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Integrated Benefits/Absence Management. Bringing Total Absence Management Into the Workplace. CAS/SOA: Enterprise Risk Management Symposium July 30, 2003 Washington, D.C. Stephanie Ramsey, B.S.N., M.P.H. Employer Motivation for Integrated Disability Management.

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integrated benefits absence management

Integrated Benefits/Absence Management

Bringing Total Absence Management

Into the Workplace

CAS/SOA: Enterprise Risk Management Symposium

July 30, 2003

Washington, D.C.

Stephanie Ramsey, B.S.N., M.P.H.

employer motivation for integrated disability management
Employer Motivation for Integrated Disability Management
  • Number 1: Escalating costs of employee absences due to illness/injury – from 3.9% of payroll in 1999 to 4.6% in 2002
  • Number 2: Heightened awareness of inherent cost structures of total costs of disability
    • Direct (Claim costs, wage replacement, premiums)
    • Indirect (Administrative expense, replacement employees, disability FICA taxes, decreased productivity)
employers time off and disability programs

53%

23%

47%

27%

14%

15%

24%

7%

Employers’ Time-off and Disability Programs

(76%)

15%

Current Practice

Planning/Considering

Consistent return-to-work policy

One STD/LTD carrier/TPA

Common occupational and non-occupational intake

Linked occupational and non-occupational claims data

One STD/LTD/WC carrier/TPA

Source: Marsh Mercer Study: Survey of Employers’ Time Off and Disability Programs 2002

(39%)

18%

employer responses
Employer Responses
  • Return to Work/Stay at Work Programs
    • Early identification/absence tracking
    • Medical case management
    • Job modifications/accommodations
    • Employee Health Promotion
  • Benefit Plan Integration
    • Plan design
    • Plan Administration
  • Information Management
return to work stay at work programs
Return to Work/Stay at Work Programs
  • Identification of all absence episodes
  • Identifying absence episode according to type
  • Incentives for return to work
  • Medical case management
  • Health Promotion
benefit plan integration
Benefit Plan Integration
  • Internal:
    • Benefit Plan language
    • “Human Capital Manager”
    • “Big picture” view of costs
  • External:
    • Single carrier or TPA
    • “One-stop shop” for claim service and statutory requirements
    • Summary reporting
information management
Information Management
  • Predictive Modeling
    • Identification of “cost drivers”
    • Identification of “risk populations”
  • Management Decision Support Applications
    • What are the steps that need to be taken to achieve the desired results?
information management and a management decision support system

EE Demographics

Absence Occurrence

Management Decision

Support Application

Med Claim

$ Information

ICD – 9 Causes of

Illness/Injury

  • Health & Productivity Management
  • Staffing & Budgeting
  • Management Practice
  • Environmental Control
  • Vendor Management

STD Claim

$ Information

Med Provider

LTD Claim

$ Information

Return to Work

Rates

Pharmacy

Management

Programs

FML Utilization

Information Management and a Management Decision Support System
total absence management supply side vendor response
Total Absence Management “Supply-Side”Vendor Response
  • 62 Suppliers of Integrated Programs

(Source: Integrated Benefits Institute)

  • Poorly Defined Product Requirements
  • “Customized” Character of Product
  • Separation of Product Process Features From Demonstrable Results
  • Data Management Challenges
the new client vendor relationship
The New Client/Vendor Relationship
  • Not “Plug-and-Play”
  • Collaboration
  • Program + Metrics + Methodology = Actionable Results
slide11

Information Management

What are the Operational Risk Management Measures that will translate these employer initiatives into the financial terms that support effective control measures?

  • Predictive Modeling
    • Identification of “Cost Drivers”
    • Identification of “Risk Populations”
  • Management Decision Support Applications
    • What are the steps that need to be taken to achieve the desired results?