Wellness Program A to Z

In the last few years, there’s been a lot of publicity about the fast-growing crime of identity theft. Greater than half happen in the workplace. Benefits and compensation files are the most vulnerable targets.

The scariest part -  Victims of benefits-related ID theft often make out worse than those who fall prey to the more common variety.  The bad guys are ahead of investigators after such thefts occur, and are often very good at covering their tracks.

Additionally, because benefits ID-theft is a relatively new kind of crime, there’s no well-established system for victims, plan sponsors and vendors to set things straight after the fact.

401(k) accounts a prime target

Not surprisingly, employees’ 401(k) accounts have become the main target for benefits thieves.  An alarming MSNBC news report showed just how easy it could be for thieves to tap into an employee’s 401(k) accounts - If an web-based account gets hacked into or account paperwork falls into the wrong hands, it takes only a few mouse clicks to wipe out the victim’s retirement savings.

With typical credit-card or bank account fraud, victims need only call their card issuer or bank, report the crime and refuse to pay for an item. But 401(k) theft is much, much harder to resolve.

Three enormous obstacles -

1. Money in 401(k) accounts is not federally insured, like a bank account.

2. 401(k) accounts rarely â.” when ever â.” come with automatic identity theft protection from the vendor, like credit cards.

3. Even when the theft is successfully resolved, the situation becomes an ERISA nightmare for plan sponsors, because your company also has to account for the way the theft affected the growth of the employee’s account before the money was restored.

A lot of EAPS fall into a common - and hazardous - category -  Management thinks the program is excellent, but staff members think it’s a waste. But it doesn’t have to be that way when you have an EAP or are considering one.

Seventy-three percent of all firms (59 percent of small employers) have an EAP. But how well does the typical employee assistance program work? Not as well as we’d hope. A Mid America Coalition on Health Care study found -

o  just 50% of 6,400 employees surveyed said they’d use the EAP when 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 employees with a short, confidential attitude survey.

Objectives -  Ask staff 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 workplace performance and/or safety. In the final section, figure out how staff would handle a serious personal issue.

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

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

2. Promote employee assistance program (EAP) through education

Your survey data ought to help you pinpoint areas where workers 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’s potential mental health issues.

o  Worker newsletter. If you have a benefits newsletter, spotlight the EAP from time to time. A number of organizations without newsletters have done e-mail campaigns or targeted mailings instead.

o  Worksite 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 contact info.

Need help locating educational material? There’s lots of free EAP-related brochures and FAQs here. Do not forget -  When doing employee assistance program (EAP) education, constantly remind staff members that the program is strictly confidential.

3. Be certain to work with supervisors

For legal reasons, supervisors need to tread carefully when they suspect an employee 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 is 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 employee gets hurt in a worksite accident he or she caused. After the fact, the employee is diagnosed with a mood disorder that previously escaped detection by the employee’s physician.

Under current regs, health insurance portability and accountability act (HIPAA)-covered plans can’t deny benefits. This puts employers 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 corporations, having a strong EAP is one of your best compliance tools.

For a lot of personnel, 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% 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 develop incentives for corporations 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 employers offering full-time telecommuting has dropped in recent years.  Nowadays, only about 20% to 25% of employers offer the benefit year-round.

Even some national companys that are well-known for their telecommuting programs have scaled back. AT&T, for instance, recently asked several 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 staff members. Why the cutbacks?

Staff Member Assistance Program - Pros and cons

Offering employees telecommuting or flex-time can be a good recruiting and morale-improveing tool, as well as a way to retain employees 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 corporations give for scaling back or eliminating them -

o  Business culture - It’s easier to build a sense of organizational stability and an individual connection between employees, peers and supervisors when people  interact face-to-face on a daily basis.

o  Security - One of the hidden costs of allowing personnel 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 - A lot of supervisors find it easier to ensure high productivity when everyone is working under one roof at the same time.  There’s also a widespread view that most workers 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 such as flex-time and telecommuting remain a useful benefit to offer employees, and a lot of corporations 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 company creates objective criteria for authorizing or denying flex/telecommuting requests, such programs can actually damage morale.

The last thing any corporation 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.

In the near future, the federal government may offer help to businesss looking to begin a health promotion program.  The help would take the form of tax breaks to offset health promotion program costs.

A current USA  Senate bill would give companys a substantial tax break for starting wellness programs. Dubbed the Healthy Workforce Act, it calls for an company tax credit of up to $200 per staff member enrolled in a newly created wellness program.

For bigger firms, there’s the $200 credit for the first 200 staff and up to $100 per staff member thereafter.  To qualify for the full credit, your wellness program would’ve to feature -

o  health risk assessments

o  staff member education drives (e.g., targeted mailings, online tools)

o  behavior modification programs (e.g., use of tobacco cessation, weight management, wellness Coaches), and

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

Certified companys would be able to claim the tax credit for up to 10 years after beginning a wellness 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 corporation already has a formal wellness program, there are proven ways to make wellness part of the corporation 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 corporation. Reason - Staff Members select up fast on whether executive management practices what it preaches when it comes to wellness.

If the individuals  in upper-level management are smokers, obese or simply reluctant to talk about health issues, it’s a tough sell to get workforce 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 generally go first, in order to break the ice about discussing some potentially sensitive issues like dieting or quitting tobacco use.

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

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

A number of companies 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, everyone at the firm â.” from seasoned managers to the newest hires â.” comes in to get weighed.  The only one who sees the number on the scale is the person 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 workforce undergo robust 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 workers 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.

In truth, 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 option.

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 people  exploring high-deductible plans ask first about the non-HSA, so insurance companies sometimes slash prices to drum up interest in those options, 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 for 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.

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

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

If your company has this common â.” and increasingly well-liked â.” fringe benefit you may be at legal risk without even knowing it.

A lot of businesses have an onsite employee fitness room as part of a formal wellness 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, organizations with fitness rooms need to be aware that the benefit isn’t risk-free.

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

Some legal experts have expressed concern that companys could also be at risk when the unthinkable happened on corporation premises while an worker 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 anybody, anywhere, anytime. It occurs more than 600 times every day in the United States, killing at least 250,000 people  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 quickly trained to use an AED â.” you don’t need any medical knowledge to use it.  The training could be obtained 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 workplace fitness room, and it’s a no-brainer that any company with on-site workout equipment should at least investigate an AED purchase and training.

Employees, supervisors and upper-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 when you’ve access to one, there’s a good chance to save an employee’s life.  And it’s easy to teach supervisors and employees how to use the device when it’s ever needed.

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

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

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

On the positive side, voluntary benefits cost employers next to nothing, yet boost employees’ morale and benefits satisfaction.  An Aon survey found 77 percent of organizations offer at least one voluntary benefit.

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

In many cases, businesss 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 business.

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

If push comes to shove, the providers will protect themselves. Indeed, some attorneys warn that a voluntary plan insurer’s first move if sued by one of your employees are going to be to attempt 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 employees about the new voluntary benefit, and

o  getting involved if there’s a dispute between an employee and the plan provider.

Be careful with announcements When you offer a new voluntary benefit, the natural tendency is to try to get workers pumped up to participate. But you are able to 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), main health plan, etc.).

Furthermore, if the vendor offering the voluntary plan has competitors, you might want to remind workers the vendor of the voluntary plan isn’t the only game in town. Some firms pass along lists of competing vendors.

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 can 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 perilous voluntary plan design is one that is partially compensated by the corporation, even if workforce pay the bulk of the cost.

In a major ruling a few years ago (Burgess v. Cigna Life Insurance), a USA  district court ruled against an company with a voluntary supplemental disability plan in which the firm compensated a portion of premiums for its lower-compensated workers.

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

In the last few years, “presenteeism” has become an even bigger concern for many businesss than absenteeism. Even though many HR/benefits managers hate the admittedly overused term, presenteeism is notwithstanding a real issue in nearly every worksite.

Most widely,  presenteeism takes the form of staff members coming to work sick. They’re  unproductive and endanger coworkers. Meanwhile, the employee isn’t forced to use a sick day. A bad deal for employers all the way around.

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

Troubling rationales

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

o  It’s too risky, due to office politics or culture, to take time off (26%)

o  The worker 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 workforce 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 workforce getting sick.

You have more power than you think to change your business culture if the “tough it out” mentality still applies to people  who come in sick. When upper management is confronted with the real dollars and cents of presenteeism, lowering the problem generally 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 â.” as evidenced by the survey â.” of staff members 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 time are the three most common ways of lowering 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.

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

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

Affects health risks

Different racial and ethnic groups tend to be more at risk â.” for genetic and/or cultural reasons â.” 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 illness than other groups.  The HIV/AIDS population is also disproportionately Hispanic.

Bottom line -  By reviewing  the ethnic breakdown of your employee population, you can set disease management (DM) program priorities with greater confidence and accuracy.

Health Care quality an issue

Several studies also show there’s an unfortunate relationship between ethnicity and quality of healthcare. Many times, minority workforce 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 doctors in the network for your Latino staff members. But the result is ordinarily higher healthcare costs for you and, often,  greater reluctance among minority staff members to seek needed treatments.

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

Almost two-thirds of organizations with health promotion programs offer personnel incentives â.” financial or otherwise â.” 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 â.” 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 may affect any worker, 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 â.” such as mammograms â.” are well worth the cost.

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

Smart staff member health promotion incentives

HIPAA has tricky non-discrimination rules for offering staff members a break on premiums or copays. You needn’t worry about health insurance portability and accountability act (HIPAA) when you -

1. Structure the wellness program as a cost-break for personnel who embrace wellness. on the flip side, imposing surcharges for uncooperative personnel can force you to jump through HIPAA hoops.

2. Make the incentive available to all workers. for example, when you offer a discount to non-smokers, an employee who recently quit use of tobacco must also be eligible.

3. Allow workforce 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? When they’re done right, yes.

Firms offering monetary rewards for wellness normally save about $20 to $50 a month, according to some estimates.

Making wellness programs simple

Many firms require personnel to work with a personal “wellness Coach” in order to earn premium discounts or other incentives. Usually, the worker sets up appointments and reports to the wellness coach on a regular basis, either by phone or in person.

The good news -  the early results are often stimulating.

The bad news -  Once workforce 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.

Health Promotion begins upstairs

No matter how much money your organization 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 employees will buy into a smoking cessation program.

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