You may not be the only person watching your waistline.
If you get health insurance through work, your employer may require you to have your weight monitored or take a health risk assessment to determine if you’re eligible for a discount of up to 30% for health benefits.
The Patient Protection and Affordable Care Act, or PPACA, that takes effect next year requires all employers to offer health insurance, but allows them to offer discounts to healthy workers. A recent survey found that 15% of employers require employees to complete some sort of health activity — such as biometric screening or health risk assessment — to determine their eligibility for one or all of the company’s health plans in 2013.
If they don’t pass the tests, employees could be dropped to a “less attractive subset of the company’s health plan,” and 3% of employers said that not completing the screening or assessment would result in losing benefits for the year, according to the survey by Fidelity Investments and the National Business Group on Health.
PPACA allows a 20% differential for workers in wellness programs, and it can increase to 30%. Smoking-based inctives can be as high as 50%, says Joseph Torella, employee benefits national practice leader at HUB International, an insurance broker.
“With such strong support for such programs under federal legislation, and increased pressure on quality and cost, a likely increase in these programs is likely,” Torella says. “We’re at a critical point in developing such programs as metabolic syndrome becoming much more common and much more visible in domestic U.S. employer populations.”
“The jury is still out on weight being a single critical driver, but all of the risks appear to be related to obesity,” he says.
While workplace wellness programs are “a good place to start” in improving the health of American workers, the programs “could be very punitive to workers who don’t have the ability to participate,” such as disabled workers or people working multiple jobs who don’t have the time to exercise and lose weight, says Carla Saporta, health policy director at the Greenlining Institute.
There’s no research that such programs work, says Saporta, who has written about workplace wellness regulations. Raising premiums based on weight and other health benchmarks will shift health care costs to the least healthy workers, she says.
Grocery giant Safeway has been lauded for cutting medical expenses by rewarding employees with healthy behavior, but expanding such a program across the country could have American families with average health benefits of $6,688 a year “riding on blood tests and weigh-ins,” according to a Washington Post story.
Telling someone to change their health habits won’t work, Saporta says. A cultural change in an organization is needed, such as not selling soda in vending machines at work, or giving away doughnuts in the office.
“It’s a behavior change issue,” she says.
Getting an employer to stop providing free doughnuts is a great idea, but if an overweight worker still won’t lose weight, it’s a good idea to charge them more for health insurance instead of passing along the cost for their extra health care on to healthy employees, says Ron Stoll, vice president of wellness at Team Excellence, which helps employers manage employees.
“There’s no reason to burden your fellow employee with your bad health choice,” Stoll says.
The 25-year-old who plays soccer all weekend, the middle-aged diabetic, and the 62-year-old who drinks a case of beer over the weekend shouldn’t have the same financial costs for health care, he says.
“From the employer’s viewpoint, it is costing them,” Stoll says.
While the PPACA law doesn’t allow health benefit costs to be increased if an employee doesn’t lose weight, it does allow employers to require workers to be in a wellness program, Saporta says. And if someone is healthy and isn’t in the wellness program, they wouldn’t get the price cut in health insurance, she says.
Wellness programs can include gym memberships, health education classes, smoking cessation programs, on-site flu shots, and adding bike racks and walking paths to workplaces. An overweight worker who joined a gym wouldn’t be monitored to ensure they attend, but they would be evaluated every year to determine if they’ve lost weight and still need to be in the program.
“Workplace wellness programs are potentially something that can help, but they’re definitely not a cure-all,” Saporta says.
Companies are spending more on wellness programs, according to the survey by Fidelity and the Business Group. Employers plan to spend an average of $521 per employee on wellness incentives, a 13% increase from the $460 average in 2011 and double the $260 average in 2009.
The study also found that 86% of employers used wellness-based incentives, with the most popular a decrease in premiums (61%), followed by cash or gift cards (55%), or an employer-sponsored contribution to a health savings account or similar account (27%).
Spouses and dependents are also part of the program, with 54% of employers expanding their wellness incentives to include dependents. Lowering your spouse’s cholesterol or blood pressure could be just as beneficial, financially, as lowering yours.
“An increasing number of employers understand how wellness programs contribute to a healthy workforce,” said Helen Darling, president and chief executive officer of the National Business Group on Health, in a statement. “And it’s encouraging to see employers take the necessary steps to tailor their wellness programs in a way that will incent and motivate their employees to engage in health-improvement activities and find ways to reward them for their progress.”
With 30% of employers surveyed saying they’ll pay workers to lower their cholesterol, 29% giving incentives to lower blood pressure, and 11% paying to get a slimmer waist, that should be plenty of incentive to get healthier and have both the employee and employer saving money on health costs, Stoll says. Watching a worker’s weight is good for business, he says.
“The employer should be involved in their workforce and vested in their employees’ wellness,” Stoll says.
