New kind of health plan at a company... feedback wanted

[Sgent]

OK... I do consulting for some HR departments of large companies RE/health plans. I wanted to get some feedback for what one company is looking at since this is going to be a huge departure from the normal:

Plan benfits -- basically pays all health expenses (but read below).

Costs:

$25/month / Body Mass Index above 25 up to $250/month.
$200/month if smoker

BMI Penalty is halved if you attend a gym (for free) 12 days a month or more
Smokers penalty is reduced to $100/month if you are invloved in a quit smoking program (again, all subsitutes, zyban, gum, counseling is free). It is elminated 6mos after successful completion.
Any employee gets access to the best health club in town free if they use it 11+ times a month, if less, then they must pay.
All doctor visits, drugs, tests, etc are free if you've recieved a (free) physical and appropriate vaccinations in the last 13 months. Otherwise you have to pay a $100 copay.
All dental exams and work is free, assuming you have 2 cleanings in the last 13 mos.
All OTC drugs are free with script.
The doctor/hospital/dentist network is the same PPO as they currently have.

They estimate the plan will cost about the same amount as a traditional PPO plan now in place. I was wondering -- any thoughts?

[thecrow]

1. Sounds pretty discrimatory to me

Some people have genes that put them above BMI of 25.

[Sgent]

2. Currently

there is nothing (in this area at least) that creates a problem on that level -- no law against discriminating due to genetic status. That being said, their might be some ADA concerns so thanks for mentioning it.

[bananas]

3. Bullshit

[Idylle Moon Dancer]

5. BMI is faulty, IMHO

at least the one that came with a pamphlet on lowering blood pressure that my doctor gave me. It says I'm obese. I am NOT obese. Overweight, yes, but not obese. I'm just built differently than the average person. The last time they weighed me, the nurse seemed moderately surprised at the reading and said "you carry it well" or somesuch.

[bananas]

6. Anorexics aren't healthy

and they get a free ride on this plan.

[radwriter0555]

8. Considering the ratio of anorexics to overweight people in the US, I'd say

their bets are hedged in the right direction.

[REP]

10. You're Right - Anorexics Die Young; Cost Less

[bananas]

11. Cats cause allergies

so there should be a penalty for cat owners.
Unless they have that hypoallergenic cat.

[REP]

14. Mental Health Screenings

Depression = $$$

[ComerPerro]

20. Heroin addicts would have a low BMI, too

of course, they would probably fail the necessary drug screening...

[bananas]

4. Low glycemic diet + moderate exercise

eat like a diabetic and live forever.

edit: two drinks a day - at least!

[radwriter0555]

7. Considering the alternative, why not? At this rate, you're lucky to even

have a health care program, the way things are going for most businesses and corporations. Promoting a healthy lifestyle is beneficial for everyone. I wish I'd been offered a gym for free, that's fantastic!

I like the incentives.

[REP]

9. Only If There's a Substantial Obstetric Penalty - $5K Per Delivery, Say

Then it'd be fair.

[Skittles]

12. I cannot stand gyms but exercise at home 6 times a week

would that be OK?

[bananas]

13. No

you would have to use the treadmill at the gym
and be forced to watch fox news.

[B Calm]

15. but, I'm too out of shape to exercise...

[Skittles]

34. honestly

I would rather be out of shape - I am serious

[Telly Savalas]

29. According to this plan, yes.

The only benefit tied to going to the gym is that you get in free if you use it 11+ times a month.

[LostinVA]

16. I wish we had a plan this good -- I think it's great

And a GREAT way to help encourage employees to stay -- or get -- healthy.

[TahitiNut]

32. The misery of poor health isn't enough of a 'punishment' ...

... so let's be sure to pile on. Let's charge people more for health care, airplane seats, clothes, and ... hell, while we're at it, let's just take their homes and property and throw them into the streets, huh?

After all, everyone knows that being sick is a moral failing. Therefore, let's form a religion and condemn sick people to Hell.

I just love the moralizing on DU. :puke:

Let's stone 'em!! Kill! Kill!

[Name removed]

33. Deleted message

Message removed by moderator. Click here to review the message board rules.

[China_cat]

17. I don't know what everybody's bitching about with this plan

Just for my husband (I can't get insurance for less than double what we make a month) insurance that might as well have 'good only until needed' at the bottom of it costs us $600/mo. He's overweight and would probably hit the $250/month penalty but a non-smoker so something like this would save us more than it costs and give him a chance of actually losing weight and being more healthy. We'd grab that in minute.

[LincolnMcGrath]

18. Look at everyone scramble to line up for discriminatory policy.

[China_cat]

21. Yeah, well, when you have nothing

or less than nothing when you're paying for something you know you'll never be allowed to use, something like this looks pretty good.

[LincolnMcGrath]

22. This is an example of how easily working class folks are divided.

[ComerPerro]

19. I think BMI is complete and total bullshit

According to BMI, someone who is six feet tall should weigh between 136.5 and 183.5 pounds.

Have you ever seen someone who was six feet tall and who weighed 150 pounds? They don't exactly look healthy to me.


No wonder so many Americans are overweight. Being 6' and weighing 185 is "overweight"!



BTW, if it were calculated on anything else, I would think this was an interesting idea for a plan. Especially if the penalty is halved for gym membership, and especially if that membership is not only free, but if the gym is accessible.

Of course, there is still the drawback that some people may not have time to work out, even a few times a month...

[alarimer]

23. Nearly everyone is obese under BMI

I think that alone might account for the "obesity epidemic". It is a crock, in my opinion and should not be given the authority that it has been given.

[ComerPerro]

24. Quaterback Tom Brady - Overweight.

He is 6'4" and 225 pounds, a BMI of 27.4. He is overweight.


Larry Johnson, breakout running back for the chiefs who racked up more yards in 10 games than most running backs do in a season:
6'1", with a BMI of 30.3, and is therefore obese.

[raccoon]

25. Some meds, such as some antidepressants cause weight gain.

Sounds pretty discriminatory to me.

[Armstead]

26. It's a bit Orwellian

Some people are just fat. It's genetic and they can't help it.

Besides that, it seems too into managing people's lives. Smoking is bd, and maybe incentives to quit should be included. But where do you draw the line. Will they start charging more if you eat the wrong food, or if you spend too much time at home on the couch?

How about peope with natutal diseases? Do they get penalized?

Maybe your client should have two plans that people can chose from.One a basic, somewhat more expensive and basic plan without all the strings attached, and another with those built-in carrots and sticks for those who choose a "welness" lifstyle.

[sinkingfeeling]

27. Maybe the preventive aspects are good, but I personally believe

in liberty. I don't care for the 'nanny state' nor for someone else to make my life decisions for me.

[Gormy Cuss]

28. "estimate.. cost about the same...

This year. Do they have any hard data to back up that assertion? Bet not. Remember when HMOs were the new best thing and promoted as lower cost alternatives to indemnity coverage?

They may be offered a plan that cooks the numbers to hold costs this year but watch out next year.

[SmokingJacket]

30. I like the focus on preventive medicine, and I'd be THRILLED

to have access to such a program. But I'm not a smoker nor overweight. I think the penalty for them is too steep -- would an overweight smoker have to pay up to $450 a month?

There are other behaviors that are risky healthwise (drinking, taking heroin, reckless driving, extreme sports, unsafe sex) but the risk for those behaviors is carried by everyone. Why should only certain behaviors be penalized?

[Love Bug]

31. I'm all for reasonable incentives to encourage healthy lifestyles but

this plan seems to imply that only fat people have health problems. Not true.

My company gives all employees a 10% discount on their premiums if they agree to participate in a voluntary health management program that works with the employee to monitor chronic conditions, such as diabetes, promote health weight control, etc. If you sign up and don't keep up with your participation, you lose your incentives and pay the normal hc premium rate.

[Cleita]

35. We need NHC. Privatization always will cherry pick the

healthier and those with healthier habits over those who actually need health care. These plans eventually fall apart because the doctors and hospitals stop accepting them once they don't get paid because the smoker or fat person they treated didn't follow the insurance company's rules.

[Book Lover]

36. Several thoughts

A) Can the "best health club in town" handle all of the new customers? And what if I hate the owner of the "bhcit" or can't make it during their hours? I have no alternative?

B) Does the BMI take into account differing muscle-to-fat ratios of people? (I honestly don't know this).Taking myself as an example, I am a large-boned woman who also is overweight - a greater amount of my BMI is taken up by "legit" weight, not fat, than a smaller-framed female. What to do?

C) I foresee a situation where I must have emergency/near-emergency care before my doctor can see me for my annual physical - would that visit be subject to the $100 copay?

D) There is a serious school of medical thought that indicates annual physicals are not effective as a preventative measure. Has that been taken into account in this plan?