Large employers are generally self-funded, meaning that they pay their healthcare claims dollar-for-dollar. Blue Cross (or whomever) serves as a claims adminis

Large employers are generally self-funded, meaning that they pay their healthcare claims dollar-for-dollar. Blue Cross (or whomever) serves as a claims administrator and takes a premium for the service, but may not provide any actual "insurance" with respect to the company (some have maximum per-year and maximum per-employee caps to the company but they aren't usually triggered by the sorts of things that wellness programs address). Big companies hope that wellness programs really will decrease healthcare spend and increase morale --- chronic conditions like diabetes and smoking do have a disproportionate impact on the healthcare bottom line. That said, once-off specialty conditions (cancer, heart surgery, etc.) have an even bigger impact and aren't addressed by this.