I promise that I will act as an advocate to encourage compliance with North Dakota's employer- based health-related health and wellness program requirements. I understand that it is illegal to provide health benefits to employees who voluntarily participate in a non-compete provision agreement except as a condition of employment. Furthermore, I understand that I will not participate in the agreement unless I am given the opportunity to choose if I want to participate. Furthermore, I understand that the North Dakota Highway Patrol is required to be completely compliant with the program requirements and to provide a written explanation of any non-compliance with the law. Furthermore, I am also under the direct supervision of Captain Steve Bock, who shall make decisions about the future of the program and any program failure. Furthermore, I will also act as your advocate by: providing support, in any way it may be possible, towards achieving a work- related wellness program for employees and dependents at the Bismarck Station; and/or reporting any non-compliance to Steve Bock, as described below. In the event I engage in, or fail to act in accordance with any of the foregoing obligations, I understand that there are provisions in North Dakota law which may result in my termination from employment with the North Dakota Highway Patrol. The provisions of this agreement are subject to North Dakota law. If this agreement should be terminated pursuant to any or all of the provisions of this agreement, I understand that I may seek to be reinstated with the North Dakota Highway Patrol. I have read, understood, and agree to the terms of this agreement and will attest that I have read, understood, and agree to the terms above.
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58643 EMPLOYER BASED WELLNESS PROGRAM COMMITMENT AGREEMENT NORTH DAKOTA PUBLIC EMPLOYEES RETIREMENT SYSTEM SON 58643 (09-2010) PAPERS PO Box 1657 Bismarck North Dakota 58502-1657 (701) 328-3900 1-800-803-7377
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