Free health care comes with a cost

COLUMBUS, Ohio — Jim Brown started doing aerobics, running and lifting weights two years ago to slim down. Now his employer is giving him another reason to stay in shape and eat right: Money.

Worthington Industries Inc. — one of the rare businesses that has been paying the full cost of employee health insurance — put limits on its generous policy last year. The company said its workers had to take responsibility for their health if they wanted to continue getting free health insurance.

"I had a choice to be lazy or lean," said Brown, 44, an information technology employee who lost 90 pounds and has reached his goal of 210 pounds. Despite being overweight, Brown didn't have any health problems, but he noted: "If I hadn't changed, things probably would catch up with me."

Worthington, a steel processing company that employs 8,000, is among a growing number of businesses turning to worker incentives, both big and small, to help slow health insurance costs.

In Minneapolis, Fairview Health Services gives gift certificates of up to $100 at the company store for workers who take part in health programs. UnitedHealthcare, headquartered in the Minneapolis area, will knock about $100 a year off health insurance premiums for filling out a 10-minute assessment that asks employees about their diet and blood pressure and then suggests ways they can improve their health.

The nation's largest hospital operator, HCA Inc. of Nashville, Tenn., said that in 2002 it saved $2.76 for every $1 it invested. The employer gave a $116 cash incentive to each participant who completed a weight-management program.

Other companies or insurance plans have offered workers financial rewards for exercising, dieting or other healthy behaviors. Some have started onsite fitness programs and are paying for gym memberships.

Health insurance costs have been rising at double-digit percentage levels for several years. The increase slowed from 12 percent in 2004 to 10 percent this year, according to a study by consulting firm Watson Wyatt of 555 employers with at least 1,000 employees.

Bruce Kelley, a senior consultant with Watson Wyatt, said in an e-mail that many companies realize that without incentives health programs tend to draw few workers or those at low risk of problems.

"That's a smart strategy," Kelley said of Worthington's Healthy Choices plan.

Worthington pays insurance premiums as long as employees work toward their goals, which could be as simple as trying to climb a few flights of stairs.