What test will be performed?
General health screening panel, including CMP,
CBC, lipid panel, hepatic panel, renal panel,
thyroid screening, diabetes screening and
prostate screening (for men age 40 and over)
If you wish to participate in IFBOT (Immunofecal
Occult Blood Test), specimen sample containers
will be given upon request only. Please contact
the Office of Human Resources to participant in
the IFBOT testing by phone at 419-772-2013 or at
[email protected]. Your request for the testing kit will
be processed and available for pick-up at the
Office of Human Resources. The office is open on
Monday through Friday from 8:00 a.m. – 5:00
p.m.
No urine tests will be performed this year.
Flu Shots
Flu shots will be available, free of
charge, to all participants of the health
screening.
Remember your Healthy
Campus Points
The annual health screening is an
excellent opportunity to earn healthy
campus points to reach the annual
goal of 40 points during 2014.
** EARN POINTS AT THE ANNUAL HEALTH SCREENING **
Please reference the table below to see potential healthy campus points
you can still earn at the annual health screening this year to receive your 2015 discount!
2014 ONU Healthy Campus
Incentive Activities and Goals 2014 -- 40 Points
Point Opportunity
Healthy Blood Result Points (available once per calendar year)
Full blood draw with follow-up wellness visit (either through ONU screenings in the Fall or with your
Points
to be earned
Note: Blood draw must occur
during the 2014 calendar year
5 points
physician)
Healthy cholesterol level (as determined by physician/clinician based on current practice guidelines)
5 points
Blood sugar levels via A1C in acceptable range (as determined by physician/clinician based on current
5 points
practice guidelines and course of treatment)
Healthy blood pressure (as determined by physician/clinician based on current practice guidelines and course of
5 points
treatment)
Healthy Weight Points Opportunities
Initial weigh-in through HealthWise screening session
3 points
Healthy weight (as determined by final HealthWise weigh-in or your physician)
7 points
Healthy Status and Preventative Points
Non-smoker status affidavit signed
2 points
Receive a flu shot
2 points
Total Potential Points to be Earned at the 2014 Health Screening
34 points
2015 ONU Healthy Campus Program
The 2015 Healthy Campus Program launch will be announced in the
upcoming weeks. Information regarding this program will be sent from the
Office of Human Resources soon.