2020 INDUSTRY TRENDS REPORT

EMPLOYEE WELLNESS
TABLE OF CONTENTS
E xecutive S ummary Tobacco Cessation.............................. 32
Weight Management........................... 33
Overview............................................. 4
Wellness Challenges............................ 34
Investment Trends.................................. 5
Deep Dive — Caregiver Support........... 36
New Wellness Offerings........................ 8
Decision Influencers............................... 9
Vendor Criteria................................... 10 D ecision I nfluencers
Overview........................................... 12 Creating Competitive Benefit Plans......... 39
Data Security...................................... 40

I nvestment T rends Matching Employer-Employee Interests.... 41

Measuring ROI From Benefit Changes.... 42
Biometric Screenings............................ 15
Rising Cost Of Benefits......................... 43
Disease Management.......................... 16
Uncertainty About Healthcare Reform..... 44
Financial Wellness............................... 17
Fitness Classes.................................... 18
Flu Shots............................................ 19 V endor E valuation
Free Healthy Food............................... 20 Top Criteria When Evaluating Vendors... 46

Gym Reimbursement............................ 21
Health Coaching................................. 22 A ppendix
Health Education/Literacy.................... 23 Survey Questions................................ 49
Health Fairs........................................ 24
Health Risk Assessments....................... 25 A bout W ell able
Mental Health..................................... 26
Mindfulness/Meditation....................... 27
On-site/Near-Site Clinics...................... 28
Sleep Management............................. 29
Stress Management/Resilience.............. 30
Telemedicine....................................... 31
EXECUTIVE
SUMMARY
OVERVIEW Executive Summary

Despite uncertainty in financial markets and global trade changes, the economy continues to show
strength with unemployment reaching its lowest point in 50 years. As a result, finding and retaining
quality employees is becoming more difficult as the labor market tightens. To address this challenge,
employers are expanding benefits, including wellness programs, to help employees thrive and enjoy
work. Since these programs are more common than ever before, companies are also practicing greater
discernment when it comes to the value of their offerings. The goal of this report is to quantify and
better understand the wellness strategy companies are implementing in 2020. Employers and brokers
can use this information to make better benefits decisions to ensure they are creating competitive
wellness plans to address the needs of current and prospective employees.

To provide a broader perspective, survey respondents included consultants and wellness directors at
health insurance brokers across the country. These professionals have insights on the thoughts and
strategies of the numerous employers they advise. As part of the research, the survey explored three key
areas: (i) investment trends, (ii) decision influencers, and (iii) vendor evaluation. For more detail and
commentary on survey responses, please see the detailed sections later in the report.

4
INVESTMENT
TRENDS Executive Summary

The survey identified 20 specific wellness programs and strategies, such as stress management, gym
reimbursement, and telemedicine, that employers may be considering investing in during the coming
year. Respondents were asked whether they expect their employer clients to invest less, the same,
or more in the associated programs. Overall, employers are increasing their investment into health
and well-being programs with more than double planning to invest more (35%) compared to those
who plan to invest less (14%). As wellness programs become more popular and the labor market
pushes employers of all sizes to offer competitive benefits, these programs will continue to see more
investment—especially for benefits that are highly valued or cost effective.

BIOMETRIC SCREENINGS HEALTH COACHING SLEEP MANAGEMENT

DISEASE MANAGEMENT HEALTH EDUCATION/LITERACY STRESS MANAGEMENT/RESILIENCE

FINANCIAL WELLNESS HEALTH FAIRS TELEMEDICINE

FLU SHOTS HEALTH RISK ASSESSMENTS TOBACCO CESSATION

FITNESS CLASSES MENTAL HEALTH WEIGHT MANAGEMENT

FREE HEALTHY FOOD MINDFULNESS & MEDITATION WELLNESS CHALLENGES

GYM REIMBURSEMENTS ON-SITE/NEAR-SITE CLINICS Investing More

Investing Same
Investing Less

5
INVESTMENT
TRENDS Executive Summary

Percentage of respondents who answered “Investing More”

80% 66%

64% 73%

100 75 50 25 25 50 75 100
FINANCIAL WELLNESS STRESS MANAGEMENT
MENTAL HEALTH MINDFULNESS/MEDITATION

RISING STARS
Mental health (80%), stress management (73%), mindfulness and meditation (66%), and financial
wellness (64%) programs ranked the highest in terms of the percentage of employers expecting to invest
more. Considering that stress levels and mindfulness both play into overall mental health, these top
three programs overwhelmingly show employers’ focus and dedication to mental wellness. This comes
as no surprise, as mental health programs have been popular for years.

In addition to mental health, financial well-being continues to be an area of focus for employers. As
noted in the 2019 Employee Wellness Industry Trends Report, educational resources, such as seminars
and webinars, are the most popular type of financial wellness program. The downfall of these types
of programs is that they do not address the specific and unique challenges each employee may be
facing. Since some employees need assistance with paying down student loan debt while others may
need help planning for retirement, employers will need to adopt more tailored solutions to truly impact
the financial health of employees.

6
INVESTMENT
TRENDS Executive Summary

Percentage of respondents who answered “Investing Less”

25% 30%
34% 39%
100 75 50 25 25 50 75 100
BIOMETRIC SCREENINGS HEALTH RISK ASSESSMENTS

FITNESS CLASSES & HEALTH COACHING HEALTH FAIRS

FALLING GIANTS
Health risk assessments (39%), biometric screenings (34%), health fairs (30%), fitness classes (25%),
and health coaching (25%) ranked the highest in terms of the percentage of employers expecting to
invest less. The common theme amongst these programs (and others that ranked high for less investment)
are that they are services, which means they are harder to scale, cost more per engaged employee,
and are often unavailable to remote employees.

Additionally, since the Equal Employment Opportunity Commission (EEOC) vacated wellness rules
at the beginning of 2019, employers requiring screenings or mandatory assessments run the risk of
being sued. As such, the number of companies planning to invest less in biometric screenings rose by
five percentage points for biometric screenings and 12 for health risk assessments. It is important to
note that after the data collection for this report was completed, the EEOC announced that it plans to
provide guidance on wellness program regulations in January 2020. Any changes in response to the
new guidelines is not capture in the report’s results.

Both health fairs and fitness classes can be replaced with more affordable and engaging options,
like newsletters or gym reimbursement. Their decline may also reflect a growing disinterest in general
or impersonal resources, as workers seek more individualized solutions. Classes and fairs, by design,
target broader audiences.

7
NEW WELLNESS
OFFERINGS Executive Summary

CAREGIVER SUPPORT
Caregivers often experience hectic and out-of-control

84%
schedules—working parents need to secure proper
supervision for children, and those with aging or ill
relatives must manage regular medical attention or,
sometimes, emergency care. Employers overwhelmingly
Flexible Work
favor resources that allow them time away from work, Schedules
with flexible schedules, remote work options, and paid

67%
time off out-ranking other offerings by more than double
or triple the percentage points. It’s crucial to note that
time alone doesn’t make these programs so important,
but also the fact that they tend to not decrease income or
Remote Work/
benefits. Offerings such as unpaid leave (12%), reduced Telecommuting
or part-time work (8%), and job sharing (1%) ranked low
because they sacrificed benefits and income needed to
cover caregiving needs.

Counseling services were the next popular (25%),

53%
Paid Time Off (PTO)
followed closely by caregiver-provider referral services
(24%). Both alleviate the stress of coordinating care,
while counseling services in particular reflect the rapidly

25%
growing focus on employee mental health. Offerings that
dealt with subsidies, on-site/near-site care, seminars,
and support networks were all valued by 8% or less of
employers. Counseling Services

8
DECISION
INFLUENCERS Executive Summary

Creating Competitive Data

Benefit Plan Security

Measuring ROI From Matching Employer-

Benefit Changes Employee Interests

Rising Costs Uncertainty About

Of Benefits Healthcare Reform

The survey identified six factors companies consider when making benefit decisions and to what
degree these factors influence their choices. As expected, companies weigh numerous considerations
when making benefit decision, which is why “significantly influenced” was the top choice across five
of the six factors. However, the extent to which “significantly influenced” was the most popular choice
varied across the options.

Rising cost of benefits and creating competitive benefit plans were the most influential factors with 84%
and 79% of respondents saying they significantly influence employer benefit decisions, respectively.
Only 1% of respondents are reportedly minimally influenced by those factors. The tightening labor
market is allowing employees to be more selective about where they choose to work, creating an
employer arms race to expand benefits while balancing costs. Since last year, data security also rose
slightly in influence, as technology becomes more ubiquitous and government organizations further
scrutinize cybersecurity practices. Despite the political turmoil in Washington, only 23% of employers
are expected to be significantly influenced by uncertainty about health care reform while 34% (the
highest of any of the factors) expect employers to be minimally influenced.

9
VENDOR
CRITERIA Executive Summary

Many employers will need to solicit the help of external vendors to implement a successful wellness
program, and they evaluate these vendors based on a number of categories. Based on the survey results,
two things are clear: (i) pricing is and remains the top criteria and (ii) customer testimonials and domain
expertise don’t really matter that much. Ninety-eight percent of brokers felt pricing was a top three
criteria when evaluating vendors, but very few felt customer testimonials and domain expertise were
a top three consideration. Innovation and technology (77%) as well as flexibility and customizability
(76%) were essentially tied for second highest criteria, followed by reporting and customer service.

Technology and innovation experienced a significant surge since last year, as apps and tools become
more numerous and easier to implement. Although pricing still ranked high, flexibility and customizability
ranked the highest for large employers. Otherwise, vendor criteria trends were relatively similar across
companies of all sizes.

98%

76% 77%
70%

57%

8%
4%

Customer Customer Domain Flexibility/ Innovation/ Pricing Reporting/

Service Testimonials Expertise Customizability Technology Measurement

10
 PART 1

PARTICIPANT
PROFILE
OVERVIEW Participant Profile

To better understand the perspectives of a vast and diverse set of employers, the 2020 Employee
Wellness Industry Trends report surveyed the trusted advisors of companies across the country—health
insurance brokers. Health insurance brokers and their wellness directors work closely with organizations
to develop short- and long-term strategies for employee wellness success as well as assist in the
identification and evaluation of vendors. Through responses from 117 of these professionals, the 2020
Employee Wellness Industry Trends report reflects the current positions of thousands of companies and
millions of employees. The survey also captured the geography, years of experience, and average
client size of the respondents to identify trends that may exist in specific demographics.

WA
NH ME
MT ND VT
OR MN
ID MA
SD NY
WI MI
WY
RI
IA PA CT
NE
NV NJ
IN OH
UT IL
CO WV
VA MD
CA KS MO DE
KY
NC
TN
AZ OK AK
NM SC

MS AL GA

TX LA

FL

12
OVERVIEW Participant Profile

62%

26%
AVERAGE
CLIENT SIZE

BROKER YEARS
OF EXPERIENCE

13
 PART 2

INVESTMENT
TRENDS
BIOMETRIC
SCREENINGS Investment Trends

Overall
The overwhelming research suggests that biometric
screenings do not deliver the results that employers
previously believed, and companies are taking note.
12%
Only 12% plan to invest more in these programs, a
decrease of 14 percentage points from just last year. 34%
While over half of companies do not plan to make
any changes, over a third plan to invest less, up from
29% in 2019. This is likely a result of the judicial
system vacating the EEOC wellness rules, which
took effect on January 1, 2019. Employers requiring
screenings run the risk of being sued. In December
2019, the EEOC did announce that it plans to provide
54%
guidance on wellness program regulations in January
2020, but this may be too late for employers making
decisions for the coming year. Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

64%
59%
55%
51% 52%
45% 45%
36% 36% 34%
29%
24% 24%
16%
13% 10%
7%
0%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

15
DISEASE
MANAGEMENT Investment Trends

Overall
Eighty-eight percent of employers will be investing
the same or more into disease management, which
suggests these programs are here to stay. Additionally,
12%
companies investing more rose by 11 percentage
points from last year. Disease management programs
are targeted, often focusing on specific chronic
conditions that may be particularly prevalent within 47%
an employee population.

Traditionally, disease management programs have 41%

been limited to larger employers that have enough
employees suffering from a specific condition to justify
the resources, but per the survey, more medium-sized
employers are continuing to adopt them. Over half
of medium-sized employers plan to invest more into Investing Less Investing Same Investing More
these types of programs in the coming years.

By Avg. Client Size By Years Of Experience

57%
54%
51%
48% 48%
45%
40% 39%
36% 38% 38%
29%
26%

14% 14%
10%
6% 7%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

16
FINANCIAL
WELLNESS Investment Trends

Overall
Financial wellness may be one of the “hottest” areas
of employee well-being. More than 64% of employers
7%
will be investing more into improving the financial
health of their employees. Only 7% plan to invest less
in the coming year.

29%
Larger employers tend to lead the way with emerging
wellness solutions, and financial wellness seems to be
no different with 86% of large employers planning to
invest more into these programs next year. No large 64%
employers plan to invest less.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

86%

67% 66% 64%

62%

48%

32% 34%
31% 31%
25%
19%
14%
10%
3% 3% 3%
0%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

17
FITNESS
CLASSES Investment Trends

Overall
A quarter of employers next year will be investing less
into on-site fitness classes. This is a slight decrease of
five percentage points from last year, accounted for 17%
by an equal increase in the number of companies 25%
investing the same. Well over half of employers are
keeping their investment the same. This may be the
result of limited scalability (i.e., space limitations, no
showering facilities on-site, not delivered digitally,
etc.). A lack of resources and infrastructure can make
it more challenging for companies to invest in this
specific resource; many companies prefer to stick to
gym reimbursements as a simpler, but similar, option.
58%

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

65% 64% 66%

58%
54%
52%

31% 31%
26% 26%
19% 21% 21%
17%
14% 14%
10% 12%

Investing
Investing
Investing
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Investing
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Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

18
FLU SHOTS Investment Trends

Overall
This survey was initiated in the middle of a flu
season, which may impact the responses. With
5%
65% of employers investing the same amount as
last year, most are sticking with their original plans.
30%
Additionally, the number of employers that plan to
invest more decreased by five percentage points from
the previous year. This may be driven by last year’s
flu shot not being effective against one virus that
appeared later in the season, thereby decreasing its
overall effectiveness to just 29%. It may have lowered
more people’s confidence in the vaccine’s ability to
65%
prevent illness.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

71% 69%
68% 69%

55%
52%
45%
42%

26% 24% 25%

21%

6% 7% 7% 5%
3% 3%

Investing
Investing
Investing
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Less Investing
Investing
Investing
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Same
Same Investing
Investing
Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

19
FREE HEALTHY
FOOD Investment Trends

Overall
Since millennials value on-site benefits in their
employment decisions, it is likely that free healthy
food as an employee benefit may partially be driven 14%
by non-wellness motives.

35%
While roughly the same number of employers as
last year expect to invest more in healthy food, the
number of companies that expect to invest less went
down by eight percentage points. It is not surprising
that large companies, most of all, plan to invest more
in this coveted benefit. However, the number of small
companies that expect to do the same went up by
51%
an impressive 17%. The sustained demand for this
benefit highlights a tightening labor market where
employers are increasing perks to recruit and retain Investing Less Investing Same Investing More
talent.

By Avg. Client Size By Years Of Experience

57% 59%
50% 51%
45% 45%
41%
39% 38%
36%
31% 31%

19%
16% 14% 14%
13%
3%

Investing
Investing
Investing
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Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

20
GYM
REIMBURSEMENT Investment Trends

Overall
Seventy-eight percent of employers will be investing
more or the same in gym reimbursement programs,
the same amount as last year. However, 11% of 19% 22%
those companies shifted from planning to invest more
to maintaining their current offerings. The shift was
largely driven by medium and small employers, as
large employers are choosing to invest more.

The trend of maintaining these programs reflects how

attractive they are in a highly competitive job market,
with millennials in particular placing a higher value
on total rewards programs and benefits.
59%

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

63% 62%
59%
55% 55%
50%

29% 27% 28%

26%
19% 19% 21% 21%
18% 17% 17%
14%

Investing
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Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

21
HEALTH
COACHING Investment Trends

Overall
Health coaching trends stayed roughly the same as
last year, with only a slight increase in companies
planning to invest more. Interestingly, small employers
are the most likely to increase their investment, up 25%
30%
by 12 percentage points from the previous year.
Companies with the least-experienced brokers are
also investing more than last year.

Health coaches have been shown to drive employee

engagement in wellness programs. Even though
small or medium companies may have less resources
to implement benefits, they can get the most value
out of their investments by encouraging participation. 45%
Additionally, younger generations tend to prefer a
more personalized approach to wellness that a coach Investing Less Investing Same Investing More
can offer.

By Avg. Client Size By Years Of Experience

57% 55%
48%
42% 41% 42%
35% 36%
29% 31% 31% 29%
29% 28%
22%
14% 16% 14%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

22
HEALTH EDUCATION/
LITERACY Investment Trends

Overall
Having access to and engaging with quality, relevant,
and timely health content is critical to well-being.
With the growing amount of misinformation available
13%
to consumers via the internet, the role of employers
29%
in facilitating health literacy has never been more
important.

However, while 87% of companies either plan to invest

to same or more in health education and literacy, this
is a decrease in nine percentage points from last year.
While it is a valuable benefit, many employees may
not immediately recognize it as important or view it 58%
as an attractive perk.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

61% 62%
57% 59%
56%
52%

35% 36% 34%

31%
25% 25%
19%
13% 14%
7% 7% 7%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

23
HEALTH FAIRS Investment Trends

Overall
Health fairs are very similar to health coaching
programs. However, as health coaching saw a slight
increase in interest this year, health fairs had an
23%
opposite trend with a decrease in interest. Three out
30%
of ten companies expect to invest less, up from 21%
the previous year.

This may be due to a shift in employee interest towards

more personalized solutions. Health fairs lack a tailor-
made feel and tend to present more generalized
information because they target a large group of
people at once. Also, as remote work continues to
increase, there are additional challenges to delivering
47%
a successful health fair.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

57% 56%
49%
41%
39% 38%
32% 34% 34% 34%
29% 29% 31%
29%
22% 21%
14%
10%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

24
HEALTH RISK
ASSESSMENTS Investment Trends

Overall
Similar to biometric screenings, the utilization of
health risk assessments (HRAs) were at risk due to the
EEOC wellness rules that were vacated on January 1, 14%
2019. In December 2019, the EEOC did announce
that it plans to provide guidance on wellness program
regulations in January 2020, but this may be too late 39%
for employers making decisions for the coming year.

The potential risk for being sued has resulted in a

decrease in HRAs’ popularity with companies across
the board. Nearly four out of ten employers now plan 47%
to invest less, a 12% increase from last year. Only
14% plan to invest more, with no large companies
interested in doing so.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

71%
69%

52%
48%
43% 44%
42% 41% 39%
35%
29%

16% 15% 17% 17%

14%
7%
0%

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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

25
MENTAL HEALTH Investment Trends

Overall
Of all wellness benefits, mental health programs
experienced the most astounding increase in
4%
popularity. They are rapidly gaining traction with
80% of employers planning on investing more into
15%
these types of programs. Only 4% are planning to
invest less. While medium and large companies are
more likely to offer these programs, small companies
are catching up. Since last year, the number of small
companies investing more in mental health almost
doubled.

According to the survey, no large employers plan to 80%

invest less into mental health. Brokers of all experience
levels understand the value of this popular benefit
and are pushing clients to invest this area. Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

90%
86% 86%
79% 78%

55%

32%

21%
14% 15%
13%
8% 10%
7%
1% 3%
0% 0%

Investing
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Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

26
MINDFULNESS/
MEDITATION Investment Trends

Overall
Mindfulness and meditation programs are directed
towards alleviating stress, a major cause of mental
9%
health concerns for employees. As interest in
mental health greatly increases, it stands to reason
that mindfulness would also grow in popularity.
Coupled with strong consumer market demand, more
25%
companies continue to prioritize these programs.

Two-thirds of companies expect to invest more in

mindfulness, with small and medium companies 66%
leading the way. Small companies experienced the
most change, with a 29 percentage point increase
from last year for those planning to expand their
mindfulness offerings. Traditionally, these services
required larger budgets to scale, but with the Investing Less Investing Same Investing More
advent of digital mindfulness and meditation tools,
organizations with limited resources are able to offer
these programs.

By Avg. Client Size By Years Of Experience

74% 76%
69%

59%
55%
50%

36%

26% 28% 27%

22%
19% 17%
14% 14%
7%
4% 3%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

27
ON-SITE/NEAR-SITE
CLINICS Investment Trends

Overall
On-site and near-site clinics are costly benefits
that have significant space and upfront capital
requirements. Also, to be cost effective, they require a
22% 24%
large enough employee population and high enough
utilization to justify the costs. This explains why larger
companies, which have more resources, are most
likely to invest more in this type of benefit.

Just one year ago, no large companies expected to

invest more. Now, 36% plan to expand on-site or
near-site clinics. As wellness programs in general
increase in popularity with companies of all sizes,
large companies may see on-site and near-site clinics 54%
as an opportunity to make their programs really stand
out. Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

56% 57% 55% 55%

53%
48%

35% 36%
28% 28% 27%
22% 22% 20%
16% 17% 17%

7%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

28
SLEEP
MANAGEMENT Investment Trends

Overall
Sleep is a critical element of overall well-being, but
until recently, it was often neglected by employee
12%
wellness programs. Companies today are starting
to acknowledge sleep’s importance, with 26% (10% 26%
more than last year) planning to invest more.

Small and medium employers are marginally leading

the way, likely due to its lower associated costs that
made this dimension of wellness — previously off
limits to groups with limited budgets — available to
address. Still, sleep management is relatively new
to many wellness programs, and the majority of
62%
companies do not plan to increase investment.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

79%

64% 62% 64%

59%
52%

31%
26% 28%
23% 24% 24%
21%
14% 12%
8% 10%

0%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

29
STRESS MANAGEMENT/
RESILIENCE Investment Trends

Overall
Under the umbrella of mental health, stress management
and resilience had similarly impressive growth in
4%
popularity. Seventy-three percent of employers will be
investing more in stress management programs, up
from 58% the year before. Only 4% are expected to
23%
invest less.

Unlike last year, which saw mostly large and medium

companies leading the way, companies of all sizes
now plan to invest more in stress management. Small
companies investing more increased by 39 percentage 73%
points, up to 65%, in just one year. Additionally, many
more less-experienced (under ten years) brokers are
encouraging their clients to invest more. This may be
due to younger generations’ growing interest in self- Investing Less Investing Same Investing More
care and mental health support.

By Avg. Client Size By Years Of Experience

78% 79%
76%
68%
65% 64%

36%

25%
22% 21% 21%
19%
16%
7%
3%
0% 0% 0%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

30
TELEMEDICINE Investment Trends

Overall
With the promise of controlling costs with more
affordable visits, telemedicine has surged over the
3%
last decade. Driven initially by large companies,
small and medium employers are now the most likely
to invest more in telemedicine. More than six out of
ten companies plan to invest more, whereas only 36%
3% of companies are investing less. These numbers
barely changed from the previous year, reflecting this
benefit’s sustained popularity.
62%
Encouraging utilization of telemedicine, however,
can be difficult for employers. Seven percent of large
companies (up from none last year) are planning to
invest less this year, up from none just a year ago.
Despite this, telemedicine still has one of the highest Investing Less Investing Same Investing More
percentages of employers expecting to invest more.

By Avg. Client Size By Years Of Experience

65% 66%
61% 61%
59%
50%
43% 41%
37%
35%
32%
28%

6% 7% 7%
0% 0% 2%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

31
TOBACCO
CESSATION Investment Trends

Overall
Tobacco use amongst adults in the United States has
steadily declined since the mid-1960s, but seems
12%
to be bottoming out around 15%. Although usage
22%
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. Many employers already
offer smoking cessation benefits; however, some
companies may not recognize tobacco usage as an
obvious problem to address because e-cigarettes and
other products have made tobacco use more discrete.

66%
Two-thirds of companies expect to invest the same this
year, a slight increase from 57% last year. This appears
to be the result of a change within small companies. Investing Less Investing Same Investing More
Last year, they were significantly more likely to invest
more in cessation programs; the majority (68%) plan
to maintain their current spending this year.

By Avg. Client Size By Years Of Experience

86%

71%
68%
61% 62%
59%

38%

26% 24%
19%
14% 15% 14%
13% 13%
7% 7%
3%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

32
WEIGHT
MANAGEMENT Investment Trends

Overall
While few employers (9%) will be investing less
in weight management programs, this is a four
9%
percentage point increase from the following year.
This change is mostly a result of more large companies
24%
deciding to spend less, up to 14% from none last
year. Large companies spending more also dropped
over thirty points, from 45% to 14%.

Still, similar to last year, two-thirds of employers plan

to invest the same into weight management programs.
These programs have largely remained steady despite
little evidence suggesting they are effective or good 68%
for employees. However, as larger companies often
lead the way in trends, this may be a sign that these
programs will decrease in popularity in the future. Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

71%
68% 67% 69% 69%
66%

26% 25% 24% 24% 24%

14% 14%
8% 10%
6% 7% 7%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

33
WELLNESS
CHALLENGES Investment Trends

Overall
Wellness challenges generally embrace technology,
making the delivery of a quality and consistent
9%
experience to multiple offices and remote employees
easy. As employers embrace flexible work
environments, the value of digital solutions increases,
which may partially explain the number of employers 40%
investing more in wellness challenges. Ninety-one
percent of employers expect to invest the same or
more in wellness challenges. The demand for these
solutions is strong across all employer sizes. Similar
51%
to last year, clients of brokers with zero to five years
of experience were the most interested in investing
more, which may be the product of having younger,
more technology-oriented advisors.

Investing Less Investing Same Investing More

By Avg. Client Size By Years Of Experience

58% 58% 59%

55%
50% 52%
43% 45%
35% 35% 34%
29%

13% 14%
7% 7% 7%
0%

Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More Investing
Investing
Investing
Less
Less
Less Investing
Investing
Investing
Same
Same
Same Investing
Investing
Investing
More
More
More

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

34
 DEEP DIVE

CAREGIVER
SUPPORT
CAREGIVER
SUPPORT Investment Trends

84%

67%

53%

25% 24%
12%
8% 5% 6% 8%
1% 1% 3% 3%

On-site Or Near-Site

On-site Or Near-Site

Service Subsidies

Service Subsidies
Voluntary Reduced
Telecommuting

Counseling
Job Sharing
Paid Time Off

Unpaid Leave

Caregiver-Provider

Caregiving Support
Flexible Work

Caregiving
Seminars/

Groups/Networks
Remote Work/

Referral Services

Classes
Services
Time/Part-Time
Schedules

Child Care

Elder Care
(PTO)

Child Care

Elder Care
Work

As the baby boomers age, millions of American workers are taking on the role of caregiver. Additionally, many households
today feature two working parents. Caregiving alongside a full-time job can strain resources and add substantial stress
to workers’ daily lives. The need for companies to support caregivers is compounded by the fact that younger workers
increasingly value mental wellness and a healthy work-life balance.

Considering how relevant caregiver support has become, this year’s survey explored what specific programs employers
are implementing to address this element of well-being. It asked each respondent to identify the top three offerings
employers are using to support caregivers. Overwhelmingly, flexible work schedules (84%), remote options (67%), and
paid time off (53%) were the most-coveted programs. Being able to monitor family members, attend appointments, or
handle emergencies can make normal work schedules unachievable. These programs are also affordable and easy for
companies to implement. Importantly, while unpaid leave (12%), part-time work (8%), and job sharing (1%) also free
up time, employees are unwilling to lose benefits and income they require to cover caregiving needs. The next important
programs were counseling services (25%) and caregiver-provider referral services (24%). Both alleviate the mental stress
associated with coordinating care.

Programs that included subsidies and on-site/near-site care also received very few votes (between 1% and 6% each),
likely due to costs. Care centers in particular require substantial resources and are not easily scalable. Seminars (8%) and
support networks (3%) were also unpopular, possibly due to a lower demand from workers.

36
 87%
87%
Flexible
Flexible Work
Work Flexible Work

81%
82%
Schedules
Schedules Schedules

83%
86%

49%
Paid
Paid Time Off
TimeOff Paid Time Off

56%
55%55%
(PTO)
(PTO) (PTO)

54%
43%

7%
13%
Unpaid
Unpaid Leave
Leave Unpaid Leave

18%
11%

12%
14%

56%
77%
Remote
Remote Work/
Work/ Remote Work/

74%
66%
Telecommuting
Telecommuting Telecommuting

69%
50%

7%
10%
Voluntary Reduced
Voluntary Reduced Voluntary Reduced
Time/Part-Time

4%
Time/Part-Time Time/Part-Time
Work
Work Work

7% 7%

10%
SUPPORT

3%
3%
JobJob Sharing
Sharing Job Sharing

Small (< 250)

0% 0%
0% 0%

0 - 5 years
CAREGIVER

35%
Counseling
Counseling Counseling 29%

25%
Services 27%
Services Services

7%

20%

37
24%
23%

Caregiver-Provider
Caregiver-Provider Caregiver-Provider

6 - 10 years
14%
18%

Referral
Referral Services
Services Referral Services

29%
57%

Medium (250 - 1,000)

By Avg. Client Size

3%
0%

By Years Of Experience
Onsite
On-site Or Or Near-Site
Near-Site Onsite Or
On-site Or Near-Site
Near-Site

7%
4%

Child
Child Care
Care Child Care

10+ years
5%
21%

Onsite
On-site Or Or Near-Site
Near-Site Onsite Or
On-site Or Near-Site
Near-Site

0% 0%
0% 0%

Elder
Elder Care
Care Large (1,000+) Elder Care

2%
7%

0%

10%
Child
Child Care
Care Child Care

4%
10%

Service
Service Subsidies
Subsidies Service Subsidies

5%
0%
0%

Elder
Elder Care
Care Elder Care

0% 0%
4%

Service
Service Subsidies
Subsidies Service Subsidies

7%
7%

7%
3%

Caregiving
Caregiving Caregiving
Seminars/
Seminars/ Seminars/

18%
11%

Classes
Classes Classes

3%
0%
0%

10%
Caregiving
Caregiving Support
Support Caregiving Support
4%

Groups/Networks
Groups/Networks Groups/Networks

0% 0%
0%
Investment Trends
 PART 3

DECISION
INFLUENCERS
CREATING COMPETITIVE
BENEFIT PLANS Decision Influencers

Overall
As the economy continues to grow and with

1% unemployment at its lowest point in decades, finding

15% and retaining quality employees is becoming
increasingly challenging. In response to the tightening
labor market, employers are expanding benefits to
secure talent, which is why the survey results presented
here should come as no surprise. Eighty-four percent
of employers are significantly influenced by their
desire to create competitive benefit plans for their
employees! Growing benefit plans are touching all
segments of employee life, including employee health

84% and well-being.

Minimally Influenced Somewhat Influenced Significantly Influenced

By Avg. Client Size By Years Of Experience

93%
87%
83% 81%
79% 79%

21% 21%
15% 17%
13%
7%
0% 1% 0% 0% 0% 2%

Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

39
DATA SECURITY Decision Influencers

Overall
In the wake of major data breaches, heightened
government scrutiny, and ethical concerns, employers
12%
remain sensitive to being good stewards of their
employees’ data. This influencer has nearly doubled
in importance in the past year, with over half of
employers being significantly influenced by this factor.

52% This is likely because employers are becoming more

36% concerned about legal and ethical issues as both

technology and regulations expand. Previously,
larger employers, many of which have dedicated
teams focused on data security, were most influenced
by this factor. This year, companies of all sizes are
taking note.

Minimally Influenced Somewhat Influenced Significantly Influenced

By Avg. Client Size By Years Of Experience

62%

52% 53% 53%

50%
43% 41% 41%
38% 36%
29% 31%

19% 17%
10% 12%
7% 7%

Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

40
MATCHING EMPLOYER-
EMPLOYEE INTERESTS Decision Influencers
Overall
Alongside creating competitive benefit plans and
rising cost of benefits, matching employer-employee
5%
interests significantly influences the decisions
companies make. Only 5% of employers are minimally
influenced by this factor. Often, the struggle between
27% these two interests can be difficult to manage, which
is regularly the case with health insurance. Many
employers want to offer attractive health insurance
options, but the growing costs associated with doing
so tempers their ability to deliver affordable and
68% attractive plans.

Smaller employers are slightly less influenced by

matching interests. Perhaps this is due to it being
easier to understand the interests of smaller groups.
Larger and medium employers are most influenced by
Minimally Influenced Somewhat Influenced Significantly Influenced
this factor.

By Avg. Client Size By Years Of Experience

72% 71% 72%

69%
64%

55%

35%
29% 31%
28%
24%
21%

10%
7% 5%
4% 3%
0%

Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

41
MEASURING ROI FROM
BENEFIT CHANGES Decision Influencers
Overall
The results from this survey response clearly suggests
that most employers are still thinking about deriving
16% a measurable return on investment (ROI) from benefit
plan changes, with 84% being significantly or
somewhat influenced by this factor.

44%
Small and medium companies are more likely to
be significantly influenced by this factor, possibly
because they want to scrutinize how well they utilize
their more limited resources. However, measuring ROI
40% continues to be difficult, which may be why clients of
experienced brokers (10+ years), who have come to
realize that measuring ROI is not always attainable or
worth the expense of tracking, are more likely to be
minimally influenced by this factor than others.
Minimally Influenced Somewhat Influenced Significantly Influenced

By Avg. Client Size By Years Of Experience

71%

52%
47% 48%
45% 45% 44%
39%
35% 34% 34%

21% 22%
16% 18% 17%

7%
3%

Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

42
RISING COST
OF BENEFITS Decision Influencers

Overall
The need to offer attractive benefits to recruit and

1% retain talent in the current labor market is increasing

the amount of financial investment required by
20%
employers. This goes beyond just the rising cost of
health insurance, as the expansion of benefits to remain
competitive is also increasing costs significantly.

This influences every type of employer with nearly all

of them being significantly or somewhat influenced
by rising costs. Brokers with the most experience also
are also the most influenced by the rising costs of
79% benefits.

Minimally Influenced Somewhat Influenced Significantly Influenced

By Avg. Client Size By Years Of Experience

85%
81% 81% 79%
71%
69%

29% 28%
19% 21%
18%
15%

1% 3%
0% 0% 0% 0%

Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

43
UNCERTAINTY ABOUT
HEALTHCARE REFORM Decision Influencers

Overall
The regulatory environment is constantly changing
so sentiment on this factor will evolve accordingly.
Specifically, this survey was initiated before the
23%
EEOC announced, in December 2019, that it plans
34% to provide guidance on wellness program regulations
in January 2020. Unfortunately, this may be too late
for employers making decisions for the coming year.
Unfortunately, the vast majority of employers cannot
do much to change the consequences health care
reform will have on their businesses, regardless of how
large the financial or non-financial impact may be. So,
for many, it is just a waiting game. Nevertheless, this
43%
does not change how influenced they are by reform,
which is why two-thirds of employers are somewhat
or significantly influenced by this factor.
Minimally Influenced Somewhat Influenced Significantly Influenced

By Avg. Client Size By Years Of Experience

57% 55%
48%
42% 41%
36% 38% 36% 37%
35%
29% 28% 27%
23% 24%
21%
17%

7%

Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly Minimally
Minimally
Minimally Somewhat
Somewhat
Somewhat Significantly
Significantly
Significantly

Small (< 250) Medium (250 - 1,000) Large (1,000+) 0 - 5 years 6 - 10 years 10+ years

44
 PART 4

VENDOR
EVALUATION
TOP CRITERIA WHEN
EVALUATING VENDORS Vendor Evaluation

76% 77%
70%

57%

8%
4%

Customer Customer Domain Flexibility/ Innovation/ Pricing Reporting/

Service Testimonials Expertise Customizability Technology Measurement

Based on the survey results, two things are clear: (i) pricing is and remains the top criteria and (ii)
customer testimonials and domain expertise don’t really matter that much. Ninety-eight percent of brokers
felt pricing was a top three criteria when evaluating vendors, but very few felt customer testimonials (4%)
and domain expertise (8%) were a top three consideration. Innovation and technology (77%) as well as
flexibility and customizability (76%) were essentially tied for second. These were followed by reporting/
measurement (70%) and customer service (57%).

Technology and innovation experienced a significant surge since last year, as apps and tools become
more available and easier to implement. Reporting also grew more with medium and large companies,
possibly out of an interest to monitor costs and identify the most valuable programs. Interestingly, the
importance of each vendor criteria remained relatively similar across companies of all sizes. One
exception was flexibility and customizability ranking the highest for large employers, which are more
likely to have the most substantial budgets.

46
TOP CRITERIA WHEN
EVALUATING VENDORS Vendor Evaluation

By Avg. Client Size

77%
73% 75% 73%

66%
61%
57% 58%
55% 53% 51%
52%
47%

39%
37%

16%

3% 4% 3%
0% 0%

Customer Customer Domain Flexibility/ Innovation/ Pricing Reporting/

Service Testimonials Expertise Customizability Technology Measurement
Small (< 250) Medium (250 - 1,000) Large (1,000+)

By Years Of Experience
83%
79%

69% 70%
63% 65%
62%
59%
52% 52% 51%
48%
41% 41%
38%

7% 7%
3% 3% 3% 3%

Customer Customer Domain Flexibility/ Innovation/ Pricing Reporting/

Service Testimonials Experti se Customizability Technology Measurement
0 - 5 years 6 - 10 years 10+ years

47
APPENDIX
SURVEY
QUESTIONS Appendix

1. Where are you based?

2. How many years of experience do you have working in employee benefits or wellness?
0-5 years 6-10 years 10+ years

3. What’s your average client size?

Small (< 250) Medium (250 - 1,000) Large (+ 1,000)

4. How much are your clients investing in the benefits listed below compared to the previous year?
Scale of 1 (Investing Significantly Less) to 5 (Investing Significantly More)

5. How much are your clients’ decisions influenced by the factors listed below?
Scale of 1 (Minimally Influenced) to 5 (Significantly Influenced)

6. What are your top criteria when evaluating wellness vendors (choose top 3)?

7. What offerings are your clients using to support caregivers in the workplace (choose top 3)?

49
ABOUT WELLABLE
Wellable is a wellness technology platform that en-
ables organizations to create programs that help employ-
ees thrive by engaging them in holistic well-being edu-
cational modules and activities. Wellable supplements
its digital experience with onsite services and rewards
administration to maximize engagement, resulting in
a healthier, happier, and more productive workforce
and greater business success. Wellable works with
employers and health plans of all sizes across the
world, with active users in more than 23 different
countries.

Visit us online at www.wellable.co and follow

us on social media!

50