1 st edition 2016 EMEA Health Survey

Transcription

1 1 st edition 2016 EMEA Health Survey

2 EMEA In the first quarter of 2016 Aon carried out its first Health Survey. The survey aims to identify health trends within EMEA, and highlights where practices differ across countries, regions and EMEA as a whole. The findings paint a fascinating picture of current health practice across the region, pinpointing areas for improvement and making recommendations that will increase health benefit take-up, improve measurement of the impact of health and any initiatives and maximise the return on any investment firms make in their employees health.

3 / EMEA Number of companies: 501 Number of employees (median value): 310 Identifying employers current challenges and priorities Aon View Attracting and retaining the best employees, and ensuring they are productive and engaged, are big themes for all EMEA employers. This is set against a backdrop of continuing financial pressures: reducing or managing cost is among the top HR challenges cited by the survey s respondents. With stress and mental health issues prevalent and the biggest recognised health issue for employers, it is disappointing to see that less than a third are addressing this with emotional or psychological health programmes. Helping to support the mental wellbeing of employees is crucial if they are to remain happy, present and productive. Financial health is a growing topic of conversation, and predicted to be the largest growth area in terms of employerprovided health programmes. Using the data at their disposal to identify health priorities and measure the impact of strategies to address them is essential and yet only a quarter of EMEA employers currently use the data they have and only a tenth measure the outcomes of current health programmes. There is clearly an appetite to do more here; the vast majority say it is an area they want to address. Taking a more data-driven approach to health strategy will pay huge dividends in terms of ROI and success, and we would urge all firms to look at this as a matter of urgency. Absence and other data can be used to great effect to pinpoint and target health issues, and to tailor your responses to them. With a few simple steps, EMEA employers could make significant improvements to the way they tackle their health and wellness challenges, and would reap the rewards of a more focused approach. Current HR challenges Increasing productivity and employee performance 52% Attracting and retaining talent 51% Improving employee engagement and morale 49% Reducing or managing cost 44% Organisational health and wellness issues today and in the future Entire survey Stress and mental health issues 65% Employees physical health 53% Unhealthy employee lifestyles 49%

4 / EMEA Examining current approaches to health Shaping health strategies EMEA employers: See a correlation between health and employee performance (93%) Connect their insurable employee benefits with their health strategy in just over half of cases (56%) Have a defined health strategy in 40% of firms across the entire survey with 21% of those without a strategy planning to define one within the next two years Are likely to focus their health strategies on both developing employee health programmes and communicating the current strategy 53% plan to do this Do not make enough use of data analytics only 26% use the data at their disposal to inform their approach to health Only have a clear view of the current impact of health issues within their organisation in 40% of cases although 65% without this insight plan to address this Current employee health programmes EMEA organisations: Recognise the employer s role in health 94% agree that employers are responsible for influencing employee health and changing behaviours Are most likely to have programmes addressing physical health or the work environment 47% have these. 43% have social programmes, 32% have emotional/psychological ones and 26% have financial programmes Will see the biggest predicted growth in financial health programmes: 23% plan to introduce these in future Are more likely to manage health initiatives locally (55%) than globally (28%) or regionally (17%) Are fairly satisfied with their communications around health and benefits 75% believe their health and benefits communications are good or fair, while 4% think they are excellent. 17% believe they are insufficient or inefficient See limited budget as their biggest challenge when it comes to implementing health-related programmes: 69% cite this. 60% believe a lack of resources is most likely to hold them back Funding and measuring ROI of employee health programmes 89% of respondents expect health programmes to be paid for, now and in future, by the employer For 46%, current and expected future provision is partially paid for by employees Just 13% measure the outcomes of their investment in employee health programmes 85% of those who do not would like to measure these outcomes 43% have a specific budget for health initiatives; 14% of those that don t intend to have one within two years

5 / AUSTRIA Number of companies: 12 Number of employees (median value): 1125 Identifying employers current challenges and priorities Aon View Austrian employers report a far higher incidence of health and wellness issues than their Western European or EMEA counterparts, with more than nine in ten identifying stress and mental health as an issue. In spite of this, only half have implemented a defined health strategy. Although this compares favourably to the EMEA region as a whole, there is still much that Austrian firms can do to support their employees health and wellbeing. Three quarters are planning to implement a health strategy within the next two years; employers need to ensure these plans come to fruition, as they will be crucial in providing a framework for health improvements. Connecting this strategy with their insurable employee benefits will help Austrian employers to reduce their premiums and make the most of any free support offered by insurers. None currently do this. Understanding the current cost impact of health issues is essential, yet no Austrian respondents do this. Similarly, none currently measure the outcomes or ROI of their health initiatives. Although they report greater proactivity than the survey as a whole in terms of the programmes they implement, without measuring the impact of health it will be impossible to quantify the benefits of these initiatives. Effective communication another area where the Austrian employers rate themselves poorly will support any health programmes and ensure that they are delivering maximum ROI. Current HR challenges Attracting and retaining talent 58% Increasing productivity and employee performance 42% Improving employee engagement and morale 42% Supporting professional and career development 42% Organisational health and wellness issues today and in the future Austria Western Europe Entire survey Stress and mental health issues 95% 65% 65% Employees physical health 67% 52% 53% Unhealthy employee lifestyles 67% 49% 49%

6 / AUSTRIA Examining current approaches to health Shaping health strategies Austrian respondents: See a correlation between health and employee performance: 100% say this Only have a defined health strategy in 50% of cases, although this still compares favourably to the survey as a whole (40%) Intend to introduce a health strategy in a third of firms (33%), with 75% planning to define a health strategy within the next two years Plan to focus any health strategy on developing employee health programmes: 63% say this, compared to 29% across EMEA Are far less likely to connect health strategy with insurable employee benefits; none of the Austrian respondents do this, compared to 56% across the survey as a whole Do not have a clear view of the impact (including cost) of health issues in their organisation: 100% of Austrian respondents claim not to have this insight, compared to 40% across EMEA Current employee health programmes Austrian organisations: Recognise the employer s role in health 100% of respondents believe employers are responsible for influencing employee health and changing behaviours Are more proactive than the EMEA region as a whole 50% have both current and planned emotional or psychological programmes and programmes relating to the physical or work environment, compared to 17% and 25% across the survey as a whole Manage health initiatives locally for 100% of Austrian respondents, these programmes are locally, rather than regionally or globally, run Could improve health benefit communications 42% rate their communications as insufficient or inefficient ; only 17% rate them good and none as excellent Face financial and resourcing barriers 75% cite limited budget as a barrier to implementing health-related programmes with 67% citing lack of resources This is in line with the survey overall Funding employee health programmes For 100% of respondents, employers currently fund health benefits and are expected to in future None make use of free add-ons from insurers, although all have some element of insurer funding None of the Austrian respondents currently measure the outcomes/roi of their employee health programmes, compared to 13% across the survey 100% want to measure these outcomes and returns in future 50% have a specific budget for health initiatives, compared to 43% across EMEA, with a further 17% planning one within the next two years

7 / BELGIUM Number of companies: 18 Number of employees (median value): 375 Identifying employers current challenges and priorities Aon View Cost and budget are repeated themes among the Belgian respondents to the survey, with reducing or managing cost their biggest HR challenge and limited budget a specific issue for over half when dealing with health initiatives. The good news is that there is much that Belgian firms can do to tackle this cost challenge. Introducing a defined health strategy can focus their spend and attention where it will deliver maximum results, while connecting their insurable employee benefits with this strategy can help to save them money in terms of premiums. Belgian firms are more proactive than the rest of EMEA, with health programmes more prevalent across most areas. Communications are also strong, which will help employers to maximise take-up and appreciation of the health programmes provided. For the 11% rating their communications as poor, though, improving communications will have a significant impact on understanding, appreciation and engagement with health initiatives. Belgian employers are more likely than those across EMEA as a whole to use data analytics to understand and improve their health strategies. Making use of this data to understand the cost impact of health issues will give them a focus to their health initiatives and a clear way to measure the effectiveness of any measures they implement. Current HR challenges Reducing or managing cost 52% Improving employee engagement and morale 44% Attracting and retaining talent 44% Supporting professional and career development 33% Organisational health and wellness issues today and in the future Belgium Western Europe Entire survey Financial health 46% 45% 48% Stress and mental health issues 41% 65% 65% Unhealthy employee lifestyles 33% 49% 49% Ageing 28% 35% 31%

8 / BELGIUM Examining current approaches to health Shaping health strategies Belgian respondents: See a correlation between health and employee performance: 89% say this Are less likely (39%) to have a defined health strategy compared to the survey as a whole (40%). A further 17% plan to introduce one Would focus a health strategy on both new initiatives and communicating existing ones in 50% of cases. 53% across the region say the same Are far less likely to connect health strategy with insurable employee benefits than the rest of EMEA; only 20% of Belgian respondents do this, compared to 56% across the region Are far more proactive than most around data analytics: 75% currently use data to understand and improve their health strategies, compared to 26% overall Are slightly less likely than EMEA as a whole to have a clear view of the impact (including cost) of health issues in their organisation. 33% of Belgian employers have this insight, compared to 40% across EMEA Current employee health programmes Belgian organisations: Recognise the employer s role in health 89% of respondents believe employers are responsible for influencing employee health and changing behaviours Are more proactive than the EMEA region as a whole in most areas of health 75% have programmes relating to the physical or work environment and 50% have current emotional or psychological programmes, compared to 47% and 32% across the survey as a whole Manage health initiatives locally for 67% of Belgian respondents, these programmes are locally, rather than regionally or globally, run Have good health and benefits communications 77% rate their communications as fair or good, with 11% rating them as excellent. However, 11% also rate them as insufficient or inefficient Face resourcing and financial barriers 61% cite lack of resources as a barrier to implementing health-related programmes, with 56% citing limited budget Funding employee health programmes For 100% of respondents, some element of health programmes are paid for by employees, some by employers and some via funding from the insurance company 17% of the Belgian respondents currently measure the outcomes/roi of their employee health programmes, compared to 13% across the survey 70% of those that currently do not, want to measure these outcomes and returns in future 39% have a specific budget for health initiatives, compared to 43% across EMEA, with a further 11% planning one within the next two years

9 / CENTRAL AND EASTERN EUROPE Number of companies: 86 Number of employees (median value): 173 Identifying employers current challenges and priorities Aon View Central and Eastern European firms face a lot of the same challenges as those seen across EMEA as a whole. Stress and mental health issues, concerns regarding employees physical health and challenges with financial health are more widely reported among CEE employers than they are across the survey as a whole and yet programmes to tackle these issues are less prevalent among Central and Eastern European firms than they are elsewhere. Budget may be one of the reasons for this; three quarters of the CEE respondents cite budget as their biggest challenge when it comes to implementing health initiatives. There is much that employers can do to maximise the budget available to them, though. CEE employers are more active than most in the survey when it comes to understanding the impact health issues have on their business; this is a positive. However, there is more they can do. In common with their wider EMEA counterparts, CEE firms are failing to make the most of the data at their disposal to inform and refine their approaches to health. And only just over one in ten measures the outcome of current initiatives. Using data such as absence statistics can help to target health strategies so they focus on the areas that most need work and that will deliver the best return. Monitoring the impact of programmes implemented will evidence their worth, giving valuable ammunition when it comes to obtaining future budget, and again ensuring that spend is targeted where it will have most impact. Current HR challenges Increasing productivity and employee performance 65% Improving employee engagement and morale 48% Attracting and retaining talent 45% Supporting professional and career development 42% Organisational health and wellness issues today and in the future Central and Eastern Europe Entire survey Stress and mental health issues 73% 65% Employees physical health 60% 52% Financial health 56% 48%

10 / CENTRAL AND EASTERN EUROPE Examining current approaches to health Shaping health strategies Respondents from Central and Eastern Europe: See a correlation between health and employee performance: 95% say this, slightly more than the figure across the EMEA region as a whole (93%) Connect their insurable employee benefits with their health strategy (77%), more than those across the whole of EMEA (56%) Are more likely to have a defined health strategy: 52% do, compared to 40% across the entire survey. 19% of those without a strategy plan to define one within the next two years Are broadly in line with EMEA as a whole regarding the focus of their health strategy: 43% plan to focus both on developing employee health programmes and communicating the current strategy, compared to 53% across the whole survey Are more likely to have a clear view of the current impact of health issues within their organisation (56%) than EMEA as a whole (40%). 75% of those who do not are taking some action to address this Current employee health programmes Central and Eastern European organisations: Recognise the employer s role in health 88% agree or strongly agree that employers are responsible for influencing employee health and changing behaviours Are less likely than their counterparts in EMEA overall to have any health programmes in place 34% have social health programmes (compared to 43% across EMEA), 31% have programmes addressing the physical or work environment (47% across EMEA), 19% have financial health programmes (26% across EMEA) and 18% have emotional/psychological programmes (32% across EMEA) Are most likely to manage health programmes locally 62% do this. 63% either fully or partially outsource their health initiatives, slightly more than across the survey as a whole (58%) Are slightly more satisfied than most of EMEA with their communications around health and benefits 78% think they are good or fair, and 8% believe they are excellent. This compares to 75% and 4% across the survey sample See limited budget as by far their biggest challenge 74% cite this as their biggest barrier to implementing health-related programmes, compared to 69% across the survey. Lack of resource is the next biggest barrier (48%) Funding and measuring ROI of employee health programmes Just under half of CEE respondents (47%) make use of free insurer add-ons or will do in future to finance their health and wellness programmes. The majority of health programmes are funded and are expected to continue being funded by the employer (77% do this and expect it to continue) Only 22% currently use data analytics to inform and improve their health strategies, although this is similar to the survey overall (26%) Just 13% measure the outcomes of their investment in employee health programmes, although again this is the same as the figure for the whole survey 82% of those who do not would like to measure these outcomes 60% have a specific budget for health initiatives

11 / DENMARK Number of companies: 10 Number of employees (median value): 295 Identifying employers current challenges and priorities Aon View Compared to EMEA as a whole, Danish firms are not taking as proactive an approach to health as they could. Across all measures, they are less likely to understand the impact of health on their business; put in place programmes to tackle specific health challenges; or measure the impact of any initiatives that are implemented. Although Danish participants report lower levels of concern regarding all health and wellness issues, they are far less likely to have defined health strategies less than half as likely as their Nordic counterparts and half as likely as other firms across EMEA. They are also half as likely to have a set budget for health programmes. Fewer make a link between insurable benefits and health strategy, a connection that could help them save money and address their recognised budget and resource challenges. None of the firms surveyed use data analytics to understand and improve their health strategies, and only a tenth have a clear understanding of the impact of health issues including cost on their business. None measure the outcomes of the health programmes they currently have in place, although more than three quarters are interested in doing so. There is much that Danish firms can do to improve their performance around health. Getting a clear picture of the current impact and cost of health is a vital first step, which will enable focused programmes to be implemented. Measuring the outcomes of these programmes will then enable them to be refined and improved, tackling firms issues with lack of budget and resource. Current HR challenges Improving employee engagement and morale 60% Increasing productivity and employee performance 50% Attracting and retaining talent 50% Supporting professional and career development 30% Handling ageing of employees 30% Organisational health and wellness issues today and in the future Denmark Nordics Entire survey Employees physical health 50% 56% 53% Stress and mental health issues 40% 62% 65% Financial health 40% 35% 48% Unhealthy employee lifestyles 30% 33% 49%

12 / DENMARK Examining current approaches to health Shaping health strategies Danish respondents: See a correlation between health and employee performance: 90% say this Are less likely (20%) to have a defined health strategy compared to the Nordics (54%) and the survey as a whole (40%), although 50% of those responding intend to introduce one Would focus a health strategy on both new initiatives and communicating existing ones 57% say this, the same as the figure for the Nordics overall and slightly more than across EMEA (52%) Are less likely to connect health strategy with insurable employee benefits (43% do this) than the rest of the Nordics (57%) and EMEA as a whole (56%) Are not using data to understand and improve their health strategies none currently do this, compared to 30% across the Nordics as a whole and 26% across EMEA. But 67% intend to start doing so Do not have a clear view of the impact (including cost) of health issues in their organisation. Only 11% of Danish respondents have this information, compared to 40% across EMEA Current employee health programmes Danish organisations: Recognise the employer s role in health 90% of Danish participants believe employers are responsible for influencing employee health and changing behaviours Are less proactive than their Nordic counterparts in terms of current health programmes 50% have programmes relating to the physical or work environment, compared to 77% across the Nordic region; 44% have social programmes, compared to 61% across the Nordics as a whole, and 44% have emotional/psychological programmes (53% across the Nordics) Manage health initiatives locally over half (56%) say their health programmes are local in scope, with 33% regional and 11% global Are fairly confident about their health benefit communications 90% believe they are good or fair See a lack of resources as their biggest challenge 80% cite lack of resources as a barrier to implementing health-related programmes. A limited budget was the next biggest challenge, cited by 70%. Across the Nordics and the survey as a whole limited budget was the most-cited barrier (by 77% and 69% respectively) Funding employee health programmes Danish health programmes are most likely to be paid for by employers: 75% of respondents currently do this, compared to 41% across the survey and 52% across the Nordics None of the Danish respondents currently measure the outcomes/roi of their employee health programmes, compared to 16% in the Nordics as a whole and 13% across the survey 78% want to measure these outcomes and returns in future 30% have a specific budget for health initiatives, compared to 64% across the Nordic region and 43% in all of EMEA. 30% plan to introduce one within the next two years

13 / FINLAND Number of companies: 10 Number of employees (median value): 125 Identifying employers current challenges and priorities Aon View Finnish firms appear to be taking positive action on health issues. They are more likely than the EMEA region overall to have a defined health strategy; more than twice as likely to use data analytics to inform and improve their strategy; and possibly as a result more likely than their EMEA and Nordic counterparts to have a clear view of the impact of health on their business. They are also more likely to have a defined health budget. While Finnish firms report higher than average incidence of stress and mental health and physical health issues than their peers across EMEA, they are also more proactive in tackling them; across all health issues, they are more likely to have implemented programmes to deal with them. In some areas, Finnish employers identify issues less prevalent in other regions; ageing and the lack of young people entering the workforce are issues identified by more Finnish respondents than those in EMEA as a whole. When it comes to barriers to implementation, Finnish firms recognise the difficulty in measuring efficiency of health programmes far more than others do. Perhaps this is because they are more advanced with this measurement, and have identified challenges along the way. Outsourcing is prevalent among Finnish firms; perhaps correlated with this tendency to entrust health programmes to external experts, Finnish participants are more likely than others to cite their health communications as effective. In spite of their positive performance in the survey, there is still more Finnish employers can do to improve the impact of their health initiatives. Three quarters do not measure the outcomes or ROI of their programmes, something that would help further focus their efforts and tackle budget/resource issues. Current HR challenges Supporting professional and career development 70% Attracting and retaining talent 60% Increasing productivity and employee performance 60% Improving employee engagement and morale 30% Reducing or managing cost 30% Organisational health and wellness issues today and in the future Finland Nordics Entire survey Stress and mental health issues 80% 62% 65% Employees physical health 57% 56% 53% Ageing 33% 17% 31% Fewer young people entering the workforce 33% 9% 20%

14 / FINLAND Examining current approaches to health Shaping health strategies Finnish respondents: See a correlation between health and employee performance: 90% say this Are on a par in terms of having defined health strategies (50% say they do) compared to the Nordics (54%) and more likely to than the survey as a whole (40%) Would focus a health strategy on developing employee health programmes 60% say this, significantly more than in the Nordics as a whole (25%) and across EMEA (29%) Are slightly more likely to connect health strategy with insurable employee benefits (60% do this) than the rest of the Nordics (57%) and EMEA as a whole (56%) Are proactive when it comes to using data analytics to understand and improve their health strategies 67% currently do this. Across the Nordics as a whole this figure is 30% and across the whole survey sample, 26%. The remaining 33% intend to start making use of data Are more likely than EMEA as a whole to have a clear view of the impact (including cost) of health issues in their organisation. 50% of the Finnish respondents have this insight, compared to 40% across EMEA Current employee health programmes Finnish organisations: Recognise the employer s role in health 90% agree that employers are responsible for influencing employee health and changing behaviours Are very proactive in terms of current health programmes 88% have programmes relating to the physical or work environment, compared to 77% across the Nordic region and 47% across EMEA; 75% have social programmes, compared to 61% across the Nordics as a whole and 43% in EMEA, and 71% have emotional/psychological programmes (53% across the Nordics; 32% across EMEA) Mostly manage health initiatives locally half (50%) say their health programmes are local in scope, with 13% regional and 38% global Are more likely to outsource health programmes 75% partially outsource their health programmes, with the remainder managing them in-house Believe their health benefit communications are effective 60% cite them as good, though none think they are excellent See a lack of resources as their biggest barrier 70% cite lack of resources as a barrier to implementing health-related programmes. Finland is unusual in recognising measuring efficiency as an issue (60%); across the entire survey, only 27% see this as a barrier Funding employee health programmes Finnish health programmes are currently paid for by employers in 38% of cases. This compares to 41% across the survey and 69% across the Nordics Only a quarter of Finnish respondents currently measure the outcomes/roi of their employee health programmes, although this compares positively to the Nordics as a whole (12%) and EMEA (13%) Of those that currently do not, 100% want to measure these outcomes and returns in future 80% have a specific budget for health initiatives, compared to 64% across the Nordic region and 43% in all of EMEA

15 / FRANCE Number of companies: 45 Number of employees (median value): 600 Identifying employers current challenges and priorities Aon View The French survey participants are generally in line with EMEA as a whole in many aspects of their health provision. In some areas, though, this does not equate to good practice; in terms of measuring the impact of health and quantifying the outcomes of any health initiatives, both the French respondents and EMEA employers overall could take simple steps that would significantly improve their health ROI. Measuring current performance and identifying the effect of any programmes implemented are vital first steps in targeting and refining health approaches. With budget and resource recognised issues, French employers need to do everything they can to maximise the resources at their disposal. Making more use of insurer-funded add-ons and interventions would be a good start point in getting better value from their health benefits and programmes. The inability to measure the effectiveness of health initiatives is identified as a barrier to their success; putting in place ways to quantify this effectiveness will evidence success and enable initiatives to improve over time. Better communication would also help with health ROI: French employers are less confident than the survey as a whole about the effectiveness of their communications. With nearly half managing all health programmes internally, and none outsourcing them completely, some external expertise, both on health strategy and communications best practice, could be invaluable. Current HR challenges Increasing productivity and employee performance 55% Improving employee engagement and morale 52% Reducing or managing cost 48% Attracting and retaining talent 45% Organisational health and wellness issues today and in the future France Western Europe Entire survey Stress and mental health issues 60% 65% 65% Financial health 44% 45% 48% Employees physical health 44% 52% 53% Unhealthy employee lifestyles 43% 49% 49%

16 / FRANCE Examining current approaches to health Shaping health strategies French respondents: See a correlation between health and employee performance: 98% say this Are marginally more likely (43%) to have a defined health strategy compared to the survey as a whole (40%). A further 23% plan to introduce one Would focus a health strategy on both new initiatives and communicating existing ones in 59% of cases, compared to 53% across the region Are in line with EMEA as a whole when it comes to connecting health strategy with insurable benefits: 55% do this compared to 56% across the region Are also in line with EMEA in terms of using data analytics to inform or improve their health strategies: 27% currently do this (EMEA: 26%) Are slightly less likely than EMEA as a whole to have a clear view of the impact (including cost) of health issues in their organisation. 32% of French employers claim to have this clear view, compared to 40% across EMEA Current employee health programmes French organisations: Recognise the employer s role in health 100% of respondents believe employers are responsible for influencing employee health and changing behaviours Are more proactive than the EMEA region as a whole in most areas of health social programmes are most likely to be in place in French firms (47% offer these, compared to 43% across EMEA); 44% have emotional or psychological programmes (32% in EMEA as a whole); 42% have programmes relating to financial health (26% in EMEA) Are more likely to manage health initiatives locally 60% of French respondents have local, rather than regional or global, programmes Are less confident about their health and benefits communications while 66% rate them as fair or good, 23% think they are insufficient or inefficient. For 7% they are nonexistent See a lack of resource as their biggest barrier 77% believe this is the biggest challenge when it comes to implementing health-related programmes. 68% cite limited budget Funding employee health programmes In 94% of firms, health benefits are employer-funded and expected to be in the future 37% make use of free insurer add-ons and will in future Only 9% of French firms currently measure the outcomes/roi of their employee health programmes, compared to 13% across the survey 84% of those that currently do not, want to measure these outcomes and returns in future Only 34% have a specific budget for health initiatives, compared to 43% across EMEA, although a further 20% are planning one within the next two years

17 / GERMANY Number of companies: 11 Number of employees (median value): 950 Identifying employers current challenges and priorities Aon View German respondents report a higher incidence of every major health risk than EMEA as a whole. Coupled with concerns around talent, performance and engagement, it is clear that more action on health and wellness is needed. With attracting and retaining talent far higher a challenge than for most of EMEA, firms need to deliver benefits that attract employees and ensure the workforce is kept healthy and productive once in place. In spite of this, many German firms have fewer health programmes, no defined health strategy and no set budget. Health and benefits communications are not seen to be effective. With budget a recognised barrier to the success of health initiatives, we would encourage German employers to make use of insurer funding. They already capitalise on free insurer add-ons around health, which is positive. Taking this a step further will help with budget issues, as well as giving them expert insurer insight into health issues and trends. German firms do not believe they understand the cost impact of their health issues, and none measure the impact of their health programmes, although there is appetite to do so. Making use of the data they have around absence and health, putting in place specific budgets and health strategies which can be informed via this data and measuring their outcome to further refine them will have a significant positive effect on German firms health and wellness issues and the ROI of their health initiatives. Current HR challenges Attracting and retaining talent 73% Reducing or managing cost 60% Increasing productivity and employee performance 45% Improving employee engagement and morale 45% Organisational health and wellness issues today and in the future Germany Western Europe Entire survey Stress and mental health issues 82% 65% 65% Employees physical health 64% 52% 53% Unhealthy employee lifestyles 64% 49% 49% Financial health 60% 45% 48%

18 / GERMANY Examining current approaches to health Shaping health strategies German respondents: See a correlation between health and employee performance: 100% say this Do not have defined health strategies: none of the companies surveyed have a defined strategy, although 64% intend to implement one Are most likely to focus a health strategy on both new initiatives and communicating existing ones. This is the case for 71%, compared to 53% across the region Do not connect their health strategy with their insurable employee benefits; only 14% currently do this, although a further 43% intend to. 56% already do this across EMEA Are in line with EMEA in terms of using data analytics to inform or improve their health strategies: 25% currently do this (EMEA: 27%) Do not understand the impact of health on their business; none say they have a clear view of the impact (including cost) of health issues in their organisation. This compares to 40% across EMEA Current employee health programmes German organisations: Recognise the employer s role in health 100% of respondents believe employers are responsible for influencing employee health and changing behaviours Are less likely to have health programmes than the EMEA region as a whole while 75% of German firms have social programmes, compared to 43% across EMEA, they are far less likely to have emotional or psychological programmes (13% vs 32% in EMEA as a whole), programmes relating to financial health (13% vs 26%) or programmes relating to physical health or the work environment (38% vs 47%) Are more likely to outsource health initiatives 88% of German respondents partially outsource health provision Are less confident about their health and benefits communications 73% think they are fair with only 18% believing they are good. In 9% of firms they are non-existent See a lack of resource and budget as barriers 73% believe that a lack of resource is their biggest challenge when it comes to implementing health-related programmes. For 64%, limited budget is the biggest barrier Funding employee health programmes In 75% of firms, the employer funds health benefits and expects to continue in future 25% use funding from their insurer, while 71% make use of free insurer add-ons None of the German firms measure the outcomes/roi of their employee health programmes, compared to 13% across the survey Among those that do not, 100% want to measure these outcomes and returns 25% use data analytics to inform their health strategy, though half intend to in future 73% do not have a specific budget for health initiatives, compared to 43% across EMEA

19 / HUNGARY Number of companies: 20 Number of employees (median value): 180 Identifying employers current challenges and priorities Aon View The Hungarian responses show some interesting differences to EMEA as a whole when it comes to HR and health challenges. Cost is far less an issue compared to the rest of EMEA, but employee engagement issues are far more prevalent. Unhealthy employee lifestyles and stress are far greater issue than EMEA as a whole (although this is in line with wider Central and Eastern European findings) and yet Hungarian employers are far less likely than their counterparts across EMEA to have put in place programmes to address these issues. Limited budget is a recognised challenge around health initiatives, but nearly half of respondents are not stretching this budget by making use of free insurer add-ons around health, which can help to increase the value they get from their insurer, as well as enabling them to tap into insurer expertise. Low utilisation of health programmes is a reported barrier; to tackle stress and unhealthy lifestyles, employee engagement with initiatives is essential. With respondents unsatisfied with their health and benefits communications, this might be an area to focus on in terms of improving employee education and engagement around health programmes. Current HR challenges Improving employee engagement and morale 60% Increasing productivity and employee performance 50% Attracting and retaining talent 50% Supporting professional and career development 45% Organisational health and wellness issues today and in the future Hungary Central and Eastern Europe Entire survey Stress and mental health issues 89% 73% 65% Unhealthy employee lifestyles 65% 58% 49% Financial health 61% 56% 48% Employees physical health 47% 60% 53%

20 / HUNGARY Examining current approaches to health Shaping health strategies Hungarian respondents: See a correlation between health and employee performance: 95% say this Are as likely to connect their insurable employee benefits with their health strategy (57%) as the whole of EMEA (56%) Have defined health strategies in 40% of firms; again, this is in line with the entire survey (40%) 43% plan to focus their health strategy on both developing employee health programmes and communicating the current strategy Use data to inform their approach to health more than their EMEA counterparts: just over half (56%) currently do this compared to 26% overall Have a clear view of the current impact of health issues within their organisation: 85% claim to have this insight, compared to 40% across the survey Current employee health programmes Hungarian organisations: Recognise the employer s role in health 100% agree or strongly agree that employers are responsible for influencing employee health and changing behaviours Are far less proactive than their counterparts across EMEA although many plan initiatives in future, today all Hungarian firms are less likely to have programmes relating to social health (20% compared to 43% across EMEA); the physical or work environment (27% vs 47%); emotional/psychological programmes (13% vs 32%) or financial health (none, compared to 26% across EMEA) Manage health programmes locally 77% of do this Are not confident in their health and benefits communications 35% rate them as insufficient or inefficient See limited budget as their biggest challenge 55% believe this is their biggest barrier to implementing health-related programmes. Low utilisation by employees is second (45%) Funding and measuring ROI of employee health programmes Employers are most likely fund health initiatives (73% do this and plan to continue) 42% are not making use of free insurer add-ons around health and don t plan to in future Only 22% currently use data analytics to inform and improve their health strategies 23% measure the outcomes of their investment in employee health programmes, compared 13% across the whole survey 80% of those who do not would like to measure these outcomes 45% have a specific budget for health initiatives, in line with the survey as a whole (43%)

21 / IRELAND Number of companies: 19 Number of employees (median value): 800 Identifying employers current challenges and priorities Aon View Attracting and retaining talent is a far bigger issue for Irish respondents than for EMEA firms overall. Having strong health benefits will help to retain hard-won talent - and the Irish appear to recognise this, being more proactive in all areas when it comes to health programmes than their EMEA peers overall. There are still steps employers could take, though, to improve their health strategies. The vast majority are not measuring the outcomes of health initiatives doing so will provide valuable evidence of their success, helping to overcome the budget and resourcing barriers respondents face. Current HR challenges Attracting and retaining talent 89% Supporting professional and career development 58% Increasing productivity and employee performance 53% Improving employee engagement and morale 47% Organisational health and wellness issues today and in the future Ireland Western Europe Entire survey Stress and mental health issues 63% 65% 65% Financial health 63% 45% 48% Employees physical health 53% 52% 53% Unhealthy employee lifestyles 44% 49% 49%

22 / IRELAND Examining current approaches to health Shaping health strategies Irish respondents: See a correlation between health and employee performance identical to that reported by the EMEA region overall (95%) Connect their insurable benefits to their health strategy: 69% do this, compared to 56% across EMEA as a whole Are slightly more likely to have a defined health strategy compared to the EMEA region (47% vs 40%) Are on a par with the rest of the region when it comes to the use of data analytics to understand and improve their health strategies: 27% do this, compared to 26% overall Current employee health programmes Irish organisations: Recognise the employer s role in health 100% agree that employers are responsible for influencing employee health and changing behaviours Are more proactive than EMEA employers overall when it comes to emotional/psychological programmes (65% have these), social ones or ones relating to physical health or the work environment (both 59%). These are all higher than the EMEA figures (32%, 43% and 47% respectively) Are less likely to run financial health programmes 19% have these compared to 26% across EMEA Are likely to have locally-run (65%) and partially outsourced (47%) health initiatives Are confident in their health and benefits communications 79% rate them as excellent or good Face financial and resourcing challenges budget and lack of resources (both 74%) are the main barriers faced by Irish firms when implementing health-related programmes. This is in line with the survey findings as a whole Funding employee health programmes The majority of Irish employers fund their employee health programmes themselves. Free add-ons to health insurance are also widely used and in 30% of firms, insurance companies fund their health programmes The vast majority fail to measure the outcomes of their health initiatives: only 6% do this, compared to 25% across EMEA Of those that currently do not, 100% would like to measure these outcomes 58% have a specific budget for health initiatives, which compares favourably with the overall EMEA region, where 43% say the same

23 / ITALY Number of companies: 18 Number of employees (median value): 425 Identifying employers current challenges and priorities Aon View Italian employers report a higher incidence of all health and HR issues than EMEA as a whole but are less likely to have defined strategies or budgets to address these. Very few less than one in ten have a clear view of the impact of health issues on their organisation, in spite of high reported use of data analytics. Although Italian firms are more proactive in terms of health programmes, communications are seen as poor, which can make any investment in health initiatives a waste of money. We would encourage firms to look at the way they communicate their health programmes as a priority; effective communication can increase take up and value, closing the resources gap that Italian organisations clearly feel. With almost half of Italian firms managing health benefit programmes entirely in-house, we would also suggest they look to external expertise to help focus, manage, communicate and measure their health initiatives; doing so can deliver significant and tangible improvements. Current HR challenges Supporting professional and career development 56% Improving employee engagement and morale 56% Increasing productivity and employee performance 44% Attracting and retaining talent 39% Organisational health and wellness issues today and in the future Italy Western Europe Entire survey Stress and mental health issues 67% 65% 65% Employees physical health 63% 52% 53% Unhealthy employee lifestyles 56% 49% 49% Financial health 53% 45% 48% Ageing 53% 35% 31%

24 / ITALY Examining current approaches to health Shaping health strategies Italian respondents: See a correlation between health and employee performance: 100% say this Connect their insurable benefits to their health strategy in half of cases: 50% do this, in line with the overall EMEA figure of 56% Are much less likely to have a defined health strategy than the EMEA region overall (17% vs 40%) Do not have a clear view of the impact of health issues, including costs, on their organisations. Only 9% claim to have this insight Report a far higher use of data analytics to understand and improve their health strategies than EMEA as a whole: 50% do this, compared to 26% overall Current employee health programmes Italian organisations: Recognise the employer s role in health, although less than EMEA as a whole 89% agree that employers are responsible for influencing employee health and changing behaviours, compared to 94% across the region Are more proactive than EMEA employers in terms of social programmes (69% have these, compared to 43% across EMEA); programmes relating to physical health or the work environment (63% vs 47%) and financial programmes (40% vs 26%). They are less likely to have emotional/psychological programmes (19% vs 32%) Are far more likely to manage health programmes locally 73% report that their programmes are local, compared to 55% across EMEA Are less satisfied with the effectiveness of their health and benefits communications while 61% rate them as good or fair, 39% believe they are insufficient or inefficient See lack of resources as their biggest barrier this is cited by 72% as the biggest challenge when implementing health-related programmes. A limited budget is second, with 67% Funding employee health programmes Employers fund health programmes in the majority of cases, and expect to continue doing so in future Funding from insurance companies for health initiatives is prevalent 63% receive insurer funding and expect this to continue Italian firms are more likely to measure the outcomes/roi of employee health programmes (33%) than those in Western Europe or EMEA overall (both 13%) Far fewer have a specific budget for health initiatives than the EMEA region (28% vs 43%)

25 / LATVIA Number of companies: 37 Number of employees (median value): 210 Identifying employers current challenges and priorities Aon View In some ways, the Latvian respondents paint a positive picture. Latvian employers are more likely to have a clear view of the impact of health on their organisation and to have defined health strategies. Measuring these outcomes will enable firms to tackle their budget challenges by clearly demonstrating the ROI of these initiatives in terms of performance, engagement and productivity all key issues for Latvian respondents. Current HR challenges Increasing productivity and employee performance 68% Attracting and retaining talent 51% Improving employee engagement and morale 49% However, in other ways, they are less proactive. Mental health and stress are their second most pressing issue, yet only 9% offer emotional or psychological programmes. In general, Latvian employers are less likely to have put in place any form of health and wellness programme. They are also less likely to use data to inform their programmes or to measure their outcomes. This use of data and measurement is essential if health and wellness programmes are to be focused on areas that will deliver most benefit. Organisational health and wellness issues today and in the future Latvia Central and Eastern Europe Entire survey Employees physical health 67% 60% 53% Stress and mental health issues 59% 73% 65% Unhealthy employee lifestyles 56% 58% 49% Financial health 45% 56% 48%

26 / LATVIA Examining current approaches to health Shaping health strategies Latvian respondents: See a correlation between health and employee performance: 92% say this Are far more likely to connect their insurable employee benefits with their health strategy (86%) than the EMEA region as a whole (56%) Have defined health strategies in 49% of firms; again, slightly more than the entire survey (40%). A further 47% plan to implement a strategy in the next two years Would focus any health strategy on communicating existing health programmes (41% say this); 36% would focus on both developing employee health programmes and communicating the current strategy State that they have a clear view of the current impact of health issues within their organisation - 61% state this. This compares to just 31% across the survey Current employee health programmes Latvian organisations: Are less likely to recognise the employer s role in health 76% agree or strongly agree that employers are responsible for influencing employee health and changing behaviours, compared to 94% across EMEA Are most likely to have programmes relating to the physical or work environment 31% have these and least likely to offer emotional/psychological programmes (9%). Overall, prevalence of health programmes is less than across EMEA as a whole Tend to manage health programmes locally 77%% of do this Are satisfied with their health and benefits communications 86% rate them as good or fair with 3% believing they are excellent See resource and budget as their biggest challenges 65% cite lack of resource as their biggest barrier to implementing health-related programmes, with 59% citing limited budget. Encouragingly, 32% see no particular barriers to implementation Funding and measuring ROI of employee health programmes The majority of employers fund health initiatives themselves and expect to continue (94%) 63% make use of free add-ons from their insurers Do not use data to inform their approach to health: just 14% currently do this compared to 26% across EMEA. 38% intend to start Just 11% measure the outcomes of their investment in employee health programmes, although this is in line with the EMEA region (13%) 77% of those who do not would like to measure these outcomes 65% have a specific budget for health initiatives, significantly more than the survey as a whole (44%)

27 / LITHUANIA Number of companies: 21 Number of employees (median value): 70 Identifying employers current challenges and priorities Aon View Although employers in Lithuania report higher-than-average incidence of all health and wellness issues than the survey sample as a whole, they are also more proactive in addressing them. Three quarters have a defined health strategy and possibly because they already have a programme of activity in place are more likely to focus any health initiatives in future on communicating what they do than introducing new programmes. Communication overall is seen as strong, and the connection Lithuanian employers make between their insurable benefits and their health strategies is likely to benefit their budget, reducing premiums and enabling them to take advantage of any support their insurers provide. While budget is an issue, the practices among Lithuanian respondents help to maximise this budget, with insurance company funding prevalent and a specific health budget identified in over half of firms. There is still room for improvement, though. Less than a third of Lithuanian firms claim to have a clear view of the impact of health issues on their business, including the cost implications. Only just over one in ten makes use of data analytics to inform and improve their health strategies; using the data at their disposal will enable Lithuanian employers to better target health initiatives where they are most needed. It will also give a clearer picture of the ROI of initiatives implemented, which less than one in five currently has. Current HR challenges Increasing productivity and employee performance 71% Improving employee engagement and morale 52% Supporting professional and career development Attracting and retaining talent 33% Reducing or managing cost 24% 52% Organisational health and wellness issues today and in the future Lithuania Central and Eastern Europe Entire survey Stress and mental health issues 90% 73% 65% Employees physical health 81% 60% 53% Unhealthy employee lifestyles 76% 58% 49% Financial health 76% 56% 48%

28 / LITHUANIA Examining current approaches to health Shaping health strategies Lithuanian respondents: See a correlation between health and employee performance: 100% say this Are far more likely to have a defined health strategy (76%) than EMEA employers as a whole (40%) Would be most likely to focus a health strategy on communicating current health programmes (50% compared to 16% across EMEA as a whole) Connect their insurable employee benefits to their health strategy over three quarters of respondents (80%) do this, compared to 56% in the EMEA region Do not currently make use of data analytics to understand and improve their health strategies. Only 12% currently do this, although 44% say they intend to. Across the whole survey sample, 26% are making use of health data currently Do not tend to have a clear view of the impact (including cost) of health issues in their organisation. Less than a third (35%) have this insight, although this is not significantly lower than the overall EMEA figure, at 40% Current employee health programmes Lithuanian organisations: Recognise the employer s role in health 95% of Lithuanian participants agree that employers are responsible for influencing employee health and changing behaviours Are most likely to have social health programmes 26% currently have social programmes, and 63% both have and plan to have them in the future. This compares to 43% and 27% across EMEA as a whole Are evenly split in terms of geographical scope of initiatives 53% manage health programmes locally, 37% are part of global initiatives and 11% are regional Partially outsource their health programmes 50% partially outsource them, with 39% managing them totally in-house and 11% fully outsourcing them Are positive about their health benefit communications 19% rate them as excellent and 48% as good, although 10% believe they are insufficient or inefficient See a limited budget as by far their biggest barrier 95% cite a limited budget as their biggest barrier, in line with the EMEA region as a whole (69%) Funding employee health programmes Lithuanian health programmes are most likely to be funded by insurance companies (38% say this is currently the case). This compares to just 19% across the EMEA region. Employees currently pay for their own health programmes in 33% of cases, compared to 16% in EMEA overall 16% of Lithuanian employers measure the outcomes or return on investment of their health programmes, although this is still higher than across the EMEA region (13%) Of those that currently do not, 88% want to measure these outcomes and returns in future 57% have a specific budget for health initiatives, compared 43% throughout EMEA. A further 19% intend to have a dedicated budget within the next two years

29 / NETHERLANDS Number of companies: 22 Number of employees (median value): 350 Identifying employers current challenges and priorities Aon View Although employers in Netherlands report higher incidences of their top health and wellness issues than those across the whole of EMEA, they are doing less to manage them. With firms less likely to offer initiatives relating to physical health or the work environment, social or financial health than their counterparts across EMEA, and fewer firms having a defined health strategy than is seen across the survey as a whole, Netherlands employers could take some easy steps that will deliver quick wins in terms of health and wellness. They are less likely than firms in EMEA as a whole to connect their insurable employee benefits with their health strategy; this can help to focus initiatives and drive down premiums. Understanding the impact including cost of health issues on their firm is a vital first step in tackling them, but almost two thirds do not measure this impact. Benefits communications are generally regarded as fair to good, but with employee take-up the biggest barrier to health initiative success, perhaps firms should revisit their communications to see if they could be improved. While firms in Netherlands are more proactive than the rest of the survey in measuring the outcomes of their health investments, by identifying the current impact of health issues and putting in place targeted programmes to address them, they will see increased ROI. Current HR challenges Attracting and retaining talent 41% Handing ageing employees 41% Encouraging sustainable employability 36% Reducing or managing cost 36% Organisational health and wellness issues today and in the future Netherlands Western Europe Entire survey Stress and mental health issues 68% 65% 65% Ageing 57% 35% 31% Unhealthy employee lifestyles 50% 49% 49%

30 / NETHERLANDS Examining current approaches to health Shaping health strategies Respondents from Netherlands: See a correlation between health and employee performance (95%), similar to that seen across the EMEA region as a whole (93%) Do not connect their insurable employee benefits with their health strategy (31%) as much as those across the whole of EMEA (56%) Are less likely to have a defined health strategy: 36% do, compared to 40% across the entire survey with only 33% of those without a strategy planning to define one within the next two years Are in line with EMEA as a whole regarding the focus of their health strategy: 56% plan to focus both on developing employee health programmes and communicating the current strategy, compared to 53% across the whole survey Do not have a clear view of the current impact of health issues within their organisation (62%) this is in line with EMEA as a whole (60%) although 60% of these plan to address this Current employee health programmes Organisations in Netherlands: Recognise the employer s role in health 96% agree that employers are responsible for influencing employee health and changing behaviours Are less proactive than their counterparts across EMEA 31% have programmes relating to physical health or the work environment compared to 47% across the survey; 25% have social programmes (43% across EMEA) and 20% have financial programmes (26%) Are less likely to manage health initiatives globally in 93% of organisations these programmes are local or regional, compared to 72% across EMEA Are fairly satisfied with their communications around health and benefits 82% believe their health and benefits communications are good or fair, compared to 75% among EMEA employers overall See employee take-up as their biggest challenge 55% cite low utilisation by employees as their biggest barrier to implementing health-related programmes, compared to 28% across the survey Funding and measuring ROI of employee health programmes 100% of respondents expect health programmes to be paid for, now and in future, by the employer For 43%, current and expected future provision is partially paid for by employees 21% measure the outcomes of their investment in employee health programmes, compared 13% across the whole survey 91% of those who do not would like to measure these outcomes 41% have a specific budget for health initiatives, compared to 43% across EMEA

31 / NORWAY Number of companies: 15 Number of employees (median value): 215 Identifying employers current challenges and priorities Aon View Overall, Norwegian employers perform well when it comes to health. They are more likely to appreciate the employer s role in influencing healthy behaviours and more likely to have a defined health strategy than EMEA as a whole and the Nordic region. They are more likely than EMEA and the Nordics to have implemented every type of health programme covered in the survey. Norwegian organisations also connect their insurable benefits and health strategy more than most others in the survey, suggesting that they are making the most of the interventions and support available through insured benefit provision. Despite this proactivity, there are changes Norwegian firms could make to get better return on investment from their health spend. Finance is the biggest barrier to health strategy implementation, yet Norwegian employers are less likely than the survey as a whole to quantify the impact of any health issues, and only half have an idea of this impact on their organisation. Two thirds have no plans to more accurately quantify what the impact might be. We would strongly advise employers to work out the cost of health to the organisation. This will provide a solid starting point for any health initiatives, enabling you to focus your attention and to measure the impact of the programmes you put in place. A proactive approach to health should be applauded, but only by targeting this approach and measuring its effect will firms be able to quantify the results of their health strategy. Current HR challenges Reducing or managing cost 53% Increasing productivity and employee performance 40% Improving employee engagement and morale 40% Attracting and retaining talent 40% Organisational health and wellness issues today and in the future Norway Nordics Entire survey Stress and mental health issues 60% 62% 65% Employees physical health 60% 56% 53% Unhealthy employee lifestyles 40% 33% 49%

32 / NORWAY Examining current approaches to health Shaping health strategies Norwegian respondents: See a correlation between health and employee performance (87%), though not as much as the EMEA region as a whole (93%) and the Nordic region (90%) Connect their health strategy and their insurable employee benefits (75%) far more than the whole of EMEA (56%) and the Nordics (57%) Are more likely to have a defined health strategy (73%) compared to 42% across the entire survey Plan to have a health strategy that focuses both on developing employee health programmes and communicating the current strategy (67%) compared to 53% across the whole sample Are more likely to have a clear view of the impact of health issues on the employer (56%) than EMEA or the rest of the Nordics (both 40%) But have no plans to more accurately quantify the impact of health issues within their organisation (67%) compared to 45% throughout EMEA Current employee health programmes Norwegian organisations: Recognise the employer s role in health 94% agree that employers are responsible for influencing employee health and changing behaviours Are proactive 83% have programmes relating to the physical or work environment; 82% have financial health programmes; 67% have social programmes and 58% have emotional or psychological programmes Manage health initiatives locally in 67% of organisations these programmes are local rather than global/regional Communicate health and benefits effectively more believe their health and benefits communications as good (73%) than EMEA employers overall (39%) Face financial barriers 87% cite limited budget as the main barriers to implementing health-related programmes, compared to 69% across the survey Funding and measuring ROI of employee health programmes In 91% of firms, health programmes are currently paid for by the employer and expected to be in future For 44%, current and expected future provision is paid for by employees 25% measure the outcomes of their investment in employee health programmes, compared 13% across the whole survey Of those that currently do not, 78% would like to measure these outcomes 67% have a specific budget for health initiatives, compared to 43% across EMEA.

33 / PORTUGAL Number of companies: 15 Number of employees (median value): 450 Identifying employers current challenges and priorities Aon View At first glance, Portuguese employers seem more proactive than EMEA firms as a whole when it comes to employee health programmes. They are far more proactive in connecting their insurable benefits to their health strategies something that will help with the lack of budget they face. Portuguese firms are also more likely to have defined health strategies, and almost twice as likely to measure the outcomes of their investment in health programmes. However, in other ways, Portuguese organisations are doing less to improve employee health than their peers, with fewer having implemented programmes to support physical, emotional or financial health, or social initiatives. They are also less likely to have a clear view of the current impact of health on their business. This insight is essential if firms are to pinpoint where health initiatives and budget; an issue for Portuguese employers as for others should be focused. With stress, physical and financial health cited as bigger issues for Portuguese respondents than for those across the survey as a whole, measuring their impact so that effective strategies can be put in place to tackle them is a crucial first step. Current HR challenges Improving employee engagement and morale 67% Reducing or managing cost 53% Increasing productivity and employee performance 53% Attracting and retaining talent 53% Organisational health and wellness issues today and in the future Portugal Western Europe Entire survey Stress and mental health issues 87% 65% 65% Employees physical health 64% 52% 53% Financial health 64% 45% 48%

34 / PORTUGAL Examining current approaches to health Shaping health strategies Portuguese respondents: See a correlation between health and employee performance (80%), though less than the EMEA region as a whole (93%) Are more proactive in connecting their insurable employee benefits with their health strategy (83%) than those across the whole of EMEA (56%) Are more likely to have a defined health strategy: 53% do, compared to 40% across the entire survey with a further 27% intending to put one in place Are more likely to focus any health strategy both on developing employee health programmes and communicating the current strategy (75%), compared to 53% across the whole survey Make better use of data analytics to understand and improve health strategy (45%) than EMEA as a whole (26%) Are slightly more likely than EMEA overall to have a clear view of the current impact of health issues within their organisation (44% compared to 40% across the whole survey). 100% of those without this insight plan to obtain it Current employee health programmes Portuguese organisations: Strongly believe in the employer s role in health 100% agree that employers are responsible for influencing employee health and changing behaviours Are less proactive than their counterparts across EMEA 43% have programmes relating to the physical or work environment compared to 47% across the survey; 25% have financial programmes (26% across EMEA); 21% have social programmes (43%) and 14% have emotional/psychological programmes (32%) Are polarised when it comes to the scope of their programmes while 50% manage them locally, 43% are global, with just 7% having regional initiatives Are less satisfied with their health and benefits communications they are more likely to rate them insufficient or inefficient (20%) than EMEA employers as a whole (17%), although 33% rate them as good Face a number of challenges to health programme implementation limited budget, lack of resources and the inability to rate their effectiveness/efficiency are all cited as barriers by 53% Funding and measuring ROI of employee health programmes 100% of respondents expect health programmes to be paid for, now and in future, by the employer For 77%, current and expected future provision is partially paid for by employees 70% receive, and expect to continue receiving, funding from their insurance companies for health programmes 21% measure the outcomes of their investment in employee health programmes, compared 13% across the whole survey Of those that currently do not, 91% would like to measure these outcomes 47% have a specific budget for health initiatives, compared to 43% across EMEA, with a further 20% planning to have one within the next two years

35 / SOUTH AFRICA Number of companies: 44 Number of employees (median value): 33 Identifying employers current challenges and priorities Aon View South African employers are, overall, less likely to have employee health programmes than their peers in the EMEA region. Fewer South African firms have initiatives relating to physical, mental or financial health. Lack of budget and resources are the biggest challenges faced when implementing health programmes; this is in line with the remainder of the survey, though possibly a more marked issue for South African firms, as they are nearly twice as likely as the rest of the survey sample to have no set budget for health programmes. The South African respondents are less likely than their African counterparts, or survey participants as a whole, to have a defined health strategy. The lack of data analytics around health in line with that seen overall contributes to a lack of insight into the impact health issues are currently having on their firms productivity, performance and budget. This lack of insight is more marked than that seen across the survey as a whole. With budget a clear challenge, understanding the impact of health is vital. It will enable South African firms to focus and refine their health initiatives, and to measure their impact, essential in evidencing their value and calculating ROI. This insight can drive a defined and effective health strategy. Current HR challenges Improving employee engagement and morale 63% Reducing or managing cost 56% Attracting and retaining talent 40% Supporting professional and career development 40% Organisational health and wellness issues today and in the future South Africa African region Entire survey Stress and mental health issues 56% 51% 65% Financial health 52% 49% 49% Unhealthy employee lifestyles 48% 42% 49%

36 / SOUTH AFRICA Examining current approaches to health Shaping health strategies South African respondents: See a correlation between health and employee performance (86%), though less than the EMEA region as a whole (95%) Are significantly less proactive in connecting their insurable employee benefits with their health strategy (36%) than those across the whole of EMEA (56%) Are less likely to have a defined health strategy (28%) than the African region (33%) or the entire survey (40%) Are more likely to focus any health strategy on communicating existing programmes (27%) than employers across the EMEA region as a whole (16%) and less likely to put in place a programme that looks at initiatives and communications (36% vs 53%) Have an insight into health data analytics on a par with EMEA as a whole (25% use data analytics to understand and improve their health strategy, compared to 26% across the survey). They are more likely (50% vs 41%) to intend to start doing this Are slightly less likely (37%) than Africa overall (42%) and EMEA (40%) to have a clear view of the current impact of health issues within their organisation Current employee health programmes South African organisations: Recognise the employer s role in health 95% agree that employers are responsible for influencing employee health and changing behaviours Are less likely than EMEA as a whole to have all types of health programme 36% have programmes relating to the physical or work environment compared to 47% across the survey; 34% have social programmes (43% across EMEA); 27% have emotional/psychological programmes (32%) and 18% have financial programmes (26%) Are more likely to manage health programmes locally or regionally 81% do this, with only 19% participating in global programmes Have a strong tendency to manage health programmes in-house 69% manage them internally, with 31% partially outsourcing. None are fully outsourced Are fairly confident in their health and benefits communications 72% rate them as good or fair, in line with the survey as a whole (75%) See budget as by far the biggest barrier to health programme implementation limited budget is rated by 67% as their biggest challenge. Lack of resources is cited by 51%. This is broadly in line with Africa (65% and 47% respectively) and the survey as a whole (69% and 60%) Funding and measuring ROI of employee health programmes 76% of respondents expect health programmes to be paid for, now and in future, by the employer 88% do not currently measure the outcomes of their investment in employee health programmes. This is in line with the survey as a whole where 87% say the same Of those that currently do not, 74% would like to measure these outcomes Just 26% have a specific budget for health initiatives, comparable to 25% across Africa but lower than the 43% across EMEA as a whole. Only a further 9% plan to have one within the next two years

37 / SPAIN Number of companies: 34 Number of employees (median value): 288 Identifying employers current challenges and priorities Aon View In some areas, Spanish employers concerns and approaches differ markedly from the EMEA region as a whole. Ageing is a far bigger future worry than it is across the survey, with Spanish respondents over twice as concerned about this as EMEA overall. Programmes supporting physical health or the work environment are far more likely to be in place in Spanish firms than EMEA ones as a whole. Few Spanish employers use data analytics to inform their health strategies, or to measure the outcomes of their health and benefits programmes. By identifying the incidences and causes of health issues, employers can more precisely target their programmes to tackle them. Measuring the impact of these programmes enables firms to evidence their impact something that would ease the budget pressure Spanish firms face. Current HR challenges Improving employee engagement and morale 65% Attracting and retaining talent 59% Supporting professional and career development 44% Reducing or managing cost 38% Spanish organisations face a cocktail of HR and health challenges and concerns, but are not always putting in place strategies to tackle them. Although stress and mental health is their biggest health concern, only 38% have emotional or psychological programmes in place. Effective communications something many of the Spanish respondents do not have will also help maximise ROI from benefits spend. Organisational health and wellness issues today and in the future Spain Western Europe Entire survey Financial health 64% 47% 48% Stress and mental health issues 62% 65% 65% Employees physical health 53% 52% 53% Unhealthy employee lifestyles 52% 49% 49%

38 / SPAIN Examining current approaches to health Shaping health strategies Spanish respondents: See a correlation between health and employee performance: 100% recognise this Are less likely to connect their insurable employee benefits with their health strategy (42%) than those across the whole of EMEA (56%) Are less likely to have a defined health strategy: 26% do, compared to 40% across the entire survey although 44% intend to put one in place Will focus any health strategy implemented both on developing employee health programmes and communicating the current strategy (58%); this is in line with 53% across the whole survey Are not making use of data analytics to understand and improve health strategy: just 18% do this, compared to 27% across EMEA as a whole Do not have a clear view of the current impact of health issues within their organisation only 47% claim to have this insight and only 33% plan to address this. This is still more than EMEA overall, though (40%) Current employee health programmes Spanish organisations: Strongly believe in the employer s role in health 97% agree that employers are responsible for influencing employee health and changing behaviours Are far more likely to have programmes relating to the physical or work environment 71% have these, compared to 47% across the survey. 38% have emotional/psychological programmes (32% across EMEA); 33% have social programmes (43% across EMEA) and 24% have financial ones (26% across EMEA) Manage health programmes globally far more than the survey sample as a whole: 72% of Spanish programmes are global, compared to 28% of EMEA ones Are less satisfied with their health and benefits communications 24% rate them as insufficient or inefficient; compared to EMEA employers as a whole (17%), although 68% rate them as fair or good See budget as by far their biggest barrier 72% cite this as a barrier to health programme implementation, with lack of resources cited by 62%. These are in line with the survey overall Funding and measuring ROI of employee health programmes 100% of respondents expect health programmes to be paid for, now and in future, by the employer 61% receive, and expect to continue receiving, funding from their insurance companies for health programmes Just 11% measure the outcomes of their investment in employee health programmes, compared 13% across the whole survey Of those that currently do not, 81% would like to measure these outcomes 47% have a specific budget for health initiatives, compared to 43% across EMEA, with a further 15% planning to have one within the next two years

39 / UKRAINE Number of companies: 15 Number of employees (median value): 217 Identifying employers current challenges and priorities Aon View With limited budget a recognised challenge, Ukranian employers are making good use of their insured benefits providers to support health programmes, either via free add-ons or by connecting their insurable benefits to their health programmes, potentially delivering insurerled interventions and premium savings. This demonstrates a proactive and determined approach to improving health. Positive reports on the programmes offered and their communications show Ukranian organisations in a good place when it comes to health and wellness but there is more they can do to refine and further improve their approach. A more focused approach will pay dividends: Ukranian employers are less likely to have a defined health strategy than their counterparts across EMEA. Four fifths do not currently use the data at their disposal to inform their health strategy; making use of this data would enable them to target any activity, increasing take-up and ROI. Measuring the outcomes of any investment in health which less than a tenth currently do will enable firms to evidence their impact, justifying future budgets and ensuring that employee health and wellness are prioritised. Current HR challenges Reducing or managing cost 73% Increasing productivity and employee performance 67% Supporting professional and career development Attracting and retaining talent 27% 53% Organisational health and wellness issues today and in the future Ukraine Central and Eastern Europe Entire survey Stress and mental health issues 53% 73% 65% Financial health 50% 56% 48% Employees physical health 33% 60% 52%

40 / UKRAINE Examining current approaches to health Shaping health strategies Ukranian respondents: See a correlation between health and employee performance: 100% say this, slightly more than the figure across the EMEA region as a whole (93%) Connect their insurable employee benefits with their health strategy (100%), far more than those across the whole of EMEA (56%) Are less likely to have a defined health strategy: 33% do, compared to 40% across the entire survey with only half of those without a strategy planning to define one within the next two years Are in line with EMEA as a whole regarding the focus of their health strategy: 56% plan to focus both on developing employee health programmes and communicating the current strategy, compared to 53% across the whole survey Do not have a clear view of the current impact of health issues within their organisation (62%) this is in line with EMEA as a whole (60%) although 80% of these plan to address this Current employee health programmes Ukranian organisations: Recognise the employer s role in health 87% agree or strongly agree that employers are responsible for influencing employee health and changing behaviours Are more proactive than their counterparts across EMEA 80% have programmes relating to social health, compared to 43% across EMEA; 53% have programmes addressing the physical or work environment (47% across EMEA) and 40% have emotional/psychological programmes (32%) Are more likely to be part of global and outsourced health programmes 57% of firms report that they manage health initiatives globally, with 78% fully or partially outsourcing them Are more satisfied than most of EMEA with their communications around health and benefits 80% think they are excellent or good, compared to 43% overall See limited budget as by far their biggest challenge 87% cite this as their biggest barrier to implementing health-related programmes, compared to 69% across the survey Funding and measuring ROI of employee health programmes 88% of respondents make use of free insurer add-ons or will do in future to finance their health and wellness programmes Only 22% currently use data analytics to inform and improve their health strategies Only 7% measure the outcomes of their investment in employee health programmes, compared 13% across the whole survey 77% of those who do not would like to measure these outcomes 67% have a specific budget for health initiatives, compared to 44% across EMEA

41 / UNITED KINGDOM Number of companies: 90 Number of employees (median value): 510 Identifying employers current challenges and priorities Aon View In some ways, UK employers demonstrate greater proactivity than their EMEA counterparts as a whole when it comes to health and wellness. They are taking steps to manage the impact of health and connect their insurable benefits with their health strategy in more than half of cases, which will help to deliver premium savings. However, only a third are confident that they understand the impact of health issues including cost across their organisation, and are less likely than the EMEA region as a whole to have a defined health strategy. Nine in ten do not measure the impact of their health investments. Understanding the cost and wider implications of your employee health issues is a vital first step in defining a strategy that addresses your biggest concerns. Currently, UK practice on health programmes is out of line with their identified challenges; stress and mental health issues are the most widely reported, yet fewer firms have emotional or psychological programmes in place than physical or social ones. A planned growth in financial health initiatives supports concerns around this, but a closer correlation between concerns and approaches would be helped by having a clear understanding of the impact of health and a defined strategy to tackle it. Fewer UK employers than those across EMEA have a specific budget for health initiatives, something else that would help to focus initiatives and measure ROI, enabling firms to quantify the benefits of any programmes implemented. Current HR challenges Attracting and retaining talent 61% Reducing or managing cost 57% Improving employee engagement and morale 49% Increasing productivity and employee performance 47% Organisational health and wellness issues today and in the future UK Western Europe Entire survey Stress and mental health issues 63% 65% 65% Employees physical health 51% 52% 53% Unhealthy employee lifestyles 48% 49% 49%

42 / UNITED KINGDOM Examining current approaches to health Shaping health strategies UK respondents: See a correlation between health and employee performance (92%), similar to that reported by the EMEA region overall (93%) Are taking steps to manage the impact of health (58%) Yet do not have a clear idea of the current impact of health issues within their organisation only 37% feel confident in this Are less likely to have a defined health strategy compared to the EMEA region (30% vs 40%). Are less likely than EMEA employers as a whole to plan a defined health strategy within the next two years: only 7% of UK employers plan to do this, compared to 21% across EMEA 54% of UK employers connect their health strategy and insurable employee benefits, compared to 56% across EMEA Current employee health programmes UK organisations: Recognise the employer s role in health 93% agree that employers are responsible for influencing employee health and changing behaviours Are more proactive around physical (57% currently have these) and social (55%) programmes than emotional/psychological (41%) or financial (24%) ones Will see greatest growth in financial health programmes 35% plan to introduce these in future Are evenly split between in-house and outsourced health provision 57% either fully or partially outsource it while 43% manage health in-house Are not confident in their health and benefits communications 42% rate them as fair but are less likely than the overall survey sample to believe they are good (28% vs 39%) Face financial and resourcing challenges budget (71%) and lack of resources (67%) are the main barriers to implementing health-related programmes. This is in line with the survey findings as a whole Funding employee health programmes 38% of UK employers fund their employee health programmes; employees fund them in 17% of firms 26% fund health initiatives via their insurance companies and 25% deliver them via free insurance company add-ons Only 29% have a specific budget for health initiatives, compared to 43% in the overall EMEA region, although 18% plan to have one within the next two years Only 9% currently measure the outcomes of the investment in employee health programmes, compared to 13% across EMEA Of those that currently do not, 85% would like to measure these outcomes

43 About the survey All the statistics displayed in this report meet the following rules: Results are available for countries which have at least 10 respondents with a validated questionnaire. Regarding questions for which only one answer is possible : Void or «not applicable» answers are not taken into account; the void answers were not included in the 100% figure. Regarding questions for which several answers are possible : The sum of results does not always equal 100%, as we considered each possible answer independently. We received data for 41 countries, and due to the rules above, we report results for 20 countries / zones. Nordics consists of African region consists of Denmark Algeria Botswana Finland Madagascar Namibia Norway South Africa Zambia Sweden Zimbabwe

44 About Aon Aon plc (NYSE:AON) is the leading global provider of risk management, insurance and reinsurance brokerage, and human resources solutions and outsourcing services. Through its more than 66,000 colleagues worldwide, Aon unites to empower results for clients in over 120 countries via innovative and effective risk and people solutions and through industry-leading global resources and technical expertise. Aon has been named repeatedly as the world s best broker, best insurance intermediary, best reinsurance intermediary, best captives manager, and best employee benefits consulting firm by multiple industry sources. Read on for more information about Aon, and visit aon.com/manchester united to learn about Aon s global partnership with Manchester United. For more information on Aon, please visit Contacts Mario Hooglugt Health Leader Health & Benefits EMEA +31 (0) mario.hooglugt@aon.nl Marion Armand Business Developer Health & Benefits EMEA +33 (0) marion.armand@aon.com