8/8/2019 Fitness Reimbursement
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Purpose
The Fitness Reimbursement program is offered by Linn County to
encourage employees
to become physically fit, with the anticipation of lower health
care claims and less frequentutilization of sick leave benefits.
Linn County has a policy to reimburse employees for
joining or belonging to a health/fitness facility. The County
will reimburse a maximum oftwenty dollars ($20) per month for a
single membership for the employee, or if theemployee has a family
membership, the County will reimburse a single membership rateup to
and not to exceed twenty dollars ($20) per month per employee.
Scope
This policy is applicable to all full-time and part-time,
regularly scheduled twenty (20)hours a week or more, Linn County
employees responsible to the Board of Supervisors;employees
responsible to an elected official, including the elected official
and theirdeputies; and the Conservation Department. Also included
are employees ofEmergency Management and the County Assessors
Office. Reimbursement for part-time employees will be prorated
based on the number of hours regularly scheduled perweek.
Exceptions
The Fitness Reimbursement is not available to part-time
employees that are scheduledto work less than twenty (20) hours per
week or temporary employees.
Specific Policy Provisions
A. The following are approved health/fitness facilities:
Alive and Well Fitness Center Northside Fitness and Tanning
College/University based facilities Curves for Women Open Court
Total Fitness Rockwell Recreation Center North Dodge Athletic Club
YMCA Power Plant
Distribution: Elected Officials, DepartmentHeads, County
Employee Handbook, Intranet
BOARD OF SUPERVISORSCounty of Linn, Iowa
Revision No:
3
Reference: BOS Minutes: 06/25/2007; 08/13/2003; 09/25/2002;
07/28/1997;06/10/1996
Initially Adopted: 12/14/1994
Directive Number:
Approval Date:
06/25/2007
Effective Date:
06/25/2007
Policy Section & Number:
PM-010
Fitness Reimbursement Policy
8/8/2019 Fitness Reimbursement
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FITNESS REIMBURSEMENT CLAIM FORM
Employee Name: ____________________________________________
Department: ___________________ Social Security #:
_____________
Work Status: Full or Part Time (circle one) Hours per week:
_______
Amount Requested: _________________________________________(the
maximum request is $20/month for full time employees)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - -
Please complete the appropriate statement:
Installment of Annual Fee:
I , __________________________ will/have (circle one) attend/ed
________________(employee name) (facility name)
an average of eight (8) times per month for
_________________________________.(list months and year)
Claim for Bank Draft or Monthly Payments:
I , ____________________________ have attended
___________________________(employee name) (facility name)
an average of eight (8) times per month for
__________________________________(list months and year)
Reminder: Attach proof of Payment - (receipt or bank
statement).
__________________________________________
______________________________
Employee Signature Date
