6 Smart Ways to Put a Dent in the Cost of Dental Care

Not only is your smile an important part of how you present yourself to the world, your dental health is strongly connected to your overall health. Oral health problems, especially if gum disease is involved, have been linked to a number of serious health conditions such as heart disease, poorly controlled diabetes, and even preterm birth.

Money is the top reason people avoid going to the dentist. Studies have shown that many adults in the U.S., even those with private insurance, struggle to afford dental care. Some people put off care until a more serious problem develops which, ironically, ends up costing more in the long run. A small cavity that costs very little to fill today can turn into an expensive root canal tomorrow.

So how can you stay up on preventative care, keep your teeth healthy and put a dent in your annual costs?

1. Cancel Your Coverage

Crunch the numbers and see if you’re spending more on dental insurance premiums than the cost of your family’s visits. This depends highly on your individual situation and insurance options. Ask your dentist to provide you with the fees for the services you’ve received and compare. If your teeth are healthy and you don’t need any major work, it might make sense to cancel for a year or set up your own savings fund (or take advantage of pretax plans) to pay for future visits. Don’t forget to include some savings for emergencies.

2. Use pretax dollars

If you have a flexible spending account (FSA) through your workplace or a health savings account (HSA), you can save by using pretax money to pay for both routine maintenance and major services such as root canals, braces or bridges. With an FSA account, it’s lose or it use it, so you’ll need to figure out your annual costs ahead of time. With an HSA account, your money grows tax free and you never lose it. Using pre-tax dollars is an easy way to squeeze a little more value out of your dental care dollars.

3. Double up on coverage

Do you have children who will need wisdom teeth extractions or braces soon? Unlike health insurance, most dental carriers allow you to have multiple plans pay toward your benefits. If you have a lot of dental expenses coming up, it might make sense to put family members on both your policy and your spouse’s policy. Not all policies cover braces, and most max out at $1,000 to $1,500 per lifetime, but every little bit helps.

4. Spread dental work across two benefit years

Major dental work – such as dentures, bridges and crowns – can cost thousands of dollars and is usually only covered at 50% with an annual limit of $1,000 – $1,500. Since most benefits reset on January 1 of each year, you can schedule some of the major work you need in the 4th quarter of this year and the rest of it in the 1st quarter of next year.

5. Make the very most of your dental insurance coverage

Are you getting the maximum value out of your coverage? Sit down at the beginning of your benefit year and schedule all your covered preventative care visits for you and your family. Make sure you’re going to a dentist who is in-network to get the lowest out-of-pocket costs.

6. Receive services at a dental school

Local dental schools can be a significant resource for reduced cost dental care. Dental students provide everything from routine cleanings and x-rays to dental implants, root canals and other major work – all at fraction of the price you would pay a regular dentist. Your procedure may take a little longer, but the work is supervised by licensed dentists who oversee student work.



Employer Premiums Rise Nearly 7% in 2017; Employees Absorb More of the Health Insurance Cost

Alpharetta, GANovember 17, 2017 – Premium renewal rates (the comparison of similar plan rates year over year) for employer sponsored health insurance rose an average of 6.6% – a significant increase from the five-year average increase of 5.6%, according to the 2017 United Benefit Advisors (UBA) Health Plan Survey, released today. Two states saw record premium increases: Connecticut saw a 24% increase in premiums in 2017, up to $655 from $530; New York also saw a large increase of 14%, up to $712 in 2017 over $624 in 2016.

On the other side, some states saw decreases in premiums, such as Arizona and Washington which saw 2% and 10% decreases, respectively.

Average employee premiums for all employer-sponsored plans rose from $509 in 2016 for single coverage to $532 in 2017 and from $1,236 to $1,272 for family coverage (a 4.5% and 3% increase respectively). Average annual total costs per employee increased from $9,727 to $9,935. However, the employee share of total costs rose 5% from $3,378 to $3,550, while the employer’s share rose less than 1%, from $6,350 to $6,401.

“Premiums have been holding relatively steady the last few years. And while this year’s increases are not astronomical, their departure from the trend does warrant attention. To mitigate these rising costs, employers are shifting more premium onto employees, offering more lower-cost consumer directed health plans (CDHPs) and health maintenance organization (HMO) plans, increasing out-of-network deductibles and out-of-pocket maximums, and leveraging continued extensions on the ability to “grandmother,” says Peter Weber, President of UBA. “We’ve also seen reductions in prescription drug coverage to defray increasing costs even further.”

Prescription Drug Plans  For a second year, prescription drug plans with four or more tiers are exceeding the number of plans with one to three tiers. Almost three-quarters (72.6%) of prescription drug plans have four or more tiers, while 27.4% have three or fewer tiers. Even more surprising is that the number of six-tier plans has surged, accounting for 32% of all plans, when only 2% of plans were using this design only a year ago.

“While employers chose to hold contributions, copays and in-network benefits steady, they dramatically shifted prescription drug costs to employees. By increasing tiering and adding coinsurance (vs. copays), employers were able to contain costs,” says Weber.

Out-of-Pocket Costs   Median in-network deductibles for singles and families across all plans remain steady at $2,000 and $4,000, respectively. Single out-of-network median deductibles saw a 13% increase in 2016, and a 17.6% increase in 2017, from $3,400 to $4,000. Both singles and families are facing continued increases in median in-network out-of-pocket maximums (up by $560 and $1,000, respectively, to $5,000 and $10,000).

Self-Funding – The number of employers using self-funding grew 48% for employers with 25 to 49 employees in 2017 (5.8% of plans), and 13.4% for employers with 50 to 99 employees (9.3% of plans).

Overall, 12.8% of all plans are self-funded, up from 12.5% in 2016, while almost two-thirds (60.9%) of all large employer (1,000+ employees) plans are self-funded.

“Self-funding has always been an attractive option for large groups, but we see self-funding becoming increasingly desirable to all employers as a way to avoid various cost and compliance aspects of health care reform,” says Weber. “For small employers with healthy populations, self-funding may be particularly attractive since fully insured community-rated plans under the ACA don’t give them any credit for a healthy group.”

Contact us at 678-533-6040 or for a customized benchmark survey based on industry, region and business size

About the 2017 UBA Health Plan Survey

Request a Benchmarking Report




2018 Annual Tax Benefit Levels

We are pleased to release to you the new 2018 Annual Tax Benefit levels. Please contact ARISTA team if we can be of assistance in leveraging any of these tax efficient tools and strategies to your organization’s benefit.

This information is brought to you by your Partner Firm of United Benefit Advisors, the nation’s leading employee benefits advisory organization with more than 200 offices throughout the United States, Canada and the United Kingdom.





7 Genius Ways to Save on Prescription Drugs. Small steps that can add up to big savings.

Prescription drug costs are growing faster than any other health care expenditure in the U.S. For most of us, these medications are not optional. Nearly 60% of adults take a daily prescription to help manage their health. The good news is that you can make a dent in your monthly out-of-pocket costs with a just a little research and action on your part. Check out these six steps you can take to help lower your costs.

1. Get your prescriptions free

The proliferation of online discount eyeglass providers has made it easier than ever to get your frames for less. You’ll typically pay 50-75% less with online sellers versus traditional retailers. Sites like Zenni Optical, Warby Parker and other online retailers have perfected the art of buying online by offering generous home try-on and return programs.

Stores like Giant Eagle, Meijer and Publix offer some common generic prescriptions for allergies, diabetes infections and high blood pressure at no cost.

2. See if it’s cheaper to pay out of pocket

Believe it or not, many chain and big-box stores such as Kroger, Publix and Walmart offer common generic drugs for less than your co-pay from your insurance company. For instance, Walmart offers a list of common generic prescriptions for $4 for a 30-day supply and $10 for a 90-day supply.

In other cases, “clawbacks” from Pharmacy Benefit Managers (PBMs) such as Caremark, Express Scripts and Optum have contracts that allow pharmacies to charge patients with insurance more than the retail cost of the prescription. An investigation in New Orleans exposed an example of this swindle. A pharmacy patient was charged her full $50 co-pay for a drug that had a retail cost of $11.65, meaning it would have been much cheaper to purchase outside the patient’s prescription drug plan.

3. Request a 90-day prescription

For prescription drugs you’ll be taking long term, ordering 90-day supplies in not only more convenient, it can save you a third of your copays – which will help lower your annual costs.

4. Compare prices

Use apps like GoodRX and OneRx to compare prices and see where you can get your prescription for the lowest price. For instance, researching Lipitor on GoodRX showed local prices ranging from $18-$144 and listed additional options to lower costs further with links to coupons.

5. Maximize your benefits

Always see if you are eligible for refills at the end of the calendar year. If you’ve already satisfied your out of pocket maximum, your refills will be free.

6. Use generics whenever possible

Generic drugs contain the same active ingredients and produce the same effects as their brand-name equivalents, but at a lower cost. According to the U.S. Food and Drug Administration, the cost of a generic drug can be as much as 85% lower on average.

7. Take advantage of special programs

Check with your pharmacist, GoodRx and OneRx about special programs, coupons or discount cards. If you use an expensive drug, see if the pharmaceutical manufacturer has a patient assistance program to help lower costs for people who have trouble affording treatment.


Qualified Sick Pay Plans 

A Qualified Sick Pay Plan (QSPP) is an agreement for employers to continue to pay an employee’s salary during a period of disability resulting in an absence from work. The employer is responsible for determining what employees qualify for QSPP and how long they will qualify for QSPP. These factors may change depending on the employee and the employee’s rank within the company.

Administration and Design 

When creating a QSPP, you should consider the following:

• Which employees are covered
• How long these employees will be paid
• When the benefits will begin
• How the benefits will be determined, if a covered employee becomes disabled
• Which company representative will approve claims and administer benefits on behalf of the plan
• How the benefits will be funded under the plan

Insured Plans 

By purchasing insurance on a QSPP, the insurance company determines the validity of a disability claim as well as when the employee has recovered. The insurance company also holds financial liability for benefit payments and takes care of tax reporting and claims service.

Self Funded Plans 

If you choose to self-fund the plan, you either pay the employee directly with current profits or set up a trust for payments. Under this option, your company determines the validity of claims and proper Federal Insurance and Compensation Act (FICA) and Federal Unemployment Tax Act (FUTA) tax withholdings and reporting requirements. Your company must also shoulder the benefit liability on financial statements under the Financial Accounting Standard (FAS) 112.

Communication to Employees 

Once the plan is in place, covered employees will be notified of this option in the event that they become disabled and cannot work. The ultimate benefit of QSPPs is that they eliminate the risk of unnecessary tax consequences for the company and covered employees when the company chooses to financially support employees while they are disabled.

To learn more about these plans, contact Arista Consulting Group today.


Court Orders EEOC to Reconsider Wellness Rules

The U.S. District Court for the District of Columbia has directed the Equal Employment Opportunity Commission (EEOC) to reconsider its final wellness rules under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA).

The final rules allow employers to offer wellness incentives of up to 30 percent of the cost of health plan coverage. The court held that the EEOC failed to provide a reasonable explanation for adopting the incentive limit. Rather than vacating the final rules, the court sent them back to the EEOC for reconsideration.

It is unclear how the EEOC will respond to the court’s decision. Due to this new legal uncertainty, employers should carefully consider the level of incentives they use with their wellness programs. Employers should also monitor any developments related to the EEOC’s rules.

Final Wellness Rules?

Federal laws affect the design of wellness programs, including two laws that are enforced by the EEOC-the ADA and GINA.
For many years, the EEOC did not definitively address whether incentives to participate in wellness programs are permissible under the ADA and, if so, in what amount. Earlier this year, the EEOC issued long-awaited final rules, but the court has now remanded the final wellness rules back to the agency for reconsideration.
Arista Consulting Group will keep you updated with any developments on this matter. In the meantime, please contact your representative with any questions about how these rules may affect you.


7 Strategies for Saving on Vision Costs                                                                                                                

Follow these tips to get the best value on your glasses, contacts, and exams

If you’ve bought glasses for you or a family member in the past year, chances are you’ve dealt with the sticker shock of eye care. Being able to see clearly is a health necessity for more than 150 million Americans who use corrective eyewear. Not only do annual comprehensive eye exams ensure safe driving, working and other activities, they’re also imperative to diagnosing and treating more serious eye conditions early on. Before you shop for your next pair of eyeglasses or contacts, check out these strategies to save on your eye care.

1. Buy your frames online

The proliferation of online discount eyeglass providers has made it easier than ever to get your frames for less. You’ll typically pay 50-75% less with online sellers versus traditional retailers. Sites like Zenni Optical, Warby Parker and other online retailers have perfected the art of buying online by offering generous home try-on and return programs.

2. Buy your contacts online

Websites such as 1-800-Contacts and Vision Direct typically sell contacts for about 25% less than a traditional eye doctor might charge. By buying in bulk and using online discount codes, you may be able to reduce your costs even more.

3. Skip the add-ons

Many people might be surprised to find that most lenses already include scratch resistant coating and UV protection. Unless your prescription is above +/- 3.00, professionals recommend skipping other expensive upgrades like antireflective coating, light adjusting lenses, or high index or ultrahigh index lenses.

4. Use FSA or HSA funds

If you have a flexible spending account (FSA) through your workplace or health savings account (HSA), you can save by using the pretax money to pay for eye exams, prescription glasses, contacts, contact cleaning solution or even lasik surgery.

5. Evaluate your coverage

Even with vision coverage, the costs can add up. Review your healthcare and vision plans to make sure you are getting the most out of your coverage. Your vision policy may have in-network providers that offer cheaper coverage than out-of-network providers. If you have children, you may want to opt out of covering them on your vision plan if an annual eye exam is included in your health plan.

6. Take Advantage of Coupons and Other Discounts

Take advantage of online coupons and watch for deals from retailers and optometrists. You can often get a second pair of glasses for free or a combination discount for buying both frames and a supply of contacts at the same time.

7. Shop at Costco

Consumer Reports recently evaluated eyeglasses retailers, and Costco Wholesale was identified as having the highest overall eye care satisfaction rating in America. Customers report excellent customer service and lower prices. At Costco, the average cost for a complete pair of eyeglasses is $186, while the industry retail average is $220 to $240.



“When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.” – Mr. Rogers.

So often I read stories in the news about the “Big Bad Insurance Companies” charging too much, denying care and excluding prescriptions. I know from firsthand experience as an employee benefits consultant that these things do happen sometimes. My experiences at work and as a patient have usually been very different. Every day, I work with carriers like Aetna, AvMed, Blue Cross, Cigna, Humana and United Healthcare. At every turn, the account representatives are caring, responsive and solution oriented. They are often the helpers.

Over the past year, I battled breast cancer and my health insurance carrier, Aetna, was by my side at every turn. They quickly approved expensive testing for the BRCA gene and six injections of Neulasta following chemotherapy. Their prescription drug unit efficiently helped me get my prescriptions moved over to mail order so I never have to worry about running out.

Over the past few weeks, I have been touched to see several health insurance carriers reach out with solutions, support and guidance for their members and anyone who has been touched by the recent hurricanes in the Southeast.

  • Aetna will provide assistance with lost ID cards, free Teladoc visits and allow members to refill prescriptions early. They have also donated $100,000 to the American Red Cross and $50,000 to Team Rubicon.
  • Anthem will refill lost or damaged prescriptions, and has relaxed requirements for pre-authorization, pre-certification and referral.
  • Cigna has lifted prescription drug refill restrictions and waived preauthorization for acute and mental health care. They have also donated $200,000 the to American Red Cross.
  • Humana will allow members to refill prescriptions at non-network pharmacies, has removed Rx refill limits and will not require referrals to see specialists. They have also donated $250,000 to the American Red Cross.
  • United Healthcare and UMR will allow early prescription drug refills, provide free Teladoc visits and a free hotline for emotional support. They have also donated $1 million to Texas communities affected by Hurricane Harvey.

An overview of services offered and donations made is linked below:

A deep heartfelt thank you to our partners in service to our clients. Though our negotiations are intense at times, your efforts are recognized and appreciated.




Senate Rejects ACA Repeal Efforts

In the early morning hours of July 28, 2017, members of the U.S. Senate voted 49-51 to reject a “skinny” version of a bill to repeal and replace the Affordable Care Act (ACA), called the Health Care Freedom Act (HCFA).

This was the final vote of the Senate’s 20-hour debate period, and effectively ended the Republicans’ current efforts to repeal and replace the ACA. However, the skinny repeal bill may be reintroduced at some point in the future.

What did the HFCA propose?

Similar to the American Health Care Act and the Better Care Reconciliation Act, the HCFA would repeal the ACA’s individual and employer mandate penalties, effective Dec. 31, 2015. However, the employer mandate repeal would only be effective through 2024.

In addition, the ACA’s reporting requirements under Sections 6055 and 6056 would remain intact.

The HCFA would have also:

  • Extended the moratorium on the medical devices excise tax.
  • Increased the contribution limit for health savings accounts up to the maximum out-of-pocket limits allowed by law for high deductible health plans.
  • Amended the ACA’s existing Section 1332 State Innovation Waivers, added stricter requirements for the Department of Health and Human Services in approving waivers, and extended waivers to eight years (instead of five), with unlimited renewals.

What are the next steps for employers?

Because the Senate was unable to pass any ACA repeal or replacement bill, the ACA remains current law, and employers must continue to comply with all applicable ACA provisions.

Following the vote, Senate Majority Leader Mitch McConnell indicated that Republicans now intend to focus on other legislative issues, although they remain committed to repealing the ACA.


Avoiding Unnecessary ER Visits Provides Win-Win Savings for Companies and Employees

Unnecessary ER visits for minor conditions – sore throats, urinary tract infections, colds, earaches, minor cuts and muscle strains – are costly, time consuming and result in increased healthcare costs for everyone. It is estimated that 13.7% to 27.1% of all emergency room care could take place at an urgent care or other alternative treatment center, potentially generating $4.4 billion in annual healthcare cost savings.

Saving money, being seen quickly and not having to take extra time off work are some of the benefits for employees who choose these alternatives over Emergency Room visits.  How can employers encourage their employees to make better decisions?

Education is the key! Most employees “vote with their wallets.” Simply educating employees about their choices can significantly reduce unnecessary emergency room visits. In one study, 40 percent of employees surveyed had never used, or were unfamiliar with, Urgent Care. Employers can help by making sure employees know ahead of time about:

  • The cost of Urgent Care vs. Emergency Room
  • The in-network Convenient and Urgent Care centers located near home and work
  • The business hours of Convenient and Urgent Care centers located near home and work
  • The ease of obtaining a prescription from a Telehealth or Convenient Care visit

Telehealth from Teladoc and Doc On Demand

Typical Total Cost: $40-$60

Typical Cost to Insured Patient: $0-$25

Online doctor visits from companies like Teladoc and Doc on Demand are available 24-hours, 7 days a week to anyone with a smart phone. Most carriers such as Aetna, Humana and United Healthcare include these features at no extra cost to insured employer groups. These doctors can quickly call in prescriptions for many common ailments. Employers can choose to charge employees nothing or the primary care visit copayment. Employees enrolled in an HSA-type plan must pay the full cost of the visit in some cases.

Convenient Care Clinic

Typical Total Cost: $75-$100 

Typical Cost to Insured Patient: $25

Convenient Care Clinics are walk-in clinics set up inside larger retail stores such as Target and Walgreens. They are staffed by nurse practitioners and physician’s assistants who diagnose and treat a range of minor illnesses and injuries that do not require emergency care – such as cold and flu symptoms, strep throat, rashes and other low-level health needs. They are highly convenient and usually can see patients very quickly, saving patients valuable wait time. Most are only open until 6 pm 6 days per week.

Urgent Care Clinic

Typical Total Cost: $100-$200

Typical Cost to Insured Patient: $60-$75

Urgent care clinics are a step above convenient care clinics and are set up to help patients with conditions that are not life-threatening but cannot wait for a primary care appointment. These include things like broken bones, burns and cuts requiring stitches. They have physicians on staff who can provide a higher level of care and more sophisticated diagnostic services such as x-rays and lab services. If emergency services are needed, they can arrange to transfer patients directly to an Emergency Room for further treatment. Most are open until 8 pm 7 days per week.

Emergency Room

Typical Total Cost: $300-$1,200

Typical Insured Patient Cost: $250-$500     

Emergency rooms specialize in life-threatening conditions and injuries that require more advanced technology and medical personnel. These facilities are fully equipped to handle any kind of illness or injury that walks through the door. This includes chest pain, head injuries, bleeding that isn’t controlled with pressure, loss of consciousness or severe breathing difficulties. They are required by law to accept all patients, regardless of their ability to pay. Because of this and other factors, ER wait times can be several hours and the average cost is much higher than a Convenient Care clinic or Urgent Care center.

It is crucial that if someone is encountering a true life threatening emergency, they call 911 or get to the emergency room immediately. However, when someone needs medical care, but it’s not life threatening, lower level care services can be smart alternatives to an emergency room visit. Making sure employees understand all their options will save them time, hassle and money and control healthcare costs for everyone. Let Arista help you design a custom communication strategy for your employees.


Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Deciding to Visit the Emergency Department for Non-Urgent Conditions: A Systematic Review of the Literature. The American journal of managed care. 2013;19(1):47-59.

Mehrotra, A., Liu, H., Adams, J., et. al. “Comparing Costs and Quality of Care at Retail Clinics with That of Other Medical Settings for 3 Common Illnesses.” Annals of Internal Medicine. September 2009.

Weinick, R. M., Burns., R. M., and Mehrotra, A. “Many Emergency Department Visits Could Be Managed At Urgent Care Centers and Retail Clinics.” Health Affairs. September 2010.




Investing in Diabetes Prevention Pays Off

The diabetes epidemic continues to grow with millions of Americans and their families being affected every day. Driven by an aging population and lifestyle factors such as obesity and inactivity, the cost of medical coverage for diabetes patients is growing nearly twice as fast than for all other insured people. Not only is this having a devastating impact on individual lives, employers and insurers are incurring billions of dollars in treatment, absenteeism and lost productivity every year.

The Centers for Disease Control (CDC) estimates that approximately 30 million Americans or 9.3% of the population have diabetes. In addition, the CDC estimates approximately 86 million American adults – 1 in 3 – have prediabetes, a precursor to full-blown type 2 diabetes. With prediabetes, blood glucose levels are elevated but are not yet high enough to be diagnosed as diabetes. Without treatment, prediabetics are at high risk of developing type 2 diabetes within 5 years and are also at increased risk of heart disease, stroke, and damage to their eyes, kidneys and nerves.

Is there anything employers can do to help? Fortunately, there are steps you can take that can lead to healthier employees and lower costs.

Provide easy access to primary care

Early treatment is important to delay or prevent the onset of type 2 diabetes and mitigate early damage to organs and blood vessels. Primary care is the first line of defense for adults at risk. Not only will regular blood testing lead to earlier diagnosis, a physician can monitor the progression of the disease and provide counseling, support and medication.

Generously cover pre-diabetic medications and other treatment

Making it easy for people diagnosed with prediabetic conditions to get the medications and other support they need to manage their condition leads to better health outcomes. For instance, a study from the CDC and National Institute for Health (NIH) found that participants who took Metformin had a 31% reduced risk of developing type 2 diabetes compared to the control group. Covering these and other medications, providing access to nutrition counseling, and educating at-risk adults can all help reduce the risk of developing type 2 diabetes. Two popular chains, Meijer and Publix, actually dispense Metformin at no cost with a prescription.

Implement workplace wellness and lifestyle change programs

The most important thing a prediabetic can do is to focus on healthy lifestyle changes. Prediabetics who lose weight by eating healthier and being more active reduce their risk of getting type 2 diabetes by 50%. Healthy workers are more productive and miss fewer days of work. Employers that offer programs to encourage wellness and physical fitness can potentially reduce health care costs and insurance premiums. According to a 2010 study, for every dollar spent on such programs, there is an estimated decrease in medical costs of about $3.27 and a reduction in absenteeism costs of about $2.73.

How can I save money today?

1. Offer onsite or easily-accessible biometric screenings to all of your employees to identify those with diabetes, high blood pressure, high cholesterol, etc.

2. Offer a small incentive to encourage participation.

3. Explore telemedicine options such as Teladoc and Doc on Demand. Many insurance carries include these tools and they generally have low or no cost sharing.

4. Educate your employees about where they can get free or nearly free Metformin.


Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014.

Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012. June 22;379(9833):2279–90.

Baicker K, Cutler D, Song Z. Workplace Wellness Programs Can Generate Savings. Health Affairs. 2010;29(2):304–311. Kramer M, Molenaar D, Arena V, et al. Improving Employee Health: Evaluation of a Worksite Lifestyle Change Program to Decrease Risk Factors for Diabetes and Cardiovascular Disease. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. 2015;57(3):284-291. doi:10.1097/JOM.0000000000000350.

Kramer M, Molenaar D, Arena V, et al. Improving Employee Health: Evaluation of a Worksite Lifestyle Change Program to Decrease Risk Factors for Diabetes and Cardiovascular Disease. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. 2015;57(3):284-291. doi:10.1097/JOM.0000000000000350.

Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin Diabetes Prevention Program Research Group*N Engl J Med 2002; 346:393-403February 7, 2002DOI: 10.1056/NEJMoa012512.