Health Visit Form
The Health Visit form is a requirement of the Healthy Choice program.
The Healthy Choice program begins each year in January.
View the Program Overview and Getting Started Guide for more details about the program.
Español Program Overview and Getting Started Guide
Employee Health Plan Health Visit Form - English and Español
To be eligible for full credit, and the best discount in the program, you must start participating each year by Mar. 31 and meet all the goals set for you by the final deadline of Sept. 30.
If you miss the first deadline, you may be eligible for partial credit if you start participating by June 30 and meet all the goals that are set for you by the final deadline of Sept. 30.
Login to your Healthy Choice portal account to view your health status, along with your Personal Program Requirements - which explain how you need to participate to earn the best discount. The Personal Program Requirements for each health status are listed below as a reference.
If you do not agree with your health status or condition diagnosis, you must contact the health plan to request an appeal. We recommend doing this prior to the Mar. 31 deadline. If you’re enrolled in Coordinated Care, contact your Care Coordinator to make this request.
Have a spouse on your health plan? To comply with HIPAA, they will need to participate and meet their own Healthy Choice requirements. At the end of the program year, their participation will be combined with yours to determine your premium discount for the following year. Together, you can earn up to a maximum discount of 30%. If you participate and they choose not to, you are still eligible for a lesser discount.
Some exclusions apply. If you have questions about your eligibility to participate in Healthy Choice, contact us.
Under HIPAA, EHP like other health insurers, is permitted to access health data for the purposes of claims payment, health program development and treatment coverage. As with any of our healthcare plans and programs, plan member privacy is protected in full compliance with HIPAA.
The Health Visit form is a requirement of the Healthy Choice program.
EHP offers over 20 Coordinated Care programs at no extra charge to members.