by Beth Shepard   Beth's profile on LinkedIn  

Women's Heart Health

Over the summer, my husband, Jim, was once again given a choice by his employer. He could complete an online health risk assessment and health screening (bloodwork, waist circumference, and blood pressure), then share this data with a designated wellness vendor — or forfeit our family’s access to the employer-sponsored health plan of our choice.

That’s right. He could decline, but then our health insurance premiums would go up — significantly. Like many families, we already struggle with high healthcare expenses. So participating in the “wellness” program didn’t feel like much of a choice for Jim. It was more like being backed into a corner to avoid a financial penalty… hardly a reward for being a hard-working, longtime employee.

We’re not the only family facing these tactics. According to a Towers Watson report, 66% of US employers use financial incentives to drive wellness participation; of those, 22% are actually penalties. Our experience makes me wonder if anyone designing these “incentives” thinks about how compliance looks and feels to the people forced to comply.

Messages in the emails and fliers we received were crafted to convey how much the company “cares” about Jim’s well-being and our family’s health. But the hoops we’ve had to jump through felt designed instead to make us give up out of sheer frustration and pay for a more expensive plan. Here’s the overview:


  • Jim completed the HRA.
  • He was told the health screening wouldn’t be offered at his location and was directed to a lab website which required him to create an account and answer a lot of questions. He didn’t have time during his workday to do so; his last option was to schedule a doctor’s visit for the screening.
  • Jim printed a form from his HR website and took it to his after-work doctor’s appointment; he specifically asked them to fax it to the wellness vendor.
  • 2 weeks later, Jim got a notice from the wellness vendor that they had not yet received his health screening data. Jim called the clinic, and nobody could verify that the form had been faxed. He had to physically go to the clinic with another form, have them complete it, ask them to fax it (again), and also fax it himself.
  • Meanwhile, Jim heard the wellness vendor was taking up to 2 weeks to verify receipt and upload the data. At this point, we had to cross our fingers and hope for the best, because we were leaving on vacation and wouldn’t be back until after the deadline.

Thankfully, Jim finally received confirmation that his HRA and clinical data had been received; we’ll be eligible for our health plan of choice after all. That’s great — until next time. Must we go through this same hassle, year after year?

In my opinion, most wellness professionals and programs are well intentioned. So, in the spirit of making things better, here are a few honest insights we’d like to share with anyone who contemplates tying benefit plan eligibility to wellness program participation:


  • Our family is not a set of data; we’re not expenses to be controlled. We’re real people with real kids and real pressures (time, financial, parenting, etc.); we’re already doing our best to keep our family healthy and happy. And being forced to comply with “wellness” requirements to get the benefits we need at a price we can afford doesn’t give us a warm, fuzzy feeling.
  • We exercise, eat our vegetables, and get regular preventive care because we want to, not because you are telling us to. We value the quality of life afforded by living an active, healthy lifestyle — and that’s not something you can put a price on. So don’t.
  • We’re not irresponsible healthcare consumers; we simply need a lot of it. We incur big expenses each year in office visits, maintenance prescriptions, and sick meds — because raising kids with chronic conditions is our reality. And the prospect of losing our coverage of choice doesn’t make things better; it adds a level of stress we could really do without.
  • When you use financial penalties to force our participation, it’s not really voluntary. In fact, adding the penalty taints the way we see the program; making it all about money communicates that it’s actually all about money — not employee and family well-being.
  • If you’re going to make employees complete requirements, test and re-test the processes until they’re smooth and hassle-free. Make sure your vendor can confirm timely receipt of employee HRA and lab results so we don’t have to worry we’ll lose coverage because something got lost in the shuffle. And… please, please, don’t roll your program out over the summer.

According to the wellness program flier, last year’s HRA and health screening revealed the top 3 conditions experienced by employees: obesity, diabetes, and high blood pressure. What a surprise. All that trouble and expense for something the company could have figured out with a quick glance at employee demographics and public health data.

It’s high time wellness and HR pros consider whether elements of their programs have unintended consequences — like increasing employee and family stress, creating financial hardships, and cultivating resentment. Financial penalties may temporarily drive participation, but they don’t drive well-being. And isn’t boosting well-being (employee, family, organizational) the point?

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