Posts from — February 2011

At the end of the day, is it worthwhile to ban use of tobacco on the premises at your business?

It depends on the steps you take to support staff members trying to kick the habit, finds a recent published study .  The Journal of Tobacco Policy and Research found that smokers do, truly  take more sick days than their non-smoking peers.

And even when the smoker is in relatively good overall health (i.e., isn’t obese, doesn’t have chronic health conditions), he or she is still likely to have higher medical costs than a comparable non-smoker over the last three years.

Just how does a smoking ban fit into the cost equation? If the smoker quits, healthcare costs even out.

But if the person only refrains from smoking on the job â.” but continues puffing away at home â.” the business sees little to no medical cost decrease.  The research study  found similar patterns for absenteeism.

Bottom line -  A worksite tobacco use ban in combo with a tobacco use cessation program gets results. A tobacco use ban alone normally doesn’t.

In the last few years, there’s been a rising trend for public companys â.” not just private corporations â.” to ban use of tobacco. Here is what your coworkers are doing.

What’s New in Benefits and Compensation lately surveyed 374 of our readers from both the private and public sectors to figure out their organization’s policy on permitting staff members to smoke on-site and hiring smokers in the first place. Here’s what we found -

o  11% have created a policy of hiring only non-smokers

o  17 percent allow workforce to smoke offsite, but ban it on all company property

o  39 percent restrict tobacco use to designated areas outside the building

o  30% allow use of tobacco anywhere outside the building, and

o   3% allow tobacco use in break rooms or other indoor areas.

Public employers get aggressive

While much of the publicity about no-hire policies for smokers centers on private businesses, it’s actually public companys in certain states who’ve been the most assertive of late.

For  instance, Florida is among the states at the forefront of the movement. Sarasota County lately became  the third Florida county to take a no-hire stance for control healthcare costs.

New hires must take a drug test that detects nicotine and sign a pledge certifying that they haven’t smoked in the past 12 months.

The ban won’t affect current staff members, but the county has undertaken smoking cessation programs aimed at employees’ wallets.

Non-smokers pay less for coverage through various incentives and the county covers the cost of participating in tobacco use cessation programs.

The reason why Florida public corporations can easily take these steps -  the state supreme Supreme Court has ruled that refusing to hire smokers doesn’t break discrimination laws.

But your state laws may vary, so proceed with caution before considering similar policies.

Quitting use of tobacco at any age can improve a person’s health.  And believe it or not, older employees often fair better with use of tobacco cessation than younger employees.

According to the Journal of American Medicine, Duke University reseearchers tracked 573 older patients over 10 years. They found that just 16% of those who joined the smoking cessation program later returned to smoking.

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

Given that workforce nationwide are retiring later and the cost of retiree healthcare is sky high, you might want to keep attempting with smoking cessation programs, even for the oldest workforce on your health plan.

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

Here is how one small organization 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 health 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 business also arranged for a qualified financial planner to speak to employees.

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 personnel. 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 several major issues that hurt both employee salary satisfaction and 401(k) participation. Numerous studies show that the No. 1 reason many people  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 - Workers were more attentive and there was a noticeable uptick in both new 401(k) enrollments and salary contributions from already-enrolled staff members.

The event was such a smash that the organization plans to make the Financial Wellness Fair a regular part of 401(k) enrollment. While the financial planning advice is generic (the organization 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 personnel to buy into a health promotion program? A recent study  suggests many personnel are even willing to pay much â.” or all â.” of the cost themselves.

Roughly 35 percent of firms with health promotion programs focus on providing workers with convenient access to weight reduction resources.

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

o  confidential support and counseling

o  Access to a professional nutritionist or personal trainer, and

o  on-site fitness programs.

Until lately, only big corporations were able offer such wellness programs as part of their wellness benefits.   But the fastest growth of these wellness 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 workers. Ordinarily, workers pay up to about 25% of the cost. But some plans are fully worker paid.

Studies show that roughly five percent of workforce drive about 80 percent of your health benefit costs.

No shocker here -  Smokers and obese employees 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 companys are taking desperate measures to avoid the costs associated with these staff.  The step can be broken down into three levels of aggressiveness and potential risk/reward.

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

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

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

Are these strategies legal? at level one, the answer is a certified yes. HIPAAs non-discrimination rules permit such incentives under several conditions.

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

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

Also keep in mindthat, by law, the size of the reward or penalty under your wellness program cant exceed 20 percent of the sum cost of coverage.

The other two are still largely uncharted waters in the courts. Companys 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?)

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

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

1. Know thine enemy You’ve to know what’s driving your biggest claim costs on your health care plan - both among staff members and their dependents.

2. Create realistic expectations. With wellness, what an corporation gets will almost always depend on how much it spends, how well it plans and how well it sustains communications with participants and the provider.

3. Maintain strong communications.  The health promotion 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 worker education.

4. Integrate wellness with other benefits. Real-life experience has shown that you ought to consider your worker 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 senior management to lead the health promotion program by establishing a positive example. If senior level managers are unwilling to participate and address their own health issues, don’t expect many employees to take the health promotion program seriously.

Here is more evidence that wellness programs pay for themselves -

Over the last two years, one company in five has seen meaningful improvement in employees’ health status â.” and started to stabilize their costs â.” as reported by one study.

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

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

1. Wellness coach outreach

Many firms require employees to work with a personal health coach to get a discount on monthly premiums or earn cash incentives.

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

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

Individuals  get off to a excellent start â.” and they’re enthusiastic about the incentive â.” 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 individuals  on the right track. Rather than requiring workforce to contact the wellness Coach, a growing number of corporations require participants to take calls from the wellness Coach.

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

2. Nutritional education/therapy

A newer â.” and cost-effective â.” feature in the battle against employee obesity -  offering an employee nutrition-education program administered by a expert nutritionist.

Just 11 percent of businesses â.” 18 percent  of large employers and 7.5 percent of small to medium ones â.” have such wellness programs, as reported by SHRM’s most recent benefits survey.

Even fewer offer (via their EAPs) nutritional therapy for people  with eating disorders. But available data on these wellness programs shows they usually 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 healthful food options, giving out nutrition-linked gift cards and extending obesity-prevention incentives to people ’s family members.

3. Aggressive smoking cessation

A small, but quickly growing number of corporations are taking more aggressive measures to avoid the costs associated with staff who smoke.

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

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

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

Level three -  the business docks pay or fires staff members who fail to control their lifestyle-related health risks.

Example -  Clarian Health made news last fall for sending notice to workers 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. HIPAAs non-discrimination rules permit such incentives within limits.

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

Additionally rememberthat, by law, the size of the reward or penalty under your health promotion program can’t exceed 20 percent of the sum cost of coverage.

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

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

Finance and the CEO want hard numbers to show 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 Return On Investment (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 typically 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 the cost of sponsoring and administering the wellness program.

By and large, the long-term cost savings from a health promotion program are going to be driven by how much you’re willing to spend. Generally, businesses get what they pay for â.” both in time and money invested.

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

The average 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 health promotion programs budget-neutral

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

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

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 large hike on top of that $5. Comparably designed wellness programs pay off about the same â.” meaning staff buy in and participate at the same rate â.” whether they’re budget neutral or the employer absorbs the cost.

But when workforce get clobbered by large-scale contribution hikes at the outset, they often resist the health promotion program.  The long-term Return On Investment for these health promotion programs is usually disappointing.

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

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

Several years ago, organization 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 workforce. More recently, companies have refined the planning of the events to serve specifically to launch or promote a wellness program.

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

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

Health Fairs -  Double-edged sword

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

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

Health Promotion program advisor 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 -

o  A booth from a local health-food store

o  A chair-massage station

o  elder-care info from the AARP, or

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

Offering incentives

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

o  A contest offering prizes to employees who visit every station

o  quizzes and prizes based on info from different vendors’ literature

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

o  cash incentives (as little as $20 and as much as $100) to people  who voluntarily take part in various screenings.