Court Ruling on High-Stakes Wellness Incentives

District court rules in favor of mandatory participation

Chalk up another “win” for employers in the latest legal battle involving wellness programs.

Over the last few years, we’ve seen a number of high-profile employers up the ante on their wellness program requirements. From requiring completion of a health risk assessment (HRA), running all staff through a biometric screening test, and/or insisting on a tobacco-free workforce (both on and off the job) in order to qualify for group health insurance, these companies are sending a clear message to employees: “We’re serious about our health initiatives.”

Can You Force Employees to Participate?

This growing trend toward high-stakes incentives to participate in group health plans has raised eyebrows at the Equal Employment Opportunity Commission (EEOC), the enforcement agency behind the Americans with Disabilities Act (ADA). The ADA prohibits covered employers from making health-related inquiries or requiring medical examinations of employees, unless participation is voluntary.

But what does “voluntary” mean? The EEOC has questioned wellness programs where the incentives to participate have been so great, or the penalties so sever, that employees claim to be coerced into participating. Employers, on the other hand, are simply doing everything they can think of to boost their participation rates and improve health outcomes.

Flambeau Wins Case to Require Participation

Recently, these competing viewpoints again came to a head in EEOC v. Flambeau. In this case, a federal district court in Wisconsin ruled that an employer did not violate the ADA by requiring completion of an HRA and biometric testing in order to participate in the company’s group health plan.

However, the court’s opinion did not hinge on whether participation was voluntary. Rather, it relied on the ADA’s safe-harbor exemption for bona fide benefit plans. Because the requirements of the wellness program were intimately tied to enrollment in the company’s group health plan, the voluntary standard did not apply.

The court’s analysis was understandably a blow to the EEOC, which argued that the “voluntariness” standard was designed specifically for wellness programs, and that such an interpretation in effect gutted the language of the act. The case has been appealed to a higher court.

New Federal Regulations on the Horizon

While, for now at least, this is a win for employers, the EEOC will soon be releasing regulations on what it considers to be ADA-compliant wellness programs.

Stay tuned for further legal developments. And be sure to involve legal counsel if you are considering implementing an employee wellness program like the ones described here.

Carrot or the Stick?

The truth about motivating people with money

There’s a reason the 900-plus employees at SAIF Corp. in Salem, Ore., were recently named the healthiest in the state. The company’s wellness program has evolved to encourage healthy behaviors with a variety of different incentives.

Just about everyone wears a fitness tracking device at the state-chartered workers’ compensation company. And employees who move more, sit less, and track their activity can earn up to $300 a year for being active.

It’s one reason SAIF Corp. earned a first place award at the Oregon Healthiest Employers event last fall. But it wasn’t always that way, says SAIF Benefits and Wellness Manager Renae Coombs.

Dangle the Carrot

New research on wellness program incentives and behavior change suggest that it may be time to rethink the paradigm surrounding incentives. The typical scenario: motivate employees with the carrot-approach and offer cash, insurance premium discounts, gifts, and other perks.

We’ve heard of employers offering bike-sharing programs, kayaking during the lunch hour, and raffle entries for participation to win big-ticket items like an all-expense paid vacation.

Ask around and most people will probably tell you these things seem like sweet incentives to adopt a healthier lifestyle. But the carrot-approach might not be as effective as motivating employees with the stick.

Motivation to Change: Understanding Human Behavior

A recent study published in the Annals of Internal Medicine found that the stick-approach was a lot more effective at motivating people to be active than the typical carrot-approach. Here’s what happened.

Researchers followed 281 overweight and obese people for 13 weeks. The participants were all tasked with walking at least 7,000 steps a day, measured by a pedometer, but they were incentivized in different ways.

  • Group 1 (the carrot) – Was paid $1.40 each day for walking 7,000 steps with the potential to earn up to $42 a month.
  • Group 2 (the stick)Was paid $42 at the beginning of each month, but would lose $1.40 per day for failing to walk 7,000 steps.
  • Group 3 – Earned a chance to win $5 or $50 in a lottery for walking 7,000 steps each day.
  • Group 4 – Received a pedometer to track progress and measure results.

Show ‘Em the Stick

So what happened? It shouldn’t be a big surprise that the lottery group (Group 3), and the group that only received a pedometer (Group 4) didn’t log as many steps as the other two groups. These two options didn’t provide enough carrot-or-stick incentive to get people to walk more. Handing someone a digital tracking device or offering entries to win a lottery prize may not be strong enough incentives to encourage active participation.

However, the group that was paid $42 at the beginning of the month (Group 2 – the stick), hit the 7,000-steps-per-day-goal 45 percent of the time and logged more steps than any other group.

Lead researcher Dr. Mitesh Patel points to a concept in psychology known as “loss aversion” to explain the behavior. The study results suggest that people are more likely to adopt healthy behaviors when the risk of losing money, or losing an incentive, is at stake.

“The science of motivation has really evolved,” Patel said in a recent presentation at the University of Pennsylvania. “The design and delivery of the incentive is actually more important than the magnitude of the incentive.”

Know Your Population

A little more than a year ago, health risk assessment data showed SAIF employees weren’t getting enough exercise. So the company refined its wellness program and incentives. It sparked some friendly office challenges, tournament-style ping pong matches, and banter about exercise, steps, and healthy eating. And now the wellness program has a 97 percent participation rate. SAIF isn’t using the stick-approach yet to motivate employees, but it’s not out of the question.

The stick-approach just might work to motivate some people. But it might not be a one-size-fits-all approach to creating wellness program incentives. In fact, it might have the opposite effect and make some people feel like you’re threatening them by taking away an incentive like cash or premium discounts.

So how do you figure out what will motivate your population to adopt healthier habits? Get to know your population. A health risk assessment, activity tracking, health challenges, and other initiatives will help you understand what works and what doesn’t to increase participation.

If you want to better understand your population, biometric screenings and health risk assessment data can help. This population health data can help you choose incentives and focus resources by knowing the health status of your population and their readiness to change.

What incentives have worked to increase wellness program participation in your organization? We’d love to hear from you. Share your success stories with us on LinkedIn or email us at

Shifting Gears

Total well-being approach to wellness gaining traction

What’s the bottom line? It’s the kind of straight-to-the-point question you would expect from a CEO, especially about spending money on wellness programs and incentives. The recurring question echoed in boardrooms and budget meetings across corporate America even prompted a team of Harvard researchers to dig up a dollar figure a few years ago.

But are health outcomes and cost-savings the only benchmarks you should look at to promote health, prevent disease, lower healthcare costs, and improve quality of life for your employees or participants? Probably not.

“There is a shift toward total well-being that has started to occur,” says wellness program consultant Shawn Meyers. “For example, last year Virgin Pulse published the results of a wellness industry survey. They found that 78 percent of employers are going beyond a focus on physical wellness to include broader well-being initiatives.”

Old-School Wellness Programs Only Part of the Solution

It wasn’t that long ago that the majority of wellness programs focused entirely on exercise, nutrition, and disease prevention. Encouraging people to lose weight or maintain a healthy weight, exercise regularly, and eat healthier makes sense. But it’s a short-sighted approach to wellness because there are so many other factors at play that can have an impact on health, happiness, and productivity.

So what do effective wellness programs look like now?

Wellness Program Initiatives Are Expanding

“Programs designed to encourage physical activity and healthy eating habits aren’t going away,” says Meyers. “Many of today’s most serious chronic diseases and leading causes of death are linked to poor nutrition and lack of exercise. But changing behaviors and promoting well-being doesn’t stop there.”

Take a snapshot of the wellness program initiatives offered by the Healthiest 100 Workplaces in America, and Virgin’s survey results about the expanding definition of wellness is evident. Exercise, nutrition, and disease prevention initiatives still top the list for most organizations trying to make a positive impact on the health and well-being of employees or participants. But wellness program initiatives are also expanding to include areas such as:

  • Financial wellness
  • Mental and emotional wellness
  • Occupational wellness
  • Social wellness
  • Environmental wellness

“Programs under one of these broader areas might include things like saving for retirement, paying off student loans, or opportunities to volunteer in the community,” says Meyers. “By initiating well-being programs that focus on areas that go beyond physical activity and nutrition, organizations have the opportunity to create great places to work with employees who are happier, healthier. and enjoy a higher overall quality of life.”

What changes have you made in your wellness program to promote total well-being?

Eat This. Not That.

Digesting the new Dietary Guidelines for Americans

What’s for dinner? Unless you’re living on the Biggest Loser ranch where every meal is made for you, it’s a choice people have to make every day. Eat this, not that. Hit the drive-thru or cook at home? You know the drill, right?

Every food choice you make has a cumulative effect on your overall health. And for the typical American, convenience often trumps healthier food choices. And that’s a problem the U.S. Department of Agriculture wants to change.

The USDA recently published the new 2015-2020 Dietary Guidelines for Americans. Boil it down to the basics, and people should be eating more fruits, vegetables, and whole foods, and a lot less sugar and processed foods.

“The new Dietary Guidelines for Americans emphasizes following a healthy dietary pattern, and shifting to healthier food and beverage choices to combat the epidemic of chronic disease in the United States,” says Wellsource medical correspondent Dr. Jane Hart. “The Dietary Guidelines, which are updated every five years, are reported to reflect current research findings on healthy eating patterns recommended for people age two and older.”

The Five Rules of the 2015-2020 Dietary Guidelines for Americans

If you don’t have time to read the 200-plus page report to get the skinny on the 2015-2020 Dietary Guidelines for Americans, we understand. It even took us a while to digest. And fortunately, the new guidelines can be summarized into five basic rules to improve your diet:

  1. Follow a healthy eating pattern (like the Mediterranean Diet).
  2. Eat more nutrient-dense, unprocessed foods.
  3. Avoid or limit alcohol and foods with added sugar, saturated fat, and salt.
  4. Make small changes to your eating habits a little at a time to improve your diet.
  5. Provide healthy food choices at home, school, work, and community settings.

What’s Different? Main Changes to Previous Dietary Guidelines

Take a quick glance at the new Dietary Guidelines for Americans, and you may be wondering if anything has changed since the guidelines were last updated. The truth? Not a lot has changed, kind of like the eating habits and activity level for most Americans. But there are a few key updates that deserve a little attention. These changes may even be reflected in the health risk assessment data for your population and could have an impact on your wellness program initiatives. The main changes from the previous Dietary Guidelines include:

Eat less sugar. This was just a general recommendation in the previous guidelines. The new guidelines put a cap on the amount of sugar people should eat. No more than 10 percent of calories per day should come from sugar. For the average adult, this caps sugar consumption at 50g per day.

This could be tough to follow for a lot of people. A typical 16-ounce bottle of soda contains about 40g of sugar. And sugar is found in a long list of other foods like sweets, sauces, salad dressings, cereals, and yogurt.

Control cholesterol. The previous guidelines recommended limiting total cholesterol to no more than 300mg per day. The 2015-2020 guidelines don’t have a cap on cholesterol, but suggest limiting cholesterol and saturated fats for heart health.
Some health professionals consider this a controversial position. People with high total cholesterol have approximately twice the risk for heart disease, according to the Centers for Disease Control and Prevention.

Eat healthy fats. People should eat no more than 10 percent of calories from saturated fat. This is the same as the previous recommendation. However, the 2015-2020 guidelines take this a step further and recommend eating healthy fats such as fish, nuts, seeds, and oils.

Take Small Steps to Improve Diet

It’s no secret that fad diets fail. Most are based on highly restrictive eating habits that just aren’t sustainable. The 2015-2020 Dietary Guidelines for Americans recognize that taking small steps to improve eating habits is the best route to a healthier population.

“It takes time to shift and change habits,” says Hart. “It takes education and perhaps help from a health coach, nutritionist, doctor, or other healthcare professional. But small steps in the right direction can make a big difference over time.”

Lifestyle Techniques to Combat Chronic Conditions

Chronic diseases affect over 117 million people in the U.S., nearly half the adults in the country. Heart disease and cancer are two chronic diseases that cause nearly 50% of all deaths each year. Meanwhile, obesity and diabetes are behind many of the painful and costly  disabilities treated annually.

There is good news amid this frightening array of statistics. Many chronic diseases can be prevented before they occur by making the right lifestyle choices. View the infographic here on   the importance of encouraging healthy lifestyle habits in the workplace.

Lifestyle Techniques to Combat Chronic Conditions

Click below to embed this infographic into your website:

Healthier Companies are More Profitable Companies

As more and more companies take advantage of corporate wellness programs like those offered by Wellsource, the most skeptical business executives and financial managers are scrutinizing the cost-benefit of bringing a health program to their organization, and are wondering how such a program will impact their bottom line. Research shows that health and wellness initiatives help businesses save money and become more profitable.

Let’s take a look at some of the ways that company health programs help improve the bottom line:

  • Reduced healthcare costs – According to the CDC, 75% of total healthcare costs in the U.S. are spent on treating and managing chronic diseases,[i] such as heart disease and type II diabetes. Most of these chronic diseases are what are known as lifestyle diseases, or diseases that can be avoided or mitigated by making healthy life decisions. When employees understand the status of their health and risk factors for disease, they may be more motivated to make regular exercise, good diet, and other healthy lifestyle choices a part of their daily lives. Employers who offer support and incentives tied to employee health assessments and wellness programs will find their employees motivated to change their lifestyle choices. According to the National Prevention Council, medical costs and costs associated with employee absenteeism are reduced by $2 to $3 for every $1 spent on workplace wellness programs.
  • More productive employees – When employees are healthy, the indirect costs associated with lost productivity due to absenteeism and poor performance are reduced. Corporate wellness programs enable businesses to reach new levels of productivity by helping employees adopt healthier behaviors – a change that has a positive impact on workers’ personal lives and on their employers’ bottom lines.
  • Increased employee loyalty – The best (and most cost-efficient) kind of employee is a loyal employee – one who cares about the company he or she works for, and who is committed to helping that company achieve its goals. Corporate wellness programs are a way for businesses to demonstrate their concern for their employees’ health and wellbeing. Wellness programs in the workplace that are designed based upon the needs, risks, and interests of employees can enhance employee retention and increase loyalty over the long-run.

Learn more about the benefits of corporate health assessments and wellness programs by contacting Wellsource today at 800-533-9355.



Corporate wellness news

How Stress at Work Hurts the Health of Your Employees

Life can be stressful, and that goes doubly so when you’re on the job. Talking with clients, meeting deadlines, and coordinating with uncooperative team members can all quickly lead to feeling overwhelmed and stressed, which often leads to a drop in productivity and workplace morale. Even more troubling, is the negative impact all that stress can have on an employee’s physical and mental health.

The Effects of Stress

Medical research has found a clear connection between stress and a multitude of negative health effects. Negative health effects from stress can be as small as headaches, to as big as panic attacks, depression, heart problems, and diabetes, just to name a few. In one study, employees who worked longer shifts were found to be more likely to suffer from hypertension, experience an accident on the job, make mistakes at work, and engage in unhealthy behavior like smoking.

Reducing Stress in the Workplace

While it’s impossible to have a completely stress-free workplace, there are steps that businesses can take to help relieve stress on their employees, making their lives healthier while also improving their performance. Some of these steps include:

  • Make employees feel appreciated – One of the leading causes of stress at work is the feeling among employees that they are unappreciated, or that they are being treated unfairly. Employees who feel that their workplace is a “just” one – one where their issues are heard, and where employees are dealt with fairly – are much less likely to suffer the negative health effects associated with stress.[iii] Being recognized for going above and beyond scope of responsibilities, for hitting challenging deadlines, and for achieving goals goes a long way toward making an employee and their teams feel like they and their work matter.
    Be responsive to employee needs – When stress starts to affect an employee’s health and/or work performance, managers should encourage and lead employees in stress relief activities and stepping away from their desks. Activities that help relieve workplace stress include a 15-minute walk, healthy snacks, laughter, and giving employees the time and space to stretch or meditate.

Wellsource offers comprehensive tools for company wellness programs. . Learn more today by calling 800-533-9355.


How to deal with stress at work




Why Fall Is a Great Time to Start a New Fitness Program

Fall Fitness TipsHave you been promising yourself you’ll start exercising more any day now? Planning on getting in better shape, but just can’t seem to find the time? We’ve got some good news for you: Fall is here, and it’s the perfect time to start a new fitness routine! Whether you’re making plans with your coworkers to improve worksite wellness or going it alone, here’s a list of reasons why there’s no better time to start exercising than right now.

  • The weather is mild – In most places in the world, the weather in fall is some of the mildest and most agreeable of the whole year. That means it’s the perfect time to go outside and start running, walking, or jogging before winter arrives and the cold adds one more reason to your list of reasons to put off exercising.
  • Get in shape for the holidays – The arrival of fall also means that the winter holidays are just around the corner. For most people, the time between Thanksgiving and New Year’s is a time for indulging in rich foods and taking a break from normal routines. In other words, it’s not a time of year when most people are thinking about exercise. By starting a new fitness routine in the fall, you’ll be able to shed some extra pounds ahead of the winter holidays.
  • You’ll already have your New Year’s resolution – For all the people who swear every New Year’s Eve that next year will be the year they get in shape, not many people actually follow through on their commitment. If you start getting in shape now, however, you’ll already have a head start on next year’s weight-loss goal.

For more great health tips for fall and the rest of the year, contact Wellsource today at (800) 533-9355.

5 Employee Health Tips for Fall

Fall Health TipsFall is here, which means it’s out with the heat, and in with the turning leaves and cool breezes. In honor of the passing of the seasons, we thought we’d pass along some staff wellness tips  to help keep you and your coworkers healthy and happy this fall.

  • Get a flu shot – Worried you might end up having to take time off work when you inevitably come down with the flu? There’s an easy solution to this problem – get a flu shot! Going to your doctor for an annual flu shot is the best possible way to avoid falling sick this flu season. You’ll be doing yourself and your coworkers a favor.
  • Drink lots of water – “But what about the common cold?” you might be asking. It’s true that the flu shot doesn’t protect against the cold, but there are ways that you can guard yourself against it. Drinking water boosts the immune system, helping the body fight off invading germs.
  • Have some pumpkin – As everyone who loves Halloween will tell you, fall is pumpkin season, and, since pumpkins are full of vitamins A and C, enjoying everyone’s favorite squash can also boost your immune system and help you get the right amount of nutrients into your body.
  • Enjoy the weather – If the summer heat kept you indoors for the last few months, then autumn is the perfect opportunity to make up for lost time outdoors. Take advantage of the moderate weather to get in some running or walking before the winter cold arrives.

Interested in learning more about worksite wellness? Contact Wellsource today at (800) 533-9355 for more information on our corporate health programs.


Why Keeping Your Work Area Clean Is So Important

Employee health tipsLook around your work station right now. How clean is it? Are there a couple of crumbs from your most recent snack on your desk? Is the floor a little dirtier than it should be? When was the last time you wiped down your work station with clean wipes? We may not think of cleaning up our work stations as a high priority task when we have so much else to do, but cleanliness in the workplace isn’t just about appearances; it’s an important part of maintaining overall staff wellness.

Part Work Desk, Part Dining Table

According to the American Dietetic Association, a huge number of Americans eat at their desks at some point during the day. As determined by their research:

  • 62% of American workers eat lunch at their desks
  • 50% eat one or more snacks at their desks
  • 27% eat breakfast at their desks1

While there’s nothing wrong with eating at your desk, in theory, the unfortunate fact is that many work stations are secret breeding grounds for many kinds of bacteria. In fact, past research has shown that your keyboard and mouse are likely to be home to unpleasant microbes, such as e coli and staph, and likely have more germs on them than a toilet seat!2

If the thought of eating on a surface dirtier than your toilet doesn’t sound very appetizing to you, then you understand the importance of keeping your work station clean. Even if you don’t eat at your desk, unclean work stations lead to more germs circulating around the office, increasing your likelihood of getting sick at work. In other words: Keeping your desk clean is good for your health.

Contact Wellsource today at (800) 533-9355 for more information on improving workplace health.