Qualification form shows how you measure up
“The behaviors Healthy Blue Living promotes have had a real impact on my health. In only eight months, I lost 90 pounds. What I like the most about Healthy Blue Living is seeing progress. My doctor and I use the health measures on the form to see if I’m within the healthy ranges. Then, we make adjustments to my health plan — together.”
Robert North
Whitmore Lake
With the Qualification Form, your doctor and you get a snapshot of your health with six high-impact health measures.
- Tobacco
- Weight
- Blood pressure
- Cholesterol
- Depression
- Blood sugar
Together, you can then create a treatment plan to improve specific health measures. Even if you use tobacco or have a health condition such as diabetes, you can qualify for enhanced benefits by following your doctor’s treatment plan.
Take the Qualification Form (PDF) with you for your doctor to fill out during your first visit each year.
The A, B, Cs of your health
Each health measure on the Qualification Form tracks your status using an easy-to-understand A, B and C grading system. You will be moved to the appropriate benefit level on the 91st day of the plan year based on your completing the necessary requirements.
- If you and your covered spouse earn all As or Bs, you will receive enhanced benefits.
- Earning one or more Cs on any of the health measures will move the entire contract to the standard benefit level.
Status:
A = You’re meeting the wellness target.
B = You have a health condition that may not be controlled, but you are actively participating in treatment to improve the condition.
C = You’re not meeting the wellness target, and you haven’t committed to treatment to improve your condition.
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page modified 01/24/2012