Benefits Buzz

Benefit Jobs From Hell - The LOA Administrator

By now, readers of the Capitalist know that I am a HR Generalist, meaning I do it all - recruit, employee relations, benefits, performance management, etc.   I'm also a firm believer that Generalist roles span the globe of HR titles - Generalists can be found at the Rep/individual contributor, manager, director and VP levels.

One of the things that is cool about being a HR Generalist is the variety - if you're sick of doing one thing, you just need to wait about 20 minutes, because you'll get a call shifting your priorities to another area as a routine course of business.

Some people call it chaos, I call it variety...

So, for me, a HR job from hell is one that includes no variety, and resides in an area of the HR practice where little joy is found.  Here's my first HR Job from Hell - the corporate Leave of Absence Administrator.

First up, let me say that me tagging the LOA Administrator as a job from hell has nothing to do with the people in the job, but instead has everything to do with what these folks have to put up with on a daily basis.  As luck would have it, a fellow HR pro is currently in the job market:

"I had a phone screen yesterday that went ok. It was for the Leave of Absence Specialist. Get this: the organization has 15,000 employees. Guess how many NEW leave of absence cases were processed last year? 4,400. That is almost a 1/3 of their workforce, yo! Geez. Anyhow the in person interviews aren't until a few weeks from now due to vacations. So, we'll see".

UGH.  That pretty much sums up why I would consider the LOA Administer role as a HR role from Dante's 9th circle.  Here's what you have to deal with in that role:

-Primary focus is interacting with folks going through very rough times.  For the right person, this would be a plus, as they could use their empathy to make a difference.  But a steady diet of this over years surely leads to burnout.

-Being the tough gal/guy regarding compliance.  Folks are going through rough times, and you're the one that has to hassle them about the FMLA certification forms even though that's the last thing on their mind.

-Deciding when to play hardball on fraud.  You have 4,000 applications for LOA, you're going to have some folks gaming the system.  You have to decide when to play hardball and go after it.  You see the 5-10% that game the system - how can you not become jaded after a year or two of that?

Let me be clear - if you are in the LOA Administrator role in your company - thank you.   You are taking multiple hits daily for the HR function as a whole, and you're likely doing it very well.  If you get burned out, I hope your company has a rotational program in place, because you have skills that are a valuable resource.

Domino's - Spending R&D Money to Destroy the Health of Your Employees....

OK, this video is a total farce from the Onion... But, with recent brainstorms/innovations in the pizza industry, like the stuffed crust pizza and bacon as a topping, can it really be far from the truth?

So, do this - get the double crust WITH Bacon three times a week for the next year.  Cholesterol and risk for a cardiovascular event higher as a result?  Who cares?  You still pay the same employee contributions for health care as the skinny guy eating carrots and running in the heat at lunchtime.

That makes you the clear winner.  Right?

I'm Off Today - If You Are Working, See How Your Holiday Policy Stacks Up....

I'm off today, so if you are reading this on Christmas Eve, welcome to the world of automation. 

If you're working today, I suspect it's going to be a light productivity day for you.  So, you may as well dig into the details about what workers across the country receive in the way of official paid holidays.  From AL.com, examining the 13 official holidays in the state of Alabama:

"The Bureau of Labor Statistics survey, released in August, said the average number of paid holidays per year, for private-sector workers who get paid holidays, was seven in businesses with 99 or fewer workers and nine in larger businesses. The survey said 12 percent of full-time workers in the private sector don't get paid holidays."

Not really sure what to make of the numbers, since comparing one staple of Paid Time Off (with the other components being vacation, personal day and sick time as well as official holidays) is basically useless.

For example, I thought for a split second about getting on my high horse regarding Alabama actually granting some workers Fat Tuesday (that's Mardi Gras parade day for you teetotalers), but then I reconsidered.  After all, the State of Alabama has 13 paid holidays, which sounds like a lot, but I don't know if they grant any personal days.  If I add up my company's official holidays (7) and personal days (7), I have 14 days, half of which I can take when I need them.

If the state workers in Alabama have 13 paid holidays but no personal days and vacation and sick time schedules are comparable, I have a better benefit.  I can use half of the holiday/personal days when I want to.   So I got that going for me, which is nice (hat tip to Bill Murray in Caddyshack).

If you're working, here's hoping you're out of there by at least 2pm.  Merry Christmas.

Friday Telecommuting - Can You Smell the Organizational Backlash?

Here's a nugget of wisdom from a manager I know.  Enjoy the organizational savvy:

Me: How's the Telecommuting Program going?  Did you get it launched?

Manager: Yes, we're starting this week in our department.  Everyone is looking forward to it, although I've got a couple of people who are unsure about how working from home is going to go.

Me: How did you split up the department in terms of what days everyone gets?

Manager: I thought it through a little bit, and I decided to make some standard telecommuting days for the department.

Me: Really?  Tell me more.

Manager: Well, the last thing I wanted, for the departments that rely on my team, is for them to come in looking for anyone on a Monday or a Friday, and not be able to find them.  To me, the perception is that the employee is creating a 3 day weekend by telecommuting on a Monday or a Friday.  Plus, let's face it, it's human nature at 3pm on a Friday to want the weekend to get here already, so it would be tempting to play a little frisbee, etc.  So, I've opted to nip that in the bud.

Me:  Smart idea...

So, here's the story...  New telecommuting program, lots of desire to telecommute in the organization, and the manager proactively takes a look at a potential organizational reaction to his team being out on a Friday afternoon, and institutionalizes something to control for that.

Smart idea, especially given the fact that the program is new and still has to "prove in."

If I could, I'd do one of those "Real Men of Genius" commercials to celebrate the organizational savvy.  I'd call it "Mr. Anticipate the Organizational Backlash" guy. 

Weight Loss Camp For Kids Avoids the Real Issue...

Before I get started on this post, let me do some self-disclosure.  I'm a relatively healthy (knock on wood) individual who is blessed with pretty good genetics when it comes to weight.  I come in at 6'2", 170 lbs., which rings me up a BMI of about 22.  All my health care metrics are in good shape (again, knock on wood)...

But, I work at it.  I run, on average, 4 times a week, and I don't eat much high fat or fried food.  Without  the exercise and diet habits, I probably track like some of my friends, which would probably put me in the neighborhood of 190 with a little pouch in the middle.  My family is like me, and physical activity is at the core of how we spend a lot of leisure time.  A healthy family diet is part of the deal too.

Personal situation aside, I'm sympathetic when I hear about people struggling with weight issues.  I'm never more sympathetic than when I read or hear about kids struggling with weight issues early in their lives.   That's why I had an interest in the recent New York Times article talking about the lack of insurance covering weight loss camp for kids. 

From the New York Times:

"There are nine million overweight or obese children in the United States. And although the prevalence of childhood obesity has tripled since 1980, there are few comprehensive or affordable programs to treat them. Summer weight loss camps are usually profit-making and can cost more than $1,000 a week. Most insurance does not cover that cost.

For Dr. Walter J. Pories, a well-known gastric bypass surgeon, the dearth of government and insurance financing for such comprehensive weight-loss programs is “the single most frustrating problem in dealing with childhood obesity.”

Several national groups are pressing for government financing or insurance reimbursement for more intensive weight loss treatment for children, including weight loss camps. In the meantime, many children mostly have to follow Tiffany King’s lead. She submitted a personal essay that was well written, sad and compelling. “If I could get on my knees and beg for this campership, I would, because I want to feel good about my life,” she wrote. “Sometimes, if I’m walking down the street, I can hear people talking about me and staring at me.”

I'm not the guy who's ordinarily going to run to the insurance industry's defense.  I get frustrated, just like my employees, when red tape holds up needed treatment.  But there's an obvious point the folks, who will shout out the need for weight loss camps, aren't sharing at the appropriate volume.

Here's the reality - A kid can go to weight loss camp, lose 10% of their body weight and pick up some great ideas how to live their lives with proper diet and exercise.  Unfortunately, if their parents are obese, sedentary or fond of fried foods, the kid generally won't keep the weight off.  The NYT was kind enough to balance the story out with the following:

"The big challenge comes later, when children resume their normal routines and confront the smorgasbord that is America — food in their own kitchens and at friends’ homes, fast-food restaurants and school cafeterias.

Dr. Pories, who also heads the Metabolic Institute at East Carolina University, found that children lost an average of about 8 percent of their body weight in a program he studied over three years; but two-thirds regained all or part of their weight.

Even Dr. Pories, who has been involved in promoting weight loss camp scholarships for underprivileged children in eastern North Carolina, says, “A two-thirds failure rate is not acceptable.”

It's all about the support system you are going back into.  If a kid has family and friends who don't exercise and eat healthy, there's no way the kid keeps the weight off.  To be fair, this is a story that transcends analysis from any single perspective.  There are cultural, socio-economic, educational and other issues at play.  The availability of weight loss camps is the least of the challenges. 

Weight loss camp for the kid isn't fixing the issue.  Perhaps weight loss camp for the family?

What An Angry Mob Looks Like - Reducing Healthcare Benefits of Retirees...

If you've been in HR for more than 5 years, you've been a part of what I'll call the "Great Benefits Crunch", which has forced your company to reduce overall benefit levels and/or pass along greater costs to employees.

You don't have to explain it to me.  I've had to explain those decisions to employees, and I'm aware that you didn't create the economic problem that is the "state of health care".  Sadly though, if you're in HR, you're left to explain the realities to a set of employees that doesn't feel great about costs being shifted their way.

You and I can understand that, because we're employees too.  Just because you manage the plan doesn't mean your health insurance is free. 

But being in HR means you take ownership of the employee relations side of the business, which means at times you're going to feel the laser on your back when employees vent their frustrations.

Watch the whole video below, which is one of the hardest rants about cost shifting I've ever seen captured on video...

Wow.  Did that get your attention?  Here are the details from the Santa Rosa Press Democrat:

"Convinced that the county no longer can afford spiraling health insurance premiums, Sonoma County (CA) supervisors told thousands of retirees and employees Tuesday that they will have to pay an increasing share of the cost.  Supervisors conceded their vote would be unpopular with the 2,500 retirees and 650 non-union workers who will be affected by the cost restructuring beginning in June.

Currently, the county provides non-union workers 85 percent of the premium for any plan selected, and gives retirees 85 percent of the lowest-cost premium, either for an individual or couple. Under the adopted recommendations, there will be a gradual reduction of 20 percent annually over the next five years in the county's contribution to retiree and non-union health benefits to $500 a month.

Nearly two-thirds of the 2,400 retirees would experience a drop in county contributions to their medical premiums. Those who insure dependents or who retired before age 65 are likely to see the biggest reductions. For example, an early retiree insuring a dependent under age 65 on the least expensive PPO plan is now getting $1,043 a month. That amount would be reduced by 20 percent each year until 2013 when the $500 monthly level would be reached."

I suspect retiree benefits will continue to be under pressure based on the economics of health care, as will the plans for active employees. 

I don't have the answers, but I do know this.  If you're an HR pro with 20 years left, you're going be a part of transitions and cost-shifting that spur reactions like what you see in the video above.  Brace yourself for a bumpy ride.

The employee relations portion of the HR Manager's role - it's the toughest job you'll ever love...

Healthcare in the USA and Mortality in China - Our System is Bad?

So, the economy is in the pits, you just took a fully-insured renewal from your medical insurance provider that gives you a company-wide 12% increase when the national trend is 6%, and you keep hearing that China is going to put the USA out of business.

Plus, you watched the Olympics, and the Chinese sure look modern.

Not so fast there, Chicken Little.  You may have been watching a made for TV event in Beijing, and for all the shiny stadiums and cute kids singing, there may be 10 kids in the countryside who live in squalor compared to our poverty level in the states, and aren't part of the picture China projects.

From Reuters:

"China's economic boom has resulted in stark health inequity between its urban and rural populations and health experts urged the Chinese government to work harder at providing healthcare for everyone.  Infant mortality in China's countryside stands at 123 for every 1,000 live births compared with 26 in the richest counties, the experts wrote in a paper published in The Lancet medical journal.

Of every 1,000 children, 64 in the countryside will not live beyond their fifth birthday, compared with 10 in the cities.

The report, by researchers in China, the United States and Britain as well as from the World Health Organisation, is part of a special series on China's health reforms.

Another paper highlighted how healthcare was taking up the bulk of household incomes, or a whopping 50 percent in 2006 (over 18 times that in 1990) because of inadequate health insurance. This compares with 45 percent in South Korea, 16 percent in Sweden, 15 percent in Japan and 11 percent in France."

Why this post on a Benefits blog?  Like you, I read a lot about our country's competitiveness in the global labor pool, and it hurts to see jobs lost to a cheaper labor market overseas.  That being said, I can't help but to be proud to live in a country, for all its challenges, that tries to do the right thing and actively has conversations about topics, like finding a way to ensure healthcare for all of our citizens.

You think serious conversations are going on in that regard in China?  Perhaps, but I suspect the context is for the ruling party to stay in control, not a drive for equality, fairness and doing what's right.

The USA - imperfect, but I like it compared to that.

Balance Billing Still an Issue for Employees, Especially Under $1,000...

If running a self-insured medical plan has taught me anything, it's that I am glad I have access to the network discounts for routine and non-routinue medical procedures provided to me by our medical provider (think Blue Cross, Aetna, Cigna, etc.).  Depending on your medical provider's market share, it's not uncommon for insurance providers to have agreements with doctors that provide up to a 50% discount from the sticker price provided by M.D.'s and surgeons.

God help those without insurance or access to government programs.  I'm guessing those folks are the ones who get stuck with the full retail sticker price for an operation, then spend the rest of their lives trying to dig out of the resulting debt since they held 100% responsibility for payment.

Here's another ugly angle to the current healthcare system.  A nasty process called Balance Billing.  A description from BusinessWeek:

"As health-care costs continue to soar, millions of confused consumers are paying medical bills they don't actually owe. Typically this occurs when an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid. The health-care provider demands the balance from the patient. Uncertain and fearing the calls of a debt collector, the patient pays up.

Most consumers don't realize it, but this common practice, known as balance billing, often is illegal. When doctors or hospitals think an insurer has reimbursed too little, state and federal laws generally bar the medical providers from pressuring patients to pay the difference. Instead, doctors and hospitals should be wrangling directly with insurers. Economists and patient advocates estimate that consumers pay $1 billion or more a year for which they're not responsible.

Yolanda Fil, a 59-year-old McDonald's (MCD) cashier in Maple Shade, N.J., got tangled up with balance billing after gall bladder surgery in 2005. She and her husband, Leon, a retired state transportation worker, have coverage through Horizon Blue Cross Blue Shield of New Jersey. Horizon made payments on Fil's behalf to the hospital, surgeon, and anesthesiologist. Then, in 2006, Vanguard Anesthesia Associates billed Fil for an unpaid balance of $518. Soon, a collection agency hired by Vanguard started calling Fil once a week, she says. Although she thought her co-payment and insurance should have covered the surgery, Fil eventually paid the $518, plus a $20 transaction fee. "I didn't have any choice," she says. "They threatened me with bad credit."

Nice.  So the doctor's have signed the insurance provider's contract, which clearly states at what rates they'll be reimbursed for different procedures.  Then, in pure "let's go fishing" mode, they send out invoices that make it appear your employees are responsible for a greater amount that they paid at the time of the procedure via co-pay/deductible. 

Who gets blamed?  A combination of the insurance provider and the HR team, for obtaining a provider who couldn't give them cost certainty.  Especially troublesome is the fact that doctor's will often go after balance billing of less than $1,000 since they know the pay rate for these will be higher.  After all, if you're threatened with a $500 bill hurting your credit rating and don't have the time or knowledge to research it, many of us are apt to dig deep, pay the bill and move on.

That stinks.  Keep your eyes out for balance billing coming to an employee near you. (More below from CBS News, email subscribers click through for video).

If running a self-insured medical plan has taught me anything, it's that I am glad I have access to the network discounts for routine and non-routinue medical procedures provided to me by our medical provider (think Blue Cross, Aetna, Cigna, etc.).  Depending on your medical provider's market share, it's not uncommon for insurance providers to have agreements with doctors that provide up to a 50% discount from the sticker price provided by M.D.'s and surgeons.

God help those without insurance or access to government programs.  I'm guessing those folks are the ones who get stuck with the full retail sticker price for an operation, then spend the rest of their lives trying to dig out of the resulting debt since they held 100% responsibility for payment.

Here's another ugly angle to the current healthcare system.  A nasty process called Balance Billing.  A description from BusinessWeek:

"As health-care costs continue to soar, millions of confused consumers are paying medical bills they don't actually owe. Typically this occurs when an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid. The health-care provider demands the balance from the patient. Uncertain and fearing the calls of a debt collector, the patient pays up.

Most consumers don't realize it, but this common practice, known as balance billing, often is illegal. When doctors or hospitals think an insurer has reimbursed too little, state and federal laws generally bar the medical providers from pressuring patients to pay the difference. Instead, doctors and hospitals should be wrangling directly with insurers. Economists and patient advocates estimate that consumers pay $1 billion or more a year for which they're not responsible.

Yolanda Fil, a 59-year-old McDonald's (MCD) cashier in Maple Shade, N.J., got tangled up with balance billing after gall bladder surgery in 2005. She and her husband, Leon, a retired state transportation worker, have coverage through Horizon Blue Cross Blue Shield of New Jersey. Horizon made payments on Fil's behalf to the hospital, surgeon, and anesthesiologist. Then, in 2006, Vanguard Anesthesia Associates billed Fil for an unpaid balance of $518. Soon, a collection agency hired by Vanguard started calling Fil once a week, she says. Although she thought her co-payment and insurance should have covered the surgery, Fil eventually paid the $518, plus a $20 transaction fee. "I didn't have any choice," she says. "They threatened me with bad credit."

Nice.  So the doctor's have signed the insurance provider's contract, which clearly states at what rates they'll be reimbursed for different procedures.  Then, in pure "let's go fishing" mode, they send out invoices that make it appear your employees are responsible for a greater amount that they paid at the time of the procedure via co-pay/deductible. 

Who gets blamed?  A combination of the insurance provider and the HR team, for obtaining a provider who couldn't give them cost certainty.  Especially troublesome is the fact that doctor's will often go after balance billing of less than $1,000 since they know the pay rate for these will be higher.  After all, if you're threatened with a $500 bill hurting your credit rating and don't have the time or knowledge to research it, many of us are apt to dig deep, pay the bill and move on.

That stinks.  Keep your eyes out for balance billing coming to an employee near you. (More below from CBS News, email subscribers click through for video).

Wondering What Your Budget's Benefit Load Should Be For 2009? Here's the Tip Sheet....

If you're an HR executive at any level with budgeting responsibilities, you've dealt with the pleasure of the Benefit Squeeze. 

What's the Benefit Squeeze?  It's the magical number that's attributed to the budget model for all your benefit and payroll tax costs.  In the golden days, the number was pretty fat and you never saw a lot of pressure on the number.  Unfortunately, with healthcare costs up 200% in the last decade, the number takes on a lot more importance.

So, the game goes like this - if you're fully insured, you have a good idea of what your entire benefit load is.  However, if you're self insured, there's some variability in the model that you want to protect yourself against.  Unfortunately, no one else in the organization cares about your needs.  They just need the number you give them to be two things - skinny and predictable. 

The U.S. Bureau of Labor Statistics recently gave some quality stats across the public and private sectors that can help.  The average cost to employers for employee pay and benefits was $28.48 per employee hour worked in June, the U.S. Bureau of Labor Statistics said today.

"The cost of wages and salaries averaged $19.85 an hour, or nearly 70 percent of employers’ total compensation costs.  As usual, there was a pay and benefits gap between average compensation costs in the public and private sectors.

Total compensation costs to employers in the private sector averaged $26.78 per work hour, compared with $38.30 an hour for state and local government workers. The report did not include federal employee compensation costs.  The cost of wages and salaries averaged $18.92 per employee hour in the private sector, versus $25.19 for state and local employees. The cost of employee benefits averaged $7.86 an hour in the private sector, compared to $13.11 an hour on the public side.

Overall, the 30 percent of total payroll costs that went to employee benefits broke down this way:

•$2.39 per employee hour worked for health, life and disability insurance.

•$2.25 an hour for legally required benefits, including Social Security, Medicare, unemployment insurance, and workers’ compensation.

•$1.99 an hour for discretionary paid leave benefits, including vacations, holidays, sick leave, and personal leave.

•$1.25 an hour for employee retirement and savings plans.

•76 cents an hour for supplemental pay, such as shift differentials, premium pay for overtime and weekend or holiday work."

Helpful stats to be sure.  At first, the total cost for health insurance seems light, until you do the multiple and see that the numbers mean a budget of around $5,000 per employee - not a bad figure.

So, take a look and use this in your budgeting sessions to justify your benefit spend number.  Just don't be alarmed when you take a 10% haircut to your budget as an across the board treatment to get to the earnings target.  It's all part of the budgeting process...

Dude! We're Getting an HMO!!!

You spend 30% of payroll on benefits for your employees.  You'd probably like them to understand the benefits you're spending all the cash on, right?

So, do they actually understand what you're providing?  They can't value what they can't understand, and of course, there's the whole thing about ensuring the spouse understands the benefits as well.

Don't bet on the fact that employees have any clue about the total value of the benefits package you're provdiding.  From CBS Marketwatch:

"Colonial Life surveyed more than 650 human resource managers and benefits administrators at the recent national conference of the Society for Human Resource Management. Employers were asked about the benefits they provide and how much their employees understand those benefits.

More than 90 percent of employers who responded said it was important to their business that employees understand and appreciate the value of their benefits. Only 21 percent of employers think their employees have a good understanding of their benefits. Nearly 5 percent think their employees know nothing at all about their benefits.

In a research study conducted by Watson Wyatt Worldwide(1), a global consulting firm that specializes in employee benefits, employees gave higher marks to employers who provided fewer benefits but explained them well, rather than a richer array of benefits they didn't understand."

If we're rating the understanding of benefits that low in a self-reported fashion, how bad must the reality be?  Additonally, what's the understanding of benefits mean?  With the right investment, can you get the number past 50%? 

If not, should your strategy be to "lead" the market when it comes to benefits?  Is it better, as the Wyatt study concludes, to do fewer things and drive the value proposition harder through a real communications plan?

What leads to increased retention or engagement?

Heavy questions to ponder.  Apparently, it takes more than the "Dude, we're getting an HMO campaign"...