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Answers to Your Vitality and Wellness Questions

What’s Inside

2 Vitality Basics7 Fitness Devices10 Vitality Check Biometric Screening13 Healthy EMS Medical Premium Savings14 Gym Rebates15 HealthyFood Program

19 Additional Programs22 Medical Accommodations 23 Taxes on Vitality Rewards 23 Challenges24 Wellness Champions

Employer Sponsored

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General Information

What’s Vitality?Vitality is a participatory wellness program you can join as a participant of your employer's health plan benefit.

How do I sign up for Vitality?Go to www.powerofvitality.com and click First time logging in? Register Now. Follow the prompts to complete your registration. You can also get to the Vitality website from Healthy EMS @ www.healthyems.com

If you’re the spouse/domestic partner of an employee, you can register at www.powerofvitality.com. Click First time logging in? Register Now and follow the prompts to complete your registration. Be sure to enter the last four digits of the employee’s Social Security Number, not yours, when registering.

Why should I participate in Vitality?Participating in Vitality can help you maintain or improve your health and earn rewards, such as savings on your medical premiums, Amazon.com gift cards, fitness devices and rebates for your gym fees.

How does Vitality work?As a Vitality member, you earn Vitality Points™ for completing healthy activities in categories such as Prevention, Physical Activity and Online Education. Your Vitality Points determine your Vitality Status®, and your Vitality Status determines your rewards.

If your health plan election is a Single then you need to earn 2,500 Vitality Points in 2017 before you can increase your current premium savings and/or earn savings for 2018.

If your spouse/domestic partner is enrolled in your employer sponsored medical plan collectively, you and your spouse need to earn 3,500 Vitality Points in 2017 before you can increase your current premium savings for 2018.

The higher your Vitality Status, the greater your savings — as shown in the chart on p. 13.

As you earn Vitality Points in 2017, your Vitality Status increases and so do your rewards. Earn the initial 2,500 Vitality Points and then keep earning points until you reach Gold Status or higher.

The savings you earn in 2017 are yours to keep for all of 2018. If you reach Silver Status or higher by December 31, 2017, your premium savings start in January 2018.

What’s the Vitality program year?The Vitality year starts on January 1 and runs through December 31 — see p. 4 to learn more about how the program year affects your Vitality Status.

What’s my Vitality Age?Your Vitality Age™ is a reflection of your health based on your health risks and lifestyle. A Vitality Age equal to or lower than your actual age is a sign of good health. You can find your Vitality Age on the Vitality homepage after logging on.

Vitality Points

How do I earn Vitality Points?You earn points by completing healthy activities in a variety of Vitality categories — Vitality Reviews, Vitality Check, Online Education, Physical Activity, Goals, HealthyFood, Certifications, Prevention and Other Activities. Visit the Total Rewards Library to see a list of qualifying Vitality activities

How many Vitality Points can I earn per plan year?Each Vitality category has a maximum number of points available. For example, the most points you can earn in the Physical Activity category is 7,000 points. To see how many points are available per category, visit Vitality > Points > Points Planner.

Does my spouse/domestic partner earn his or her own Vitality Points?Yes. If your spouse/domestic partner is enrolled in the employer sponsored medical plan, he/she can sign up for Vitality and earn his/her own points. However, your spouse/domestic partner’s points (and the Vitality Bucks® that come with those points) are added to your Vitality account. You and your spouse/domestic partner also share your Vitality Status. Your spouse/domestic partner can’t redeem your Vitality Bucks, except to order a free Fitbit® device or buy a more expensive fitness device.

Vitality Basics

¡Usa Vitality en español!Entra a Vitality, ve hasta abajo y haz clic en Languages > Español para cambiar de idioma.

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Do my Vitality Points roll over each year?Ten percent of your Vitality Points from 2017 roll over to 2018. This yearly rollover is known as your Kick-start Bonus. Your Kick-start Bonus doesn’t count toward the initial 2,500 Vitality Points you need to unlock savings. Once you’ve earned 2,500 Vitality Points, your Kick-start Bonus can help you reach a higher Vitality Status quickly.

Points earned betwen May 1st 2017 through December 31th 2017 will drive your premium savings for ALL of 2018. So, earn as many Vitality Points as possible to unlock your 2018 savings!

Can I earn Vitality Points for gym workouts?Yes, if your gym offers either cardio or strength training equipment. Pilates, yoga, CrossFit and boot camp programs count as gym workouts.

"Check in" at your gym using the Vitality Today™ app or track your workouts with an approved fitness device. You’ll see your workout posted on the Vitality website about 24 hours after you sync your device. See P.14 to learn about earning a gym rebate.

Can I earn Vitality Points using a fitness device?Yes, as long as your device is compatible with Vitality. Simply link your fitness device to Vitality to submit your workouts automatically. Learn more about fitness devices, including how to link your device and which devices are compatible with Vitality on pp. 7-9.

Can I earn Vitality Points for a sports league or event that isn’t listed on the website?Yes, as long as the league or event meets certain requirements and you verify your participation. Learn more at Vitality > Learning Center > Guide to Vitality > Physical Activity > Sports League.

What can I submit to verify my participation in a sports league or athletic event?You can submit one of the following:

• Copy of your league schedule with your team’s nameunderlined and highlighted

• Copy of an award or certificate of league participation

• Official copy of the race results with your name underlined orhighlighted

• Copy of your race bib

• Certificate of event completion

• Proof of registration (charity events only)

How do I submit workouts or other activities I haven’t tracked with a device?You can self-report any workouts, including gym workouts, at Vitality > Your Account > Forms & Waivers > Self-Reported Workout.

Which prevention activities can I submit for points?You can submit these prevention activities for points: flu shot, dental screening, mammogram, pap smear, colorectal screening, childhood immunizations (for children under the age of 18) and vision screening.

How long does it take Vitality to update my points after I complete an activity?Your points are updated shortly after Vitality gets and verifies your activity information. For example, if you upload the the steps you tracked with your fitness device, your points are posted in about one business day. It can take up to 45 days for your points to post if Vitality needs to verify your activity or your medical carrier needs to send information.

After completing an activity, how much time do I have to submit it for points?Submit your activities as soon as possible. In general, you have up to 90 days to submit a completed activity for points. You can submit activities at Vitality > Your Account > Forms and Waivers.

Vitality Basics

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Vitality Bucks

What are Vitality Bucks?Vitality Bucks are part of your Vitality rewards. Use your Vitality Bucks on the Vitality website to buy items like iTunes® and Amazon.com gift cards, movie passes and fitness devices* from Fitbit, Polar® and Garmin®. You get one Vitality Buck for each Vitality Point you earn, and Bonus Bucks™ each time you increase your Vitality Status.

* You pay sales tax for the fitness devices you buy on the Vitality website.

Do Vitality Bucks roll over?Yes. Your unused Vitality Bucks roll over from one year to the next. You can save your bucks or spend them right away on the Vitality website. Click Rewards > Redeem your Vitality Bucks to see all you can get. You can check how many bucks you have on the Vitality homepage.

Vitality Health Review

What’s the Vitality Health Review (VHR)?The VHR is a voluntary online questionnaire that can help you assess your current health. Completing the VHR only takes 10-15 minutes and is worth 500 points. Your results are confidential, and Vitality uses them to suggest goals and activities that can help you improve your health.

When can I take the VHR?You can take the VHR whenever you like. If you take the VHR within the first 90 days of the Vitality year, you earn a bonus of 250 points.

Where do I take the VHR?Go to Vitality > Learning Center > Health Resources > Vitality Health Review. You can also take it on the Vitality Today mobile app.

Can I update my VHR answers?You can update your VHR answers as many times as you like. Updating your answers doesn’t earn you additional points beyond the original 500 points for taking the VHR. However, you may get updated goals and see changes to your Health Profile page.

To change the Key Measurements section of your VHR, you need to verify and submit your biometric screening results through Quest Diagnostics or online at Vitality > Your Account > Forms and Waivers > Vitality Check.

Vitality Status

What’s a Vitality Status?Your Vitality Status determines your level of rewards. There are four status levels: Bronze, Silver, Gold and Platinum. Your Vitality Status is based on the number of Vitality Points you earn — see the chart below.

Medical CoverageYour Vitality Status in 2017

Bronze Silver Gold Platinum

• You• You +

Child(ren)

0 pts

2,500 pts

6,000 pts

10,000pts

• You + Spouse/DomesticPartner

• You + Family

0 pts

3,500 pts

9,000 pts

15,000 pts

You can learn about saving on your employer medical premiums by speaking with your HR department.

Vitality Basics

Get a Higher Status by DECEMBER 31As you earn Vitality Points in 2017, your Vitality Status increases and so do your rewards. Earn the initial 2,500 Vitality Points to unlock your savings and then keep earning points until you reach SILVER Status or higher. The savings you earn in 2017 are yours to keep for all of 2018. If you reach Silver Status or higher by December 31, 2017, your savings start in January 2018. The activities you submit after December 31, will start as soon administratively possible, but not retroactively.

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Can I add a Vitality Status Badge to my E-mail profile?Showing off your Vitality Badge is easy and encouraged!

Vitality Basics

My Goals

How do I set a goal?Under Health Profile, select Goals. There are goals recommended by Vitality or you can choose All and find goals that interest you. Click Set, describe your goal and choose a timeframe.

What are Personalized Activities?Personalized Activities appear on the right side of your Goals page. Vitality suggests these additional activities based on your active goals. Personalized activities can help you work on specific areas of your health along with your Goals to help you achieve the best results.

Do I have to complete Personalized Activities?No. Personalized Activities are suggested by Vitality to help you improve your health. You earn full points for completing an active goal even if you don’t complete the Personalized Activity.

Can I complete Personalized Activities that aren’t tied to an active goal?Yes, but you only earn points for some Personalized Activities that are tied to a recommended or active goal.

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Vitality Basics

Eligibility

Who is eligible for Vitality?Vitality is open to all full-time, benefit eligible employees. If you aren’t enrolled in the employer sponsored medical coverage, you won’t earn medical premium savings. But you can still earn other exciting Vitality rewards, such as Vitality Bucks to spend on the Vitality Rewards page. Your spouse/domestic partner can join Vitality if he/she is enrolled in the medical plan.

What happens to my Vitality Points if my medical coverage changes in the middle of the year due to a qualifying change?

• If you add a child to your medical plan, this doesn’taffect your Vitality Status, Vitality Points or Vitality Bucks.You keep the same status.

• If you add a spouse/domestic partner to your medical plan, you keep your Vitality Points, VitalityBucks and Vitality Status. However, the number ofVitality Points you need to reach the next status level isadjusted.

• If you drop a spouse/domestic partner from your medical plan, you lose the Vitality Points he/she earned.However, you keep your Vitality Status and the VitalityBucks you both earned. Note that the number of VitalityPoints you need to reach the next status level is adjusted.

I started working part-time. Can I still be in Vitality?Yes. You can still participate in Vitality but you will be responsibilie for the cost to participate. To remain part of Vitality, you must register as an INDIVIDUAL at Healthy EMS, www.healthyems.com.

Do I get my Vitality account back if I return to full-time status?Yes. If you return to full-time status, you get your account back and you regain access to the Vitality website, your Vitality Points and your Vitality Bucks. If you get your account back during a new Vitality year, you only get 10% of the Vitality Points you had before you started working part-time.

Can I earn Vitality Points during a leave of absence? .If you’re covered under the employer medical plan during your leave, you still have access to Vitality and can earn Vitality Points. If you’re unsure of your medical plan coverage during your leave, contact the HR.

When is the last day I can use my Vitality Bucks?You can use your Vitality Bucks until the last day you work at the organization you started Vitality at. You lose all your Vitality Bucks after your last day at work.

I no longer work at the employer, but have the employer medical coverage through COBRA. Can I still participate in Vitality? Yes. If you continue medical coverage through COBRA, you can participate in Vitality. Your spouse/domestic partner is also eligible if he/she is enrolled in the employer medical plan. You no longer earn savings on your employer medical premiums and lose any Vitality Points and corresponding Vitality Bucks you have accumulated. If you’re rehired by the employer, you get your account back, but not the Vitality Bucks you lost.

Participation in Vitality is voluntary and activities are completed outside employees’ regular working hours. The program is intended to improve the well-being of employees, covered spouses/domestic partners and dependents.

What if I change employers who offer the Healthy EMS program using Vitality?It will be up to the new employer whether they opt to recognize your current Vitality Status.

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Fitness Devices

Which fitness device is right for me?

• I prefer to walk, jog or hike The best device for walking is a pedometer, such as aFitbit. You may also want to consider an app for yoursmartphone.

• I prefer to run The best device for running is the MapMyFitness mobileapp. If you run or walk at least 30 minutes and wishto get a more dynamic view of your workout, a heart ratemonitor is another device that both novice and experiencedrunners can enjoy.

• I prefer to cycle For cycling, use a GPS device, such as a Garmin Fit or themobile app MapMyFitness/MapMyRide. You may alsochoose to use a heart rate monitor.

• I prefer to swim For swimming, use either a heart rate monitor, GarminSwim or, if you’re an open-water swimmer, a GPS watch.

• I prefer to work out at home For home workouts, whether you follow instructionalDVDs, lift weights, run on a treadmill or completerigorous home projects, you may wish to purchase aheart rate monitor or Fitbit activity tracker.

What does a pedometer do?A pedometer counts your steps as you walk, jog or run. To earn Vitality Points for a verified workout using a pedometer, complete a Light, Standard or Advanced workout.

Activity Vitality Points*

Light workout 5,000–9,999 steps 5

Standard workout10,000–14,999 steps 10

Advanced workout15,000+ steps 15

* You’re awarded points for only one verified workout per day.

What distance is covered in 10,000 steps?10,000 steps is about 4-5 miles.

Helpful Hint: It takes Vitality up to 48 hours to reflect your hard work on their website. If your activities don’t show up right away on Vitality, make sure your device is properly linked. If your Points Statement shows you’re earning points for your daily activity, then your device is linked.

Mobile/Smartphone Apps

How does a mobile app track my workouts?If you use fitness apps, such as MapMyFitness, Fitbit MobileTrack, Apple Health or Vitality Today™, be sure to link your apps to Vitality to receive Vitality Points.

Mobile/smartphone apps use the Global Positioning System (GPS) in your smartphone to track your distance and pace. The app combines this information with the information you provide in your profile (such as gender, height, weight and age), and calculates the number of calories you burn. To earn Vitality Points for a verified workout using the app, complete a Light, Standard or Advanced workout. You can check your calorie count under Stats on your app.

Activity Vitality Points*

Light workoutBurn 100–199 calories in a single session 5

Standard workoutBurn 200–299 calories in a single session 10

Advanced workoutBurn 300+ calories in a single session 15

* You’re awarded points for only one verified workout per day.

How do I link my mobile app to Vitality?If you use the MapMyFitness, Fitbit MobileTrack or Vitality Today app, you need to link your account to Vitality on the Vitality website under Manage Your Links > Devices > I want to use my smartphone.

Be sure you know your Vitality username and password before trying to use the Vitality Today app for the first time. You can click Forgot username? or Forgot password? on the Vitality homepage for help getting your log in information. If you need help resetting your username or password, call Customer Support at 877.224.7117.

I don’t know my Vitality username or password How can I get a username and password?You need to create a username and password at www.powerofvitality.com as if you were a new member. If you’re registering for the first time, go to www.powerofvitality.com, click First time logging in? Register now and follow the prompts.

Fitness Devices

TIP

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How do I get the Vitality Today app?Before using the Vitality Today app for the first time, you need to be registered on the Vitality website at www.powerofvitality.com. Once you know your Vitality username and password, go to your smartphone’s app store and search for “Vitality Today.” Follow the prompts to download it to your smartphone. Then:

1. Tap on the Vitality Today app.

2. Tap Get Started.

3. Read the Disclaimer and tap Agree.

4. Enter your Vitality username and password.

5. Tap log in.

I can’t reset my Vitality username/password on the Vitality website or on the Vitality Today app. What can I do? Call the Vitality Customer Service Center at 877.224.7117 to reset your username or password. You can only get the username/password for your own Vitality account. If your spouse/domestic partner needs to get his or her username/password, he or she needs to make the call.

How do I link my Apple Watch to Vitality?You need to link your Apple Watch to Vitality Today to automatically submit your workouts for points. Follow the steps below to link your Apple Watch to Vitality.

1. Log on to Vitality Today.

2. Click More in the lower right-hand corner of thescreen, then click Apple Health.

3. Click Settings at the top of the Apple Watch screenand follow the prompts to connect.

4. After connecting, you receive a message that says,“You’re Connected. Vitality Today is now synced toApple Watch.”

How can I share data between my Apple Health app/Apple Watch and Vitality?You can share self-reported health data, such as your Vitality Health Review™ (VHR) results, between your Apple Health app/Apple Watch and Vitality by following the steps below. You don’t earn Vitality Points for self-reported health data.

1. Log on to Vitality Today.

2. Click My Health Results and follow the prompts topush the VHR data to Apple Watch.

3. Click Update Apple Watch, then Let’s do it! to pushyour data from Apple to Vitality.

4. You receive a message that says, “AppleWatch App was updated. 3 of 5 values havebeen saved successfully.”

Fitness Devices

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Fitness Device SupportContact the manufacturer if your device isn’t working right.

Fitbithelp.fitbit.com

MapMyFitness www.mapmyfitness.com

877.623.4997Garminwww.garmin.com/us/support800.800.1020

Polarwww.polar.com/support800.227.1314

Link All Your Fitness DevicesYou can link multiple fitness devices to Vitality and keep earning points when you switch between them. Any device you get from Vitality can link to Vitality during the initial setup. Simply click the special Vitality pop-up box and follow the prompts.

Fitness Devices

Heart Rate Monitors

How does a heart rate monitor work?A heart rate monitor uses two parts — a chest strap and a watch — to monitor your heart rate. The chest strap detects your heart rate and transfers that data to the watch, which displays and stores the information. To earn points for a verified workout using a heart rate monitor, complete a Light, Standard or Advanced workout.

Activity Vitality Points*

Light workout 15–29 minutes at 60% of max heart rate = 5 points

Standard workout 30–44 minutes at 60% of max heart rate = 10 points

Advanced workout 45+ minutes at 60% of max heart rate = 15 points

* You’re awarded points for only one verified workout a day.

What kind of heart rate monitor should I get?There are many heart rate monitors on the market today. Polar® and Garmin® can link directly to Vitality. If you have another brand, you may be able to import your workouts to Vitality through MapMyFitness.

How do I link my heart rate monitor to Vitality?If you have a Polar device, make sure you can transfer the data to your computer (most commonly done through the Polar Flowlink device) and upload that information to www.polarpersonaltrainer.com. Link to Vitality through the Polar website:

• Place your cursor over your name in the upper right cornerand select Partners.

• Click on Add a New Partner and select Vitality from thedropdown menu.

• Enter the last four digits of your Social Security Number,your Vitality ID number, and check the box to accept thedata share. This last step is very important. Your data isonly transmitted from the date of your registration forward.

If you have a Garmin device, link your account to Vitality on the Vitality website under Manage Your Links > Devices > I have a device > Garmin.

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Vitality Check Biometric Screening

What’s the Vitality Check biometric screening? The Vitality Check biometric screening is a health assessment that uses physical measurements and blood tests to determine your Body Mass Index (BMI), blood glucose, blood pressure, cholesterol level and cotinine level.

Am I eligible for a Vitality Check biometric screening?If you can enroll in a employer medical plan, you can get a Vitality Check biometric screening at no cost to you once a year. Your spouse/domestic partner needs to be enrolled in your employer medical plan so he or she can get a no-cost screening.

How do I schedule a biometric screening?Log on to Vitality and under the Health Profile tab, click Vitality Check. Then, go to Quick Links > Schedule your Vitality Check with Quest.

Do I have to take the biometric screening?No. The biometric screening, like all wellness activities, is voluntary.

How does the biometric screening affect my Vitality Status?If your biometric screening results are in the healthy range, you could earn enough Vitality Points to move directly to a higher Vitality Status. This is because the biometric screening is worth 500 points once a year, and you can earn up to an additional 3,525 points once a year for in-range results. You get your points when Vitality receives your results.

Biometric Screening

Healthy Range

Vitality Points Earned (once a year)

Per screening

Per in-range

result

Body Mass Index (BMI)

< 25 & > 18.5or waist

circumference:Men < 40”

Women < 35”

125 1,000

Blood Glucose < 100 mg/dL 125 600

Blood Pressure < 120 mmHg systolic &

< 80 mmHg diastolic

125 600

Total Cholestrol or LDL

< 200 mg/dL < 130 mg/dL 125 600

Cotinine Test < 10 ng/mL 0 725

Total Points 500 3,525

How do I get my biometric screening results?You can get your results online three to four days after your screening at My.QuestForHealth.com. You get a profile explaining your results in the mail 10-14 business days later. Your profile includes a medical summary page for you to share with your doctor. Your results also appear on the Vitality website under Health Profile > Health Results about two to four weeks after your screening.

How does Vitality use my biometric screening results?Vitality uses your biometric screening and VHR results to suggest personalized wellness goals and adjust your Vitality Age. Find your goals at Vitality > Health Profile > Goals.

Can I dispute my biometric screening test results?If you don’t agree with your screening results, you can retest (employer doesn’t pay for retesting). Discuss the results with your doctor to determine if a retest is right for you.

Recently Hired?You may be able to earn Vitality Points by submitting proof that you completed a biometric screening within six months of your most recent hire date.

Vitality Check Biometric Screening

TIPAsk your doctor to code the biometric screening as preventive care to avoid out-of-pocket costs.

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How can I contact Quest Diagnostics?Call 855.623.9355 — 7 a.m. - 8:30 p.m. Central time, M-F and 7:30 a.m. - 4 p.m. Saturday. You can also visit My.QuestForHealth.com.

Are screening results confidential?Yes. We respect the privacy of your personal health information. Quest Diagnostics handles every aspect of biometric screenings, including linking your information to Vitality. Quest Diagnostics provides Vitality with an anonymous summary of screening results for all participants. The summary doesn’t identify any individuals. (Although you can choose to share your results with your spouse/domestic partner, you don’t have direct access to each other’s screening information.)

Are my screening results shared with my empoyer? No. employer only sees combined data for purposes of healthcare operations, such as quality assessment and improvement activities. Any individually identifiable health information, maintained or transmitted by Quest Diagnostics and Vitality, is protected health information (PHI) under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended. PHI isn’t shared with your employer unless you provide a signed release form.

How do I prepare for my screening?• Continue to take all of your medications.

• It’s important to fast — don’t eat or drink anything butwater — for 9-12 hours before the screening. If you have amedical condition that prevents you from fasting (e.g.,diabetes), talk with your doctor about how to prepare.

I’m pregnant. Will I still be able to take the biometric screening?As always, follow your doctor’s advice. If biometric screenings are already part of your regular care, you may find it’s easiest to submit your results using the Vitality Check Form. You can download the form from the Vitality website — Your Account > Forms and Waivers > Vitality Check. Be sure to update your medical history in the VHR to reflect that you’re pregnant or submit the Prenatal Care Verification form (Vitality > Your Account > Forms and Waivers > Waivers and Accommodations). Vitality can adjust your goals as needed with this information.

Vitality Check Biometric Screening

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My Health Results

What does it mean if my results are in range?In-range results are good indicators that you’re taking the right steps to stay healthy. Keep practicing better health by getting regular checkups, staying active and participating in our wellness programs.

What does it mean if one or more of my results are out of range? Out-of-range results may be a sign of potential health risks. We encourage you to discuss your results with your doctor. He/she can answer your questions and use your results to suggest ways to maintain or improve your health.

Reasonable Alternative Standards

Why should I complete a Reasonable Alternative Standard?When you receive an out-of-range result, Vitality automatically provides you with an alternative goal, or Reasonable Alternative Standard, designed to help you get closer to the in-range result. And, by completing the Reasonable Alternative Standard, you can earn the same number of points awarded for the in-range result.

What’s an example of a Reasonable Alternative Standard?For example, if you have an out-of-range result for cotinine, you can participate in the Living Smoke Free program through Vitality. To start the program, simply set an eight-week Quit Smoking goal at Vitality > Health Profile > Goals.

Where can I find my Reasonable Alternative Standards?Find your specific Reasonable Alternative Standards at Vitality > Health Profile > Goals. Activate and complete these goals to take steps toward a healthy level.

What happens if I can’t meet a Reasonable Alternative Standard?If you can’t meet a Reasonable Alternative Standard, you may qualify to earn the same reward by different means with your doctor’s approval. To see if you qualify, talk to your doctor and submit a completed Biometrics Physician Waiver to Vitality. The waiver requires you to submit a letter from your doctor stating that you can’t meet the alternative in-range standard. Find additional details at Vitality > Your Account > Forms and Waivers.

Vitality Check Biometric Screening

Medical AccommodationsIf you’re unable to meet any Vitality outcome-based standard, Vitality automatically offers you ways to earn the same reward by different means, regardless of any medical condition and without your doctor’s approval. If you think you’re unable to meet an activity-only Vitality standard, see p. 22 for more information.

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Save on Employer Medical PremiumsHow are my medical premiums affected by my Vitality Status?You need to reach Silver Status before you and your spouse can increase your current savings and/or earn savings starting in 2018

As you earn Vitality Points, your Vitality Status increases and so do your savings. Take action to earn the achieve Silver Status and then keep earning points until you reach Gold Status or higher. The higher your status, the more money you'll save off your medical premiums.

How much can I save on employer medical premiums?The amount you save depends on your Vitality Status (see table below).

Do my premium savings carry over to the following year?Yes. The savings you earn in 2017 carry over to 2018. If you’re a returning Vitality member, the savings you earned in 2016 are yours for all of 2017.

Employer Medical Premium Savings

Get a Higher Status by November 30Reach the highest Vitality Status you can by November 30 to ensure your medical premiums savings for next year start on January 1. The savings you earn by reaching a higher status after November 30 will start as soon administratively possible, but not retroactively.

Can I use my Kick-start Bonus to unlock my Employer medical premium savings?No. You need to earn 1,000 Vitality Points each year apart from your Kick-start Bonus to work toward increasing your 2017 savings and earn savings for 2018.

How do I know if I’ve completed the requirements I need to earn a higher Vitality Status?You can track your Vitality Status at Vitality > Rewards > Employer Incentive Plan.

How do I reach a higher Vitality Status and earn savings?You can reach a higher Vitality Status by earning Vitality Points. Find ways to earn points at Vitality > Points > Points Planner.

Employee Only or Employee + Children

Vitality Status Points Needed

Bronze 0 pts

Silver 2,500 pts

Gold 6,000 pts

Platinum 10,000 pts

Employee + Spouse/Domestic Partner or Family

Vitality Status Points Needed*

Bronze 0 pts

Silver 3,500 pts

Gold 9,000 pts

Platinum 15,000 pts

Vitality Points

Premium Savings/payroll period

See savings examples at www.healthyems.com > Medical Plans & Programs > How to Save on Medical Premiums.

How are my medical premiums affected if I don't participate? For employees and spouses who do not sign up or remain at the Bronze level through December 31th, starting on January 1 of 2018, your cost sharing will increase based on the plan and coverage tier you elected. (see table below).

A "+" indicates added payroll withholdingA "-" indicates a reduction in payroll withholding

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General

How do I earn a Gym Rebate?

1. Join a qualifying* gym if you haven’t already.

2. Complete at least 48 Standard or Advanced workoutsby December 31, 2017 (see chart on p. 7).

To get credit for a workout, either:

• Check in at your gym using the Gym Visits button onthe Vitality Today app.

or

• Wear a Vitality-approved fitness device and complete aStandard or Advanced workout.

You receive 10 Vitality Points for workouts you complete at the gym using the Vitality Today app. Or, if you prefer to use a fitness device, you can receive 10 Vitality Points for each Standard workout or 15 Vitality Points for each Advanced workout you complete at the gym.

If you use a fitness device to complete your gym workout, it needs to capture data equal to a Standard or Advanced workout at the gym, or continue to capture data equal to a Standard or Advanced workout throughout the day.

Before you workout, see if your fitness device is approved at Vitality > Learning Center > Guide to Vitality > Fitness Devices.

3. Request your rebate on the Forms and Waivers pageafter you’ve completed at least 48 Standard orAdvanced workouts.

4. Get your once-a-year rebate of up to $275.

* A qualifying gym is one that offers cardio and weight-training equipment or isa Vitality-approved, non-standard athletic facility, e.g., a yoga or Pilates studio,martial arts studio, boot camp (when it’s a program and not a gym) or CrossFitestablishment.

What if I don’t have a gym contract?If you don’t have a copy of your signed gym contact, Vitality will accept other forms of proof of payment. You can also submit a letter from your gym stating the amount you pay in membership fees, the type of membership you have and how long you’ve been a member.

Are there any other options for reporting a gym workout if I don’t want to use a fitness device or Vitality Today app to check in at my gym?Yes. You can submit a gym workout to qualify for Vitality Points. You need to complete your workout at a gym offering cardio or strength training equipment, such as a Pilates or yoga studio, CrossFit or boot camp program. You need to include a printout from your gym or program verifying your attendance. You have 90 days to submit your workout after you complete it. For more details go to Vitality > Your Account > Forms & Waivers > Gym Workout.

Is my spouse/domestic partner eligible for a rebate?Yes, if you both meet the workout requirements.

Are my children eligible for a rebate?No.

When can I request my rebate?You can request your rebate as soon as you complete 48 Standard or Advanced workouts. It’s a good idea to wait until you pay at least $275 in gym fees. If you pay less than $275 a year, wait until the end of the year to get the most savings. You have 90 days from December 31, 2017 to request your rebate for 2017 gym fees.

Where do I submit my Rebate Request Form?You can only submit your Rebate Request form after you’ve completed at least 48 Standard or Advanced workouts. Go to Vitality > Your Account > Forms & Waivers > Wellness Rebates.

When do I get my rebate?Your rebate will be deposited in your bank account as soon as administratively possible.

Can I get a gym rebate for the previous program year?Yes, as long as you submit your Wellness Rebates form within 90 days of the end of the program year.

Gym Rebates

TIP

What are partner gym discounts?If you sign up with a partner gym, such as 24 Hour Fitness, Curves or LA Fitness, you may be able to get some discounts. The discount type and amount depends on the gym you go to. You can learn more at Vitality > Rewards > Partner Gym Discounts.

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HealthyFood Program

Vitality HealthyFood™ Program

What’s the HealthyFood program?This program makes it more affordable to buy fresh and nutritious foods at grocery stores across the country. As you buy qualifying foods, you earn:

• Up to 50 Vitality Points a month

• Up to 10% savings on the healthy food you buy

• Exclusive coupons

How do I participate?There are two ways — through Walmart and NutriSavings.

I shop at Walmart. How do I sign up for the HealthyFood program?

1. Register for a HealthyFood card atwww.powerofvitality.com > ManageYour Links > HealthyFood > Walmart.

2. Use your HealthyFood card at any of Walmart’s 4,000U.S. locations when you buy foods labeled Great ForYou™ to:

• Receive a 5% discount on your Great ForYou purchases — 10% if you complete theVitality Check™ biometric screening.

• Earn 2 Vitality Points for each Great For You itemyou buy. Visit Vitality > Rewards > VitalityHealthyfood > Great For You Foods > Great ForYou catalog to see a list of all the foods you can buy to earn rewards.

If I sign up for the Walmart HealthyFood program, can I also sign up for NutriSavings?Yes. Whether you participate in the HealthyFood program through Walmart, NutriSavings or both, you can earn up to 50 Vitality Points a month.

How do I sign up for NutriSavings?

1. Register at www.powerofvitality.com > ManageYour Links > HealthyFood >NutriSavings.

2. Link your favorite grocers’ loyalty cards toNutriSavings.

3. Use your grocers’ loyalty cards when buying healthy foodto earn 2 Vitality Points for each eligible healthy fooditem you buy.

Log on to the NutriSavings website at www.nutrisavings.com and select Food Catalog from the homepage to see a complete list of eligible healthy foods. You can also find recipes, articles and other information about healthy food on the NutriSavings website.

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Condition Support Program

What’s the Condition Support program?The Condition Support program is available to help you (or a covered family member) understand and manage certain chronic medical conditions, such as asthma, diabetes, heart disease, high blood pressure and high cholesterol. A condition support manager can address your questions and health concerns, and assist you in following your doctor’s treatment plan.

Am I eligible for the Condition Support program?You need to be enrolled in the HSA, HSA Plus or HRA Core medical plan to use the Condition Support Program.

How do I enroll?You can find enrollment details at Vitality > Learning Center > Guide to Vitality > Additional Programs. Be sure to contact your medical plan carrier’s condition support manager.

I’m covered by a medical plan other than the HSA, HSA Plus or HRA Core plan. Can I earn Vitality Points for participating in a different Condition Support program? If you’re not covered by the HSA, HSA Plus or HRA Core plan, contact your medical plan carrier to see if they offer similar programs. To get Vitality Points for participating in a similar program, you need to complete the Disease Management form and submit it directly to Vitality. You can find the form at Vitality > Your Account > Forms and Waivers > Disease Management.

Can I earn points by participating in the Condition Support program?Yes. You can earn 300 points (once each quarter) by enrolling and participating in one of the following support programs:

• Asthma

• COPD

• Coronary Artery Disease

• Congestive Heart Disease

• Diabetes

• Depression

• Heart Failure

• High Blood Pressure

• High Cholesterol

Your Vitality Points show up automatically as long as you enroll in the program and complete your participation. It can take up to 90 days for the points you earn through the program to show up on your Vitality Points Statement.

Where can I learn more about the Condition Support program?You can learn more at Your Account > Forms and Waivers > Disease Management.

Additional Programs

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Maternity Care Program

How can the program help me have a healthier pregnancy?The Maternity Care program can give you and your covered spouse/domestic partner prenatal education and guidance during the early stages of pregnancy through your newborn’s first months.

What can I learn from the program?The Maternity Care program can help you learn about pre-term births, risk factors, preventive measures, and signs and symptoms of pre-term labor and postpartum depression. Depending on your medical plan, a nurse may guide you as you learn about your pregnancy, your baby’s development and how to practice healthy habits during pregnancy.

Am I eligible to participate? You and your covered spouse/domestic partner are eligible to participate in the Maternity Care program, at no cost to you, if you’re enrolled in the HSA, HSA Plus or HRA Core plan.

If you’re not enrolled in one of these plans, contact your medical plan carrier to see if they offer a similar program.

Can I earn Vitality Points by participating in the program? Yes. You earn 300 points each quarter you participate (max four quarters). To get points, submit a Maternity Management form directly to Vitality each quarter you participate. You can find the form at Vitality > Learning Center > Guide to Vitality > Additional Programs > Maternity Care. For questions about earning points and submitting the form, contact Vitality at 877.224.7117 or wellness@powerofvitality.com.

How do I enroll?Contact your medical plan carrier to enroll in the Maternity Care program, as shown below.

Medical Plan Carrier Maternity Care Program Phone

Aetna Beginning Right Program 800.272.3531

Anthem Future Moms Program 866.820.0763

Cigna Healthy Babies Program 800.244.6224

Volunteer Program

What’s the Volunteer program?The Volunteer program is one of the ways Healthy EMS & your employer helps you help your community.

Who can participate in the program?Only benefit eligible employees can participate in the Volunteer program.

Can my spouse/domestic partner also earn points for volunteering?No.

Can I earn points for volunteering?Yes. For every 25 volunteer hours, you earn 250 points each quarter.

How do I submit my volunteer hours?Log on and submit your hours at www.healthyems.com. Go to Volunteer > Manage My Activities > Record Hours for an Individual Project. After you record 25 hours, Healthy EMS submits your volunteer hours to Vitality.

How many points I can earn for volunteering?You can earn up to 1,000 points a year.

Can I earn retroactive points for my volunteer hours?Yes. You can submit any volunteer hours you completed since May 1, 2017.

Additional Programs

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Living Smoke Free

What is Living Smoke Free?Living Smoke Free is an eight week interactive program that supports your efforts to successfully quit smoking. You can access the program on the Vitality website and the Vitality Today mobile app. After signing up, you get personalized Newsfeed interactions, helpful resources and Vitality Today mobile app notifications that encourage and increase your motivation. The first two weeks of the program prepare you to quit. The next six weeks give the guidance and support you need to reach your goal.

What kind of interactive support can I get?You get:

• Monday motivations

• Personalized Newsfeed information

• Messages and tips about how to handle cravings,mood problems, smoking cessation aids, relapsesand weight gain

How do I sign up?Set an eight-week Quit Smoking goal at Vitality > Health Profile > Goals.

How do I earn Vitality Points for participating?You need to set an eight-week Quit Smoking goal and check in on your goal for at least four of the eight weeks to earn 725 Vitality Points. You also earn 30 points each week that you check in on any (or all) of your active goals — up to 1,500 points a year.

Additional Programs

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Medical Accommodations

I have a medical condition that limits my ability to meet a Vitality standard. What can I do?When a short-or long-term medical condition limits your ability to engage in physical activities or meet a Vitality standard, Vitality makes it possible for you to stay on track with a medical accommodation.

How do medical accommodations work?For each activity-based standard you’re physically unable to meet, Vitality offers an alternate activity that allows you to earn the same amount of Vitality Points. For example, if you typically earn 10 points a day for a 30-minute workout, Vitality recommends a non-physical activity worth 10 points.

For each outcome-based standard you’re unable to meet, such as a blood pressure range, Vitality automatically offers you ways to earn the same amount of points by different means.

How do I request a medical accommodation?You need to complete a form and submit it to Vitality. Go to Your Account > Forms and Waivers and select the appropriate form based on the standard or activity you’re unable to meet. If you need to, have your doctor complete his/her portion of the form and submit your completed form by email to wellness@powerofvitality.com or fax it to 877.224.7110.

Be aware that submission via email isn’t secure until received by Vitality. For your protection, Vitality strongly recommends sending your form via their secure fax.

Why does my doctor have to complete a portion of the form?Based on your doctor’s suggestions, Vitality offers alternative activities you can complete to earn points. Your doctor may also need to approve the alternative activities.

Medical Accommodations

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Taxes on Vitality Rewards

What Vitality rewards are considered taxable?The total value of items purchased on Vitality with Vitality Bucks and your gym rebate are considered taxable.

Do I pay taxes on Vitality rewards?Possibly. Please contact your tax planning professional for guidance relevant to your individual tax needs.

Taxes on Vitality Rewards

Challenges & Showcase Challenges

Challenges Showcase Challenges

What are challenges?On a monthly basis, starting on the 1st of each month Healthy EMS sponsoring the following challenges:

Steps Challenge Workout challenge Silver status in 60 days Gold status in 90 days

Additionally, your employer and/or a Vitality Champ can sponsor challenges just for their employees

How do Challenges contribute to my Vitality status? Employees who participate in a challenge are given points for simply signing up. Winners of a challenge receive up to 1,000 Vitality points.

What are Showcase challenges?Starting January 1st, 2018, Healthy EMS will introduce the following Showcase Challenges:

Healthiest Individual in 2018 Healthiest Team in 2018Burning Soles Most Engaged Champion

These challenges are longer in duration and require more effort then monthly challenges.

How do Challenges contribute to my Vitality status? In addition to earning Vitality points, the winners of the Showcase events will win prize money from corporate sponsors. Prizes could be $10,000 or higher for the winners.

Are Challenge participation required?No, challenges, whether set by your employer or sponsored by Health EMS are not required and do not effect any premium savings opportunity.

Challenges are meant solely to keep an active lifestyle fun and fresh for all those who participate.

Are Showcase Challenge participation required?No, challenges, whether set by your employer or sponsored by Health EMS are not required and do not effect any premium savings opportunity.

Challenges are meant solely to keep an active lifestyle fun and fresh for all those who participate.

Why should I participate in a Challenge?Bragging rights and friendly competition amoung fellow EMS peers should be your primary motivation to particiapte.

From time to time, your employer and/or Healthy EMS my offer rewards for your involvement and/or winning a challange. A reward may be as a cash or gift card, premium holiday for a pay-period and/or some other employer specific reward.

Why should I participate in a Showcase Challenge?Bragging Showcase Challenges are designed to be longer in duration and more rigerious in nature. Since these challenges really test a person or team's endurance, the prizes associated are much larger.

Additionally, Showcase Challenges are what we call systemwide, meaning any ambulance company or ambulance provider can particiapte. In otherwords, a team in the northeast WILL BE competing against a team in the southeast and southwest.

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June 2017

Vitality 877.224.71178 a.m. - 5 p.m. Central time, M-Fwellness@powerofvitality.com En español — entra a Vitality, ve hasta abajo y haz clic en Languages > Español.

Visit the Vitality website:

www.powerofvitality.com

Spouses/Domestic PartnersGo to www.powerofvitality.com. Use your name, birth date and email address, and the last four digits of the employee’s Social Security Number to register.

Wellness ChampionTalk with your Wellness Champion to learn about upcoming events and healthy activities at your location. You can find out who your Wellness Champion is at www.Healthyems.com

Your employer is committed to helping you achieve your best health and offers all employees Vitality Points for participating in Vitality. If you are unable to meet any Vitality outcome-based standard, Vitality automatically offers you ways to earn the same reward by different means, regardless of any medical condition and without your doctor’s approval. If you think you are unable to meet an activity-only Vitality standard (or a reasonable alternative to such standard), you might qualify for an opportunity to earn the same reward by different means with your doctor’s approval. Visit the Forms and Waivers page on the Vitality website to download the applicable waiver form. If necessary, complete your portion of it, have your doctor complete his/her portion of it and then submit it to Vitality. Vitality will use your doctor’s recommendations to apply a medical accommodation for you in light of your health status. If you have any questions, contact the Vitality Customer Service Center at 877.224.7117.

Wellness Champions

Wellness Champions

How can I help promote better health at my worksite? Think about becoming a Wellness Champion to help promote better health. As a Wellness Champion, you can be a leader and earn rewards for creating healthy events at work.

What are my duties as a Wellness Champion?As a Wellness Champion, you create fun events to inspire your coworkers to maintain or improve their health and well-being. You also help promote our health and wellness programs. You would spend about two to three hours a month on Wellness Champion activities. These include:

• Linking coworkers with the Health and Wellness Team.

• Going to monthly meetings.

• Asking coworkers about their interests and needs.

• Making a plan to schedule, promote and assess eventsat work.

• Reporting to the Health and Wellness Team about programactivities, progress, problems and next steps.

Can I earn Vitality Points for being a Wellness Champion?Yes. You can earn up to 2,000 Vitality Points. Email your HR Department to learn more about the perks of becoming a Wellness Champion.