From Health Insurance to Wellness Insurance

There has been a lot of speculation about how The Affordable Healthcare Act (ACA) will impact healthcare in general and the insurance industry. Recent information about the wellness side of the ACA gives a glimpse into how insurance plans may emphasize staying healthy and allow companies to increase rewards for employees who meet new wellness criteria.

A recent article from J. J. Keller & Associates, “Agencies propose wellness, benefits, market rules,” reported that the U. S. Department of Health and Human Services, Department of Labor and the Internal Revenue Service released guidelines on the ACA’s provisions regarding health, wellness and market reforms that will take effect January 2014. These provisions will encourage employees to stay healthy while protecting them from discrimination.

1. Increases the amount of reward from 20 percent to 30 percent for meeting requirements of a health-contingent plan. This is quite a boost for those who successfully meet wellness-plan criteria such as keeping cholesterol levels within a certain range, weight loss or other wellness programs. The increased reward amount puts money back into the employee’s paycheck.
    
2. Increases the reward amount to up to 50 percent for the prevention or cessation of the use of tobacco products. Making the reward to stop or never start using tobacco products saves the company money in claims experience, lost time and productivity. 
    
3. Non-discrimination. Aside from the change in the size of reward percentages, the new ACA regulations continue to follow the 2006 HIPPA guidelines. 

The ACA provides for standard wellness provisions, such as preventative and wellness services, rehabilitative care, chronic disease management and maternity and newborn care. Changes in the ACA and insurance plans are only effective if employees take advantage of the programs. Benefits administrators can begin now to plan employee information materials and meetings to explain the advantages of the changes and encourage employees to take advantage of them by getting on board with wellness. 

1. Use the benefits. A reduced or free membership to a fitness club isn’t worth much if you never show up. Some health-contingent programs record fitness club usage as criteria for the reward. Instead of promoting the “carrot-and-stick” of rewards, promote the benefits of a healthy lifestyle on and off the job.
    
2. Communicate. Adults learn in different ways. Some will “get it” just by reading an email or paycheck stuffer. Others need to hear the information in an employee meeting, or podcast. Some will be energized by bringing in someone from the health club, Employee Assistance program (EAP) or other speaker to speak and demonstrate with slides, visuals or interactive events. Make communication an ongoing process; through your website, online learning, podcasts, and interactive meetings.
    
3. Set an example. Get your management team on board and become role models for the health and wellness programs. It’s tough to promote wellness when the boss darts out of the building every 15 minutes for a cigarette or continuously brings in calorie-busting lunches or snacks. Respect the efforts of your employees by supporting them with your own commitment. 

Healthcare reform is a reality. Insurance providers and companies can team up to offer programs that promote wellness and preventive care. In the end, a healthier workforce is an all-around win.

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