Lesson 10

Question 1

1.1 List some of the issues and EAP can help with (8)

Answer 1

mental health, 
substance abuse, 
addition, 
marital problems, 
parenting problems, emotional problems,
 financial problems, 
and legal concerns

Question 2

1.1 Describe the characteristics of an employee assistance or member assistance program

Answer 2

Designed to assist with personal and family problems so the employee can remain at work.

They originated with a focus on addictions

Can include services to management, leadership and the overall organization including

Question 3

1.1 What services might an EAP offer to management (5)

Answer 3

Prevention
training
consultation
organizational development
crisis response

Question 4

1.2.a Explain the premise that underpins EAP

Answer 4

There is a direct link between an individual’s well being and productivity.

Troubled employees are prone to absenteeism and presenteeism (attending work while sick/injured/anxious) and have more serious on job accidents

Question 5

1.2.b What objectives do EAPs serve (5)

Answer 5

1) Promoting workplace health and wellness and increasing plan member’s awareness of the importance of their well being and the resources available to them
2) Providing plan members who have personal or workplace difficulties with voluntary and confidential access to professional services with the goal of resolving an issue before it negatively affect job performance
3) Providing plan sponsors with an alternative to normal disciplinary procedures for an employee whose performance has declined due to issues
4) Adding value to the benefits package to make it more competitive, aiding in attracting employees
5) Supporting plan sponsor initiatives to manage and reduce health care and disability incidence and benefits costs as part of a greater health and productivity strategy

Question 6

1.3 Explain the role of EAPs in shielding a plan member who accesses EAP from disciplinary action if they are unable to perform a job

Answer 6

While an EAP is designed to assist plan members with problems that affect their job it isn’t a shield from disciplinary action. However the use of EAP doesn’t impact job security or chances of promotion

Question 7

1.4 Identify the factors that influence a plan sponsor’s choice of services to offer in its EAP (7)

Answer 7

1) Socioeconomic issues affecting plan members or the workplace as a whole
2) Stresses and nature of the work particular to the plan sponsor’s organization or industry
3) Plan member health needs and issues
4) Existing plan benefits
5) Plan sponsor’s health and productivity objectives
6) Plan sponsor’s management practices
7) Legislative environment and related responsibilities that specifically relate to mental health

Question 8

1.5 Contrast employer awareness of its responsibility for mental health and safety with awareness of its responsibility for physical health and safety

Answer 8

The legislative landscape that specifically relates to mental health includes regulations related to occupational health and safety (OH&S), WC and human rights law, law of torts, employment standards, labour relations and standards with respect to employment contracts.

In short the responsibility employers have with respect to employment contracts a responsibility to physical health and safety and to mental health and safety.

However only a few employers are aware of their risks in connection to this legislative accountability, and many acknowledge the issue isn’t well known

Question 9

1.6 Outline the guiding principles of the National Standard of Canada for psychological Health and Safety in the Workplace (8)

Answer 9

1) Legal requirements associated with psychological health and safe workplaces applicable to the organization are identified and complied with as a minimum standard of practice.
2) Psychological health and safety is a shared responsibility among all workplace stakeholders and commensurate with the authority of the stakeholder
3) The workplace is based on mutually respectful relationships including the maintenance of confidentiality of sensitive information
4) Individuals have a responsibility for their own health and behavior.
5) A demonstrated and visible commitment from senior management for the development and sustainability of a psychologically healthy and safe workplace
6) Active participation with all workplace stakeholders
7) Organizational decision making incorporates psychological health and safety in the processes
8) A primary focus on psychological health, safety, awareness and promotion as well as the development of knowledge and skills for those persons managing work arrangements, organization, processes and/or people

Question 10

1.7 Describe the basic services included in an EAP (5)

Answer 10

1) Crisis intervention
2) Short term professional counselling services for personal and emotional issues
3) Short term work/life services for issues such as nutrition, financial support, legal advice, career planning, child care, and elder care

4) Triage/referral for individuals with more complex issues ranging from hospital care to home treatment with intermediate services such as day treatment centres or halfway houses
5) Self help groups or community based referrals that provide ongoing support for a specific problem

Question 11

1.8 Identify the challenge an EAP provider can face in determining eligibility for plan benefits

Answer 11

Typically eligibility is determined by the plan sponsor.

EAPS typically use presumed eligibility when contacted and verify later.

Some plan sponsor provide lists but this can be problematic if the list isn’t current given the sensitive nature of the services and the cost of a delay in their provision

Question 12

2.1 Identify challenges associated with providing an EAP on an in-house basis (4)

Answer 12

1) Requires an investment in facilities and human and technology resources. Staffing often includes a social worker or psychologist so the program must be frequently used if it is to make sense from a cost/benefit perspective
2) There is increased risk of perception by plan members of lack of confidentiality which, real or perceived, can endanger the success of the EAP plan
3) Services provided by on site staff tend to be limited to business hours
4) Delivery options may be limited as in-house services may be focused on in-person counselling only. Plan sponsors should consider plan member preferences for obtaining support and whether it is provided equitably to all locations.

Question 13

2.2 Outline benefits of providing EAP on an external basis (5)

Answer 13

1) It facilitates protection of confidentiality
2) Offers more specialized support that can respond faster
3) Support is usually 24/7/365 including crisis intervention
4) External providers may provide auxiliary services such as monthly manager and plan member newsletters, web based and in person wellness education and online health promotion campaigns
5) Contracting alleviates facility and staff involvement, infrastructure and administrative responsibilities

Question 14

2.3 Explain how EAP claims are administrated (3 points)

Answer 14

EAP is provided directly and members don’t submit claims to an insurer or bill for reimbursement.

The claims costs are billed directly from the provider to the insurer for the number of hours used but does not know which covered individual used the services.

Claimant information is verified via external audit

Question 15

2.4 Provide examples of types of information regarding EAP services that can and cannot be released to plan sponsors

Answer 15

Names or ID numbers of members who use EAP services cannot be released to plan sponsors.

Information about a member’s progress in treatment is protected by privacy laws and can only be released with individual’s consent.

Provided the group is large enough that it wouldn’t be identifying statistical Information about usage levels, aggregate data on services used and the number of cases involving certain issues may be released to the plan sponsor.

These reports are useful in identifying the value of the EAP

Question 16

3.1 Contrast the fixed and reconcilable arrangements for funding EAPs

Answer 16

Fixed is similar to nonrefund accounting. However actual utilization may be taken into account at renewal.

A reconcilable arrangement is similar to refund accounting. There are a number of variations on this including only upwards reconciliation.

There may also be a cap on max utilization for which payment would be owing. For example if budgeted utilization is 7% and the contract is reconcilable up to a 10% cap and actual utilization is 12% the reconciliation owing is only payment up to 10%.

There can also be a reconciliation floor.

Question 17

3.2 Explain how group size impacts the funding decision for EAPs

Answer 17

Fixed arrangements are more common in smaller groups but can also be used for larger groups. There isn’t as clear a distinction based on group size. Fixed and reconcilable arrangements are common for groups with 500+ lives. Self insurance is not common

Question 18

4.1 List the three key kinds of value plan sponsors can expect from implementing and EAP according to the EAP business value model

Answer 18

1) Workplace performance value
2) Benefit cost value
3) Organizational value

Question 19

4.1 Describe Workplace performance value

according to the EAP business value model

Answer 19

Reflects the savings in the area of indirect business costs.

Includes less absenteeism, less presenteeism, less turnover and enhanced work engagement.

Question 20

4.1 Describe Benefit cost value according to the EAP business value model

Answer 20

Includes the impact of EAP on plan sponsor paid claims for group benefits in areas of medical and pharmacy, mental health, disability and WC.

These are considered direct costs to the business

Question 21

4.1 Describe Organizational value according to the EAP business value model

Answer 21

Cost savings related to EAP outcomes in the areas of workplace safety risk management, positive changes to morale, improved workplace culture and improved recruitment.

These reflect benefits at a work team and organizational level

Question 22

4.2 Describe best practices a plan sponsor can adopt for designing, implementing and managing an EAP in order to achieve the most value (6)

Answer 22

1) Leadership and commitment - use a dedicated representative to manage EAP and train senior level employees and orient them to the program
2) EAP policy and procedures. Develop well written policies and communicate them to members. Monitor implementation
3) Plan member involvement - introduce an explicit and effective advisory process to support the EAP including key employees and union leadership where it exists
4) Planning and evaluation. Base program design on plan sponsor and member needs. Implement it through a formal planned process
5) Communication and education of employees and managers
6) Program elements and quality. Design the program to meet the needs of the population in terms of the amount, type and modalities of services offered

Question 23

Explain how ROI of an EAP can be measured (not looking for a formula, 3 points)

Answer 23

Through pre and post intervention data compilations.

Members rate physical health, mental health, productivity and absenteeism when the case is opened and again when closed.

The productivity and absenteeism scores can be converted into a percentage associated with wage loss

Question 24

4.4 Assume that for Textile Corporation, prior to implementing its EAP, a typical plan member had an estimated annual cost of absence of $5,000 and lost productivity of$14,000. One year after implementing its EAP, Textile Corporation’s cost of absence for a typical plan member fell to $2,000 and productivity loss fell to $9,000. The savings were $8,000 (an approximate 42% reduction in total cost) for a typical plan member, as calculated below. Textile Corporation pays $50 per year per plan member for the EAP, and it is a 1,000-employee company with a 10% EAP utilization
rate.

Calculate the overall ROI of the EAP.

Answer 24

150% or a 15:1 return

8,0001,000-501,000)/
(50*1,000

Question 25

4.5 Explain the factors a plan sponsor should consider when selecting an EAP provider (9)

Answer 25

1) Scope of services
2) Qualifications and network of counsellors
3) Access - online, phone, in person
4) Independence - plan sponsors should assess low or no cost EAPs that basically act as referral services to make sure they are independent of the entities that they refer people to
5) Financial stability and solvency of the provider
6) Account management and communications with a variety of stakeholders including members, plan sponsor staff, dependents and other professionals
7) Quality of services
8) Fees and costs
9) Protection of privacy - an EAP should explain legal limits to confidentiality to covered individuals on the plan

Question 26

5.1 Identify factors that influence a plan sponsor’s decision to implement a wellness program (7)

Answer 26

1) Desire to support health and productivity objectives relating to absenteeism and productivity
2) Physical health risk profile of the workforce
3) Demographic factors
4) Economic factors
5) Employee morale
6) Increased provincial/territorial costs shifting and higher prescription drug costs
7) Desire to be competitive and offer an attractive health value proposition to plan members

Question 27

5.2 Explain how a plan sponsor can leverage its relationship with the EAP provider to get the most value from its wellness initiatives (4)

Answer 27

1) Engaging the EAP provider when planning the wellness program
2) Leveraging health awareness tools and health education opportunities offered by the EAP as part of the wellness program
3) Taking advantage of EAP orientation sessions offered to ensure that plan members are fully informed.
4) Leveraging EAP resources to train managers with respect to workplace mental health and early detection of plan member issues

Question 28

5.3 Identify common components of wellness programs (8)

Answer 28

1) Fitness and exercise
2) Nutrition and weight management
3) back care and repetitive strain injury prevention
4) Stress management
5) Routine screening for blood pressure
6) Immunization clinics
7) Smoking cessation
8) Health education and information

Question 29

5.4 Describe the purpose of a workplace health audit

Answer 29

To assess various factors in the organization and identify any gaps that can be addressed by a wellness program.

Possible questions include whether preventative measures such as back care programs, should be offered during business hours, whether meetings tend to be scheduled during lunch when employees might otherwise exercise and whether managers/senior staff lead by example in terms of a healthy lifestyle

Question 30

6.1 Explain the tax treatment of employer provided EAPs and MAPs

Answer 30

Benefits aren’t considered taxable income for employees. Except help on income taxes.

Employers may deduct contributions from their taxes.

If an employer pays an outside entity for use of facilities such as pools, golf courses, etc. and this is only available to a certain class of employees then the fees may be a taxable benefit even if fees aren’t deductible by the employer

Wellness benefits in MEPs must meet income tax folio S2-F3-C2 requirements in order to be tax exempt to plan members and tax deductible by employers.

This tax status also extends to MAP benefits paid from a MEP that qualifies as a health and welfare trust covered by the special rules outlines in CRA interpretation bulletin IT-852 or an employee benefit plan under IT-502

Question 31

6.2 Explain the tax treatment of wellness programs

Answer 31

Income tax folio S2-F3-C2, Benefits and Allowances Received from Employment outlines common types of benefits and allowances received from employment and indicates whether or not their values should be included as income.

When an employer pays membership fees for a social or athletic club the employee is not deemed to have received a taxable benefit if the membership is principally for the employer’s advantage. The onus is on the employer and employee to establish that it is to the employers advantage. Otherwise the fees are taxable benefits to employees even where not deductible by the employer.

Question 32

In single employer plans is the cost of providing wellness plans tax deductible?

Answer 32

No

Question 33

Are fees paid by the employer on behalf of the employee deductible if the main purpose of the facility is dining, recreation, or sporting (yacht clubs, golf courses, etc).

Answer 33

No

Question 34

When an employer pays membership fees for a social or athletic club is the employee is deemed to have received a taxable benefit if the membership is principally for the employer’s advantage

Answer 34

Yes, but the onus is on the employer and employee to establish that it is to the employers advantage. Otherwise the fees are taxable benefits to employees even where not deductible by the employer.