Tobacco-free Affidavit Available November 5 to 16
A One-time Only Opportunity for 2013
Those who are tobacco-free during Open Enrollment
The Tobacco-free Affidavit for 2013 will be available as a one-time only opportunity for 2013 during Open Enrollment, November 5 - 16. Employees will be able to sign and submit the affidavit online, for themselves and covered spouse/domestic partner, in Onestart when making their medical plan selection.
- The employee's medical plan contribution will be reduced by $25 per month for an employee or spouse/domestic partner
($50 for both) who do not use tobacco.
- Employees must complete the affidavit annually for themselves and for their covered spouse/domestic partner.
Employees who complete the affidavit through OneStart will receive instant email confirmation that the affidavit was completed,
along with confirmation of 2013 benefit elections. Employees who cannot complete the affidavit online should contact , from November 5 - 16, for a paper affidavit form.
Those who are not tobacco-free at the time of Open Enrollment
Those who are not tobacco-free at the time of Open Enrollment can participate in the Quit For Life® tobacco cessation program to receive the premium reduction.
- Program participation is defined as completing at least five calls with a Quit Coach.
- Participants will receive the premium reduction upon third-party certification of program completion.
- To enroll in Quit For Life, call 1-866-784-8454 or visit the Quit For Life Program Web site.