# Anyone use Blue Cross/Blue Shield "Wellness Program"? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 24, 2019, 7:32pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252 "2019-10-24T19:32:33Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![actualliberalnotoneofthose](https://avatars.discourse-cdn.com/v4/letter/a/e79b87/32.png) [@actualliberalnotoneofthose](https://boards.straightdope.com/u/actualliberalnotoneofthose)\ **Post date:** [October 25, 2019, 9:21pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/21 "2019-10-25T21:21:05Z")
I have an HSA and I think BCBS is just the administrator of the employer’s plan… or something. So I don’t know if this applies to me. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [October 25, 2019, 9:37pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/22 "2019-10-25T21:37:05Z")
> [@actualliberalnotoneofthose](#): > > I have an HSA and I think BCBS is just the administrator of the employer’s plan… or something. So I don’t know if this applies to me. It’s possible that your employer (particularly if you work for a larger company or big governmental agency) has what is known, in the business, as [a “self-funded” health insurance plan](https://www.bbgbroker.com/self-funding-insurance-switch-4-reasons/). In a self-funded plan, the company usually does, indeed, hire a third-party health insurance company (such as a Blue Cross and Blue Shield plan, UnitedHealthcare, etc.) to administer the plan, and to give their employees access to the insurance company’s provider network and negotiated rates. The big difference between self-funded plans and traditional health insurance is who’s managing the risk pool, and who’s ultimately responsible for paying claims – in a traditional group plan, the employer pays the premiums to the insurer, and the insurer then is taking on the risk for insuring employees. In a self-funded plan, the company itself is taking on the financial risk, and is ultimately liable for paying out claims. In my experience, self-funded plans are actually _more_ likely to be interested in getting employees to participate in wellness programs, as those companies have more to lose if they have a lot of expensive health claims from their employees. ---
**Author:** ![HMS\_Irruncible](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hms_irruncible/32/7394_2.png) [@HMS\_Irruncible](https://boards.straightdope.com/u/HMS_Irruncible)\ **Post date:** [October 25, 2019, 9:57pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/23 "2019-10-25T21:57:35Z")
> [@Urbanredneck](#): > > Looking at insurance options this year we have BCBS and they require within 1 year to accumulate like 4200 points in this “Wellness program”. These include things like cholesterol screening and mandatory exercise. You do such and such and you get so many “points” . If you dont do 4200 in a year they charge an extra $20 more a month. They said if I voted for Hillary, the system would make us play stupid games to make us get access to healthcare. And they were right! ---
**Author:** ![Two\_Many\_Cats](https://avatars.discourse-cdn.com/v4/letter/t/8dc957/32.png) [@Two\_Many\_Cats](https://boards.straightdope.com/u/Two_Many_Cats)\ **Post date:** [October 26, 2019, 1:33am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/24 "2019-10-26T01:33:59Z")
> [@slash2k](#): > > This has nothing to do with “personal freedom”; it has to do with money. The company pays lower health insurance premiums by having employees get flu shots and check their cholesterol. Since it is an employer-provided benefit, it is no different than requiring employees to use the company’s vision-plan administrator to get cheap glasses. If you don’t like the rules and requirements associated with a particular benefit, you are of course free to decline it, or to lobby your company to pay more in premiums to remove particular requirements. It has everything to do with an employee’s personal freedom. The money side of it is the employer’s concern. Why do you think the employer’s side is the only side that matters? I don’t smoke, but I firmly believe that those who do should have the personal freedom to do so without the insurance companies and the employers penalizing them for it. So you fall below baseline if they detect nicotine in your health screen and you get penalized. What if it was second hand smoke from a spouse who smokes or a parent? What’s to stop these greedy fucks from penalizing you if your BMI number goes up? Or your A1C? Or your bad cholesterol? What’s to stop them from ordering genetic testing to look for what diseases you might get down the road? And as for being free to decline employer based health insurance, you know your average person can’t afford to do that. ---
**Author:** ![lorene](https://avatars.discourse-cdn.com/v4/letter/l/65b543/32.png) [@lorene](https://boards.straightdope.com/u/lorene)\ **Post date:** [October 26, 2019, 3:15am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/25 "2019-10-26T03:15:56Z")
> [@Two\_Many\_Cats](#): > > So you fall below baseline if they detect nicotine in your health screen and you get penalized. What if it was second hand smoke from a spouse who smokes or a parent? The tests actually generally screen for cotinine, which your body produces when you process nicotine. Tests have the ability to measure the levels of metabolites In your system, which will differentiate between a smoker and someone who lives with a smoker. In part these incentives are in response to many people protesting that they shouldn’t have to pay the same premiums as Chuck from Accounts Payable who smokes like a chimney or that guy in the warehouse who eats bacon double cheeseburgers for lunch three times a week despite needing bypass surgery last year. ---
**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\ **Post date:** [October 26, 2019, 5:23am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/26 "2019-10-26T05:23:59Z")
> [@Two\_Many\_Cats](#): > > I don’t smoke, but I firmly believe that those who do should have the personal freedom to do so without the insurance companies and the employers penalizing them for it. As a group, smokers have more (and more expensive) health problems than people who don’t. Are you arguing that people who don’t smoke should be forced to pay more (“penalized”) in order to subsidize those who do? What does that do to the personal freedom of non-smokers? > [@Two\_Many\_Cats](#): > > What’s to stop these greedy fucks from penalizing you if your BMI number goes up? Or your A1C? Or your bad cholesterol? What’s to stop them from ordering genetic testing to look for what diseases you might get down the road? People who bought health insurance on the individual market pre-ACA usually DID pay more for health insurance if they had a high BMI or other risk factors, or familial history, or pre-existing conditions (assuming they could buy health insurance at all). Similarly, people in risky occupations or with poor health pay more for life insurance, people with lousy driving records pay more for auto insurance, people with swimming pools and pit bulls pay more for homeowners insurance, etc., etc. Employer-based group health insurance is fairly unusual in that it is not based on your personal risk factors, but instead on the risk profile of the entire group. Schemes to reduce the risk factors of the group save money for whoever is paying for the group’s insurance, which is usually a combination of employer and employees. > [@Two\_Many\_Cats](#): > > And as for being free to decline employer based health insurance, you know your average person can’t afford to do that. So? It’s still a fringe benefit, not something the employer is required to adjust to cater to everybody’s personal situation and preferences. ---
**Author:** ![Two\_Many\_Cats](https://avatars.discourse-cdn.com/v4/letter/t/8dc957/32.png) [@Two\_Many\_Cats](https://boards.straightdope.com/u/Two_Many_Cats)\ **Post date:** [October 26, 2019, 3:15pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/27 "2019-10-26T15:15:21Z")
> [@lorene](#): > > In part these incentives are in response to many people protesting that they shouldn’t have to pay the same premiums as Chuck from Accounts Payable who smokes like a chimney or that guy in the warehouse who eats bacon double cheeseburgers for lunch three times a week despite needing bypass surgery last year. Oh, so now your co-workers can inform on you to your corporate overlords? How very Maoist of them. Unless my stupid health decisions are putting my colleagues in immediate danger, like showing up drunk to work the forklift, what I do on my off hours is nobody’s business but my own. ---
**Author:** ![lorene](https://avatars.discourse-cdn.com/v4/letter/l/65b543/32.png) [@lorene](https://boards.straightdope.com/u/lorene)\ **Post date:** [October 26, 2019, 3:38pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/28 "2019-10-26T15:38:05Z")
> [@Two\_Many\_Cats](#): > > Oh, so now your co-workers can inform on you to your corporate overlords? How very Maoist of them. I’m not sure how you got that from what I posted. Can you explain? ---
**Author:** ![Two\_Many\_Cats](https://avatars.discourse-cdn.com/v4/letter/t/8dc957/32.png) [@Two\_Many\_Cats](https://boards.straightdope.com/u/Two_Many_Cats)\ **Post date:** [October 26, 2019, 3:44pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/29 "2019-10-26T15:44:04Z")
> [@slash2k](#): > > As a group, smokers have more (and more expensive) health problems than people who don’t. Are you arguing that people who don’t smoke should be forced to pay more (“penalized”) in order to subsidize those who do? What does that do to the personal freedom of non-smokers? > > People who bought health insurance on the individual market pre-ACA usually DID pay more for health insurance if they had a high BMI or other risk factors, or familial history, or pre-existing conditions (assuming they could buy health insurance at all). Similarly, people in risky occupations or with poor health pay more for life insurance, people with lousy driving records pay more for auto insurance, people with swimming pools and pit bulls pay more for homeowners insurance, etc., etc. Employer-based group health insurance is fairly unusual in that it is not based on your personal risk factors, but instead on the risk profile of the entire group. Schemes to reduce the risk factors of the group save money for whoever is paying for the group’s insurance, which is usually a combination of employer and employees. > > So? It’s still a fringe benefit, not something the employer is required to adjust to cater to everybody’s personal situation and preferences. I’m sure the nonsmoking others in the group have personal quirks that endanger their health, so it probably evens up over all. Do people who die younger doing risky behaviors cost the insurance companies and the taxpayers through Medicare more than healthy people who live years longer and succumb to old age diseases that cost big time? If you don’t like it that your smoky co-worker pays the same premium as you do in your group health plan, find something else to obsess about that actually is your business, like giving up candy and soda. Or else start smoking Marlboros yourself, so you can enjoy the same unfair privilege that your smoky co-worker enjoys. ---
**Author:** ![Two\_Many\_Cats](https://avatars.discourse-cdn.com/v4/letter/t/8dc957/32.png) [@Two\_Many\_Cats](https://boards.straightdope.com/u/Two_Many_Cats)\ **Post date:** [October 26, 2019, 3:52pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/30 "2019-10-26T15:52:46Z")
> [@lorene](#): > > I’m not sure how you got that from what I posted. Can you explain? If these penalty policies resulted from employees complaining about their co-workers habits to their bosses as you posted, then it’s not that different from turning someone in for anti-social behavior in a totalitarian society hoping for a reward. It’s only the scale of brutality that’s less. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [October 26, 2019, 4:04pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/31 "2019-10-26T16:04:29Z")
My health insurer sends me envelopes filled with information about their various health programs weekly. After the first few mailings I stopped opening them. ---
**Author:** ![Odesio](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/odesio/32/20003_2.png) [@Odesio](https://boards.straightdope.com/u/Odesio)\ **Post date:** [October 26, 2019, 4:24pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/32 "2019-10-26T16:24:49Z")
> [@Two\_Many\_Cats](#): > > Oh, so now your co-workers can inform on you to your corporate overlords? How very Maoist of them. I have never heard of an employee turning in a coworker for being a closet smoker or eating too many cheeseburgers. Why would they? The results of your biometric screening and the details of your health insurance benefits is protected information that most other employees outside of HR won’t have access to. > [@](#): > > Unless my stupid health decisions are putting my colleagues in immediate danger, like showing up drunk to work the forklift, what I do on my off hours is nobody’s business but my own. You’re not required to participate in any wellness program. It’s your choice. My company offers an incentive in the form of a monthly credit applied toward employee premiums if the employee choose to participate in the yearly biometric screening where they check BMI, tobacco use, blood sugar, cholesterol, and blood pressure. Hell, for tobacco we don’t run any test we just ask about it. And even if an employee fails some of the criteria they can still get credit by participating in the wellness programs offered. But we have some employees with the same attitude as you and they choose not to participate. Which is fine because that’s their right. But they’re paying higher premiums and I don’t see any problem with that. ---
**Author:** ![Two\_Many\_Cats](https://avatars.discourse-cdn.com/v4/letter/t/8dc957/32.png) [@Two\_Many\_Cats](https://boards.straightdope.com/u/Two_Many_Cats)\ **Post date:** [October 26, 2019, 5:53pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/33 "2019-10-26T17:53:19Z")
> [@Odesio](#): > > But we have some employees with the same attitude as you and they choose not to participate. Which is fine because that’s their right. But they’re paying higher premiums and I don’t see any problem with that. Well, I do. One of my former workplaces had a wellness program type of thing where they decided they should start screening for colon cancer. They sent emails to their employees asking for details on what their shit looked like, with cartoon turds to choose from. Aw no! That’s not invasive or embarrassing at all! Thank god I was a temp. I didn’t have to participate. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [October 26, 2019, 7:44pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/34 "2019-10-26T19:44:50Z")
> [@Two\_Many\_Cats](#): > > Well, I do. One of my former workplaces had a wellness program type of thing where they decided they should start screening for colon cancer. They sent emails to their employees asking for details on what their shit looked like, with cartoon turds to choose from. Aw no! That’s not invasive or embarrassing at all! I am not necessarily an expert on the minutiae around the HIPAA law, but if the employer was asking employees to reply/respond to those emails with descriptions of their poop, that may well have been a non-secure request for personal health information (PHI), and might have a violation of the law. ---
**Author:** ![Two\_Many\_Cats](https://avatars.discourse-cdn.com/v4/letter/t/8dc957/32.png) [@Two\_Many\_Cats](https://boards.straightdope.com/u/Two_Many_Cats)\ **Post date:** [October 26, 2019, 8:01pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/35 "2019-10-26T20:01:35Z")
> [@kenobi\_65](#): > > I am not necessarily an expert on the minutiae around the HIPAA law, but if the employer was asking employees to reply/respond to those emails with descriptions of their poop, that may well have been a non-secure request for personal health information (PHI), and might have a violation of the law. Yeah, but who’s gonna turn the boss in? Anyone? ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [October 26, 2019, 10:21pm UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/36 "2019-10-26T22:21:53Z")
> [@Two\_Many\_Cats](#): > > Yeah, but who’s gonna turn the boss in? Anyone? Fair enough, but my point is that the example you gave may be beyond the pale on what an employer’s “wellness program” is allowed to do. ---
**Author:** ![needscoffee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/needscoffee/32/1076_2.png) [@needscoffee](https://boards.straightdope.com/u/needscoffee)\ **Post date:** [October 27, 2019, 12:56am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/37 "2019-10-27T00:56:59Z")
> [@kenobi\_65](#): > > I am not necessarily an expert on the minutiae around the HIPAA law, but if the employer was asking employees to reply/respond to those emails with descriptions of their poop, that may well have been a non-secure request for personal health information (PHI), and might have a violation of the law. It’s not a violation of HIPAA, which applies to medical personnel/facilities. ---
**Author:** ![needscoffee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/needscoffee/32/1076_2.png) [@needscoffee](https://boards.straightdope.com/u/needscoffee)\ **Post date:** [October 27, 2019, 1:00am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/38 "2019-10-27T01:00:00Z")
The last time I had to apply for my own health insurance, monthly premiums were higher for smokers. Because it costs far more for healthcare of a smoker than an equivalent nonsmoker. ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [October 27, 2019, 3:23am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/39 "2019-10-27T03:23:15Z")
> [@needscoffee](#): > > It’s not a violation of HIPAA, which applies to medical personnel/facilities. Thus proving that my knowledge of HIPAA still needs refinement. 🙂 ---
**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\ **Post date:** [October 27, 2019, 4:27am UTC](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252/40 "2019-10-27T04:27:42Z")
> [@Two\_Many\_Cats](#): > > I’m sure the nonsmoking others in the group have personal quirks that endanger their health, so it probably evens up over all. Do people who die younger doing risky behaviors cost the insurance companies and the taxpayers through Medicare more than healthy people who live years longer and succumb to old age diseases that cost big time? No, it DOESN’T “even up”; that’s the point. A smoker, on average, costs the health insurer more than a non-smoker of the same age. The conditions caused or exacerbated by smoking include not just lung cancer and COPD but stroke, coronary heart disease, other kinds of cancer, high blood pressure, type 2 diabetes, rheumatoid arthritis, and decreased immune response (among others). Smokers tend to get the same “old age diseases that cost big time”; they just get those diseases in middle age, where the expense is borne by private insurers rather than Medicare. > [@Two\_Many\_Cats](#): > > If you don’t like it that your smoky co-worker pays the same premium as you do in your group health plan, find something else to obsess about that actually is your business, like giving up candy and soda. If I’m paying more for my health insurance to subsidize the premiums of those who choose to smoke and thereby has greater healthcare costs, that is money coming directly out of my pocket. Why do you think issues that directly affect my pocketbook are not my business? [Previous page](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252.md?page=1) [Next page](https://boards.straightdope.com/t/anyone-use-blue-cross-blue-shield-wellness-program/842252.md?page=3)