Is Employee Health Company Business?

Most companies provide employees health insurance and some offer additional wellness programs, but is employee health any of their business?

In the corporate world, employees have come to expect their employers to sponsor health insurance coverage.

According to the American Benefits Council, 177 million people rely on employer-sponsored coverage, and they want that to continue.

Furthermore, employer review site Glassdoor found in 2015 that 79 percent of employees would choose new benefits over a raise. The most popular benefit was health care, which 40 percent chose, with 37 percent choosing paid time off.

While employer-sponsored health insurance is a valuable talent attraction and retention tool, is the health of employees really the business of companies?

“Maybe it’s a point in time when employers need to say enough is enough,” said Laurence Kotlikoff, professor of economics at Boston University and a research associate at National Bureau of Economic Research. “This is not our job. It’s not our business to be managing health insurance.”

Kotlikoff says the government should handle health care coverage instead of private businesses. Employers would be happy to not deal with health insurance management and headaches; they would rather focus on the company’s products and performance. With a good system where people have incentives to get checkups and use preventative care, they would more healthy, he said. Instead, people today avoid checkups because of the high co-pays and other out-of-pocket costs. Thus, the current system does not deliver healthy workers, according to Kotlikoff.

The question of why health insurance is tied to employment is a valid question, said LuAnn Heinen, a vice president of workforce well-being, productivity and human capital at the National Business Group on Health, a Washington, D.C.-based member group of employers and health industry partners aiming to improve health. However, the arrangement works very well for those who have it, and it’s an effective talent retention tool.

“There’s a direct tie to your benefit offering and having motivated, engaged talent,” said Deb Smolensky, vice president of well-being and engagement at NFP Corp., an insurance broker and consultancy based in New York City. Health insurance coverage is a benefit critical to what employees expect in their compensation package, she said. This likely will not disappear soon.

Well-Being at Work

Beyond health insurance, companies tend to offer wellness plans that can include smoking cessation, weight management, in-office physicians and more informal programs to keep employees in good physical shape. Workplace wellness programs gained popularity in the past 15 years, mostly focusing on physical health, said NBGH’s Heinen. However, the past five years have given rise to a more holistic approach of “well-being,” which includes physical health, as well as emotional health, social connection, financial security and job satisfaction.

Heinen said this is because job performance depends on employee well-being overall. “Focusing on well-being is a winning business strategy, for sure.”

For example, if employees face the stress of debt, they’re less likely to focus on diabetes management, she said. Therefore, employers need to consider the hierarchy of needs, she said, which states that basic needs of safety, security and shelter must be present before people can meet their needs of esteem and belongingness, eventually reaching self-actualization.

Gallup research compared employees with physical well-being to those who thrived in the more holistic well-being, finding that those with more needs met had 41 percent fewer unhealthy days, were 65 percent less likely to be in a workplace accident and were 81 percent less likely to seek a new job.

In efforts to improve employee well-being, though, employers can go wrong when perceived as being too paternalistic, such as when advocating their employees to do certain things.

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Heinen told of a time she ran focus groups on well-being in the corporate world, segmenting people based on BMI, or body mass index, race and gender. Regardless of the segments, people were happy their employer offered programs, but the individuals needed to decide if they participate. “Telling someone else what they ought to do is generally not a winning strategy, but supporting their best intentions and making it easy to do what they want to do works,” Heinen said.

“I completely agree with autonomy,” said NFP Corp.’s Smolensky. Companies that take an intervention approach won’t do well in their efforts. Instead, employers should communicate the tools available and show those offerings in an employee portal or other central area, as well as through the recruiting and onboarding processes.

Another pitfall of well-being initiatives is when they lack a big-picture focus, Smolensky said. If programs do not address company culture, then there can be a disconnect between the goals of the programs and actual office culture. For example, a culture of having donuts in every meeting will derail efforts toward increased walking and healthy eating, she said.

Beyond the food available, toxic workplaces and managers make well-being efforts difficult, said Joel Bennett, president and founder of Organizational Wellness and Learning Systems Inc., a Fort Worth, Texas-based consulting and training service focused on well-being in the workplace. Highly demanding work environments are a predictor of employee stress and health issues, so the environment needs addressing before the program can be effective, he said.

The aforementioned Gallup research states that managers account for 70 percent or more of variation between teams when it comes to employee engagement. Thus, healthy managers will set the tone for others to work in a more healthy way.

“If they really were concerned about their employees’ health and well-being, they wouldn’t just throw a program at them,” Bennett said.

Lauren Dixon is an associate editor at Talent Economy. To comment, email editor@talenteconomy.io.