Smoking Cessation
Success Hinges on Identifying Willing Workers

When it comes to improving employees’ health, employer-sponsored smoking- cessation programs can make a real difference. The biggest challenge to these programs, experts say, is tracking down the smokers.

A recent report by the National Business Coalition on Health (NBCH) finds that health plans report that the range of smoking rates covered in their populations averages 4 percent. However, the Centers for Disease Control and Prevention estimates that 21 percent of the U.S. population smokes.

“Tobacco cessation is a complex issue for employers and health plans,” said Dennis White, a vice president with NBCH. “There is a significant process from identification of individuals needing support to successful treatment.”

Ninety percent of health plans use health risk assessments to identify smokers. Eighty-five percent use disease management programs, and the same number use self-referral, according to the NBCH study. Only 7 percent of those polled said they asked employees at enrollment.

While pinpointing smokers can be challenging for all employers who support a cessation program, certain industries can expect to have a higher percentage of smokers. A new study by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) finds that 45 percent of employees in the food- preparation and serving-related occupations admitted to smoking in the previous month. Second on the list were construction workers and miners at 43 percent. The lowest rates were seen in education, training and library jobs (12 percent) and the life, physical and social science professions (15 percent).

Eric Broderick, acting administrator at SAMHSA, said the study could be used to tailor cessation programs to “specific workplace groups.”

Narrowing a program’s target group, however, isn’t always the best option, according to a labor law expert. “The inclusion of one group of employees in a smoking-cessation program, and not others, could result in allegations of discrimination,” said Nickolas Spiliotis, an attorney with the Cozen O’Connor law firm in Houston.

“While smoking habits of employees differ by profession for a number of reasons, a program that provides the right kind of incentives in the form of rebates and discounts, without discriminating against smokers, could increase the health of workers and decrease the cost of health insurance offered by employers,” Spiliotis said.

Enrollment Trends
Employers Opt for Higher Premiums, Carve-outs

Enrollment season for 2010 benefits is shifting into its final weeks, and experts are seeing a number of cost-containing trends emerge.

Moving to plans with higher premiums and deductibles is a popular strategy this year, according to a new survey. Hewitt Associates expects 2010 health care costs per employee to jump 6 percent from last year to an average of $9,120. Employees should expect to pick up most of that increase, with individual coverage premiums and out-of-pocket expenses rising 10 percent next year, according to Hewitt.

Employers are sticking with wellness programs and are offering incentives for better management of chronic conditions, the survey found.

Industry observers also are witnessing a shift to “spousal carve-out plans,” in which a self-funded employer will cover the employee but not the employee’s spouse if the spouse can obtain health coverage in his or her workplace.

While this move can cut costs for employers, it’s not appealing to workers, experts said, because separate single-coverage plans often cost a couple more than a family plan.

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• REFORM UPDATE: The House of Representatives on Nov. 8 passed a landmark health care reform bill. Attention now shifts to the Senate, where majority leader Harry Reid (D-Nev.) hopes to have a bill finalized sometime in November. However, Sen. Dick Durban (D-Ill.), said it was unlikely that a final bill that combines House and Senate legislation would be finalized in 2009. The House bill would expand coverage to millions more Americans. Insurance and business groups, however, have criticized the plan because it includes a government-run public plan and a series of employer mandates and penalties.