UBP blog


Do you know what the five costliest health conditions are?

As an employer, when asked what the five costliest health conditions are what do you think would top your list, cancer and heart disease, correct? It depends on what factors you look at to determine cost.

The Journal of Occupational and Environmental Medicine (JOEM) recently published a study revealing that employers who focus solely on employees’ direct medical and pharmacy costs in creating cost-containment strategies are missing a major component of the picture. These findings were based on data from over 51,000 employees and 1.13 million medical and pharmacy claims.

Where employers could be missing the point:

Employers who just consider direct medical costs are missing out on “presenteeism” costs. These costs are incurred when workers have health conditions that aren’t severe enough to keep them home. They come into work, cannot perform their jobs at full tilt and cause a drain on company productivity. 

In fact, for every dollar spent on employees’ direct medical and pharmacy costs, employers can expect roughly $2.30 in productivity related costs.

The  JOEM study found that when considering direct medical and drug costs alone, the top 5 conditions driving health care costs up are:

  • Cancer (other than skin cancer)
  • Back/neck pain
  • Coronary heart disease
  • Chronic pain
  • High cholesterol

This means that those of you who guessed cancer and heart disease got numbers 1 and 3 on this list.

But, when they factor health-related productivity costs, the top 5 conditions driving health care costs are:

  • Depression
  • Obesity
  • Arthritis
  • Back/neck pain
  • Anxiety

In light of these findings, what’s one major step employers can take to improve productivity and bottom-line results?

When developing your overall employee health strategies and disease management programs, make certain to first recognize and prioritize these conditions. That way you can create targeted solutions that address them head on and save health care dollars in the long run.

These solutions are just a small component of Benefit Plan Optimization (BPO™). So many employers out there are paying too much for their benefits and getting far too little in return. They’re definitely not getting the most out of their benefits and our 13 point diagnostic test could be just what the doctor ordered.

Call us now at 617-859-1777 to schedule yours or visit our website www.universalbenefitplans.com and fill out one of our contact forms letting us know your biggest benefits problem. We’ll certainly get in touch with you ASAP to discuss possible solutions.


Recent anti-discrimination laws make rules on wellness program questionnaires a lot tougher

A new year is under way and companies everywhere are getting started with their 2010 resolutions. Given the rising health care costs that have plagued us all lately, it’s no surprise that improving employee wellness is a popular one.

Many employers are beginning to incorporate wellness programs and initiatives into their overall group health plan design. When implementing a wellness program, health risk assessments (HRAs) are a great tool employers can use to track employee progress and generate plan effectiveness metrics.

However, for employers that use HRAs in wellness programs, there are quite a few Federal rules to follow. Recent Federal laws such as the Americans with Disabilities Act Amendment (ADAA) and Genetic Information Nondiscrimination Act (GINA) have only made the rules tougher.

The new, tougher anti-discrimination rules as they stand:

ADA (and ADAA amendment):

Health risk assessments included in a group health plan’s wellness program (even if they are HIPAA compliant) still run the risk of being non-compliant with the ADA.

As amended by the ADAA, the ADA prohibits employers from requiring employees to undergo medical examinations or inquiries unless they are made on a post-job offer basis and they’re either job-related or designed to meet a specific business need. Also, medical examinations and questionnaires that are voluntary and part of a worksite wellness program do not violate the ADA.

So, essentially, if employees can opt-in to or opt-out of taking your wellness program’s HRA and their incentive/penalty does not violate HIPAA (i.e. the value of the incentive or penalty cannot exceed 20% of the cost of an employee’s coverage on the group health plan), then your group should be fine with ADA compliance.


Effective the first of the plan year following December 7, 2009, employers must comply with the Genetic Information Nondiscrimination Act (GINA). But, how does GINA affect wellness program HRAs?

The GINA Act’s interim final rule prohibits (in most cases) the use of an HRA in conjunction with a wellness program if “genetic information” (i.e. result’s of an employee’s genetic tests or information on family medical history) is collected for “underwriting purposes”.

In the context of GINA, collecting information for “underwriting purposes” does not just mean you’re collecting it for the purpose of setting rates, the definition is very broad.  The Act’s “underwriting” exclusion restricts employers from collecting, requesting and requiring genetic information in connection with an incentive (i.e. premium discount or rebate, reduction in co-pays or deductibles). So, if you have an incentive-based wellness program, it’s better to be safe than sorry and leave genetic information out of your questionnaires.

What employers need to do:

To avoid costly excise taxes and civil penalties, employers that have or are considering incentive based HRAs for HIPAA-compliant wellness programs should consider the following:

  1. Partner up with your legal counsel and perform an objective review of your current wellness program. From this review you should determine whether or not your plan complies with GINA and ADA as amended. Also, if your plan’s not compliant, know what steps you’ll need to take to bring it into compliance.
  2. Keep the lines of communication open with your legal counsel on new developments related to HRAs in incentive-based wellness programs.
  3. Involve your service providers in developing HRAs, employee communication and wellness plan features that will comply with GINA and the ADA.


Employee wellness starts with a positive attitude

In the midst of the worst recession since the 1930s, employers are doing more with less and employees feel the pressures of it every day. With employees overworked, stressed out and worrying constantly about their job and financial security, it’s no surprise that their overall well being is declining as a result.

The nonprofit organization Families and Work Institute recently reported that only 28% of employees say they are in “excellent health” (down from 34% 6 years ago). Businesses inevitably feel the effect of this decline too, both in terms of direct costs and indirectly as well. Research shows that employees in poor health are less likely to be loyal, engaged and satisfied with their jobs than their healthier counterparts.

Employer-sponsored health benefits do make a positive difference, as individuals with health insurance coverage are more likely to report sleeping well, being less stressed and being in excellent health than the uninsured. However, to truly achieve a healthy workplace, businesses need to go one step further, facing the issue with a holistic approach.

“Effective” workplaces are healthier ones:

So many employees go to work every day and face a demanding boss, have little to no support from supervisors and colleagues and have little to no access to learning and/or growth opportunities because they are simply not in the budget right now. On top of all this, employees, especially the ones who’ve seen several rounds of layoffs, still worry that their jobs are on the line.

Add this all up and what does it equal?  STRESS.

When employees are stressed and don’t have a supportive work environment, eating right and exercising are probably the last things on their minds.

On the opposite side of the coin are “effective” workplaces, where employees are trusted and supported. The Families and Work Institute study reports that at these workplaces, 40% of employees report being in excellent health. This is double the number of employees who report being in excellent health at the least effective companies.

What employers can do:

As you can probably see, achieving a healthy workplace goes beyond having an on-site fitness center and offering healthier options in your cafeteria. It starts with understanding and flexible senior management teams who make exercising and eating well easily accessible to everyone.

Employers’ efforts to make wellness accessible shouldn’t stop with diet and exercise or creating a supportive company culture; employers should also consider the physical environment of their workplace.

For example, studies have shown that natural sunshine and views of nature help workers boost productivity. Can you identify any ways to bring more natural light into your workspace?

Also, have you thought of ways you can make your workplace more green at little to no cost? A recent Boston Globe article discussed how a Vermont company reduced employee sick-days and had fewer reported allergies and colds just by moving into a green building.

After all is said and done, the one question that employers will need to ask themselves is, “How do I create an employee-friendly environment that makes everyone feel good about coming to work?”

A great way to start your answer is with a positive attitude– it’s good for your health.


Premium discounts for meeting wellness goals: Great incentive or employee relations nightmare?

If employees had the opportunity to get a 20% premium discount for achieving certain health goals do you think they’d want it to end there? What if they were offered a 30 or 50% discount, would that be better?

Congress is considering provisions in the health care reform legislation that would allow employers and insurers both to offer employees who meet specific health targets (i.e. keeping body mass index, cholesterol, blood pressure, etc. within the healthy range) premium discounts up to 50%. Under the current law, these discounts are allowable but can be no greater than 20%.

The Senate Finance Committee recently passed an amendment that would raise the maximum premium discount to 30% and allow the secretaries of Health and Human Services, Labor and Treasury to up the cap to 50% at their discretion.

What does this mean for employers?

Many employers have already designed and implemented workplace wellness programs with goals of keeping employees’ weight, cholesterol and blood pressure within a healthy range, encouraging workers to quit smoking, etc.

In light of the fact that nearly 40% of deaths annually can be attributed to preventable causes (i.e. smoking, lack of exercise and poor nutrition) and health care cost growth significantly outpaces both wage and inflation growth, workplace wellness programs are rapidly growing in popularity.

This year’s Kaiser Family Foundation “Employer Health Benefits Survey” revealed that:

  • 58% of companies offering employee health benefits had wellness programs
  • 93% of companies offering employee health benefits with 200+ employees had wellness programs

However, not all wellness programs are created (and designed) equally and this proposed legislation could significantly add to the number of employers that tie wellness programs to premium discounts. The Kaiser Family Foundation reports that just 4 percent of employers offering wellness programs do this.

Following the lead of this 4% may sound wonderful in theory but in practice, employers can run into some issues.

The issues are…

In any given workplace, keeping weight, cholesterol and/or blood pressure within the levels deemed healthy by the medical community might not be within everyone’s control. For instance, some employees may have a genetic predisposition towards obesity. These employees could be enrolled in your company’s wellness program and could be working just as hard, if not harder, than the others who are able to reach the “normal weight”.

Should these employees be penalized by having to pay more for health insurance just because they can’t reach a target “normal weight” or is there a way that they can be rewarded for their hard work?

What about employees who live in lower-income neighborhoods where only convenience stores and fast food restaurants are readily accessible? They might not be able to eat as nutritiously as others and may have a harder time reaching the employer’s health targets as a result. Should they be penalized just because of where they live?

 What employers can do:

In order to avoid having wellness program incentives perceived as discriminatory or unfair to certain employee groups, employers should prepare themselves to change the rules of the game a bit.

Let’s go back to the example of employees who are genetically predisposed towards obesity and may have a harder time reaching “normal weight” than others do. One thing employers can consider doing is giving incentives for efforts and not meaningful outcomes. For instance, they could give incentives based on the amount of weight these employees lost or for being consistent in their weight loss, as apposed to giving incentives for whether or not these employees are able to reach a target weight in a given time frame.


Face your stuff or stuff your face. Here’s where so many workplace wellness programs are “missing the boat”

When someone mentions the term “workplace wellness program”, what are the first things that come to mind?

Many people would start off by naming some common services that almost all traditional programs have (i.e. weight management and smoke cessation).

There’s a lot of research out there showing us that these services are a good thing. Study after study reveals that obesity and smoking both lead to higher levels of absenteeism, “presenteeism” (you know, when someone is there are work but isn’t 100 percent “there”) and other productivity-related cost issues in a workplace. It’s plain to see why employers put programs with these services into place: they improve the bottom line.

Wellness programs that improve the bottom line are definitely not a bad thing, and they’re easy to keep around. All you’ll have to do is show that they produce a quantifiable return on investment (ROI) and management will give you the green light to keep them.

But, the question that you’ll need to ask now is this one, are traditional wellness programs really doing their job of promoting total workplace wellness?

Are they addressing the root causes for employees “stuffing their faces” with food, drugs, alcohol, etc. or are they just addressing the symptoms (i.e. smoking, obesity, substance abuse) once employees faces have already been “stuffed”?

To answer these questions we’ll need to take a deeper look at what exactly total wellness is, and where traditional wellness programs that focus solely on physical health issues fall short.

What is total wellness?

Total wellness is a state of being made up of three different components, Physical, Mental and Spiritual wellness. Let’s leave the spirits out of this blog and focus on mental wellness, our emotional wellness.

Our emotional wellness is what helps us to stay on the right track towards physical health. When employees are emotionally well, they are better able to make healthy lifestyle choices and steer clear from “stuffing their faces” with substances and habits that compromise their physical health.  

Step #1 to total wellness, Know Your Health Plan:

When employees know their health plans, they not only know about the service available to them for their physical health, they also know where to go for the mental health needs of themselves and their families.

One great thing that you can do in your workplace to help employees out with the mental health component of total wellness is to host a lecture series on mental health topics (i.e. eating disorders (includes both overeating and under-eating), alcoholism, substance abuse, etc.) that employees may attend to learn what to do if they, a co-worker or a family member at home are dealing with these issues. Also, the lecturers could let them know where they can go to for help.

Knowing your plan is only the beginning:

Knowing your health plan is just the first step to total wellness in your workplace. To help employers achieve total “wellness workplaces”, Universal Benefit Plans has created our proprietary 13 steps to total wellness. To get your very own 13 steps to total wellness plan, give us a call at 617-859-1777 or fill out a Contact Form on our website, www.universalbenefitplans.com


This is your brain on obesity

Filed under: Wellness — ubpblogger @ 8:18 am
Tags: , ,

Most of us remember the Partnership for a Drug Free America’s fried egg commercial and its tagline this is your brain; this is your brain on drugs.” The brain in this commercial obviously looked like a fried egg and communicated the dangers of drug abuse. If you abuse drugs it will “fry” your brain.

A similar philosophy could be applied to obesity in light of recent findings from a UCLA study.

Researchers conducted brain scans of 94 individuals in their 70s and found that:

  • Obese people had 8 percent less brain tissue than normal weight individuals and their brains appeared 16 years older than those of their normal weight counterparts.
  • Overweight people had 4 percent less brain tissue than normal weight individuals and their brains appeared 8 years older than those of their normal weight counterparts.

From these findings you can see that your brain on obesity would look like something that is old and shrunken, possibly like an egg that has been overcooked.

What this means for employers:

The study’s findings from older adults in their 70s are actually fairly relevant to today’s workplaces (much more so than they were in the past). That’s because number of adults over 65 years old is growing at a faster rate than our nation’s overall population and many people are not retiring until their 70s (or even 80s).

Also, aging of the brain doesn’t happen overnight. One can speculate that if a doctor did brain scans of obese, overweight and normal weight people in their 40s and 50s, the overweight and obese people would have already lost noticeably more brain tissue on average than their normal weight counterparts.

As you can see, if you want your employees to stay at their best and brightest through all the years of their careers, it’s vital for them to make healthy lifestyle choices starting now.

Study also links obesity to higher risk of Alzheimer’s:

According to UCLA professor of neurology Paul Thompson, the senior author of this study, the major losses in brain tissue experienced by obese (and even overweight) people put them at a higher risk for Alzheimer’s disease.

This is bad news for many of us, especially in light of the fact that according to the CDC’s National Center for Health Statistics (NCHS), 34 percent of U.S. adults were obese as early as 2004 (and roughly 34% of adults were overweight).

 Reducing your risk of Alzheimer’s:

The good news however is that we all have a way to decrease our risk of Alzheimer’s. We can do this by keeping a good diet (and staying away from processed foods), staying fit and taking all other proactive measures for weight control.

 HR Professionals, do you want to help your employees reduce their risk of Alzheimer’s Disease at little cost to your company?

If your answer is “yes”, you should consider putting into place a workplace wellness program with quarterly Body Mass Index (BMI) screenings and employee access to coaching on proper nutrition and fitness, as well as weight loss support groups for workers who want to lose weight (and reduce their risk of Alzheimer’s) together.


Naturapathic Medicine: The AMA says it might not be safe or effective, should insurance cover it?

More and more Americans are going to naturopathic (i.e. natural and holistic) doctors like acupuncturists and mind-body healers. Yet, so many in the medical community (including the doctors of the AMA) continue to dismiss these doctors saying their treatments don’t work.

Despite what AMA doctors say, an influential group of U.S. Senators (led by Senator Tom Harkin and Barbara Mikulski) are giving naturopathic medicine a chance.

Harkin and Mikulski back an amendment that would bar health insurance carriers from “discriminating” against healthcare providers with licenses issued by their states. This amendment’s goal is to get alternative medicine covered by health plans.

All in favor see cost-savings:

Those who are in favor of this amendment say it could bring huge long-term health care cost-savings—tens of billions to be exact.

Savings could come from the following two things, among others:

  1. More people leaving behind costly prescription drugs in favor of alternative medicine
  2. More people seeing naturopathic doctors who help them make lifestyle changes (i.e. stress reduction, improved diet, vitamins and minerals) and in turn becoming healthier 

Naturopathic doctors do say that you should absolutely use prescription drugs and have surgery when it is medically necessary. However, for things such as neck and back pain, insomnia, head colds, anxiety and stress, there are new (and less costly) alternatives to popping a pill.

With all of this in mind (and what the medical experts say), do you think health insurance should cover both licensed alternative and regular medical treatments?


Two small steps to cure the big $194 billion price tag of type 2 diabetes

Filed under: Wellness — ubpblogger @ 4:35 pm
Tags: ,

As early as 2007, here’s how much it cost to care for all Americans with type 2 diabetes:

• $116 billion in Direct Costs (i.e. their medical care)

• Approximately $58 billion in Indirect Costs (i.e. disability benefits, money lost through work absences, premature death)

This all adds up to a grand total of $194 billon, or 10% of all healthcare dollars spent in the United States.

Let’s take a look at this issue on an individual level. The medical care for a person with diabetes is twice as expensive as the care for a person without diabetes.

On top of this, 16% of Americans with serious health problems have delayed necessary medical treatments (according to the Kaiser Family Foundation). So, if diabetics are a big part of this 16%, by delaying treatment now they will become more expensive to treat in the future; this is because they will develop major complications if they cut back on disease management efforts.

At a very modest cost, employers can reap substantial long-term cost savings, just by doing a couple of things:

1. Blood pressure monitoring

Blood pressure monitoring is a great preventative measure to help both employees at risk for developing type 2 diabetes and those who have the disease as well.

The Center for Disease Control and Prevention (CDC) research has shown that blood pressure control can lower the risk of heart attack and stroke in people with type 2 diabetes 33-50% and lower the risk of eye, kidney and nerve diseases by approximately 33%. Lowering blood pressure also reduces diabetics’ decline in kidney functioning 30-70%.

One value-added service Universal Benefit Plans offers to many clients that could help achieve the above risk reductions is free health screenings. Each year, we have a registered nurse come in and check the blood pressure of all employees among other things.

Would it be helpful if your broker offered free health screenings to your employees as a value-added service?

2. Lifestyle interventions

Lifestyle interventions such as having employees work with fitness trainers and nutrition educators, can reduce diabetes development in high-risk adults by 58% (and an alarming 71% for high-risk adults ages 60 and up).

Reduced diabetes development in high-risk adults is just one of the many things that adding wellness benefits for everyone at your company can accomplish for your employees’ overall health.

As early as 2007 the SHRM’s Benefits Survey Report found that 68% of companies offer wellness benefits. Is your company one of them?


Considering on-the-Job Wellness Initiatives? Keep tabs on these four things

Filed under: Wellness — ubpblogger @ 9:23 am

Employees are spending more time at work than they ever have before, mostly in sedentary careers. At the same time, both healthcare-related costs and the obesity epidemic are on the rise in our nation.

One way employers are responding to these trends is by introducing wellness initiatives such as fitness classes and nutrition specialists into the workplace. Employers who do this make it easier for their employees to access and participate in activities that will improve their heath. When effective, workplace wellness programs help employers to reduce employee absenteeism, curb increasing healthcare costs, increase employee productivity and reduce costly employee injuries.

It isn’t any wonder that studies show workplace wellness initiatives are growing in popularity. In January 2009, The Boston Globe reported findings from a study showing that 75% of major U.S. companies now offer wellness initiatives. However, when attempting to create a culture of wellness in your workplace, it is important for you, the employer, to keep several things in mind.

1. Make it optional:

While many of your employees will automatically embrace your wellness initiatives, others could view them as coercive or paternalistic. Employees could possibly resent the perceived fact that you are trying to tell them how to live their lives. As an employer, one way that you can avoid this possible setback with wellness programs is to make them optional.

2. Provide equal access:

Worksite wellness programs should provide equal access to all employees. This means that shift workers should have the same access to wellness programs as employees who work during the day. Also, the needs of single parents and commuters should be taken into consideration when planning the delivery of workplace wellness initiatives. A possible tactic to consider in providing equal access is allowing employees to use work time to participate in wellness initiatives

3. Hire a specialist:

If you offer fitness classes for employees to take on-site, please make certain that you hire a certified trainer to conduct these classes. Also, it’s important to make certain your workers compensation benefits are set in place to cover any employee injury that may occur during these classes.

4. Educate employees and management at all levels:

Make sure you educate both your employees and management team on the importance of overall well-being as well as the purpose of your workplace wellness initiative. In order for your company’s workplace wellness program to be a success, and for employees to want to participate, upper management must buy in to the program and mid-to-lower level management must be easily able to convey the purpose and advantages of the program to direct reports.

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