Man breaking cigarette in half

Complete Tobacco Attestation Form in four clicks

Each fall, benefits-eligible faculty and staff may complete the Tobacco Attestation Form indicating their tobacco use status. Completing the form is one of two steps to be eligible for the Wellness Incentive Program in 2018. Those who complete the form and the Quest biometric screening will earn $25 extra in their paycheck every month in 2018 if they also elect to use one of the university’s medical plans.

To complete the form, log into Human Capital Management (HCM), then navigate through the following pages:

  1. Main Menu
  2.  Self Service
  3. Benefits
  4. Tobacco Attestation Form

Scroll to the bottom of the form, select your tobacco use status and hit save. Participants must attest for 2018. If the form says 2017, click on the “Add Next Benefit Year” button.

Those who use tobacco are still eligible for the 2018 incentive as long as they complete a tobacco cessation program in 2018. Cessation options are described on the Wellness website. More details about the Tobacco Attestation Form can be found on the Wellness FAQ page.

For this fall only, the Wellness Program is requiring participants to complete just the Tobacco Attestation and the Biometric Screening. The Health Risk Appraisal is on hold until 2018.

Take just one minute to complete this form; it will earn you $300 in 2018.