Saving by Insurance

Alabama goes to bat against staff obesity, ties insurance costs to Body Mass Index

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-->One in three American adults is obese. Medical costs for obesity-related illnesses (diabetes, cardiovascular disease, asthma, some cancers) eat up one out of every six health care dollars. Should obese people pay more for health insurance than those of normal weight?

The state of Alabama thinks so, as do a small but growing number of government agencies and corporations. Health insurance premiums tied to your Body Mass Index strike at personal responsibility in the choices you make every day to exercise - or not, and eat a healthy diet - or not.

And the good news is that these choices are under your control.

BMI determines if your weight is appropriate for your height by estimating your body fat. However, it's not always reliable. "It doesn't differentiate between body fat and lean muscle mass," says Wayne Westcott Ph.D., fitness researcher and author of several fitness books. BMI can be a poor indictor of body fat in:

- Athletes;

- People with muscular builds;

- Those engaged in strength training, dense muscle mass may classify them as overweight when they aren't; and

- Older people and those who've lost muscle mass.

Even given these drawbacks, BMI is a good indicator of how healthy you are and can help you decide if you should make lifestyle changes.

Here's the formula:

- BMI = [your weight in pounds] divided by [your height in inches times your height in inches] times 703.

- For instance: 140 pounds divided by [5'8" or 68" x 68" =] 4624 = .0302768 x 703 = 21.28 my healthy BMI

- Or go online for BMI calculators.

What it means:

- Below 18.5: Underweight, high risk, possible protein-energy malnutrition or effects of wasting or a disease process;

- 18.5-24.9: Normal, low risk for diabetes and cardiovascular disease; and

- 25-29.9: Overweight, moderate risk;

- 30 and higher: Obese, high risk.

If your BMI is 25 or above and you're not an athlete nor do you have a muscular build, you could be at risk for numerous health conditions. If you're underweight, ask your doctor if you should gain weight.

Alabama's approach requires state employees to go through a no-cost health screening by January 2010, or pay $25/month for health coverage, which now costs them nothing. If the screening turns up issues with cholesterol, blood pressure, glucose or obesity, employees will have one year to visit a physician at no cost, enroll in a wellness program or take steps on their own to improve their health.

If follow-up screenings don't indicate progress, they'll pay $25/month starting January 2011. A BMI of 35 and above will be considered obese.

William Ashmore, executive director of Alabama's insurance board, said the plan will cost approximately $1.6 million for screenings and wellness programs but likely will save significantly over the long-term because those with BMIs of 35-39 account for $1,748 more in annual health care costs than those with a normal BMI under 25.