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  • September 2021
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One Size Doesn’t Fit All: What Can Behavioral Science Tell Us About Designing Attractive Wellness Programs?

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In Brief
To innovate, insurers must marry a deeper understanding of how consumers make decisions with sophisticated product development based on the principles of behavioral science. RGA's customer research in Asia reveals surprising insights about the most successful insurance-linked wellness programs.

That’s one compelling finding from recent RGA Asia customer research conducted as part of the company’s solution design process. This is an end-to-end approach to product design that begins with market research and applies behavioral science to achieve customer-insight-led product design and marketing. When it comes to wellness programs, RGA’s research suggests that these propositions are not one-size-fits-all. Instead, they can vary widely based on age, perceived health status, and loss aversion, as predicated by key behavioural science principles.

Wellness programs attempt to tap into the way humans are naturally wired. People prefer immediate gratification, yet normally life insurance consumers realize value only after filing a claim or cashing in a policy. By incentivizing healthier behaviour with reduced premiums and other more-immediate rewards, insurance-linked wellness programs aim to improve consumer perceptions and insurers’ risk pools.

Through the solution design process, RGA Asia sought to test this premise by unpacking how consumers make choices among different wellness programs in a specific market and evaluating whether these initiatives and incentives motivate behaviour change. This insight can help product design teams more rapidly prototype, test, and continuously improve program designs, as well as customize programs for different markets.

To understand what drives consumers to make decisions, RGA presented a test group of consumers with four potential wellness plan designs. The goal was to identify how differences in initial, ongoing, and maximum discounts, as well as penalties, influenced consumer behaviour. Each of the four plans offered unique features to attract the audience.

  • Plan A had the highest initial discount and penalty, but the lowest ongoing discount.
  • Plan B offered the lowest initial discount, but the highest ongoing discount.
  • Plan C eliminated the penalty but also moderated the initial and ongoing discounts.
  • Plan D offered a moderate initial discount and penalty, but the highest ongoing and maximum discount.

To allow for comparison, these choices were presented to the same potential consumer base, which varied by age and gender.

Consumers were asked to rate the likelihood of enrolling in a wellness program and to explain the reasons behind their decisions. Findings suggest that wellness program effectiveness depends on the program design. RGA uncovered three significant findings that can inform future product designs:

  • Enrolment can vary widely based on demographic group.
  • Earning rewards sooner can be more attractive than delayed gratification.
  • Packing more options into a plan may not necessarily lead to stronger participation.

The Fear Factor

Wellness program participation may be shaped by loss aversion. Older consumers and those with middle- to low-level exercise regimens in RGA’s consumer research gravitated toward Plan C, the “zero-penalty” plan design. This design offered no chance of losing earned rewards even when a participant failed to meet targets, although the initial premium discount was lower. This result revealed a distinct preference for guaranteed benefits. In contrast, younger participants proved far more likely to accept challenging health goals in return for a chance to earn greater rewards. The maximum discount program, or Plan D, was favoured only by younger consumers, suggesting greater confidence among the young in their physical condition and chance of achieving rewards.

RGA’s survey gives some support to the premise that high-reward wellness programs are more likely to attract people who are healthy anyway, while unhealthy people who could benefit the most would be more unlikely to enroll into the highest penalty plans, such as Plan A, due to a fear of loss or failure.

When it comes to wellness programs, RGA’s research suggests that propositions are not one-size-fits-all.

In many ways, these outcomes only reinforce our growing understanding of human psychology and motivation. The loss aversion and inertia principles in behavioural science predict that consumers would prefer a program with a lower penalty, because avoiding loss often outweighs the potential for gain in influencing choice, especially when a reward requires effort to adjust behaviour.

Many wellness program designs reinforce existing behaviours, such as exercising and eating well, and provide incentives for participants to adopt healthy habits for the longer term. Indeed, healthier individuals tend to be more engaged in such programs. Such self-selection is also common with wellness and fitness smartphone apps. While some research suggests these apps can influence diet and exercise, apps that specifically integrate behavioural science techniques are more likely to be effective in engaging users and influencing longer term healthy behavioural change.

Buy Now, Pay Later?

Beyond the fear of loss, participants in RGA’s study were driven by the anticipation of short-term gain. Immediate gratification through small wins proved more motivational than the promise of greater reward with a longer-term investment in time or money. Conversely, low-points, high-investment activities (in terms of both effort and money) appeared to sap motivation to participate. Consumers simply did not perceive the rewards to be commensurate with the risk of loss.

What were these activities? RGA researchers found that the offer of an easy, online health assessment was preferred over either a gym membership or a physical check-up. The self-reported health questionnaire provided slightly fewer points/rewards but required much less investment of time and effort than either the check-up or the gym membership, both of which were perceived as costly and too time-consuming. This research emphasizes the delicate balance between behavioural and risk management objectives: Even though the discounts could be deeper with a verified physical check-up or a gym membership, consumers perceived the additional potential for gain was not worth the opportunity cost. These findings suggest that more ambitious wellness incentives may, in fact, have the unintended effect of discouraging healthy activities and revealed how easily a gulf could open between consumers’ perceptions of points allocations and program designers’ intent.

Beyond the fear of loss, participants in RGA’s study were driven by the anticipation of short-term gain.

Participants also responded negatively when points for physical activities were expressed in smaller numbers (although the total points gained can be very high). Some noted that the perception of low value was demotivating and would make them less likely to exercise. In fact, survey participants voiced a strong desire for benefits that were not only frequent and fast, but meaningful and relevant to each consumer’s preferences and lifestyle choices.

The idea of instant gratification is consistent with behavioural science research. Numerous studies have concluded that people tend to pursue more modest payoffs sooner, rather than delaying gratification for a greater reward. The very act of reaching a goal is motivational so long as the target is perceived to be both useful and achievable.

In addition, more choice did not result in stronger participation rates for the wellness program design in RGA’s study. Quite the opposite proved true: The more complexity and optionality offered, the more survey participants expressed concern that plan designs appeared “overwhelming” and the less inclined many were to participate, even when some of the options presented would result in greater points accumulation and the possibility of additional rewards.


Perceptions of wellness plan designs can vary widely based on a number of factors, from age and health status to lifestyle choices. However, the most successful programs do share some commonalities: They meet an immediate and socially and emotionally resonant need and reflect both behavioural science and risk assessment considerations.

Sustainable innovation requires insurers to marry a deeper understanding of how consumers make decisions with sophisticated product development based on the principles of behavioural science. RGA's research to determine which wellness program designs attract consumers demonstrates the value of applied behavioural science. These insights into how to predict decision-making can inform insurers' solution design and marketing well beyond wellness programs

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Meet the Authors & Experts

Fang Zhong
Fang Zhong
Executive Director, Research and Marketing, Hong Kong and Southeast Asia Markets