Work-site Wellness

Building a Culture of Health at Unum Work-site Wellness

By Michael Booth, HR BenefIts Health Programs Manager
and Andrew P. Molloy, Assistant Vice President for Health Management and Insurance Programs, Unum

Today’s tough economic times aren’t deterring companies from focusing on employee wellness. 

In fact, a recent survey of 489 large U.S. employers by Watson Wyatt and the National Business Group on Health (NBGH) showed that there was increased interest in programs that promote a healthier workforce. 

One company at the forefront of helping employees maintain and improve their health is Unum, a leading provider of employee benefits products and services in the United States and United Kingdom. 

Last year, Unum was among 63 companies nationwide honored with the 2008 Best Employers for Healthy Lifestyles Gold Award from NBGH. This was the fourth time in five years that Unum has received national recognition for its commitment to the health of its U.S. employees. 

What’s the secret to this employer’s successful efforts at promoting health at the work site?

According to Linda Levesque, Unum’s vice president of HR benefits, having a healthy work force is tied directly to the company’s strategic vision. “Employee wellness has been identified by our CEO as one of the key ‘pillars’ of our corporate strategic vision,” she noted. “Top-level executive support illustrates the importance this issue has for us as a business and an employer.” 

It Wasn’t Always this Way 

Between 2000 and 2003, Unum—like many U.S. companies—was operating in a challenging environment during the recession.

With escalating medical costs putting pressure on financial results, the directive was to reduce benefit expenses. And like many other U.S. companies at the time, the response was to shift costs to employees through premiums and other medical plan design changes. Unfortunately, these changes made the plan uncompetitive, and medical costs continued to grow at unsustainable levels. 

Realizing that a new approach was needed, Unum implemented a comprehensive long-term health care strategy in 2004 that included on-site health programs along with the tools, resources, and education to ensure employee accountability and participation. 

“We used the slogan ‘Take Advantage, it’s to Your Benefit’ because we felt it would resonate with employees and reinforce the goals of our health care strategy,” said Michael Booth, health programs manager, HR benefits. The principles underlying that strategy include: 

The Path to Building a Culture of Health 

As Unum’s long-term health care strategy began to unfold, a consensus was reached about five key factors needed for its ongoing success: 

A major objective of the program was to ensure that the company’s medical plan supported the strategy.

The plan was designed to encourage employees and their families to lead healthier lives by using the appropriate health programs and services available. These include personal health coaching, health assessments, low- or no-cost preventive and early detection care, work-life balance programs, flu shots, and on-site health resource centers and fitness facilities, among others.

In addition, medical plan benefits also support nutrition education by offering 100% reimbursement for up to three visits annually to a registered dietician, as well as subsidizing a Weight Watchers at Work program at the company’s major campuses, and subsidized memberships for employees in other communities.

Assistance with smoking cessation is also part of the plan, with 100% coverage for the cost of over-the-counter and prescription smoking cessation products. 

It All Starts with a Health Risk Assessment 

All Unum employees are expected to complete an annual health risk assessment (HRA).

Since 2005, the company has provided a $120 annual discount on medical plan premiums as an incentive for employees to complete the HRA. That year, participation grew to 68% and in the past three years climbed to 72%.

Unum views the HRA as an effective tool that helps employees identify, avoid, reduce, and better manage health risks. In fact, the company has found that the HRA is the best tool to identify employees with a borderline health condition. 

To reduce barriers to completing the HRA, Unum offers free biometric screening–including a full lipid profile, body mass index, and blood pressure reading at the company’s health resource centers (HRC).

The nurse educator at each center talks with employees about health issues and encourages them to take advantage of health coaching, education, or enrollment into one or more of the health improvement programs the company offers. Conversations can include coaching about conditions such as hypertension, obesity, diabetes, stress, musculoskeletal, and pain management. 

A new tool introduced this year offered in conjunction with the HRA is the personal health record, a secure and confidential online record that makes it easier for employees to keep track of their health information.

Doctors’ visits, prescriptions, and other care employees receive through Unum’s medical plan are automatically captured in their record. Employees can add other medical information, such as allergies, to keep all their health information organized and in one place. 

Providing Convenient Access to Health Services 

A central part of Unum’s health strategy is the company’s health resource centers. HRCs were introduced in 2005 to provide an accessible resource to help employees improve their health. Employees can use the on-site HRC as a one-stop shop for access to all the health programs Unum offers. 

Unum’s four HRCs are staffed and managed by Take Care Health Systems, one of the largest providers of workplace-based health care services in the United States.

The nurse educators who staff the HRCs often refer employees to condition management programs or simply coordinate care with the employee’s primary care physician. The nurse educator, in effect, becomes a trusted source who can assist employees to become their own health care advocate. 

Unum expects the nurse educators to be visible, and one way they do this is by sponsoring “Lunch and Learn: Your Health Matters” programs. With approximately five sessions a month, these lunchtime meetings focus on the top five or six medical conditions identified in aggregate through the HRA. 

Employees get information and can ask questions, and feedback about the sessions has been positive. Nurse educators can also direct employees to a library of written information in the HRC that is continuously updated. 

Because the HRC nurse educators and fitness staffs are on the front lines in identifying what employees need and want in the way of wellness, they often develop innovative programs to meet those needs. For example, on the Unum campus in Chattanooga, TN, the company partnered with a bike coalition to make bikes available for rent at lunchtime so employees could ride as part of their exercise program.

In Portland, ME, the nurse educator responded to a need to bring together all the community resources related to cancer care. These “partners” came to the campus to provide information and answer employee questions. 

Unum has developed a comprehensive communications plan to promote the company’s benefits offerings. The plan clearly articulates the full range of services and pro- grams accessible to Unum employees and their families. Employees can learn about available programs through Unum’s weekly internal e-newsletter, as well as the employee magazine, and the company’s Intranet site. These resources are complemented by home mailings, targeted e-mail distribution lists, brochures, and other publications.

In addition, the HR benefits team has delivered more than two dozen live “road shows” at all major locations to educate employees about company benefits and services. Webinars and videotaped presentations were made available to those locations that didn’t get the road show. And when employees have a question or need help beyond the extensive information and self-service tools on the Intranet site, they can always reach a member of the dedicated HR response team. 

Integrating the Programs and Services 

One objective of the HRC nurse educators is to coordinate services for employees, including fitness programs, disease management programs, life balance (EAP) services, the maternity program, and phone-based health coaching for weight management, smoking cessation, and stress management. 

Because many of these services are offered by outside providers, Unum has held bi-annual Health Benefit Vendor Summits since the spring of 2007. The company’s vendors have integrated their services so employees have improved access to all Unum’s health benefits. When a need is identified, each vendor is equipped to provide referrals to the appropriate best-in-class vendor.

For example, if an employee is enrolled in a diabetes program and the vendor determines that the employee is ready to address weight issues, the diabetes coach will refer the employee to a weight management coach. 

Unum has found that health coaching has tremendous potential to impact employee health and health care costs. The nurse educators are the principal source for health education and programs and the first point of referral to available services. By building on their referral process and program integration, Unum has improved awareness of the health resources and motivated more employees to use its programs. 

Integrating Data to Measure Success 

To measure the effectiveness of its health strategy, Unum has invested in a “data warehouse” capability. This tool integrates medical and pharmacy claims, data along with data collected from its disease management programs, online health risk assessments, and the HRCs. No identifiers are used, so employee privacy is protected, but this data enables Unum to identify trends and areas where targeted investments could leverage medical plan design and HRC programs. 

For example, Unum has measured medical costs for employees with chronic conditions who use a health resource center frequently vs. those who use one infrequently. In tracking claims per year, data showed that for employees with chronic conditions who were nonusers or one-time users of the HRC, claims rose 13% between 2005 and 2008. Frequent users (twice or more a year) had only a 2% rise in claims for the same years, helping to reduce company medical costs. 

In another measure of success, Unum found that the health risk assessment, which brings approximately 40% of employees into the HRCs, is also correlated to better health management. An assessment of pharmacy claims shows that employees with diabetes who complete the HRA and acknowledge their condition are twice as compliant in their use of daily diabetes medication. 

“Our mission as a business helps us understand the value of an engaged, healthy and productive work force,” said Levesque. “Finding ways to help our employees maintain and improve their health is an important element of Unum’s commitment to the wellness of individuals and their families.” 

Michael Booth, MJ, BS, SPHR, is HR benefits health programs manager for Unum. Michael has 16 years of professional experience, including roles in corporate fitness facilities as health educator and wellness program manager, and is an American College of Sports Medicine health fitness instructor. Andrew P. Molloy is the assistant vice president for health management and insurance programs at Unum. Andrew joined Unum in 2006 and is responsible for the management, analysis, and design of the company’s health programs.