Want insurance? Get on the scale

More employers are requiring workers to weigh in and have blood tests taken in order to get the best health insurance rates.

By MSN Money Partner Mar 6, 2013 6:32PM

This post comes from Jen Wieczner at partner site MarketWatch.


MarketWatch logoThe Affordable Care Act requires employers to offer health insurance, but some companies are making workers jump through new hoops to get it.


Image: Overweight © Image Source, Getty ImagesIn order to be eligible for some -- or all -- of the company health plan, 15% of employers now require employees to undergo biometric screening or fill out a health assessment, according to a survey by Fidelity Investments and the National Business Group on Health.


In the case of screenings, employees typically have to step on a scale, have their waistline measured, and get blood drawn to test cholesterol and glucose levels.


"There are some companies saying, 'Gee, we're spending an awful lot on health care. We would like you to do certain things,'" says Adam Stavisky, a Fidelity benefits consultant.


While most of those companies required such measurements only for access to their richer, top-tier health plans -- which commonly offer higher employer reimbursement or a wider doctor network -- 3% of employers said they would cut benefits for workers who didn't complete the screenings.


Benefits experts say it's no more unreasonable to make employees get their vital measurements taken than to fill out paperwork during health plan enrollment. Even the required blood work is usually part of a routine checkup, they say, and people can only get healthier if they know where they stack up on crucial measures.


"It's something that everybody needs to have for their own sake," says Helen Darling, president and CEO of the NBGH. "The people who might claim that they are discriminated against would be the very people you'd want to have a primary care physician, and talking to doctors and nurses."


Biometric screenings may not be the gatekeeper for most health plans, but they are increasingly becoming a pillar of modern corporate wellness programs. More than 40% of employers currently -- or are planning to -- tie biometric measurements to premiums or health plan incentives, according to the survey. About a third of companies reward employees for lowering cholesterol or blood pressure, while 11% pay employees who get skinnier.

Critics, however, worry that the practice of using so-called "outcomes-based incentives" amounts to insurance underwriting and could decrease access to health care -- something the Affordable Care Act is trying to prevent.


"There's real concern that if people perceive some of the new incentives rules as penalizing people for their health behaviors, then that could actually distance people from accessing health care," says Paul Terry, CEO of StayWell Health Management, a company that offers wellness services to employers, including biometric screenings.


Asking employees to pay up to 30% more in premiums -- the wellness incentive maximum beginning 2014, according to proposed Affordable Care Act guidelines -- for being "morbidly obese" is "just really unrealistic," Terry adds. (He has recently stopped using the term "outcomes-based" for employer wellness incentives in favor of "health-contingent programs" to avoid this connotation.)


Employers who charge different health premiums based on biometric test results must legally allow people who fail to hit the targets to pay the same amount if they provide a doctor's note or enroll in a program to achieve their goal, like Weight Watchers. That means employees can get the same rewards just for participating in a health-promoting program, whether or not they actually lose weight or get healthier.


StayWell, on the other hand, recommends that companies find a middle ground by rewarding people for taking the biometric test and then achieving personalized, realistic goals based on the measurements. "Rather than simply saying 'hit the outcome or else,'" Terry says, "why wouldn't we say to employees, 'show us some progress that you're moving in the right direction in order to achieve the reward?'"


More on MarketWatch and MSN Money:


Mar 6, 2013 11:28PM
Can the liver be tested to estimate how much a person drinks?  Or the lungs, to determine how much a person smokes? If I am to get dinged for being fat, others should be dinged for drinking and smoking - and I haven't even touched illegal drugs or misused prescription drugs.
Mar 7, 2013 10:34AM
Want to make a bet that the 300 pounders and up that live off of Food Stamps and get their Medicaid don't have to lose a single pound to keep their healthcare....ALL people on welfare and Medicaid should be drug tested and have to live by the same rules the workers do but they don't...they stay at WalMart riding their buggies around because they can't walk but love to shop...
Mar 7, 2013 9:39AM
Sounds like we have come full circle.  It's becoming survival of the fittest again!  I'm sorry, if you have something wrong with you, just go off and die some wheres.  We are here to make profit, not make life easier for anyone.  Welcome to the 21st century!
Mar 7, 2013 12:26PM
All this is in anticipation of an expectation that under Obamacare, corporations may be subject to higher premiums or surcharges for employee health insurance when some are deemed higher risk for adverse health issues due to risk factors such as obesity, smoking, drinking, and high cholesterol. Liberals always want to control us from cradle to grave based on what they perceive to be what is best for us. Bloomberg is among the most over the top control freak of them all. Next will be DNA testing and rates based on your profile. Individual liberties are attacked at all levels under socialism.
Mar 7, 2013 11:43AM
"The people who might claim that they are discriminated against would be the very people you'd want to have a primary care physician, and talking to doctors and nurses."

That's like saying " You shouldn't object to me searching you unless you have something to hide." 

The very ones who want to trample your RIGHTS and PRIVACY are the ones who say things like THAT.
Mar 7, 2013 11:12AM

If the job is to sell health - I can see wanting the employee to be a good example to hold up to the clients.  However, if the job is to sit still 8 hours a day and work in a call center, where they never meet a client face to face and have little to no opportunity for a break in the day - I find it intrusive to require them to go to the doctor constantly to find out if they still at the healthy weight, height, blood pressure, etc.  I don't feel it is necessary to get a doctors note saying that they don't smoke, drink excessively, take drugs, have no signs of diabetes...etc.


Besides...if the doc did come back and say the employee is a diabetic, or has some other expensive health condition, it could be used by the company to push that employee to the top of the 'layoff' list the next time they need to get rid of people. Health isn't a protected status so technically, they could use this status for exactly this type of selection.  (Sorry, John, your doctor says you could drop dead so, we don't want to take that risk...nice knowing you)

Mar 7, 2013 5:43PM

@shrinking woman...you're EXACTLY the type of person that had no problem with others getting "dinged" for having THEIR rights infringed upon because they smoked, etc.., but suddenly you're a major complainer because now it's YOUR rights that are being infringed upon...


That is the pathetic nature of people at their worst.  We should be supporting each other's rights regardless whether the DING currently affects us...not just whine when gov't/industry gets to something that happens to relate to your own situation.  I'm not fat, so should I just IGNORE the fact that you are getting screwed...maybe laugh a little because fat people are finally getting what they deserve and I've been paying for their ill health my whole life?  Isn't the general intent of group insurance NOT TO SINGLE OUT individual participants?  But you know...it's a new revenue stream for the insurance companies and a way for corporations to pay less out of their own pocket.  They are getting away with it now and won't be stopping anytime soon due to guilt or remorse.


This is how it happens...small steps that condition everyone to accept when PERSONAL LIBERTIES are taken away.  Or maybe you just think this will end at smoking, or drinking, or weight, or doctor's visits per year, or soft drinks, or coffee...  They are on a roll now and seeing no real citizen backlash, they will push it to the LIMIT.  It's up to US to voice our opinions and outrage together as a country...before it's too late.


Apr 17, 2013 11:03AM
Want insurance? Get on the scale- MSN Money : Try this site where you can comapre quotes from different companies:  usainsurancequotes.net
Mar 7, 2013 11:01AM

Since the Insurance companies OWN our politicians they can do are charge pretty much what they want. I am not over weight do not drink or smoke so I should say good to this idea. BUT I always thought we where supposed to have a group style insurance system! By allowing the new federal socialized medicine policy to take affect the government has given the insurance companies huge legal holes in which to NOT cover certain groups at the same rates and or to diminish coverage. Sure, every one will have access but with all the stipulations the out of pocket costs are going to be ASTRONOMICAL! Well for those how work for a living any way!

Apr 8, 2013 2:46PM
Want insurance? Get on the scale- MSN Money : Try this site where you can comapre quotes from different companies:  usainsurancequotes.net
Mar 7, 2013 10:26AM
greed has become so rapid is this country, it is now imposable to live like a human being......the insurance companies and the utilaty companies are running this country into the ground, there rates go up every yr and if we get raises it eaten up by some utilaty or insh. company......there going in the opposite direct that the need to be,were suppose to be making it easier to to be able to run a company here but there making it more costly, thats why eveyrbody sends work over seas and the japs continue to kick are asses............
Mar 7, 2013 2:18PM
For profit health insurance companies should be eliminated. They are just a middleman sucking money into rising healthcare cost. Smokers and obese people cost more to treat over their lifetimes.  Everyone else is paying more because of them. There should be incentives for them to be healthier.
Mar 7, 2013 12:21PM
Mar 7, 2013 1:37PM
It's a matter of expecting adults to act like adults.  Associating with a primary care physician to manage your healthcare, having basic medical screenings on a regular basis, and taking steps to manage chronic health conditions are things adults should just do because they are responsible, productive members of society.  Since they don't, the financial backers of their healthcare plan need to use a carrot and a stick.
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