“The raise is ridiculous every year. It's getting scary,” said human resources director Lauren Allen. “I'm afraid that in five years we won't be able to afford it.”

Allen Marine, a boat-building company based in Sitka, is hardly alone. But the company is taking small steps to start a wellness program, an attempt to make their employees aware of their health risks and help them find ways to get healthier.

The company last year entered into a pilot program through carrier Premera Blue Cross Blue Shield. Allen Marine set up computers and during work hours had all their 55 employees receiving benefits fill out a health risk assessment.

The company, with Premera, held a health fair during work hours to do blood draws from workers so they could see their various levels for cholesterol and could get their blood pressure and stress levels checked.

“It's a small step, but you can measure it,” Allen said. “One percentage point makes a difference at these levels. It lets employees know you care about them and gives them a chance to get healthier.”

Employers across the nation are exploring various wellness programs, which could be as simple as offering time from work to get a checkup to negotiating discounts with local health clubs to offering full-fledged get-healthy programs with personal coaches, nutrition tips and an office gym.

“What it's all about is helping people to stop and look at the road they're on,” said Jeff Davis, president of Premera in Alaska. “If this is where they want to go, fine. But if not, let us help you.”

According to a recent study by the Institute of Social and Economic Research, spending for health care in Alaska hit $5.3 billion in 2005, compared to $1.6 billion in costs in 1991, the last time ISER reviewed health care costs. That averages about 9 percent growth a year.

About 87 percent of Alaskans have some form of health-care coverage, either through private insurance or government programs. In 2003, insurance premiums for family coverage at private firms were about $10,500 in Alaska and $9,200 nationwide. That's a steep jump from 1993, when premiums cost $6,200 in Alaska and $4,800 nationwide.

Alaska Pacific University systems administrator Brad Bice skis along a campus trail as part of a university wellness event. Bice is a member of the APU wellness committee that helps determine which events are held. Photo/Melissa Campbell/AJOC

Nationally in 2004, the median health costs were at nearly $18,000 per employee, costs that include health claims, absenteeism and turnover, among other factors, according to information provided by Larry Chapman, a senior vice president of WebMD Health Services. Chapman spoke at a daylong wellness program seminar recently at the Alaska Health Care Roundtable.

As the workforce ages, benefits are used more often. Studies also show that a small percentage of the workforce accounts for the largest percentage of claims.

Chapman cited information that shows health care costs increase with higher health risks. Topping the risk chart were depression, stress and blood sugar, followed by obesity, smoking, high blood pressure and the lack of exercise.

It costs about 25 percent more on average for treatment in Alaska when compared to the national average, the ISER study said.

Many of the risks, and their costs, are preventable.

“If we're lucky, we are born healthy with no risk factors and no disease. And when you decide to die, you die quickly and get it over with,” said Dr. Dave Johnson, regional medical director at Premera. But, he acknowledged, most aren't that lucky.

It's Friday fun day at Alaska Pacific University. Want to learn how to cross-country ski? Or do some rock climbing? How about some salsa dancing?

APU staff members who do an hour of exercise get to go home an hour early. On a Friday. Who could argue?

On a recent just-below-freezing Friday afternoon, Marc Phillips slipped on his skis and started around the track, pausing to help out a cross-country newbie get going. On the other side of the campus, a group of staffers were sledding, though more often falling off their sleds and rolling down the little hill.

The events are as much to get staffers together as it is to get them to exercise, said Ann Hale, APU spokesperson.

Every week, an average of 20 of the 60 full-time staff members show up for one of the three choice activities of the day. It gets people away from their desks, and entices a bit of friendly competition, said Phillips, director of recreational programs at APU.

“They always feel better after the exercise,” he said. “They may not feel better the next day, but É”

APU developed a wellness committee three months ago to help determine the activities. The activities department puts on the events and offers the equipment and the training for the beginners.

That's one example of a wellness program. The Alaska Railroad Corp. offers reimbursements on health club dues. Allen Marine is working on a deal to offer bi-monthly family days at a local multi-use facility to help relieve stress and to encourage activities. Managers plan to offer healthy snacks around the shop, and provide pamphlets on good health habits.

If all else fails, offer cold, hard cash, Johnson said.

“Do give-aways, coffee cards, days off work,” he said. “It's dirt cheap and it works.”

To save money on health costs, Allen Marine had already raised the deductible for doctor visits to $750 and increased the co-pay at pharmacies. The company began self-insuring dental coverage.

Premera, meanwhile, had started offering wellness benefits to customers, but few companies had shown interest. The insurance carrier started offering cash incentives if companies joined a pilot wellness program.

Allen Marine signed up. The company gave back to its employees the credit issued by Premera for employee participation.

Premera offers health risk assessments. Participants take a survey, about 60 questions, to determine risk factors and their readiness to change. If they take it online, they immediately get a report stating their level of risk, the dangers of those behaviors and some information about how to change their habits.

Sometimes, depending on the level of the program, employees can get individualized coaching to help with lifestyle changes.

The company, if it has more than 50 employees, gets a general report about its employees risk levels. This report helps the company focus on activities or issues it needs to help its employees.

“It gives them a focus, where the risks are, what kind of programs should they develop,” Johnson said.

It's all confidential and private, he said.

The costs for the employer: $3 to $5 for each risk assessment, and $130 to $150 per participant per year for the coaching segment.

National studies have shown that for every dollar spent, returns range from a payback of $3 to nearly $15, depending on program levels, according to statistics from Chapman.

Johnson said it's still too early to see the bottom line return on that investment through Premera, but employers should expect to see healthier workers with a higher level of productivity and lower absenteeism.

For Allen Marine, the efforts truly paid off.

“We had a few thank us, saying they had no idea they were so close to a heart attack,” Allen said. “If you can do that for even one person, it's worth it.”

So what do the insurance companies get out of it?

“If we develop a pool of employers that have healthier workers, then our rates are lower than our competitors,” Davis said. “That helps us stay in business. We don't get anything when we give double-digit increases to our clients except unhappy clients. We're seeing some people drop coverage altogether, or reduce the benefits they offer. That's not a good situation for anybody.”