Narrative Description of Program

In 1982, our president Leon Gorman implemented a company sponsored Wellness Program at L.L.Bean. While speaking at a national conference that same year he stated, “A business is in a unique and responsible position to effectively enhance the well-being of its employees”. The foresight and leadership commitment he exhibited at that time remains strong within our company today, thirty years later.

At L.L.Bean, we have worked to create a healthy culture and environment as well as comprehensive health programming. What began in 1982 with a single onsite fitness facility has evolved into a comprehensive Employee Wellness program that reaches out to over 5,000 employees, family members and retirees.

The goal of L.L.Bean’s Employee Health, Safety and Wellness program is to provide programs and create an environment that encourage people to take individual responsibility for achieving their personal best in health and safety. We achieve this by:

• Providing comprehensive onsite wellness programming for employees and spouses (See 30th Anniversary Resource Guide)
• Maintaining a strong corporate culture (Safe & Healthy Living Core Value, strong leadership support, Employee Outdoor Club)
• Maintaining a healthy environment (Tobacco free campuses, healthy food subsidies, OSHA VPP sites for safety, indoor and outdoor walking paths)
• Incenting participation in a comprehensive Health Risk Appraisal program (Healthy Lifestyles) connected to our Benefit plan
• Integrated communication and marketing efforts
• Ongoing program evaluation focused on participation, health risk changes, health care cost containment and ROI (See results, part II Narrative Description)

We have 12 onsite fitness centers for employees in Maine (available at no cost) and offer fitness center subsidies for all employees who don’t have access to onsite facilities. We offer a wide variety of health education and activity classes, heavily subsidized in an effort to keep them affordable for all. We target our offerings by areas within the company based on aggregate data obtained from our Health Risk Appraisals. Targeted health risks include obesity, physical activity, heart health, diabetes and mental health programming.

In 2007, L.L.Bean introduced the Healthy Lifestyles Program, a comprehensive Health Risk Appraisal program linked to the company’s health insurance plan. Employees and spouses/domestic partners who choose to participate in the programs pay significantly less for their health insurance premiums (up to $2,900 less/year). Over the five years the program has been in place we have maintained an 85% participation rate and a 98% completion rate.

We have experienced significant improvement in employee health risks, reduced health care costs and increased program participation. In addition, we have experienced a positive ROI ranging from 1.7:1 to 5.3:1 for the first four years that our Healthy Lifestyles program has been in place.

Program evaluation has proven to be critical to the success of our Employee Wellness program. We look at participant satisfaction, health risk reduction, health care cost trends and ROI in an effort to make sure that we are doing the right things to help employees achieve and maintain a healthy lifestyle.

Regular surveys show participant satisfaction is high in all areas from the health education and activity classes we offer to our communication efforts and most recently, all aspects of our Healthy Lifestyles Program.

Our greatest success in health risk reduction comes in the area of tobacco use. In 1985, our smoking rate was 24%. Through smoking cessation programs, free nicotine patches and gum and creating a tobacco free environment we have reduced our smoking rate to 5.6% in 2011. This means that out of 5000 employees, there are approximately 920 fewer employees who smoke today compared to 1985.
L.L.Bean’s total medical claims have remained significantly below the Maine state average for the past three years and below regional averages for the same period (see previous L.L.Bean Medical Claims comparison chart).

The Healthy Lifestyles Program (HLP) has shown positive ROI in the first four years of programming. The program produced an 85 percent HRA participation rate among its eligible population, has nearly 100% engagement in telephonic health coaching, and has high levels of participant satisfaction.

HLP participants complete an annual Health Questionnaire (HQ -Health Risk Assessment), a biometric health screening on alternate years, and based on self-reported levels of modifiable risk individuals were grouped into one of three telephonic coaching programs:

• High risk (unlimited outbound and inbound coaching sessions).
• Moderate risk (up to 4 outbound and unlimited inbound coaching sessions).
• Low risk (1 outbound and unlimited inbound coaching sessions).

Results for the 2007-2010 program years were compiled by WebMD, the coaching vendor, along with L.L.Bean and Aetna, its health care provider. A “pre-to-post” study design was used to assess the difference in the actual growth-rate from the expected growth rate of the population. For each of the first four program years, medical and pharmaceutical claims were monitored for the year prior to coaching program and through the coaching program year. Note that these studies also accounted for the impact of the major benefits design changes that occurred during that time frame (including the replacement of the co-pay plan with a deductible plan, the introduction of a HDHP option, and an increase in the deductible).

The study also calculated absenteeism-related savings based on the change in self-reported absenteeism. Imputed presenteeism-related savings based on data in published literature were calculated for the 2007 and 2008 program years, while self-reported presenteeism scores from the Work Limitations Questionnaire (WLQ) were used to calculate presenteeism in 2009 and 2010 program years.

Key program evaluation results include:

• Using avoided medical claims only, the program saw a positive ROI in all four evaluated program years ─ ranging from 1.7:1 to 5.3:1.
• From 2007 to 2010, the program yielded a cumulative net savings of more than $2M from medical claims alone, increasing to more than $3M in net savings when the impact of absenteeism and presenteeism are included.
• Overall annual medical trend rates over the four program years ranged from 1.9% from 8.8% -- comparing favorably with an expected growth rates that were greater than 11% in all program years.
• A cohort of 1,965 individuals saw consistent prevalence decreases from 2008 to 2011 in all eight behavioral risk factors with statistically significant improvements in physical activity, diet, and emotional health risks.
• Three biometrics risks (blood pressure, blood sugar, and cholesterol) saw declines in prevalence from 2007 to 2010 (the only two years in which screenings were required). These improvements were made in spite of an aging population for which biometrics values are expected to increase over time.
• Generally, the groups with the highest level of coaching intervention demonstrated the highest moderation of risk factors over time.

• L.L.Bean,Inc Evaluation

The following are verbatim remarks made by the reviewers:

A

• Historical design with Mercer controls
• Good cost trend levels
• High participation rates
• Better health habits
• Positive ROI
• Claims generally lower than controls but not very consistently (e.g. benefit lost in their year)
• Excellent tobacco cessation

B

• Long-standing program – since 1982
• Strong culture of health
• Environmental/policy support for healthy lifestyle
• 12 on-site fitness centers (no cost)
• Program tied to insurance premium reductions (worth close to $3,000)
• 85% participation and 98% completion rates
• Smoking rates have dropped from 24% (1985) to 5.6% (2011)
• Risk prevalence has slowly declined in key risk factors for a cohort of 1965 (2007-2011)

C

• Well-documented application with program description and history.
• Long-standing, comprehensive program, available to both employees and spouses, with well-articulated goals, excellent communications, management support, and policies that promote health.
• Very good engagement in health assessment and excellent engagement in health coaching.
• Good documentation of impact on health; with good results.

D

• Excellent programs
• Excellent participation rates
• Excellent sustained programs
• Great progress on tobacco use reduction

E

• Set-up 12 onsite fitness centers since 1982
• Targeted risk programs
• Includes employees, spouses, and domestic partners with up to $ 2,900/Yr reductions in medical insurance premiums
• Employees (2/3 are women, spouses, and retirees are eligible)
• Medical claims below State of Maine average for last 3 years
• Pre-post design with actual vs expected growth of medical costs
• HRA at 85% and 100% in telephonic coaching completion
• Cohort of 1,965 employees from 2008-2011 decreased all 8 risk factors
• ROI of 1.7:1 to 5.3:1

F

• Program participation strong
• Comprehensive programs and accessibility
• High levels of participation
• Sustained program and culture over time
• Ability to engage diverse workforce
• Impact on health risks trending over time

G

• Good program components including assessment, coaching, and environmental reinforcement.
• Good participation over time.
• Health improvement among repeat participants and positive cost trends.