Amid the litany of measures to scale back rising benefits costs, employers are actually becoming more aggressive with their wellness program dollars. And if you think health management initiatives are all about breaking bad health habits, think again. There may come a point when no one will be able to receive medical coverage unless they're taking part in the company wellness program.

The seismic shift of accountability to workers is progressing quickly as premiums rise and workplaces are plagued with chronic health problems and preventable conditions. More than 60 percent of companies with 10,000 or more employees said they had a wellness program in 2008, according to a MetLife survey. And almost 60 percent of employers agree incentive-based programs had a better than expected success rate at increasing employee participation, according to a new survey from Fidelity Investments and the National Business Group on Health.

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