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The Vaccine Mandate/Surcharge Debate
By Kyle Von Ruden

May we, the Employer, mandate, surcharge, or incentivize COVID-19 vaccinations? Simple answer, yes.  But do so with caution and legal assistance. A bigger question might be, should we? Well, what are your company’s values, vision, culture, etc. and how have these changed or remained the same since the pandemic? To clarify right off the bat, this article will not answer the “should we” question but will perhaps help you take a step back and look at your options not through a narrow microscope but through a wide lens.
  

After initially preparing this blog then re-reading it, I realized I was regurgitating statistics and recommendations we’ve known since the EEOC update on May 28, 2021. Every day another employer is announcing some type of vaccine mandate, surcharge, or incentive so the pressure is no doubt mounting. As benefit consultants, we are seeing questions from all sorts of industries more and more each week. What has become quite evident are the parallels to smoking surcharges/cessation incentive programs and general wellness surcharges/incentive programs as we review the pros and cons. These are not new and certainly don’t seem to have the public and private moral dilemma with which COVID-19 has challenged us.     

One constant over time continues to be employers holding the responsibility, or perhaps privilege, of being conduits for informing and educating their workforces. For financial wellness, health and mental health awareness, legal and travel assistance, dependent care, on-the-job training, and certifications, in addition to the many other benefits offered. All somewhat easy, and for the most part, non-confrontational employer/employee topics. Before we dive into COVID vaccinations and what to do, let’s revisit some simple data on tobacco use and obesity. 

Wisconsin tobacco use ─ in 2017, 16% of adults smoked, 7.8% of high school students smoked cigarettes, 4.3% of adults used e-cigarettes and 4.3% used smokeless tobacco, 11.6% of high school students used e-cigarettes, and 5.9% used smokeless tobacco (https://truthinitiative.org). No news here, tobacco use causes cancer, increases medical costs, hampers productivity, and can kill people.  Therefore, not a bad idea to create opportunities for folks using tobacco to stop through surcharging or incenting them to quit for their overall good, the good of those around them, reducing health care costs, and improving the employer group’s bottom line.

Wisconsin obesity – 64% of adults are either obese or overweight, 32% over a BMI of 30. Among high school students 15% over BMI of 30 (www.dhs.wisconsin.gov). Obesity leads to coronary heart disease, stroke, diabetes, etc. According to the CDC, medical costs associated with obesity hover in the $150B range. Again, not a bad idea to create opportunities for folks leading “unhealthy” lifestyles to change through surcharging or incenting them for their overall good, reducing health care costs, and improving the employer group’s bottom line.

Wisconsin COVID-19 vaccinations – 655,657 confirmed COVID cases, 7,577 confirmed deaths to date.  Medical data is showing vaccines are making a difference, yet only 51.1% of Wisconsinites have completed the vaccine series. According to the DHS, immunizing 80% of the eligible population in WI is the goal for herd immunity. Clearly, we are not close to that goal and vaccines have been available long enough. Unlike tobacco use and obesity, COVID is too new to collect data on loss of productivity, but we’ve seen the high costs for treatment and most of us have had employees miss work due to exposure, signs of COVID, or testing positive for COVID.

So, for now, the question remains should you mandate, surcharge, or incent employees per EEOC guidelines? To quote a co-worker of mine, “Which approach addresses the core issue of what the employer is trying to achieve? Is it that everyone is vaccinated? Is it that they believe unvaccinated people will cost their health plan more?” 

Perhaps before you design a plan with legal assistance, review through a wide lens the reasons why you are intending to engage your company in the topic of COVID vaccinations on an employer/employee level. I personally don’t know the correct answer, but I do think employer groups know themselves better than anyone else and should make decisions for the good of their companies.

For further information on the May 2021 EEOC update and its applicability to wellness regulations under the ADA and GINA, please reach out to Hausmann-Johnson Insurance or The Benefit Services Group, Inc.

 
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