With more than 80 percent of the U.S. population having a connection to an employer, incorporating a worksite wellness program into the place where many employees spend the majority of their day makes perfect sense. The Commonwealth’s second largest writer of workers’ compensation insurance, A.I.M. Mutual Insurance Companies, has done just that. In developing A.I.M Works™, the mutual insurer has integrated the expansion of its loss control services along with a workplace wellness program for its workers’ compensation insureds.
The mutual insurer says this results in happier employees, less workplace injuries, and quicker recovery times for injured employees all while organically improving the mutual insurer’s own loss ratios.
Traditional workers’ compensation carriers’ loss control focuses on reducing workplace accidents
In Massachusetts, the insurance model for workers’ compensation arose out of accident insurance. As a result, not surprisingly, workers’ compensation insurers have focused their loss control efforts on reducing workplace accidents by advising on working conditions and procedures.
While the incidence rate of workplace accidents in Massachusetts is lower than the national average, workers’ compensation insurers have known for a very long time that unhealthy employees can present a greater risk of injury and have longer recovery times than healthy employees. Traditionally however, workers’ compensation carriers have, more or less, left worker wellness issues to health insurers. In turn, these health insurers often simply offer insureds, on a take-it-or-leave-it basis, reimbursement for health club memberships, exercise classes, weight-loss programs, such as Weight Watchers or a telephone counseling service to quit smoking.
Tracking claim costs leads to new approaches for A.I.M. in worker wellness
Since 2005, A.I.M. Mutual has partnered with the Best Doctors Occupational Health Institute (“Best Doctors”), an organization that has a special focus on the 3-5% of injured workers who generate up to 75% of a workers’ compensation insurer’s loss experience. With Best Doctors’ help, A.I.M has been able to track, statistically, the major factors that prolong recovery from an occupational accident covered by workers’ compensation insurance.
As a result, the Burlington-based mutual insurer has been able to determine that there are fundamental limits to improving its claim results. This means that where an injured employee has additional factors affecting his health, these factors will likely exacerbate an injury they received at work. For example, employees with tobacco addictions, alcohol issues, a body mass index (“BMI”) indicating obesity, or uncontrolled Type 2 diabetes statistically take a longer time to recuperate from an injury versus employees without these additional health issues. Not only is this not beneficial to the employee who takes longer to return to work, it often translate into adverse workers’ compensation claim results as well.
In response to its detailed loss causation statistics, A.I.M. Mutual decide to develop and implement, over a period of years, an entirely new and novel approach to workers’ compensation loss control: It now includes worksite wellness.
From loss control to Worksite wellness
In deciding to turn workers’ compensation loss control on its head, A.I.M. Mutual decided to help employees lead healthier lives. Not only would this result in happier employees, A.I.M. Mutual contends, but it would to reduce or even prevent workplace accidents which result in workers’ compensation claims. For example, the mutual insurer points to various statistics demonstrating how relatively common conditions such as smoking, obesity, alcohol consumption, and Type 2 diabetes can substantially exacerbate not only a worker’s health and ultimate recovery, but also the worker’s compensation claim.
Martha Gagnon, an Employee Benefits and Wellness Specialist at A.I.M. Mutual, has helped design portions of the A.I.M. Mutual worksite wellness program. She notes an important statistic based on a study by the University of Michigan Health Management Research Center which found that, without any additional health risks, the regular consumption of a pack or more per day of cigarettes could increase the cost of a workers’ compensation claim by as much as 1200%.
As a result, A.I.M. Mutual has been introducing over the past few years, a set of very specific tactics and strategies to identify and manage these worker wellness risks. In 2012, A.I.M. Mutual redefined the company’s traditional loss control mission and renamed its loss control department as the company’s “Injury Prevention and Worksite Wellness Department.”
Later in 2014, the company trademarked one its signature programs for improving workplace wellness as, A.I.M Works™ and rolled it out for qualified employers.
A.I.M. Works™ breaks new ground in workers’ compensation loss control
A.I.M Works™ is a specific program that targets employers, particularly those with less than 200 employees, to help them improve the overall health of their workforce and thereby improve claim outcomes on workers’ compensation loss ratios.
The program offers companies, who are looking to enhance their workers’ quality of life and health, a comprehensive program to motivate employees to improve their health. The program identifies and promotes the kind of lifestyle changes that most often pose a major challenge for a person, such as a smoking or drinking addiction or where an employee is simply trying to lose weight to avoid the problems of obesity.
A program for educating employees about wellness
The A.I.M Works™ program is a twelve month program that selects and enrolls eligible policyholders, on an annual basis, to participate in the program based upon their size, loss ratio and worker health concerns.
The program’s goal is two-fold. First, it aims to teach employers how to set up a comprehensive worksite wellness program that will help them be eligible for the Massachusetts Wellness Tax Credit (See below). Second, and more importantly, it aims to help a company build its own sustainable worksite wellness program that they can use to benefit their employees not only from a worker’s compensation standpoint, but also from a health care standpoint for the foreseeable future.
The program – once implemented – begins with a comprehensive employee lifestyle survey of the employer’s workforce. The survey collects employee responses to questions such as, “Are you a tobacco user?”, “Do you wear a seat belt when you drive?”, “How often do you drink?”
Additionally, the survey seeks, with permission, information on the employee’s physical and mental health.
The goal of the survey is to understand whether or not the worker has a healthy quality of life. Once that assessment has been made, the employer can develop – with A.I.M. Mutual’s help – a wellness program. With this information, the program developed by the employers has a better chance to change an employee’s habits for the better.
Based on the survey results, the program may include:
- A 12-month training program for management;
- Three years of data collection to determine the program’s ongoing results;
- An on-site training module, where employers in the program meet four times during the program to identify what the specific risks are within their employee population, and create a continuing plan of action;
- Webinars created by A.I.M. Mutual tailored to the specific needs of that employer’s worker wellness issues;
- Ongoing technical assistance from A.I.M Mutual so that the employer can overcome barriers or challenges that may arise during the course of the program.
Are workplace wellness initiatives just a fad or do they really work?
A.I.M. Mutual’s states that its own data now shows that significant gains in workers’ compensation insurance results for the benefit of the employee, the insurer and the employer follow from an overall wellness program that focuses upon a number of factors that may prolong recovery and make workers’ compensation claims costlier.
A.I.M. cites, as an example, a group of manufacturing companies in Massachusetts that implemented a wellness program to reduce the incidence of tobacco dependency among its employees.
The group’s employees had a tobacco prevalence of 53% combined in 2013 (36% higher than the state average). The companies identified a tobacco cessation program through their corporate health plan and offered it, at no charge, on a weekly basis to all employees using tobacco. Once introduced, 44% of these employees registered and began the program. From there, 57% of those employees had successfully completed the tobacco cessation program 10 weeks later. This level of success, while not typical, is attainable if employee needs are addressed and employers are provided with the right supports.
Long-term benefits to employer, employees, and the insurer
While the results from A.I.M. Mutual’s new focus on workplace wellness are not final, initial results have been very encouraging. The wellness programs at A.I.M. Mutual and the A.I.M Works™, in particular, demonstrate benefits to all the stakeholders involved in the programs.
- Enhanced employee productivity including reduced sick days.
- Reduced chronic disease burden.
- Decreased rates of injuries and accidents.
- Reduced absenteeism.
- Improved morale and higher job satisfaction.
- Improved retention.
The benefits accruing from worksite wellness also flow directly to employees as well as to employers. These benefits can include for each employee:
- Improved health.
- Improved well-being.
- Improved self-esteem and self-image.
- Improved health decisions.
- Reductions in the cost and number of medical services provided.
- Reduction in the cost and number of prescriptions.
- Reductions in the use of independent medical exams and on-site case management.
- Reductions in invasive surgeries such as spinal fusion, shoulder surgeries and spinal cord stimulation.
Workplace Wellness Programs and the Massachusetts state tax credit
Workplace wellness programs, like A.I.M Works™, have also received a boost from the State of Massachusetts. In 2012, the Legislature passed an Act providing for a state tax credit to employers of 25% of the cost associated with implementing a certified wellness program.
Eligible companies must have 200 or fewer employees, the majority of whom work in the Commonwealth. The program must be certified by the Massachusetts Department of Public Health prior to the business filing for a wellness tax credit.
The tax credit is based upon the total dollars invested in a comprehensive work site wellness program. If the program has been approved by the state, the company may take a credit against state taxes of up to $10,000 or 25% percent of the amount expended for the program whichever is less.
(Information on the exact requirements of the tax credit program can be found at: http://www.mass.gov/wellnesstaxcredit.)
A.I.M. Mutual’s focus on improving workplace wellness recognized by AM Best
In January 2014, A.M. Best published its innovation showcase awards for 2013.
The publisher recognized A.I.M. for its “Injury Prevention and Wellness Model” that included paying close attention to personal health and behavior of workers both prior and after injury and recording how the most-costly injuries no longer all arose from worksite hazards.
Additionally, A.I.M.’s commitment to fostering worksite wellness programs was recognized in September 2015 by the Worksite Wellness Council of Massachusetts by granting A.I.M. a worksite wellness leadership award for its commitment to the advancement of worksite wellness programs.
A.I.M. Mutual was formed in 1989 as a Massachusetts reciprocal insurer by the business trade association, Associated Industries of Massachusetts. Reformed as a mutual insurer in the 1990s, A.I.M. Mutual has grown over the past 27 years to become a leading domestic workers’ compensation insurer in Massachusetts.
A.I.M. Mutual markets through independent agents and brokers to provide employers workers’ compensation insurance. The independent insurance agents of Massachusetts currently write approximately two-thirds of all the workers’ comp. insurance in the Commonwealth. However, besides insurance policies that provide benefits mandated by the Massachusetts Workers’ compensation law, A.I.M. Mutual has carved a unique path by providing wellness programs for the whole person that is having a dramatic effect on workers’ compensation injuries and recoveries.