A Look at Employer ACA Wellness Incentives and Savings


A section of Kaiser’s 2014 Employer Health Benefits Survey delved into employers’ use of wellness incentives in their employee healthcare benefits strategy. How can they help employers to save moving forward?


Wellness Programs

Wellness programs include a wide range of activities that promote health and fitness or help employees achieve health goals. The Kaiser survey found:

– 74% percent of firms* offering health benefits offer at least one wellness program, and large employers are more likely than smaller employers (98% vs. 73%) to offer at least one wellness program: 

Wellness Program

Large Firms

Small Firms

Flu shot



Employee Assistance Program



Web-based resources for healthy living



Gym membership discounts or on-site exercise facilities



Smoking cessation programs



Wellness newsletter



Lifestyle or behavioral coaching



Biometric screening



Weight loss programs



Class in nutrition or healthy living







– Of firms offering both healthcare benefits and a wellness program, 36% of large firms and 18% of smaller firms offer employees a financial incentives to participate—smaller premium contributions, smaller deductibles, higher HSA/HRA contributions, gift cards, travel, merchandise, or cash.

– Twelve percent of large firms offer a financial incentive to employees who complete a wellness programs and 32% of these firms reported that the maximum value of the incentive is $500 or more. 

– 14% of firms offering health benefits and at least one of the listed wellness programs think that financial incentives are “very effective” in encouraging employees to participate, with large firms more likely than smaller ones to believe incentives are “very effective”

Health Risk Assessments

A health risk assessment (HRA) is an evaluation of a person’s health status, medical history, and lifestyle to identify any potential health risks. It usually includes a questionnaire, a calculation or score, and feedback designed to motivate the participant to engage in healthier behavior or make positive lifestyle changes. The Kaiser study showed:

– 33% of firms offering healthcare benefits provide employees an opportunity to complete a health risk assessment; large firms are more likely than smaller firms to do so (51% vs. 32%)

– Among these large firms, 51% provide a financial incentive to employees who complete the assessment and 36% of these firms report the maximum value of the incentive is $500 or more

– 3% of large firms that offer health risk assessments require employees to complete a HRA in order to enroll in a health plan

Biometric Screening

Often used in conjunction with a health risk assessment, a biometric screening is a health exam that measures a person’s risk factors (i.e. body weight, cholesterol, blood pressure, stress, and nutrition) that are often associated with common preventable diseases such as diabetes and hypertension. The results provide a baseline used to set the course of a wellness program. The Kaiser study revealed:

– 51% of large firms, compared with 26% of smaller firms offering healthcare benefits, offer biometric screenings to employees

– Among these large firms, 8% reward or penalize employees for meeting biometric outcomes and 42% of these firms offer a maximum financial incentive of $500 or more

– 1% of large firms offering biometric screenings require employees to complete biometric screenings in order to enroll in a health plan 

Moving Forward

With new provisions of the Accountable Care Act taking effect over the next few years, namely the employer mandate in 2015 and the Cadillac Tax in 2018, many employers are preparing to make more changes to their employee benefits strategy—and this includes wellness programs. The Aon Hewitt pulse survey of 317 U.S. employers revealed that “increasing the use of wellness incentives in their plans” is among the changes many employers will make to their healthcare plans in 2015 to help them avoid triggering the excise tax on high cost health plans when it goes into effect in 2018. Healthcare Trends Institute will monitor changes in employers’ use of wellness benefits and share relevant data and insights as they become available.

*In this study, large employers have 200 or more employees and small employers have between 3-199 employees.  Read Kaiser’s complete 2014 Employer Health Benefits Survey.

Learn more about wellness programs: 

6 Trends That Show Workplace Wellness Programs Are Here To Stay 
Sweeten Your Wellness Program With Financial Incentives
Wellness Program Trends: A Closer Look at Health Coaching

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