Who teaches the employees in self care? Gulick says companies often hire a health-management company to handle the whole wellness package. For those who don't want to take that step, the group's national web site, www.elcoa.org, has materials that a company can use to create something for employees on its own.

In workplace wellness, the insurance broker or agent's role is that of the middle person in the support team working to promote employee health. “When a broker partners with a management company like HI, they will be the person to negotiate with the client and can be involved in helping personalize the plan because of having access to the client company's utilization data.”

Some management companies do select parts of a wellness program, e.g., testing, implementing a fitness center, etc. Full-service companies, such as Health Impact, work with senior management to secure company-wide support, screen employees, perform testing and health-risk appraisals (HRAs), and develop intervention programs and individual health plans for employees. Some management companies also monitor employees throughout the year and, armed with data collected, they report to management what lifestyle behaviors can be positively impacted.

Ideally, companies of 150 or more employees can make use of the structured programs already in place. Size is important, Gulick explained, to gather utilization data and claim information, keeping within HIPPA guidelines.

One creative company, BCBS/Rhode Island, in seeking to reduce health insurance costs, told its employees: “We will pay your entire health-benefit package if you take a health-risk appraisal and agree to set three lifestyle goals for the coming year, and you agree to allow our outside vendor to do health coaching with you. If you choose not to, you will be paying a larger part of your health-care costs.” In this setting, it isn't critical that employees meet set goals, but whether or not they enroll and start learning determines their level of benefit costs.

In addition, Gulick has worked with Blue Cross Blue Shield of Florida, which has sent clients to Well Workplace University through the Wellness Council. Some of these employers have gone on to become designated National Well Workplaces.

Smaller Business Support

Again, in smaller agencies/companies, support from the top for improving employees' health is essential. Somebody within the company must step up to lead the wellness initiative, determine what health topics are of interest, and what employees would like to do.

County health departments are great resources for the highest risk factors in any given area. This gets small businesses the broad topics they need to address, without violating employees' privacy in smaller office settings. Common community risk factors, such as allergies, diabetes, etc., can provide a starting point for raising employee awareness.

Very important, Gulick points out, is building elements into the program that “get the employees moving. They need to do some sort of physical activity – walking programs are excellent.” Bringing in someone who will help with nutrition is important, along with making healthy lunches and snacks available when possible. She also urges that companies designing their own programs have some kind of newsletter. Many free versions that can be adapted with a company logo are available for downloading from the “store” on the national web site.

There is no need to create programs from scratch. A wealth of proven and successful plans are waiting to be accessed at www.wellcoa.org. There you also can download flyers, incentive ideas, brochures, self-care and lifestyle-management guides.

All this comes with the annual $365 fee to belong to the Florida Council (which automatically signs you up at the national level). Members also can attend the Council's Well Workplace University at reduced fees. On the other side of the ledger, company-based programs can cost from $25-$110 per month per employee to support.

Connecting employees with health-related community events can make people feel a part of a shared and larger cause. Information can be provided announcing breast cancer and heart walks, bike rides for multiple sclerosis, etc. Smaller companies (50 or fewer workers) also can work through the Florida Council toward national Small Business Well Workplace awards.

Wellness programs are applicable to any plan type. If only an HMO is offered, an employer can purchase services based on costs per person. Additional components, such as personal-health coaches, gym membership subsidies, and personal trainers can be included. Many programs offer popular self-care books full of symptoms, treatments, when-to-call-the-doctor advice, etc. Sometimes there are “must-attend” events such as “Lunch 'n' Learn” sessions on high-risk topics.

Worth the Effort?

One welcome byproduct of a successful wellness program that nearly all studies reflect is lower employee turnover. Gulick's opinion is that the companies allowing time off for wellness activities, or making them as easy as possible to take advantage of, are the ones that will be most successful: “They're making a statement that the health and wellness of their employees matters to them.”

Florida can claim some kudos for wellness efforts. The state Wellness Council is the second largest in the country; Jacksonville was the first Well City in 1995, and Gainesville is the only Gold Well City (and will be for awhile, according to Gulick).

Kay Gulick has been with the Wellness Council of Florida for 11 years, having previously worked for the Florida Medical Association as executive director of its State Alliance. She can be reached at (904) 306-0250.