1. 1 Health Management A Mandatory Business Practice Presented by Erick Hathorn, Health Management Practice Leader

2. 2 Today’s Agenda Why Wellness Today’s Reality Healthcare is Changing Gallagher Health Management

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4. 4 Every 100 Employees 68 are overweight or obese 21 smoke 31 use alcohol excessively 20 don’t wear seatbelts 24 don’t exercise 25 have cardiovascular disease 12 are asthmatic 10 are diabetic 26 have high blood pressure 30 have high cholesterol 4 suffer from stress

5. 5 The Facts Heart Disease Costs Employers $18,618 PEPY $5,617 Healthcare Plan $6,052 Sick Leave $4,845 STD $981 Workers Comp. $945 Unpaid Leave $178 LTD Smoking Costs Employers $5,318 PEPY $2,295 Excess Medical Expense $2,175 Smoke breaks $465 Absenteeism $206 Death $176 Workers Comp. Diabetes Costs Employers $11,744 PEPY More

6. Cost Reality

7. 7 Obesity is an Epidemic 68% of the American population is either overweight or obese Obese Employees are 4x more likely to be absent from work Obese Employees pay 77% more in RX 36% more at Physicians 45% more for hospital stays OUCH!

8. 8 1999 Obesity Trends* Among U.S. Adults 1990, 1999, 2009 2009 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

9. 9 High Claims & Body Weight

10. 10 High Claims & Inactivity

11. 11 Today’s Reality

12. 12 Healthcare is the second largest business expense to most organizations 87% of corporate leaders listed rising healthcare costs as their #1 concern

13. 13 Industry Misconceptions Wellness – Wellness is not screening your employees, its helping them make better health decisions Engagement – Engagement is the value proposition between the company and employee Return On Investment – There is no such thing as a like company. There are over 50 different variable to consider. Budget – Wellness programs are expensive

14. 14 Why Healthcare Costs Continue To Rise AdministrativeInflationTechnology Sedentary Society

15. 15 How the Industry has Managed Rising Healthcare Costs Increased Employee Contributions Decreased BenefitsSwitched Carriers

16. 16 Healthcare is becoming a question of Sustainability 10% Trend

17. 17 The Total Impact of Health Productivity Costs Presenteeism Absenteeism LTD STD Overtime Turnover Temp Staffing Administrative Replacement Retention 25% of Cost 75% of Cost Medical Health Costs Medical Care Pharmacy $3,376 PEPY $10,128 PEPY

18. Keep the Healthy, Healthy Claims Continuum 20% 75% Contributing Factors: Aging Population Obesity Inactivity Stress Smoking 50% of claims cost --- Chronic Condition Chronic Disease

19. 19 Healthcare is Changing

20. 20 The Evolution of Health Management 1930’s Risk Management 1970’s Disease Managemen t 1990’s Wellness 2010’s Enterprise Health Management

21. 21 From Disease & Cost, to Health & Investment Enterprise Health Management Wellness Disease Management Care Management RxHealth Advocacy Behavioral & Clinical Coaching Culture & Environment Absenteeism & Presenteeism Behavioral HealthOnsite MedicalCommunications Benefit Plan Design & Incentives Aligning Your Company Vision With That of Your Employees A Shift In Thinking

22. 22 Zero Trend Healthcare Breaking Down Barriers & Driving Engagement Incentives Lead to participation 1st Participation Leads to Employee Engagement 2nd Engagement Leads to a Cultural Shift 3rd A Cultural Shift Plus Empowered Employees Leads to Trend Reductions 4th Wellness is not finding out what’s wrong; its fixing what’s wrong.

23. 23 Incentives Lead to Engagement Contribution Premium Differential (Incentive/Disincentive) Eligibility Participation on Insurance Participation on Richer Plan Plan Design Diabetes Plan Design Waiver of Deductible/Coinsurance Rewards—Gift Cards or Prizes

24. 24 Healthcare Reform & Legislation 20% Employee Premium Differential for Attainment 2014 30% Employee Premium Differential for Attainment

25. 25 Keys to Success Communication Strategy The Assessment – Strive to Maximize Participation The Fix – Four key behavioral change components Weight Management Physical Activity Stress Management Tobacco Coaching – Clinical & Behavioral Integration – Wellness and Disease Management

26. 26 Gallagher Health Management

27. Exclusive Prepared By Wellness starts with Communication

28. 28 The Science of Engagement Stages of Behavior Change Communication FocusCommunications Activities and Resources Pre-contemplation Capturing participant attention Ongoing promotion of Healthy Enterprise components through postcards, newsletters, annual enrollment communications, Web site features, etc. Promotion of program incentives to drive initial entry into program (e.g. via health risk assessment) Contemplation Relating to the participant and his/her needs Health risk assessment follow-up communications with clearly identified next steps and actions Promote preventive care benefits Preparation Education Connecting the participant with information regarding programs that target his/her condition – or lifestyle-specific needs Action Support Connecting the participant to lifestyle coaching or disease management resources Explanation of how the benefits program supports participant’s health needs Maintenance Engagement and sponsorship Recognition and promotion of participant success stories (via testimonial) Check-in communication with the participant at regular intervals

29. Readiness For Change Evaluation Inventory

30. Building A Case For Wellness

31. Market Scans Master Profile Carrier Drill Down

32. Multi-Year Plan

33. 33 Thank You