recommending a benefits strategy

Recommending a Benefits Strategy for Today and Tomorrow

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Recommending a Benefits Strategy. for Today and Tomorrow. What is your Health Care Cost Containment Strategy?. for Today and Tomorrow. By 2016 Health Care Costs are projected to reach $4.2 trillion This represents 20% of every dollar we spend!. - PowerPoint PPT Presentation


Page 1: Recommending a Benefits Strategy

Recommending a Benefits Strategyfor Today and Tomorrow

Page 2: Recommending a Benefits Strategy

What is your Health Care Cost Containment Strategy?

for Today and Tomorrow

Page 3: Recommending a Benefits Strategy

By 2016 Health Care Costs are projected to reach $4.2 trillion

This represents 20% of every dollar we spend!

Here comes a “perfect storm” in the workplace driven by three factors.

One: Medical costs are acceleratingTwo: Employees and dependents have more health needs

than ever before with an obesity epidemic, tobacco related illness and sedentary life styles

Three: A great skilled worker shortage lies just ahead

Page 4: Recommending a Benefits Strategy

Results of a Healthy Workforce… Productivity goes up Turnover goes down Workplace injuries decline Disabilities decline Work life expands Morale improves Applicants gravitate to a healthy workplace

Page 5: Recommending a Benefits Strategy

Tomorrow’s Challenge:Mandating Employee Wellness

What is a mandatory Wellness Plan? Requires employees to participate Imposes a penalty if you do not participate Must take a health risk assessment, blood pressure, cholesterol,

BMI, fasting glucose etc. If an employee refuses to participate they lose coverage Some plans even assign professional “health coaches” who will

draw up action plans and will follow up to monitor progress

Note: An incentive that is conditioned on participation in a health program, rather than achievement of a particular health target or standard, generally is not discriminatory under HIPAA.

Page 6: Recommending a Benefits Strategy

INSIDE THE PLAN: HIPAA Rewards or penalties cannotexceed 20% of total cost Reasonably designed to promotehealth or prevent disease Annual eligibility Alternative standards forparticipants with medicalconditions Plan material must disclosealternatives and waiver

Mandatory Wellness Plans

ROI is from $2 to $10 for every dollar invested in a wellness plan.

OUTSIDE THE PLAN• Disability discrimination• Age discrimination• Workers compensationretaliation claims• Lawful off-duty conduct• Privacy statutes• Collective bargaining agreements• Retaliation claims

Page 7: Recommending a Benefits Strategy
Page 8: Recommending a Benefits Strategy

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 0%–14%

Page 9: Recommending a Benefits Strategy

Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Page 10: Recommending a Benefits Strategy

Pulmonary diseaseabnormal functionabnormal functionobstructive sleep apneaobstructive sleep apneahypoventilation syndromehypoventilation syndrome

Nonalcoholic fatty liver diseasesteatosissteatosissteatohepatitissteatohepatitiscirrhosiscirrhosis

Coronary heart disease Diabetes Dyslipidemia Hypertension

Gynecologic abnormalitiesabnormal mensesabnormal mensesinfertilityinfertilitypolycystic ovarian syndromepolycystic ovarian syndrome



Gall bladder disease

Cancerbreast, uterus, cervixbreast, uterus, cervixcolon, esophagus, pancreascolon, esophagus, pancreaskidney, prostatekidney, prostate

Phlebitisvenous stasisvenous stasis


Medical Complications of ObesityIdiopathic intracranial hypertension



Severe pancreatitis

Page 11: Recommending a Benefits Strategy

Health Risk Factors Matter .. Let’s learn about each employee’s

Metabolic Syndrome Risk Cluster HDL Cholesterol Triglycerides Waist Circumference Blood Pressure Fasting Glucose

Page 12: Recommending a Benefits Strategy

Now let’s Graph these Important Risk Factors ... Complete a Health Risk Assessment Form

Perform Biologics (BP; HDL vs. LDL; Waist Size, Glucose)



BMI 18-25 BMI 30-34 BMI 35-39 BMI 40+

Medical Cost

WC Cost

WC Lost Time

Recommended Obesity Class I Obesity Class II Obesity Class III

Page 13: Recommending a Benefits Strategy

10 Week Program will address: Eating habits Hunger Hydration Exercise Personal health habits