Wellness plans that work are comprehensive.

More than five years after passage of the Affordable Care Act, employers are under just as much pressure to address health-care insurance costs as they were when ACA became law of the land.

Many have turned to workplace-wellness programs to help address their challenges, in the belief that a healthier work force would yield bottom-line results with lower insurance premiums. While that has occasionally proven to be the case, the greater likelihood is that the needle on those costs hasn’t moved much.

That, however, is no reason to give up on the concept of a fitter, healthier staff at your company.

The biggest gains from implementing a successful workplace wellness program—or from breathing new vitality into one that has hit a plateau—come from improvements in company culture and team-building. At McCownGordon, our own wellness program is now more than eight years old and, like other corporate initiatives, is and probably always will be a work in progress.

Why? Because staffing changes, work-force composition, organizational needs and economic factors outside our control will continue to evolve. No successful wellness initiative goes into place and succeeds without constant review, assessment and changes to improve outcomes.

Our own experience has shown that in-house fitness challenges and outside competitions allow the staff to do fun things together and enhance team-building. This is not a benefit to be taken lightly: Each employee is encouraged to share the entrepreneurial spirit of our founders, and good health contributes to that. Countless studies nationally confirm our own experience:  associates who are healthy and well-balanced are more productive, have better performance, have lower absenteeism, and have fewer health-insurance claims, all of which lead to higher revenues or lower costs, and ultimately, to higher profits for the company.

That’s a particularly effective incentive for employee-owned companies. But even in more traditional ownership structures, the same factors can pay off. This year, we did not see an increase in insurance premiums, which is rare in business these days.

What role did our wellness initiatives play in that outcome? That’s hard to say, given the other factors involved. We became self-funded, for example, and went to a high-deductible structure with our health-savings accounts, which encourage associates to take more ownership of their own health and to be more conscious of the personal decisions they make. It’s clear that all of those factors, working together, led to that success.

If you’re thinking of launching or revitalizing a wellness program, here are a few things to keep in mind:

• Leadership matters. When top executives demonstrate that fitness is important to them, employees see that, and they get it. When those same leaders are joining in with the team-building competitions, the effect is even more pronounced.

• Culture matters. If a critical mass of employees buys into the vision, and their success demonstrates the benefits of eating healthier and exercising regularly, others will have an incentive to get on board.

• Communication matters. You have to start with awareness and education, including things like lunch-and-learns, and fitness or walking challenges. They are critical foundations for success.

• Consistency matters. Nobody wins every battle. But you can initiative holding actions with things like No-Gain Holidays. If you can maintain your weight in these tempting times, that’s a step up—and 10 pounds you won’t find yourself resolving to lose come Jan. 1.

• Metrics matter. Each year, we look back to see what worked, we survey employees and set new goals for the next year, we keep what worked well and we add new initiatives based on employee suggestions.

• Incentives matter. When employees understand that they can share the rewards of lower health-insurance premiums, and see it show up in their paycheck, they’re more likely to buy in.

Not every business, especially smaller ones, can offer in-house fitness centers, but many can team with health clubs to offer special rates for employees, or subsidize membership. Remember, too, that there are tools like off-the-shelf, customizable programs that are robust and results-oriented. They can provide incentives not just for the employee but that employee’s family, as well.

A final point: One of the biggest challenges is understanding your own work force. Some will be all-in with eating well and exercising. A certain percentage will be on the other end of the spectrum, resistant to almost any incentive or program.

The Malleable Middle is where you can make a difference: They are interested, may just need a bit of a push or an incentive. They are your chance for the biggest impact. Make it easy for them, with regular on-site biometric screening, blood draws to measure cholesterol, glucose, triglycerides and blood pressure, which keep them on track.

What you’ll find is more of those in the middle will join the active group, redefining the middle, and that identifies the next group that can be brought into the fold.

HR managers know that company programs are evolving from awareness to achieving results. This is a great time for your company to start seeing results for itself, and for your employees.