Smokers squeezed by soaring cigarette costs and workplace smoking bans are increasingly being hit with another cost increase -- this time for health insurance.
A growing number of private and public employers are requiring employees who use tobacco to pay higher premiums, hoping that will motivate more of them to stop smoking and lower health care costs for the companies and their workers.
Meijer Inc., Gannett Co., American Financial Group Inc., PepsiCo Inc. and Northwest Airlines are among the companies charging or planning to charge smokers higher premiums. The amounts range from about $20 to $50 a month.
"With health care costs increasing by double digits in the last few years, employers are desperate to rein in costs to themselves and their employees," said Linda Cushman, senior health care strategist with Hewitt Associates, a human resources consulting and services firm.
She said the practice of smoker surcharges is becoming such a significant trend that this year, it will be part of Hewitt's annual survey of companies' current and future health care plans.
Cushman said a general benefits survey of 950 U.S. employers last year showed at least 41 percent used some form of financial incentives or penalties in their health care plans.
She estimates at least 8 to 10 percent of the businesses probably aimed some of the incentives or penalties at smokers and says that percentage is growing.
"With smokers costing companies about 25 percent more than nonsmokers in the area of health care, it just makes good business sense," she said.
The companies imposing the surcharges are mostly self-insured, with employers and employees sharing the insurance premium costs.
Other companies or insurance plans have offered workers financial rewards for exercising, dieting or other healthy behaviors. Some have started onsite fitness programs and are paying for gym memberships.
The Centers for Disease Control and Prevention estimates $92-billion in lost wages annually in the United States from smokers who die prematurely. In addition, the economic cost of smoking includes $75.5-billion per year in direct health care costs.
"In addition to employers having to pay out more in health care costs, public opinion is now solidly on the side of eliminating smoking and workers are realizing increasingly that they are having to pay for others' lifestyle choices," said Helen Darling, president of the National Business Group on Health, a nonprofit agency representing more than 200 of the nation's large employers.
Gannett Co., the nation's largest newspaper publisher, this year began charging its employees who smoke an extra $50 a month for the company's insurance coverage.
"We have some strong feelings that smoking is really bad for employees, and a healthier employee is better for us," said Tara Connell of the McLean, Va., company.
PepsiCo Inc. has been charging employees who use tobacco $100 annually for a couple of years, and Meijer Inc. started charging smokers $25 a month this year. That fee is dropped if smokers complete a smoking-cessation program, spokeswoman Judith Clark said.
American Financial Group holding company and its subsidiaries waive the $37.92 monthly fee for a year if smokers make a good-faith effort and complete the company's stop-smoking program, said Scott Beeken, a vice president with the Great American Insurance Group subsidiary. If the employee starts smoking, the fee would be reinstated the next year.
About 35 workers were expected to enroll if the voluntary program had not included the financial incentive, but 325 have signed up.
"The charge probably was a motivating factor," Beeken said.
Public employers also are requiring smokers to pay for their habit.
The state of Alabama on Oct. 1 began charging $20 a month extra per employee insurance contract. The charge applies if anyone covered under a contract, such as a spouse, smokes.
"We know smokers cost more as far as health care goes," said Gary Matthews, deputy administrator of the Alabama State Employees' Insurance Board. "We are putting the burden on them to take responsibility for their own health."
Georgia charges $40 a month for smokers covered under the state's health plan. Employees caught lying on their insurance form about whether they smoke could lose their insurance for a year.
The state health plan kept having cost overruns because of rising costs and high use, said Georgia state Sen. Tommie Williams, R-Lyons.
Employers say the surcharges are incentives rather than penalties, but that's not the way many smokers see it.
"Where is it going to end?" asked Jim Clark, a smoker and owner of Strauss Tobacconist in Cincinnati. "Are they going to start saying you can't wear a blue shirt on Monday or drive a green car on Thursday?"
Lewis Maltby, president of the National Workrights Institute, says making smokers pay more for insurance and take more responsibility for their health choices is not inherently wrong, but he worries about the precedent the surcharges may set.
"They could be the first step down a very dangerous road," Maltby said. "Do we really want to live in a world where employers penalize us for everything in our private lives that isn't healthy?"
Some employers have turned to even stronger measures to discourage smoking. Weyco Inc., a medical benefits administrator, fires employees who smoke even if it is on their own time.
Jim Wendling, a 45-year-old employee for Kroger Co., recently acknowledged on Kroger's health survey that he is a smoker. Even though Kroger doesn't charge smokers more for insurance, he fears the survey may be the first step in that direction.
"I personally don't think a company should tell employees what to do when they are not at work," Wendling said.
WHERE SMOKERS PAY MORE
Some private and public employers that require tobacco-using employees to pay more than nonsmokers for their health insurance:
American Financial Group Inc.
General Mills Inc.
Western & Southern Financial Group
Blue Cross of Idaho
State of Georgia
State of Alabama
State of West Virginia
State of Kentucky
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