COEUR d'ALENE - The LMM Leadership Group pitched Kootenai County commissioners on managing a new wellness program for county employees Friday, but not everyone was in favor of the program.

County Clerk Cliff Hayes and his Chief Deputy Clerk, Pat Raffee, took exception to the program, which if implemented would penalize county employees for not participating by doubling their insurance premiums.

Hayes said he is looking into the legality of the program.

"I smoke, so I can't participate in Healthy Measures (the county's current wellness program)," he said. "I have to take a tobacco cessation course to get points, and I am not going to do that."

He said it won't matter much to him financially if his premiums are doubled under the new proposal, but considering that roughly 300 lower paid county employees do not participate, he is concerned that they may not be able to afford it.

"We are talking about people making $12 an hour, and we are going to raise their premiums," he said after the meeting. "That is unacceptable to me."

He said it reminds him of New York Mayor Michael Bloomberg's efforts to ban soda pops over 16 ounces in size.

Commissioner Jai Nelson told Hayes at the meeting that it is his decision to smoke or not and if chooses to continue that behavior he should have to pay more.

Hayes said that the county should consider a program that penalizes people who are actually filing claims instead of picking on smokers who, like him, haven't been to the doctor in years.

"If they want to charge us more, it should be based on usage," Hayes said. "It shouldn't be based on what might happen in the future. If something goes wrong and they have to file claims then charge them more."

Wade Larson, with LMM Leadership Group, told Hayes that federal healthcare laws would not allow that to occur.

During his presentation, Larson told commissioners under his proposal smokers and other employees with health risks could still participate in the program and realize the savings in premiums.

At North Idaho College where he managed a similar system, he said they realized after about 3 years that they had alienated smokers, so they found a way to incentivize them in the program as well.

"Smokers who are exercising are healthier than smokers who are not," he said.

The proposed plan would essentially penalize anyone who didn't participate in the plan by doubling their insurance premiums and increasing their out-of-pocket costs.

In his presentation, Larson said that the Centers for Disease Control estimates the return on investment at $3.27 for every dollar spent on wellness programs.

To have LMM manage the program it would cost $2,500 to set up and $3.75 per employee per month based on 680 employees. That comes to $2,550 per month or, $30,600 per year.

The county's current program penalizes those who don't participate in the wellness program by raising their deductible expenses from $500 per year to $1,500 per year.

Hayes said he can support the deductible plan because smokers and other people who don't participate in wellness for whatever reason would only be penalized if they had to use their deductibles.

Larson said there are other incentives the county could offer employees to get them engaged in wellness, such as offering gift cards or cash bonuses to participate in things like biometrics screening.

He would also like to create in-house wellness programs like "biggest loser" weight loss competitions and on-site fitness courses, as well as "lunch and learn" wellness lectures and benefit fairs.

He explained that other incentives could be offered such as increased contributions to Health Reimbursement Accounts. He said the incentives could be paid for out of the increased premiums that non-participating employees are paying.

After Larson's presentation, Raffee told commissioners that she did not favor the new program either.

"In the last few weeks, we have learned that we are not paying our employees what they should be earning and we are no longer allowed to give bonuses," she said. "But now we are going to pay people to play games and ride bikes?"

Raffee said the county was also struggling with productivity.

"We have productivity and fair pay challenges," she said. "Now, we are going to be exercising on-site and holding monthly meetings."

Commissioner Nelson said it is untrue that the commissioners have stopped bonuses.

"I support bonuses, but we found out there was another pot that was being used, and that is what we were concerned with," she said.

Larson said that meeting and exercise times would be held during non-productive hours, such as lunch and break times.

Commissioner Todd Tondee said that part of the commissioners' goal with the new wellness program is definitely to save money, but also to improve employee morale.

"There are all these other things that come into play," he said. "To say the focus is on play is not a fair characterization of what is going on here."

He said the commissioners will be holding more meetings to discuss the proposal before making a decision on the program.