Category — Worksite Wellness Programs

Quitting smoking at any age can improve a person’s health. and believe it or not, older employees often fair better with smoking cessation than younger workers.  

As reported by the Journal of American Medicine, Duke Univ. reseearchers tracked 573 older patients over 10 years. They found that just 16 percent of those who joined the tobacco use cessation program later returned to tobacco use.  

Previous research has found young smokers who try to quit have a 35% to 45% relapse rate within two years.

Given that staff members nationwide are retiring later and the cost of retiree health care is sky high, you may want to keep trying with use of tobacco cessation programs, even for the oldest staff members on your health plan.

In this recession economy and out-of-control worker debt, many employers who don’t have automatic 401(k) enrollment have seen participation drop.

Here’s how one small business in Arizona cleverly tied 401(k) education to employees’ other financial concerns. Rather than simply holding its usual 401(k) open enrollment education meeting, it held a “financial wellness fair.”

Stressed 401(k) importance

How it worked -  on the same day the company’s 401(k) provider sent a plan rep to discuss the retirement plan, the company also arranged for a licensed financial planner to speak to workers.

The financial planner went first. She started the session by pointing out that she wasn’t affiliated in any way with the management of the 401(k) plan.

That was vital both for the company’s legal protection under ERISA and for building trust with workers. She then discussed why it’s vital for people  to participate in the 401(k) plan, and offered attendees budgeting tips and basic strategies for cutting their debt.

The financial planner’s talk cut to the heart of a few major issues that hurt both worker salary satisfaction and 401(k) participation. Numerous studies show that the No. 1 reason many individuals  avoid 401(k) participation is that they feel they can’t sacrifice any part of their entire paycheck and still survive financially.

The second part of the session was the standard 401(k) enrollment presentation from the vendor. End result -  Employees were more attentive and there was a noticeable uptick in both new 401(k) enrollments and salary contributions from already-enrolled workers.

The event was such a smash that the corporation plans to make the Financial Wellness Fair a regular part of 401(k) enrollment. While the financial planning advice is generic (the corporation may add third-party personal finance planning as a voluntary benefit in the future), it’s also timely.

The 401(k) signup appeal comes while the financial planning tips are still fresh in employees’ minds and they’re motivated to do something to help themselves.

Looking for incentives to get overweight workers to purchase into a wellness program? A recent study  suggests many workers are even willing to pay much - or all - of the cost themselves.

Roughly 35 percent of firms with wellness programs focus on providing workers with convenient access to weight loss resources.

A poll of 1,352 employees by the Strategies to Overcome and Prevent Obesity Alliance found that many individuals  would gladly chip in for the cost of the program if they believed it’d help them lose weight. What employees want -

• confidential support and counseling

• access to a specialist nutritionist or fitness trainer, and

• onsite fitness programs.

Until recently, only big companies were able offer such programs as part of their wellness benefits.   But the fastest growth of these programs in the last two years has been in smaller firms (sometimes with as few as 50 full-time employees).

The majority of firms split the cost with employees. Typically, employees pay up to about 25 percent of the cost. But some plans are fully worker paid.

Studies show that roughly five% of workers drive about 80% of your health benefit costs.

No shocker here -  Smokers and obese staff members are the highest risk group for developing the sorts of chronic health problems that send costs through the roof.

A small, but quickly growing number of corporations are taking desperate measures to avoid the costs associated with these staff members. the step can be broken down into three levels of aggressiveness and potential risk/reward.

Level one -  the employer installs a wellness program in which non-use of tobacco staff members and those who commit to maintaining a healthful weight receive financial incentives that lower their share of monthly insurance premiums.

Level two -  the employer disqualifies job candidates who smoke or are significantly overweight from hiring consideration. Alternatively, some firms require new hires to undergo a health risk (assessment|appraisal} as a condition of being hired.

Level three -  the corporation docks pay or fires staff members who fail to control their lifestyle-related health risks. Example -  A corporation called Clarian Health has sent notifications to staff members that beginning in 2009, staff members who smoke or chew tobacco will be charged $5 per paycheck.

Are these strategies legal? at level one, the answer is a qualified yes. health insurance portability and accountability act (HIPAA)s non-discrimination rules permit such incentives under a few conditions.

Wellness incentives walk a fine line respecting health insurance portability and accountability act (HIPAA)s non-discrimination rules. It’s legal to reward workers for wellness participation but its illegal to punish those who fail to improve their health.

Example -  When an worker follows a weight-loss program in good faith but fails to lose weight, you can’t withhold the incentive. Similarly, if an worker fails repeated tries to quit smoking, you’re still legally obligated to give them another shot next year.

Also rememberthat, by law, the size of the reward or penalty under your wellness program cant exceed 20% of the total cost of coverage.

The other two are still largely uncharted waters in the courts. Employers considering these policies should proceed with extreme caution.  Remember that the question of “can you do it” (i.e., is it legal?) is different from “should you do it?” (i.e., is it good business?)

Wellness programs come in all shapes and sizes. But regardless of plan design there are five common components that set the successful programs apart from the rest.

At their core, wellness programs require constant monitoring and periodic adjustments. the programs that get mediocre results are the ones that are left to run on autopilot. That’s why it’s crucial to -

1. Know thine enemy You have to know what’s driving your largest claim costs on your healthcare plan - both among workers and their dependents.

2. Develop realistic expectations. With wellness, what an company gets will nearly always depend on how much it spends, how well it plans and how well it sustains communications with participants and the vendor.

3. Maintain strong communications. the wellness programs that achieve the greatest success are those which are communicated aggressively from the get go and are sustained. Repetition is your friend when doing staff member education.

4. Integrate wellness with other benefits. Real-life experience has shown that you should consider your staff member assistance programs (EAPs) an extension of the wellness program. You should also consider issues like absenteeism, disability and worker’s compensation to be pieces of the wellness puzzle.

5. Practice what you preach. the key to ensuring employee buy-in is for management to lead the program by setting a positive example. If senior level managers are unwilling to participate and address their own health issues, don’t expect many staff members to take the program seriously.

Here’s more evidence that wellness programs pay for themselves -

Over the last two years, one organization in five has seen significant improvement in employees’ health status - and started to stabilize their costs - as reported by one study.

Among firms noting improvement, almost two-thirds (64%) feature wellness programs offering incentives for healthier lifestyles.

Here are three twists on traditional incentives that’re getting good results -

1. Health coach outreach

A lot of firms require workers to work with an individual health coach to get a discount on monthly premiums or earn cash incentives.

The most common set-up -  on a regular basis, the worker must set up appointments with and report to (either over the phone or face to face) his or her health coach.

But experience has shown there’s often a high dropout rate.

People  get off to a great begin - and they’re enthusiastic about the incentive - but once they realize there’s some effort involved, they lose interest.

The good news -  Firms have found a simple-to-arrange alternative that keeps  people  on the right track. Rather than requiring staff members to contact the health coach, a growing number of organizations require participants to take calls from the health coach.

Potential result -  Fewer folks fall off the wagon. There’s no outreach effort involved, and the health coach keeps individuals  accountable.

2. Nutritional education/therapy

A newer - and cost-effective - feature in the battle against worker obesity -  offering an worker nutrition-education program administered by a professional nutritionist.

Just 11 percent of organizations - 18 percent  of large companys and 7.5 percent of small to medium ones - have such programs, as reported by SHRM’s most recent benefits survey.

Even fewer offer (via their EAPs) nutritional therapy for people  with consuming disorders. But available data on these programs shows they generally pay for themselves.

The stronger the firm’s emphasis on teaching healthy eating, the faster and more dramatic the reduction in major health claims.

Common plan features -  lunch and learns featuring healthy food options, giving out nutrition-linked gift cards and extending obesity-prevention incentives to individuals ’s family members.

3. Assertive tobacco use cessation

A small, but quickly growing number of companys are taking more assertive measures to avoid the costs associated with workers who smoke.

The step could be broken down into three levels of aggressiveness and potential risk/reward.

Level one -  the employer installs a wellness program in which non-tobacco use workers and those who commit to maintaining a healthful weight receive financial incentives that lower their share of monthly premiums.

Level two -  the company disqualifies job candidates who smoke from hiring consideration. Alternatively, some firms require health risks assessments as a condition of being hired.

Level three -  the corporation docks pay or fires employees who fail to control their lifestyle-related health risks.

Example -  Clarian Health made news last fall for sending notice to employees that as of Jan. 1,  2009, people  who smoke or chew tobacco would begin be charged $5 per paycheck.

Are these strategies legal? at level one, the answer is a certified yes. health insurance portability and accountability act (HIPAA)s non-discrimination rules permit such incentives within limits.

In a nutshell, it’s legal to reward workers who quit smoking but illegal to punish those who attempt and fail. When an staff member tries but fails to quit smoking, you’re still legally obligated to give them another shot next year.

Additionally keep in mindthat, by law, the size of the reward or penalty under your wellness program can’t exceed 20% of the total cost of coverage.

At levels two and three, it remains to be seen when such policies would hold up in court. Proceed with caution.

Wellness programs are a long-term investment. But how long should you wait for results?

Finance and the CEO want hard numbers to show return on investment (ROI). and wellness ROI is tougher to calculate than, say, a 401(k).

18-month guideline

Recent studies have established some benchmark data on wellness ROI you are able to use as a guideline. It’s useful whether you already have a wellness program or are thinking about beginning one.

It normally takes at least 18 months from the launch of a wellness program to see any causes your health care plan bottom line.

For many firms, 18 months is the point at which workers’ improving health starts to cancel out the cost of sponsoring and administering the wellness program.

By and large, the long-term cost savings from a wellness program will be driven by how much you’re willing to spend. Ordinarily, corporations get what they pay for - both in time and money invested.

As a rule of thumb, the typical cost to the employer is about $3 to $5 per participating worker per month. Within three years of launch, you should be seeing meaningful savings.

The typical ROI tends to be about $4 to $5 saved for every dollar spent. So how can you manage the costs in the short-term for achieve the long-term savings?  and how can you maximize the long-term payoff?

Consider making wellness programs budget-neutral

For a lot of companys, the most effective way to manage the cost of a wellness program in the start-up phase is to make it a budget-neutral expense.

In other words, the program neither adds to your healthcare costs at the outset, nor lowers them. Example -  You plan to roll out a wellness program effective Jan. 1. the program will cost the company $5 per staff member.

You can roll the $5 per month cost directly into the employee’s monthly share of their healthcare premium. In this age of continuous cost-shifting, most staff members are used to seeing small increases in their monthly contributions each plan year.

Just make sure you’re not hitting folks with a big hike on top of that $5. Comparably designed wellness programs pay off about the same - meaning workers purchase in and participate at the same rate - whether they’re budget neutral or the business absorbs the cost.

But when employees get clobbered by large-scale contribution hikes at the outset, they often resist the wellness program. the long-term ROI for these programs is often disappointing.

If you’re faced with a situation where achieving a budget-neutral program would cause push-back, your firm is better off absorbing most or all of the wellness costs.

The largest hurdle is to get over the hump for those first 18 months or so.

A few years ago, business wellness fairs were all the rage. Now they’re making a comeback, with a slight twist.

In the past, the fairs often better served the vendor(s) who came on-site than the needs of the hosting corporation or their workers. More recently, businesses have refined the planning of the events to serve particularly to launch or promote a wellness program.

To be successful, the events need to serve two purposes -  increaseing employee education and building their enthusiasm to participate in the wellness program.

To make certain you and your employees get the most out of a health fair, it assists to be aware of the plusses and minuses - and some little touches that can mean the difference between a so-so event and a hit.

Wellness Fairs -  Double-edged sword

On the plus side, workers received easy-to-grasp information on key wellness topics such as illness detection, symptom control and smarter medication practices. They also receive important services like free blood-pressure screenings.

On the down side, some professionals said the more newfangled events were more like “disease fairs” than “health fairs.” In other words, the tone was little too somber and staff members weren’t specifically tuned in because they weren’t enjoying themselves.

Wellness program consultant Dr. Ron Goetzel believes that the savviest firms strike a balance in their health fairs. Stick with the screenings, but also feature exhibitors who offer “lighter,” more enjoyable services. Examples -

• a booth from a local health-food store

• a chair-massage station

• elder-care info from the AARP, or

• a “complimentary medicine” info booth (e.g.,a chiropractor or an acupuncturist).

Offering incentives

In many cases, employees still need an incentive to attend the fair and get the desired screenings, and to doing the fun stuff. Some real-life programs that’ve worked -

• a contest offering prizes to workers who visit every station

• quizzes and prizes based on info from different providers’ literature

• flex-scheduling or time-off incentives for getting screened (e.g., a comp day or an extra afternoon off), and

• cash incentives (as little as $20 and as much as $100) to people  who voluntarily participate in various screenings.

Medical research has long shown quitting use of tobacco at any age can improve a person’s health.

But a Duke Univ. shows that the group you could think would be the least likely to quit - individuals  over the age of 50 -  may actually have the best odds for quitting through a smoking cessation program.

Researchers tracked 573 older patients over 10 years. They found that just 16% of those who joined the smoking cessation program later returned to smoking.  Meanwhile, previous research has found young smokers who try to quit have a 35% to 45% relapse rate within two years.

Bottom line -   Given the aging employee population and the cost of retiree healthcare, you may want to keep trying with smoking cessation education for your older staff members.

The organizations with the most cost-efficient health plans are the ones that streamline the services staff members receive for both their physical and mental health.

As a long-term goal, having your general health plan, employee assistance program (EAP) and wellness program communicating regularly with one another about employees’ treatments is the single best way to reduce redundant or contradictory treatments, eliminate unnecessary claims and improve the quality of the plans for which you pay.

Let’s look at the relationship between your wellness program and your EAP to illustrate the importance of attacking health costs cross a wide front.

You can start a wellness program with a health risk (assessment|appraisal} and then, when appropriate, roll out a use of tobacco cessation program or a weight loss program.

But ultimately you want to make certain that your wellness vendor works along with your employee assistance program vendor.

Here’s why -  It’s very common for an employee to contact the employee assistance program because the individuals feels depressed about his or her weight. What you want is for the employee assistance program provider to treat the employee’s depression and behavioral issues, plus you want the employee assistance program to refer the employee to the wellness program to deal with the root cause of the problem - obesity.

The same thing accompanies the relationship your wellness program and your workers’ comp vendor, STD and LTD vendors, rehab people , and/or disease managers. You want all them talking to - and sharing data with - each other. If they’re not, it’s costing you money.

In general, the companys who achieve the greatest cost savings through their wellness programs are the ones who overlap wellness with behavioral and occupational health issues.