Clarian Health of Indianapolis, Indiana, has announced that it will begin to charge employees who smoke, are obese, or fail to control high blood pressure or cholesterol. Management believes that a $5 per-paycheck fine will motivate people to change. But according to expert Lisa Ballentine, wellness rewards do a better job.
Most companies sponsor wellness initiatives with the goal of reducing ever-increasing costs of healthcare coverage. Clearly, that works, and such savings are surely Clarian Health’s goal in doling out penalties. But there’s much more at stake, attorney Ballentine said in an interview with BLR® editors.
Employees who exercise regularly bring good attitudes to work with them, because working out gets their endorphins flowing, Ballentine said. And, because they have more energy, they are more productive than their less-active colleagues.
More to Fitness than Saving Healthcare Costs
It’s clear that lack of exercise, smoking, and excess weight cause or exacerbate serious health risks. Some 23 percent of U.S. adults smoke, while 65 percent are either overweight or obese. So why not just refuse to hire smokers and obese people?
No Smokers Allowed
Employers in Michigan, Nebraska, Washington, and a few other states can legally reject smokers. But in more than 30 states, Ballentine warned, it’s illegal to discriminate against candidates who engage in legal activities outside of work.
So as long as smoking, alcohol, and overeating are legal, employers can’t consider these habits in hiring. Furthermore, she cautions, obesity can sometimes be classified as a disability under the Americans with Disabilities Act—especially if a spurned applicant can show in court that the employer regarded him or her as disabled based on appearance.
Corporate wellness programs show great ROI. And they are win-win—employees feel better and are more productive, and employers reap the benefits. Even small improvements make a difference. Test drive Workplace Wellness with no cost or risk.
Take a Positive Approach
“Invest in your people,” Ballentine said. Take a positive rather than a punitive approach to wellness. A cornerstone of her strategy is to educate employees about the benefits of staying healthy and the risks of failing to do so. “Foster a culture that values and rewards health progress,” she advised.
For example, she suggested:
- Bring in health experts to offer ‘lunch and learn’ sessions about various aspects of wellness.
- Create company walking programs.
- Invite a weight-loss provider to sign your employees up for meetings on your premises.
- Sponsor employees for a stop-smoking program and reward them if they succeed.
- Conduct a health fair.
- Offer stress-reduction classes or information.
Positive Spirit Infectious
When wellness programs catch on with a few employees, Ballentine said, “You’d be amazed how contagious the spirit can become,” with more and more people joining the effort to exercise, lose weight, or quit smoking.
Ballentine suggested affordable incentives that are easy to find and have a wide appeal to employees. For example:
- Cater a luncheon for program participants.
- Give movie tickets.
- Give free DVD rentals.
- Offer a paid day off.
- Give a small gift certificate from a local merchant.
How Much Can You Reward Participants for Succeeding?
Don’t just pay for employee participation in stop-smoking courses, but also reward employees if they succeed in quitting, Ballentine suggested. Of course, while it is possible to do that, HIPAA (Health Insurance Portability and Accountability Act) privacy regulations make it a bit tricky. The following are some compliance tips for wellness programs.
Participation Only Rewards
Employee rewards based on participation only, rather than achievements or outcomes, are generally acceptable.
However, alternative means of participation must be devised and offered to employees who cannot, because of a medical condition, participate in the expected way. Examples might be someone in a wheelchair or someone with lung disease who must carry supplemental oxygen, either of whom might be unable to participate in an exercise program.
Wellness—NO downside! Impressive ROI, so management’s happy. Better health and employees are happy. And that means HR is happy. BLR’s Workplace Wellness is the key to developing your workplace wellness program.
Achievement Rewards
If employers want to offer rewards based on achievement rather than on participation (e.g., actually quitting smoking as opposed to just participating in the program), their programs must meet five requirements:
1. The total individual reward cannot exceed 20 percent of the total cost of employee-only healthcare coverage.
2. The programs that give rewards must be reasonably designed to promote health or prevent disease.
3. Participants in a program must be given the chance to earn the reward at least annually.
4. Programs must be available to all employees, so reward programs must give any employee for whom achieving the basic standard would be unreasonably difficult or medically inadvisable the chance to earn the reward in another way.
5. All communications material about the programs must state clearly that reasonable alternatives to the basic standard are available or that the standard can be waived if necessary.
In tomorrow’s Advisor, we’ll look at more tips for dealing with legal but unhealthy behaviors, and we’ll take a look at a trusted program for developing a wellness program with a great ROI.
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We need to define “obese”.
We are fixating on this term while turning a blind eye to the fact that many “heavy” people are perfectly healthy. Their lipid profiles are fine; blood sugars are fine; blood pressures are fine; and all other “health” indicators show they are healthy. These people lead energetic and active lives. The “obese” issue turns into a genetic factor that cannot be overturned. Are we going to go down the slippery slope of conducting full medical work-ups and looking at all factors before punishing and sanctioning genetic predispositions. For example; if someone has high cholesterol and triglycerides and is not controlling this with medication and is within “normal” weight ranges – then they are a candidate for a monetary sanction. The same goes for the individual with high blood pressure, high blood sugar, or a whole host of conditions that are controllable – but attributable to genetics. Sanctioning and fining someone for having a genetic predisposition to a medical condition is the same as fining someone for the color of their skin. It is unthinkable and is goes against the Bill of Rights. Any policy that begins to fine an individual for ‘obesity’ opens the door for major lawsuits for infringement of civil liberty and civil rights.
I have always been heavy, what you might call fat, and have been fighting it all my life. You bet I would jump on a chance to loose wieght, and I have several times, only to gain it back. There are people out there that think I am just lazy, but that is not true. Certain metabolisms are just programmed that way. A recent Time article supported the theory that exercise does not equal weight loss.
I have been discriminated against because of my weight several times. The old antage “fat and lazy” is deeply rooted in our culture.
A co-worker is very fit, running and riding his bike all the time. His insurance bills are 10x mine because he keeps having joint operations and chiro visits for his aches and pains. He misses a lot of work due to his doctor visits. Plus he crashed on his bike and spent several days in the hospital. I have not missed a day in years. So “fit” does not always equal “cheap”!! And “fit” does not always mean “productive”!!
I support the views of the author(s) and would like to add that if companies really want to avoid future costs and help their employees, add coverage for obesity surgery and stop smoking clinic coverage to their policies. And stop all sterotypes, including toward the last accepted form of discrimination: obesity.
Thank you for listening and the opportunity for a different view,
Big Guy
$5 a pay is not a big enough dent in employees’ pockets to cause them to take action toward becoming healthier. Beginning in January of this year, my husband’s employer told employees that is they do not work with its wellness company to maintain good health – average BMI, controlled blood pressure, stop smoking, etc., that they would charge them $5 per pay. The target of this effort, of course were the overweight workers, smokers, those with high absence rates, etc. Over 85% of the target employees chose to pay the $5 per week. If the charge had been $50 per week, I am sure they would have gotten more buy-in. As an alternative, if the employer is paying the majority of those employees’ health insurance, it would be a wise move to make them pay at least $50 more each pay, than the cooperating employees.
You cannot do this. In most states they have laws restricting what may be deducted from an employees pay. Union dues can be deducted, federal, state and local taxes can be deducted. Court ordered garnishments can be deducted. Nothing not authorized by law may be deducted from a workers paycheck. You can’t even take deductions from employees pay if they cause damage to company property. If you can’t deduct to pay damages to company property, then you certainly can’t deduct on the basis of someone’s health or appearance. Companies will be setting themselves for lawsuits if they start taking deductions from workers pay that are not authorized by law.