Health Management & Wellness: A Global Perspective Carl Redondo | Marion May

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Welcome and Introductions Carl Redondo Global Benefits Consulting Leader, UK 15 years with Aon Hewitt in London, Seoul, Hong Kong and Shanghai Helps multinationals and big locals with employee benefits issues around the World Marion May Senior Global Benefits Consultant, London 5 years with Aon Hewitt’s global benefits consulting practice Develops and implements strategic health and wellbeing solutions for clients Joining via Webex Approximately 150 clients from around Europe representing major multinationals

1 2 3 4 5 Agenda Introduction – The Coming Crisis in Global Health Carl Redondo 2 Global Healthcare Trends – Aon Hewitt Survey 3 Wellness Trends Marion May 4 Absence Management 5 Q & A

The Coming Crisis in Global Health Delivery of health insurance benefits globally is under major financial pressure The reasons are as follows: 1. Populations are living longer— putting extreme financial pressure on social care 2. Medical Cost Inflation (MCI) is continuing to rise rapidly in most countries 3. Lifestyle risk factors are growing globally—the global burden of non-communicable disease is now greater than that of communicable disease 4. Workforces are aging in most countries (1–2 years every 5 years) 5. Major competitive pressure to expand scope of private health insurance benefits 6. Employers are coming under pressure to provide retirees with access to group health insurance in many countries Costs of health insurance is increasing by 3% - 5% above GDP in most markets around the World

Medical Trend Rates and Non-Communicable Diseases Increases in year on year costs for members of EU Measure 2013 2014 Inflation 2.0% Real GDP 0.4% 1.6% Medical costs 6.2% 5.9% Source: European Commission Autumn 2013 Economic Forecast, Aon Hewitt 2013/4 Global Medical Trend Rate Survey Key causes of medical claims around the World   Asia Pacific Europe Latin America Middle East/Africa 1 Respiratory 47% Cancer 60% 68% 67% 2 Gastrointestinal Mental Health 45% 58% Diabetes 56% 3 40% 53% 33% 4 Infectious Diseases 35% Prescription Drugs 42% Gynaecological 5 27% 25% Accident Source: Aon Hewitt 2013/4 Global Medical Trend Rate Survey

Aon Hewitt Healthcare Study

2011/12 Health Care Survey – Participant Profile A total of 1,028 individuals participated in Aon Hewitt’s 2011/12 Global Health Care Survey. The participant profile by overall worldwide employee size is as follows:

Health Strategy – Top 5 Desired Outcomes Participants asked to select top 3 desired outcomes

Health Strategy – Top 5 Challenges Participants asked to select top 3 biggest challenges

Health Strategy – Top 5 Priority Tactics All are wellness related activities Participants asked to select top 3 tactics to achieve strategy

Reduce Expenses – Absence Management Participants asked the metrics used to measure the impact of absence

Improve Workforce Health – Strategy Components Participants asked what the components are of workforce health strategy

Improve Workforce Health – Key Tactics

Improve Workforce Health – Future Trends

Total Health Management – Integrating Wellness and Absence

Wellness trends

Employers’ responsibility Trends in Wellness Clear goal setting Trends Employers’ responsibility Global Wellness Solution Metrics and ROI 17 17

What do Recent Surveys Tell Us? 48% of employees said say stress negatively impacts their lives, and 17% say they get no support from their employer – Canada Life Feb 2013 68% of respondents think their employer should take responsibility for their general health at work – British Heart Foundation Jan 2013 After introducing health-related benefits, 83-89% respondents reported increased productivity, improved wellbeing and reduced sickness absence – Aviva Dec 2012 78% of employers would consider contributing towards the cost of cancer screening for employees – Helm Godfrey Jun 2012 45% of respondents said long-term absence is a big concern and 22% indicated that it affected the business financially – Aviva Health Aug 2012

Global Recognition of Employer’s Role “The wealth of business depends on the health of workers.” Dr. Maria Neira, Director, Department of Public Health and Environment, The World Health Organisation Definition of a Healthy Workplace A healthy workplace is one in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety and well-being of all workers and the sustainability of the workplace by considering the following, based on identified needs: • health and safety concerns in the physical work environment; • health, safety and well-being concerns in the psychosocial work environment including organization of work and workplace culture; • personal health resources in the workplace; and • ways of participating in the community to improve the health of workers, their families and other members of the community.

The Growing Role of the Employer Employers say they share responsibility for their employees’ health 0% see this as only a government responsibility Source: Hewitt’s 2010 Global Health Promotion Survey

What are Employers Doing? Percentages of Companies with Programmes to Combat Non-Communicable Diseases 2013 2014 Incentives for Exercise 21% 35% Physical Health 23% 42% Stress Reduction 14% 32% Anti Smoking 37% 74% Anti Alcohol 61% Source: The Workplace Wellness Alliance. Delivering on Health and Productivity (2011) WEF

What are Employers Doing? Programmes/Services Offered in 2012 Offered in 2013 Absolute Increase Biometric screening 63% 71% 8% Physical activity challenges 47% 53% 6% Telephone health improvement coaching 46% 52% Nutrition programmes 31% 37% Stress reduction initiatives 29% 35% Source: Aon Hewitt 2013 Health Care Survey

Improving productivity Employee engagement Goals - Why do Wellness? Improving morale Improving productivity Employee engagement Talent retention and attraction Reducing sickness / absence Reducing healthcare costs (direct and indirect) Employer of choice Social corporate responsibility Reducing presenteeism 23

Health and Wellbeing Model What might a Global Wellness Programme look like? Generally, significant increase in interest among global companies and an increasing number are moving to action 3 Categories of Employers Global EAP/Challenge Lifestyle Focus Health and Wellbeing Model A starting point Relatively low cost and low risk Reasonably mature marketplace Some programme expansion possible through additional services Solution driven by corporate; adopted locally Primary focus is lifestyle behaviour modification (common: smoking cessation, nutrition, sleep, and exercise) One-stop shop solutions are emerging - simplified administration Solution driven by corporate – adopted locally Broader philosophical view of health and wellbeing Core components driven by corporate Core programmes localised based on in country needs and risks Significant emphasis on local programme expansion beyond the core

ROI Health metrics Engagement metrics Productivity metrics Wellness ROI Improved Outcomes Health metrics Building Engagement Engagement metrics ROI Productivity metrics Cost Reduction (indirect & direct)

Absence Management

Total Health Solution UK – A Case Study An outsourced absence recording and monitoring service, identifying absences for early intervention, providing support and advice to employees A specialist psychologist led service for stress related absences, providing initial assessment and treatment A specialist absence case management service where the referred absence is reviewed and actions are recommended to enable the employee to return to work at the earliest opportunity A service providing clinical advice and support to employers for employees with health problems that are impacting on work performance 24/7/365 confidential helpline offering lifestyle support and advice to employees. Services include short term counselling options and lifestyle support services such as debt management, legal information and child/elder care services A specialist service providing physiotherapy rehabilitation treatments

What does Absence Management Deliver ? Certainly: Insight into health risks Reliable absence data Lower absence rates Lower insurance premiums Return on investment Integrated view of health Reference point for wellness/preventative campaigns Potentially: Information about reasons for absence Improved employee engagement Healthier behaviours leading to employee wellbeing both physically and mentally

Conclusions

Why Focus on Health Management ? Good for Employees Good for the Organisation Lower sickness absence Lower sick pay Lower long-term disability claims Lower turnover Lower retention and recruitment costs Lower temp agency costs Better Health & Safety record Good governance

How Aon can Help? Wellness: Audit and strategy development Implementation Communication Monitoring Absence management:

Q&As