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Making obese pay higher health premiums slammed

Posted by dipps
On September 17th, 2007 at 07:09

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Posted in Insurance, Law

This is a bandwagon employers might want to think twice about before jumping on.

Some companies nationwide are tackling health-care costs by charging obese employees higher premiums. But local experts, including attorneys who represent employers, have poohpoohed the approach because they believe the solution could be worse than the problem.

Commack attorney Allen Breslow said that the weight- differential costs could violate obese employees’ rights. “I have serious questions about whether that is an appropriate way to treat a medical problem,” he said. “It might be an ADA [Americans With Disabilities Act],” violation … I just wouldn’t let my clients touch it.”

In fact, an attorney for the U.S. Equal Employment Opportunity Commission, which enforces the ADA, echoed that concern, especially regarding the morbidly obese, generally considered to be individuals at least 100 pounds overweight.

“If they targeted the morbidly obese, then I think there would be an ADA claim,” said Elizabeth Grossman, regional attorney in the EEOC’s Manhattan Office.

Another local lawyer questioned whether singling out individual employees could violate state insurance law.

“An employer has to be very careful when it comes to offering insurance coverage to staff under a group policy if it attempts to make selections that are based on someone’s individual characteristics,” said Carmelo Grimaldi, a partner at Meltzer, Lippe, Goldstein & Breitstone in Mineola. “Insurance statues could potentially prohibit that.”

Many companies in New York State couldn’t charge obese employees for health insurance even if they wanted to. State-mandated “community-rated” premiums for small businesses with fewer than 50 employees (the majority of businesses on Long Island, for example) require an insurance company to charge all its customers in the same geographical region the same premium for the same products.

“This law was passed to avoid an employer paying higher premiums because of the demographics of the employees,” said Susan Sajiun-Fitzharris, president of United Benefit Consulting Inc., a Smithtown brokerage and consulting company.

Obesity has become a hot-button issue because of the dramatic increase in the number of obese Americans, illnesses associated with being overweight and the rising costs of health benefits.

The condition can lead to diabetes, which in turn leads to illnesses such as blindness, kidney failure and heart problems, said Toni A. Riedel-Lehmann, associate director of the Long Island chapter of the American Diabetes Association, which recently launched a national initiative to encourage employers to partner with the group to tackle diabetes among workers.

She said employers pay an average $13,000 annually to cover an employee’s cost of managing diabetes, compared with $2,300 for an employee without the disease.

Increasingly, though, local companies and their insurance companies are offering programs to encourage employees to improve their health, said Sajiun-Fitzharris.

For example, she said a corporate client in Manhattan offers $250 to employees who successfully complete a 10-week Weight Watchers program.

Oxford, a health-maintenance organization, offers the employees of its corporate clients $200 if they document that they have gone to a gym that promotes cardiovascular wellness at least 50 times in a six-month period, she said. Spouses are reimbursed $100.

Oxford even has a program to encourage the children and grandchildren of employees to eat healthy, she said. “Insurance companies have valuable resources to promote wellness and reduce risk associated with illness,” she said.

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