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Group Disabilitys Weight Problem

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By Allison Bell

Insurance agents who visit the offices of group disability clients are seeing more workers who are really fat. And group disability insurers are seeing the claims.

The percentage of U.S. workers who are obese has skyrocketed over the past 40 years, and more than half of the workers filing disability claims with the Kansas City, Mo.-based benefits arm of Assurant Inc., New York, are obese, according to Dr. Polly Galbraith, the units medical director.

A few workers file claims simply because they are so heavy that, even if they are in reasonably good health despite their weight, they have a hard time functioning in an ordinary workplace. “There are a significant number that cant be weighed in a normal doctors office,” Galbraith notes.

Assurant might have to help persuade those claimants employers to change uncomfortable workstations and buy bigger chairs, Galbraith says.

Assurant gets many more claims from obese workers who suffer from diabetes, heart disease, back pain and other health problems partly because of their weight and their eating habits. Internal Assurant statistics show that the obese claimants “dont recover as fast,” Galbraith says. “Their period of recovery is much longer.”

Several recent major studies have reviewed the effects of rising U.S. obesity rates on life insurers. Swiss Reinsurance Company, Zurich, has suggested that rising disability rates could be hurting life insurance profits by slowing improvements in mortality rates.

Group disability insurers have an even greater interest in rising obesity rates than group life insurers do, because obesity is more likely to lead to disability than to death, says Larry Schneider, a disability insurance broker who owns the Disability Insurance Resource Center, Albuquerque, N.M.

Insurers insist that producers include the height and weight of every employee on the typical group disability application form.

If underwriters notice one obese employee in a group of 30 or 40 healthy, desirable employees, they probably will offer the employer coverage, but, if several employees are obese, “they could turn the group down,” Schneider says.

In some cases, an insurer might offer coverage to the group but insist on charging the obese workers a higher rate or excluding the obese workers from the plan, Schneider adds.

He points out that agents who visit an employer are supposed to be the “eyes and ears” of the insurance company. An agent who visits an employer, sees a large number of obese workers and fails to warn a group disability insurer about the employers obesity problem may be guilty of saddling the insurer with a pig in a poke, he says.

In some cases, a group disability producer could give an employer friendly advice about the value of comprehensive weight-loss programs and the effects of high obesity rates on access to group disability coverage, but “it has to be done very diplomatically,” Schneider says.

Today, however, the typical group disability producer is unlikely to give the employer any formal, systematic advice about coping with worker obesity.

“Its not our responsibility,” Schneider says.

But many of the companies that insure and administer group disability programs do seem to be interested in playing a more active role in fighting obesity, says Karen English, a partner at Spring Consulting Group L.L.C., Boston.

“Some of the disability carriers are really increasing their capabilities with respect to data,” and one possible use of that analysis is to prevent and manage obesity before it leads to claims, English says.

A unit of MetLife Inc., New York, recently published “A Year In the Life Of A Million American Workers,” a health and disability almanac by Dr. Ronald Leopold, the national medical director of the companys disability insurance unit. A section at the end of the book discusses the role that MetLife and other large life insurers played in overcoming tuberculosis, diphtheria and other ills that once plagued the United States.

Could group disability insurers mount a similar campaign against obesity?

Possibly, Leopold says, but the problem is that, when it comes to weight, “solutions are very employer-specific.”

“Whats good for one [employer] is not necessarily good for all,” Leopold says.

Some of the barriers to fighting the obesity epidemic include employee defensiveness, long-term changes in the typical American diet, some employees belief that they are too burdened by work and family obligations to take proper care of themselves, health privacy laws and regulations that limit employers ability to gather and use employee health information, and the cruel fact that losing weight and keeping it off can be very difficult.

Differences that affect wellness plan designs can include factors such as where most workers go to eat and whether a facility is in a setting that is better suited to jogging clubs or indoor exercise programs.

Leopold, for example, works in a large MetLife office in the Atlanta suburbs. The office has tried to fight obesity and related health problems by offering free blood pressure and cholesterol screenings, healthy foods in the cafeteria, an onsite Weight Watchers program, and access to a subsidized fitness center.

Many companies are earning, and measuring, a significant return on investments in similar wellness programs, Leopold says.

But Schneider says a more realistic strategy for helping small and midsize employers might be to arm producers with the ability to refer clients to community-based obesity-management programs.

Disability insurers that expect producers to make those referrals should be prepared to compensate the producers for their assistance, Schneider says.


How big is obese?

Government researchers use a measure called the “body mass index” when classifying people as underweight, normal weight, overweight or obese.

To calculate the BMI, researchers take the weight of an individual in kilograms and divide it by the square of the individuals height in meters.

The government defines individuals with BMIs over 25 as overweight and individuals with BMIs over 30 as obese.

Government researchers would count a woman who was 5 feet tall and weighed 128 pounds as overweight. If she weighed 154 pounds, she would be obese.

The typical disability insurance weight chart is somewhat more generous, according to Larry Schneider, owner of the Disability Insurance Resource Center, Albuquerque, N.M.

A typical disability insurer might offer standard rates to a woman who was 5 feet tall and weighed up to 179 pounds, Schneider says.

The insurer might then ask for progressively higher rates up to a weight of 213 pounds, when the rate would be twice the standard rate.

In most cases, disability insurers reject applications for workers who would have to pay more than 200% of the standard rate, but, if they did offer coverage to a 5-foot-tall woman who weighed more than 213 pounds, they probably would charge a rate that was more than 200% of the standard rate, Schneider says.


Who is obese?

Back in the late 1970s, the typical obese American was an older woman, according to survey figures from the National Center for Health Statistics.

Older women were not all that likely to work outside the home when Jimmy Carter was president, and many of them who did work had jobs at employers far from group disability insurers core white-collar and executive markets.

The picture has changed.

When government researchers weighed U.S. residents in 1999 and 2000, they found that obesity rates were still a little higher for older workers than for younger workers. But some of the most dramatic increases have affected adults in the 20-34 age group.

The percentage of young men who were obese increased to 24.1% during the 1999-2000 survey cycle, from 9.2% during the 1960-62 survey cycle.

The percentage of young women who were obese increased to 25.8%, from 7.2%.

The next generation of workers could be even more obese: The percentage of children between the ages of 6 and 19 who are overweight increased to more than 15% during the 1999-2000 survey cycle, from about 6% in the late 1970s.

Reproduced from National Underwriter Edition, May 7, 2004. Copyright 2004 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.