Rising health care costs aren't just a challenge for big companies with expansive health coverage. Small businesses are feeling the pinch of skyrocketing costs, as well. Yet many smaller employers still haven't tapped into wellness programs to help ease the pain of year-over-year insurance increases.

A recent survey by YourWellnessAdvantage.com, a free online wellness resource, found that 28 percent of smaller companies (with 10 to 99 employees) supported wellness programs or were in the process of starting one, compared with 78 percent of companies with 100 to 2,499 employees.

While cost is always a concern for small businesses when considering a wellness initiative, the study suggests that small companies simply are unaware of the real financial benefits of wellness, said Lisa Gable, executive director of the Healthy Weight Commitment Foundation, in a recent UPI report.

Only 20 percent of polled small businesses said they strongly agreed that wellness benefits exceed costs, compared with 38 percent of larger companies, Gable said.  However, Gable cited a National Business Group on Health study that shows employers can gain as much as $3.27 for every $1 spent on wellness. "Smaller companies have an even greater stake in the health and productivity of their workforce than larger employers," Gable said.

These programs don't have to be expensive to be effective, especially if they are championed by employees themselves. The Atlantic Eye Institute of Jacksonville, Fla., wanted to start a wellness program but couldn't afford an outside consultant. So, they tapped Rochelle Cordero, a staff member, to start and manage a wellness program for the entire practice, which has more than 30 employees. Cordero was excited about the program and happily took on the endeavor, according to a report by American Medical News.

Cordero took advantage of free and low-cost resources, such as The President's Challenge, which aims to increase participants' physical activity. She also started a smoking cessation initiative and a lunchtime walking program. Under her direction, the practice also started supplying jump ropes and weights for staffers to use during breaks.

The practice is a strong example of how a small company can use internal resources to kick-start a wellness initiative that can save employers money and improve employees' well-being.

"Any small company can do wellness for a low cost," Fiona Gathright, president of Wellness Corporate Solutions, told American Medical News. "This is not something that has to cost a lot of money."

While support from the rank-and-file can elevate a wellness initiative, leadership from the employer is key to any program's ultimate success, experts say. Take Borislow Insurance Agency Inc. in Massachusetts, an independent employee benefit advisory firm and a United Benefit Advisors member with 26 employees, which started its own wellness program to serve as an example for its clients.

The addition of a new on-site gym -- including access to personal trainers -- is a testament to the commitment that the firm's leaders have made to wellness.

"We have a leadership team that supports all of our initiatives, not only financially but really participate and are in there on a daily basis encouraging us to be as healthy as we can be," said Karen L. Kelly, the firm's director of health and wellness, in a recent Boston Business Journal report.

Despite the continuing pressures of health care costs on their businesses, most employers remain cool to a universal, government-funded system, according to a new survey by United Benefit Advisors (UBA).

Only one in six employers (16.3 percent) say they favor a federally tax-funded universal health care system, according to the 2011 UBA Benefit Opinions Survey, which included responses from thousands of employers across the country. In 2006, 27.7 percent of employers favored a universal system paid for with taxes.

"This is important for legislators and regulators to recognize as reform solutions are put forth for consideration," according to a UBA press release. "This lack of desire by employers to see these programs funded with tax dollars will derail programs that cannot sustain support for funding."

Although employers are hesitant to see Washington take over health care, most agree that the federal government has a role to play regarding health. Nearly three-quarters of respondents said the government should require the disclosure of cost and quality information of hospitals and physicians.

Employers remain highly concerned about the future of health care costs, the study found. Nearly all (99.4 percent) top decision makers said they are concerned with the impact that health care costs are having or are going to have on their overall corporate costs. Just slightly fewer (97.9 percent) are also concerned with the impact that health care costs are having on their employees, up nearly 20 percent from three years ago and nearly identical to last year. These results were consistent regardless of industry, employee size category or geographic region, the UBA survey found.

"On an encouraging note, there is a trend of employers implementing wellness and health management strategies that they feel are having a positive impact on chronic conditions and the effectiveness of these programs in general," according to William Stafford, UBA's vice president, member services.

Other findings include:

• 96.9 percent of employers still believe a good benefits program helps attract good employees while 93.8 percent believe good benefits keep employees from leaving.
• Employers are not prepared to meet the legislative and regulatory requirements placed upon them, and those requirements are becoming increasingly complex.

Contact us for more about the benchmarking data and trends reflected in this survey.

Employees have plenty of things to worry about these days: high health care bills, gas prices, steep college tuition for the kids, and of course, saving for retirement. For small businesses, the last challenge presents a solid opportunity to offer a benefit that boosts retention and improves employees' lives.

In a recent survey by the American Institute of Certified Public Accountants, employees listed retirement as the top financial concern, according to a report in PLANSPONSOR. More than half (55 percent) of workers said they are unsure of how much they need to save to retire, and 40 percent think they'll never be able to afford to leave work.

One way employers can aid their employees' retirement outlook is by adding a 401(k) plan to their benefit offerings. Before starting a plan, however, employers need to do a little homework, according to retirement expert Stuart Robertson.

Small companies need to find the right fit for their individual needs, Robertson wrote in a recent Forbes online report. Robertson highlighted three main types of 401(k)s that can work for small employers:

The safe harbor 401(k): This plan is a popular choice for employers with fewer than 15 employees because they allow business owners to put the maximum deferral amount into their own accounts and still satisfy IRS nondiscrimination rules. A company must provide a small "safe harbor" match or contribution, but the owner can take advantage of this, as well.

The traditional 401(k): The benefit of this plan is flexibility. This plan may or may not have a match, and the company can determine the percentage if it decides to go with an employer contribution. The traditional model is a good fit for companies with seasonal workers or for those with employees who are likely to contribute 7 percent or more of their salaries in employee contributions, Robertson said.

The tiered profit-sharing 401(k): This plan -- a good fit for a business with strong profits and fewer than 50 employees -- rewards employees based on their groups. The plan can provide a different percentage of salary as profit sharing for each individual group, based on that group's performance. These plans often include a safe harbor match to satisfy IRS rules, as well.

Once a plan is in place, employers need to offer information and support that will help employees make the most of this benefit, according to Liz Davidson, founder and CEO of Financial Finesse. In a recent article on 401khelpcenter.com, Davidson pointed out that when it comes to communicating investment information to employees, age is more than just a number.

"Every individual is unique, but at the same time, generations undeniably share a world view and have their own unique group characteristics," Davidson wrote. "Participation in financial education and employee behavioral change are both significantly higher when programs are designed to effectively meet the needs and priorities of specific generations."

Davidson offered a few tips on tailoring retirement and financial information for today's workforce:

Baby boomers (born 1946-64): Use annual retirement "checkups" and provide personal coaching that allows them to interact with the same advisor multiple times.

Generation X (born 1964-80): This group is highly cynical and won't respond well to sources that might have a "hidden agenda." Provide objective and unbiased information.

Generation Y (born 1980-2000): These young workers are open to communication through social media and crave information on basic money-management topics, such as household budgeting, saving and debt management.