Healthy Actions Program Overview and Instructions
This file provides detailed information about the Healthy Actions wellness program, including eligibility, rewards, and how to participate. It outlines the steps required to submit the necessary documentation and answers common questions. Users can learn about potential health rewards and the support available to them through the program.
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How do I fill this out?
Filling out the Healthy Actions form is straightforward. Begin by completing an online health assessment to understand your current health status. Afterward, consult with your doctor to receive guidance on any health goals and submit the necessary form.

How to fill out the Healthy Actions Program Overview and Instructions?
1
Complete the online health assessment.
2
Consult your doctor about your health goals.
3
Receive the Healthy Actions form from your doctor.
4
Fill out the form with the required information.
5
Submit the form through computer, fax, or mail.
Who needs the Healthy Actions Program Overview and Instructions?
1
Employees enrolled in Blue Cross Blue Shield of Massachusetts plans need this form to participate in the wellness program.
2
Individuals looking to achieve health goals for rewards will benefit from completing this form.
3
Members who have been assigned health improvement targets by their doctors must fill out this form.
4
Anyone who wants to earn financial incentives for maintaining good health should utilize this form.
5
Patients seeking alternative methods to qualify for health programs might find guidance within this form.
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What are the instructions for submitting this form?
To submit the Healthy Actions form, you can use multiple methods including online submission through the program website, faxing it to the designated number provided, or mailing it to the official address. Ensure all necessary fields are accurately completed to avoid delays in processing. For assistance, contact Member Services at the number on your health ID card.
What are the important dates for this form in 2024 and 2025?
For 2024, important deadlines for the Healthy Actions form submission will be communicated in advance. If you begin your plan after the commencement of the year, be aware of the timelines for the next enrollment opportunity. Make the most of your health journey by adhering to these critical dates.

What is the purpose of this form?
The Healthy Actions form serves to enroll employees in a wellness program that emphasizes personal health improvement. By completing this form, participants can access potential financial rewards based on their health behaviors and goals identified by their healthcare provider. This process not only incentivizes healthier lifestyles but also facilitates a supportive environment for achieving health objectives.

Tell me about this form and its components and fields line-by-line.

- 1. Health Assessment: A section for completing details about your online health assessment.
- 2. Doctor's Recommendations: Field for documenting health goals assigned by your healthcare provider.
- 3. Personal Information: Basic details including your name, contact information, and plan details.
- 4. Submission Method: Options to choose how you will submit the form (online, fax, mail).
What happens if I fail to submit this form?
If the Healthy Actions form is not submitted, participants may miss out on potential rewards linked to their eligibility. Failure to submit can lead to postponed opportunities in future wellness program participation. It is crucial to adhere to deadlines to maximize benefits.
- Missing Rewards: Participants will not be able to claim financial incentives for their health improvements.
- Loss of Eligibility: Not submitting the form may render you ineligible for the program in the next plan year.
- Negative Health Impact: Without participation, individuals may lack motivation to pursue personal health goals.
How do I know when to use this form?

- 1. Post Health Assessment: Once you complete your health assessment and receive your results.
- 2. Doctor's Consultation: During or after your visit to discuss health goals with your physician.
- 3. Reward Application: When aiming to apply for rewards based on health improvements.
Frequently Asked Questions
How do I access the Healthy Actions form?
You can access the Healthy Actions form by logging into your account on our website and navigating to the wellness section.
What are the eligibility requirements for this program?
Employees enrolled in qualifying plans offered by Blue Cross Blue Shield of Massachusetts are eligible to participate.
What rewards can I earn through the program?
Participants can earn up to $300 based on their health assessment results and goal completions.
Can I submit the form online?
Yes, you can submit your completed Healthy Actions form online via our submission portal.
What if my doctor does not assign me health goals?
If your doctor determines that you have no health goals, you will still receive the full reward for being healthy.
How do I check my submission status?
You may check your submission status by logging into your account and accessing the wellness program details.
Is there support available if I have questions?
Yes, customer support is available via the contact number listed on your ID card for any inquiries.
What happens if I miss the submission deadline?
Submissions must be made by the deadline to qualify for rewards, otherwise, you will have to wait for the next opportunity.
Can I receive alternative recommendations for health goals?
Yes, you can discuss alternative health goal recommendations with your doctor that accommodate your specific medical conditions.
How do I know when my plan year starts?
Your plan year start date is detailed in your welcome letter, which you will receive after enrollment.
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