Casino Connection Atlantic City

Staying Healthy

Casinos combine healthcare with wellness programs to take a proactive approach to employee health

by Joseph Harrison

Small businesses aren’t the only ones that sweat the rising costs of healthcare. Even though casinos rake in money by the millions, gaming executives stress over healthcare plans on a regular basis, trying to find the right plans that fit their employees while not breaking the bank.

Although the casino union employees are covered by their respective unions’ plans, casinos still have many non-union employees to worry about.

The recent trend in healthcare seems to be wellness. Most casinos are taking aggressive measures to help their employees avoid health issues instead of treating them once it’s too late.

“We are working to promote wellness and healthy lifestyles in order to keep costs down,” said Signe Huff, vice president of talent for Borgata Hotel Casino & Spa. “We review providers and costs yearly. Unfortunately, some of the rising costs must be passed on to our associates, but we carefully monitor all costs and work to keep this to a minimum.”

Borgata isn’t the only casino passing some of the buck to the employees. All of the casinos in town require employees to pay a portion of their benefits—typically around 20 percent of the cost. So, casinos and their employees have a lot to gain by staying healthy. Healthier employees mean fewer claims need to be paid, hopefully resulting in steady or eventually reduced rates.

“The future is wellness… without a doubt,” said Judy Fisher, executive director of human resources administration for Trump Entertainment Resorts. “I really don’t see how we can reasonably shift any more costs. We have tweaked and tweaked our plan design to where you can’t move them much more than they have been moved. It’s really a matter of being more aggressive in making our employees healthier—and for that matter, our population healthier.”

Wellness Centers

Harrah’s is helping set the bar at Atlantic City casinos. The company invested more than $4 million to provide a convenient and affordable Health & Wellness Center that opened in 2005 and was expanded last year.

The center, located inside Showboat, is the only casino-owned and operated wellness center in the city, staffed with a team of health professionals providing a full-service office visit including lab work and x-rays. A nutritionist also is available. The center can also dispense many standard prescription medications in conjunction with the office visits.

A $2 million fitness center was added in 2006, equipped with state-of the-art weight training and cardio equipment. The center also offers group fitness classes. A fitness director and certified instructors are available to help design individualized fitness programs. And there are lockers, showers and towel service to make it convenient for employees to use before or after their shifts. The best part of the deal is that the fitness center is free to all “team members” from Harrah’s, Showboat, Bally’s and Caesars.

“Preventive-care doctor visits and diagnostic testing are important to monitoring health with regularity,” said Linda Guntner, director of compensation and benefits for Harrah’s Atlantic City operations. “Health problems that may go unnoticed can be treated before they become chronic or serious. Many times this can be done through lifestyle changes, like healthier eating habits and incorporating exercise and relaxation techniques into your daily life. Our Health & Wellness Center and Fitness Center make this more convenient for our team members. The facility is centrally located for our employees and even provides free parking for office visits. An ounce of prevention is worth a pound of cure.”

Borgata, which uses Horizon Blue Cross/Blue Shield for medical and dental and Cigna for prescriptions, is very active in promoting wellness. Horizon provides a health-risk assessment that associates can complete online. And, associates are also treated to discounted memberships at Tilton Fitness, Island Gym, Atlanticare health systems, Curves and the Brigantine aquatic center.

The casino also hosts at least one wellness event a month. In January, a “Lunch and Learn” on weight loss as well as a smoking cessation class were held. And in February, an information session on heart care was offered.

Banking on Prevention

That is in conjunction with ongoing preventative procedures that include flu shots and other free vaccinations. Trump actually has a self-funded healthcare plan, meaning they pay claims dollar for dollar. However, Trump uses two providers for medical, Horizon Blue Cross and Amerihealth—Horizon for dental, VSP for vision and Medco for prescriptions.

Wellness is also a priority for Trump, which encourages employees to go for free wellness exams, prostate checks and mammograms.

“Prevention is the best way to go,” Fisher said. “And those routine check-ups are so important.”

To help busy employees, Trump brings a traveling mammography van to its casinos at least once a year and offers Weight Watchers programs on site, while also offering discounted gym memberships and waived initiation fees for Tilton Fitness centers.

“We try to make it as convenient as possible,” Fisher said. “We offer payroll deduction for gym memberships and things like smoking cessation classes. But sometimes, like the smoking cessation classes, it just doesn’t work. We want to try it again, but we had one recently, and it was not terribly successful. You can’t make people do something they don’t want to do.”

Fisher said Trump also occasionally hosts “fairly large” wellness fairs, in which healthcare professionals are invited to talk to employees, who hopefully walk away with ideas to achieve better health.

“There’s chiropractors and healthcare professionals but also financial professionals and local schools and colleges because we also promote mental health for our employees,” Fisher said. “We try to have one at each property every year.”

Trump also offers blood pressure and cholesterol screenings that have proved beneficial.

At Resorts Atlantic City and Hilton Atlantic City, employees are offered Cigna benefits for medical, dental, vision and prescriptions, providing nice consistency when it comes to claims.

“Convenience is important,” said Patti Rocco, regional vice president of human resources for the Hilton and Resorts. “Our goal is to offer the best and most fair package we can for our employees, and with escalated prices, we realize wellness plans are the best way for us to keep doing that.”

Resorts and Hilton offer programs including smoking cessation, discounts for gym memberships, and monthly wellness education seminars that include topics ranging from cholesterol to baby wellness.

“We had a wellness walk and a weight-loss challenge last year,” Rocco said. “Benefits aren’t there just when you are sick. They are there to help you detect sickness, and that’s why things like free mammograms, which we offer, are so important. If we can promote good health, that is going to help us in the future with expenses. But more importantly, it means we have a healthier workforce.”

Casino-Related Issues

Some casinos even go the extra mile to help all employees cope with traditional casino-related health issues like back and foot problems.

Borgata offers programs on the care of the back and feet, as well as training on proper lifting techniques. Trump’s impressive program includes a safety shoe program, in which a company comes on site to help employees receive orthopedic support for their feet and back while offering kitchen workers soles to reduce the chances of slipping. Another major factor in keeping healthcare costs down is to identify trends.

“We look at where the dollars are being spent,” Fisher said. “And then we try to address specific areas of concern or try to figure out why a certain thing may be happening and what we can do to avoid it. So, for example, if we have a lot of claims regarding premature babies, we might get out there and try to encourage people to their prenatal exams.”

Casinos are constantly trying to find the right packages to fit their employees. Trump recently unbundled its benefits package to save money for some of their employees who might not need all of the coverage they were receiving.

“We wanted them to have more choices,” Fisher said. “Now, they can hand-pick a plan to fit their particular needs. Maybe one person doesn’t need medical, but wants the dental and vision. Some people don’t need everything. Or maybe some people would rather not have a certain benefit to save some money. So now they are broken apart and people can build their own plans to fit their needs. It affects their contributions, and we have received some positive feedback about that. Now employees can spend their dollars more freely.”

Sometimes, it just comes down to negotiating.

“Absolutely,” Fisher said. “You have to go out there and negotiate every year with providers and find out what you can get for your company and your employees, to see if you can do better than what you already have. We recently found a silent network for our dental program and not only are we getting a better bang for our buck, but so are our employees. The same thing goes for our vision product. We negotiated a deal so that our employees are now paying significantly lower prices for their glasses.”

As for the future, casinos will keep trying to find more economical plans while maintaining the level of healthcare they want for their employees. That may include rewarding people with financial incentives if they score well at their yearly physical or don’t smoke.

“We are actually beginning a volunteer experimental program in the near future,” Fisher said. “The plan is to have employees take a series of tests and then have a health counselor reach out to them if they need to get healthier… to actually work with these people to achieve results. That is something we are really looking forward to.”

The Hilton and Resorts recently hired an outside company, Health Advocate, to assist employees.

“They are so great because they can do everything from helping an employee find a doctor on the network to helping someone with a claim or to look for elder care. They can turn the case over to Health Advocate and let them deal with the problems. People have a lack of free time, and this company helps our employees get the most out of their benefits.”

The bottom line: employees are more conscious and concerned about their benefits than ever before.

“Benefits are extraordinarily important,” Fisher said. “In the old days, employees didn’t seem as concerned. But now, it’s a major factor. We want to make sure they get a quality product for a reasonable price, and that’s always a battle.”

“If anyone were to go out and purchase a plan on the market, they would realize how expensive it is,” Rocco said. “It’s a huge benefit that attracts employees. They are very important.”

Guntner agreed: “The cost of health care is a major concern to everyone these days. A comprehensive and affordable healthcare plan is part of a competitive total compensation package and important to attracting the best employees.

“Harrah’s strongly believes that healthy and happy employees are less likely to get sick and less likely to miss scheduled shifts. The overall benefits of better health and wellbeing result in a more engaged workforce.”