spotlight Providing insights and information on industry trends and developments.
Issue 3
Summer 2017
aTHEfDIAGNOSIS ter Discovering the Real Value of a Benefits Plan
PLUS: HCSA
Upcoming Changes to EI Parental Leave
Staying Ahead of the Game on Financial Wellness
When Disability Leads to Dismissal
Change Management
A Benefit Rescue Mission in Action
aTHEfDIAGNOSIS ter Discovering the Real Value of a Benefits Plan
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What goes through a person’s mind when a specialist delivers the results of medical tests?
What did Dr. Google deliver during the person’s internet surfing leading up to the appointment?
What did well-meaning but unqualified family and friends have to add—if they are even aware that something might be wrong?
And at what point did the words of the Doctor stop being heard after the worst-case scenario result was delivered?
As a life stressor, being diagnosed with cancer, multiple sclerosis, Crohn’s disease, rheumatoid arthritis, ALS, or any one of a number of life-impacting illnesses, can top the charts. A welldesigned employee benefit plan might not remove the stress, but it sure can help—and here’s how. Taking a second look Does your plan have a second opinion resource? Some insurers partner with other companies to include a resource that will help the patient gain access to a second medical opinion. Employers can independently add the service to their suite of employee benefit plan offerings as well as engage the services of a health care concierge, or patient advocate, to guide the patient through the journey. It can all add up Many people find out that the non-medical expenses associated with a medical event can be a drain on income. Critical Illness (CI) coverage pays a flat dollar amount that can be used to offset these out-of-pocket costs. The money can be used to pay for hospital parking, travel expenses, daycare fees, or to access medical treatment outside of Canada. It can even be used to check off a few bucket list items—the choice is yours. Not all CI plans are the same, so it’s important to check the fine print. Some will pay upon diagnosis, while others require a survivor period after diagnosis before payment is made. continued
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Don’t underestimate how an EFAP can help How can the Employee and Family Assistance Plan (EFAP) help? The goal of an EFAP is short-term, focused assistance with any stressor. The plan is available to both the employee/patient and their dependents and can offer help with coping skills. If co-workers find themselves struggling with a colleague’s illness, they may benefit from what an EFAP offers as well. The value of an EFAP should be well communicated to employees and their families. Getting a plan in place Not everyone will be absent from work while treating and learning to manage their disease, but some may need work accommodation from their employer. It is in the best interest of the patient/employee to be at work as much as medically possible. As an employer, you will need to consider if you will be able to accommodate this. If an employee is off for an extended period, is there short and long-term disability coverage available? Does your plan allow for an accumulation of days for the longterm disability qualifying period over an extended period? Income replacement while sick through an employer’s plan is possibly the second most important coverage item available to an employee. Redefining the plan design? The most important coverage item to an employee confronting a life changing diagnosis is the drug plan. We spend a lot of time debating the cost of medication at the expense of the value of the medication. Late last year we took a look at the wide reach of an employer’s drug spend http://www.williamsongroup. com/en/blog/wide-reach-employer-s-drug-spend, and how specialty medications are changing lives and keeping people at work. An even greater value is the cultural impact gained by providing a comprehensive drug plan. Comprehensive does not mean that everything is covered in the all-encompassing way that it once was. High frequency, low cost drug expenditure needs to be financially managed to allow for coverage of high cost, low frequency, insurance medications. The steps to do this have been available to employers for years and only recently have some— not all—actually been utilized. Employer drug spend stewardship still has tools waiting to be acted on if only the “employee experience fear” can be resolved. Support programs and preferred providers When an employee/patient is prescribed a specialty medication—i.e. one over $10,000 per year—it is almost certain that the drug will require prior authorization approval before payment. The drug will also likely be part of a patient support program sponsored by the pharmaceutical company. This support program aims to ease the burden of navigating the payment system for the patient/employee, and may be administered through a third party or managed directly through the manufacturer. Assistance to patients includes submitting prior authorizations, confirming coverage, accessing alternative sources of coverage and, if need be, accessing the pharmaceutical company’s financial assistance. The plan sponsor’s drug adjudicator should have a preferred provider network for the distribution—and possibly the delivery—of the medication. Some of these networks are voluntary or mandatory depending on the carrier. How these networks can impact an employee’s stress level—either positively or negatively—should be fully understood by an employer when assessing a carrier.
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If there will ever be a time when an employee will come to appreciate the real value of their employee benefits plan, it is when a life changing diagnosis is encountered.
Will your benefits plan be there to help? For more information regarding this article or for more information about how to get the most out of your benefit plan, please contact your Cowan/TWG consultant.
CONTRIBUTOR Noel MacKay Principal Consultant, National Benefits The Williamson Group 519-756-8830 x234 NMacKay@williamsongroup.com
HCSA—
Yea or Nay?
When discussing plan options with our clients, we are often asked about implementing Health Care Spending Accounts as an alternative to traditional benefits programs. A Health Care Spending Account (HCSA) is a pre-determined amount of money set aside by an employer for employees to use to offset the cost of eligible expenses. HCSA’s have traditionally been used as a “top-up” to benefits plans, but an increasing number of small businesses are opting out of traditional benefits programs and into the idea of providing an HCSA to employees in lieu of a formal health and dental plan.
The good news
Removing the actual “insurance” portion of a benefits plan transfers the potentially devastating impact of death, disability, critical illness, or high-cost health claims to your employees. And should they choose to purchase their own insurance, employees run the risk of not being able to secure insurance in cases of a pre-existing condition, or being charged a higher rate than what an employer could obtain through a group plan.
A happy medium? As with most things in life, there are benefits and drawbacks to simply offering a standalone HCSA to employees. The potential loss of core risk coverage is the primary reason why HCSA’s are commonly implemented as a top up to more traditional or catastrophic benefit offerings. How do you find a solution that works for you? The key is to stay informed. We would be happy to discuss the options in more detail with you—just ask.
HCSA’s are usually funded entirely by the employer. Employees access the account when they have an eligible claim, and the funds in the account are traditionally replenished annually. Employees can direct their allotted dollars towards the services and supplies they use the most, which translates into flexibility at no additional cost to them. The main advantage for employers, on the other hand, is the fixed capped cost in a standalone HCSA— the maximum amount that every employee can spend (plus applicable administration fees) is a known budgetary expense.
And the not-so-good news The biggest drawback to a standalone HCSA is that it can cut off coverage for those employees that may need it most. Implementing a maximum on the overall amount that employees can spend is a shift away from the fundamental reason that many employers offer benefits in the first place— to protect workers and their families when they need it most.
CONTRIBUTOR Lauren Tucker Consultant, National Benefits The Williamson Group 519-756-9560 x315 LTucker@williamsongroup.com
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UPCOMING CHANGES
to EI Parental Leave—Are You Ready? Earlier this year, the federal government announced the details of its 2017 Budget— Building A Strong Middle Class. Changes of particular interest to employers and human resources professionals include: Employment Insurance (EI) reforms, with more flexible maternity and parental benefits Changes to federally regulated employment standards under the Canada Labour Code, with flexible work arrangements, leave of absence provisions, and unpaid internships Employment-related tax reforms This article focuses on potential changes to EI maternity/parental leave, to which (as of the time of publication) no official start date has yet been announced. Under the existing EI benefit, parents can take a maximum of 15 weeks of maternity benefits and 35 weeks of parental benefits, for a total of 50 weeks of paid EI leave. These EI benefits are paid at a rate of 55 percent of average weekly earnings. Currently, pregnant women are entitled to EI maternity benefits starting up to eight weeks before their due date. The 35 weeks of Parental benefits can begin no earlier than the birth or adoption of the child. The 2017 Budget proposes to allow pregnant women to start EI maternity benefits up to 12 weeks before their due date, even though the total duration of the maternity leave benefits will not change. Parents will also have the option of choosing to take EI parental benefits over: An 18-month period (at 33 percent of average weekly earnings), OR To receive parental EI benefits at the current rate (55 % of average weekly earnings) over the current maximum 12-month period.
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To qualify, parents must accumulate 600 hours of insurable employment in the 12 months before taking the leave. This requirement will remain unchanged even though parents who have low-paying jobs, work part-time, or do freelance work, often already do not accumulate the necessary amount of hours to meet this criterion, and will thus remain ineligible. Critics of the budget suggest that its focus appears to be more on middle-income rather than on lower-income families in need of more support. Also of concern is that the approximate $550 million allotted for child care over the next four years is a decrease from the current daycare budget. When distributed between the provinces and territories—who are already spending $4.2 billion annually on regulated child care—the current budget only provides day care spaces for one in four children under the age of six.
Extended parental leave from an employer’s perspective A longer leave may benefit new parents, but business owners have mixed feelings about the government’s plan to extend the parental leave. From a benefits perspective, employers will need to carefully review the current terminology used in their top-up plans to ensure that proposed provisions do not result in an unintended increase in cost. But employers are also concerned about the burden of managing without an employee who will now be away for an additional six months. While there are a few exceptions, an employee must be reinstated back into the same or comparable position when they return to work, and employers will have to hold a position for a longer period of time. A major challenge for organizations is the time and
cost associated with hiring and training temporary staff, only to have to let them go when the new parent returns to work. There is also a downside for the employees filling these extended maternity/paternity contract positions, as they now may have to potentially wait an additional six months to secure permanent status and become eligible for paid vacation days and group benefits. With the rapidly changing pace of our Canadian work environment, the retraining and additional reintegration under the proposed legislation could carry a hefty price tag. However, with advanced planning and open communication between employers and employees, a majority of these hurdles can be overcome. Putting the complexities aside, the extended leave and its intended effect—more flexibility and options for new parents—will have a positive impact overall on Canadian families.
CONTRIBUTOR Louise Delic Senior Benefits Specialist, Client Partnerships Cowan Insurance Group 519-650-6364 x51414 louise.delic@cowangroup.ca
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Staying Ahead of the Game ON FINANCIAL WELLNESS
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Life is busy. Employers and employees strive for a healthy work/life balance, but as time efficient as we try to be, the days can be filled with wasted time. How can organizations ensure that the financial wellness information they provide to employees is relevant and not just more wasted time? Below are a few tips that will contribute to ensuring that the financial literacy education you are providing is hitting the mark. Have you ever wondered what information is most relevant to your employees? Why not go straight to the source and have them answer the question. By providing education that is relevant and in the appropriate format, you can save your organization time and money. Financial stress has been shown to be a leading factor in reduced productivity and increased absenteeism/presenteeism in the workplace. By providing the right information to help reduce the stresses that are unique to your team, you can accelerate the positive impacts of employee engagement and productivity. At the same time, you will be reminding members that your organization cares about their well-being and values their input.
And the survey says Surveys are an excellent way to determine areas of need and interest for your employees. Cowan Insurance Group has utilized surveys—electronically or in paper format—to determine which topics interest your staff the most. If you are concerned about a low response rate, consider offering a small prize where an employee gets entered into a draw if they complete the survey. A customized survey could list education session topics for employees to choose from, ask questions about how comfortable an employee feels with the plan or their investments, and drill down to determine areas of concern or need on general finances. You can also use a survey to determine what the preferred method of education may be for your group—face-to-face group sessions, workshops, written communications, or short videos. Identifying the preferred media is as critical as determining the right content.
The Cowan Financial Literacy Index In addition to surveys, Cowan Insurance Group has developed a Financial Literacy Tool—seven questions related to investments and financial planning—to help organizations gauge their level of financial literacy. Once the survey results are analyzed, the index can be used to develop targeted educational strategies that will meet the specific needs and interests of your team. Gone are the days of plan refreshers and irrelevant information just for the sake of checking off “education” from our to-do lists. Life—and work—are too busy for wasted time, so it’s important to take the time to find out what members want. If you are interested in rolling out a survey, or the Financial Literacy Index, in your organization, contact your consultant at Cowan/TWG for more information.
C O N TA C T Paul Webber Director & Principal Consultant Cowan Insurance Group 1-800-268-2628 x51654 paul.webber@cowangroup.ca
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Change is the one constant in life and nowhere can that be more apparent than in the workplace. If change is inevitable, why do we often try to resist it? This article takes a closer look at a few concepts that may help employers better understand—and ease—the impact of transition. The ability to cope with change is highly personal and is a result of temperament, state of mind, and past experiences. Many factors can affect the capacity to adjust to new circumstances and individual tolerance levels to cope. Among these is state of mind at the time of the change, as well as life events, emotional attachments, and personal challenges.
management. Fears of failure and the unknown are the main reasons that people resist change. Employees need to be aware that change is coming, but they also need details so they can understand the change and what its impact on them will be. Companies that share as little information as possible with staff often assume that announcing change will create anxiety. Surprisingly, however, the opposite is true, and in silence, people will draw their own, often incorrect, conclusions. Transparency fosters trust. With ample time and space allotted for reaction and questions, the more that employees are kept informed, the more in control they will feel. Most importantly, however, people need to be encouraged to believe that they can be successful with the change.
Change Management
When planning transition, employers should first carefully assess people’s readiness for change. Organizations will often be cognizant of their end goals but forget to look at the starting Easing the Impact point. Assessing the current situation can help employers decide on the best path to take to get to the end result. And sometimes that path will need to be adapted for everyone to get to the same destination. Change may create excitement for some people, but for the vast majority, it elicits anxiety and insecurity. A fundamental way to support employees who are experiencing change is to normalize their stress and recognize it. There are many approaches to change, and they can all be helpful when planning for, and going through, change. Kotter’s 8-Step Change Model, GE’s model of 7 strategic steps, Mento’s model, and Shields for example. What all of these approaches have in common is communication. A well thought out communication plan is the key to successful change
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Another way to manage change and gain support is to identify early adopters. They are the individuals who are eager and excited by change and can represent twenty percent of your employees. Excitement is contagious and early adopters can have a significant influence on others.
of Transitional Times
As employers, we all recognize that change is necessary, but we also need to ensure we do not lose focus on the impact that change can have on the entire organization. Everyone involved will have their reaction and adjustment period. The impact of change can be managed with effective communication, careful timing, and a positive outlook. With effective change management, transitions can be implemented effectively and efficiently.
When Disability Leads to Dismissal
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Terminating an employee is never easy—dismissing an employee who is on long-term disability leave can be one of the most complicated and difficult situations that an employer can face.
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s an employer, are you aware of the options you have when an employee no longer meets the definition of disability outlined in your policy? Every long-term disability policy includes a clearly outlined definition of disability. Insurance carriers will require an employee to demonstrate their inability to perform the job for which they were hired—or the job in which they were engaged at the time of disability—in order to remain eligible to receive the benefit. The “own occupation” period may last up to two years, depending on the terms of the specific policy, and may include work accommodation. Once the “own occupation” period is up, the employee will be required to satisfy the “any occupation” definition. When reviewing “any occupation” eligibility, carriers will typically take into account an employee’s medical condition, age, education, training, and experience—as well as their ability to secure employment that would equal the percentage of remuneration under the disability benefit.
Does a long-term disability claim ever end? Any of the following circumstances can terminate a long-term disability claim. The employee no longer meets the definition of disability. The employee no longer meets the “any occupation” definition, typically at the two-year mark. The long-term disability maximum benefit period has been reached. An employee may request to return to their pre-existing role—or to any other position with the same employer—if any of these situations occur. In Canada, when an employee requests to return to work following the loss of longterm disability benefits, employers must take specific steps to determine if the request can be accommodated. The duty to accommodate is established in the Human Rights Code of each province, as well as by the Government of Canada. Ontario also has AODA (Accessibility for Ontarians with Disabilities Act) legislation in place. Every employer has a legal responsibility to accept an employee’s request for accommodation in good faith; this requires
the employee to provide their medically necessary restrictions and limitations for the type of work they are requesting. If work accommodation is available and accepted, the employee can be reintegrated in the workforce. If the employer can prove undue hardship under the law and declines the work accommodation, however, they then have the further option of ending the employment relationship. If this occurs, the employer must follow employment standards regulations regarding notice and severance, which need to be upheld in order to comply with frustration of employment regulations.
Successful disability leaves management You can manage an employee’s leave while staying on top of their return-to-work status and ongoing progress by following these tips. Communication is key. Implement a communication protocol with your carrier to notify you on a regular basis of the claim status and/or any changes in writing. Keep detailed written records of all interactions with the employee, and regarding the disability leave. Ensure that all communication is made in writing for documentation and for future reference. Ask the right questions. If the employee is involved with the carrier’s rehabilitation team, what is the purpose of the rehabilitation? Does it focus on a predisability return to work? Or is it retraining the employee for an alternate occupation? If the employee is not participating, take steps to understand why not. Familiarize yourself with the details. Confirm that CPP benefits have been applied for and whether they have been approved. Determine if there was a carrier buy-out, which is typically a lump-sum payment—the offer of the lump-sum payment should include the termination of employment.
Stay on top of status. Maintain regular scheduled updates with the disabled employee throughout the entire claim period to confirm status and their desire to return to work. Document your meetings with a summary letter to the employee. Be prepared. If the employee is not likely to meet the “any occupation” definition, schedule meetings with the employee six months in advance of the carrier’s decision, to determine if they will return to work, and under what circumstances. This will help with planning an accommodation request. Once again, make sure that all communication with the employee is made in writing. Review and update your employment policies. Ensure that a loss of employment provision is established in the company policy. This helps employees understand their return-to-work opportunities. Our Disability Management team recommends a period of 36 months, which is in line with frustration of employment regulations and practices. Employees should be reminded of this policy—as well as of the schedule of meetings and updates that will be expected—at the commencement of the disability claim. This is also a good time to remind employees about accommodation requests for return-to-work planning, and the process to be followed as noted above. Following these steps can help prepare an employee for their return to work, and help protect your organization from the legal challenges that terminating an employee who has been on medical leave can pose. However, always be sure to seek advice from your legal team when handling any potentially complex employment situation.
For recommendations on this, or any disability management-related matter, contact our Return to Health® and Disability Management specialists.
CONTRIBUTOR Catherine Vandenberg Manager, Return to Health, Health, Disability & Wellness The Williamson Group 519-756-8830 x229 CVandenberg@williamsongroup.com
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A BENEFITS
IN ACTION
For a company that has many benefit decisions to make globally—with overlapping renewal dates in numerous countries—once decisions are made, and renewals are finalized, the case is typically closed. But imagine learning that you need a new consultant just six months into your benefits year. Which was exactly the challenging situation that one of The Williamson Group—A Cowan Company’s US-based clients suddenly found themselves facing in 2016, after losing confidence and trust in their global benefits consultant earlier that year. The organization needed new representation, fast. As soon as they made their need for a new Canadian group benefits consulting representative known, our Asinta Partners quickly stepped in to meet the company’s needs and to offer peace of mind, with sensitivity and tact. 13
CASE STUDY “ Relationship is key—understanding a client’s needs through open communication and following through to deliver on the expectations is what forges superior long-term client relationships, and builds the trust needed to have comfort and confidence in the global marketplace.” Jacquie Fritsch, Senior Consultant, International Practice
“The decision to make a move to a new consulting firm was sudden, with a pressing need for immediate action. After meeting Jacquie Fritsch at the Asinta Conference in San Francisco—face-to-face, as well as through previous discussions—I was more than willing to make that move. The team at The Williamson Group was nimble enough to process all the necessary contractual arrangements that made the move swift and comfortable. The strong relationships developed from the onset have been further solidified by a strong team approach, meticulous attention to detail, and an ability to translate our benefit needs into clear and concise communications, directed to our employees. I have been delighted with the decision and continue to work with Jacquie and the TWG team in my new role at a new organization.” Rachel Frazier—Senior Global Benefits Manager
Putting out the fire
Once the air cleared
Through the Asinta partnership, the company’s Senior Global Manager, Rachel Frazier, had been introduced in 2015 to Jacquie Fritsch, Global Consultant for The Williamson Group. The timing, however, had not been quite right for a consultant change in Canada.
After things settled down, Jacquie and Mark took the time to talk to Rachel and get a better sense of what she really wanted her Canadian benefits offering to communicate to her employees. The organization’s corporate environment was progressive and high-tech, and in direct competition with the likes of Google and Facebook.
But just a few days after the company’s need for a new advisor surfaced, Jacquie had the opportunity to cross paths with Rachel again at an employee benefits event in San Francisco. Our US Asinta Partner, Mark Juneau, Alliant’s VP and Director of Global Benefits Consulting—and the client’s homeland benefits consultant—re-introduced the two women and brought to light the true value that an Asinta Partnership can offer. Jacquie took charge of the situation and helped the company get their Canadian benefits program back on track by the end of the month—which meant a ten-businessday turnaround. This included terminating the client’s relationship with their previous benefits consultant on the client’s behalf. Plan amendments and compliance, as well as client/employee education, were all brought back on track, and a number of neglected policies were reanalyzed and renegotiated. The TWG team fulfilled all deliverables accurately and on time, allowing the client to refocus their energies on their US plan.
With her challenging conversations and unique insights and perspectives about global benefits, Jacquie was able to give the client new ideas on how to meet their needs and manage costs, while still maintaining plan flexibility. Jacquie also ensured that the smaller Canadian employee segment was treated with the same importance given to the much larger US contingent, making the global benefits program fair and equitable for all employees internationally. We were excited to continue working with this client and to continue the relationship with Rachel, who has moved to another tech firm and brought The Williamson Group and Jacquie’s team along with her.
C O N TA C T Jacquie Fritsch Senior Consultant, International Practice The Williamson Group 519-756-8830 x238 JFritsch@williamsongroup.com
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