Worksite wellness programs are called many things like health improvement health promotion or disease prevention. But, whatever you call it they all have several of the same characteristics. Really what we are trying to improve is our employees health and prevent the risk of disease. So, in order to do that, we need to focus on changing our employees behaviors and our own culture at our worksite. Worksite wellness programs are designed to promote healthy lifestyles for employees and their families. These programs can be simple or complex, and can require a minimal investment of time and money, if done correctly. More substantial programs often use more resources, yet there are many benefits to supporting and encouraging employee health and safety – and they typically outweigh the costs.
Rising health care benefit costs are a significant concern, and poor health habits and unnecessary medical care costs consume portions of many companies’ corporate resources, as well as employee paychecks. Since employees spend many of their waking hours at work, the workplace is an ideal location to address health and wellness issues.
Try to look at this from the perspective of wellness as just an expense. Manufactories used to inspected the quality of there product coming in and would look at the convoy belt after the product was manufactured and would then take out the defects. So, with wellness we believe we can intervene early so we can fix it before bad habits begin.
Before we get far into creating and implementing our Wellness program. We need to make sure they are legal. This is not the sexy fun part of wellness programs. So, one our goals today is to provide a framework of what different kinds of wellness programs you can provide. 1 st step would be to define your program. Your company can provide a very broad program or a more narrow program. And we have listed some examples of the types of programs we have seen in the past. 2 nd step-we need to look at which laws apply to each type of program. So we will go through scenarios on different types of programs elements. 3 rd step take any steps to comply with those laws.
This is really the alphabet soup of the wellness program in terms of acronyms. ACA-Grants for small businesses. This law has set aside $200 Million in grants. They define a small biz as having fewer than 100 employees HIPAA-has a couple of points to it both with privacy and with a wellness program that is tied into a group health plan and we will speak about that. COBRA-continuation of coverage, again…if you fall under the group health plan ADAAA- GINA-this is a broader act and designed to protect employees against the use of an employee using an employee family history against them.
EEOC-title 7 prohibits discrimination of the basis of race, color, religion, sex, and national origin, person over 40, employee compensation and benefits. So, if we have a wellness program that establishes a standard that is more difficult for individuals in a protected class to meet, may be a violation of the EEOC. Some ADA issues may arise in the context of wellness programs may involve an employers obligation to provide a reasonable accommodation to disabled employees in order to ensure participation in the program. GINA-We will discuss what a health risk assessment is they are one the most common component in any wellness program. So we will refer to them as and HRA. HRAs are survey that include questions about workers’ habit, person health and family medical histories. The are used to direct workers into wellness programs such as weight loss classes and smoking cessation programs. Generally there is a low response rate regarding HRAs
The EEOC enforcement guidance has given clarification on this. So , asking a question or examination is voluntary” as long as you the employer neither require participation nor penalize employees who do not participate. So, an employee provided prior, knowing voluntary and written authorization: For example, An Employer offers $150 to complete a 100 question survey, 20 questions of which concern family medical history(genetic information). Employees still receive the $150 as long as they answer the 80 no-genetic questions. The assessment must make clear which questions must be answered and which need not be answered.
HIPAA Programs It is important to note that employers can discriminate against unhealthy employees with respect to things like health insurance premiums, but the employer must follow certain additional HIPAA rules to do it under the umbrella of “HIPAA-compliant wellness programs.” There are five (5) prerequisites to this kind of “discrimination”: 1. The size of the reward or penalty can’t exceed 20% of the total premium cost for the employee’s health coverage. This amount will be raised to 30% in 2014. 2. The program must be reasonably designed to promote good health. Examples include on-site chair massage, aromatherapy or nutrition coaching. 3. Eligible individuals must have the opportunity to qualify for a reward at least once each year. 4. The reward must be available to all similarly situated individuals. 5. The employer must publicize its willingness to provide an alternative standard for receiving the award. The final regulations suggest the following language on all program materials: “ If it is unreasonably difficult due to a medical condition for you to achieve the standards for the reward under this program, or if it is medically inadvisable for you to attempt to achieve the standards for the reward under this program, call us at [insert telephone number] and we will work with you to develop another way to qualify for the reward.” U.S. Department of Labor
The Wellness Councils of America (WELCOA), an organization dedicated to the promotion of worksite wellness, has identified the seven best practices for employers to follow when building a comprehensive, effective worksite wellness program within an organization. Visit www.welcoa.org for more information.
Wellness webinar october 2013
Welcome to:Establishing an Effective Wellness Program Please Dial in using: 800-925-9789 Access Code: 2831265
Worksite WellnessEstablishing an Effective Wellness Program Brought to you by:
What is a worksite wellness programDefinition of Workplace Wellness Workplace wellness programs are long-term strategies for reducing benefit costs through sustained improvements in workforce health.This may include:•Education classes•Subsidized use of fitness facilities•Internal policies that promote healthy behavior•Other activities, policies or environmental changes thataffect the health of employees
Benefits of a Wellness Program• Lower health plan utilization, which in turn lowers health benefit costs and increases bottom line• Improved employee health• Improved productivity as healthy employees tend to perform better• Reduction in sick leave absenteeism• Improved reputation as a company who cares about their employees – aids in recruiting and community perception• Improved employee morale and stronger employee retention
Changing Employer Perspectives on WellnessEmployee Wellness is….• Not an expense, but an investment• Not just a benefit program, but a new mindset• Not just an initiative(fad), but a way of life – As with quality, an effort to review risks early and intervene to prevent ill health rather than waiting to “fix it after the fact” – As with learning, a belief that healthy lifestyle skills can be taught – As with culture, an integral part of the way our organization thinks and acts
Health Care Facts: Lifestyle Choices• Unhealthy employee behaviors cost U.S. employers an average of $670 per employee each year. Obesity accounts for about $400 of those costs.*• Alcohol and drug abuse costs the American economy $193 billion per year in lost productivity, health care expenditures and crime.**• Tobacco use costs employers billions of dollars each year in medical care, workers’ compensation, disability benefits and lost productivity. * Source: Society for Human Resource Management ** Source: The National Drug Intelligence Center
Wellness Programs-A legal Perspective 1. Define the ProgramExamples: – Disease Management -Fitness Center reimbursement – Wellness Fairs -Weight loss programs – Health Education Classes -Health risk assessments – Health Screenings -Tobacco cessation – Preventive care -Flu shots 2. Determine which laws apply to each 3. Take any necessary compliance steps
Which Federal laws affect wellness programs• Affordable Care Act of 2010• HIPAA• COBRA• ADAAA• Genetic Information Nondiscrimination Act(GINA)• Age Discrimination in Employment Act• EEOC
EEOC-The Fork in the Road• EEOC guidance states that a wellness program is “voluntary” as long as the employer neither requires participation nor penalizes employees who do not participate.• Title II of GINA prohibits employers and other covered entities from requesting, requiring, or purchasing genetic information, subject to six limited exceptions – Example: Employees who voluntarily disclose a family medical history of diabetes, heart disease, or high blood pressure on a health risk assessment that meets the requirements and employees who have a current diagnosis of one or more of these conditions are offered $150 to participate in a wellness program designed to encourage weight loss and a healthy lifestyle. This does not violate Title II of GINA.
Which Laws Apply• Is the wellness program related to your health plan, or does it provide medical care itself(HIPAA, ERISA, and COBRA)?• Does the program involve any genetic information (GINA)• Always consider the tax consequences(IRS)• Always consider the program’s impact on disables individuals(ADA)
“Voluntary”• What is the difference when an employer considers a worksite wellness program?
The HIPAA Applicability TestNon-HIPAA Programs HIPAA ProgramsParticipatory-based Achievement-basedExamples are programs that: Examples are programs that: Provide incentives for completing anHRA regardless of results Offer different coinsurance rates, co-pays or deductibles for smokers vs. non-smokers Reimburse fitness center dues Offer premium discounts based on an employee’s acceptable body mass index Encourage preventive care by waivingco-payments or deductibles Offer discounts based on maintaining low cholesterol levels as checked by annual health risk assessments Reward employees for attending monthlyhealth-education webinars Provide free on-site flu shots Provide fresh fruit in the workplace
Common Wellness Programs-Which Laws Apply and How• Fitness Center reimbursements• Tobacco cessation programs• Health risk assessments• Weight watchers programs at work
Fitness Center ReimbursementsI am Thor Company reimburses monthly fitness center dues up to $50 for any employee who turns in a receipt showing payment of his/her monthly fitness center dues
Health Risk Assessments I am Thor Company offers a voluntary health risk assessments to all of its employees. Employees do not need to complete a health risk assessment in order to participate in I am Thor’s health plan. However, employees who complete the HRA will receive a $25 gift card
Worksite Wellness Trends The most common Wellness Programs include: • Onsite flu shots • General health and safety communications for employees • Weight management programs • Health fairs • Health risk assessments • Smoking cessation programs However, it is important to learn about your employee group and develop programs that address their particular goals, risks and needs.
Workplace Wellness Program Implementation Timeline STEP 1 STEP 2 STEP 3 STEP 4 Get Management Form a Team Analyze Data to Develop Your Plan Buy-In -Workplace Wellness: Creating Determine Focus -Workplace Wellness: Focusing a Successful Wellness Team Your Efforts-Workplace Wellness: An -Workplace Wellness: EmployeeEmployer’s Guide to Promoting -Workplace Wellness: Breathing Needs and Interest Survey -Workplace Wellness: UsingWellness at the Workplace Energy into a Wellness Team Incentives in Wellness -Workplace Wellness: Health Programs-Workplace Wellness: Gain Risk AppraisalsSenior Management Support for -Workplace Wellness: Action -Workplace Wellness: WellnessWellness Programs Plan Environment Assessment-Workplace Wellness: Why -Wellness Program Work Plan -Workplace Wellness:Promote Wellness? Assessment Checklist-Worksite Wellness – Small -Workplace Wellness: SourcingSteps to Healthier Employees Data to Enhance Your WellnessPresentation Program-Workplace Wellness: Potential -Workplace Wellness: GINA andLegal Issues Associated with its Impact on WellnessWorkplace Wellness Plans ProgramsSenior leadership shouldcommunicate company’scommitment to employeehealth:-Workplace Wellness:Introduction to WellnessProgram Email
Workplace Wellness Program Implementation Timeline STEP 5 STEP 6 STEP 7 Decide on Programs Support Programs Evaluate Results -Health Newsletter: Monthly Live -Workplace Wellness: Tobacco- -Workplace Wellness: Evaluation Well, Work Well Newsletter Free Workplace Policy -Workplace Wellness: Sample -Target specific physical -Workplace Wellness: Evaluation Tool & Measures conditions with LWWW flyers Maintaining Motivation and -Workplace Wellness: -Workplace Wellness: Low-Cost Interest Calculating Your ROI Resources for Small Businesses -Workplace Wellness: Keeping -Workplace Wellness: Low-Cost Your Healthy Employees Healthy Activities That Work -Supportive Practices and -Workplace Wellness: Low-Cost Supportive Benefits Activities to Promote Weight -Live Well, Work Well monthly Loss newsletter -Posters: Hand Hygiene, An Apple A Day Poster -Programs: Designing the Healthy Vending Machine, Designing a Stay Well Stairwell Program
Creating a Workplace Wellness Program Gain Upper Management Support Management must understand the benefits of the program for both the employees and the organization, and be willing to put funds towards its development, implementation and evaluation. To capture senior-level support: • Link health promotion to business goals, values and strategic priorities. • Discuss the specific benefits to the company as employees become healthier (health care costs will decline, productivity will improve, etc.). • Engage mid-level management to participate to show that the program is for everyone.
Creating a Workplace Wellness Program Create a Wellness Team Your team should be individuals who will have a role in program development, implementation and evaluation. Role of a wellness team: • Help to garner “buy-in” from both management and participants. • Develop a program that is responsive to the needs of all potential participants. • Responsible for overseeing all of the company’s wellness efforts, including implementation and evaluation of various programs and activities.
Creating a Workplace Wellness Program Tailor Your Initiatives to Employee Needs Gather data to help assess your employees’ health interests and risks. Data can be collected in the following ways: • Employee interest surveys • Health risk assessments • Claims data analysis to determine current employee disease risks • Biometric testing
Creating a Workplace Wellness Program Create an Annual Plan An annual operating plan should include a mission statement for the program, along with specific, measurable short- and long-term goals. Written plans can provide: • Link between wellness initiatives and the company’s needs and strategic priorities. • A means to evaluate the effectiveness of the program. • Direction as the program grows and changes.
Creating a Workplace Wellness Program Annual Operating Plan A successful operating plan should include the following: • Vision statement outlining what you are trying to achieve with the program • Goals for the program • Program objectives and health initiatives to support them • A timeline • A budget • Communication plan • Implementation plan • Evaluation – how will the success of the program be measured
Creating a Workplace Wellness Program Choose Appropriate Programs and Initiatives Select health initiatives that are relevant to the data you collected. • Should address risk factors of employees • Should be in line with what management and employees want from the program
Creating a Workplace Wellness Program Create a Supportive Environment Provide employees with ongoing encouragement, support, opportunities and rewards. • Offer healthy food choices in your vending machines • Implement a no-smoking policy on your premises • Offer flexible scheduling arrangements that allow workers to exercise at their convenience • Reward healthy achievements
Creating a Workplace Wellness Program Consistently Evaluate Outcomes Take a close look at your goals and objectives, and determine whether you have achieved the desired result. • Evaluation allows you to celebrate achieved goals and discontinue efforts that are not as successful. • Surveying employees again can be effective – after participating in the wellness program thus far, they can provide feedback about what they liked, what they would change, etc.