Employee Wellness Program

Employee wellness programs, also frequently referred to as worksite wellness programs or employee well-being programs, have no official definition. It commonly refers to a collection of initiatives within an organization to promote healthy lifestyles among employees, and in some cases, spouses and dependents of employees. There are numerous types of initiatives that, if implemented, would qualify as an employee wellness program. These initiatives address different areas, or dimensions, or well-being.

The notion of wellness is frequently associated with gym memberships or green smoothies, limiting the scope to just physical well-being. In reality, well-being is a result of complex interactions among many dimensions that, when nurtured in harmony, improve health and quality of life. Effective wellness programs are ones addressing and promoting holistic dimensions of well-being. Below are eight common dimensions of well-being that can be addressed through a workplace program.

While commonly thought of the aesthetic of being fit, physical well-being actually encompasses the smooth running of all physical bodily functions. This includes the skeletomuscular system as in the case of fitness, but also the digestive, circulatory, and other systems. Physical wellness is arguably the easiest dimension to promote in employee wellness programs due to its ubiquity and people's familiarity to the concept. Initiatives addressing anything from exercising to nutrition to sleep fall under the umbrella of physical wellness.

Emotional wellness refers to one's ability to manage their own emotions and effectively express it to others. Being emotionally well is more than just the ability to handle stress; it also involves being attentive to one's thoughts, feelings, and behaviors, whether positive or negative. A closely related concept is mental health. The WHO defines mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community." Mental health encompasses all aspects of emotional and psychological well-being, affecting how an individual acts, thinks, and feels. There are many tools organizations can use to effectively enhance employee mental health and emotional well-being.

Financial wellness commonly refers to one's financial stability, which is a function of income, expenses, and debts owed. Financial wellness can also be defined as being in a place where an individual is spending and saving money thoughtfully and their behaviors and thinking around personal finances contribute positively to their short-term and long-term goals. Achieving this state requires financial literacy, which is where employers can be of assistance.

Social wellness can be thought of as the state of one's personal social network. As a social species, humans depend on one another and their well-being critically depends on a sense of belonging. Wellness programs can be designed to promote positive social interactions, boost team cohesion, and improve engagement. Virtual events with a wellness twist can also be a part of wellness programs.

Occupational wellness describes an individual's satisfaction, fulfillment, and contentment with their work. Factors such as work-life balance and professional development play a significant role in determining one's occupational wellness. While occupational well-being is not commonly discussed in the framework of wellness programs, it is, in fact, a crucial piece of the puzzle since it influences other dimensions of wellness such as mental and financial health. For example, long-term job dissatisfaction is a known trigger for stress. Initiatives that aim to address occupational wellness, in this sense, fall under the umbrella of wellness programs and should be coordinated accordingly. Also, occupational well-being is an important driver of value for employee wellness programs as companies are increasingly focused on recruitment and retention benefits from their programs.

Being and feeling well includes having values and beliefs that provide purpose in life, which allows an individual to feel at peace and in harmony with themselves and others. It also includes the ability to stay open-minded to others' beliefs. This dimension of well-being is often referred to as spiritual well-being.  Addressing purpose in wellness programs can be tricky since it is an individualized journey. However, raising awareness of this important dimension can help employees become more purposeful and satisfied with their lives, both professionally and personally.

Intellectual well-being refers to the active participation in scholastic, cultural, and community activities. When a person is intellectually well, they continuously work on expanding their knowledge and skills, which lead to a more stimulating and successful life. Organizations can nurture intellectual well-being by promoting creativity, curiosity, and life-long learning.

Climate change isn't just a matter of keeping the planet habitable for future generations or merely a topic for environmentalists. It has very real health risks for individuals across the globe, which makes it bad for business and an important cause for employers to champion. Organizations can play their part by promoting sustainable living, raising awareness, and implementing sustainable operations as a part of their wellness program. Although small changes in sustainability amongst a few individuals is hard to recognize in a community or across the globe, they do make an impact. For immediate results, employers can focus on the work environment (e.g., office air quality), which is within their locus of control.

To help employees improve their well-being across all dimensions, companies can employ a wide variety of solutions. Not every solution makes sense for every employer, and some solutions make sense for no employers. The types of wellness programs below should serve as a guide for what is available as well as provide context on who the solution is best suited for. Each solution addresses at least one dimension of well-being, but many address multiple dimensions.

• Biometric Screening
• Disease Management
• Financial Counseling/Planning
• Fitness Classes
• Flexible Work Schedules
• Flu Shots
• Free Healthy Food
• Gym Reimbursement
• Health Coaching
• Health Education/Literacy
• Health Fairs
• Health Risk Assessment (HRA)
• On-Site/Near-Site Clinics
• Telemedicine
• Tobacco Cessation
• Weight Management
• Wellness Challenges

An old staple of wellness programs, biometric screenings involve measuring employees' physical characteristics, such as body mass index (BMI), blood pressure, cholesterol, glucose level, and more. This type of program mainly aims to address physical wellness. The rationale for providing biometric screenings at work is the belief that early detection of diseases and assessment of health risks can help employees become aware of and more effectively treat their health conditions. Some biometric screening programs act as a funnel to register high-risk employees for disease management programs.

Who should invest in biometric screening programs?

Likely, no one. There is an overwhelming body of research that suggests biometric screenings do not deliver the results that employers previously believed. In fact, the Society for General Internal Medicine even put annual physicals, which contain elements of biometric screenings, on a list of things doctors should avoid for healthy, asymptomatic adults. This is because they do little to avert death or disability from acute problems and also tend to be ineffective in helping with chronic conditions without significantly useful interventions. In some cases, additional testing from false positives can even put employees at risk (and waste money).

Disease management programs are structured treatment plans that aim to help people better manage chronic disease(s) and maintain and improve quality of life. A team of health professionals, including physicians, nurses, pharmacists, dietitians, etc., are involved to educate participants on an ongoing basis about how to better manage their conditions. Some programs might be more patient-directed and include counseling, home visits, 24-hour call centers, and appointment reminder systems to support individuals who are managing their chronic condition(s). Increasingly, these programs are becoming digitized and more affordable, as less human intervention is required.

Who should invest in disease management programs?

Mostly medium to large organizations. Disease management programs are targeted, often focusing on a specific chronic condition that may be particularly prevalent with an employee population. Because these programs tend to be costly, companies should only invest in these programs if they identify enough employees suffering from a specific condition to justify the resources. Small employers tend not to have enough individuals with the same chronic condition to justify the expense.

As one of the "hottest" areas in many health and wellness programs, financial wellness offerings are rapidly rising in popularity. To provide employees with personalized help, many organizations enroll the assistance of financial professionals to provide them with counseling or financial planning. These sessions may be one-on-one (more expensive) or in a group format (more affordable).

Who should invest in financial wellness programs?

Many surveys have shown that employees are universally struggling to achieve financial well-being on their own and are stressed out about money, leading to lowered productivity at work. All employers would be wise to help them combat this problem. However, hiring financial professionals can come at a steep price tag, making this type of program more suitable for companies with larger wellness budgets. For an affordable (likely free) option, employers should contact their 401(k) plan administrator. These organizations often offer free financial wellness seminars.

For many companies looking to encourage fitness during the workday, on-site fitness classes are a great solution. These classes are often held in conference rooms or other open spaces. In addition to a great work out, group fitness classes provide employees with opportunities to get together, build camaraderie, and have fun. Research also suggests that group exercise is the most impactful exercise for improving mental health. As such, fitness classes are a versatile tool that can address physical, mental, and social well-being. Fitness classes do not necessarily need to be limited to physical fitness. Guided meditation sessions are great ways to improve well-being and manage stress without needing to provide shower facilities.

Who should invest in fitness classes?

Organizations with appropriate open spaces to hold classes. Weather permitting, companies can opt to hold these classes in the parking lot or a nearby park. Additionally, there should be a showering facility on-site if the classes will be held prior to the end of a workday. Companies with a significant remote population should consider carefully before offering this perk as their remote employees will not have access to classes. In this case, it might be wiser to provide all employees with fitness reimbursements to exercise on their own time.

Flexible work schedules allow employees to alter their workday start and finish times to better accommodate their needs outside of the office. It might also include remote work options where employees can complete their work-related tasks away from the office. Employees have personal priorities and responsibilities, from spending time with loved ones to caring for themselves, that often need to be addressed at different times of the day. Flexible work arrangements put employees in the driver seat and allow them to design a work schedule for their personal situation. As such, flexible work has the potential to improve multiple dimensions of wellness, from emotional to physical to occupational well-being.

Who should offer flexible work schedules?

Most organizations. Flexible work schedules are also a cost-effective solution. While some organizations rely heavily on shift work (e.g., hospitals, restaurants, hotels, etc.), most do not need their employees to be in the office at set hours every day to be productive. Remote work may also help employers save on office expenses, from rental payments and furniture to healthy snacks in the kitchen. However, it is important that organizations implementing these arrangements actively work to combat employee loneliness, as studies are exploring the link between flexible and remote work and the adverse impact it may have on social well-being.

Flu shot clinics mainly address employees' physical wellness. According to the Centers for Disease Control and Prevention (CDC), the flu costs the U.S. approximately $10.5 billion in direct costs, hospitalizations, and outpatient visits for adults. The indirect costs of lost productivity and sick leave for employers are also quite significant. Likely driven by recent flu seasons being some of the worse in decades, more companies are looking to launch flu shot clinics as part of their employee benefits. These clinics are usually one-day events with nurses coming to the office/facility and administering flu shots.

Who should offer flu shots?

Every group that can meet the minimum size requirements to have a clinic should consider doing so. However, similar to other on-site offerings, companies with a significant remote population should consider having equivalent benefits for off-site employees. If budget considerations prevent offering this wellness benefit, employers should consider educational campaigns to encourage employees to get a flu shot at their local pharmacy or physician's office.

Free food has always been an employee-favorite perk. However, salty chips and candies, while appealing, might not be the best option for a mid-afternoon snack. To promote healthy eating, organizations are opting to stock their kitchen with more nutritious options, such as snacks with whole grains, healthy fats, and protein. This perk falls under the umbrella of physical wellness, as it impacts nutrition.

Who should offer free health food?

Everybody! Healthy snacks can be purchased in bulk and do not have to be expensive.

For organizations looking to double down on physical well-being, providing standing desks might not be enough. Reimbursing employees for the membership cost of exercise facilities can encourage them to work out without eating into normal work hours as on-site fitness classes may. This is an attractive benefit, especially for millennials, who place high consideration on total rewards programs and benefits.

Who should offer gym reimbursement?

Everybody. However, this can be a significant investment and therefore might be more suitable for medium and large employers. Some health plans might have gym or fitness reimbursement built-in to their policies, which can help subsidize the cost. Gym reimbursement works especially well for organizations with remote employees as it does not limit access.

Employee health coaching refers to personalized educational sessions with a certified health expert that can be conducted in either one-on-one or group formats. Some companies offer health coaching as a next step for employees identified as high-risk through a biometric screening or health risk assessment, while others extend the benefit to anybody in the organization who is looking for guidance and support to improve their health. Because health coaching sessions are personalized, they can address any dimension of well-being in which employees request assistance.

Who should offer health coaching?

Personalized programs with human interventions can be costly and less scalable, and health coaching is no different. If an organization has a limited wellness budget, offering health coaching sessions might not be the best use of these dollars. However, for organizations with mature wellness programs, getting personalized guidance from health coaches is the excellent next step employees can take to improve their well-being.

FREE EBOOK: EMPLOYEE HEALTH COACHING 101

Health education/literacy programs are usually the first initiative to be offered at organizations due to its scalability and low cost. These programs provide employees with access to relevant, quality, and timely health content either through on-site seminars or online webinars as well as through other media such as newsletters or wellness brochures. With the growing amount of misinformation available to consumers via the internet, employer-facilitated health literacy is becoming increasingly important. These educational sessions can be tailored to address any dimension of wellness as the employer sees fit for their population.

Who should offer health education/literacy resources?

Everybody! These programs can be low-cost (newsletters, etc.) and can serve a diverse population. If budget is not a significant limitation, employers can invest more in programming by bringing in professionals for seminars or webinars.

Health fairs are educational and interactive events where employers can provide employees with basic health education as well as overviews on health benefits available to them. Usually scheduled during a workday, employees get to take a break to visit a number of booths to learn about well-being topics and identify helpful benefits that they may not be using. Similar to other on-site events, remote employees and satellite offices will not be able to participate in the event, so employers should take this into consideration.

Who should offer health fairs?

Health fairs tend to work better for mid-size to large employers. Since the costs to hire vendors are fixed, the economics makes sense when it is spread out among many attendees. If budget does not permit having a health fair, employers can use wellness newsletters as an alternative to educate employees on well-being as well as benefits available to them.

Also referred to as health risk appraisal, an HRA is an instrument used to collect health information on employees. It is typically coupled with biometric screenings to assess an individual's health status, risks, and habits. Unlike biometric screenings, HRA data is self-reported, so the information being collected for employers and used to provide feedback for employees is subject to the bias and limitations of the respondent.

Who should offer HRAs?

Likely, no one. Similar to biometric screenings, there are many questions surrounding the efficacy of HRAs. They do little to improve health or cut costs, and there are regulatory hurdles surrounding its application.

These clinics provide convenient access to health care for employees and are also staffed with clinicians who are familiar with the organization's policies, benefit plans, and work environment. In many cases, on-site or near-site clinics can resolve a majority of its visits without referring employees to other facilities, which can result in cost-reduction for both the organization and its employees.

Who should offer clinics?

Mostly large employers. These clinics are costly benefits that have significant space and upfront capital requirements. Also, to be cost-effective, they require a large enough employee population and high enough utilization to justify the staffs' time. Smaller organizations can partner with each other to gain the scale to offer this benefit.

With the promise of controlling costs with more affordable visits, telemedicine has surged over the last decade. It involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. It is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation, and other clinical services.

Who should offer telemedicine service?

In its early history, telemedicine was a benefit primarily reserved for larger employers. However, many health plans now offer telemedicine to their fully-insured customers, which has broadened the size of employers that can offer this benefit. The convenience and cost savings make telemedicine a great benefit for all employers to provide employees.

Smoking amongst adults in the United States has steadily declined since the mid-1960s but seems to be bottoming out around 15%. When employers consider the use of e-cigarettes, which is increasing, as well as other tobacco products, nearly one out of four U.S. adults could benefit from a tobacco cessation program. Although usage has dropped significantly, the adverse impact of tobacco use is so strong that employers continue to see financial and non-financial reasons to pursue cessation programs. A tobacco cessation program can (and should be) multi-faceted, but the main goal is to provide tobacco smokers the support and resources they need to quit.

Who should offer tobacco cessation program?

Everybody! While smoking cessation programs might be costlier than other educational programs, employers can find programs that charge per-participant, which means that they only pay if the employees take advantage of the resource.

Weight management programs specifically focus on helping employees achieve a healthy weight. Through a combination of digital and human interventions that primarily focus on exercise and nutrition, weight management programs hope to reduce the health risks of employees. Since most individuals are not at a healthy weight, the benefit has to potential to be useful to a broad audience.

Who should offer weight management program?

Likely no one. These programs have largely remained a steady presence despite little evidence suggesting they are effective or good for employees. Employers are better off investing in health literacy programs that educate employees on topics such as nutrition and promoting physical activity throughout the work day with wellness challenges and on-site fitness classes.

Wellness challenges are a set of activities and contests to encourage employees to engage in healthy behaviors. They are also a great team building tool that helps improve employee engagement and a sense of belonging within the organization. Wellness challenges can be designed to address a broad range of topics, including physical, mental, financial, social, and environmental well-being, and with the advancement of wearable devices and mobile apps, the technologies needed to make tracking easy and simple now exist in a way that was not available ten years ago.

Who should offer wellness challenges?

Everybody! Wellness challenges, especially technology-driven ones, are affordable and scalable. Here is our wellness challenge library to get any organizations started.