Florida insurers are opening the doors of a new, first-in-the-nation healthy
lifestyle program offering rebates to employers whose employees adopt healthy
The program grew out of House Bill 169, which became effective on July 1, 2004.
The bill created a number of incentives encouraging employers in Florida to
offer or expand health coverage, including provisions requiring HMOs, individual
carriers, and small group carriers to make available rebates of up to 10 percent
to employers whose employees meet agreed-upon standards for, for example, weight
loss, smoking cessation, and exercise.
For employees, the advantage is that healthy habits could translate into lower
healthcare deductions. For employers, the advantage is healthier employees who
are more productive and less frequently absent. For insurers, the incentive
is that healthier plan members will be less likely to raise medical costs. The
first rebate will be available in calendar year 2006 for the earned premiums
in calendar year 2005. The law requires insurers to pass the savings on to employers,
but doesn't require employers to pass them on to employees.
Some insurers have already received approval of their plans, Frank Dino, chief
actuary at the state Office of Insurance Regulation, told the Miami Herald.
Vista Healthplan of Fort Lauderdale will pay up to $125 to its overweight plan
members who enroll and lose weight in an approved weight-loss program and is
offering rebates of $50 per quarter (up to $150 a year) to those who join a
fitness club and use it at least three times a week for 3 weeks a month. Blue
Cross/Blue Shield is offering members of its preferred physician plan $50 checks
if they quit smoking and successfully pass a blood test a year later.
Unanswered questions. Meanwhile, as insurers are brainstorming the programs
they'll offer, they're wondering how much to rebate, how much paperwork
will be involved, and how hard it will be to monitor results. Employers are
wondering how to implement programs without invading employee privacy. In fact,
Representative Frank Farkas, who sponsored the bill, told the Herald
that "[w]e don't have all of the answers. We may have to go back and
tinker with some of the details."