PHYSICAL

ACTIVITY
INITIATIVE
For MGM DCHP & PPO Participants

Deanna Kachinosky
 Physical Activity Initiative (PAI)
For MGM DCHP & PPO Participants

Physical activity can have a great impact on a person’s body and mind. Maintaining a regular
habit of physical activity can decrease numerous chronic diseases such as type 2 diabetes and
cardiovascular disease. Currently only 24% of adults aged 18 and over met the recommended
guidelines for the amount of physical activity they perform in a day (Source: Healthy People,
2020). Numerous amounts of research have been done to indicate the benefits of partaking in as
little as 30 minutes of physical activity a day.

 Regular physical activity can reduce your risk of a heart attack and lower blood
cholesterol levels
 Individuals who exercise regularly are often reported to have more energy, be more
productive, and have a better mood throughout the day
 Active individuals have a lower risk of developing osteoporosis and often recover better
and quicker from injury or sickness.

Goals
To create a program that incentivizes employees to participate in at least 30 minutes of physical
activity a day which should help improve productivity within the work place and decrease stress
and absenteeism.

Eligibility
All employees are eligible after 61 days of employment. Covered Direct Health Plan members
and PPO participants aged 18 and older are eligible for the program. COBRA members who
maintain eligibility within the Health Plan are eligible. Program members should maintain
continuous enrollment in the Health Plan to sustain eligibility in this program. Health Plan of NV
Plan members have separate benefits and should contact Health Plan of NV for information.

Program Requirements of the Patient

In order for this benefit to be covered by the plan, classes Must only be taken at Desert Valley
Fitness Center (DVFC). Any classes being pre-authorized or performed outside of this group will
be denied for payment. Services provided prior to program acceptance are not eligible medical
expenses under the plan.

1. Program Participants must be evaluated by their Primary Care Physician (PCP) to determine
their current state of health and assess any personal risk or precautions that should be taken when
engaging in physical activity. This form will state that Desert Valley Fitness Center is not
responsible for any injury or health related risk that could occur when taking classes at this
center
 Physical Activity Initiative (PAI)
For MGM DCHP & PPO Participants

2. Once the participant has met with their PCP they must turn in their evaluation form to the
program manager within 90 days of receiving the form.

3. The program manager will then submit the evaluation to Desert Valley Fitness Center where
the participant will then be registered for a membership.

4. The participant will be emailed with their membership details and with instructions of how to
retrieve their pass at the front desk of the fitness center upon their first arrival at the facility.

5. Program criteria include the following:

 Program participants must:
– Exceed 61 days of employment at this company
– Receive medical clearance to participate in physical exercise
– Acknowledge that DVFC is not liable for injury occurring within their facility
– Be a member of Covered Direct Health Plan or a PPO participant
– Maintain good standing within the company which implies that the employee has
not been reported for any unethical or inappropriate behavior

6. This program covers:

 Up to 3 fitness classes a week
 Access to a personal trainer during these classes
 Wellness workshops to target specific goals
 24/7 access to an online database of health-related tips and recommendations

7. In the event that a participant has extenuating circumstances and requires individual fitness
coaching. They must obtain proper reasoning by their PCP with written referral for individual
coaching. Proper reason can include but is not limited to: impairment of hearing or sight,
cognitive, or physical limitations.

8. Participants can attend up to 3 fitness classes per week at no expense to them. If a participant
wishes to exceed three classes per week they must pay out of pocket for any additional class.

9. Bi monthly program participants must provide feedback about what they like/dislike about the
program as well as how the use of this program is benefiting them. This will evaluate the
program performance and help to measure the return on investment.

Out of Pocket Expenses

At the time, facility and membership expenses will be waived for employee participants who
sign up through our program.

Participants will be required to pay any applicable PCP co-payments at time of visit.
 Physical Activity Initiative (PAI)
For MGM DCHP & PPO Participants

Plan Expenses
The total allowed expense for the program is $200 per class. As there are 3 classes per week this
totals $600 a week and around $2,000 a month. Individual classes on an as-needed basis and
must be pre-authorized from the Program Manager before attending. The qualification for the
individual rate is as follows: Any patient unable to benefit from group classes due to impairment
of hearing or sight, cognitive, or physical limitations.

Desert Valley Fitness center is the exclusive provider for this program. Desert Valley Fitness
Center will bill in weekly increments. Group fitness classes will be $200 per session (3
classes/week). Authorized individual classes will be $100/hour (billed hourly).

Billing Procedures
D37401 Group fitness classes $200 per class
D37402 Individual fitness classes $100 per hour