THE REAL CAPTAIN PHILLIPS OFFERS LEADERSHIP INSIGHTS

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THE REAL CAPTAIN PHILLIPS OFFERS LEADERSHIP INSIGHTS
PRINCIPLED.                                                                                                                            VOLUME 7, ISSUE 4
INFORMED.                                                                                                                                     APRIL-MAY
TRUSTED ADVISOR.                                                                                                                                        2014

for your benefit
    THE REAL CAPTAIN PHILLIPS OFFERS                                                                            INSIDE THIS ISSUE
    LEADERSHIP INSIGHTS
                                                                                                        Zero copay program achieves better
                                                     locked. “We tried to get everyone on the           patient adherence                           2
    By Allen Greenberg
    April 9, 2014                                    same page,” Phillips said. “A few days later,
                                                     everyone was happy we had planned for              Premium increases slowing down: ADP         2
    ORLANDO, Fla. – Capt. Richard Phillips, the      the worst.”
    merchant mariner whose cargo ship was                                                               2014 is a pivotal year for reassessment
    seized by Somali pirates, said Wednesday         His training, Philips said, didn’t include         of benefits strategy                        3
    he might never have survived the                 dodging bullets.
    experience were it not for teamwork and                                                             Evaluation of self-funded benefit plans
    some of the leadership skills he had picked      “But somewhere within us we find strength          helps avoid outsourcing headaches           5
    up in his years as a “floating CEO.”             to do what must be done,” he said.
                                                                                                        HR Resources: Welcoming new
    Among others, the most germane, if not           It was the first act of piracy against a U.S.      employees: Schedule, mentor,
    classic, lessons of the experience, he said,     vessel in 200 years.                               reevaluate                                  6
    is that people are often much stronger
    than they know, that the only time all is        Phillips said he felt the best way to protect      HR Resources: Get Well First                7
    lost is when we choose to quit, and that a       his crew was to get the pirates off the
    focused, professional team can overcome          ship as soon as he could. That’s why he
    almost any problem.                              risked his life by entering into the ship’s
                                                     lifeboat with the pirates, in hopes of
    Phillips’ ship, the Maersk Alabama, was          engineering some sort of exchange for his
    boarded by a band of four Somalis in the         release. Phillips was held hostage for five       Phillips noted that he developed
    Indian Ocean in March 2009. The story was        days and eventually rescued by a team of          relationships with the pirates, despite
    made into a film last year.                      Navy SEALs.                                       the fact that they threatened him and
                                                                                                       played mind-games with him, including
    Speaking on the second day of the Human          His decision to join the pirate on the            repeatedly pretending to execute him and
    Capital Summit and Expo, Phillips recalled       lifeboat, he said, underscored the                telling him that his family wouldn’t miss
    that, after flying from the United States to     importance of stopping to question                him when he was killed.
    join the vessel, he didn’t feel the crew was     personal training and judgment to
    properly prepared for a security breach,         ascertain the best course of action.              “One pirate told me that when we got to
    especially given the level of pirate activity                                                      Somalia, we’d go to the movies and he’d
    in the waters the Alabama was crossing.          The time he spent as a hostage, he said,          introduce me to his girlfriend’s mom.”
    And so he ordered an emergency safety            also illustrated the importance of flexibility
    drill.                                           and not panicking. Even when the situation        “Of course, the real heroes are the
                                                     wheeled out of control, Phillips and his          Navy seals,” he said near the close of his
    “I always told my crew it was a matter of        crew were able to adjust, he said.                presentation. “We are all riding on ever-
    when, not if,” Phillips said. “Hope for the                                                        shifting waves and so we’re all better off
    best, but plan for the worst.”                   “I realized I never prayed for rescue, but for    facing these challenges as a team, rather
                                                     strength to never give up,” Phillips said. “For   than alone.”
    The drill revealed some problems.                as long as you don’t give up, there’s still a
    Members of the crew didn’t know the              chance.”                                          http://www.benefitspro.com/2014/04/09/
    signal for a pirate attack, doors weren’t                                                          capt-phillips-offers-leadership-insights

                          For the most recent news on Healthcare Reform, please contact your Benefit Controls representative.
THE REAL CAPTAIN PHILLIPS OFFERS LEADERSHIP INSIGHTS
PA G E 2                                                                                                       FOR YOUR BENEFIT

   ZERO COPAY PROGRAM ACHIEVES BETTER PATIENT ADHERENCE
   By Andrea Davis                              enrolled. Both the enrolled diabetic and        cholesterol and diabetes, because that
   April 8, 2014                                high cholesterol populations had higher         where you can get your zero copay,
                                                adherence. The diabetic group’s adherence       but we’re also seeing across individuals’
   Employees enrolled in a zero copay           rate was 70% compared to about 45% for          medication profile -- even in other
   program for their diabetes and high          those not enrolled; the high cholesterol        conditions -- them seeking out generic
   cholesterol drugs had better adherence       group’s adherence rate was about 66% vs.        medication for other medications they
   to those medications than employees not      55% for those not enrolled.                     might be taking,” says McMurray.
   enrolled in the program, according to a
   recent retrospective case comparison study   “With what we were seeing in the market,        To qualify for the zero copay program, plan
   from Walgreens.                              with the success of these value-based           members had to speak with a health coach
                                                benefits designs, we wanted to provide          at least five times.
   The Walgreens study examined an              that financial incentive for individuals
   employer-based value-based insurance         to become more engaged with their               “I think the key takeaways are that
   design program implemented in January        condition, when it comes to talking a the       employers should try to reach out to those
   2010, which eliminated the copay             health coach,” says Jennifer P. McMurray,       employees who are in greatest need for
   for generic anti-diabetic and anti-          PharmD, director, health care products and      whatever program they offer,” says Dr.
   hyperlipidemic (cholesterol) medications.    services with Walgreens. “In order to do        Bobby L. Clark, PhD, MSPharm, Walgreens
   Eligible members (diabetic and/or high-      that, we felt that financially rewarding them   director of clinical outcomes and reporting.
   cholesterol beneficiaries) were required     with a zero copay for these medications         “For example, for our particular program,
   to participate in a case management or       would be a great way to engage.”                in order to do the greatest good, we
   wellness program to receive the zero copay                                                   need to try to enroll those who are
   benefit.                                     The study also showed a slightly higher         sickest, as determined by the number of
                                                switch rate to generic medications for          comorbidities they may have.”
   About 4,100 beneficiaries enrolled, while    those enrolled in the zero copay program.
   almost 22,000 elected not to. Among those                                                    http://ebn.benefitnews.com/news/zero-co-
   that enrolled, 3,400 had diabetes and high   “Not only are people seeking out generic        pay-program-achieves-better-patient-adher-
   cholesterol, compared to 2,400 of the non-   medications for the medications of              ence-2740553-1.html#Login

   PREMIUM INCREASES SLOWING DOWN: ADP
   By Andrea Davis                              Other findings from the 2014 ADP Annual           to participate in their health plan did so.
   April 4, 2014                                Health Benefits Report include:                   In all groups 40 and older, participation
                                                                                                  was over 70% in 2014. In comparison,
   While average monthly health plan            • Between 2010 and 2014, the percentage           among employees under age 30, just
   premiums have increased 15% since 2010,        of full-time employees who were eligible        over half participated in their employer’s
   to $870, new data from ADP show the rate       for employer-provided health benefits           health benefits program in 2014. In
   of increase is slowing down. After a sharp     remained relatively steady at an average        this group the take rate declined 7.6%
   increase of 6.9% from 2010 to 2011, the        of 90%.                                         between 2010 and 2014.
   rate of increase was just 1.7% between
   2013 and 2014.                               • The overall percentage of those               • In 2014, of the 20 states analyzed,
                                                  participating in health benefits also           New Jersey had the highest monthly
   Employer share of contributions to health      remained relatively constant at an              premium, $999, and Georgia had the
   premiums, meanwhile, declined slightly for     average of 68%. However, the averages           lowest, $807. New York had the largest
   all groups from 2010 to 2014, regardless       do not reflect the marked variances             percentage of employer contributions at
   of age or number of dependents. The            among specific age groups, where                78%. In Georgia, Missouri and New York,
   largest decrease was 1.5% for those            participation rose among baby boomers           average premiums actually declined in
   with dependents. For those with no             as they continue to work into their later       the past year.
   dependents, the decrease was 1.0%.             years, and participation declined among
   Employer contribution decreased across         younger employees.                            http://ebn.benefitnews.com/news/premi-
   all age groups according to the report’s                                                     um-increases-slowing-down-adp-2740464-1.
   findings.                                    • 73% of employees aged 50-59 eligible          html
PA G E 3                                                                                                           FOR YOUR BENEFIT

   PERSPECTIVES: 2014 IS A PIVOTAL YEAR FOR REASSESSMENT OF
   BENEFITS STRATEGY
   by Amy Bergner and Michael Thompson            • What is my commitment to offering            THE 2018 ‘CADILLAC PLAN’ TAX
   March 30, 2014                                   health coverage to different groups of
                                                                                                 The health reform law aims to rein in health
                                                    workers, and what kind of coverage
                                                                                                 care costs partly through a tax on high-cost
   Employers should re-evaluate their role in       should I be offering and how? What
                                                                                                 or “Cadillac” plans, slated to start in 2018.
   providing health care coverage and better        about family members?
                                                                                                 This 40% excise tax is not deductible and,
   define the value in their benefits strategy,
                                                                                                 furthermore, is not avoidable by simply
   say Amy Bergner and Michael Thompson of        • Have I revisited the cost of the pay-
                                                                                                 sharing more of the cost of the programs
   PricewaterhouseCoopers L.L.P.                    or-play mandate? Have I selected and
                                                                                                 with employees. It applies to the value of
                                                    verified the lookback or measurement
                                                                                                 all employer-sponsored group coverage,
   Many employers face a turning point this         period, an administration period, and a
                                                                                                 whether paid for by employees or the
   year in providing health care coverage,          stability period when those treated as
                                                                                                 employer. While some employers may
   largely because of the Patient Protection        full time are in the group that must be
                                                                                                 believe that they don’t have to worry about
   and Affordable Care Act. Soon, the               offered coverage?
                                                                                                 this excise tax because of intervening
   consternation or complacency will need
                                                                                                 elections or a belief that the tax just won’t
   to be replaced by a focus on several key       REPORTING AND COMPLIANCE
                                                                                                 be implemented, this approach may be
   provisions of the health care reform law.
                                                  In addition, to enforce the employer           dangerous. Implementing any “fix” at the
   In addition, now is an opportunity for
                                                  mandate, employers will have to start          last minute is bound to be less successful
   employers to fundamentally re-evaluate
                                                  reporting to the Internal Revenue Service      than a measured and phased-in approach.
   their role in providing health care coverage
                                                  and to employees in 2016 about coverage        And even if the excise tax in its present
   and double down their efforts to better
                                                  available in 2015. It’s also likely that       form is eliminated or revised, there’s a good
   define and rethink value as it relates to
                                                  employers, insurers and governments will       likelihood that policymakers will pursue
   their benefits strategy.
                                                  have to tell the IRS and employees about       a course to limit or toss out tax-favored
                                                  the coverage they actually had in 2015.        employer-sponsored benefits that are a
   PREPARE FOR PAY-OR-PLAY RULES
                                                  The reporting will be a heavy lift for many    huge contributor to the federal budget
   While employers have known for                 employers and their vendors, as it uses data   deficit.
   several years now about the pay-or-play        that may be housed in separate systems
   requirements — officially known as the         and documentation and record keeping           This is the year all employers should
   Employer Shared Responsibility Payment         may be challenging.                            revisit their exposure to the excise tax.
   penalties — 2014 is the time to execute                                                       Many employers evaluated their potential
   against this core provision as its 2015        • Am I ready for the record keeping            exposure to the tax in 2010 or 2011,
   effective date nears. In doing so, employers     and reporting that relate to these           shortly after the ACA was enacted. Many
   should be asking themselves several key          requirements?                                employers responding think the excise tax
   questions, and then taking some concrete                                                      will affect them. Some of the key strategies
   action steps to prepare:                       • Can I track hours for and report on those    to consider regarding the excise tax are:
                                                    workers who aren’t regular full-time
   • Have I correctly identified my                 employees?                                   • For self-insured employers, have you
     employees or are there challenges                                                             collected claims data and determined
     and opportunities posed, such as with        • What data aggregation will I need?             projected medical trends, counting not
     independent contractors, globally                                                             only medical coverage but certain other
     mobile employees or temporary                • How will I monitor the cost of the             benefits as well?
     workers?                                       pay-or-play mandate and workforce
                                                    management strategies?                       • For insured plans, have you projected
   • What should I be doing around                                                                 forward premiums and reconsidered
     workforce management to deal with            • How will I reassess the strategies I           self-insurance in light of the higher
     the requirement, effective in 2015, to         have deployed for the measurement,             health insurance industry taxes? Have
     offer coverage to at least 70% of my           administration and stability periods?          you considered that while the excise
     full-time employees, then in 2016 and                                                         tax will be paid by the insurance carrier
     succeeding years to at least 95% of full-    • How will I know I am in compliance?            for an insured plan, it will ultimately be
     time employees?
                                                                                                 Continued on page 4
PA G E 4                                                                                                       FOR YOUR BENEFIT

   Continued from page 3                          a step toward “defined contribution” health    • How will the public and private
                                                  benefits.                                        exchange “shopping” experience
      passed to you, the employer?                                                                 compare to that offered to employees
                                                  The public and private exchanges offer           today, and will it improve over time?
   • Have you started down the path toward        the chance to shop online for health             What will be the employee experience
     implementing strategies that will            plans, leveraging digital communications         post-enrollment?
     provide higher-value choices for the         and personalized information to inform
     health care dollars spent to help mitigate   decisions. But no two private exchanges        • Will the focus on wellness and physical
     the tax?                                     are the same.                                    health promotion as an extension of
                                                                                                   the medical plan shift to be a more
   • Are you considering eliminating “richer”     Now employers are recognizing that these         independent and broader focus on
     plans and moving between now                 new health exchanges put new delivery            employee well-being strategy?
     and 2018 to full-replacement, high-          options on the table and are changing the
     deductible health plans, perhaps limiting    expectations around consumer experience        This is the big year for the Affordable
     or dropping the employer contribution        and choice. Some employers have told           Care Act rollout. It also is a turning point
     to a health account?                         groups of employees — particularly             for employer health benefits strategies
                                                  part-timers — to get insurance on the          in general. In the short term, the key
   • Are you executing a “choice” strategy        public exchanges. According to the Private     priority will be deploying the strategy and
     that will allow a more seamless transition   Exchange Evaluation Collaborative 2013         infrastructure to mitigate, prepare for and
     for employees to “buy down” as 2018          employer survey, 45% of employers will         support the shared responsibility reporting
     nears?                                       consider using a private exchange by 2018      and interfaces with the public exchanges.
                                                  to offer health coverage to their full-time,
   • Have you assessed the effectiveness of       active employees. Some new questions           This is the beginning of a new post-ACA era
     your strategies to more aggressively         being asked include:                           drive toward higher-value plans that will
     manage costs through health                                                                 mitigate the Cadillac plan tax, workforce
     management including case                    • Can these private exchanges offer            management strategies that consider the
     management of high-cost and complex            a financial value proposition saving         economics of the new health economy
     patients, support of people with               money not just in the first year but over    and the growing use of public and private
     chronic conditions and general wellness        the longer term? How should the private      exchanges as alternatives to support the
     initiatives?                                   exchanges be financed?                       health security and enhanced choices for
                                                                                                 our workforce.
   • Have you investigated the opportunities      • Which private exchange sponsors (e.g.
     presented through delivery-based               broker/consulting firms, insurers and        Amy Bergner is a managing director of hu-
     strategies such as the use of patient-         technology companies) offer the best         man resources solutions at Pricewaterhouse-
     centered medical homes, accountable            value and consumer experience? Which         Coopers L.L.P. in Washington. She can be
     care organizations, medical tourism and        will be the better stewards over time?       reached at 202-312-7598 or amy.b.bergner@
     high-performance networks?                                                                  us.pwc.com. Michael Thompson is a principal
                                                  • How can value be promoted more               with PricewaterhouseCoopers L.L.P. in New
   • Are you executing strategies for workers       effectively through the private              York. He can be reached at 646-471-0720 or
     to better understand, seek and receive         exchanges? Will the exchanges enable         michael.thompson@us.pwc.com.
     value for health care while reducing the       employees to better manage their
     cost of care, including more advanced          health, including transparency and high-     http://www.businessinsurance.com/ar-
     transparency strategies or reference-          performing networks?                         ticle/20140330/SUE0401/140329940?ta
     based pricing?                                                                              gs=|307|74|278|342#full_story
                                                  • Which classes of employees and former
   THE ROLE OF HEALTH CARE EXCHANGES                employees may be better served by the
   In 2014, the public health insurance             public insurance exchanges?
   exchanges are making their debut and
   offering a new experience for people           • If the public exchanges stabilize, should
   seeking coverage. At the same time,              we get out of the business of providing
   there’s a growing buzz around private            health care coverage for employees or
   exchanges, with more employers seeing            potentially subsidize toward the public
   an opportunity to offer more choice,             exchanges over time?
   potentially simplify administration and take
PA G E 5                                                                                                             FOR YOUR BENEFIT

   EVALUATION OF SELF-FUNDED BENEFIT PLANS HELPS AVOID
   OUTSOURCING HEADACHES
   EVALUATE TPAS BASED ON HEALTH PLAN REQUIREMENTS, EMPLOYEE NEEDS

   by Karen Pallarito                                                         Merchants 5 Star Inc., a Marietta, Ohio, moving and storage
   March 30, 2014                                                             company, learned that that hard way when its now-defunct TPA,
                                                                              Employer Benefit Services of Ohio Inc., aligned with a questionable
   Employers that outsource administration of their self-funded               stop-loss insurer, Mr. Stitt said.
   health benefits plans to third-party administrators expect great
   service at a fair price.                                                   Jeff Starner, the trucking company’s CEO, said his insurance agent
                                                                              vouched for the TPA but missed a giant red flag: The TPA’s stop-loss
   With potentially millions of health-plan dollars at stake, that            provider, United Re, was neither an insurance company nor was it
   relationship can sour quickly if problems arise.                           licensed to offer insurance in Ohio.

   But employers can avoid hassles with their TPA by asking the right         When claims went unpaid, Ohio State University Hospital sued
   questions upfront and negotiating contract terms, benefits experts         Merchants 5 Star, leading the trucking company to sue the agent
   say.                                                                       and insurer. The case ultimately was settled, he said.

   “You should not just sign a boilerplate agreement without really           “We had such a bad experience, and it cost us so much money,
   reading through (it),” said Carl Mowery, managing director of              that we returned to a fully insured plan,” Mr. Starner said.
   compensation and benefits consulting at Grant Thornton L.L.P.,
   a Chicago-based audit, tax and advisory company. The employer              With health care reform, employers have even more reason to vet
   needs to understand its responsibilities and those of the TPA, he          their TPA.
   said.
                                                                              Donald Mollihan, a partner at Phoenix-based Arizona Benefits
   Working with a TPA allows self-funded employers significant                Consultants L.L.C., said employers should ask TPAs what
   leeway to tailor an administrative services package, but widely            compliance services they offer, noting that most provide a
   varying capabilities mean it’s important to evaluate providers             significant amount of Patient Protection and Affordable Care Act
   based on plan requirements and employee needs.                             compliance services, including required reporting and notices.

   Some TPAs provide basic services, such as claims processing and            Employers also need to find a TPA with a provider network that is
   enrollment, while many offer everything from case management               in sync with their local, regional or national presence.
   and COBRA services to summary plan descriptions.
                                                                              “The beautiful part of a TPA is they can represent several different
   “It makes it so easy, so attractive, that sometimes employers              rental networks, and so they’re going to have a really good idea,
   forget that you really need to look at the underlying agreement,”          based on your utilization, where employees are going, where
   said James Napoli, a Fairfax, Va.-based partner at labor and               maybe the best deal is going to be,” said Bob Charlesworth, an
   employment law firm Constangy, Brooks & Smith L.L.P.                       owner of Overland Park, Kan.-based Charlesworth Benefits L.C.,
                                                                              whose clients include mostly small and midsize employers.
   Many TPAs try to include language in the service agreement to
   limit their financial liability, but the health plan fiduciary — usually   http://www.businessinsurance.com/article/20140330/NEWS03/30330
   an administrative committee or a plan administrator — must                 9997?tags=|307|65|74|342#full_story
   understand the potential risk it assumes if that language remains,
   he said.

   Some TPAs offer stop-loss protection through a preferred reinsurer.

   “Sometimes that’s fine, and sometimes this isn’t the stop-loss
   carrier you would have bought on your own,” said Scott Stitt, a
   partner and Employee Retirement Income Security Act attorney
   with Columbus, Ohio-based James E. Arnold & Associates L.P.A.
PA G E 6                                                                                                         FOR YOUR BENEFIT

   WELCOMING NEW EMPLOYEES: SCHEDULE, MENTOR, REEVALUATE
   by J. J. Keller & Associates, Inc.                                      know his or her daily job duties for the orientation period and
   April 9, 2014                                                           beyond.

   New job jitters can be common for any new employee. This is             Adults learn better with a hands on approach, so make sure
   mostly due to all of the unknown factors new workers face such as       they can be active participants. Managers can have mentors
   measuring up, learning what the job really entails, fitting in with     demonstrate a task and provide written instructions, then have
   coworkers, and wondering if they made the right employment              the new employee work on his or her own, asking the mentor for
   choice.                                                                 guidance as needed.

   Managers want employees to feel like accepting the job was              CHECK IN WEEKLY/MONTHLY
   the right decision. An organized onboarding program may help
                                                                           The manager will want to check in with the new employee often.
   ease some of the nervousness. It can also increase employee
                                                                           For the first week, the manager might check in daily to see how
   retention by providing the new employee with effective and
                                                                           the job is going and answer any questions. After that perhaps
   structured training, an understanding of the company culture, an
                                                                           weekly, then once a month may be sufficient. The length of time
   understanding of expectations, a feeling of being connected, and
                                                                           a manager will check in depends on the type of position, but
   a feeling of being a productive contributor.
                                                                           managers will do this for anywhere from generally 60 days up to
                                                                           six months.
   Welcoming a new employee shouldn’t end after the first day of
   orientation. In fact, continuing to check in, offering support, and
                                                                           Managers should also tailor their approach to the employee’s
   providing feedback for the first six months or even the first year
                                                                           needs. Some individuals desire frequent feedback, while others
   can be beneficial.
                                                                           may prefer to work independently and ask for help when needed.
   PREPARE AN ONBOARDING SCHEDULE
                                                                           REEVALUATE EXPECTATIONS
   A schedule provides the new employee with structure and lets him
                                                                           Once the employee has been onboard for several weeks, managers
   or her know what to expect during the first days or weeks. It also
                                                                           may have to realign his or her tasks based on the individual’s
   provides the employee with knowledge of the job expectations by
                                                                           strengths. Managers may have to allow extra time and perhaps
   listing out tasks to complete daily. Typically, managers will provide
                                                                           provide additional training for some duties such as computer
   the schedule to the new employee before the start date to give
                                                                           classes.
   him or her an idea of what to expect.
                                                                           This is also a good opportunity for managers to assign duties
   The schedule may include meetings with each member on the
                                                                           to the new employee based on his or her strengths. This will
   team and other key employees the new hire will work with directly;
                                                                           maximize productivity and the employer’s return on investment.
   check in meetings with the supervisor; and maybe a team lunch to
   get to know one another.
                                                                           Preparing for a new employee may seem time consuming up
                                                                           front, but the hard work does pay off by helping the individual feel
   ASSIGN A MENTOR
                                                                           welcome and relaxed, developing the employee, and therefore
   A mentor (also known as the “buddy system”) can help the new            increasing the chance of retaining the new hire. Losing new
   employee feel connected to the job, coworkers, and the company,         employees and starting the hiring process over could be even
   so he or she can start building relationships with coworkers. A         more time consuming and costly to the company.
   mentor should not only help with learning job functions, but
   should teach the “corporate culture” which will help the new            http://links.e.jjkelleronline.com/servlet/MailView?ms=NDU1ODQ3M-
   employee feel connected to the company.                                 jkS1&r=Nzk0MjE3MTg0MTUS1&j=NDIxMDgzOTkyS0&mt=2&rj=NDIx-
                                                                           MDgzOTkyS0&rt=0
   PROVIDE CLEAR INSTRUCTIONS/TRAINING

   Instructions and training will allow the new employee to work
   independently and feel like a productive contributor. During
   training, priorities are usually established letting the employee
PA G E 7                                                                                                             FOR YOUR BENEFIT

   GET WELL FIRST
   By Jill Cueni-Cohen                                                       Therefore, “prevention is the best policy. Health and productivity
   April 1, 2014                                                             programs keep a workforce healthy and engaged,” she says,
                                                                             adding that research has found organizations that invest in health
   As a general rule, Americans are bred to be hard workers, even            strategies have 1.3 less absence days per 100 employees.
   when they’re sick. However, a recent study out of the San
   Francisco-based Integrated Benefits Institute shows the short-term        Research has also shown that people who have access to paid-
   productivity gains of working through illness could affect long-          leave policies heal faster and are ready to go when they come back
   term productivity costs.                                                  to work, says Jeff Hayes, study director for the Washington-based
                                                                             Institute for Women’s Policy Research.
   “The issue becomes problematic when you have people who are
   saying that when they’re ill, they go to work anyway and work a           “PTO policies are effective,” he says. “The evidence shows that you
   modified routine,” says Brian Gifford, senior research associate and      can save money when people are more likely to return to same
   one of the study’s co-authors.                                            employer, which provides long-term productivity benefits.”

   “We don’t know what their performance is like on the job,” he says,       Hayes says that recent IWPR research showed half of U.S. workers
   “but when they say they have too much work to do to take time             take “zero” hours of sick leave a year.
   off, [then] people aren’t taking care of their own health. If these
   are acute episodes related to a chronic illness and they don’t take       “They show up sick,” he says, “even people with access to paid sick
   time off to recuperate, they may be worsening the problem by              days. The median taken is three a year, and there’s little evidence
   causing a more serious illness, which could require longer-duration       that U.S. workers abuse this.”
   disability leave or even lead to early exit from the workforce.”
                                                                             This issue will become more acute when the employer mandate
   Flu symptoms aside, Gifford says issues -- including mental-              kicks in next year, says Rich Fuerstenberg, disability- and absence-
   health issues, back pain and other problems -- tend to lower job          management expert in the health and benefits business of
   performance.                                                              Washington-based Mercer.

   “Some people have chronic issues, and every day they’re                   “The cost of bringing in a substitute worker would not just be
   performing less and less, thinking that it’s not legitimate to take       about payroll costs,” he says. “If the strategy is to not allow people
   time off,” he says. “When people are working so hard that they’re         to work more than 30 hours a week, that creates more complexity
   not attending to their health, this causes long-term consequences.”       and more costs associated with that absence. This is an issue that
                                                                             needs to be on HR’s radar.”
   http://www.hreonline.com/images/76660843getwellfirstM.jpgTo
   combat this, HR leaders need to develop programs or structure             On-site clinics for companies in remote locations can help
   benefits in a way that allows an individual who’s truly ill to take the   employees with basic preventative care and physical therapy, says
   time they need to get better and not feel penalized, says Jackie          Fuerstenbeg.
   Reinberg, a senior consultant in Towers Watson’s Philadelphia
   office.                                                                   “This can impact more than healthcare costs, and telemedicine
                                                                             is another way of leveraging that capability,” he says. “Some
   Reinberg says sick leave gives workers the ability to demand              employers have even set up video conferencing and are
   discretionary time, but only a small amount of people are taking          integrating that into their disability programs.”
   it. Indeed, a recent Towers Watson survey found that, on average,
   people use between two and five days of sick leave a year.                Whether a medical issue is minor or major, preventative or
                                                                             manageable, he says, the disability vendor is someone the
   “Paid time off provides a no-fault way that makes it OK for               employee has to talk to, and that’s a teachable moment.
   employees to go home and get better,” she says.                           Employees should receive a call from a health coach who lets them
                                                                             know about programs that exist.
   And while flexible work schedules may prove helpful to sick
   workers in some industries, says Reinberg, it’s simply not possible
   for workers in industries such as manufacturing or retail.                Continued on page 8
PA G E 8                                                                                                            FOR YOUR BENEFIT

   Continued from page 7                                                    be at the office, and that includes when they’re ill. It starts with a
                                                                            culture that when people are sick, their health and their colleagues’
   “That’s the perfect time to get them into a management program,”         health comes first. Don’t bring illness into the office.”
   he says.
                                                                            He says the company’s PTO plan starts out generous and then
   Getting workers to buy into a health-management program                  “continues to increase” with an employee’s tenure.
   may be an easier task if the company’s culture supports such
   efforts from the get-go, says Matt Nagler, a managing partner of         “We don’t want people to feel that if they’re sick, then they can’t
   the Bedford, N.H.-based BANK W Holdings, which is the parent             take a vacation,” he says, “because it will limit their time off. We
   company of three specialized staffing firms and winner of                built our PTO policy to be generous without being over the top.
   numerous awards for workplace culture.                                   People don’t feel like taking that [sick] time will negatively affect
                                                                            them. This started with the culture and led to the policy.”
   “The overall culture of flexibility and people being invested in us as
   an organization started from the first day we opened our doors 10        When a new employee joins the organization, he says, “they
   years ago,” says Nagler. “One of the goals of our organization was       have to understand how they need to be here, and it needs to be
   that someone could have a long-term career here … . People who           reinforced.
   work here are able to grow and develop their career with us and
   stay with our organization and be productive.                            “Restrictive policy is what you learn, and it’s a hard habit to break.”
                                                                            he says. “But we say ‘If you come in sick and you’re unfocused, it’s
   “Relationship drives what we do, and there’s a huge value to that,”      better for you to take a few days and handle that issue than impact
   he says, “both for our team internally and externally with our           the company and other employees.’ Once they understand that,
   clients.”                                                                and they’re not looked down upon for taking time off, they get it.”

   Nagler says BANK W Holdings has a generous PTO policy because,           http://www.hreonline.com/HRE/view/story.jhtml?id=534356880
   he says, “in a very connected day and age, people feel pressure to
PA G E 9                                                                                                                          FOR YOUR BENEFIT

                               Benefit Controls Companies is the 7th largest U.S. Benefits Specialist,
                               according to Business Insurance magazine (July 2013).

                               We provide health and welfare consulting, insurance brokerage,
                               human resources consulting, wellness consulting, and strategic
                               planning for employers and employees across the country.

                               To learn more about how Benefit Controls can help you provide
                               employee benefits and wellness strategies that support your
                               business objectives, visit us at www.benefitcontrols.com.

   DISCLAIMER: This e-newsletter and the materials discussed in this newsletter are for informational purposes only and are not to be construed as tax or legal
   advice. Although the information has been gathered from reliable sources, we cannot and have not verified the accuracy of the materials published.
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