Tobacco Surcharge Frequently Asked Questions

Click here for a PDF with instructions on how to complete your tobacco attestation! OR click here for a webinar!

Why a surcharge?

The purpose of the policy is to encourage employees and spouse plan members toward tobacco cessation in the service of creating a healthier workforce.  Through this policy, Einstein intends to give more employees and spouses on the health plan an opportunity to actively engage with a tobacco cessation coach, get questions around tobacco cessation answered, and take the next step toward cessation.  It is all our responsibility to be an example by role modeling health behaviors and avoid compromising others' health as a result of the ill-effects of secondhand smoke.

What is the surcharge?

Tobacco users will pay a surcharge for their health plan coverage beginning October 1, 2020.  Plan members need to attest to their tobacco status in their RedBrick portal by August 31, 2020.  The $25 surcharge (per person, per pay) applies to employees and spouses covered under the Einstein health plan.  Plan members who are tobacco users can avoid a surcharge if they want to make an effort to quit.  This means completing 3 calls with a RedBrick Quit Smoking coach.  They can also have access to a free 90-day supply of NRT by completing a call with a CareBridge coach.  If they are still smoking after the completion of the program, they can get extra counseling sessions if they chose, but will not incur the surcharge that year.

How do I attest my tobacco status?

All employee and spouse plan members will need to log into their RedBrick portal each year to attest to their tobacco-free status, or complete 3 quit smoking calls with a RedBrick health coach to avoid the $25 surcharge.

Who needs to attest to their tobacco status in the RedBrick portal?

Employee and spouses who were on the health plan as of April 1, 2019.

What if I don't attest my tobacco status?

Your status will default to a tobacco user and the surcharge will be deducted from your paycheck each pay.

What is the relationship between smoking and healthcare costs?

According to a recent and well recognized research study, tobacco users increase an employer's healthcare cost by roughly $5,000 more than non-smokers per employee each year.  The Center for Disease Control reports that smoking is the leading preventable cause of death, disease and disability in the United States.  It is responsible for more than 480,000 deaths per year, costs more than $289 billion a year, including at least $133 billion in direct medical care for adults, and costs more than $156 billion in lost productivity.

How is "tobacco use" defined for purposes of the surcharge?

Tobacco use is defined as any form of tobacco (cigarettes, cigars, E-cigarettes, vaping, pipes, all forms of smokeless tobacco, etc.) regardless of the frequency or method of use.

Will Einstein verify my smoking status?

Employee and spouse plan members will attest each year.  All employees are expected to uphold integrity and our standards of behavior.

What are the consequences for providing false or incorrect information?

Falsifying tobacco status is subject to performance accountability and a breach of professionalism.  We expect and rely on all employees to uphold Integrity as well as other Standard of Behaviors and apply it to the tobacco use attestation by "keeping [their] word" and "conducting [themselves] with honesty and fairness."

May I participate in a different tobacco cessation program to quit in order to avoid the surcharge?

All employee plan members are welcome to engage in multiple methods to help them quit.  However, to avoid the surcharge, plan members need to participate in the tobacco cessation program offered through RedBrick.

What nicotine replacement therapies (NRT) are available to participants?

Employees and covered spouses/partners enrolled in the health plan are eligible to receive the nicotine patch or gum by speaking with a Carebridge Counselor (800-437-0911).

How do I get the free NRTS?

Plan members may receive up to a 90 day supply of free NRT per fiscal year from the LiveWell Employee Pharmacy.  Once the plan member completes an assessment with a Carebridge counselor, the plan member will receive instructions about obtaining the free supply.  It's important to note that this is a separate benefit from the RedBrick Quit Smoking program.

What support to quit does Einstein offer?

Einstein offers free tobacco coaching and free NRT (90 day supply) to current plan members who use tobacco if they are interested in quitting and wish to avoid the surcharge.  This program requires 3 sessions of telephonic coaching with a RedBrick health coach.  After the required 3 sessions, plan members who need additional coaching can receive unlimited coaching if they choose.  Einstein also provides a list of other programs and resources available to those interested in quitting, including programs that are reimbursable through Independence here.

What happens with the information obtained from my attestation?

Your healthcare is personal, and Einstein and RedBrick takes the confidentiality and security of your personal health information very seriously.  In addition, the Health Insurance Portability and Accountability Act (HIPAA) protects your privacy, giving you rights over your health information and setting rules and limits on who can see it.  HIPAA protects an individual's personal health information that is created, kept, filed, used or shared and written, spoken or electronic.  Einstein only receives a payroll deduction file from RedBrick.

Do other employers have tobacco surcharges?  Is it legal?

Yes.  Many hospitals in the area, including Jefferson, have tobacco surcharge policies.  In fact, Towers Watson's annual survey of large employers, "Reshaping Healthcare," found that 48% of employers were using surcharges for tobacco users in 2017, and that percentage is expected to increase to 59% in 2019.

Yes.  Employers can offer health plan-related financial incentives to encourage healthy behaviors under the wellness program exemption from HIPAA's nondiscrimination rules when the program helps employees - even those with health issues - improve their health.  To meet federal guidelines, a tobacco surcharge, as part of a wellness program, must promote good health, prevention of disease, and participants must be given a reasonable alternative or chance to avoid the tobacco surcharge at least once per year.  Einstein is providing this reasonable alternative by smokers opting into the RedBrick Quit Smoking program.  Additionally, any employee who has a medical condition that makes participation in the tobacco cessation program unreasonable difficult or medically inadvisable and who wishes to avoid paying a surcharge, may provide verification from his/her physician.  If there is no clear medical reason for being excused from the program, regulations may preclude Einstein from honoring the physician's request.