Employee Wellness Forms

What are my wellness options?

• Nivati - Online wellness portal and EAP service
• PEHP MyWellness Tracker - PEHP online wellness portal
• Nutrition Logs - Submit monthly nutrition logs to HR for points.
• Exercise Logs/Gym Reimbursements - Submit monthly logs to HR for points and reimbursements.
• Preventive Screening - Submit doctor's note, receipt, or insurance explanation of benefits to HR for points.
• Coaching - Participate in a coaching program through PEHP; Blomquist Hale or Nivati
• Sheriff's Office PT - Complete and pass sheriff's office PT (Anyone can participate)
• Weight Management - Lose 10 pounds and submit to HR for points
• Hiking/Races/Events - Submit proof of participation or form to HR for points.
• Community Events - Attend county party and receive participation points.
• Wellness Reading - Submit to HR for reading health-related articles, books.

Gym Reimbursements:

Box Elder County will pay up to 100% of you gym membership or other fees related to the use of a physical fitness facility. A copy of your paid invoice or receipt along with a statement of participation should be submitted to Human Resources for processing of payment. In order for reimbursement to take place , you must have a statement from the facility showing that you attended at least 10 times for 30 minutes or more in one month. If you attend an organized  class 7 times per month (for 60 or more minutes) you will be allowed reimbursement in place of the 10 times for 30 minutes.

*** Special rule for Weight Watchers: if you choose to receive your reimbursement for the Weight Watchers program, you must provide proof of 90% attendance per 12/week session.

Preventative Procedure Reimbursement Guideline:

The county will pay $35 for any of the preventative procedures listed under "Procedures Covered" below. While at the doctor for one of these procedures, just have the doctor write a note saying that the procedure was done. You can bring a receipt or Explanation of Benefits in lieu of a doctor's note.

Procedures Covered:

• Mammogram - starting at the age 40 or referred by doctor
• Pap Smear - starting at the age 18
• Prostate Exam - starting at the age 40
• Rectal Exam - starting at the age 45
• Colon Exam - starting at the age 50 or referred by doctor
• Blood Lipid Profile - preventative only; limit 1 per year
• Cancer Screenings
• Physical Exam - Once a year
• Eye Exam

**Some procedures required a minimum age requirement or a family history of health problems that could be found early by having the proper tests conducted. To receive reimbursement, the employee must be over the minimum age or have sufficient family history that would be the cause for the exam before the minimum age. In either situation, a doctor's note is still required.

Wellness Reimbursement Program Limits:

Up to $250 can be reimbursed annually for wellness participation per employee. Reimbursements will be processed through payroll for appropriate tax requirements. Once the budget is exhausted, employee program will be put on hold until the next budget cycle.

Other qualifying reimbursements:

• Massage - You will need to turn in your receipt to HR.
• Foot zoning