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Karen Ackley is Vice President, specializing in Employee Benefit Consultation, at Bolton & Company Insurance Br-ok ers. She has expertise in various aspects of the insurance industry in her more than 20 years of industry involvement. Karen's primary emphasis is in the medium-to-large size employer arena, providing consultation in all areas of employee benefits. Nationally, Consumer Directed Health Plans (CDHP) represent a small but ever-increasing share of the healthcare insurance market, however, it remains a rarity in California—a state that typically leads the nation in new healthcare strategies. What is a CDHP?
Pricing Insurance providers Tax savings Recent HSA improvements Controversies and challenges Critics also question whether CDHP’s can contain healthcare costs and utilization, without discouraging consumers from seeking needed care. Conversely, recent studies indicate the opposite is true. According to Cigna’s year-long study, most CDHP participants are becoming more cost conscious, benefit financially from their plans and are still getting appropriate care. The rate for preventive care use was higher for CDHP’s than traditional plan participants. This isn’t surprising since most consumer-directed plans waive the deductible for preventive care, and these plans often provide financial incentives for consumers to enroll in disease management programs, health-risk appraisals, and wellness initiatives. A study just released by the Employee Benefits Research Institute and the Commonwealth Fund found that many of the consumers insured by CDHP’s can't afford to fund the health savings accounts that make these high-deductible plans work. Only 20% of employees enroll when there is no contribution from employers. These findings hint at disturbing trends that may risk the success of their HSA if the employer under funds the plan. Impact on California In summary Although the advantages of HRA’s and HSA’s can be significant, employers will want to do their homework prior to setting them up. The type of consumer directed health plan that best fits your organization will depend on your corporate structure, the accompanying administrative requirements and the overall objectives of your group health insurance plan. While supporters and cynics continue to debate whether these plans are really working, they offer an intriguing option for increasing the efficiency of healthcare and reducing health care costs. Time will tell whether these products will relieve California employers’ healthcare woes. (Editor’s Note: Bolton & Company is one of Employers Group’s preferred partners for insurance services. For more information or to reach the author of this article, contact Katherin Scott, kscott@employersgroup.com.) |
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Diana B. Henderson is the founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm. She has worked in both the corporate and service provider communities over her 25-year career. In the past five years, there have been numerous reforms to California’s workers’ compensation system. By virtue of these reforms, chances are that you have been experiencing dramatic decreases in the cost of your workers’ compensation insurance. The time is now for you to take advantage of these cost savings and reforms, developing good habits that will stand the test of time and assist in riding out any future wave of premium increases. The following is a summary of tips for impacting your workers’ compensation bottom line. Timely reporting
By providing adequate and accurate information immediately at the time of reporting, you can assist the claims handler in adjusting the claim and providing the appropriate benefits to the injured worker. In order to properly calculate compensation rates, timely and accurate wage statements should be provided to the claims handler. This will minimize the potential for either the under-payment or overpayment of benefits. Employers who complete internal investigation documents such as incident/accident reports and employee accident statements and send these documents to the claims handler are providing invaluable assistance in the adjusting of the claim. Questionable claims need immediate attention so that the investigation activities can be completed within the 90-day window for making a compensability decision. The employer’s date of knowledge is the trigger for the 90-day clock to begin. It can be knowledge from any source; the employee, a family member, a physician, or even an attorney. Immediate reporting of these questionable claims is also imperative. Take control Employees do have the right to pre-designate their own personal physician thereby taking control of their own medical treatment. In addition, those employees who work for employers who do not utilize the MPN process will also have the right to pre-notice their employer of their desire to utilize a chiropractor or acupuncturist for medical care. The right to pre-designate and/or pre-notice was to have expired on April 30, 2007, however AB 2068 signed by Gov. Schwarzenegger on September 30, 2006 has extended this right to December 31, 2009 and has repealed the limit on the maximum percentage of employees that may pre-designate. Whether you control medical treatment for only 30 days or for the life of the claim through the MPN process, you do have some basic and simple regulatory requirements to follow in order to assert and maintain such medical control. These can be found in the California Code of Regulations, 8 CCR §9880. The first requirement is to ensure that you display the requisite informational posters and, second, to distribute required pamphlets. The poster entitled “Notice to Employees -Injuries Caused by Work“ must be posted in a conspicuous place frequented by all employees. The California Division of Workers’ Compensation (DWC) has an English and Spanish version that can be downloaded and printed from this website link: http://www.dir.ca.gov/dwc/DWCProp-Regs/ClaimForm_Poster%20_Final.doc AB749, effective January 1, 2003, requires that all employers provide information regarding workers’ compensation benefits to their new hires. You can easily fulfill this requirement via a pamphlet entitled “Facts About Workers’ Compensation,” published by the California Workers’ Compensation Institute and approved by the DWC. This information must be provided no later than end of the new hires’ first pay period. Your insurance carrier or claims administrator may also be able to provide these documents to you. Just remember, absent the requisite poster and pamphlet, even the most basic form of medical control is lost. Return to work If you employ 50 or fewer full time employees, beginning August 18, 2006, the DWC may reimburse you for the cost of new tools, equipment, furniture or modifications made in order to bring an injured worker back to temporary modified or permanent modified/alternative work. This reimbursement incentive can be as much as $1,250 for the cost of temporary work modifications and up to $2,500 for permanent work modifications (less any amount previously paid). The rebate form can be found on this website link: www.dir.ca.gov/dwc/forms/DWC_AD-10005_August2006.pdf If you employ more than 50 full time employees, the cost of a claim can be impacted either negatively or positively depending upon the ability to offer a return-to-work opportunity for a worker injured on or after January 1, 2005. This is done via a 15% reduction or a 15% increase for each payment of permanent disability indemnity. The reduction is applied if return to work is offered. Conversely, the increase is applied if return to work is unavailable and/or NOT offered. Time is of the essence in making a return to work decision and must be made within 60 days of the employee reaching a permanent and stationary status (also referred to as Maximum Medical Improvement). Stay engaged and connected (Editor’s note: For information about Diana’s consulting/training services, contact Employers Group’s Vice President of Consulting Services, Leslie Hollis, at 800-748-8484 or lhollis@employersgroup.com.) |
Understanding Experience Modification Rates If workers’ compensation rates are going down, why are my premiums going up? We asked EG’s insurance partner Bolton & Company to explain the role that experience modification rates play. Workers’ compensation costs are based on your payroll, your classification, and your experience modification. The wild card in the equation for 2007 is the way the experience modification is calculated. If you’ve ever seen your Experience Modification Worksheet (you and your broker should be reviewing this worksheet annually), it is made up of the data that will determine the experience modification for the upcoming policy year. The worksheet shows the reported payroll, the claims experience, and the Workers’ Compensation Insurance Rating Bureau’s (WCIRB) factors that determine your experience modification. For the 2007 experience modifications, the policy years that will be used will be 2005, 2004 and 2003. The “factor” that will have the most dramatic impact on 2007 experience modifications as compared to 2006 is the “Expected Loss Rate.” The Expected Loss Rate represents the average losses per $100 of payroll estimated for the renewing policy year for employers within the same classification category. As a result of legislative reforms, the “expected losses” (and the ELR factor) will be lower and therefore mathematically, any claims within the reporting period will have a more substantial impact on the modification, as compared to 2006. In a recent review, we compared the impact of the Expected Loss Rate factors against a number of companies’ modifications. When the 2006 Expected Loss Rate factor was compared to the 2007 Expected Loss Rate (using the same payrolls and claim information), we saw a difference (increase) of 10%-17% in the experience modification! For many businesses that have struggled with managing their claim history, this increase in the modifications will likely be more than any decrease in a classification’s rate. Of course, if you have managed your safety program, claims administration and have seen the benefits of the reforms, this change in the Expected Loss Rate shouldn’t have a significant impact on your experience modification. But, if your claims frequency hasn’t changed, the change in the calculation factors will have a significant impact on the price of your Workers’ Compensation coverage. It is important to recognize that while we do not have control over the fluctuations in Workers’ Comp rates or the WCIRB rating factors, we do have control over our safety program and the management of the existing open claims. This is the area that all businesses (with the help of their insurance broker) should focus their attention on and allocate the resources to first try and prevent accidents, but if an accident does occur, manage the claim process until the claim is closed. (Editor’s Note: If you have any questions, you can reach Bolton & Company by contacting Katherin Scott at EG, kscott@employersgroup.com,(213) 765-3949.) |
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Herbert M. Greenberg, Ph.D. is the founder, president and CEO of Caliper, an international management consulting firm. A recognized authority on the relationship between personality and job performance, Dr. Greenberg developed the Caliper Profile, a proprietary personality assessment that identifies the potential, motivations and strengths of applicants and employees. Over the past four decades, Caliper has assessed the management, sales and service potential of more than two million individuals for more than 25,000 companies around the world. How often, after hiring someone who does not work out, have you thought to yourself, “But they seemed so good in the interview?” While interviews can provide valuable input during the hiring process, they often confuse as much as clarify. Part of the problem is the inherent limitation of interviews. Instead of lending insight, interviews can often become a form of theatre in which all of the actors are tripping over one another, trying to put their best feet forward. The employers are busy attempting to leave a favorable impression of themselves and of their company, while the applicants are trying to mold themselves into whatever they perceive is desired. Meanwhile, it must be kept in mind that any bookstore worth its salt has a shelf full of guides for playing this game to the hilt. And anyone serious about applying for a job has read at least one of these guides. Getting below the surface A first step is to conduct a personality assessment, which can provide insights into an individual's strengths, limitations and motivations. For example, a comprehensive, in-depth personality assessment can provide insight to whether someone is assertive, confident and a self-starter. It can also tell you if the individual you’re considering has the relationship-building skills, problem-solving capabilities, and work ethic necessary for success in your organization. As one client puts it, “Personality testing gives me a six-month head start in really knowing who I’m hiring.” Second, and equally important, is to compile a list of the key attributes that are going to be required for the individual to succeed in the job, and to work effectively with their manager. For instance, for a sales position, persuasiveness, service-orientation, independence, reasoning ability, empathy, and the ability to bounce back from rejection are increasingly important as customers seek quality. Once these attributes are identified, develop some questions that will help you determine the extent to which each applicant possesses these traits and if they can effectively make use of them in the job at hand. Identifying traits through effective interviewing In assessing an individual’s problem solving and decision making abilities, ask, “If you could change a policy at your present company, what would it be?” Ask them what are the easiest kinds of decisions to make? What are the hardest? Then, again, listen. There are many other questions to pursue to help assess an individual's level of independence, initiative, sales skills, caution, energy, leadership, organizational ability, communication skills, ability to follow directions, and service orientation. These questions can be windows into an individual's personality. Coupled with the findings from a valid personality test, an effective interview can provide you with an accurate read on an individual's motivations - before you bring them on board. Conclusion (Editor’s Note: Employers Group has partnered with Caliper to provide its assessment services to our members. For more information, contact Katherin Scott at Employers Group, 213.765.3949, or email kscott@employersgroup.com.) |
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By Mark Nelson, J.D., Helpline Consultant When does an employee’s behavior compel you to consider the possibility of workplace violence? The short answer is: whenever the thought is more than a fleeting one. That declaration may sound like an overstatement and perhaps it is. But the obvious concern is that when you witness behavior that is inappropriate enough to give you or anyone pause, you ignore those incidents at your peril. In other words, trust your instincts when they tell you something is not right. One very important qualification when calling out any abnormal behavior is, of course, when it signals a potential disability. Keep in mind, however, even disability law takes exception to behavior that presents a direct threat to the health and safety of your employees. When you’re called on to investigate behavior that an employee found disturbing, investigate the behavior; don’t “armchair” diagnose any imagined underlying conditions. If an employee puts you on notice of a disability that requires accommodation, have the employee clarify any restrictions via a doctor’s note and follow the interactive process afforded individuals under disability law. Thus, even if the behavior leads you to suspect an employee has a mental disability, invite them to draw the connection between the behavior and medical condition, but don’t make the connection for them. Implement a zero-tolerance policy with clearly defined complaint procedures Train your supervisors to know what to look for and how to respond Make criminal background checks part of the hiring process Carefully investigate all allegations of suspect behavior If you are dealing solely with an employee’s (well-founded) hunch, there may be little you can actually investigate but a lot that concerns you; consult legal counsel, as indicated below. If you think an individual may become combative during questioning, have security measures in place before you call in the individual. When to involve legal counsel, the authorities or outside specialists If the actions made someone uncomfortable enough to complain, they warrant your time. That said, intervening without sufficient grounds can lead to significant problems (e.g., defamation, “regarded as disabled” claims, etc.). Your legal counsel, in concert with a workplace violence specialist, can tell what can and should be done. (Editor’s Note: Employers Group offers an online training course on How to Recognize and Prevent Workplace Violence, as well as a public training workshop on “Workplace Security.” For more information about these courses, email training@employersgroup.com.) |
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By Jennifer Shin, Research Marketing & Communications Coordinator Any intelligent employer knows that as the heart and soul of a business, good em-ployees are essential. Consequently, hiring and retaining good employees is a challenge that all employers face. However, as many businesses are looking to become more competitive by expanding their operations in 2007, retaining and recruiting good employees has, for many employers, moved from difficult to nearly hopeless. Some signs your workers are ready to jump ship So what are some signs that your employees might be ready to leave? Here are some key signs your employees are looking for a new job:
Benefits and work/life balance play a huge part in retention and recruitment Consequently, with numbers showing that a majority of employees are dissatisfied with their benefits package, there’s little surprise that employers are reassessing their benefits and compensation packages, as well as increasing their recruitment efforts for 2007. According to Employers Group’s 2007 Human Resources Practices and Benefits Survey (HRPBS) providing career-development opportunities and well-being benefits are among the best employee retention strategies. For example, 35.6 percent of employers claim that in 2007 they will offer flex time compared to the 32.7 reported in 2005, while employee education assistance programs also continue to become more popular among employers, rising from to 64.8 percent for production, service and maintenance employees from 64.1 percent in 2005. Some questions are too costly not to ask About Employers Group surveys Topics include:
For more survey information or benefits questions, please call us at 213.765.3935 or email: surveys@employersgroup.com. |