January 1, 2017 December 1, 2017 Wellness Program. Guide. Wellness Coordinator: Miranda Mitchell

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1 January 1, 2017 December 1, 2017 Wellness Guide Wellness Coordinator: Miranda Mitchell

2 Welcome to your 2017 Wellness! Koss Construction employees and spouses enrolled in the medical plan will have opportunities to participate in various wellness activities that can reward you with a premium reduction in details are outlined throughout this guide. Welcome Overview Complete steps 1-3 listed below to be eligible for an incentive. Details on each step are listed on page (3). STEP 1 - Complete an Annual Preventative Exam STEP 2 - Complete the Know Your Number Assessment STEP 3 - Meet 3 out of 5 Healthy Ranges OR complete one (1) wellness activity Wellness Portal Your Wellworks For You account has already been generated for employees and spouses enrolled in the medical plan. Please follow the steps below to login to your Wellworks For You account. PLEASE NOTE: If you have a hyphenated last name, do NOT include the hyphen in your username. In accordance with HIPAA confidentiality laws, your individual data is accessible only to you and the third party vendor, Wellworks For You. Employee Login: 1. Go to 2. Your login username will be: Koss, first letter of first name, up to first 4 letters of last name followed by Koss employee ID 3. Your temporary login password will be: Date of Birth in YYYYMMDD format For Example: Team Member Name: Kelly Smith Koss Employee ID: 100 Date of Birth: 10/15/1975 Username: Kossksmit100 Password: Spouse Login: 1. Go to 2. Your login username will be: Koss, first letter of first name, up to first 4 letters of last name followed by year of birth 3. Your temporary login password will be: Date of Birth in YYYYMMDD format For Example: Team Member Name: Kelly Smith Date of Birth: 10/15/1975 Username: Kossksmit1975 Password: Update your Profile information to receive communications via and text message If you would like to receive text message reminders/communications about the Wellness, please login to your Wellness Portal, select My Profile>Profile and select the Communication Settings option at the bottom of the Profile page and enter your information. Please note: Spouses will need to enter their personal address to the profile section. Upon logging in for the first time, please review the pre-populated profile information. To ensure accurate communication, spouses must enter their personal address. 2 P a g e

3 Employees and covered spouses must complete steps 1, 2, and 3 by December 1, 2017 to earn a monthly premium discount in Requirements STEP 1 ANNUAL PREVENTATIVE SCREENING You must complete one (1) of the following options by December 1, 2017: Participate in the offsite screening program through Quest Diagnostics. Lab work completed through Quest will be sent directly to Wellworks For You. Employees can begin scheduling their appointments with Quest after February 9, For instructions on how to schedule an appointment, locate the Quest Registration Instructions under My Profile>Wellness Toolbox. Requirements Visit your Primary Care Physician and submit the Physician Results form by December 1, The form is located on the Wellness Portal under My Profile>Wellness Toolbox. Screenings must be completed between January 1, 2017 and December 1, Please note: The results of your annual preventative screening will determine your healthy ranges and possible completion of Step 3. Please be sure Step 1 is completed as soon as possible to allow ample time to complete the Step 3 activities, if applicable. STEP 2 KNOW YOUR NUMBER ASSESSMENT Complete the health questionnaire located on the Wellness Portal under My Health Assessments>Know Your Number Assessment. Answer all questions except those in the Health Metrics section and click Save. Health Metrics (weight, height, glucose, etc.) will be added by Wellworks after you submit the Physician Results form or complete the Quest program. If you complete the questionnaire after your Health Metrics have been uploaded, click Finish to submit your responses. STEP 3 HEALTHY RANGES OR ADDITIONAL ACTIVITIES Meet 3 out of 5 Healthy Ranges (see details below) OR complete one (1) of the following wellness activities: HEALTHY RANGES HDL Cholesterol Blood Pressure Waist Circumference/Prenatal Visit Forms Fasting Glucose Triglycerides Men: greater than or equal to 40 mg/dl Women: greater than or equal to 50 mg/dl Systolic: less than or equal to 120 mmhg Diastolic: less than or equal to 80 mmhg Men: less than or equal to 40 inches Women: less than or equal to 35 inches Less than or equal to 126 mg/dl Less than or equal to 150 mg/dl WELLNESS ACTIVITIES Three (3) Health Coaching calls with a Wellworks For You Health Coach - Each session must be at least one week apart. To schedule an evening or weekend session, employees must call during regular business hours, Monday-Friday, 8:00 AM-6:00 PM EST, to schedule their appointment. You can reach a coach by calling Your first call must be scheduled by 8/18/17. Three (3) Community Events - Community Events include a walking, running, swimming, or bicycling event with a minimum distance of 5K. Submit proof of participation such as confirmation , receipt, registration information, race bib, final results, etc. to Miranda at m.mitchell@wellworksforyou.com or fax to by 12/1/17. Nutrition Learning Series - Complete the six week Learning Series on the Wellness Portal under the Learning tab, including the Pre and Post-Module Surveys and all six (6) modules. This is a six week series. If you do not pass a quiz, you must wait 24 hours before retaking it. You must begin the series by 10/13/17 to complete the series by the program deadline. Complete two (2) Preventative Exams - Preventative Exams include dental, vision, dermatology, ob/gyn, mammogram, prostate or colonoscopy. Print the Proof of Visit form located under My Profile>Wellness Toolbox and bring it with you to your visit. Submit completed forms to Miranda at m.mitchell@wellworksforyou.com or by 12/1/17. 3 P a g e

4 Incentives Earn a $30 Premium Reduction in 2018 Employees and spouses enrolled in the medical plan who complete the Wellness requirements are each eligible to receive a $30 monthly premium reduction, up to $60 total. Incentive and Additional Information Avoid $30 Tobacco Surcharge in 2017 (up to $60 with spouse) Employees and spouses who submit the Tobacco Attestation form and certify as non-tobacco users, OR those who complete a Tobacco Cessation, will avoid a $30 Tobacco Surcharge. See below for more details. EMPLOYEES HIRED BEFORE JANUARY 1, 2017: If you certify that you are a tobacco user, you must complete the Tobacco Cessation. You may complete one of the following options to avoid the surcharge in 2018: National Quit Hotline ( ). Completion certificate must be submitted to HR. Wellworks For You Smoking Cessation Learning Series located under the Learning tab on the Wellness Portal. This is a six week series. EMPLOYEES HIRED AFTER JANUARY 1, 2017: If you certify that you are a tobacco user, you must complete one of the following options within 90 days of becoming enrolled in the medical plan, to avoid the surcharge in 2018: National Quit Hotline ( ). Completion certificate must be submitted to HR. Wellworks For You Smoking Cessation Learning Series located under the Learning tab on the Wellness Portal. This is a six week series. Additional Information FORGOT YOUR PASSWORD? Go to Select the Forgot Password link, enter your address to initiate the password reset process or contact to have a temporary password set VIEW DETAILS FOR ALL PROGRAMS, EVENTS, AND ACTIVITIES Events are listed on your personal Wellness Portal ( under My Profile>s and Events. To view extended details about each program, select Click Here for Details next to the event title. VIEW AND DOWNLOAD DOCUMENTS FOR COMPLETION All required forms are located on the Wellness Portal under My Profile>Wellness Toolbox. Participants can download and print all PDF forms for completion. VIEW YOUR PARTICIPATION CREDIT Wondering what you ve completed so far? Log into your Wellness Portal ( and go to My Profile>ResultsNow. Please allow at least 2 weeks for participation to be updated in the Wellness Portal after completing an activity. If there are any questions about your participation or completion, please contact Miranda Mitchell at m.mitchell@wellworksforyou.com. FITBIT TECHNOLOGY Our Wellness Portal is compatible with all Fitbit pedometers. As a wellness partner, Koss Construction employees and spouses are eligible to receive a discount on the purchase of Fitbit pedometers. Print the Pedometer Order Form located in your Wellness Toolbox to order your Fitbit today. 4 P a g e

5 Wellness The Fine Print Koss Construction offers a voluntary wellness program available to all employees and spouses enrolled in the medical plan. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete a voluntary health risk assessment, the Know Your Number Assessment (KYN), which asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). You will also be asked to complete an annual physical screening, which will include a blood test for a full cholesterol panel (total cholesterol, high density lipoprotein, calculated low density lipoprotein, triglycerides). This will also include body measurements, such as height, weight, and waist circumference. You are not required to complete the HRA or to participate in the blood test or other medical examinations. However, employees who choose to participate in the wellness program will receive a premium discount for completing the Annual Preventative Screening, the Know Your Number Health Assessment (KYN), and meeting 3 out of 5 Healthy Ranges or completing one (1) wellness activity. Although you are not required to complete the Know Your Number Assessment (KYN) or Annual Preventative Screening, only employees and spouses who complete all listed requirements of the Wellness will receive the incentive. If you are unable to participate in any of the health-related activities or achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by contacting Wellworks For You at The information from your Know Your Number Assessment (KYN) and the results from your annual physical screening will be used to provide you with information to help you understand your current health and potential risks, and may also be used to offer you services through the wellness program, such as Health Coaching, online Learning Series, and Wellness Challenges. You also are encouraged to share your results or concerns with your own doctor. PROTECTIONS FROM DISCLOSURE OF MEDICAL INFORMATION We are required by law to maintain the privacy and security of your personally identifiable health information. Although the Wellworks For You Wellness and Koss Construction may use aggregate information it collects to design a program based on identified health risks in the workplace, Wellworks For You will never disclose any of your personal information either publicly or to the employer, except as necessary, to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment. Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements. The only individual(s) who will receive your personally identifiable health information are the Wellworks For You team and Health Coaches in order to provide you with services under the wellness program. In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately. You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate. If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact Wellworks For You at P a g e