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13 <br />NC Association of County Commissioners <br />Risk Management Pool <br />Wellness Grant Program Pre-Assessment Tool <br />Member: Name of Person Title of Person Phone of Person <br />Orange County Completing Completing completing <br /> Assessment: Assessment: Assessment: <br /> Maria Hitt Senior Public Health 919 968-2033 x 291 <br /> Educator, Healthy <br /> Carolinians <br /> Coordinator <br />Mailing Address: <br />P O Box 8181, Hillsborough, NG 27278 <br />Name of person Title of person Phone of person <br />coordinating coordinating coordinating the <br />wellness program: wellness program: wellness program: <br />Ellen Young Senior Public Health 919 968-2022 x 292 <br /> Educator, Health <br /> Promotion <br /> Coordinator <br />The wellness The wellness program will be available only to the following <br />program will be department(s): <br />available to all <br />employees: <br />Yes <br />No ^ <br />Have you Have you received Have you made a Please estimate the <br />investigated the the EHP analysis decision upon what post of the EHP <br />EHP program from BCBS NC? programs outlined programs you wish <br />through BCBS NC? in the EHP analysis to implement: <br /> you will implement? <br />Yes ® Yes ® Yes ® $20,000 annually <br />No ^ No ^ No ^ <br />If you have not received an EHP analysis from BCBS NC, are you interested in learning <br />more about EHP? <br />Yes ^ <br />No ^ <br />