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Alla tua Salute!


Patience and persistence pay off for our 2011 employer wellness award winners

 Story by Sean Fitzgerald, New North B2B publisher


Even through all the discussions of so-called ObamaCare during 2010, the overall health of Americans continues to suffer. And while the federal Health Care Reform Bill signed into law more than a year ago is aimed more specifically at health insurance reform, it does little to encourage habits of healthy living.

The new law offers an approach toward preserving many of the longstanding paradigms of Americans’ poor diet and sedentary lifestyles while ensuring more citizens receive insurance coverage. Opponents of the federal legislation argue the United States missed a real opportunity for health care reform to mean something substantial – mainly, that health care can change institutionally simply by creating programs encouraging individuals to take greater responsibility for their own health and wellness.

That’s the belief and the message heralded by the employers recognized in New North B2B’s Alla tua Salute! Awards, presented each year since 2006 to those companies in the region who’ve actively sought to minimize their group health insurance rate increases by creating a genuine culture of wellness within the workplace. These companies have expanded benefits offerings to educate employees about their health and provided avenues to improve their health, often offering tangible incentives to do so. These employers have fully bought into the concept of wellness, from the ownership and top-level management all the way down to the entry-level members of the staff.

Workplace wellness programs are typically offered as a risk-management practice for an employer’s group health insurance plan. From B2B’s perspective, we’ve witnessed a heightened aptitude among the nominations we’ve received in the six years we’ve conducted our annual employer-based wellness awards – Alla tua Salute!

Derived from the Italian phrase meaning “to your health,” our four award winners in 2011 – selected by a panel of some of the region’s leading experts in health plan and wellness program design – represent excellence in employer-based wellness programming at the top of its game in northeast Wisconsin.

In our 6th annual corporate wellness awards, our panelists acknowledged Miles Kimball Company of Oshkosh and J. J. Keller Inc. of Neenah as Emeritus Wellness Program Award honorees, WOW Logistics of Appleton with our Leadership in Wellness Award – Large Employer, and Integrated Community Solutions Inc. of Ashwaubenon with the Leadership in Wellness Award – Small Employer.

Leading the way

With more than a decade each of robust wellness initiatives in the workplace, both Miles Kimball Company and J. J. Keller Inc. have become mentors for other employers in the area starting out on the path of their own wellness journeys. For their efforts, our panel recognized both companies with our Emeritus Wellness Program Award.

Catalog and Internet retailer Miles Kimball received B2B’s inaugural Alla tua Salute! Award in 2006, and has been recognized in five of the past six years. The company’s Wellness Connection initiative began conducting annual health risk assessments with its employees and their spouses dating back to 2000, and has 11 years of concrete data to illustrate its employees are much healthier today than ever before. At the same time, its group health insurance premiums have increased at a far lesser rate than its industry counterparts.

Results from its recent January 2011 health risk assessments indicated 77 percent of its group health plan participants ranked in the low health risk population, with 20 to 23 percent in the medium-risk group, according to Susan Boettcher, human resources manager at Miles Kimball.

Miles Kimball has less than a 3 percent rate of employees within the high-risk group, but federal health regulations require third-party administrators of HRA data to report a minimum of 3 percent in the high-risk category – even though actual results may be less – so employers can’t easily identify and potentially target those few employees with poor health.

Compare that to results 11 years ago when the company reported a low-risk population of just 23 percent, a medium-risk group at 58 percent and a high-risk segment at 18 percent of its workforce. It’s a rate of improvement almost any company would envy.

For its efforts, Miles Kimball was recognized this past year with the gold level Well Workplace award from the Wellness Council of America.

And yet, the company continues to evolve and improve its Wellness Connection program.

In 2010, the 600-plus employee company initiated its Live Lean Challenge, a weight management program aimed at encouraging employees to end the year at a lesser weight than the beginning of the year. Boettcher reported 82 percent of employees at the company’s warehouse and fulfillment facility dropped pounds by the end of last year, while about two-thirds of staff at its corporate offices met the challenge. The weight management challenge stemmed from a recognition that composite body mass index statistics had been increasing slightly from past HRA screenings.

Additionally, the company’s fleet of vending machines – which have long subsidized the low-cost on healthier food choices – have continued to increase sales of items with less than eight grams of fat. Even more healthy options were offered in 2010.

“We continue to modify and make the healthier items even healthier,” Boettcher said.

The company’s medical plan covers the cost of routine physicals, well-care child visits, mammograms, vision exams and colorectal screenings. Flu immunizations are provided to employees onsite at no cost each year.

And if being healthier isn’t enough, money always serves as a good incentive. Miles Kimball employees and their spouses scoring “excellent” or “good” on the HRA can receive a discount of up to $60 per pay check on their health insurance premiums.

Paying employees back

Toward the end of 2010, executives at J. J. Keller realized the company’s self-funded health plan would likely finish the year being overfunded. As a result, the company didn’t deduct health insurance premiums from any employee’s paychecks during the month of November.

“We actually debated not having any for December as well. It was close,” said Tim Pingel, the safety, security and wellness supervisor for J. J. Keller.

The news was a holiday shopping stimulus package for employees, Pingel joked, but offered a direct and tangible reward for the effort employees made over the year in staying healthy and keeping health insurance claims at a minimum.

Wellness is deeply ingrained into the culture of J. J. Keller. The Neenah-based provider of safety and regulatory compliance products and services has 15 years of health risk assessment data. It opened a 2,000-sq. ft. state-of-the-art fitness center for employees back in 1998, and boasts the longest-running Weight Watchers at Work program in the state. The company launched the in-house program back in 1995 and pays 25 percent of the cost for employees.

In early 2009, J. J. Keller established an onsite health clinic staffed by a fulltime nurse practitioner and a part time medical assistant. With a goal of increasing productivity by allowing employees to receive health care treatment sooner, as well as reduce time away from the office traveling and waiting for appointments, the clinic has been a hit with staff. Pingel said nearly 64 percent of employees went in to use the clinic during the first 12 months it was open, demonstrating $150,000 in direct savings compared to what otherwise would have been health plan expenses for doctor’s office visits.

“Utilization was booming right from Day One when we opened the clinic,” Pingel said.

  1. J. Keller operates its own onsite food service cafeteria – as opposed to having it run by a third-party caterer – allowing company officials to determine and provide healthier nutrition options like a salad and sandwich bar and a wide variety of fruits and vegetables. Cookies don’t need to be gigantic in order to charge a few bucks to increase margins. As an in-house entity, food service doesn’t need to make a profit, so Pingel and his staff make the call on menu selections and portion sizes.

Preventative care is also a critical component of J. J. Keller’s wellness program. During the past three years, the company experienced a dramatic 21 percent decrease in chronic disease claims.

Both J. J. Keller and Miles Kimball are serving as mentors for the ongoing, respective Well City – Fox Cities and Well City – Oshkosh initiatives. Each are hosting learning circles on an every-other-month basis to help less-experienced leaders of wellness initiatives at other employers in the community learn best practices to develop a culture of wellness and get the most bang for their company’s wellness budget.

Focus on prevention

In a period of just four years, Appleton-based WOW Logistics has gone from zero to 60 with a robust, well-rounded wellness offering that includes several initiatives often not employed in more experienced wellness programs.

After determining two years ago that HRA indicators were pointing to employees having high blood pressure and high levels of bad cholesterol, the company began offering coronary artery calcium examinations to qualifying employees as a preventative approach to detecting various heart risks, said Amy DeBruin, a human resources generalist for the warehousing and logistics company. During the course of the past two years, about 20 employees have taken advantage of the offer, in which they receive a certificate to go into a cardiac specialist and receive a CT scan of their heart. The company picks up the bill.

The company hosts a variety of activity challenges throughout the course of the year, often partnering employees with one another, aimed at losing weight and encouraging staff to become more physically and mentally fit.

“We do a lot of ‘partner challenges’ because we’ve found that you have better success when you’re able to hold each other accountable,” DeBruin said, adding that each challenge is usually accompanied by prizes or other incentives.

WOW Logistics sports a more attentive focus on mental health, resulting from past HRA indicators that stress levels have been high among employees. Such a focus has led to periodic breaks during the work week to engage mental activities like crosswords and other brain teaser puzzles. It also offers a “Pay it forward” program, in which the company gives each employee two $25 gift cards with the stipulation that one of the cards is given to someone in need, based on the notion that giving generates a positive emotional reaction that fosters mental health.

The company has been offering HRAs to employees for the past four years, and has witnessed its aggregate score increase by more than 6 percent since 2009. To encourage staff, employees can earn a discount on their health insurance premium by scoring at least 76 or higher on their HRA, or by improving their score at least five points from one year to the next.

In addition to the CT scan, all preventative screenings are covered at 100 percent of the cost, leaving employees with no excuse to miss regular mammograms or colorectal checkups .

The company also provides fresh fruit at each location every Monday, typically enough to last employees throughout the week. It’s fostered more of a healthy grazing atmosphere, and has all but eliminated unhealthier birthday festivities in which employees bring in cake and doughnuts.

Another component of WOW’s wellness repertoire – the use of Patient Care advocacy services – was praised by our panelists as a progressive measure to align employees with their health care experience. Patient Care, the brand name for the health advocacy agency, has professionals available by telephone or online to help employees resolve their insurance issues, as well as provide specific cost and quality information to help make decisions about tests, surgeries and other health care services.

WOW just began offering the service to employees back in January, DeBruin said, and employees have been using it to research medical procedures and receive an in-depth explanation of their benefits.

Persistence pays off

Not-for-profits typically lag behind private industry on various employer-based trends because the costs to support such initiatives generally aren’t essential to the organization’s mission. That’s particularly the case with wellness programming.

But for Ashwaubenon-based Integrated Community Solutions Inc. – or ICS, for short – employee wellness initiatives were borne out of necessity more than a decade ago.

In the late 1990s, the agency – which delivers self-sufficiency and home ownership programs for low-income families throughout Brown County – found itself with an unhealthy workforce that was racking up a disproportionate amount of catastrophic claims. It was maximum-rated on its group health insurance plan, and paying exorbitant premiums, according to Lori DeGrave, human resources manager at ICS.

About eight years ago and with no guidance from health care professionals, management at ICS requested healthier choices in vending machines, introduced fun and educational weight loss challenges among staff, and nixed the longstanding tradition of filling the break room as much as three times a week with less-than-healthy treats employees would randomly bring in for co-workers to nosh on throughout the day.

“It’s pretty progressive for a small group,” said panelist Barbara Van Gorp, vice president of employee benefits for Menasha-based McClone Insurance Group. “They have a wellness champion in there doing some great work.”

Four years ago, the agency enrolled in the Green Bay-based Health Lifestyles Cooperative, joining a cohort of other employers from the region who were formalizing their wellness journey down a defined path of improvement. The 31-employee agency began taking health risk assessments annually, routinely measuring their activity by time and with pedometers, and educated staff about improving their diet.

The result to its bottom line – the 2011 group health insurance renewal increase was zero percent.

“To get that phone call (that insurance rates wouldn’t go up for the coming year), that was the best news I had in my professional life,” DeGrave said.

It was the first time the agency didn’t experience an increase in its rates from one year to the next, said Jon Syndergaard, who’s been president and CEO of the organization since 1995. With the uncertainty of federal and state budgets in the upcoming cycle and the fact that ICS relies on various government grants to fuel its program costs, Syndergaard said the health plan savings are especially good news because it means the organization can stretch its benefit dollars even further in 2011.

“We’re going to have to do more with less. A lot less, in some cases,” Syndergaard said in regard to potential funding uncertainty.

Despite not having many of the wellness perks of larger employers, the organization has continued its enthusiasm toward healthy living. Last year, their wellness program cut back on the incentives given to employees for reaching particular fitness milestones or marked improvement on their HRAs.

Health risk assessments are mandatory for all employees and their spouses enrolled on the groups health insurance plan. Through the Healthy Lifestyles Co-op, ICS employees have access to health coaches and other information to help improve their health and ultimately their HRA scores.

For its part, Integrated Community Solutions has been patient as its aggregated group HRA scores have remained about the same and in some years improved slightly. But they haven’t gone down. That level of wellness program stamina captured the attention of our panelists.

“I thought this company showed great patience even after their results were flat, said Michael Bina, principal partner with Green Bay-based IntellectualMarketing, which conducts substantial amounts of health care and wellness publicity.

But from the agency’s perspective, careful and steady improvement is part of the long-term strategy.

“We understand it takes time to form new habits and make lifestyle changes,” DeGrave said. “Gradual change versus drastic change will lead to new habits that stick for a lifetime.”