Plan design and EAP Flashcards

1
Q

What STATUTORY coverage to provide?

A

A) Statutory:

  • CPP (Canadian Pension Plan)
  • EI (Employment Insurance)
  • WCB (Workers Compensation Board)
  • Paid Time Off
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2
Q

What NON-STATUTORY coverage to provide?

A

B) Non-Statutory:

  • Mandatory Group Life
    (flat amount or time earnings)
  • AD&D (Accidental Death and Dismemberment Insurance)
  • Weekly Indemnity (WI), also known as Short-Term Disability (STD)
  • Long-Term Disability (LTD)
  • Medical Service Plan (MSP)
  • Dental Care
  • Extended Health
    (including Vision Care and Drug Coverage)
  • Paid Time Off
    (Non-statutory)
  • RRSP (Registered Retirement Saving Plan) / Pension Contributions
  • EAP (Employee Assistance Program)
  • HCSA (Health Care Spending Account)
  • Critical Illness Insurance
  • Non-Insurance benefits / Perquisites
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3
Q

Who pays for the coverage?

A

Premium coverages:
- Employee
- Employer
- Split
(tax implications - especially WI / LTD)

Contributory, Non-Contributory, Employee paid

Coinsurance for health, dental, and other benefits:

      - % of eligible expense above deductible that is paid by benefits insurance plan - (e.g.: 80% coinsurance for drug costs)  
      - Deductibles: inflation and incentives
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4
Q

What are the types of plan design?

A
  • Fixed: One size plan fits all
  • Flex Modular
  • Flex Core Plus Options
  • Flex Cafeteria Design
  • Flex Health Care Spending Accounts
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5
Q

When and why were the FLEX PLANS designed?

A

When: They were designed in late 70s / early 80s

Why: In response to workplace diversity, once that different employees have different needs

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6
Q

What does the Flex Plan Modular offer?

A
  • It offers either a plan A, B, or C
  • Administration is relatively simple for this plan
  • It limits employee’s choice
  • Employees need to pay something if they want a “better” option or want to add something to this plan
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7
Q

What does the Flex Core Plus options offer?

A
  • It offers a common core benefits such as LTD, WI, Life, AD&D, MSP, Statutory Benefits, basic Extended Health, and Dental
  • It offers more choice, but then administration becomes more complex (maybe MUCH more such as Credit System, HSCA, Cafeteria Style)
  • Employees may pay something for “better” options
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8
Q

What does the Flex Cafeteria Style Plan offer?

A
  • The Statutory ones (which are mandatory for any Benefit Plan design) plus employee chooses whatever he/she wants to add according to his/her needs and pay for that difference/customization
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9
Q

What does the Flex Health Care Spending Account offer?

A
  • It pays attention to tax treatment when establishing plan

- Consider: ASO (Administrative Services Only)

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10
Q

Describe the Flex Plan Design process.

A

1) Establish objectives
2) Status quo? Design new plan?
3) Test - focus groups
4) Adjustments

5) Implementation:
- Communication for roll out
- Administration
- Election periods / triggers

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11
Q

What is Employee Assistance Program?

A
  • Its purpose is to identify and resolve personal problems
  • It can be defined as a employer-sponsored benefit program designed to assist employees and with the identification and resolution of personal issues which may be impacting productivity
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12
Q

What are the EAP Services provide?

A
  • Substance abuse
  • Mental health
  • Grief counseling
  • Stress reduction
  • Anger management
  • Legal problems
  • Credit counselling
  • Health maintenance consultation
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13
Q

What is the history of EAP?

A
  • Substance abuse programs:
                            * 1940's - Eastman Kodak, duPont
                            * 1947 - Bell Canada
  • Expanded programs (new needs):
                            * 1960's - workforce diversification
                            * 1970's - economic stability
                            * 1980's - technological change
                                          - globalization
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14
Q

Some statistics about this issue…

A
  • Annual costs of Mental Health:

“In any given year, ONE in FIVE people in Canada experiences a mental health problem or illness, with a cost to the economy well in excess to $50 billion. This represents 2.8% of 2011 GDP.”

Retrieved from [Mental Health Commission of Canada]

  • Annual costs os Substance Abuse:

Indirect costs of productivity losses $24.3 (2002)

Data retrieved from [Canadian Centre on Substance Abuse - CCSA]

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15
Q

What does Regulatory Framework consist?

A
  • Privacy Legislation:
  • Safeguards client information in records or gathered in counselling sessions
  • Advise what info being collected as well as its purpose and the time it will be kept on file
  • Individual written consent for release of info
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16
Q

What are the potential problems with Regulatory Framework?

A
  • Defamation of character
  • Discrimination
  • Negligence
  • Breach of Contract
17
Q

What are the potential Design Issues?

A
  • Objectives of EAP
  • Definition of eligible employees
  • Types of services offered
  • Qualifications of EAP practitioners
  • Roles of the different parties
  • Methods of access to the program
  • Evaluation and/or audit procedures
  • Accessibility
  • Timeless
  • Confidentiality
  • Quality of service
  • Communication support
  • Utilization reports
18
Q

What are the potential Operational Issues?

A
  • Culture of concern
    * Assistance not a personal weakness
    * No disciplinary action
    * Confidentiality
  • Supervisory training
  • Early intervention
  • Choosing an EAP
  • Cost of EAP program
  • In-house vs. External program
19
Q

What are the potential External Operational benefits and issues of EAPs?

A
  • Contracted services:

Benefits

                * Efficient start-up
                * Confidential service
                * Evaluation and accountability

Issues

                * Unfamiliar with workplace/issues
                * Problem of follow-up
20
Q

What is expected from the future of EAPs?

A
  • Newer services
    * Eldercare, retirement counselling
  • New delivery systems
    * Internet information site
    * Online tutorials, exercises, counselling
    * Email therapy
  • New educational approaches
    * Role situations, workshops, seminars
    * Goal to educate about problems, self-diagnosis
  • Work-life committees
  • Small business services