Top trends in corporate wellness

Employers are in the business of supporting employee health. According to the Society for Human Resource Management’s 2022 Employer Benefits Survey, nearly half of employers consider wellness benefits a significantly important offering.

But striking the balance between helping employees without overreaching into employee privacy can be tricky. HR Dive spoke with Steven Goldberg, MD, MBA, vice president and chief health officer, employee and population health, at Quest Diagnostics about how the company has managed efforts directed at employee health — while also respecting worker privacy.

Editor’s note: This interview has been condensed and edited for clarity.

INDUSTRY DIVE: Why do you think it’s important for employers to be involved in employee health?

STEVEN GOLDBERG: The first [reason] is cultural. Employees want their company to convey care for them, and health and health benefits and related offerings are a high priority for employees in terms of total rewards. So to message and offer a good portfolio of benefits is important for retention, especially in the setting of the Great Resignation and what people have called the Great Rethink.

Companies that invest in health and well-being also have better performance in terms of income. Studies show a high level of correlation between healthy employees and healthy corporate performance. And in the long term, companies will be affected by people’s health and well-being impacting their health costs, especially large employers that are self-insured.

How does a company identify the appropriate level of involvement in employee health?

We ask our employees what they want from a total rewards perspective, and we also check in with our employees on a quarterly basis, not only on that but a broad range of issues. In terms of what you can or cannot do in general, you can offer a wide range of offerings but there’s a certain threshold in the amount of incentive that can be offered to employees or disincentive for not participating. We operate within guidelines from ERISA and the Department of Labor.

How do you address concerns from employees if they feel their bosses might access sensitive health information, or that they’re being targeted with messaging about diet and weight loss?

There are multiple levels of things we have to do. The first is all our communications have to be HIPAA appropriate and that is not negotiable. Second, you want to think about the language, the tone and the characterizations of health improvement opportunities. You want to be very sensitive because people process words differently based on economic backgrounds, social determinates of health and culture. We really put our communications through a lot of vetting.

A third thing is, in general, you can’t reach out to employees based on particular health features, so we have to do general communications and general descriptions of offerings. Also, people have to opt in rather than opt out.

Some national companies have pledged transportation benefits to employees who need to travel for abortion access. How has Quest addressed this issue?

We want to be culturally sensitive to the fact that our employee pool likely has a broad range of perspectives on the topic. We also want to make sure we’re complying with federal and state laws. We want to make sure that if, on the assumption we’re complying with federal law and on the assumption we’re compliant with state law, that there is a benefit opportunity for us to make sure people will have access.

Those are decisions we have [to make] in our benefits committee. Like other large employers, we did a review of transportation benefits. If we want to do something different with our transportation benefits, how do we do so in a way that doesn’t make it about a particular service but more thematically — in that it confirms that we are driving access and equity? We don’t want people to have barriers to any service that’s available according to state and federal law, whether it’s for reproductive rights or access to diabetes care.

That’s how we think about it in a general perspective. The Supreme Court decision prompted us to look at our equity strategy, so we went ahead and did some revising to our travel benefits.

What advice do you have for other companies, especially smaller ones, that want to make sure they’re doing the right thing when it comes to employee health?

A key strategic intent of Quest is to contribute to a healthier world. It creates certain obligations on the part of our leadership team. We envision a healthier world and therefore our employee health program mission is to do well by our employees.

Companies also need to engage their employees on what they need to make healthy the easier choice. Our workforce is 70% female, and many of our jobs are first jobs for folks. Employers needs to think about age, gender and socioeconomic status and therefore the needs of the employee pool. What challenges do they confront? We have our own data and analytics platform where we look at our claims. It’s a way to look for patterns at a population level, not ever at an individual level. That informs our strategy.

Employers can adopt a five-point framework in order to help workers recover their mental health and well-being, according to a document recently published by U.S. Surgeon General Vivek Murthy.

The release of the “Surgeon General’s Framework for Mental Health & Well-Being in the Workplace” follows more than two years of discussion about the COVID-19 pandemic’s impact on mental health. That impact has been persistent, according to a recent Conference Board survey, which found that more than one-third of employees said their self-reported mental health had declined compared to six months ago.

In the document, Murthy said that while the pandemic changed the nature of work as well as the relationship workers have with their jobs, it also presents “an opportunity to rethink how we work.” Murthy sketched out a process of five “essentials” that he said employers could follow in order to achieve that goal:

• Protection from harm.
• Connection and community.
• Work-life harmony.
• Mattering at work.
• Opportunities for growth.

“This may not be easy,” Murthy said. “But it will be worth it, because the benefits will accrue to both workers and organizations.”’

The framework builds off concepts that may be familiar to HR departments. For example, under the “Protection from Harm” subheading, Murthy said leaders should work to ensure physical as well as psychological safety at work; grant employees sufficient rest time; offer mental health support services; and implement diversity, equity, inclusion and accessibility policies and programs.

Murthy also pointed to a variety of compensation and benefits topics in the document, stating that employers should create flexible and predictable scheduling policies that do not penalize workers for taking time off to care for personal or family needs. He said employers should increase access to paid leave, pay “equitable, stable and predictable” wages and provide benefits that support mental health — such as healthcare plans, retirement plans, workers’ compensation and caregiver support.

The framework also provides guidance for employers to follow regarding normalization and supporting mental health through culture change, Myra Altman, VP of clinical strategy and research at mental health solutions firm Modern Health, said in an email to HR Dive.

“The last several years have seen a significant change in how employers and employees think about the role of work in their lives with much more acknowledgment of the role of work in supporting or hindering mental health,” Altman said. “It is terrific to see the Surgeon General come out and reinforce this important, and often overlooked, aspect of health.”

A July 2022 survey by the American Psychological Association found that 8 in 10 U.S. workers said that they would consider an employer’s approach to mental health when looking for jobs, but other indicators show many employers lag in terms of adopting mental health support. Only 23% of employees in an August Yoh survey said their employers offered no-cost on-site or remote mental health resources.

Well-being is no longer a “nice to have,” according to Indeed, so employers need to get serious about tracking well-being metrics.

“Workers won’t settle for the bare minimum when it comes to well-being,” the hiring firm said, announcing the results of an employee survey. Nearly half of respondents said their expectations around work happiness increased during the past year.

That means well-being can’t be an afterthought, Indeed said; instead, employers need to consider well-being a business strategy that boosts performance, reduces burnout and increases talent acquisition and retention.

That includes defining and tracking metrics. “You can’t manage what you don’t measure,” Indeed said. The company recommended employers periodically conduct surveys on how employees feel. Being transparent about those efforts may be important, too: Employees who said their employers measure well-being were 80% more likely to say they planned to stay for another year, according to Indeed’s findings.

And to track that metric, employers will need a strong understanding of what drives well-being, the firm continued. Indeed itself, for example, said it measures employee happiness, stress, satisfaction and purpose. “We also look at key drivers such as ‘foundational needs,’ which are aspects like fair pay, flexibility and trust; ‘social needs’ like belonging, inclusion, support and appreciation, and being well-managed; and ‘growth needs’ such as learning, achievement and being energized by your work,” it said; “By examining all of these holistically, you’ll have a better idea of where your organization stands.”

Eight in 10 U.S. workers surveyed by the American Psychological Association said an employer’s approach to employee mental health will be “an important consideration” when job hunting, according to a recent APA report.

But those ideal resources go beyond health benefits. Employees want flexible work hours, a workplace culture that respects time off, the ability to work remotely and a four-day work week, the survey said.

A large stressor for employees is compensation; 71% of employees surveyed said they are worried about their compensation keeping up with inflation. Additionally, 18% of all employees said they had a somewhat or very toxic workplace; 30% said they experienced harassment, verbal abuse or physical violence in the workplace in the past year.

After over two years of intense change, hard work and personal tragedy, worker mental health is in dire straits, various experts and studies have shown. Between February 2020 and February 2022, searches for “how to ask for a mental health day” grew by 1,000%, according to marketing platform Semrush.

In response, employers have continued to adopt mental health and telehealth coverage, stating they are among the most important benefits they can offer, according to a Society for Human Resource Management survey released in June.

While employers have tried various strategies to improve worker mental health, including whole office shut-downs, organizations are still struggling to articulate an overall well-being strategy, a February Willis Towers Watson report said — despite stating mental health, stress and burnout are top priorities. Mental wellness issues, including financial wellness and behavioral health, are thus often addressed separately with limited success.

Notably, the APA survey points out that the work environment and how the work is done can impact mental health considerably. Employers have continued to warm up to flexible work and hybrid work formats, letting go of considerations such as when and where work gets done and thinking harder about how everyone is contributing.

Flexibility, however, is a cultural challenge — and one HR is responsible for tackling, according to HR Dive’s 2022 Identity of HR survey. As such, to improve general mental health for the long term, managers may need to be trained to work in a hybrid environment, experts told HR Dive.

Professional services company PwC is launching a $2.4 billion program intended to revolutionize its personnel experience. The program, called “My+,” will allow employees “to build personalized careers, from choosing the types of assignments they work on, to the hours they work, to where they work and the benefits they need,” the company announced.

As part of My+, PwC will expand its flexibility options, providing two weeklong company shutdowns per year and 20% pay leaves of absence, ensuring “no vacation days go unused” and allowing employees to work from anywhere, even internationally. In its benefits realm, all parents will now have 12 weeks of parental leave, employees will have 12 free annual visits with a mental health professional, and out-of-network mental health reimbursement will be upped from 70% to 90%. In the learning space, employees will have access to quarterly sessions featuring external speakers and skill-building opportunities, with an emphasis on intersectionality and soft skill development. Finally, the company will extend community and resources to employees who have moved on from the firm.

“The most meaningful workplace experiences are those that are created with people’s interest top of mind,” Tim Ryan, U.S. chair and senior partner at PwC, in the post. “It is extremely important for people to be seen, heard and valued; for people to be able to make choices based on their preferences, sense of purpose and ambitions.”

As the war for talent drags on and the pandemic seems to be winding down, a distinct fork in the road has appeared before employers: enthusiastically embrace the wishes of employees and allow the workplace to evolve, or resist the turning tide and hope work culture returns to its pre-pandemic norms. 

PwC appears to have chosen the first path. It joins a number of other prominent companies in aiming to prioritize worker happiness, particularly those with the budget and will to fight for top talent.

As is often the case with workplace innovations, the tech industry seems to be leading. In late April, Airbnb declared a new policy that employees can “live and work from anywhere,” even internationally, a decision that nicely aligns with its mission “to create a world where anyone can belong anywhere.” Fintech company Bolt and cloud storage company eFileCabinet were among those that recently made permanent a four-day workweek. Google has established a minimum of 20 days’ vacation. And last year, Bumble, LinkedIn and Hootsuite were among those that instituted a companywide week off to combat burnout.    

With the labor market exceptionally thin, many retail employers have also added perks. Target will up its starting hourly wage to $24 per hour in some cases, and Walmart will offer salaries up to $110,000 for long-haul truck drivers, the company announced in April. Companies in the space are increasingly embracing learning benefits as well; Dollar General recently announced a no-cost degree program, for example. 

Some in the finance industry, however, seem to be following the second path. Goldman Sachs employees have complained of being tracked to ensure they come into the New York office and CEO David Solomon has called remote work an “aberration.” JPMorgan Chase workers also have said their in-office attendance is being watched. Perhaps conversely, however, some finance companies have embraced pay bumps for interns and are considering abortion travel reimbursement policies.

Employers' well-being strategies will factor heavily into their worksite return plans, according to an annual joint survey conducted by Fidelity Investments and the Business Group on Health.

Flexibility was a common theme, with 60% of the 166 surveyed organizations stating that a majority of their employees would operate under a hybrid work model in 2022. About half of respondents said they expected most employees to work on-site three days per week. Additionally, 57% said work-life balance initiatives would be "integral components" of their return-to-worksite strategies.

Overall budgets for well-being programs declined slightly for 2022, the two firms said, but the average budget for large employers with more than 20,000 employees increased from $10.5 million in 2021 to $11 million this year. Meanwhile, employers with fewer than 5,000 workers saw a 60% increased well-being spend per employee. The average maximum financial incentive within well-being programs increased 22% year over year.

Employee well-being took a direct hit from the pandemic. The Business Group's May 2021 survey, conducted in tandem with outsourcing firm Alight Solutions, found that just 40% of employees said they held a positive view of their overall well-being, down from 49% prior to the pandemic. That decline was steeper for respondents of color and those who belonged to Generation Z.

Many also are still hesitant to return to physical worksites due to the risk of disease. A January 2022 survey by Pew Research Center found that while 77% said they were at least somewhat satisfied with the measures their workplaces had taken to protect them from COVID-19 exposure, only 36% said they were "very satisfied." Black, Hispanic, lower-income and younger respondents were less likely to say they were very satisfied with protection measures.

While many companies have acknowledged employees' well-being concerns, some studies have shown employers may not be prepared to address those concerns. An October 2021 Willis Towers Watson survey, for example, found that nearly half of employers had not formally articulated a well-being strategy.

Mental health is a common focus for employer-sponsored benefits programs in 2022 given the impact two years of a pandemic have had, even as access and cost concerns prevented some employees from taking advantage of employers' offerings. Some employers have acknowledged shortcomings in their mental health support during that time. It may be worth noting the various approaches organizations took to add support in recent months.

For example, consulting firm EY previously spoke to HR Dive about its offer to pay 75% of the cost, or up to $1,000, toward items such as home office equipment, fitness classes, workout equipment, electric bikes and meal delivery kits. HR technology vendor Phenom similarly announced in January a $1,000 benefit that employees could put toward mental health costs.

Beyond emotional and mental well-being, physical well-being also might be a priority for worksite reopening operations, especially for employees who are recovering from COVID-19 or who exhibit persistent symptoms of the disease. Those experiencing long COVID-19, for instance, could benefit from the support that well-being programs provide, sources recently told HR Dive.

It's not every day that the words "compensation" and "benefits" inspire giddiness in employees. But wellness stipends — particularly those eligible for glorious, sometimes indulgent, but still necessary instruments of self-care — often elicit that reaction.

Take professional services firm EY's Well-being Fund, for example. The company pays 75% of the cost — up to $1,000 — of home office equipment, fitness classes, workout equipment and meal delivery services. Electric bikes and converter kits, blenders, juicers, air fryers, massages, tents and camping equipment are also eligible.

Frank Giampietro, EY's newly appointed chief well-being officer for the Americas, said employees were excited at the mere thought of how to spend the money. "You know, just that anticipation of Christmas, a winter holiday or a birthday," he said. Giampietro told HR Dive that EY has actively championed employee well-being for almost a decade. 

In the past, his team considered what protocols were in place, whether EY employee needs were being met and what gaps needed to be filled.

EY's people team started reimbursing employees in 2015, courtesy of what was once called "Quality of Life Fund." In 2018, the perk came from the "Fitness Fund." In 2020, EY doubled the money from $500 to $1,000 and renamed the resource the "Well-being Fund." An evolving nomenclature is indicative of the company's ethos to address employee well-being with agility and wonder. Giampietro said the stipend was always intended to hold space for what was "meaningful" and to reject the "one-size-fits-all" approach to mental health."People saw it as a way we're continuing to invest in them and that we really care about their well-being," he said.

A prime example: as of 2022, EY employees can spend their stipend on mattresses. Airfare, rental cars, hotels and other lodging are now also eligible. "We added in vacations because, as we come out of the pandemic and people want to start to travel again, we know the impact that can have for people from a mental and emotional health perspective," Giampetro said.

EY has also expanded the fund to include a form of self-care that its chief well-being officer acknowledges as "controversial." Gaming consoles and chairs, headsets and ear buds, controllers, monitors and webcams are all eligible for reimbursement by EY. Ditto the video games themselves. 

"Our folks work hard like everybody else does. If they want to check out at the end of a long day, one way they like to do that is getting on a game [and] going away to a different place for a little while," he said. "Get their brain off of work, and then come back and maybe be more productive. So we decided to add that into the fund as well this year."

An EY spokesperson added that for the past two years, the company has incrementally invested $2 billion in total rewards. Along with increasing compensation, this has looked like upping free counseling and mental health coaching sessions from five per year to 25 per year — available to EY employees and each family member in their household. The people team also expanded backup care from 12 to 24 days, and have increased access to tutoring, child care and adult care resources. 

The benefits of the Well-being Fund go beyond the mental health of EY employees — literally and figuratively. The stipend touches EY employees and provides community care. Giampietro recounted how EY employees were able to use the stipend not just for themselves, but also their spouses and children. 

Figuratively speaking, this stipend isn't just a fun add-on to a robust mental health package. The opportunity to buy a Nintendo Switch, unwind with a massage or blend up a collagen smoothie could be a secret weapon amid the Great Resignation. For HR teams, wellness stipends can be another tool in their arsenal against attrition.

"Everybody wants to be proud of their workplace," Giampietro said. "It's like, 'Hey, look at how they're taking care of us.' It was very personal for folks. They felt like we were hearing them, listening to them, providing meaningful benefits [for] them."

As for the future of the Well-being Fund, the possibilities are abundant. 

"I think as long as we keep in the spirit of what's going to make people feel better — and how [they're] improved from either a mental, emotional, physical or financial health perspective — that's kind of what we're getting at," Giampietro said. "That gives us a pretty wide open lane to figure out what comes next."