Question Title

* 1. Please indicate your employer (or primary insured employer).

Question Title

* 2. What is your First and Last name? (This must be completed for HSA contributions).

Question Title

* 3. What is your gender?

Question Title

* 4. What is your age?

Question Title

* 5. What type of beneficiary are you (on the medical benefit plan)?

Question Title

* 6. How would you rate your current knowledge of the CCT Wellness Program? (What is offered, cost to you etc.)

CCT offers on-site screenings annually such as Health Risk Assessments (cholesterol panels, blood sugar, blood pressure etc.), Mammograms, Prostate Screenings, Cardiac and Organ Screenings and much more.

CCT covers all wellness screenings and offerings required by Health Care Reform at 100% and gives each member an additional $500 to be used towards preventive/wellness services at in-network providers and on-site screenings.

To check your preventive benefit balance, you can call Ameriben at (855) 258-6455 or log onto your Ameriben account.

Question Title

* 7. How would you rank your overall health?

Question Title

* 8. Are you well informed of upcoming wellness activities?

Question Title

* 9. How would you prefer to hear about upcoming wellness activities?

Question Title

* 10. Do you participate in the CCT Wellness Program?

T