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Milliman has an interesting case study of a retail client which introduced “a modest wellness initiative in 2010 that had quickly gained traction with employees: 61% reaped a reduction of $1,040 on 2011 annual premiums for full participation. In 2012, the company took a bold leap, upping the ante with a radical plan design. Their primary objective was to create a culture of health and responsibility. To achieve this, they decided to link responsibility and rewards in a very direct and dramatic way. First, they defined two wellness steps that focused on awareness of individual health: (1) Getting an annual check-up with a primary care doctor and (2) taking a health risk assessment.”

“Next, they linked the steps to major incentives to drive the desired behavior change.”

For employees who took:

• Both wellness steps—medical premiums for the following year would stay flat (reflecting a 70% employer subsidy of the total cost); after several years of increased premiums, this was a particularly welcome message for employees.
• One step—the employee portion of premiums would jump to 70% (30% employer subsidy).
• No steps—the employee would be responsible for the entire cost of premiums (0% employer subsidy).

“With this design, the employer was sending a loud and clear message: It pays to step up to wellness!”