Wellness Plans

The most common chronic health conditions among US workers contribute to much reduction in productivity and many lost annual work days, for conditions such as: depression, cancer, respiratory disorders, asthma, migraines, allergies, heart disease, arthritis, diabetes and hypertension. Wellness programs have been around for a long time, but with the trend towards “consumer-oriented” health plans, with more deductibles and out-of-pocket expenses, both NJ employers and employees have big incentives to promote and improve employee health.

Wellness programs give businesses the opportunity to take some control of the underlying factors that are driving up their insurance costs. Corporate wellness programs help businesses assess health risks, develop programs and interventions to address health and wellness needs, track participation and effectiveness of the plan. Structured properly, most wellness plans are a good investment of time, money and effort. Most large companies offer wellness plans, reporting multiple returns on money invested. The most prevalent types of plans, with and without (participation, behavior or results) incentives (e.g. cash, gift cards and premium reductions) include the following:

  • Health Risk Questionaire, to identify risk measures (such as: alcohol, blood pressure, body weight, cholesterol, existing medical problem, illness days, life satisfaction, perception of health, physical activity, safety belt usage, smoking, stress);
  • Biometric Testing (such as: asthma peak flow, blood glucose, blood pressure, creatinine, HDL cholesterol, hemoglobin A1C, LDL cholesterol, total cholesterol, triglycerids, weight, body mass index/BMI);
  • Nutrition (healthy eating);
  • Lifestyle (weight-loss, sleep);
  • Emotional Health (stress management, mood);
  • Family (time management, relationship management);
  • Physical Activity/Fitness.

A wellness program may start with a “Health Risk Assessment” (HRA) whereby participants get immediate feedback on the current state of their health. Typically, the HRA will help to identify applicable Risk Factors, while also educating the participant about ways to mitigate them. Employers may use the scores (but not the private medical details) to incent employees to address their risk factors, creating a win-win for employees and employers who actively work the plan. It has been deterined that high risk individuals experience the most loss of productivity and medical costs. One study identified that 6 risk factors in 23% of an employee population led to 81% of the medical costs:

1. Hypertension – Hypertension; HBP; Blood pressure – high

Hypertension is the term used to describe high blood pressure.

Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Blood pressure readings are usually given as two numbers — for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure.

  • Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
  • High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.
  • If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.

2. Heart failure – CHF; Congestive heart failure; Left-sided heart failure; Right-sided heart failure – Cor pulmonale; Cardiomyopathy – heart failure

Heart failure is a condition in which the heart can no longer pump enough blood to the rest of the body.

3. High blood cholesterol levels – Lipid disorders; Hyperlipoproteinemia; Hyperlipidemia; Dyslipidemia; Hypercholesterolemia

Cholesterol is a fat (also called a lipid) that your body needs to work properly. Cholesterol levels that are too high can increase your chance of getting heart disease, stroke, and other problems.

The medical term for high blood cholesterol is lipid disorder, or hyperlipidemia.

4. Major depression (Depression – major; Unipolar depression; Major depressive disorder) – True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for weeks or longer.

5. Asthma (Bronchial asthma; Exercise-induced asthma) – a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.

6. Diabetes – a lifelong (chronic) disease in which there are high levels of sugar in the blood.

  • Gestational diabetes (Glucose intolerance during pregnancy). Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.
  • Metabolic syndrome (Insulin resistance syndrome; Syndrome X). Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes.
  • Type 1 diabetes  (Insulin-dependent diabetes; Juvenile onset diabetes; Diabetes – type 1). Type 1 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood.
  • Type 2 diabetes (Noninsulin-dependent diabetes; Diabetes – type 2; Adult-onset diabetes). Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

Simple wellness plans, which might have incentives for employees to go to the gym or join weight-loss programs, can pay big dividends. Employees feel better and morale is improved, making the workplace more productive. Many benefits plans include a variety wellness features and tools to help employers and employees stay healthy. An experienced broker will highlight these features and encourage employers and employees to take full advantage of the features/programs that are readily available. The best campaigns are the ones that employees are most excited about. This increases engagement, participation and outcomes. Incentives have been proven to boost wellness participation and ROI, but how can you make sure your incentives are successful? A recent article offers some tips:

  • Offer cash incentives of $50 per employee per month. This amount has been proven to produce a 75% participation rate.
  • Offer incentives to all employees, not just those who already have medical conditions. That way, you will be more likely to identify at-risk employees.
  • Use secondary incentives to engage high-risk employees. For example, offer cash rewards for those who follow through with health coaching.

Successful wellness plans should be driven from the top of a business, with specific, measurable, action-oriented, realistic and time-bound objectives. Plans need to be mindful of employee privacy and non-discrimination rules, DOL/EBSA, HIPAA, ADA, ADEA, COBRA and tax laws for plan incentives and costs. Periodically, data from the plan should be reviewed to modify/improve the plan:

  • Health assessments;
  • Biometric data;
  • Participant records;
  • HR/Payroll data (sick days, attendance, etc.);
  • Claims data;
  • Program evaluation surveys.
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