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Cover:PLANSPONSOR 2009 Ultimate Buyer's Guide: Wellness: Truth and Consequences

Illustration By Fernanda Cohen
More employers with wellness programs consider requiring participation

"We are seeing people move more toward 'sticks' rather than 'carrots,'" says Cathy Tripp, National Leader for Consumerism at consultant Watson Wyatt Worldwide, about how the economy has affected employers' thinking on wellness programs.

Before, an employer might have offered workers a gift card as an incentive to do a health screening. "Now, the employer may say that, if the health-risk assessment indicates you need to participate in a disease-management program and you do not, your deductible is going to be $500 higher. We even have seen some employers say employees have to do a health-risk assessment if they want coverage. In this economy, there is the latitude to push these things a little further."

As employers with wellness programs plan for 2010, "they are being much more aggressive" about their expectations, says Jay Savan, a St. Louis-based Principal at consultant Towers Perrin. "It is much less of a value-added approach, and more expressly around identifying health risks and addressing them." Prior to the economic meltdown, he says, "Many employers felt that they were not necessarily in a position to mandate that kind of approach."

A lot of the discussions Savan currently has with clients explore the idea of requiring or strongly encouraging participation in programs like biometric screening. "An employer might say, 'I am going to offer you two medical plans. One is much higher in value than the other—however, to participate in that plan, we require you to complete a health-risk assessment, and if the risk assessment determines that you are eligible for case management or should be in a wellness program, you have to participate," he says.

Or an employer may make its health savings account (HSA) contribution to an employee contingent on participation in a wellness program, says Jerry Ripperger, National Practice Leader of Consumer Health for the Principal Financial Group. "We are seeing more employers saying, 'Let's start having a conversation about consequences,'" he says.

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