Workplace Wellness Tools
Within the broad confines of health and personal wellness, there is no “one size fits all” corporate wellness program. While some corporations have instituted comprehensive programs, others have achieved savings or increased productivity with a few relatively easy activities that promote healthier lifestyles. Establishing a plan and instituting just one or two wellness activities to start can serve as a foundation for building a more comprehensive corporate wellness program in the future.
This section is intended to provide you with a number of practical tools and insights that can greatly improve your planning and implementation of a cost-effective employee wellness program for your employees and their family members.
It is important to note that the choice of specific worksite wellness activities will include consideration of what other employers have done (best practices), what health risk factors are of concern for the groups involved, the objectives and resources of the program, and how objectives can be addressed in a legally compliant fashion.
“Wellness in a Box”
The following materials and informative guides will provide you with tools to assess and identify workplace health risks and implement wellness solutions.
- Building Healthy Texans Worksite Wellness Toolkit is brought to you by Building Healthy Families, a Texas coalition that includes the Texas Department of State Health Services, Blue Cross and Blue Shield of Texas, H-E-B, the Texas Medical Association, the Texas Hospital Association, the American Heart Association and the Caring for Children Foundation. This guide includes an explanation of how to choose the right type of workplace wellness program, steps for getting started and success stories.
- Engaging Consumers @ Work is a communication program developed by the Blue Cross and Blue Shield Association to enhance and support existing workplace wellness initiatives. It can be implemented at little-to-no cost and delivers results supported by rigorous testing from Harvard Medical School’s Department of Health Care Policy. This program provides human resource professionals with actionable information to elevate employee awareness of how their daily choices impact their health and the overall costs of health care, as well as communications in both English and Spanish that have been developed through in-market testing to ensure messages resonate with employees.
Resources available from Engaging Consumers @ Work include: posters, postcards, paycheck stuffers, a nutrition guide and a tracking card. Files have been designed for electronic use on a company intranet site, or for hardcopy distribution to employees. It’s your choice! - Healthy Workforce 2010, a worksite health promotion program developed by Partnership for Prevention, is driven by Healthy People 2010 – the prevention agenda for the United States. It highlights the particularly opportune time for employers to invest in health promotion programs as America embarks on a major initiative to achieve national health objectives by 2010, providing strategies that translate Healthy People 2010 Goals to the business setting.
- Investing in Health: Evidence-Based Health Promotion Practices for the Workplace is an additional Partnership for Prevention guide that provides employers with guidance that can improve employee health by controlling tobacco use, promoting cancer screening and early detection, and encouraging physical activity and healthy eating. Investing in Health translates evidence-based recommendations from the U.S. Preventative Services Task Force on Community Preventative Services into easy-to-follow action steps that will enhance employee productivity, help employers manage health care spending and improve employee morale.
- Worksite Resource Kit – Colorado Physical Activity and Nutrition Program was developed by the Colorado Department of Public Health and Environment to provide resources and program ideas for all worksites, large or small, to start or further wellness initiatives. Although this kit primarily focuses on improving physical activity and nutrition habits, it provides an array of strategies and action steps that can be built into more comprehensive program efforts.
- Worksite Wellness Implementation Guide, created by Wellsteps.com, is designed to assist with the planning, implementation and evaluation of worksite wellness programs. For the purposes of this guide, wellness programming includes health education classes, subsidized use of fitness facilities, policies that promote healthy behaviors and any other activities, policies, or environmental changes that affect the health of employees.
Getting Ready for Wellness
Before starting the planning and implementation of a wellness program, it is important to secure support from your organization’s management team and clarify the extent of your proposed activities. A wellness program needs the support of leadership so that all employees understand its high priority and are aware of the program’s incorporation into the strategic plan of the organization.
There are several things that can be done to extend or deepen your rationale for a wellness program and solidify the commitment of your senior managers:
- Circulate materials about other company wellness programs offered by peer organizations or competitors
- Utilize trade or industry information that shows number of peer organizations that are conducting wellness programs and the extent of their employee involvement
- Use an employee survey or focus group to catalyze interest
- Build short-term cost-savings strategies into your wellness program proposal
After your program is in place, it will be necessary to keep lines of communication open and continuously evaluate the program to ensure continued success. Sharing participation numbers and employee testimonials will go a long way in maintaining management support in the program.
For additional insight on selling wellness programs to management, refer to:
- “Planning Wellness: Getting Off to a Good Start” (Part 1) – Absolute Advantage, The Workplace Wellness Magazine
Best Practices
Employers who support and promote their employees’ efforts to maintain healthy lifestyles benefit in terms of reduced absenteeism, reduced insurance costs, fewer incidences of disabling injuries and illnesses, increased productivity and improved morale. Results from some of America’s most successful wellness initiatives and company programs, summarized here, are reason enough to consider incorporating wellness into your workplace.
- CEO Roundtable on Cancer
Founded in 2001 when former President George H.W. Bush challenged a group of executives to "do something bold and venturesome about cancer within your own corporate families," the CEO Roundtable has since become a leading advocate of initiatives that reduce the risk of cancer, enable early diagnosis, facilitate better access to best-available treatments, and hasten the discovery of novel and more effective diagnostic tools and anti-cancer therapies. To that end, it implemented the prestigious CEO Cancer Gold Standard™ accreditation. Organizations that adopt the CEO Cancer Gold Standard demonstrate model programs and practices related to risk reduction, early detection, and access to quality care, such as:
- Communicating the importance of screening for cancer and including a schedule of cancer screenings by type of cancer, based on age, sex and risk factors
- Educating employees about how preventive procedures and tests are covered under health benefit plans
- Encouraging employees to work with their health care provider to develop a personal plan for cancer screening based on age, sex and risk factors
- Making it easy for employees to access screening by offering onsite or near-site screening programs for skin cancer and breast cancer
- Offering programs such as flextime to assist employees in keeping health care provider appointments for cancer screening
- Partnership for Prevention
The Partnership for Prevention (PFP) is an organization comprised of businesses, nonprofit organizations and government agencies advancing policies and practices to prevent disease and improve the health of all Americans. In 2004, PFP developed the CEO-focused “Leading by Example” initiative, designed to capitalize on the dynamics of the workplace to improve employee health by promoting greater business involvement in health promotion and disease prevention. The CEO-driven efforts of this initiative are described in PFP’s 2005 publication, Leading by Example: CEOs on the Business Case for Worksite Health Promotion. While best practices in this report are too numerous to list, they include programming details from a wide array of successful programs, including Johnson & Johnson’s Healthy People, covering almost 110,000 people; Pfizer’s Healthy Directions, which addresses the health needs of more than 50,000 people; and even much smaller enterprises, like the U.S. Chamber of Commerce’s Healthy Lifestyle Program, which covers approximately 500 staff members.
- “State Employee Wellness Initiatives” – National Governor’s Association (NGA)
Citing rising health care costs and alarming health statistics, several governors have implemented wellness and prevention programs in their states in the last few years. The programs generally promote healthy habits, understanding of risks associated with lifestyles, disease management practices and regular physical activity.
Many governors have started their initiatives with state employees, as state government is the largest single employer and health coverage purchaser in many states. State employee wellness programs are often launched as pilots for broader health initiatives and serve as examples of best practices for private organizations to potentially follow.
- Noteworthy Corporate Wellness Achievements
- Du Pont Co. saw that each dollar invested in workplace health promotion yielded $1.42 over two years in lower absenteeism costs for the company. Absences from illness unrelated to the job among 45,000 blue-collar workers dropped 14 percent at 41 industrial sites where the health promotion program was offered, compared with a 5.8 percent decline at 19 sites where it was not.
Bertera, Robert L. Du Pont: The effects of workplace health promotion on absenteeism and employment costs in a large industrial population. American Journal of Public Health, September 1990; 80(9): 1101-05. - Superior Coffee and Foods, a Bensenville, Illinois-based subsidiary of Sara Lee Corporation, attributes impressive results to the success of the company’s comprehensive wellness program. Superior showed 22 percent fewer admissions to a hospital, 29 percent shorter hospital stays, and 42 percent lower expenses per admission when comparing costs for this division’s 1,200 employees with costs for other divisions. Long-term disability costs were down by 40 percent. Superior Coffee and Foods has earned WELCOA’s Well Workplace Gold Award.
Superior Coffee and Foods: Speech by Lee Ahsmann, Vice President of Human Resources, at Well Workplace awards dinner, Worksite Wellness Council of Illinois, 1994. - The Coors Brewing Co. eight-week “Lifecheck” program significantly reduced employees’ risk for cardiovascular disease. The program, which cost $32 for each of the 692 participants, resulted in documented reductions in blood pressure, blood cholesterol and weight.
Clifford, FW and Diaz, RJ. Wellness on Tap at Coors. Financial Executive, March-April 1995; 11(2): 21-4. - Sunbeam-Oster Co., a producer of small electrical appliances with a largely female workforce, attempted to control health costs by providing mandatory prenatal care classes for pregnant employees. Classes were held on-site during work hours and women received full pay for attending. The result? A reduction in premature births as well as a decline in maternal and newborn care costs by 86 percent in just two years. Overall, costs fell from an average of $27,243 per employee to $3,792.40.
1999 National Worksite Health Promotion Survey: Conducted by the Association for Worksite Health Promotion; William M. Mercer, Incorporated; and the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion; 1999.
- Du Pont Co. saw that each dollar invested in workplace health promotion yielded $1.42 over two years in lower absenteeism costs for the company. Absences from illness unrelated to the job among 45,000 blue-collar workers dropped 14 percent at 41 industrial sites where the health promotion program was offered, compared with a 5.8 percent decline at 19 sites where it was not.
Legal and Sensitivity Issues*
As employer support and investment in wellness programming increases, it is important to understand the federal legal requirements that impact how these programs have evolved and how they are currently structured and operated.
Employee assistance programs were an early effort, usually offering assistance to employees dealing with drug and alcohol issues and situational stress. From there, employers began to offer a variety of rewards including cash incentives, discounts on health insurance premiums and lower deductibles, and smoking cessation and weight loss programs. No requirements were established, but if an employee was ready to take greater responsibility for his or her health then employers were more than willing to subsidize the effort. Today, the continuum has been extended further, with employers investigating mandatory wellness programs.
So, at what point can wellness programs threaten to infringe upon employee rights? What protections are available for employee privacy? Are certain categories of employees being treated differently under particular wellness plans? Whether your organization suggests wellness options or is considering wellness as a required activity, programs must be drafted carefully so as to comply with a few prominent federal laws:
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
In 1996, the Health Insurance Portability and Accountability Act (HIPAA) established requirements for group health plans and health issuers in the group market to prohibit discrimination against individuals based on a health factor. In 2006, the Employee Benefits Security Administration, Department of Labor and Internal Revenue Service issued final regulations relating to wellness programs, which apply to both voluntary and mandatory wellness plans beginning on or after July 1, 2007. While the regulations will govern what an employer may or may not do under a wellness plan, they do not prohibit wellness plans themselves.
Any employer with a wellness plan or contemplating a wellness plan should consult legal counsel to determine how these new regulations will impact the existing or contemplated plan. However, a few general rules of thumb exist for HIPAA compliance:- A plan or issuer is not prohibited from establishing wellness programs that allow individuals to be eligible for discounts, rebates, or other incentives (such as modified co-payments or deductibles) when an individual adheres to a program that promotes wellness or prevents disease
- Wellness Programs that do not provide a reward based on a health factor (i.e. health status, medical condition, claims experience, receipt of health care and medical history) generally are considered non-discriminatory under HIPAA
- A wellness 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
- A plan or issuer is not prohibited from establishing wellness programs that allow individuals to be eligible for discounts, rebates, or other incentives (such as modified co-payments or deductibles) when an individual adheres to a program that promotes wellness or prevents disease
- Discrimination Against Persons with Disabilities
Issues surrounding the American Disabilities Act (ADA) may arise particularly in mandatory wellness programs when:- employers ask questions about an employee’s health or require the employee to have a medical examination;
- employees impose requirements on the disclosure of medical information; or,
- if an employee is able to perform the essential functions of his or her job but, because of a disability, is unable to achieve a health factor requirement under a mandatory wellness plan.
- Age Discrimination in Employment
To be in compliance with the Age Discrimination in Employment Act (ADEA), a wellness program should be crafted to the reasonable expectations of the older worker. For example, a wellness program can mandate employee participation in an exercise or fitness program without requiring that everyone be able to run a certain distance at a certain speed.
In addition, several states have enacted laws to protect the off-duty conduct of employees. Some laws are limited to smoking, the use of tobacco products or the use of "lawful products," but others, such as in California, have broader coverage that includes any lawful activity occurring away from the employer's premises during nonworking hours. When contemplating a wellness plan, employers should review state laws prohibiting employment discrimination to be sure the proposed program complies with state requirements.
For additional insight on legal and sensitivity issues, refer to:
- Wellness Program Checklist – The Department of Labor’s Wellness Program Checklist asks a series of questions to help employers identify whether plans comply with the law
- “The Legal Implications of “Bona Fide Wellness Programs” – Bender’s Labor & Employment Bulletin
- “Wellness Programs May Face Legal Tests” – The Wall Street Journal (January 16, 2008)
