Based in Hong Kong, Heather Valteris is chief marketing officer of international markets at insurance firm Cigna. In particular, Valteris oversees the company's thought leadership focus on wellbeing, which has included global research into which countries are most stressed, and why. That campaign took on a more specific tack last year, when the company visualised the impact of stress to drive home the emotional and physical effects. 

That positioning — around wellbeing and stress — is one that lends itself well to our current pandemic. Valteris recently sat down with PRovoke to discuss how people are holding up during Covid-19, along with Cigna's marketing goals in conjunction with agency partners McCann and PR firm Sandpiper Communications.  

Why did you decide to focus on stress?

So the starting point was, could we find something that would resonate across all the markets which were so diverse? We operate in 150 countries but we’ve probably got a core of 15 businesses that we really wanted this to resonate with, everywhere from North America to Asia Pacific to New Zealand. So we needed to find something that was common that everybody could relate to, but not boring, that was important, and also accessible. The 360 Wellbeing study is something we’ve been doing every year since 2014. And it always gets a ton of traction, people are really interested to understand the benchmarks. So that was one of our starting points. 

We pulled all the markets together and said what resonates with you in your particular market? And stress kept coming through. Stress kept rising to the top as something that was accessible. It didn’t frighten people. It was quite flexible and it was insight based. We have such a wide array of businesses in terms of B2C, B2B, going through brokers — we needed to resonate with providers as well as all our core stakeholders. And then we talked about in the community, regardless of business, just what we stand for. 

So it ticked all those boxes. We brought McCann through that insight building process, so that we could develop the strategy and partnership. That’s when it got really interesting because we started to say — how can we talk about it in a way that’s compelling? Everybody knows about stress but some people think that it's good, some people think that it’s bad —and we wanted to have a non-judgemental way of talking about it. So it was just to understand what stress does to you physically.  The first aspect of it was just visualising it. We brought in a digital artist, Sean Sullivan, and he had done work in this space before where he could connect into technology and measure different readings from the human body, and come up with a pretty good indication of stress that’s occurring in somebody’s body right in this moment. He turned it into a really compelling visual. So we created online versions of that, offline versions of that, and what was really interesting, I think, was the offline version where people would sit there and put on this headset and see it created in front of them. It became really compelling from the B2B perspective. It really opens up the conversation with brokers and clients and prospects or in conferences when we want to talk to people. 

The next phase of that is then helping people understand if you’re experiencing that non-stop and it doesn’t come down over time, what does that do to your body, what does that do to your mental health, your physical health. We also commissioned a research study, which is the predecessor to some stuff we’re doing now around the cost of stress in healthcare systems. We really wanted it to be meaningful and not only in terms of the conversations but also to help inform future solutions. It was just getting everyone out there talking about it and understanding the physical impact of it and understanding that it’s not good or bad. If this is continuous and you don’t come down from the constant adrenaline — there’s plenty of studies that we’ve called in to say that it’s detrimental. 

How does that fit into your ongoing focus on wellbeing?

Since 2014 we’ve been doing this wellness study — a perception-based study — and we were starting to see the two converge. When Covid-19 struck we were in a really interesting situation because we had just completed our annual flagship 360 Wellbeing survey right before Covid was being discussed and we were watching the responses and as soon as they started to skew a little bit in China we stopped the survey because we wanted a clean baseline. That’s when we started saying, I’m not sure if stress by itself resonates right now — what’s the storyline here now? And we said one of the things we need to do in order to inform our storyline, it should be not necessarily what we think but what are people talking about, what’s important to them — we should be listening.

So we said let’s commission this Pulse (survey), where we check in with various markets and say how are you feeling now relative to loneliness, working from home, stress, financial stability, virtual health. We started with a sample of markets and decided to actually expand it moving forward, expecting that the curve of the pandemic was going to change by market and by region. It also became very interesting to see how people responded. So you saw people in USA saying 'oh life is never going to be the same again' and then a lot of markets here [in Asia] are saying it will eventually get back to normal and we’ll be OK. We need to keep testing that but it’s interesting to see those differences. Then also how people respond to lockdown. We thought all of the wellness scores were going to be down but in fact they kind of offset each other. 

Did that surprise you?

Yes it did. I thought we were going to see a decline and I was thinking more in terms of comparing the different markets as opposed to the nuances within a market. So it was even deeper than I thought it would be. In general, people are worried, of course, about their financial stability, financial wellness, and social is down. Whereas the workplace and their work wellbeing is actually stabilised and even slightly better in some cases. So it was interesting that there’s these offsetting effects and, as you dig into the data, you can see where it’s coming from because there’s sub-questions. People who are working from home more now, there’s a culmination of things — you’re appreciating the flexibility of it, working your own hours, but there's also more quality time with your family. So there's family drivers —  I can take care of my spouse or my partner or my children.

So you have this ability to track wellbeing through the pandemic. Are you also measuring stress levels in line with that?

Yes. I expected it to skyrocket but it’s more about trade-offs. A cautionary note is that we are doubling the sample size to make sure we are getting an accurate reading, but what we are looking at now is that, globally, those reporting being stressed remains relatively stable. Now, it’s a huge amount of people. It’s about 84% of the world say they are stressed. Those that say it’s unmanageable, I think that fluctuated by 8%, 9%. We are starting to see little changes there. Financial is always at the top of the list. Health has gone up in terms of the ranking of stress level.

One of the interesting things, though, is loneliness. Obviously there’s outliers, because there’s many people who are isolated at home — I’m sure their loneliness has gone up. So we expected that to go up but in fact we are seeing it improving. Again, cautionary note, we’ll see how that plays out, but the theory is that people are connecting or making more of an effort to connect with each other and feel like they’re in something together, they’re using technology more to connect with colleagues as well as friends. 

So has loneliness gone down?

Loneliness has gone down. Not in every single market but in most markets. Which was fascinating. So we want to continue to monitor that. And see if there’s something we can do to help. If there’s something they’re doing that is working to help them. But there’s an extraordinary number who say that they’re lonely too. That doesn’t mean that it’s not a problem. 

NB: 8% of the 10k+ respondents said they always felt isolated from others in April, compared to 11% in January. When asked if people felt closer to other people, 73% said they did in April, compared to 69% in January. Notably, some markets with comprehensive lockdowns saw improvements with UAE up from 71% to 80%; the UK up from 70% to 79%; and Spain from 81% to 91%.

What would you say are your marketing goals with this particular campaign?

I want to have a differentiated point of view based on what we have a right to talk about. I don’t just want to go out there to talk about something because it’s getting a lot of attention at that moment in time. It needs to be something that we have unique, or at least are striving to have unique capabilities to address and analyse, that intersects with what we try to do for our members and what we try to do for our employers. I mean we’re not out there to be a commodity, we were taking the high road in that.

Our ambition is to make healthcare more affordable, more accessible, easier to access, and we think by accessing wellbeing, both physically and mentally, we have better outcomes in this. We’re playing a long game on that. So to have a point of view that intersects with that mission and yet resonates across so many different markets is my goal with this particular campaign. From a broader marketing perspective, I’d say my goal is that we’re the connective tissue between what our stakeholders' needs are and what our main capabilities are. When marketing can be that connective tissue, then I think we’ve accomplished what marketing should do.

How do you measure the success of a campaign like this?

It’s so challenging, as you know. Measuring marketing, measuring thought leadership, measuring PR — all of that is really challenging and we have a very business minded group of leaders, as it should be. That’s our obligation, right? Given how challenging that is, we have really put a huge amount of effort into how to measure it. We don’t want to be overhead for our markets so we need to be as savvy as possible in terms of how we invest — so we tend to be digitally oriented and digital is very measurable. So, it’s very straightforward to figure out, even if it’s not the individual itself but what audiences are coming back and looking at, how long they’re looking at it and how that varies by market. So one of the unique metrics we came up with was what we called the 'cost of quality re-targetable cookie' (CQRC).

It’s a really interesting metric because usually when you think about cost per lead — which ultimately we want to get to — but if you go up the funnel, you don’t know who the person is. You just know that you’ve got the cookies, so you know if they came and visited you. But the cost of getting a cookie in the paid media world — is it a quality cookie, is it not a quality cookie? And it depends on how long they stayed on and looked at your content. So we defined what quality was and then how much it cost to get that. And it needs to be re-targetable because the idea is that we nurture them and we pull them through the funnel.

Another really important part of it we changed this year. We used to do an annual brand health tracker because basically we could only afford to do it annually, it’s really expensive. We’ve gone to what we call a pulse check, similar to what we do with our 360 Wellbeing survey — so it’s a lighter version but we do it more frequently. And I really want to use that, and it’s funny because it’s been an evolution in people’s thinking — they think you’re just measuring your campaign. No, I’m actually measuring everything that’s happening in the market. I want to see us relative to the competitors.

There might be something that happens in the industry, there might be something that happens politically, there might be something that we’ve come out with in the thought leadership perspective or something one of our leaders spoke about and see how our perception changes over time. But then we can see, is there a spike when we do a campaign or is there not a spike? And if we do have a spike or if we didn’t have a spike is that because we didn’t have a relevant share in voice? So all those things, that’s why it has to be a dashboard because all those things come together. 

I presume you are also measuring perceptions of Cigna. Have there been any interesting shifts in that regard? 

The metrics we’ve done since September are very much awareness, favourabilities, consideration. But I can say that, as we were easing into this, there are several markets where we did start to see a shift of being perceived as more of a health insurer versus a general insurer. I saw that, for instance, in Hong Kong. That’s not necessarily because of this campaign but that’s what we’re looking for. I shouldn’t even use the word insurer. We want them to see us as a health services provider. Now it’s going to take time. We have to earn our right to that but that’s who we are so we need to be doing things that address that. 

Were there any concerns about risk with this campaign at all?  Tying Cigna to the idea of increased stress and loneliness. Was that just something you were happy to address?

We needed to be bold but we did talk about it. I remember having lunch with our partners and it was like — do we need to test stress one more time? I want to make sure we’re not adding stress by talking about stress. But at this point we’d already talked about the visualisations being non-judgemental and that the idea was that we are helping people visualise it, not worry about it. And we needed to quickly follow that up with 'here’s what you can do about it'. And I remember the person advising me said, sometimes you just need to take a leadership position. You know this is the right thing to do, everybody is telling us it’s the right thing to do, we’re doing it in a way that opens people’s eyes, and it worked. 

The difficulty in running multi-marketing campaigns has always been that local markets are so different. Do you feel like the pandemic has actually made it easier to run a multi-market campaign? In terms of more of a common, shared experience you can tap into.  

I would say it’s a change versus a benefit.  It’s not just about prospecting, it’s also about the existing relationships and giving them something meaningful to talk about, clients and customers that already have our services and products. I think everyone was pleasantly surprised that there could actually be something that we all talked about that worked for everyone and that created demand — but that’s not tied to the pandemic.  It just changes it and I think it needs to be more thought leadership oriented.