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

And even when the smoker is in relatively good overall health (i.e., isn’t obese, doesn’t 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.

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

But when the individuals only refrains from use of tobacco on the job â.” but continues puffing away at home â.” the corporation sees little to no healthcare cost decrease.  The research 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 usually doesn’t.

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

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

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

o  39 percent restrict smoking to designated areas outside the building

o  30% allow smoking anywhere outside the building, and

o   3% allow use of tobacco in break rooms or other indoor areas.

Public businesss get aggressive

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

The reason why Florida public companys can easily take these steps –  the state supreme Supreme Court has ruled that refusing to hire smokers does not break discrimination laws.

But your state laws may vary, so proceed with caution before considering similar policies.

According to the Journal of American Medicine, Duke University 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 attempt to quit have a 35 percent to 45 percent relapse rate within two years.

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

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 health fair.”

Stressed 401(k) importance

Precisely how it worked –  on the same day the company’s 401(k) vendor sent a plan rep to discuss the retirement plan, the organization also arranged for a certified financial planner to speak to workforce.

The financial planner went first. She began the session by pointing out that she wasn’t affiliated in any way 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 staff. 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 several major issues that hurt both staff member 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 workers.

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 aroused to do something to help themselves.

Roughly 35 percent of firms with health promotion programs focus on providing staff with convenient access to weight reduction resources.

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

o  confidential support and counseling

o  Access to a professional nutritionist or fitness trainer, and

o  on-site exercise programs.

Until lately, only large corporations were able offer such wellness programs as part of their wellness benefits.   But the fastest growth of these wellness 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 personnel. Ordinarily, personnel pay up to about 25 percent of the cost. But some plans are fully employee paid.

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

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

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

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

Level three –  the company docks pay or fires workers who fail to control their lifestyle-related health risks. Example –  A company called Clarian Health has sent notifications to workers that beginning in 2009, workers who smoke or chew tobacco are going to 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 as for HIPAAs non-discrimination rules. It is legal to reward personnel for wellness participation but its illegal to punish those who fail to improve their health.

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

Additionally rememberthat, by law, the size of the reward or penalty under your wellness program cant exceed 20 percent of the total cost of coverage.

The other two are still largely uncharted waters in the courts. Businesss 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?)

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

1. Know thine enemy You have to know what’s driving your largest claim costs on your health care plan – both among personnel and their dependents.

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

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 staff member education.

4. Integrate wellness with other benefits. Real-life experience has shown that you ought to consider your staff member assistance programs (EAPs) an extension of the health promotion 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 worker buy-in is for executive management to lead the wellness program by setting a positive example. When upper managers are unwilling to participate and address their own health issues, don’t expect many workers to take the wellness program seriously.

Over the last two years, one company in five has seen meaningful improvement in employees’ health status â.” and started to stabilize their costs â.” according to one study.

Among firms noting improvement, nearly 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

A lot of firms require workforce to work with an individual wellness coach for get a discount on monthly premiums or earn cash incentives.

The most common set-up –  on a regular basis, the worker 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 start â.” and they’re enthusiastic about the incentive â.” 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 individuals  on the right track. Rather than requiring workforce to contact the wellness Coach, a growing number of companies require participants to take calls from the wellness 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 â.” and cost-effective â.” feature in the battle against worker obesity –  offering an worker nutrition-education program administered by a specialist nutritionist.

Just 11 percent of companies â.” 18 percent  of big corporations and 7.5 percent of small to medium ones â.” have such health promotion programs, as reported by SHRM’s most recent benefits survey.

Even fewer offer (via their EAPs) nutritional therapy for people  with eating disorders. But available data on these wellness programs shows they ordinarily pay for themselves.

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

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

3. Assertive use of tobacco cessation

A small, but quickly growing number of businesss are taking more assertive measures to avoid the costs associated with workers who smoke.

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

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

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

Level three –  the corporation docks pay or fires personnel who fail to control their lifestyle-related health risks.

Example –  Clarian Health made news last fall for sending notice to employees that as of Jan. 1,  2009, people  who smoke or chew tobacco would begin be charged $5 per paycheck.

Are these strategies legal? at level one, the answer is a qualified yes. HIPAAs non-discrimination rules permit such incentives within limits.

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

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

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

Finance and the Chief Executive Officer (CEO) want hard numbers to show Return On Investment.  And wellness Return On Investment is tougher to calculate than, say, a 401(k).

18-month guideline

Current studies have established some benchmark data on wellness Return On Investment (ROI) you can use as a guideline. It’s useful whether you already have a health promotion program or are thinking about beginning one.

It generally takes at least 18 months from the launch of a health promotion program to see any causes your healthcare plan bottom line.

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

By and large, the long-term cost savings from a health promotion program are going to be driven by how much you’re willing to spend. Usually, organizations get what they pay for â.” both in time and money invested.

As a rule of thumb, the typical cost to the company is about $3 to $5 per participating employee per month. Within three years of launch, you must be seeing meaningful savings.

The typical Return On Investment (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 a lot of companys, the most effective way to manage the cost of a health promotion program in the start-up phase is to make it a budget-neutral expense.

In other words, the wellness 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 wellness program will cost the company $5 per employee.

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

Just be sure you’re not hitting folks with a big hike on top of that $5. Comparably designed health promotion programs pay off about the same â.” meaning workers buy in and participate at the same rate â.” whether they’re budget neutral or the company 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 Return On Investment for these wellness programs is usually disappointing.

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

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

In the past, the fairs often better served the provider(s) who came onsite than the needs of the hosting company or their workforce. More lately, businesses have refined the planning of the events to serve particularly to launch or promote a wellness program.

To be successful, the events need to serve two purposes – boosting worker education and building their enthusiasm to take part in the health promotion program.

To make certain you and your personnel get the most out of a wellness fair, it helps to be conscious 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, employees received easy-to-grasp information on key wellness topics like illness detection, symptom control and smarter medication practices. They also receive important services like free blood-pressure screenings.

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

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

o  A booth from a local health-food store

o  A chair-massage station

o  elder-care info from the AARP, or

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

Offering incentives

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

o  A contest offering prizes to workers who visit every station

o  quizzes and prizes based on info from different vendors’ literature

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

o  cash incentives (as little as $20 and as much as $100) to people  who voluntarily take part in various screenings.