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THE HERO HEALTHAND WELL-BEING BESTPRACTICES SCORECARDIN COLLABORATIONWITH MERCER MANUFACTURING PRODUCTSBENCHMARK REPORTJANUARY, 2019

A benchmark report fromThe HERO Health and Well-being Best PracticesScorecard In Collaboration with MercerAbout the HERO ScorecardThe HERO Health and Well-being Best Practices Scorecard is designed to help employers, providers, andother stakeholders learn about and determine employee health management best practice. It's also aneffective means of gathering data on the state of health and well-being in the US today -- data that can beused to develop benchmarks. The Scorecard is divided into six sections representing the foundationalcomponents that support exemplary health and well-being programs. While no inventory of best practiceswill include all innovative approaches to health and well-being, we have included those most commonlyrecognized among industry thought-leaders and in published literature.The Scorecard asks detailed questions about employers’ health and well-being program design,administration, and experience, and assigns respondents an overall best practice score out of a possible200 points. While a Scorecard score of 200 is theoretically possible, it is not likely nor even desirable for anemployer to have every possible health and well-being program and strategy in place. A separate ProgramOutcomes section is included to serve as a guide for a “dashboard” of measures that may be useful inassessing program success. Information in this section does not contribute to an organization’s bestpractice score, but is used to develop outcomes benchmarks.About this Benchmark ReportThis Benchmark Report is based on the responses of the 1026 employers that have submitted completedScorecards as of September 30, 2018. It provides both their aggregated scores and their aggregatedquestion responses. These results have been sorted by organization size to allow employers to comparetheir programs to organizations representing manufacturing products organizations of varying size. Formore information, please visit the HERO web-site at www.hero-health.org.NUMBER OF PARTICIPANTSAll employersDISTRIBUTION OF SCORES ACROSS RESPONDENTS1026Employer size*Employers with fewerthan 500 employees375Employers with 500-4,999employees432Employers with 5,000 or moreemployees195*Among employers providing data150 - 200125 - 149points,points,0.0886930.150097 957466100 - 124points,0.1705653021 - 24 25 - 49points, points,0.0536060.12475623833550 - 74points,0.18421052675 - 99points,0.228070175

Scorecard CommentaryManufacturing: Their Approach to Health and Well-beingBy Colleen Saringer, PhD, MEd, Alliant Employee BenefitsAlthough it’s been established that health and well-being initiatives in the workplace can improve health,reduce absenteeism, and positively impact employee productivity and retention, some organizations arehesitant to embrace these initiatives to their fullest. That’s the reason benchmarking becomes so important; sothat organizations can gain an understanding of what others comparable in sector and demographics are doing.The HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer (Scorecard) supportsorganizations in their health and well-being benchmarking efforts. The Scorecard includes six sections (strategicplanning; organizational and cultural support; programs; program integration; participation strategies; andmeasurement and evaluation) as well as demographic information on employer size, turnover rates, male tofemale ratios, and percentage breakdowns of employees who occupy full time and part time employmentpositions. The highest possible score is 200; the highest score attained to date is 180. The purpose of thiscommentary is to discuss the collective results of organizations classifying themselves as manufacturingproducts (e.g. equipment, chemicals, food/beverage, printing/publishing, etc.) from the perspective of currentbest practices and future opportunities.As of September 2018, 10,026 organizations had completed the US version of the HERO Scorecard. Of theScorecard completers providing information on their industry, 16% self-identified their primary sector asmanufacturing products, representing the highest of all industry types. Of the organizations within this groupproviding demographic data, 67% of their employees are male, with an average age of 44, and primarily workfull-time (95%). This group of manufacturing employers has an average overall score of 92 on the Scorecard.Among the 13 industry categories represented on the Scorecard, the manufacturing products sector is the fifthhighest in overall scoring, falling behind hospitals and health care clinics (116), government (104), andprofessional/technical services (93).Although benchmarking by industry type is critical to organizations, obtaining insight by size within industrytype is equally important. Analysis of the HERO Scorecard benchmark database examined scores within eachsector, with responses and scores broken down by small ( 500 employees), mid-size (500 – 4,999 employees),and large (5,000 or more employees) employers. Within the manufacturing products organizations whocompleted the Scorecard, 57 were small employers with an average score of 85 points, 78 were mid-size withan average score of 88 points, and 31 were large employers with an average score of 109 points. In pastScorecard analyses large employers have tended to have the higher scores followed by the mid-size and smallemployer groups. This analysis finds large manufacturing employers have the highest scores but comparisonsbetween the mid-size and small employer groups yield less obvious differences. The greatest difference in theScorecard results between the large- and small-sized manufacturing groups is a 7-point higher score by largeemployers in the Programs section and the Participation Strategies section. Although only a speculation, thisdifference may be a result of budgeting. Meaning, smaller companies may not have the budget to makeavailable programs to their employees which in turn, would impact participation strategies. Smaller employerscould potentially address this deficit by gaining an understanding of what programs the larger manufacturinggroups offer to their employees and either working internally with available resources and/or externally withcollaborative partners to provide similar offerings at a smaller scale.Best Practice ScoresThe average manufacturing products sector overall score (92) is equal to the overall HERO Scorecard norms.Component scores are also quite similar. As previously stated, the manufacturing products group makes up thelargest sector in the scorecard which could explain why there is such close alignment with the NationalScorecard. A deeper dive into the four industry groups that exceed in score over the manufacturing products

sector yields insights for ways to improve the strength of initiatives in the manfucturing sector. Specifically: Organizational and culture support: colleges and universities average 28 points, hospitals and health careclinics average 27 points, and financial and other health services average 26 points in comparison to themanufacturing products score of 21 points. Programs: colleges and universities average 27 points, hospitals and health care clinics average 26 points, andfinancial average 24 points in comparison to manufacturing products score of 23 points. Participation strategies: hospitals and health care clinics average a score of 28 points while colleges anduniversities and financial services organizations average a score of 27, in comparison to the manufacturingproducts score of 23 points.Also as previously discussed, understanding the differences by group size within a business type is equallyimportant. Within the manufacturing products small, mid-size, and large employer groups, Scorecard pointsachieved by section resemble the following: Strategic planning: small 10 points; mid-size 9 points ; large 11 points Organizational and cultural support: small 21 points ; mid-size 20 points ; large 22 points Programs: small 21 points; mid-size 23 points; large 28 points Program integration: small 4 points; mid-size 4 points; large 6 points Participation strategies: small 22 points; mid-size 22 points ; large 29 points Measurement and evaluation: small 9 points; mid-size 9 points; large 11 pointsInterestingly, what we see within manufacturing products breakout is that regardless of size, scores alignclosely in organizational and culture support and program integration. Past HERO Scorecard business sectorcommentaries have noted similar observations. What’s been speculated is that practices in these sectionsmight be harder to implement in larger organizations due to a greater number of, and more widely dispersed,worksites coupled with a more complex organizational structure.Strengths and OpportunitiesA deep dive into each one of the scorecard sections by manufacturing products group company size is outsideof the scope of this commentary. However, strengths and opportunities have been observed.The HERO Scorecard manufacturing products sector had 166 companies completed the scorecard. This is anotable number given the challenges manufacturing plants often face when initiating health and well-beinginitiatives such as competing priorities (e.g. production goals versus allowing employees time to leave the plantfloor to participate in onsite programming) and high turnover rates. 1Scorecard results suggest that manufacturing organizations want to make a healthy workplace and cultureavailable for their employees. For example, 55% survey their employees for interest, feedback and overallprogram satisfaction; and when union employees are a present, 82% make key components of their health andwell-being initiatives available to this group. Although healthy behavior policies are less commonly reported tohave been implemented, efforts around tobacco and nutrition are the most commonly reported (59%).As difficult and important as it is to engage leaders, 52% of leaders within this group are reported to haveparticipated in the health and well-being programs made available. Given the importance peer support plays ininfluencing behavior, wellness champions are reported as part of the initiative 47% of the time, and are heavilysupported through regular meetings, resources, and rewards/recognition.

Although onsite programming is often a challenge in the manufacturing plants due to limited and/or no timeavailable for employees to leave the plant floor to participate, biometric screenings, in-person behavior changeprogramming, EAP, and disease management programs are most often available ( 70%). Financial incentivesare commonly utilized (74%), and most often delivered in the form of a premium reduction (54%) or cash/giftcards (40%). Finally, outcomes/metrics are most often tracked in the form of employee participation inprograms (e.g. biometrics) and health care costs.Organizations within the manufacturing sector have a distinct opportunity to enhance their health and wellbeing efforts through increased collaboration with their safety programs. Of these manufacturing organizations,more than 91% noted safety as a priority within their organization but only a small number reported integratingtheir safety and health and well-being programs. Because employees tend to trust their safety department andsafety managers, health and well-being offerings that appear integrated rather than as a “stand alone” can buildon this credibility to achieve greater employee participation and impact on key health behaviors: 2,3 Coordinated programs result in increased smoking cessation, physical activity, dietary improvements, andstrengthened safety programs. A reduction in injury rates are experienced when an employee is in good physical condition, is absent ofchronic disease, and has good mental health.ConclusionOrganizations that manufacture products are making substantial investments in health and well-beinginitiatives. As with all business sectors, opportunities exist for enhancements. The HERO Scorecard plays avaluable role in helping manufacturing companies identify strengths and opportunities within their current andfuture health and well-being initiatives.References1.United States Department of Labor. Bureau of Labor Statistics: annual quit rates by industry and region, 2017.2.Sorensen G, et al. Integrating worksite health protection and health promotion: a conceptual model forintervention and research. Prev Med. 2017: 91:188-196.3.Centers for Disease Control and Prevention. The National Institute for Occupational Safety and health. 2018.

The HERO Health and Well-being Best Practices Scorecard in Collaboration with Mercer MFG Manufacturing Products OrganizationsSmall 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employeesNumber of respondentsOverall average score (maximum score: 200 points)National ALL Small Medium LargeResults MFG MFGMFGMFG102616657783192928588109101010911Section 1: Strategic PlanningAverage score for section 1 (maximum score: 20 points)123Data sources used in strategic planning for health and well-being programWORKFORCE HEALTH MEASURESMedical / pharmacy claimsBehavioral health claims70%34%84%37%78%22%82%41%97%52%Health assessmentBiometric screeningFitness assessmentDisability %30%85%88%15%33%Absence / sick days dataNone of the aboveNumber of 3EMPLOYEE SURVEYSEmployee interest / feedbackEmployee morale / satisfaction / engagement dataNone of the aboveNumber of 39%36%7567%67%9%33BUSINESS MEASURES / ORGANIZATIONAL ASSESSMENTEmployee / business performance dataEmployee retention / recruitment dataCulture / climate assessmentNone of the aboveNumber of 35%4925%28%30%48%6734%19%41%31%32Have a long-term plan (2 or more years) onlyHave an annual plan onlyHave both a long-term and annual planDon't have a formal %9%21%36%33%Number of respondents1018166547933Formal, written, strategic plan for health and well-beingMeasurable objectives included in health and well-being strategic plan (among employers with a plan)Participation in health and well-being programs88%92%90%91%95%Changes in health risksImprovements in clinical measures / outcomesAbsenteeism reductionsProductivity / performance impactFinancial outcomes measurement (medical plan cost or otherhealth %24%15%86%59%27%32%52%64%65%64%64%Winning health and well-being program awards (e.g., Koopaward)Recruitment / retentionEmployee satisfaction / morale and engagementCustomer 5%55%9%41%9%41%14%None of the aboveNumber of respondents4%5591%860%310%335%22THE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 6

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees45National ALL Small Medium LargeResults MFG MFGMFGMFGKey components of the health and well-being program are available to various populations (amongemployers with each population segment)Union employees82%82%69%78%95%Spouses / domestic partners (DP)Dependents other than spouses or DPsPart-time %57%Employees located outside of the U.S.English as a Second Language (ESL) 13%9%14%17%Employees on disability leaveNumber of respondents82%87780%15072%4683%7284%32Program specifically addresses the needs of employees with different health statusesHealthy95%95%98%93%97%At riskChronically illAcute health needs (or catastrophic health 8%72%Number of respondents9241514871326Employer opinion: To what extent is your health and well-being program viewed by senior leadership asconnected to broader business results?To a great extent27%21%29%19%12%To some extent53%56%60%49%64%Not seen as connected20%24%12%32%24%Number of respondents10021605275337Employer opinion: How effective is the strategic planning process for health and well-being?Very effectiveEffectiveNot very effectiveNot at all effectiveNumber of %537%47%41%5%7612%52%30%6%33Section 2: Organizational and Cultural SupportAverage score for Section 2 (maximum score: 50 points)82321212022Company vision / mission statement supports a healthyworkplace culture34%31%33%29%33%Employee health and well-being is included in organization’sgoals and value statements38%36%38%33%39%Senior leaders consistently articulate the value and importance ofhealth (for example, by connecting health to productivity /performance and business results)42%35%42%34%24%None of the aboveNumber of respondents37%101541%16437%5243%7945%33Methods of communicating health valuesTHE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 7

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees9Policies relating to employee health and well-beingAllow employees to take work time for physical activity30%25%30%18%36%Provide opportunities for employees to use work time for stressmanagement and %59%58%53%53%61%48%64%Policies promoting responsible alcohol use38%35%26%38%39%Support work-life balance (for example, with flex time or jobshare options)53%50%45%49%61%None of the aboveNumber of respondents7%10187%1659%536%796%33Healthy eating choices are available and easy to access67%64%62%65%67%Physical activity is explicitly encouraged by features orresources in the work environmentStress management and mental recovery breaks are supportedSafety is a priority within the environmentNone of the aboveNumber of %5362%27%95%3%7973%36%94%3%33Leadership development includes the business relevance ofworker health and well-being28%20%21%18%24%Leaders actively participate in health and well-being programs54%52%58%46%55%Leaders are role models for prioritizing health and work/lifebalance (for example, they do not send e-mail while on vacation,they take activity breaks during the work day, etc.)22%19%21%22%9%Leaders publicly recognize employees for healthy actions andoutcomes28%27%25%28%27%Leaders are held accountable for supporting the health and wellbeing of their employees16%11%15%8%12%Leaders hold their front-line managers accountable for supportingthe health and well-being of their employees15%10%13%9%6%A senior leader has authority to take action to achieve theorganization's health and well-being goals39%32%40%26%33%None of the aboveNumber of 9%7939%18%33Support healthy eating choices (for example, by requiring healthyoptions at company-sponsored events)Encourage the use of community health and well-being resources(for example, community gardens, recreational facilities, healtheducation resources)Tobacco-free workplace or campus101112National ALL Small Medium LargeResults MFG MFGMFGMFGComponents of company's physical ("built") environmentLeadership's support of health and well-beingEmployee involvement in health and well-being programEmployees have the opportunity to provide input into programcontent, delivery methods, future needs and communicationchannelsWellness champion networks are used to support health and wellbeingEmployees are formally asked to share their perception oforganizational support for their health and well-being (forexample, in an annual employee survey)None of the aboveNumber of respondentsTHE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 8

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees131415National ALL Small Medium LargeResults MFG MFGMFGMFGResources used to support employee champions or ambassadors (among employers with wellnesschampions or ambassadors)Training49%43%47%29%61%Toolkit including resources, information, and contacts, etc.Rewards or recognitionRegularly scheduled meetings for champion teamNone of the 4%70%61%4%Number of respondents50274173423Level of support for mid-level managers and supervisors in their efforts to improve the health and wellbeing of employeesManagers/work group supervisors are given a lot of support13%10%15%10%3%Some supportNot much supportNo 7%Number of respondents1009164537833Employer opinion: How effective are your current organizational support strategies in promoting thehealth and well-being of employees?Very effectiveEffectiveNot very effectiveNot at all effectiveNumber of 533%44%44%9%790%52%48%0%332323212328Section 3: ProgramsAverage score for section 3 (maximum score: 40 points)1617Approaches used to assess the health of individuals / populationHealth assessment questionnaire(s)Biometric screeningsEmployee 5%Claims data mining (medical, pharmacy, behavioral health,disability)Monitoring or tracking devicesOtherDo not currently assess population healthNumber of 5376%23%6%6%7991%36%6%0%33Provide on-site or near-site biometric screenings63%72%58%72%94%Offer biometric screenings through a lab, home test kits, or otheroff-site 25%5320%793%33Methods of promoting biometric screeningsConduct awareness campaigns / actively promote gettingbiometric screenings from health care providerDo not provide biometric screenings or conduct awarenesscampaignsNumber of respondentsTHE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 9

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees18Referral and follow-up process is in place for individuals whose biometric screening results are out of thenormal rangeYes65%71%78%66%72%NoNumber of ide health behavior change programs that are offered to all individuals eligible for health and wellbeing program, regardless of health statusYes76%78%74%76%91%No24%22%26%24%9%Number of respondents1014165537933Method of delivery of health improvement programs (among employers that provide health behaviorchange programs to all, regardless of health status)Phone-based (can include group conference calls)54%60%42%59%83%Email or mobile (SMS)Web-based method (other than email)In person (includes individual or group meetings or activities)Number of 9%69%5960%90%53%30Features incorporated into one or more health improvement programs (among employers that providehealth behavior change programs to all)Program incorporates use of tracking tools such as a pedometer,glucometer, or automated scale60%63%71%57%67%Program is mobile supported (allows individuals to monitorprogress and interact via smart phone)57%52%42%52%67%Program incorporates social connection (for example, allowsindividuals to communicate with, support, and/or challenge otherindividuals or to form teams)None of the aboveNumber of %30Offer any individually targeted lifestyle management services that allow for interactive communicationbetween an individual and a health professional or expert systemYesNoNumber of respondents23National ALL Small Medium LargeResults MFG 33Types of interventions provided by targeted lifestyle management program (among those that providetargeted lifestyle management services)Phone-based coaching79%83%74%81%100%Email or mobile (SMS)Web-based interventions (other than email)On-site one-on-one coachingOn-site group 8%34%56%75%31%44%Paper-based bi-directional communication between theorganization and the individualNumber of respondents16%74220%13724%3816%6722%32THE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 10

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees242526Resources provided by organization to support individuals in managing their overall health and well-beingOn-site or near-site medical clinicEmployee Assistance Program (EAP)28%87%26%91%9%83%28%94%48%100%Child care and / or elder care assistance32%32%19%33%52%Initiatives to support a psychologically healthy workforceLegal or financial management n about community health resourcesHealth advocacy program46%36%45%44%43%28%50%51%33%52%Executive health programMedical decision support programNurse advice line %None of the aboveNumber of respondents5%10083%1648%531%780%33Offer disease management (DM) program(s) that addresses the following 8%82%Autoimmune disorders (multiple sclerosis, rheumatoid arthritis,etc.)CancerChronic obstructive pulmonary disease (COPD)Congestive heart failure (CHF)Coronary artery disease (CAD)DepressionDiabetesMaternityMetabolic syndromeMusculoskeletal / back painObesityDon’t offer any DM programsNumber of %33Provide or use electronic consumer tools to assist participants with managing health data, utilizing healthresources, or tracking benefitsYesNoNumber of respondents27National ALL Small Medium LargeResults MFG 33Employer opinion: How effective are your health and well-being programs in promoting a healthier, moreproductive workforce?Very effective10%8%15%4%6%Effective50%50%40%54%58%Not very effective34%37%38%37%36%Not effective at allNumber of respondents5%10145%1658%535%790%33THE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 11

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees2829National ALL Small Medium LargeResults MFG MFGMFGMFGSteps taken to manage employee disabilitiesFormal goals for disability programs13%7%4%5%15%Performance standards to hold leaders, managers, andsupervisors accountable for disability management programgoals9%4%4%4%6%Written return-to-work programs with policies and procedurescovering all absences53%58%59%54%64%Modified temporary job offers for employees with disabilitiesready to return to productive activity but not yet ready to return totheir former job57%60%67%55%61%Complex claims receive clinical intervention or oversight (by inhouse or outsourced staff)34%43%31%38%70%Standards for ongoing supportive communication with employeethroughout the duration of leave43%44%53%37%48%Developed metrics to regularly monitor and manage disabilitytrends with emphasis on established key performance indicators19%13%6%11%30%Strategies to triage individuals with certain disabilities intorelevant health and well-being programNone of the aboveNumber of 3Employer opinion: How effective are your disability management programs in promoting a healthier, moreproductive workforce?Very effectiveEffectiveNot very effectiveNot effective at allNumber of 505%37%43%15%759%33%55%3%3355446Health and well-being partners (internal and external) referindividuals to programs and resources provided by other partners51%60%46%59%81%Health and well-being partners provide “warm transfer” ofindividuals to programs and services provided by other 9%14%40%10138%33%1638%48%528%32%799%13%32Section 4: Program IntegrationAverage score for section 4 (maximum score: 16 points)30Integration of different health and well-being programsThe referral process (by employer or third-party) is monitoredfor volume of referralsAll partners collaborate as a team to track outcomes forindividual employeesAll partners collaborate as a team to track progress towardscommon organizational goals and outcomesNone of the aboveNumber of respondentsTHE HERO HEALTH AND WELL-BEING BEST PRACTICES SCORECARD IN COLLABORATION WITH MERCERPage 12

Small 500 employeesMedium 500 to 4,999 employeesLarge 5,000 employees313233Health and well-being program components are integrated in at least one way indicated in item 30 above(among employers that have at least some degree of integration)Lifestyle management and disease management61%62%67%57%69%Lifestyle management and behavioral healthDisease management and behavioral healthDisease management and case managementCase management and behavioral %30%72%66%66%59%Specialty lifestyle management (e.g. tobacco cessation, obesity,stress, etc.) with any health management programNone of the above69%6%72%6%74%4%64%8%86%3%Number of respondents604109275329Integration of disability management program and health and well-being programsIndividuals in disability management are referred to health andwell-being programs19%16%16%12%27%Individuals who participate in appropriate health and well-beingprograms receive more generous disability benefit2%1%0%1%0%Disability data is combined with health and well-being programdata for identifying, reporting, and performing analyticsNone of the aboveNumber of 33Integration of wo

A benchmark report from The HERO Health and Well-being Best Practices Scorecard In Collaboration with Mercer 1 - 24 points, 0.053606 238 25 - 49 points, 0.124756 335 50 - 74 points, 0.184210 526 75 - 99 points, 0.228070 175 100 - 124 points, 0.170565 302 125 - 149 points, 0.150097 466 150 - 200 points, 0.088693 957