1. Property of Occupational Care South Africa (Pty) Ltd.1 RGA TECHNICAL SEMINAR: INTEGRATION AGATHA PRETORIUS, MANAGING DIRECTOR OCTOBER 2008

2. Property of Occupational Care South Africa (Pty) Ltd.2 OCSA aims at reducing healthcare related cost by identifying and managing the wellness risk of the human capital RISK BASED EMPLOYEE WELLNESS

3. Property of Occupational Care South Africa (Pty) Ltd.3 An average of 33% of payroll cost are spent on employee health:  Medical scheme company contribution  Disability and life insurance premiums  Sick leave  Occupational health OCSA believes that a changed paradigm of integrated employee wellness can drastically reduce this. Property of Occupational Care South Africa (Pty) Ltd.3 FINANCIAL IMPACT OF HEALTHCARE COST

4. Property of Occupational Care South Africa (Pty) Ltd.4 4 WORKPLACE  Risk exposure e.g. chemicals, ergonomic  Shift work  Working away from home LIFESTYLE  Smoking  Drinking  Promiscuity  Attitude to risk factors MEDICAL RISK  Tendency to develop serious conditions  Acute conditions INJURIES  On duty  Off duty CHRONIC DISEASE  HIV / AIDS  Hypertension  TB  etc. ABSENTEEISM  Trends MANAGER’S INPUT  Concerns  Complaints  etc. PSYCHOLOGICAL  Relationship  Financial  Work environment e.g. stress, job satisfaction EMPLOYEE WELLNESS INTEGRATED RISK APPROACH TO EMPLOYEE WELLNESS

5. Property of Occupational Care South Africa (Pty) Ltd.5 5 HOW DO OCSA IMPLEMENT RISK BASED INTEGRATED WELLNESS? Sick leave records Workplace risk assessments Consultations Questionnaires Wellness Days Interviews Cost calculations & predictions Benchmarking Database approximately 150 000 employees Integrated report Data Collection Reporting OCSA IWS

6. Property of Occupational Care South Africa (Pty) Ltd.6 6 RISK BASED INTEGRATED WELLNESS CYCLE RISK BASED INTEGRATED WELLNESS Determine Risk Recommendations to HR / Management Early intervention and prevention Measure effect of interventions Corrective actions

7. Property of Occupational Care South Africa (Pty) Ltd.7 Absenteeism Presenteeism Premature ill health retirement Chronic illness (HIV, hypertension, etc.) Occupational injury Occupational related disease Cost estimation Property of Occupational Care South Africa (Pty) Ltd.7 DETERMINE RISK

8. Property of Occupational Care South Africa (Pty) Ltd.8 Wellness programs Vaccinations e.g. Flu Awareness campaigns Regular health monitoring of employee Case management E.A.P. Travel advisory service Absenteeism management Deployment of employee Involvement of family Property of Occupational Care South Africa (Pty) Ltd.8 EARLY INTERVENTION AND PREVENTION

9. Property of Occupational Care South Africa (Pty) Ltd.9  Productivity  Absenteeism  Presenteeism  Injuries  Periods of incapacity  Premature ill health retirement Cost saving Happier employee (less stress related conditions) Property of Occupational Care South Africa (Pty) Ltd.9 EFFECT OF INTERVENTION

10. Property of Occupational Care South Africa (Pty) Ltd.10 OCSA undertook a study to measure the effect of flu vaccines on the sick leave taken for colds and flu’s over the period 1 March 2007 – 31 March 2007 Involved 4148 employees 38.6% (n=1600) received flu vaccines @ R32 per vaccine Property of Occupational Care South Africa (Pty) Ltd.10 FLU VACCINE CASE STUDY

11. Property of Occupational Care South Africa (Pty) Ltd.11 Property of Occupational Care South Africa (Pty) Ltd.11 FLU VACCINE CASE STUDY SICK LEAVE TAKEN FOR COLDS AND FLU’S Total Employees: 4148 Employees who received flu vaccines: 1600 Number of employees who took sick leave for colds and flu’s Total number of sick leave days taken for colds and flu’s 32.1% (n=1333) 3033 0.12% (n=2) 7

12. Property of Occupational Care South Africa (Pty) Ltd.12 Average sick leave days Average sick leave days for colds and flu’s per incident = 2.27 days per incident Property of Occupational Care South Africa (Pty) Ltd.12 FLU VACCINE CASE STUDY

13. Property of Occupational Care South Africa (Pty) Ltd.13 Property of Occupational Care South Africa (Pty) Ltd.13 FLU VACCINE CASE STUDY FINANCIAL IMPACT OF SICK LEAVE TAKEN FOR COLDS AND FLU’S Average daily rate per employee = R310 Total Employees: 4148 Employees who received flu vaccines: 1600 Total cost of sick leave taken for colds flu’s = Average daily rate X days sick leave R310 X 3033 days = R940 230 4148 = R226.67 per employee R310 X 7 days = R2170 Average sick leave cost per employee = Total sick leave cost Total employees = R2170 1600 = R1.35 per employee Total cost per employee including flu vaccine = Flu vaccine + Average sick leave cost per employee who received flu vaccine = R32+R1.35 = R33.35 per employee

14. Property of Occupational Care South Africa (Pty) Ltd.14 CONCLUSION The administration of 1600 flu vaccines resulted in a cost saving of R53 360 (R193.32 per employee) If 80% (n=3318) of the employees received flu vaccine the cost saving might have been R 641 436 (R193.32 per employee) We can therefore assume that the administration of flu vaccines can reduce the cost related to sick leave significantly. Property of Occupational Care South Africa (Pty) Ltd.14 FLU VACCINE CASE STUDY

15. Property of Occupational Care South Africa (Pty) Ltd.15 In 2006 OCSA measured the number of sick leave days taken by overweight and obese employees. Involved 545 employees Overweight / obese employees contributed towards 20% of the sick absenteeism days taken This equates to a cost of R700,077 Note that the sick leave was not due to overweight or obesity. Further investigation needed to determine if the leave was due to health related problems linked to obesity. Property of Occupational Care South Africa (Pty) Ltd.15 RELATIONS BETWEEN OVERWEIGHT AND SICK LEAVE

16. Property of Occupational Care South Africa (Pty) Ltd.16 NUMBER OF RISK INDICATORS PER AGE GROUP

17. Property of Occupational Care South Africa (Pty) Ltd.17 Integrated risk based wellness approach contains cost and contributes to a healthier employee Property of Occupational Care South Africa (Pty) Ltd.17 CONCLUSION

18. Property of Occupational Care South Africa (Pty) Ltd.18 FOR FURTHER INFORMATION PLEASE CONTACT AGATHA PRETORIUS, MANAGING DIRECTOR 011 803 3538 083 325 6821 OR VISIT OUR WEBSITE: WWW.OCSA.CO.ZA