Jaynes Wellness Options

Name*

First NameLast Name

E-mail- Please use previous email if have participated in Nuvita Wellness Programs before.*

If you are a Jaynes employee please provide your 6 digit employee number, if you are a spouse, please provide your spouse’s 6 digit employee number.

If you are uncertain of your employee #, please log onto UltiPro -https://ew41.ultipro.com. You will be able to see your employee number in a few places, on your Employee Summary tab (The path is Menu, Myself, Personal, Employee Summary) or Pay Stub. If you need assistance in locating your employee # please reach out to HR or Michelle Macy-Stuart.

Employee ID#*

Which is your location?*

Do you have a spouse on the Jaynes Health Plan?

YesNo

What is your spouses email address? (for communication purposes)

Select your Wellness Success Incentive Option:*

OPTION 1: Receive a PAID Wellness Day off by completing 2 of the 3 challenges offered between Jan 1 - Jun 30 at 90%+ participation and 1 of 2 challenges offered between July 1 and Dec 30 at 90%+ participationOPTION 2: Receive $100 for yourself (and $100 for your spouse, if applicable) for each Nuvita Challenge completed at 90%+ participation, up to 5 total Challenges. THAT'S $500 POSSIBLE FOR YOU AND $500 POSSIBLE FOR YOUR SPOUSE, IF APPLICABLE!

Jaynes Wellness Options

Wellness Incentive