A nonprofit organization asked us to look at its benefits as it continually experienced high and increasing premiums. The benefits were not great. In fact, the organization’s 2010 premiums were $526.12 for individuals and $1,683.62 for families. It was an 80/20 coinsurance with a $3,000 deductible and $6,000 out-of-pocket maximum–and this was before Obamacare!
We surveyed the 52 employees and discussed what was important to them and how they used their benefits. We quickly realized the problem: WEIGHT. In fact, 20 percent of the group was morbidly obese (meaning a body mass index of 35 or higher) and 55 percent were obese (having a BMI greater than 30). The loss ratio had to be high.
Because the client had less than 100 employees and was using a fully-insured health insurance product, the actual loss numbers were not available. However, we were able to determine the issues through interviews and medical statements. We also knew that:
- A 1 percent reduction in weight, blood pressure, glucose and cholesterol risk factors would save the organization $83 to $103 annually in terms of medical costs per person. (325)
- People who increased physical activity (to at least 2 ½ hours a week) and achieved a 5 to 7 percent weight loss reduced their risk of developing type 2 diabetes by 58 percent, regardless of race, ethnicity or gender. (323)
Obviously, human behavior cannot modified unless an individual is ready and willing to change. And certainly a lifetime of poor eating habits will not turn around overnight. This takes time.
What Made the Biggest Impact?
What can be done is to have a little fun and simultaneously, keep the advantages of being healthy and losing weight in the forefront of people’s minds. This is exactly what we did for this client. We provided some fun activities–a Biggest Loser-style contest, access to Weight Watchers ® tools, and regular educational communication–along with instituting some other reminders to encourage the employees to stick with their health goals. These efforts were a huge success! What made the biggest impact? We put scales in the bathrooms at all 10 locations and a copy of the height and weight chart on the wall above each scale. It worked!
At the time of its 2017 renewal – seven years later and including the launch of Obamacare – this client now has a premium of $578.55 for individuals and $1,735.65 for families. It is still a 80/20 coinsurance plan, but with a $2,000 deductible and $6,000 out-of-pocket maximum.
Truly, though, it’s the human factor that has been our greatest reward. One employee at this nonprofit lost over 100 pounds. She was very emotional when she told us about her journey at an employee meeting several years ago. We couldn’t help but be moved too. This woman explained that until we educated everyone on the high cost of weight (both to employees and to the business), she had not even paid attention. Because this is a nonprofit organization, employee income is relatively low and the cost of doctor copays and medication is often a financial strain for employees. Being able to support these individuals through their journey was very rewarding for our entire team.