Who better to participate in Employee Benefit Adviser's second annual Broker Fitness Challenge than a woman who became a benefit broker precisely because she was looking for a challenge?

Entering the industry as a customer service representative with BlueCross BlueShield Association, Rae Bunce quickly moved up the ladder to the MVP sales department. But being tied to one carrier wasn't enough for Bunce. About two years ago, she left to join the Benefit Group of New England as an employee benefit specialist.

"The reason I enjoy my job is because of the challenge," says Bunce, 46. "With cold calling you never know what you're going to get when you dial out to somebody. Or you get to a meeting and there's always that challenge piece to get the relationship going with the person, and then get the sale in the end."

After Thom Mangan lost 40 pounds in last year's Fitness Challenge, Bunce seemed like the perfect fit to follow in Mangan's (now lighter) footsteps. "To lose the weight would be a great opportunity," Bunce said as the Challenge kicked off in May, "but also to learn a healthy lifestyle and every month challenge myself to lose a little more. It's in my bloodstream to always be challenging something."

The game plan

For six months, Bunce teamed up with Nationwide Better Health to improve her outward appearance - and her outlook on wellness. "It's a great way to show my clients and prospects that I'm motivated to do a wellness program and to get myself moving toward a healthy lifestyle," she says.

Bunce started the Nationwide Better Health program with a health risk assessment looking at factors such as personal and family history, lifestyle choices, clinical measurements, preventative exams and immunizations, according to Katie Hill, the Nationwide Better Health lifestyle coach assigned to her. On her first phone call with Bunce, Hill got to know her new client by going over Bunce's "wellness vision" of where she'd like to see herself in six months to a year: "For Rae, it ended up to be something like this: An active, engaged, energetic grandmother; someone who wants to learn how to eat healthy, develop and start doing a consistent exercise routine."

Linked to the wellness vision are the reasons behind it. Because each participant enters the program in a different state of change, it is essential to know their motivation for participating. Calls between Bunce and Hill started on a weekly basis and became more spaced out as the program advanced. Through a series of educational kits, the pair reviewed topics such as stress management or how to read and get the most out of nutrition labels. "It works really well because you're accountable," says Bunce. "I don't want her to call me and I say, 'Well, I've just been sitting on the couch.'"

No hypocrites here

It's about sending the right message to clients as well. "If I go in and I'm 70 pounds overweight and my car is full of Coke bottles and empty coffee cups, I'm not really practicing what I'm telling them to do to get their utilization down," says Bunce. "But if I can go in and say, 'Well, this is what I do ...' or if I can offer a tip to somebody that may be struggling, that's much more effective than having an overweight, tired broker come in who clearly is not practicing any kind of wellness."

In the larger broker universe, "there are a lot of us who could definitely practice what we preach," says Bunce. "Just by going to different broker events I can see clearly that there are people in my shoes that need to do something about it. There are many that are very healthy and participating in wellness but the majority I think are more like me."

One factor that compelled Bunce to join BGNE in the first place was the Vermont company's progressive thinking on the future of consumer-driven health care plans. "That's the piece that I really like," says Bunce. "I felt like doing this wellness program and the Broker Challenge just made me a better consumer and more informed and I'm not just saying things, I'm actually doing them. You have to believe in what you're selling."

By August, Bunce was regularly discussing wellness initiatives with all of her clients. Many of them were already involved in some form of a wellness program, but through her experience with Nationwide Better Health, Bunce felt empowered to speak with them further about "a lot of these things I wasn't even aware of that were available inside of these contracts," such as a health coach.

Having worked with clients across a broad range of industries, at the beginning of the challenge Hill felt that even though Bunce is a benefits broker with intimate knowledge of the health care industry it didn't made her stand out from Hill's other participants.

"Rae is just like everybody else," she said. "She has almost the exact same challenges as everybody else. She has a dynamic job. She has a busy lifestyle."

After six months together, Hill added that Bunce "might have had some more external motivation seeing as how this is her job - she does sell the product." But, she maintained that Bunce is "just an average person really wanting to make these changes."

As Chief Medical and Science Officer with Nationwide Better Health, Dr. Neil Gordon has overseen numerous studies on the effectiveness of wellness programs across a broad range of demographics and says no one profession's success rate stands out.

"Different people have different factors that motivate them to make changes," he says, "but we've seen that individuals from very diverse backgrounds are able to derive substantial benefits from participating."

Who knew?

When Bunce started the Challenge she was all about one goal: lose the weight. "But it's so much more involved than that," she realized in July. "There are so many pieces that go into it and it's just really interesting to learn because not only is it helping me get healthier myself, but it's easier to talk to clients about it and prospect if I've actually done it."

In the beginning, Bunce's tunnel vision on weight loss kept her skeptical about the path Hill was setting for her. "It was all about the weight loss number when I first started. So to look at her plan, I thought, 'ugh, that's not going to work. That's not going to happen fast enough,'" she says.

So instead of just following Hill's recommendations, Bunce kept "tweaking" and doing her own thing. Meanwhile, the usual setbacks and "flip-flopping around" that kept her off a healthy track in the past took hold. One obstacle? Never saying 'no.'

But the more times the women talked and the more Bunce read the materials in the educational kits, the more she realized that Hill just might know what she's doing. Once Bunce embraced the program mind, body and soul, she began to see results. She started a Jazzercise class, then added a treadmill routine. "I couldn't believe the difference," says Bunce. "I haven't run 30 minutes on a treadmill in probably 20 years."

Before working with Hill, Bunce admits she didn't give enough credit to health coach programs when she came across them in a client's contract. "I thought, 'that's not for everybody.' But after doing it, it's a 15 minute phone call. A lot of that stuff you can do right online," she says.

The "go-it-alone" mentality is a common obstacle to starting a new healthy routine, says Gordon, but even the greatest athletes in the world still retain coaches, he points out. "When it comes to leading a healthy lifestyle, people think that they already know what to do and it's a matter of just simply doing it. But in many cases people don't really know what to do or they don't know how to do it in the best manner. Also what people don't often realize is that just being accountable to somebody can actually help," says Gordon, who has a health coach of his own.

The Challenge has "absolutely" changed Bunce's perspective on talking to customers about wellness. "That part is huge," she says. "Now, instead of going to these groups and just talking about wellness I've actually participated in it so I know that it works."

Bunce's own employee health plan at BGNE had wellness built into it, but she never took advantage because she didn't know where to start - an obstacle she credits Hill with helping her overcome. A full 90% of the BGNE block of business is on consumer-driven health plans, with 60% of clients participating in structured wellness plans.

CDHPs are "one of our main focuses - to get employees engaged," she says. "So if we can engage them in a wellness program, it gives them more responsibility for the benefits that they're using, and they're more aware of the cost of the benefits out there."

At Nationwide Better Health, Gordon says the employer interest level in wellness programs has "definitely increased." The company works predominately with groups of 5,000 or more, but smaller employers are increasingly jumping on board as well.

"I believe it's driven primarily by rapidly escalating health care expenditures," he says. "Employers are starting to realize that the health and productivity of their employees is their most valuable asset."

A new way of life

Although she's never had any major health issues, in the last couple of years Bunce has been watching her blood pressure and scale numbers rise. "Every year something new will creep up," she says. "If I don't do something now it will progress and I don't want to be one of those people who sit on the sidelines while their grandkids are playing."

It's about setting a good example for her son and daughter who are in their mid-20s, along with her two-year-old granddaughter: "I want to be around for my kids and my grandkids. I put more of a priority on my health, which is exactly what this program did. I didn't lose phenomenal amounts of weight. What it did was it opened my eyes to how to live a healthy lifestyle."

One of the most fun parts of participating in the Challenge was beginning to notice the differences in her physicality. "I time myself when I go for a walk at night and I notice that now in an hour I cover a lot more ground than I did when I first started," Bunce said in July.

During one coaching session with Hill that took place via cell phone in an airport lounge, Bunce was feeling bummed about travel preventing her from getting to the gym. Then Hill suggested a revolutionary idea: "Walk around the airport."

When it comes to sticking with a healthy routine, anything and everything can get in the way, says Hill. "Anything. Seriously," she says. "I'm not trying to be flippant about it but: 'too much work,' 'my commute's too long,' 'I travel too much,' 'I don't have time to make healthy choices,' 'I don't do the shopping in my family,' 'the kits are too long.' Those are all the cons, the things that you think you can't get past and that's what's been keeping you there forever."

As the program progresses and participants gain confidence they realize it isn't about all or nothing. "Exercise for five minutes is better than no minutes and ten minutes is better than five," says Hill.

Soon after one of her last talks with Bunce, Hill noted the broker's progress: "She's picking healthier items at the grocery store, doing a little more pre-planning before she goes and sticking with the personal trainer, so she's doing really well. She's really on target with where she wanted to be with her vision."

To not only maintain but also build upon healthy habits once the Nationwide Better Health program is over, it's essential to preplan, adds Hill. If eating out is difficult, have three tactics ready to make the experience healthier. If you're getting bored at the gym, be prepared to change up your routine.

Perhaps the most important tactic is to keep healthy habits habitual. "A lot of people think, 'OK, great, I'm finally feeling good. This is awesome, so I'm just going to ease off.' Well that would be the last thing I would want you to do because the whole reason you're feeling great is because you're preventing," says Hill. "Don't stop any of those healthy habits because that's your supportive environment. That's what's really getting you to the next level and sustaining you there."

While she lost 25 pounds, Bunce would still have liked to see more go. "But it really isn't about the weight loss numbers so much as the fact that I really believe I've finally figured it out," she says. "I am much happier that I made the change and I'm excited. I never used to be excited about going to the gym. I never thought I'd be one of those people that look forward to going. And now it's a challenge. Every time I go in I can run a little bit further, I can run longer. I don't even know how to put it into words, but it's made such a difference, it really has."

It's that individual accountability that is missing from much of the proposed health care reform legislation, she adds. "While they're focusing on getting the funds together to promote these subsidies so that everybody has health insurance, there is nothing in there to say 'if we give you X amount of dollars in subsidies we expect that you're going to maybe shop for second opinions, use your primary care over the emergency room,'" says Bunce. "It seems like they [should] build in wellness programs, maybe help people get a gym membership, pay for smoking cessation, different programs for people to work toward getting healthier rather than just giving them access to free health care."

If utilization remains high, health insurance rates won't be coming down, Bunce points out. But if wellness programs were a more central part of reform, then health care would start to improve on a preventative level -"to not just cover people once they become chronic and catastrophic. Try to keep them in that lower tier. Move them back to needing just basic health care."

According to Gordon, the U.S. currently spends less than 3% of all health care dollars on prevention while potentially preventable illnesses make up about 70% of the total burden of disease in terms of premature death and associated costs. "Most potentially preventable chronic diseases do have a very strong lifestyle component," he says. "If people were to become more accountable and lead healthier lifestyles there's no doubt that it would have a very favorable impact on health care-related expenditures."

Of course, there will always be people who are not interested in a healthier lifestyle, but if there's one thing Bunce has learned from participating in the Broker Fitness Challenge, there are people in the middle, such as herself, "who would benefit from it and they would actually participate if they could find a way how to do it."

I knew I was on the right path when

• I began to have more energy at the end of the day.
• I started buying bottled water in the store instead of soft drinks.
• I went to the gym to see how long I could run on the treadmill and was exhilarated to reach 30 minutes.
• I took the tools my health coach provided for me, believed in them, and implemented them in my daily routine.
• I turned down dinner with friends because I had already eaten out that week and didn't want to skip a healthier meal I would prepare at home.I have to say this one was an eye opener... the old Rae would not have considered this for a second!

... A new Rae

Height 5' 2"

Weight
Then: 232
Now: 207

Blood pressure
Then: 140/90
Now: 115/68

BMI
Then: 42.43
Now: 37.86

Cholesterol
Then: 208
Now: 192

Triglycerides
Then: 65
Now: 65

HDL
Then: 55
Now: 60

LDL
Then: 140
Now: 135