When it comes time to proffer a drop or vial of blood, or to step on a scale and to stand tall for a body mass index calculation in the work place, not everyone is on board.
Biometric screenings are increasingly common as companies try to catch employee health problems early, preventing them from becoming big health costs. But distrust can derail that effort.
"They just don't believe us when we tell them we don't know those results," said Dyer Town Administrator Rick Eberly.
Dyer has about a 72 percent participation rate in its annual biometric screening for employees.
"We still have that 25 to 30 percent not participating," he said.
The percentage has remained consistent, and Eberly believes distrust may be to blame.
People concerned the findings will raise their rates might actually have it backward, said Matt Glaros, vice president of Employer Benefit Systems in Dyer.
"If an employee takes the screening, the premium is typically less," he said.
Many employers offer a financial incentive for workers to undergo biometric screenings.
"We tried to create a positive incentive by giving people a break on their portion of the premium," Eberly said. "The problem is, ours is so reasonable to begin with."
Fear of health information being shared is another obstacle.
The Health Insurance Portability and Accountability Act, commonly known as HIPAA, prevents employers from receiving private health information about employees, Glaros said.
"The employer doesn't get a line-by-line, person-by-person description of what they've got going on in the group," he said. "When we get those reports back, there's no way to ever know who's in there."
Numbers appear on a graph, not associated with a specific worker. Such reports are not usually issued unless there are at least 25 participating employees, as a way to preserve anonymity, he said.
Jamie Curts, vice president of business development for Spectrum Health Systems in Indianapolis, said the company focuses on management and delivery of corporate wellness programs. Biometric screenings are among its services.
To quell confidentiality concerns, Curts said the company likes to host a kickoff meeting.
"If we can get in front of their employees, it helps with the initial perception so much better," she said. "If they can meet us and hear how confidentiality is so important to us, that's the first step."
The law is on the employees' side, she said.
"We are not allowed to share your personal heath information with anyone," she said. "Even if you wanted us to share with your doctor, we would need written permission to do that."
Screenings can include a lipid profile, glucose, A1C, body mass index, waist circumference, full blood panels and sit-and-reach flexibility tests, among others, Curts said.
Employers have something to gain from the screenings. A healthier workforce leads to lower use of the company health plan and lower costs.
"Nobody is going to lose their job because of blood pressure," Curts said.
Eberly said he is running out of ideas to get full participation.
"Early on, we had a couple of people who said they do this at the doctor's office anyway," Eberly said.
Until last year, town employees were not allowed to use doctor's office findings in lieu of attending the town screenings because the tests were not always apples to apples for comparison.
"We decided last year to take those results and include them in the overall census," Eberly said. "It still didn't increase our participation rate."
Findings are used to bargain with the town's insurer to keep premiums low. This year being the exception, Dyer went eight years without a health insurance premium increase, and only slight increases in dental and vision insurance costs, Eberly said.
"This past year, there was a 4.5 percent increase, but that's because of fees mandated in the Affordable Care Act," he said.
Companies that offer biometric screenings tend to have rate increases below 5 percent year after year, Glaros said.