From awareness to action: Employee wellness

The inside story of how one employer tackled double-digit health-care increases
By Jennifer Hubbard
|Canadian HR Reporter|Last Updated: 01/31/2011

Organizations categorize many initiatives under the moniker of wellness, including recognition programs, time off in lieu of overtime and flexible work arrangements. While these may contribute to well-being, their relationship is indirect.

But approaches are emerging that are much more strategic and targeted at addressing health risks. Companies are starting to:

• use health-risk assessments to identify risk areas

• implement health clinics, education programs, and health and disease management coaching to build awareness

• use incentives to motivate behaviour changes.

Case study: Tackling wellness

The Economical Insurance Group (TEIG) is a property and casualty insurer with about 2,500 employees across Canada. But a few years back, the company’s medical plan costs had been increasing at an annual rate of eight per cent to 12 per cent.

So members of the HR department began to think seriously about the wellness strategy in the summer of 2008. TEIG needed a program that would meet the following goals:

• Build employee awareness of individual health.

• Enhance employee engagement.

• Reward employees for a broad range of wellness behaviours.

• Enhance organizational health.

• Have the flexibility to evolve as needs changed.

•Produce measureable results in group benefits experience, absenteeism and other key areas in three to five years.

To execute a program that would meet the goals, HR hired a benefits consultant to provide guidance on how the company could leverage its flexible benefit plan. TEIG’s benefits carrier also provided information. The executive team then approved the necessary funding and the corporate communications group assisted in delivering the message.

For the first year, the company focused on enhancing the awareness of individual employees and overall organizational health, as this would set the baseline for future strategies and initiatives. A wellness campaign was designed, including biometric clinics and wellness assessments, and a new personal wellness account through the flexible benefit plan was introduced.

Employee screening clinics

The biometric screening clinics involved voluntary, confidential 15-minute appointments with a registered nurse to look for six heart disease risk factors. Employees were provided with wallet cards documenting their measures so they could monitor changes speak with their physicians and enter the information into their wellness assessments.

The nurses provided high-level health coaching to those who demonstrated significant risk factors. On a number of occasions, employees were counselled to visit their physicians at their first opportunity.

Almost one-half (48 per cent) of employees participated in the biometric screening clinics. A satisfaction survey was conducted with all clinic participants and it was overwhelmingly positive, with many people requesting annual clinics.

The confidential wellness assessment was housed on the benefit carrier’s website and contained 32 questions assessing 10 health risks (such as health habits, readiness to change, culture and productivity). Each employee received an individualized report summarizing their results, along with tips to improve areas needing attention. Employees who completed the assessment within the promoted time frame were provided with $300 in wellness credits deposited into a personal wellness account through their flexible benefit plan. More than one-half (54 per cent) of employees participated.

Communication of this program was highly intensive and critical to its success. Over the course of six weeks, employees received information in the form of posters, emails and links to more detailed information. They were asked to sign up for biometric clinic appointments through an online calendar system. Leaders were provided with information so they could “chat up” the initiative.

While employees became more aware of their overall health, so did the company. TEIG received an aggregate report of biometric clinic and wellness assessment information in order to focus future wellness initiatives on specific risk areas.

One of the report’s findings was employees had high proportions of body fat. While this is consistent with sedentary environments, it is a concern that will be addressed through TEIG’s wellness strategy. The wellness assessment report also revealed 83 per cent of participants were not receiving proper nutrition and only 41 per cent were eating five or more servings of fruit and vegetables per day. TEIG also learned 83 per cent of employees were ready to change their eating habits.

Challenging, rewarding employees to get healthy

Building on the 2008 awareness campaign with a more robust communication strategy, the 2009 wellness campaign again included biometric clinics and the wellness assessments. It also required employees to take action by participating in a team wellness challenge focused on the particular risk areas identified in the aggregate report. Teams worked toward common health goals and logged activities using an online journal. Individual scores were combined to make team scores and the team with the most points won.

The main challenge included: a minimum amount of physical activity and bonus points for nutrition, drinking water and taking time for oneself. Employees who did the team challenge were rewarded with $150 for their personal wellness accounts while those who completed a wellness assessment received a further $150. However, the incentive strategy changed from the first year to the second year. This is a purposeful, multi-year approach that progressively requires employees to adjust behaviours.

The current wellness campaign builds on the momentum created in previous years. TEIG is now in a position to create a holistic wellness strategy, encompassing all components of employee health and well-being, including the wellness program, employee assistance program, occupational health and safety program and medical absence management.

To more effectively spread the wellness word, TEIG has also created a committee of wellness ambassadors at each location. These people are passionate about health and well-being and have volunteered to champion wellness activities, address wellness-related inquiries, ensure wellness communications are effectively and efficiently distributed, and participate in quarterly meetings to feed information to the HR department.

To create a year-round focus on physical activity, the company also created and launched a four-week spring walking challenge that involved more than 70 per cent of employees walking more than 111,000 kilometres. Senior executives acted as role models by sharing their personal wellness-related stories.

These initiatives, together with the successful biometric screening clinics, wellness assessments and the fall team wellness challenge, will keep wellness front and centre at TEIG.

Measuring the results

Reviewing the results against objectives has proven gratifying. Employees are learning more about their individual health — 92 per cent of biometric screening clinic participants said it helped them learn more about cardiovascular health and 71 per cent said they will be making changes to their lifestyle.

And the wellness program is evolving. In the first year, the focus was on building awareness. In the second year, it continued the learning and caused employees to take action. In the third year, it intends to challenge employees and sustain behaviour change. Finally, within another two years, the program should see measurable improvements in the group benefits experience and absenteeism.

TEIG believes it has developed a program that is accessible to a large proportion of employees, regardless of location or comfort level with physical activity. The rewards include testimonials from employees who have begun to change their lifestyles and see real health gains. Ultimately, through careful measurement and monitoring, it is hoped the wellness campaigns that are now part of TEIG’s benefit offering will enhance employee health, engagement and productivity, and help to contain rising health-care costs.

Jennifer Hubbard is assistant vice-president of HR at the Economical Insurance Group in Waterloo, Ont., where she has led the design, development and delivery of rewards programs for the past 10 years.

Tips for employers

10 steps to healthy wellness plan

Understand the current state and build the case for change: When developing a wellness business case, communicate the issues in the current environment. Consider the experience of the benefit plan, absenteeism rates and the kind of feedback employees are providing. Externally, consider what is happening socially, competitively and in the labour market. This information will help build the case for change.

Set objectives: The objectives for the organization will depend on the health and wellness circumstances of collective employees, and what your organization has previously offered. This will depend on factors such as how many employees are in your organization, where they are located and the amount of available funding.

Gain support from key stakeholders: Determine who in the organization you need on your side and engage them in the process.

Partner with great service providers: Sourcing a vendor to schedule and run biometric screening clinics at TEIG’s 18 locations would have been a nightmare. But, in this case, the vendor liaised wtih a contact in each location. For employees, scheduling a session with the nurse was a breeze, all through an online booking tool.

Use rewards to motivate behaviour change: The initial incentive was generous. TEIG needed to make its program competitive so it took a large step up from its former fitness reimbursement program. Depending on your culture, you may not need to use as significant an incentive.

Do what you can with what you’ve got: When time is short, ensure you communicate the basics. The sizzle is extra and can come when you have the necessary resources.

Leverage all the data: The aggregate reports provided about 80 pages of data and analysis from both the clinics and the wellness assessments. This helped target campaigns to problem areas.

Link program design to objectives: TEIG rewarded people for continuing to raise their awareness and an equal amount for taking action. This will continue to evolve.

Ensure the program fits the organizational culture: TEIG employees are competitive and participation increases when departments or teams compete against each other. The company has seen this behaviour through its United Way campaigns, food drives and social activities. But this may not be the case in a different organizational culture — such as one that is more individualistic or where people are more private. For a program to work, it cannot fight the culture.

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