WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE

WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE

INTRODUCTION The National Small Business Association (NSBA), America s longest-running small business advocacy organization, operating on a staunchly nonpartisan basis, has been a leader in health care policy for more than a decade. A key component of our health care platform has always been the role workplace wellness programs can play in keeping health care accessible and affordable for small-business owners and their employees. 93% of small business decision-makers say the health of their employees is important to their business bottom line. NSBA partnered with Humana to develop a groundbreaking survey conducted by third-party research firm, Edelman Berland, on workplace wellness in America s small businesses. What we found is eye-opening. Figure 1: Importance of employee health to bottom line 6% 1% For the last 50 years, five behavioral issues have consumed an estimated 80 percent of the nation s health care budget poor diet, stress coupled with inactivity, smoking and drinking. NSBA and Humana understand small businesses role in supporting the U.S. economy and is committed to helping these employers and their employees combat such issues and achieve lifelong well-being. Humana in collaboration with NSBA will be working to provide information that small businesses can use to help address barriers to wellness. While small businesses place high importance overall on workforce health--93 percent say the health of their employees is important to their businesses bottom line, just 22 percent currently are offering a wellness program. 39% Extremely Important Very Important 54% Somewhat Important Not Very Important WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE 2 NSBA HUMANA

EMPLOYEE WELLNESS CONCERNS Some of the more surprising results we found showed that the smallest businesses--those with two to nine employees--actually placed greater emphasis on wellness and expressed higher confidence in their ability to manage a wellness program than larger businesses. This enhanced attention to employee wellness can be attributed to a few key factors. First, nearly half (48 percent) of the smallest companies surveyed those with two to nine employees said their employees take few sick days, compared to 52 percent of the larger small companies whose employees take a normal amount of sick days. While this may appear as a positive, 57 percent said their employees work when they are sick. Second, 37 percent of start-ups those companies less than ten years old said they see an immediate decrease in productivity when employees are out sick as compared to just 29 percent of all other respondents. Among the health and wellness issues facing employees, the top concern among small-business owners was high stress levels, followed by psychological well-being, weight management and alcohol or other drug habits. Figure 2: Confidence in Ability to Help Employees Manage Health and Wellness 2 9 EMPLOYEES 10 49 EMPLOYEES 50 100 EMPLOYEES Figure 3: Top Concerns for Employee Well-Being 15% 9% 11% 39% 29% 21% 42% Stress levels more than triple other employee well-being concerns 11% 13% High stress levels Psychological well-being Weight management Alcohol or other drug habits Smoking habits Don t know/unsure NSBA HUMANA 3 WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE

OFFER RATE OF WELLNESS PROGRAMS As expected, the larger small business those with 50-100 employees in the study sample had a higher rate (27 percent) of offering a health and wellness program. Health and wellness programs were defined as an initiative aimed at encouraging employees to make healthier choices such as getting preventative care, eating right and exercising. The smallest companies, those with 2 9 employees, were not far behind larger companies at an offer rate of 20 percent. Interestingly, business age seemed to play a significant role in the offer-rate of wellness programs. Those firms in operation less than five years had the highest offer rate at 34 percent compared with just 19 percent of companies that have been in existence for 15 years or longer. Younger businesses those less than 10 years old and small businesses with 50 to 100 employees, were more inclined to agree that wellness programs are critical tools for employee recruitment and retention. Figure 4: Status of Health and Wellness Programs Figure 5: Agreement with Health and Well-Being Statements 11% Never Had Currently Have 65% 22% EMPLOYEE SIZE 2 9 Employees: 20% 10 49 Employees: 27% 50 100 Employees: 27% {2% BUSINESS AGE Under 5 years: 34% 6 10 years: 29% 10 15 years: 25% 15+: 19% Used to Have Don t Know 2-9 Employees 10-49 Employees Figure 6: Agreement with Health and Well-Being Statements 50-100 Employees I pay close attention to my employees health 75% 71% 81% I would be more interested in a wellness program that I could customize to the needs of my small business Employee health and wellness programs are worth the investment There is not enough information available to small businesses about implementing health and wellness programs for small businesses Health and wellness programs are critical for employee retention recruiting top talent A health and wellness program is a differentiator for employee recruitment 68% 70% 73% 59% 60% 73% 59% 57% 52% 43% 41% 52% 37% 41% 65% Start-Up Non-Start-Up Health and wellness programs are critical for employee retention 54% 41% A health and wellness program is a differentiator for employee recruitment 53% 38% WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE 4 NSBA HUMANA

BARRIERS TO IMPLEMENTING WELLNESS PROGRAMS Small-business owners are not unlike their larger counterparts in that the bottom line drives their decision making. Certainly, small businesses often are more familial, however when considering employee benefit plans, the owners rely heavily on the bottom line. Among the small firms who offered a health and wellness program in the past, 49 percent said they believe such a program would positively impact their bottom line. Among those who never had a wellness program, just 35 percent believe a wellness program would positively impact their bottom line. Figure 7: Health and Wellness on the Bottom Line Health of employees is important to bottom line Currently have a health and wellness program Used to have a health and wellness program Never had a health and wellness program Figure 8: Biggest Implementation Motivators Convinced a program would positively impact bottom line 35% 49% 78% 92% 92% 93% Comparatively, among those businesses currently offering a wellness program, 78 percent believe the program positively impacts their bottom line. When asked to rank their biggest motivators in implementing a wellness program, lower long-term health costs was ranked number one by both those firms who have a wellness program and those that do not. Improved morale and increased productivity came in second and third. Any efforts to increase the offer rate of wellness programs at small businesses surely must include clear evidence of the positive implications such a program can have not just on the employees, but the overall business. Another key factor driving the low offer rate of wellness programs in small business is a lack of employee interest. In fact, 46 percent of all businesses surveyed said lack of interest was the key barrier to implementing a wellness program, followed by 21 percent of smallbusiness owners who pointed to difficulty to administer such programs. Figure 9: Biggest Implementation Barriers Lack of interest among employees Difficulty to administer Concern for employee privacy Fear of singling out employees Don t know/unsure Currently have health and wellness programs 12% 7% 11% Do not have health and wellness programs Lower health care costs in the long term 25% 36% Improved morale 21% 13% Increased productivity 13% 15% Increased employee retention/reduced turnover 11% 7% Competitive advantage in recruiting top talent 7% 3% High Demand 6% 3% Lower absenteeism 5% 5% None of the above 9% 15% Don t know/unsure 1% 3% 21% 46% NSBA HUMANA 5 WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE

INCENTIVES TO OFFERING WELLNESS PROGRAMS There is no question small-business owners are closely engaged with their employees health and well-being. In fact, 60 percent of small-business owners said they believe that employee health and wellness programs are worth the investment. Unfortunately, a nearly identical amount, 58 percent, also said there is not enough information available to small businesses about implementing wellness programs. When asked what health and wellness programs they would be most likely to invest in, 26 percent of small-business owners said stress management followed closely by health education, prevention or screening (24 percent) and weight management programs (12 percent). As with any number of business issues lending, taxes, regulation a one-size-fits-all approach doesn t work for small businesses. Sixty-nine percent said that they would be more interested in a wellness program they could customize to the needs of their small business. 42% of small-business owners say high stress levels concern them the most when it comes to overall productivity of their business and employee health. Figure 11: Health and Wellness Programs Most Likely To Invest In Stress management programs Health education, prevention, or screening Weight managements programs Counseling, including psychological, marriage, legal, and financial counseling Addiction management programs None of the above Don t know/unsure 5% 4% 12% 11% 19% 26% 24% Figure 10: Agreement With Health and Well-Being Statements 74% 69% 60% 58% 43% 40% I pay close attention to my employees health I would be more interested in a wellness program that I could customize to the needs of my small business Employee health and wellness programs are worth the investment A health and wellness program is a differentiator for employee recruitment programs are critical for employee retention Health and wellness programs are critical for employee retention There is not enough information available to small businesses about implementing health and wellness programs for small businesses WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE 6 NSBA HUMANA

CONCLUSION While policymakers, think-tanks and interest groups continue to discuss the best way to move forward in making the U.S. health care system accessible, affordable and of the highest quality, there are existing programs that stand to reduce costs today. Addressing some of the largest barriers to implementing a health and wellness program as well as ensuring information is accessible and not just plentiful will surely help small businesses move one step closer to achieving better overall workplace wellness. Methodology The survey was conducted by Edelman Berland using a telephone custom survey among a nationally-representative sample of 1,005 U.S. owners and decisionmakers of businesses with 2 to 100 employees. Surveys were conducted from Friday, June 29, 2012 to Tuesday, July 10, 2012. The margin of error is ± 3.1% assuming a 95% confidence. NSBA HUMANA 7 WORKPLACE WELLNESS PROGRAMS IN SMALL BUSINESS: IMPACTING THE BOTTOM LINE