Implementing a Successful Wellness Program in the Workplace

Transcription

1 Implementing a Successful Wellness Program in the Workplace July 24 th, 2013 Presented by Dawn Alvarez, PHR, CCWC Compliance & Wellness Director Filice Insurance

2 Just because you build it doesn t mean they will come.. 2

3 Making the Connection If your employees are your #1 asset.. then the health of your employee is as critical to your business as the products and services your company sells. 3

4 Can you Afford That? Erika The average cost of delivering a baby now exceeds $12,350 and complicated births average $36,884. That difference equals $24,534 per birth, plus any additional costs that would be required if the child is not healthy or the mother suffers from post-partum complications. 4

5 Can You Afford That? George The reoccurrence of prostate cancer is 57% more likely without proper screening and continuous treatment. The average cost for treatment is $47,010 over a five year period for stage one, $58,762 over a two-year period for stage two and $73,453 over a one-year period for stage three. 5

6 Can You Afford That? Maria It is common for obese individuals to become pre-diabetic, resulting in comorbidity that they are not aware of. It costs $2,860 to treat someone for hypertension if they do not have diabetes and an additional $10,536 if they do. 6

7 If left on Their Own Erika is young and a first time mother, so she will probably be relying on the education pieces provided by her doctor and the use of her insurance carrier nurse hotline. Genetically, she is also at a higher risk of gestational diabetes and predisposed to sickle cell anemia. George, unless he has a family member actively engaged in his care, will probably rely on self-screenings and may be going to a PCP instead of a urologist or oncologist. He probably won t follow up with person who treated his cancer. Maria will probably will just take her medications as prescribed and not look at behavioral change to address her hypertension. She may also try to self-medicate and may not know the warning signs of a more serious condition such as diabetes or cancer. 7

8 The Health of Your Employees 21% of American adults have high cholesterol 24% engage in binge drinking 25% suffer from a diagnosable mental disorder 40% engage in no leisure-time physical activity 67% are now considered overweight or obese 72% of those age 2 and older don t consume enough fruits and vegetables 75% of Americans don't take their prescription drugs as directed 8

9 Productivity Losses Are Underestimated When considering the medical and drug costs alone, the top five conditions driving costs are cancer, back/neck pain, coronary heart disease, chronic pain and high cholesterol. When health-related productivity costs are measured along with medical and pharmacy costs, the top five chronic health conditions driving cost shift significantly to depression, obesity, arthritis, back/neck pain, and anxiety. On average, every $1 of medical and pharmacy costs is matched by $2.3 in productivity costs. 9

10 Position Wellness as a Business Strategy Some employers have included wellness participation as a metric in employee performance reviews. Segment your population to create targeted strategies. Develop impactful employee communications. Leverage a technology-enabled approach Plug into social media Create a fully integrated approach Understand and communicate how you will measure success. 10

11 Out With the Old and In With the New HRAs and Biometrics Preventive Care Visit and Physician Form Fully Insured vs. Self Insured Show me the ROI Lower Rates Lower Claims Higher Productivity Higher Engagement One program for all Figure out what to measure set expectations Give employee choices Self-segmentation model Tailored Messaging Smart Incentives 11

12 Best Practices for Wellness When implementing a physical activity program remember that not all employees are at the same fitness or motivation level. Healthy work environment by offering healthy lunch choices, hold walking or standing meetings, replace chairs with exercise balls. Consistent communication touch-points..it will take many messages and the use of many marketing channels to get the message across. Setting realistic and achievable goals based on human nature, individuals must be mentally ready to make a change before they engage in healthy activities 12

13 Best Practices Cont.. Internal policies consistently applied Wellness champions at all locations and different departments Include health and safety leads Celebrate success Appropriate incentives 13

14 The Need to Create Wellness Committees throughout Your Company An effective workplace wellness team can dramatically improve the health initiatives within your organization. Formally Appoint Team Members Wellness Initiative role in the Team Members Job Description Promote the Wellness Team within the Organization/Location Establish a Strong Team Leader Include Employees from Various Hierarchies into the Team Team Should Meet on a Regular Schedule with a Formal Agenda Communication Must Remain a Staple within the Team Incorporate Continuing Wellness Education into the Program 14

15 An Employee Health Strategy 1. Health Plan Design Alternative plan designs Ease of receiving preventative care Looking for centers of excellence 2. Health Plan Management Utilization patterns Health risk assessments & biometrics Actuarial analysis 3. Strategy to Drive Healthy Behavior Incentives to maintain good health Rewards for healthy activities Educational materials 15

16 Wellness Rewards under ACA Employers can offer rewards of up to 30% of the cost of coverage not included in affordability Tobacco cessation programs can have rewards of up to 50% - included in affordability CA SB 189 Proposed to weaken wellness program offerings did not pass 16

17 S A M P L E P L A N D E S I G N Sample Wellness Plan Design Participation-Based Healthy Measures Based Non-Participant Plan Wellness Action = Non-Participant No funding into the HSA/HRA Participant Plan Wellness Action = Complete Health Assessment & Biometric Screen, but do not achieve Bronze level health measures Reward: $250 Individual /$500Family HSA/HRA funding Bronze Plan Wellness Action: achieve Bronze level health measures Reward: $500Individual /$1,000Family HSA/HRA funding Silver Plan Wellness Action: achieves Silver level health measures Reward: $1,000 Individual / $2,000 Family HSA/HRA funding Gold Plan Wellness Action: achieve Gold level health measures Reward: $1,250 Individual / $2,500 Family HSA/HRA funding Employee must meet all biometric values of an incentive level to qualify for that level s incentive otherwise employee will be awarded the next incentive level lower until all biometric values are met. Alternative medical standards and retest opportunities are available during play year; see next slide 17

18 A L T E R N A T I V E R E W A R D O P P O R T U N I T I E S Alternative Reward Opportunities 1. Retest Option Biometric re-test quarterly through your personal physician only, at your own expense complete re-test by 3/15, 6/15 or 9/15 Only need to re-test values needed to achieve next level Submit results to (screening/wellness partner) for validation If Healthy Reward level met, incentive begins next quarter, not paid retro 2. Participation Option Submit Personal Physician Affidavit to wellness partner stating your condition is being treated by a physician with medication, and Complete an approved wellness program (such as Living Lean or Tobacco Cessation) 3. Alternative Standard Option If medical condition exists that prevent achieving healthy measures (i.e. pregnancy), contact (wellness partner) to determine alternative standard option to obtain incentive 4. Appeal Process All appeals will be managed by third party vendor and instructions will be included in your benefits/wellness communication materials distributed in Fall 2013 Appeal process must be submitted within 30-days from the date on your personal wellness results. 18

19 S A M P L E P L A N D E S I G N Wellness HRA/HSA Option (90% employee only premium paid) Up-front deductible of $1,250 single / $2,500 per family No coinsurance once the deductible is met You can use an HRA/HSA to pay for your out-of-pocket expenses with a $600 / $1200 Company contribution. Wellness PPO Option (80% employee only premium paid) Co-payments for the office visits are $40 or $65 per visit (emergency room is $250) Pharmacy co-pay is 25 percent ($70 maximum) per prescription Deductible of $750 single / $1,500 family applies to all other services Note: Plans above require Annual Physician and Tobacco Affidavit. See Wellness activities below for additional funding into HRA/HSA. Classic Option (80% employee only premium paid) Up-front deductible of $1,500 single / $3,000 per family- but no coinsurance once the deductible is met You can still use an HRA/HSA to pay for your out-of-pocket expenses, but Company will not make a contribution to your HRA/HSA. Wellness Credits: Biometric Screenings/HRA $300 Tobacco Free Affidavit $200 Validated Physical Activity $100 Attend 2 out of 4 onsite events $50 Participate in campaigns (2) $100 Other Community Events $50 Internal Resource Requirements: Online Health Portal for engagement and tracking ($1000-$2500/mo) Monthly commitment to post/distribute health & wellness information Executive led communications and actions with campaigns/events Wellness committee to meet on a quarterly basis Internal policies around tobacco, food, vending, values, missions, etc., to match wellness efforts within the organization. Acceptance of documentation for reward distribution 19

20 W E L L N E S S P L A T F O R M S 20

21 Stress Reduction Stress Reduction/Healthy Lifestyle Incentive Campaigns What s included/required: 1. Guide for implementation: how to launch, when to launch and how to administer 2. Meeting and Lunch & Learn ideas 3. Introductory letter and registration form 4. Pre-campaign, Mid-campaign and Post-campaign newsletters 5. Promotional materials 6. Participant packet 7. Motivational messages 8. FAQs 9. Program Evaluation 10. Gift Guide Requirements: 1. Wellness Champion to coordinate efforts and timeline 2. Management Buy-In and Participation 3. Consistent communication and employee support 4. Matching the environment: flexible work schedules, support around work/life balance Budget: 1. $ $ per campaign 2. Winner Rewards $25.00-$150 per campaign

22 Proper Nutrition Proper Nutrition Campaigns What s included/required: 1. Guide for implementation: how to launch, when to launch and how to administer 2. Meeting and Lunch & Learn ideas 3. Introductory letter and registration form 4. Pre-campaign, Mid-campaign and Post-campaign newsletters 5. Promotional materials 6. Participant packet 7. Motivational messages 8. FAQs 9. Program Evaluation 10. Gift Guide Requirements: 1. Wellness Champion to coordinate efforts and timeline 2. Management Buy-In and Participation 3. Consistent communication and employee support 4. Matching the environment: food, vending machines, soda, etc. Budget: 1. $ $ per campaign 2. Winner Rewards $25.00-$150 per campaign

23 Physical Activity Programs Physical Fitness Incentive Campaigns What s included/required: 1. Guide for implementation: how to launch, when to launch and how to administer 2. Meeting and Lunch & Learn ideas 3. Introductory letter and registration form 4. Pre-campaign, Mid-campaign and Post-campaign newsletters 5. Promotional materials 6. Participant packet 7. Motivational messages 8. FAQs 9. Program Evaluation 10. Gift Guide Requirements: 1. Wellness Champion to coordinate efforts and timeline 2. Management Buy-In and Participation 3. Consistent communication and employee support Budget: 1. $ $ per campaign 2. Winner Rewards $25.00-$150 per campaign 3. $3.00-$4.00ea/pedometers

24 SAN JOSE 738 North First Street San Jose, CA LAFAYETTE 3736 Mt. Diablo Blvd. #301 Lafayette, CA SACRAMENTO 111 Woodmere Rd. #290 Folsom, CA ABOUT FILICE Founded in 1989, Filice Insurance was the first consultancy in Northern California to offer a full suite of employee benefits and business insurance services. Our industry leadership continues today. We leverage the latest market research and product offerings to craft insurance and benefits programs that help our clients achieve their long-term strategic goals. Our team will listen to you. Our holistic approach to Benefits Consulting starts with an understanding of your employees culture, includes competitor benchmarking and market ORANGE COUNTY Enterprise Court Lake Forest, CA SAN JOSE 1330 S. Bascom Avenue Suite D San Jose, CA FILICE License # analysis and continues through plan compliance and modeling, contract negotiations, employee communication and ongoing plan management. Through our targeted analysis, design and implementation, we identify solutions that employees embrace and value, and employers are proud to communicate. Whether your plan is fully or self-insured, our solutions are designed to be sustainable over the long-term and supportive of your company culture.