Benefits Buzz

Is IBM the Innovator in the 401(k) Business?

Let's face it - it's a bad time to talk 401k to employees.  With a market that topped at 14,000 in the dow and dropped all the way down in the 7,000 range, most employees who were fully invested in stocks took haircuts in the range of 30-40% of total assets.  That means when it comes time to pump up the old 401k, the audience isn't exactly receptive in most companies to benefit and HR pros - in fact, it can be hostile.

One of the areas I've struggled with in the past few years is running HR shops for companies that fall below the Fortune 500 space.  Buying power is a big deal in the 401k business, and if you are a venture capital-held firm with a couple of hundred employees, you've got limited power to minimize the things you might be able to control for employees - plan design, mutual fund fees, etc.  As an example, I was told last year that in order to enter the 401k space with Vanguard (a mutual fund company that believes in "indexing" and thus is among the best in the company at keeping fees low), you need at least 25 million in assets in your 401k.  Less than that?  You need not apply.

I give you that intro as a backdrop to a recent BusinessWeek article on 401ks at IBM, which recently dropped its pension line to create a supercharged 401k for its employees:

"Back in January 2008, IBM (IBM) replaced the last of its pensions with a new-and-improved 401(k). The plan came with plenty of enticements, befitting a company that earned more than $10 billion on $99 billion in revenue the previous year. There were generous matching contributions, super-low fees, custom-designed portfolios, free access to financial coaches, and more. Even so, critics hammered IBM's move as one more sign of retreat from the secure retirement benefits of the past.

Today, hardly anyone is complaining about IBM's 401(k), least of all the participants. The plan is sumptuous compared with offerings from most companies. Across the U.S., 401(k)s have been bludgeoned by the financial crisis. Balances have shrunk to a fraction of their former value, and many companies have slashed matching contributions. Yet IBM is sticking with its plan—one of the largest in the U.S., with $27 billion in assets. "In my job, I often hear horror stories," says J. Randall MacDonald, senior vice-president for human resources, who led the shift from pension to 401(k). "I don't hear horror stories about the 401(k)."

IBM's creation isn't revolutionary in design or implementation. But it combines most of the best features of 401(k) plans at other companies, then leverages IBM's size to wrangle cut-rate fees from investment firms that want to manage its retirement assets. With 94% participation among more than 100,000 active U.S. employees, the plan boasts an average employee balance of $127,000, more than double the national average. Fees, which have a bigger impact on long-term results than most people realize, typically are just 10 basis points, or 0.10%. "IBM takes a very paternalistic and serious attitude in terms of the quality and the cost to participants," says Ted Benna, chief operating officer of pension consultant Malvern Benefits and the man considered to be the father of the 401(k).

Having weathered the recession, at least so far, IBM is now toying with some truly radical ideas. MacDonald hopes someday to meld retirement and health benefits into compensation, leading to a performance-based 401(k) through which top performers could be rewarded with better benefits. Given IBM's size and clout, any trail it blazes in this area could alter the retirement landscape dramatically.

 

Is there any doubt that size matters?  One example - fees in the IBM plan are .10% on average?  That's clearly related to the purchasing power of the small nation that is IBM.  A small company is lucky to have one or two funds out of 15 that have fees of .30%, with the rest of them moving toward 1.00% in a pretty quick fashion...

So, the IBM plan is great, but the biggest benefits are a reflection of the size of the company...

Paying for Health Care By Eliminating Pre-Tax Treatment of Healthcare Premiums...

In an interview on June 28, David Axlerod, political advisor to President Obama, commented on ABC’s “This Week” that the President would not “…rule out the possibility that the White House might agree to a tax hike on health insurance plans that would hit middle-income Americans.”  This follows a campaign during which then candidate Obama promised not to raise taxes for American’s making more than $250,000 (a threshold that was subsequently lowered to $200,000).  Furthermore, he ridiculed John McCain for making just such a proposal:  "For the first time in American history, he wants to tax your health benefits.  Apparently, Senator McCain doesn't think it's enough that your health premiums have doubled. He thinks you should have to pay taxes on them, too."  I’m reminded of a former president whose hopes for a second term came to an end when he reneged on a promise made during his first run for office: “Read my lips -- no new taxes.”

It continues to be a busy year on the health care front.  The President has made no secret of his intention to make significant changes to the way health care is delivered and paid for in this country.  At the forefront of the argument is whether or not a public insurance option should be established to “compete” with private insurers.  As expected, private insurers are up in arms about this.  President Obama has said that private insurers have nothing to worry about, claiming, “If private insurers say that the marketplace provides the best quality health care, if they tell us that they're offering a good deal, then why is it that the government -- which they say can't run anything -- suddenly is going to drive them out of business? That's not logical.”  What hasn’t been said is that, while private insurers have to turn a profit to stay in business, the federal government does not -- at least not in the near term.

The latest estimates from the Congressional Budget Office and Max Baucus, Chairman of the Senate Finance Committee, put the expense for a public insurance option somewhere between $1 trillion and $1.6 trillion over 10 years.  So the trillion dollar question left unanswered is where to find the funding to pay for this public option.  If the federal government is looking for a stash of cash that hasn’t been tapped, employees’ pre-tax contributions for health care coverage is a logical place to look.  Estimates are that these tax savings to Americans cost the federal government nearly $200 billion per year in tax revenue.

The dot that most Americans haven’t yet connected is that this loss of tax savings will result in an increase in their personal tax burden.  A change of this nature will hit 170 million Americans like a ton of bricks when they see their tax liability increase the year after the tax savings is eliminated.  I’m no accountant, so I’ll use simple math.  An employee paying $250/month in health care coverage through his/her employer will see an increase in taxable earnings of $3,000/year.  Assuming a 28% tax bracket, that’s an additional $840/year s/he will owe Uncle Sam.  This doesn’t include imputed income that could be added for employees covered by employer sponsored health plans that provide coverage over and above some actuarial threshold defined by the government, nor the potential loss of tax exempt status for flexible spending accounts.

The next few months will be interesting.  Opposition has been building and will continue to build against the public option being proposed.  There are more than a few lobbyists with their hands full in Washington these days.  But the President wants to sign something by the end of this year, even if that “something” lacks detail.  Whether he’ll be able to garner enough support from both sides of the aisle is yet to be seen.  Failure to do so could spell political suicide (if taxing employee benefits alone doesn’t do it).  Keep your eyes peeled -- things will be moving fast this summer.

Editor's Note - Greg Dagley is a Benefits Consultant for a large multinational employer in Houston, TX. While his company has employees all over the globe, his job keeps him focused on US benefits and spending a lot of his time managing external vendors.  Is there any doubt his Excel skills are more advanced than yours?

Pfizer Program Helps Unemployed Maintain Access to Rx

There's no shortage of discussion about the risk of rising health care costs and tightening budgets discouraging people from taking important prescription drugs. It is a problem for both those with insurance (but high copays for brand name drugs) and those without insurance who can't fork out the cash for pricey prescriptions every month. And, it is a short-term personal budget fix that has awful long-term health implications (which, of course, means long-term health expenses too -- for the individual, their employer, really all of us).

So, this Pfizer program caught my eye. MAINTAIN is a program that lets unemployed individuals (and their families) who are in financial need and lack prescription coverage continue to get their Pfizer medicines free-of-charge for up to one year (or until they become insured, whichever comes first).

This is right from the official Pfizer info: 

Through MAINTAIN, more than 70 Pfizer medicines are offered that treat a range of chronic health conditions. It is easy to learn if you may be eligible, by visiting www.PfizerHelpfulAnswers.com or calling 866-706-2400. The program is user-friendly, with a one-page application that Pfizer will typically process within two to three weeks. The program is expected to accept applications through December 31, 2009.

There are four eligibility requirements for MAINTAIN:

• Applicants must be able to demonstrate loss of employment since January 1, 2009;
• Lack prescription coverage;
• Attest to financial need; and,
• Be on their Pfizer medicine for at least three months prior to unemployment and enrolling in the program.

Uninsured patients who need a Pfizer medicine but who do not qualify for MAINTAIN may qualify for Pfizer’s other Patient Assistance Programs.

No matter what you think of big pharma, you can't complain about this program. And, what I like even more is this nifty little tool on their website to help you find Assistance Programs that are right for you (available in Spanish too). Medical plans can be super confusing, and prescription drug programs are notorious for being anything but user friendly (my favorite being the all-too-common labels "preferred" and "non-preferred" for brand name drugs--usually the "non-preferred" is the higher copay, meaning "not preferred by your PBM--we don't really care about your perspective.")  So, it is really nice to see the extra step taken to make these programs accessible, not just out there for the good-guy status.

Also, I'm often asked what employers can do to "soften the blow" of layoffs. There's not really any way to make getting laid off seem like good news, but employers can provide departing employees with helpful resources like this program and other assistance programs. That's a simple step that shows real concern for your workforce--even after they leave. 

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication.

Do the Rich Get Special Treatment in the Organ Transplant Biz?

When it comes to organ transplants, you probably know that it's illegal in America to buy/sell organs from donors.  If you need an organ, you have to get on the transplant list regardless of your socioeconomic status.  Most people stop there with the thought process and assume that everyone's created equal.

Of course, money matters in the USA, and even if you can't buy an organ, the fact you can travel and pay your own frieght at several different "centers of excellence" across the company can dramatically increase your chances of getting the transplant you need.

Case in point, Apple CEO Steve Jobs, who is reported to have recently received a liver transplant in Tennessee.  More for ABC News:

"Reports that Apple CEO Steve Jobs traveled to an unidentified hospital in Tennessee for a liver transplant this March have sparked a debate over whether the wealthy are able to use their resources to game the national organ donation system.

Jobs couldn't pay for an organ. Nor could he pay to cut the queue. But what someone with Jobs' resources could do, according to liver transplant surgeons and ethicists, is to use money and mobility to improve the odds either by going to an area of the country where there are more organ donors, or by signing up at multiple transplant centers.

"It's not for anybody but the rich. It's called multiple-listing, a practice some would say is unethical," said Arthur Caplan, co-chair of the United Nations Task Force on organ trafficking and chair of the department of medical ethics at University of Pennsylvania.

When a person needs a liver in the United States, the patient must go to a hospital with a transplant center for an extensive medical, mental and financial consultation. Then if he or she is determined a good candidate, the patient will be put on that transplant center's waiting list.

When a liver becomes available, the nearest of the 49 national Organ Procurement Organizations (OPO) will run a database search and algorithm to match the liver to people on all the transplant centers within that OPO's designated local and regional area.

"The local area is not a state, it's that donor service area of that OPO," explained Anne Paschke, spokesperson for the United Network of Organ Sharing (UNOS). "For a liver they're going to look in the local and regional areas before they look nationally."

According to the Organ Procurement and Transplantation Network, 15,771 people are currently waiting for a liver in the United States. Last year, 1,481 people died waiting for a donor liver, almost all of which come from the recently deceased. The national average waiting time for a transplant is about a year, but it can average as little as a few months at some centers, organ experts said.

Paschke said UNOS requires transplant centers to encourage patients to do "multiple listings" at transplant centers in multiple geographic areas to increase the odds of being matched to a liver. The only catch, Paschke said, is that health insurance policies often cover only one medical evaluation to get on one transplant center list. Most people simply don't have the money to pay for multiple extensive evaluations at far-flung locations.

Unfair advantage or necessary evil in our system so organs don't go wasted?  I'm not judging Jobs, but it's an interesting question.

Is Coffee the Wonder Drug to Prevent and Treat Alzheimer's?

Sure I've got stained teeth and I'm more than a little hyper.  The good news about my fondness for coffee ALL DAY LONG?  It might help me prevent Alzheimer's disease has received an extra boost from two new studies.

From the Atlanta Journal Constitution:

"Florida researchers report that a daily dose of 500 milligrams of caffeine -- the equivalent   found in five 8-ounce cups of coffee -- reversed memory issues in mice bred to develop Alzheimer-like symptoms. After two months on the stimulant, the mice rebounded to score just as well on memory tests as normal mice of the same age that had never exhibited signs of dementia.

The studies, published in the July 5 online edition of the Journal of Alzheimer's Disease, also found that caffeine cut by half the mice's excessive blood and brain levels of beta amyloid, the protein linked to characteristic plaque found in human Alzheimer's disease.

"The new findings provide evidence that caffeine could be a viable 'treatment' for established Alzheimer's disease, and not simply a protective strategy," lead author Gary Arendash, a University of South Florida neuroscientist, said in a news release. "That's important because caffeine is a safe drug for most people, it easily enters the brain, and it appears to directly affect the disease process."

Studies to test whether caffeine can help people with mild cognitive impairment or early Alzheimer's disease are likely to follow, investigator Huntington Potter, director of the Florida Alzheimer's Disease Research Center, said in the news release."  In the most recent experiments, the researchers also found that caffeine did not improve the memory of normal mice as it did for the Alzheimer's mice."

Coffee (and other forms of caffeine) is looking more and more like a good thing.  Have a cup today.  Make it three, maybe five.

Not a problem for me...

Was Denis Leary Right About Preventative Care?

Denis Leary had a great line from his Broadway show/CD "No Cure for Cancer".  It goes a little something like this:

"I love these little facts. "Well you know. Smoking takes ten years off your life." Well it's the ten worst years, isn't it folks? It's the ones at the end! It's the wheelchair, kidney dialysis years. You can have those years! We don't want 'em, alright!?

The Leary premise is quality over quantity.  If the late years aren't good ones, the theory goes that you may as well do what you want.  No mention of the cost of health care during the late years.  That doesn't translate too well into comedy, especially the Leary version of comedy.

Not to worry.  Arthur Garson's got you covered in this column from Governing Magazine, where he and Carolyn Englehard argue that preventative care just doesn't pay out:

"If you're among those who think prevention saves money, and will help reduce the overall cost of medical care, you're not alone. But while an apple a day might keep the doctor away, at least for awhile, it also might cost more than you think. Preventive medicine can help avoid costly illnesses earlier in life, only to increase the population of elderly and infirmed people who will most likely require expensive treatments for other illnesses later.

Even worse, unhealthy habits such as tobacco smoking may actually save money in the long run as people who smoke die earlier and use fewer health care dollars. "This doesn't make sense," you say, "Smokers are less healthy than nonsmokers." That may be true, and smokers do use up to 40 percent more medical care while they are alive. A recent study from Holland showed that, on average, smokers die at age 77 and save $100,000 in lifetime medical care costs compared with non-smokers who die at 83.

The same is true for people who are obese. While obesity-related conditions such as Type-2 diabetes, high blood pressure and heart disease are associated with high medical expenditures, the costs that are saved by preventing obesity will only be offset later in life by diseases unrelated to obesity that accompany living a longer life. In the Dutch study, obese people die at 80 and save $50,000 compared with non-obese people who die at 83."

Wow, there it is.  It's cheaper to allow people to make their own decisions about lifestyles because we don't have to spend money on them once they're gone - it's cheaper overall to let them do what they want. 

What the column doesn't explore is ramifications of preventative care for employers.  The ten years at the end are largely funded by the government.  What about the 5/10 year ROI scenario for employers that invest in programs that get people to stop smoking or drop their blood pressure.  Is the ROI there for the companies that choose to do that?

That's the million dollar question (literally) for employers in America.

Focusing on Surgery - Part of the Reason Effectiveness Trails Cost in the USA?

I've always been amazed that the USA always shows up in the mid-teens regarding outcomes/effectiveness of care when compared to other industrialized nations.  All the money we spend, and we trail Europe? 

One reason might be a over-reliance on surgery, which we've been trained is the path to take when you're serious about getting healthy.  A recent BusinessWeek article focuses on this tendency in the USA using heart disease and prostate cancer as examples:

"Each year, more than 1.3 million Americans have their clogged arteries widened with a tiny balloon and then kept open with slender mesh tubes called stents, made by companies like Johnson & Johnson (JNJ) and Boston Scientific (BSX). The total bill for these angioplasties is more than $21 billion a year. But while many patients and doctors firmly believe that angioplasties prevent heart attacks, the data say otherwise. A series of studies—the newest published in the June 11 issue of The New England Journal of Medicine—finds that stable patients with chronic heart disease who have the procedure get little benefit compared with similar patients treated just with drugs, such as Pfizer's (PFE) cholesterol-lowering Lipitor and other statins, and aspirin. "There are still many patients who undergo angioplasty without really understanding that it will not reduce chances of heart attacks or death—though it will reduce symptoms," says Dr. Judith S. Hochman, director of the Cardiovascular Clinical Research Center at the New York University School of Medicine.

That's why there's a growing effort, led by physicians, health insurers, and even state legislatures, to make sure patients truly understand the medical evidence about angioplasty and other treatments and procedures. Once informed, the patients are encouraged to make their own choices. This idea goes by the somewhat clunky name of shared, or informed, decision-making. Instead of being routinely whisked in for a prostate screening PSA test, for instance, men would first be told that major studies have failed to show the test saves lives. What's more, the test increases the chances a patient will undergo surgery or treatments that cause incontinence, impotence, and other problems. "The fact that PSA screening is more likely to cause mischief than save a life is not intuitive to patients or even physicians," says Dr. Paul J. Wallace, medical director for health and productivity management programs at health-care provider Kaiser Permanente, which is testing this approach.

Studies show this process, using comprehensive videos and other materials prepared by groups such as the nonprofit Foundation for Informed Medical Decision Making (FIMDM), leads patients to choose conservative options more often. It reduces rates of angioplasty or prostate surgery, for instance, by 15% to 30%. Put into widespread use, the approach has the potential to trim hundreds of billions of dollars from the nation's $2.4 trillion health-care bill. Yet patients do as well or better than if they had opted for the procedures. Surveys done after the decision also show patients to be more satisfied, no matter which choice they made. "That's the kind of win that doesn't fall into your lap very often," says Washington State Senator Cheryl Pflug, a Republican.

Hundreds of Billions.  Kinda catches your eye, although the specter of making decisions in terms of who gets surgery and who doesn't would be a rallying cry for those who claim nationalized health care will take the decision out of the hands of the patient/doctor.

It'll be interesting to see this play out in the scope of nationalizing health care...

There's No Such Thing As Private Health Information in the Big Time....

Most of us get to control access to our private healthcare information.  If we're on blood thinners and we want to keep that confidential from future employers, we control it - we just don't say anything.

Not so in some professions, especially where public safety is involved.  Still, in professions with public safety at issue, your employer would put safeguards in place to ensure the disclosure of your medical issues through questionaires and full-blown physicals, but your medical conditions aren't widely known by the public.

Not so in professional sports.  Consider the case of DeMarre Carroll, as reported by SI.com:

"Former Missouri forward DeMarre Carroll earned the nickname "Junkyard Dog" for his blue-collar approach and relentless work ethic. Now he must convince NBA teams that a previously undisclosed liver disease won't keep him from being a pro.

Agent Mark Bartelstein confirmed Wednesday that Carroll, a first-team All-Big 12 pick and potential first-round draft selection, was diagnosed with a liver ailment "a couple of years ago." He downplayed the possibility that Carroll might eventually require a liver transplant.

"It's jumping the gun," said Bartelstein, a Chicago agent whose NBA clients include former Kansas star Brandon Rush and Eddie House of the Boston Celtics. "There's a possibility (of a transplant) way in the future, maybe 20 or 25 years down the road."

Carroll has been treated by Dr. Jeffrey Crippin of Washington University in St. Louis, a specialist in gastroenterology, liver disease and transplants. Crippin declined comment, referring questions to Carroll's agent.

Bartelstein said that Crippin is preparing a letter for NBA coaches, general managers and team doctors outlining Carroll's health before the June 25 draft."

In your workplace, such public disclosure would be the cause for a lawsuit.  In professonal sports, it's given that everyone has the info and the info becomes public.  Strange contrast...

Discounted Health Care for Buying Local Veggies? Is this Heaven?

I live in the mecca of local and organic produce. There are so many farmer's markets to choose from on a given week that you could eat like royalty nearly year-round and hardly step foot in a grocery store. The daddy of them all, the Ferry Plaza Farmers Market, and my favorite low-key version, The Alemany Market, are bustling year round and have arguably some of the best coffee, specialty food, gourmet treats and, of course, produce in the country. (Not that I'm biased or anything.) 

But, one of my favorite treats of the summer is my Community Supported Agriculture (CSA) veggie box. Once a week I pick up a box of the tastiest just-picked fruits and veggies. I read the info sheet on all the obscure or not-so-obscure items inside and plot out what to cook, freeze or eat on the spot (the strawberries don't always make it all the way home). I'll be the first to admit I'm a bit of a geek about this but it is so much fun--kind of like Christmas morning once a week (plus supporting the community and all that good stuff too). Unless you threw in a chef to cook the veggies for me, I would never have thought a CSA could get better. Until now.

In Madison, people are getting rebates on their health care for joining a CSA! The Madison Area Community Supported Agriculture Coalition (that is a mouthful!) has a program called Eat Healthy Rebate where their CSA members get rebates on their health plans--up to $200 bucks! This info from the Minneapolis Star Tribune:

CSAs are particularly popular around Madison, Wis. There, Physicians Plus Insurance Corp. in 2005 began offering $200 premium rebates to member families who joined CSAs. The program appears to have been the first of its kind in the country. In 2006, the first full year of the program, 972 members got the CSA rebate; heading into this season, 1,460 will qualify, said Physicians Plus marketing manager Scott Shoemaker.

If people are motivated to eat "healthier foods, exercise and practice preventive health measures, they're going to be healthier in the long run and need less health management down the road," Shoemaker said. "They'll go in to the doctor less. And costs will go down."

This is pure brilliance in my opinion. Why not pair eating healthy with lowering your health care costs -- and supporting the local community all at the same time?

This could be a great fit for employer wellness incentives too. Employees are often offered reimbursements for gym memberships that go unused--maybe for some employees those incentive dollars could be better spent on healthy eating? 

Are there other examples of pairing local agriculture with health incentives? Please leave examples--or your ideas!--in the comments below. 

Jack of All Trades & Master of None

Poor focus hampers wellness implementation.

Are you updating your facebook status via Twitter from your iPhone as you apply your make-up or eat your burger on the driveto your next open enrollment meeting?  Many Americans feel as though they are good at multitasking and engaging in multiple activities simultaneously leads them to believe they are accomplishing more. 

In her book, Distracted: The Erosion of Attention And The Coming Dark Age, author Maggie Jackson points to a growing body of research studies that seem to suggest the opposite.  A flood of stimulation, interruption and fleeting human contact have created a culture of "diffusion, fragmentation."

She points out the consequencesof what most of us consider par for the course in our lives and working environments:

Interruption and the knowledge worker:

• Knowledge workers switch tasks every three minutes. And once interrupted, a worker takes an average 25 minutes to return to their original task, according to informatics scientist Gloria Mark.
• How often are we interrupted?  The average worker gets 156 emails a day, according to the Radicati research group. And that's just the beginning; instant-messages, phone calls, faxes and snail mail add to the influx.

Making a national habit of multitasking:

• Sixty-five percent of people eat while they drive.
• Sixty percent of kids age eight to 18 multitask some or most of the time they're doing homework.
• Twenty-five percent of restaurant meals are ordered from the car, up from 15 percent from 1988.
• American kids are exposed on average to nearly six hours a day of non-print media.
• Two-thirds of children under six live in homes that keep the tv on half or more of the time, an environment linked to attention-deficiencies.

Time and time again in the world of wellness we see this habitual tendency toward mindless overcommitment, interruption, and multitasking lead to programs that are too diffuse to do much good if the desired outcome is a healthier workforce and reduced health care costs.

Why wellness fragmentation does not equal results

How does ROI for wellness work?  It is more of a cost avoidance than an actual savings in most cases.  Here is a simple (and maybe a little too simplistic) example to help walk you through the "savings." 



Half of your workforce participates in a risk based population health strategy (wellness program) and the other half does not.

For the participating half of the population, whose risk is known, you are able to offer outbound (active) and passive programs that directly impact and address the risks you've identified as prevalent to this group. 

Let's say the programs you've implemented are effective, engagement in them is high, and you retain these employees.  Over a series of years you should see something happen that is counter to what will have happened with no intervention. 

That is to say, this group will not get sick as often as non-participants because your interventions were effective and employees stuck around long enough for you to see results.

The non-participants at your company, as an aggregate, are an unknown entity to you.  You have very little data on their risks and, as a group, they will most likely continue to use health care at the same rate as before. 

Yet, if your company-wide wellness communications are effective and appealing, your participant group is vocal and influential, and your non-participants stay at your company without developing any major illness then some studies indicate that your wellness program might actually have a halo effect. 

That is to say, even non-participants will learn a little more about self care whether they participate or not.  Sure, that could slow the rate of health care cost growth in that group, though probably not by a lot.

Both groups' cost trends together is your overall trend.  Both may continue to rise, but your participant group's trend over several years will rise more slowly - making your overall costs appear to grow more slowly. 

UNLESS.  Yes, there is an unless.  Unless, your participant group is so small and the growth in the cost of health care is so large that your non-participants' health care usage effectively nullifies any impact you had on participants.    

Wellness is not Wii Fit.  You need to focus.

As much as we know that on an individual level good health is as simple as: sleep well, eat right, and move more, achieving a successful organizational wellness strategy is as much an art as it is a science.  It takes focus, discipline and rigorous measurement to impact behavior, motivate and sustain participation, and to quantify results.

If your program is to be successful then you will need to engage a large chunk of your workforce, stratify their risks, and follow a disciplined series of stepsover several years in order to see return on investment.  Oh, and do all of this while simultaneously carrying out the core work of your company.

Fight the urge to multi-task

While multi-tasking may be transitioning out of vogue when it comes to work effectiveness, its cousin  - work sequencing - can help break large and complex tasks into more manageable pieces. 

Plan to succeed by drafting a multi-year strategy with a realistic timeline.  Schedule monthly (core team), quarterly (key shareholders and decision makers) and annual reviews (company wide) of a the wellness program before you even begin work.  This will hold you accountable for reporting progress toward implementing your strategy and plan. 

Build up to maximum efficiency by starting with only a few key program components that will get you the most bang for your buck.  Gradually add complexity as your initial program begins to show results. 

More often than not, companies initially underestimate how much time it takes to implement a strategic wellness program.  They allocate too few resources and take on too many program components to ever really get much traction.  As a result, their programs suffer from poor participation due to fragmented management and the overall program shows high attrition.  Plan intelligently and sidestep this common trap.

Editor's Note: By day, Kris Dunn is the VP of People at DAXKO, a cool software firm dedicated to providing solutions to the best membership-driven organizations in America. At night, he morphs into a blogger at The HR Capitalist and the Founder and Executive Editor of Fistful of Talent. That makes him a career VP of HR, a blogger, a dad and a hoops junkie, the order of which changes based on his mood. Tweet him @kris_dunn...