There is little research on health-promoting workplace settings focused on people with an intellectual disability. There are a range of supported and open employment workplaces where people with an intellectual disability work, and this is an important setting that can influence health and wellbeing outcomes. The health promotion research that has been conducted with people with an intellectual disability has been programmatic in focus and lacks a broader settings and ecological perspective. This paper reports on analysis conducted across four organisations that employ people with an intellectual disability and included 47 in-depth interviews conducted with staff and supported employees. The aim was to examine the organisational characteristics, structures, and cultural elements that contribute to positive wellbeing. The key elements were offering a diversity of roles and opportunities, customised training and task matching, a flexible approach to work rosters, offering a range of workplace environments (e.g., busy versus calm environments), and providing holistic and tailored support. The results illustrate that providing positive wellbeing outcomes in the workplace for this cohort cannot be considered from a program perspective but as a whole of organisation design and culture. With the current movement towards more opportunity in open employment, it will be important that these features are replicated in all workplaces where people with an intellectual disability are employed. Further research and policy work is required for this ambition to be realised.