Wellness Programs Pay Off Fitness with Lower Premiums

Wellness Programs Pay Off Fitness with Lower Premiums

By Anne Geggis, Staff Writer
Daytona Beach News-Journal
February 19, 2010

HOLLY HILL -- Denise Albright steps on the scale and silently waits for her number to come up.

"Three pounds," the weight-recorder tells Albright, who works as a referral nurse at Florida Health Care Plans. And from the look on Albright's face and a slight victory shake of her fist, you can tell this is not addition.

"That rocks," Albright says.

This scene might be typical for millions of Weight Watchers meetings, but what makes this one the weigh-in of the future is that it takes place in the Florida Health Care Plans building -- an employer-sponsored session held during the work day.

In today's emerging health care reality, your weight, whether you smoke and, in some cases, even your blood sugar level could have an impact on how much you pay for health care premiums. The more fit you stay, the less you're likely to pay.

It's called a wellness program. The idea of getting people to do the right thing for their health with cash incentives was promoted by the Bush administration and has become enshrined in the U.S. Senate health care reform bill, to the dismay of some.

The idea: People who don't smoke, weigh within certain parameters and are maintaining a diet or medications so they don't suffer from high blood pressure, high cholesterol or abnormal blood sugar will cost the system less and therefore should be charged less for their health care premiums.

For Linda James, 52, an administrative assistant at Florida Health Care Plans, the incentives her employer started offering in 2007 were the final impetus for beginning a journey that's made her one of the biggest losers around: 160 pounds' worth.

With Florida Health Care Plans paying 80 percent of Weight Watchers dues, access fees to area gyms and 100 percent of any health care premium increases for eligible employees -- nonsmoking with a body mass index less than 27.5 -- James asked herself, "Why not?" The decision has freed her from the cane she used to need to walk and the back pain that often had her doubled over.

"I always tried to lose weight, but I never tried Weight Watchers and I never stuck to an exercise program," she said.

The wellness provisions in the Senate's health care reform bill, however, have generated opposition from groups representing older Americans and those with disabilities. They say that giving people up to a 30 percent break on health care premiums -- or a $4,000 discount based on the average cost of family coverage -- amounts to shifting costs from healthier to sicker employees.

"Such exorbitant penalties undermine a fundamental goal of health care reform -- the creation of a system in which no one can be charged more based on their health status," reads the letter signed by 105 organizations.

Bill Allen, an associate professor and director of the Bioethics, Law and Medical Professionalism program at the University of Florida College of Medicine, said wellness incentives could end up penalizing those with genetic conditions that can't necessarily be controlled -- an ethical problem. He said a fairer approach would be to tax bad behavior, such as cigarette smoking and sugary beverage consumption, rather than reward certain health outcomes.

"Some people could eat something and not have the bad (health) outcome," he said. "It's genetic."

Companies offering wellness initiatives can't say whether employees' slimming down has fattened their bottom line in reducing doctor visits and their insurance premium ratings. But they say it's increased employee morale.

At Florida Health Care Plans, 93 percent of their employees qualify for the wellness benefits. And at Hudson Technologies, which has won awards for its wellness program, between 75 and 80 percent qualify for the company to pay an extra 10 percent of employees' health care premium.

"One person's success just snowballs," said Pam Price, human resources director at Hudson, which developed its wellness program in cooperation with Florida Health Care Plans.

Mark Andrews, president of the company, said, "Our absentee level is way down from where it was . . . When you are here, and feel good about yourself, you are engaged. I don't know any downside."

Roy Braddy, director of supply chain management at Hudson, is just glad to have metamorphosed from the 325-pound smoker of up to two Marlboro packs a day he used to be. Getting rid of the blood pressure medicine, inhalers and breathing machine he needed overnight is just one part of it, he said.

"To be rid of that shame (of being overweight) is so liberating," he said. "It brings out a new part of your personality and it's really cool."

Do You Measure Up?

Florida Hospital Flagler offers health care premium discounts of either $480 a year for a single person or $840 a year for a couple for those who don't smoke and meet five of these six criteria:

·        A body mass index of 25 or less. (BMI is calculated by converting your height into inches and multiplying that number by itself. Then divide your weight in pounds by your height squared and then multiply your answer by 703 or go to an online calculator such as www.nhlbisupport.com/bmi.

·        A diastolic blood pressure value of 84 or less;

·        A blood sugar level at 100 milligrams per deciliter or less;

·        Triglycerides, or fat in the blood, at 150 milligrams per deciliter or less.

·        Low-density lipoprotein (LDL) at 130 milligram per deciliter or less.

·        High-density lipoprotein (HDL) at 40 milligrams per deciliter or greater.

SOURCE: Florida Hospital Flagler