Smokers' suspensions spotlight incentive plans

Most companies are not taking punitive action against employees who fail to live up to terms of an insurance discount.

By Karen Caffarini — Posted May 12, 2008

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Whirlpool Corp. suspended 39 workers caught smoking or chewing tobacco on company grounds.

The Benton Harbor, Mich.-based company in late April said the suspended employees, all at its Evansville, Ind., refrigerator factory, signed insurance paperwork stating they were tobacco-free in exchange for a $500 break on their premiums.

About 38% of all companies with 20,000 or more employees use some sort of incentive program, including a discount on insurance premiums, to encourage healthy behavior, according to Mercer, a human resources consulting firm.

But experts say few have taken punitive action against their employees who were deemed to be lying about their status, or have even investigated whether anyone has been lying. Whirlpool is meeting with the 39 suspended employees to determine whether there might be further action, including firing them.

"It would be unduly harsh if Whirlpool would terminate these employees. For all we know, they may have in good faith been trying to quit smoking and had this one cigarette," asked Andrew Wachler, a health care attorney from Royal Oak, Mich.

Whirlpool did not say whether any of the employees had taken smoking-cessation classes or had tried other means to quit, if they had tried at all.

Most companies prefer to take a softer approach to keeping their work force healthy. About 80% of large companies offer some type of wellness program -- including weight loss, smoking cessation and disease management -- according to the Mercer survey. There have been no studies to determine whether the wellness programs have been successful in improving employee health, but 64% of the companies responding to the Mercer study said they lowered health costs.

In 2006, the Indiana General Assembly passed an amendment to state law, which was supported by the Indiana State Medical Assn., that allows employers to implement financial incentives intended to reduce tobacco use. The association has no stand on whether there should be repercussions to employees who refuse to participate in the programs, or who lie about their unhealthy habit. But spokeswoman Adele Lash pointed out, "the ultimate repercussion for those employees is poor health."

WellPoint, on its Web site, said 80% participation by employees and their families in wellness programs is needed for a company to reduce its insurance costs. To achieve that, it recommends providing incentives such as premium discounts, cash, gift cards or more health coverage.

Clarian Health Partners, an Indianapolis-based hospital system, originally determined it would charge employees up to $30 per paycheck for health problems in five areas, including smoking, high blood pressure and high cholesterol. After receiving employee input, Clarian decided to provide cash incentives for positive results, instead of charging for negative results.

"We want to encourage our employees, not punish them. We trust our employees," said Clarian spokesman James Wide.

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Encouraging participation

More employers are using incentives to encourage healthy behavior. Among large employers offering each type of program, the percentages represent those who connect it to an employee incentive.

Requirement 2005 2006 2007
Completing a health risk assessment 17% 22% 29%
Participating in a behavior modification program 12% 19% 22%
Completing a behavior modification program 11% 16% 16%
Participating in a disease management program 7% 8% 11%

Source: "National Survey of Employer-Sponsored Health Plans: 2007 Survey Report," Mercer

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