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Employers need guidance on wellness programs


Personally, I think annual physicals are a good thing. I don't bother having them, but I think they are a good thing.

Fortunately, I've always enjoyed good health, though I'm well aware that that is a situation that can change quickly and unexpectedly, and it would make a lot of sense to have medical professionals perform basic tests every so often to make sure everything is still OK. Who knows, I may be a lot less healthy than I think.

It would make even more sense to go a step further and have biometric testing done, to assess things such as aerobic fitness, especially as age makes the joints stiffer and physical exercise becomes more of a chore. Test results showing a decline in physical fitness could provide a jolt for more action.

Procrastination, however, is a powerful force, which is why more and more companies are providing financial incentives or penalties to encourage employees to undergo biometric testing and engage in other wellness activities. By prodding workers to undergo the tests, employers hope that they'll wind up with a healthier, more productive workforce, as well as lower corporate health care costs.

But should that encouragement be a gentle nudge in the direction of wellness awareness or a firm shove into the doctor's office? That's a question playing out in federal courts as the U.S. Equal Employment Opportunity Commission seeks to bar employers, including most recently Honeywell International Inc., from penalizing workers that don't participate in its wellness program. In the Honeywell case, the company plans to impose a $500 surcharge, hold back up to $1,500 in contributions to health savings accounts and impose a $1,000 tobacco surcharge on employees who refuse screenings.

That adds up to more than $100 per bimonthly paycheck for workers who don't participate, which is pretty strong encouragement to get with the program. Whether it's too much is a matter of opinion — and that's the problem. Employers have no formal guidance from the EEOC on what it considers to be reasonable wellness participation incentives under the Americans with Disabilities Act and other federal nondiscrimination laws.

The informal guidance from the EEOC is that participation should be voluntary, which seems a little too soft. While the principle of health insurance is that costs are shared across a broad population of healthy and not-so-healthy people, the huge effect that certain lifestyle choices can have on the costs of health plans would suggest that there should be some financial consequences to those choices. But those penalties should not be so severe that they curtail basic principles relating to freedom of choice.

It's a tough call and one that employers need help making. Constructive guidance on wellness incentives from the EEOC would be a huge help.

But all this talk of financial penalties makes me queasy. I'd better go see the doctor.