Anderson Family Wellness

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If your business has this common – and increasingly popular – fringe benefit you might be at legal risk without even knowing it.
Some corporations have an onsite employee fitness room as part of a formal wellness program. Others simply do it as a way for folks to get their juices flowing before work or blow off steam afterwards.
No matter the reason, businesses with fitness rooms need to be aware that the benefit isn’t risk-free.
Over the last few years, several privately owned health clubs have been sued – and agreed to expensive settlements – after exercisers suffered sudden cardiac arrest (SCA) and died before help arrived. In each case, the facility either didn’t have lifesaving equipment on the premises or didn’t have personnel properly trained to use it.
Some legal specialists have expressed concern that companys could also be at risk when the unthinkable happened on business premises while an employee worked out.
SCA is of particular concern. Reason – Even seemingly healthful, active adults are at risk of sudden cardiac arrest. It can’t be prevented. There’s no vaccine.
And few victims survive by the time an ambulance arrives. But there’s a way to save the employee’s life and potentially save your firm from a lawsuit.
Learning about SCA
Sudden cardiac arrest (SCA) is a frequently misunderstood killer. It’s different thing as a heart attack. SCA can affect anyone, anywhere, anytime. It occurs more than 600 times every day in the U.S., killing at least 250,000 individuals each year.
The only hope – using a device called an automated external defibrillator (AED) within 10 minutes.
The good news is any individuals at your corporation could be rapidly trained to use an AED – you don’t need any medical knowledge to use it. the training could be obtained for free through a local Red Cross or civic group. the devices themselves cost under $2,000.
Compare that to the financial risk of being sued for not having an AED near a workplace fitness room, and it’s a no-brainer that any business with on-site workout equipment should at least investigate an AED buy and training.
Staff Members, supervisors and upper-level managers alike will probably need education about SCA and AED use. A excellent teaching resource is available here.
Key talking points – Without an AED, 90% of victims die. But when you have access to one, there’s a good chance to save an employee’s life. and it’s easy to teach supervisors and staff members how to use the device when it’s ever needed.
The vast majority of facilities with AEDs never need to use them – and that includes medical facilities. But it only takes one tragic event, and subsequent lawsuit, to cause pain for both the business and an employee’s family.
Don’t forget – Avoidance and education are always your company’s best tools for avoiding liability. In this case, where human life is involved, the choice seems rather obvious.

For most firms, voluntary benefits are a win-win arrangement. But there could be hidden risks.
On the positive side, voluntary benefits cost employers next to nothing, yet boost employees’ morale and benefits satisfaction. an Aon survey found 77 percent of organizations offer at least one voluntary benefit.
But what happens when there’s a legal dispute between one or more of your staff members and the provider?
In many cases, businesss unwittingly get dragged into court. the vendor may argue that the plan is covered by ERISA, and the employee’s lawsuit should instead be filed against his or her business.
If the court agrees, the legal burden shifts. Some courts have ruled that a voluntary benefits might be covered under ERISA, even if it wasn’t an employer’s intention to formally “sponsor” the plan.
If push comes to shove, the vendors will protect themselves. In fact, some attorneys warn that a voluntary plan insurer’s first move when sued by one of your workers will be to attempt to get the legal burden shifted from itself to you.
Two seemingly innocent things that could be turned against you in court –
• the written announcement to tell workers about the new voluntary benefit, and
• getting involved when there’s a dispute between an worker and the plan provider.
Be cautious with announcements When you offer a new voluntary benefit, the natural tendency is to attempt to get staff members pumped up to participate. But you are able to get in trouble if individuals get the impression the firm endorses the plan. Helpful practices –
• Don’t put the announcement on organizational letterhead
• Put a disclaimer on the description
• either exclude your voluntary offerings from employees’ benefits manuals or list them separately, and
• hold open enrollment at a different time than for ERISA plans (401(k), primary health plan, etc.).
Additionally, if the provider offering the voluntary plan has competitors, you may want to remind staff members the provider of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing providers.
Avoid involvement in disputes as with your ERISA plans, chances are workers will come to you when they have a problem with a voluntary plan. Your first inclination is to help.
But many specialists warn it’s better to stay out. Reason – Courts see this as the action of a plan sponsor. But you can steer someone in the right direction (e.g., giving a contact name to call) while remaining neutral in the dispute.
Good intentions gone bad
From an ERISA standpoint, the most hazardous voluntary plan design is one that is partially compensated by the corporation, even when employees pay the bulk of the cost.
In a major ruling a few years ago (Burgess v. Cigna Life Insurance), a United States district court ruled against an employer with a voluntary supplemental disability plan in which the firm compensated a portion of premiums on behalf of its lower-compensated staff members.
While most employees paid the entire premium – and firm made clear to people the plan was a voluntary benefit -the court said it didn’t matter. the act of contributing to some employees’ premiums made it an ERISA plan.

In the last few years, “presenteeism” has become an even larger concern for a lot of companys than absenteeism. Although many HR/benefits managers hate the admittedly overused term, presenteeism is however a real issue in nearly every workplace.
Most widely, presenteeism takes the form of employees coming to work sick. They’re unproductive and endanger peers. Meanwhile, the employee is not forced to use a sick day. A bad deal for businesss all the way around.
A recent survey by LifeCare revealed that 93% of employees (polled from 1,500 organizations) admit that they at least ocassionally come to work when they’re sick enough to stay home. More important, the published study looked at the reasons why folks do it.

The No. 1 reason employees cited for coming to work sick was a belief that they’d be “letting other people down” if they call out. Nearly 30 percent of respondents cited this as their main reason. Beyond that, the top responses were –
• It’s too risky, due to office politics or culture, to take time off (26%)
• the staff member is too busy at work to be able to stay home a day (15%)
• the staff member saves up sick days for childcare/eldercare emergencies (12%), and
• the employee saves up sick days to use as additional vacation time (8%).
Many of these rationales are troubling to HR/benefits managers.
In the first place, supervisors who hassle employees about taking legitimate sick leave are, at best, being pennywise and poundfoolish. Presenteeism costs more than absenteeism, once you figure in the uncharged sick days, lack of productivity and risk of other employees getting sick.
You have more power than you think to change your corporation culture if the “tough it out” mentality still applies to individuals who come in sick. When senior level management is confronted with the real dollars and cents of presenteeism, decreasing the problem typically becomes a priority. at the very least, firms shouldn’t invite it.
In terms of supervisor- and employee-education, repetition of the “stay home when you’re sick” message is the key. Eventually, it’ll sink in.
Of course, there’s still the problem – as evidenced by the survey – of staff members who misuse their sick days by attempting to hoard them for other purposes.
Adopting PTO, no-fault absence policies or use-it-lose-it sick time are the three most common ways of decreasing the risk, but be aware that each of these policies have risks of their own.
At the end of the day, the more open the lines of communication are between management and employees, the less prevalent the presenteeism problem becomes.

In many segments of society, we hear about racial and ethnic profiling in negative ways. But what about when it comes to wellness programs?
When used for the specific purpose of beginning – or investigating - a wellness or disease management (DM) program, profiling isn’t just legal. It’s also encouraged.
Affects health risks
Different ethnic and racial groups tend to be more at risk – for genetic and/or cultural reasons – of certain medical problems. Examples –
• African-American, Latino, Native American and Pacific Islanders are at higher risk of diabetes than Caucasian employees
• Chinese women are statistically twice as likely to get cervical cancer
• Caucasians have disproportionately high rates of obesity and high blood pressure, and
• Latinos have higher rates of asthma and chronic obstructive pulmonary illness than other groups. the HIV/AIDS population is also disproportionately Hispanic.
Bottom line – By analyzing the ethnic breakdown of your worker population, you can set disease management program priorities with greater confidence and accuracy.
Healthcare quality an issue
A few studies also show there’s an unfortunate relationship between ethnicity and quality of health care. A lot of times, minority staff members receive inferior treatment and health education at the same facilities where others receive top-notch care.
This generally happens for innocent reasons. A common scenario – a lack of Spanish-speaking physicians in the network for your Latino staff members. But the result is generally higher healthcare costs for you and, often, greater reluctance among minority staff members to seek needed treatments.
By profiling staff members against the physicians in the network, you ultimately help staff members get the care they need and the company to better control long-term costs.

Nearly two-thirds of organizations with wellness programs offer workers incentives – financial or otherwise – to participate.
But only one firm in five has seen major betterment in employees’ health status (and lower costs) within two years of launching the incentive. Here are three keys to getting good results – and a red flag for failure.
Cancer screenings pay off big
Most wellness programs feature health-risk assessments for things like high cholesterol and diabetes. But many overlook the need for early detection of cancer, which could affect any worker, regardless of his or her age or general health.
In many cases, you can line up certain screenings, like skin cancer detection (the most common type of cancer and, in its early stages, the most easily treated) for free or at a nominal cost.
These resources are often available through community agencies or the American Cancer Society. More involved and expensive screenings – like mammograms – are well worth the cost.
A single case of cancer identified early ordinarily saves thousands of dollars in medical claims and disability costs – not to mention trauma for the staff member.
Smart worker wellness incentives
Medical Insurance Portability and Accountability Act (HIPAA) has tricky non-discrimination rules for offering employees a break on premiums or copays. You needn’t worry about HIPAA if you –
1. Structure the program as a cost-break for staff members who embrace wellness. on the flip side, imposing surcharges for uncooperative staff members can force you to jump through HIPAA hoops.
2. Make the incentive available to all workers. for example, when you offer a discount to non-smokers, an worker who recently quit use of tobacco must also be eligible.
3. Allow staff members who fail to earn the incentive to have another shot at it next plan year.
Bottom line – Make the financial incentive a reward, not a punishment. Do the incentives work? If they’re done right, yes.
Firms offering monetary rewards for wellness ordinarily save about $20 to $50 a month, as reported by some estimates.
Making wellness programs simple
Many firms require employees to work with a personal “health coach” to earn premium discounts or other incentives. Usually, the staff member sets up appointments and reports to the health coach on a regular basis, either by phone or in person.
The good news – the early results are often encouraging.
The bad news – Once staff members realize there’s ongoing effort involved, many lose interest. But many firms have found a simple alternative. Rather than having participants contact the health coach, the health coach calls them.
In many cases, this minor program tweak keep folks on the right track and cuts dropout rates.
Wellness starts upstairs
No matter how much money your company spends on wellness, the odds of success depend largely on the example set by top management.
Example – If your Chief Executive Officer (CEO) is a smoker, chances are few staff members will purchase into a tobacco use cessation program.
In like manner, it’s hard to sell employees on subsidized fitness center memberships if your organization culture is sedentary. for wellness to work, the top brass must practice what the firm preaches.

Are your healthcare programs delivering on your vendors’ promises?
Just as importantly, how can you hold providers accountable if you’re not getting what you compensated for?
Here’s one proven way – Develop a vendor scorecard. Scorecards alone won’t bring down your health care costs. But they’ll at least help make sure your company – and workers – get everything you’re paying for.
The tool can help you measure plan performance with greater precision – and identify specific areas that need improvement. Best of all, any company can adopt the technique to fit their needs. Here’s how it works.
1. Pick specific rating areas
Benefit pros who’ve successfully adopted the scorecard system recommend grading vendors on five to 10 measurable areas, like –
• Claims processing. Are employees’ medical claims turned around in a timely fashion? Are you hearing complaints that the explanations of benefits (EOBs) are slow to arrive or hard to understand?
• Disputed and resolved claims. Do employee questions and complaints about denied or still-pending claims get answered quickly and thoroughly? How often are you forced to go to bat for employees?
• Accessibility. Are plan reps quick to answer phone calls? Do they attend regularly scheduled meetings?
• Reports. Do you receive timely paid claim and utilization reports?
• Open enrollment. Did you receive effective support preparing for and conducting open enrollment events?
• Staff Member education. Do your employees find the written and/or one-on-one services provided through the plan helpful in answering questions about managing specific chronic illnesss (such as diabetes or depression)? Do you receive support in educating your employees to make healthful lifestyle options, such as tobacco use cessation?
2. Pick a workable rating scale
There are two schools of thought when it comes to selecting a rating method – subjective or objective. Many benefit pros – namely those from smaller firms – use a simple pass/fail or 1 to 5 score to rate their satisfaction.
Others develop more elaborate, statistic-based ratings. One method – take the provider’s guarantees (e.g., addressing disputed claims within 3-5 company days) and then measure by percentage how often these objectives are met.
These rating data could be acquired through quarterly performance reports, worker surveys, issue and complaint files and, for bigger plans, external audits.
3. Feedback triggers improvement
It’s good practice to share your scorecard system with the provider before meeting to review the results. Reason – This lets you iron out any provider questions about the review categories and scoring system.
Once that’s settled, you are able to meet to go over the numbers and prioritize the areas that need improvement. A lot of firms then add a new scorecard category – providers’ followup.

At the end of the day, is it worthwhile to ban tobacco use on the premises at your company?
It depends on the steps you take to support staff members attempting to kick the habit, finds a recent research study . The Journal of Tobacco Policy and Research found that smokers do, truly take more sick days than their non-tobacco use coworkers.
And even when the smoker is in relatively good overall health (i.e., isn’t obese, doesn’t have chronic health conditions), he or she is still likely to have higher medical costs than a comparable non-smoker over the last three years.
How does a smoking ban fit into the cost equation? When the smoker quits, health costs even out.
But if the individuals only refrains from use of tobacco on the job – but continues puffing away at home – the corporation sees little to no health cost decrease. the study found similar patterns for absenteeism.
Bottom line – A workplace tobacco use ban in combo with a tobacco use cessation program gets results. A tobacco use ban alone ordinarily doesn’t.

In the last few years, there’s been a rising trend for public businesss – not just private companies – to ban tobacco use. Here’s what your peers are doing.
What’s New in Benefits and Compensation recently surveyed 374 of our readers from both the private and public sectors to find out their organization’s policy on permitting workers to smoke on-site and hiring smokers in the first place. Here’s what we found –
• 11% have created a policy of hiring only non-smokers
• 17% allow staff members to smoke offsite, but ban it on all corporation property
• 39% restrict tobacco use to designated areas outside the building
• 30% allow tobacco use anywhere outside the building, and

Public companys get aggressive
While much of the publicity about no-hire policies for smokers centers on private corporations, it’s actually public corporations in certain states who have been the most assertive of late.
For instance, Florida is one of the states at the forefront of the movement. Sarasota County lately became the third Florida county to take a no-hire stance in order to control health care costs.
New hires must take a drug test that detects nicotine and sign a pledge certifying that they haven’t smoked in the past 12 months.
The ban won’t affect current workers, but the county has undertaken smoking cessation programs aimed at employees’ wallets.
Non-smokers pay less for coverage through various incentives and the county covers the cost of participating in smoking cessation programs.
The reason why Florida public corporations are able to take these steps – the state supreme Supreme Court has ruled that refusing to hire smokers doesn’t break discrimination laws.
But your state laws may vary, so proceed with caution before considering similar policies.

Quitting smoking at any age can improve a person’s health. and believe it or not, older workers often fair better with smoking cessation than younger workers.
As reported by the Journal of American Medicine, Duke University reseearchers tracked 573 older patients over 10 years. They found that just 16% of those who joined the use of tobacco cessation program later returned to use of tobacco.
Previous research has found young smokers who try to quit have a 35% to 45% relapse rate within two years.
Given that staff members nationwide are retiring later and the cost of retiree healthcare is sky high, you could want to keep attempting with tobacco use cessation programs, even for the oldest staff members on your health plan.

In this recession economy and out-of-control staff member debt, many companys who don’t have automatic 401(k) enrollment have seen participation drop.
Here’s how one small corporation in Arizona cleverly tied 401(k) education to employees’ other financial concerns. Rather than simply holding its usual 401(k) open enrollment education meeting, it held a “financial wellness fair.”
Stressed 401(k) importance
How it worked – on the same day the company’s 401(k) vendor sent a plan rep to discuss the retirement plan, the corporation also arranged for a qualified financial planner to speak to workers.
The financial planner went first. She started the session by pointing out that she wasn’t affiliated in any way with the management of the 401(k) plan.
That was crucial both for the company’s legal protection under ERISA and for building trust with employees. She then discussed why it’s crucial for people to participate in the 401(k) plan, and offered attendees budgeting tips and basic strategies for cutting their debt.
The financial planner’s talk cut to the heart of several major issues that hurt both worker salary satisfaction and 401(k) participation. Numerous studies show that the No. 1 reason many people avoid 401(k) participation is that they feel they can’t sacrifice any part of their entire paycheck and still survive financially.
The second part of the session was the standard 401(k) enrollment presentation from the provider. End result – Workers were more attentive and there was a noticeable uptick in both new 401(k) enrollments and salary contributions from already-enrolled workers.
The event was such a smash that the company plans to make the Financial Wellness Fair a regular part of 401(k) enrollment. While the financial planning advice is generic (the company may add third-party personal finance planning as a voluntary benefit in the future), it’s also timely.
The 401(k) signup appeal comes while the financial planning tips are still fresh in employees’ minds and they’re motivated to do something to help themselves.