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2014 Employer Health Benefits Survey

Section Twelve: Wellness Programs and Health Risk Assessments

A large majority of firms offering health benefits offer some type of wellness program, with large firms (200 or more workers) being more likely than smaller firms (3-199 workers) to do so.  Thirty-six percent of large firms and 18% of small firms offering at least one wellness benefit offer financial incentives to employees who participate in wellness programs.  Thirty-three percent of firms offer employees the opportunity to complete health risk assessments, with some of these firms tying financial penalties or rewards to employees who do so.  Some employers have increased the complexity of their incentive programs, and are providing rewards and/or penalties to workers who complete a range of activities including health risk assessments, biometric screening and wellness programs.  The interactions among these programs are difficult to capture in a survey.  Only firms offering health benefits were asked about their wellness and health promotion programs

Wellness Benefits

For a variety of reasons, including efforts to improve health and lower costs, many employers and health plans offer wellness programs.  Wellness programs may range from classes in nutrition or healthy living to a wellness newsletter.

  • Seventy-four percent of firms offering health benefits offer at least one of the following wellness programs:
    • Weight loss programs
    • Biometric screenings
    • Gym membership discounts or on-site exercise facilities
    • Smoking cessation program
    • Lifestyle or behavioral coaching
    • Classes in nutrition or healthy living
    • Web-based resources for healthy living
    • Flu shot or vaccinations
    • Employee assistance program (EAP)
    • Wellness newsletter
  • Large firms (200 or more workers) offering health benefits are more likely to offer each of the listed wellness programs than smaller firms.  In addition, large firms (200 or more workers) offering health benefits are more likely to offer at least one of the listed wellness programs than smaller firms (98% vs. 73%) (Exhibit 12.3).
  • The percent of large firms (200 or more workers) and small firms offering wellness programs is similar to last year.
  • About half of firms offering health benefits offer flu shots or vaccinations (53%), a wellness newsletter (34%) or web-based resources for healthy living (39%).  The offer rate for each type of wellness benefit included in the survey is presented in (Exhibit 12.1), (Exhibit 12.2) and (Exhibit 12.3).
  • Among firms offering health benefits and at least one wellness program, 74% report that most of the wellness benefits they offer are provided by the health plan (Exhibit 12.4).1  Small firms (3 to 199 workers) are more likely than larger firms to report that most wellness programs are provided by the health plan (75% vs. 55%) (Exhibit 12.4).  Some employers may have wellness programs offered by both the firm and their plan.
Incentives for Wellness benefits
  • In order to encourage participation in wellness programs, firms may offer financial incentives to employees who participate.2
    • Nineteen percent of firms offering wellness benefits offer at least one of the following financial incentives for participating in a wellness program:
      • Lower premiums
      • Reduced cost sharing
      • Higher health reimbursement arrangement or HSA contributions
      • Gift cards, travel, merchandise, or cash
    • Large firms (200 or more workers) are more likely to offer these incentives for participating than smaller firms (36% vs. 18%) (Exhibit 12.5).
    • A small percentage of firms offering health benefits and at least one of the listed wellness programs offers gift cards, travel, merchandise, or cash (14%),  lower worker premium contributions (8%) or cost sharing (such as lower deductibles) (1%) as an incentive to encourage employees to participate.  Among firms that offer a high-deductible health plan paired with a HRA or HSA, 2% offer workers who participate in wellness programs receive higher HSA or HRA contributions (Exhibit 12.5).
  • In addition to offering employees incentives to participate in wellness program, some employers offer incentives to employees who complete programs or activities.  The Affordable Care Act allows employers to increase the size of their financial incentives for completing wellness programs.  Under new rules, firms can increase an employee’s premium contribution up to 30% of the cost of the plan for not completing wellness programs provided that the wellness program is reasonably designed and there are alternatives for employees who cannot meet the standard.
    • Twelve percent of large firms offer a financial incentive to employees who complete a wellness program (Exhibit 12.7).  Of these firms, 32% of employers reported that the maximum incentive an employee can be awarded for completing a wellness program is $500 or more.
  • Firms with one of the listed incentives above for participating in wellness programs (lower premiums, reduced cost-sharing, higher HRA/HSA contributions or gift cards, travel, merchandise, or cash) were asked how effective they believed incentives were for encouraging participation.  Only 14% of firms offering health benefits and at least one of the listed wellness programs think that financial incentives are “very effective” in encouraging employees to participate.  Large firms (200 or more workers) offering incentives for participating in wellness programs are more likely than smaller ones to believe incentives are “very effective” (33% versus 12%) (Exhibit 12.6).
Health Risk Assessments

Some firms give their employees the opportunity to complete a health risk assessment to identify potential health issues.  Health risk assessments generally include questions about medical history, health status, and lifestyle.

  • Overall, 33% of firms offering health benefits offer their employees the opportunity to complete a health risk assessment.  Large firms (200 or more workers) are more likely than smaller firms to offer employees this option (51% vs. 32%) (Exhibit 12.8).
  • Some firms offer financial incentives to encourage employees to complete health risk assessments.
    • Fifty-one percent of large firms (200 or more workers) offering health risk assessments give financial incentives to employees who complete a health risk assessment, and 36% of these offer a financial incentive that may be worth more than or equal to $500 (Exhibit 12.10).
    • Three percent of large firms (200 or more workers) that offer health risk assessments require employees to complete a health risk assessment in order to enroll in a health plan (Exhibit 12.9).
    • Seven percent of large firms (200 or more workers) that provide employees the opportunity to complete a health risk assessment penalize employees with identified health risks factors who do not complete a wellness program (9%) (Exhibit 12.9).
  • Among firms offering health benefits, the percentage of large firms (200 or more workers) who offer their employees the opportunity to complete a health risk assessment is similar to last year (Exhibit 12.14).
Biometric Screening

Biometric screening is a health examination that measures an employee’s risk factors, such as cholesterol, blood pressure, stress, and nutrition.  Biometric outcomes may include meeting a target body mass index (BMI) or cholesterol level.

  • Twenty-six percent of small firms (3 to 199 workers) and 51% of larger firms offering health benefits offer biometric screenings as a wellness benefit (Exhibit 12.1).
  • Firms which offer their employees biometric screenings may include additional incentives for those employees who complete screenings.  Among large firms (200 or more workers) offering biometric screenings, one percent require employees to complete biometric screenings in order to enroll in a health plan (Exhibit 12.12).
  • Among large firms (200 or more workers) offering biometric screenings, eight percent reward or penalize employees for meeting biometric outcomes. Of these firms 42% offer a maximum financial incentive of $500 or more (Exhibit 12.13).

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Section Twelve: Wellness Programs and Health Risk Assessments

exhibits

8625 - Exhibit 12.1
Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, Region, and Industry, 2014
8625 - Exhibit 12.2
Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, Region, and Industry, 2014
8625 - Exhibit 12.3
Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, 2014
8625 - Exhibit 12.4
Among Firms Offering Health and Wellness Benefits, Percentage of Firms Providing Wellness Benefits Through the Plan or Firm, by Firm Size and Region, 2014
8625 - Exhibit 12.5
Among Firms Offering Health and Wellness Benefits, Percentage of Firms That Offer Specific Incentives to Employees Who Participate in Wellness Programs, by Firm Size and Region, 2014
8625 - Exhibit 12.6
Among Offering Firms that Provide Incentives to Employees Who Participate in Wellness Programs, Firms’ Opinions on How Effective Incentives are for Employee Participation, by Firm Size, 2014
8625 - Exhibit 12.7
Among Large Firms (200 or more Workers) that Offer Health and Wellness Benefits, the Percentage that Offer Incentives for Completing Wellness Programs and the Maximum Value of the Incentive, by Firm Size, 2014
8625 - Exhibit 12.8
Among Firms Offering Health Benefits, Percentage of Firms That Offer Employees the Opportunity to Complete a Health Risk Assessment, by Firm Size, Region and Industry, 2014
8625 - Exhibit 12.9
Among Large Firms (200 or More Workers) That Offer Health Benefits and Provide Employees the Opportunity to Complete a Health Risk Assessment, The Percentage of Firms that have Incentives and Penalties for Various Employee Actions, by Firm Size, 2014
8625 - Exhibit 12.10
Among Large Firms (200 or More Workers) that Offer Health Benefits and Provide Employees the Opportunity to Complete a Health Risk Assessment, the Percent that Offer Financial Incentives Upon Completion and the Maximum Value of the Incentive, 2014
8625 - Exhibit 12.11
Among Large Firms that Offer Health Benefits and Provide Employees the Opportunity to Complete a Health Risk Assessment, the Percent that Require Employees with an Identified Health Risk Factor to Complete a Wellness Program or Face a Financial Penalty and the Maximum Value of the Penalty, 2014
8625 - Exhibit 12.12
Among Large Firms (200 or More Workers) Offering Health Benefits and Biometric Screenings, the Use of Incentives or Penalties for Various Activities, 2014
8625 - Exhibit 12.13
Among Large Firms (200 or More Workers) Offering Health Benefits and Biometric Screenings, the Use and Value of Incentives, 2014
8625 - Exhibit 12.14
Among Firms Offering Health Benefits, Percentage of Firms That Offer Employees the Opportunity to Complete a Health Risk Assessment, by Firm Size, 2008-2014
Section Eleven: Retiree Health Benefits Section Thirteen: Grandfathered Health Plans
x

Exhibit 12.3

Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, 2014
8625 - Exhibit 12.3
x

Exhibit 12.1

Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, Region, and Industry, 2014
8625 - Exhibit 12.1
x

Exhibit 12.2

Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, Region, and Industry, 2014
8625 - Exhibit 12.2
x

Exhibit 12.4

Among Firms Offering Health and Wellness Benefits, Percentage of Firms Providing Wellness Benefits Through the Plan or Firm, by Firm Size and Region, 2014
8625 - Exhibit 12.4
x

Exhibit 12.5

Among Firms Offering Health and Wellness Benefits, Percentage of Firms That Offer Specific Incentives to Employees Who Participate in Wellness Programs, by Firm Size and Region, 2014
8625 - Exhibit 12.5
x

Exhibit 12.7

Among Large Firms (200 or more Workers) that Offer Health and Wellness Benefits, the Percentage that Offer Incentives for Completing Wellness Programs and the Maximum Value of the Incentive, by Firm Size, 2014
8625 - Exhibit 12.7
x

Exhibit 12.6

Among Offering Firms that Provide Incentives to Employees Who Participate in Wellness Programs, Firms’ Opinions on How Effective Incentives are for Employee Participation, by Firm Size, 2014
8625 - Exhibit 12.6
x

Exhibit 12.8

Among Firms Offering Health Benefits, Percentage of Firms That Offer Employees the Opportunity to Complete a Health Risk Assessment, by Firm Size, Region and Industry, 2014
8625 - Exhibit 12.8
x

Exhibit 12.10

Among Large Firms (200 or More Workers) that Offer Health Benefits and Provide Employees the Opportunity to Complete a Health Risk Assessment, the Percent that Offer Financial Incentives Upon Completion and the Maximum Value of the Incentive, 2014
8625 - Exhibit 12.10
x

Exhibit 12.9

Among Large Firms (200 or More Workers) That Offer Health Benefits and Provide Employees the Opportunity to Complete a Health Risk Assessment, The Percentage of Firms that have Incentives and Penalties for Various Employee Actions, by Firm Size, 2014
8625 - Exhibit 12.9
x

Exhibit 12.14

Among Firms Offering Health Benefits, Percentage of Firms That Offer Employees the Opportunity to Complete a Health Risk Assessment, by Firm Size, 2008-2014
8625 - Exhibit 12.14
x

Exhibit 12.12

Among Large Firms (200 or More Workers) Offering Health Benefits and Biometric Screenings, the Use of Incentives or Penalties for Various Activities, 2014
8625 - Exhibit 12.12
x

Exhibit 12.13

Among Large Firms (200 or More Workers) Offering Health Benefits and Biometric Screenings, the Use and Value of Incentives, 2014
8625 - Exhibit 12.13

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