Wellness incentives: how well do they work? Companies are offering everything from Green Stamps to days off in order to get participation

Business & Health, April, 1991 by Nancy Madlin

Prizes are offered for participation in a pre-work warm-up program, in "wellness walks" of predetermined length, in team weight loss competitions, and in weekly wellness meetings which offer speakers and videos on various topics. For taking a voluntary drug test, employees receive an extra half vacation day.

Monetary awards in the form of increased employer payments for health insurance are offered for participation in the company's health assessment screening. Just taking the screening (for cholesterol, blook pressure, flexibility, heart rate, body fat, and oxygen uptake) saves the employee $20 per month on health insurance. Assessment results are then rated, with health insurance rebates awarded on the basis of scores; amounts range from $60 to $480 a year. Two hundred and fifty people participated in the program last year.

About 15 people a month also receive cash bonuses for participating in Foldcraft's "health practice program" for aerobic activity pursued outside of work. Employees accumulate points for activities practiced at a certain level (walking two miles within 30 minutes, for instance, gives you five points), and anyone who has 100 points or more at the end of the month gets $15 in cash. At the end of the year, the six top scorers receive $150.

At Howard County Community Hospital in Kokomo, Inc., eligible employees can save up to $20 a month on their health insurance payments if they meet certain health guidelines: blood pressure meeting the American Hospital Association standard (with or without medication); not using tobacco products; and weight within five percent of ideal, according to the 1983 Metropolitan Life tables. Last year, 405 employees participated in the assessment.

In 1989, U-Haul Corp. of Phoenix, Arizona, paid $18.6 million for medical care for employees and dependents. "A large portion of that," says spokesman Allen Weinstein, "covered illnesses attributed to the use of tobacco and to weight problems."

To encourage employees to quit smoking and lose weight, U-Haul is offering to waive its health insurance copayments of $5 each biweekly pay period (for a single employee; $10 for one with a covered spouse) to those who don't use tobacco in any form and meet weight guidelines.

"In general, financial incentives are still quite rare," says David Gobble, associate director of the Institute for Wellness at Ball State University in Muncie, Ind. Of such incentives, cash bonuses are extremely rare and rebates on health insurance the most common.

Check-ups, not checks

Although rebates seem logical to many, it's not always easy to put such a plan into effect. "I think that tying wellness participation to lower insurance costs would have a positive effect on our program," says a wellness manager at an oil company. "I've suggested it to management several times since 1983, but they always have a problem with how you can prove that people aren't smoking, or that they are exercising at home?"

"Some companies want to prove or document everything, while others tend to take peoples' words," says Ed Stasica, cost-containment and wellness consultant in Mount Prospect, Ill. "It really depends on the overall philosophy of the company." At present, more companies than not seem to be relying on an honor system, with the employee simply filling out and signing a form to "prove" that he's done the incentivized activity. Although most companies do not do specific tests to see if the employee is telling the truth--like testing the blook of an alleged non-smoker for nicotine--it's clear that, in the case of smoking and exercise, outright lying would almost certainly be visible in the overall general assessments periodically performed.