Overview: Establishing A Wellness Program

Designing and establishing a wellness program involves several steps and decisions. Companies first select the programs they wish to include in their health activities and determine what resources they are willing to devote to the program.

The amount of a company's investment-in terms of management, personnel, physical plant, employee time and financial resources-is a major consideration. A wellness program committee comprised of management and employees is usually necessary to oversee the establishment of a program.

Wellness programs and COBRA

Wellness programs encourage improved health and a healthier lifestyle through education, exercise, nutrition, and health promotion. The programs can take a variety of forms, ranging from educational classes to on-site exercise facilities. As a result, they raise some interesting questions with regard to COBRA continuation requirements.

To be a group health plan subject to COBRA, a wellness program must provide medical care, including amounts paid for the prevention of disease, to employees. The crucial question involving wellness programs and COBRA is whether a wellness program is used by employees for the relief of health and medical problems or whether it simply furthers employees' general good health. An employer-maintained spa, swimming pool, or exercise/fitness program that is used by employees for reasons other than relief of health or medical problems does not qualify as a health plan subject to COBRA. An employer-maintained health clinic intended to relieve or alleviate a physical condition or health problem would be likely to qualify as a health plan subject to COBRA.

Accordingly, continued participation by former employees and their families in employer-maintained wellness programs may be required by COBRA. Each program should be evaluated individually. Qualified beneficiaries must be given the opportunity to continue coverage in an on-site clinic that qualifies as a health care plan, even if the clinic cannot be used by the qualified beneficiaries because they have moved away.

ESTABLISHING A WELLNESS PROGRAM

Discussed below are some of the many factors to be considered in establishing a wellness program.

Data gathering

The initial data gathering tasks are best assigned to a particular person or a subcommittee. Working within prescribed deadlines, this person or committee should check records regarding insurance claims, health benefits use, absenteeism, and other relevant factors.

Surveying employees and management

A survey of employees and management is the best way to learn of employee interest, desire to participate and perceived needs. Surveys should seek information on employee preferences and interest.

Management involvement

Company management and key decision-makers in the company must be interested and involved in the wellness program to make it successful. Wellness activities need to be perceived by employees to be as important as other areas that come under management's review.

Existing company resources

Many informal activities, such as sports teams or walking groups, are already in action at many companies that are thinking of formalizing a wellness program. These are good areas in which to start because employee interest has already been proven. In addition, most companies have meeting rooms or cafeterias that can be used for health promotion education classes, so that they have a head start on providing program facilities.

Employee leadership as a resource

Company employees can be viewed as health promotion resources as well. For example, employee leaders can instill a sense of employee ownership of the program through employee investment of time and talent. They can also reinforce positive health behavior changes and can help to motivate other employees.

Community facilities

Other wellness program resources are found in the local community. Companies may find it more feasible to rent community facilities or to subsidize club or YMCA memberships for employees. Government, public and private agency programs concerning nutrition, cancer, smoking cessation, heart disease, lung disease, weight control and so forth are good sources for literature, speakers and education classes.

Physical fitness facilities

Companies planning to add physical fitness facilities to their workplaces need to consider safety and function in designing these facilities. Equipment choice for programs and design of health facilities and programs are services that can be contracted by the wellness program committee since committee members may not have the expertise to handle all safety and design details. In general, the committee will need to consider facility traffic flow, locker room design and equipment, size of fitness area, staff and equipment.

Incentive programs

Developing a system of employee incentives encourages employees to adopt good health habits. Such a system can include free courses, free course materials, cash awards, prizes, gifts or gift certificates to award such achievements as weight loss, smoking cessation, regular exercise or maintenance of low blood pressure or low cholesterol levels.

Incentives must be fairly administered. It is wise to include rewards for employees who are already healthy as well as for those who wish to change their health habits. Incentives should not be coercive or manipulative. They may take the form of additional vacation days, additional pay, or paid-time off for employee participation in wellness programs or activities, rather than a negative form such as a decrease in benefits for non-participation or failure to meet goals.

Employees' families should be encouraged to participate when feasible, so that healthy habits receive encouragement away from the worksite. This may also encourage employee participation.

Company philosophy and climate

Health promotion programs will enjoy greater success if they are in tune with the facilities available at the company, primary management objectives, and employee needs. For instance, a good nutrition education program may have little impact on employees if the only company lunch facility available is a lunchroom with junk food in its vending machines. A company with a cafeteria can more easily foster a good nutrition program.

A clear pronouncement of corporate philosophy in health and wellness is most valuable. If high productivity is most important, then a wellness program might seek to immediately address absenteeism by starting with safety education, stress management, or chronic disease management. If company philosophy emphasizes loyalty and employment longevity, then programs that offer long-term lifestyle education for employees and their families might work best.

Staffing

A competent staff is one of the most important contributions to the success of a wellness program, particularly a fitness facility. Staff should be professional, friendly, enthusiastic and creative. They are responsible for planning and implementing programs, recruiting participants, keeping accounts and records and operating the programs and facilities on a day-to-day basis. They may also oversee the risk screening for participants and arrange for more extensive medical examinations for higher-risk employees.

Liability

Another element of cost is involved in the issue of the employer's liability for accidents or injury to employees in the course of wellness activities. Liability should be covered through specific insurance or workers' compensation plans.

Liability can be reduced by:

____ 1. hiring competent staff;

____ 2. educating participants concerning risks;

____ 3. screening employees prior to admitting them to exercise programs and prescribing their exercises based on the medical histories and condition; and

____ 4. safely maintaining facilities and equipment.