BEST PRACTICES IN CORPORATE WELLNESS

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1 BEST PRACTICES IN CORPORATE WELLNESS INDUSTRY FOCUS: FOOD SERVICES FEATURED COMPANY: JACK IN THE BOX Jack in the Box Inc. stands out in the restaurant industry as a company with a progressive health and wellness policy for its employees. The San Diego, California- based firm, which includes a nationwide network of company-owned and franchised restaurants under the Jack in the Box and Qdoba Mexican Grill brands, is three years into a corporate wellness program that is setting precedents for other restaurant chains to follow. Last year we began offering incentives for completing a health risk assessment, staying tobacco-free and participating in other wellness initiatives. Our goal was to initiate a dialog about health risks and personal responsibility, says Susan Doherty, Program Manager of Health Management at Jack in the Box. This year, we raised the bar by offering biometric screenings. Not everyone sees a doctor on an annual basis. Our goal is for them to know their risks for heart disease and diabetes.

2 Jack in the Box is working with BioIQ to create a multi-year strategy to improve wellness outcomes and increase the return on investment. Their wellness program also includes Weight Watchers at Work, a smoking-cessation campaign called the Great American Smoke-Out, an activity-based program through Virgin HealthMiles, and a corporate gym where employees are encouraged to exercise regularly. The company s health plans cover annual physicals at 100 percent. This year, they increased the wellness rewards in the form of reduced health care premiums for employees who receive baseline biometric screenings. Program Year 3 Biometrics Screening Methods Eligible Population Incentive Next Steps Lipid Panel, Fasting Glucose At-Home (87%), Lab Visits (13%) Employees, Spouses / Domestic Partners $260/participant ($10/paycheck) Increase Engagement, Outcome-based Incentive Structure After careful review of several screening companies, we chose BioIQ to conduct our biometric screening program based on the simplicity of their approach, the quality of their website, and their pricing structure, Doherty reports. We especially liked being able to see year-over-year trending through personal health dashboards. The online experience is very user-friendly. The pricing was also competitive and in most cases better than other vendors we looked at. BioIQ offers several methods for gathering biometric data from employees and dependents: through home test kits, onsite screening events, local labs, and physician visits. Regardless of which method people choose they enjoy a cohesive interface for ordering tests, scheduling appointments, and viewing results through BioIQ Personal Health Dashboards, with colorful graphs to monitor year-over-year trends. We see BioIQ as the gateway to our Wellness Rewards program. It is important for people to know their current health status. Biometric screenings provide a window into this information.

3 TOTAL POPULATION ACCESS Participation in the Jack in the Box screening program was limited to employees and covered spouses or domestic partners who are enrolled in a comprehensive medical plan. Because Jack in the Box and Qdoba have a highly dispersed population, with restaurants distributed throughout the country, they determined that offering the BioIQ Home Testing option would make it easy for everyone to participate. For those people who preferred to be tested in a professional setting, they offered the BioIQ Lab Visit option. We chose BioIQ to conduct our biometric screening program based on the simplicity of their approach, the quality of their website, and their pricing structure. In both cases the test included a complete cholesterol/lipid panel to screen for heart disease and a fasting blood glucose test to screen for diabetes and pre-diabetes. Nearly 90 percent of the participants opted for the home test, primarily for the convenience and privacy aspects. They simply supplied a few drops of blood to a unique sample platform. After dropping the samples in the mail they were processed by a certified laboratory. About a week later these participants could view their lab results online through BioIQ s secure dashboards. Employees who preferred to be tested in a lab completed the same online enrollment process, but instead of clicking a button to order a home test kit, they clicked through an interactive screen to locate a nearby lab from BioIQ s nationwide network, made an appointment, printed a lab requisition, and obtained directions. They were notified by when their lab results were ready and could log into their secure, personal BioIQ dashboards to check their results. Rebecca Aoun, Property Analyst Utilities, Jack in the Box, opted for the home test. I checked my results online and found the BioIQ lab reports easy to understand, she says. Having the option for regular biometric health screening is an important health benefit, and I especially appreciate seeing the difference in my paycheck. An active Weight Watchers member who likes to walk and swim for exercise, Aoun believes that regularly monitoring cholesterol and blood pressure are essential measures of good health. While all BioIQ results in the Jack in the Box program remained private, viewable only by the individual participants, BioIQ rolled up the results from both groups into one cohesive aggregate report for management. BioIQ Aggregate Reports provide a detailed assessment of the health of the population and identify opportunities for improvement. The home testing group had the highest compliance rate: 84 percent of those who ordered a test kit followed through to completion. For the lab testing group, the completion rate was 65 percent still comparatively high by industry standards. Jack in the Box also utilized the BioIQ Health Coaching option, which permits participants to call a toll-free number if they have questions about their lab reports especially if their results indicate a high-risk condition. We encourage employees to talk with their doctors about their health and wellness. But BioIQ Health Coaching is a great option for employees who want to

4 learn how they can improve their health, especially those whose test results suggest they could be at risk, says Doherty. Jack in the Box promoted the program through their web-based portal, open enrollment materials, messages, and home mailings. Along with BioIQ s customized promotional materials and regular reminder messages, employees were systematically alerted about the opportunity to know their numbers, and kept well informed about where to go, what to do, and how to complete the screenings. INCENTIVES AND RESULTS Employees who completed the biometric screening program earned credits toward their medical premiums of $10 per paycheck ($20 if a covered spouse or domestic partner also participated). With 26 paychecks per year, the savings can exceed $500 annually. We are hoping that by knowing their numbers, employees and their families will start to make improvements where needed, says Doherty. For employees with covered spouses, both parties were required to participate to qualify for the incentives. To facilitate this requirement, Jack in the Box utilized BioIQ s Auto Spousal Enroll feature, which makes it easy for employees to enroll their spouses at the same time as they enroll themselves. As a result, 58 percent of the enrollees also included their spouses.

5 Jack in the Box also encouraged participants to complete the BioIQ Health Risk Assessment (HRA), an online questionnaire that assesses risk factors for chronic diseases based on personal history and lifestyle factors, and integrates the results into each participant s personal health dashboard. More than 50 percent of the enrollees completed the HRA, even though it was optional and there was no incentive attached to its completion. Jack in the Box is committed to biometric screening on a long-term basis as a fundamental way to gauge the health of its workforce and to hold employees accountable to measurable standards. Next year, they will institute outcomes-based incentives, in which employees will receive monetary incentives partially based on whether their lab results fall within the healthy range. While it will take time to see a reduction in personal overall health care costs, Doherty believes that growing employee awareness is having a decisive impact. Participation rates have been rising and we are confident that the year-over-year improvements will pay off, she says. Every month someone one tells me about an important lifestyle change they have made, such as quitting smoking. Doherty s advice to other HR pros implementing wellness programs is to start slow, introduce programs with minimal requirements, offer incentives for participation, and increase the requirements year over year. Your employees should know what your goals are, she emphasizes. Have a multi-year strategy and communicate it with them. Using biometric data to reveal their crucial numbers is a great way to set a baseline for the future. We plan to offer BioIQ screening again next year and to include outcome-based incentives to help employees meet their health and wellness goals. Participation rates have been rising and we are confident that the year-over-year improvements will pay off.