For the 10th year in a row, Turner Construction will be giving discounts on premiums to each of its employees who participate in the wellness program. The annual discount—$300 pre-tax for an individual and $600 for a couple or family—is included in an employee's paycheck. Other perks of the program include generous discounts on annual gym memberships: $360 for individuals and $500 for couples or families.

"Wellness has become part of our culture. Turner is interested in our employees' health for all the obvious business reasons, keeping claims down and lowering absences, but we also know that healthier employees are more productive and happier. That make us a stronger company," says Tim Logan, Turner's vice president of compensation and benefits.

Turner started its wellness program in 2004 to help minimize health care claims through its self-funded insurance plans. With multiple offices nationwide, the company relies on human resources in each unit to administer the program at the local level. Turner takes pride in having made only minor cutbacks in coverage over the past decade due in large part to savings realized through the wellness program—the company's increases in claims have consistently run a few percentage points below the national average, Logan says.

Turner emphasizes preventive care, requiring program participants and their spouses or domestic partners to have an annual physical exam from their primary-care physician to earn the discount. Additionally, all participants must undergo an annual biometric screening in March. If three or more risk factors are identified during the screening, then the employee must complete a 10-week online lifestyles class that teaches healthy-eating principles.

Turner's wellness program, like that of many companies, targets obesity, and with good reason, according to Kevin Ring, lead analyst with the Institute of WorkComp Professionals.

A 2010 study produced by the National Council on Compensation Insurance shows a greater risk that injuries will create permanent disabilities if the injured worker is obese. Additionally, a 2012 NCCI study shows that an injured worker with an existing medical condition (such as hypertension, obesity or diabetes) is twice as expensive to treat.

"The health of an employee is an important factor in how long it takes an employee to recover from an injury and therefore how much a company will pay out in workers compensation," Ring says.

Questions About Costs

Some employers remain hesitant about the up-front investment of wellness programs, despite studies that suggest their long-term profitability. Notably, a 2010 Harvard University study, "Workplace Wellness Programs Can Generate Savings," found that medical costs fall about $3.27 for every dollar spent on wellness programs, and absentee-day costs fall by about $2.73 for every dollar spent.

While there is no specific wellness credit at the federal level, the expense of an employer-provided wellness program is tax-deductible as a business expense. Additionally, some states are introducing tax credits for wellness programs. In late 2012, Massachusetts enacted legislation providing an annual wellness tax credit of up to $10,000, or 25% of the cost of implementing an employee wellness program.

"The cost of implementing and operating a wellness program tends not to be very great, depending on what kind of program you want to have," says Dustin Boss, an insurance agent and lead educator for the Institute of Benefits and Wellness Professionals (IBWP). Boss and his father launched the IBWP in 2011 to train insurance agents and brokers to help clients implement wellness programs as a risk-management tool.

"There is no one-size-fits-all wellness model. Quite often a company will implement a fancy wellness program based on what another company is doing and then wonder why the adoption rate is low," Boss says. "When it comes to wellness, every company is different. You must start by identifying your company's risk factors and then tailor your wellness activities to address those risks."

The high population of male workers makes the construction industry a good environment for wellness programs to thrive, Willis' Morales notes.

"Males generally resist going to the doctor. They tend to be cheaper to insure in their younger years and then become more expensive as they grow older, largely because of diseases and ailments that could have been avoided with better preventive care in their younger years. That is where wellness programs can make a real difference over the lifetime of a worker," he explains.

"The proof is always in the numbers. Companies should work with their brokers and agents to understand where they spend their money. What conditions cause their large claims? A significant number of large claims are due to avoidable situations, like end-stage renal failure from diabetes. If employees treat their diabetes before it escalates, then they can likely avoid kidney failure," he adds.

While countless studies point to the effectiveness of wellness programs, some health care insiders say the evidence of their success is still unproven. "Wellness programs are good and intuitively they make sense, but the research and evaluation of these programs needs to be tightened up. It is really unclear what is actually working and how effective these programs are," says Brandon Hemmings, a health-care analyst for the Center for Healthcare Research and Transformation, a nonprofit research partnership between the University of Michigan and Blue Cross Blue Shield of Michigan that focuses on health policy and practices.

However, Pronk is confident that, when executed properly, wellness programs can be effective in curtailing insurance premiums.

"The financial benefits of wellness programs are very real, but they do not happen overnight. Companies will see savings in absences, disability and workers compensation sooner, within the first few years. It may take several years to see savings in health-care costs, but they will come," she says.