They don't even use step 4. They just raise the "non-participation" penalty so high that you, for all intents and purposes, have to participate.

The company I work for charges a $50 per week penalty for not participating.

I'd happily cease to participate in working there if that happened to me.

Unfortunately in the US, the lack of good health insurance options in spite of Affordable Care Act (ACA) means that even after paying the penalty for opting out of soul-crushing health tracking, it is probably still cheaper to work for a company for a company-subsidized health plan than to pay for it all oneself :(.

I'm unfamiliar with these programs. What does participation entail?

For mine, participation entails a yearly health screening. The screening measures blood pressure, BMI, nicotine usage, and cholesterol (via a blood draw).

Depending on the findings, you fall into 1 of 3 tiers, which results in a penalty on every pay check if you don't fall into the numbers.

I know someone who works for Blizzard; if they wear a Fitbit and meet the goal set on it, they get a healthcare discount or a small cash kickback, I forget which.

Found a detailed presentation of the incentive plan here: http://www.myablife.com/files/HIP-Presentation.pdf

Of course this is junk, but what's more junk is that your employment is tied to health insurance.

America should have combo of single payer and private. You can get either regardless of your employment status and/or how generous your employer feels like being.

Yeah, I always thought that was insane. If you had a medical emergency when you were out of work (and with no insurance coverage), it would cost the most, precisely when you could afford it the least.