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1 Welcome Today’s presentation will begin shortly.
In order to hear the audio for this presentation, please turn up your speakers or click on the “Info” tab above this presentation in the upper-left hand corner of your screen. The toll-free dial-in number and access code can be found under this tab. All lines have been placed on mute. If you’d like to ask a question, please use the chat feature in the bottom right corner and send your question to “all panelists.” A PDF of this presentation will be available at 24-hours after the event. The appropriateness and legal permissibility of the wellness programs and strategies discussed in this presentation should be confirmed independently by groups before undertaking. All results described are for purposes of example only. Actual program results will depend on various factors and cannot be guaranteed.

2 Proving Wellness is Important to your Business Strategy
Thanks for joining us today. During today’s presentation, we are not going to be going into great detail about our health and wellness programs like previous events. Instead, today’s presentation is about providing you with information to have a conversation with executive leadership of the importance of wellness and the steps you should take to build wellness into the workplace. We go into greater detail on how to execute wellness in the workplace in later webinar presentations, so if you have not already, you should visit our registration site to sign up for our upcoming topics. But today, we’ll help you to make the argument of why wellness is important to your business strategy and how to get senior leadership invested. May Employer Webinar

3 Healthier employees, healthier companies
Your employees are your most valuable asset. You want them to be healthy, but there’s more to it than that. When your employees are healthy… Productivity can increase Premiums or total medical spending may be reduced Wellness programs and a corporate “culture of health” can help employees change their lifestyle and improve their health Providing wellness solutions for employees is a sound business strategy and can help control costs According to the Bureau of Labor Statistics, the average person spends 53% of their waking hours at work.¹ We all know that healthier employees may lead to healthier companies. Healthy employees are more productive at work and also spend less on medical care. Wellness programs can help increase the health of your employees by encouraging positive behavior changes and building awareness of health. When employees are educated on health, they are more likely to take positive actions to achieve better health. In fact, Dr. Steven Aldana [do we need permission to use his name?] and , renown health and wellness speaker says that if companies are not providing wellness programs then their healthcare costs will escalate at a much more rapid rate than those companies that do offer wellness programs. [this almost seems like scare tactics – is this doctor an appropriate source and are his statements supported? Is he an authority that meets Empire/WellPoint standards?] The reason why is because employees spend approx. 53% of their waking hours at work- that means you have a tremendous opportunity to influence your workforce and encourage healthy habits- which can ultimately impact health care costs for the employee, your as their employer and for our healthcare system. 1. U.S. Department of labor, Bureau of Labor Statistics website, American Time Use (June 2010),

4 A case for 360° Health: Lifestyle behavior
“There is clear evidence that the major chronic conditions that account for so much of the morbidity and mortality in the U.S., and the enormous direct and indirect costs associated with them, in large part are preventable-and that to a considerable degree they stem from, and are exacerbated by, individual behaviors. In particular, overweight and obesity, lack of physical activity, and smoking greatly increase the risk of developing the most serious chronic disorders.” “By changing the way they live, individual Americans could change their personal health status and the health landscape of the Nation dramatically” This graph shows the impact that positive lifestyle behaviors can have on morbidity and mortality. Things like not smoking, taking the stairs, walking at work, eating enough vegetables, and coping with stress in a healthy way can have a bigger impact on health than things like environment and biology combined. [what is the source for this statement? We should not be making blanket statements such as this w/o appropriate back-up] See comments to this slide on hand mark-up. Lifestyle behavior can have a huge impact on the prevalence of chronic conditions. 91% of Diabetes is caused by unhealthy behaviors, 82% of heart diseases and 71% of cancers. [SOURCE & clarify percentages are approximate] Source: Prevention Makes Common Cents” DHHS accessed

5 The Business Value of Wellness
Helping your employees improve their health is one of the best long-term strategies for reducing your health care costs. Based on a 2010 study, Nine out of ten wellness program participants said they had success in losing weight and getting regular checkups More than 80% said that they had increased their level of exercise, improved their diet and nutrition, or managed blood pressure, cholesterol levels, and stress More than half (57%) of employees who participated in their companies’ health & wellness programs said they are very effective at impacting their productivity 8th Annual Study of Employee Benefits Trends, Findings from the National Survey of Employers and Employees, MetLife 2010

6 Employees Expect Wellness
89 % of employees expect their workplace culture to promote healthy lifestyle concepts1 91% of employees believe employers have a responsibility to maintain and improve the health and well-being of their employees2 Nearly two out of three individuals are interested in participating in wellness programs and 20% are even willing to pay extra for a wellness program3 Employees want wellness and expect it. In addition, many employees are so interested in wellness programs that they would pay extra for them Faircloth, Inc 2009) SOURCE: HMC Building a Culture of Health study. Q (outcomes validated Q Results do not relate to Empire members. 2008 Survey of Health Care Consumers. Deloitte Center for Health Solutions.

7 What is Wellness Employer Perception of Wellness
An opportunity to change the lives of employees for the better, resulting in a healthier business through increased productivity and reduced medical Member Perception of Wellness: Wellness is having the energy and vitality to be productive and feel our and perform our best. Definition of a Culture of Health? A Culture of Health as one in which your employees know that it is important to you/the company that they make decisions and behave in such a way as to help them be as healthy as possible. Wellness is defined differently by employer groups and members. Wellness programs help to build a corporate culture of health – which helps employees change their lifestyle. It works similar to peer pressure, but in a positive way! When employees start seeing health successes because of employee programs, other employees are more likely to join in. And a culture of health lets your employees know that you care about their health and well being which helps build employee satisfaction and retention. In addition to the soft benefits, wellness solutions can help companies control health care cost. Concrete goals Tobacco Free Workplace Onsite health coaching 24/7 NurseLine Internally Published Metrics Preventive Health Services Formal Wellness Committee On-site classes

8 What are the Financial Impacts of Having a Culture of Health?
Large companies with a Culture of Health have a greater impact on their medical trend over time From 2006 to 2008, what was the average annual percent change in your medical trend? We used a third party to vendor to conduct telephonic surveys among company decision makers to understand who was building a Culture of Health and what kind of outcomes they were having. Small companies ( employees) = 200 interviews Large companies (1000 employees) = 200 interviews Respondents were read the following introduction regarding a culture of health: “This study is about establishing or maintaining a Culture of Health at your company. You may already have certain programs in place to help employees make healthy lifestyle choices. For the purposes of this survey, please think about a Culture of Health as one in which your employees know that it is important to you/the company that they make decisions and behave in such a way as to help them be as healthy as possible.” A Culture of Health is a comprehensive, consultative program that supports healthier behaviors in your total population of employees and their family members. A Culture of Health engages management’s support from the top-down while empowering your associates to create personal and cultural change from the bottom-up. A Culture of Health results in long-term lifestyle changes of employees, their families and local communities, and increases engagement in all wellness programs being offered by your company. Large companies that do have a culture of health have a greater impact on their medical trend over time. Large = 1,000+ Employees HMC Building a Culture of Health study. Q (outcomes validated Q4 2008). Based on 2009 telephone survey of 400 company decision makers to ask whether they were working to build a “Culture of Health” and, if so, what kind of outcomes they were having. Note that results depend on various factors and cannot be guaranteed. 8

9 What Other Benefits Could my Company See with a Culture of Health?
Companies with a Culture of Health may experience greater outcomes than their peers Perceived Positive Outcomes Compared to Peer Companies (mean Agreement score) 10-point scale: 1= My company is much worse than peer group; 10= My company is much better than peer group This graph shows the variety of benefits that our survey participants saw as a result of their culture of health. As you can see it’s much more than ROI. HMC Building a Culture of Health study. Q (outcomes validated Q4 2008). Based on 2009 telephone survey of 400 company decision makers to ask whether they were working to build a “Culture of Health” and, if so, what kind of outcomes they were having. Note that results depend on various factors and cannot be guaranteed. 9

10 360° Health®: Your Total Health Solution
Wellness can mean different things to people depending on where they are on the continuum. You’ve heard of the health care continuum. It’s the line where people fall when it comes to their health. Those who are fit and healthy are at one end; those who are very sick at the other. And most people fall somewhere in between. We have programs that address a population's health needs along the two main life continuums: 1) continuum of life – infancy to senescence and 2) continuum of health – healthy to at-risk, to chronically ill, and/or to critically ill. 360° Health has relevance for everyone. And our goal is to have products and services that engage all members, no matter where they are on the continuums. 15% of those at the right of the continuum consume 85% of your costs. Examples: Critically Ill member – on a defibrillator or in the intensive care unit Chronically Ill member – diabetes or another condition that has to be managed for life At-Risk member – broken bones due to an accident or unhealthy lifestyle choices (smoking, diet) Healthy member – 80% of the population that is perceived to be in good health

11 360°Health® Programs Management Guidance Tools & Resources
Comprehensive Medical Management: Utilization Management, Case Management, ComplexCare *, NICU * & Transplant ConditionCare * End Stage Renal Disease * Support Programs MyHealth Coach Guidance 24/7 NurseLineSM Future Moms Behavioral Health UM MyHealth Advantage * Pharmacy * Healthy Lifestyles Worksite Wellness EAP Staying Healthy Reminders Productivity Solutions * Tools & Resources MyHealth Assessment MyHealth Record Anthem Care Comparison [Note: Aren’t some of the un-asterisked programs above also included for FI LG’s?] All 360° Health programs are not listed above. Not all programs available to all market segments. The programs listed above are included for fully insured Large Groups accounts (non-bolded). The programs listed in bold are optional and available for Large Group accounts at additional cost. The programs listed with an asterisk (*) may be optional for ASO and may vary by market segment.

12 Anthem resources for you
Wellness Promotion Resources: Time Well Spent ( Wellness Calendar ( MyHealth Assessment Promotional Toolkit on Time Well Spent Employer Guide to Wellness in the Workplace Wellness Topics Employee Survey Wellness at Work flier Here are just a few of the resources and programs that we have that can support wellness for our clients.

13 Approach to Health Promotion & Wellness
Organizational commitment can maximize engagement and outcome Multi-year program helps build a culture of health and wellness awareness and participation Enhances readiness of the population for change Helps foster level of trust and confidence in programs Can increase levels of intervention and engagement Step wise approach can build momentum based on success in prior phases Multiple modalities provide greater accessibility and drive participation Incentive based programs (rewards), when permitted, can provide additional encouragement to increase engagement and participation levels Program Components Over time Member Promotional Campaign Health Promotion & Wellness Topics My Health Advantage Worksite Wellness Healthy Lifestyles Incentives

14 Take it to the next level: Integrate wellness into your workplace
Every company is different so you need to discover what wellness programs would mean the most to your employees: Take a look at your demographics Examine ways that are best to communicate to your employees and don’t forget about their dependents at home as they are the segment of your population that can drive the most cost. Evaluate HRA data Implement an employee survey Work with your Anthem Account team to analyze your claims information to find trends Consider environmental changes (no smoking policy, bike racks) The more information you have, the better your plan will be. We support your employees with the tools they need to get well and stay well, but if you really want to move the needle, then start to integrate wellness into the workplace. The first step is to evaluate your company’s wellness needs.

15 Employer Guide to Promoting Wellness in the Workplace
Helps you and senior leaders start putting a wellness plan into action – step by step Build a wellness team Lay out a specific plan for your wellness campaign Set specific goals and objectives Develop a timeline Delegate roles and responsibilities Itemize a budget Promote health and wellness ideas Begin communicating directly to employees Set up a wellness fair Evaluate your results To help achieve your goal to build a lasting culture of health at your company, the best way to begin is with our Employer Guide to Promoting Wellness in the Workplace. It will help as you get senior leadership to support wellness initiatives from the top down since they can be your best wellness champions by sending s directly to employees encouraging them to participate. Other ideas can include adding healthy tips to regular communications, sponsoring or participating in wellness challenges and even sharing success stories of their own path to wellness. 15

16 Best Practices When You Have a Small Budget
You can encourage healthy behaviors for your employees without a robust wellness budget. Here are some best practices : Executive support Build a Wellness Team Understand what health issues matter most to your employees Provide Access to Discounts and Health Improvement programs Ongoing Communication Create Healthy Competition Measure Outcomes Executive support – this could be as simple as the President sharing a personal health goal with his team or sending out an announcing a health competition. This is also a great opportunity for employees to hear that their management team cares about their health and wellbeing. Ongoing Communication – we have some great tools to help you keep health information in front of your employees on a monthly basis. Provide Access to Discounts and Health Improvement programs – Anthem has great programs that are free to all members that can help you with this piece Create healthy competition - We know that competition ramps up behavior change. Working as a team encourages camaraderie, builds in a support group, and creates a sense of togetherness. Make it fun and be creative.

17 Propose: $tbd/associate:
When you want to Expand your Wellness Program Sample 3 Year Wellness Strategy Increase Company Paid Wellness Credit Propose: $tbd/associate: $tbd/spouse CDH & PPO/Cost-efficient HMOs Wellness programs Introduction of Wellness credits paid out as premium credits in the following year Results (Be in Healthy Range/Show Improvement) Company Paid Wellness Credit: $400/associate; $400/spouse Participation (Programs + Tobacco-Free or Tobacco Cessation Program) Participation (Programs + Tobacco-Free or Tobacco Cessation Program) Company Paid Wellness Credit: $200/associate When you are ready to expand your wellness program we suggest building a three- five year plan. Here is a sample here, this is actually our company’s three year plan. Awareness (Screening + Health Assessment) Awareness (Screening + Health Assessment) Awareness (Screening + Health Assessment) Year 1 Year 2 Year 3

18 Measure Your Results When it comes time to size up your wellness program, you’re going to need proof that your plan is working and how it’s affecting your company’s bottom line. Track attendance of events and competition participation Conduct pre/post surveys to determine the value of the event and if people learned something new or plan to use the information Your wellness plan could have an impact on attendance, sick leave usage, and employee turnover Compare pre/post aggregate program results, biometric screening results, or health assessment results Analyze claims experience and impacts from previous benefit changes Communicate the results to participants, company leadership, and your Anthem rep! When it comes time to size up your wellness program, you’re going to need proof positive that your plan is working and how it’s affecting your company’s bottom line. How should you be measuring it? See how many employees registered for the program. Use surveys and pre/post questionnaires to get feedback on employees and develop next year’s plan. Use aggregate reports from health screenings or the MyHealth Assessment. Check attendance, sick leave usage and employee turnover. What should you be measuring? Ask yourself: Who is participating? Are employees happy with the program? Did they learn anything new? Will they make a behavior change as a result of what they learned? Did their numbers change (weight, cholesterol, blood pressure, etc.)? How to use your results: Keep communicating. Make sure feedback is clear, constant and is shared with management, the wellness team and employees. When providing feedback, recognize employees’ successes by sharing aggregate campaign results and thank everyone who participated. Encourage employees to volunteer and share their successes so they can inspire others. Justify your budget dollars: volunteer time, newsletters, business and professional publications, program enhancements. Let people know! Share success stories with your employees and with your Anthem representative. They can be really great motivators.

19 ROI and The Broader Picture
ROI is difficult to measure, however it’s better to take a comprehensive look at programs to understand the full benefits. Engagement/ Participation Rates Employee Satisfaction & Retention Improved Health Biometrics and Clinical Measures Enhanced Productivity Reduced Absenteeism Reduced Benefit expense (Workers Comp. & Disability included) ROI We all know that ROI is difficult to determine sometimes on wellness programs. The idea is health issue avoidance, so we don’t know what types of costs have been averted because of healthy lifestyle choices. When leadership asks about ROI, be sure to share with them the other ways that program effectiveness can be measured. Engagement/ Participation Rates Employee Satisfaction & Retention Improved Health Biometrics and Clinical Measures Enhanced Productivity Reduced Absenteeism Reduced Benefit expense (Workers Comp. & Disability included)

20 Success Stories

21 Worksite Wellness: Case Study
Client: 5250 employees, Primary manufacturing -- specializing in marketing and publishing services Multiple locations, employees include off site sales teams and seasonal workers. Worksite Wellness Strategy: Offer Health Screenings: Total Cholesterol, HDL, LDL, Triglycerides, Blood Glucose, Blood Pressure, BMI Held 30 on-site events. Added physician fax back options to reach off site employees. Employees received financial incentive for participation in addition to monthly premium contribution based on scoring results. (Additional incentives were available for participation in other wellness programs). , communications from on-site coordinators, letters to the home. Population:  5250 Description:  Visant Corporation, together with its subsidiaries, operates as a marketing and publishing services enterprise serving school affinity, direct marketing, fragrance and cosmetics sampling, and educational and trade publishing markets in the United States, Canada, and Europe. Its Scholastic segment produces, markets, and sells class rings, jewelry, and graduation products, such as caps, gowns, diplomas and announcements, and graduation-related accessories; and other scholastic affinity products to students and administrators primarily in high schools, colleges, and other post-secondary institutions. Biometric screenings were incentivized – $20 credit per month for benefits. Credit is issued if employee participates and falls within a healthy range. In all cases, results depend on various factors and cannot be guaranteed.

22 Worksite Wellness: Case Study
Population Participation: 47.7% (=2504/5250) Screening Results and Satisfaction*: 37.2% of participants had an obese BMI ** (compared to 34.1% of American adults ) 8.1% of participants had high total cholesterol ** (compared to 16.3% of American adults ) 8.1% of participants had high blood pressure ** (compared to the U.S. average of 17.9%) 98% of the attendees found the health screening useful 86% of the attendees learned something new about their health 90% said they would share the information they learned with their physician 89% said health screening motivated them to make at least one healthy behavior change Participation for this client was higher than average because they tied a benefits incentive to the events. Typical participation rates are around 9-15% without incentives. Cash and merchandise can increase the level to 40-45%. Benefit plan incentives drive the highest participation (typically 80-90%) *Source: Hunnicutt, David. Wellness Councils of America (WELCOA) National Wellness Institute The success here is that by implementing some on-site screening, we were able to uncover a lot of people who were at-risk for future conditions and by identifying them, the employer understood what to focus on in terms of benefits, health programs, incentives and wellness communication. *2,325 satisfaction surveys were returned (return rate of 93.8%). Percentages include the number of members who “agreed” or “strongly agreed” with the statements. ** Compare to the most recent U.S. estimates by the Centers for Disease Control and Prevention (CDC)

23 Case Study Lifestyle Management Client Example
3,922 employees, financial institution- locally owned, multiple locations across two states 65% female, average age 41 Lifestyle Management Strategy: Launched Healthy Lifestyles Complete which includes Online, Telephonic and Gym network in January 2008 Drove participation by adding incentives Results 22% of enrollees participated in lifestyle campaigns, which is the highest among benchmark 900K total estimated savings for both health care and productivity during 2010 Estimated 2.8 million saving from thru 2010 Financial institution independent and locally owned company serving multiples communities in the surrounding area. Located in Indiana Multiple locations in Indiana and Kentucky 3,922 Anthem-covered employees and dependents Launched Healthy Lifestyles Complete which includes Online, Telephonic and Gym network in January 2008 Demographics 65% female 35% male Average age of 41 years Delivery – improve Lifestyle Management behavior s by introducing program and incentives. Healthy Lifestyles and Anthem account management teams collaborated with client to implement and customize launch and ongoing marketing Actively participates in all campaigns that Healthy Lifestyles offers 22% of enrollees participated in lifestyle campaigns, which is the highest among benchmark Outcomes: 900K total estimated savings for both health care and productivity during 2010 Estimated 2.8 million saving from thru 2010 In all cases, results depend on various factors and cannot be guaranteed.

24 Case Study Lifestyle Management Client Example
Telephonic Coaching Risk Reduction 2010 program year enrollees reported a total of 994 health risk and have improved or eliminated 36% of those risks. In the 2009 program year 1,119 health risks were reported and enrollees improved or eliminated 33% of those risks. In the 2008 program year, 2,541 health risks were reported and participants improved or eliminated 29% of those risks. Almost two-thirds of the eligible population is enrolled and nearly three-quarters of enrollees have completed a Health Assessment (HA). Client is best in class compared to the Book of Business (BoB) for all 2010 utilization metrics. At 64% of telephone coaching referrals exceeded the BoB rate of 57% even though most clients in their third year see a decline. 65% of members continued to enroll in year three for lifestyle programs which is 25% above enrollment for 2008 and 31% above our BoB metrics. Other Key Facts: 51% of enrollees with high risk for exercise habits dropped to 33% - a 35% reduction since 2008. 43% of enrollees improved their risk profile for stress dropping to 19% a 56% reduction. 51% of enrollees improved their risk profile for body weight dropping to 35% - a 31% reduction . Telephone coaching program results are considered for each program year. The 2010 program year is still in progress and will conclude on December 31, 2011 to allow individuals to complete 12 months of coaching support.

25 It Doesn’t Take Much to Move the Needle
Once you have wellness programs for your employees, you can have a greater impact on future health care costs For people with pre-diabetes, lifestyle changes, including a 5%–7% weight loss and at least 150 minutes of physical activity per week, can reduce the rate of onset of type 2 diabetes by 58%1 A 1% reduction in health risks such as weight, blood pressure, glucose, and cholesterol risk factors would save $83 to $103 annually in medical costs per person2 For every gram of salt that Americans reduce in their diets daily, a quarter of a million fewer new heart disease cases and over 200,000 fewer deaths would occur over a decade3 As you can see from these statistics that once wellness programs in place they can have a big impact on employee health very quickly. Just a 5-7% weight loss and regular exercise can reduce a pre-diabetic’s onset of Type 2 diabetes by 58%. In the same vein, health programs that help to reduce health risks like weight, blood pressure, blood surgar and cholesterol would equate to $83 to $103 in medical costs savings per person. So we encourage you to take the information you’ve heard today and get started. Help your employees achieve their wellness goals and you’ll see a positive impact to your overall bottom line. 1 National Diabetes Education Program Provider toolkit Your Game Plan for preventing type 2 diabetes 2003 2 Henke, R.M., Carls, G.S., Short, M.E., Pei, X., Wang, S., Moley, S., Sullivan, M., and Goetzel, R.Z. (2010) The Relationship between Health Risks and Health and Productivity Costs Among Employees at Pepsi Bottling Group. Journal of Occupational & Environmental Medicine, 52(5), 519–527. 3 American Heart Association’s 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention 2009

26 Sign Up for Other Events in 2012
June 20th Wellness on a Dime: Low or No cost Wellness tools to help you build your Wellness Strategy July 18th Amp it Up- What you can do to get your employees engaged: Employer success stories and Open Enrollment opportunities August 15th Walking the Walk: How to plan a health fair and other on-site wellness events September 19th Free Wellness Tools on Online resources to help employees manage their health stop smoking and lose weight We’d like to share our upcoming webinar topics to register for any of these events, visit Sign up at:

27 Q & A Session If you would like to pose a question to our presenter, please type in the Q&A box to the right side of your screen and send to all panelists Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

28 Thank You! If you have further questions, please contact your broker or Anthem representative.

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