Wellness, Social Media, and the Law

Transcription

1 Wellness, Social Media, and the Law CBIA s 2014 Compensation & Benefits Conference Robin Bouvier & George Kasper November 4, 2014

2 Aon Hewitt s 2014 Health Care Survey: Key Findings What are the top health care outcomes your organization would like to achieve in 2014 and the most significant challenges facing your organization (internal or external) in terms of accomplishing these outcomes? Desired outcomes Increase participation in wellness, health improvement and disease management programs (66%) Increase awareness of, and decision making related to, health issues (65%) Challenges Motivating employee health behavior change (70%) Complying with government regulations/ ACA (51%) Source: Aon Hewitt s 2014 Health Care Survey 1

3 How to Use Communication & Social Media to Motivate Employees Source: 2014 Consumer Health Mindset Survey; Aon Hewitt, National Business Group on Health and The Futures Company 2

4 Hurdles that Prevent Employees from Making Healthy Decisions I m not always honest with myself about how healthy I am. for the employer Getting healthy is not easy. for the employer Many aspects of life are stressing me out. for the employer 59% say they re in at least good health but are actually overweight or obese for the employer 85% of consumers say at least one obstacle gets in the way Lack of time and affordability are the hurdles cited most often Top 5 Stressors 47% Financial situation 40% Work changes 37% Work schedule 34% Work relationships 34% Control over how I do my work Source: 2014 Consumer Health Mindset Survey; Aon Hewitt, National Business Group on Health and The Futures Company 3

5 Target Behaviors and Risks that Impact Health and Performance 8 15 Risks and Behaviors drive Chronic Conditions accounting for 80% of Total Cost of all Chronic Illness Worldwide By focusing on three major risk factors, employers can save an average of $700 per employee per year in health care costs and productivity improvements Source: 2010 World Economic Forum 4

6 Best Practices to Promote Sustainable Behavior Change Incorporate appropriate activity and health practices into daily job functions Make services accessible, easy, meaningful, confidential and personal Emotional Social Healthy, High Performing Financial Physical Make healthy the new organizational norm Support health practices outside of the work environment Adapted from World Health Organization Healthy Workplace Framework & Model 5

7 The role of incentives is to ACTIVATE employees to learn about health and wellness, engage in program components and begin behavior change. Source: Joint Consensus Statement, Journal of Occupational and Environmental Medicine

8 Incentive Design Principles Employers are seeking new ways to increase engagement and influence employees to change health behaviors, making interest in using incentives very high 1. Use data to help determine behaviors or areas of focus 2. The workforce must value the incentive Magnitude Frequency Immediacy 3. The incentive must be earned, not just given 4. Incentives paired with positive social interactions are optimal 5. Excellent communication is a must Communications Social Reinforcement Data-Driven, Evidence- Informed Environment and Culture Incentive Design Principles Legal Regulations Contingency Value Proposition 7

9 Incentive Tactics Reward Behavior with Behavior (Sit/stand work stations, fitness devices, personal training) Cash, Gift Cards Creating Greater Purpose (Charity) Benefit Differentials, Payroll Deductions, HSA Contributions Recognition Tactics Time Off 8

10 Sample Participatory Incentive Design Must be provided at no cost Reasonable alternative not required Incentive earned regardless of health status/ outcome Program Design/Eligibility Complete Health Assessment & Biometric Screening Employees & Spouses/Domestic Partners enrolled in Medical Plan Incentive Must complete both activities $400 per person Full reward must be available to all similarly situated individuals No limit on incentive value Employee incentive cannot be contingent on spouse/domestic partner participation 9

11 Sample Health-Contingent Incentive Design: Activity-Based Program Design/Eligibility Participate in walking program If criteria met: Incentive earned regardless of health status/ outcome If criteria not met, Reasonable Alternative Standard must be offered: Waiver from physician on behalf of participant for whom the standard is unreasonably difficult due to a medical condition or medically inadvisable to attempt Incentive Requirement: Meet walking program requirements Incentive earned upon meeting program requirements Incentive earned upon satisfying Reasonable Alternative Standard Employees & Spouses/Domestic Partners enrolled in Medical Plan $400 per person Full reward must be available to all similarly situated individuals Incentive value limited to 30% of total cost of coverage (50% if program addresses tobacco use) Employee incentive cannot be contingent on spouse/domestic partner participation 10

12 Sample Health-Contingent Incentive Design: Outcome-Based Program Design/Eligibility Complete Health Assessment & Biometric Screening If criteria met: If criteria not met, Reasonable Alternative Standard must be offered: Participate in Health Risk Coaching (3 sessions): Physical activity, nutrition, self-management, tobacco, weight, stress Incentive Requirement: Meet 3 out of 5 biometric measures in healthy range Incentive earned upon meeting program requirements Incentive earned upon satisfying Reasonable Alternative Standard Employees & Spouses/Domestic Partners enrolled in Medical Plan $400 per person Full reward must be available to all similarly situated individuals Incentive value limited to 30% of total cost of coverage (50% if program addresses tobacco use) Employee incentive cannot be contingent on spouse/domestic partner participation 11

13 Additional Compliance Requirements for Health-Contingent Programs 1. Opportunity to qualify for reward must be available at least once per year No limits on number of annual attempts 2. Total reward cannot exceed specified percentage of total cost of coverage 30% for program that doesn t address tobacco use 50% if program addresses tobacco use 3. Program must be reasonably designed to promote health or prevent disease Based on facts and circumstances Not subterfuge for discriminating based on a health factor 4. Uniform availability and reasonable alternative standards (RAS) For activity-based, must provide RAS waiver for those who have a medical condition or medically inadvisable For outcome-based, RAS required for those who do not meet measurement, test or screening standard regardless of medical condition or medically inadvisable 12

14 Additional Compliance Requirements for Health-Contingent Programs Wellness incentive programs are subject to numerous laws and regulations, including HIPAA Nondiscrimination and Privacy ERISA GINA ADA Tax Rules State Laws The Equal Employment Opportunity Commission ( EEOC ) recently sued two employers for violations of the wellness incentive program rules 13

15 Broad Program Scope Drives Better Outcomes 7-year study of PepsiCo s HealthyLiving wellness program authored by three RAND researchers and Pepsi H&W directors Featured in January 2014 issue of Health Affairs and January 7, 2014 New York Times Key Findings Health risk and lifestyle management approaches are not effective on a standalone basis (ROI <1.0) Managing diseases works well (ROI >3.5) Source: Caloyeras et. al., Health Affairs,

16 The Link Between Employee Wellbeing, Engagement & Business Results Employees with strong overall wellbeing are nearly 6X as likely to be engaged than those who are at risk Engagement Health & Wellbeing Business Results Employees who have strong overall wellbeing are: 2x as likely to be engaged in their jobs compared to employees with moderate wellbeing 6x as likely to be engaged compared to those who are at risk Engaged employees with strong wellbeing: 46% fewer unhealthy days as a result of physical or mental illness 39% less likely to be diagnosed with new disease in the next year 43% less likely to be newly diagnosed with anxiety and depression 32% more likely to stay with the company High engagement business units provide better business results: 10% better customer ratings 21% higher productivity 37% decreased absenteeism 25% lower turnover (high-turnover organizations)/65% lower turnover (low-turnover organizations) 22% higher profitability 70% of employees in America are disengaged/actively disengaged Source: Gallup, State of The American Workplace Employee Engagement Insights for US Business Leaders, 2013 Engaged employees" are those who are involved in, enthusiastic about and committed to their work and contribute to their organization in a positive manner 15

17 Not the Silver Bullet But Incentives Are Having an Impact Increased engagement 7% 40% 18% 35% Increased participation in taking action 6% 42% 18% 35% Improved health behaviors 7% 42% 8% 43% Changes in health risks 10% 36% 6% 48% Cost savings (health care costs, absence, workers' comp, productivity) 15% 29% 6% 51% Positive changes in employee morale, satisfaction and/or attitudes 12% 38% 9% 40% Little or No Impact Some Impact Major Impact Do Not Know Source: Aon Hewitt 2014 Health Care Survey 16

18 Contact Information Robin L. Bouvier Aon Hewitt Tel: George Kasper Pullman & Comley, LLC Tel:

19 These slides are intended for educational and informational purposes only. Readers are advised to seek appropriate professional consultation before acting on any matters in this update. These slides may be considered attorney advertising. Prior results do not guarantee a similar outcome. BRIDGEPORT HARTFORD STAMFORD WATERBURY WHITE PLAINS