Health Wellness ProgramHealth and Wellness Programs and Wellness Program Consulting

Which costs your business more – staff members who miss work or ones who show up physically but take a mental PTO day?

For most employers, it’s the latter. So why do even savvy senior managers and finance directors (we’re not just talking about the bean-counters) worry about absenteeism while downplaying so-called presenteeism as a drain on corporation productivity, not to mention the compensation and benefits budget?

In some cases, upper managers seem to think that admitting that presenteeism even exists at the firm is akin to saying, “We’re a poorly run organization.” In reality, presenteeism exists in every workplace.

Virtually every employee, manager, supervisor and executive who has ever tried to “tough it out” at work when he or she has been sick has been a presentee on those days.

So has anybody who’s ever been distracted at work by non-work issues – whether it’s spending the day trying to resolve an individual financial matter, checking on a sick child at home or constantly checking for scoring updates from a sporting event.

In brief, unless we’re to believe that every worker is productive every single day, no corporation in the world is immune from presenteeism.

Some organizations that don’t bury their heads in the sand about presenteeism still don’t track it. Why? Usually, there’s a belief that chronic presentees eventually get rooted out of the corporation.

And short of watching over every other employee’s shoulder throughout the workday, it’s too challenging (and even counterproductive) to try to estimate the cost to the business.

Here are some strategies that firms have used to not only measure the cost but also reduce the problem.

Creating a cost estimate

If your organization is like most, senior level management worries endlessly about health benefit costs without realizing undetected presenteeism is just as expensive, but easier to control.

Consider these facts from a recent CSG study – Nearly 10% of the average yearly pay and benefits

budget is spent on non-productive (but treatable) personnel.

Add in staff who call out at the last second and the percentage rises to 17 percent, according to SHRM.

But how do you estimate the actual dollars-and-cents cost to your firm?

Let’s assume you’ve 50 employees, who make an typical $40,000 a year. Over the while the year, the typical worker is non-productive 2.5 % of the time, due to assorted personal issues or minor illnesses that serve as distractions.

In this instance, presenteeism costs your corporation $50,000 a year. When you have a 5 percent presenteeism rate, the figure shoots up to $100,000.

While it’s impossible to entirely stamp out presenteeism, even small reductions in presenteeism add up to large bucks in controlling compensation and benefit costs.

The next step, of course, is doing something about the issue. Broadly speaking, the process typically works in three phases –

• review current policies and procedures for things that accidentally increase presenteeism

• get supervisors and workforce involved on the front end, and

• stress the importance of work-life programs to upper-level management and supervisors.

Let’s look at each area to see how they work in real-life practice.

Unintentional effects

Three common ways many firms try to cut absenteeism often increase presenteeism –

1. Over-stressing attendance in employee’s annual reviews

2. Having supervisors check up on personnel who take sick days to verify they are really ill, and/or

3. Disciplining personnel for last-moment sick callouts.

From a practical and cost standpoint, the best solution may  be to switch from separate vacation and sick-day benefits to a single paid time off (PTO) bank.

When folks have no-questions-asked control over their off days, they’re sometimes more likely to use a PTO day when they’re sick.  Of course, you know that PTO carries some risks of its own.

Early detection

Fewer than one corporation in 10 gets both managers and personnel involved in the process of spotting and eliminating presenteeism.

That’s too bad, says consultant Mary Beth Chalk, because it can been done pretty easily.

Ask a sampling of workforce to rate how energetic and productive they typically feel at work, on a percentage scale. Have supervisors estimate their staff as well. Then split the difference.

The result is a pretty good barometer of your organization’s current and future presenteeism risk.

Work-life balance

Anything you are able to do to promote work-life programs at your firm can have a positive effect on the bottom line. Proven ideas include –

• rewarding supervisors who support flexible work arrangements

• sending sick workforce home

• cover onsite flu shots, and

• Actively promote your existing Staff Member Assistance Program.

Any benefits HR/manager can adopt these ways to make employees feel more appreciated.

The common thread –  using your own communication skills as a powerful tool for improveing morale.

1. Put in face time

When time permits, managers may want to put in some “face time” with employees. This in and of itself is a type of staff member recognition. Example –  There’s a lot of value in simply walking around the building, chatting with employees.  Ask employees about the personal items they display at their workstations.

In the short-term, folks will notice and appreciate your interest.  Long-term, this may inspire ideas for rewards and incentive programs.  The same technique works at  firms with multiple locations.  Make a site visit to get a feel for the morale. This is much cheaper – and often more effective – than designing a formal benefits survey.

2. Send ‘em customized stuff

Looking for a simple way to show employees that HR/Benefits cares? Develop a template from which you can send customized “Welcome” letters to new hires or “Happy Anniversary” notes for employees’ company anniversaries.

3. Target overlooked employees

Most firms have employees (e.g. part-timers) who aren’t eligible for the 401(k), medical plan and other company-sponsored benefits.  Small gifts help firms connect with these often-overlooked employees.

Example –  on the first day of spring, send them a packet of flower seeds and attached a note from Benefits. Burston-Marsteller Worldwide has used this simple, low-cost idea and gotten good results.

Looking for recognition ideas that get results?  Here are two keys to success –

The most common characteristics of high-Return On Investment recognition programs – regardless of their monentary value – are their spontaneity and perceived value by employees themselves.

In reality, the cost of some of most effective spot awards and bonuses often amount to less than 1 percent of base pay – and the awards don’t even have to be given in cash.

Less sense of entitlement

Part of the problem with traditional end-of-year or quarterly bonuses (apart from the fact that they cost companys an typical of 10 percent of base pay) is that employees expect to receive them for reaching certain goals.

Sometimes staff members simply expect it no matter what. for example, at many firms, an annual holiday bonus is viewed as an entitlement and individuals  inevitably grumble that it’s not high enough. on the flip side, with spontaneous awards and bonuses, staff members are often pleasantly surprised.

Benefits advisor Ken Stahlmann spells out four keys to making the latter type of awards work, even if they’re lower in cost –

1. Creativity is crucial

The most effective programs generally give out awards weekly or monthly.  To avoid over-stretching the budget – and avoid a ho-hum attitude establishing in – creativity is a must.

One way that never gets old –  combining time off with a second, non-cash award. Example –  One firm gives a half-day off in combo with movie passes once a month.

Another, at weekly staff meetings, holds a random drawing for a dinner gift certificate, plus permission to leave work early once.

2. Make it personal

Rewards have more lasting impact when they’re geared to individuals ’s personal needs or interests. Two examples –

• one firm with many foreign-born, low-wage workers awards a $20 pre-compensated phone card after 90 days of service, and a $100 card for outstanding work, and

• Another business with a lot of sports nuts took a few top-performers to a ball game. Managers said it was the best $200 they’ve ever spent as for creating ongoing enthusiasm.

3. Add structure

The awards might seem spur of the moment, but top programs have a fixed budget and structure set before anything is handed out. Example –  One retail firm awards “points” for good work. Folks can then trade in their points for store merchandise.

By letting people  bank points for more valuable rewards, the employer saw a solid jump in retention.

Other companies prefer to let employees reward each other. for example, a small healthcare provider keeps a “goodies box” on-site – paid for in petty cash and stocked by employees themselves.

When someone spots a colleague going the additional mile, he or she pulls out a prize and awards it.

The program is a gigantic hit –  It’s immediate and personal, yet structured.

4. Don’t let good intentions backfire

Most spot awards go over well. But keep these four issues in mind –

• For most cash or cash-value awards, there are tax implications (just as with traditional bonuses)

• Awards need to be spread around or else resentment can creep in

• Be certain honorees don’t mind being the center of attention (some firms have accidentally alienated individuals  they tried to reward), and

• Make certain the reward is something people  actually want. One firm that awarded a VIP parking space next to the Chief Executive Officer (CEO) found no one used it. No one wanted the Chief Executive Officer (CEO) knowing what time he or she came and left.

Looking for ways to improve morale, productivity and retention? Spot awards may  be the way to go.

They’re the most popular recognition incentives among workers, a recent research study  shows.  The best part –  the incentives ordinarily amount to less than 1% of base pay. That also can makes this option attractive to C-levels.  And the awards don’t even have to be given in cash.

Spontaneity grabs ‘em

Traditional end-of-year or quarterly bonuses cost companys an average of 10% of base pay yet often have a lower payoff in morale and retention.

Reason – Employees appreciate them less because they expect to receive them for reaching certain objectives. By their nature spot awards are spontaneous and compensated out immediately. Honorees are pleasantly surprised and see the business values their work.

Here are four keys to successful spot bonus programs, as reported by benefits advisor Ken Stahlmann –

1. Creativity is crucial

The most effective programs normally give out awards weekly or monthly.  To avoid over-stretching the budget – and avoid a ho-hum attitude setting in – creativity is a must.

One way that never gets old –  combining time off with a second, non-cash award.

Example –  One firm gives a half-day off in combo with movie passes once a month. Another, at weekly staff meetings, holds a random drawing for a dinner gift certificate, plus permission to leave work early once.

2. Make it personal

Rewards have more lasting impact when they’re geared to individuals ’s personal needs or interests. Two examples –

• one firm with many foreign-born, low-wage staff members awards a $20 pre-compensated phone card after 90 days of service, and a $100 card for outstanding work, and

• Another firm with a lot of sports nuts took a few top-performers to a ball game. Managers said it was the best $200 they’ve ever spent in terms of building ongoing enthusiasm.

3. Add structure

The awards might seem spur of the moment, but the most effective programs have a fixed budget and structure set before anything is handed out.

Example –  One retail firm awards “points” for good work. Folks can then trade in their points for store merchandise. By letting people  bank points for more valuable rewards, the business saw a solid jump in retention.

Other corporations prefer to let workforce reward each other. for example, a small health care provider keeps a “goodies box” onsite – paid for in petty cash and stocked by workforce themselves.

When someone spots a peer going the extra mile, he or she pulls out a prize and awards it.

The program is a huge hit –  It’s immediate and personal, yet structured.

4. Don’t let good intentions backfire

Most spot awards go over well. But keep these issues in mind –

• For most cash or cash-value awards, there are tax implications (just as with traditional bonuses)

• Awards need to be spread around or else resentment can creep in

• Make sure honorees don’t mind being the center of attention (some firms have accidentally alienated individuals  they tried to reward), and

• Make sure the reward is something individuals  actually want. One firm that awarded a VIP parking space next to the Chief Executive Officer (CEO) found no one used it. No one wanted the Chief Executive Officer (CEO) knowing what time he or she came and left.

In the last few years, there’s been a lot of publicity about the fast-growing crime of identity theft. More than half happen in the worksite. Benefits and compensation files are the most vulnerable targets.

The scariest part –  Victims of benefits-related ID theft often make out worse than those who fall prey to the more common variety.  The bad guys are ahead of investigators after such thefts occur, and are often very good at covering their tracks.

Furthermore, because benefits ID-theft is a relatively new type of crime, there’s no well-established system for victims, plan sponsors and vendors to set things straight after the fact.

401(k) accounts a prime target

Not surprisingly, employees’ 401(k) accounts have become the primary target for benefits thieves.  An alarming MSNBC news report showed just how easy it could be for thieves to tap into an employee’s 401(k) accounts – When an web-based account gets hacked into or account paperwork falls into the wrong hands, it takes only a few mouse clicks to wipe out the victim’s retirement savings.

With average credit-card or bank account fraud, victims need only call their card issuer or bank, report the crime and refuse to pay for an item. But 401(k) theft is much, much harder to resolve.

Three huge obstacles –

1. Money in 401(k) accounts is not federally insured, like a bank account.

2. 401(k) accounts rarely – if ever – come with automatic identity theft protection from the provider, like credit cards.

3. Even when the theft is successfully resolved, the situation becomes an ERISA nightmare for plan sponsors, because your corporation also has to account for the way the theft affected the growth of the employee’s account before the money was restored.

A lot of EAPS fall into a common – and dangerous – category –  Management thinks the program is great, but staff think it’s a waste. But it doesn’t have to be that way when you have an EAP or are considering one.

Seventy-three percent of all firms (59 percent of small companys) have an EAP. But how well does the typical employee assistance program (EAP) work? Not as well as we’d hope. A Mid America Coalition on Healthcare study found –

• just 50 percent of 6,400 staff surveyed said they’d use the employee assistance program (EAP) if they felt overwhelmed by personal issues, and

• one-third said they didn’t even know how to access its resources.

The good news –  Firms like yours have seen dramatic improvements in three relatively simple steps

1. Employee attitude surveys

The best beginning place –  Take the pulse of your staff with a short, confidential attitude survey.

Goals –  Ask employees when they know how to use the EAP’s resources. Then test workers’ knowledge and opinions of depression and other personal issues that might affect their worksite performance and/or safety. In the final section, find out how employees would handle a serious personal issue.

In other words, determine where your individuals  would likely turn for help. Would workers seek out the EAP? Would they prefer to discuss the issue with their family doctor? A psychological health expert?

The Mid America Coalition’s survey remains an excellent design model from which to craft a recent survey for your own workers.

2. Promote EAP through education

Your survey data ought to help you pinpoint areas where workers need more education about your EAP. Some awareness-improveing techniques that have gotten results –

• Lunch-and-learn sessions. Possible topics include dealing with personal-finance stress, caring for elderly parents, understanding depression or dealing with a dependent who has potential mental health issues.

• Worker newsletter. When you have a benefits newsletter, spotlight the employee assistance program (EAP) from time to time. Some businesses without newsletters have done e-mail campaigns or targeted mailings instead.

• Workplace posters spotlighting EAP.  The ones that work best are often posters designed around a specific theme (e.g., anxiety about personal debt) rather than a general “need help?” message. In addition to posters, you may want to distribute wallet cards with employee assistance program (EAP) contact info.

Need help locating educational material? There’s lots of free EAP-related flyers and FAQs here. Do not forget –  When doing employee assistance program (EAP) education, constantly remind workforce that the program is strictly confidential.

3. Make sure to work with supervisors

For legal reasons, supervisors need to tread carefully when they suspect an staff member has a mental health issue.

What you don’t want –  supervisors taking disciplinary actions without consulting HR or playing amateur psychologist and “diagnosing” the employee’s problems. Here’s a PDF of some proven tips and talking points for doing supervisor-specific employee assistance program education.

HIPAA compliance –  Beware non-discrimination issues

HIPAA’s non-discrimination rules impact both psychological health benefits and general health plans. Under current interpretations, health care plans can no longer have benefits exclusions that deny benefits for injuries resulting directly or indirectly from pre-existing psychological health issues.

That’s true even when the psychological condition wasn’t diagnosed until after the injury and even when the injury was self-inflicted. Example –  Suppose an employee gets hurt in a worksite accident he or she caused. After the fact, the employee is diagnosed with a mood disorder that previously escaped detection by the employee’s physician.

Under current regs, health insurance portability and accountability act (HIPAA)-covered plans can’t deny benefits. This puts corporations in a bind. Mental health issues like depression, anxiety or bipolar disorder are among the medical conditions that’re most likely to go undiagnosed or underdiagnosed.

That’s why, in most organizations, having a strong employee assistance program (EAP) is one of your best compliance tools.

For a lot of workers, telecommuting and flex-time are highly desired work-life benefits. But a growing number of businesses are reluctant to offer these programs.

Demand for these benefits remains high.  One study found that 87 percent of job applicants are familiar with the idea behind telecommuting and flex-time, and the majority express a desire to have at least periodic access to such programs.

Environmental interest groups have pushed the feds for years to create incentives for companys to encourage telecommuting.  The pressure has risen as gas prices have continued to soar.

However, flex-time programs have leveled off in some sectors, and there’s been a decrease in telecommuting.

Today, about half of all organizations where telecommuting is feasible permit personnel to work from home on a case-by-case basis. But the percentage of employers offering full-time telecommuting has dropped in recent years.  Nowadays, only about 20% to 25% of employers offer the benefit year-round.

Even some national businesss that are well-known for their telecommuting programs have scaled back. AT&T, for example, recently asked a few thousand home-based staff members to come back into the office.

Hewlett-Packard and Intel have done the same thing.  and the federal government lately noted a 7.3% drop in telecommuting personnel. Why the cutbacks?

Employee Assistance Program – Pros and cons

Offering workforce telecommuting or flex-time can be a good recruiting and morale-improveing tool, in addition to a way to retain workforce who need to relocate, would otherwise have a need to quit or take leave or commute long distances to work.

But the programs are not without their drawbacks. Some of the main reasons corporations give for scaling back or eliminating them –

• Corporation culture – It’s easier to build a sense of organizational stability and a personal connection between personnel, colleagues and supervisors when people  interact face-to-face on a daily basis.

• Security – Among the hidden costs of permitting personnel to telecommute (or else come in early or stay late) is keeping sensistive information safe. Some the cutbacks are being driven by companies’ IT departments.

Namely, managers have raised concerns about stolen laptops, identity theft or other crimes driven by hackers gaining access to information via workers’ home Internet connections.

• Productivity – Many supervisors find it easier to ensure high productivity when everybody is working under one roof at the same time.  There’s also a widespread view that most staff members get things done faster and more accurately when they’re not distracted by things at home.

The bottom line on the bottom line

Work-life programs like flex-time and telecommuting remain a useful benefit to offer workers, and a lot of businesses still provide these benefits for economic reasons.

But once the potential hidden costs are weighed, it’s often better for the bottom line to limit the scope of these programs.

Organizations that are thinking about starting a telecommuting program should look closely at job descriptions and telecommuting candidates. Some positions are poorly suited for remote work, and some personnel are more up to the challenge than others.

But unless the business creates objective criteria for allowing or denying flex/telecommuting requests, such programs can actually damage morale.

The last thing any employer wants is to open supervisors(and the company) up to accustations of favoritism or discrimination because of seemingly random decisions on which personnel in their department can and can’t flex their schedules or work from home.

In the near future, the federal government might offer help to businesss looking to begin a wellness program.  The help would take the form of tax breaks to offset wellness program costs.

A current United States  Senate bill would give employers a substantial tax break for beginning health promotion programs. Dubbed the Healthful Workforce Act, it calls for an employer tax credit of up to $200 per employee enrolled in a newly developed health promotion program.

For bigger firms, there is the $200 credit for the first 200 personnel and up to $100 per employee thereafter.  To qualify for the full credit, your wellness program would’ve to feature –

• health risk appraisals

• worker education drives (e.g., targeted mailings, internet based tools)

• behavior change programs (e.g., smoking cessation, weight control, wellness Coaches), and

• “meaningful” participation incentives (e.g., lower co-pays).

Certified employers would be able to claim the tax credit for up to 10 years after beginning a wellness program.

The bill has enjoyed bipartisan support, but like many things in Washington, the parties disagree over how to fund the cost of the tax credit.  As a result, it’s been bogged down in committee.

When and when the bill is ratified, businesss could claim the federal tax credit the following year.

In the meantime, whether or not your organization already has a formal health promotion program, there are proven ways to make wellness part of the organization culture. Best of all, they don’t have to cost an extra cent.

Health Promotion town meetings

It’s often said that successful health promotion programs start at the top of the business. Reason – Employees pick up fast on whether senior level management practices what it preaches when it comes to wellness.

If the individuals  in upper management are smokers, obese or simply reluctant to talk about health issues, it’s a tough sell to get personnel engaged in taking control of their health.

That’s the idea behind the wellness town meeting.

Once a week (or once a month), everybody in the corporation attends a short meeting to discuss their own recent efforts to get healthier.

Managers normally go first, for break the ice about discussing some potentially sensitive issues like dieting or quitting use of tobacco.

In most companies, the meetings are arranged to encourage casual, free-flowing conversation.

One key – Individuals  speak from where they’re seated, rather than standing up front, with all eyes staring at them.

Some companies take a more formal approach, which could also work.  For example, at Old National Bank in Indiana, folks file into an auditorium to face their worst enemy, the scale.

Each week, everyone at the firm – from seasoned managers to the newest hires – comes in to get weighed.  The only one who sees the number on the scale is the individuals getting weighed. Even so, the health promotion program has inspired a lot of folks to lose weight.

Free tests and screenings

While there’s no substitute for having staff members undergo robust health risk assessments, it’s also wise to home in on screening for common conditions that aren’t necessarily lifestyle related.

Example –  skin cancer. It’s not just sun worshippers who are at risk of the most common (and in its early stages, treatable) form of cancer. Heredity plays a part. So does luck.

Fortunately, corporations can get their staff members screened for free. Through the American Academy of Dermatology’s National Melanoma and Skin Cancer Screening program, volunteer physicians perform skin cancer screenings at no cost.

In like manner, other medical associations and public health agencies offer free or nominal-cost screenings for a selection of other common conditions.

In fact, it varies.  In some cases, an HSA-eligible plan may cost the same as a non-HSA high-deductible plan. In others, the premiums can actually be more expensive, a recent NHPI report finds.

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 choice.

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

Nowadays, fewer people  exploring high-deductible plans ask first about the non-HSA, so insurance organizations sometimes slash prices to drum up interest in those choices, 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 in favor of 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’s 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.

In addition, HSA-eligible plans have to follow rules that limit sum out-of-pocket costs. But this can push up the premiums compensated on the front end.

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

When your business has this common – and increasingly well-liked – fringe benefit you may be at legal risk without even knowing it.

Some businesses have an onsite staff member 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, corporations 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 – and agreed to expensive settlements – 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 specialists have expressed concern that businesss could also be at risk if the unthinkable happened on corporation premises while an worker worked out.

SCA is of particular concern. Reason –  Even seemingly healthy, 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 is 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 not the same thing as a heart attack. SCA can affect anyone, anywhere, anytime. It occurs more than 600 times every day in the United States, killing at least 250,000 individuals  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 company could be quickly trained to use an AED – you don’t need any medical knowledge to use it.  The training could be acquired 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 company with onsite workout equipment should at least investigate an AED buy and training.

Workers, 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 if 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 if it’s ever needed.

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

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