Health and Safety in the Workplace: Company health management as a key element in Gothaer demography management

  • Logo des Gothaer Konzern
    Name of the company
    Gothaer Versicherungen
    Corporate headquarters
    Germany. The main office is in Cologne
    Size and sector
    Mutual insurance group with over 4.1 million members. € 4.5bn in premium income, 5,815 employees (as at: 2015)

Background to introducing the measure

In the context of demographic change and the raising of the pension age, occupational healthcare promotion is becoming particularly important: it makes valuable contributions to maintaining the well-being and work performance of the growing number of older employees, and also to creating attractive working conditions for the next generation, where supply is increasingly scarce. In the Gothaer Group, Occupational Health Management (OHM) has a long history and is seen as a key element in present-day, forward-looking HR work.

The trigger for launching OHM came from the 2002 staff survey: employees expressed a desire for offers relating to preventing back pain – a classic problem for activities mainly undertaken when sitting. Initial experiences were gathered in a pilot project at the medical insurer Gothaer Krankenversicherung. The project aims were improving back health and the well-being of employees as well as reducing absenteeism.

Implementation date/duration

The pilot project was prepared in 2003 and implemented in 2004. It ran for 12 months. From the start, there was a strong emphasis on a systematic approach and rigorous project evaluation. In the starting analysis, which took the form of back screenings with integrated interviews of participants, people with back pain and deficiencies in the core muscles were identified. These people were subsequently offered movement and relaxation courses and coaching sessions. The close of the project involved a re-check with subsequent evaluation of the project data. The resonance was overwhelmingly positive. In addition to being very popular with employees, in the course of the project there was significant improvement in physical fitness of the core muscles amongst the training group, which was associated with a clear decrease in stress symptoms and a decline in back complaints. This was reflected in a fall in work absence by 22%. Given this pleasing development, the Executive Board decided to continue this prevention programme and to expand it to other areas of the company.

The next steps on the route to integrated and sustainable OHM were completed by expanding the range of offers within the Group, strategic anchoring of the issue and developing suitable structures, publicly announced via the signing of the Luxembourg Declaration on Workplace Health Promotion in the European Union.

Partners involved

Internal staff as well as external service providers carry out OHM activities at Gothaer. In addition, the Works Council is involved in the Gothaer OHM. In the Group subsidiary „MediExpert Gesellschaft für betriebliches Gesundheitsmanagement mbH“ Gothaer owns its own competence centre for occupational healthcare promotion, which also offers a wide range of health services externally to Gothaer corporate clients (

Object of the measure

Integrated Occupational Health Management

Occupational health management is anchored culturally, strategically and structurally within the Gothaer Group. The target of „employee health“ has already been set out in the Group guidelines, company philosophy and HR strategy for years. In addition, OHM is a fixed component of Gothaer's demography management which was awarded the prize for „Demography“ at the 2010 Corporate Health Awards.

A steering group with representatives of all occupational health service providers in the Group works continuously on maintaining and further developing OHM under the management of the Head of HR.


The overriding priority of Gothaer's OHM is to create added value by maintaining the employees' health and performance during their entire working life. Therefore in the long-term the positive influence of health-related late indicators such as absenteeism, employee fluctuation or quality of work through sickness prevention and promotion of good health is a core issue. Secondary issues arising from this are the early identification and prevention of health risks as well as encouraging employee responsibility for their health potential and resources (employee empowerment).

These objectives apply to all age groups. But since certain patterns of illness (e.g. musculoskeletal problems) increase statistically with increasing age, as is also demonstrated by age-specific health analyses amongst the Gothaer staff, they become particularly important for the growing number of older employees.

Key action areas

The focus of the Gothaer OHM initiative covers the areas of „Corporate Reintegration Management“, „Ergonomics in the Workplace“, „Nutrition“, „Leadership“, „Occupational Health and Safety“, „Medical Services“, „Sport and Movement“, „Stress“ and „Addiction“. These include a standardised procedure for reintroducing the long-term sick into the workplace, health screenings, a course offer focussing on „Back Training“, „Relaxation“ and „Cardio Training“, ergo-coaching, a wide range of sports offers, diverse advisory services, management training, canteen initiatives for healthy nutrition, active movement breaks and various offers on stress prevention and stress management.

Comprehensive Occupational Healthcare Promotion offer locally, even at the company's smallest sites

To make healthcare promotion offers also available to employees in outlying locations, Gothaer has developed its own prevention modules for small and very small sites. Thus, since 2012, 25 small units with three to 40 employees have been supported, alongside the five major sites. The content is adapted annually to current needs.

Innovative concepts for direct approaches to employees

One of the key success factors of Gothaer health management are the concepts developed by „MediExpert“ for direct approaches to employees in the workplace. For these, specialists undertake initiatives where they visit the offices and offer employees 15-minute coaching sessions – for instance, ergo-coaching on ergonomic arrangement of the working area, a guided activity break to loosen up cramped muscles, a short relaxation exercise for managing acute stress situations better, or „bio-feedback“, where muscular tension levels in the shoulder-neck region are recorded and suggestions are given on how to improve them. In 2015/2016 the theme of „Healthy Eating“ was taken up for the first time in the direct approach in the workplace.

Handouts, additional development of multipliers, and needs-appropriate referrals to further offers are supporting long-term impact.

Evaluation: monitoring and quality control with the aid of the Gothaer Health Index

Using the „Gothaer Health Index“, an in-house developed evaluation and management instrument, health-related key data is fed in and compared with the evaluation outcomes from OHM. By comparing target and actual values, the goal achievement level is determined on an annual basis. This reveals correlations and also enables continuous quality and success checking. The Index also reflects the current need for action, and facilitates a continuous improvement process.

Ensuring sustainability

The year 2013 saw the implementation of various intervention offers in the Group's standard processes. These include the „Ergo“ sustainability concept, which includes ergonomic coaching on health-appropriate adjustment of the working area and which is used for new appointments, relocations, when returning from parental leave or in the event of long-term illness. The „Stress Management“ sustainability concept should also be mentioned; it provides one-to-one coaching to employees experiencing increased stress within seven working days. Thus, in the event of an acute need rapid assistance is possible.

Effects and benefits realised

All healthcare services are evaluated regularly – with consistently positive results. For instance, the number of attendees at prevention courses has been high for several years. Like in previous years the 2015 participants' survey revealed positive feedback:

  • 100% rated the course quality and competence of trainers as „very good“ or „good“,
  • 91% feel they are better able to manage their working day,
  • 77% feel that their back complaint has improved,
  • 76% experience an improvement in their capacity to relax, and
  • 75% identify an improvement in their fitness.


In two pilot studies which were scientifically supervised and published in the medical press, a significant reduction in levels of illness amongst participants – by up to 31% – was demonstrated, in addition to an improvement in medical well-being*.

There was also a very positive result from an age-group specific analysis of participation in back courses. It revealed:

  • Older employees attend courses to maintain and improve back health more than younger employees.
  • As part of back screenings, the over-50s age group exhibited the strongest positive improvements in the core muscles over the course of the programme.


The mature OHM at Gothaer has won a number of health awards – including the „Deutscher Unternehmenspreis Gesundheit“ in 2008 and 2011, and the Corporate Health Award in 2011, 2013 and 2015. 

According to an analysis of media resonance, the reporting on the Gothaer OHM in print and online media achieved equivalent advertising value of €350,000 in the period 2011 to 2013.

*Benner, V., Burnus, M., Ochs, S. (2007): Ergebnisse eines Interventionsprogramms zur betrieblichen Gesundheitsfürsorge: Signifikante Reduktion von Rückenbeschwerden, subjektive Abnahme von Stress-Symptomen und Reduzierung von Fehlzeiten, in: Ergo-Med. 31, Volume 6, pp. 162-167. Burnus, M., Benner, V., Gutmann, B., Steinke, U. (2008): Ergebnisse eines Modellprojekts zur Prävention branchenspezifischer Erkrankungen in einem Kunden-Service-Center. Arbeitsmed.Sozialmed.Umweltmed. 43, Volume 8, pp. 386-393.

Key success factors/obstacles

Even the most professional healthcare promotion offers can only realise their effect if they reach those employees with relevant needs. However, in companies this is often not the case. There are a number of obstacles preventing employees from participating in OHM measures – like a lack of time or a fear of stigmatisation, particularly if the issue relates to sensitive subjects such as managing stress. In this context, the concepts mentioned earlier for „direct approaches in the workplace“ have proven outstandingly effective. Between 60% and 80% of employees can be reached per initiative.

Another secret of its success lies in the comprehensive cultural, strategic and structural anchoring of the theme of OHM within the company and in the systematic interlinking of the elements „Needs Analysis“, „Measures Framing and Implementation“ and „Evaluation“ as part of an iterative, continuously advancing process.

Certain limits are imposed on OHM at Gothaer by the factors of „Time“ and „Money“. Given the cost pressure which is ever-present in the sector and the wide range of topics and projects in the Group, priorities also need to be established and emphases set in OHM.