2016 Mondelēz Global LLC Fuel4Life Wellness and Incentive Program
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1 2016 Mondelēz Global LLC Fuel4Life Wellness and Incentive Program Eligibility Each employee who is eligible for the Mondelēz Global Medical (with medical coverage administered by Blue Cross Blue Shield of Illinois (BCBSIL) or Kaiser) ( Medical ), as an active employee of Mondelēz Global LLC or another participating employer under the Medical, or while on salary continuation. (Mondelēz Global LLC ( Mondelēz Global ) and each other participating employer under the Medical are referred to as Participating Employers for purposes of this document.) Eligibility for certain Fuel4Life Wellness Program incentives requires enrollment in the Medical. Notwithstanding the foregoing, the following classes of individuals are not eligible: Contract or leased employees even if later reclassified as an employee of a Participating Employer Seasonal or temporary employees Bargaining unit employees U.S. Expatriates who work outside of the U.S. Non-U.S. Inpatriates who work in the U.S. Employees who work in Hawaii or Puerto Rico Under this program, an employee who is receiving Short Term Disability ( STD ) benefits under the Mondelēz Global Disability Benefits is treated as an active employee. However, an employee who is on disability leave, but is not receiving STD benefits, is eligible to participate in activities and incentive programs, but is not eligible to receive benefits under this Policy until the employee s return to active employment. The spouse or domestic partner of an eligible employee is eligible to participate in certain activities under the Program. No spouse or domestic partner is eligible for any monetary incentive benefit under the Program. Married Mondelez Global employees will be treated as follows; if an employee covers the other employee as a dependent on their medical coverage, the dependent will receive incentives as if they were a waived employee. The Fuel4Life Wellness Program is not an ERISA plan The Fuel4Life Wellness Program is not an employee benefit plan subject to the Employee Retirement Income Security Act of 1974, as amended ( ERISA ). No individual who loses eligibility under this Program, has any right to elect continuation coverage. Mondelēz Global has the right to amend or terminate the Fuel4Life Program at any time, for any reason and without prior notice.
2 Benefits Dollar denominated benefits for each activity, or Fuel4Life Wellness incentives are based both on being eligible to participate in the applicable activity and on completing the activity in accordance with its applicable standards and within applicable timeframes. For the 2016 calendar year, an employee can receive up to, but not exceeding, $800 regardless of the number of activities completed. Incentives will be contributed directly to the employee s Health Savings Account (HSA) except, if the: employee does not maintain a Wells Fargo HSA; employee is not eligible to contribute to an HSA when the incentive benefit is payable; or benefit deposited into the employee s HSA would cause the HSA to exceed the maximum allowable contribution for the year. In the above mentioned cases, the reward will be applied to the employee s paycheck, as taxable wages, subject to applicable withholding. An employee must be in active status or on salary continuation at the time the incentive is payable. If an employee is not in active status or on salary continuation at the time the incentive is payable, the payment will be forfeited, regardless of whether the employee terminated employment voluntarily or involuntarily, retired or died. Timing of Incentive Payments Fuel4Life wellness incentives will be paid out on a monthly basis throughout Payments may take up to 90 days from the date the activity has been completed for processing. If an employee has not received an incentive after the 90 day processing period, the employee may contact the Mondelēz International Benefit Center at , or via MyBenefits Online (MyHR Online Quick Links North America select Benefits for U.S. Benefits to access MyBenefits Online) to inquire into the status of the reward. Please note that it may take up to 30 days to determine the status of the inquiry. Important note regarding the timing of incentive payments: Incentives apply to the calendar year during which they are paid not when the activity has been completed. Therefore, activities completed in late 2015 under the 2015 Fuel4Life Wellness incentives policy and paid in 2016 apply toward the 2016 calendar year dollar maximum. For 2016, it is critical that employees attempt to complete activities before the end of Activities completed after October 31, 2016 may not be payable in 2016 and may not be payable in certain circumstances for example, if the Program is not maintained after Any incentive payments made to an HSA will not be subject to withholding or employment taxes to the extent that Mondelēz Global reasonably believes that such payments are not considered taxable income to the employee. Any incentive payments made to an employee s paycheck are fully taxable and are subject to applicable employment and income tax withholding and reporting. Incentives are not considered eligible pay for purposes of any Mondelēz Global benefits plan. Health Screening (Biometric Screening) Eligibility Employee must be enrolled in the Medical. Spouses and Domestic Partners must also be enrolled in the Medical as a dependent of an eligible employee.
3 How to Get Tested For more information on finding an eligible health screening location near you, or to schedule an appointment, log into Redbrick Health and click on health screening. You can get tested using one of the following: 1. Fasting blood panel during annual physical exam between October 15, 2015 and November 30, On-site biometric testing event (at Mondelēz Global work locations) starting February 1, (Employees only) 3. Testing at a Patient Service Center, between January 1, 2016 and December 31, A patient service center is a lab that individuals can visit at their convenience. 4. Testing through Community Access partners between January 1, 2016 and December 31, There are numerous additional testing places in the community available at some retail locations. Employees at Mondelēz Global sites where on-site testing will be made available will be notified of the on-site testing. Employees who choose to be tested at an on-site event will be responsible for enrolling for the event timely. If tested at your Health Care Provider s office: If testing is done at your health care provider s office, you must first obtain the standard Health Screening Form From the Redbrick website. You must complete the employee portion of the form and provide it to your health care provider to complete the form. Your health care provider must the sign the completed form, and fax or mail it to Redbrick so that it is received no later than November 30, If your form is incomplete it will not be processed and will be returned to you. If tested onsite or at a Patient Service Center: If testing is done on-site, or you registered and completed your screening at a Patient Service Center, your results are updated in the Redbrick website within 10 to 15 business days of the screening date. Important Note Regarding Expenses Incurred Under the Medical There are no special exceptions that apply under the Medical to cover expenses incurred in obtaining biometrics through your health care provider. While preventive coverage such as your annual physical is at no cost to you under the Medical, other covered expenses are subject to the annual deductible and coinsurance. Mondelēz Global will pay the entire cost of on-site biometric testing where offered and pay the entire cost for biometric testing at a Patient Service Center, provided you visit an eligible location. See the Redbrick website for a list of Patient Service Centers where testing is at no cost to you. Charges associated with a health care provider completing and sending in the Health Care Provider Form are not covered under the Medical. Privacy of Biometric Information Biometric information will not be shared with Mondelez Global. If you think you might be unable to meet a standard for an incentive under this Program, you might qualify for an opportunity to earn the same incentive by different means. Contact a Redbrick representative and they will work with you (and, if you wish, with your doctor) to find an activity with the same incentive that is right for you in light of your health status.
4 2016 Fuel4Life Wellness Incentives In 2016, the Fuel4Life Wellness Program will be powered by Redbrick Health ( Eligible employees and spouses/domestic partners may receive wellness incentives by participating in the Fuel4Life Wellness activities listed below. Employees enrolled in a Mondelez Global Medical may receive up to a combined total of $800 in wellness incentives. Employees who have waived Mondelez Global Medical coverage may receive up to $400 for participating in certain activities (see column 3). Spouses and Domestic partners may participate in the activities and receive points to qualify for quarterly Redbrick raffles. Activity Redbrick Compass Health Assessment (formerly Personal Health Assessment (PHA) Begin your journey by completing the Redbrick Compass Health Assessment. To receive the incentive, you must complete the Redbrick online Compass Health Assessment on the Redbrick site. The assessment is a user-friendly health questionnaire that takes only a few minutes to complete and provides a detailed comparisons report on health strengths and risks. Health Screening (formerly Biometric Screening) This simplified Health Screening requires only a finger stick blood draw (no fasting required), which can be completed at an onsite workplace screening event, through a Quest diagnostics service center, at approved retail locations or by a physician visit and completion of the physician form. Next-Steps Consult Based on your Compass results, an expert guide will help you find the activities that are the best fit for your needs and goals during a scheduled 15-minute phone call. Wellness Challenges A total of three company-wide challenges will be held during 2016 to help you achieve your wellness goals. If you want to receive the incentive, you must complete the specific challenge within the applicable timeframe. Stay tuned for details on Challenge dates and registration. Incentive $200 Employee Partner: 200pts $250 Employee Partner: 250 pts $50 Employee Partner: 50 pts $75 per challenge $225 maximum Partner: 75 pts per challenge/225 pts maximum Partners Enrolled in the BCBSIL Medical Partners Enrolled in Kaiser Medical WAIVED MEDICAL Employees Not Enrolled in a Medical X X N/A X X NA
5 Activity Health and Wellness Coaching Personalized telephonic coaching helps address your target areas of concern such as nutrition, weight management, smoking cessation, stress management and more. You must schedule and complete personalized coaching calls with Redbrick to receive the incentive. Journeys Journeys offer a unique small-steps approach for changing healthrelated behaviors and are selected by you on the Redbrick website based on personal interest. There are numerous Redbrick Journeys to choose from including: improving sleep, techniques for stress management, fitness, etc. Journeys must be completed via the Redbrick site. Tracking Activity Tool The Redbrick online Track tool tracks personal challenges and healthy habits across a variety of areas: physical activity, nutrition, wellbeing and specific biometric measures. This tool can also be integrated with your personal wellness tracking devices. Participant must track progress through the RedBrick Track online activity tracking tool. Blue Care Connection Disease Management Program Blue Care Advisors (registered nurses and other health care professionals) work with members and doctors to provide education, coaching and monitoring if you are at risk for or already have a chronic condition, such as diabetes, cancer, pulmonary, vascular and renal diseases. Incentive $50 per completed coaching Partner: 50pts per coaching program/200 pts maximum $50 each Partner: 50pts per Journey/200 pts maximum $2 per day/ Partner: 2 pts per day/ 200 pts maximum $200 Partner: 200 pts Partners Enrolled in the BCBSIL Medical Partners Enrolled in Kaiser Medical WAIVED MEDICAL Employees Not Enrolled in a Medical
6 Activity Castlight Healthcare Shopping Tool To receive incentives, you must complete one or more of the following programs at 1. Complete a one-time Castlight registration (only for participants not currently registered) ($50) 2. Complete a general search for medical/dental providers, Rx or procedures ($50 max) 3. Select a Rewards Location for a CT Scan or MRI ($100) 4. Select a Rewards Location for lab work. ($50) 5. Select a Rewards Location for Mammogram ($50) 6. Select a Rewards Location for Colonoscopy ($50) 7. View the Castlight Tutorial Video ($25 max only once annually) Annual physical and/or well woman exam To receive the incentive you must have an annual physical or well woman exam. The incentive will be paid after the claim is processed. The claim must be coded as preventive to satisfy the annual physical or well woman incentive requirement. Telemedicine from MDLive This new virtual medical service through MDLive ( lets you get access to expert advice conveniently from your home computer or mobile device or by calling to speak with a health care provider. To receive the incentive, you must complete a video consult or phone call with the participating telemedicine medical provider. Incentive Partner: 200 pts maximum $100 per calendar year Partner: 100 pts per calendar year $40 each $80 maximum Partners Enrolled in the BCBSIL Medical Partners Enrolled in Kaiser Medical WAIVED MEDICAL Employees Not Enrolled in a Medical
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