Vice President for Human Resources

Tobacco-User Additional Premium: Questions and Answers

Basic Information

• When did the tobacco-user additional premium go into effect?
  
  
  January 2012
• To whom does the additional premium apply?
  
  
  All employees and spouses/same-sex domestic partners covered by a Purdue employee medical plan who are tobacco users and have not completed an approved tobacco cessation program.
• How much is the additional premium?
  
  
  $500 per person, per year for 2013.
• How will the additional premium be administered?
  
  
  The annual additional premium for you and your covered spouse/SSDP will be divided by your number of annual Purdue pays; an equal amount will be taken from each of your pays throughout 2013.
• How will the additional premium appear on my pay stub?
  
  
  The tobacco-user additional premium is combined with the medical plan premium shown on your pay statement; it is not listed separately.
• How does Purdue define a "tobacco user"?
  
  
  A tobacco user is a person who has used tobacco in the past 12 months. Tobacco includes cigars, cigarettes, chewing tobacco, pipe tobacco or any other tobacco product.
• Are electronic cigarettes included as tobacco use for the additional premium?
  
  
  Yes, because they may contain tobacco, or they may contain nicotine, which is derived from tobacco. The health effects of using electronic cigarettes are currently unknown. Several studies regarding the long-term health effects of nicotine vapor, both inhaled directly and secondhand, are currently in progress. The FDA will be developing regulations on electronic cigarettes as tobacco products under the Family Smoking Prevention and Tobacco Control Act.
• I use the nicotine patch, does that count as tobacco use?
  
  
  No. Nicotine replacement therapy, such as the nicotine patch or nicotine gum, does not count as tobacco use.
• Are electronic cigarettes recognized as nicotine replacement therapy?
  
  
  No. A number of FDA-approved smoking cessation aids are available for tobacco users, depending on their dependence on nicotine. These include nicotine gum, nicotine transdermal patches, nicotine lozenges, nicotine inhalation products, nicotine nasal sprays, Chantix tabs, and Bupropion 150 mg SR/Zyban 150 mg.
• Why are tobacco users being charged more?
  
  
  Studies show that a tobacco user's annual medical costs are on average $1,700 higher than the costs of a non-tobacco user. The additional premium was set at $250 for 2012 and $500 for 2013 to recover a portion of these additional costs.
  
  According to the Centers for Disease Control and Prevention, men and women who smoke have more lifetime medical expenses and are absent from work more days each year than those who do not smoke. In addition, smoking increases costly complications of pregnancy, such as pre-term delivery and low birth-weight infants.
  The state has identified the following statistics about what tobacco costs Indiana each year:

  • For every pack of cigarettes sold in Indiana, Hoosiers spend $7.57 in health care costs related to smoking.
  • Indiana residents' state and federal tax burden from smoking-caused expenditures is $566 per household.
  • Annual smoking-related economic costs (including smoking-attributable medical expenditures and smoking-attributable neonatal medical expenditures) total $3,391 per smoker.
• Why are we focusing on tobacco?
  
  
  According to the National Institute on Drug Abuse:

  • Smoking harms nearly every organ in the body. It's been linked to cataracts and pneumonia, and it accounts for about one-third of all cancer deaths. The overall rates of death from cancer are twice as high among smokers as among nonsmokers.
  • Smoking has been linked to about 90 percent of all cases of lung cancer and is associated with many other cancers and lung diseases. It's also been well documented that smoking substantially increases the risk of heart disease, including stroke, heart attack, vascular disease and aneurysms.
  • All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The amount of nicotine absorbed from smokeless tobacco is 3-4 times greater than that delivered by a cigarette, and while nicotine is absorbed more slowly from smokeless tobacco, more nicotine per dose is absorbed and stays in the bloodstream longer.
  • Chewing tobacco and snuff contain 28 carcinogens (cancer-causing agents). Smokeless tobacco increases the risk for cancer of the oral cavity, which can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth. Other effects include oral leukoplakia (white mouth lesions that can become cancerous), gum disease, and gum recession (when the gum pulls away from the teeth).
• How can Purdue charge me more for being a tobacco user?
  
  
  The wellness program exemption from HIPAA's nondiscrimination rules allows employers to offer health plan-related financial incentives to discourage tobacco use as long as the total reward is limited, promotes good health or prevents disease, and is available to all similarly situated individuals.
• Will other health-related additional premiums be considered in the future for things like obesity, alcohol use and so forth?
  
  
  Substantial research links tobacco use to increased medical costs. The University will continue to evaluate medical research regarding other health factors as we develop plan design recommendations for 2013 and beyond. Our ultimate goal is to build a culture of health and wellness in which employees choose to become healthier.

Avoiding the $500 Additional Premium for 2013

• How can I avoid the additional premium for 2013?
  
  
  To avoid the additional premium in 2013, you must have certified during benefits open enrollment that you had been a non-tobacco user for the 12 months immediately prior to completing your enrollment or that you were a tobacco user who had completed an approved tobacco cessation program between Sept. 1 and Nov. 16, 2012.
• What if I didn't certify my tobacco user status during open enrollment?
  
  
  You and your covered spouse/SSDP are considered tobacco users and are charged the $500 additional premium in 2013 if you are covered by a Purdue medical plan and did not certify your non-tobacco user status.
• What if employees certify that they are not tobacco users when, in fact, they are?
  
  
  When you certify your tobacco-user status, you attest that you are telling the truth. If it is later discovered that you made a false statement, you will be subject to disciplinary action, which may affect your employment.
• If I complete 12 months as a non-tobacco user during 2013, can my additional premium be waived at that time?
  
  
  Yes. When you have been a non-tobacco user for at least 12 months, complete the Tobacco User Certification Form and submit it to Human Resources. Your additional premium will be waived on Purdue pays you receive during the rest of the calendar year, after allowing appropriate time for processing of your waiver.
• If I complete an approved tobacco cessation program during 2013, can my additional premium be waived at that time?
  
  
  If you complete an approved tobacco cessation program by one of the dates below, your additional premium will be waived on all pay you receive in 2012 on or after the listed waiver date.

  • Complete approved cessation program by Feb. 28 and qualify for waiver of the additional premium beginning on April 1.
  • Complete approved cessation program by May 30 and qualify for waiver of the additional premium beginning on July 1.
  • Complete approved cessation program by Aug. 31 and qualify for waiver of the additional premium beginning on Oct. 1.
• If I complete an approved tobacco cessation program during 2013, will Purdue refund the tobacco-user additional premium that's already been taken from my pay?
  
  
  No. Some of your future additional premium will be waived, but you will not receive a refund of any amount you have already been charged.
• How do I complete an approved tobacco cessation program?
  
  
  Information about approved tobacco cessation programs is available through Human Resources WorkLife Programs.
• How much will I pay to participate in an approved tobacco cessation program?
  
  
  The approved tobacco cessation programs made available by Purdue are at no charge to you or your covered spouse/SSDP. Purdue provides the approved programs as a benefit to you.
• Are there other options for tobacco cessation programs?
  
  
  Community Alternative: If you take part in a tobacco cessation program through other campus resources, hospitals or community organizations, you may qualify for waiver of the tobacco-user additional premium, depending on the specifics of the offering. Before taking part, contact Human Resources WorkLife Programs to review the details of the offerings and find out if completion of the program will qualify you for the additional premium waiver. If the program qualifies, Human Resources WorkLife Programs will provide you with a Community Alternative form that you must have signed by the community program's representative when you have finished the program. Please note, there may be costs to you for community programs.
  
  Medical Alternative: If you are unable to participate in a traditional program due to a medical condition, contact Human Resources WorkLife Programs to develop an alternative way to qualify for waiver of the tobacco-user additional premium.
• I've talked with my doctor about stopping tobacco use, and I am using a prescription to aid my efforts. Do I qualify for waiver of the additional premium?
  
  
  When you have been a non-tobacco user for 12 months, you will qualify for waiver of the additional premium. Prior to being a non-tobacco user for 12 months, you can qualify for waiver of the additional premium by completing an approved tobacco cessation program.
• I only use tobacco occasionally. How do I qualify for the waiver?
  
  You have two options:

  • You may complete an approved tobacco cessation program.
  • When you have been a non-tobacco user for at least 12 months, complete the Tobacco User Certification Form and submit it to Human Resources. Your additional premium will be waived on Purdue pays you receive during the rest
• If I complete an approved tobacco cessation program, will that also qualify me for non-tobacco user rates on my Purdue life insurance through Minnesota Life?
  
  
  No. The option to earn a waiver by completing an approved tobacco cessation program applies only to Purdue's medical plans.
  
  However, when you are 12 months tobacco free, you may contact Minnesota Life at 866-293-6047 to certify your non-tobacco user status.