Could obese state workers pay higher premiums?

Montgomery - State employees who are significantly overweight could pay more in health insurance premiums.

The State Employees Insurance board will meet in August to discuss whether to charge extremely overweight state employees $24 a month more in health insurance premiums, the same charge for smokers, SEIB chief operating officer Gary Matthews said Thursday.

"Anybody with a (body mass index, BMI) of 35 or greater would pay a surcharge," Matthews said. "(This is) to (encourage them to) lose weight or make sure they are under a doctor's care - because it is unhealthy - and to try to promote exercise and proper eating."

Alabama State Employees Association Executive Director E.J. "Mac" McArthur Jr. said he hopes any wellness program is positive rather than a negative one that sticks employees with higher costs.

"We want to do everything to make our work force healthy," McArthur said. "If you approach this with education in a positive manner, you'd have much more merit than punishing someone."

The SEIB March/April newsletter said the medical cost of extremely overweight state employees is $50 million a year, so there's a financial advantage in encouraging weight loss.

"Obesity has become an epidemic that is destroying the health of state employees," the newsletter said. "The number of state employees who are obese continues to rise."

The SEIB notes that in 2007, nearly 43 in 100 state employees were overweight and 19 in 100 were extremely overweight with a body mass index of 35 or above.

Based on 37,500 state employees, that's about 7,100 extremely overweight employees who would have to pay the $288 annual surcharge unless they start to lose weight or have medical excuses.

In 2006, between 25 percent and 29 percent of Alabama's residents were overweight. Only two states had a higher percentage of overweight residents.

BMI is a measure of body fat based on a person's height. Overweight is a BMI of more than 25, and obesity is defined as having a BMI of greater than 30, the SEIB notes.

The "normal" weight of a 5 foot 10 inch man is 167 pounds. That height with a BMI of 35 pushes the weight to at least 243 pounds, Matthews said.. The "normal" weight for a 5 foot 6 inch woman is 148 pounds. A woman of that height with a BMI of 35 weighs at least 216 pounds, Matthews said.

In 2007, taxpayers and state employees paid $374.2 million to cover state employee medical costs. The year before it was $333.1 million, according to the Legislative Fiscal Office.

Medical costs of a state employee with a BMI greater than 35 is at least $1,700 a year more than a state employee of "normal" weight and a BMI of less than 25, the SEIB notes.

Matthews said the Legislature in 2005 authorized the SEIB to consider lifestyle in setting insurance premiums. A single state employee pays nothing for the state's self-funded insurance plan while family coverage is $180 a month. There are co-pays.

Matthews said in practice, all state employees would have to pay the obesity premium but it would be waived for an employee with a BMI of less than 35, or is exempt for medical reasons, or is successfully losing weight.

The weight surcharge wouldn't take effect until 2011 if approved, Matthews said.

"The state has only so much money," said Matthews. "Would you rather pay health insurance premiums or get a pay raise?"

Dana Beyerle can be reached at (334) 264-6605 or dtb123@aol.com.