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Driving Innovation In the Health Care Marketplace:

A CEO Report

Principal Financial Group, Inc.

Our 14,000+ employees are our greatest asset, so their personal well-being is critical. We use extensive data to identify targeted interventions, encourage informed use of health care services and make wellness part of our culture.
Meaningful incentives drive participation:

  • Annual health screening program: Employees and spouses/domestic partners complete a wellness assessment and biometric screening to earn a medical plan contribution savings of $520 per person. Ninety percent of employees enrolled in our medical plan complete the screenings, gaining valuable information to help them monitor/improve their health.
  • Healthy pregnancy program: Pregnancy and childbirth drive a significant portion of our health care cost. We encourage participation in our healthy pregnancy program with a $600 contribution to participants’ health savings accounts or payroll deposits.
  • Centers of excellence: We provide travel and lodging expenses for employees who work with centers of excellence for transplants and bariatric services. This encourages use of providers that have demonstrated good outcomes and lower costs.

Transparency is key:

  • Plan design: We offer employees the choice of a traditional PPO plan or an account-based health plan (ABHP)/health savings account. In recent years, as we’ve focused more on consumerism in healthcare, our enrollment in the ABHP has grown from 16 to 30 percent.
  • Onsite pharmacy: Offered at our corporate campus, pharmacy staff educates employees on lower-cost alternatives and the importance of drug therapy compliance.
  • Tools: We provide robust tools to help employees make smart health care decisions. Our corporate culture encourages healthy living:
  • Road race challenge: Wide-scale health initiatives underscore the importance of making health a priority, and our annual road race challenge is a great example. I challenge all employees to train for and participate in a road race, and I lead training runs and blog about the experience. Thousands participate!
  • Onsite wellness: Dedicated staff in our wellness centers provides constant support for employees working toward optimal well-being.
  • Communications: Creative communications keep wellness top-of-mind. These include employee blogs, testimonials, workshops, videos and fairs.
  • Environment: The current full-scale remodel of our corporate campus incorporates well-being into our environment with features like open staircases, more access to natural light, sit/stand desks, and more.


As a result of these programs, our health care plans have outperformed national and industry metrics. Currently, 80 percent of our employee population is considered low risk (just 0–2 risk factors), a best-in-class result. We’ve diverted an estimated $10.1 million in health-related expenses since 2010.



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BRT companies provide health coverage to more than 40 million Americans. We help American workers and their families remain healthy, receive quality treatment when necessary and achieve better health outcomes. The private-sector innovations in the insurance marketplace that enable us to provide these services to our employees and their families serve as models for public programs — but additional reforms are necessary.

This report highlights the innovations we have made and the public policy changes we believe would drive value by promoting health and improving outcomes.