Download - Recommending a Benefits Strategy
Recommending a Benefits Strategyfor Today and Tomorrow
What is your Health Care Cost Containment Strategy?
for Today and Tomorrow
By 2016 Health Care Costs are projected to reach $4.2 trillion
This represents 20% of every dollar we spend!
Here comes a “perfect storm” in the workplace driven by three factors.
One: Medical costs are acceleratingTwo: Employees and dependents have more health needs
than ever before with an obesity epidemic, tobacco related illness and sedentary life styles
Three: A great skilled worker shortage lies just ahead
Results of a Healthy Workforce… Productivity goes up Turnover goes down Workplace injuries decline Disabilities decline Work life expands Morale improves Applicants gravitate to a healthy workplace
Tomorrow’s Challenge:Mandating Employee Wellness
What is a mandatory Wellness Plan? Requires employees to participate Imposes a penalty if you do not participate Must take a health risk assessment, blood pressure, cholesterol,
BMI, fasting glucose etc. If an employee refuses to participate they lose coverage Some plans even assign professional “health coaches” who will
draw up action plans and will follow up to monitor progress
Note: An incentive that is conditioned on participation in a health program, rather than achievement of a particular health target or standard, generally is not discriminatory under HIPAA.
INSIDE THE PLAN: HIPAA Rewards or penalties cannotexceed 20% of total cost Reasonably designed to promotehealth or prevent disease Annual eligibility Alternative standards forparticipants with medicalconditions Plan material must disclosealternatives and waiver
Mandatory Wellness Plans
ROI is from $2 to $10 for every dollar invested in a wellness plan.
OUTSIDE THE PLAN• Disability discrimination• Age discrimination• Workers compensationretaliation claims• Lawful off-duty conduct• Privacy statutes• Collective bargaining agreements• Retaliation claims
Obesity Trends* Among U.S. AdultsBRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 0%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Pulmonary diseaseabnormal functionabnormal functionobstructive sleep apneaobstructive sleep apneahypoventilation syndromehypoventilation syndrome
Nonalcoholic fatty liver diseasesteatosissteatosissteatohepatitissteatohepatitiscirrhosiscirrhosis
Coronary heart disease Diabetes Dyslipidemia Hypertension
Gynecologic abnormalitiesabnormal mensesabnormal mensesinfertilityinfertilitypolycystic ovarian syndromepolycystic ovarian syndrome
Osteoarthritis
Skin
Gall bladder disease
Cancerbreast, uterus, cervixbreast, uterus, cervixcolon, esophagus, pancreascolon, esophagus, pancreaskidney, prostatekidney, prostate
Phlebitisvenous stasisvenous stasis
Gout
Medical Complications of ObesityIdiopathic intracranial hypertension
Stroke
Cataracts
Severe pancreatitis
Health Risk Factors Matter .. Let’s learn about each employee’s
Metabolic Syndrome Risk Cluster HDL Cholesterol Triglycerides Waist Circumference Blood Pressure Fasting Glucose
Now let’s Graph these Important Risk Factors ... Complete a Health Risk Assessment Form
Perform Biologics (BP; HDL vs. LDL; Waist Size, Glucose)
020406080
100120140160180200
BMI 18-25 BMI 30-34 BMI 35-39 BMI 40+
Medical Cost
WC Cost
WC Lost Time
Recommended Obesity Class I Obesity Class II Obesity Class III
10 Week Program will address: Eating habits Hunger Hydration Exercise Personal health habits