1. Fat Fees and Smoker Surcharges. More states adopt tough-love wellness initiatives By Melba Newsome Time Magazine Nov 30, 2009 Presentation by Anna Schneider

2. Introduction Employer sponsored wellness plans is no new idea, but there have been some recent developments to make them more effective. The Kaiser Family Foundation states that nationwide, employee premiums have increased by 131% over the last decade making this an issue that needs to be controlled. Obesity and smoking/tobacco related are estimated to cost employers $108 million and $137 million annually, respectively according to the North Carolina State Plan. North Carolina and Alabama are implementing different programs to state workers attempting to achieve the same goal: a healthier group which will lead to less insurance claims and costs to the company.

3. Sticks VS Carrots North Carolina: Sticks Starting in July 2010, all state workers that smoke will move from an 80% co-pay to a 70% co-pay unless they enroll in a smoking- cessation program. In 2011, a person with a BMI under 40 can remain at the 80% co- pay for the first year, but must be down to 35 by the next year, or must enroll in a weight loss program to qualify for the 80% co-pay Alabama: Carrots All state workers have a $70 monthly premium for their benefits. For those that do not smoke, they will get $30 off. After the 31 st, those who allowed themselves for a screening could get an additional $25 off their monthly premium, or those with a BMI above 35 could enroll in a weight loss program to receive discount

4. Additional Annual Cost Per Employee

5. Pros and Cons Since the anti-smoking Alabama plan began in 2005, there has been a 4% decline in the number of smokers. Safeway supermarket chain implemented a wellness plan similar to that of Alabama, and has found a way to decrease their employees insurance premium by $800 a year, and the employer has been able to keep its per capita insurance cost flat for the past 5 years. American Heart Association, American Cancer Society and 61 other organizations were not in favor of either plan deeming it a penalty for failing to achieve a specific health status. Other government programs aimed at anti-smoking and wellness. Authors last statement: people who get caught speeding have to pay higher car insurance. Has that made us all safer drivers? Democratic and Republican support in the senate for raising the premium reductions from 20% to 50% and also support lifestyle bonuses.

6. Bibliography Newsome, Melba. "Fat Fees and Smoker Surcharges. More states adopt tough-love wellness initiatives." Time 30 Nov. 2009: 63- 64. Print.