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2549 Washington Blvd., Suite 220 Ogden, Utah 84401 TEL (801)629-8737 FAX (801)629-8735 Let’s be Tobacco Free! Ogden City values your health and continues to identify programs and tools to assist you in managing your overall wellness. Starting this year, each full-time employee will need to sign and complete a Tobacco-Free Affidavit during the 2017 Open Enrollment, verifying tobacco use. This form must be completed before June 30, 2017 and turned into HR in order to be eligible for the reduced premium, effective July 1st, 2017. If you are a tobacco user (including, but not limited to: cigarettes, cigars, pipes, e-cigarettes, dipping, chewing tobacco, snuff and/or inhaled products) and would like to be eligible to receive the lower medical premiums or receive your opt-out money, you will be asked to voluntarily enroll in and complete the Utah Quit Now Tobacco Cessation Program. To be eligible for the reduced premiums, employees must complete the following steps by December 31 st, 2017: 1. Call and enroll in the telephonic tobacco cessation coaching program through the Utah Tobacco Quit Line. You must enroll in the 5 coaching call program. a. English: 1.800.QUIT.NOW (784.8669) b. Spanish: 1.855.DEJELO.YA (335.3569) 2. Let the coach know you are an Ogden City employee and covered with SelectHealth, if applicable. 3. Once you complete your 5 coaching calls, you will need to request a verification form of completion from your quit coach. **This is the employee’s responsibility to request the completion form. Failure to do so will result in an incompletion of the program. 4. Turn in your Letter of Completion to HR by December 31st, 2017, to be eligible for the reduced premium. For more information regarding the Tobacco Cessation Program, please contact Heidi at [PHONE REDACTED] or visit http://www.ogdencity.com/1150/Employee-Portal Department of Management Services Human Resources Division