Category: Human Capital Management

By Bobbi Kloss, BAN Director of Human Capital Management – October 12, 2021

Published in America’s Benefit Specialist Magazine, October 2021

Life has felt like a proverbial rollercoaster over the past year and a half. It seems no matter how much more prepared the industry is or how much better it gets, the more outside forces continue to disrupt business continuity, constantly challenging the industry to think differently and more strategically as employers plan their annual benefit offerings. Couple this with the most hectic time of year—the fourth quarter— and health and welfare insurance agencies are feeling the pressure from all angles.

These influencing forces, typically called workforce dynamics, can hit employers globally, nationally, regionally, or even locally.

For the 2021-2022 open-enrollment period, examples of such dynamics are COVID-19, damaging hurricanes in the south and east, ongoing fires in the western portion of the United States, and workplace violence.

Cultural and generational changes also impact the way we view plan designs for the year, such as gender diversity, Baby Boomers aging out and Generation Z entering the workforce. Last but not least, the labor market has seen its share of ups and downs over the past year and a half. The unprecedented labor shortage may leave employers wondering how to design their benefit plans to attract and retain qualified employees in such a competitive market. Trusted advisors are needed to be knowledgeable on all these considerations as employers are looking for a one-stop strategic agency.

MEDICAL SPEND INCREASE

With COVID-19 and its variants continuing to plague the globe and confound the medical community, U.S. health plan carriers are making this fourth quarter a bit more of a challenge as they navigate through skyrocketing healthcare costs. While carriers had waived deductibles and copayments for COVID-19 related treatments for insureds, these waivers are ending and it is anticipated that premium increases are on the rise. According to PWC, medical spend is expected to increase six percent for 2022—higher than it was between 2016 and 2020.1 Driving factors in the cost increases are a result of COVID-19 expenses, increased mental-health and substance-abuse services, return to regular care that had been deferred, and health of the overall population, which worsened due to a lack of exercise, isolation and increase substance abuse during COVID-19. Employers will be weighing all their options and strategizing if and how they can pass on increases to their workforce.

TO SURCHARGE OR INCENTIVIZE

Advisors are being called upon to provide guidance on the question “Should employers incentivize or pass on surcharges to employers to encourage vaccinations?” Not only does this question generate serious compliance concerns over equal employment opportunity, HIPAA privacy rules, and the ACA, it also spotlights challenges with employee relations. In a labor market where it is difficult to attract and retain quality employees, would employers be further damaging their ability to maintain or grow their workforce by penalizing unvaccinated workers through surcharges, mandates for only vaccinated hires, or incentivizing the vaccinated? Who is being affected? It is both internal staff and external candidates. It is important to also question whether it is the disenfranchised who are only being affected by policy decisions. Advisors should engage their human resources consultant for a holistic approach to plan and policy development alongside the company culture, turnover, and organizational growth.

PLAN DESIGN

Typically when we think of plan design, we think of stereotypical employees and their medical needs. Gender diversification, parental needs, generations leaving and entering the workforce, and the emotional wellbeing of employees working through workforce dynamics are a primary are a focus of this fourth quarter for employers. We should also be promoting a holistic well-being culture. Be fluid, resourceful, and strategic, and think holistically.

Physical, emotional, financial, and social wellbeing create a productive and profitable culture in the workforce—no matter the size of the client.

COMMUNICATION

In addition to the potential of carrier increases and plan-design considerations, advisors are still faced with the continuing challenges of timing, communication, participation, and compliance with new legislation. Lessons learned throughout the pandemic continue to be strategies to put into play to work through these challenges.

Don’t assume because the client is small that it doesn’t need technology to be more efficient. Smaller clients are run on tighter staff and tighter budgets and could use the added assistance. Also, many employees are still working remotely and need access to current technologies that will allow them to do their jobs efficiently and effectively.

Challenges exist for employers in the age of technology, including budgets and employee access. Brokers should align themselves with resources that can vet the most efficient, cost-effective technology solutions.

Effective communication is key to making sure benefit plans are clearly, concisely presented. Be creative and flexible with presentations and style. Engagement surveys show employees don’t know or understand their benefits. Communicate and educate in ways that make it easy, fun, and impactful to learn.

THE TOTAL PACKAGE

Benefits are part of a total rewards package. Broadening your scope of services to offer human capital management solutions is necessary to continue to be competitive in today’s marketplace. Total rewards encompass compensation, well-being, benefits, recognition, and development. Together, these lead to optimal organizational performance.

IN CONCLUSION

Be innovative, be strategic, and think holistically. Remember that health and welfare is a competitive market—not only against the traditional competitors but HR consultants are also now at the playground, and they have friends in benefits. If advisors are not talking about and presenting strategies and creative ideas to clients concerning holistic thinking in innovation, organizational growth, flexibility, technology, and compliance, someone else is.

¹ http://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html

___________________________________________

Bobbi Kloss has served as BAN’s director of human capital management services since 2014. She also oversees all HR-related functions for BAN internal practices. She has a deep

understanding of the increasingly complex and diverse HR industry, with more than 20 years of human resource generalist and executive-level human capital management experience. Bobbi began her career as an employment law compliance paralegal for a national PEO after graduating with high honors from the Career Institute for Paralegals. She has a passion for service and has helped establish two nonprofit organizations in

Texas, co-founding Teenage Parent Program Scholarships in Houston and founding Heritage Children San Antonio in 2003 to help at-risk youth develop necessary life skills. She currently volunteers her time mentoring women in addictive behavior recovery.

Experts share practical advice on how to improve the enrollment process despite an uncertain future.

By Alan Goforth | October 13, 2021 at 09:54 AM

Every pain point may present an opportunity, but easing that pain is easier said than done. (Illustration by Sjored van Leeuwen)

Brokers often prepare for open enrollment as if it were a 100-meter dash, only to find they would have been better off training for a marathon.

“One thing I always remind employers and brokers alike is that because benefits are so complicated, we can’t focus on them just once a year,” says Kim Buckey, vice president of client services for DirectPath. “It’s a year-round process. We need to put tools, mechanisms and systems in place where there is a good mix of push and pull communications throughout the year. If you have those systems in place and make use of them during the year, open enrollment is going to be much less painful.”

Related: Back-to-school: A preview for open enrollment season

Despite careful preparation, open enrollment brings a number of pain points, even in the best of times. The ongoing pandemic has only added more of them.

“One of the biggest challenges is that we are trying to serve a large, diverse audience with something that is very complex,” Buckey says. “Add to that constantly changing regulations about what we can and cannot provide and how these various plans can be communicated, and it’s a challenge.”

Brian Uhlig, senior partner, employee benefits, for Alera Group agrees.

“First and foremost, the carriers don’t make it easy—especially for smaller clients—-by not releasing renewal information far enough in advance to allow sufficient time to work closely with the client on any changes or the communications that would be required for those changes,” he says. “Additionally, there is the aspect of today’s multigenerational workforce and all of the differences employees have when it comes to communication preferences.

“Older generations might still prefer to have an actual brochure to read and review, while younger generations do not want to read anything. They prefer videos or possibly even an artificial intelligence app that helps walk them through the benefits and allows questions to be asked through a chat-box feature. The challenges lie in the timing of renewals and the multiple generations that inhabit today’s workforce.”

The pandemic triggered a number of changes in 2020 that will continue to be felt this year. “COVID forced an almost unilateral shift to online open enrollment,” says Bart Sheeler, CEO and cofounder of Benezon. “Much of this is likely to remain online, so the challenge will be in advanced messaging and preparation prior to open enrollment to leverage opportunities, streamline the process for employers, and maximize engagement participation with employees.”

Although many of these changes may prove to be positive in the long run, they add to the short-term complexity for brokers.

“In light of the pandemic, what we are starting to see across our book of business is higher-than-normal increases in the renewals from prior years,” Uhlig says. “And we believe that much of that is due to some of the catchup on claims that were avoided during the lockdowns in 2020 and 2021, as well as the lack of employees seeking preventive care, whether that be through normal annual checkups, cancer screenings or other regular visits with their physicians.”

These impacts are beginning to show up in higher emergency department utilization and inpatient admissions.

“The other component driving these trends is an almost universal increase in specialty drug utilization that is starting to get close to 50% of overall pharmacy spend for many of our clients,” Uhlig says. “What we are finding with employers is that due to the challenging environment of both hiring and retaining employees, most are absorbing these increases and not passing them on to employees.”

Providing relief

Every pain point may present an opportunity, but easing that pain is easier said than done. Industry leaders shared their recommendations to not only make open enrollment smoother this fall, but also to set the stage for a successful 2022.

Ease clients’ pain. Remember that open enrollment can be as stressful for clients as it is for brokers. Understanding client needs must come before delivering solutions.

“Technology is rapidly changing how we interact within the health care and insurance industries,” says John Kelly, founder and CEO of Nexben. “Most consumers have a smartphone, and they are used to checking it regularly to gather information and communicate frequently with family, friends and even businesses. Consumers don’t think twice about purchasing anything online, from cars to running shoes. Why can’t buying health insurance online be like buying a car online?

“The face of the health insurance consumer is changing, and they are demanding a more streamlined and efficient way to use technology to purchase goods and consume services. These consumer needs are a driving force for change to occur in health insurance, too. Brokers must understand this and adapt to these changes so they can continue to provide value to their clients.”

Lean in to technology. Technology that has become essential during the pandemic will continue to boost efficiency and convenience in the future.

“We learned during the pandemic that, when forced to use technology, we can step up to the plate,” says Bobbi Kloss, director of human capital management services for Benefit Advisors Network. “Advisors need to use the same technologies and processes that they are suggesting for their clients: Be present on Zoom or other meeting platforms, and use whiteboards and other creative tools.”

Keep the personal touch. An emphasis on technology should never come at the expense of the personal touch, though.

“There is still tremendous value in having benefit counselors participate in the enrollment process,” Uhlig says. “If they are easily accessible to employees, they can help them enroll in plans that are best suited for their individual needs. Personal touch is all about providing options for all different types of needs. One person’s personal touch is not another’s. The key is multichannel communications to meet the needs of all different individuals.”

Address the fear. Some employees would rather go to the dentist than think about benefits. “Understand that benefits are scary for many people,” Buckey says. “Anything we can do to simplify the process, make benefits more appealing and help employees understand how the decisions they make are going to affect not just their wallets, but their overall well-being, is critically important. Brokers have a key role in helping the employer put together a package that meets both employer and employee needs, and then changing hats and helping employees understand what’s available and why they should care about it.”

Plan ahead. Some benefits remain the same year in and year out, so there is no reason to put off planning ahead for them.

“Start working on the communication pieces for those aspects that you know will not change in order to get them done and ‘cleaned up’ before the renewal process even starts,” Uhlig says. “When it comes to being able to communicate with all of the different generations, you should be working with marketing specialists or benefit communications specialists to help create clear and concise open enrollment and new-hire guides. There are dozens of benefit communication apps that are available to help with this process, as well.”

Emphasize voluntary benefits. Working from home around their spouses, children and pets has many employees rethinking their benefits mix.

“Because of COVID, they may be questioning whether their coverage is still adequate and wondering what their disability coverage looks like,” Buckey says. “They are asking, ‘What else is available to protect my family if I am in the hospital for three weeks?’

“I have had a number of clients this year tell me they are adding hospital indemnity and critical illness in particular, and they are also expanding their mental health programs. The nice thing about voluntary benefits is that because they are voluntary and paid after taxes, the enrollment period doesn’t necessarily have to coincide with open enrollment. If someone is late to the game and would like to add them, they can do so later.”

Challenge clients’ thinking. “More and more employers need to push their brokers and consultants for different ideas if they are continuing to remain in a traditional, fully bundled health insurance plan,” Uhlig says. “Employers who are working with forward-thinking brokers and consultants are seeing improved plan designs, improved employee satisfaction and lower annual increases.”

Educate and engage. “Education and engagement are key to driving successful outcomes,” Sheeler says. “Technology permits communication and engagement to happen in one centralized place, both during open enrollment and then throughout the year as the benefits are needed or as questions arise at the member level. Put all the information in one place and make it convenient, and adoption rates will increase.”

Play to strengths. Never underestimate the value that a good broker can bring to an organization.

“Brokers’ expertise is really put on display during open enrollment,” Kelly says. “Brokers have a unique opportunity to enhance their relationships with their clients by tuning into the pain points these HR teams are facing. HR professionals need more hours in the day, better benefit offerings for their employee base and ways to control costs.

“Brokers can lessen the load for their HR partners by incorporating technology solutions into their portfolio of options. They need to weed through the various technology options available and then determine what will provide the most value and be the least disruptive to all of their HR partners.”

In short, perhaps the best way for brokers to ease their own pain during open enrollment is to first look for ways to do the same for the partners they work with and the clients they serve.

“Times are changing,” Kelly says. “Now’s the time to embrace new solutions that can make the jobs of both the brokers and their clients easier.”

Read more: 

• Open enrollment is a kickoff for your ongoing engagement strategy
• Technology will be key to upcoming open enrollment season
• Online open enrollment: What’s working?

The COVID-19 pandemic has negatively affected many people’s mental health and created new challenges for those already suffering from mental illness. According to the Kaiser Family Foundation (KFF), approximately  4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder, up from one in ten adults who reported these symptoms from January to June 2019. A KFF Health Tracking Poll from July 2020 also found that many adults are reporting specific negative impacts on their mental health and well-being, such as difficulty sleeping (36%) and eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%). 

Needless to say, the emotional and mental stress is taking a toll on employees across the county. For this reason, many employers are focused on the emotional wellbeing of their employees and turning to their benefit advisor to evaluate the services provided by Employee Assistance Programs (EAP’s). What they are finding is that there is a difference in the level of service providers and the level of available services. Thankfully, there are resources for not only the emotional wellbeing of their workforce, but physical, financial, and social wellbeing as well, leading to higher levels of employee engagement.

Evidence shows that when an employee is holistically balanced there are equal benefits to the employer in their ability to attract and retain quality employees. In a  Harvard study, 71% of employers ranked employee engagement as “very important to achieving overall organizational success.” Yet, many of those same leaders said they knew employees were not highly engaged. So, how is an EAP one of the solutions to achieve employee engagement? 

Fundamentals of Employee Assistance Programs
EAP’s came into existence in the early to mid 20th Century. Starting as hybrids of 19th Century community social services programs, occupational social work programs were developed to support the workers and their families and were considered as early human capital management programs. These social work programs included hiring and supporting management with personnel issues and focused on the wellbeing of the employee and those in the family affecting the employee.  

In the 1940s and beyond EAP programs were expanded to include:

1. Alcohol treatment programs.
2. Support of employers compliant with the Drug Free Workplace Act. 
3. Services that assisted women transitioning by the multitudes in the workforce during WW1 and WII.
4. Financial services for those affected by war times.

In the 1980s, professors Terry Blum and Paul Roman sought to develop a definition of Employee Assistance Programs as well as the core technology of such programs. Their definition says EAPs are “the work organization’s resource that utilizes specific core technologies to enhance employee and workplace effectiveness through prevention, identification, and resolution of personal and productivity issues.” 

Blum and Roman identified those core technologies for EAP’s, which have been modified through the years as:

1.     Consultation with, training of, and assistance to work organization leadership (managers, supervisors, and union officials) seeking to manage troubled employees, enhance the work environment and improve employee job performance.

2.     Active promotion of the availability of employee assistance services to employees, their family members, and the work organization.

3.     Confidential and timely problem identification and assessment services for employee clients with personal concerns that may affect job performance.

4.     Use of constructive confrontation, motivation, and short-term intervention with employee clients to address problems that affect job performance.

5.     Referral of employee clients for diagnosis, treatment, and assistance, as well as case monitoring and follow-up services.

6.     Assisting work organizations in establishing and maintaining effective relations with treatment and other service providers, and in managing provider contracts.

7.     Consultation to work organizations to encourage the availability of and employee access to health benefits covering medical and behavioral problems including, but not limited to, alcoholism, drug abuse, and mental and emotional disorders.

8.     Evaluation of the effects of employee assistance services on work organizations and individual job performance.

The first of these technologies has to do with prevention and workplace consultation.  Many believe EAPs are for the employee and family members only, but the reality is counseling and life management services are a portion of how EAPs work with employers. Employers seek to mitigate risk within their organizations to avoid increased costs and yet often there is a failure to see the biggest asset – human capital – is also the biggest risk.  A work organization that understands that prevention of risk equals awareness of changes in human behavior and a plan to eliminate the risk and retain the employee is an organization that gets the value of EAP.  Employee assistance is first and foremost about the work organization and retaining employees. The cost of salvaging an employee through the utilization of an EAP is much less than losing that employee, hiring, and retraining a new employee. 

EAP In Action
Life happens, and events occur every day that we rarely give a second thought to while we go about our daily routines almost mechanically. We may even have disruptive events that can come about with minimal or zero impact on the disruption of our lifestyle. We get up, we go to work. If the car has a flat tire, we stop and put air in the tire. If we run out of milk, we go to the grocery store. This is how life happens and we easily can move through our day.

High impact life events, however, are another story. When a high-impact life event occurs, not only does it disrupt our daily routine, but it can stop us dead in our tracks and affect us physically, emotionally, financially – and even socially. These events can be joyous occasions or tragic happenings. Even the planning for such an event to occur can seem to be overwhelming and disruptive and as shown in the chart below, can impact one or more of the areas of our wellness.

When the person going through a high-impact life event is an employee, the repercussions can even have a ripple effect throughout the workplace.  The distractions of the event can cause good performance to deteriorate, absenteeism to occur, cooperation with team members can erode, and a once focused employee becomes distracted. Supervisors and Human Resources traditionally have dealt with these issues through Performance Improvement Plans (PIP) up to and including termination of employment. Consideration should be given to using the EAP in conjunction with PIPs to set an employee up for success.

As an example, take the case of Jack, a sales manager and highly valued employee for a manufacturing company. Jack has been employed for over 15 years and has been promoted to a leadership position.  The plant manager, Jim, has been approached by several members of Jack’s team with concerns about his explosive temper. Multiple employees have threatened to quit because of his anger. Jim doesn’t want to lose his sales manager or employees, and he knows he needs to have a conversation with Jack. As a first step, Jim goes to HR who suggests he call the company’s EAP.  She explains to him, although he did attend training for workplace leadership, the EAP consultant can walk him through the conversation he needs to have with Jack as well as discuss the operational changes Jim expects from Jack.  They will also discuss the EAP formal workplace referral process where Jack will be put in touch with the consultant.  The EAP consultant will assess with Jack the change in his behavior as well as his understanding of the workplace expectations.  The conversation Jim has with Jack will also discuss the behavioral expectations and the EAP referral is confidential. Jack will sign a release so Jim can know of his attendance, participation, and progress in the EAP. Depending on the EAP, Jack could be seen by an internal counselor/consultant or be referred out to someone in the EAP’s provider network. That referral source will follow up with Jim each session as well as seek to see if there are changes in Jack’s workplace behavior.  The counselor will have an understanding this referral is due to Jack’s behavior at work and the expectations of the workplace.  They will do a thorough assessment of Jack to see if he is experiencing any mental health or substance use problems or issues around life management. 

Jack meets with his counselor and explains he is dealing with a lot of stress. His father has been ill and in and out of the hospital. Jack has been trying to help his mother and make decisions for his father.  He also reports he and his wife are having communication issues that have led to a lot of tension at home. He admits he has been more hot-headed at work. The counselor, along with Jack, set goals for how he will work on these underlying issues. The counselor is aware the EAP can help Jack with his questions regarding plans for his father through their elder care services. The counselor also lets Jack know the EAP can help with legal and financial questions as well.  They discuss how Jack can be more emotionally aware of when he is feeling tense and improve communication at work and home. They set a plan for several more sessions to work on understanding feelings and communicating more effectively and a suggestion is made to Jack that he could benefit from some leadership coaching and recommends he mention this to Jim. Many EAPs offer coaching alongside other training for managers.  It is also recommended Jack and his spouse seek to do some work to strengthen their marriage.  

Jack returns to the workplace with a renewed interest in being his best self at work. He meets with his sales team and reviews the services of the EAP and encourages others to reach out confidentially. Jim and Jack talk about the improvement in Jack’s performance as well as the performance of the sales team.  They discuss with HR other ways they can utilize the services of their EAP and talk specifically about a situation from several years ago when a beloved employee died in a car accident and employees struggled with the loss. 

Most EAPs offer crisis management or disruptive event services to help the workplace and employees when events happen that disrupt workflows, such as an employee death or a workplace robbery.  Having someone onsite to normalize and discuss emotional reactions makes good business sense for the organization.  It shows the employer cares about its workforce, and it provides stability in what can sometimes be a traumatic situation. 

There are so many things Employee Assistance Programs can do to help the organization as well as its employees. Most EAPs offer counseling and life management services to employees and family members. It is important to understand that when an EAP is workplace-focused, it can provide a variety of components to prevent the people problems that can derail a company and create a loss.  Seek to find out how EAPs work with member organizations and their vision for helping the workplace.

Evaluating EAP’s
A trusted advisor will want to understand the needs of the organization’s workforce to offer the right EAP solutions to the employer. For example, is the employer looking to provide referral support to employees undergoing specific mental health situations?  Alternatively, is the EAP needed to support management in employee relations, counseling, leadership training, and assist in moments of workplace crisis?

Some questions to consider during the evaluation process:

• Do the EAPs being evaluated offer up the eight core technologies outlined above?
•  Are services provided for not just mental health, but financial, social, and physical health?
• How does the EAP work with the organization to promote utilization?
• What is turnaround time from when an employee accesses the EAP? 
• How is management supported in handling employee relations situations? 
• If referrals are made for an employee to the EAP what guidance is provided to ensure that the employee’s work performance is also addressed?
• What is response time if a workplace crisis occurs?
• What are the credentials of the counselors?
• What is the cost of the program?
• Are policies in place to support EAP programs, i.e. Drug Free Workplace and rehabilitation policy?

An EAP can be offered as part of a carrier’s group health plan or EAPs exist as a stand-alone service.  Some EAPs just offer referral services to outside providers while others provide what would be considered health-related services and these may be subject to ERISA, COBRA, ACA, and/or Mental Health Parity and the Addiction Equity Act (MHPAEA). Advisors should also be aware of any state-specific laws that may apply as well.  It will be important for the advisor to guide their employers through the compliance maze.  

Be sure when providing solutions that the employer is not just checking a box that an EAP is in place. Understanding the organizational needs will uncover other questions to properly evaluate individual solutions. A solution that is not needed, not promoted, and not supported will ultimately fail. 

 EAP at the Worksite
Many times EAPs are promoted once a year during open enrollment. With this type of exposure, the EAP the return on such a highly valuable program is diminished. The EAP should be a prominent fixture in the workplace. From posters to webinars, to training programs, HR should be taking advantage of all the available marketing material. 

Employers will want to erase any existing bias or stigmas that employees may have towards an EAP. Therefore, the more exposure to all the available services, the confidentiality in employees using an EAP, and most importantly the support of leadership will be critical to the success of the program. It will be important that HR is supporting management in training on the services, introducing an EAP referral when appropriate, and positively promoting the service when talking to employees. 

Conclusion
In determining the components of the EAP, benefit advisors can help their employers think strategically and not only about the employee’s top concerns. Helping the employer move towards a corporate philosophy focused on its employee’s wellbeing, the benefit advisor can then begin to establish the framework for the structure of an EAP as a component of a wellness plan to meet that philosophy. This philosophy is then translated into the operating plan for the program. 

Bobbi Kloss is the Director of Human Capital Management Services for the Benefit Advisors Network – an exclusive, national network of independent employee benefit brokerage and consulting companies. For more information, please visit: www.benefitadvisorsnetwork.com or email the author at bkloss@benefitadvisorsnetwork.com.

With more than 30 years of EAP experience, Lucy Henry, LPC, CEAP, is Vice President of Stakeholder Relations at First Sun EAP. For more information, visit https://firstsuneap.com or contact the author at lucy.henry@firstsuneap.com.