Empire plan gym reimbursement form

Getting active. just got easier™. Access 17,200+ fitness centers and studios, 8,100+ on-demand workout videos, home fitness kits, free daily workouts, lifestyle coaching, and more—available through your health plan or employer.*. WATCH …16 hours ago · Provider Forms & Guides. At Anthem, we're committed to providing you with the tools you need to deliver quality care to our members. On this page you can easily …With our Active&Fit ExerciseRewards program, you can earn up to $600* just for working out. Active&Fit ExerciseRewards is designed to keep you moving. Earn points by either completing a fitness center visit or 10,000+ steps in a day and get rewarded once you reach 100 points each 6-month reward period. mickey mod Claim this business (305) 876-7000. Website. More. Order Online. Directions Homes similar to 30 NW 24th Ave are listed between $595K to $6,500K at an average of $435 per square foot. $1,175,000. 4 Beds. 3 Baths. 2,271 Sq. Ft. 1414 Galiano St, Coral Gables, FL 33134. $2,500,000.Miami International Airport (MIA) 2100 NW 42nd Ave, Miami,FL.Privacy Practices; Terms of Use; Privacy Policy; Customer Support © 2023 CDPHP. All Rights Reserved | Capital District Physicians' Health Plan, Inc. | 500 Patroon ...NYSHIP Administrative Forms and Empire Plan Claims Forms. Contact Information Empire Plan Programs and Administrators Contact Info Contact information for The Empire Plan program administrators and the circumstances when you must call. Health Benefits Administrators A searchable directory of Health Benefits Administrators. Telephone Numbers cva paramount pro 50 for sale Please note the following about the Gym Reimbursement Program:}}Gym Reimbursement is only available if your employer has purchased the program separately or a medical plan that includes the program. Please check with your human resources department or call the number on the back of your ID card to determine whether you are eligible for the program. pug rescue nj According to federal guidelines from the US Department of Health and Human Services, adults should do at least 150 minutes a week of moderately intense aerobic physical activity. That’s just 22 minutes a day of activity to maintain a good l...— The Gym Reimbursement . gym bill and proof of payment, should be . submitted within six months (180 days) to the . following address: nitedHealthcare Community Plan U Essential Plan Gym Reimbursement. One Penn Plaza, 8th floor. New York, NY 10119. Attention: Member Services Important: Please complete the form in its entirety, or the processing of your claim may be delayed or denied. Complete one form per member, for eachDiscover wellness programs, discounts, benefits, and more for Empire members. Learn about fitness programs and gym reimbursements to help you save money. Discover wellness programs, discounts, benefits, and more for Empire members. Learn about fitness programs and gym reimbursements to help you save money. For Employers home depot shuttersempire plan a. other insured’s policy or group number b. reserved for nucc use c. reserved for nucc use d. insurance plan name or program name 10d. claim codes (designated by nucc) d. is there another health benefit plan? yes no if yes, complete items 9, 9a and 9d. read back of form before completing & signing this form. 12. Posted: (2 days ago) Feb 25, 2020 · AmeriHealth – $150 in fitness fees reimbursement. Aetna – $200 for you and $100 for your eligible spouse every 6 months. Oscar – $400 for policyholders and $200 for … View Details Glenninsurance.com Fitness View More Nyship Empire Plan Gym Membership - 2022 | www.alfitness.com.auRF Empire PPO Exercise Rewards - Gym Reimbursement Form: Gym Membership. Up to $300 annual reimbursement; 50 visits required semi-annually: Health Insurance, Dental and Vision: RF Empire PPO Exercise Rewards-Gym Reimbursement: RF Empire PPO Exercise Rewards-Gym Reimbursement: Health Insurance, Dental and Vision tdiu preparation for decision reddit Experience the official GoT empire-building strategy experience on mobile with Game of Thrones: Conquest. Recovering takes a great deal of time and resources. Selling Average Android and iOS GOT Conquest Lvl 24 Keep, 12 mil power,469 mil food,259 mil wood,123 mil stone, lvl 34 dragon. gotc new kingdom openings.Follow these simple instructions to get Anthem Gym Reimbursement Form completely ready for sending: Find the form you will need in the collection of templates. Open the template in our online editing tool. Read the guidelines to discover which info you have to include. Select the fillable fields and add the necessary information.Find the forms, instructions, publications, educational products, and other related information useful for retirement plans in one convenient place. An official website of the United States Government Form 5500 Corner Filing tips & updates,...The Grove At 600 Apartments Rome Gacom (706) 291-2154 Get Directions 600 Redmond Rd Rome, GA 30165 Apartments in Rome Frequently Asked Questions about The Grove at Six Hundred Apartment Homes What forms of payment are accepted? The Grove at Six Hundred Apartment Homes accepts credit cards.Claim Form - The Empire Plan's Provider Directory. Posted: (11 days ago) When you get home, submit the original records to the appropriate Empire Plan carrier and retain a …automatic bank withdrawal statement) for the fitness facility fee, as well as any money you paid for fitness classes, during the six-month period.1 3. Enclose a copy of the brochure or flier that describes the cardio equipment at the facility you used or the cardio benefits of the class or organized group fitness event in which you participated. 4. north olmsted police reports online 2021 NYSHIP General Information Book for NY Retirees (Empire Plan and NYSHIP HMO) Health Insurance, Dental and Vision: 2021 On the Road with the Empire Plan: ... Gym Reimbursement Form: Gym Membership. Up to $300 annual reimbursement; 50 visits required semi-annually: Health Insurance, Dental and Vision ...Jennifer Lopez revealed on Wednesday that it was her husband Ben Affleck's idea to have a secret Las Vegas wedding in July last year. The American actress, 53, appeared on Sunrise to promote her ...Sep 26, 2017 · Health plan ID number Signature Date Gym Reimbursement Form Check boxes that apply, and fill in the year for all months for which you are requesting … where to buy psychedelics in san diego Health Plan Grievance & Appeal Form (Non-HMO) Used to appeal a coverage decision and request formal written review of how a claim was processed. Member Appeals Appointment of Representative (AOR) Form Used by members to appoint someone to represent them in connection with a specific claim.The year 1962 was important for the US and included many notable events that affected pop culture, politics and business. A recent update to Game Of Thrones Conquest allows us to craft armor from past events and gain new, persistent bonuses. com, complete this survey, or fill out the form below. the dog lawyer It’s a quick form that tells you whether a preauthorization is needed for specific services. You will need your member ID and the following details from your provider before you can use the tool: Procedure Code —also known as CPT or HCPCS Code Diagnosis Code Place of Service —where the services will be performed. It's a quick form that tells you whether a preauthorization is needed for specific services. You will need your member ID and the following details from your provider before you can use the tool: Procedure Code —also known as CPT or HCPCS Code Diagnosis Code Place of Service —where the services will be performed. ford dpf regeneration process Jan 20, 2023 · Debit Cardholder Agreement & Dispute Form. Debit Cardholder Agreement. Card Dispute Form.form with your ExerciseRewards® Reimbursement Request Form/Log and proof of payment to: ExerciseRewards, P.O. Box 509117, San Diego, CA 92150-9117 . Please be advised that a copy of your itness facility agreement may be requested. Failure to submit this form completed with all required information may result in a denial of reimbursement. Last Name Empire Ny Gym Reimbursement - Free PDF eBook. Posted: (6 days ago) Mar 16, 2016 · Services provided by Empire HealthChoice HMO, Inc. and/or Empire. … used knuckle boom truck for sale for these services. I understand that Blue Cross Blue Shield of Massachusetts may require proof of payment for a reimbursement decision. I authorize the release of any information about my qualified fitness program to Blue Cross Blue Shield of Massachusetts. Subscriber’s or Fitness Reimbursement Form Program Description Fidelity has a long-standing commitment to the health and wellness of our associates and their families. We are proud ... You will receive your fitness reimbursement through your normal payroll distribution process, typically within six to eight weeks. 3.FI-H-491B.114 1.960611.102 Page 2 of 2.The Fitness Reimbursement begins January 1st, 2022 and ends on December 31st, 2022.Deadline for Fitness Reimbursement for 2021 is March 31st, 2022 . You should follow the steps below to receive reimbursement for your fitness participation: Visit the gym or enroll to a structured exercise program. reddit askmen girlfriend material You are responsible for submission of accurate claims requests. This reimbursement policy is intended to ensure that you are reimbursed based on the code that correctly describes the procedure performed. This and other UnitedHealthcare Community Plan reimbursement policies may use CPT, CMS or other coding methodologies from time to time.Complete the Fitness Reimbursement Form (PDF). ... receipts that show individual visits to the gym, or verification from your employer that indicates your ... 1965 ford f100 for sale craigslist With our Active&Fit ExerciseRewards program, you can earn up to $600* just for working out. Active&Fit ExerciseRewards is designed to keep you moving. Earn points by either completing a fitness center visit or 10,000+ steps in a day and get rewarded once you reach 100 points each 6-month reward period.Empire Plan Claim Form - An ERISA Segment 502(a) prepare can be professed in a variety of techniques. Both for dental and medical providers, statements forms are available. Your medical provider will require that you total and distribute these claim documents to UnitedHealthcare. thompson center compass 10 round magazine Jennifer Lopez revealed on Wednesday that it was her husband Ben Affleck's idea to have a secret Las Vegas wedding in July last year. The American actress, 53, appeared on Sunrise to promote her ...1 day ago · The normal Empire Plan filing deadline is 120 days after the end of the calendar year in which covered services are performed. Based on the IRS/DOL regulation, the … hancock county indiana jail current inmates Call UnitedHealthcare. 1-855-357-9462, TTY 711. Stay active. Stay focused. Stay you. Renew Active®. The gold standard in Medicare fitness programs for body and mind. Renew Active is available at no additional cost, exclusively from UnitedHealthcare® Medicare Plans.2022 Empire Plan Advanced Flexible Formulary - October 2022 Empire Plan Providers, Pharmacies and Services Forms - Empire Plan Claim Forms, Non-Participating Provider Claim Forms and Administrative Forms. 360 forged wheels corvette Browse our forms library for documentation on various topics including pharmacy, enrollment, claims and more.than 90 days following the end of each benefit plan year. How to Claim Your Reimbursement To claim your reimbursement, simply follow these steps: 1. Have your fitness facility complete a Fitness Facility Member Verification Form. A new Fitness Facility Member Verification Form will need to be completed each year. 2.Please call us at 866-414-5533, or at the number on the back of your member ID card. You can also email us at [email protected] or go to Member.MassGeneralBrighamHealthPlan.org to start a live chat with a Customer Service Professional. We are available Monday through Friday, 8:00 AM to 6:00 PM and 8:00 AM to 8:00 PM on ... melatonin for hiatal hernia In this case, if you want Medicare to pay for your care, you must send a form requesting reimbursement. Can I Be Reimbursed By Medicare for Seeing a Non-Participating Doctor? A doctor who accepts Medicare patients but has not agreed to Medicare's rates may charge you extra for care. orthopedic doctor 1 day ago · The normal Empire Plan filing deadline is 120 days after the end of the calendar year in which covered services are performed. Based on the IRS/DOL regulation, the …Our reimbursement process is quick, easy, and online. Good thing, because look what you can save on: Health club memberships Online fitness memberships, subscriptions, programs, or classes Fitness classes including spin, yoga, and kickboxingPosted: (2 days ago) Feb 25, 2020 · AmeriHealth – $150 in fitness fees reimbursement. Aetna – $200 for you and $100 for your eligible spouse every 6 months. Oscar – $400 for policyholders and $200 for … View Details Glenninsurance.com Fitness View More Nyship Empire Plan Gym Membership - 2022 | www.alfitness.com.au usa hockey nationals 2023 locations information requested below and return this form(s), along with a valid receipt to the address listed at the bottom of this form. _____ _____ Subscriber Last Name First Name Date of Birth Phone Number _____ Street Address City State Zip Step 1-Complete Activity for Reimbursement information and include a receipt. Reminder, a separate form must ...Follow these simple instructions to get Anthem Gym Reimbursement Form completely ready for sending: Find the form you will need in the collection of templates. Open the template in our online editing tool. Read the guidelines to discover which info you have to include. Select the fillable fields and add the necessary information.automatic bank withdrawal statement) for the fitness facility fee, as well as any money you paid for fitness classes, during the six-month period.1 3. Enclose a copy of the brochure or flier that describes the cardio equipment at the facility you used or the cardio benefits of the class or organized group fitness event in which you participated. 4. automatic bank withdrawal statement) for the fitness facility fee, as well as any money you paid for fitness classes, during the six-month period.1 3. Enclose a copy of the brochure or flier that describes the cardio equipment at the facility you used or the cardio benefits of the class or organized group fitness event in which you participated. 4. rochester nh police Learn more about Renew Active®, the gold standard in Medicare fitness programs for body and mind. Available with select UnitedHealthcare® Medicare Advantage plans at no additional cost. laramie county circuit court judges The information provided in these publications relates to Medicare. Medicare & NYSHIP On the Road Planning for Retirement Back to Work Links and Phone Numbers: Social Security Administration: 1-800-772-1213, http://www.ssa.gov Medicare: 1-800-633-4227, http://www.medicare.gov The Empire Plan: 1-877-769-7447The Oxford gym reimbursement form is a great way to get some of your hard-earned money back. If you're a student at the university, you can use the form to receive up to £10 per month in reimbursements for your membership fees. This article holds specifics of oxford gym reimbursement.View and download claim forms by following the link to the Global Resources Portal opens in new window and clicking on My Claims. smith and wesson sd9ve extended magazine Members of Blue365, the health and wellness program for Blue Cross and Blue Shield Association participants, will have access to Fitbit fitness trackers and memberships to Fitness Your Way gyms starting this summer. The smartwatch and gym offer is available to BCBS Blue365's 60 million members.Please note the following about the Gym Reimbursement Program:}}Gym Reimbursement is only available if your employer has purchased the program separately or a medical plan that includes the program. Please check with your human resources department or call the number on the back of your ID card to determine whether you are eligible for the program.for these services. I understand that Blue Cross Blue Shield of Massachusetts may require proof of payment for a reimbursement decision. I authorize the release of any information about my qualified fitness program to Blue Cross Blue Shield of Massachusetts. Subscriber’s or stradman sophia garcia de leonDiscover wellness programs, discounts, benefits, and more for Empire members. Learn about fitness programs and gym reimbursements to help you save money. Discover wellness programs, discounts, benefits, and more for Empire members. Learn about fitness programs and gym reimbursements to help you save money. For Employers Posted: (2 days ago) Feb 25, 2020 · AmeriHealth – $150 in fitness fees reimbursement. Aetna – $200 for you and $100 for your eligible spouse every 6 months. Oscar – $400 for policyholders and $200 for … View Details Glenninsurance.com Fitness View More Nyship Empire Plan Gym Membership - 2022 | www.alfitness.com.au empire plan a. other insured’s policy or group number b. reserved for nucc use c. reserved for nucc use d. insurance plan name or program name 10d. claim codes (designated by nucc) d. is there another health benefit plan? yes no if yes, complete items 9, 9a and 9d. read back of form before completing & signing this form. 12. tnt tony call today The information provided in these publications relates to Medicare. Medicare & NYSHIP On the Road Planning for Retirement Back to Work Links and Phone Numbers: Social Security Administration: 1-800-772-1213, http://www.ssa.gov Medicare: 1-800-633-4227, http://www.medicare.gov The Empire Plan: 1-877-769-7447 Step 1:Log in to bluecross blueshield reimbursement form Step 2:Click the “Forgot Password?” link. Step 3:Type your email address into the appropriate field, and then click the “Submit” button. Step 4:bluecross blueshield reimbursement form will send you an email with additional instructions on how to reset your password. small round pink pill no imprint from mexico MINNETONKA, Minn.: UnitedHealthcare’s gym reimbursement program, Gym Check-In, has expanded to include more than 124,000 facilities across the United States, potentially saving consumers hundreds of dollars a year on their gym fees.Empire Plan Claim Form 1500 - An ERISA Section 502(a) prepare might be reported in many different methods. For both dental and medical solutions, statements types can be purchased. Your health care provider will require you to comprehensive and publish these claim paperwork to UnitedHealthcare.Anthem reimbursement policies are developed based on nationally accepted industry standards and coding principles. These policies may be superseded by mandates in provider or state contracts, or state, federal or CMS requirements. System logic or setup may prevent the loading of policies into the claims platforms in the same manner as described ... female husky for adoption near me 2022 Empire Plan Advanced Flexible Formulary - October 2022 Empire Plan Providers, Pharmacies and Services Forms - Empire Plan Claim Forms, Non-Participating Provider Claim Forms and Administrative Forms. Gym Reimbursement Form Enjoy the benefits of exercise and get reimbursed toward your fitness facility dues! ... than 90 days following the end of each benefit plan year. How to Claim Your Reimbursement To claim your reimbursement, simply follow these steps: ... Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice ...empire plan a. other insured’s policy or group number b. reserved for nucc use c. reserved for nucc use d. insurance plan name or program name 10d. claim codes (designated by nucc) d. is there another health benefit plan? yes no if yes, complete items 9, 9a and 9d. read back of form before completing & signing this form. 12. Jan 17, 2023 · for both PPO plans are administered by Express Scripts, and have the same copayments for both plans. Both plans offer a gym membership fee reimbursement of … statics hibbeler 14th edition solutions pdf If you require access to gyms in NYC, use the Green Membership application. Send the completed applications c [email protected] If you are currently …2021 NYSHIP General Information Book for NY Retirees (Empire Plan and NYSHIP HMO) Health Insurance, Dental and Vision: 2021 On the Road with the Empire Plan: ... Gym Reimbursement Form: Gym Membership. Up to $300 annual reimbursement; 50 visits required semi-annually: Health Insurance, Dental and Vision ...Your employer doesn't have to include reimbursement to you for your gym membership on your W-2 if they use an 'accountable plan'. If you submitted a bill from the gym, and were partially reimbursed, you don't need to include this amount in your income. Click this link for more info on Employer Reimbursements.Follow the step-by-step instructions below to design your empire plan hEvalth insurance claim form: Select the document you want to sign and click Upload. Choose My Signature. Decide on what kind of signature to … gmod top 10 nextbot Health Insurance Transaction Form – PS-404 Waiver of Empire Plan Premium – PS-452 Change of Address – PS 850 Health Insurance Affordability and Accountability Act – EBD-543 Copyright © 2020 | CSEA Local 1000, AFSCME, AFL-CIO facebook twitter youtube 143 Washington Avenue, Albany, NY, 12210 Phone: 1-800-342-4146 CSEA Privacy Policy | sauer danfoss pump parts Complete Aetna Fitness Reimbursement Form 2013-2023 online with US Legal Forms. Easily fill out PDF blank, edit, and sign them. Save or instantly send your ready documents. ... Most Aetna Medicare Advantage plans offer fitness benefits to plan members, including membership to SilverSneakers. SilverSneakers is a wellness program designed to ...Jan 1, 2023 · Renew Active®. The gold standard in Medicare fitness programs for body and mind. Renew Active® by UnitedHealthcare® is a fitness program for body and mind to …This page outlines the basis for reimbursement if the service is covered by an Empire member’s benefit plan. Keep in mind that determination of coverage under a member's plan does not necessarily ensure reimbursement. Industry practices are constantly changing, and Empire reserves the right to review and revise these policies periodically. is biochemistry at wgu hard You can get reimbursed up to $400 per plan year. That’s $200 for every six-month sign-up period you visit the gym at least 50 times. Can you use Renew active in more than one gym? The other way Renew can help you achieve your fitness goals is with Renew Active™2, a leading Medicare fitness program for mind and body.And the gym is probably healthier because its members are more motivated to stay healthy. Here are other ways you can use your reimbursement: When joining the gym or class for the first time, you'll often be reimbursed the first few classes or times.2 You'll get reimbursed each and every time. However, the reimbursement won't last forever.This page outlines the basis for reimbursement if the service is covered by an Empire member’s benefit plan. Keep in mind that determination of coverage under a member's plan does not necessarily ensure reimbursement. Industry practices are constantly changing, and Empire reserves the right to review and revise these policies periodically. my husband keeps waking me up on purpose Good thing, because look what you can save on:Health club membershipsOnline fitness memberships, subscriptions, programs, or classesFitness classes including spin, yoga, and kickboxingCardiovascular and strength-training equipment for fitness that is purchased for use in the home, such as stationary bikes, weights, exercise bands, treadmills ...If so, we can help you make the most of your benefits—and possibly save you money! Simply complete this form and mail to: Attn: OCL Department (A) - 00119. Blue Cross & Blue Shield of Rhode Island. 500 Exchange Street. Providence, RI 02903-2699.The program will reimburse members and their spouse/domestic partner up to $250 after each six-month consecutive period. This is a taxable fringe benefit. The member and member's spouse/domestic partner must submit separate claim forms for this benefit, including proof of payment from the health club after every six-month period.fitness reimbursement program. Your 365-day benefit year begins with the date of your first workout. You must be enrolled in a health plan administered by Independence Administrators for the entire 365-day fitness benefit period. Complete a form for each member (eligible spouse and dependents must beempire plan a. other insured’s policy or group number b. reserved for nucc use c. reserved for nucc use d. insurance plan name or program name 10d. claim codes (designated by nucc) d. is there another health benefit plan? yes no if yes, complete items 9, 9a and 9d. read back of form before completing & signing this form. 12. adhd and avoidant personality disorder reddit That's right; we will send you a reimbursement for each six-month period that you are in the program, provided you meet the required goals and submit a completed reimbursement form. Does Empire Nyship cover gym memberships? You can get reimbursed up to $400 per plan year.form with your ExerciseRewards® Reimbursement Request Form/Log and proof of payment to: ExerciseRewards, P.O. Box 509117, San Diego, CA 92150-9117 . Please be advised that a copy of your itness facility agreement may be requested. Failure to submit this form completed with all required information may result in a denial of reimbursement. Last Name Starting or staying with an exercise routine isn't always easy. ... your fitness goals, we provide reimbursement ... Gym Reimbursement Form, which is shown.The carriers will reimburse you directly for covered expenses. If you are Medicare Primary, remember that Medicare does not provide coverage outside the United ... sermon titles for pastor appreciation 2. Sign the form. Also have a fitness center employee sign the bottom of the form. 3. Date the form when completed. Keep a copy for your records. (We will not return the form.) 4. Send the completed Fitness Reimbursement Form, completed log card or fitness center printout and original receipt to: Claims Department Anthem Blue Cross and Blue ShieldProvider Forms & Guides At Anthem, we're committed to providing you with the tools you need to deliver quality care to our members. On this page you can easily find and download forms and guides with the information you need to support both patients and your staff. All Forms & Guides Forms Guides Category Show All Sort By A to Z 1 2 3 4 5Step 1:Log in to bluecross blueshield reimbursement form Step 2:Click the "Forgot Password?" link. Step 3:Type your email address into the appropriate field, and then click the "Submit" button. Step 4:bluecross blueshield reimbursement form will send you an email with additional instructions on how to reset your password.Health and Fitness Reimbursement Form. Submitted by smg_admin on Fri, 11/10/2017 - 11:39. File: Fitness Reimbursement Form 040820 FILLABLE.pdf. Site location: ... By clicking on this link you will be leaving the Capital Health Plan Medicare Advantage (HMO) information. OK, I Understand No, Stay Here + CHPConnect; About Us; Individual & Family ... appliance liquidation phoenix than 90 days following the end of each benefit plan year. How to Claim Your Reimbursement To claim your reimbursement, simply follow these steps: 1. Have your fitness facility complete a Fitness Facility Member Verification Form. A new Fitness Facility Member Verification Form will need to be completed each year. 2. pyle bluetooth speaker with mic Find the forms, instructions, publications, educational products, and other related information useful for retirement plans in one convenient place. An official website of the United States Government Form 5500 Corner Filing tips & updates,...The Essential Plan. Plans with access to essential health benefits like doctor visits, lab tests, prescription drugs, hospitalization, urgent care, emergency care, vision, dental, and more—all for a $0 monthly plan premium. These plans are for qualified individuals ages 19-64. walmart chest of drawers Stick to these simple instructions to get Metroplus Gym Reimbursement Form ready for sending: Choose the sample you need in the collection of templates. Open the document in our online editing tool. Read through the guidelines to learn which information you will need to give. Choose the fillable fields and add the requested info.than 90 days following the end of each benefit plan year. How to Claim Your Reimbursement To claim your reimbursement, simply follow these steps: 1. Have your fitness facility complete a Fitness Facility Member Verification Form. A new Fitness Facility Member Verification Form will need to be completed each year. 2.Comments and Help with capital health plan gym reimbursement form. Preview of sample chp fitness reimbursement form. Сomplete the chp reimbursement form for free Get started! Rate free chp fitness reimbursement form. 4.0. Satisfied. 31. Votes. Keywords relevant to chp reimbursement form.RF Empire PPO Exercise Rewards - Gym Reimbursement Form: Gym Membership. Up to $300 annual reimbursement; 50 visits required semi-annually: Health Insurance, Dental and Vision: RF Empire PPO Exercise Rewards-Gym Reimbursement: RF Empire PPO Exercise Rewards-Gym Reimbursement: Health Insurance, Dental and Vision unn