H1N1 Employee Self-Funded No Waiver Letter

PROTECT YOURSELF AND YOUR FAMILY – LEARN ABOUT PREVENTION OF H1N1 AND SEASONAL FLU VIRUSES TODAY!

Month , 2009

Addressee Name

Addressee Addr1

Addressee Addr2

Addressee Addr3

City, ST XXXXX-XXXX

Dear :

This year the flu season is expected to be particularly aggressive with the potential for widespread impact of the H1N1 (swine) flu virus in additional to the seasonal flu virus. We encourage all our employees to protect themselves and their families to help stay healthy and minimize the impact of these flu viruses on you, our company and our communities.
We encourage you to learn more about these viruses and how to prevent them. The H1N1 flu vaccines (serum only) are paid for by the Federal Government, but there is a cost associated with the administration of the vaccine. Both the H1N1 and seasonal flu vaccines are subject to applicable plan limitations, co-pay, deductibles, coinsurance and eligibility at time of service.
Who should get the vaccines:

The Centers for Disease Control and Prevention (CDC) have issued guidelines for who should receive the H1N1 and seasonal flu immunizations. These guidelines are available at www.cdc.gov/h1n1flu/general_info.htm or by visiting www.premera.com.

Where you can get the vaccines:

Seasonal flu vaccines are available now at doctors’ offices and community sites, such as grocery stores and pharmacies.
For the H1N1 vaccine, please contact your doctor’s office or the local department of public health for more information about the availability. You may also check your local pharmacy or grocery chain to see if they will be distributing the H1N1 vaccine. And check local news sources for locations where you may be able to obtain an immunization.
For more information please contact our Department at
or . You may also visit www.premera.com.
Sincerely,

Company Executive Name

Company Name

021040 (Rev. 10-2009)