Category: Benefits

On the third Friday of every month, a LinkedIn employee somewhere around the world may be telling young adults to call their parents or help pay for a wedding at city hall. Maybe they’re volunteering at their child’s school or with their favorite charity.

These Fridays are called InDays. Each month has a theme chosen by someone on the executive team, and employees have that day to focus on transforming themselves, their team, the company or the world with that theme in mind, said Nina McQueen, vice president of global benefits and employee experience at LinkedIn. Five people run the program globally for the 30 countries in which LinkedIn has offices, and 240 “culture champions” help manage it in individual locations.

“InDay is meant to have you catch your breath and focus on something that inspires you that you’re passionate about,” she said. “It fuels you for the next 30 days ahead.”

These themes create the essence of what it means to work at LinkedIn, she added, and they stay the same year to year. They include vision, reflection, environment, play, culture, relationships, wellness and learning. Employees, in groups of three or four, can either participate in an event on a LinkedIn campus or outside of it. They show their participation by posting on social media with the hashtag #LinkedInLife.

February’s InDay had the theme of “Community” and each employee received $25 with instructions to “pay it forward” through a random act of kindness. Employees went into their community to do what inspired them, McQueen said. One team in India pooled their money and bought lunch for the office’s janitorial staff, she added. Another team in London bought several prepaid Starbucks cards and hung outside with a sign saying, “Let us buy YOU a cup of coffee.”

“They take pictures, they come back, they tell their story,” McQueen said.

Family was the theme in November 2016, and it provided a unique spin on a well-known work practice.

“Rather than do ‘Bring Your Child to Work Day’ we do ‘Bring Your Parent to Work Day’ because we have quite a large millennial population and we understand that parents are still a huge resource for young people,” McQueen said. The CEO and head of HR also brought their parents.

Once an InDay ends, McQueen said, “We take visual accounts, participation counts, we look at social media and see how many posts we had and the different places it’s mentioned in social media.” A team then puts together a package for the executive staff on the following Tuesday’s executive meeting including photos and anecdotes of the activities LinkedIn employees accomplished around the world.

Setting days aside for specific purposes isn’t unique to LinkedIn.

“We’ve seen an uptick in companies taking time during the workday to promote self-care and self-improvement for employees,” said Richard A. Chaifetz, CEO of employee assistance program provider ComPsych. The Chicago-based EAP has received requests to host training sessions and workshops on topics such as legal, financial and caregiving matters. Other popular topics include stress, mindfulness and relationships, he added.

SunTrust Banks provides employees a fiscal health day every year for employees to get their finances in order, according to The New York Times. Entrepreneur recently listed the types of activities companies plan correlating to the seasons, including a summertime camping trip by a Salt Lake City marketing company.

“These practices are part of employers’ efforts to improve and enhance their culture,” Chaifetz said. “Which is especially important for attraction and retention of millennials, who value work-life balance and self-improvement.”

Andie Burjek is a Workforce associate editor. Comment below or email editors@workforce.com.

The common argument by employers against instituting a more robust paid family leave policy is its prohibitive cost. That certainly was the thinking at Bora Architects, along with fears that employees would misuse the policy.

That mindset quickly changed in 2015 for the Portland, Oregon, firm when a valued receptionist announced she was going to become a single mother. The pending birth and the possibility of losing a quality employee set off alarm bells for Amy Donohue, a principal with the firm, and Dawn Ridenour, the chief financial officer, launching them into a cost-benefit analysis. They had 65 employees at the time.

Ridenour pored over company data from the previous five years and identified all the instances in which an employee could have triggered a paid family leave policy. Donohue said she discovered the cost was reasonable. Specifically, the events she looked at fell under the Oregon Family Leave Act, which covers maternity and paternity leave, time off for adoption and foster care, and care for self, spouse, parent or child.

“It was something we could put in our budget every year,” Donohue said. “Some years we’re going to spend less, and others we might spend more. But on average it’s not a significant expense, especially compared to what it would cost to replace that person if they left. It isn’t just the Googles of the world that can afford it. Smaller companies can, too.”

The patchwork of paid family leave policies dotting the United States reveals a desire on the part of states, municipalities and businesses advocating for such programs. New York is the next state implementing paid family leave beginning Jan. 1, 2018, joining California, Rhode Island and New Jersey.

Politically, paid family and medical leave is supported by 71 percent of Republicans and 83 percent of Democrats, according to the May 2017 “Paid Family and Medical Leave” report by the AEI-Brookings Working Group on Parental Leave. The disagreement for a comprehensive federal policy lies not in the real need for the United States to adopt a solution, but in the messy details of how leave is funded, how long it lasts and who is eligible, the report states.

Although the Trump administration has not given any indication that federal paid family leave is on the horizon, first daughter Ivanka Trump has advocated for its implementation in some form, said Tracy Billows, partner at Chicago-based law practice Seyfarth Shaw.

“Whether that will ultimately come to fruition, we’ll have wait and see,” she said.  “I don’t think that paid family leave on a federal level is completely off the table as we’ve sometimes seen in prior administrations.”

Meanwhile, a growing number of employers are adopting policies of their own.

Financial service company State Street Corp., which employs 33,000 people, is one of the many companies to enhance its paid family leave policy. Part of the reason the company chose to improve the policy in 2014 was to be a more attractive employer. “Our global total rewards team is constantly looking at the competitiveness of our paid leave policies,” said Mike Scannell, senior vice president and president of the State Street Foundation, the company’s charitable arm.

State Street also solicited feedback from employees through surveys and listening sessions, he said. The executive team wanted to create more channels for employees to share what’s on their minds. “A significant and consistent theme was the value of flexible work time, personal time off and the need for greater work life balance,” Scannell said.

Larger employers with deep financial resources, such as State Street, may be able to afford to offer these policies more easily, while small to midsized employers may be more sensitive to cost or temporary lack of manpower while an employee is out of the office.  There are ways around these challenges, though, as Bora Architects and others show.

Companies’ Practices 

The structure of Bora’s policy is such that employees would not take advantage of it, according to Donohue. Employees who have been there a year get six weeks and can receive 20 percent of their salary. Employees who have been there two years get six weeks at 40 percent. And those who have been there for three years or more get the full benefit, six weeks at 60 percent of their salary. “We want to make sure people have been here a while to realize the full benefit,” Donohue said.

Even a person receiving the full benefit won’t be motivated to stay home from work longer than necessary, Donohue said, because 60 percent of one’s salary is still a challenge for a family to take on. These people would be living on a compromised salary for six weeks, and they’ll make the point to thoughtfully decide how much time to take.

While an employee is on leave, work still must run smoothly for up to six weeks.  This transfer of power can go well if the company culture is supportive, according to Donohue. At Bora, where teams usually run from four to 12 people, those groups may be able to function one person short if a project is winding down. It’s also possible for them to borrow someone from a different team for a short length of time.

A supportive culture is also imperative at Change.org, said Allie Roseman, HR operations director for the petition website, which has 150 employees, 10 of whom took paid family leave in the past year. Stressing that if people are overworked, they hire a contractor. Roseman noted that taking on extra work can be a valuable learning experience.

“It’s often a very good learning opportunity for more senior employees to be able to take on some work and learn something new outside of their scope,” she said.

In 2015, Change.org began to offer 18 weeks of paid family leave for both mothers and fathers, Roseman said. The policy is flexible in that employees can take time off in one block or in smaller, staggered amounts of time, as long as the time is used within a year after the child’s birth.

Roseman took on extra work when the HR department’s most senior member, who is now the chief operating officer, went on leave to take care of his baby. She felt like she was ready to take on new duties, and some have since become her responsibility.

“I see that across the organization,” she said. “A more junior employee will take on a project that a more senior employee had when they were out on leave.” Then, she added, they have a new skill set that they’re happy with and they can contribute on a higher level.

Employers’ Attitudes and Actions 

These organizations were able to make something work, but that’s not a common theme for much of the business community. The AEI-Brookings Working Group report addressed the challenges employers may face and potential solutions. The working group, comprised of a politically diverse group of individuals, discussed paid family leave and came up with a compromise policy. Although it did not satisfy everyone, it was an idea that everyone could get behind, said Isabel Sawhill, senior fellow in economic studies at the Brookings Institution.

A major idea behind the compromise was that it could not take form as an employer mandate or as something that would burden businesses with more taxes. “Even if you have a payroll tax to both employers and employees, most economists think it ends up being paid by employees because the employer could pass that along in the form of lower wages,” Sawhill said. The group decided an additional payroll tax on employees was the best option.

Despite the cost concerns of employers, the group ultimately believed it would be in employers’ best interests to offer paid leave. Research suggests that there is less turnover when a company allows paid time off. “Turnover is more disruptive and expensive than any temporary interruption,” Sawhill said.

Temporary absences or inconveniences in the workplace while an employee is on leave is something employers will have to get used to if they care about supporting parents. “It’s going to be inconvenient when an employee gets pregnant and has a baby, period, whether there’s paid time off or not,” Sawhill said.

The current paid family leave landscape, although riddled with its own contradictions, debates and tensions, is not nearly as controversial as other types of paid leave. Seyfarth’s Billows compared the current employer attitudes about paid family leave with that of paid sick leave, which confuses employers because of the variations in state laws.  Acceptable reasons of use, family members covered and employee eligibility could differ widely between states, which creates an administrative nightmare for nationwide employers.

She doesn’t expect the same concern regarding paid family leave.

“Many companies are supportive of paid parental leave and they’re doing so for a number of reasons. For many clients, they’re already doing this because they know it’s an important benefit for recruiting and retaining top talent,” Billows said. “From my perspective, I don’t think there will be any backlash to paid parental leave or paid family leave.”

The voice of businesses is important in the discussion of paid family leave. Bora Architects’ Donohue met with Oregon Gov. Kate Brown to talk about paid leave policy. She, along with other business owners, discussed with the governor what the companies were doing, what had been successful, what the challenges were and what could potentially be implemented at a state level. Donohue also testified in front of the Oregon House of Representatives as a business owner who supports a statewide paid family leave policy.

“Businesses have taken this into their own hands because the governments have been slow to act,” she said. “It’s nice to see people understand this is an investment that pays off in the future.”

Andie Burjek is a Workforce associate editor. Comment below or email editors@workforce.com.

 

 

 

 

 

 

Lee Damiano felt ill one day in May 2015. The previous year when she signed up for her employer’s new telemedicine benefit that would allow her to contact a doctor any time, any day of the week, she thought she’d never actually use it.

She was wrong. Initially thinking, “I might as well wait until Monday,” Damiano ultimately called and was speaking to a doctor within 10 minutes. “As we went through the symptoms, the doctor encouraged me to go to the ER. I’m so glad I listened,” she said. “I had several pulmonary embolisms that could have been fatal over the weekend.”

Damiano, the senior vice president of Denver-based Westerra Credit Union, is now a big proponent of telemedicine for the organization’s 260 employees. “A number of things happen off hours and on the weekend,” she said. “It is critical to provide our employees cost-effective options.”

Westerra is one of many U.S. companies offering telemedicine, which is the usage of technology to deliver medical care that would otherwise be delivered on-site or in person. Telemedicine — a term that’s commonly used interchangeably with telehealth, although technically the words have slightly different meanings — can include texting, video and phone calls.

But despite employers’ newfound infatuation with it, employees don’t appear nearly as enamored. Only 3 percent of employees in the companies that offer telemedicine used those services in the first half of 2016, according to the National Business Group on Health’s “Large Employers’ Health Plan Design Survey.” Conversely, the same report found that 90 percent of the large employers offered the service in 2016.

As more employers look toward telemedicine as a low-cost, convenient alternative to an in-person visit for routine types of medical care, they’ll need to address skeptics’ concerns. Many employees are not accepting the technology as an appropriate substitute for in-person doctors with the same enthusiasm as their employers.

Meanwhile, some physicians remain neutral regarding telemedicine. Dr. Jack Resneck, professor and vice chair of dermatology at the University of California at San Francisco and an American Medical Association board member, said telemedicine is not something they are for or against.

“We see it as an additional tool that actually has great potential,” Resneck said. “This is an area we’re excited about. We just want to see it done right so patients get good quality care.”

 

Employee Utilization and Communication 

Although the trend for employers is rapidly increasing adoption of telemedicine, employees aren’t necessarily buying in as quickly, said Dr. Aamir Rehman, partner and senior clinical and total health management strategy consultant at Mercer. Growth is steadily increasing, but it’s still low.

A couple of factors may influence low utilization rates, Rehman said. In some cases, it’s simply informational. Employees might not know that their employer offers it.

Other employees may know it’s an option for them but feel more comfortable seeing a provider face to face. Rehman added they could be uncomfortable using telemedicine and have qualms or questions such as, Is this person a real doctor? How can this doctor tell what’s wrong with me without being in the same room?

“These are issues employees have brought up, and employers with a high utilization rate have succeeded in communicating and addressing these concerns,” said Rehman.

There are certain talking points for employers to focus on when communicating telemedicine, he added.

“If you can get me to the right provider at the right time, then the outcomes will be better. If you have a problem at midnight or it’s noon and you’re at work and (telemedicine) can take that hassle out of accessing health care, then the outcomes will be better. That is the primary message,” he said.

Clinical outcomes are often equal to that of a brick-and-mortar provider while costing less, said Rehman. It’s less expensive to access care through telemedicine than an office visit. On average, a telemedicine consultation costs $40 compared to $125 for an office visit.

About half of Westerra Credit Union’s workforce use telemedicine throughout the year, said Damiano. One important factor in getting that high usage was a robust communication strategy, especially during allergy season in the spring and flu season in the winter. This communication included giving instructions about using telemedicine and in which cases it should and should not be used.

The Alvin Independent School District in Alvin, Texas, also successfully uses communication strategies to increase utilization. Donnie Marek, director of risk management, runs a self-funded medical plan for the district, which employs about 3,000 people across 30 campuses.  “Any time you have a self-funded plan, you look for opportunities to slow down claims and provide better services for your employees,” he said.

The district began offering telemedicine in September 2014 through Teladoc Inc. after Marek researched opportunities to reduce claims. It averages a 21 to 25 percent monthly utilization rate, which is good for an organization of its size, he said. Communication is key to its success rate, he added.

“Our district was a very reactive district for health insurance. When I was hired I flipped that to be very proactive. [Employees] are constantly getting information from my office,” he said.

Marek sends out monthly emails to all employees, provides information to new hires and looks for employee testimonials with a positive experience with telemedicine. “If I get a good testimony from someone who has used it, I’ll ask them to write up a quote, and I’ll put it in the next blast that goes out. We’ve branded it well at our district,” said Marek. It’s also helped to have leadership buy-in from several school principals.

To communicate the telemedicine benefit to employees who still do not use it, Marek has other plans for the fall 2017 semester. He, along with one other person, will visit each campus throughout the calendar year and attend faculty meetings at the current 30 campuses, along with two more opening up this fall.

“We’ll talk about insurance and wellness, and telemedicine will be a huge part of the presentation. Getting in front of each employee in a smaller setting, they’ll listen,” he said. “I’m sure I’ll be blown away by how many people don’t know about it, simply because people still don’t read emails. I’m excited about this.”

 

 

Making the Practical and Ethical Choice

There are hundreds of telemedicine providers with varied focuses, said Richard Foust, chief business officer of Chicago-based laboratory diagnostics company Analyte Health.

When choosing a provider, “It’s important to ask questions about their approach to telehealth, because they’re all different,” he said. “If the HR manager is really thinking about what’s important, based on the size of the company and the employees they have, the decision will be different.”

Employers should question the telemedicine company’s growth, Foust said. Adding lab testing will become increasingly critical to a telemedicine company’s development since physicians would then be able to make decisions not only based off what they see and hear from the patient, but also medical facts that come back from a test.

Questioning quality is also important. “If I am going to be getting access to a physician at any point in time, how does that telehealth company ensure that I will get a good doctor?” said Foust. “And is that doctor part of a practice that readily reviews how they are treating patients, the outcomes they get and the feedback they receive?”

When an employer chooses a provider, it also has a responsibility to offer telemedicine ethically, said Resneck. “I’ve seen some things that have worried me and been challenging around some quality and patient-safety issues.”

The AMA released a set of guidelines for ethics in telemedicine in June 2016. It took three years for the AMA to develop the guidelines, which define a high standard of care to strive for in telemedicine.

“The area that’s concerned me the most is care coordination,” said Resneck. Care coordination — defined as “deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care” by the Agency for Healthcare Research and Quality  — is an area where employers may fumble, said Resneck.

“In the employer market, we have seen a lot of employers reaching out and looking at this as a benefit for employees, which is great, but the temptation I think has been to take the thing that’s the easiest to scale up quickly,” he said. Sometimes what’s been the easiest to scale up has been telemedicine providers that provide fragmented care.

Resneck sometimes sees a patient using a telemedicine model where the provider of care doesn’t know who the patient is, doesn’t have their medical history and doesn’t share medical records after the virtual visit. Also, sometimes when a patient uses a telemedicine service to set up a consultation, the health plan may not cover a follow-up with the primary care physician they regularly see.

Large and midsized employers shopping for health insurance or working with health plans are in a unique position to drive the conversation. They have an opportunity to say, “If we are going to work with a health plan to include telehealth as a benefit, let’s sit down and talk with the health plan and talk about ways to cover this coordinated care,” Resneck said.

“If we saw employers pushing health plans to actually cover things like follow-up care with established physicians and care teams who know those patients, we could provide high-quality, coordinated care in a way that would be more efficient for patients,” he added.

Employers should also push for proper identification of the physician, he added. Patients should know who their physician is and what their credentials are when they are seeking out care via telemedicine. “We definitely see telehealth providers where that is the case and others where that is not the case,” said Resneck. Employers should encourage proper identification and transparency of credentials when they’re in talks with these health plans.

That all being said, doctors and physicians embrace innovation, he added, and they see incredible potential for telemedicine to improve patients’ access to care.

Westerra’s Damiano has seen this potential in her employees’ experiences. Many of them access the service off hours and avoid going to the ER for something that ends up being relatively minor, like an earache. Meanwhile, in her own experience, it’s meant something even more significant than one unnecessary ER visit. A pulmonary embolism, a sudden blockage of the major blood vessels in the lung, can be deadly.

“If I hadn’t called the doctor, I wouldn’t have gone to the hospital,” said Damiano. “It was a lifesaver for me.”

Andie Burjek is a Workforce associate editor. Comment below, or email at editors@workforce.com. Follow Workforce on Twitter at @workforcenews.