When it comes to the health of its employees, Affnia Group, Inc. is in it for the long haul. The company, whose benefit plan covers more than 5,000 people, including employees and dependents, throughout the United States, has successfully nurtured a culture of health that is paying off in terms of health outcomes and financial savings.

Based in Ann Arbor, Mich., Affinia produces automotive parts, including filters, brakes and chassis, along with numerous global aftermarket products. The company has 9,500 employees worldwide and nearly 3,800 in the United States.

Like employers of all sizes, Affinia was becoming increasingly concerned with the amount of money the company was spending on employee health care. In 2000, the company spent $3,813 per employee per year on health care, and by the end of 2003 that number had nearly doubled to $7,576. Management realized something had to be done.

A paradigm shift

A quick fix for Affinia would have been to shift more cost to its employees through higher premiums and increased deductibles. But the company's leaders did not believe this was the best long-term solution.

Instead, Affinia embraced health management as a strategy to reduce costs by keeping employees healthy. And keeping employees healthy started with assessing who was at risk for disease and then intervening to prevent the development of serious illness.

Embracing industry best practices for health management programs, Affinia even changed its corporate mission statement to reflect its commitment to the health of its employees.

To bring its new commitment to life for employees, Affinia began working with StayWell Health Management in 2003 to offer a workplace wellness program that included onsite biometric screenings, a health assessment and follow-up lifestyle- change programs to help people reduce their overall health risk.

Gaining momentum

After a strong initial response of 94% of employees completing the health assessment, Affinia implemented a full-replacement consumer-directed health plan in 2004 and continued to evolve its benefit strategy to include a "Partners in Health" covenant and an incentive for employees to participate in the company's wellness program.

By signing the covenant, Affinia employees agreed to support two corporate goals: to make smart use of their health care dollars and to take part in the company's prevention and wellness program.

Employees and spouses who sign the covenant receive a $1,000 premium discount and a generic-only drug card that is not charged against their health plan dollars. With these two benefits additions, Affinia's wellness participation rate hit 99%.

Changing behaviors and outcomes

Affinia's success goes beyond the health assessment to real-life results achieved through follow-up programs, a reduction in the number of employees with health risks, and improved health outcomes across a number of health areas:

* Weight management. Because 65% of employees were overweight and 45% were obese, Affinia offered Weight Watchers as a corporate benefit. As an incentive to participate, employees received a $200 contribution to their health reimbursement account. Some facilities now have more than 10% of eligible participants enrolled and more than 250 employees nationwide have signed up.

* Smoking cessation. More than 20% of Affinia's workforce uses tobacco. To support them in their efforts to quit, Affinia offers a "Kicking Butts" program, which includes counseling and one month of nicotine replacement therapy. To date, more than 300 workers are tobacco-free.

* Prenatal care. To support expectant mothers among Affinia's workforce and help them achieve a full-term, healthy delivery, Affinia provides a $200 health reimbursement account reward for participation in the prenatal program and for signing an agreement - co-signed by a physician - to refrain from using tobacco or alcohol during pregnancy and to take prenatal vitamins.

* Colon cancer screenings. To encourage screening and early detection, Affinia offers a $200 health reimbursement account reward for plan members over age 50 who receive a colonoscopy. To date, nearly 200 people have been screened.

* High blood pressure. High blood pressure affects one-third of Affinia's employees. To encourage them to effectively monitor their condition, the company's benefits team launched a voluntary program at Affinia's largest filter plant in Gastonia, N.C. Participants received a blood pressure wrist-cuff, as well as a pocket diary to track their blood pressure three times a day. After one month, they review the results with a nurse practitioner from the onsite clinic at that facility.

Healthy people, healthy savings

Affinia's health promotion program has been a long-term success. Not only has this effort generated significant financial savings, but the company has also seen an amazing reduction in health risks:

* In 2003, 33% of employees were at high health risk. By 2006, this number had dropped to 14%, and by 2007 it dropped to 10%.

* A sizeable percentage of Affinia's employees deemed high-risk transitioned to medium-risk. The medium-risk group expanded from 55% in 2003 to 65% in 2006 and 2007.

* By 2006, the low-risk group grew from 12% in 2003 to 21% in 2006 and 27% in 2007.

* The generic-only drug card that Affinia offered as an incentive for signing the covenant reduced the annual drug spend by about 25%. This savings alone is two times the entire cost of Affinia's worksite wellness program.

* The five-year compound annual average growth rate in the company's medical claims cost is 1%.

When comparing the company-paid portion of medical, drug and dental costs on a per person per year basis against industry averages, Affinia's results are also impressive. When examining employer-only portion of health care costs, the industry average in 2003 was $5,100 and in 2008 was $7,272, a 43% increase. For Affinia, costs increased from $7,580 to $7,950 over the same time period - just a 1% increase.

Affinia's formula for success

To achieve success with its health management program, Affinia started with a visible commitment by corporate leadership. At Affinia, top executives are well-informed on the issue of health care and realize that employee health is a long-term investment, not just a short-term expense item on the P&L statement.

In addition, the benefits team receives ongoing education about the health of Affinia employees. This comes in the form of annual updates on the health status of the workforce, broken down by location.

Affinia's leadership views the wellness program as a true partnership between eligible participants and company management. By making a commitment to health as a core value in its business, Affinia has achieved substantial health care cost-savings and worker productivity gains.