Benefits Buzz

42% of Tampa Bus Drivers Have Signed Up for Intermittent Leave..(!)

WOW.  It's been a few years since I supported a big consumer call center as part of my practice, so I had really forgotten about the pain that Intermittent Leave under FMLA can cause employers. 

The desire for maximum flexibility and at times, the avoidance of accountability, can cause Intermittent Leave to spread like a virus through an operating unit of a company.

For me, I thought bad news in this area would be about 3-4% of all employees in a division or company being approved for Intermittent Leave (10-12 employees in a call center of 300 would cause a big impact to scheduling, etc.).

But 42% of all employees?  You're kidding me, right?  Apparently not - from the Tampa Tribune:

"...Case in point is HARTline, the county's(Tampa metro) public transit service. Forty-two percent of the bus drivers have signed up for a benefit the federal law calls "unscheduled intermittent leave." Many of them are using the law to extend weekends and go home "sick" to avoid unwanted assignments.

The law designed to cost nothing is costing HARTline and other employers many millions of dollars. The family leave act was intended to cost little or nothing while providing 12 weeks of job security to help workers through challenges (sic) times - such as bringing home a new baby, recovering from illness, or helping an incapacitated relative.

Some workers, including many HARTline drivers, have discovered that minor ailments also qualify, such as back pain and headaches. A one-time doctor's certification can give a worker a perpetual excuse for going home early, sleeping late, or not showing up at all.

Lawmakers were wrong in thinking that two features would minimize employee abuse and employer expense: One, the worker on leave under the act gets no pay and thus has no incentive to malinger, and two, the law applies only to organizations with 50 or more workers, which seems to be ample manpower to make up lost productivity."

But employers like the bus agency can't make up in the afternoon for a bus that doesn't run in the morning. In many businesses, schedules must be kept.

To keep its buses on time, HARTline is spending $2 million a year on overtime, an agency spokesman says, and 39 percent of that cost is attributed to FMLA absences."

42% of all employees.  Maybe it would be easier for that HR Team to certify the people who don't need intermittent leave....

Ralph Kramden would never approve...

Update - The Likelihood of You Being Forced to Provide Sick Time (in addition to PTO) in 2009 Just Increased...

Back in December, I riffed about the proposed Healthy Families Act (HFA), which would require employers with more than 15 employees to offer full-time employees seven days of paid sick leave.  The HFA would also mandate the sick time could be used for the employee's illness or to care for a child/parent/spouse/individual related by blood/domestic partner.   Here's some commentary on the merits of the bill....

UPDATE - The District of Columbia just passed something called the Accrued Safe and Sick Leave Act.  That can't be a good precursor to what might happen with the HFA.  Details from the Washington Post:

"The D.C. Council voted unanimously yesterday to make Washington the second city in the country to require employers to grant their workers paid sick leave, but not before council members added several amendments that business leaders applauded and labor leaders said significantly weakened the legislation.

Under the Accrued Sick and Safe Leave Act, full-time employees at businesses with 100 or more workers will get seven days of paid leave, and employees at businesses with 24 or fewer workers will get three days.

Advocates say the legislation could affect 200,000 workers who don't have paid sick leave, but an amendment will require new workers to wait for the benefit. That measure will require an employee to be on the job for 12 months before becoming eligible for sick leave."

As far as the HFA, it's a broad bill that is likely to get a lot of traction in 2008/2009, if Congress continues to be controlled by the Democrats and the White House goes "blue state" as well. 

Here's the catch and why more government isn't always the best solution - the HFA as currently written, would also prohibit employers from eliminating existing leave coverage in order to comply with the Act.  That can get complicated.  Early readings suggest that if you are an employer trying to do the right thing, by offering a Paid Time Off (PTO) plan, you couldn't adjust the total number of PTO days, to reflect the legal requirement, for a stand-alone sick-time policy.   You would have to simply add the seven to what you currently offer to be in compliance.  For those of us offering a great benefit, that's crazy talk...

Here's hoping someone gets to the bill's sponsors and explains that if an employer is already offering 3 weeks of PTO to new employees, they're taking care of people.   Otherwise, expect companies to start breaking out their PTO policies into vacation/sick designations, if it looks like the bill will pass. 

Wal-Mart Asks Former Employee for $471M for Past Medical Claims...

One thing that most HR people aren't aware of is that medical plans can ask for documentation from any third party action (that's a lawsuit for all my plain English friends), related to settlements that might be used to pay medical expenses.

Why?  Let's say you are involved in a crash with a drunk driver, and as part of the insurance settlement, the drunk driver's insurance provides a settlement that includes $$ for your medical care. From the insurers point of view, if there are other funds available to pay your claims, it's in their best interest to force you to utilize those funds.

I see requests for documentation flowing through our plans at least once a month.  That type of process is alive and well in plans that are self insured, as well as fully insured. 

Of course, it's best to ask for clarification before the claim is paid.  If you try and go back after the claim is paid, it's like asking someone to dig into their own wallet to pay the claim, regardless of the terms of the settlement.  The Blue Cross networks I've worked with are pretty sensitive to the negative press that can go along with this.

Then there's Wal-Mart - for every step it takes forward to repair its image, it seems like it takes two steps back.  Like this one, where the big retailer is seeking 470K from a brain-damaged ex-employee's trust fund.  CNN.com has the details:

"Debbie Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.

It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.

Eight years ago, Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.

Wal-Mart had paid out about $470,000 for Shank's medical expenses and later sued for the same amount. However, the court ruled it can only recoup what is left in the family's trust.

The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit."

Good call on Wal-Mart's part?  I report, you decide.  Here's one stat I'll provide.  Wal-Mart earned about 348 billion in revenue in 2007.  So what's 470K come to as a percentage of revenue?  Maybe some of my economics friends can run the numbers in the comments. 

Now say you are running a HR shop at a company with 100M in revenue.   What would a proportional claim be to your plan? 

I'd say most of us would walk away from that because of the internal PR damage alone.... Especially if we had to go back to the employee after the fact, once the claim had already been paid...

Posted by Kris Dunn on March 31, 2008 at 04:01 AM

One thing that most HR people aren't aware of is that medical plans can ask for documentation from any third party action (that's a lawsuit for all my plain English friends), related to settlements that might be used to pay medical expenses.

Why?  Let's say you are involved in a crash with a drunk driver, and as part of the insurance settlement, the drunk driver's insurance provides a settlement that includes $$ for your medical care. From the insurers point of view, if there are other funds available to pay your claims, it's in their best interest to force you to utilize those funds.

I see requests for documentation flowing through our plans at least once a month.  That type of process is alive and well in plans that are self insured, as well as fully insured. 

Of course, it's best to ask for clarification before the claim is paid.  If you try and go back after the claim is paid, it's like asking someone to dig into their own wallet to pay the claim, regardless of the terms of the settlement.  The Blue Cross networks I've worked with are pretty sensitive to the negative press that can go along with this.

Then there's Wal-Mart - for every step it takes forward to repair its image, it seems like it takes two steps back.  Like this one, where the big retailer is seeking 470K from a brain-damaged ex-employee's trust fund.  CNN.com has the details:

"Debbie Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.

It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.

Eight years ago, Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.

Wal-Mart had paid out about $470,000 for Shank's medical expenses and later sued for the same amount. However, the court ruled it can only recoup what is left in the family's trust.

The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit."

Good call on Wal-Mart's part?  I report, you decide.  Here's one stat I'll provide.  Wal-Mart earned about 348 billion in revenue in 2007.  So what's 470K come to as a percentage of revenue?  Maybe some of my economics friends can run the numbers in the comments. 

Now say you are running a HR shop at a company with 100M in revenue.   What would a proportional claim be to your plan? 

I'd say most of us would walk away from that because of the internal PR damage alone.... Especially if we had to go back to the employee after the fact, once the claim had already been paid...

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