Employee Leadership in Health Insurance and Wellness Programs in Montgomery, Ohio
The City of Montgomery, Ohio (population 10,163), takes a comprehensive wellness approach to improve employee health and well-being and to reduce health care costs.
The city relies on an employee-based committee to make decisions about and communicate with staff about health insurance.
The committee’s goal is to encourage people to use their health insurance to “improve their physical and mental health through intelligent, educated decision making.” Becki Wellbrock, Montgomery’s tax commissioner and a member of both committees, says the Health Care Benefits Committee relies on the Wellness Committee to provide the incentive for employees to become healthier, which reduces health incidents and results in richer insurance coverage at less cost.
Health Care Benefits Committee
In 1999, employee health care costs made up 3 percent of Montgomery’s annual budget and were rapidly increasing. A Health Care Benefits Committee was established to represent the employees’ health care concerns and to negotiate with insurance providers, maintain comprehensive coverage, and communicate with each work group about key health care issues. Four of the committee’s members represent the primary work groups within city government and the fifth represents management.
This group is responsible for making decisions about the city’s employee health insurance coverage, using guidelines and cost ceilings set by the city. The committee works with the city’s insurance provider and broker to learn about health care issues, options, and costs. Every year, it develops proposals for insurance renewals, solicits employee input and concerns, and submits a renewal package to be reviewed and approved by the city manager and city council, then executed with the insurance provider.
Early in the process, the committee changed the structure of Montgomery’s health insurance program from 100 percent city-paid coverage to premiums partly paid by employees and co-pays. The committee provides ongoing education to employees about choosing providers, using urgent care facilities rather than emergency rooms, and requesting generic drugs, so they become better, more cost-conscious consumers.
Wellness Program
The wellness program grew out of the Health Benefit Committee’s work as a way to involve employees in the management of this comprehensive approach to improving employees’ overall health while containing costs. The program use incentives — employees can earn between $200 and $500 per year for taking an active approach to their health and wellness. All participants must take an initial and annual health risk assessments, and must take part in activities on their own time. According to City Manager Cheryl Hilvert, “Health risk assessments need to be a prerequisite, as you can’t document progress without this data.”
According to Amber Morris, Wellness Committee chair and Recreation and Community Relations director, the health risk assessment aggregate report protects employee privacy, but it also allows the committee to target the top three changeable risk factors in developing its yearly calendar of topics, activities, health fairs, and educational forums, optimizing its impact on the health of employees and the bottom line in health care costs and productivity.
The key program elements include:
- Physical Participation: Demonstrated improvement in aerobic and strength performance or in
workout sessions. - Education: Participation in monthly Lunch & Learn lectures and city-sponsored health fairs.
- Preventive Care: Preventive check-ups, such as dental cleanings, comprehensive physical exams, eye
exams, wellness screenings, and health fair screenings. - Team Activities: Participation in team building events.
The annual General Fitness Assessment (GFA) is the cornerstone of the physical fitness component. It allows participants to assess their strength, flexibility, and aerobic condition at the end of each year and compare it to performance in previous years as well as to accepted standards for their age group. “The GFA offers tremendous flexibility for a participant because they can earn a large number of points using their own preferred exercise program,” says Frank Davis, Community Development director and member of the Wellness Committee. “For those who don’t like taking organized exercise classes or keeping track of all the miles they walk or run, they can exercise in their own way, on their own schedule, and still get credit as an active participant in the program.”
With 75 percent of all employees participating, there is no doubt that the wellness program has caught on. The program is designed to accommodate a wide range of physical abilities and interests, methods of exercise, personal nutrition choices, and healthy lifestyle changes. City Manager Hilvert also attributes much of Montgomery’s success to its aggressive communication campaign to educate employees about the program as well as providing convenient educational opportunities.
The committee continually works to improve the program, and two years ago reached out to the part-time employees to encourage their participation in the program and share in its rewards. Sharon Savitt, a part-time payroll clerk, agrees that including part-time employees is a great benefit to the city “because our personal health does affect the bottom line with productivity, morale, and attendance.”
Results
Montgomery’s new approach to health and wellness has brought dramatic benefits to the city:
- As much as a 24 percent decline in sick leave usage per year.
- Significant containment of health care premiums. Between 2003 and 2007, annual health care rate
increases averaged 4.99 percent, compared with 13.25 percent increases for the Cincinnati region as a whole. - Between 2007 and 2008, average annual medical claims dropped from $2,437.44 per person to
$2,262.57.
Wellness Program data show that between 2007 and 2008:
- Participants whose total cholesterol is above 200 dropped to 14 percent from 44 percent.
- Three percent of participants increased their frequency of physical activity to three or
more times per week. - Use of sick days decreased by 6 percent.
- Participants whose blood pressure is greater than 140/90 dropped to 32 percent from 62 percent.
- Body mass index of greater than 25 percent declined to 76 percent from 97 percent.
- Tobacco use among participants fell to 16 percent from 32 percent.
- Participants who have more than two drinks per day dropped to 11 percent from 27 percent.
“Our city council is very pleased with what we have been able to accomplish in terms of cost containment and the movement to the consumer-driven health care products, such as high deductible health plans and health savings accounts,” says City Manager Hilvert. “Additionally, we’ve seen real results in the health and wellness of our employees and that is truly a benefit of this approach!”
Contact
Cheryl Hilvert
City Manager
City of Montgomery, Ohio
513-891-2424
[email protected]
