Organizational Health Snapshot Question Title * 1. Organization Name Question Title * 2. Number of employees Question Title * 3. What is the estimated percentage of employees in each gender: Male: Female: Question Title * 4. Which Industry Category best fits your organization? Agriculture, Forestry, Fishing, and Hunting Mining Utilities Construction Manufacturing Wholesale Trade Retail Trade Transportation and Warehousing Information Finance and Insurance Real Estate, Rental, and Leasing Professional, Scientific, and Technical Services Educational Services Healthcare and Social Assistance Arts, Entertainment, and Recreation Accommodation and Food Services Public Administration Other Question Title * 5. Where are your employees located? Select all that apply Corporate Headquarters Remote Locations Work from home Traveling (do not have a home office) Multi-state International Question Title * 6. What are the applicable working statuses of your employees? List estimated percentage. Full-time Part-time Temporary/Seasonal Question Title * 7. What are the top two objectives for your organization's wellness program? Improve employee health Reduce absenteeism Improve productivity Improve recruitment and retention efforts Reduce healthcare costs Improve safety metrics Impact employee morale and overall job satisfaction Health Care Reform (ACA) N/A - We do not have a wellness initiative Other (please specify) Question Title * 8. In the past three years, what has been your average increase to employer plus employee premium costs? 0%-10% 11%-20% 21%-30% 31%-40% >40% Question Title * 9. What is your average annual turnover rate? <5% 6-10% 11-15% 16-20% 21-25% >25% Question Title * 10. How would you evaluate your employees' current level of engagement? Engaged - Employees work with passion and feel a connection to their company. They drive innovation and move the organization forward. Not Engaged - Employees are "checked out." They sleepwalk through the workday, putting time - but not energy or passion - into their work. Actively Disengaged - Employees aren't just unhappy at work, they're busy acting out their unhappiness. These workers undermine what engaged coworkers accomplish. Question Title * 11. Do you have a formal, written strategic plan for your wellness initiative? Yes No N/A - We do not have a wellness initiative Question Title * 12. Do your executive leaders support and buy into your wellness program as a business strategy? Yes No N/A - We do not have a wellness program Question Title * 13. Does your organization have a clear mission statement? Yes No Question Title * 14. Does your organization have clearly defined core values? Yes No Question Title * 15. What type of incentive and/or recognition programs are currently in place (including plans that are unrelated to wellness initiatives)? Annual incentive bonus Profit sharing Stock purchase program Cash Gift Cards Premium discounts Paid Time Off Merchandise (ex: t-shirts, cups, bags, etc) Drawings for prizes Certificates/awards Referral Bonuses None Other (please specify) Question Title * 16. What would you estimate is your total incentive/recognition cost per employee per year? Question Title * 17. Which of the following do you currently have in place? (select all that apply) A learning and development strategy Formal succession planning process Leadership development/leadership training Mentoring program Formal career development planning None Question Title * 18. Over the past three years, has your budget for learning and development: Increased Decreased Stayed the same Question Title * 19. What community activities and/or sponsorships does your organization actively engage in? Question Title * 20. What does your organization do to encourage fun and excitement in the workplace? Question Title * 21. What offerings do you currently have for employees to improve their emotional wellbeing? (select all that apply) Employee Assistance Programs Onsite Counseling Services Stress Management Education/Training Flexible Work Schedule Paid Leave None Other (please specify) Question Title * 22. What resources and education do you provide your employees on financial wellness? (select all that apply) Retirement Planning Budgeting Buying a Home Saving for College Managing Medical Expenses None Other (please specify) Question Title * 23. What physical wellbeing initiatives are you currently offering your employees? Select all that apply Health Assessments Biometric Screenings Health Coaching Financial Reimbursement/Discounts for Health Club Memberships or Weight Loss Programs On-site Health Clinic On-site Fitness Center or Classes Weight Management/Weight Loss Programs Disease Management Programs Corporate Sports Programs Health Fair Web-based Resources for Healthy Living Workplace Wellness Competitions Nutritional Counseling Educational Seminars None Other (please specify) Done
