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Broomfield Healthy Rewards

Get the Certification Form!

The Broomfield Healthy Rewards Program is a new initiative for 2012!

The purpose of the Broomfield Healthy Rewards program is to reward employees and spouses (on the Medical Care Expense Plan) for knowing their health numbers.  This program will provide a discount on your health insurance premiums if you meet the requirements.  In order to qualify for the discounted family rate, your spouse must participate if he/she is on the plan.  If your spouse chooses not to participate, you will not receive any benefit.

Type of Coverage Regular 2012 Monthly Rate Broomfield Healthy Reward Monthly Savings Broomfield Healthy Reward 2012 Monthly Rate
Single $30 $10 $20
Family $270 $20 $250

How it Works

You have two ways to qualify for this benefit.  You must meet 5 out of the 6 requirements, and be TOBACCO FREE.

  1. BMI under 30, or Body Fat % in the healthy range (see charts below)

  2. Fasting Blood Glucose <100

  3. Triglycerides <150

  4. Cholesterol Ratio <4.98

  5. LDL Cholesterol <100

  6. Blood Pressure <120/80

OR if you do not meet 5 out of the 6 above requirements, you can take your biometric data and the Certification Form to your doctor.  Your doctor will then complete Option II on the form, certifying the items listed below:

  1. he/she has discussed these health factors with you

  2. you and your doctor have discussed steps that can be taken to bring these factors into acceptable ranges and

  3. you are tobacco free or your doctor feels you are unable to stop using tobacco products and he/she has made a recommendation for an alternative method of achieving tobacco cessation usage. 

How do I let HR know I qualified?

Once you have determined which way you will qualify for this benefit, check out the two ways you can notify the Wellness Coordinator to make it effective.  Please note that the deadline for qualification for 2012 is November 30th, 2011 at 5 pm.

  1. Bring your health information and Certification Form to the Wellness Coordinator in Human Resources for certification.  HR will NOT keep a copy of your health information on file.  HR will only keep the Certification Form. 

  2. Take your health information and Certification Form to your doctor for verification and completion. Then bring form to Wellness Coordinator in Human Resources. HR will NOT keep a copy of your health information on file.  HR will only keep the Certification Form. 

Please note that on both options you must sign the back of the form, agreeing to the following:

I certify that 1) I am tobacco free and I must be tobacco free for the duration of this program unless my doctor has certified that I am unable to stop using tobacco products and he/she has made a recommendation for an alternative method of achieving tobacco cessation usage, 2) I provided my health care provider or Wellness Coordinator with a copy of my biometric data from the past 12 months for verification, and 3) that all information contained within this form is factual and true to the best of my knowledge.  If I am an employee, I also understand that falsification of any information on this form is a violation of the Personnel Merit System, and I may be subject to corrective or disciplinary action.  Further, I understand that any falsification may also result in disqualification from the premium reward program.


Body Fat Guidelines:

BMI Chart: