Employee Benefit Adviser

By Lydell C. Bridgeford

September 1, 2008

Top-down buy in is consistently listed as a key component of wellness program success by health and productivity experts. ... [Anytime] an adviser or employer can work shoulder-to-shoulder with employees engaged in wellness programs, they have a better opportunity to inspire, influence and steer behavior.

Bill Germanakos was able to do this because his personal journey to health was well publicized at work - and nationally. Last year, Germanakos, a medical sales representative for Quest Diagnostics, won top prize on "The Biggest Loser." He lost 164 pounds - 49.1% of his body weight - in 34 weeks, dramatically improving his health. In April, Quest Diagnostics appointed Germanakos, who had previously led a sales team selling new technologies, as its director of employer wellness initiatives...

Leading by example

... Quest Diagnostics was named a Gold Award winner among the 2008 Best Employers for Healthy Lifestyles - making a case for the strength of a message sent by HR execs and advisers who practice what they preach.

The company's HealthyQuest employee wellness program, has resulted in more than 70% of participants achieving an assessment rating that indicates a low risk of developing major health problems, compared to 60% when the program began.

Programs include physical fitness, weight, and stress management resources, tobacco cessation counseling and efforts to improve the healthful quality of food choices at onsite cafeterias and vending machines. The company is beginning to see a positive ROI from the programs and employees appreciate the changes in their lifestyle, says Fred R. Williams, director of health benefits management at Quest Diagnostics.

...Having Germanakos share his wellness story encourages others to share their own, which gives wellness participants confidence that they can make a change as dramatic as his, whether it's quitting smoking or losing weight, notes Williams, adding that improving health is a metric that the company tracks.

Unexpected payoff

Thom Mangan, president of the benefits division of Hub International, Northeast, has found that making his personal commitment to health and wellness public has helped make the wellness conversation with clients more meaningful. ...

Mangan, whose goal is to lose 30 pounds, has been steadfast in his wellness approach. ... He's also ordering salmon, rather than steak, and often skipping the cocktails when he's out and about with clients and prospects.

"I'm going through it. I know it can be done. And it's not easy," says Mangan.

... Now, Mangan has the opportunity to frame his wellness services differently and push clients a little more forcefully than he has in the past.

Neil Simons, president of Rockville, Md.-based Independent Benefit Services also thinks wellness is a crucial element to lowering premiums and developing a happier, more productive workforce. He attributes his advisory firm's success with implementing wellness programs for clients to IBS' internal wellness advocacy.

"I don't know if [participating in wellness] is critical to your success in business, but I do know it helps if you are practicing what you preach. ..." says Simons.

..."We have a fitness guru on retainer that we bring in to talk to our clients. And he comes in to our office every Monday and takes everybody's blood pressure every week. ... And he keeps everybody moving and thinking about fitness," says Simons.

..When advisers and employers share in employees' wellness journey there is also the opportunity to share additional tips and tactics on how to accomplish health goals.

"I am making public appearances and letting people know what I have accomplished," Germanakos says. "I am trying to spread the word and educate people about health and wellness ..."

...

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EBA Managing Editor Molly Bernhart contributed to this story.

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Achieving and maintaining behavior change

Motivating participants is a major challenge facing worksite wellness. But maintaining the healthy behaviors participants learn to embrace through the plan is even more difficult. Here are some tips for overcoming obstacles that could cause employees to fall back on bad behaviors once the honeymoon is over:

Meet people where they are.

The smoking cessation strategy for a 50-year-old who smokes three packs of cigarettes a day should differ significantly from the treatment plan for a 21-year-old who consumes just three cigarettes every other day.

Personalize the experience.

... Lifestyle coaching programs can be an effective way to help people create an individualized strategy, as coaches can assess each individual's specific needs, develop a customized action plan, solve problems and prevent setbacks. They also can help identify the emotional triggers of unhealthy habits.

Measure success.

... Participants need to feel motivated to continue making progress, which may include having increased confidence, experiencing psychological mood changes and finding the right support network.

Matthew M. Clark is a clinical psychologist with the Department of Psychiatry and Psychology at Mayo Clinic in Rochester, Minn., and a medical director for Mayo Clinic.

InvestmentNews

Those who pay the costs themselves can quickly go into debt

By Darla Mercado
September 22, 2008, 6:01 AM EST

...The coverage protects clients against the financial blow from a serious illness. While disability insurance makes up for one's missing wages while being laid up with an injury and medical insurance pays for illness-related expenses, critical-illness insurance covers out-of-pocket expenses that arise immediately.

Those expenses can easily drive clients into piles of debt, according to a new survey, "Benefits & Behavior: Spotlight on Group Critical Illness Insurance," from The Guardian Life Insurance Company of America in New York. ...

Barry Petruzzi: Critical-illness insurance isn't well-known.

"[Critical-illness insurance is] something that's not well-known as a [type of] coverage, but it's very important to have," said Barry Petruzzi, second vice president for group benefits at Guardian.

Typically, the customer takes out insurance against specific major illnesses or serious conditions, such as cancer and kidney failure. If a client develops a condition that is covered in the policy, he or she receives a lump sum payment upon confirming the diagnoses with the insurer.

...Still, not many advisers recommend the coverage to their clients, and some are skeptical of using it.

"You might never collect on your cancer insurance, and you won't be covered on the other things that can go wrong," said Ed Stuart, a CFP and wealth manager at Regent-Atlantic Capital LLC of Morristown, N.J.

"I'd want to be sure that the client's insurance needs are well-covered and that they would be covered by any catastrophic expense, but to pick an illness out and buy extra coverage doesn't make much sense to me."

However, there are still purposes for the insurance. For instance, a disability policy may not kick in for 90 days, and the lump sum from the critical-illness policy can go toward paying bills until then.

Still, Mr. Grant pointed out that there are pitfalls for advisers who are unfamiliar with the way critical-illness policies work. For example, a client and a carrier can have very different definitions of "critical illness."

Most policies will cover what is known in the actuarial world as "the Big Five": cancer, stroke, major organ transplant, kidney failure and heart attack. However, if a policyholder goes blind or develops Lou Gehrig's disease, they will bear the full brunt of the out-of-pocket expenses, said Kevin Grant, a certified financial planner at Higgenbotham & Associates in Dallas. ...

"Be very careful to read the agreement," Mr. Grant said . "It's just like disability: What's in the contract is what's covered. And it's a bad thing if you have a client who thought he would be covered and the money doesn't come in."

E-mail Darla Mercado at dmercado@investmentnews.com.

Employers are paying more attention to the impact mental illness can have on the bottom line, but determining the causes of many such illnesses merits a more muscular approach.
Risk & Insurance Online

By Maurice Preter and Jeffrey Kahn

Employee mental health affects the bottom line and the culprits are many. Stress disability rates have been growing and mental health is also the leading cause of prolonged disability in people with a physical illness. ...

In a trend reversal, more scrutiny of workplace mental health is starting to come about. ...

Ideally, added outlays for quality mental healthcare will be more than offset by savings in such costs as absenteeism, recruitment and training, reduced productivity, presenteeism and physical healthcare expenses. From the employees' perspective, the desired outcome of mental healthcare is accurate identification of the problem, appropriate treatment and, ideally, resolution of the problem.

Many people don't realize that psychiatric medication and psychotherapy are not replacements for each other. They work very well together, but they do different things. ...

RIGHT THE FIRST TIME

...Just as elsewhere in medicine, the initial evaluation is where highly skilled clinicians with broad and advanced training are most useful. ...

... Poor job performance attributed to work stress can be due to such things as a hidden conflict with a supervisor, an unrecognized depression or even an undiagnosed medical illness. Skilled mental health evaluators are trained to sort out these issues, and psychiatrists have the most comprehensive diagnostic training of all. ...

... Untreated depression, thyroid disease, family problems, alcoholism, interpersonal skill deficiencies or unexplained chest pain can be both financially and morally expensive.

... There haven't been many guidelines on such dilemmas as when to refer, but the accompanying chart lists some good starting points. The full 2008 source article (recognition, diagnosis and referral of workplace depression) can be downloaded for free (WorkPsych.com/publications.html).

...What else can be done? Manhattan-based WorkPsych Associates has recently completed a project that allowed a large employer to address productivity concerns by quantifying the specific mental health and workplace root causes of absenteeism, presenteeism and more. ... The custom data yielded targeted and effective solutions for both employer and employee, sometimes addressing unexpected issues with straightforward strategies.

WorkPsych has now teamed up with Golden Valley, Minn.-based OptumHealth to make more employers aware of this approach (a press release can be downloaded at WorkPsych.com/publications.html). A separate OptumHealth project recently reported that improved follow-up care for depression meant a 40 percent increase in depression recovery, a 40 percent reduction in employment loss and the equivalent of two more work weeks of productivity per year.

Solutions are there. Let's start using them!

Urgent Indications for Psychiatric Referral*

--Risk of Suicide or Self Harm

--Risk of Violence to Others (notify appropriate authorities and potential victims when required)

--Pronounced Symptoms (anxiety, depression, psychosis)

--Cognitive Disorganization or Acute Cognitive Changes (thought processes)

--Substance Abuse (substance abuse clinician)

--Child Abuse (notify appropriate authorities when required)

--Urgent Life Issues or Emotional Crises Requiring Rapid & Integrated Treatment

* Referral to a specialized evaluator is indicated whenever these phenomena are present and are beyond the expertise of the initial evaluator. Always consider possible need for urgent referral.

Other Indications for Psychiatric Referral

--Support During an Emotional Crisis

--Interpersonal or Personality Issues

--Less Than Full Remission (inadequate treatment response)

--Reconsidered or More Definitive Diagnosis or Treatment Planning

--Troublesome Patient or Clinician Emotions (that interfere with treatment)

--Significant Co-Occurring (or potentially contributing) Medical Illness

--Distressed Executives (heightened confidentiality concerns)

--Management Consultation Issues

--Long-term Life and Lifecycle Issues

--Concerns About Suicide or Violence

MAURICE PRETER, M.D., is a psychiatrist and neurologist, and JEFFREY P. KAHN, M.D., is a psychiatrist; both are Manhattan-based, where Dr. Kahn is also CEO of WorkPsych Associates.

Modern ocean power systems look to convert the mechanical energy of waves or tidal movement to electrical energy. But that’s not all the sea has to offer. It may also be possible to capture and convert the enormous quantities of heat produced by magma escaping through seafloor vents—an undersea version of geothermal energy.

POWER Magazine, July 2008

By Dr. Robert Peltier, PE

The attraction of renewable energy sources is that nature continuously replenishes them. ... Examples that come to mind include power-generating geothermal energy systems that use deep wells to extract hot brine (POWER, December 2007, “Raft River Geothermal Project”) or naturally produced steam (Calpine’s Geysers Project in Northern California). ...

... Southern California inventor Bruce C. Marshall (www.marshallsystem.com) laments the lack of attention paid to ... hydrothermal vents on the ocean floor. Magma from deep within the earth is constantly ... forcing the planet’s tectonic plates apart. As two plates separate, the rock below them partially melts to produce magma that rises and fills the gap and produces further seafloor spreading (Figure 1).

1. What lies beneath. Ridges are formed as tectonic plates pull away from each other, forming hydrothermal vents along the boundary. Source: U.S. Geological Survey

Drilling down

 ... The earth’s surface has 10 to 12 major tectonic plates and many smaller minor ones. These plates, ... move relative to one another about 1 inch a year.

Hydrothermal vents are natural geysers of magma-superheated water found atop mid-ocean ridges across the planet at an average depth of 7,500 feet (Figure 2). ...

2. Where to expect earthquakes and active volcanoes. The red dots indicate known hydrothermal and geothermal locations. This is only a partial map, as there are tens of thousands of kilometers of mid-ocean ridges that have never been explored. Source: U.S. Geological Survey

Tectonic plate movement opens fissures on the seafloor into which seawater is forced ... Magma superheats the seawater to a temperature as high as 750F, creating a geyser (an underwater version of Old Faithful) with a velocity of 3 to 15 feet per second (fps). ... But the cold surrounding seawater causes a cocktail of metals and minerals to precipitate out of the fluid and rain down on the seabed. Precipitates include iron, gold, silver, copper, and zinc, to name a few elements (Figure 3).

3. Thank you for smoking. Plumes from sites on the ridge crest are often caused by the intrusion of a magma dike during an episode of seafloor spreading. The hot fluids rise and are diluted by the surrounding seawater. Courtesy: U.S. Geological Survey

...  Mapping and tapping volcanic vents may not any more technically challenging than drilling for oil. It will, however, probably be much harder to capture hydrothermal energy and economically convert it to electrical energy.

... The sizes of the vents that have been surveyed are truly amazing. For example, the Juan de Fuca Ridge 200 miles off the coast of Seattle has an active vent field over 500 feet wide and 1,000 feet long. Within that field are more than 15 vents up to 90 feet in diameter that continuously eject water at 700F at a rate of 9 fps to 15 fps. Each of the vents theoretically offers 40 GW equivalent of thermal energy.

Reality check

... Marshall proposes a system that would bring the high-temperature fluid to the surface through a network of insulated pipes to an offshore power plant on a platform similar to that used by oil companies. ...

A second, ... approach, would be to mimic the closed-loop ground-source or geothermal heat pump. In this case, the hydrothermal system would use a heat exchanger to absorb energy from the ocean vents... The working fluid would transfer its heat energy to a binary power system much like those used by today’s geothermal plants. ... The electricity would then be moved to shore through a system of undersea high-voltage DC cables (Figure 4).

4. Energy from the ocean. Collecting thermal energy from vents on the ocean floor may be the ultimate renewable power generation scheme. Source: Bruce C. Marshall

Unknown unknowns

... It has many technical and environmental issues that have yet to be identified. Recent explorations of hydrothermal vents by the U.S. National Oceanic and Atmospheric Administration and the Woods Hole Oceanographic Institute have turned up an amazing variety of life forms that do not exist elsewhere on our planet. Among them are plants that use chemosynthesis, rather than photosynthesis, to stay alive at these black depths. ...

Undersea vents were discovered just 30 years ago... The December 12, 2005, issue of National Geographic News carried a story about a hydrothermal megaplume in the Indian Ocean that is ... thought to have the energy equivalent of 100,000 MW. The story went on to estimate the thermal output of all the known vents in the world at about 17,000,000 MW—about the same as current worldwide power generating capacity. ...

Fact or fiction?

“Whatever one man is capable of conceiving, other men will be able to achieve,” wrote Jules Verne. ...

... For example, if a closed hydrothermal power cycle with an efficiency of just 1% were to be applied to the 15 vents mapped at the Juan de Fuca Ridge, we’d have 6 GW of dispatchable renewable equivalent capacity.

... However, the idea does deserve further investigation by experts in deep ocean platform drilling, volcanologists, biologists, and a geothermal power plant engineer or two. ...

Clients who are in good health receive discounts

InvestmentNews

By Darla Mercado
June 2, 2008

As life insurance carriers reward clients for wellness, financial advisers look for more ways to help investors scale back on their coverage costs, and that means getting involved in their health.

"I am often in conversations about these issues, whether it be stopping smoking or lowering cholesterol," said Lisa Kirchenbauer, a certified financial planner and president of Kirchenbauer Financial Management and Consulting. ...

Lisa Kirchenbauer: Smokers can pay triple the premiums non-smokers pay, she says.

The push for rewarding good health has come from the health and life branches of the insurance industry, with the most recent effort coming from London-based Aviva PLC, which is hosting a roadshow across the country to promote its Wellness for Life rider. ...

Specifically, clients have access to health assessments and other wellness resources from Mayo Clinic Health Solutions, part of the Mayo Clinic in Rochester, Minn. In exchange for visiting the doctor regularly or maintaining a weight within a specified range, consumers can save money on their life insurance coverage. ...

BUILDING RELATIONSHIP

Certainly, life carriers will benefit if they can wait a few more years to pay off on an insured's claim, but advisers say that by becoming involved in their clients' health, they are adding to their relationship and saving investors money on premiums.

"Good health is a tremendous financial asset; bad health is a tremendous financial liability," said Robert W. Brown, a CFP with RB Brown Insurance Agency Inc., a Frankfort, Ky.-based office of State Farm Mutual Automobile Insurance Co. of Bloomington, Ill. ...

"The dialogue needs to change dramatically," Mr. Brown said.

However, this type of intercession requires a light touch, especially if the client is less than forthcoming about his or her unhealthy habits, advisers observed.

"It's not something that all planners feel comfortable getting into," Ms. Kirchenbauer said.

For instance, one of her clients didn't mention that he was a smoker but came in to his appointments smelling like an ashtray. The client wouldn't admit to it, but the question finally came up when he was considering a long-term-care insurance policy, and the adviser asked point-blank if he smoked or had any health conditions.

Only then did the client admit to his habit.

But encouraging clients to drop the cigarettes helps.

"We have clients who have stopped smoking," Ms. Kirchenbauer said. "Then they go back to reapply and have their premium lowered."

Smokers can pay up to double or triple the life insurance premiums of non-smokers, Ms. Kirchenbauer said. ...

Despite the awkwardness behind approaching clients for their health details, advisers observed that it is ultimately their duty to see how their investors' health will affect their financial plan — especially if it is a problem that can be corrected.

"Health is a piece of the total equation," Mr. Brown said. "Ultimately, there needs to be in a more direct sense more reward for being proactive and taking care of your health — and a penalty if you don't."

E-mail Darla Mercado at dmercado@investmentnews.com.

Risk & Insurance. March 1, 2008.

Companies are taking unprecedented steps in their efforts to purge smoking--and its health effects--from the workplace.
By Barbara Worthington

When General Dynamics Electric Boat sent a letter from the company's president to each of its employees last August announcing the establishment of the company's tobacco-free workplace policy and the proposed start date, one employee sent the company's leaders a succinct response via e-mail.

It read, "Thank you. You've just established my retirement date." Though a bit startling, the message was the only negative response among the many received from employees, according to Robert Nardone, the Groton, Conn.-based company's vice president of human resources. Most of the employee feedback was overwhelmingly positive, says Nardone, even the responses from employees who smoked. "Some even said 'Thank you. This is going to help me do what I know I need to do anyway,' " he says.

Despite the recognition of serious health consequences linked to cigarette smoking, more than 45 million adults in the United States still use tobacco, according to Seattle-based Free and Clear, a provider of coaching-based treatment services for health plans and employers.

...The Society of Actuaries has determined that secondhand smoke costs the U.S. economy about $10 billion a year--$5 billion in estimated medical costs associated with exposure to secondhand smoke and an additional $4.6 billion in lost wages.

If all workplaces were to implement 100 percent smoke-free workplaces, the reduction in heart-attack rates due to exposure to secondhand smoke would save the United States $49 million in direct medical savings within the first year alone, according to the July 1, 2004 issue of the American Journal of Medicine. Over subsequent years, the savings would only increase....

[EB President John P.] Casey offered the services and support of EB's medical staff and wellness team members to help employees comply with the new policy. EB agreed to provide smoking-cessation programs and to share the cost of over-the-counter and prescription medicines such as nicotine patches and gum.

The company also offered to provide experts who specialize in quitting smoking to train employees who want to help co-workers quit. "We're trying to be sensitive to [the smokers'] situation because we know it's not an easy thing to kick," says Nardone. "We're doing it in a way that's manageable for them."...

EB executives view the introduction of the smoke-free workplace as a part of its holistic approach to employee health, which includes its Building Better Health initiative, a program launched in 2001 that offers employees incentives for undergoing physicals and participating in free screenings for cholesterol, diabetes and high blood pressure. "I see this as a logical extension of the integrated health-management program," says Medical Director Dr. Robert P. Hurley. "Clearly, the greatest impact you can have on improving health is smoking cessation." ...

THE "FIFTH VITAL SIGN"

When it comes to enforcing the new policy, Hurley says, the most important message to impart to employees is "if you slip, we don't consider it a failure." Evidence-based medicine suggests the greatest health interaction involves a periodic questioning or interview between a smoker and clinical provider, he says. "The focus here is not to punish; it is to support."...

Employee noncompliance with the smoke-free workplace policy is an important consideration, Nardone says. EB does not conduct employee testing or actively monitor employees to detect policy abuse. But management knows it will happen....

At Stamford, Conn.-based Pitney Bowes, which has 4,000 employees, the company's campuswide smoke-free policy has been in place since the early 1990s. The policy is bolstered by an incentive-based program called "Count Your Way to Health," in which employees accrue numbers for practicing healthy behaviors such as enrolling in smoking-cessation programs.

By accruing enough numbers, employees can earn up to $225 to be applied to benefits selections, says Dr. Brent Pawlecki, the company's associate medical director. It's essential to keep the message positive and supportive, he says, considering that the average smoker undergoes several attempts before successfully quitting....

Lewis Maltby, president of the National Workrights Institute in Princeton, N.J., fears that companies are venturing into dangerous territory by establishing such policies. "If employers start controlling one aspect of employee conduct, what else is there to control?" he asks....

Transitioning to a tobacco-free campus fits perfectly in organizations already committed to the concept of employee wellness. The smoke-free policy is "just one component of our overall dedication to creating a culture where health is just part of our everyday work environment," says Marcy Zauha, director of health and safety at Omaha-based Union Pacific. That company, which has 50,000 employees, adopted its "no smoking on company property" rule in July of 2005.

"A corporate wellness program is vital to a smoke-free campus," says Zauha. Such a program is essential to employees' recognition of the importance the company places on health and the commitment of the company to a healthy workforce. That recognition goes a long way in motivating employees to embrace programs and changes, she says.

"Employees who are smokers and are going to be restricted from [smoking] should be given ample time as well as the tools necessary to help them change their behaviors so that they can be compliant with the new policy," Zauha says.

BARBARA WORTHINGTON lives in Pennsylvania.

March 1, 2008

Copyright 2008© LRP Publications

The glory of lungs, legs, and steel
March/April 2008 - Sierra Magazine

THE BICYCLE IS A MASTERPIECE of physics. It harnesses human muscle power directly to that old-time marvel--the wheel--and yields a vehicle more energy efficient than any other devised, ever, by anyone. A human on a bicycle is more efficient (in calories expended per pound and per mile) than a train, truck, airplane, boat, automobile, motorcycle, skateboard, canoe, or jet pack. Cycling is more efficient than walking, which takes three times as many calories per mile. Pound for pound, a person riding a bike can go farther on a calorie of food than a gazelle can running, a salmon swimming, or an eagle flying.

Oh, and the bicycle is hugely democratic: It is equally available to all. That's why on the highways, byways, and bikeways in most of the world, the bicycle is the most ubiquitous transport vehicle. Bicycles outnumber automobiles almost two to one worldwide, and their production outpaces cars by three to one. Rush-hour traffic in China is dominated by these human-powered vehicles. Even in the wealthy cities of Europe and Japan, a large share of the populace gets around by bike. Only here is it treated as little more than a plaything. About 50 million U.S. adults (and 40 million children) ride their bikes at least once each year, but only about 2 million are regular bike commuters.

A bike is a blessing for your wallet, health, and legs, but bicycles are wonders because of what they don't do to the world. At zero pounds of carbon dioxide emissions, versus a car's one pound per mile, a bike does not alter the global climate. A cyclist fuels up on carbohydrates, not fossil fuels and imported oil. Bicycles don't require paving over landscapes at the expense of croplands, government coffers, and livable neighborhoods. And bicycles are not the leading killer of Americans and Canadians 2 to 24 years old or, worldwide, of men 15 to 44 years old. That distinction is reserved for the automobile.

Bicycles are not for everyone, and they're not for every trip. Cars do many things that bicycles cannot easily do: carry heavy loads uphill, protect riders from the elements, and cover long distances quickly. But a surprising number of car trips could easily be made by bike. Nearly half of all trips in the United States are three miles or less; more than a quarter are less than a mile. While advertising sells cars and trucks as tools for the open road, most often they help us inhabit a small daily realm--"Errandsville"--defined by home, store, job, and school. Many of these trips are easily bikable--or walkable--even on roads designed without bicycles or pedestrians in mind. A bicyclist can cover a mile in 4 minutes, while a pedestrian requires 20.

Short car trips are, naturally, the easiest to replace with a bike trip (or even walking). Mile for mile, they are also the most polluting. Engines running cold produce four times the carbon monoxide and twice the volatile organic compounds of engines running hot. And smog-forming (and carcinogenic) VOCs continue to evaporate from an engine until it cools off, whether the engine's been running for five minutes or five hours.

British author H. G. Wells summed up cycling's promise best more than a half century ago: "When I see an adult on a bicycle, I do not despair for the future of the human race."

This article is excerpted from Seven Wonders for a Cool Planet, by Eric Sorensen and the Sightline Institute (Sierra Club Books, May 2008).

Note from DMW--I don't always agree with the Sierra Club, but I think they got it right this time. Being an avid commuting cyclist, I am including this article in my blog purely for cycling promotion.

Risk & Insurance Online December 1, 2007

The American workplace is getting fatter, but employers are the ones that are expected to suffer and there's no better time for companies to implement a wellness program.
By Joshua Clifton

As the workplace becomes more sedentary, many employees are becoming fatter, sicker and less productive due to chronic conditions, according to a new report.

The study, prepared by the PricewaterhouseCoopers Health Research Institute and released last February, identified chronic disease as a growing and costly threat to corporations and their workers. ...

With obesity a growing epidemic, researchers said employers are paying the price. Experts estimate that nearly two-thirds of U.S. adults are overweight.

According to statistics compiled by the Institute on the Costs and Health Effects of Obesity, a creation of the National Business Group on Health, the total cost of obesity to U.S. companies is estimated at $13 billion per year. Health insurance costs related to obesity represent the largest percentage of the total--$8 billion, followed by paid sick leave, life insurance and disability insurance. ...

The study found that approximately 2 percent of capital spent on the workforce is lost to disability, absenteeism and presenteeism--diminished productivity from ill employees who go to work but work below par--due to chronic disease. Combined, these indirect costs are more than the additional direct medical claim costs that some employers incur.

Wellness programs offer a solution to the problem.

Researchers said preventable risk factors such as poor diet, lack of physical activity, stress and smoking are the biggest contributors to chronic disease. To target these preventable risk factors, employers should turn to corporate wellness programs. Researchers said corporate wellness programs have been shown to provide a three-to-one return on investment....

What incentives can employers provide? Although deciding to lose weight and live a healthy life is ultimately up to the employee, companies can encourage employees to improve their health in many ways. Some strategies used by other companies to promote healthy living and weight loss include:

- Discounted health club memberships. ...

- Healthy living and weight loss seminars. ...

- A company fitness club. ...

- Healthy items in the vending machines. ...

- Support. ...

JOSHUA CLIFTON is editor of the Workers' Compensation Report, a newsletter owned by the parent company of Risk & Insurance®.

December 1, 2007

Copyright 2007© LRP Publications

Risk & Insurance Online 12/01/2007

Obesity increases the cost of workers' compensation claims and the risk of traumatic workplace injuries, new surveys show.
By Joshua Clifton

Getting fat is expensive.

A recent analysis from Duke University Medical Center has found that obese workers filed twice the number of workers' comp claims, had seven times higher medical costs from those claims, and had lost 13 times more days of work from work injury or work illness than nonobese workers.

Researchers also says workers with higher-risk jobs were also found to be more likely to file workers' comp claims, and obese workers in high-risk jobs incurred the highest costs--both economically and medically....

The study, published in the Archives of Internal Medicine, was supported by a grant from the National Institute for Occupational Safety and Health. Researchers examined the records of 11,728 employees of Duke University who received health risk appraisals between 1997 and 2004. ...

For the study, researchers looked at the relationship between body mass index, or BMI, and the rate of workers' comp claims. Because the BMI takes into account both a person's height and weight when measuring body fat, Truls Ostbye, professor of community and family medicine at Duke and co-author of a study on obesity and claims says it is considered the most accurate measure of obesity. For Americans as a whole, a BMI of 18.5 to 24.9 is considered normal, 25 to 29.9 is considered overweight, and 30 and above is considered obese.

Researchers found that workers with a BMI greater than 40 had 11.65 claims per 100 workers, compared with 5.8 claims per 100 for workers within the recommended BMI range. ...

According to statistics, the total cost of obesity to U.S. companies is estimated at $13 billion per year. Obesity is also a major contributing factor in industrial accidents. Even when obesity is not a factor in causing a traumatic injury, researchers say it can complicate treatment and extend the time necessary for recovery....

TRAUMATIC INJURY RISK

In a separate study, researchers at the Johns Hopkins Bloomberg School of Public Health's Center for Injury Research and Policy have found that having a BMI in the overweight or obese range increases the risk of traumatic workplace injury....

Employer-sponsored weight-loss and maintenance programs should be considered as part of a well-rounded workplace safety plan, according to authors of the Advance Access study recently published in the American Journal of Epidemiology.

The researchers used medical and injury surveillance data on hourly workers employed in eight plants of the same aluminum manufacturer to determine whether increased BMI was a risk factor for workplace injury.

... BMI was calculated using National Institutes of Health criteria. Employees were grouped into five categories: underweight, normal, overweight, obesity levels I and II, and obesity level III.

Of the 7,690 workers included in the study, 29 percent were injured at least once between Jan. 2, 2002, and Dec. 31, 2004. Approximately 85 percent of the injured workers were classified as overweight or obese. More than 28 percent of injuries occurred among employees classified as overweight, 30 percent in the obese I and II category, and almost 34 percent in the obese III category....

The researchers say that more work will be needed to test the effectiveness for reducing weight among hourly, nonoffice employees who face a number of barriers to participating in work-site physical activity programs, such as the need to remove protective clothing for midday exercise and a lack of time because of additional employment or home responsibilities.

JOSHUA CLIFTON is editor of the Workers' Compensation Report, a newsletter owned by the parent company of Risk & Insurance®.

December 1, 2007

Copyright 2007© LRP Publications

Risk & Insurance Online - Story

Employers need a variety of work outcome data to calculate the impact of health-related absences.
 By Robert Hall

It makes intuitive sense that when an employee is not at work because of an illness, injury or another issue, there is an impact on the company's productivity and, therefore, the bottom line. But what exactly is that impact? And, more to the point, how should companies mitigate that impact by keeping employees healthy and on the job?

Employee absences aren't cheap. A report, "How to Present the Business Case for Healthcare Quality to Employers," published two years ago, found that the estimated annual cost of workforce absences due to illness to be equivalent to $55 billion, assuming the cost of an absence is equal to the wage of the absent worker.

The report found the estimated cost is 35 percent higher ($74 billon) if one considers the spillover effect absences can have on the output of an entire team, through the impact of lost sales and overtime costs.

IMPORTANCE OF DATA BENCHMARKING

Washington, D.C.-based National Business Group on Health's Council on Employee Health and Productivity, in collaboration with numerous sponsors, partners, Fortune 500 employers and their suppliers, has designed and implemented a program known as Employer Measures of Productivity, Absence and Quality, or EMPAQ.

EMPAQ allows employers and their suppliers to measure and evaluate the cost-effectiveness or quality in disability and absence management programs by using standardized definitions and metrics, which are supported by a common lexicon and platform for measurement through a training and certification program.

HEALTH AND WELLNESS

To compare the costs of health-related absenteeism and the benefit of offering health and wellness programs, companies have traditionally looked at medical claims and pharmacy data. Dee W. Edington, director of the University of Michigan Health Management Research Center in Ann Arbor, Mich., however, cautions that those reveal an incomplete picture.

Recognizing the value of wellness, Edington notes, requires a shift in thinking for employers that traditionally have "paid for sickness"--meaning shouldering all or some of the cost of medical claims.

"Companies want to continue to pay for sickness when it occurs, but also to pay for wellness," Edington says. "Companies will not be competitive in the world with unhealthy employees. They can only be competitive with healthy and productive people."

ROBERT HALL is a commissioner of the Certification of Disability Management Specialists Commission, principal of Presagia Inc., and director of the Work & Health Technologies Center at San Diego State University, where he teaches in the graduate Rehabilitation Counseling Program.

October 15, 2007

Copyright 2007© LRP Publications

Financial Advisor Magazine

November 08, 2007
    When it comes to motivating American workers to think about the state of their health, employers are finding that money talks.
Three years ago, ABB Ltd. (ABB), a global electrical engineering firm based in Switzerland, began offering U.S. employees enrolled in its company-sponsored health plan a $20 gift certificate for filling out a health questionnaire. Only 8% to 10% of eligible employees—who number around 8,000 nationwide—participated.
   So instead, last year ABB offered a $240 credit toward each employee's health-care premium. Participation at its sites jumped to 55% to 65%.
   "We wanted to get employees on board and thinking about their health," says Bill Lockhart, manager of health & welfare at ABB Inc., a subsidiary based in Norwalk, Conn.
    Because wellness programs are relatively new, at this stage, the primary goal of most employers is simply to get workers to participate so that they can raise awareness about the importance of adopting a healthy lifestyle.
    Ultimately, though, employers want to use wellness programs such as smoking cessation or weight loss to reduce direct medical expenses and boost productivity. ...

    "A perfect storm" of increasing global competition, escalating health-care costs and the nation's growing obesity crisis is driving employers to use incentives, says Shelly Wolff, North America practice leader for health and productivity at Watson Wyatt....

    By educating employees about health matters, employers aim to nip medical problems in the bud before they develop into costly, debilitating conditions. For instance, by leading a healthy lifestyle—such as maintaining a healthy weight, exercising regularly, eating right and not smoking—Americans can lower their risk of heart disease by as much as 82%, according to the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
    Such interventions not only can reduce the cost associated with medical claims, but also decrease expenses relating to absenteeism or losses associated with workers who aren't as productive at work as they might be due to health problems, according to the Integrated Benefits Institute, a national non-profit focused on issues surrounding health, productivity and the bottom line. In about one in five cases, those incentives are worth $400 or more per employee, IBI found in a poll of 500 employers using Harris Interactive....
    Despite the outlay, using incentives appears to be a strategy that's paying off for businesses. According to the Watson Wyatt/NBGH study, companies with effective health and productivity programs have cost increases that are five times lower for sick leave; four and one-half times lower for long-term disability; four times lower for short-term disability; and three and one-half times lower for general health coverage.
    One employer already seeing a financial return is Crown Equipment Corp., which has about 6,000 employees. The privately owned, Ohio-based company makes electric forklift trucks. Since 2004, the $1.5 billion company has offered a $260 contribution toward the health-care premiums of employees enrolled in its insurance plan who take a health-risk appraisal and wellness screening. The HRA is administered by the University of Michigan Health Management Research Center (UMHMRC). Each year, more than 90% of eligible Crown employees participated.
    Dr. Jim Heap, corporate medical director for Crown Equipment, says that though the company's health-care costs (medical claims and drug costs) continue to rise, the rate of increase is lower for people who participate in the initiative. In 2004, the difference between participants and non-participants was $240, climbing to $480 in 2005 and $720 in 2006.
    "The data are very encouraging," says Dr. Heap. Cost savings are accrued, in part, because the UMHMRC analyzes the HRAs and alerts employees to health risks and also advice on ways to improve their health.
    Now Crown is casting the net wider by reaching out to employees' dependents. This year, it offered a $195 incentive for dependent spouses who complete an HRA and wellness screening. ... Employees and spouses can each receive an additional $100 cash award if they agree to undergo further health coaching.         Educating spouses is crucial as they share similar health habits and are often responsible for important decisions, such as what the family eats, according to Dr. Heap.
    Other employers are taking it one step further. International Business Machines Corp. (IBM) recently announced the launch of a program to curb childhood obesity among employees' children. IBM will next year pay $150 to employees who sign up their children for a 12-week online family wellness program. The initiative—which doesn't have weight-loss targets or exercise requirements—offers tips on how to prepare nutritious family meals and get active together.
    "Healthy families mean healthy and productive employees," says Randy MacDonald, senior vice president of human resources at IBM.

—Dow Jones Newswires