Well Being

Selling Health Insurance By The Pound: More Plans Charge Extra For High BMI

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weighing in

I used to smoke cigarettes. When the whole “smokers should pay higher health insurance premiums” movement started gaining momentum — I'm gonna say, like, 2005? 2006? — I was constantly going around agreeing that would be perfectly fair, if obese people paid extra, too (and while we're at it, why not charge premiums for poor diet and high alcohol consumption?).Very few people were sympathetic. Most people looked at me like I was kind of a jerk.

Boy, have times changed. While the call for smokers to pay extra for health coverage seems to have held steady, more and more businesses are implementing or seriously considering making overweight employees pay extra premiums — or “selling health insurance by the pound,” as MarketWatch puts it.

Writer Jen Wieczner explains how it works:

Employees go through medical and biometric testing as part of their health insurance open-enrollment process. They are weighed, their height and blood pressure are measured, and their blood is drawn. Those with high scores on cholesterol, glucose and blood-pressure and — or with chronic conditions like diabetes — are told they will have to pay higher premiums unless they actively try to improve their risky condition. The premiums can also be tied directly to one’s body-mass index.

A BMI above 25 is considered overweight, and above 30 obese. Some companies have begun charging employees extra for BMIs as low as 27, according to health management consultant Michael Wood.

In the individual insurance market (i.e., not employer-sponsored coverage), people in the obese BMI category paid an average of 22% more in monthly insurance premiums, according to an eHealthInsurance report. Obese men paid 29% more; smokers paid only 14% higher premiums. [More on how various insurers charge for different BMI levels here.]

The latest figures on employer-sponsored health plans show about 38% of companies planned to charge higher premiums or deductibles in 2012 to employees who smoked, had high cholesterol or had other chronic conditions, like diabetes or high blood pressure, that they weren't trying to treat. But companies also planned to reward employees for healthy behavior. Eighty percent said they planned to implement financial incentives for insured employees who did things like lose weight or partake in disease-management programs.