Category: Benefits

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Overcoming 4 Barriers in Communicating High-Value Health Plans to Employees

health care education, health literacy, stethoscope and book

Once a promising benefit design to reduce unnecessary health care spending, the consumer-driven health plan (CDHP) has had in improving consumer decision-making and employer cost savings. In theory, CDHPs encourage consumers to “shop” for health care by paying close attention to cost and quality tradeoffs. In fact, evidence shows that the exact opposite is true. Instead CDHPs have caused consumers to skip both necessary and unnecessary care due to the out-of-pocket costs they face prior to meeting their annual deductible.

To manage cost without sacrificing quality or access, more employers are thinking carefully about how to combine health care payment and delivery reform, benefit design and provider network design, such as in an accountable care organization model. ACOs, which feature a network of health care providers that have responsibilities to coordinate care and manage the cost of care, along with incentives and disincentives to do so effectively, now cover more than 10 percent of the U.S. population.

Employers, other health care purchasers and payers are investing in these efforts by building benefit and provider network designs that encourage consumers to use ACOs. However, to get consumers to select these benefit options, purchasers and payers face some barriers.

Also read: How Employers Can Get More Involved With Maternity Care

Cognitive biases are pervasive in every aspect of decision-making, and health care is no exception. Understanding the obstacles consumers must overcome to make informed choices about insurance products and health care providers can help employers design and implement effective benefits offerings and communications strategies.

First Barrier: Health Care Complexity

A deciding factor in whether consumers choose to take action the way we want them to is whether they understand what they are being asked to do. But according to the Employee Benefit Research Institute, there is strong evidence that workers lack the ability to successfully navigate the complex and technical nature of health care. Moreover, a Consumer Health Mindset study found only 40 percent of consumers know where to go to figure out the price of a health service they need or want. Research also shows most adults have a low level of health literacy, lacking the ability to process, understand and act on health information to make appropriate choices.

Learn from employees. As a result, employers must learn what employees care about and where they struggle in their health care experience. What motivates employees to enroll in a particular plan — such as cost or convenience — or prevents them from enrolling may not be obvious.

Second Barrier: Apathy, Inertia and Status Quo

There is an implicit bias toward the status quo when making decisions. This predisposition prevents consumers from carefully considering cost and quality tradeoffs or researching them prior to the moment of decision (in cases where information is available). Change can be uncomfortable and even upsetting.

A large tech company, for example, learned that the primary reason employees chose not to enroll in their new ACO plan was that it was easier to stay in the plan they already knew. Along with deciding whether to enroll in a new plan option, consumers were weighing whether the change, and potential losses from it (e.g., losing access to a key medical provider), were greater than the potential benefits (e.g., ability to access a provider after hours or virtually).

Design the easy choice. For consumers to make a change, the benefits must clearly outweigh the risks. When employers design programs that make it hard for employees to say “no” to enrolling and that inspire confidence that they made the right choice, employees may be more likely to select them. This could mean, for example, offering coverage levels comparable to those in existing plans and/or lower premiums.

Require active enrollment. Requiring active participation during annual enrollment and defaulting those who do not participate into the new plan can be very effective. Employers that include space in benefits communications for employees to write down in concrete terms the action they plan to take and how to do it can also increase active enrollment’s effectiveness. However, employers should use active enrollment sparingly, so it retains its power when they must drive action.

Also read: Employers are Key to Reform in Our New Health Care World

Third Barrier: Established Providers Are Not in the Network

Consumers value their relationship with their doctor with 89 percent saying it’s important. They want to be able to continue seeing the same familiar person who administers their care and may be unwilling to change providers.

One large company asked its employees who didn’t enroll in a new ACO plan, “What would it take to enroll?” Over 60 percent of respondents answered, “my doctor needs to be in-network.”

Make it easy to see who is in the new network. The survey also revealed the main reason employees do not change plans is uncertainty around whether their current providers are in the new network. Therefore, it is critical to provide robust provider-search tools that help employees quickly and easily determine if they can keep their current provider. Communications to employees should boldly promote such tools.

Fourth Barrier: Information Overload

With so many competing sources of information — employers, health plans, doctors, commercials and more — it can be hard for consumers to know what to do and whom to trust. As choices increase, the likelihood that someone will take action decreases.

Also read: When Your Workday Is Interrupted Again and Again…

Think like a marketer. Borrow a page from the consumer marketing playbook and develop multi-channel communication campaigns that are targeted and fully-branded, with simplicity at the core. Personal stories can make communications more relatable and compelling. If a plan has been around at least one year, testimonials from current enrollees can help. If it’s the initial launch phase, quotes from leadership about why they’re choosing the new plan can also help.

Changing deeply ingrained behaviors requires persistent nudging and smart design. To do this, employers need to communicate effectively about the new plans to draw employees’ attention to them while simultaneously shifting their focus from the numerous barriers to enrollment.

It takes effort, but by leveraging these best practices, employers can successfully drive enrollment into high-value health plans.

Suzanne Delbanco is the executive director at Catalyst for Payment Reform, and Lindsay Kohler is a senior consultant at Benz Communications. Comment below or email editors@workforce.com.

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Gift Cards Cook Holiday Turkey’s Goose as Employee Incentive

Cash isn’t always king. Employees can feel the love when they receive noncash rewards from their employer.

The 2017 “Trends Study” from the Incentive Research Foundation found that 70 percent of U.S. businesses used gift card programs and 60 percent gave merchandise as some form of reward to their employees. The report also found that U.S. businesses spent $24 billion annually on gift cards.

Noncash rewards such as gift cards help keep employees connected to the greater whole of the organization, according to Jeremy Tolley, chief people officer at CareHere LLC, a Nashville-based health care and wellness provider.  Its noncash rewards include sending its nurses a card during National Nurses Week or giving employees an Amazon gift card with a note, “Buy yourself a book! You deserve to curl up, relax and read a book.”

Such noncash rewards work well with CareHere’s widely dispersed employee population. “[We’ll] have a pocket of three or four employees in a rural location,” Tolley said.

An extra $25 in a paycheck might not be something they notice, especially with direct deposit, he said. If a company wants to reward an employee, a gift card can make that recognition more memorable.

“It makes the thank-you or the occasion last a little longer because they have that in their purse or pocket, and they can take it and cash it in later,” Tolley said.

Such rewards come with legal guidelines. Employers must keep IRS rules in mind and remember that de minimis items — something like a fringe benefit, for example, whose value is too small to be considered legally — are not taxed. However, the IRS does not define what value is considered de miminis.

“It’s important [that] you have a good relationship with your finance department and make sure that they are aware of the taxation fees, because you don’t want to have a problem and get in trouble with that,” said Paula Harvey, vice president of human resources and safety at Schulte Building Systems Inc., a construction company in Hockley, Texas. “Any time I’m thinking about these things, my CFO and I talk about it.”

Experts consider $25 or less to be a safe amount, she added. Years ago, Schulte began to offer $25 grocery store gift cards during the holidays when there were complaints about the annual Christmas ham and Thanksgiving turkey. A gift card allowed employees to buy what they needed rather than be limited to one item.

Vendors have ventured into the gift-card space and created a system in which employers don’t have to deal with taxation issues, Harvey added — one reason for their popularity over the years.

Buffalo Wild Wings launched a corporate gift card portal in 2014 to allow organizations to buy cards in bulk. They saw it as an opportunity to remain competitive as more large retailers entered the business-to-business incentive space, said Kim Sobasky, director of gift cards at the Minneapolis-based company.

“To be brand-forward and competitive, we wanted to get as easy and simple for companies to purchase directly from us,” she said.

Although legal considerations are important, other guidelines can help companies use gift cards more effectively.

Gift cards shouldn’t be used to recognize good safety records, Harvey said. She’s seen companies reward employees who went a year without a safety incident, prompting some employees to take advantage of the gift. “[Some employees] want to get the reward and then don’t report when they get hurt,” she said.

Offering a gift card to a place an employee does not like may be seen as a disincentive, CareHere’s Tolley said. Many gift cards go unused, he added, because employees lose them or don’t patronize that store or restaurant. People seem to be happy with something more general, like Amazon.

“My No. 1 rule when someone proposes a gift card incentive is, do we know this is a gift card this person will have a use for?” Tolley said.

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A New Look at Caregiving

This past spring, I got that phone call no one ever wants to receive. My mother had experienced a cardiac incident and had to be resuscitated. Mom, heart stopped, resuscitated was about all I heard or understood before I was on a flight.

When I walked into her hospital room the next day, my mom looked decades older than the last time I had seen her. She was stable but weak. I soon learned that the issue was a pulmonary embolism; a big blood clot had traveled from her leg to her lungs and stopped her heart. Had she not been at the hospital when it happened — literally in the arms of a nurse — she would not have survived.

The next several days were some of the most worrisome and stressful of my entire life, and certainly for my dad, sister, and the rest of our family. When my mom was cleared to go home, she faced a double whammy: recovery and physical therapy for her knee replacement (the reason she was in the hospital in the first place), while needing a ton of rest and ongoing monitoring following the embolism.

I spent 2.5 weeks with her, first worrying at the hospital and then helping her at home. All the while, doing my best not to let too much fall through the cracks.

I was only back home for a week when I learned that my grandmother had been rushed to the ER and was in the ICU, awaiting surgery. She is 89 and had been hospitalized not long before. Again, I booked a flight and got to her as soon as I could. For a week, I traded shifts at the hospital with my cousins, aunts and grandfather, spending the night there before and after her surgery.

Fortunately, my mother and grandmother are both doing well now, and the urgency is over. My mom is looking and feeling like her usual vibrant self, and our family is now trying to figure out the right amount of support for my grandparents so they can continue to live independently.

This was all new to me. But my experience is just an example of what is happening all over the country, to millions of families, every day. According to the Bureau of Labor Statistics, more than 44 million people provide unpaid care to elders. And very few people have the flexibility or job security I do. So, in addition to all the stress and fear about their loved ones, they worry about their job and paycheck — and the long-term impact on their career.

I’m more concerned than ever about how we address this within our organizations, large and small. Common-sense programs like referral resources and backup child care and elder care already exist. And although 99 percent of employees surveyed by Bright Horizons Family Solutions said backup care is important in helping them complete their regular work responsibilities, only a portion of employers offer this as a benefit.

There are a host of other programmatic benefits that better support caregiving: extended leave, support transitioning back from leave, flexible schedules and work-from-home options, on-site child care and more. We have seen time and time again that introducing these benefits has a positive impact on the whole company, not just those who use them. Yet, McKinsey’s 2017 “Women in the Workplace” report states “support for parents on an ongoing basis is relatively scarce.”

Clearly there’s an opportunity to provide more programs for employees. But it isn’t enough to simply put benefits in place that support navigating care or filling gaps.

Organizations must also have cultures of trust and compassion, so employees can be transparent about the burdens they manage outside of work and so their work can flex around those needs. This is especially important for women — and the organizations that need to and want to retain them.

The burden of caring for others falls disproportionately on women. They’re more likely to take breaks from their careers to help a family member and they are less likely to have a partner who stays at home to care for the family. The impact in the short term is job insecurity and stress. In the long term, it means women have less savings.

The Women’s Institute for a Secure Retirement estimates that women caregivers lose an average of $324,044 in wages, Social Security benefits and retirement income over a lifetime. As a result, they’re twice as likely as non-caregivers to end up in poverty.

Caring for loved ones is real life. It is time for us to build work around that reality.

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Some Employers Bringing the Gas Pump to Employees

As consumers brace for a spike in gas prices this summer, some employees may be feeling a little less pain at the pump thanks to a relatively new perk — fuel delivery at the workplace.

In the past few years, a number of startups that offer this service have popped up across the country, promising to spare employees the hassle of filling up at the gas station. There is Booster Fuels in the Bay Area, Filld in Silicon Valley, Yoshi, which launched last year in Southern California, and Neighborhood Fuel in Miami, among others.

“It’s a perk that doesn’t cost the employee or the employer anything, that puts time back into your schedule, saves you money and eliminates a chore that no one enjoys,” said Jorge Camaraza Jr., founder of Neighborhood Fuel.

He said he got the idea in 2015 after a frustrating experience at a gas station with a broken pump and a faulty credit card reader.

“The workplace is a great market for this,” he said. “There are a large amount of cars and predictable parking opportunities to service the client. They can park their car, push a button on an app and leave work with a tank full of gas.”

Employees request fuel delivery through their smartphone and designate the location where their car is parked. A truck carrying fuel will stop by and fill their tank and the employee will get a notification on their app and a receipt, he explained.

Some startups add a per gallon surcharge or a monthly fee, but Camaraza said that Neighborhood Fuel makes money by buying gas directly from suppliers at a lower cost than at the pumps.

With gas prices at their highest level since 2014, commuters will be paying more, but some will be doing it from the comfort of their office chair.

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Senior Living Facility Employees Benefit from Art Therapy

Elder Care Alliance Employees participate in creative activities in the Create Art at Work program. Photo courtesy of Dr. Erin Partridge. Photo courtesy of Dr. Erin Partridge.
Elder Care Alliance Employees participate in creative activities in the Create Art at Work program. Photo courtesy of Dr. Erin Partridge.

Last month I asked you readers if your company has ever incorporated something creative or art-based in your wellness program. One organization, Elder Care Alliance, a nonprofit senior living organization based in California, responded with a unique program they launched a year ago called Create Art at Work. I enjoyed this as a mini-case study and hope that you find some ideas here that could work at your organization as well!

Management at the nonprofit knew that it needed to do something novel to address the issues its workforce was facing, including stress, burnout and turnover, said with Rosemary Jordan, vice president of business development and strategy at Elder Care Alliance. Jordan leads the team that launched the Create Art at Work program.

The direct care employees at Elder Care Alliance have emotional, physically demanding and fast-paced jobs even with meals and breaks planned in their schedules. But they also see their job — taking care of older adults — as a calling and do this type of work to make a difference in their lives.

“We were feeling, especially because we’re a not-for-profit organization focused on taking care of our employees as well as our residents, that we needed to do something different,” Jordan said.

Traditional wellness programs did not fit this workforce, she added. “They weren’t, in our experience, catapulting us toward results the way we needed them,” she said.

Then Dr. Erin Partridge joined the company in January 2017 as an experimental researcher in residence. As a licensed art therapist, she had both practical and research experience in how to implement an art therapy program. Also, there was already an art therapy program for the residents of the living facility, so bringing something similar to the organization’s workforce was a manageable idea.

One thing I’d like to note here: When I blogged about this topic before, I focused on art as a social event for employees, not as an actual evidence-based, therapeutic exercise. What this organization is doing is very different and actually aligned to the real definition of art therapy.

“We’re not just going to paint by numbers or play with clay. While it is fun, we don’t see it as entertainment or play,” Jordan said. “It’s not a one-off. In fact, we’re trying to situate this as truly embedded in the day-to day work experience. We’re trying to normalize it and make creative arts practice like a fully legitimate thing to be doing.”

Rosemary Jordan, vice president of business development and strategy at Elder Care Alliance, leads the Create Art at Work Program.
Rosemary Jordan, vice president of business development and strategy at Elder Care Alliance, leads the Create Art at Work Program.

There are a few activities that are designed to help employees in different ways, Jordan said. Group journaling is one that individuals can do on their own time while they’re drinking coffee in the morning, or any part of the day they wish. They all respond to the same prompt — which can be something thoughtful or something as simple as “Pie or Cake?” — and everyone’s contributions are accumulated in the same place. Even the “Pie vs. Cake” prompt led to positive results, inspiring a bake-off that engaged many employees.

The organization also hosts a “creative break” once a month in which anyone can drop in on a two-hour-long open studio and participate in a creative project next to your colleague. This is designed to be more collaborative than the individual journaling.

Another area they’re working on is getting people in analytical or leadership roles to abandon PowerPoints and boring charts and think more creatively about how they present ideas. This is difficult because many of these people have been in the workforce for 20 or 30 years, and through job training or business school they’ve learned how to do things a certain way. It takes a while to get people out of their comfort zones, Jordan said, but it’ liberating when it happens. She pitched a business plan to the CEO via a gallery walk rather than a traditional PowerPoint.

This program stuck with the Elder Care Alliance Employees while other wellness programs didn’t for a few reasons, Jordan said. Many people in the workforce don’t speak English as a first or primary language, and art can appeal to anyone no matter what language they feel comfortable with. “It’s seldom to see wellness programs that are truly accessible in terms of preferred language,” Jordan said. “But the language of art is universal. Everyone can feel confident and competent.”

One activity in which leadership participated in was this tree mural in which each member of the leadership team, responding to a prompt, contributed a leaf to the tree. Photo courtesy of Dr. Erin Partridge.
One activity in which leadership participated in was this tree mural in which each member of the leadership team, responding to a prompt, contributed a leaf to the tree. Photo courtesy of Dr. Erin Partridge.

Also, the gamification and competitive elements that are common in many types of wellness programs don’t appeal to everyone. It might appeal to populations like employees in a start-up bro culture, but not the employees at Elder Care Alliance.

“When we’re talking about a 45-year-old mom who was born in Honduras and struggling with three jobs; that’s not really going to get it done for her,” Jordan said. “It’s not going to feel meaningful or relevant.”

Finally, many wellness programs require a lot of commitment and many gadgets, which just aren’t practical or realistic for these employees at their worksite. By focusing on art therapy, the employer created an accessible space for employees, and all employees have to do is come.

“It’s flipping the script on whose responsible, which has a lot of currency right now,” Jordan said. “Frankly, I think there’s been a little too much of finger wagging and putting a lot of pressure on employees to be better at wellness.”

I enjoy this wellness program example for many reasons. Most importantly, it’s truly personalized to the organization’s workforce, which isn’t something I hear too often as a wellness blogger. Yes, everyone loves to say their program is personalized and holistic, but oftentimes it sounds like a simple reiteration of any other wellness program.

The other part of this example that I enjoy is how this program is utilized in the health care industry. No surprise, the health care industry is a stressful place to work, and burnout is common.

I love seeing these real-world examples of how to incorporate the stress-reducing qualities of creating art in the workplace. Thanks for sharing, Elder Care Alliance!

The “On My Mind Prompt” is one activity which program participants have been able to interpret hundreds of ways. Photo courtesy of Dr. Erin Partridge.
The “On My Mind Prompt” is one activity which program participants have been able to interpret hundreds of ways. Photo courtesy of Dr. Erin Partridge.

Final Thoughts:

Not related to the art therapy program, Jordan has many interesting things to say about wellness in the workplace, specifically around mental health and holistic well-being. I found this conversation to be especially relevant after seeing all the conversation around mental health in the workplace following the suicides of Kate Spade and Anthony Bourdain.

“Our national conversation about mental health is still in its infancy,” Jordan said. While it’s great that there’s now more public discussion about mental health and that people are trying to reduce stigma, there’s more work to be done. There’s more than just depression, but sometimes depression is all people focus on. There’s a broader conversation to be had about mental health.

My question for readers: Besides depression, what are other areas of mental health you can focus on or you have been focusing on in the workplace, via benefits, wellness programs or another vessel? Feel free to share!

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The Unique Challenges of Workplace Accommodation for Psychiatric Disabilities

The number of psychiatric disability discrimination claims brought under the Americans with Disabilities Act of 1990 has been increasing significantly in recent years, now comprising nearly 30 percent of all ADA charges filed with the Equal Employment Opportunity Commission.

If a particular workplace and labor force has not already been impacted by this unmistakable national trend, it may well be in the near future. For both psychiatric and physical disabilities, an employee must satisfy two criteria in order to be entitled to a reasonable accommodation under the ADA.

First, the employee must have a “disability,” defined as a “physical or mental impairment that substantially limits one or more major life activities,” a “record of such impairment,” or be “regarded as having such impairment.”

Second, the employee must be a “qualified individual,” meaning that he or she is capable of performing the essential functions of his or her job with or without an accommodation. If the employee satisfies both of the above criteria, the employer must provide the employee with a reasonable accommodation, provided that the accommodation does not impose an undue burden on the employer.

The application of these requirements in ADA psychiatric disability cases presents very distinct challenges. For example, if an employee works in the customer service industry where appropriately interacting with the public is an essential function of the job, an employee with a psychiatric disability that causes inappropriate behavior such as shouting or making offensive comments to customers may or may not be qualified within the meaning of the ADA. This ultimately depends on whether he or she is capable of complying with the conduct standards of the job with or without a reasonable accommodation.

To assess whether a reasonable accommodation that will allow the employee to perform the essential functions of the job is possible, it is absolutely critical that the employer and human resources team communicate effectively with the employee. There needs to be a consistent, honest and ongoing dialogue to explore and identify, if possible, a set of accommodations that works well for everyone.

The often complex and multifaceted issues involved with psychiatric disabilities can only be effectively addressed on an individualized basis. Constructive and ongoing feedback from the employee is absolutely essential for this to happen, and further enhances the value of a workplace offering a professional atmosphere that values trust and openness.

It is also crucial to keep in mind that an employee who violates the conduct standards at his or her place of employment is not immune from discipline just because the violation is a direct result of the psychiatric disability.

For example, in one particular case [Higgins v. Maryland Department of Agriculture, No. L-11-0081, 2012 WL 665985, at *2, 6 (D. Md. Feb. 28, 2012)], the court held that a director with bipolar disorder who was responsible for interacting with health professionals, government officials and members of the public on a daily basis was properly terminated because his abusive and abrasive behavior was inconsistent with company policy and incompatible with an essential function of the job.

In contrast, in situations where an employee’s conduct is not incompatible with the job’s standards, courts may determine that the employer had a legal duty to provide a reasonable accommodation.

Examples of what could be appropriate accommodations for employees with psychiatric disabilities, depending on the particular circumstances, include permitting the use of accrued paid leave or additional unpaid leave for treatment or recovery; modifying the employee’s work schedule; installing room dividers or partitions; relocating the employee to a quieter workspace or permitting the use of headphones; adjusting supervisory methods; providing or otherwise allowing a job coach to accompany the employee or reassigning an employee to an equivalent position.

If the ADA psychiatric disability filings are an accurate indicator, we are in the midst of a growing recognition that accommodating psychiatric disabilities in the workplace is an increasing employment concern. Employers, of course, must understand their legal obligations with respect to the ADA (as well as state and local anti-disability discrimination laws they may be subject to).

Employers are encouraged to explore how to accommodate their employees with psychiatric disabilities through engaging in an open dialogue with them to understand their workplace challenges and the unique ways in which they manage those challenges each and every day.

A. Jonathan Trafimow is a partner at Moritt Hock & Hamroff and chair of the firm’s Employment Law practice. Caitlyn M. Ryan is an associate at the firm. Comment below or email editors@workforce.com.

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Five Practical Ways to Support Mental Well-being at Work

The American Institute of Stress reports that stress is the nation’s top health problem. This makes sense, as mental capacity is highly valued in the workplace but can also be highly vulnerable. Today’s workplace, with technology, fast-paced growth and decreased resources, can contribute to increased stress.

Companies should value the mental health of their employees as a top asset and fiercely protect it. Mental well-being impacts engagement, presenteeism, absenteeism and productivity — all of which impact businesses bottom lines. More importantly, supporting and protecting the mental health of your employees is the right thing to do.

Here are five best practices to support mental health in the workplace.

  1. Normalize the conversation.

Top-down support of mental health is crucial in creating an open dialogue, as is an open-door policy. Senior leaders should participate in the conversation about mental wellbeing to show buy in. Normalizing the occurrence of a grief reaction or stress disorder can insure that your employees seek help when it happens to them.

Establishing mental health champions within your organization is another way to encourage a healthy dialogue. People with mental health conditions who want to help others are great candidates for this role.

Use awareness days that focus on stress and mental health as external nudges to educate staff about these important issues. Importantly, remind staff that a diversity of perspectives, including those with lived mental health experiences, are valued and encouraged in inclusive environments.

  1. Implement strong policies and procedures.

Disclosure can help an employee seek the appropriate resources and care before conditions worsen, so having proper policies and procedures in place are important in removing barriers to disclose.

This includes protection against discrimination, which is usually a top concern for employees, as well as providing appropriate workplace accommodations. Ensure managers are aware of key resources, like employee assistance programs, and maintain confidentiality when an employee discloses information.

Beyond this, educate employees on policies, procedures and proper protocols to increase employee awareness. Here’s a tip: Repeat key messages and tailor your communications to better reach your staff.

  1. Prevention is better than cure.

It’s essential to remember that anyone is susceptible to stress and a resulting decline in their mental health, whether a preexisting condition exists or not. Big life events like having a baby or losing a loved one and every day struggles like money worries, relationship issues or work-related stress can cause or aggravate mental health conditions to the point of interfering with work. 

Mental wellness sessions or work/life balance programs can help. Bring in an expert and talk to your staff about how to safeguard their own mental health, build resilience and recognize signs of distress in others.

  1. Tailor your benefits package to support mental wellbeing.

Choose a major medical plan that gives employees access to quality mental health specialists in network, as these costs can add up significantly. Helping employees have access to and triage the right specialist support is crucial in managing conditions.

EAPs can act as a first line of defense for a wide range of problems – from money and relationship worries to support for working caregivers. They provide both practical and emotional support for employees through confidential counseling and can help prevent issues from escalating and impacting productivity. These programs are often offered as part of a major medical or disability plan, so your company may already have access to them.

Money worries can also take an emotional toll on wellbeing. In fact, financial concerns were the leading cause of stress across all generations in a recent consumer study conducted by my company, Unum.

Help your employees establish a strong financial foundation by offering financially-focused benefits, like life and disability insurance, retirement savings options and supplemental health benefits that can close the rising financial gap in medical plans.

If your budget doesn’t cover these benefits, consider offering them on a voluntary basis. Access to financial protection benefits are more affordable when offered through the workplace, even if the employee picks up the cost.

Flexible hours or remote working options can also help employees schedule their work days when they’re feeling most productive. This can help reduce presenteeism for mental ill-health, and it also signals to employees that you’re supportive of a healthy work/life balance.

  1. Encourage self-care.

Self-care plays a critical role in overall wellbeing. Encourage employees to do small tasks that’ll help them build resilience over time.

The basics like getting plenty of sleep, eating healthy, drinking water, and exercising are foundational in overall wellbeing.

Beyond these staples, developing appropriate time management and work/life balance skills are also important. Delegating and collaborating are also key to ensure healthy work behaviors which also decrease stress.

While technology and our always-on culture make it hard to disconnect, encourage employees to set device off-times so they can fully recharge before the next day. And most important, model this behavior to your staff and limit after hours work and emails.

Having a holistic mental well-being strategy that includes prevention, intervention and protection is essential for unlocking a workforce’s true potential.

Michelle Jackson is assistant vice president for workforce solutions at employee benefits provider Unum. Comment below or email editors@workforce.com.

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Sector Report: Anxiety and the Employee Assistance Program

American workers are stressed, and for a lot of reasons.

The American Psychological Association’s 2017 “State of the Nation” report found that health care, financial concerns and trust in the government top the list of stress-inducing issues. It also found respondents are more likely to report symptoms of stress, which include anxiety, anger and fatigue, than they have in the past.

This is not good news for employers, said LuAnn Heinen, lead expert on employee assistance programs for the National Business Group on Health, a Washington, D.C.-based nonprofit organization focused on national health-policy issues.

“Stress and anxiety are huge issues in the workplace and it is spreading globally,” she said. Stress can have a huge impact on productivity and performance, and drive up absenteeism and turnover, all of which affects the bottom line — which is why EAP programs are so important.

EAPs were originally designed to address employee drug and alcohol abuse problems, but they have expanded over the years to cover many aspects of mental health, including anxiety, depression, sleep disorders and stress, Heinen said. These programs can have a positive impact, but only if employees feel confident taking advantage of them.

Despite more open dialog about the importance of mental health, many employees can be embarrassed to take advantage of these services. “It’s important to destigmatize their use and to communicate that anyone can benefit from an EAP,” Heinen said. “For a lot of people, just a few conversations can be enough.”

Companies can foster a more open attitude around mental health by training managers to identify signs of stress or other issues, and by supporting peer advocacy and employee groups to support use of mental health programs, said Barb Veder, vice president of clinical services and research lead for Morneau Shepell, an HR services and technology company headquartered in Toronto. She also encourages benefits managers to think about the barriers of use for EAPs, and to work with their vendors to ensure they are offering a variety of platforms, education materials and communication strategies to encourage its use. For example, offering multiple digital services including apps, telecounselling and remote support tools provides greater flexibility in how these services are accessed and can reduce some of the anxiety around being found out, she said.

These varying EAP platforms also address the way different generations want to take advantage of support services. “Millennials are all about ease of access,” Veder said. They want multiple ways to access information, including videos, online content and self-paced solutions that don’t require any human intervention, whereas older workers may still prefer to talk to someone on the phone or face-to-face. “You need to design programs that adapt to these needs, and offer many ways to access information,” she said.

Millennials’ digital upbringing also impacts the kinds of EAP services they may use.  This generation tends to feel more lonely and isolated, compared to prior generations, in part because they spend so much time online. A 2017 study found that young adults who use a lot of social media feel more socially isolated than their peers. Millennials also report higher stress levels than other generations according to the APA report. Providing services that address these issues and target younger workers may make the service offerings more relevant. “It’s important to be mindful of these dynamics, and to create programs that address these issues,” Veder said.

Heinen agreed. “When you create an employee centric program that provides access to services based on learning style and lifestyle preferences, the likelihood that employees will use the program is higher.”

Sarah Fister Gale is a writer in Chicago. Comment below or email editors@workforce.com.

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Workplace Loneliness Is Sad for People and Bad for Business

“Loneliness can contribute to depression, which is a costly problem, It’s important to teach managers how to start a conversation with an employee who seems lonely,” said one source.

From communication tech tools to open-floor office plans, employers are finding ways to encourage collaboration. Yet loneliness in the United States is on the rise and that is proving detrimental to worker well-being and bad for business.

Nearly three-fourths of Americans experience loneliness, according to a 2016 Harris poll. For many it’s not an occasional occurrence but a persistent problem, with one-third saying that they feel lonely at least once a week, the survey found.

Those at the top are especially at risk for feeling socially disconnected, with half of CEOs reporting feelings of loneliness in their roles, according to a 2012 survey by RHR International, a leadership development firm. More than half of that group believe their performance suffers as a result.

Employees without close or supportive relationships at work are more likely to feel disconnected from their jobs and that can affect their performance, according to Darcy Gruttadaro, director of the Center for Workplace Mental Health. The center is a program of the American Psychiatric Association.

“That’s the cost of loneliness and social disconnection,” Gruttadaro said. “There is a direct correlation between loneliness and productivity and absenteeism.”

The quality of an employee’s interpersonal relationships has a significant impact on how they perceive and connect with their workplace, according to research conducted by California State University and the Wharton School of Business. The 2012 report found that loneliness at work “triggers emotional withdrawal,” which affects not only the individual but co-workers as well, leading researchers to conclude that loneliness is an organizational problem not a personal one.

One way employers can address the problem is by measuring and tracking perceptions of inclusion and belonging, said Laura Hamill, chief people officer and managing director of the Limeade Institute, the research arm of HR technology and wellness company Limeade.

The Bellevue, Washington-based company recently launched an online platform called Inclusion Plus, which surveys employees and uses the data to develop strategies to building a more inclusive workplace, according to Hamill.

“You have to feel like your voice matters in order to feel engaged,” she said. “Employers tend to think about how connected we are from a tech perspective, but that doesn’t mean that employees feel connected or included. We tend to think of inclusion in terms of diversity but once that person is hired, what happens in their day-to-day experience? Do they feel included or that their voice is being heard?”

The platform sends supervisors a list of recommended activities based on employee survey results, such as prompting managers to ask all their employees for project status updates so that everyone feels valued, Hamill said.

At Nielsen, the company tackles loneliness by promoting human connection through its wellness program, which is called The Whole You.

“We’re partners, spouses, friends, neighbors, members of our community and it’s my mission to support all of them,” said Jackie Good, wellness manager for Nielsen Audio, a consumer research company based in Columbia, Maryland. “We want to embrace the idea that we see the person as an entire person and not just an employee. We were thoughtful in how we branded our wellness program to reflect that.”

Each of the company’s more than 100 locations host regular social gatherings for employees from painting parties and picnics to community volunteer projects, such as dog walking at the local shelter or exercising with seniors at a retirement center, Good said.

“It’s important to foster social connection because it’s part of being human and it’s as important to our survival as food and water,” she said.

Nearly two decades ago, Gallup Press published a list of 12 elements of great managing. The most controversial finding revealed that having a best friend at work could improve job performance. A Gallup researcher noted at the time that leaders who balked at the idea of workplace friendships viewed close social ties between employees as “detrimental to productivity.”

But those views are changing, according to Gruttadaro.

“My sense is that employers are starting to pay attention to loneliness along with workplace mental health,” she said.

She recommends surveying employees to determine how socially connected they feel and examining how office design and alternative work arrangements, like telecommuting, can affect relationships.

“Loneliness can contribute to depression, which is a costly problem,” she said. “It’s important to teach managers how to start a conversation with an employee who seems lonely.”

Rita Pyrillis is a writer based in the Chicago area. Comment below or email editors@workforce.com. Follow Workforce on Twitter at @workforcenews. 

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This Is How You Reasonably Accommodate a Disabled Employee

Jon Hyman The Practical Employer

I’ve spent a lot of time over the past 16 months discussing bad employers — those that so mishandled employees that they earned a spot on my list of America’s Worst Employers.

Today, I thought I’d take a look at the brighter side — an employer that handled a tricky employee issue correctly.

Jablonski v. WalMart (9th Cir. 4/26/18) concerns an issue that often confounds employers and presents many opportunities for mistakes that lead to difficult lawsuits — the sick or injured employee who needs repeated reasonable accommodations.

Lidia Jablonski worked as a supervisor in the dairy, frozen and meat departments of a Las Vegas WalMart. She took 12 weeks of FMLA following a workplace injury suffered from a falling box of frozen chicken.

Here is how WalMart accommodated Jablonski’s injury following her FMLA leave:

  • Near the end of her leave, WalMart reached out to Jablonski to see if she needed an additional leave of absence, which it granted upon her request.
  • When that leave expired, Jablonski’s doctor certified her to return to work under certain temporary restrictions. Accordingly, WalMart offered, and Jablonski accepted, a 90-day temporary cashier position under WalMart’s Temporary Alternate Duty program.
  • Ultimately, Jablonski’s doctor released to permanent light-duty restrictions. Two supervisors met with her and offered the only vacant position at the store at the time that fit her restrictions, as a part-time cashier.
  • Jablonski declined the offer, stating that she could only accept a full-time cashier position. Since there was no such position available, WalMart considered her “voluntarily terminated.”
Jablonski sued, and lost. And appealed, and lost.

As noted by the court of appeals:

WalMart officials corresponded with her about her leave, granted multiple leave requests, and spoke to her about her future position. WalMart offered Jablonski several accommodations: personal leave when she ran out of FMLA leave, a ninety-day TAD position that accommodated her medical restrictions, and eventually a permanent cashier position — which she rejected. Jablonski argues that WalMart should have transferred her to another store. But she did not ask to be transferred at the time, and she has not presented any evidence that there were vacant positions for which she was qualified at other stores.

The lessons?

    1. When you can demonstrate a documented history of accommodating an employee’s disability, you make it that much more difficult for the employee to establish discriminatory animus, even if you later deny an accommodation request or even terminate the employee.
    2. The ADA does not require employers to be mind readers. If an employee does not request a certain accommodation as part of the interactive process, an employer is not obligated to offer it. Thus, even though Jablonski later complained that WalMart did not offer her a full-time cashier position at a different store, she also did not ask for a transfer to an open position.
    3. The ADA also does not require employers to create positions that do not exist as accommodations. It only requires transfers to open and available positions for which an employee is qualified. Thus, WalMart had no obligation to create for Jablonski a full-time cashier position within her store. Because the only open and available position was part-time, WalMart met its obligation.
Next time you are faced with the difficult situation of a disabled employee who needs repeated accommodations, think of WalMart and this case, and ask, have we done all that we could have done for this employee, or is there more we can do? How you answer this question will tell you if you have best positioned yourself to defend a discrimination or reasonable accommodation lawsuit.
Jon Hyman is a partner at Meyers, Roman, Friedberg & Lewis in Cleveland. Comment below or email editors@workforce.com. Follow Hyman’s blog at Workforce.com/PracticalEmployer.