JACKSONVILLE, Fla.—As a health insurance company it would make sense for Blue Cross Blue Shield of Florida to be progressive in terms of its own wellness program. Wellness efforts at BCBS began in 2006, according to Damian Monticello, corporate foodservice liaison, with the department working with vendors to establish what items could be labeled as healthy and then sold at a discount to encourage consumption.
“We established a criteria on items that would receive a discount at the register,” Monticello says. “That was really the baseline from where [our wellness program] started on the foodservice side. We’ve worked with our current and former provider [the BCBS of Florida in Jacksonville is currently managed by Sodexo] on utilizing their individual wellness programs. We take items that have been deemed healthy by the program and highlight them in our cafés through signage. We have created standards on what percentage of the menu has to be [qualified as] wellness items in order to get rid of that stigma that you always hear about, which is, ‘well, I can’t afford to eat healthy.’”
Monticello says by giving the customers a discount on healthy items those items’ cost became the same or below what some of the traditional non-healthy items cost. Once the cost stigma associated with healthy items was addressed, Monticello says the department turned attention to the other stigma of healthy food: taste.
“[You always hear that] healthy items can’t taste good,” Monticello says. “[To combat that] we do healthy cooking demonstrations for different departments around the company. We take some of the healthy recipes that are on our menu and show BCBS employees how they can scale and prepare our recipes at home. We also try to teach them what a properly composed plate looks like. So when they are eating, they know what percentage of the plate should be protein, what should be starch and what should be vegetables.”
Some of the newest things the department has done in regards to wellness in the café was to revise the lists of qualified recipes, says Monticello.
“When we started in 2006 there was a lot of discussion about what constitutes healthy,” Monticello says. “We were trying to appease everybody at one point by doing things like low-carb items. Then we had to ask, ‘was it healthy simply because it was low carb?’ For example, a piece of veggie pizza may or may not be healthy depending on what the crust is made of and how much cheese is on it. We wanted to look at making set criteria on what makes something healthy. So we worked with [Sodexo] and said, ‘OK, here is a complete nutrition criteria, and a healthy item can’t just meet one of these items, it has to meet all.’”
Monticello says The criteria the department uses for items to receive the healthy item discount is the set criteria for Sodexo’s “Your Health Your Way,” which means items must be 600 calories or less, have 35% calories from fat or less, 10% calories from saturated fat or less, contain zero trans fat, 100 milligrams cholesterol or less, 800 milligrams sodium or less and three grams of fiber or more. By refining the focus of the program and coming up with a more defined idea of what wellness meant for the department, rather than trying to be everything to everybody, the department has a program it is much happier with.
Rebecca Westbrooke, senior manager of employee benefits and wellness, says the marketing of the foodservice piece of the wellness program included such initiatives as labeling the spoons at the salad bar with green for healthy items, yellow for items that should be used sparingly and red for items to avoid.
“A lot of the marketing goes on at the point of consumption,” Westbrooke says. “We have also got the nutritional content for all the foods online and at the point of sale. We’ve done some promotion around the actual discount itself but also done marketing around nutrition and the things we do with personal health assessments. The employees receive coaching on how many fruits and vegetables they should be eating and what does a portion size look like. We also encourage employees to use Weight Watchers at work. If they lose 5% of their body weight goal within a 12-week period then we reimburse half the cost of the [WW] program to them. I think the marketing of the wellness program starts from what we are doing directly with the foodservices, but it’s also the overall focus for all the other aspects within the company.”
Not only food: Those other aspects include an onsite YMCA, which does its own food promotions.
“People are hearing [the healthy message] from a lot of different sides so that’s helping get the message through to employees, Westbrooke says.
For the past three years Westbrooke’s team has been designing the overall corporate wellness program to have a robust incentive—$500— behind it.
“It was really us just saying let’s try and make a link between the activities [of healthy eating and exercise] and this incentive amount, which is up to $500 that goes in an employee’s health fund. If employees improve their health in certain categories [blood pressure, BMI, etc.] then they will receive the incentive. The incentive is tied into our personal health assessments. We have a corporate goal of improving our overall health score, which is measured by these personal health assessments. We’re trying to lose 5% of our group body weight.”
Westbrooke says the department is looking into a theme for next year that will tie into the healthy items in the café.
“We want to leverage this whole idea of the employees should be looking for a healthy meal and looking to improve their health assessment scores so here is what you have to do between now and the personal health assessment. When you go to the cafeteria you are going to be able to say ‘here is a meal that speaks to all my nutrition requirements.’ That’s where Damian and I have been working really closely together to get people where they need to be.”
Monticello’s role in the wellness program has evolved to include the management of employee wellness centers in some of BCBS field offices, which are similar to the YMCA center Monticello’s location has on site.
“We have a complex here that supports our wellness initiative from an intramural or fitness standpoint,” Monticello says. “My responsibility has changed in that I’m now responsible for the management of those facilities through our third-party vendor, which was completely new territory for me. In my mind, given what we were looking at from a corporate perspective on wellness from the foodservice side, it made sense. There is definitely a line of sight between what people eat and how active they are.”
A new thing for the wellness complex this year is an intramurals program, which Monticello says is showing signs of success.
“We just launched our enrollment for our intramural league yesterday,” Monticello says. “By lunchtime today, we already had a couple 100 people who had completed their registration for the various intramural leagues.”
As with any change, Westbrooke says that getting the employees to buy into the programs available was the biggest challenge.
“Our company has taken more for a ‘pull’ strategy,” Westbrooke says. “We’re trying to get [the wellness program] to be something that people really want to do. We are starting to see results. Last year we saw pretty dramatic improvement in incremental changes in BMI and blood pressure and things like that.”
Monticello says the biggest challenge with the foodservice piece was trying to get rid of the preconceived notion that customers couldn’t find healthy options in the café.
“When we took a good look at our menu, and what we were doing when we first launched this program, there were already a lot of balanced choices,” Monticello says. “So it was figuring out how we draw attention to it? So we put the nutrition info out there and online. We did the color-coded salad bar. We tried to show customers that we could do great tasting food that is still good for them.”
“I think the overall message for us has been you’ve got to hit on a couple of key levers,” Westbrooke added. “Our three areas of focus are nutrition, exercise and stress management. Those are the underlying factors that result in weight issues and weight is a primary driver of health issues. If we can focus on those three elements, then weight loss becomes part of that.”
Monticello says his best advice for other operators who want to improve their wellness programs would be to be persistent and use all available resources.
“Each of the foodservice companies we work with [BCBS of Florida uses several vendors for different locations including Sodexo and Eurest] have programs and dietitians,” Monticello says. “Even on the vending side companies have healthy vending programs. There are resources available to you. Ask the questions and be persistent; that’s the biggest thing we learned. It wasn’t necessarily pulling our employees to get involved in the wellness program; sometimes it was pulling our vendors. Get engaged and work with them and find out what will work for you.”
