Lori Casselman , AVP, Health & Wellness Sun Life Assurance Company of Canada

1. The Case for Wellness: Current Research on the ROI of Wellness A Solareh National Advisor Conference Series November 2012 Lori Casselman, AVP, Health & Wellness Sun Life Assurance Company of Canada

2. Launched in May 2011 with mandate to provide insight and evidence to support workplace wellness in Canada 3 core projects to date Canadian Health Index Study Including the Burnout Factor Buffett National Wellness Survey Strategic alliance Ivey: ROI Study The Sun Life Wellness Institute

3. Workplace wellness no longer a nice to have • Chronic disease a growing toll on organizations • 35% increase in health and productivity costs since 2009 • Effective health and productivity programs deliver results • 11% higher revenue and 28% greater shareholder returns • More organizations offering or considering wellness Source: Towers Watson Staying@Work 2011/2012

4. 677 respondents Responses collected during the spring and summer of 2011 Current state: ‘wellness initiatives’ Buffett National Wellness Survey Source: 2011 Buffet National Wellness Survey

5. Highest ranked organizational health risk concerns • Work related stress • Mental health issues • High Blood Pressure • Diabetes Source: 2011 Buffet National Wellness Survey

6. Risk Areas vs. Program Offerings Source: 2011 Buffet National Wellness Survey

7. Bridging the gap 97% of respondents agree that employee health is directly related to corporate success 72% of organizations are offering at least one wellness program. BUT only 26% are taking a strategic approach to wellness Including calculating an ROI Source: 2011 Buffet National Wellness Survey

8. Case Studies THE FOCUS ON RESULTS

9. Case Study

10. Wellness Program Components • Health Risk Screenings • Health Challenges • Smoking Cessation Programs • Surveys for on-going measurement • Continuous analysis and reporting • Management support • Program success built into management performance metrics

11. The Results • 3400 Employees • Multi-site locations • Diverse workforce • Wellness programs since 2006 • Projected 5 year savings from Health Screening and Smoking Cessation alone = $240,000 • Measurable improvements in employee engagement and culture

12. Case Study • 789 people (63 %) lost weight (61 of these moved into a healthy zone) • 152 (12 %) improved on four or more of risk factors • 41 stopped smoking for one full year or more • Total cost avoidance of over $358,000 • Comprehensive wellness program • Strong leadership commitment • Senior management forms and participates as a team in challenge

13. Case Study • 70% overall participation in wellness programs • Creation of PWA delivered +16% increase in employee engagement levels • Over $610,000 in cost avoidance since inception of program • Move from fitness re-imbursement to comprehensive wellness strategy in 2008 • Incentive: Earn $300 toward Personal Wellness Account (PWA)

14. What is still missing? • The measurable return-on-investment for wellness • US further ahead • In Canada • Gap in rigorous data • Varying measures and benchmarks • Opportunity to build a healthier Canada, one organization and one employee at a time

15. Our commitment to results: Canadian ROI Study • Strategic alliance with Richard Ivey School of Business at Western University • Multi-year study, launched in 2011 • Phase 1 meta analysis • Phase 2 in-field study

16. Why? • Little rigorous examination of workplace wellness programs in Canada or indeed outside of the United States • Even within the US, there are few studies that are comparable and that provide sufficient data and analytical rigour to underpin a solid, evidence-based business case. Richard Ivey ROI Study Phase1, Spring 2012

17. Academic & grey literatures, & popular press promote the potential of a positive return for employers & benefits to workers but is the evidence there? Employers who want to do the right thing still need to make the business case We need evidence, an assessment of studies that are robust & demonstrate analytical rigour, i.e., meta-analytical & systematic Where is the Evidence ?

18. Most recent meta-analysis (Baicker et al., 2010) published in Health Affairs Methods Literature review of previous meta-analyses & computerized searches looking for peer reviewed US research Yielded “more than 100” studies 30 years of research represented Harvard Study

19. ROI of Wellness Programs for 9 studies Savings $394 per employee per year Average program cost $159 per employee/yr Absenteeism for the 9 studies Absentee days saved 1.7 days/employee/yr Estimated savings $274 per employee/yr Estimated costs $132 per emp/yr (from 12 studies) Estimated ROI absenteeism = $2.08 Harvard Study Findings

20. Computerized search based on: Commonly cited terms, e.g., employee, wellness, workplace, cost benefit analysis, etc., plus keywords from published studies Review articles were scanned for additional papers Yielded 504 studies Oldest paper 1977 Ivey Study Methods

21. Papers Published

22. The included studies met the following criteria: Experiment & control groups Pre and Post intervention data New intervention (excluded retrospective evaluations of ongoing programs) Length of intervention was provided Days absence reported Sufficient number & quality for meta-analysis Meta-analysis (Phase 1) Criteria

23. Phase 1 Findings • Wellness programs save about 1.5 to 1.7 days absenteeism per worker over 12 months • Absenteeism ranges from 4.7 days to 11.2 days (Statistics Canada, 2011) • Employers can expect to receive substantial savings in terms of reduced absenteeism from Workplace Wellness Programs • Results are statistically significant and robust and comparable to the US results

24. Absenteeism Comparison Ivey Study Harvard Study 9 studies (7 independent) All from USA Programs: Online programs, Fitness, Education materials, Classes or workshops Strict inclusion/exclusion criteria • 4 studies • All from Europe • Programs: Personalized, Fitness training, Counseling, Exercise program • Strict inclusion/exclusion criteria

25. Absenteeism Comparison Ivey Study • 2.43 days employee/year (equal weight) • 1.5 days per employee per year saved with wellness programs • Estimated savings $251 per employee per year with wellness programs Harvard Study • 1.7 days per employee per year saved with wellness programs • Estimated savings $274 per employee per year with wellness programs

26. Phase 2: • Select organizations who meet criteria will implement a Sun Life HealthyRETURNS program over a 2-year in-field study period • Canada wide; multiple industries and sites • Comparisons will be made between control groups and treatment groups with respect to: • Biometric measures (e.g. blood pressure; cholesterol; body mass index; waist circumference, body fat) • Prescription drugs • Extended health • Absence and disability • Lifestyle habits and respective risk levels • Begins Jan 2013

27. Phase 2: What we will study • Some of the hypotheses • Positive Return on Investment • Reduction in absenteeism and presenteeism • Decreased employee turnover • Increased employee working life satisfaction • Increased productivity • Decreased employee stress • Reduced health care costs • Healthier employees

28. ROI Study • Sun Life’s sponsored research will be a widely cited effort in Canada, and has the potential to be a major contribution to workplace wellness knowledge worldwide

29. For more informationVisit: www.sunlife.ca/wellnessinstitute www.sunlife.ca/healthyreturns Contact: lori.casselman@sunlife.com

30. Questions?