At the end of the day, is it worthwhile to ban smoking on the premises at your company?

It depends on the steps you take to support employees trying to kick the habit, finds a recent research study .  The Journal of Tobacco Policy and Research found that smokers do, in truth  take more sick days than their non-smoking peers.

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 healthcare costs than a comparable non-smoker over the last three years.

How does a use of tobacco ban fit into the cost equation? When the smoker quits, healthcare costs even out.

But when the person only refrains from smoking on the job - but continues puffing away at home - the business sees little to no medical cost decrease. the study  found similar patterns for absenteeism.

Bottom line -  A workplace smoking ban in combo with a smoking cessation program gets results. A smoking ban alone normally doesn’t.

In the last few years, there’s been a rising trend for public businesss - not just private corporations - to ban tobacco use. Here’s what your peers are doing.

What’s New in Benefits and Compensation lately surveyed 374 of our readers from both the private and public sectors to find out their organization’s policy on allowing workers to smoke onsite and hiring smokers in the first place. Here’s what we found -

• 11% have developed a policy of hiring only non-smokers

• 17 percent allow workers to smoke offsite, but ban it on all corporation property

• 39% restrict use of tobacco to designated areas outside the building

• 30 percent allow smoking anywhere outside the building, and

•  3% allow smoking in break rooms or other indoor areas.

Public companys get aggressive

While much of the publicity about no-hire policies for smokers centers on private companies, it’s actually public corporations in certain states who have been the most aggressive 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 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 tobacco use cessation programs.

The reason why Florida public employers 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 use of tobacco at any age can improve a person’s health. and believe it or not, older employees often fair better with use of tobacco cessation than younger employees.  

As reported by the Journal of American Medicine, Duke Univ. reseearchers tracked 573 older patients over 10 years. They found that just 16% of those who joined the smoking cessation program later returned to smoking.  

Previous research has found young smokers who attempt to quit have a 35% to 45% relapse rate within two years.

Given that employees nationwide are retiring later and the cost of retiree healthcare is sky high, you might want to keep trying with use of tobacco cessation programs, even for the oldest employees 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 business 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 company also arranged for a licensed financial planner to speak to workers.

The financial planner went first. She started the session by pointing out that she wasn’t affiliated by any method with the management of the 401(k) plan.

That was vital both for the company’s legal protection under ERISA and for building trust with employees. She then discussed why it’s vital for individuals  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 a few major issues that hurt both worker salary satisfaction and 401(k) participation. Numerous studies show that the No. 1 reason many individuals  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 -  Staff Members were more attentive and there was a noticeable uptick in both new 401(k) enrollments and salary contributions from already-enrolled staff members.

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 excited to do something to help themselves.

Looking for incentives to get overweight employees to buy into a wellness program? A recent research study  suggests many employees are even willing to pay much - or all - of the cost themselves.

Roughly 35% of firms with wellness programs focus on providing staff members with convenient access to weight loss resources.

A poll of 1,352 staff members by the Strategies to Overcome and Prevent Obesity Alliance found that many people  would gladly chip in for the cost of the program if they believed it’d help them lose weight. What staff members want -

• confidential support and counseling

• access to a professional nutritionist or fitness trainer, and

• onsite fitness programs.

Until recently, only big companies were able offer such programs as part of their wellness benefits.   But the fastest growth of these programs in the last two years has been in smaller firms (sometimes with as few as 50 full-time employees).

The majority of firms split the cost with workers. Typically, workers pay up to about 25% of the cost. But some plans are fully employee paid.

Studies show that roughly five percent of staff members drive about 80 percent of your health benefit costs.

No shocker here -  Smokers and obese staff members are the highest risk group for developing the sorts of chronic medical problems that send costs through the roof.

A small, but quickly growing number of businesss are taking desperate measures to avoid the costs associated with these staff members. the step can be broken down into three levels of aggressiveness and potential risk/reward.

Level one -  the employer installs a wellness program in which non-tobacco use workers and those who commit to maintaining a healthy weight receive financial incentives that lower their share of monthly insurance premiums.

Level two -  the company disqualifies job candidates who smoke or are significantly overweight from hiring consideration. Alternatively, some firms require new hires to undergo a health risk (assessment|appraisal} as a condition of being hired.

Level three -  the employer docks pay or fires staff members who fail to control their lifestyle-related health risks. Example -  A business called Clarian Health has sent notifications to staff members that starting in 2009, staff members who smoke or chew tobacco will be charged $5 per paycheck.

Are these strategies legal? at level one, the answer is a licensed yes. health insurance portability and accountability act (HIPAA)s non-discrimination rules permit such incentives under a few conditions.

Wellness incentives walk a fine line for health insurance portability and accountability act (HIPAA)s non-discrimination rules. It’s legal to reward staff members for wellness participation but its illegal to punish those who fail to improve their health.

Example -  If an worker follows a weight-loss program in good faith but fails to lose weight, you can’t withhold the incentive. Similarly, if an worker fails repeated tries to quit use of tobacco, you’re still legally obligated to give them another shot next year.

Additionally keep in mindthat, by law, the size of the reward or penalty under your wellness program cant exceed 20% of the sum cost of coverage.

The other two are still largely uncharted waters in the courts. Corporations considering these policies should proceed with extreme caution.  Keep in mind that the question of “can you do it” (i.e., is it legal?) is different from “should you do it?” (i.e., is it good business?)

Wellness programs come in all shapes and sizes. But regardless of plan design there are five common components that set the successful programs apart from the rest.

At their core, wellness programs require constant monitoring and periodic adjustments. the programs that get mediocre results are the ones that are left to run on autopilot. That’s why it’s vital to -

1. Know thine enemy You’ve to know what’s driving your biggest claim costs on your health care plan - both among workers and their dependents.

2. Develop realistic expectations. With wellness, what an employer gets will nearly always depend on how much it spends, how well it plans and how well it sustains communications with participants and the provider.

3. Maintain strong communications. the wellness programs that achieve the greatest success are those which are communicated aggressively from the get go and are sustained. Repetition is your friend when doing employee education.

4. Integrate wellness with other benefits. Real-life experience has shown that you should consider your staff member assistance programs (EAPs) an extension of the wellness program. You should also consider issues like absenteeism, disability and worker’s compensation to be pieces of the wellness puzzle.

5. Practice what you preach. the key to ensuring employee buy-in is for management to lead the program by setting a positive example. When upper managers are unwilling to participate and address their own health issues, don’t expect many staff members to take the program seriously.

Here’s more evidence that wellness programs pay for themselves -

Over the last two years, one organization in five has seen significant betterment in employees’ health status - and began to stabilize their costs - according to one study.

Among firms noting improvement, almost two-thirds (64%) feature wellness programs offering incentives for healthier lifestyles.

Here are three twists on traditional incentives that’re getting good results -

1. Health coach outreach

Many firms require employees to work with an individual health coach to get a discount on monthly premiums or earn cash incentives.

The most common set-up -  on a regular basis, the staff member must set up appointments with and report to (either over the phone or face to face) his or her health coach.

But experience has shown there’s often a high dropout rate.

People  get off to a great begin - and they’re enthusiastic about the incentive - but once they realize there’s some effort involved, they lose interest.

The good news -  Firms have found a simple-to-arrange alternative that keeps  people  on the right track. Rather than requiring employees to contact the health coach, a growing number of organizations require participants to take calls from the health coach.

Potential result -  Fewer folks fall off the wagon. There’s no outreach effort involved, and the health coach keeps individuals  accountable.

2. Nutritional education/therapy

A newer - and cost-effective - feature in the battle against worker obesity -  offering an worker nutrition-education program administered by a specialist nutritionist.

Just 11 percent of organizations - 18 percent  of large businesss and 7.5 percent of small to medium ones - have such programs, according to SHRM’s most recent benefits survey.

Even fewer offer (via their EAPs) nutritional therapy for individuals  with consuming disorders. But available data on these programs shows they usually pay for themselves.

The stronger the firm’s emphasis on teaching healthful consuming, the faster and more dramatic the reduction in major health claims.

Common plan features -  lunch and learns featuring healthy food options, giving out nutrition-linked gift cards and extending obesity-prevention incentives to people ’s family members.

3. Aggressive use of tobacco cessation

A small, but rapidly growing number of companys are taking more aggressive measures to avoid the costs associated with staff members who smoke.

The step could be broken down into three levels of aggressiveness and potential risk/reward.

Level one -  the business installs a wellness program in which non-use of tobacco workers and those who commit to maintaining a healthy weight receive financial incentives that lower their share of monthly premiums.

Level two -  the company disqualifies job candidates who smoke from hiring consideration. Alternatively, some firms require health risks assessments as a condition of being hired.

Level three -  the employer docks pay or fires workers who fail to control their lifestyle-related health risks.

Example -  Clarian Health made news last fall for sending notice to workers that as of Jan. 1,  2009, individuals  who smoke or chew tobacco would start be charged $5 per paycheck.

Are these strategies legal? at level one, the answer is a licensed yes. health insurance portability and accountability act (HIPAA)s non-discrimination rules permit such incentives within limits.

In a nutshell, it’s legal to reward staff members who quit tobacco use but illegal to punish those who attempt and fail. If an employee tries but fails to quit tobacco use, you’re still legally obligated to give them another shot next year.

Also keep in mindthat, by law, the size of the reward or penalty under your wellness program can’t exceed 20% of the sum cost of coverage.

At levels two and three, it remains to be seen if such policies would hold up in court. Proceed with caution.

Wellness programs are a long-term investment. But how long should you wait for results?

Finance and the CEO want hard numbers to show return on investment (ROI). and wellness ROI is tougher to calculate than, say, a 401(k).

18-month guideline

Recent studies have established some benchmark data on wellness ROI you are able to use as a guideline. It’s useful whether you already have a wellness program or are thinking about beginning one.

It normally takes at least 18 months from the launch of a wellness program to see any causes your health care plan bottom line.

For many firms, 18 months is the point at which workers’ bettering health starts to cancel the cost of sponsoring and administering the wellness program.

By and large, the long-term cost savings from a wellness program will be driven by how much you’re willing to spend. Generally, businesses get what they pay for - both in time and money invested.

As a rule of thumb, the average cost to the employer is about $3 to $5 per participating employee per month. Within three years of launch, you should be seeing significant savings.

The typical ROI tends to be about $4 to $5 saved for every dollar spent. So how can you manage the costs in the short-term in order to achieve the long-term savings?  and how can you maximize the long-term payoff?

Consider making wellness programs budget-neutral

For many corporations, the most effective way to manage the cost of a wellness program in the start-up phase is to make it a budget-neutral expense.

In other words, the program neither adds to your healthcare costs at the outset, nor decreases them. Example -  You plan to roll out a wellness program effective Jan. 1. the program will cost the business $5 per staff member.

You can roll the $5 per month cost directly into the employee’s monthly share of their health care premium. In this age of continuous cost-shifting, most workers are used to seeing small increases in their monthly contributions each plan year.

Just make sure you’re not hitting folks with a big hike on top of that $5. Comparably designed wellness programs pay off about the same - meaning staff members buy in and participate at the same rate - whether they’re budget neutral or the employer absorbs the cost.

But when employees get clobbered by large-scale contribution hikes at the outset, they often resist the wellness program. the long-term ROI for these programs is often disappointing.

If you’re faced with a situation where achieving a budget-neutral program would trigger push-back, your firm is better off absorbing most or all of the wellness costs.

The largest hurdle is to get over the hump for those first 18 months or so.

A few years ago, business health fairs were all the rage. Now they’re making a comeback, with a slight twist.

In the past, the fairs often better served the vendor(s) who came on-site than the needs of the hosting company or their staff members. More recently, businesses have refined the planning of the events to serve especially to launch or promote a wellness program.

To be successful, the events need to serve two purposes -  increaseing staff member education and building their enthusiasm to participate in the wellness program.

To be sure you and your employees get the most out of a wellness fair, it helps to be aware of the plusses and minuses - and some little touches that can mean the difference between a so-so event and a hit.

Health Fairs -  Double-edged sword

On the plus side, staff members received easy-to-grasp information on key wellness topics such as illness detection, symptom control and smarter medication practices. They also receive important services like free blood-pressure screenings.

On the down side, some professionals said the more newfangled events were more like “disease fairs” than “health fairs.” In other words, the tone was little too somber and workers weren’t in particular tuned in because they weren’t enjoying themselves.

Wellness program advisor Dr. Ron Goetzel believes that the savviest firms strike a balance in their wellness fairs. Stick with the screenings, but also feature exhibitors who offer “lighter,” more enjoyable services. Examples -

• a booth from a local health-food store

• a chair-massage station

• elder-care info from the AARP, or

• a “complimentary medicine” info booth (e.g.,a chiropractor or an acupuncturist).

Offering incentives

In many cases, workers still need an incentive to attend the fair and get the desired screenings, as well to doing the fun stuff. Some real-life programs that’ve worked -

• a contest offering prizes to workers who visit every station

• quizzes and prizes based on info from different providers’ literature

• flex-scheduling or time-off incentives for getting screened (e.g., a comp day or an additional afternoon off), and

• cash incentives (as little as $20 and as much as $100) to people  who voluntarily participate in various screenings.