A shockingly serious proposal has been floated to first persuade (and later possibly compel) publicly traded companies to disclose to shareholders quite literally how fat their employees are. Also, how much they drink, how well they sleep and how stressed and depressed they are. This proposal, advocating what is known as a fat tax, shouldn’t even merit a discussion among rational businesspeople, and yet here we are, discussing it. Even Harvard Business Review (HBR) is discussing this. Why? Because the well-financed, well-organized cabal behind this fat tax proposal include corporate names like Johnson & Johnson, PepsiCo, Humana, Merck, Novo-Nordisk and Unilever. The leader of this group is a South African insurer called Discovery Health. If you guessed that any critique written by me would also implicate Ron Goetzel, you would be correct. Despite having now himself admitted that most wellness programs fail, he is the one justifying this entire scheme by claiming that wellness programs increase stock prices -- even though they don’t. We’ve already offered a completely transparent analysis to the contrary. He also made a rookie mistake in his own analysis. The stock prices of companies in his study diverged greatly in both directions from the averages, and he didn’t rebalance existing holdings annually. It’s simple compounding arithmetic. Suppose the stock market rises X% a year. If every stock in your portfolio increases at that rate, you’ll match the averages. However, if half your stocks increase 2X% a year while the other half don’t appreciate at all, and you don’t rebalance, you’ll beat the averages. Simply by doing nothing. Goetzel’s study appeared right before the fat tax proposal was floated at Davos. No coincidence here -- Discovery Health (the sponsor of the Vitality Institute) cites the study as a basis for wanting shareholders to “pressure” companies into disclosing the number of fat employees they have. And the more fat employees a company has, the more shareholders will insist on wellness programs, thanks to this study. Johnson & Johnson and Discovery both sell wellness programs, while Merck and Novo-Nordisk sell drugs for various wellness-related conditions. We urge reading the HBR link in its entirety to see why a fat tax would be even worse than it sounds. Some highlights:

• No one knows how to measure this stuff. Example: Keas tried to measure stress and failed hilariously…and they all want to use body mass index (BMI) for weight, but BMI turns out to be an inaccurate measure of health;
• Two of the companies in this cabal, PepsiCo and Discovery/Vitality, can’t even get their own employees to lose weight;
• Employer weight loss programs don’t work;
• As this blog noted last week, even wellness promoters – including Goetzel – say it loses money.

Most importantly, though – and you don’t need Harvard to learn this – it’s just not nice to stigmatize employees for their weight or other shortcomings unrelated to job performance. Basic human decency should have been taught to this cabal a long time ago. We’ve pointed out many times in ITL that these wellness people were absent the day the fifth-grade teacher covered arithmetic. This proposal suggests that they were also absent the day the kindergarten teacher taught manners.

Perhaps the most important thing an insurer can do to keep clients and brokers happy is to implement the right kind of customer relationship management system and process. CRM lets the insurer anticipate needs and communicate effectively. The most obvious benefits of a good CRM system are:

• Accessible client information, with the ability to view it in multiple dimensions
• An automated tool for reminders
• The ability to document prospect and broker files

But those are just the baseline benefits. With a more comprehensive system, you get usability that exceeds these minimal expectations. It can bring an insurer to a whole new technological landscape that improves retention levels and increases efficiency. Choosing the Right CRM Before selecting CRM software, determine who’s considered a customer, because that will dictate the features the CRM software must have. Prospects and policyholders are certainly customers, but many insurers miss out when they neglect to recognize that brokers are customers, too. The CRM software chosen needs to serve them, as well. For maximum efficiency, choose a CRM that has certain integration functions. It should connect with other sales technology systems that you and your brokers use often, because service is the key differentiator. To take sales and service to the next level, the CRM system should allow for data to be entered once and then pushed out to other systems, including quoting and underwriting. Distribution channel and prospect information can then be populated into a sales and underwriting system. Not only is this a more streamlined way to conduct business, it also helps the process feel more personal and customized for each user. Every sales representative can have all her information immediately. It also provides for more effective self-service on the web. One-time entry also makes selling much easier for brokers and sales offices of the insurance company, which will always have access to updated information. This, in turn, makes your products more accessible and appealing. An advanced CRM system will also make reporting and reviewing analytics easier, allowing insurers to identify issues more easily and respond to them more quickly. Activity tracking is also an important feature. Having an accurate record of changes and updates is important in both relationship management and regulatory compliance. Regulators increasingly demand insurers be able to document compliance. Finally, you want to make sure your CRM software has configuration options that will maximize its utility for your company and brokers. Every company is unique, and CRM software that forces you into its box isn’t useful. You should be able to tailor a CRM system to make it work more efficiently for you, not have to work around it. CRM software isn’t just about tracking and storing information—it’s about creating a collaborative environment among product managers, brokers, carriers and clients. Let the data flow—in a well-organized, transparent way that treats every person as a distinct individual with her own needs and expectations.

As a veteran of the worker’s compensation claims trenches, I saw first-hand how the expensive nature of the system drove employers out of business. It sad to see businesses go belly-up, and it was equally sad for the workers who were suddenly unemployed. It was definitely a case of lose-lose. One way to combat the high costs of workers' compensation was to opt out of the traditionally expensive system in states that allowed it. By opting out, employers were forced to be more engaged in the administration of their program and focus more on the outcome. The result was a less expensive system, providing quality benefits to the injured workers and improving the overall outcome. Oklahoma was one of the states that seemed to have found the right mix. So I was quite dismayed to learn of the recent decision by the Oklahoma Workers’ Compensation Commission (WCC). The case, Vasquez v. Dillard’s Inc., involved a worker for Dillard’s who was denied benefits after a work injury that was determined to be an aggravation of a pre-existing injury. The WCC declared the opt-out portion of the workers’ compensation system unconstitutional because they felt it created a dual system where the injured worker is treated differently. The most intriguing facet is how the WCC abandoned its traditional administrative role for that of a judiciary in deciding what law is, and is not, constitutional. That, I suppose, is another story. However, the WCC completely ignored the already approved opt-out option and remanded the case back to the administrative law judge within the traditional workers’ compensation system. Not only am I concerned about that sort of pretzel logic, but I also see it as another attack on exclusive remedy. Right now, my company doesn’t do business in any of the opt-out states. That doesn’t mean we wouldn’t consider it if that option presented itself down the road. But that is probably on hold as any state considering moving forward with the opt-out system has now been stopped dead in its tracks. Best to sit tight for now. As for whether the Oklahoma ruling will change what I do with regard to workers’ compensation remains to be seen. As I’m sure many employers will do now, I’ll wait on the sidelines and see how this plays out. This is basically what I was doing before the Oklahoma ruling … observing from afar to see if the opt-out system (if it came to my states) was not only cost-effective but also fair to the workers. I would never consider an alternate workers’ compensation system unless I was convinced it offered our injured workers the same, or better, benefits as the traditional system. I would also need to be convinced that it produced better outcomes.

I recently interviewed more than 200 ultra-productive people: seven billionaires, 13 Olympians, 20 straight-A students and more than 200 successful entrepreneurs. I asked them a simple, open-ended question: “What is your No. 1 secret to productivity?” After analyzing their responses, I coded their answers into 15 unique ideas. SECRET #1: They focus on minutes, not hours Average performers default to hour and half-hour blocks on their calendar. Highly successful people know where each of the 1,440 minutes in a day goes, and they know there is nothing more valuable than time. Money can be lost and made again, but time spent can never be reclaimed. Olympic gymnast Shannon Miller told me, “To this day, I keep a schedule that is almost minute by minute.” You must master your minutes to master your life. SECRET #2: They focus only on one thing Ultra-productive people know their Most Important Task (MIT) and work on it for one to two hours each morning, without interruptions. Tom Ziglar, CEO of Ziglar Inc., shared, “Invest the first part of your day working on your No. 1 priority that will help build your business.” What task will have the biggest impact on reaching your goal? What accomplishment will get you promoted at work? SECRET #3: They don’t use to-do lists Throw away your to-do list; instead, schedule everything on your calendar. It turns out only 41% of items on to-do lists are ever actually done. And all those items that aren't done lead to stress and insomnia because of the Zeigarnik effect. Highly productive people put everything on their calendar and work and live from that calendar. Jordan Harbinger, co-founder of The Art of Charm, advises, “Use a calendar and schedule your entire day into 15-minute blocks. It sounds like a pain, but this will set you up in the 95th percentile." SECRET #4: They beat procrastination with time travel Your future self can’t be trusted. That’s because we are “time inconsistent.” We buy veggies today because we think we’ll eat healthy salads all week, then we throw out rotting green mush in the future. I bought P90x because I thought I would start exercising vigorously, yet the box sits unopened one year later. What can you do right now to make sure your future self does the right thing? Anticipate how you will self-sabotage in the future and come up with a solution to defeat your future self. SECRET #5: They make it home for dinner I first learned this secret from Intel’s Andy Grove, who told me, “There is always more to be done, more that should be done, always more than can be done.” Highly successful people know what they value in life. Yes, they value work, but what else should they value? There is no right answer, but, for many, values include family time, exercise and giving back. They allocate their 1,440 minutes a day to every area they value (i.e., they put it on their calendar), and then they stick to the schedule. SECRET #6: They use a notebook Richard Branson has said on more than one occasion that he wouldn’t have been able to build Virgin without a simple notebook, which he takes with him wherever he goes. In one interview, Greek shipping magnate Aristotle Onassis said, “Always carry a notebook. Write everything down…That is a million-dollar lesson they don’t teach you in business school!” Ultra-productive people free their mind by writing everything down. SECRET #7: They process email only a few times a day Ultra-productive people don’t check their email throughout the day. They don’t respond to each vibration or ding to see who has intruded into their inbox. Instead, like everything else, they schedule time to process their email quickly and efficiently. For some, that’s only once a day; for me, it’s morning, noon and night. SECRET #8: They avoid meetings at all costs When I asked Mark Cuban to give me his best productivity advice, he quickly responded, “Never take meetings unless someone is writing a check.” Meetings are notorious time killers. They start late, have the wrong people in them, meander in their topics and run long. You should get out of meetings whenever you can and hold fewer of them yourself. If you do run a meeting, keep it short. SECRET #9: They say “no” to almost everything Billionaire Warren Buffett once said, “The difference between successful people and very successful people is that very successful people say 'no' to almost everything.” James Altucher colorfully gave me this tip: “If something is not a 'hell, yeah!', then it’s a 'no!' " Remember, you only have 1,440 minutes in every day. Don’t give them away easily. SECRET #10: They follow the 80/20 rule Known as the Pareto Principle, in most cases 80% of outcomes come from 20% of activities. Ultra-productive people know which activities drive the greatest results, and they focus on those and ignore the rest. SECRET #11: They delegate almost everything Ultra-productive people don’t ask, “How can I do this task?” Instead, they ask, “How can this task get done?” They take the “I” out of situations as much as possible. Ultra-productive people don’t have control issues and are not micro-managers. In many cases, good enough is, well, good enough. SECRET #12: They create themes for days of the week Highly successful people often "theme" days of the week to focus on major areas. For decades, I’ve had “Mondays for Meetings” to make sure I’m doing one-on-one check-ins with each direct report. My Friday afternoons are themed around financials and general administrative items I want to clean up before the new week starts. I’ve previously written about Jack Dorsey’s work themes, which enable him to run two companies at once. Batch your work to maximize your efficiency and effectiveness. SECRET #13: They touch things only once How many times have you opened a piece of regular mail—a bill, perhaps—and put it down, only to deal with it again later? How often do you read an email and close it, leaving it in your inbox to deal with later? Highly successful people try to “touch it once.” If it takes less than five or 10 minutes—whatever it may be—they’ll deal with it right then and there. This reduces stress because it isn't in the back of their mind, and it is more efficient because they won’t have to re-read or reevaluate the item in the future. SECRET #14: They practice a consistent morning routine My single greatest surprise while interviewing these more than 200 highly successful people was how many of them wanted to share their morning ritual with me. Hal Elrod, author of The Miracle Morning, told me, “While most people focus on ‘doing’ more to achieve more, The Miracle Morning is about focusing on ‘becoming’ more so that you can start doing less, to achieve more.” While I heard about a wide variety of habits, most people I interviewed nurtured their body in the morning with water, a healthy breakfast and light exercise. They nurtured their mind with meditation or prayer, inspirational reading and journaling. SECRET #15: Energy is everything You can’t make more minutes in the day, but you can increase your energy—which will increase your attention, focus, decision-making and overall productivity. Highly successful people don’t skip meals, sleep or take breaks in the pursuit of more, more, more. Instead, they view food as fuel and sleep as recovery, and they pause with “work sprints." Tying It All Together You might not be an entrepreneur, Olympian or millionaire—or even want to be—but their secrets just might help you get more done in less time and help you to stop feeling so overworked and overwhelmed.

According to the Bureau of Labor Statistics (BLS), the incidence of musculoskeletal injuries (MSD) cases for heavy and tractor-trailer truck drivers increased to 355.4 cases per 10,000 full-time workers in 2014, up from 322.8 in 2013. This is more than three times greater than the rate for all private sector workers.

Companies are faced with increasing exposure from MSD claims, not only from state regulations but from compliance with federal mandates that increase potential exposure for these types of injuries. (The Centers for Disease Control and Prevention (CDC) defines MSD as injuries or disorders of the muscles, nerves, tendons, joints and cartilage as well as disorders of the nerves, tendons, muscles and supporting structures - the upper and lower limbs, neck and lower back - that are caused, precipitated or exacerbated by sudden exertion or prolonged exposure to physical factors.)

Safety will always play a role in mitigating risks, but, no matter how safe an environment, an employer will always have MSD claims. In the transportation industry, the higher rates of injury can be attributed, in part, to several factors.

The nature of the work is one. Many drivers maintain a poor diet, rarely get enough sleep and are sedentary. As a result, they find themselves more susceptible to heart attacks and diabetes, as well as a myriad of strains, sprains and other musculoskeletal disorders.

Additionally, the percentage of older workers is higher in transportation than in most industries, with the Transportation Research Board estimating as many as 25% of truck drivers will be older than 65 by 2025; that translates into more severe musculoskeletal disorder claims.

So, how can a transportation company turn this around and provide a win for all parties? Let's explore through a case study:

Marten Transport is a multi-faceted provider of transportation services offering over the road (OTR), regional, intermodal and temperature-controlled truckload services. The company has 15 operational centers and more than 3,670 employees and contractors. It needed to provide better care for MSD injuries while not accepting liability for injuries occurred outside the scope of work. Marten decided to institute the EFA Soft Tissue Management (EFA-STM) program in February 2015 to determine which injuries were work-related and which were not, as well as to provide better care.

According to Deborah Konkel, the work comp claims manager for Marten, the company uses the EFA-STM "as a fact-finding tool to help us, our employees and their medical providers better understand the nature of their injury and determine the best course of action going forward." Under the EFA-STM program, workers are given a baseline test that is unread; after a reported injury, a second test is conducted. That data is compared with the baseline test to identify the new acute condition, distinct from any pre-existing chronic conditions.

The EFA-STM program is a paradigm shift in workers' compensation because it provides benefits for all stakeholders by accurately separating work-related injuries from those that are not work-related and by providing objective information and, thus, better care for the work-related condition. The key question is what the physical condition of the employee was before the incident and what needs to be done to return him to pre-injury status. EFA-STM provides the required data.

To determine the benefit of the EFA-STM program, Marten's workers' compensation claims data from 2010-2014 was compared with claims data from 2015. The average rate of MSD injuries per 100 hires from 2010-14 was compared with the 2015 rate. The result was a 60% drop in the rate of MSD injuries per 100 hires in 2015. This translated into almost 40 fewer MSD claims in 2015. Using the 2010-14 average cost per MSD claim, the EFA-STM program yielded a direct ROI of 3.7: 1.

"Based on these results, we believe that the EFA-STM program has been a win for all parties involved and a must for companies, especially in the transportation industry" Konkel said.

There is a big PR problem brewing, one receiving very little attention in the media or in industry publications. It's one I think will resonate among those who typically support the politicians who supported the Affordable Care Act. The issue stems from the delay in the 1094/1095 reporting under section 6055 and 6056 of the IRS code specifically created under the Affordable Care Act. In English: This is the reporting requirement for carriers and employers that lets the government know if an offer of coverage was made to a particular employee, if it met certain requirements and if it was “affordable” according to one of several calculations set forth by the bill. If an “applicable large employer” does not report or does not meet the minimum requirements for coverage and affordability, there are serious fines at play. The deadline for the first reports, barring any further delays, is March 31.  (The initial deadline was pushed back because of the burden on employers.) Why is this important? Well, Obamacare established subsidies to help reduce out-of-pocket costs. The subsidy amount is based on household income in relation to the federal poverty level. Your job also must not offer insurance that meets the requirements about the base level of coverage and affordability. Without employer reporting, however, the government has, thus far, relied on individuals' assessments of coverage and affordability. Even if the employer plan meets the affordability test, most people would still call their plans through their employer “unaffordable.” The confusion is compounded by something the industry refers to as the “family glitch.” Let’s say I am offered coverage at my job, and my employer pays 80% of the premium for me. But my employer pays nothing toward the cost of carrying my dependents, an all-too-common scenario. This coverage would likely meet the affordability test for my coverage alone, on the lowest-cost plan my employer offers. If my employer pays nothing toward my family, however, it could easily cost me $1,000 or more per month out of my pay to cover my family. That's clearly not affordable to most Americans, but, because my coverage met the test, the entire household becomes ineligible for a subsidy. You could have hundreds of thousands of people who honestly believed their coverage was not affordable, didn’t think their employers plan met the coverage requirements or outright lied because there appeared to be no one checking. These people received what could amount to significant subsidies they weren't entitled to. Technically, they received an advanced tax credit. If it is determined you were not eligible for that tax credit, you now have a liability, and it is widely believed the IRS will have the right to garnish wages, freeze assets and place liens on property. How much are we talking here? Well, I have seen subsides as big as $1,500 per month. The average is around $2,890 per year, per person (according to the Kaiser Family Foundation). So, if a family of four owes the entire year back at the average subsidy, we are talking more than $10,000 a year plus (most likely) penalties and interest from the IRS. What is the average working person going to do if he gets a demand for $1,000 from the IRS? $10,000?  More? And if the IRS exerts the same force it does on normal tax debts, things such as frozen bank accounts, liens and garnished wages could follow pretty quickly. All in all, this reporting we are now preparing for employers will likely have significant financial impact on many American workers who should not have received the subsidy to begin with. In all likelihood, many did not fully understand that. The timing of all this will largely depend on how quickly the government aggregates the data it is collecting from numerous sources. But get ready for what I believe will be a vocal, angry and desperate group of people with compelling stories facing a very difficult financial situation.

The first three articles in this series by David Toomey and me are here, here and here. Over the last few years, the buzz in the healthcare industry has been about accountable care organizations (ACOs), and the next wave will be the promotion of “value-based contracting.” These are similar approaches, different words. Generally, an ACO is formed around a physician group or a hospital linked to physicians. The basic concept is for the provider system to be accountable for patients, with the providers financially motivated to affect their patient population’s overall costs. Makes sense, right? For the past 25 or so years, physicians have been linked to independent practice associations, medical groups and management services organizations. Many of these provider organizations have had financial incentives tied to performance. Data have been available to assess physician performance. So, what’s different now? Today the Feds are re-emphasizing performance in their physician contracting under the new Medicare Access and CHIP Reauthorization (MACRA), which replaces the current reimbursement formula. Beginning in 2019, the existing incentive programs now used for Medicare physicians will be replaced by a new performance-based model with four components. Those components are 1) quality, 2) resource use, 3) meaningful use of technology and 4) clinical practice improvement. Based on the Medicare physicians’ results, the reimbursements can be decreased by as much as 4% (adjusting to 9% by 2022). The program will have upside incentive for achieving exceptional performance of as much as 12% in 2019. As the largest purchaser, Medicare is striving to establish per-unit cost consistency in every market. Yet Medicare’s 2014 costs vary from $6,631 to $10,610 across markets. Why? Even if the cost per unit of service is standardized, extremely wide variation exists in how patients are treated for given conditions. When wide variation in care plans exists, some are right and some are wrong, as regular readers of Cracking Health Costs know. Some are better, and some are worse. Period. It’ll be interesting to see if the four new performance measures under MACRA will have a better impact than what’s in place today. Self-insured employers don’t need to wait four or five years to see the results. They can leverage their purchasing scale with the providers to drive out both inappropriate care and unit price variations. The time to start is now.

Spear phishers continue to pierce even well-defended networks, causing grave financial wounds. Spear phishers lure a specific individual to click on a viral email attachment or to navigate to a corrupted Web page. Malicious code typically gets embedded on the victim’s computing device, giving control to the attacker. A recent survey of 300 IT decision-makers in the U.S. and the U.K.—commissioned by threat-protection solutions provider Cloudmark—found that a spear-phishing attack penetrated the security defenses of more than 84% of respondents’ organizations. Free resource: Planning ahead to reduce breach expenses Spear phishing continues to turn up time and again as the trigger to massive network breaches, including widely publicized attacks on JPMorgan Chase., eBay, Target, Anthem, Sony Pictures and the U.S. Office of Personnel Management. “Criminals have achieved high success rates with spear-phishing attempts, and that success is breeding even more attempted attacks,” says Angela Knox, Cloudmark’s senior director of engineering and threat research. Angela Knox Respondents to Cloudmark’s survey said that, on average, their organizations lost more than $1.6 million from spear-phishing attacks during the 12 months before the survey. Spear phishers install malware, seek privileged access accounts and scour breached networks for confidential business plans, information about current negotiations and other valuable data. And the attackers are in a position to manipulate, disrupt or destroy systems. Related video: CEO fraud caper nets $450,000 Attacks on banks, credit unions and professional services firms that help conduct financial transactions often focus on persuading employees to wire money to the phishers’ accounts. “Even if the money can be recovered, it takes time and effort to recover it,” Knox says. “In one high-profile incident, a company lost $46.7 million due to email spoofing.” Resist oversharing One reason spear phishing persists is because people reveal a wealth of personal and behavioral data on the Internet. Attackers tap this information to profile victims and create email and social media messages crafted to appear to come from a trusted source—in a context that puts the targeted victim at ease. The end game: Get the person to open a viral email attachment or click to a malicious Web page. “Everyone is now a target, and users can no longer depend on spelling mistakes or random scams,” says Chester Wisniewski, senior security adviser at antimalware vendor Sophos. Peter Cassidy, secretary general of the Anti-Phishing Working Group, an international coalition fighting cyber crime, says spear phishers in recent years have gone to greater depths in focus and planning. Peter Cassidy “These days, it’s not uncommon to see an attack that targets specific personalities for their access within an enterprise and loads a malware payload to execute an exploit that will open a pathway the attackers are waiting for—and will use to gain access to data they prize,” Cassidy says. “Talk about orchestration! Stravinsky and these guys would have a lot to talk about.” Employees part of solution A primary defense is to continually train employees to be vigilant, and a cottage industry of training services and technologies has arisen in recent years to assist companies of all sizes. But even trained employees remain susceptible to sophisticated trickery. Nearly 80% of organizations surveyed by Cloudmark reported using staff training to prevent attacks. Of organizations that test their employees’ responses to spear-phishing attacks, only 3% said that all employees passed. Respondents estimated that 16% of staff members failed their organizations’ most recent spear-phishing tests. “Humans are flawed,” Wisniewski says. “You can never stop spear phishing entirely,” because “it is not a technical problem that can be solved.” It’s human nature for employees who spot something wrong or who believe they may have been tricked to hesitate reporting the incident. Yet quick reporting is a key to remediation. “Accidents happen, but detection and remediation are more successful the less time the criminal has to take advantage of your errors,” Wisniewski says. This post was written by Gary Stoller.

Sometimes other drivers can make you crazy. Maybe you’ve gestured to boneheaded motorists, safe in the anonymity of your car and the flow of traffic. Perhaps you’ve let your anger at other drivers get the best of you at times because there’s no one else in the car to judge. But State Farm is on the case. It has developed plans to monitor your every move while you’re driving, measure your emotions, detect angry behavior and deliver stimuli such as music to calm you down. The plans, as revealed in a patent application, would combine biometric measurements with automotive data to create a “total impairment score” that could be used to set customized car insurance rates. “Every year, many vehicle accidents are caused by impaired vehicle operation,” State Farm says in its application, recently filed with the U.S. Patent and Trademark Office. “One common kind of impaired vehicle operation is agitated, anxious or aggressive driving.” Are you sweating, yelling or waving your arms while you drive? State Farm’s “emotion management system” would use a variety of sensors and cameras to monitor your biometrics, including:

• Heart rate
• Grip pressure on the steering wheel
• Body temperature
• Arm movement
• Head direction and movement
• Vocal amplitude and pattern
• Respiration rate

The system could use “infrared optical brain imaging data” to get deeper inside your head. State Farm might even know if you’re giving the evil eye to another driver: Measurements include gaze direction and duration, eyelid opening and blink rate. And impaired driving is not confined to angry and aggressive drivers. State Farm also would consider nervousness, distraction and drowsiness. Other sensors would keep track of your vehicle: Are you swerving, accelerating or driving too close to other objects? [Compare car insurance quotes through NerdWallet’s Car Insurance Comparison Tool.] Smell this and calm down If you are “emotionally impaired” – as measured by State Farm, not your spouse – the patent-pending system would select and deliver stimuli to change your behavior. The patent application outlines a variety of options, including relaxing music, a recorded message, sounds of nature, fragrance or a blast of cold air. The system might even suggest you stop at a coffee shop or scenic overlook. Robert Nemerovski, a licensed clinical psychologist in the San Francisco area and an expert on anger management and road rage, was skeptical about State Farm’s patent. He questioned whether an automated system could be sophisticated enough to account for the unique characteristics of individual drivers. “I would be concerned about individual differences: people on medication, the elderly vs. the young,” he said. “Maybe they have PTSD, or they’re in recovery from a heart attack. [State Farm] would need to know nuances of human behavior and human bodies.” In addition, “People don’t want someone patronizing you or telling you to calm down. I’m not sure it would be successful psychologically because it would be rather annoying,” he says. State Farm envisions an “emotion management system” that goes beyond just monitoring behavior. The system would store profiles for each driver so, for example, it would learn which music might reduce your hard braking or persuade you to stop tailing the car in front of you. This might spell an end to your loud music. Each time you end a trip, the State Farm system would analyze the data and update your impairment score, which you could check on your mobile device. Because the purpose of the patent application is only to describe the system, it leaves many unanswered questions, including:

• How much would it cost per vehicle?
• Who would pay?
• How often would you have to refill your fragrance containers?

State Farm, the nation’s largest car insurance provider, declined to comment on specifics of the patent application but provided this statement to NerdWallet: “State Farm is actively innovating in a number of areas that are important to improving how we meet the needs of our customers. The patent  . . . is just one example of State Farm’s innovation. Because of the nature of our innovation work and patent program, we are unable to provide further comments at this time.” Angry about car insurance bills, too? According to the application, State Farm is considering applying the “comprehensive impairment level” to car insurance in several ways, including:

• Adjusting your insurance rate, up or down.
• Requiring you to buy a minimum amount of auto insurance, or limiting how much it will sell you.
• Offering you a discount for using the system.
• Flagging your policy for possible cancellation.

While State Farm’s plans may never be implemented, the carrier clearly has many ambitious ideas about monitoring customer behavior, such as its previously described ideas to price car insurance by the trip and deliver targeted ads based on where you drive. Many consumers aren’t aware that auto insurers are preparing to unleash a tsunami of such services based on telematics, systems that track your car and driving habits. Progressive was the first to enter the space and dominated it for a while with its Snapshot usage-based insurance program. “Other big auto insurers don’t want to be in second or third place again,” says Donald Light, director of North America property/casualty insurance for Celent, a research and consulting firm that focuses on information technology in financial services. “I believe in about five years it will be a standard part of an auto insurance policy,” Light says.  “Insurers will say, ‘If you don’t want to use it that’s fine, too, but we’ll charge you based on not having it.’” Light sees one large hurdle to State Farm’s emotion-management plan: The company will have to convince state insurance regulators that the emotional impairment scores accurately reflect risk. “The key qualifier is that these kinds of data have to make actuarial significant difference in the ‘risk’ of different drivers,” Light says. For example, if State Farm wants to charge more based on driver agitation, the company will have to prove that agitation causes crashes. Nemerovski says State Farm’s emotional management system might appeal to millennials, who are comfortable with the idea of measuring physical and other metrics so they can be improved. “But I don’t think people would want it to be shoved down their throats,” he says.

Please join me for “Path to Transformation,” an event I am putting on May 10 and 11 at the Plug and Play accelerator in Silicon Valley in conjunction with Insurance Thought Leadership. The event will not only explore technological breakthroughs but will explain how companies can test and absorb the technologies, in ways that then lead to startling (and highly profitable) innovation. My son and I have been teaching these events around the world, and I hope to see you in May. You can sign up here. “I don’t care if you have to take drugs, you have to build it in six months,” said my boss, Khurshed Birdie, when I told him that he was on drugs if he thought my team could create a software development tool set in less than three years. This was in 1986 at Credit Suisse First Boston, one of New York City’s top investment banks. We were rebuilding the company’s trade processing systems to run on a client–server model of computing. This technology is common now, but then it was as futuristic as “Star Wars.” My team worked day and night to build a technology that became the foundation of the company’s information systems. It gave Credit Suisse First Boston a competitive edge and led IBM to invest $20 million in a spinoff company that was formed to market the tools we had developed. I was a lowly computer programmer, an analyst when Birdie hired me, a computer geek who didn’t own any three-piece suits, white two-ply cotton shirts or wing-tipped Oxford shoes — the uniform of investment bankers. Yet I was hired on the spot. I had some far-out ideas about how computer systems could be built but didn’t believe for a second that I could implement them. My boss did: He believed in me more than I did, and he bet a $100 million project on my vision. He allowed me to expand my team from four to 54 people and shielded me from criticism by other teams who had to use my tools to build their systems — and who thought I was crazy. There were a lot of problems along the way, and Birdie allowed me to learn from my mistakes. And then he promoted me to vice president of information technology when I achieved success. Birdie was what Sydney Finkelstein, a Dartmouth business professor, in his new book, Superbosses: How Exceptional Leaders Manage the Flow of Talent, calls a “superboss.” As Finkelstein explains, superbosses take chances on unconventional talent. Oracle’s founder, Larry Ellison, hired candidates who had accomplished something genuinely difficult, rather than those with formal qualifications, because he believed they would rise to the technical challenges. Designer Ralph Lauren offered jobs to strangers whom he met while dining in New York City restaurants. Superbosses take raw talent and build self-confidence. They hire for intelligence, creativity and flexibility — and are not afraid of people who may be smarter than they are. Under Finkelstein’s definition of superbosses, Birdie would be categorized as a “glorious bastard”: someone who cares only about winning. Deep down, he had a good heart —  but was ruthless in setting expectations and driving people to work extremely hard. I’ll never forget him telling me that “Christmas was an optional holiday.” These bosses realize that, to get the very best results, they need to drive people to perform beyond what seems reasonable and achievable. Even though I achieved a lot, I hated working for Birdie, because I had to neglect my family for months on end. This isn’t something I would ever do to my employees. My next boss, Gene Bedell, was very different. He left his job as managing director of information technology to found Seer Technologies, the start-up that IBM had funded. Bedell convinced me to leave my high-paying investment-banking job to join him in a No. 2 role, as chief technology officer, at the low-paying, high-risk, start-up. Bedell was what Finkelstein calls a “nurturer”: someone who coaches, inspires and mentors. These superbosses take pride in bringing others along and care deeply about the success of their protégés; they help people accomplish more than they’d ever thought they could. Bedell managed by a method he called “outstanding success possibilities.” He challenged his executives to set ultra-ambitious goals and then find unconventional ways to achieve them. Instead of managing to what was achievable and possible, we shot for the impossible. And then did whatever it took to get there — without worrying about failure or looking back. It is amazing what you can achieve when you have a single-minded focus. We took Seer Technologies from zero to $120 million in annual revenue and an IPO in just five years — faster than any other software company of that era, including Microsoft and Oracle. Superbosses create master–apprentice relationships. They customize their coaching to what each protégé needs and are constant fonts of practical wisdom. Bedell taught me how to sell. A year after the company was formed, he sent me to Tokyo to sell IBM-Japan on an $8.6 million deal to fund the creation of a Japanese version of our product. I didn’t think that a techie like me could do these things; he taught me that selling was an art that could be learned and perfected. I helped our salespeople close more than $200 million in software deals. And that is another skill that superbosses have, building what Finkelstein calls the “cohort effect”: teamwork and competition combined. Lorne Michaels, for example, who created "Saturday Night Live," judged writers and performers by how much of their material actually went to air — but they had to do it with the support of their coworkers, the people they were competing with. A common trait of superbosses is the ability to delegate work and build jobs on the strengths of their subordinates. They trust subordinates to do their jobs and are as supportive as can be. They remain intimately involved in the details of the businesses and build true friendships. Bedell often invited my family to his vacation home near the Outer Banks of North Carolina. He took me to Skip Barber Racing School to learn how to race a Formula Ford and built a gym in his basement so that his executive team could lift weights together. You will find the alumni of our project at Credit Suisse First Boston and Seer Technologies in senior leadership roles now, at companies such as IBM, PayPal, American Express and every one of the top investment banks. Many started their own companies, as I later did. There are literally hundreds of people who built successful careers because of my two superbosses. When I became an academic later in life, I was fortunate to have two superboss deans at Duke’s Pratt School of Engineering, Kristina Johnson and Tom Katsouleas, who nurtured me. Superbosses aren’t just in corporations — they can be found everywhere. Yes, I know that I got lucky in having good bosses; most are jerks who demotivate employees, slow their growth, backstab and take credit for others’ work. You are usually stuck with whomever you get. But there is nothing that stops you from being a superboss. As you begin to achieve success, start helping others and nurturing your colleagues and subordinates. Show the leadership qualities that you’d like your own boss to have. You will gain as much as the people you help — and build a better company. This article first appeared at the Washington Post.