As someone who has been in human resources for the past 30-plus years, Christine Durkee can talk all day about the evolution she has seen in employee benefits. Different plan designs. New technologies. Administrative changes. Skyrocketing costs. The introduction of the Affordable Care Act.
But nothing, she says, has excited her more than when she was introduced to workplace wellness — or rather, the importance of such a concept.
It was back in the early aughts, and she heard a speaker likening the country’s healthcare cost woes to — of all things — a river of dead bodies.
“[He] was talking about how everyone was always focused on cost-shifting, but no one got to the top of this stream. [It was all about] putting Band-Aids on a broken system; he likened it to watching bodies floating down a river,” says the vice president of human resources operations of BJ’s Wholesale Club. “Everyone kept seeing the bodies in the river, but no one was figuring out how they were falling in. He said we need to go to the top of the river.”
The “top of the river” was chronic conditions. The solution was wellness.
“How he presented it went off like a lightbulb for me,” she says. Durkee went back to her then employer, Putnam Investments, and developed her first wellness program.
It was a hit. “It made everyone happy,” she says. “A lot of things with benefits aren’t particularly exciting. No one is looking forward to their next premium increase or their new higher deductible, but there was something exciting about doing these walks and challenges, and people figuring out their numbers.”
Durkee’s enthusiasm, passion and persistence in the field — not to mention a history of cutting healthcare costs and improving benefits understanding — are among the reasons she was named EBN’s Benefits Professional of the Year.
Still, it hasn’t always been an easy journey. When Durkee joined BJ’s Wholesale Club in 2010, she inherited a new demographic of workers — 25,000 of them — as well as a host of problems.
Workers were much more diverse than at Putnam, where she dealt with a generally highly educated group of people who sat in front of computers all day. In contrast, BJ’s workers were all across the map. Team members were in 213 remote club locations and three distribution centers, in addition to corporate headquarters in Westborough, Mass. They spoke different languages. They were a mixture of bakers, meat cutters and cake decorators, store managers, cashiers and forklift drivers. Most of them didn’t have desks.
The numbers spoke for themselves. Tobacco use afflicted a whopping 25% of the population. There was a lack of nutrition and physical fitness across the board. And the company was spending more than $100 million each year on medical.
“It was trending over 10% a year. That’s not sustainable,” Durkee says. “A lot of our team members are minimum wage earners, and they can’t afford to keep taking on 10%, 10%, 10% on their premiums.”
Taking action
Durkee knew she had to act right away. Her first priority was tobacco cessation. She had a unique approach.
“Rather than telling them what to do, we thought, ‘What’s in it for them?’” she says. After all, she explains, the Hispanic communities — a large component of BJ’s employees — are very family-oriented, so the conversation became pragmatic.
“We would tell them, ‘You want to quit because you want to spend more time with your family and feel good,’” she says. She created signage with the slogan “Today Is the Day,” with facts about how quitting smoking would help workers breathe better as well as give them more energy and more time.
Eliminating barriers was a vital component.
“We didn’t want them to have any barriers. If today was their day, we wanted them to get started right away,” she explains. “So for eight months, we had free tobacco-cessation programs. We put a $0 copay on any prescription drugs like Chantix; we allowed people to take nicotine gum or patches off the shelf and reimbursed the Clubs if any team members took them.”
Efforts paid off. Nearly 800 team members, 22% of BJ’s smokers, completed a tobacco cessation program.
Next up was nutrition. Store managers helped with that initiative, Durkee says, by simply being more mindful about food offerings. Gone were Danishes, bagels and muffins for morning meetings; in their place were nuts, fruit and yogurt. Soda machines were replaced with water and seltzers. Adult coloring books started to appear in the breakrooms so “people had something else to do instead of mindlessly eating,” Durkee says.
In addition, each Club elected a “wellness ambassador”— who was given a $50 stipend every month and would report to the corporate office about how things were going. Ambassadors helped maintain a “wellness board” in the breakroom — which would include things like upcoming 5Ks or fitness challenges initiated by employees. All of this, Durkee says, “created a wellness community in each of the Clubs.”
The result?
“We went from about 12% healthcare cost increase [in 2011] to 3% this year. That’s money in the pocket for employees.”
A missing component
Though the wellness component worked wonders, it dawned on Durkee that there was an important piece missing: education. Getting healthy was one thing; trimming costs was another. But were employees actually understanding just how their benefits worked?
“As the plan started to get more complex, with the ACA and deductibles and health reimbursement accounts, we were thinking, ‘How are these people going to understand this?’ It takes us six months to plan and design this stuff. So how are we going to put it out in three weeks and have people understand what the right choice is for their family?”
BJ’s worked with DirectPath, an employee engagement and healthcare compliance firm, to educate employees about their offerings and to explain why all of what they were doing — the wellness, the tobacco cessation — was so important.
Under the new model, employees began to meet with benefits educators one-on-one, either remotely or on-site, to reexamine their benefits options, explains Bart Yancey, CEO at DirectPath.
“This approach enabled the company to drive employees to more cost-effective programs, created an opportunity to build employee loyalty by highlighting the advantages of the available benefits programs, and facilitated the collection of demographic information,” he says.
As a result, enrollment in BJ’s basic medical plan has more than doubled as enrollment in the premier medical plan has fallen, creating even more cost-saving opportunities for BJ’s. Over the past three years, enrollment in the basic plan grew from 9% to 22%.
“You don’t want people overinsuring,” Durkee explains. “I really think the healthcare environment is so scary and confusing for people, between the compliance issues that are coming down through the Affordable Care Act and everything else.
“There’s more cost being passed on to team members, and pennies mean a lot to them. If they can pick a plan that costs them $20 dollars a week instead of $50, and they understand what the risk is, and they can make that [decision] in an educated manner, I think that’s a service [they deserve].”
Knowledge as power
Perhaps more important than saving pennies, though, is the power of knowledge.
“We were amazed by the feedback [after the benefits education]. Team members were telling us that they knew more about their insurance than they ever had before, or that they bought a less expensive health plan and were saving money. Or we would hear that they didn’t know about disability coverage and now they did, and they selected it. The perception of the [benefits] department improved dramatically.”
For Durkee, it’s more than a job; it’s a calling.
“I love to be a resource to people, because what comes naturally to me is a big deal to other people when they don’t understand it. I just love to explain it to people and see their face change from confused to, “OK, I get it now.’”
