Posts from — October 2010

Company health promotion is among the most important investments which a business will make. Businesses that begin health promotion programs are not only investing in the physical health and wellness, safety, and psychological health of their workers, but they are also taking preventive measures by building a more healthy environment.

By establishing a health promotion program, companies have the ability to increase the overall productivity and have the ability to save money on health costs. Typically, companies are concerned regarding the actual wellness ROI but the fact is that by stimulating healthier lifestyles, companies are creating healthier workers who’ll work more diligently and miss fewer days of work because of illness.

It’s very important that businesses not only offer company wellness options for their workers, but that they also sustain ongoing knowledge about safety and wellness techniques. Employers need to keep up to date on health statistics and stay aware of methods to motivate specific wellness concerns such as use of tobacco cessation or losing weight.

It is often ideal for a corporation to speak with doctors who participate in medical Continuing Medical Education to ensure they’re current with how they may assist their staff to maintain wellness.

In addition, when a organization maintains an onsite health club, it’s necessary that the organization employs individuals that have received the appropriate training and certification, which makes up the health club management, for assist workers with exercising safely.

Despite the fact that corporations may establish a robust health promotion program with a lot of alternatives, an incentive health promotion program is usually required for encourage staff to actually participate in the programs.

Whether or not one is creating a employee health promotion Chicago or a employee health promotion small-town Nebraska program, the issue that organizations often have in common, is the lack of motivation of staff to actually participate. Providing incentives for staff, such as a free lunch or gift cards, may  be simple enough rewards to encourage staff to participate in employee health promotion.

Do you know the fastest-growing reason for employee assistance program (EAP) use since 2003?  

It isn’t for substance abuse or depression. Actually, it’s financial in nature. Over the last five years, there’s been a stated 69 percent jump in worker employee assistance program use related to personal financial concerns.

The trend isn’t all that surprising in this era of salary freezes, high deductibles and cost-sharing of benefits premiums.

Statistics show that, for the first time since the Great Depression, the typical American has negative savings – in other words, debt exceeds income – in a typical month.

Many staff are racking up high credit card debt, make the problem worse.

Troubling trends

Here are some ominous numbers from a recent staff member survey –

• 27 percent of respondents said they were “one major setback away from financial disaster”

• 22% say they were “worse off than last year, with less take-home income and more debt”

• 40% say their employer is “insensitive to their employees’ financial needs,” and

• only 6% said they felt comfortable with their current financial situation and ability to manage their debts.

The majority of personal-finance related employee assistance program use arises from concerns over debt management, household refinancing and/or failed investments.

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Permitting workers to bring camera phones to work can carry hidden legal risks.  

But should you tackle this issue aggressively or trust your workers to do the right thing?  Every company wants to develop an environment where workers feel trusted by management. But there’s also the need to stay protected legally, and it isn’t always easy to balance the two.

The cell phone issue is especially delicate since most personnel carry them nowadays, and improper use at work is a non-issue for the vast majority. But there are always several bad apples in every bunch.

Growing number of complaints

There has been an explosion of lawsuits – and complaints to upper management – about staff taking inappropriate photos at work with their cell phone cameras.

Most cases revolve around embarassing or expliclit photos of coworkers (sometimes but not always posted on the Internet or e-mailed to others in the office). Nonetheless, a handful of lawsuits have arisen from employees taking photos of confidential documents or other internal information.

As most benefits and HR veterans would tell you, the most valuable benefit an organization can offer its workforce is a worksite where they feel trusted and valued. Contrarily, it only takes one “joke” gone too far to stir up a hornet’s nest of trouble.  And no company is immune from this risk.

Three options

One step every employer ought to take is circulating a memo or having a face-to-face meeting with workforce about the need to restrict camera phone use at work, says labor lawyer William Hannum.

This is the time to answer questions and make clear that the policy is a matter of a legal concern, not a case of Big Brother watching over employees’ shoulders. for added legal protection, you may want to create a formal camera phone policy to be written worker handbooks.

Some employers have gone so far as to take the step of banning camera phone (or personal cell phone) use at work and prohibiting people  from posting personal photos or videos from corporation computers.

Nevertheless, these policies are challenging to enforce and run the risk of alienating the majority of employees who use the devices responsibly.

As an alternative, a few firms that haven’t banned camera phones have had workforce sign a policy that gives managers permission to review photos or videos on the phone if there’s a complaint. If you go down either of these routes, remember –

• The policy should be enforced consistently

• your policy must explain specific steps for filing and reviewing  a complaint, and

• The policy should obviously describe the disciplinary steps for violations.

The enforcement aspect is in particular tricky. In cases where the phones are corporation property, businesss clearly have the right to control non-work use – which includes requiring workers to turn over the contents stored on the phone in cases of suspected abuse. Staff Members have no legal expectation of privacy in such cases.  

However, there’s a slippery slope when the phone is an employee’s property.  As a rule of thumb, employers generally have the right to inspect the contents as they pertain to alleged inappropriate behavior within the worksite.

Where it gets tricky is dealing with behavior that takes places on the employee’s private time, but overlaps with the worksite (e.g., workforce go out socializing at a bar after work, and potentially embarassing camera phone photos get spread around the worksite). Legal professionals caution businesss to tread very carefully in these cases.

Where does your business stand?

Does your company have – or is considering a policy on staff member camera phones? Do you think such policies are workable or even appropriate?

In my conversations with attendees at the SHRM conference in Chicago, HR and benefits managers appear to be divided on the issue.

In a value-based plan, the idea is to reward employees for seeking treatments that promote wellness.

The more clinically viable the treatment, the less an employee pays out of pocket for it.

Example –  Women over 40 and younger staff members with a family history of breast cancer pay less for a annually mammogram than staff members for whom the test isn’t as necessary.

Value-based plans often work better than high-deductible plans when used in combination with standard wellness program features like health risk assessments.

Five target areas

According to the May 2008 issue of Simply Well, there are four quality-of-care criteria that have emerged as key benchmarks of the quality of care – healthcare management, preventive screenings and treatments, member service and access to care.

Areas of care that are of particular concern –

• Employees’ dependents receiving appropriate and timely childhood/adolescent immunizations

• Breast cancer screenings for female health plan enrollees, ages 52 to 64

• Diabetic staff receiving hemoglobin A1C and LDL-C testing

• Members receiving proper referrals and treatment for mental health issues (e.g., primary care physician refers a patient to a expert to ensure proper prescription and management of an anti-depressant medication)

• Pregnant workers receivig time and appropriate prenatal and postpartum care, and prevention of antibiotic treatment in adults with acute bronchitis.

The quality of care for many of the aforementioned issues can suffer when personnel foot too much of the bill out of their own pockets.

The hope for value-based plans is that workers get some cost relief and obtain treatments that will reduce costs in the long run.

As scary as they seem at first glance, complying with HIPAA’s privacy rules can be relatively painless.

Contrary to common belief, the rules – with a few key exceptions – apply only to a fraction of the health information Benefits handles.

As long as the corporation remains legally “hands off” of employee’s private medical information, you can dodge most of the health insurance portability and accountability act (HIPAA) bullet.

For health insurance portability and accountability act (HIPAA) privacy purposes, your firm is considered “hands off” even when you obtain de-identified personal information, aggregate claims data and routine enrollment info.

Bottom line – If your organization’s healthcare plans are fully insured and the claims administered through a TPA, the insurance organization – not your firm – bears the brunt of the HIPAA privacy compliance responsibility.

One major exception –  medical cafeteria plans. In most cases, you’ve two compliance choices –

• Process reimbursement requests first through your TPA, with the TPA making sure the claim qualifies beneath the terms of the cafeteria plan before your firm reimburses it, or

• Develop a written cafeteria plan privacy policy, issue a notice to personnel, appoint a privacy officer and amend your plan documents.

Rarely affects FMLA

A lot of people  - including health care providers – misunderstand how health insurance portability and accountability act (HIPAA) affects medical certifications for FMLA leave.  The key – health insurance portability and accountability act (HIPAA) only applies to personal information that filters through your health plan, not certifications obtained from a physician.

Under FMLA, you’re allowed to obtain the minimum information you need to approve and administer leave. Likewise, health insurance portability and accountability act (HIPAA) doesn’t apply to most workers’ comp, return-to-work notices or disability claims.

Even so, it pays to be careful how you ask for and use the information. Other state and federal privacy laws often protect the same types of info individuals  assume falls under HIPAA.

Following procedures

The health insurance portability and accountability act (HIPAA) privacy rules are heavy on paperwork and procedure.

But if your firm follows  the info-gathering process spelled out in your health plan documents, the HIPAA privacy rules ought to present few major obstacles.

Many firms are still missing an opportunity to trim some health plan expenses.

Generic versions of high-cholesterol drug Zocor have been on market for two years now, but a fair share of corporation drug store plans have yet to make the switch.

When your PBM gives generic Zocor favored status on the formulary, now’s a good time to remind employees –

• most individuals  on cholesterol-control meds will get the same therapeutic value from generic Zocor as from the label brand and the more potent – and still patented – Lipitor

•  they are able to save $10 to $50 (or more, depending on your drug plan design) on their co-pay by switching, but

•  they should ask their doctor first. People  with cholesterol levels over 200 and/or family histories of  ultra-high cholesterol may  be better off staying on Lipitor.

Reason –  It takes four times the amount of a Zocor-type medication  to equal one dose of Lipitor.

When it comes to health-coverage laws, there’s often a domino effect.

As individual states require insurers – and in some cases, businesss – to cover or offer coverage of specific people  and procedures, similar laws can spread quickly to other states.

The effect on plan sponsors –  Some mandates can increase your costs by 20 percent to 45 percent.

Small firms targeted, too

States are no longer targeting  just the Wal-Marts and other giant companies anymore.  The pressure has increased on employers of all sizes.

That’s specifically true for the new “universal coverage” laws passed in Massachusetts and Vermont.

The Massachusetts law requires every firm with 11 or more employees either to cover or contribute toward everybody’s health coverage, or else pay an annual fee of $295 per staff member to a state fund.

Vermont’s similar version sets the yearly fee at $365 per full-time equivalent worker.  The Vermont law also requires all uninsured, low-income hourly workforce to have access to a state-subsidized plan (called Catamount Health) sold through private insurance companies.

It’s up to companys to deduct the monthly premiums – $60 to $135, depending on the person’s wages – and send it to the state.

There are rumblings in at least 10 states about lawmakers pushing for universal-coverage laws. Several have formed committees to study the Massachusetts law and see when a version may be adapted to their state.

Here are three proactive steps to consider now. These could potentially save money, time and compliance headaches later –

• look into offering mini-med or similar lower-cost programs to satisfy minimum coverage requirements for uninsured staff. Monthly premiums range from about $25 to $200

• educate low-income workers about the earned income-tax (EIT) credit the federal government offers. This can make a mini-med plan free or nearly free to eligible workers, and

• use flexible spending accounts to create a tax savings on premiums for other workforce and your firm.

Required procedures

The universal-coverage laws draw national headlines, but far more employers are currently affected by state laws requiring coverage for certain types of procedures. Three of the biggies –

• diabetes self-management. Nineteen states require your medical plan to cover all the steps workers with diabetes take to control their condition, including nutritional therapy (if prescribed by a physician)

• in vitro fertilization. This large ticket service adds 3 percent to 5 percent to your premiums, and is now a required benefit in 15 states, and

• cervical cancer screenings. In the last year, four more states have required all employer plans to cover yearly cervical cancer screenings for all covered female workforce, spouses and dependents age 18 and older. That brings the total to 24 states.

The good news about the diabetes management and cervical cancer mandates is they can lower your  long-term costs, even if they increase them in the short-term.

Here’s a good resource  for keeping abreast of mandatory coverage trends around the United States.  The site also features  state-by-state breakdowns of changes in insurance laws  mandating the coverage of different treatments and conditions.

For example, this report from 2006 is the most comprehensive coverage-mandate study that I’ve ever seen.

Who worries more about healthcare costs –  lower-paid or higher paid employees?

Answer –  Both groups worry equally about their out-of-pocket medical costs, according to a PNC Services Group survey of 1,485 workforce. Nearly 52% of all respondents – regardless of income -cited the unpredictability of medical expenditures as their No. 1 financial-planning concern.

Other common financial-planning fears that affect personnel of all salary levels –

• eldercare. Over half the respondents with children were afraid their offspring may be forced to pay for the parents’ long-term care, and

• financial stability. 47% of mid- to high-salary personnel said they were concerned about sustaining or increasing wealth.

It may be easier than you think to eliminate a major reason employees sue.

How? Well, roughly 75% of worker lawsuits happen because of accidental disconnects between an business’s internal policies and procedures, and what’s written in the plan documents.

Here are two areas where some the costliest errors lurk, and three steps your fim can take to catch and correct the mistakes before you’re ever sued.

1. Policy/coverage discrepancies

A lot of firms’ written benefits policies and plan documents are like siblings who begin to drift apart as they grow up.

In the benefits realm, however, the plan sponsor has the “parental” power – and legal responsibility – to be certain written policies and plan documents remain close as they grow and change.

As a routine practice, firms should make sure changes in their benefits policies are also written into the formal plan documents, as reported by benefits attorney William Wright.

When push comes to shove in court, any inconsistency with plan documents can prove fatal for the organization. Example – Senior level management passes a new rule that workforce must work 30 hours a week to be eligible for the health plan.

Benefits and HR then write the new coverage policy into employees’ benefits  handbooks and hold meetings with personnel to explain the change.

Now suppose an worker drops to part-time status. Are you legally protected when the worker challenges the loss of benefits?

Not necessarily. for the policy in  the handbook to stand up in court, the plan documents must also say there’s a 30-hour-a-week eligibility requirement.

Same thing goes for disputes over run-out coverage.  Suppose it’s your firm’s policy to carry over coverage for a terminated worker during the COBRA election period, but the requirement was never written into the plan document.

Several weeks later, the employee has a major health claim.  The TPA denies it, saying coverage had expired. Reason –  the plan document says “active employees” are covered, but does not specify that the insurer pay claims until the end of the month.

The likely result –  the ex-employee sues, saying the business is liable for the mistake.

2. Coordination of benefits

Watch out for cases where an employee’s claim might  be covered under two or more policies (e.g., your firm’s plan and one from a spouse’s business).

Be sure there’s a clear-cut coordination-of-benefits policy in all your plan documents. Typically, when a plan contains no instructions for coordination of benefits, it’s expected to pay first. Two key areas to check –

1. Be sure there’s a statement that says only the amount actually paid by each plan are going to be charged against the maximum benefit, and

2. Be sure that the order of benefits determination spells out which plan compensates first for a covered child if the worker is divorced from his or her spouse.

Likewise, when your firm offers domestic partner coverage, make sure there’s a coordination-of-benefits statement for dependent and non-dependent partners.

Three best practices

On an ongoing basis, you can cut your lawsuit risk by 75% if you –

• gather all materials related to specific plans into a binder, including renewal letters from vendors and materials distributed to employees

• perform a yearly self-audit, checking to see if plan-document wording matches your current policies, and

• pay special attention to keeping benefits descriptions up to date.

Reminder – If you don’t have a formal plan document, your contract with the vendor legally serves as the “control document” for the plan. By law, all workforce must have access to the plan document and be notified in writing of any alterations, including minor ones.

Nine of 10 HR managers polled by Colonial Life feel that personnel have at least a vague notion that benefits are a valuable part of working at a business.

Notwithstanding, the same study found that only 21% of those corporations believed their workers had a strong understanding of the workings of their own benefits.  and 5% believed that their workers didn’t know anything about their benefit choices.

Implication –  the greater emphasis placed on worker education, the more likely workforce understand the role of benefits in sum compensation.