Putting Humanity into HR Compliance: Compassionate Employee Benefits Administration

Jathan Janove, J.D. By Jathan Janove, J.D. February 25, 2019
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​Health, disability and retirement laws and plans have something in common: They can be frustratingly complex. Following them can be intense exercises in deciphering and interpreting many rules, words and numbers.

But employees are guided by their hearts and instincts when they think about the circumstances in which they must use these plans: "What happens if I get sick, become disabled or want to retire? What's the impact on my family and me?"

It's understandable, given the potential for large penalties if they don't follow the letter of the law, that some employers take a compliance-oriented approach to employee benefits administration. But such an approach may conflict with a fundamental reason the employer provides employee benefits: to enable employees to work productively for the employer without worrying about their family's health or financial security.

Notwithstanding the daunting plethora of rules and regulations, what if employers were to view their benefits programs from their employees' perspectives? How would that change the way employers talk and think about employee benefits? Would employees use—and appreciate—the benefits more?

Misty Paxton, director of people experience at 1-800 Contacts in Draper, Utah, suggests employers examine how employees enroll in benefit programs—and why they may not. "Ask what obstacles prevent employees from enrolling, even when it's in their best interest to enroll, and how employers might help employees overcome the obstacles. Some assistance might be structural, such as automatic enrollment in health, disability and retirement plans unless the employee affirmatively opts out. Some assistance might be technical: accessible web-based information and forms with which to make choices. Some assistance might be human: a freely available consultant to help employees choose the option best for them."

Thomas Kramer, employee benefits attorney at Bullard Law in Portland, Ore., suggests some "What if?" questions for employers to consider: 

  • Denial of a medical claim (or a request for preauthorization of a medical procedure) can stress an employee. What if the employer's benefit consultant or another third party were to serve as an "ombudsman" to help the employee appeal the denied claim or get approval of an acceptable alternative?
  • Most of us know we could adopt a healthier lifestyle (and we often make doing so a New Year's resolution). What if the employer made available a coach to advise, encourage and monitor employees' lifestyle choices?
  • It may be in the employer's best interest (as well as the employee's) if an impaired employee took time off with disability benefits. What if the employer were to make available a consultant to assist employees in obtaining insured or Social Security disability benefits, or both?
  • Employers generally sponsor retirement plans to permit employees to retire when their desire and ability to continue working productively wanes. What if the employer held retirement-readiness meetings with employees to show the value of saving early? What if the employer made available a consultant to advise employees about Social Security and Medicare benefits to make retirement less daunting?

"Benefit offerings should be about choice and flexibility. What is important to one employee may not be important to the next," said Lindsey Prout, HR director for First Tech Federal Credit Union in Portland, Ore.

"Focus on introducing different delivery channels for your benefits so employees can access them at the time of need. You can provide an abundance of materials to employees, but if they cannot easily access the information at the time of need, then the materials are ineffective. It's important to show employees why they should want to download the app or go to this link. We call this the 'What's in it for me?' approach.

"Do a deep dive into your plans with your brokers each year. Find the included benefits and perks that are imbedded in the plans but are not always visible (e.g., health coaching, weight loss management, veteran's benefits, travel assistance, etc.). Often, companies don't even realize their plans have these extra benefits, which are constantly being added and improved. You're paying for those hidden benefits, so use them to show the richness of your plans.

"Being able to communicate benefit offerings to employees is critical. If you have a marketing or communications team, work very closely with them to develop a benefits communication strategy that will surface and highlight all the great benefits. Focus on one topic a quarter so as not to overwhelm employees and to capitalize on repetition of the topic. It's always beneficial to align the focus around a company goal, company initiative or even a nationally recognized day. You can always change up the material, but the underlying topic should remain consistent within the quarter.

"Market your benefit offerings through quick videos or micro-learnings. Remove the fear behind using a benefit by showing a demonstration or short video (i.e., telehealth).

"In 2018, we piloted and implemented Cigna One Guide, which is a service through our Cigna plan that offers a variety of assistance for our employees, from scheduling doctors appointments to appealing denied claims. It has proven to be a huge success for many employees who have complicated medical challenges."

Lastly, Prout offers this advice to HR professionals: "Leverage your broker for compliance so HR can focus on the value-add items."

Tom Christina, employee benefits attorney with Ogletree Deakins in Greenville, S.C., summed things up this way:

"Given what employers spend on employee benefits every year, doesn't it make sense to give those benefits their best chance to achieve the employer's goals of attracting, retaining and increasing productivity of good workers? Why not try to look at benefit design and administration from the employees' point of view, to see whether the employees believe they're getting the security from the benefit program for which the employer is paying? And if a significant portion of the workforce is not getting the desired security from the benefit program, would a human assist, in addition to a structural or technological one, provide the benefit desired by both the employee and employer? That could be a real return on investment."

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