1. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 1 prepared for: CIGNA September/October 2008 Health & the Economy

2. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 2 In addition to the cost of gas, healthcare and keeping up with the cost of living, Americans show high concern for today’s economy. –Ninety percent of Americans are very/a little worried about the economy. Those generations approaching retirement show higher economic concern, as over 7 in 10 Americans between the ages of 45 and 64 are very worried. –Since September, more Americans are very worried about the stock market. Again, Americans between the ages of 45 and 64 are most worried. About one in three Americans say that today’s economy has caused them to change their health behavior. –Of those that admit the economy has impacted their health behavior: Over half (55%) say they are taking better care of their health. –To achieve this end, more than six in ten say they are exercising more and eating healthier. While four in ten (41%) say they are taking worse care of their health. –Thirty-five percent of these Americans say that they are not going to the doctor as often/at all as a result. There Is a Link Between the Economy and American Health Behaviors

3. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 3 Please tell me whether you are very worried, a little worried, or not at all worried about: (Summary of Very/A little worried) America’s Top Three Concerns: the Economy, the Cost of Gas, and the Cost of Healthcare America’s Top Three Concerns Roughly half of Americans are also very worried about keeping up with the cost of food (46%), cost of living (54%), and the cost of medicine (50%). A little worriedVery worried 92% 91% 88% 87% 80% 69% 65% 43% 87% *Base: Among Total, N = 1,004. Data from September 12 th – 15 th.

4. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 4 Please tell me whether you are very worried, a little worried, or not at all worried about: (Summary of Very/A little worried, Data from Oct. 2 nd – 5 th ) The Economy Remains the Number One Concern *Base: Among Total, N = 1,004. Data from October 2 nd – 5 th. America’s Top Concerns Since September 12 th – 15 th, more Americans are “very worried” about the stock market. Other areas have seen a decline in the number “very worried.” A little worriedVery worried 90% 86% 79% 76% 72% 58% 37% 79% 11 percentage point increase saying “very worried” since Sept. 12 – 15

5. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 5 Women are more likely than men to change the way they take care of their health because of today’s economy (41% vs. 30%). Has today’s economy caused you to change the way you take care of your health? The Economy Has Impacted a Third of Americans’ Health Behaviors *Base: Among Total, N = 1,004. Data from September 12 th – 15 th. MenWomen Yes30%41%

6. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 6 Women are still more likely than men to change the way they take care of their health because of today’s economy (26% vs. 36%). Has today’s economy caused you to change the way you take care of your health? (Data from Oct. 2 nd – 5 th ) With Volatility in the Market, About a Third Still Say Their Health Behaviors Have Been Impacted *Base: Among Total, N = 1,004. Data from October 2 nd – 5 th. MenWomen Yes26%36%

7. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 7 Many Americans Are Taking Better Care of Their Health Due to the Economy *Base: Among Those that said Yes, the Economy has Changed My Health Behaviors, N = 334 compared to Among Total, N=1,004 (Sept. 12 – 15) And as a result of today’s economy, are you taking better or worse care of your health?* Among those who say that today’s economy has caused them to change the way they take care of their health, over half say they are taking better care (55%). Has today’s economy caused you to change the way you take care of your health? MenWomen Better Care54%56% Worse Care41%

8. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 8 Americans Say They Are Exercising More and Eating Healthier to Stay On Top of Their Health What sorts of things are you doing to take better care of your health?* (Unaided question, multiple responses recorded) *Base: Among Those that said Yes, the Economy has Changed My Health Behaviors AND I’m taking BETTER care of my health, N = 168 (Sept. 12 – 15) And as a result of today’s economy, are you taking better or worse care of your health?

9. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 9 For Those Who Are Taking Worse Care, Many Are Not Going To the Doctor as Often *Base: Among Those that said Yes, the Economy has Changed My Health Behaviors AND I’m taking WORSE care of my health N = 148 (Sept. 12 – 15) How are you changing the way you take care of your health?* (Unaided open-end, responses were coded) And as a result of today’s economy, are you taking better or worse care of your health?

10. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 10 Americans recognize the importance of their health, and many would like ways to improve it. –Nine in ten agree/strongly agree that now more than ever a healthy diet and regular exercise are crucial to safeguarding their health. –Thirty-six percent say their health is important and that they exercise and eat well whenever they can, and just over a quarter (27%) say they work on their health every day. –Looking ahead, many Americans say they will be more likely to engage in specific healthy behaviors such as exercising and eating healthier in response to today’s economy. –However, about a third (30%) of Americans recognize they should be doing more or could use help. Many Americans recognize that maintaining a healthy lifestyle will benefit them in the long run, including increased wealth and saving money. –Seventy-eight percent of Americans believe that exercise and eating right can save you money in the long run. –More than six in ten (65%) agree/strongly agree that “Better health can lead to greater wealth.” –Over half (54%) believe that a healthy lifestyle can help you earn more money in the long run. However, today’s concerns (cost of food, cost of healthcare, the economy, etc.) are preventing some Americans from investing in those long term benefits: –Many Americans agree/strongly agree that healthy meals are more time consuming (44%) and difficult to prepare (36%). –Sixty-three percent of Americans agree/strongly agree that healthy foods cost more than unhealthy foods. –Almost half (49%) agree/strongly agree that “being healthy is expensive.” Americans See the Benefits of Investing in Good Health, Yet Many Perceive Cost As a Barrier

11. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 11 And fewer than one in four (22%) agree that it takes too much time to exercise. Now More Than Ever: Exercise and a Healthy Diet Are Crucial to Safeguarding Health *Base: Among Total, N = 1,004. Data from September 12th – 15 th. AgreeAgree Strongly 92% 91% 22% Would you say you agree strongly, agree, disagree or disagree strongly with each of the following? (Summary of Agree strongly/Agree)

12. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 12 Looking Ahead, Americans Anticipate Changing Their Behavior Less likely No change More likely Given the state of today’s economy, are you more or less likely to do each of the following things in the next 12 months? Given the state of the economy, Americans see the need to change their habits. Many say they are more likely to engage in healthy behaviors over the next year. *Base: Among Total, N = 1,004. Data from October 2 nd – 5 th.

13. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 13 Nearly two thirds of Americans say their health is a priority. About a third have good intentions; saying they should be doing more, or could use help. Which of the following statements best describes the priority you place on a healthy lifestyle? While Most Americans Say They Lead Healthy Lives, Many Want to Improve Their Health 63% of Americans say their health is a priority. … and 6% aren’t concerned or feel they have no control. … 30% have good intentions. *Base: Among Total, N = 1,004. Data from September 12th – 15 th.

14. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 14 Americans agree that in the long run, healthy behaviors can: –Help you save money and –Help you earn more money. Thinking about the possible benefits of healthy behaviors, what do you think exercise and eating right will do for you? Will it… (Percent saying “Yes, it will”) Many Americans Link Healthy Behaviors To Having More Money *Base: Among Total, N = 1,004 (Multiple Responses Allowed) (Sept 12 – 15)

15. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 15 While one-in-three disagree and do not see the link between health and prosperity. “Better health can lead to greater wealth” Most Americans Agree Better Health Leads to Greater Wealth 65% of Americans agree. *Base: Among Total, N = 1,004. Data from September 12th – 15 th.

16. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 16 Many find healthy meals more time-consuming (44%) or difficult (36%) to prepare. Furthermore, many agree that healthier foods cost more (63%). However, Americans Also Agree that Being Healthy Costs Time and Money Cost Time / Effort Agree 63% 49% 44% 36% Agree Strongly Would you say you agree strongly, agree, disagree or disagree strongly with each of the following? (Summary of Agree strongly/Agree) *Base: Among Total, N = 1,004. Data from September 12th – 15 th.

17. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 17 Americans are very interested in a number of health services, but few actually know if their health plan offers them. –Seventy-eight percent of Americans have interest in a website that shows the price you’d pay at different pharmacies to find the best deals on medications. However, only 15% of Americans know if their health plan offers this service. –Seventy-five percent of Americans would like to discounts for weight loss programs, fitness centers, etc., But less than three-in-ten (28%) know if their health plan offers this option. –More than seven-in-ten Americans (71%) would like a phone number to call, or a website to access, in order to get a price for a doctor visit or other common test or procedure before they go. However, only 25% of Americans know if their health plan offers this service. Younger Americans are more interested in health services than older consumers. –More than nine-in-ten Americans (94%) aged 18-24 would like a website that shows prices at different pharmacies (to find the best deals on medications). Whereas only 54% of Americans aged 65 or older show interest. –Eight-in-ten younger Americans show interest in access to an Employee Assistance Program to improve work/life balance or cope with personal/family issues. Less than four-in-ten Americans (35%) aged 65 or older show interest. Americans Aren’t Sure What Their Health Plan Offers

18. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 18 Americans Want as Much Health Help as They Can Get Age Total18-2425-3435-4445-5455-6465+ A website that shows the price you’d pay at different pharmacies (to find the best deals on medications) 78%94%92%76%77%76%54% The ability to get ratings of your doctors based on the opinions of their existing patients 77%75%86%81%79%74%63% The ability to order your medications by phone or online for home delivery 76%82%80%78%73%74%68% Discounts for things like weight loss programs, fitness centers, massage therapy, and chiropractic care 75%84%83%82%78%69%55% The ability to speak to a nurse 24 hours a day74%73%83%76%73%71%69% A phone number to call/website to get a price for a doctor visit or other common test/procedure 71%74%83%73%72% 51% Access to an Employee Assistance Program to improve your work/life balance or cope with issues 67%80%77%74%69%68%35% Online coaching or health information60%62%67%66%60%61%44% Health coaching over the phone43%38%51%42%44%46%32% The following services would be helpful: Younger generations generally find health services more useful than older consumers. *Base: Among Total, N = 1,004. Data from September 12th – 15 th.

19. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 19 Yet Few Americans Say They Are Aware Their Health Insurance Provider Offers the Services They Want Do you know if your health insurance offers any of the following services? *Base: Among Total, N = 1,004. Data from September 12th – 15 th.

20. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 20 The Gap Between What Services Americans Want and Which They Know Are Offered Is Significant Gap between Services Desired and Known Offered 75% 71% 74% 67% 60% 76% 43% 15% 28% 25% 39% 35% 29% 47% 17% 78% A website that shows the price you’d pay at different pharmacies (to find the best Discounts for things like weight loss programs, fitness centers, massage therapy A phone number/website to get a price for a doctor visit or common test/procedure The ability to speak to a nurse 24 hours a day Access to an Employee Assistance Program help improve your work/life balance Online coaching or health information The ability to order your medications by phone or online for home delivery Health coaching over the phone Services Americans find helpful Services Americans are aware their health insurance provides Gap of 63 percentage points 47 46 26 29 31 32 35 *Base: Among Total, N = 1,004. Data from September 12th – 15 th.

21. © Yankelovich, Inc. 2006 The Segmentation Company a division of Yankelovich © Yankelovich, Inc. 2008 The Segmentation Company a division of Yankelovich 21 Methodology Two separate telephone interviews were conducted among a national probability sample of 1,004 American adults 18 years of age or older, living in private households in the continental United States. These random-digit-dial samples were fully replicated and stratified by region. Only one interview was conducted per household. All sample numbers selected were subject to up to four attempts to complete an interview. The interviews took place between the 12 th and 15 th of September and the 2 nd and 5 th of October, 2008. The second survey was fielded in response to increasing uncertainty about the economy. Data are weighted by age, gender, geographic region, and race to ensure reliable and accurate representation of the population. The sampling error for this study is +/- 3%.