As a matter of fact, a non-HSA plan offering similar coverage can carry a monthly per-employee premium that’s about $15 to $25 lower and a deductible that’s $500 to $1,000 lower than the HSA option.

Sometimes the difference is due to price-jacking –  the HSA plans are the ones that’ve been hyped in radio commercials and mentioned in newspapers in recent years.

Nowadays, fewer individuals  exploring high-deductible plans ask first about the non-HSA, so insurance businesses sometimes slash prices to drum up interest in those options, too. Another factor –  Not all deductibles work the same.

Deductible cuts both ways

Two deductibles can look similar but work differently, and the cost scales can tilt for either an HSA or a non-HSA plan. Example –  HSAs by law can no longer allow first-dollar coverage of prescription drugs. But a non-HSA plan can.

On the flip side, HSAs often feature better preventive-care coverage. In some non-HSA plans, a person who has yet to meet the deductible must pay out of pocket for standard tests (example –  cholesterol testing) that’re part of the routine physical. Only the office visit itself is covered.

Likewise, HSA-eligible plans have to follow rules that limit total out-of-pocket costs. But this can push up the premiums paid on the front end.

Best bet –  Double-check with your broker to make certain you’re comparing apples to apples when analyzing  the costs of HSA and non-HSA plans.

A number of corporations have an onsite worker fitness room as part of a formal wellness program. Others simply do it as a way for folks to get their juices flowing before work or blow off steam afterwards.

No matter the reason, organizations with fitness rooms need to be aware that the benefit isn’t risk-free.

Over the last few years, a few privately owned health and fitness centers have been sued â.” and agreed to costly settlements â.” after exercisers suffered sudden cardiac arrest (SCA) and died before help arrived. In each case, the facility either did not have lifesaving equipment on the premises or didn’t have personnel properly trained to use it.

Some legal experts have expressed concern that employers could also be at risk when the unthinkable happened on organization premises while an worker worked out.

SCA is of particular concern. Reason –  Even seemingly healthful, active adults are at risk of sudden cardiac arrest. It can’t be prevented. There’s no vaccine.

And few victims survive by the time an ambulance arrives. But there’s a way to save the employee’s life and potentially save your firm from a lawsuit.

Learning about SCA

Sudden cardiac arrest (SCA) is a frequently misunderstood killer. It’s different thing as a heart attack. SCA can affect anybody, anywhere, anytime. It occurs more than 600 times every day in the USA, killing at least 250,000 people  each year.

The only hope –  using a device called an automated external defibrillator (AED) within 10 minutes.

The good news is any person at your corporation may be quickly trained to use an AED â.” you don’t need any medical knowledge to use it.  The training may be obtained for free through a local Red Cross or civic group.  The devices themselves cost under $2,000.

Compare that to the financial risk of being sued for not having an AED near a worksite fitness room, and it’s a no-brainer that any corporation with on-site workout equipment should at least investigate an AED purchase and training.

Employees, supervisors and senior managers alike will probably need education about SCA and AED use. A great teaching resource is available here.

Key talking points –  Without an AED, 90 percent of victims die. But when you have access to one, there’s a good chance to save an employee’s life.  And it’s easy to teach supervisors and personnel how to use the device when it’s ever needed.

The vast majority of facilities with AEDs never need to use them â.” and that includes medical facilities. But it only takes one tragic event, and subsequent lawsuit, to cause pain for both the company and an employee’s family.

Do not forget – Prevention and education are always your company’s best tools for avoiding liability. In this case, where human life is involved, the choice seems rather obvious.

On the positive side, voluntary benefits cost corporations next to nothing, yet increase employees’ morale and benefits satisfaction.  An Aon survey found 77 percent of businesses offer at least one voluntary benefit.

But what happens if there’s a legal dispute between one or more of your personnel and the provider?

In many cases, corporations unwittingly get dragged into court.  The vendor may argue that the plan is covered by ERISA, and the employee’s lawsuit should instead be filed against his or her corporation.

When the court agrees, the legal burden shifts.  Some courts have ruled that a voluntary benefits might  be covered under ERISA, even when it wasn’t an employer’s intention to formally “sponsor” the plan.

When push comes to shove, the providers will protect themselves. Indeed, some attorneys warn that a voluntary plan insurer’s first move if sued by one of your workers are going to be to try to get the legal burden shifted from itself to you.

Two seemingly innocent things that could be turned against you in court -

o  The written announcement to tell employees about the new voluntary benefit, and

o  getting involved if there’s a dispute between an worker and the plan provider.

Be careful with announcements When you offer a new voluntary benefit, the natural tendency is to attempt to get employees pumped up to participate. But you can get in trouble if individuals  get the impression the firm endorses the plan. Helpful practices -

o  Don’t put the announcement on organizational letterhead

o  Put a disclaimer on the description

o   either exclude your voluntary offerings from employees’ benefits manuals or list them separately, and

o  hold open enrollment at a different time than for ERISA plans (401(k), main health plan, etc.).

Likewise, if the provider offering the voluntary plan has competitors, you may want to remind staff the provider of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing providers.

Prevent involvement in disputes as with your ERISA plans, chances are workforce will come to you when they have a problem with a voluntary plan. Your first inclination is to help.

But many experts warn it’s better to stay out. Reason –  Courts see this as the action of a plan sponsor. But you are able to steer someone in the right direction (e.g., giving a contact name to call) while remaining neutral in the dispute.

Good intentions gone bad

From an ERISA standpoint, the most perilous voluntary plan design is one that is partially paid by the organization, even when workers pay the bulk of the cost.

In a major ruling several years ago (Burgess v. Cigna Life Insurance), a United States  district court ruled against an corporation with a voluntary supplemental disability plan in which the firm compensated a portion of premiums on behalf of its lower-compensated staff.

While most workers paid the entire premium â.” and firm made clear to individuals  the plan was a voluntary benefit â.”the court said it didn’t matter.  The act of contributing to some employees’ premiums made it an ERISA plan.

Most commonly,  presenteeism takes the form of workforce coming to work sick. They’re  unproductive and endanger colleagues. Meanwhile, the worker is not forced to use a sick day. A bad deal for corporations all the way around.

A recent survey by LifeCare revealed that 93 percent of personnel (polled from 1,500 corporations) admit that they at least ocassionally come to work when they’re sick enough to stay home. More important, the published study  looked at the reasons why folks do it.

Troubling rationales

The No. 1 reason workforce cited for coming to work sick was a belief that they’d be “letting other individuals  down” if they call out. Almost 30% of respondents cited this as their primary reason. Beyond that, the top responses were -

o  It’s too risky, because of office politics or culture, to take time off (26%)

o  The staff member is too busy at work to be able to stay home a day (15%)

o  The employee saves up sick days for childcare/eldercare emergencies (12%), and

o  The employee saves up sick days to use as extra vacation time (8%).

A lot of of these rationales are troubling to HR/benefits managers.

In the first place, supervisors who hassle employees about taking legitimate sick leave are, at best, being pennywise and poundfoolish.  Presenteeism costs more than absenteeism, once you figure in the uncharged sick days, lack of productivity and risk of other employees getting sick.

You’ve more power than you think to change your company culture when the “tough it out” mentality still applies to individuals  who come in sick. When upper-level management is confronted with the real dollars and cents of presenteeism, lowering the problem ordinarily becomes a priority.  At the very least, firms shouldn’t invite it.

In terms of supervisor- and employee-education, repetition of the “stay home if you’re sick” message is the key. Eventually, it’ll sink in.

Of course, there’s still the problem â.” as evidenced by the survey â.” of staff who misuse their sick days by attempting to hoard them for other purposes.

Adopting PTO, no-fault absence policies or use-it-lose-it sick time are the three most common ways of reducing the risk, but be aware that each of these policies have risks of their own.

At the end of the day, the more open the lines of communication are between upper-level management and staff, the less prevalent the presenteeism problem becomes.

When used for the specific purpose of beginning â.” or evaluating  â.” a wellness or disease management program, profiling isn’t just legal. It’s also encouraged.

Affects health risks

Different racial and ethnic groups tend to be more at risk â.” for genetic and/or cultural reasons â.” of certain medical problems. Examples -

o  African-American, Latino, Native American and Pacific Islanders are  at higher risk of diabetes than Caucasian employees

o  Chinese women are statistically twice as likely to get cervical cancer

o  Caucasians have disproportionately high rates of obesity and high blood pressure, and

o  Latinos have higher rates of asthma and chronic obstructive pulmonary illness than other groups.  The HIV/AIDS population is also disproportionately Hispanic.

Bottom line –  By analyzing  the ethnic breakdown of your worker population, you can set disease management program priorities with greater confidence and accuracy.

Health Care quality an issue

Several studies also show there’s an unfortunate relationship between ethnicity and quality of healthcare. A lot of times, minority workers receive inferior treatment and health education at the same facilities where others receive top-notch care.

This generally happens for innocent reasons. A common scenario –  a lack  of Spanish-speaking doctors in the network for your Latino staff members. But the result is generally higher health costs for you and, often,  greater reluctance among minority staff members to seek needed treatments.

By profiling workforce against the physicians in the network, you ultimately help workforce get the care they need and the corporation to better control long-term costs.

But only one firm in five has seen major improvement in employees’ health status (and lower costs) within two years of launching the incentive. Here are three keys to getting good results â.” and a red flag for failure.

Cancer screenings pay off big

Most wellness programs feature health-risk assessments for things like high cholesterol and diabetes. But many overlook the need for early detection of cancer, which may affect any worker, regardless of his or her age or general health.

In many cases, you can line up certain screenings, such as skin cancer detection (the most common type of cancer and, in its early stages, the most easily treated) for free or at a nominal cost.

These resources are often available through community agencies or the American Cancer Society. More involved and expensive screenings â.” such as mammograms â.” are well worth the cost.

A single case of cancer identified early typically saves thousands of dollars in medical claims and disability costs â.” not to mention trauma for the worker.

Smart worker health promotion incentives

HIPAA has tricky non-discrimination rules for offering staff a break on premiums or copays. You needn’t worry about HIPAA when you -

1. Structure the wellness program as a cost-break for employees who embrace wellness. on the flip side, imposing surcharges for uncooperative employees can force you to jump through health insurance portability and accountability act (HIPAA) hoops.

2. Make the incentive available to all staff. for example, when you offer a discount to non-smokers, an employee who recently quit tobacco use must also be eligible.

3. Allow staff members who fail to earn the incentive to have another shot at it next plan year.

Bottom line –  Make the financial incentive a reward, not a punishment. Do the incentives work? When they’re done right, yes.

Firms offering monetary rewards for wellness typically save about $20 to $50 a month, according to some estimates.

Making health promotion programs simple

Many firms require personnel to work with an individual “health Coach” for earn premium discounts or other incentives. Typically, the employee sets up appointments and reports to the health coach on a regular basis, either by phone or in person.

The good news –  the early results are often stimulating.

The bad news –  Once personnel realize there’s ongoing effort involved, many lose interest. But many firms have found a simple alternative. Rather than having participants contact the wellness Coach, the wellness coach calls them.

In many cases, this minor health promotion program tweak keep folks on the right track and cuts dropout rates.

Health Promotion begins upstairs

No matter how much money your organization spends on wellness, the odds of success depend largely on the example set by top management.

Example – If your CEO is a smoker, chances are few staff will buy into a use of tobacco cessation program.

In like manner, it’s hard to sell staff on subsidized fitness center memberships if your corporation culture is sedentary. for wellness to work, the top brass must practice what the firm preaches.

Just as importantly, how can you hold vendors accountable if you’re not getting what you paid for?

Here’s one proven way – Create a vendor scorecard. Scorecards alone won’t bring down your health care costs. But they’ll at least help make certain your corporation â.” and staff members â.” get everything you’re compensating for.

The tool can help you measure plan performance with greater precision â.” and identify specific areas that need improvement. Best of all, any company can adopt the technique to fit their needs. Here is how it works.

1. Choose specific rating areas

Benefit pros who’ve successfully adopted the scorecard system recommend grading providers on five to 10 measurable areas, like -

o  Claims processing. Are employees’ medical claims turned around in a timely fashion? Are you hearing complaints that the explanations of benefits (EOBs) are slow to arrive or hard to understand?

o  Disputed and resolved claims. Do staff member questions and complaints about denied or still-pending claims get answered rapidly and thoroughly? Just how often are you forced to go to bat for employees?

o  Accessibility. Are plan reps quick to answer phone calls? Do they attend regularly scheduled meetings?

o  Reports. Do you receive timely paid claim and utilization reports?

o  Open enrollment. Did you receive effective support preparing for and conducting open enrollment events?

o  Employee education. Do your workforce find the written and/or one-on-one services provided through the plan helpful in answering questions about managing specific chronic diseases (such as diabetes or depression)? Do you receive support in educating your workforce to make healthy lifestyle choices, such as use of tobacco cessation?

2. Choose a workable rating scale

There are two schools of thought when it comes to selecting  a rating method –  subjective or objective. Many benefit pros â.” in particular those from smaller firms â.” use a simple pass/fail or 1 to 5 score to rate their satisfaction.

Others develop more elaborate, statistic-based ratings. One method –  take the vendor’s guarantees (e.g., addressing disputed claims within 3-5 organization days) and then measure by percentage how often these objectives are met.

These rating data can be acquired through quarterly performance reports, employee surveys, issue and complaint files and, for larger plans, external audits.

3. Feedback causes improvement

It’s good practice to share your scorecard system with the vendor before meeting to review the results. Reason –  This lets you iron out any vendor questions about the review categories and scoring system.

Once that’s settled, you are able to meet to go over the numbers and prioritize the areas that need improvement. A lot of firms then add a new scorecard category â.” providers’ followup.

It depends on the steps you take to support staff attempting to kick the habit, finds a recent published study .  The Journal of Tobacco Policy and Research found that smokers do, truly  take more sick days than their non-tobacco use colleagues.

And even when the smoker is in relatively good overall health (i.e., isn’t obese, does not have chronic medical conditions), he or she is still likely to have higher healthcare costs than a comparable non-smoker over the last three years.

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

But if the individuals only refrains from use of tobacco on the job â.” but continues puffing away at home â.” the company sees little to no healthcare cost decrease.  The research study  found similar patterns for absenteeism.

Bottom line –  A workplace tobacco use ban in combo with a tobacco use cessation program gets results. A tobacco use ban alone normally doesn’t.

What’s New in Benefits and Compensation recently surveyed 374 of our readers from both the private and public sectors to determine their organization’s policy on permitting staff members to smoke on-site and hiring smokers in the first place. Here is what we found -

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

o  17% allow personnel to smoke offsite, but ban it on all organization property

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

o  30% allow smoking anywhere outside the building, and

o   3 percent allow smoking in break rooms or other indoor areas.

Public employers get aggressive

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

For example, 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 for 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 staff, but the county has undertaken use of tobacco cessation programs aimed at employees’ wallets.

Non-smokers pay less for coverage through various incentives and the county covers the cost of participating in smoking cessation programs.

The reason why Florida public corporations can 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.

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

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

Given that staff members nationwide are retiring later and the cost of retiree health care is sky high, you may want to keep attempting with smoking cessation programs, even for the oldest staff members on your health plan.