Requirements & Forms

Due to Covid-19 related cancelations of Biometric Screening Events the biometrics and labs have been eliminated from the 2021 wellness requirements.

The Requirements:
Spouses on a CRMC medical plan must meet the same requirements as employees for both to qualify.

Complete the Vitality Health Review
After you register at powerofvitality.com you’ll be prompted to complete a 10-15 min health survey. You’ll get a Vitality Age when you’re done.

 

Complete a Preventative Care Wellness Visit with your PCP
Visit your PCP in person or via telehealth for a wellness checkup between January 1st and September 30th 2020. Afterwards, send proof of your visit to bestlifewellness@crmcwy.org.

 

All requirements must be complete and submitted to bestlifewellness@crmcwy.org by 5 p.m. on September 30th, 2020!

 

Earning Points for Requirements in Vitality:

PCP Visit Only:

  1. Log into your Vitality account at powerofvitality.com
  2. Click My Account then select Forms and Waivers.
  3. Select Healthcare Support of the left.
  4. Enter in the date of your PCP visit then click Add File to attach your proof of the visit.
  5. Click Submit. It may take up to 30 days for you points to show in your account.
  6. Don’t forget to submit a copy to bestlifewellness@crmcwy.org too!

PCP Visit, Biometrics and Labs:

  1. Log into your Vitality account at powerofvitality.com
  2. Click My Account then select Forms and Waivers.
  3. Select Vitality Check of the left.
  4. Fill in all the applicable information then click Add File to attach your proof of the visit.
  5. Click Submit. It may take up to 30 days for all the points to show in your account.
  6. Don’t forget to submit a copy to bestlifewellness@crmcwy.org too!

Forms

PCP Visit Form
Fill out and have your PCP sign section C of this form. Though not required anymore you may still get your biometrics measured and get your labs drawn. Your CRMC medical insurance plan will cover a yearly wellness visit as well as a fasting glucose and lipid panel ordered by a tier 1 provider. Log into your UMR account for a list of eligible providers. Once your form is filled out you can submit it in your Vitality account for points but also send a copy to bestlifewellnes@crmcwy.org!

Click Here for the PCP Visit Form

GINA Authorization Form
The GINA Authorization Form must be completed by spouses to be able to participate in the wellness program. Please send completed forms to Wednesday Storm, RN at wednesday.storm@crmcwy.org.

Click Here for the GINA Authorization Form

ADA Wellness Program Notification
Participant rights, protections and alternatives for the Wellness Program.

Click Here for the ADA Wellness Program Notification