After becoming a licensed massage therapist, Ranieri realize that massage could be a great low-cost benefit that employers could offer to show employees their appreciation.

Founded six years ago, the New York-based Massage at Work provides onsite massages for employees, and is growing rapidly. Ranieri said he has seen an 80 percent increase in business just in the first quarter of this year, reaching clients in Austin, Chicago and San Francisco, to name a few.

Employers are finding that massage helps employees stay focused on work by reducing their stress level. "Massage reduces that fight or flight response," Ranieri says. Massage is also shown to boost circulation, which increases consciousness. All of these positive aspects boost morale, too, Ranieri says.

Ranieri Massage at Work events are typically paid for by the employer, but the return on investment is huge: For every $1 a company spends on massage or other health initiative, they save $4 to $5 on health costs, Ranieri says. 

Many of Ranieri's employer clients are in the creative industry, but he also has many in the accounting, architeture and even oil industries. Employees with repetitive work especially benefit, and accounting employees who get massages have been shown to make fewer calculation mistakes.

Cut out the middle man

Some employers are getting creative and are starting their own wellness programs. Mary Jo Keyes is the former personal trainer to Pure Romance CEO Patty Brisben. Brisben wanted to help staff feel better, sleep better and eat better, much like she did through her own fitness routine, and together she and Keyes worked on developing a company wellness program.

Keyes is now the director of wellness programs for Pure Romance, an intimacy and relationship-enhancement products company, based in Loveland, Ohio.

Pure Romance's wellness program started with a small fitness center where Keyes would train employees. That first effort has expanded now into a full corporate wellness program, and includes yoga classes, mixed martial arts classes and coming soon, hour-long ballroom dancing lessons after work.

They have also hired on a nutrition coach who helps employees with meal planning. Teaming with human resources, they've been planning quarterly events, such as free mammography screenings and a blood donation drive.

Half of the 107 full-time employees have participated in the Biggest Loser-style weight loss competition and so far have lost a collective 250 pounds.  

All of this, with no cost to employees. Keyes says they'll have to wait until the end of the year to get a better grasp on ROI numbers. But employee feedback has been nothing but positive. "Employees are saying that they are not sick as much, that they are drinking more water, and are sleeping more," Keyes said.

Coaching back to health

Some companies are even providing health coaches for employees. WellPoint's health coach program now serves about 90 employer groups and 16,000 members, and sales are rising.

The odds are that a health emergency could take an employee away from work any time, for a substantial period of time. And, according to Anthem's 2009 Integrated Health, Absence and Disability Management Report, half of all Americans say they can't afford to be sidelined by health issues for three months or more.

Employers can't afford the lost productivity either, with absences costing them $74 billion and 2.8 million hours of lost work time per year—a loss of almost four times greater than actual health costs.

WellPoint's health coach program has been designed with both issues in mind. The core philosophy of the program is getting the employee "back to health, back to life and back to work."

Working one-on-one with a coach, who is more like an advocate, employees are encouraged and supported, as well as assisted with things such as establishing goals, preparing to go back to work, reminded about medications, setting up appointments and more.

The program has been shown to reduce disability and medical costs by getting employees back to work, faster and healthier.  "Our program has a 21 percent reduction in claim turnaround time and connects applicants quickly to their health coach," said Pat Murphy, president and general manager, WellPoint's Life and Disability business. "On average, our members return to work one week faster than with other programs. And we know every day counts."

The program also decreases the risk of employees going back on disability, which is common. "The program allows coaches to follow-up, which helps employees stick to goals," Murphy said.

The coach program comes at no cost for fully-insured employees and is available to self-insureds for a nominal fee that is built into premiums, says Murphy.

Walk while you work

Bryce Williams, director of wellness for Blue Shield of California, says they realized that despite being a health company, they were not immune to the risks and costs that come with less-than-healthy employees. To practice what they preach, they needed to do something to create a culture of health in the workplace.

"We started with a promise to the employee, that we would meet them where they're at," Williams said, acknowledging that every employee is different, but was confident that they could be provided the tools to be successful in the new programs.

Williams says he wanted to improve on typical wellness programs and offer employees something out of the box. In 2008, Blue Shield launched their internal wellness program, "Wellvolution," which aimed to offer innovative solutions.

One of the most popular features of Wellvolution is the walking workstation—a treadmill employees walk on, at a low-level speed, while working. Employees can sign up to walk on the treadmill up to two times per week for 45 minutes to an hour per session. With six stations now, Williams says the sign-up sheet is full through the rest of the year and hopes to add more.

Another popular program offering is Shape up Shield, a social media-based platform where employees can log on to interact with other employees, set and track goals and come up with new health challenges for each other.

Employees can also earn discounts on health insurance premiums and get more time off if they participate in programs. Williams says that employees have saved more than $1.5 million in health care costs and have collectively earned about 3,000 health days off.

Williams says the program is paying off for the employee. While it may be a couple more years before they see returns, he says since implementing Wellvolution, claims costs for non-participating employees are 150 percent higher than those who do participate.

Through Wellvolution, claims processor Tiffany Villafuerte has lost 68 pounds. She participates in the Weight Watchers program and has even started her own boot camp class at work. She also loves the Shape-up Shield program, where she can track how many steps she walks each day. She says the walking treadmill is an "incredible idea." "Getting to work out and process claims at the same time is great," she said.