School panel retracts its flu-shot incentive

Agency chief: Enforcement too hard

At the urging of a state official, an advisory panel on Friday recommended that state and public school employees not be required to get a flu shot, or promise to get one, to qualify for a discount on their health insurance premiums in 2019.

The recommendation by the State and Public School Life and Health Insurance Board’s benefits subcommittee on Friday differed from one made in July by a special committee formed earlier this year to explore changes to the plans’ wellness program.

The wellness committee recommended that employees be required to attest that they received a flu shot in 2018, planned to get one, or had a medical reason for not getting one, to qualify for the premium discount in 2019.

But Chris Howlett, director of the Department of Finance and Administration’s Employee Benefits Division, told the benefits subcommittee on Friday that he had concerns about the requirement.

“Our biggest struggle would be operationalizing the flu shot based on the timing of the flu shot being available, the parameters in which we would be designing our wellness program to capture that data and to be able to facilitate that,” Howlett said.

He said he also received a “legal opinion” late Thursday about the “liability risk and other things associated with the flu shot.”

After the meeting, Howlett said it would be difficult to verify whether someone had gotten a flu shot or had a valid medical reason for not getting one.

Such verification wasn’t part of the wellness committee’s recommendation. But, Howlett said, “I can’t justify giving a financial incentive to someone that might not have done what they said they did, and I can’t prove it otherwise.”

He said he had also received about 10 letters, several phone calls and a few emails from employees who were opposed to the requirement, and also received “a lot of pushback” during meetings with school district representatives.

“I’ve not had a single individual tell me they wanted” the flu shot requirement, he said.

As for the legal opinion, he said a department attorney told him the state could be considered responsible for a “work-related injury” if an employee suffered complications from a shot.

He said he had not yet received a written opinion.

With no discussion, the subcommittee agreed to Howlett’s request to recommend leaving out the requirement. The recommendation will go to the board’s quality of care committee on Tuesday and to the full board a week later.

The health plans cover about 148,000 people, including 45,000 school employees and 26,000 state employees as well as retirees and the spouses and dependents of employees and retirees.

In an effort to hold down employees’ health costs, the plans since 2015 have offered a premium discount of $75 a month to employees who meet wellness requirements.

Currently, employees and covered spouses are required to visit a doctor and complete an online health questionnaire.

Under the revamped program, the doctor’s visits would no longer be required, and the questionnaire would be revised to focus on educating employees about their health, rather than on collecting data.

Employees would be tested for tobacco use, and those who test positive would be required to enroll in a smoking cessation program. Employees would also have to submit measurements on their height, weight, blood sugar and blood pressure.

Board and benefits subcommittee member Shelby McCook said after the meeting that the board could consider adding the flu shot requirement in the future.

“It looked like they were having trouble logistically with coming up with some practical way to enforce it,” he said.

Marc Watts, senior legislative analyst for the Arkansas State Employees Association, said he didn’t know of any objections the association had voiced to the flu shot requirement.

The requirements that were recommended could save money for the plan and “have a positive effect on the health of the members,” he said.