Company Health and Wellness Programs

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Why Employees Hate EAPs.

A lot of EAPS fall into a common – and dangerous – category –  Management thinks the program is excellent, but workers think it’s a waste. But it doesn’t have to be that way when you have an employee assistance program or are considering one.

Seventy-three percent of all firms (59 percent of small employers) have an EAP. But how well does the average EAP work? Not in addition to we’d hope. A Mid America Coalition on Healthcare study found -

o  just 50 percent of 6,400 employees surveyed said they’d use the EAP if they felt overwhelmed by personal issues, and

o  one-third said they didn’t even know how to access its resources.

The good news –  Firms like yours have seen dramatic improvements in three relatively simple steps

1. Worker attitude surveys

The best beginning place –  Take the pulse of your workers with a short, confidential attitude survey.

Objectives –  Ask employees when they know how to use the EAP’s resources. Then test workers’ knowledge and opinions of depression and other personal issues that might affect their worksite performance and/or safety. In the final section, find out how employees would handle a serious personal issue.

In other words, figure out where your people  would likely turn for help. Would staff seek out the EAP? Would they prefer to discuss the issue with their family doctor? A psychological health professional?

The Mid America Coalition’s survey remains an excellent design model from which to craft a recent survey for your own staff.

2. Promote employee assistance program (EAP) through education

Your survey data should help you pinpoint areas where workforce need more education about your EAP. Some awareness-improveing techniques that have gotten results -

o  Lunch-and-learn sessions. Possible topics include dealing with personal-finance stress, caring for elderly parents, understanding depression or dealing with a dependent who has potential psychological health issues.

o  Staff Member newsletter. When you have a benefits newsletter, spotlight the employee assistance program (EAP) from time to time. Many corporations without newsletters have done e-mail campaigns or targeted mailings instead.

o  Workplace posters spotlighting EAP.  The ones that work best are often posters designed around a specific theme (e.g., anxiety about personal debt) rather than a general “need help?” message. In addition to posters, you could want to distribute wallet cards with employee assistance program (EAP) contact info.

Need help finding educational material? There’s lots of free EAP-related flyers and FAQs here. Don’t forget –  When doing EAP education, constantly remind staff members that the program is strictly confidential.

3. Make sure to work with supervisors

For legal reasons, supervisors need to tread carefully when they suspect an worker has a psychological health issue.

What you don’t want –  supervisors taking disciplinary actions without consulting HR or playing amateur psychologist and “diagnosing” the employee’s problems. Here’s a PDF of some proven tips and talking points for doing supervisor-specific employee assistance program (EAP) education.

HIPAA compliance –  Beware non-discrimination issues

HIPAA’s non-discrimination rules impact both mental health benefits and general health plans. Under current interpretations, health care plans can no longer have benefits exclusions that deny benefits for injuries resulting directly or indirectly from pre-existing mental health issues.

That’s true even if the psychological condition wasn’t diagnosed until after the injury and even if the injury was self-inflicted. Example –  Suppose an staff member gets hurt in a worksite accident he or she caused. After the fact, the staff member is diagnosed with a mood disorder that previously escaped detection by the employee’s physician.

Under current regs, HIPAA-covered plans can’t deny benefits. This puts businesss in a bind. Mental health issues like depression, anxiety or bipolar disorder are one of the health conditions that’re most likely to go undiagnosed or underdiagnosed.

That’s why, in most companies, having a strong employee assistance program (EAP) is one of your best compliance tools.

February 22, 2011   No Comments

Employee Assistance Program Demand

For many workforce, telecommuting and flex-time are highly desired work-life benefits. But a growing number of businesses are reluctant to offer these programs.

Demand for these benefits remains high.  One study found that 87 percent of job applicants are familiar with the idea behind telecommuting and flex-time, and the majority express a desire to have at least periodic access to such programs.

Environmental interest groups have pushed the feds for years to create incentives for companys to encourage telecommuting.  The pressure has risen as gas prices have continued to soar.

Notwithstanding, flex-time programs have leveled off in some sectors, and there’s been a decrease in telecommuting.

Today, about half of all organizations where telecommuting is feasible permit employees to work from home on a case-by-case basis. But the percentage of corporations offering full-time telecommuting has dropped in recent years.  Nowadays, only about 20% to 25% of corporations offer the benefit year-round.

Even some national employers that are well-known for their telecommuting programs have scaled back. AT&T, for instance, recently asked a few thousand home-based personnel to come back into the office.

Hewlett-Packard and Intel have done the same thing.  and the federal government recently noted a 7.3 percent drop in telecommuting employees. Why the cutbacks?

Employee Assistance Program – Pros and cons

Offering workforce telecommuting or flex-time could be a good recruiting and morale-improveing tool, in addition to a way to retain workforce who need to relocate, would otherwise have a need to quit or take leave or commute long distances to work.

But the programs aren’t without their drawbacks. Some of the primary reasons employers give for scaling back or eliminating them -

o  Corporation culture – It’s easier to build a sense of organizational stability and an individual connection between workers, colleagues and supervisors when individuals  interact face-to-face on a daily basis.

o  Security – One of the hidden costs of allowing staff to telecommute (or else come in early or stay late) is keeping sensistive information safe. Some the cutbacks are being driven by companies’ IT departments.

Namely, managers have raised concerns about stolen laptops, identity theft or other crimes driven by hackers gaining access to information via workers’ home Internet connections.

o  Productivity – Many supervisors find it easier to ensure high productivity when everybody is working under one roof at the same time.  There’s also a widespread view that most staff members get things done faster and more accurately when they’re not distracted by things at home.

The bottom line on the bottom line

Work-life programs like flex-time and telecommuting remain a useful benefit to offer staff, and a lot of businesses still provide these benefits for economic reasons.

But once the potential hidden costs are weighed, it’s often better for the bottom line to limit the scope of these programs.

Organizations that are thinking about beginning a telecommuting program should look closely at job descriptions and telecommuting candidates. Some positions are poorly suited for remote work, and some staff are more up to the challenge than others.

But unless the corporation creates objective criteria for authorizing or denying flex/telecommuting requests, such programs can actually damage morale.

The last thing any company wants is to open supervisors(and the company) up to accustations of favoritism or discrimination because of seemingly random decisions on which personnel in their department can and can’t flex their schedules or work from home.

February 21, 2011   No Comments

Tax Credits for Wellness.

In the near future, the federal government might offer help to employers looking to begin a wellness program.  The help would take the form of tax breaks to offset wellness program costs.

A current United States  Senate bill would give companys a substantial tax break for starting health promotion programs. Dubbed the Healthful Workforce Act, it calls for an company tax credit of up to $200 per employee enrolled in a newly developed health promotion program.

For larger firms, there’s the $200 credit for the first 200 employees and up to $100 per worker thereafter.  To qualify for the full credit, your wellness program would have to feature -

o  health risk assessments

o  worker education drives (e.g., targeted mailings, internet based tools)

o  behavior change programs (e.g., smoking cessation, weight control, wellness Coaches), and

o  ”meaningful” participation incentives (e.g., lower co-pays).

Qualified corporations would be able to claim the tax credit for up to 10 years after starting a health promotion program.

The bill has enjoyed bipartisan support, but like many things in Washington, the parties disagree over how to fund the cost of the tax credit.  As a result, it has been bogged down in committee.

If and when the bill is ratified, employers could claim the federal tax credit the following year.

In the meantime, whether or not your business already has a formal wellness program, there are proven ways to make wellness part of the business culture. Best of all, they don’t have to cost an extra cent.

Wellness town meetings

It’s often said that successful health promotion programs start at the top of the company. Reason – Staff Members choose up fast on whether upper-level management practices what it preaches when it comes to wellness.

If the individuals  in executive management are smokers, obese or simply reluctant to talk about health issues, it’s a tough sell to get staff engaged in taking control of their health.

That’s the idea behind the wellness town meeting.

Once a week (or once a month), everyone in the organization attends a short meeting to discuss their own recent efforts to get healthier.

Managers typically go first, to break the ice about discussing some potentially sensitive issues like dieting or quitting use of tobacco.

In most corporations, the meetings are arranged to encourage casual, free-flowing conversation.

One key – Individuals  speak from where they’re seated, rather than standing up front, with all eyes staring at them.

A number of businesses take a more formal approach, which can also work.  For example, at Old National Bank in Indiana, folks file into an auditorium to face their worst enemy, the scale.

Each week, everybody at the firm ?.” from seasoned managers to the newest hires ?.” comes in to get weighed.  The only one who sees the number on the scale is the individuals getting weighed. Even so, the wellness program has inspired a lot of folks to lose weight.

Free tests and screenings

While there’s no substitute for having staff members undergo extensive health risk appraisals, it’s also wise to home in on screening for common conditions that aren’t necessarily lifestyle related.

Example –  skin cancer. It’s not just sun worshippers who are at risk of the most common (and in its early stages, treatable) form of cancer. Heredity plays a part. So does luck.

Fortunately, companys can get their personnel screened for free. Through the American Academy of Dermatology’s National Melanoma and Skin Cancer Screening program, volunteer physicians perform skin cancer screenings at no cost.

In like manner, other medical associations and public health agencies offer free or nominal-cost screenings for a selection of other common conditions.

February 20, 2011   1 Comment

When it comes to health savings accounts, you’ve to separate the hype from the reality. Among the big myths –  a high-deductible plan with an HSA means lower premiums.

Indeed, it varies.  In some cases, an HSA-eligible plan may cost the same as a non-HSA high-deductible plan. In others, the premiums can actually be more expensive, a recent NHPI report finds.

As a matter of fact, a non-HSA plan offering similar coverage can carry a monthly per-employee premium that’s about $15 to $25 lower and a deductible that’s $500 to $1,000 lower than the HSA choice.

Sometimes the difference is because of price-jacking –  the HSA plans are the ones that’ve been hyped in radio commercials and mentioned in newspapers in recent years.

Nowadays, fewer individuals  exploring high-deductible plans ask first about the non-HSA, so insurance organizations sometimes slash prices to drum up interest in those choices, too. Another factor –  Not all deductibles work the same.

Deductible cuts both ways

Two deductibles can look similar but work differently, and the cost scales can tilt in favor of either an HSA or a non-HSA plan. Example –  HSAs by law can no longer allow first-dollar coverage of prescription drugs. But a non-HSA plan can.

On the flip side, HSAs often feature better preventive-care coverage. In some non-HSA plans, a individuals who has yet to meet the deductible must pay out of pocket for standard tests (example –  cholesterol testing) that’re part of the routine physical. Only the office visit itself is covered.

Also, HSA-eligible plans have to follow rules that limit sum out-of-pocket costs. But this can push up the premiums compensated on the front end.

Best bet –  Double-check with your broker to make certain you’re comparing apples to apples when reviewing  the costs of HSA and non-HSA plans.

February 19, 2011   No Comments

Health Promotion Program Risks.

When your organization has this common ?.” and increasingly well-liked ?.” fringe benefit you could be at legal risk without even knowing it.

A lot of organizations have an onsite worker fitness room as part of a formal health promotion program. Others simply do it as a way for folks to get their juices flowing before work or blow off steam afterwards.

No matter the reason, corporations with fitness rooms need to be aware that the benefit isn’t risk-free.

Over the last few years, several privately owned health clubs have been sued ?.” and agreed to expensive settlements ?.” after exercisers suffered sudden cardiac arrest (SCA) and died before help arrived. In each case, the facility either did not have lifesaving equipment on the premises or didn’t have personnel properly trained to use it.

Some legal experts have expressed concern that employers could also be at risk if the unthinkable happened on company premises while an staff member worked out.

SCA is of particular concern. Reason –  Even seemingly healthy, active adults are at risk of sudden cardiac arrest. It can’t be prevented. There’s no vaccine.

And few victims survive by the time an ambulance arrives. But there’s a way to save the employee’s life and potentially save your firm from a lawsuit.

Learning about SCA

Sudden cardiac arrest (SCA) is a frequently misunderstood killer. It’s different thing as a heart attack. SCA can affect whoever, anywhere, anytime. It occurs more than 600 times every day in the United States, killing at least 250,000 individuals  each year.

The only hope –  using a device called an automated external defibrillator (AED) within 10 minutes.

The good news is any person at your business could be rapidly trained to use an AED ?.” you don’t need any medical knowledge to use it.  The training could be acquired for free through a local Red Cross or civic group.  The devices themselves cost under $2,000.

Compare that to the financial risk of being sued for not having an AED near a worksite fitness room, and it’s a no-brainer that any corporation with onsite workout equipment should at least investigate an AED purchase and training.

Staff Members, supervisors and senior level managers alike will probably need education about SCA and AED use. A excellent teaching resource is available here.

Key talking points –  Without an AED, 90% of victims die. But if you have access to one, there’s a good chance to save an employee’s life.  And it’s easy to teach supervisors and workers how to use the device if it’s ever needed.

The vast majority of facilities with AEDs never need to use them ?.” and that includes medical facilities. But it only takes one tragic event, and subsequent lawsuit, to cause pain for both the organization and an employee’s family.

Don’t forget – Prevention and education are always your company’s best tools for avoiding liability. In this case, where human life is involved, the choice seems rather obvious.

February 18, 2011   No Comments

Hidden Legal Risk for Companys.

For most firms, voluntary benefits are a win-win arrangement. But there may be hidden risks.

On the positive side, voluntary benefits cost businesss next to nothing, yet improve employees’ morale and benefits satisfaction.  An Aon survey found 77% of corporations offer at least one voluntary benefit.

But what happens when there’s a legal dispute between one or more of your personnel and the provider?

In many cases, employers unwittingly get dragged into court.  The provider may argue that the plan is covered by ERISA, and the employee’s lawsuit should instead be filed against his or her employer.

When the court agrees, the legal burden shifts.  Some courts have ruled that a voluntary benefits could  be covered under ERISA, even if it wasn’t an corporation’s intention to formally “sponsor” the plan.

When push comes to shove, the providers will protect themselves. Truly, some attorneys warn that a voluntary plan insurer’s first move if sued by one of your workers will be to try to get the legal burden shifted from itself to you.

Two seemingly innocent things that could be turned against you in court -

o  The written announcement to tell workers about the new voluntary benefit, and

o  getting involved when there’s a dispute between an staff member and the plan provider.

Be cautious with announcements When you offer a new voluntary benefit, the natural tendency is to try to get staff pumped up to participate. But you can get in trouble when individuals  get the impression the firm endorses the plan. Helpful practices -

o  Don’t put the announcement on organizational letterhead

o  Put a disclaimer on the description

o   either exclude your voluntary offerings from employees’ benefits manuals or list them separately, and

o  hold open enrollment at a different time than for ERISA plans (401(k), primary health plan, etc.).

Also, if the provider offering the voluntary plan has competitors, you might want to remind personnel the provider of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing providers.

Prevent involvement in disputes as with your ERISA plans, chances are workers will come to you when they have a problem with a voluntary plan. Your first inclination is to help.

But many experts warn it’s better to stay out. Reason –  Courts see this as the action of a plan sponsor. But you are able to steer someone in the right direction (e.g., giving a contact name to call) while remaining neutral in the dispute.

Good intentions gone bad

From an ERISA standpoint, the most hazardous voluntary plan design is one that is partially paid by the company, even when workers pay the bulk of the cost.

In a major ruling a few years ago (Burgess v. Cigna Life Insurance), a United States  district court ruled against an employer with a voluntary supplemental disability plan in which the firm compensated a portion of premiums on behalf of its lower-compensated staff members.

While most personnel compensated the entire premium ?.” and firm made clear to people  the plan was a voluntary benefit ?.”the court said it didn’t matter.  The act of contributing to some employees’ premiums made it an ERISA plan.

February 17, 2011   No Comments

Why Do Sick Employees Come to Work?

In the last few years, “presenteeism” has become an even bigger concern for many employers than absenteeism. While many HR/benefits managers hate the admittedly overused term, presenteeism is nevertheless a real issue in almost every worksite.

Most widely,  presenteeism takes the form of staff coming to work sick. They’re  unproductive and endanger peers. Meanwhile, the staff member is not forced to use a sick day. A bad deal for employers all the way around.

A recent survey by LifeCare revealed that 93% of staff (polled from 1,500 companies) admit that they at least ocassionally come to work when they’re sick enough to stay home. More important, the study  looked at the reasons why folks do it.

Troubling rationales

The No. 1 reason personnel cited for coming to work sick was a belief that they’d be “letting other individuals  down” if they call out. Nearly 30% of respondents cited this as their primary reason. Beyond that, the top responses were -

o  It’s too risky, as a result of office politics or culture, to take time off (26%)

o  The staff member is too busy at work to be able to stay home a day (15%)

o  The employee saves up sick days for childcare/eldercare emergencies (12%), and

o  The employee saves up sick days to use as extra vacation time (8%).

A lot of of these rationales are troubling to HR/benefits managers.

In the first place, supervisors who hassle staff members about taking legitimate sick time are, at best, being pennywise and poundfoolish.  Presenteeism costs more than absenteeism, once you figure in the uncharged sick days, lack of productivity and risk of other staff members getting sick.

You have more power than you think to change your organization culture when the “tough it out” mentality still applies to individuals  who come in sick. When senior level management is confronted with the real dollars and cents of presenteeism, decling the problem usually becomes a priority.  At the very least, firms shouldn’t invite it.

In terms of supervisor- and employee-education, repetition of the “stay home if you’re sick” message is the key. Eventually, it’ll sink in.

Of course, there’s still the problem ?.” as evidenced by the survey ?.” of employees who misuse their sick days by trying to hoard them for other purposes.

Adopting PTO, no-fault absence policies or use-it-lose-it sick leave are the three most common ways of decreasing the risk, but be aware that each of these policies have risks of their own.

At the end of the day, the more open the lines of communication are between senior management and workforce, the less prevalent the presenteeism problem becomes.

February 16, 2011   No Comments

Health Promotion Programs and Ethnic Profiling.

In many segments of society, we  hear about racial and ethnic profiling in negative ways. But what about when it comes to wellness programs?

When used for the specific purpose of starting ?.” or reviewing  ?.” a wellness or disease management (DM) program, profiling isn’t just legal. It’s also encouraged.

Affects health risks

Different ethnic and racial groups tend to be more at risk ?.” for genetic and/or cultural reasons ?.” of certain health problems. Examples -

o  African-American, Latino, Native American and Pacific Islanders are  at higher risk of diabetes than Caucasian employees

o  Chinese women are statistically twice as likely to get cervical cancer

o  Caucasians have disproportionately high rates of obesity and high blood pressure, and

o  Latinos have higher rates of asthma and chronic obstructive pulmonary disease than other groups.  The HIV/AIDS population is also disproportionately Hispanic.

Bottom line –  By analyzing  the ethnic breakdown of your worker population, you are able to set disease management (DM) program priorities with greater confidence and accuracy.

Healthcare quality an issue

Several studies also show there’s an unfortunate relationship between ethnicity and quality of health care. A lot of times, minority employees receive inferior treatment and health education at the same facilities where others receive top-notch care.

This ordinarily happens for innocent reasons. A common scenario –  a lack  of Spanish-speaking physicians in the network for your Latino employees. But the result is ordinarily higher health costs for you and, often,  greater reluctance among minority employees to seek needed treatments.

By profiling employees against the doctors in the network, you ultimately help employees get the care they need and the business to better control long-term costs.

February 15, 2011   No Comments

Health Promotion Program Obstacles.

Nearly two-thirds of corporations with health promotion programs offer staff members incentives ?.” financial or otherwise ?.” to participate.

But only one firm in five has seen major improvement in employees’ health status (and lower costs) within two years of launching the incentive. Here are three keys to getting good results ?.” and a red flag for failure.

Cancer screenings pay off big

Most health promotion programs feature health-risk assessments for things like high cholesterol and diabetes. But many overlook the need for early detection of cancer, which can affect any staff member, regardless of his or her age or general health.

In many cases, you can line up certain screenings, such as skin cancer detection (the most common type of cancer and, in its early stages, the most easily treated) for free or at a nominal cost.

These resources are often available through community agencies or the American Cancer Society. More involved and costly screenings ?.” like mammograms ?.” are well worth the cost.

A single case of cancer identified early usually saves thousands of dollars in medical claims and disability costs ?.” not to mention trauma for the worker.

Smart employee health promotion incentives

HIPAA has tricky non-discrimination rules for offering staff members a break on premiums or copays. You needn’t worry about HIPAA if you -

1. Structure the wellness program as a cost-break for workers who embrace wellness. on the flip side, imposing surcharges for uncooperative workers can force you to jump through health insurance portability and accountability act (HIPAA) hoops.

2. Make the incentive available to all staff. for  instance, when you offer a discount to non-smokers, an employee who lately quit smoking must also be eligible.

3. Allow personnel who fail to earn the incentive to have another shot at it next plan year.

Bottom line –  Make the financial incentive a reward, not a punishment. Do the incentives work? If they’re done right, yes.

Firms offering monetary rewards for wellness usually save about $20 to $50 a month, as reported by some estimates.

Making wellness programs simple

Many firms require employees to work with a personal “wellness Coach” for earn premium discounts or other incentives. Usually, the staff member sets up appointments and reports to the wellness coach on a regular basis, either by phone or in individuals.

The good news –  the early results are often stimulating.

The bad news –  Once workers realize there’s ongoing effort involved, many lose interest. But many firms have found a simple alternative. Rather than having participants contact the health Coach, the health coach calls them.

In many cases, this minor wellness program tweak keep folks on the right track and cuts dropout rates.

Wellness starts upstairs

No matter how much money your business spends on wellness, the odds of success depend largely on the example set by top management.

Example – If your Chief Executive Officer (CEO) is a smoker, chances are few staff members will buy into a smoking cessation program.

In like manner, it’s hard to sell staff on subsidized health club memberships when your business culture is sedentary. for wellness to work, the top brass must practice what the firm preaches.

February 14, 2011   No Comments

Health Insurance Business Accountability.

Are your health care programs delivering on your vendors’ promises?

Just as importantly, how can you hold providers accountable when you’re not getting what you paid for?

Here is one proven way – Develop a provider scorecard. Scorecards alone won’t bring down your health care costs. But they’ll at least help make certain your organization ?.” and workers ?.” get everything you’re compensating for.

The tool can help you measure plan performance with greater precision ?.” and identify specific areas that need improvement. Best of all, any organization can adopt the technique to fit their needs. Here is how it works.

1. Pick specific rating areas

Benefit pros who’ve successfully adopted the scorecard system recommend grading providers on five to 10 measurable areas, like -

o  Claims processing. Are employees’ medical claims turned around in a timely fashion? Are you hearing complaints that the explanations of benefits (EOBs) are slow to arrive or hard to understand?

o  Disputed and resolved claims. Do employee questions and complaints about denied or still-pending claims get answered quickly and thoroughly? Precisely how often are you forced to go to bat for employees?

o  Accessibility. Are plan reps quick to answer phone calls? Do they attend regularly scheduled meetings?

o  Reports. Do you receive timely paid claim and utilization reports?

o  Open enrollment. Did you receive effective support preparing for and conducting open enrollment events?

o  Worker education. Do your staff find the written and/or one-on-one services provided through the plan helpful in answering questions about managing specific chronic diseases (such as diabetes or depression)? Do you receive support in educating your staff to make healthy lifestyle options, such as use of tobacco cessation?

2. Pick a workable rating scale

There are two schools of thought when it comes to selecting  a rating method –  subjective or objective. A lot of benefit pros ?.” specifically those from smaller firms ?.” use a simple pass/fail or 1 to 5 score to rate their satisfaction.

Others create more elaborate, statistic-based ratings. One method –  take the vendor’s guarantees (e.g., addressing disputed claims within 3-5 corporation days) and then measure by percentage how often these objectives are met.

These rating data can be obtained through quarterly performance reports, staff member surveys, issue and complaint files and, for bigger plans, external audits.

3. Feedback causes improvement

It’s good practice to share your scorecard system with the vendor before meeting to review the results. Reason –  This lets you iron out any vendor questions about the review categories and scoring system.

Once that’s settled, you are able to meet to go over the numbers and prioritize the areas that need improvement. A lot of firms then add a new scorecard category ?.” vendors’ followup.

February 13, 2011   No Comments