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RedShirt Rewards Program Consent

The Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) require employers that offer wellness programs to provide you notification about the type of information that will be collected, how it will be used, who will receive it, and what will be done to keep it confidential. The wellness program offered to you is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the ADA and GINA, among others. If you choose to participate in this wellness program, you may be asked to complete various challenges including an annual well visit, routine blood work, and/or a well-being assessment. These challenges may ask questions about your health-related activities and behaviors, including whether you have or had certain medical conditions such as cancer, diabetes, or heart disease. Additionally, the wellness program challenges may include completion of claims-verified preventive services, registering an account with a telemedicine provider, completion of food or nutrition questionnaires or participation in community volunteer activities and wellness events.

Your health information is confidential. We are required by law to maintain the privacy and security of your personally identifiable health information. The medical information collected will not be available to your employer in a way that allows your employer to identify member health information except as minimally necessary to confirm completion of a tier or challenge associated with your wellness program. We may also use aggregate or summary (i.e., deidentified) information to design or provide additional health services. Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program (including the health plan which it is a part of). We may disclose your information as necessary to respond to a request from you for a reasonable accommodation to allow you to participate in the wellness program, or as expressly permitted by law. Your employer (or spouse’s employer) has provided or will provide you a notice describing the specific requirements of the wellness program and the incentives you may receive if you choose to participate.