September 14, 2018

Preventive Benefits Are a Win-Win

The Affordable Care Act requires non-grandfathered health benefit plans to offer preventive benefits with no cost sharing. While this is an inflexible legal mandate, there are valuable long-term gains when employees use these benefits. These gains include having healthier and more productive employees and catching chronic health conditions in the early stages before they become catastrophic.

Encouraging your employees to use their preventive benefits can contribute to decreased utilization rates, lower absenteeism and less health care spending. Western Growers Assurance Trust encourages its participating employers to leverage preventive benefits to boost your employees’ health and productivity.


The True Cost of Having Unhealthy Employees

Encouraging the utilization of preventive care benefits can help employers curtail the staggering cost of providing health care coverage each year.  In 2016 alone, U.S. health care spending reached $3.3 trillion, or $10,348 per person, according to the Centers for Medicare and Medicaid Services. The three top health care spending areas were:

•   Hospital care. This area made up about one third of all health care spending, reaching $1.1 trillion.

•   Physician and clinical services. This area made up about 20 percent of all health care spending, $664.9 billion.

•   Prescription drugs. Ten percent of all spending was for prescription drugs, which reached $328.6 billion. The rise in prescription costs was attributed to an increase in spending on new medicines and price growth for existing brand-name drugs.

In addition to health care spending, the Centers for Disease Control and Prevention (CDC) Foundation, Business Pulse, reports that U.S. employers lose approximately $225.8 billion a year, or $1,685 per employee, due to absenteeism caused by illness, chronic diseases and work-related injuries.

By far, the biggest hit to an employer’s health care budget is for the treatment of employees with chronic health conditions. According to the CDC, chronic conditions such as heart disease, cancer, chronic obstructive pulmonary disease and stroke account for 75 percent of the nation’s healthcare spending. The CDC states that “most chronic diseases can be prevented by eating well, being physically active, avoiding tobacco and excessive drinking, and getting regular health screenings.”

Annual preventive screenings give doctors the opportunity to check an employee’s current health status and can typically catch a potential chronic health condition when it is less expensive to treat. Once diagnosed, a care management program, like the one operated by WGAT’s affiliate company, Pinnacle Health Management (PHM), can provide a next-step managed approach to those who have one of the chosen conditions. PHM takes a three-pronged approach to managing top chronic conditions such as diabetes and high cholesterol by providing participants with discounted or free medications, educational materials and monthly counseling sessions with a registered nurse.

Don’t be stuck paying extra health care dollars annually when you can maximize the preventive services you offer to employees. Here are some ways to encourage your employees to use these benefits:

•   Regularly communicate what free annual screenings are available for all adults, women and children, encouraging employees to get them done each year. An updated list is provided at by searching preventive health benefits.

•   Remind employees to get their dental cleanings twice a year. If employees do not have dental coverage, encourage them to seek affordable teeth cleanings through local dental providers.

•   August is National Immunization Awareness Month and a perfect opportunity to publicize the importance of vaccinations for people of all ages. An updated list is provided at by searching NIAM.

•   Publicize websites that provide information on practicing safe sex to prevent unwanted pregnancies and the spread of sexually transmitted diseases. Current information is provided through and by searching safe sex.

•   Promote discounted health services such as a telehealth program if your company offers one. For example, every WGAT health plan includes access to a Doctor on Demand telehealth program, which connects employees with board-certified physicians via computer or phone to discuss common medical or mental health issues. Doctor on Demand also coordinates lab services.

•   Also for purchasers of the WGAT health plan with staff who live or work in Salinas, Watsonville, Santa Maria, or Oxnard, encourage them to use their local Cedar Health and Wellness Center in these areas. Every Cedar Center offers low co-pays, convenient hours and bilingual services.

Encouraging your employees to use their preventive services makes good business sense. It helps prevent employees from getting sicker so employers like you don’t have to pay those bills for higher cost treatments and services. If you want more information on the WGAT health plan or are interested in purchasing the plan, contact Western Growers Insurance Services at (800) 333-4WGA.