Wellness programs offered by employers are all the rage. Intended to improve workers’ health and hold down insurance costs, they are broadly defined. As one shrewd researcher told a Register editorial writer: “If you’ve seen one wellness program, you’ve seen one wellness program.” And workers are frequently not interested in participating.
So some employers are taking advantage of a provision in the Affordable Care Act. It allows them to impose penalties on workers who do not participate. Companies must meet requirements in federal rules intended to prevent discrimination and cap penalties, but an employee who refuses to undergo a health screening, join a weight loss program or try to quit smoking may pay more for insurance coverage.
Honeywell International, a technology and manufacturing company headquartered in New Jersey, fined workers up to $4,000 for not agreeing to biometric testing, according to the New York Times. Flambeau Inc, which makes plastic products, required employees to fill out a health questionnaire and undergo screenings for, among other things, weight and blood pressure. A worker who missed the deadline for screening lost his coverage, prompting a lawsuit.
While the details about what employers can and can’t do are sorted out by courts and federal agencies, workers are wondering how companies are defining “healthy.” Many wellness programs offered by large employers use body mass index (BMI) as a measure of health, according to the Kaiser Family Foundation. If rules proposed last year by the Equal Employment Opportunity Commission are adopted, the number of “health contingent” wellness programs may grow and BMI may be even more widely used as an indicator of overall health.
That’s why employers should pay attention to a new UCLA-led study, which confirms what many of us have long suspected: Your BMI is not an indicator of how healthy you are. Body mass index is derived simply by dividing a person’s weight by height and then assigning them a magic number that falls into one of four categories: underweight, normal, overweight or obese. For example, someone who stands 5-foot-6 and weighs 155 pounds would have a BMI of 25 and be considered “overweight” by a federal government calculator which considers nothing else about you, including muscle mass. Lose a few pounds and you’re no longer considered fat.
The UCLA study found using BMI classifies more than 54 million Americans as “unhealthy,” even though they are not. More than 30 percent of the people with numbers in the “normal” range are unhealthy based on their other health data examined by researchers, including triglyceride and glucose levels.
The cost of health insurance can be an albatross around the neck of any employer, large or small. The desire to offer wellness programs is understandable. But requiring participation raises concerns, and singling out workers based on a faulty health measure is wrong.