Employer Sponsored Wellness Programs

Wellness Programs

Introduction

Employers may sponsor wellness programs as a means to promote better health and higher morale among employees, with the hope that helping employees to embrace a culture of health will lead to higher productivity with lower health-related costs.
Wellness plans may be included in health insurance programs, or they may stand alone. These plans may include, but are not limited to, the following:

  • Tobacco cessation, exercise, weight management, or other behavior modification programs.
  • Health risk assessments.
  • High blood pressure or cholesterol screenings.
  • Health education.
  • Subsidized health club memberships.

While participation in wellness programs is voluntary, employers may offer incentives for participation or even disincentives for nonparticipation.

Advantages

While employers are searching for definitive methods to establish return on investment (ROI) for dollars spent on wellness programs, development of financial measurement tools for wellness ROI is not yet mature. Still, it is logical for employers in the United States to seek financial advantages from promoting a culture of health in an environment where the onset of chronic disease is shifting to people of younger age who, prior to becoming eligible for Medicare, are most frequently covered under health plans paid for by employers. Advantages for both employers and employees arise when employers seize the opportunity to use their access to employees as an opportunity to provide education and facilitate changes leading to an increase in emotional well-being and reduced risk of illness.

According to the U.S. Centers for Disease Control and Prevention, chronic diseases are the leading causes of death and disability in the United States. Among the most common, manageable or preventable chronic diseases are diabetes, heart disease, stroke, arthritis, and cancer. Obesity is also an urgent health concern, affecting as many as one in three adults and one in five children. Rising rates of obesity are leading to more diabetes and heart disease. Reducing the prevalence or severity of these diseases and conditions can reduce the emotional stress experienced by individuals, empowering them to focus more on productive work-related activities. Additionally, preventing or delaying the onset of diseases will likely correlate to less demand for employers to pay for expensive hospitalization and fewer treatments with costly specialty pharmaceutical medications.

Financial Savings

To appreciate the potential financial savings possible through the prevention or delay in onset of disease, it is important for employers to understand how small percentages of high-utilization participants in health plans may drive much of the cost. In general, 20 percent of a health plan’s population drives 80 percent of cost for all medical and prescription claims paid in a plan year. Often, just 5 percent of a health plan’s population in a given year will be high-cost claimants accounting for approximately half of all paid claims. Such individual high-cost claimants increasingly include inpatient hospital treatment and pharmaceutical claims costing in excess of $500,000 for a single claimant’s course of care. For example, a claimant could cost more than $600,000 annually for treatment of diabetes that has advanced to end stage renal disease requiring kidney dialysis. Similar costs are associated with other diseases moving from chronic to acute stages. On the other hand, $600,000 could be more than it would cost in a year for an employer-sponsored plan with 1,000 enrolled employees to pay for all employees plus dependents to have annual preventative physical examinations performed by their primary care physicians. When average coverage for an employee plus family enrolled in a plan costs over $16,800 per year, it can be frustrating for the employer to realize that there will not be significant, immediate discounts in return for providing wellness benefits. However, it takes premium payments from a pool of many members to offset the claims paid for just one high-cost claimant.

The financial rewards associated with the successful movement of a pool of insured members into a culture of health are likely to be more prevalent over the long term. Efforts directly promoting healthy behaviors can change the trajectory of employees’ long term health. Employers with low turnover and high average tenure of employees may be in the best position to reap the financial benefits of effective wellness programs targeting reduction in illness risks. However, all employers have the potential to benefit from the coordination of wellness initiatives with existing workplace safety initiatives and performance improvement plans. Workers’ compensation, disability benefits, and paid sick leave expenses all have the potential to be reduced as employee performance increases in an improving culture of health.

If you would like more information please contact Cleary Insurance, Inc. at 617-723-0700.

Working for Yourself? Don’t Sacrifice Your Retirement

Self-employment can be rewarding personally and financially, but it comes with some tough challenges including long hours, an uncertain income, and a lack of structured benefits such as health insurance and retirement plans.

But this is not the only reason it may be worthwhile to divert a sizable chunk of your earnings into tax-deferred retirement accounts. Doing so generally reduces your taxable income.

Anyone can set up an IRA, but contribution limits are relatively low — $5,500 in 2018, or $6,500 if you are 50 or older.

Here are two additional options that may allow larger contributions.

Solo 401(k). A solo 401(k) is a one-participant plan for business owners who have no other employees. Tax-deductible (or pre-tax) contributions to an individual 401(k) can be made in two ways.

As the employee, you can contribute as much as 100% of your annual compensation, up to the $18,500 annual maximum in 2018 ($24,500 if you are age 50 or older).

As the employer, you can also contribute an additional 20% of your earnings (25% if the business is incorporated) and deduct it as a business expense. Total contributions are capped at $55,000 in 2018 ($61,000 for those age 50 and older). A solo 401(k) plan may also allow plan loans and/or hardship withdrawals.

The deadline to establish an individual 401(k) and formally elect salary deferrals is December 31 of the year in which you want to receive the tax deduction (or before fiscal year-end for corporations). For businesses taxed as sole proprietors and partnerships, salary deferrals and profit-sharing contributions for 2018 must be deposited into the account by the April 2019 personal tax filing deadline.

SEP-IRA. You can make tax-deductible employer contributions of as much as 25% of net earnings, up to $55,000 in 2018. If you have eligible employees, you must contribute the same percentage to SEP-IRAs in their names; of course, the dollar amounts would be different for different salary levels. You are not required to contribute to a SEP-IRA every year.

In addition to any employer SEP-IRA contributions, you and your eligible workers can generally make pre-tax employee contributions up to the normal IRA contribution limits. You have until the April 2019 tax filing deadline to set up a SEP-IRA and make 2018 contributions.

Distributions from 401(k) plans and SEP-IRAs are taxed as ordinary income. Early withdrawals (prior to age 59) may be subject to a 10% federal income tax penalty.

Why This New Year’s Resolution Should Be the First One You Complete

Each year, as many as 60 percent of Americans make New Year’s resolutions. One of the most popular is saving money, yet it’s also one of most common resolutions to fail.1 As you look ahead to the rest of the year, we’ll show you what could be the difference-maker to keep your finances in check.

Must-Do Resolution: Evaluate your Homeowner’s Insurance

Your home is one of your largest assets, and not protecting it properly could be financially devastating. So if you’re looking to safeguard your finances over the long-term, here are a few things to look for in your homeowner’s insurance policy:

  1. Does it pay actual cash value or replacement value?
    If your policy pays actual cash value for a loss, you’ll receive enough money to pay what the home or item was worth when you bought it, with depreciation factored in. If you want to replace your home with items of the same quality, you’ll need a policy that pays replacement value.
  2. Are your home improvements reflected?
    If you’ve made recent improvements to your home, such as updating the kitchen or adding a bonus room, make sure those are reflected in your policy. That way, if your home is damaged or destroyed, you’ll be able to replace that new addition too.
  3. Does it cover temporary housing?
    If you experience a loss and are unable to live in your home while it’s being repaired or rebuilt, you’ll need a place to stay. Make sure your policy covers a temporary residence in your neighborhood or school district, and other out-of-pocket living expenses.
  4. Does it cover special losses, like floods or hurricane damage?
    Did you know that water damage makes up 45% of all interior property damage, happening more often than fire or burglary2? In the wake of wildfires, hurricanes, and floods, you may look back and wish you’d been more prepared. Now is the time to make sure you’re covered for whatever Mother Nature sends your way. Take an inventory of your home, assemble a disaster preparedness kit, and talk to your agent about the types of coverage you need.

Want additional tips for in sticking with your financial wellness resolutions? Check out this article.

1 https://www.inc.com/peter-economy/10-top-new-years-resolutions-for-success-happiness-in-2019.html

2 https://www.chubb.com/us-en/individuals-families/water/