Reaping the Rewards of Benefits Integration
Discussions at this week’s Disability Management Employer Coalition conference held in New Orleans included measures for keeping employees healthy, injury free, and on the job.
Conference participants also reviewed risk reduction, ease of administration, and cost saving advantages obtained by integrating absence management and disability benefit programs such as workers’ compensation, the Family and Medical Leave Act, and short-term disability offerings.
Proponents say integration makes sense because of overlaps among the range of programs under which workers can be absent and the cost to organizations regardless of the reasons for missed work days.
They also point to potential compliance risks when the administration of programs is segregated and improperly aligned.
“There is hardly any situation where there is just one perfect claim going on,” said Karen English, a partner at Spring Consulting Group. “If someone is [out] on workers’ comp, they are probably on FMLA [and] STD. Then we have all our concurrent leaves going on. So keeping workers’ comp to the side can actually be viewed as a risk to your organization.”
Failing to integrate can lead to lost opportunities, such as the ability to appropriately minimize the amount of time employees spend away from the job by concurrently running FMLA leave with a workers’ compensation absence.
“Just as an example, if you have a workers’ comp claim and that person is out eight weeks for a surgery, if you don’t run it concurrently, you are allowing that employee to come back from that workers’ comp claim and then go out for 12 additional weeks of FMLA time,” said Trina Mouton, manager of disability management and wellness at CenterPoint Energy.
“So it is really advisable to run those concurrently,” Mouton continued. CenterPoint experiences a 2-to-1 return on investment from its efforts, she added.
Employers speaking at the conference cited their gains from integrating programs, although their results are also influenced by several efforts including implementing return-to-work programs.
“We compare ourselves to the hospital industry in terms of [employee restricted-duty days] and lost time,” said Jane Ryan, return to work recovery and claims services at Mayo Clinic. “Our lost time rates are actually lower than the national industry [average] and I think that speaks to the ability we have to keep people at work or return to work early.”
“There is not one silver bullet or only one way to integrate benefits delivery. Every company is so different.” — Karen English, partner, Spring Consulting Group
The paths that employers take to integration and the programs they integrate vary considerably depending on each company’s needs, speakers said.
“There is not one silver bullet or only one way” to integrate benefits delivery, English said. “Every company is so different.”
English will join DMEC’s CEO, Terri Rhodes, in a discussion on how to integrate workers’ comp, disability, and leave programs on Dec. 1, at the National Workers’ Compensation and Disability Conference® & Expo that will also take place in New Orleans.
At the DMEC conference held this week, meanwhile, other discussion topics focused on specific illnesses and corresponding wellness efforts for keeping employees healthy and productive.
Diabetes, for example, impacts employers’ profitability by driving medical costs that are 2.3 times greater than for people without the illness as well as by increasing employee absences and work disruptions.
“There is no question that diabetes affects the bottom line,” said Matthew Ceurvels, director of disability products at Sun Life Financial. “Productivity can be impacted by presenteeism, when an employee is working sub-optimally, by ad-hoc absences, and by long-term absences when employees go out on a disability claim.”
More employer disease management programs focus on diabetes than on other common illnesses like asthma or heart disease, Ceurvels said.
Diabetes care, for example, is a key component of a wellness program CNIC Health Solutions Inc. offers its workers, said Linda Benedict, human resources manager for the third party administrator of employee benefit plans.
CNIC Health Solutions’ employee wellness program’s overall offerings include a recreation center, free access to a CrossFit trainer, encouragement to engage in desk exercises, and online health assessments tied to biometric screenings that provide employees with private information about their individual risk factors.
As part of its health plan, the company also provides free monitoring and testing supplies for diabetes sufferers along with a third-party tracking service for the diabetes testing results.
“We also offer a discount on what the employee pays for their portion of health insurance premiums,” Benedict said. “That is one of the biggest components of our wellness program.”
The discount works as an incentive, providing employees with a 25 percent health care premium reduction, first for participating in the biometric screening, and then as they maintain a certain screening result level.
That led to a 23 percent improvement in employee health risk over one year, as measured by the biometric screenings.
The wellness efforts have improved employee engagement and morale, lowered workers’ comp losses and reduced absenteeism, she said.
“One key metric for us is that in the last year and a half, we have not had one FMLA leave,” Benedict said. “It has really limited FMLA leave for our employees because they are more engaged. They are taking care and looking at their metrics, and sharing them with their physicians. It is really starting to pay off.”
Sensors Show Promise for Recovery and Prevention
Emerging technologies in biomechanics offer huge promise for the workers’ compensation world.
Take the Motus Pro: a multi-sensor training tool that tracks the throwing and batting movements of baseball players, particularly those who are rehabilitating from injuries.
Developed by the Massapequa, N.Y.-based biomechanics software and analytics firm Motus, the sensor provides feedback to baseball teams’ medical staff to aid in their return-to-play programs.
But the firm has always set its sights beyond baseball, developing its physics engine, hardware and training tools in a manner that would allow the firm to eventually address the larger population beyond athletes, said co-founder and chief executive Joe Nolan.
“We are starting to work on early projects with partners outside the world of sports to refine applications that can be applied to worker safety, human performance optimization and evidence-based, quantified-outcome physical therapy programs,” Nolan said.
There are dozens more products like the Motus Pro that could have a place in the workers’ comp industry, including some of the wearable technology currently being used in baby sensors and monitors to track fetal movement in the womb, said Zack Craft, vice president of rehab solutions, complex care education at One Call Care Management in Jacksonville, Fla.
Wearables could be used in the ergonomics space to potentially prevent carpel tunnel syndrome by monitoring the position of the elbow, total muscles used and the speed of muscles being used by employees during the workday, Craft said.
If a worker has already filed a claim for carpel tunnel, the tool could be used to monitor appropriate positioning and could validate recommendations and potential retraining by providing solid outcome data.
“The small sensor is easily attached using a plastic clip on a glove or through the use of a compression garment,” he said. “For individuals working in an office environment, a very simple postural device can really help them learn to avoid poor positions and improve their posture.”
Wearable technology also has the potential to benefit clinical studies, Craft said. An example is the impact wearables can have on paraplegic patients in the prevention of shoulder injuries such as rotator cuff damage.
Sensors could be used to evaluate the movements of paraplegics in wheelchairs to determine whether they are properly forming a full propelling stroke to avoid damage to their wrist or shoulders.
“This data could then be collected and used to educate the injured worker and any caretakers to prevent the development of bad habits, or to help them relearn appropriate movements,” he said.
“Prevention of these types of injuries is key for paraplegics since the use of their shoulders is critical to complete transfers and pressure shifts.”
Apple recently announced an enhancement to its new Health app to assist wheelchair users in tracking their wheelchair propelling strokes as well calorie burn, periodically reminding them to stay active and take a “roll” around the block, Craft said.
“Wouldn’t it be great if we were able to get an injured worker in physical therapy to upload their exercise information to their workers’ comp treating doctor and claims manager, to see if they were meeting their daily goals?” — Dr. Teresa Bartlett, SVP, medical quality, Sedgwick Claims Management Services
Kathryn L. Havens, assistant professor of clinical physical therapy at the University of Southern California’s Division of Biokinesiology and Physical Therapy in Los Angeles, said that sensors have many great applications, but the difficulty is processing and interpreting all of the data.
Havens has had many discussions with other biomechanists about how to detect certain movement patterns from these velocities and accelerations, because the output from sensors “isn’t so straightforward.”
“I think there is potential and engineers are developing better algorithms for this,” she said. “But at this point we still need trained movement scientists to analyze the data from these sensors in order for the data to be useful.”
Dr. Teresa Bartlett, senior vice president, medical quality at Sedgwick Claims Management Services Inc., believes that technology will eventually be interspersed throughout all of medicine.
“In fact, I am looking for a client that wants to engage some wearable technology in a workers’ comp setting,” Bartlett said. “There are large manufacturers that could benefit from a health and safety perspective.”
Bartlett believes there is a place for such emerging technologies in a manufacturing setting to help prevent worker injuries. For example, sensors could be used by people to prevent elbow and shoulder injuries, to understand mechanics, thrust and the amount of energy it takes to perform certain jobs.
Moreover, existing technologies like the Apple Watch or Fitbit could help mitigate low back strain by getting workers to walk more during the day, Bartlett said.
“Wouldn’t it be great if we were able to get an injured worker in physical therapy to upload their exercise information to their workers’ comp treating doctor and claims manager, to see if they were meeting their daily goals?”
It would also help practitioners better understand if injured workers are being compliant with the quality of their exercise programs and to understand duration and intervals, she said.
For example, practitioners could determine whether workers are walking only in small increments such as one-minute intervals to the bathroom, whether they are walking five miles in one exercise period, or whether they’re walking five miles in one-mile increments.
“This information could make a big difference in their treatment plan and discussion with their doctor or nurse case manager,” Bartlett said.
Electronic Waste Risks Piling Up
The latest electronic devices today may be obsolete by tomorrow. Outdated electronics pose a rapidly growing problem for risk managers. Telecommunications equipment, computers, printers, copiers, mobile devices and other electronics often contain toxic metals such as mercury and lead. Improper disposal of this electronic waste not only harms the environment, it can lead to heavy fines and reputation-damaging publicity.
Federal and state regulators are increasingly concerned about e-waste. Settlements in improper disposal cases have reached into the millions of dollars. Fines aren’t the only risk. Sensitive data inadvertently left on discarded equipment can lead to data breaches.
To avoid potentially serious claims and legal action, risk managers need to understand the risks of e-waste and to develop a strategy for recycling and disposal that complies with local, state and federal regulations.
The Risks Are Rising
E-waste has been piling up at a rate that’s two to three times faster than any other waste stream, according to U.S Environmental Protection Agency estimates. Any product that contains electronic circuitry can eventually become e-waste, and the range of products with embedded electronics grows every day. Because of the toxic materials involved, special care must be taken in disposing of unwanted equipment. Broken devices can leach hazardous materials into the ground and water, creating health risks on the site and neighboring properties.
Despite the environmental dangers, much of our outdated electronics still end up in landfills. Only about 40 percent of consumer electronics were recycled in 2013, according to the EPA. Yet for every million cellphones that are recycled, the EPA estimates that about 35,000 pounds of copper, 772 pounds of silver, 75 pounds of gold and 33 pounds of palladium can be recovered.
While consumers may bring unwanted electronics to local collection sites, corporations must comply with stringent guidelines. The waste must be disposed of properly using vendors with the requisite expertise, certifications and permits. The risk doesn’t end when e-waste is turned over to a disposal vendor. Liabilities for contamination can extend back from the disposal site to the company that discarded the equipment.
Reuse and Recycle
To cut down on e-waste, more companies are seeking to adapt older equipment for reuse. New products feature designs that make it easier to recycle materials and to remove heavy metals for reuse. These strategies conserve valuable resources, reduce the amount of waste and lessen the amount of new equipment that must be purchased.
Effective risk management should focus on minimizing waste, reusing and recycling electronics, managing disposal and complying with regulations at all levels.
For equipment that cannot be reused, companies should work with a disposal vendor that can make sure that their data is protected and that all the applicable environmental regulations are met. Vendors should present evidence of the required permits and certifications. Companies seeking disposal vendors may want to look for two voluntary certifications: the Responsible Recycling (R2) Standard, and the e-Stewards certification.
The U.S. EPA also provides guidance and technical support for firms seeking to implement best practices for e-waste. Under EPA rules for the disposal of items such as batteries, mercury-containing equipment and lamps, e-waste waste typically falls under the category of “universal waste.”
About half the states have enacted their own e-waste laws, and companies that do business in multiple states may have to comply with varying regulations that cover a wider list of materials. Some materials may require handling as hazardous waste according to federal, state and local requirements. U.S. businesses may also be subject to international treaties.
Developing E-Waste Strategies
Companies of all sizes and in all industries should implement e-waste strategies. Effective risk management should focus on minimizing waste, reusing and recycling electronics, managing disposal and complying with regulations at all levels. That’s a complex task that requires understanding which laws and treaties apply to a particular type of waste, keeping proper records and meeting permitting requirements. As part of their insurance program, companies may want to work with an insurer that offers auditing, training and other risk management services tailored for e-waste.
Insurance is an essential part of e-waste risk management. Premises pollution liability policies can provide coverage for environmental risks on a particular site, including remediation when necessary, as well as for exposures arising from transportation of e-waste and disposal at third-party sites. Companies may want to consider policies that provide coverage for their entire business operations, whether on their own premises or at third-party locations. Firms involved in e-waste management may want to consider contractor’s pollution liability coverage for environmental risks at project sites owned by other entities.
The growing challenges of managing e-waste are not only financial but also reputational. Companies that operate in a sustainable manner lower the risks of pollution and associated liabilities, avoid negative publicity stemming from missteps, while building reputations as responsible environmental stewards. Effective electronic waste management strategies help to protect the environment and the company.
This article is an annotated version of the new Chubb advisory, “Electronic Waste: Managing the Environmental and Regulatory Challenges.” To learn more about how to manage and prioritize e-waste risks, download the full advisory on the Chubb website.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Chubb. The editorial staff of Risk & Insurance had no role in its preparation.