GET ENGAGED BE INFORMEDPROGRAM GUIDE

Proprietary & ConfidentialProgramGuide_20150305_v1.0

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The mission behind the Color of Health WellnessProgram is to provide all members with the toolsand support to become healthy, productiveindividuals in work and life, and to improve bothphysically and mentally through education andencouragement, leading to more balanced,healthy lifestyles.

Roppe Holding Company continues to team upwith Bravo Wellness to present you with anexciting voluntary opportunity to take control ofyour healthcare costs. Over the next severalmonths, you will be assessed on your healthwith the ultimate goal of helping you maintaingood health and make improvement.

Bravo Wellness is a company that works withorganizations like yours, to administer compliantwellness programs. As experts in the industry,Bravo Wellness is committed to data integrityand will ensure your information is kept privateand never shared with your employer.

This year, we encourage you to embark on ajourney that can improve your health and thehealth of your organization.

INCLUDED IN THIS PROGRAM GUIDE

GETTING STARTED

INCENTIVE PLAN DESIGN

HEALTH SCREENING TESTS

TOOLS & RESOURCES

FAQ’s

PROGRAM INFORMATION

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WHY YOU SHOULD PARTICIPATETo manage your monthly health care costs.To improve the health of you and your family.

HOW TO GET STARTED…Reaping the benefits of wellness is easy:

1) Sign up to participate. Go to bravowell.com/rhc and get started using the instructions in the “ScreeningRegistration & Scheduling” sheet found in the Wellness Incentive Plan

2) Select your screening appointment time. Employee’s spouses will have to register and scheduleseparately.

3) Attend the confidential health screening conducted by a qualified health professional, at no cost to you& your spouse.

4) Compare your results against the National Institute of Health’s goals. Be sure to take advantage of theappeal process and alternative programs that may be available for those with medical exceptions.

5) Bravo Wellness is voluntary and completely confidential. Your individual lab results will not be sharedwith your employer.

6) Decide for yourself what the next health step will be. Your employer is offering you several resources forimproving your health. Be sure to check them out!

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THERE ARE TWO TYPES OF APPEALS FOR PARTICIPANTS.• Type 1: You can file an appeal if you dispute the accuracy of the results.• Type 2: You can file an appeal if your physician feels it is unreasonably difficult or medically inadvisable for you to reach your

employer’s goal.

What timeframe do I have to file an appeal?Appeals must be filed within 30 days of the date displayed on your original results letter.

Who pays for the retesting that is submitted with the appeal?Any retesting will be at the expense of the participant.

What paperwork is needed to file an appeal?A completed appeal application, with physician documentation and copies of any additional testing results that apply to the appeal.

What specific information does my physician need to provide?

FOR A TYPE 1 APPEAL:

Blood Pressure: Re-tested by the approved provider; any passing reading taken 90 days prior to the screening dateand up to the appeal deadline date listed on the results letter.

LDL Cholesterol: Re-tested by the approved provider; any passing reading taken 90 days prior to the screening dateand up to the appeal deadline date listed on the results letter.

BMI: Re-tested by an approved healthcare provider, including waist & hip circumference measurements inaddition to height and weight, any passing reading taken within 30 prior to the screening date and upto the appeal deadline date listed on the results letter. Height & weight to be measured withoutshoes.

Tobacco/Nicotine: If your lab value is being disputed, you must be re-tested by a CLIA certified laboratory. If response isbeing disputed, an affidavit will be considered. Blood or urine-based nicotine tests will be acceptedwithin 30 days prior to the screening date and up to the appeal deadline date listed on the resultsletter. Must include lab report. If a response/answer is disputed - An affidavit will be considered.

Glucose (if applicable): Re-tested by the approved provider; any passing reading taken 90 days prior to the screening dateand up to the appeal deadline date listed on the results letter.

FOR A TYPE 2 APPEAL:Your physician should write a statement on the appeal form with an explanation why attempting to achieve the goals would beunreasonably difficult or medically inadvisable with supporting documentation attached as deemed necessary.

NEED ASSISTANCE? CONTACT BRAVO WELLNESS 877.662.72864

APPEALS PROCESS

BLOOD PRESSURE (mmHg)Employer Goal: ≤ 120/80

Systolic Diastolic

Desirable 120 or Below 80 or Below

Elevated I 121 - 135 81 - 85

Elevated II 136 - 139 86 - 89

Elevated III 140 - 159 90 - 99

Elevated IV 160 or Higher 100 or Higher

LDL CHOLESTEROL (mg/dL)Employer Goal: ≤ 100

Desirable 100 or Below

Elevated I 101 - 130

Elevated II 131 - 159

Elevated III 160 or Higher

GLUCOSE (mg/dL)Employer Goal: ≤ 100

Desirable 100 or Below

Elevated I 101 - 110

Elevated II 111 - 125

Elevated III 126 or Higher

BODY MASS INDEX (kg/m2)Employer Goal: ≤ 24.9

10% Weight loss since last screening (as long as it was 6+ mos. ago)

Included in your employer’s plan design this year are alternative goals. If you failed to meet your employer’s goal, but madeimprovement in that area from one category level to the next since the last health screening, you can still earn the credit!Participants must be actively employed, still enrolled in the plan and have completed the reasonable alternative in order to earncredit for meeting the alternative goal.

What defines improvement?As an example: If your 2015 screening result for LDL is 170 (Elevated III), you would need to either improve your LDL into the ElevatedII range of 131-159 – OR – achieve your employer goal of ≤ 100 at your 2016 screening.

Improvement category levels are not intended to identify risk or medical appropriateness. Always consult with your medicaldoctor before starting any new exercise or nutrition program.

If we have results from your last Bravo screening, your improvement will be automatically considered. If Bravo does not haveprior results, you will be provided the information you need to request an alternative goal in your results letter.

Contact Bravo Wellness at 877.662.72865

ALTERNATIVE GOALS

Appeals process continued…

Administration of new employees/spouses coming on to the health plan:PRIOR to Screening Registration Close Date: New employees or an employee/spouse with a qualifying event, must register onlineand select a screening appointment if choosing to participate in the health management program. In addition, if a new employeehas a spouse coming on to the plan, the spouse must follow the same procedure.

AFTER the Screening Registration Close Date: A new employee, a person with a qualifying event or a person coming on to thehealth plan during the open enrollment period will automatically be awarded a base rate until the end of the effective healthplan year.

Outside Sales Rep Screening Requirements (if applicable)Outside Sales employees will be contact by our contracted screening vendor to schedule a time for a health professional toconduct a biometric screening. They will come to your home or any location you may be traveling at the time for yourconvenience.

Outside Sales Rep Cancellation FeeIf an employee schedules a remote screening, they will be responsible for attending their scheduled appointment. If for anyreason, a participant is unable to attend their scheduled screening, they will be responsible for cancelling the remote screeningeven within the allowed time frame (48 hours—required by Bravo) prior to the date.

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Where do I obtain an appeal application form?An appeal application may be printed from the www.bravowell.com/rhc website or by calling Bravo Customer Service at877.66.BRAVO (877.662.7286), Monday-Friday, 8 a.m.- 6 p.m. EST. Please note: only one appeal per wellness criteria will beevaluated.

When will I be notified of the decision and when will the adjustment be made if approved?You will receive a decision in the mail if the Type 1 or Type 2 appeal is approved, or you achieve your alternative, it will be as ifyou passed the category originally. Participants must be actively employed, still enrolled in the plan, and have completed thereasonable alternative in order to obtain the refund.

Appeals process continued…

GENERAL INFORMATION

BODY MASS INDEXBody Mass Index (BMI) is a measurement of your weight distribution compared to your height. Many health conditions,including cholesterol levels and total heart health, are related to your body mass. Elevated BMI can result in healthproblems associated with heart and kidney disease. To improve your BMI, aim to live a more balanced lifestyle byincreasing your physical activity, drinking plenty of water, and choosing a balance diet.

BLOOD PRESSUREBlood pressure is the force of blood against the walls of the arteries. It is recorded in two numbers: the systolic/topnumber (pressure as the heart beats) and diastolic/bottom number (pressure as the heart relaxes between beats). Toimprove your blood pressure, follow a healthy eating pattern by eating foods low in salt and sodium, maintain a healthyweight, and increase physical activity. Smoking can also increase your risks of hypertension (elevated blood pressure).

LDL CHOLESTEROLCholesterol is a waxy substance in the blood stream and the body’s cells which aids in forming some hormones andother body functions. Specifically, LDL cholesterol is labeled as the “bad” cholesterol and if too much is circulating, it canbuild up in the walls of arteries that serve the heart and brain and increase in individuals risk of heart disease andstroke. To improve your LDL, it’s important to start with a healthy diet that is low in saturated fats, and increase yourphysical activity.

GLUCOSEMost of the food you eat is broken down into glucose, a form of sugar in the blood. Glucose is the main source of fuelfor the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy.Uncontrolled glucose levels increase risk for diabetes. To improve your glucose, be conscious of your sugar intake andmaintain healthy eating habits.

TOBACCO/NICOTINECigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 1 ofevery 5 deaths in the United States each year. Cigarettes, cigars, e-cigarettes, other tobacco products (such as chewingtobacco and snuff), and tobacco smoke contain nicotine. It is recommended to quit using these products to eliminate thetobacco/nicotine in your system. Different treatments work for different people. The most important thing is to try, try,and try again until you succeed! You can find an effective way to quit.

CONSULT YOUR DOCTORFor more information about these health measures, you are encouraged to talk with your doctor.

Source: http://www.cdc.gov

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FASTINGFor the most accurate results, fast 12 hours prior to your scheduled time of testing. Do noteat. Note: If you know you are diabetic, hypoglycemic, or on medication, please follow yourdoctor’s instructions regarding fasting.

HIGH CHOLESTROL/ SODIUM FOODSLimit your intake of salt and high cholesterol foods 24 hours prior to screening.

DRINKSYou may drink water or black decaf coffee (no creamer or sweetners of any kind). In fact, it isrecommended that you drink a glassful (6 to 8 ounces) of water at least one hour prior toyour scheduled testing time.

EXERCISEDo not engage in strenuous physical activities 24 hours before your exam.

ADDITIONAL BLOOD DRAW TIPS• Being hydrated is very important! Your veins are larger when you are well-hydrated. Drink

8 oz. of water before your screening. This will make it easier for the health professional tofind a vein.

• Don’t hold your breathe while blood is drawn.• Let the person taking your blood know if you have a preferred arm and some them any

good veins that have been used successfully in the past to draw blood.• Keep calm prior to and during the blood draw. Find ways to stay distracted for those few

short moments.

Screening Preparation

YOU WILL NEED TO BRING A PHOTO ID8

Your employer has given you a number of tools and resources to help you achieve your health goals. If you have questions regarding the resources below, contact your Human Resources representative for more information.

EMPLOYER RESOURCES

Onsite health screening

Smoking Cessation ProgramQuitlogix

Targeted Ongoing Coaching(See following page for more details)

Additionally, you will see links to free health resources when you view the results of your health screening on your web portal, take advantage of these programs from nationally recognized organizations such as the National Institutes of Health (NIH) and the American Heart Association. In addition, on the web portal you will see a link that says “Get Active.” Clicking on that button will take you to a page dedicated to improving your health. You can access nutrition information, find tips for your mind and body, sign up for 5k races, learn yoga from home, and much more!

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ONGOING COACHING

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Your employer may provide you access to a number of ongoing coaching sessions to help you achieve your health goals and improve any areas of health risk. You will be assigned a dedicated coach and can schedule coaching sessions at times that are convenient for you.

WHAT IS ONGOING COACHING?Through Bravo’s partnership with Health Solutions, ongoing coaching offers a recurring 30 minute phone call with a dedicated health coach to review health risk areas that can be improved upon, set and review health goals, and work toward changing your lifestyle for better health. These ongoing calls will also help you to identify available health plan resources and appeals/alternatives being offered. The coach will also assist you with making healthy lifestyle changes, offer support for achieving your health goals, and may work with a clinical pharmacist and your primary care physician, if required.

HOW DOES IT WORK?You must first complete your health screening. Based on your results, you may be identified for this targeted coaching. Review your results letter first before you schedule your initial call. The results letter will indicate if you qualify for the targeted ongoing coaching.

HOW DO I SIGN UP FOR ONGOING COACHING?

1. Go to www.bravowell.com/rhc and login to your account. If you do not have an account, click

“Create An Account” and follow the instructions.

2. Locate the scheduler called “Ongoing Coaching”. Schedule your first session in the same manner to

which you scheduled your health screening.

3. Set reminder notice. You can add your scheduled call to your calendar, or set up a text message

and/or email reminder.

If you have questions regarding program resources, contact Bravo for more information at 877.662.7286.

WHAT IF I DON’T MEET MY PROGRAM GOAL?If your program requires the achievement of a goal, there may be alternative ways to qualify. If we have results from your lastBravo screening, your improvement will be automatically considered. If Bravo does not have prior results, you will be provided theinformation you need to request an alternative goal in your results letter. Alternatives are typically based on improvement fromprior results or on completion of a program that is related to health improvement within a certain biometric. Contact BravoWellness and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that isright for you in light of your health status.

WHAT IF MY RESULTS ARE NOT CONSISTENT WITH RECENT TESTS?In the event that the screening results differ significantly from recent medical results, a Type 1 (dispute of accuracy) appeal may besubmitted with supporting documentation within 30 days of the date displayed on your original results letter. Any retesting may beat the expense of the participant.

WHAT IF I HAVE A MEDICAL CONDITION AND I CANNOT MEET THE GOAL OR THE ALTERNATIVE GOAL (IF APPLICABLE)?If your employer’s goal(s) or reasonable alternative goal(s) are considered unreasonably difficult due to a medical condition ormedically inadvisable (Type 2 Appeal), Bravo Wellness manages appeals and coordinates personalized alternatives for these goals.Any retesting may be at the expense of the participant. Contact Bravo Wellness for more information.

IS THIS PROGRAM LEGAL? CAN MY EMPLOYER REALLY BASE MY PREMIUM ON MY HEALTH RESULTS?Bravo administers programs in compliance with the Affordable Care Act’s (ACA) Incentives for Non-Discriminatory WellnessPrograms in Group Health Plans. This allows employers to adjust healthcare cost for those on the health plan who meet certainhealth goals. At Bravo, we also adhere to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and ProtectedHealth Information (PHI) protocols. This ensures that your personal information, including your results, will not be shared with anyunauthorized parties, including your employer.

DOES EVERYONE HAVE TO PARTICIPATE?No, participation in this program is voluntary. However, if you choose not to participate, you may miss out on significant financialimpacts, and may be responsible for contributing an additional amount towards your health insurance premium if you enroll in thehealth plan.

HOW WILL I RECEIVE MY RESULTS?Results will be posted to your secure account on the portal you registered on. You will receive an email notification to alert you when they are available.

WILL MY EMPLOYER SEE MY RESULTS?No, Bravo Wellness will not share your individual results with your employer. They will be given a summary of the number ofwellness points each employee received as a result of the health screening, but will not know which category or any specificlaboratory results. Your employer may request that your results be sent to an approved third party for coaching or to be includedin your health assessment.

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Bravo Wellness partners with screening vendors trained to make your experience the best it can be! But we realize from time to time there may be difficulty in obtaining a blood draw.

WHAT IS A “HARD STICK”?A “hard stick” is the term used when a health professional is unable to draw blood for various reasons. In most cases, this is due to the participant being dehydrated, however it may be attributed to the participant having small or difficult veins. We have foundthat less than 1% of participants will fall into this category.

WHAT ARE THE NEXT STEPS IF THE HEALTH PROFESSIONAL CONSIDERS ME A HARD STICK AND/OR IS UNABLE TO DRAW MY BLOOD?If this happens, the lab nurse will record this as a "hardstick". If the participant wants to continue to earn pointsfor purposes of the incentive plan, they must follow the appeal process outlined in the Program Guide. This hard stick proceduredirects employees to their physician to complete the necessary tests to be considered a participant. The form will be filed between Bravo and the physician to submit any results; therefore the employee would be considered a participant and would receive results.

WHAT ARE WELLNESS POINTS?With the plan design, you will undergo a confidential health screening to assess basic health in key areas: blood pressure, cholesterol, glucose, body mass index (BMI), and tobacco/nicotine use. If the results fall within the established goals, you will earn wellness points. Your wellness points will be used towards managing healthcare costs. If you are unable to meet a goal, you may qualify to earn the same financial impact by different means.

DO SPOUSES AND ADULT DEPENDENT CHILDREN NEED TO BE SCREENED?RHC is allowing spouses that are eligible for the health plan (due to company spousal waiver) to be screened in order to contributeto the premium incentive. Dependent children will not be screened.

IF I TAKE MEDICATION THAT ALLOWS ME TO ACHIEVE THE GOALS, DO I STILL QUALIFY FOR WELLNESS POINTS?Even if you have a pre-existing condition like high blood pressure or high cholesterol, you may receive points if you are following the prescribed treatment for your condition and fall within the target goal ranges. If you are genetically or otherwise predisposed to a condition and you minimize related risks by taking prescribed medications that bring your test results to the desired levels, you may still be awarded wellness point(s).

HOW OFTEN DOES THE WELLNESS SCREENING TAKE PLACE?The screening is performed at least once a year and typically coincides with your employer’s annual benefits enrollment period.

WHO CONDUCTS THE SCREENING?Health screenings are performed by qualified health professionals who are contracted by Bravo Wellness.

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WHAT IS BMI?Body Mass Index (BMI) is a measurement of your weight distribution compared to your height. Carrying excess weight based on healthy ranges for your height may predispose you to various medical conditions. Even a small amount of weight loss (5-10% of your total body weight) will result in improving weight-related health problems. Many health factors, including cholesterol levels and total heart health, are related to your body mass.

WHAT IS A BMI SECONDARY MEASURE?A BMI secondary measure is a measurement used to automatically correct an elevated BMI result that is due to lean muscle mass, even if you fail the BMI plan goal. This means that if your BMI result is above your employer’s plan goal, and the result is because of your lean muscle mass, then a secondary measure will allow you to earn the BMI point.

WHAT ARE THE BMI SECONDARY MEASURE OPTIONS?The secondary measure is a waist measurement. Waist measurements are requested at all screenings, but if measurements are not obtained at the time of the screening, a secondary measure can be provided through the appeals process.

WHAT IS A BMI PROGRESSIVE GOAL?BMI progressive goal rewards you for improvement made in your BMI. If you can reduce your weight by 10% between two health screenings, you may received the point given for the BMI progressive goal. Both the goals and points awarded for the BMI progressive goal are determined by the employer and are subject to change. A BMI progressive goal is used as a way to encourage individuals to make progress toward achieving a healthier BMI.

WHAT CAN I DO TO IMPROVE MY HEALTH?Discuss your screening results with your healthcare provider. Ask him or her to help you set goals and come up with a plan that will allow you to qualify next screening for any points you might have not earned. Also, take advantage of the wellness materials and programs being offered to you.

NEED ASSISTANCE? CONTACT BRAVO WELLNESS AT 877.662.7286*NWO is only available to certain locations. Facilities outside of Ohio should use their primary care physician.

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