This chart shows the points assigned to each health factor.

Health & Wellness Evaluation Scoring — Initial Visit

Health Factor	Adult 18+	Child 2-17
Smoking Status Non-smoker	30 Points	N/A
Blood Pressure Less than 120/80	20 Points	N/A
Influenza Immunization	20 Points	60 Points
Cholesterol Levels Acceptable LDL cholesterol per guidelines	15 Points	N/A
BMI Measures/Percentile Adult: Measure between 19 and 25 Child: Between 5 and 85 Percentiles	15 Points	40 Points
Maximum	100 Points	100 Points

Reward Levels

Family members that earn 100 points receive a Healthy Reward – $300 as an individual adult or as much as $700 for a family.*

If you don't qualify for a Healthy Reward, you can work with your personal PCP to develop a Healthy Action Plan and potentially qualify later in the plan year.

* Important Note: Any Healthy Reward earned may be considered taxable income; please check with your tax advisor if you have questions.

Developing a Healthy Action Plan

Based on your evaluation results, you may still be able to qualify later in your plan year:

• Your personal PCP will develop a customized Healthy Action Plan to improve your health.
• You and your doctor agree on your Healthy Action Plan.
• Your personal PCP decides when you should return to check your progress and if more testing is needed.
• If you've improved during your plan year, you may get a partial or full reward:
  • You and your PCP must sign and send CareFirst a new Health & Wellness Evaluation form.
  • CareFirst will score your results and let you know if you've qualified for a reward.
• If you're medically unable to qualify for a reward due to a health condition or if it's medically inadvisable, then your personal PCP will notify CareFirst.
• An alternative standard may be available for you and you may still qualify for a reward.
• If you disagree with CareFirst's decision about your Healthy Reward, you can call the member services number on your ID card for more information or to begin the appeal process.

Health & Wellness Evaluation Scoring — Follow Up Visit

Health Factor	Adult 18+	Child 2-17
Smoking Status Non-smoker	30 Points	N/A
Blood Pressure Less than 120/80 Less than 140/90	20 Points 10 Points	N/A N/A
Influenza Immunization	20 Points	60 Points
Cholesterol Levels Acceptable LDL cholesterol per guidelines LDL less than 160	15 Points 5 Points	N/A N/A
BMI Measures/Percentile Adult: Measure between 19 and 25 Child: Between 5 and 85 Percentiles	15 Points	40 Points
Adult: Measure between 26 and 30 Child: Reduced Percentile by 5%	5 Points	20 Points
Maximum	100 Points	100 Points

Reward Levels

 

* Important Note: Any Healthy Reward earned may be considered taxable income; please check with your tax advisor if you have questions.