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 attempt to quit have a 35% to 45% relapse rate within two years.

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

Here is how one small company 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

Precisely how it worked –  on the same day the company’s 401(k) vendor sent a plan rep to discuss the retirement plan, the business also arranged for a qualified financial planner to speak to personnel.

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

That was critical both for the company’s legal protection under ERISA and for building trust with staff members. She then discussed why it’s critical for individuals  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 staff member 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 provider. End result – Workers 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 business plans to make the Financial Wellness Fair a regular part of 401(k) enrollment. While the financial planning advice is generic (the business 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 excited to do something to help themselves.

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

A poll of 1,352 personnel 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 personnel want –

• confidential support and counseling

• Access to a professional nutritionist or personal trainer, and

• on-site fitness programs.

Until recently, only large businesses 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 staff members. Typically, staff members pay up to about 25% of the cost. But some plans are fully worker paid.

No shocker here –  Smokers and obese personnel are the highest risk group for developing the sorts of chronic medical 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 employees.  The step can be broken down into three levels of aggressiveness and potential risk/reward.

Level one –  the business installs a wellness program in which non-smoking employees and those who commit to maintaining a healthful weight receive financial incentives that lower their share of monthly insurance premiums.

Level two –  the company 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 business docks pay or fires employees who fail to control their lifestyle-related health risks. Example –  A organization called Clarian Health has sent notifications to employees that beginning in 2009, employees who smoke or chew tobacco are going to 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 under several conditions.

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

Example – If an staff member follows a weight-loss program in good faith but fails to lose weight, you can’t withhold the incentive. Similarly, when an staff member fails repeated tries to quit tobacco use, you’re still legally obligated to give them another shot next year.

Likewise rememberthat, by law, the size of the reward or penalty under your wellness program cant exceed 20 percent 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. Keep in mind 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?)

At their core, wellness programs require constant monitoring and periodic adjustments.  The wellness 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’ve to know what’s driving your biggest claim costs on your healthcare plan – both among staff members and their dependents.

2. Develop realistic expectations. With wellness, what an employer 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 staff member 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 health promotion 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 staff member buy-in is for senior management to lead the wellness 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 wellness program seriously.

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

Among firms noting improvement, almost 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. Health coach outreach

A lot of firms require staff to work with a personal wellness coach to get a discount on monthly premiums or earn cash incentives.

The most common set-up –  on a regular basis, the employee 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 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 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 corporations – 18 percent  of large businesss and 7.5 percent of small to medium ones – have such health promotion programs, according to SHRM’s most recent benefits survey.

Even fewer offer (via their EAPs) nutritional therapy for individuals  with eating disorders. But available data on these health promotion programs shows they usually pay for themselves.

The stronger the firm’s emphasis on teaching healthful consuming, 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 people ’s family members.

3. Assertive smoking cessation

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

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

Level one –  the company installs a wellness program in which non-tobacco use staff members and those who commit to maintaining a healthy 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 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, individuals  who smoke or chew tobacco would start 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 within limits.

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

Likewise rememberthat, 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.

Finance and the Chief Executive Officer (CEO) want hard numbers to show ROI.  And wellness ROI is tougher to calculate than, say, a 401(k).

18-month guideline

Current studies have established some benchmark data on wellness ROI you can use as a guideline. It’s useful whether you already have a wellness program or are thinking about starting one.

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

For a lot of firms, 18 months is the point at which workers’ improving health begins to cancel out the cost of sponsoring and administering the health promotion 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. Ordinarily, businesses get what they pay for – both in time and money invested.

As a rule of thumb, the average cost to the employer is about $3 to $5 per participating employee per month. Within three years of launch, you should be seeing significant 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 to achieve the long-term savings?  and how can you maximize the long-term payoff?

Consider making wellness programs budget-neutral

For many corporations, 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 health promotion program neither adds to your healthcare costs at the outset, nor reduces them. Example –  You plan to roll out a health promotion program effective Jan. 1.  The health promotion program will cost the business $5 per worker.

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

Just make certain you’re not hitting folks with a big hike on top of that $5. Comparably designed health promotion programs pay off about the same – meaning staff buy in and participate at the same rate – whether they’re budget neutral or the business 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 ROI for these health promotion programs is often disappointing.

If 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 the wellness costs.

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

In the past, the fairs often better served the provider(s) who came onsite than the needs of the hosting organization or their personnel. More lately, organizations have refined the planning of the events to serve in particular to launch or promote a health promotion program.

To be successful, the events need to serve two purposes – increaseing staff member education and building their enthusiasm to take part in the wellness program.

To be sure you and your staff members get the most out of a health fair, it helps to be conscious of 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, staff members 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 experts said the more newfangled events were more like “disease fairs” than “health fairs.” In other words, the tone was little too somber and workforce weren’t namely 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 –

• 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, staff still need an incentive to attend the fair and get the desired screenings, besides to doing the fun stuff. Some real-life health promotion 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 additional afternoon off), and

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

But a Duke University 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 use of tobacco cessation program.

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

Bottom line –   Given the aging employee population and the cost of retiree health care, you may want to keep attempting with smoking cessation education for your older workforce.

As a long-term goal, having your general health plan, worker assistance program (EAP) and health promotion program communicating regularly with one another about employees’ treatments is the single best way to reduce redundant or contradictory treatments, eliminate unnecessary claims and enhance 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 care costs cross a broad front.

You can start a wellness program with a health risk 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 joined with your EAP vendor.

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

The same thing escorts the relationship your health promotion program and your workers’ comp vendor, STD and LTD vendors, rehab individuals , and/or illness 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 employers who achieve the greatest cost savings through their health promotion programs are the ones who overlap wellness with behavioral and occupational health issues.