This is what SINGLE-PAYER/UNIVERSAL CARE--Medicare for All being pushed by FAKE ALT RIGHT ALT LEFT global 1% pols KNOW will be the only access to health care 99% of WE THE PEOPLE will receive right there on that global corporate campus where we work, live, eat, are schooled, and are expected to use that window of free time FULFILLING WELLNESS PROGRAMS.
So this is what all those billions of dollars in structural build-out of online medicine leads to------throwing that few million to patronage 5% to the 1% small wellness businesses while already existing global health corporations partner with US Foreign Economic Zone global corporate campuses to install here in US what has been installed overseas.
We have discussed earlier about how SMART CITY MEGA DATA will be reporting on everything we eat, drink, smoke, how we transport ourselves, a profile made especially for the global health industries and our employer. Our employment will be allowed to predicate our willingness and commitment to these WELLNESS PROGRAMS.
What are Wellness Benefits?
Workplace Wellness Benefits
Employee Wellness Benefits
Wellness Programs Benefits
Corporate Wellness Benefits
Employee Wellness Programs
Health And Wellness Benefits
- Written By: wiseGEEK Writer
- Edited By: O. Wallace
- Last Modified Date: 10 September 2017
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Wellness benefits are simple to complex things offered by an employer to its employees to encourage healthy behavior that may improve overall health. They may be offered in the context of medical insurance, which might have a wellness program attached to it that subscribing employees could access. Alternately companies may choose to add certain amenities to the workplace in order to help employees pursue healthier lifestyles or they might provide access to nutritional, exercise or mental health counseling on a short-term basis. Another way in which the term wellness benefits could be understood is as incentives when employees meet certain health objectives. Many employers feel that that these benefits serve employees and the company, because they reduce things like medical insurance costs and sick time, and because they may result in a healthier workforce.
It’s a growing trend for health insurance companies to have benefits of some kind to promote wellness. These could include providing informational materials to subscribers on subjects like healthy diet, cardiovascular health, or quitting tobacco use. Some insurance companies will pay for employees to participate in programs designed to increase health like tobacco subsistence programs, and others merely offer information and advice, that if subscribers follow, is likely to assist in healthier living. Sometimes encouraging employees to get regular scans or physical exams at certain ages is thought of as part of wellness benefits, since this gives doctors the opportunity to help patients that have any markers or risks for diseases.
Obviously, health insurance led programs confer benefits in several ways. For insurers, they may reduce total cost of claims paid, which maximizes profits. This assists employers too, because a healthier workforce translates to less expensive premiums. Additionally, employees may be served by these programs because by following the advice given by insurance companies on how to lead more healthful lives, they may truly improve health.
Of course, some people won’t read insurance sites to find out how to be healthy, and this has led many companies to pursue offering benefits promoting wellness on a much more direct level. Having access to a free gym and wellness classes on site at the company may be easier for a lot of people. It’s an ever-present reminder that part of healthful living means working out regularly. With no fees to pay and easy access before or after work or during lunch hour, this is one benefit that can prove very helpful, especially if the gym is staffed by knowledgeable trainers who can watch over workers so they don’t get injured. A cafeteria on a worksite with lots of nutritious food may provide the same kinds of benefits.
Employers may also encourage employees to access wellness benefits through incentive based programs. These could include financial rewards or prizes for participating in wellness activities like training for a marathon or quitting smoking. When offered in context of many onsite benefits, great encouragement can exist for the employee to participate.
There are wellness benefits that might prove of use including things like free access to short term mental health, drug, or financial counseling, through programs like the Employee Assistance Program. These tend to be prepaid by an employer so they require no copayments. Moreover they’re usually offered through whatever health insurance coverage is available to the employee. They may not fix bigger problems but they’re often a good first stop for advice on how to deal with life’s stressors or for how to tackle a specific issue.
Many ways exist in which wellness benefits can be defined, but it seems that more dramatic gestures by companies don’t go unappreciated by their employees. Not only can these programs contribute to greater health, but they can also make employees feel less like part of an impersonal workforce. When a business makes a strong statement that it cares about the health and welfare of its employees, workers may respond not only by getting healthier but also by evolving stronger loyalty to their companies.
GONE IS CADILLAC PLANS GOLD-PLATED FOR WHAT IS UNIVERSAL CARE SINGLE-PAYER PREVENTATIVE CARE WELLNESS
'What is it, and what does it offer the consumer?
'Sometimes referred to as a “Cadillac” or “gold-plated” insurance plan, a high-cost policy is usually defined by the total cost of premiums, rather than what the insurance plan covers or how much the patient has to pay for a doctor or hospital visit.
People who have Cadillac plans often have low deductibles and excellent benefits that cover even the most expensive treatments, but this is not always the case. Premium costs can be high for reasons other than generous benefits, including the age, gender and health status of the customer. In an employer-based plan, premiums are based on the pooled risk of employees and may be higher if many of the employees are sick, older, female or live in a region with expensive health costs'.
Below we see an article from 2013 discussing what may happen----what Obama and Clinton neo-liberals intended that CADILLAC TAX to do----it is always framed as making corporations pay their fair share but of course Congress then allows corporations make the workers pay. Here we see PREVENTATIVE CARE/WELLESS all done on a global corporate campus----no doctor's office in sight.
'Expect to have your blood pressure checked or a prescription filled at a clinic at your office, rather than by your private doctor'.
High-End Health Plans Scale Back to Avoid ‘Cadillac Tax’
By REED ABELSONMAY 27, 2013
Abbey Bruce, a nursing assistant who works a second job cleaning, will pay a sharply higher deductible. Credit Matthew Ryan Williams for The New York Times
Say goodbye to that $500 deductible insurance plan and the $20 co-payment for a doctor’s office visit. They are likely to become luxuries of the past.
Get ready to enroll in a program to manage your diabetes. Or prepare for a health screening to determine your odds of developing a costly health condition.
Expect to have your blood pressure checked or a prescription filled at a clinic at your office, rather than by your private doctor.
Then blame — or credit — the so-called Cadillac tax, which penalizes companies that offer high-end health care plans to their employees.
While most of the attention on the Obama administration’s health care law has been on providing coverage to tens of millions of uninsured Americans by 2014, workers with employer-paid health insurance are also beginning to feel the effects. Companies hoping to avoid the tax are beginning to scale back the more generous health benefits they have traditionally offered and to look harder for ways to bring down the overall cost of care.
In a way, the changes are right in line with the administration’s plan: To encourage employers to move away from plans that insulate workers from the cost of care and often lead to excessive procedures and tests, and galvanize employers to try to control ever-increasing medical costs. But the tax remains one of the law’s most controversial provisions.
Bradley Herring, a health economist at Johns Hopkins Bloomberg School of Public Health, suggested the result would be more widely felt than many people realize. “The reality is it is going to hit more and more people over time, at least as currently written in law, ” he said. Mr. Herring estimated that as many as 75 percent of plans could be affected by the tax over the next decade — unless employers manage to significantly rein in their costs.
The changes can be significant for employees. The hospital where Abbey Bruce, a nursing assistant in Olympia, Wash., worked, for example, stopped offering the traditional plan that she and her husband, Casey, who has cystic fibrosis, had chosen.
Starting this year, they have a combined deductible of $2,300, compared with just $500 before. And while she was eligible for a $1,400 hospital contribution to a savings account linked to the plan, the couple is now responsible for $6,600 a year in medical expenses, in contrast to a $3,000 limit on medical bills and $2,000 limit on pharmacy costs last year. She has had to drop out of school and take on additional jobs to pay for her husband’s medicine.
“My husband didn’t choose to be born this way,” Ms. Bruce said. The union representing her, a chapter of the Service Employees International Union, has objected to the changes. Her employer, Providence Health & Services, says it designed the plans to avoid having employees shoulder too much in medical bills and has reduced how much workers pay in premiums.
Proponents of the law say the Cadillac tax is helping bring down costs by making employers pay attention to what their health care costs are likely to be in the long run. “It’s really one of the most significant provisions” in the Affordable Care Act, said Jonathan Gruber, the M.I.T. economist who played an influential role in shaping the law. “It’s focusing employers on cost control, not slashing,” he said.
Cynthia Weidner, an executive at the benefits consultant HighRoads, agreed that the tax appeared to be having the intended effect. “The premise it’s built upon is happening,” she said, adding, “the consumer should continue to expect that their plan is going to be more expensive, and they will have less benefits. ”
The trend is accelerating. The percentage of employers revising their plans as a result of the tax has increased to 17 percent this year from 11 percent in 2011, according to a survey of United States companies released this month by the International Foundation of Employee Benefit Plans.
Although the tax does not start until 2018, employers say they have to start now to meet the deadline and they are doing whatever they can to bring down the cost of their plans. Under the law, an employer or health insurer offering a plan that costs more than $10,200 for an individual and $27,500 for a family would typically pay a 40 percent excise tax on the amount exceeding the threshold.
“I’m actually much more focused on the Cadillac tax in 2018 than on 2014,” Steve First, a benefits executive at Pfizer, said at a recent meeting of employers. “For us, 2018 is a challenge.”
Raising deductibles is one way to lower the cost.
Since 2009, the percentage of workers in plans with a deductible of at least $2,000 has doubled, to 14 percent, by 2012, according to the Kaiser Family Foundation. A little over a third of workers are in plans with a deductible of at least $1,000 a year.
Larger companies are also trying a variety of initiatives to improve the health of their workers — experimenting with an array of disease management and wellness programs, for instance, or even setting up their own work-site clinics as a way to sidestep the tax.
“These changes will take time, and employers seem to recognize that,” said Barry Schilmeister, a consultant for Mercer.
Cummins, the Columbus, Ind., engine manufacturer is one example of a company experimenting with both approaches. The tax “is in our line of sight,” acknowledged Dr. Dexter Shurney, the company’s chief medical director.
Cummins has switched employees to plans with deductibles as high as $6,000 for a family and is working with health coaches to educate employees on the dangers of high sodium present in processed food, for example, as a way to start reducing the cost of treating chronic diseases like high blood pressure. “There’s a lot of savings there,” said Dr. Shurney. “It’s not only good for us, but good for employees.”
Even employers who won’t talk about details acknowledge the tax is bringing about change. “You’re getting taxed at 40 percent,” explained Larry Boress, the chief executive of the Midwest Business Group on Health. “That kind of hit is something that is viewed as untenable by employers in general.”
But one critic pointed out that employers have been raising deductibles and asking employees to contribute more for many years. Tom Leibfried, a legislative director for the A.F.L.-C.I.O., one of the unions whose plans are vulnerable to the tax, says the demands that workers pay more for their care is a perennial aspect of labor negotiations. “We’re very concerned about the hollowing out of benefits in general,” he said. “What the excise tax will do is just fuel that.”
Others say some of the plans at risk of being taxed as overly generous simply reflect of the high costs of care in certain regions. “These plans are costly, just by the nature of where they are,” said Kinsey M. Robinson, the president of the Roofers’ union, which has recently called for significant changes to the law or its repeal. “The cost of good health care is expensive.” The law does make adjustments, including for older workers or those in certain high-cost professions.
Many employers say they were already taking steps to address rising costs, even as the increases have abated somewhat in recent years. “The 2018 date was looming out there,” said Mary Cranstoun, the senior director of medical benefits for Providence Health, where Ms. Bruce works. But Ms. Cranstoun said Providence had already decided to move more of its employees into high-deductible health plans.
The goal was to have employees pay more attention to costs, which have been rising some 5 to 8 percent a year. “As for any other company, when you take that out long term, those are big trend numbers,” she said.
The hospital system says the move is less about cost-shifting than engaging employees about their health, including offering financial incentives to undergo a health screening or using a high deductible to make them think twice about an expensive test.
The ultimate goal is to make sure the cost of coverage does not eventually exceed the system’s ability to pay for it, Ms. Cranstoun said. “We really are committed to offering our employees benefits in the long term, so we really want to make sure that we can do so,” she said.
Here we have that university public CADILLAC plan having these white collar professionals feeling like WINNERS ---this article written in 2017 just as the economic crash and US Treasury/state municipal bond market collapse paints a great picture for one population group in US. We can be sure our 5% TO THE 1% pols and players appointed to government positions may keep these plans so don't care if MOVING FORWARD takes 99% of WE THE PEOPLE to CORPORATE WELLNESS PREVENTATIVE CARE ONLY-----but our rank and file Federal and state employees will fall right into this global labor pool UNIVERSAL COVERAGE.
'While pension promises are legally binding, backed by explicit state constitutional guarantees in some states and protected by case law in others, retiree health benefits generally are not. States and localities generally are free to change any provisions of the plans or terminate them entirely'.
I have a Cadillac health insurance plan in a land of jalopies. How is that fair?
Jennifer Anne Moses, Opinion contributor Published 7:43 a.m. ET July 26, 2017 | Updated 12:56 p.m. ET July 26, 2017
People born at the top of the heap have access to everything we need while the working poor often can't afford care or medicine. It's a moral disgrace.(Photo: Brian Harkin, USAT)
My husband is a professor at Rutgers University in New Jersey, so I have a gold-plated health care plan that's similar in many respects to the insurance enjoyed by people who work for the federal government. In their case, no matter what plan they choose from the insurance smorgasbord, the feds subsidize 72% of the premium cost.
Rutgers is a state university so my husband is a state worker. Like federal employees, he was given a long menu of plans to consider, and he opted for higher upfront costs in the form of premium to get better coverage on the back end. In our case, we ended up in a State Blue Cross/Blue Shield PPO. And even though I couldn’t tell you the difference between a PPO and a UFO, I’m well aware that we’ve got a Cadillac in a land of jalopies.
Good thing, too, because for the past year alone, maintaining myself in good health has come with a price tag that exceeds the average U.S. salary. Specifically, during the 12-month period from last summer to this, my heath bills totaled $39,003.00, of which my plan paid $33,251.00 — leaving me with a bill of $5,752. At our income level. that means we have to skimp on precisely nothing.
No wonder people are ticked off — and they should be, too. Health care for the wealthy and not for those who struggle to make ends meet isn’t real fair, now is it? The polls are terrible, the protests are constant and many Republicans have nagging doubts about the drive to repeal the Affordable Care Act and replace it with large tax cuts for people who already have way more money than they could possible spend in several lifetimes. Yet I’m not sure that those who continue to oppose Obamacare, and continue to swear that they’ll rip the thing up, really get it.
So here’s my own small health story, from a gal who was born on the right side of the tracks and, by virtue of that one giant piece of good luck, has stayed there.
Back to my tally of $39,003.00. I must have a serious, even a life-threatening condition, right? Wrong.
However, I do see a psychotherapist regularly (at $280 a pop, of which I pay $25) and, because I sometimes vomit uncontrollably and for no discernible reason, my doctor has theorized that I’m suffering from either this or that condition, to be verified by having the proper, high-tech, high-price test.
Thus, over the past 12 months, I’ve had two MRIs, a CAT scan, an endoscopy and an ultrasound — all of which came with a hefty price tag — and yet can buy a round-trip to London, plus an imported hand-knotted Turkish rug or two, plus a few dozen nights on the town, if I so desire. And my gastroenterologist still hasn’t found the reason for my occasional spasmodic bouts of vomiting — so more tests are coming.
Meanwhile, my house painter is struggling to afford the blood pressure medication he needs if he doesn’t want to have a stroke. The man who occasionally helped me with my garden when I lived in Louisiana can’t afford to go to the dentist. Opioid addicts struggle to find any treatment at all. This is a national and moral disgrace.
A few more items from my long list of medical experiences:
Cost of 2013 hip replacement, plus hospitalization, plus at-home physical therapy appointments, plus home-nursing: $62,680.
Out of pocket expenses for me: zero.
Cost of getting my back whacked into place by my chiropractor when my back goes out, which it does when I’m stressing out: about $130.
Cost to me: $15.
Cost of going to a doc-in-the-box in upstate New York when, during my winter holiday, I slipped on the ice and my back went into spasm: $240.
Cost to me: $15.
Yup, I’ve had my challenges, including cancer, but I’m healthy as a horse.
It’s an obscenity that people like myself — already born at the top of the heap — have access to everything it takes to keep us perking along at a healthy clip, while people who work two and sometimes even three jobs can’t even buy the medicine they need to keep them alive.
Here we have rank and file labor unions knowing their CADILLAC HEALTH PLANS are on the hit list. So, we first see our working class CADILLAC PLANS thrown under the bus to become CORPORATE WELLNESS----and we saw above how our white collar professionals at state and Federal level are still holding on to that CADILLAC PLAN.
Know who will get hit in this coming US Treasury and state municipal bond market fraud and collapse? STATE AND FEDERAL PUBLIC PENSIONS AND BENEFITS. Now, we can be sure our 5% TO THE 1% POLS AND GOVERNMENT APPOINTMENTS will keep a strong health coverage, but our public universities, rank and file Federal and state employees will be pushed to CORPORATE WELLNESS ONLY.
'Finally, between 2016 and 2017 the so-called “Cadillac tax” springs to life. It will impose a tax equivalent to 40 percent of the value of some plans with lavish benefits'.
We can bet all those global Wall Street FAKE ALT LEFT groups will blame TRUMP as these policies are installed in 2017-2018. Now, our international labor unions bound tightly to Clinton neo-liberals these few decades and now working for the INTERNATIONAL LABOR ORGANIZATION BRANCH OF UNITED NATIONS knew Bill and Hillary were trying to do in the 1990s in their health care reforms what Obama did these several years -----labor unions KNEW those CADILLAC health plans were GONE WITH THE WIND and KNOW today that UNIVERSAL SINGLE-PAYER is that United Nations preventative health care only----CORPORATE WELLNESS.
'As of 2017, there is a bipartisan effort in Congress to repeal the 40% tax--H.R. 2050 introduced by Rep. Joe Courtney (D-CT) and H.R. 879 introduced by Rep. Frank Guinta (R-NH). In addition, the Alliance to Fight the 40, a broad based coalition of public and private sector employer organizations, unions, health care companies, businesses, and other stakeholders that support employer-sponsored health coverage, is working to repeal the 40% tax'.
Union: ObamaCare Will Kill Our Health Plan by 2017
By Ashton Ellis
Thursday, March 13 2014
After ObamaCare, no one’s privately funded health plan is safe.
With Democrats trying to pivot to income inequality before the 2014 midterms, a new labor union report says ObamaCare threatens to do tremendous harm to low-wage workers.
“Ironically, the [Obama] Administration’s own signature healthcare victory poses one of the most immediate challenges to redressing inequality,” warns UNITE HERE, one of the largest culinary unions. That’s because ObamaCare’s redistribution scheme takes from the bottom middle class to enrich the poor.
Pointing to a Brookings Institution study, UNITE HERE highlights a sobering fact. In order for people in the lowest two tenths of income to receive gains of 5.3-7.2 percent from ObamaCare, the third and fourth lowest brackets will lose between 0.9-1.1 percent of their income. The bracket least affected by the controversial health law is the top tenth, losing a relatively small 0.3 percent.
“Only in Washington could asking the bottom of the middle class to finance health care for the poorest families be seen as reducing inequality,” the union concludes sarcastically.
It gets worse for UNITE HERE’s membership. In a simple two-page chart the union explains how ObamaCare’s mix of incentives and penalties will kill its current health insurance plans by 2017.
Starting in 2013, 388 employers began cutting back hours to avoid meeting the law’s threshold for full-time employees. In 2014, all insurers must pay a new tax of $63 per enrollee. But while some companies can recoup part of that tax via ObamaCare subsidies, those that do not participate on an ObamaCare exchange cannot. In 2015, the employer mandate goes into effect, forcing a choice between paying $8,000-$12,000 per employee for ObamaCare-compliant coverage, or dropping coverage and paying a fine of $2,000 per employee. Finally, between 2016 and 2017 the so-called “Cadillac tax” springs to life. It will impose a tax equivalent to 40 percent of the value of some plans with lavish benefits.
Taken together, the whole system looks like a way to force people off of their current insurance plan in favor of an ObamaCare-approved alternative.
UNITE HERE, one of the earliest supporters of President Barack Obama, wants an exemption.
The problem with ObamaCare as UNITE HERE sees it is the refusal of the Obama administration to qualify its health insurance plans for subsidies. Making subsidies available to union members is the only way for the union’s preferred plans to compete on price since ObamaCare undeniably raises the cost of coverage.
But UNITE HERE and the other unions agitating for similar treatment aren’t being completely candid about their dilemma.
UNITE HERE operates a non-profit Taft-Hartley insurance company funded mostly by the employers of its members. Taft-Hartley plans enable labor unions to deliver generous benefits at highly subsidized prices.
But all that is changing under ObamaCare. Even though all health insurance companies must comply with the health law’s premium-spiking regulations – such as covering dependents up to age 26 and accepting enrollees with preexisting conditions without penalty – only a portion of insurers get access to ObamaCare’s subsidies. That’s because subsidies are only available for plans sold on an ObamaCare exchange, because the company agrees to sell to any customer wanting to buy. UNITE HERE cannot comply with that mandate.
The reason is simple. Employers of UNITE HERE’s members fund Taft-Hartley plans as a way to reduce demands for higher wages. Since health benefits are tax-free if paid by an employer, many unions prove their worth to members by escalating benefits when wages stay flat. If UNITE HERE’s health company qualifies for subsidies, then that means anyone – including non-union members – must be allowed to purchase the union’s health plan. But that would put the employers of the union’s members on the hook for subsidizing a generous health package for non-union members. UNITE HERE’s leadership knows employers won’t go for that.
On the other hand, if Taft-Hartley plans continue to be barred from receiving ObamaCare subsidies, then the law’s combination of mandates and taxes will make union-run health insurance a more expensive proposition than plans offered on ObamaCare exchanges.
In either scenario, UNITE HERE and other Taft-Hartley unions are beginning to realize what conservatives have suspected all along: After ObamaCare, no one’s privately funded health plan is safe. It’s a lesson both sides could be teaching voters during the 2014 midterm elections.
We KNOW this is the future of UNIVERSAL CARE PREVENTATIVE CARE ONLY and in addition to the concerns listed here we also are watching as global corporations buy into these wellness corporations as shareholders or actually spinning off their own wellness brand. This is what will occur. The degree of worker control in having access to all medical data and being able to require employees meet health standards set by vendors----making corporate drug testing look like child's play. Remember when our BILL OF RIGHTS to privacy meant if one is capable of doing that job a worker's health status was not to be considered----
AFFORDABLE CARE ACT did just the opposite----it places our employers front and center in a worker's health care and able to control the results.
While our upper-middle/affluent class continue to keep that quality health care affording those Gold and Platinum plans----coming in just a decade or two-----only the global 1% and their 2% will be receiving our US strong quality health care for ALL HEALTH CONCERNS.
'But it's a potentially toxic combination that's ripe for abuse. Employers eager to control exploding healthcare costs and vendors eager to sell programs claiming big ROI with little scientific evidence and no legal review. What could possibly go wrong'?
Jul 16, 2014 @ 09:20 PM 12,854 12 Stocks to Buy Now
Are Workplace Wellness Programs Legal?
Dan Munro , Contributor
I write about the intersection of healthcare innovation and policy. Opinions expressed by Forbes Contributors are their own.
On the one hand, workplace wellness programs are openly endorsed by the Affordable Care Act. On the other, how they're constructed and implemented is critical in determining any potential benefit or legal risk.
"There are at least 10 different Federal laws and numerous state laws that employers need to be aware of relative to any company sponsored "wellness program." Most of the employers that come to us for a legal review of their program are shocked at the significant complexity ‒ and are in violation of at least one of these legal requirements ‒ often more than one. Of course, there are thousands of companies that simply choose no legal review at all. I can count on one hand the number of employers I've seen who have gotten this right on their own. Kate Ulrich Saracene ‒ Partner ‒ Nixon Peabody's Health and Welfare Employee Benefits practice
The global law firm recently published an alert on the topic ‒ Wellness Programs after the Affordable Care Act (Part II) ‒ which included this chart highlighting the individual Federal regulations and their applicability by plan type.
Released earlier this year, Fidelity Investment's fifth annual wellness survey (here) shows just how popular workplace wellness programs have become.
- 95% of companies plan to offer some kind of health improvement program for their employees
- Corporate employers plan to spend an average of $594 per employee on wellness-based incentives this year
- Companies offering incentives to participate in these initiatives has increased from 57% in 2009 to 74% in 2014
- 93% of companies indicated they plan to expand or maintain funding for their program over the next 3-5 years
- 44% of companies said they plan to maintain or increase their investment in wellness programs, even if their company were to move away from direct involvement in employer-sponsored health coverage
Earlier this year, a CVS cashier filed a class action lawsuit against the retail healthcare giant for a "Wellness Exam" she claims included questions on sexual activity and blood testing for "a variety of medical conditions." The survey was required in lieu of an annual $600 fine.
Another program raised a faculty firestorm at Penn State (New York Times here) which quickly prompted the university to suspend their annual $1,200 non‒compliance fee (here).
In a desperate effort to find an elusive ROI, wellness vendors are pushing all the boundaries ‒ including legal and privacy.
We should absolutely expect to see more employee pushback with lawsuits like the one at CVS and public relations disasters like the one at Penn State. Shifting age-old paternalism from the clinical side to the employer side is really antiquated thinking ‒ and will fail spectacularly.
Tom Emerick ‒ Co-Founder of Edison Health and former Vice President, Global Benefits Design for Walmart Stores, Inc.
That elusive ROI is getting ever harder to find too. Last year The RAND Corporation concluded their 5-year analysis with this assessment.
“Our statistical analyses suggest that participation in a wellness program over five years is associated with a trend toward lower health care costs and decreasing health care use. We estimate the average annual difference to be $157, but the change is not statistically significant.” RAND ‒ Workplace Wellness Programs Study ‒ Final Report (PDF here).
In January, Reuters had this quote highlighting similar results after a 7-year RAND study at PepsiCo PEP -0.3%.
Released on Monday in the journal Health Affairs and based on data for thousands of PepsiCo employees over seven years, the findings "cast doubt on the widely held belief" that workplace wellness programs save employers significantly more than they cost concluded Soeren Mattke of the RAND Corporation and his co-authors. "Blanket claims of 'wellness saves money' are not warranted." PepsiCo's workplace wellness study fails the bottom-line study (Reuters)
Vik Khanna has studied the industry at length and co-authored (with Al Lewis) a book on the topic and industry.
The entire wellness charade, including the potentially actionable behaviors of many vendors, could easily be avoided by adherence to one simple fact: you cannot make people well by shoving more medical care down their throats. The fundamental flaw of the wellness industry is that, much like the government that empowers it, all it can conceive of are "programs." The successful long-term pursuit of health within a company is exactly like it is within a family: create positive atmospherics, make choosing healthy the right, easy and happy thing to do, and have leaders who live and breathe the philosophy, with no expectation other than that their people will feel better and appreciate the support. Not a single one of those things has any legal impediments. Vikram Khanna ‒ Co-Author of Surviving Workplace Wellness ... with Your Dignity, Finances, and Major Organs Intact
Not satisfied with their tepid results, chip giant Intel INTC +0.85% is embarking on an even more aggressive approach. After ten years of applying traditional levers like workplace wellness, Intel announced a program last year that engages "directly and deeply in benefit design, plan design, and delivery optimization for employees and dependents at its Rio Rancho, New Mexico, facility." Intel White Paper (pdf here)
Brian DeVore, director of healthcare strategy and ecosystem at Intel, said Intel's new direct contracting initiative follows the company's previous efforts to slow spending and improve workers' health through consumer-directed health plan designs, wellness checks and biometric screening. “I think we've done what most employers have done,” he said. “We realized that wasn't going to bend the trend.” Intel adopts narrow network to better manage care ‒ Modern Healthcare, July 2013 (registration required)
The challenge for all programs is a risk/reward profile that almost demands an aggressive approach ‒ regardless of clinical efficacy, ROI or legal risk. It comes as little surprise then that the popularity of the "stick" approach over the "carrot" is growing.
As we get closer to the end of the year and employers realize the mandate [for providing health coverage] and the fines are here to stay, there is going to be a big shift to the “stick’ and “penalty” approach in wellness. Employers who aren't offering health insurance now, and do so to avoid the fines, will implement the stick approach simply as a cost savings approach and to shift some of the burden and responsibility to employees. Since the ACA doesn't reduce healthcare or insurance costs, those with existing wellness programs are going to be forced to consider and utilize the stick/penalty approach simply as a long term way to make employees accountable and to cost shift. Jonathan Edelheit ‒ Director of Corporate Health and Wellness Association
But is any of this truly in the best interest of employees ‒ or is it simply another desperate measure to control the runaway economics of healthcare? A PayScale study (here) shows that about 400 of the Fortune 500 companies have a median employee tenure of less than 5 years. That means that any accrued health benefits to an employer would likely be lost completely ‒ potentially to a competitor. Similarly, the employee loses any long term benefit of coordinated and continuous health coverage. According to that PayScale study ‒ Intel's Median Employee Tenure is 4.3 years.
Actual healthcare delivery is definitely a new approach for many employers eager to grab hold of the healthcare tiller, but it also raises a lot of legitimate questions about our "accident of history" ‒ Employer Sponsored Insurance (ESI). Perhaps the largest single question ‒ as highlighted recently in the Berwell v. Hobby Lobby Supreme Court decision is simply this: Who's health insurance is it?
We read that ATLANTA'S mayor installed a wellness center for city employees -----while all this is FEEL GOOD----most people like this idea of wellness----what we are shouting is this-----it is replacing what used to be our strong health care plan benefits and will be the only health care 99% of people will be able to afford. Being fearful of any or all exposures that may down the road effect health to where REAL hospital and disease vector care is need hits against FREE WILL, CHOICE, PRIVACY RIGHTS, but as importantly it walks WE THE PEOPLE THE 99% right into the hands of far-right, authoritarian, militaristic, dictator global 1% corporate FASCISM.
THIS IS VERY, VERY, VERY, VERY, VERY BAD FOLKS---PLEASE THINK BEYOND THIS DECADE OR TWO TO SEE WHERE THESE HEALTH REFORMS WILL END.
For those not caring ---social Darwinism citizens-----these kinds of mental and physical aptitudes for workplace go beyond being 'athletic and top shape'. An IVY LEAGUE university did a several decade study of what makes that TOP ACHIEVER getting to that BEST OF THE BEST IN THE WORLD.
'Most significantly, the law said employers could provide more rewards — or levy more surcharges, depending on how it’s framed — than they could previously: Maximum rewards or penalties now cannot exceed 30 percent of the total cost of the worker’s insurance, up from 20 percent, including both the employee’s and employer’s shares. (And if a tobacco cessation program is included, the figure rises to 50 percent)'.
Remember, China's #1 employment status is prison labor, forced free labor-----those employees not keeping that mental and physical fitness in line can be routed to that global corporate campus rehabilitation factory.
The Sticks and Carrots of Employee Wellness Programs
By TARA SIEGEL BERNARD OCT. 30, 2015
PhotoCredit Robert Neubecker
The notices arrived in employee mailboxes: Provide us with your weight, cholesterol levels and other sensitive medical details, or pay up to $2,250 in health insurance penalties — and up to $4,000 if you’re married.
The packets were delivered to employees of Honeywell, a manufacturing conglomerate based in New Jersey, as part of its annual health plan enrollment. It started levying the hefty surcharges two years ago, though it has eased the penalties for its wellness program for the coming year — they are now capped at $1,500.
Federal regulations require that such wellness programs be voluntary. But for some workers, it may not feel that way.
On the surface, the programs are seemingly a win-win: Encouraging workers to get up and move or submit to annual blood tests to prevent future problems appears to help both workers and their employers.
But the program’s biggest critics say the programs are yet another way to push more costs onto employees, and even worse, potentially a backdoor way to discriminate against less healthy workers by making them pay more if, for instance, they fail to meet a goal of lower cholesterol. For lower-income employees, who may feel more pressure to participate, there is the potential for another type of discrimination.
“Even if the program fails to improve employee health or lower costs over all, they can come out ahead by shifting more of the responsibility to employees in the form of larger contributions,” said Matt Lamkin, a professor at the University of Tulsa College of Law who specializes in bioethics and medical consumerism.
Privacy is another concern. Many workers may fear that their sensitive medical information — like their blood pressure or data collected by a wearable device — could end up in the wrong hands or become exposed in a data breach. Consider the questions in a typical health assessment: Do you feel so stressed that nothing can cheer you up? Have people annoyed you by criticizing your drinking? And don’t forget to include your waist circumference.
While most large employers — with 500 workers or more — ask employees to complete some sort of health assessment to identify potential risk factors, nearly 60 percent also ask them to prick their fingers for biometric screening, according to a 2015 report by Mercer, a consulting firm. And the number of employers offering financial incentives to complete any of these wellness-related tasks has inched higher: About 56 percent of large employers dangled an incentive in front of their workers last year, the most common being a premium reduction.
The programs may have become more prevalent, at least in part, because of the Affordable Care Act. That law expanded existing rules for a certain type of wellness program where incentives are contingent on a specific health outcome (like reducing blood pressure) or an activity (like walking).
Most significantly, the law said employers could provide more rewards — or levy more surcharges, depending on how it’s framed — than they could previously: Maximum rewards or penalties now cannot exceed 30 percent of the total cost of the worker’s insurance, up from 20 percent, including both the employee’s and employer’s shares. (And if a tobacco cessation program is included, the figure rises to 50 percent).
So for a family with coverage that is valued at $17,545 — that was the annual average total cost in 2015, according to the Kaiser Family Foundation — it would be perfectly fine for the employer to charge up to about $5,264 more, or 30 percent, for not fulfilling a goal like filling out a health risk assessment form or completing a biometric screening. That is a significant chunk of most families’ budgets.
Amy Gordon, right, an employee benefits lawyer for McDermott Will & Emery, on a morning run with two friends, Lainie Dorneker, left, and Jessica Interlandi, in Chicago. Credit Joshua Lott for The New York Times
“Some employers are really pushing the envelope with the 30 percent; some are coming close,” said Amy M. Gordon, a partner at McDermott Will & Emery in Chicago, who helps employers construct the plans. But plenty of other employers may offer different incentives, she added, like gift cards or the chance to win a piece of exercise equipment.
The financial incentives — and the whole notion of whether a program is truly voluntary — have received a lot of attention over the last year, particularly after the Equal Employment Opportunity Commission tried to stop Honeywell last October from penalizing employees who did not take medical tests. The commission claimed that the penalties made the testing involuntary and so violated the Americans With Disabilities Act. A Federal District Court judge denied the commission’s motion for a temporary restraining order in November and let Honeywell’s policy stand.
In April, however, the commission proposed its own rules for wellness programs, which are similar to those in the Affordable Care Act. Honeywell said it capped its penalties at $1,500 for 2016 — they can be avoided by completing biometric screening — to try to comply with the commission’s proposed rules, which have not yet been completed.
The commission further clarified its position on wellness incentives this week. On Thursday, it proposed to amend another rule, the Genetic Information Nondiscrimination Act, which generally prohibits employers from requesting or collecting a worker’s genetics or family history. Those rules still stand, but the proposed update would permit employers to provide rewards to or impose penalties on workers’ spouses in exchange for data on their current or past health status, though not their family history or genetic information.
So where does all of this leave employees?
For individuals concerned about privacy, this is yet another case of caveat emptor; workers need to fully understand what they are signing up for. Medical information collected through a wellness program that is part of a group health plan should have better protections, including safeguards provided by the Health Insurance Portability and Accountability Act (known as Hipaa). Details collected by wellness programs may be disclosed to employers only in aggregate form — anonymously — except when they are needed to administer the health plan. And the wellness program must disclose who will receive the data and how it will be used.
But here’s the catch: Many wellness programs require participants to sign up on their website, where workers must agree to the wellness vendor’s policies.
And if you have a Fitbit or another type of wearable technology, the data may not have any special protections, particularly if an employer bought the devices for its workers outside its formal health plan. “The details very much matter in this case,” Dr. Slomovic said.
Then there is the continuing debate about whether wellness programs are actually helping employees. It’s hard to argue with the value of on-site gyms, help with smoking cessation and an overarching goal to adopt a healthier lifestyle. But while some wellness programs said they followed national guidelines set out by groups like the American Medical Association, critics argue that some take screenings too far.
“Wellness vendors screen everyone every year to maximize profits, even if harms exceed benefits,” said Al Lewis, a health consultant and a frequent critic of the $7.2 billion corporate wellness services industry. He said they routinely ignored screening guidelines set out by the U.S. Preventive Services Task Force, a well-known authority on the issue.
For now, only a minority of companies are levying penalties on people who don’t meet specific health goals. And exceptions must be made for people with medical issues who cannot participate or meet specific targets. Still, critics have concerns about a policy that requires already-stressed workers to pay extra if they miss the mark.
“If you can’t make yourself well, you have to pay more,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a nonprofit group focusing on health policy issues. “Some people ask, ‘How is that different from medical underwriting?’”