Corporate Wellness Blog

For many workforce, telecommuting and flex-time are highly desired work-life benefits. But a growing number of businesses are reluctant to offer these programs.

Demand for these benefits remains high.  One study found that 87 percent of job applicants are familiar with the idea behind telecommuting and flex-time, and the majority express a desire to have at least periodic access to such programs.

Environmental interest groups have pushed the feds for years to create incentives for businesss to encourage telecommuting.  The pressure has risen as gas prices have continued to soar.

Nonetheless, flex-time programs have leveled off in some sectors, and there’s been a decrease in telecommuting.

Today, about half of all companies where telecommuting is feasible permit personnel to work from home on a case-by-case basis. But the percentage of employers offering full-time telecommuting has dropped in recent years.  Nowadays, only about 20% to 25% of employers offer the benefit year-round.

Even some national corporations that are well-known for their telecommuting programs have scaled back. AT&T, for example, recently asked several thousand home-based workforce to come back into the office.

Hewlett-Packard and Intel have done the same thing.  and the federal government recently noted a 7.3% drop in telecommuting employees. Why the cutbacks?

Worker Assistance Program – Pros and cons

Offering staff members telecommuting or flex-time may be a good recruiting and morale-improveing tool, as well as a way to retain staff members who need to relocate, would otherwise have a need to quit or take leave or commute long distances to work.

But the programs are not without their drawbacks. Some of the main reasons companys give for scaling back or eliminating them –

• Business culture – It’s easier to build a sense of organizational stability and a personal connection between staff members, peers and supervisors when individuals  interact face-to-face on a daily basis.

• Security – Among the hidden costs of allowing employees to telecommute (or else come in early or stay late) is keeping sensistive information safe. Some the cutbacks are being driven by companies’ IT departments.

Specifically, managers have raised concerns about stolen laptops, identity theft or other crimes driven by hackers gaining access to information via workers’ home Internet connections.

• Productivity – A lot of supervisors find it easier to ensure high productivity when everybody is working under one roof at the same time.  There’s also a widespread view that most workers get things done faster and more accurately when they’re not distracted by things at home.

The bottom line on the bottom line

Work-life programs like flex-time and telecommuting remain a useful benefit to offer staff, and a lot of corporations still provide these benefits for economic reasons.

But once the potential hidden costs are weighed, it’s often better for the bottom line to limit the scope of these programs.

Organizations that are thinking about beginning a telecommuting program should look closely at job descriptions and telecommuting candidates. Some positions are poorly suited for remote work, and some staff are more up to the challenge than others.

But unless the corporation creates objective criteria for permitting or denying flex/telecommuting requests, such programs can actually damage morale.

The last thing any employer wants is to open supervisors(and the company) up to accustations of favoritism or discrimination because of seemingly random decisions on which personnel in their department can and can’t flex their schedules or work from home.

In the near future, the federal government may offer help to employers looking to start a wellness program.  The help would take the form of tax breaks to offset wellness program costs.

A current United States  Senate bill would give employers a substantial tax break for starting wellness programs. Dubbed the Healthful Workforce Act, it calls for an employer tax credit of up to $200 per staff member enrolled in a newly created wellness program.

For bigger firms, there is the $200 credit for the first 200 staff members and up to $100 per worker thereafter.  To qualify for the full credit, your wellness program would have to feature –

• health risk appraisals

• worker education drives (e.g., targeted mailings, internet based tools)

• behavior change programs (e.g., tobacco use cessation, weight management, wellness Coaches), and

• “meaningful” participation incentives (e.g., lower co-pays).

Certified businesss would be able to claim the tax credit for up to 10 years after starting a health promotion program.

The bill has enjoyed bipartisan support, but like many things in Washington, the parties disagree over how to fund the cost of the tax credit.  As a result, it’s been bogged down in committee.

If and when the bill is ratified, companys could claim the federal tax credit the following year.

In the meantime, whether or not your company already has a formal wellness program, there are proven ways to make wellness part of the company culture. Best of all, they don’t have to cost an additional cent.

Health Promotion town meetings

It’s often said that successful health promotion programs begin at the top of the organization. Reason – Employees pick up fast on whether senior management practices what it preaches when it comes to wellness.

When the individuals  in senior management are smokers, obese or simply reluctant to talk about health issues, it’s a tough sell to get workers engaged in taking control of their health.

That’s the idea behind the wellness town meeting.

Once a week (or once a month), everyone in the business attends a short meeting to discuss their own recent efforts to get healthier.

Managers typically go first, to break the ice about discussing some potentially sensitive issues like dieting or quitting smoking.

In most corporations, the meetings are arranged to encourage casual, free-flowing conversation.

One key – People  speak from where they’re seated, rather than standing up front, with all eyes staring at them.

Some corporations take a more formal approach, which can also work.  For example, at Old National Bank in Indiana, folks file into an auditorium to face their worst enemy, the scale.

Each week, everybody at the firm – from seasoned managers to the newest hires – comes in to get weighed.  The only one who sees the number on the scale is the individuals getting weighed. Even so, the health promotion program has inspired a lot of folks to lose weight.

Free tests and screenings

While there’s no substitute for having staff members undergo extensive health risk assessments, it’s also wise to home in on screening for common conditions that aren’t necessarily lifestyle related.

Example –  skin cancer. It’s not just sun worshippers who are at risk of the most common (and in its early stages, treatable) form of cancer. Heredity plays a part. So does luck.

Fortunately, businesss can get their staff screened for free. Through the American Academy of Dermatology’s National Melanoma and Skin Cancer Screening program, volunteer physicians perform skin cancer screenings at no cost.

Likewise, other medical associations and public health agencies offer free or nominal-cost screenings for a variety of other common conditions.

In fact, it varies.  In some cases, an HSA-eligible plan may cost the same as a non-HSA high-deductible plan. In others, the premiums can actually be more expensive, a recent NHPI report locates.

As a matter of fact, a non-HSA plan offering similar coverage can carry a monthly per-employee premium that’s about $15 to $25 lower and a deductible that’s $500 to $1,000 lower than the HSA choice.

Sometimes the difference is due to price-jacking –  the HSA plans are the ones that’ve been hyped in radio commercials and mentioned in newspapers in recent years.

Nowadays, fewer individuals  exploring high-deductible plans ask first about the non-HSA, so insurance organizations sometimes slash prices to drum up interest in those options, too. Another factor –  Not all deductibles work the same.

Deductible cuts both ways

Two deductibles can look similar but work differently, and the cost scales can tilt for either an HSA or a non-HSA plan. Example –  HSAs by law can no longer allow first-dollar coverage of prescription drugs. But a non-HSA plan can.

On the flip side, HSAs often feature better preventive-care coverage. In some non-HSA plans, a person who’s yet to meet the deductible must pay out of pocket for standard tests (example –  cholesterol testing) that’re part of the routine physical. Only the office visit itself is covered.

Additionally, HSA-eligible plans have to follow rules that limit sum out-of-pocket costs. But this can push up the premiums paid on the front end.

Best bet –  Double-check with your broker to be certain you’re comparing apples to apples when assessing  the costs of HSA and non-HSA plans.

If your organization has this common – and increasingly popular – fringe benefit you might be at legal risk without even knowing it.

Some organizations have an on-site employee fitness room as part of a formal wellness program. Others simply do it as a way for folks to get their juices flowing before work or blow off steam afterwards.

No matter the reason, businesses with fitness rooms need to be aware that the benefit isn’t risk-free.

Over the last few years, several privately owned fitness clubs have been sued – and agreed to expensive settlements – after exercisers suffered sudden cardiac arrest (SCA) and died before help arrived. In each case, the facility either didn’t have lifesaving equipment on the premises or didn’t have personnel properly trained to use it.

Some legal professionals have expressed concern that companys could also be at risk if the unthinkable happened on organization premises while an worker worked out.

SCA is of particular concern. Reason –  Even seemingly healthful, active adults are at risk of sudden cardiac arrest. It can’t be prevented. There’s no vaccine.

And few victims survive by the time an ambulance arrives. But there is a way to save the employee’s life and potentially save your firm from a lawsuit.

Learning about SCA

Sudden cardiac arrest (SCA) is a frequently misunderstood killer. It’s different thing as a heart attack. SCA can affect whoever, anywhere, anytime. It occurs more than 600 times every day in the U.S., killing at least 250,000 people  each year.

The only hope –  using a device called an automated external defibrillator (AED) within 10 minutes.

The good news is any individuals at your company may be quickly trained to use an AED – you don’t need any medical knowledge to use it.  The training may be obtained for free through a local Red Cross or civic group.  The devices themselves cost under $2,000.

Compare that to the financial risk of being sued for not having an AED near a worksite fitness room, and it’s a no-brainer that any corporation with onsite workout equipment should at least investigate an AED buy and training.

Employees, supervisors and upper-level managers alike will probably need education about SCA and AED use. A great teaching resource is available here.

Key talking points –  Without an AED, 90 percent of victims die. But if you have access to one, there’s a good chance to save an employee’s life.  And it’s easy to teach supervisors and staff how to use the device if it’s ever needed.

The vast majority of facilities with AEDs never need to use them – and that includes medical facilities. But it only takes one tragic event, and subsequent lawsuit, to cause pain for both the corporation and an employee’s family.

Don’t forget – Prevention and education are always your company’s best tools for avoiding liability. In this case, where human life is involved, the option seems rather obvious.

For most firms, voluntary benefits are a win-win arrangement. But there could be hidden risks.

On the positive side, voluntary benefits cost businesss next to nothing, yet boost employees’ morale and benefits satisfaction.  An Aon survey found 77 percent of businesses offer at least one voluntary benefit.

But what happens if there’s a legal dispute between one or more of your workers and the vendor?

In many cases, employers unwittingly get dragged into court.  The provider may argue that the plan is covered by ERISA, and the employee’s lawsuit should instead be filed against his or her employer.

If the court agrees, the legal burden shifts.  Some courts have ruled that a voluntary benefits may  be covered under ERISA, even when it wasn’t an corporation’s intention to formally “sponsor” the plan.

If push comes to shove, the providers will protect themselves. Truly, some attorneys warn that a voluntary plan insurer’s first move when sued by one of your workers are going to be to attempt to get the legal burden shifted from itself to you.

Two seemingly innocent things that can be turned against you in court –

• The written announcement to tell workers about the new voluntary benefit, and

• getting involved if there’s a dispute between an staff member and the plan provider.

Be careful with announcements When you offer a new voluntary benefit, the natural tendency is to attempt to get personnel pumped up to participate. But you are able to get in trouble if individuals  get the impression the firm endorses the plan. Helpful practices –

• Don’t put the announcement on organizational letterhead

• Put a disclaimer on the description

•  either exclude your voluntary offerings from employees’ benefits manuals or list them separately, and

• hold open enrollment at a different time than for ERISA plans (401(k), primary health plan, etc.).

In addition, when the provider offering the voluntary plan has competitors, you may want to remind staff the provider of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing providers.

Avoid involvement in disputes as with your ERISA plans, chances are staff will come to you when they have a problem with a voluntary plan. Your first inclination is to help.

But many specialists warn it’s better to stay out. Reason –  Courts see this as the action of a plan sponsor. But you are able to steer someone in the right direction (e.g., giving a contact name to call) while remaining neutral in the dispute.

Good intentions gone bad

From an ERISA standpoint, the most dangerous voluntary plan design is one that is partially paid by the organization, even if staff members pay the bulk of the cost.

In a major ruling several years ago (Burgess v. Cigna Life Insurance), a United States  district court ruled against an employer with a voluntary supplemental disability plan in which the firm compensated a portion of premiums for its lower-compensated workers.

While most workers compensated the entire premium – and firm made clear to people  the plan was a voluntary benefit -the court said it didn’t matter.  The act of contributing to some employees’ premiums made it an ERISA plan.

In the last few years, “presenteeism” has become an even bigger concern for a lot of businesss than absenteeism. Although many HR/benefits managers hate the admittedly overused term, presenteeism is nevertheless a real issue in almost every workplace.

Most commonly,  presenteeism takes the form of personnel coming to work sick. They’re  unproductive and endanger coworkers. Meanwhile, the worker is not forced to use a sick day. A bad deal for employers all the way around.

A recent survey by LifeCare revealed that 93 percent of workforce (polled from 1,500 companies) admit that they at least ocassionally come to work when they’re sick enough to stay home. More important, the study  looked at the reasons why folks do it.

Troubling rationales

The No. 1 reason personnel cited for coming to work sick was a belief that they’d be “letting other people  down” when they call out. Almost 30% of respondents cited this as their primary reason. Beyond that, the top responses were –

• It’s too risky, as a result of office politics or culture, to take time off (26%)

• The employee is too busy at work to be able to stay home a day (15%)

• The employee saves up sick days for childcare/eldercare emergencies (12%), and

• The worker saves up sick days to use as additional vacation time (8%).

Many of these rationales are troubling to HR/benefits managers.

In the first place, supervisors who hassle staff members about taking legitimate sick time are, at best, being pennywise and poundfoolish.  Presenteeism costs more than absenteeism, once you figure in the uncharged sick days, lack of productivity and risk of other staff members getting sick.

You’ve more power than you think to change your company culture if the “tough it out” mentality still applies to individuals  who come in sick. When upper management is confronted with the real dollars and cents of presenteeism, decling the problem ordinarily becomes a priority.  At the very least, firms shouldn’t invite it.

In terms of supervisor- and employee-education, repetition of the “stay home if you’re sick” message is the key. Eventually, it’ll sink in.

Of course, there’s still the problem – as evidenced by the survey – of workforce who misuse their sick days by trying to hoard them for other purposes.  

Adopting PTO, no-fault absence policies or use-it-lose-it sick time are the three most common ways of lowering the risk, but be aware that each of these policies have risks of their own.

At the end of the day, the more open the lines of communication are between executive management and personnel, the less prevalent the presenteeism problem becomes.

In many segments of society, we  hear about racial and ethnic profiling in negative ways. But what about when it comes to health promotion programs?  

When used for the specific purpose of starting – or reviewing  - a wellness or disease management (DM) program, profiling isn’t just legal. It’s also encouraged.

Affects health risks

Different racial and ethnic groups tend to be more at risk – for genetic and/or cultural reasons – of certain health problems. Examples –

• African-American, Latino, Native American and Pacific Islanders are  at higher risk of diabetes than Caucasian employees

• Chinese women are statistically twice as likely to get cervical cancer

• Caucasians have disproportionately high rates of obesity and high blood pressure, and

• Latinos have higher rates of asthma and chronic obstructive pulmonary disease than other groups.  The HIV/AIDS population is also disproportionately Hispanic.

Bottom line –  By reviewing  the ethnic breakdown of your staff member population, you can set disease management (DM) program priorities with greater confidence and accuracy.

Healthcare quality an issue

Several studies also show there’s an unfortunate relationship between ethnicity and quality of healthcare. A lot of times, minority employees receive inferior treatment and health education at the same facilities where others receive top-notch care.

This normally happens for innocent reasons. A common scenario –  a lack  of Spanish-speaking doctors in the network for your Latino personnel. But the result is normally higher healthcare costs for you and, often,  greater reluctance among minority personnel to seek needed treatments.

By profiling staff against the physicians in the network, you ultimately help staff get the care they need and the corporation to better control long-term costs.

Nearly two-thirds of organizations with wellness programs offer workers incentives – financial or otherwise – to participate.

But only one firm in five has seen major improvement in employees’ health status (and lower costs) within two years of launching the incentive. Here are three keys to getting good results – and a red flag for failure.

Cancer screenings pay off big

Most wellness programs feature health-risk assessments for things like high cholesterol and diabetes. But many overlook the need for early detection of cancer, which may affect any employee, regardless of his or her age or general health.

In many cases, you can line up certain screenings, such as skin cancer detection (the most common kind of cancer and, in its early stages, the most easily treated) for free or at a nominal cost.

These resources are often available through community agencies or the American Cancer Society. More involved and costly screenings – such as mammograms – are well worth the cost.

A single case of cancer identified early generally saves thousands of dollars in medical claims and disability costs – not to mention trauma for the worker.

Smart staff member wellness incentives

Health Insurance Portability and Accountability Act (HIPAA) has tricky non-discrimination rules for offering workers a break on premiums or copays. You needn’t worry about HIPAA if you –

1. Structure the wellness program as a cost-break for workforce who embrace wellness. on the flip side, imposing surcharges for uncooperative workforce can force you to jump through health insurance portability and accountability act (HIPAA) hoops.

2. Make the incentive available to all personnel. for  instance, if you offer a discount to non-smokers, an employee who lately quit use of tobacco must also be eligible.

3. Allow staff who fail to earn the incentive to have another shot at it next plan year.

Bottom line –  Make the financial incentive a reward, not a punishment. Do the incentives work? When they’re done right, yes.

Firms offering monetary rewards for wellness ordinarily save about $20 to $50 a month, according to some estimates.

Making health promotion programs simple

Many firms require staff to work with a personal “wellness Coach” in order to earn premium discounts or other incentives. Normally, the worker sets up appointments and reports to the wellness coach on a regular basis, either by phone or in individuals.

The good news –  the early results are often encouraging.

The bad news –  Once workers realize there’s ongoing effort involved, many lose interest. But many firms have found a simple alternative. Rather than having participants contact the wellness Coach, the wellness coach calls them.

In many cases, this minor wellness program tweak keep folks on the right track and cuts dropout rates.

Health Promotion starts upstairs

No matter how much money your organization spends on wellness, the odds of success depend largely on the example set by top management.

Example – When your Chief Executive Officer (CEO) is a smoker, chances are few staff will purchase into a smoking cessation program.

Likewise, it’s hard to sell staff members on subsidized health club memberships if your corporation culture is sedentary. for wellness to work, the top brass must practice what the firm preaches.

Are your healthcare programs delivering on your providers’ promises?

Just as importantly, how can you hold vendors accountable if you’re not getting what you paid for?

Here is one proven way – Develop a vendor scorecard. Scorecards alone won’t bring down your health care costs. But they’ll at least help make sure your corporation – and staff members – get everything you’re compensating for.

The tool can help you measure plan performance with greater precision – and identify specific areas that need improvement. Best of all, any corporation can adopt the technique to fit their needs. Here is how it works.

1. Choose specific rating areas

Benefit pros who’ve successfully adopted the scorecard system recommend grading providers on five to 10 measurable areas, like –

• Claims processing. Are employees’ medical claims turned around in a timely fashion? Are you hearing complaints that the explanations of benefits (EOBs) are slow to arrive or hard to understand?

• Disputed and resolved claims. Do employee questions and complaints about denied or still-pending claims get answered rapidly and thoroughly? Just how often are you forced to go to bat for employees?

• Accessibility. Are plan reps quick to answer phone calls? Do they attend regularly scheduled meetings?

• Reports. Do you receive timely paid claim and utilization reports?

• Open enrollment. Did you receive effective support preparing for and conducting open enrollment events?

• Employee education. Do your employees find the written and/or one-on-one services provided through the plan helpful in answering questions about managing specific chronic illnesss (such as diabetes or depression)? Do you receive support in educating your employees to make healthful lifestyle options, such as use of tobacco cessation?

2. Choose a workable rating scale

There are two schools of thought when it comes to choosing  a rating method –  subjective or objective. Many benefit pros – especially those from smaller firms – use a simple pass/fail or 1 to 5 score to rate their satisfaction.

Others develop more elaborate, statistic-based ratings. One method –  take the provider’s guarantees (e.g., addressing disputed claims within 3-5 corporation days) and then measure by percentage how often these goals are met.

These rating data could be acquired through quarterly performance reports, worker surveys, issue and complaint files and, for larger plans, external audits.

3. Feedback triggers improvement

It’s good practice to share your scorecard system with the vendor before meeting to review the results. Reason –  This lets you iron out any vendor questions about the review categories and scoring system.

Once that’s settled, you are able to meet to go over the numbers and prioritize the areas that need improvement. A lot of firms then add a new scorecard category – providers’ followup.

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

It depends on the steps you take to support workforce attempting to kick the habit, finds a recent published study .  The Journal of Tobacco Policy and Research found that smokers do, indeed  take more sick days than their non-tobacco use coworkers.

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

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

But when the person only refrains from tobacco use on the job – but continues puffing away at home – the business sees little to no medical cost decrease.  The 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 ordinarily doesn’t.