If you're overweight, have high blood pressure, smoke or are diabetic, your employer may soon require you to improve your health, get counseling on the issue or pay a fine, especially if you work for a large corporation.
In an effort to rein in soaring medical-insurance costs -- now estimated at more than $12,000 per employee -- big companies are increasingly turning from incentives to penalties to change their workers' unhealthful habits.
The most recent example is CVS Caremark, which has ignited controversy by requiring its 200,000 employees to undergo screenings to record their weight, body fat, blood glucose and blood-pressure levels. If they don't do so by May 1, they'll have to pay an extra $600 for health insurance in the coming year.
Already, 20 percent of firms surveyed impose consequences on employees if they "don't utilize the health-awareness tools the company provides," according to a recent report from human-resources researcher Aon Hewitt. And roughly 60 percent of employers said they plan to impose penalties in the next three to five years for workers who don't take action to improve their health.
The shift is drawing fire from patients' rights groups, which consider the policies coercive and a violation of privacy. At Michelin North America, the tire manufacturer, workers with thick waistlines -- 40 inches and over for men, 35 and over for women -- will have to pay up to $1,000 more a year in health insurance premiums than their leaner co-workers.
And Honeywell International Inc. has imposed a $1,000 penalty for workers who undergo certain joint-replacement or back surgeries without first participating in a program that provides data on nonsurgical options.
"We have had a lot of discussion about sticks versus carrots," said Karen van Caulil, president of the Florida Health Care Coalition, an employer group. "Studies have shown that some people are more motivated by concerns of loss than by gain or positive reinforcement."
But Dr. Michael Siegel, a professor at Boston University School of Public Health, sees policies such as CVS' as "a slippery slope."
"What are people going to be penalized for next?" Siegel said. "Will they ask how many times you go out for fast food each week? Are they going to ask how much people drink? Are they going to ask about sexual behavior? What if an employee is having unsafe sex? It opens the door to asking people all kinds of personal questions that have nothing to do with how well you do your job."
For its part, CVS insists the policy is merely "the most effective way to encourage our colleagues to take control of their own health, reduce risks and manage their costs." Further, chief medical officer Dr. Troy Brennan said the requirements "meet all federal and state privacy regulations."