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Utah's largest hospital chain is bent on snuffing out tobacco use.
Intermountain Healthcare hospital campuses went smoke-free earlier this year. Now they're tacking a monthly $20 surcharge on to the health insurance premiums of workers who use tobacco.
The move is an effort to improve employee wellness and set a healthy example, said spokesman Daron Cowley. "Intermountain felt that this surcharge was fully in line with its mission of helping [to] encourage healthier communities."
Intermountain is hardly the first employer to butt into employee's personal habits. Earlier this year health insurer Humana and the Baylor Health Care System in northern Texas imposed outright bans on tobacco. These companies no longer hire workers who smoke cigarettes or use other tobacco products — a policy enforced with pre-employment urine screens.
Businesses outside the health care industry are embracing similar get-tough policies, according to Bloomberg Businessweek. Among them: Macy's, PepsiCo, publisher Gannett and Union Pacific.
If such policies seem unfair, they're not discriminatory.
Erik Strindberg, an employment attorney in Salt Lake City, likens them to hospitals requiring workers to get flu shots.
In Utah, it might be possible to argue smoking bans disproportionately effect non-Mormons and make a case for religious discrimination, Strindberg said. But companies need only prove there are legitimate health reasons behind the rule.
Christina Jepson Schmutz, a lawyer at Parsons Behle & Latimer in Salt Lake City, said some states have passed laws "saying what you do on your own time, you're free to do." But not Utah.
Workplace tobacco rules are likely to proliferate leading up to 2018 when, under national health reform, a federal tax is attached to high-cost health plans — those costing more than $10,200 for an individual or $27,500 for a family.
The tax is imposed on insurers, but that includes large self-insured employers. The Congressional Budget Office predicts businesses will respond by lowering premiums and raising deductibles and copayments.
"In a challenging economy, organizations are using financial incentives [and] a mix of rewards and penalties, to motivate behavior change," said Jennifer Boehm, a health benefits consultant at Aon Hewitt.
Because tobacco use is linked to all manner of health woes, from cancer and strokes to heart disease, it is a powerful lever for improving peoples' health.
Cigarette smoking is estimated to cost this country $193 billion in lost productivity and health care spending, according to the Centers for Disease Control.
Businesses are also monitoring employees' waistlines.
HCA MountainStar hospitals in Utah, including St. Mark's in Salt Lake City, are offering workers just one health insurance option in 2012 — unless they submit to an annual health screening. Those who agree get up to $500 in a health reimbursement account, while those who decline the evaluation will be placed in a high-deductible plan with low premiums but high out-of-pocket costs.
Intermountain is dangling cash prizes of up to $100 for workers who agree to step on the scales and get their cholesterol, blood pressure and blood sugar levels checked.
Their tobacco surcharge takes effect on Jan. 1, 2012, and applies only to covered employees, not their spouses or dependents.
It works on the honor system. The hospital chain won't test workers for nicotine. Instead, during open enrollment this month employees will be asked if they use tobacco.
Those who say yes will pay an extra $20 per month for their health benefits. Come 2013 the monthly surcharge will be $50.
Employees can avoid the tax by enrolling in a free tobacco cessation program; Intermountain will pick up the tab. Or they can work with their personal doctor to quit.
"I like it. I don't smoke. But maybe it will force people who do to stop, or at least think twice," said 29-year-old Fabi Zavala, a nurse at Intermountain-owned LDS Hospital. "It's bad for your health and we all pay the costs."
Twitter: @kirstendstewart —
Help for smokers
Services from the Utah Tobacco Quit Line are available by calling 1-800-QUIT-NOW. Both smokers and people who want to help someone quit are invited to call.