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.

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

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

Even some national businesss that are well-known for their telecommuting programs have scaled back. AT&T, for example, lately asked a few thousand home-based personnel 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 staff members telecommuting or flex-time can be a good recruiting and morale-increaseing tool, as well as a way to retain staff members 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 businesss give for scaling back or eliminating them –

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

• Security – One of the hidden costs of allowing employees 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 – A lot of 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 employees 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 such as flex-time and telecommuting remain a useful benefit to offer staff members, and a lot of companies 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 workers are more up to the challenge than others.

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

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

A current USA  Senate bill would give employers a substantial tax break for beginning health promotion programs. Dubbed the Healthy Workforce Act, it calls for an employer tax credit of up to $200 per staff member enrolled in a newly created health promotion program.

For larger firms, there is the $200 credit for the first 200 staff members and up to $100 per staff member thereafter.  To qualify for the full credit, your health promotion program would’ve to feature –

• health risk appraisals

• staff member education drives (e.g., targeted mailings, online tools)

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

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

Licensed corporations would be able to claim the tax credit for up to 10 years after starting 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, employers 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 wellness programs start at the top of the business. Reason – Workers select up fast on whether senior level management practices what it preaches when it comes to wellness.

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

That’s the idea behind the wellness town meeting.

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

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

In most corporations, 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 corporations 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, everybody 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 person getting weighed. Even so, the wellness program has inspired a lot of folks to lose weight.

Free tests and screenings

While there’s no substitute for having staff undergo robust health risk appraisals, 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, businesss can get their workers screened for free. Through the American Academy of Dermatology’s National Melanoma and Skin Cancer Screening program, volunteer doctors perform skin cancer screenings at no cost.

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

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 option.

Sometimes the difference is because 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 businesses sometimes slash prices to drum up interest in those options, 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 has 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.

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

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

Some companies have an onsite employee fitness room as part of a formal health promotion 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, businesses 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 didn’t have lifesaving equipment on the premises or didn’t have personnel properly trained to use it.

Some legal professionals have expressed concern that employers could also be at risk if the unthinkable happened on corporation premises while an employee 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 different thing as a heart attack. SCA can affect anyone, anywhere, anytime. It occurs more than 600 times every day in the U.S., 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 can be quickly trained to use an AED – you don’t need any medical knowledge to use it.  The training can 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 organization with on-site workout equipment should at least investigate an AED buy and training.

Staff Members, supervisors and senior level managers alike will probably need education about SCA and AED use. A excellent teaching resource is available here.

Key talking points –  Without an AED, 90% 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 staff 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 – Prevention and education are always your company’s best tools for avoiding liability. In this case, where human life is involved, the choice seems rather obvious.

On the positive side, voluntary benefits cost employers next to nothing, yet improve employees’ morale and benefits satisfaction.  An Aon survey found 77% of organizations offer at least one voluntary benefit.

But what happens when there’s a legal dispute between one or more of your staff members and the provider?

In many cases, employers unwittingly get dragged into court.  The provider may argue that the plan is covered by ERISA, and the employee’s lawsuit should instead be filed against his or her employer.

When the court agrees, the legal burden shifts.  Some courts have ruled that a voluntary benefits could  be covered under ERISA, even when it wasn’t an employer’s intention to formally “sponsor” the plan.

If push comes to shove, the vendors will protect themselves. In truth, some attorneys warn that a voluntary plan insurer’s first move if sued by one of your staff members will be to attempt to get the legal burden shifted from itself to you.

Two seemingly innocent things that may be turned against you in court –

• The written announcement to tell workers about the new voluntary benefit, and

• getting involved if there’s a dispute between an staff member and the plan vendor.

Be cautious with announcements When you offer a new voluntary benefit, the natural tendency is to try to get workforce pumped up to participate. But you can get in trouble when people  get the impression the firm endorses the plan. Helpful practices –

• Don’t put the announcement on organizational letterhead

• Put a disclaimer on the description

•  either exclude your voluntary offerings from employees’ benefits manuals or list them separately, and

• hold open enrollment at a different time than for ERISA plans (401(k), main health plan, etc.).

Moreover, if the vendor offering the voluntary plan has competitors, you may want to remind staff members the vendor of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing vendors.

Prevent involvement in disputes as with your ERISA plans, chances are workforce will come to you when they have a problem with a voluntary plan. Your first inclination is to help.

But many professionals warn it’s better to stay out. Reason –  Courts see this as the action of a plan sponsor. But you can steer someone in the right direction (e.g., giving a contact name to call) while remaining neutral in the dispute.

Good intentions gone bad

From an ERISA standpoint, the most perilous voluntary plan design is one that is partially paid by the company, even if staff members pay the bulk of the cost.

In a major ruling several years ago (Burgess v. Cigna Life Insurance), a USA  district court ruled against an business with a voluntary supplemental disability plan in which the firm paid a portion of premiums for its lower-paid personnel.

While most personnel paid the entire premium – and firm made clear to people  the plan was a voluntary benefit -the court said it didn’t matter.  The act of contributing to some employees’ premiums made it an ERISA plan.

Most widely,  presenteeism takes the form of workers coming to work sick. They’re  unproductive and endanger colleagues. Meanwhile, the worker isn’t forced to use a sick day. A bad deal for businesss all the way around.

A recent survey by LifeCare revealed that 93 percent of personnel (polled from 1,500 corporations) admit that they at least ocassionally come to work when they’re sick enough to stay home. More important, the research study  looked at the reasons why folks do it.

Troubling rationales

The No. 1 reason employees cited for coming to work sick was a belief that they’d be “letting other people  down” if they call out. Almost 30 percent of respondents cited this as their main reason. Beyond that, the top responses were –

• It’s too risky, because of office politics or culture, to take time off (26%)

• The employee is too busy at work to be able to stay home a day (15%)

• The staff member saves up sick days for childcare/eldercare emergencies (12%), and

• The staff member saves up sick days to use as additional vacation time (8%).

Many of these rationales are troubling to HR/benefits managers.

In the first place, supervisors who hassle workforce about taking legitimate sick leave are, at best, being pennywise and poundfoolish.  Presenteeism costs more than absenteeism, once you figure in the uncharged sick days, lack of productivity and risk of other workforce getting sick.

You’ve more power than you think to change your company culture if the “tough it out” mentality still applies to individuals  who come in sick. When senior management is confronted with the real dollars and cents of presenteeism, decling the problem generally becomes a priority.  At the very least, firms shouldn’t invite it.

In terms of supervisor- and employee-education, repetition of the “stay home if you’re sick” message is the key. Eventually, it’ll sink in.

Of course, there’s still the problem – as evidenced by the survey – of employees who misuse their sick days by trying to hoard them for other purposes.  

Adopting PTO, no-fault absence policies or use-it-lose-it sick time are the three most common ways of reducing the risk, but be aware that each of these policies have risks of their own.

At the end of the day, the more open the lines of communication are between senior management and personnel, the less prevalent the presenteeism problem becomes.

When used for the specific purpose of beginning – or assessing  - a wellness or disease management (DM) program, profiling isn’t just legal. It’s also encouraged.

Affects health risks

Different ethnic and racial groups tend to be more at risk – for genetic and/or cultural reasons – of certain health problems. Examples –

• African-American, Latino, Native American and Pacific Islanders are  at higher risk of diabetes than Caucasian employees

• Chinese women are statistically twice as likely to get cervical cancer

• Caucasians have disproportionately high rates of obesity and high blood pressure, and

• Latinos have higher rates of asthma and chronic obstructive pulmonary disease than other groups.  The HIV/AIDS population is also disproportionately Hispanic.

Bottom line –  By assessing  the ethnic breakdown of your employee population, you are able to set disease management (DM) program priorities with greater confidence and accuracy.

Healthcare quality an issue

A few studies also show there’s an unfortunate relationship between ethnicity and quality of health care. Many times, minority workers receive inferior treatment and health education at the same facilities where others receive top-notch care.

This typically happens for innocent reasons. A common scenario –  a lack  of Spanish-speaking physicians in the network for your Latino employees. But the result is typically higher health care costs for you and, often,  greater reluctance among minority employees to seek needed treatments.

By profiling staff against the doctors in the network, you ultimately help staff get the care they need and the business to better control long-term costs.

But only one firm in five has seen major improvement in employees’ health status (and lower costs) within two years of launching the incentive. Here are three keys to getting good results – and a red flag for failure.

Cancer screenings pay off big

Most health promotion programs feature health-risk assessments for things like high cholesterol and diabetes. But many overlook the need for early detection of cancer, which may affect any employee, regardless of his or her age or general health.

In many cases, you can line up certain screenings, like skin cancer detection (the most common type of cancer and, in its early stages, the most easily treated) for free or at a nominal cost.

These resources are often available through community agencies or the American Cancer Society. More involved and expensive screenings – such as mammograms – are well worth the cost.

A single case of cancer identified early usually saves thousands of dollars in medical claims and disability costs – not to mention trauma for the worker.

Smart worker health promotion incentives

Medical Insurance Portability and Accountability Act (HIPAA) has tricky non-discrimination rules for offering employees a break on premiums or copays. You needn’t worry about health insurance portability and accountability act (HIPAA) when you –

1. Structure the wellness program as a cost-break for employees who embrace wellness. on the flip side, imposing surcharges for uncooperative employees can force you to jump through health insurance portability and accountability act (HIPAA) hoops.

2. Make the incentive available to all workforce. for  instance, when you offer a discount to non-smokers, an staff member who recently quit use of tobacco must also be eligible.

3. Allow workers who fail to earn the incentive to have another shot at it next plan year.

Bottom line –  Make the financial incentive a reward, not a punishment. Do the incentives work? If they’re done right, yes.

Firms offering monetary rewards for wellness ordinarily save about $20 to $50 a month, according to some estimates.

Making health promotion programs simple

A lot of firms require workforce to work with an individual “wellness Coach” for earn premium discounts or other incentives. Generally, the employee sets up appointments and reports to the wellness coach on a regular basis, either by phone or in individuals.

The good news –  the early results are often encouraging.

The bad news –  Once staff realize there’s ongoing effort involved, many lose interest. But many firms have found a simple alternative. Rather than having participants contact the health Coach, the health coach calls them.

In many cases, this minor wellness program tweak keep folks on the right track and cuts dropout rates.

Wellness begins upstairs

No matter how much money your company spends on wellness, the odds of success depend largely on the example set by top management.

Example – When your CEO is a smoker, chances are few workers will buy into a tobacco use cessation program.

In like manner, it’s hard to sell personnel on subsidized health and fitness center memberships if your corporation culture is sedentary. for wellness to work, the top brass must practice what the firm preaches.

Just as importantly, how can you hold vendors accountable if you’re not getting what you paid for?

Here’s one proven way – Develop a provider scorecard. Scorecards alone won’t bring down your healthcare costs. But they’ll at least help make sure your business – and employees – get everything you’re paying for.

The tool can help you measure plan performance with greater precision – and identify specific areas that need improvement. Best of all, any business can adopt the technique to fit their needs. Here is how it works.

1. Select specific rating areas

Benefit pros who’ve successfully adopted the scorecard system recommend grading providers on five to 10 measurable areas, like –

• Claims processing. Are employees’ medical claims turned around in a timely fashion? Are you hearing complaints that the explanations of benefits (EOBs) are slow to arrive or hard to understand?

• Disputed and resolved claims. Do employee questions and complaints about denied or still-pending claims get answered rapidly and thoroughly? Exactly how often are you forced to go to bat for employees?

• Accessibility. Are plan reps quick to answer phone calls? Do they attend regularly scheduled meetings?

• Reports. Do you receive timely paid claim and utilization reports?

• Open enrollment. Did you receive effective support preparing for and conducting open enrollment events?

• Staff Member education. Do your workforce find the written and/or one-on-one services provided through the plan helpful in answering questions about managing specific chronic conditions (like diabetes or depression)? Do you receive support in educating your workforce to make healthful lifestyle choices, like smoking cessation?

2. Select a workable rating scale

There are two schools of thought when it comes to selecting  a rating method –  subjective or objective. Many benefit pros – namely those from smaller firms – use a simple pass/fail or 1 to 5 score to rate their satisfaction.

Others create more elaborate, statistic-based ratings. One method –  take the vendor’s guarantees (e.g., addressing disputed claims within 3-5 business days) and then measure by percentage how often these objectives are met.

These rating data may be obtained through quarterly performance reports, staff member surveys, issue and complaint files and, for larger plans, external audits.

3. Feedback causes improvement

It’s good practice to share your scorecard system with the vendor before meeting to review the results. Reason –  This lets you iron out any vendor questions about the review categories and scoring system.

Once that’s settled, you can meet to go over the numbers and prioritize the areas that need improvement. Many firms then add a new scorecard category – providers’ followup.

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

And even if the smoker is in relatively good overall health (i.e., isn’t obese, does not have chronic health conditions), he or she’s still likely to have higher health care costs than a comparable non-smoker over the last three years.

How does a tobacco use ban fit into the cost equation? If the smoker quits, health costs even out.

But when the individuals only refrains from smoking on the job – but continues puffing away at home – the company sees little to no medical cost decrease.  The study  found similar patterns for absenteeism.

Bottom line –  A worksite smoking ban in combo with a smoking cessation program gets results. A smoking ban alone normally doesn’t.