workplace wellness trends - timewellspent-ca.anthem.com · workplace wellness trends 2015 survey...

Workplace Wellness Trends

2 0 1 5 S u r v e y r e S u l T S

This survey report was prepared by the International Foundation of Employee Benefit Plans. Although great care was taken in researching the information in this report and the underlying sources are considered to be reliable, the accuracy and completeness of the report cannot be guaranteed.

This publication is sold with the understanding that the publisher is not engaged in rendering any business, financial, investment or other professional advice or service. This report is not a substitute for the services of a professional, nor should it be used as a basis for any decision or action that may affect your business. Consult a qualified professional. The International Foundation shall not be responsible for any loss sustained by any person who relies on this publication.

Written and compiled byNeil MrkvickaJulie Stich, CEBSJustin Held, CEBS

Edited by Kathy Bergstrom, GBA

Copies of this report may be obtained fromPublications DepartmentInternational Foundation of Employee Benefit Plans18700 West Bluemound RoadBrookfield, WI 53045

Call (888) 334-3327, option 4, for price information or see www.ifebp.org/bookstore.

Published in 2015 by the International Foundation of Employee Benefit Plans, Inc. ©2015 International Foundation of Employee Benefit Plans, Inc.All rights reserved.ISBN 978-0-89154-754-9

Printed in the United States of America

RS150128

Workplace Wellness Trends: 2015 Survey Results | ii

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

About the International Foundation of Employee Benefit Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

About Research at the International Foundation of Employee Benefit Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

II. Key Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

III. Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

IV. Offerings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

V. Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

VI. Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

VII. Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

VIII. Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

IX. Appendix A: U.S. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

X. Appendix B: Canada Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Exhibits

Exhibit 1: Offer Wellness-Related Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Exhibit 2: Primary Reason for Offering Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Exhibit 3: Number of Years Offering Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Exhibit 4: Have Budget Specific to Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Exhibit 5: Wellness Budget Changes in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Exhibit 6: Adopting a Wellness Budget in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Exhibit 7: ACA Impact on Wellness Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Exhibit 8: Top Barriers to Implementing Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Exhibit 9: Screening and Treatment Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Exhibit 10: Fitness and Nutrition Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Exhibit 11: Social and Community Health Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Exhibit 12: Mental Health Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Exhibit 13: Worker-Growth and Purpose-Related Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Exhibit 14: Increasing Emphasis of Wellness-Related Offerings in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . . 15

Exhibit 15: Use of Incentives/Disincentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Table of Contents

| International Foundation of Employee Benefit Plans ii

Exhibit 16: Initiatives With Attached Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Exhibit 17: Success of Wellness Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Exhibit 18: Types of Incentives Under ACA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Exhibit 19: Offering Maximum ACA Wellness Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Exhibit 20: Measures Used for Outcomes-Based Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Exhibit 21: Reasonable Alternative Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Exhibit 22: Reasons for Offering Health-Contingent Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Exhibit 23: Workforce Reactions to Health-Contingent Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Exhibit 24: Reasons for NOT Offering Health-Contingent Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Exhibit 25: Likelihood of Offering Health-Contingent Incentives in the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Exhibit 26: Wellness Information and Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Exhibit 27: Forms of Targeted Wellness Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Exhibit 28: Forms of Technology/Gamification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Exhibit 29: Types of Outside Vendors Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Exhibit 30: Have Prepared a Picture of Plan Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Exhibit 31: Top Conditions Impacting Plan Health Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Exhibit 32: Average Wellness Initiative Participation Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Exhibit 33: Measure ROI of Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Exhibit 34: Average ROI of Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Exhibit 35: Wellness ROI Calculation Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Exhibit 36: Data Tracked to Measure Wellness Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Exhibit 37: Have Found Positive Impact of Wellness Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Exhibit 38: Respondent Sector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Exhibit 39: Primary Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Exhibit 40: Public Employer Jurisdiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Exhibit 41: Respondent Region (U.S.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Exhibit 42: Respondent Region (Canada) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Exhibit 43: Number of Active Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Workplace Wellness Trends: 2015 Survey Results | iii

Appendix A: U.S. Results Exhibits

Exhibit 1a: Offer Wellness-Related Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Exhibit 2a: Primary Reason for Offering Wellness Initiatives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Exhibit 3a: Number of Years Offering Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Exhibit 4a: Have Budget Specific to Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Exhibit 5a: Wellness Budget Changes in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Exhibit 6a: Adopting a Wellness Budget in the Next Two Years. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Exhibit 7a: Top Barriers to Implementing Wellness Initiatives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Exhibit 8a: Screening and Treatment Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Exhibit 9a: Fitness and Nutrition Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Exhibit 10a: Social and Community Health Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Exhibit 11a: Mental Health Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Exhibit 12a: Worker-Growth and Purpose-Related Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Exhibit 13a: Increasing Emphasis of Wellness-Related Offerings in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . 47

Exhibit 14a: Use of Incentives/Disincentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Exhibit 15a: Initiatives With Attached Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Exhibit 16a: Success of Wellness Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Exhibit 17a: Wellness Information and Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Exhibit 18a: Forms of Targeted Wellness Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Exhibit 19a: Forms of Technology/Gamification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Exhibit 20a: Types of Outside Vendors Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Exhibit 21a: Have Prepared a Picture of Plan Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Exhibit 22a: Top Conditions Impacting Plan Health Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Exhibit 23a: Average Wellness Initiative Participation Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Exhibit 24a: Measure ROI of Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Exhibit 25a: Data Tracked to Measure Wellness Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Exhibit 26a: Have Found Positive Impact of Wellness Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Exhibit 27a: Respondent Sector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Exhibit 28a: Primary Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Exhibit 29a: Public Employer Jurisdiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Exhibit 30a: Respondent Region (U.S.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

Exhibit 31a: Number of Active Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

| International Foundation of Employee Benefit Plans iv

Appendix B: Canada Results Exhibits

Exhibit 1b: Offer Wellness-Related Initiatives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Exhibit 2b: Primary Reason for Offering Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Exhibit 3b: Number of Years Offering Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Exhibit 4b: Have Budget Specific to Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Exhibit 5b: Wellness Budget Changes in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Exhibit 6b: Adopting a Wellness Budget in the Next Two Years. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Exhibit 7b: Top Barriers to Implementing Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Exhibit 8b: Screening and Treatment Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Exhibit 9b: Fitness and Nutrition Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Exhibit 10b: Social and Community Health Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Exhibit 11b: Mental Health Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Exhibit 12b: Worker-Growth and Purpose-Related Initiatives Offered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Exhibit 13b: Increasing Emphasis of Wellness-Related Offerings in the Next Two Years . . . . . . . . . . . . . . . . . . . . . . . . 67

Exhibit 14b: Use of Incentives/Disincentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Exhibit 15b: Initiatives With Attached Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Exhibit 16b: Success of Wellness Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Exhibit 17b: Wellness Information and Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Exhibit 18b: Forms of Targeted Wellness Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

Exhibit 19b: Forms of Technology/Gamification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Exhibit 20b: Types of Outside Vendors Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Exhibit 21b: Have Prepared a Picture of Plan Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Exhibit 22b: Top Conditions Impacting Plan Health Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Exhibit 23b: Average Wellness Initiative Participation Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Exhibit 24b: Measure ROI of Wellness Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Exhibit 25b: Data Tracked to Measure Wellness Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Exhibit 26b: Have Found Positive Impact of Wellness Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Exhibit 27b: Respondent Sector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Exhibit 28b: Primary Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

Exhibit 29b: Public Employer Jurisdiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

Exhibit 30b: Respondent Region (Canada) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

Exhibit 31b: Number of Active Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

Workplace Wellness Trends: 2015 Survey Results | vv

Acknowledgments

We are very grateful to the industry experts who reviewed the survey questionnaire and the individuals who contributed their time to complete the survey.

About the International Foundation of Employee Benefit PlansThe International Foundation of Employee Benefit Plans is a nonprofit organization, dedicated to being a leading objective and independent global source of employee benefits and compensation education and information. Total membership includes 33,000 individuals representing multiemployer trust funds, corporations, public employer groups and professional advisory firms throughout the United States and Canada. Each year, the International Foundation offers over 100 educational programs, including conferences and e-learning courses. Membership provides access to personalized research services and daily news delivery. The International Foundation sponsors the Certified Employee Benefit Specialist® (CEBS®) program in conjunction with the Wharton School of the University of Pennsylvania and Dalhousie University in Canada.

About the International Society of Certified Employee Benefit SpecialistsThe International Society of Certified Employee Benefit Specialists (ISCEBS) is a membership organization for those who have earned or are pursuing the Certified Employee Benefit Specialist (CEBS), group benefits associate (GBA), retirement plans associate (RPA) and compensation management specialist (CMS) designations. Members have access to educational programs, information resources, networking at the local and national levels, publications and other services. Nearly 4,000 CEBS, GBA, RPA and CMS designees are members of ISCEBS; they work for corporations, consulting firms, multiemployer funds, insurance companies and in other industry professions.

About Research at the International FoundationThe International Foundation conducts, writes and disseminates research studies, surveys and special reports on a range of benefits, compensation and financial literacy issues. The purpose of International Foundation research efforts is to enhance the capacity of its members and constituents to understand, design and deliver employee benefits that improve the financial security of plan participants and employees. Research programs include benchmarking studies, attitudinal surveys, special reports, hot topic surveys and collaborative projects.

(This page intentionally left blank.)

Workplace Wellness Trends: 2015 Survey Results | 11

In October 2014, the International Foundation of Employee Benefit Plans deployed a survey to members representing corporations, multiemployer trust funds and public employers/governmental entities across the United States and Canada.1 The study examines the various types of wellness offerings organizations provide to their employees and participants. In total, the survey received 479 completed responses.

To gain further insight, open-ended questions were asked throughout the survey, and common themes from submitted responses are discussed in the results. Data are broken down by sector (i.e., corporate, public employers and multiemployer funds, designated throughout by CP, PE and ME, respectively). Differences by sector, country and organization size are discussed when appropriate throughout the results.

Results from Canadian organizations are in many cases very similar to those from U.S. organizations. However, some general differences, likely because of contrasts in health care systems, were noticed. U.S. and Canadian data are displayed separately in the appendices. Some questions on insurance-based incentives, health care costs and the Affordable Care Act (ACA) were directed only to U.S. respondents. Some of the key differences in the results from the United States and Canada include:

■ U.S. organizations are more likely to offer wellness initiatives for the purpose of controlling health-related costs—Canadian organizations are more likely to focus on investing in worker health and engagement. U.S. organizations are more likely to track return on investment (ROI) via health costs, while Canadian organizations are more likely to track disability, absenteeism and employee assistance program (EAP) usage and conduct engagement surveys.

■ U.S. organizations are more likely to offer physical health screening/treatment initiatives and incentives and to be expanding health literacy education, whereas Canadian organizations are more likely to offer many mental health initiatives and mental health communication. Mental illness/depression are far and away the biggest cost drivers in Canada. Diabetes and heart disease are the biggest cost-driving conditions in the United States.

Survey results are designed for plan sponsors to benchmark their actions against their peers. The reader is cautioned that the limited sample size and nonrandomized sampling methodology may restrict the extent to which findings can be generalized. Due to rounding, some column percentages may not total 100%.

1. A multiemployer plan is an employee benefit plan maintained under one or more collective bargaining agreements to which more than one employer contributes. These collective bargaining agreements typically involve one or more local unions that are part of the same national or international labor union and more than one employer. If the multiemployer plan is a “Taft-Hartley” plan in the United States, the plan sponsor is a joint board of trustees consisting of equal representation from labor and management; these trustees are responsible for the overall operation and administration of the plan. The board of trustees is generally the “named fiduciary” and allocates or delegates the administrative functions to persons or entities with expertise regarding the particular function.

I. Introduction


II. Key Findings

The International Foundation’s Workplace Wellness Trends: 2015 Survey Results uncovers the most prevalent types of initiatives, emerging wellness offerings and trends, wellness outcomes and ROI, wellness incentives and strategies and ACA’s impact. Responses were received from 479 members. Of the total, 372 responses were from U.S. organizations and 107 were from Canadian organizations (78% vs. 22%, respectively). Surveys were received from single employers/ corporations (58%), multiemployer benefit plans (22%) and public/governmental plans (20%). Organizations of a variety of sizes, regions and industries/jurisdictions were represented. Key findings include:

■ More than half of all organizations (55%) have budgets devoted to wellness, and more than four in five offer some type of wellness initiative. Among organizations with wellness offerings, seven years is the average amount of time these efforts have been in place.

■ Organizations are divided in their purposes and strategies for wellness—59% are primarily offering wellness to invest in/increase worker health and engagement, while 41% aim to control/reduce health-related costs.

■ More than three in five organizations with wellness budgets (62%) expect their budgets to increase in the next two years. One in five organizations without a wellness budget expects to adopt a budget in the next two years. Nearly two in five organizations say ACA has increased their organization’s emphasis/interest in wellness.

■ The top barriers to wellness implementation are not enough time for workers to participate, dispersed worker populations and difficulty keeping momentum going.

■ Flu shot programs (71%), smoking-cessation programs (54%), health risk assessments/appraisals (HRAs) (51%) and health screenings (50%) are among the most popular screening and treatment initiatives.

■ Wellness competitions (42%), health coaching (39%), healthy food choices (38%) and weight-loss/management programs (38%) are the most prevalent fitness and nutrition wellness initiatives.

■ Social and community health initiatives commonly offered by organizations include community charity drives (57%), on-site events and celebrations (50%) and community volunteer projects (46%).

■ The most common mental health initiatives offered are employee assistance programs (EAPs) (80%), mental health coverage (63%), critical incident/crisis response counseling (33%) and stress-management programs (24%).

■ The most common worker-growth and purpose-related offerings are encouraged vacation time (66%), service recognition (63%) and tuition reimbursement (63%).

■ Organizations are looking to increase emphasis in a wide variety of areas in the future, including wellness communication (58%), wellness incentives (45%), health literacy education (44%), physical health offerings (35%), wellness-related technology and/or gamification (31%), financial education (29%) and mental health and stress-related offerings (29%).

■ Nearly four in five organizations are using some type of incentive to encourage healthy behaviors. The most common wellness initiatives for organizations to attach incentives to are HRAs, health screenings, smoking-cessation programs and fitness programs.

■ About half of all U.S. organizations’ insurance-based wellness incentives are classified under ACA as participation-only, about one-quarter have health-contingent activity-only incentives and about one-quarter have health-contingent outcomes-based incentives.

| International Foundation of Employee Benefit Plans 4

■ More than one in ten U.S. organizations (12%) with health-contingent incentives are offering these incentives up to the full 50% of coverage limit for tobacco cessation, and 17% are offering up to the full 30% of coverage limit provided by ACA for other health standards/activities.

■ Outcomes-based incentives are most commonly dependent on HRA/screening score improvements, tobacco use and fixed HRA/screening scores. Health coaching is the most commonly used reasonable alternative standard.

■ The most common methods for communicating wellness initiatives include benefit newsletters (61%), health fairs (49%), seminars and speakers (49%) and nurse advice hotlines (45%).

■ More than one-third of organizations (36%) survey their workers about desired wellness programs and changes, 34% design programs based on identified health risks and 29% include families/spouses in wellness initiatives.

■ Wearable tracking devices are made available free or at a discount in 28% of organizations, wellness apps are promoted or used in 27% and gamification is incorporated into 16% of responding programs.

■ Two in five organizations (41%) have prepared a general picture of their organization’s health status. The conditions most frequently identified as affecting costs are diabetes, heart disease, arthritis/back/musculoskeletal conditions, cancer, hypertension/high blood pressure, obesity and depression/mental illness.

■ Commonly offered initiatives with the highest worker participation rates include health screenings (47%), flu shot programs (46%), HRAs (46%) and health fairs (41%).

■ Of the responding organizations with wellness initiatives, about one in four (26%) is analyzing its wellness program ROI. Proof of wellness results is in uniquely high demand—Just 4% of organizations that calculate wellness ROI also analyze the ROI of other initiatives/benefits. Among organizations analyzing and aware of their wellness ROI, 93% are achieving positive ROI and the average ROI per $1 spent is $3.

■ Organizations are tracking a variety of measures related to their wellness efforts beyond health care costs, including HRA/screening data (44%), engagement surveys (33%), overall organization financials (29%) and absenteeism (24%). Among organizations analyzing these measures:

• 62% say wellness efforts have improved their organization’s HRA/screening data. • 54% say wellness efforts have improved engagement survey results.• 45% say wellness efforts have reduced absenteeism.• 38% say wellness efforts have positively affected their organization’s overall bottom line.


III. Approach

More than four in five organizations (81.6%) offer one or more wellness initiative (Exhibit 1). This figure varies widely by sector—corporations (89.5%), public/governmental plans (88.7%) and multiemployer benefit plans (54.7%). Larger organizations are also much more likely than smaller organizations to have wellness initiatives.

Organizations offer wellness initiatives for different reasons—58.6% offer wellness primarily to invest in/increase worker health and engagement, while 41.4% primarily aim to control/reduce health-related costs (Exhibit 2). Corporations are more likely than public employer and multiemployer plans to offer wellness programs with the primary purpose to invest in/increase worker health and engagement.

Among organizations with wellness offerings, seven years is the average amount of time their efforts have been in place (Exhibit 3). More than one in five organizations (23%) have just started offering wellness initiatives in the last two years. On the other hand, 21.4% have been offering wellness initiatives for ten years or more.

More than half of all organizations (54.7%) have budgets devoted to wellness (Exhibit 4). More than three in five organizations with wellness budgets (62.1%) expect their budgets to increase in the next two years (Exhibit 5). In addition, one in five organizations without a wellness budget (19.8%) expects to adopt a budget in the next two years (Exhibit 6). Nearly two in five U.S. organizations (37.9%) say ACA has increased their organization’s emphasis/interest in wellness (Exhibit 7).

The top barriers organizations have encountered when incorporating wellness initiatives are workers’ lack of time (35.5%), dispersed worker populations (21.9%) and difficulty keeping momentum going (19.4%) (Exhibit 8).

ExhIbIT 1

Offer Wellness-Related Initiatives Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Offer wellness-related initiatives 81.6% 89.5% 88.7% 54.7%

Do not offer any wellness-related initiatives 18.4% 10.5% 11.3% 45.3%

ExhIbIT 2

Primary Reason for Offering Wellness Initiatives Overall CP PE ME n = 391 n = 247 n = 86 n = 58

To invest in/increase worker health and engagement 58.6% 64.0% 55.8% 39.7%

To control/reduce health-related costs 41.4% 36.0% 44.2% 60.3%


ExhIbIT 3

Number of Years Offering Wellness Initiatives Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Less than 1 year 5.4% 3.5% 9.1% 8.7%

1-2 years 17.6% 16.4% 18.2% 21.7%

3-4 years 26.8% 30.8% 18.2% 21.7%

5-9 years 25.6% 26.9% 24.2% 21.7%

10-14 years 13.7% 12.9% 18.2% 10.9%

15-20 years 3.5% 3.0% 3.0% 6.5%

More than 20 years 4.2% 4.0% 6.1% 2.2%

Don’t know 3.2% 2.5% 3.0% 6.5%

Average number of years offering wellness initiatives 7.0 6.7 7.8 6.9

ExhIbIT 4

Have Budget Specific to Wellness Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Yes 54.7% 59.1% 66.3% 19.0%

No 45.3% 40.9% 33.7% 81.0%

ExhIbIT 5

Wellness Budget Changes in the Next Two Years* Overall CP PE ME n = 214 n = 146 n = 57 n = 11

Increase significantly 7.9% 8.2% 5.3% 18.2%

Increase somewhat 54.2% 54.1% 54.4% 54.5%

Stay the same 36.9% 37.0% 38.6% 27.3%

Decrease somewhat 0.9% 0.7% 1.8% 0.0%

Decrease significantly 0.0% 0.0% 0.0% 0.0%

*Among organizations with wellness budgets.


ExhIbIT 6

Adopting a Wellness Budget in the Next Two Years* Overall CP PE ME n = 177 n = 101 n = 29 n = 47

Yes 19.8% 18.8% 27.6% 17.0%

Maybe 50.3% 51.5% 44.8% 51.1%

No 29.9% 29.7% 27.6% 31.9%

*Among organizations without wellness budgets currently.

ExhIbIT 7

ACA Impact on Wellness Approach* Overall CP PE ME n = 372 n = 222 n = 76 n = 78

Increased emphasis/interest significantly 8.9% 7.2% 13.9% 9.0%

Increased emphasis/interest somewhat 29.0% 27.5% 31.9% 30.8%

No change 59.9% 64.0% 52.8% 55.1%

Decreased emphasis/interest somewhat 1.1% 1.4% 0.0% 1.3%

Decreased emphasis/interest significantly 1.1% 0.0% 1.4% 3.8%

*Results are U.S. only.


ExhIbIT 8

Top Barriers to Implementing Wellness Initiatives* Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Difficult for workers to find enough time to participate 35.5% 38.8% 27.8% 34.0%

Dispersed worker population 21.9% 17.4% 25.8% 30.2%

Difficult to keep momentum going 19.4% 23.9% 13.4% 13.2%

Privacy concerns among workers/participants 19.2% 21.4% 24.7% 8.5%

Don’t believe these initiatives will change worker behavior or cost/quality of care 18.6% 18.5% 14.4% 22.6%

Lack of worker/participant understanding of these initiatives 16.3% 14.5% 19.6% 17.9%

Lack of senior management support 15.2% 14.9% 23.7% 8.5%

Lack of adequate internal staff 13.2% 14.1% 16.5% 7.5%

Lack of sufficient financial incentives to encourage participation in programs 12.9% 14.1% 15.5% 7.5%

Cost is prohibitive 12.3% 10.1% 21.6% 9.4%

Lack of organizational structure to support it 10.6% 9.1% 16.5% 9.4%

Lack of information about the best evidence-based practices 10.4% 9.8% 9.3% 13.2%

Lack of time for design/implementation 9.2% 9.8% 6.2% 10.4%

Lack of effective communication with workers 7.7% 6.2% 10.3% 9.4%

Workers perceive themselves as invincible 6.9% 6.5% 4.1% 10.4%

Difficult to implement 6.3% 5.8% 1.0% 12.3%

Culturally diverse or non-English- speaking workers 5.0% 5.8% 3.1% 4.7%

Lack of union support 4.8% 2.5% 7.2% 8.5%

Lack of actionable data/difficult to obtain and integrate data 4.6% 4.3% 6.2% 3.8%

No barriers 3.5% 5.4% 1.0% 0.9%

have not considered offering initiatives 6.7% 4.3% 4.1% 15.1%

*Respondents were asked to select up to three responses.


IV. Offerings

The concept of wellness has been expanding in recent years to include initiatives geared more broadly toward worker engagement and total well-being. This section analyzes some of these newer elements of workplace wellness efforts as well as more traditional elements.

Flu shot programs (71.2%), smoke-free worksite policies (61.2%), smoking-cessation programs (54.3%), chiropractic services coverage (52.4%), HRAs (50.7%) and health screenings (50.1%) are among the most popular screening and treatment initiatives (Exhibit 9). Wellness competitions (41.8%), health coaching (38.8%), healthy food choices (38.4%), weight-loss/management programs (37.8%), nutrition counseling/diet programs (34.4%) and organized group run/walk events (32.6%) are the most prevalent fitness and nutrition initiatives (Exhibit 10).

The most common social and community health initiatives offered by organizations are community charity drives (57%), on-site events and celebrations (50.1%), community volunteer projects (45.9%), staff outings (45.7%) and blood drives (44.5%) (Exhibit 11). The most common mental health initiatives offered are EAPs (80.4%), mental health coverage (62.8%), critical incident/crisis response counseling (32.8%), stress-management programs (23.6%) and mental health assessments included in an HRA (21.1%) (Exhibit 12). The most common worker-growth and purpose-related offerings are encouraged vacation time (65.8%), service recognition (63%) and tuition reimbursement (62.6%) (Exhibit 13). Other common growth- and purpose-related offerings are all-staff notifications of job openings (54.1%), retirement celebrations (46.1%), flexible workhours/telecommuting (45.9%) and performance reviews tied to the organizational mission (45.3%).

Corporations and public employer plans are more likely to offer the most wellness initiatives—This is likely because of broader sector and industry differences (Exhibit 14). As seen in the section above, the dispersed population and implementation challenges are strongest in the multiemployer sector. That said, across all sectors, organizations are looking to increase emphasis in a variety of wellness areas going forward, including wellness communication (57.6%), wellness incentives (44.5%), health literacy education (44.1%), physical health offerings (34.7%), wellness-related technology and/or gamification (30.9%), financial education (29.4%) and mental health/stress-related offerings (29%).


ExhIbIT 9

Screening and Treatment Initiatives Offered* Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Flu shot program (free or discounted flu shots) 71.2% 81.5% 79.4% 36.8%

Smoke-free worksite policy 61.2% 67.0% 70.1% 37.7%

Smoking-cessation program 54.3% 59.4% 60.8% 34.9%

Chiropractic services coverage 52.4% 52.2% 55.7% 50.0%

health risk assessments/appraisals (hRAs) 50.7% 60.1% 53.6% 23.6%

health screenings sponsored on site or through structured program 50.1% 56.5% 57.7% 26.4%

Disease management program 40.7% 44.2% 49.5% 23.6%

Case management (patient care model focusing on coordinating medical services for individuals) 36.1% 37.3% 35.1% 34.0%

Acupuncture coverage 29.2% 28.6% 34.0% 26.4%

On-site massage therapy 18.8% 25.0% 18.6% 2.8%

On-site or near-site health care clinics 10.2% 11.6% 11.3% 5.7%

On-site or near-site pharmacies 6.7% 5.1% 10.3% 7.5%

On-site or near-site physical therapy 5.6% 5.4% 7.2% 4.7%

None of the above 7.7% 4.7% 4.1% 18.9%

*Respondents were asked to select all that apply.


ExhIbIT 10

Fitness and Nutrition Initiatives Offered* Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Wellness competitions such as walking/fitness challenges 41.8% 50.0% 55.7% 7.5%

health coaching 38.8% 44.2% 43.3% 20.8%

healthy food choices in cafeteria or vending machines 38.4% 50.4% 39.2% 6.6%

Weight-loss/management program (on site or subsidized) 37.8% 42.8% 50.5% 13.2%

Nutrition counseling/diet program 34.4% 38.4% 37.1% 21.7%

Organized group run/walk events 32.6% 40.6% 36.1% 8.5%

On-site fitness equipment/center 29.0% 34.8% 37.1% 6.6%

Off-site fitness program subsidies 27.8% 34.1% 28.9% 10.4%

On-site exercise/yoga classes 27.3% 33.7% 36.1% 2.8%

healthy food at staff/trustee meetings 26.3% 29.0% 23.7% 21.7%

Activity/exercise breaks encouraged during work time 25.5% 30.1% 28.9% 10.4%

Standing workstations 25.3% 34.1% 19.6% 7.5%

On-site walking trails/paths 21.1% 25.7% 29.9% 0.9%

Employer-sponsored sports teams 14.4% 19.2% 10.3% 5.7%

Fitness equipment discounts 11.7% 14.9% 12.4% 2.8%

None of the above 18.8% 7.2% 14.4% 52.8%



ExhIbIT 11

Social and Community Health Initiatives Offered* Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Community charity drives/events (e.g., food drives, school supplies, etc.) 57.0% 64.9% 66.0% 28.3%

On-site events/celebrations (e.g., wedding/ baby showers, cook-offs, bake sales, department parties/potlucks, etc.) 50.1% 61.6% 53.6% 17.0%

Community volunteer projects 45.9% 57.6% 39.2% 21.7%

Staff outings (e.g., golf, tours, parks, bowling, holiday parties, pro sports games, picnics, etc.) 45.7% 57.2% 41.2% 19.8%

blood drives 44.5% 49.6% 58.8% 17.9%

Cultural/diversity initiatives or training 25.5% 26.4% 40.2% 9.4%

Themed dress-up days 23.0% 25.0% 33.0% 8.5%

Game leagues (e.g., bocce, cribbage, etc.) 9.2% 10.1% 7.2% 8.5%

None of the above 20.5% 11.2% 8.2% 55.7%



ExhIbIT 12

Mental Health Initiatives Offered Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Employee assistance program (EAP) 80.4% 87.7% 88.7% 53.8%

Mental health coverage 62.8% 67.4% 70.1% 44.3%

Critical incident/crisis response counseling 32.8% 37.3% 46.4% 8.5%

Stress-management program 23.6% 25.7% 29.9% 12.3%

Mental health assessment included in health risk assessment/appraisal 21.1% 23.9% 26.8% 8.5%

Massages 20.9% 24.6% 23.7% 8.5%

Gratitude/appreciation journals/initiatives 11.5% 14.9% 10.3% 3.8%

Mental health return-to-work program 11.1% 10.1% 18.6% 6.6%

End-of-life counseling/care 11.1% 12.3% 14.4% 4.7%

Mental health first aid training (i.e., training to identify and help individuals who may be developing a mental health problem or in a mental health crisis) 6.5% 5.4% 9.3% 6.6%

On-site meditation classes 4.4% 4.7% 7.2% 0.9%

None of the above 10.6% 5.8% 5.2% 28.3%

*Respondents were asked to select all that apply.*


ExhIbIT 13

Worker-Growth and Purpose-Related Initiatives Offered* Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Vacation/time off is encouraged 65.8% 75.7% 66.0% 39.6%

Service recognition 63.0% 72.1% 73.2% 30.2%

Tuition reimbursement 62.6% 72.8% 73.2% 26.4%

All staff is notified of internal job openings and qualified candidates are encouraged to apply 54.1% 59.1% 69.1% 27.4%

Retirement celebrations 46.1% 47.1% 63.9% 27.4%

Flexible work hours/telecommuting 45.9% 60.1% 44.3% 10.4%

Performance reviews tied to organizational mission 45.3% 55.4% 49.5% 15.1%

Financial education 40.5% 48.6% 40.2% 19.8%

Subsidized continuing education opportunities 39.9% 48.6% 40.2% 17.0%

Manager training 36.7% 42.8% 44.3% 14.2%

Transfers are encouraged when internal opportunities better fit worker interests 30.9% 38.4% 34.0% 8.5%

Leadership opportunities outside job hierarchy structure via teams, committees and/or councils 25.9% 27.9% 40.2% 7.5%

Mentorship program 24.0% 30.4% 23.7% 7.5%

Workers can review job descriptions and edit/redesign their jobs 11.3% 10.1% 22.7% 3.8%

Creative/autonomous built-in worker time (i.e., flexibility to spend a certain amount of time on independent/pet projects) 6.9% 8.7% 4.1% 4.7%

Stay interviews (i.e., periodic meeting designed to keep and engage talented workers) 5.4% 7.6% 0.0% 4.7%

None of the above 7.9% 1.4% 4.1% 28.3%



ExhIbIT 14

Increasing Emphasis of Wellness-Related Offerings in the Next Two Years* Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Wellness communication 57.6% 55.8% 71.1% 50.0%

Wellness incentives 44.5% 43.5% 54.6% 37.7%

health literacy education 44.1% 43.8% 52.6% 36.8%

Physical health offerings 34.7% 34.4% 46.4% 24.5%

Wellness-related technology and/or gamification 30.9% 31.9% 41.2% 18.9%


Mental health/stress-related offerings 29.0% 28.6% 39.2% 20.8%

Initiatives designed to enhance professional and personal growth/purpose 24.2% 25.7% 32.0% 13.2%

Community engagement opportunities 23.0% 22.5% 27.8% 19.8%

Workplace design changes 22.3% 22.1% 35.1% 11.3%

Work-life balance promotion/initiatives 22.1% 22.5% 30.9% 13.2%

Staff social opportunities 13.2% 12.7% 13.4% 14.2%

* Respondents were asked if their organization would be increasing, decreasing or keeping the same emphasis on these wellness-related initiatives in the next two years. Results for decreasing and keeping the same are not shown. Very few respondents are decreasing emphasis on any of these wellness-related initiatives.


V. Incentives

Nearly four in five organizations (77%) are using some type of incentive to increase participation in wellness programs and encourage healthy behaviors (Exhibit 15). Gift cards/certificates and noncash incentives are the most prevalent (37.6% and 30.2%, respectively). Also common are insurance premium reductions (28.4%), fitness center discounts (17.6%), contributions to health accounts (16.6%) and cash awards (16.1%). The use of incentives is generally less common in the multiemployer sector compared with corporations and public employers.

Organizations most commonly attach incentives to HRAs (47.2%), health screenings (36.9%), smoking-cessation programs (29.2%), fitness programs/competitions (28.6%) and weight-loss/management programs (24.6%) (Exhibit 16). About two-thirds of organizations (65.4%) describe their wellness incentives as somewhat successful—18.9% describe their incentives as very successful, while 15.6% say their incentives have been unsuccessful (Exhibit 17).

U.S. respondents were asked additional questions about health insurance-based incentives and wellness-specific provisions of ACA. About half (47.9%) of surveyed U.S. organizations’ insurance-based wellness incentives are classified under ACA as participation-only, about one-quarter are health-contingent activity-only (27.3%) and about one-quarter are health-contingent outcomes-based (25.5%) (Exhibit 18).2 More than one in ten organizations (12%) are offering incentives up to the full 50% of coverage limit for tobacco cessation, and 17.3% are offering incentives up to the full 30% of coverage limit provided by ACA for other health standards/activities (Exhibit 19). Outcomes-based incentives are most commonly dependent on HRA/screening score improvements (57.1%), tobacco use (54.8%), and fixed HRA/screening scores (45.2%) (Exhibit 20). Health coaching is the most common reasonable alternative standard used with health-contingent incentives (41.3%) (Exhibit 21).3

Organizations seem to be somewhat split regarding the use of health-contingent incentives. The top reasons organizations offer health-contingent incentives are to motivate healthy behaviors (82.7%) and reduce health costs (74.7%) (Exhibit 22). Additionally, nearly nine in ten (89.3%) organizations with health-contingent incentives say the overall workforce reaction has been positive (Exhibit 23). However, organizations without these initiatives rarely attribute it to a lack of capacity/money—Two of the main reasons are the potential negative impact on employee culture/stress (31.5%) and concern that these incentives could be considered unfair or discriminatory (23.1%) (Exhibit 24). Additionally, about two-thirds of organizations without health-contingent incentives (65.2%) say they are unlikely or unsure about adding them in the future (Exhibit 25).

2. Activity-only programs require individuals to complete an activity related to a health factor to obtain the reward, whereas outcomes-based programs require individuals to attain or maintain a specific health outcome in order to obtain the reward. 3. A reasonable alternative standard is required for health-contingent programs as a separate alternative path to the reward that must be reasonable and work to achieve a similar health goal for participants.


ExhIbIT 15

Use of Incentives/Disincentives* Overall CP PE ME

Gift cards or gift certificates 37.6% 38.1% 44.2% 25.9%

Noncash incentives/prizes/raffles (merchandise such as T-shirts, gym bags, water bottles, etc.) 30.2% 31.6% 37.2% 13.8%

Insurance premium reduction/incentive (“carrot” approach)** 28.4% 35.8% 19.7% 8.7%

Gym/fitness center discounts 17.6% 19.4% 22.1% 3.4%

Contributions to health accounts (e.g., hSAs, hRAs, FSAs or hCSAs in Canada) 16.6% 20.6% 10.5% 8.6%

Cash awards 16.1% 15.8% 23.3% 6.9%

Insurance premium penalty/disincentive (“stick” approach)** 13.7% 13.9% 13.6% 13.0%

Reimbursement of worker costs upon completion of an outside wellness initiative 6.6% 6.1% 9.3% 5.2%

Waivers or reductions for health plan deductibles or copayments (“carrot” approach)** 6.4% 3.5% 6.1% 19.6%

Additional time off 6.1% 6.5% 8.1% 1.7%

Increased health plan copays, coinsurance and deductibles or reduced benefits (“stick” approach)** 4.5% 3.0% 3.0% 13.0%

Access to health plan coverage is contingent upon initiative participation** 1.6% 2.0% 0.0% 2.2%

Salary incentives/disincentives 0.8% 0.8% 1.2% 0.0%

hiring/promoting dependent on tobacco use or health 0.8% 0.4% 1.2% 1.7%

No incentives offered 23.0% 20.6% 14.0% 46.6%

*Respondents were asked to select all that apply. **Response options were available for U.S. respondents only. N’s differ for these options.


ExhIbIT 16

Initiatives With Attached Incentives* Overall CP PE ME n = 391 n = 247 n = 86 n = 58

hRA 47.2% 48.5% 45.9% 41.9%

health screening 36.9% 38.3% 39.2% 22.6%


Fitness program/competition 28.6% 30.1% 28.4% 19.4%

Weight-loss/management program 24.6% 21.9% 29.7% 29.0%

Flu shot program 19.9% 19.4% 21.6% 19.4%

health care coach/advocate 19.3% 20.4% 14.9% 22.6%

Nutrition program 17.9% 16.8% 21.6% 16.1%

health fair 17.6% 15.3% 24.3% 16.1%


ExhIbIT 17

Success of Wellness Incentives* Overall CP PE ME n = 301 n = 196 n = 74 n = 31

Very successful 18.9% 18.9% 21.6% 12.9%

Somewhat successful 65.4% 65.8% 64.9% 64.5%

Somewhat unsuccessful 13.6% 14.3% 9.5% 19.4%

Very unsuccessful 2.0% 1.0% 4.1% 3.2%

*Among respondents with wellness incentives.

ExhIbIT 18

Types of Incentives Under ACA* Overall CP PE ME n = 165 n = 117 n = 30 n = 18

Participation-only 47.9% 51.3% 43.3% 33.3%

health-contingent—activity-only 27.3% 27.4% 36.7% 11.1%

health-contingent—outcomes-based 25.5% 26.5% 20.0% 27.8%

Not sure 12.7% 9.4% 10.0% 38.9%

* Among U.S. respondents with insurance-based incentives. Respondents were asked to select all that apply (i.e., organizations can offer multiple types of programs).


ExhIbIT 19

Offering Maximum ACA Wellness Incentives* Overall CP PE ME n = 75 n = 53 n = 15 n = 7

Yes, 50% for tobacco cessation 12.0% 13.2% 13.3% 0.0%

Yes, 30% for other program participation or health standards 17.3% 18.9% 6.7% 28.6%

No, but considering 22.7% 18.9% 40.0% 14.3%

No 46.7% 50.9% 40.0% 28.6%

Not sure 8.0% 5.7% 6.7% 28.6%

*Among U.S. respondents with health-contingent wellness incentives.

ExhIbIT 20

Measures Used for Outcomes-Based Incentives* Overall CP PE ME n = 42 n = 31 n = 6 n = 5

Not using tobacco 54.8% 61.3% 50.0% 20.0%

hRA/screening total score improvement 57.1% 54.8% 66.7% 60.0%

hRA/screening fixed total score (i.e., must meet fixed benchmark) 45.2% 48.4% 50.0% 20.0%

* Among U.S. respondents with outcomes-based incentives. Respondents were asked to select all that apply.

ExhIbIT 21

Reasonable Alternative Standards* Overall CP PE ME n = 75 n = 53 n = 15 n = 7

health coaching 41.3% 43.4% 26.7% 57.1%

health education classes 18.7% 18.9% 26.7% 0.0%

have not established 10.7% 7.5% 20.0% 14.3%

Not sure 20.0% 18.9% 20.0% 28.6%

Other 9.3% 11.3% 6.7% 0.0%

*Among U.S. respondents with health-contingent incentives.


ExhIbIT 22

Reasons for Offering Health-Contingent Incentives* Overall CP PE ME n = 75 n = 53 n = 15 n = 7

Motivate healthy behaviors 82.7% 92.5% 73.3% 28.6%

Reduce health care costs 74.7% 79.2% 66.7% 57.1%

More fairly distribute health care costs 21.3% 22.6% 6.7% 42.9%

It is an industry trend 9.3% 11.3% 6.7% 0.0%

*Among U.S. respondents with health-contingent wellness incentives. Respondents were asked to select all that apply.

ExhIbIT 23

Workforce Reactions to Health-Contingent Incentives* Overall CP PE ME n = 75 n = 53 n = 15 n = 7

Very positive 29.3% 26.4% 40.0% 28.6%

Somewhat positive 60.0% 58.5% 60.0% 71.4%

Somewhat negative 10.7% 15.1% 0.0% 0.0%

Very negative 0.0% 0.0% 0.0% 0.0%

*Among U.S. respondents with health-contingent wellness incentives.


ExhIbIT 24

Reasons for NOT Offering Health-Contingent Incentives* Overall CP PE ME n = 238 n = 148 n = 51 n = 39

Potential negative impact on employee culture/stress 31.5% 29.7% 41.2% 25.6%

Application of incentive could be considered unfair or discriminatory 23.1% 21.6% 31.4% 17.9%

Incentive research is still not clear 14.3% 14.9% 15.7% 10.3%

Lack of money 10.5% 8.8% 15.7% 10.3%

Tried and did not work 2.5% 3.4% 2.0% 0.0%

Not sure 18.9% 21.6% 7.8% 23.1%

Other 13.4% 10.1% 23.5% 12.8%

have not considered/awaiting further information 23.9% 23.0% 23.5% 28.2%

* Among U.S. respondents without health-contingent wellness incentives. Respondents were asked to select all that apply.

ExhIbIT 25

Likelihood of Offering Health-Contingent Incentives in the Future* Overall CP PE ME n = 238 n = 148 n = 51 n = 39

Very likely 7.6% 8.1% 11.8% 0.0%

Somewhat likely 27.3% 25.7% 25.5% 35.9%

Somewhat unlikely 16.4% 16.2% 13.7% 20.5%

Very unlikely 28.2% 29.7% 35.3% 12.8%

Not sure 20.6% 20.3% 13.7% 30.8%

*Among U.S. respondents without health-contingent wellness incentives.


VI. Strategies

Incentives are one of many techniques organizations use to enhance their wellness program efforts. This section takes a look at wellness strategies beyond incentives, including communication, leveraging vendors, using data and targeting information and offerings.

Educating health plan participants about the risks of unhealthy behavior and teaching them how to build healthier habits are keys to an effective wellness program. More than 90% of organizations offer some type of wellness communication/information resources (Exhibit 26). The most common methods for communicating wellness initiatives include: benefit pamphlets, brochures and newsletters (60.6%); health fairs (49.4%); seminars and speakers (49.4%); nurse advice hotlines (45.3%) and health care coaches/advocates (41.4%).

Organizations are increasingly looking to provide targeted information to participants and design initiatives based on their specific populations. More than one-third of organizations (35.8%) survey their workers about desired wellness programs and 22.5% solicit feedback via suggestion/comment boxes (Exhibit 27). One-third (34.3%) design initiatives based on health risks and 26.6% target communications based on health risks. Three in ten (29.2%) include families/spouses in staff events/wellness offerings and 27.6% target family/spouses with wellness communications. More than one in ten (11.8%) target retirees with wellness communications and 10% include retirees in staff events/wellness offerings. Wearable tracking devices are made available free or at a discount in 27.9% of organizations, wellness apps are promoted or used in 26.9% and gamification is incorporated into programs in 15.6% (Exhibit 28).

Corporations and public employers are more likely than multiemployer funds to provide most types of wellness communication and incorporate technology into program efforts, while multiemployer funds are more likely to engage retirees in wellness communication and initiatives (likely because of a greater prevalence of retiree health care among these plans).

Organizations do not have to build wellness programs from scratch. Professional providers and vendors offer a variety of products and services related to wellness. More than 85% of survey participants that have a wellness initiative use an outside vendor to implement or assist with their program (Exhibit 29). Common types of vendors used include insurance providers (55.2%), wellness/benefits consultants (53.2%) and health care providers (39.9%) (Exhibit 29).

Collecting and analyzing data in a cost-effective way can be a challenge but, as a starting point, organizations can prepare a general picture of their participants and their health plan’s status to understand the issues that have the greatest impact (i.e., a basic analysis and stratification of participant demographics, risk factors and disease burdens). More than two in five organizations (41.1%) have used data to prepare a general picture of their health plan status (Exhibit 30). The conditions most frequently cited as having the most impact on health plan costs include diabetes (44.2%), heart disease (37.1%), arthritis/back/musculoskeletal problems (34.5%) and cancer (32%) (Exhibit 31). Hypertension (28.9%), obesity (26.9%) and mental illness (22.8%) were also commonly cited as conditions that significantly affect health plan costs.


ExhIbIT 26

Wellness Information and Communication* Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Wellness benefit pamphlets, brochures or newsletters 60.6% 60.7% 67.4% 50.0%

health fairs 49.4% 49.4% 57.0% 37.9%

Wellness seminars and speakers 49.4% 50.6% 64.0% 22.4%

Nurse advice hotline 45.3% 51.8% 38.4% 27.6%

health care coach/advisor/advocate 41.4% 43.3% 40.7% 34.5%

Leadership communicates support for wellness efforts to staff 35.0% 36.8% 43.0% 15.5%

Mental health information 30.2% 24.3% 46.5% 31.0%


Shared worker personal health stories/testimonials 20.5% 21.1% 26.7% 8.6%

Personal health record (interactive record that allows individuals to store, update and share health information with health care providers) 18.9% 21.1% 16.3% 13.8%

Wellness books, DVDs, videos or tapes 16.6% 17.0% 22.1% 6.9%

benefits/wellness information included in pay envelope (“payroll stuffer”) 15.6% 12.6% 23.3% 17.2%

Social media/networks 15.6% 14.6% 19.8% 13.8%

None of the above 6.9% 6.9% 4.7% 10.3%



ExhIbIT 27

Forms of Targeted Wellness Communication* Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Surveys of desired programs and changes 35.8% 37.7% 40.7% 20.7%

Programs/initiatives are designed based on health risks 34.3% 35.2% 41.9% 19.0%

Families/spouses are included in staff events/wellness offerings 29.2% 28.3% 30.2% 31.0%

Families/spouses are targeted with wellness communication 27.6% 29.1% 20.9% 31.0%

Targeted communication based on health risks 26.6% 25.5% 25.6% 32.8%

Suggestion/comment box 22.5% 21.9% 33.7% 8.6%

Retirees are targeted with wellness communication 11.8% 5.7% 16.3% 31.0%

Targeted communication for different segments of workforce 11.0% 10.9% 15.1% 5.2%

Retirees are included in staff events/wellness offerings 10.0% 4.0% 16.3% 25.9%

Targeted communication based on generation/age group 9.0% 9.3% 7.0% 10.3%

None of the above 24.0% 26.3% 18.6% 22.4%



ExhIbIT 28

Forms of Technology/Gamification* Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Free or discounted wearable tracking devices (e.g., pedometers, Fitbits, etc.) 27.9% 30.8% 32.6% 8.6%

Apps are promoted and/or used in programs/initiatives 26.9% 30.8% 25.6% 12.1%

Gamification incorporated into programs/initiatives 15.6% 18.6% 14.0% 5.2%

Spreadsheets for workers to track wellness activities/participation 14.6% 13.4% 25.6% 3.4%

None of the above 51.9% 47.4% 46.5% 79.3%


ExhIbIT 29

Types of Outside Vendors Used* Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Insurance provider 55.2% 57.5% 66.3% 29.3%

Wellness/benefits consultant 53.2% 53.0% 57.0% 48.3%

health care provider 39.9% 35.6% 44.2% 51.7%

None of the above 12.5% 13.0% 9.3% 15.5%


ExhIbIT 30

Have Prepared a Picture of Plan Health Status Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Yes 41.1% 42.0% 49.5% 31.1%

No 41.8% 43.1% 34.0% 45.3%

Don’t know 17.1% 14.9% 16.5% 23.6%


ExhIbIT 31

Top Conditions Impacting Plan Health Costs* Overall CP PE ME n = 197 n = 116 n = 48 n = 33

Diabetes 44.2% 37.9% 58.3% 45.5%

heart disease 37.1% 32.8% 39.6% 48.5%

Arthritis/back/musculoskeletal 34.5% 37.9% 35.4% 21.2%

Cancer 32.0% 35.3% 29.2% 24.2%

hypertension/high blood pressure 28.9% 28.4% 27.1% 33.3%

Obesity 26.9% 25.9% 33.3% 21.2%

Depression/mental illness 22.8% 25.0% 22.9% 15.2%

high cholesterol 19.3% 20.7% 16.7% 18.2%

Smoking 8.6% 7.8% 8.3% 12.1%

high-risk pregnancy 5.6% 8.6% 0.0% 3.0%

Chronic obstructive pulmonary disease 4.1% 2.6% 6.3% 6.1%

Allergies 3.6% 5.2% 0.0% 3.0%

Asthma 2.5% 1.7% 2.1% 6.1%

Substance abuse/chemical dependency/ pain medication abuse 1.5% 0.0% 0.0% 9.1%

Migraine/headache 1.0% 1.7% 0.0% 0.0%

Osteoporosis 0.5% 0.0% 0.0% 3.0%

Not sure 6.6% 7.8% 4.2% 6.1%

* Respondents that have prepared a picture of their plan health status were asked to select the top three conditions that impact costs.


VII. Outcomes

Participation is one measure of success for a wellness program. Organizations will not realize benefits without sufficient participation. Participation rates vary by type of initiative. Among commonly offered initiatives, the highest average participation rates are seen for health screenings (46.6%), flu shot programs (46.1%), HRAs (45.5%) and health fairs (41.1%) (Exhibit 32).4 Participation rates are generally higher in the corporate sector compared with public employers and multiemployer funds.

In theory, with adequate participation, participants and organizations can realize several benefits from wellness programs. However, there has been some concern whether organizations are actually experiencing these benefits. Benefits can be difficult to measure because improvements in worker health, morale, productivity, health care costs, absenteeism and turnover are influenced by a combination of factors. Among responding organizations with wellness initiatives, about one in four (26.4%) is analyzing ROI (Exhibit 33). U.S. organizations analyzing their wellness ROI were asked to report their results. Most organizations with knowledge of their ROI have found between a $1 and $4 return per $1 spent—Very few have discovered a negative wellness ROI or loss (Exhibit 34). The average wellness ROI among all organizations with knowledge of their ROI was $3 per $1 spent. ROI analyses appear to be somewhat unique to wellness—Less than 5% of responding organizations measuring wellness ROI said they also measure the ROI of other benefit offerings or programs.

Organizations use a variety of different methods to calculate their ROI (Exhibit 35). Two in five (40.9%) use their total health care cost trend line, 27.3% use HRA/screening conditions trends, 23.9% use specific health care utilization trends and 17% compare individual-level wellness program participant data to nonparticipants in their ROI calculation. Only 9.1% use broader workforce measures such as productivity, engagement or absence in their actual ROI calculations.

Although broader workforce measures are rarely included in ROI cost calculations, many organizations track how wellness efforts affect broader workforce measures and some are finding positive results. Notably, more than one-quarter (28.6%) relate their overall organizational financial growth to their wellness efforts (Exhibit 36). Others commonly track the impact of wellness efforts on disability/workers compensation data (32.7%), turnover (24.8%) and absenteeism (23.8%). One-third (32.7%) use engagement surveys to measure the impact of wellness initiatives and more than half have found positive results (53.9%) (Exhibit 37). Among organizations analyzing these measures: 62% say wellness efforts have improved their organization’s HRA/screening data, 45% say wellness efforts have reduced absenteeism and 38% say wellness efforts have positively affected their organization’s overall bottom line.

4. Targeted initiatives such as health care coaches and weight-loss/management programs may have lower participation rates because they may be based on the entire population versus only targeted workers.


ExhIbIT 32

Average Wellness Initiative Participation Rates* Overall CP PE ME


Flu shot program 46.1% 48.7% 44.8% 31.9%

hRA 45.5% 51.8% 35.4% 28.6%

health fair 41.1% 47.1% 35.2% 27.4%


Wellness seminars 27.9% 30.9% 22.2% 26.3%




Smoking-cessation program (among workers who smoke) 16.9% 15.4% 18.6% 21.5%

*N’s differ for each initiative. Refer to previous tables for prevalence of initiatives.

ExhIbIT 33

Measure ROI of Wellness Initiatives Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Yes, by a wellness vendor, provider or consultant 11.0% 10.1% 9.3% 17.2%

Yes, by an actuary 3.1% 1.6% 3.5% 8.6%

Yes, by internal staff 11.5% 9.7% 17.4% 10.3%

Yes, other 0.8% 0.8% 1.2% 0.0%

No 58.8% 61.1% 59.3% 48.3%

Not sure 14.8% 16.6% 9.3% 15.5%


ExhIbIT 34

Average ROI of Wellness Initiatives* Overall CP PE ME n = 103 n = 55 n = 27 n = 21

Less than $1 in benefits (loss) 1.9% 3.6% 0.0% 0.0%

$1 in benefits (break even) 4.9% 3.6% 7.4% 4.8%

$1.01-$2 in benefits 12.6% 14.5% 14.8% 4.8%

$2.01-$3 in benefits 12.6% 16.4% 11.1% 4.8%

$3.01-$4 in benefits 5.8% 5.5% 3.7% 9.5%

$4.01-$5 in benefits 1.0% 0.0% 3.7% 0.0%

$5.01-$6 in benefits 1.9% 1.8% 0.0% 4.8%

$6.01-$7 in benefits 0.0% 0.0% 0.0% 0.0%

$7.01-$8 in benefits 1.0% 0.0% 0.0% 4.8%

$8.01-$9 in benefits 0.0% 0.0% 0.0% 0.0%

$9.01-$10 in benefits 2.9% 1.8% 3.7% 4.8%

More than $10 in benefits 1.0% 0.0% 0.0% 4.8%

Don’t know 54.4% 52.7% 55.6% 57.1%

Average Program ROI $3.00 $2.42 $2.75 $5.00

*Average ROI per dollar spent. Results are U.S. only.

ExhIbIT 35

Wellness ROI Calculation Methods* Overall CP PE ME n = 103 n = 55 n = 27 n = 21

Total health plan cost trend line is used in the calculation 40.9% 30.4% 54.2% 50.0%

hRA/screening condition/risk trends are used in the calculation 27.3% 32.6% 20.8% 22.2%

Specific utilization trends are used in the calculation 23.9% 21.7% 25.0% 27.8%

Individual-level wellness program participant data is compared with nonparticipants and used in the calculation 17.0% 21.7% 20.8% 0.0%

broader workforce measures are used in the calculation (e.g., productivity, engagement, absence, etc.) 9.1% 13.0% 4.2% 5.6%

Not sure 39.8% 45.7% 29.2% 38.9%

*Respondents were asked to select all that apply. Results are U.S. only.


ExhIbIT 36

Data Tracked to Measure Wellness Efforts* Overall CP PE ME n = 391 n = 247 n = 86 n = 58

Absenteeism 23.8% 23.1% 30.2% 17.2%

Disability/workers’ compensation claims 32.7% 30.8% 38.4% 32.8%

EAP usage 40.4% 39.7% 51.2% 27.6%

Engagement/satisfaction/culture surveys 32.7% 36.8% 34.9% 12.1%

Exit interview data 23.8% 26.7% 20.9% 15.5%

health care costs 59.3% 58.3% 67.4% 51.7%

hRA/screening risk data 44.0% 44.9% 53.5% 25.9%

Overall organization financials/ sustainability and growth 28.6% 27.5% 30.2% 31.0%

Prevalence of diseases 29.7% 26.7% 39.5% 27.6%

Productivity 18.4% 19.8% 17.4% 13.8%

Pursuit of advancement and development opportunities 17.4% 19.4% 15.1% 12.1%

Recruitment/job referral rates 15.3% 17.4% 15.1% 6.9%

Retirement plan participation, contribution or withdrawal rates 24.6% 25.9% 17.4% 29.3%

Turnover 24.8% 27.1% 24.4% 15.5%

*Respondents were asked what trends they are tracking in relation to their wellness efforts.


ExhIbIT 37

Have Found Positive Impact of Wellness Efforts* Overall CP PE ME

Absenteeism 45.2% 49.1% 42.3% 30.0%


EAP usage 36.1% 33.7% 38.6% 43.8%







Productivity 41.7% 40.8% 46.7% 37.5%




Turnover 24.7% 25.4% 19.0% 33.3%

*Results are among respondents that are tracking each element. N’s differ for each initiative.


VIII. Demographics

Nearly three in five respondents (57.6%) were from single employers/corporations, 22.1% multiemployer benefit plans and 20.3% public/governmental plans (Exhibit 38). Most corporate respondents were from the insurance industry (23.9%), professional service firms (17.4%) and the manufacturing/distribution industry (16.7%). The majority of multiemployer plans (63.2%) represent the construction industry (Exhibit 39). Among public/governmental organizations, nearly one-third (32%) represent counties/districts, 25.8% are from municipalities, 21.6% represent a college or university, 15.5% are from state governments and 5.2% are from the federal government (Exhibit 40).

Three in ten U.S. organizations (30.4%) are located in the Midwest, 29.3% are from the Northeast/Mid-Atlantic region, 26.3% are from the West and 14% are from the South (Exhibit 41).5 Most responding Canadian organizations are located in Western or Central Canada (47.7% and 45.8%, respectively) (Exhibit 42). As for the number of active participants per organization, 18.1% of the organizations have 5,000 or more participants, 38% fall into the range of 500 to 4,999 participants, 28.6% are in the range of 50 to 499 active participants and 15.2% have fewer than 50 participants (Exhibit 43).

ExhIbIT 38

Respondent Sector(n = 479) CP PE ME

Total 57.6% 20.3% 22.1%

5. The four U.S. regions are defined as follows: Midwest (IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI); Northeast/Mid-Atlantic (CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VA, VT, WV); South (AL, AR, FL, GA, KY, LA, MS, NC, NM, OK, SC, TN, TX); and West (AK, AZ, CA, CO, HI, ID, MT, NV, OR, UT, WA, WY).


ExhIbIT 39

Primary Industry Overall CP ME n = 382 n = 276 n = 106

Accommodation and food services 0.8% 0.7% 0.9%

Arts, entertainment and recreation 2.6% 1.1% 6.6%

banking and finance 4.5% 6.2% 0.0%

Communications/telecommunications and high technology 3.7% 5.1% 0.0%

Construction 20.2% 3.6% 63.2%

Education 2.4% 2.5% 1.9%

Energy, utilities and mining 4.5% 5.8% 0.9%

health care and medicine 4.7% 6.2% 0.9%

Insurance 18.3% 23.9% 3.8%

Manufacturing/distribution 12.8% 16.7% 2.8%

Nonprofit 5.2% 5.8% 3.8%

Professional service firm (e.g., accounting, law, consulting) 12.6% 17.4% 0.0%

Retail/wholesale trade 3.1% 1.4% 7.5%

Transportation 2.1% 1.4% 3.8%

Other services 2.6% 2.2% 3.8%

ExhIbIT 40

Public Employer Jurisdiction County/ College/ (n = 97) Municipality District State University Federal

Public Employer Total 25.8% 32.0% 15.5% 21.6% 5.2%

ExhIbIT 41

Respondent Region (U.S.) Overall CP PE ME n = 372 n = 222 n = 72 n = 78

Northeast/Mid-Atlantic 29.3% 29.3% 30.6% 28.2%

Midwest 30.4% 33.3% 23.6% 28.2%

South 14.0% 16.2% 15.3% 6.4%

West 26.3% 21.2% 30.6% 37.2%


ExhIbIT 42

Respondent Region (Canada) Overall CP PE ME n = 107 n = 54 n = 25 n = 28

Atlantic Canada (Nb, NL, NS, PE) 5.6% 3.7% 8.0% 7.1%

Central Canada (ON, QC) 45.8% 61.1% 20.0% 39.3%

Northern Canada (NT, NU, YT) 0.9% 1.9% 0.0% 0.0%

Western Canada (Ab, bC, Mb, SK) 47.7% 33.3% 72.0% 53.6%

ExhIbIT 43

Number of Active Workers Overall CP PE ME n = 479 n = 276 n = 97 n = 106

Fewer than 50 15.2% 3.1% 5.7% 10.6%

50-499 28.6% 18.6% 16.0% 23.8%

500-4,999 38.0% 49.5% 49.1% 42.8%

5,000-9,999 10.1% 11.3% 16.0% 11.7%

10,000 or more 8.0% 17.5% 13.2% 11.1%


Ix. U.S. Results

ExhIbIT 1A




ExhIbIT 2A




ExhIbIT 3A


Less than 1 year 5.4% 3.5% 9.1% 8.7%

1-2 years 17.6% 16.4% 18.2% 21.7%

3-4 years 26.8% 30.8% 18.2% 21.7%

5-9 years 25.6% 26.9% 24.2% 21.7%

10-14 years 13.7% 12.9% 18.2% 10.9%

15-20 years 3.5% 3.0% 3.0% 6.5%

More than 20 years 4.2% 4.0% 6.1% 2.2%

Don’t know 3.2% 2.5% 3.0% 6.5%


ExhIbIT 4A


Yes 54.0% 58.2% 63.6% 21.7%

No 46.0% 41.8% 36.4% 78.3%

ExhIbIT 5A




Stay the same 33.7% 35.9% 28.6% 30.0%




ExhIbIT 6A


Yes 22.2% 21.4% 33.3% 16.7%

Maybe 48.6% 51.2% 41.7% 47.2%

No 29.2% 27.4% 25.0% 36.1%



ExhIbIT 7A

















No barriers 5.9% 5.9% 4.2% 7.7%




Privacy concerns among workers/ participants 3.8% 5.4% 1.4% 1.3%




ExhIbIT 8A







Disease-management program 51.1% 54.1% 65.3% 29.5%








None of the above 6.7% 5.0% 2.8% 15.4%



ExhIbIT 9A



health coaching 43.5% 47.3% 48.6% 28.2%









healthy food at staff/trustee meetings 25.3% 27.9% 20.8% 21.8%





None of the above 16.4% 6.3% 11.1% 50.0%



ExhIbIT 10A




blood drives 48.7% 55.9% 59.7% 17.9%






None of the above 20.4% 11.3% 9.7% 56.4%



ExhIbIT 11A



Mental health first aid training (i.e., training to identify and help individuals who may be developing a mental health problem or in a mental health crisis) 69.4% 73.9% 75.0% 51.3%




Massages 17.2% 21.6% 22.2% 0.0%






None of the above 11.0% 6.3% 2.8% 32.1%



ExhIbIT 12A






Flexible workhours/telecommuting 45.4% 59.5% 41.7% 9.0%







Leadership opportunities outside job hierarchy structure via teams, committees and/or councils. 26.1% 28.8% 38.9% 6.4%





None of the above 8.6% 1.4% 5.6% 32.1%



ExhIbIT 13A
















ExhIbIT 14A

Use of Incentives/Disincentives* Overall CP PE ME n = 313 n = 201 n = 66 n = 46



Insurance premium reduction/incentive (“carrot” approach) 28.4% 35.8% 19.7% 8.7%

Access to health plan coverage is contingent upon initiative participation 18.2% 21.9% 13.6% 8.7%

Cash awards 18.2% 16.9% 28.8% 8.7%


Insurance premium penalty/disincentive (“stick approach”) 13.7% 13.9% 13.6% 13.0%

Waivers or reductions for health plan deductibles or copayments (“carrot” approach) 6.4% 3.5% 6.1% 19.6%



Increased health plan copays, coinsurance and deductibles or reduced benefits (“stick” approach) 4.5% 3.0% 3.0% 13.0%

Contributions to health accounts (e.g., hSAs, hRAs, FSAs) 1.6% 2.0% 0.0% 2.2%






ExhIbIT 15A


health risk assessment/appraisal 51.2% 50.3% 55.0% 48.1%






Flu shot program 20.9% 19.8% 23.3% 22.2%


health fair 18.1% 15.0% 26.7% 18.5%


ExhIbIT 16A


Very successful 19.7% 19.2% 23.3% 14.8%






ExhIbIT 17A



health fairs 55.3% 53.7% 66.7% 45.7%












None of the above 5.8% 6.0% 3.0% 8.7%



ExhIbIT 18A












None of the above 24.0% 27.9% 16.7% 17.4%



ExhIbIT 19A






None of the above 50.5% 47.8% 40.9% 76.1%


ExhIbIT 20A





None of the above 12.5% 13.4% 9.1% 13.0%


ExhIbIT 21A


Yes 45.4% 43.7% 59.7% 37.2%

No 39.2% 43.7% 23.6% 41.0%

Don’t know 15.3% 12.6% 16.7% 21.8%


ExhIbIT 22A


Diabetes 46.7% 39.2% 65.1% 44.8%

heart disease 40.8% 35.1% 44.2% 55.2%

Cancer 36.1% 40.2% 32.6% 27.6%


Obesity 28.4% 27.8% 34.9% 20.7%




Smoking 7.1% 5.2% 7.0% 13.8%



Allergies 3.0% 4.1% 0.0% 3.4%

Asthma 3.0% 2.1% 2.3% 6.9%



Osteoporosis 0.6% 0.0% 0.0% 3.4%

Not sure 5.9% 8.2% 2.3% 3.4%



ExhIbIT 23A



hRA 46.9% 53.8% 36.9% 28.6%

Flu shot program 46.6% 48.7% 47.4% 31.7%

health fair 41.4% 46.8% 37.1% 28.1%








ExhIbIT 24A



Yes, by an actuary 3.5% 2.0% 4.5% 8.7%


Yes, other 1.0% 1.0% 1.5% 0.0%

No 57.8% 62.2% 54.5% 43.5%

Not sure 14.1% 14.9% 9.1% 17.4%


ExhIbIT 25A


Absenteeism 17.6% 16.4% 24.2% 13.0%


EAP usage 36.7% 34.3% 50.0% 28.3%







Productivity 16.9% 16.9% 21.2% 10.9%




Turnover 22.4% 23.9% 24.2% 13.0%



ExhIbIT 26A


Absenteeism 50.9% 51.5% 56.3% 33.3%


EAP usage 31.3% 26.1% 36.4% 46.2%







Productivity 41.5% 35.3% 50.0% 60.0%




Turnover 21.4% 22.9% 12.5% 33.3%

*Results are among respondents that are tracking each element. N’s differ for each initiative.

ExhIbIT 27A


Total 59.7% 19.4% 21.0%


ExhIbIT 28A







Education 2.0% 2.3% 1.3%



Insurance 15.7% 19.8% 3.8%


Nonprofit 6.0% 6.8% 3.8%





ExhIbIT 29A




ExhIbIT 30A

Respondent Region (U.S.) Overall CP PE ME n = 372 n = 222 n = 72 n = 78

Northeast/Mid-Atlantic 29.3% 29.3% 30.6% 28.2%

Midwest 30.4% 33.3% 23.6% 28.2%

South 14.0% 16.2% 15.3% 6.4%

West 26.3% 21.2% 30.6% 37.2%

ExhIbIT 31A


Fewer than 50 10.2% 14.0% 1.4% 7.7%

50-499 21.5% 26.6% 16.7% 11.5%

500-4,999 43.5% 41.4% 48.6% 44.9%

5,000-9,999 13.2% 9.9% 15.3% 20.5%

10,000 or more 11.6% 8.1% 18.1% 15.4%


x. Canada Results

ExhIbIT 1b




ExhIbIT 2b




ExhIbIT 3b


Less than 1 year 3.8% 0.0% 5.0% 16.7%

1-2 years 9.0% 10.9% 10.0% 0.0%

3-4 years 9.0% 10.9% 0.0% 16.7%

5-9 years 34.6% 41.3% 30.0% 16.7%

10-14 years 12.8% 15.2% 10.0% 8.3%

15-20 years 10.3% 6.5% 15.0% 16.7%

More than 20 years 9.0% 4.3% 15.0% 16.7%

Don’t know 11.5% 10.9% 15.0% 8.3%


ExhIbIT 4b


Yes 57.7% 63.0% 75.0% 8.3%

No 42.3% 37.0% 25.0% 91.7%

ExhIbIT 5b




Stay the same 48.9% 41.4% 66.7% 0.0%




ExhIbIT 6b


Yes 9.1% 5.9% 0.0% 18.2%

Maybe 57.6% 52.9% 60.0% 63.6%

No 33.3% 41.2% 40.0% 18.2%



ExhIbIT 7b















Privacy concerns among workers/participants 8.4% 7.4% 16.0% 3.6%






No barriers 2.8% 5.6% 0.0% 0.0%




ExhIbIT 8b














Disease management program 4.7% 3.7% 4.0% 7.1%

None of the above 11.2% 3.7% 8.0% 28.6%



ExhIbIT 9b



healthy food at staff/trustees’ meetings 29.9% 33.3% 32.0% 21.4%




health coaching 27.1% 35.2% 40.0% 0.0%










None of the above 27.1% 11.1% 24.0% 60.7%



ExhIbIT 10b







blood drives 29.9% 24.1% 56.0% 17.9%



None of the above 20.6% 11.1% 4.0% 53.6%



ExhIbIT 11b








Mental health first-aid training (i.e., training to identify and help individuals who may be developing a mental health problem or in a mental health crisis) 16.8% 18.5% 16.0% 14.3%



Massages 10.3% 11.1% 16.0% 3.6%


None of the above 9.3% 3.7% 12.0% 17.9%



ExhIbIT 12b









Flexible workhours/telecommuting 47.7% 63.0% 52.0% 14.3%




Leadership opportunities outside job hierarchy structure via teams, committees and/or councils 25.2% 24.1% 44.0% 10.7%





None of the above 5.6% 1.9% 0.0% 17.9%



ExhIbIT 13b
















ExhIbIT 14b

Use of Incentives/Disincentives* Overall CP PE ME n = 78 n = 46 n = 20 n = 12




Contributions to health accounts (e.g., hCSAs) 10.3% 15.2% 0.0% 8.3%

Cash awards 7.7% 10.9% 5.0% 0.0%







ExhIbIT 15b


health risk assessment/appraisal 25.5% 37.9% 7.1% 0.0%





Flu shot program 14.9% 17.2% 14.3% 0.0%

health fair 14.9% 17.2% 14.3% 0.0%





ExhIbIT 16b


Very successful 14.9% 17.2% 14.3% 0.0%





ExhIbIT 17b







health fairs 25.6% 30.4% 25.0% 8.3%








None of the above 11.5% 10.9% 10.0% 16.7%



ExhIbIT 18b












None of the above 24.4% 19.6% 25.0% 41.7%



ExhIbIT 19b






None of the above 57.7% 45.7% 65.0% 91.7%


ExhIbIT 20b





None of the above 12.8% 10.9% 10.0% 25.0%


ExhIbIT 21b


Yes 26.2% 35.2% 20.0% 14.3%

No 50.5% 40.7% 64.0% 57.1%

Don’t know 23.4% 24.1% 16.0% 28.6%


ExhIbIT 22b





Diabetes 28.6% 31.6% 0.0% 50.0%


Obesity 17.9% 15.8% 20.0% 25.0%

Smoking 17.9% 21.1% 20.0% 0.0%

heart disease 14.3% 21.1% 0.0% 0.0%

Allergies 7.1% 10.5% 0.0% 0.0%

Cancer 7.1% 10.5% 0.0% 0.0%

Asthma 0.0% 0.0% 0.0% 0.0%




Osteoporosis 0.0% 0.0% 0.0% 0.0%


Not sure 10.7% 5.3% 20.0% 25.0%



ExhIbIT 23b


Flu shot program 43.6% 48.8% 34.2% 33.0%

health fair 38.5% 49.3% 21.7% 21.7%


hRA 36.3% 40.4% 21.0% 28.3%








ExhIbIT 24b



Yes, by an actuary 1.3% 0.0% 0.0% 8.3%


Yes, other 0.0% 0.0% 0.0% 0.0%

No 62.8% 56.5% 75.0% 66.7%

Not sure 17.9% 23.9% 10.0% 8.3%


ExhIbIT 25b


Absenteeism 48.7% 52.2% 50.0% 33.3%


EAP usage 55.1% 63.0% 55.0% 25.0%







Productivity 24.4% 32.6% 5.0% 25.0%




Turnover 34.6% 41.3% 25.0% 25.0%



ExhIbIT 26b


Absenteeism 36.8% 45.8% 20.0% 25.0%


EAP usage 48.8% 51.7% 45.5% 33.3%







Productivity 42.1% 53.3% 0.0% 0.0%




Turnover 33.3% 31.6% 40.0% 33.3%

* Results are among respondents that are tracking each element. N’s differ for each initiative and some are very small.

ExhIbIT 27b


Total 50.5% 23.4% 26.2%


ExhIbIT 28b







Education 3.7% 3.7% 3.6%



Insurance 28.0% 40.7% 3.6%


Nonprofit 2.4% 1.9% 3.6%





ExhIbIT 29b




ExhIbIT 30b

Respondent Region (Canada) Overall CP PE ME n = 107 n = 54 n = 25 n = 28

Atlantic Canada (Nb, NL, NS, PE) 5.6% 3.7% 8.0% 7.1%

Central Canada (ON, QC) 45.8% 61.1% 20.0% 39.3%

Northern Canada (NT, NU, YT) 0.9% 1.9% 0.0% 0.0%

Western Canada (Ab, bC, Mb, SK) 47.7% 33.3% 72.0% 53.6%

ExhIbIT 31b


Fewer than 50 12.1% 20.4% 8.0% 0.0%

50-499 31.8% 37.0% 24.0% 28.6%

500-4,999 40.2% 24.1% 52.0% 60.7%

5,000-9,999 6.5% 11.1% 0.0% 3.6%

10,000 or more 9.3% 7.4% 16.0% 7.1%

workplace wellness trends - timewellspent-ca.anthem.com · workplace wellness trends 2015 survey...

Documents