Think about why you offer paramedical benefits in order to manage them effectively
By Bill Zolis
“If you build it, they will come.” Okay, it’s a line from a movie, but it applies to paramedical benefits, too, and that’s what I want to talk about. If we offer a range of paramedical services as part of our benefits plans to employees – things like massage therapy, naturopathy, acupuncture, chiropractic services, and osteopathy – we should not be surprised or alarmed if people start using them.
But it’s not really about Field of Dreams. There’s a flip side to that movie quote: “If they come, someone will build it.” That’s where some of the concerns I’ve heard from clients come in. Simply put, as most benefits plans provide coverage for paramedicals, more and more providers of those services are popping up – and even adapting their service offerings to be in line with benefits coverage.
That’s where the grey areas, the uncertainties and a lot of the grumbling come into the picture. Is such-and-so really a legitimate treatment? Is this service really indicated for that employee? Is it really going to make a difference? What about the employee who just maxes out his or her claims for every service every year? Or the paramedical provider who maxes out one item and then refers the employee to a colleague offering similar services under a different item?
My advice would be to get comfortable with that, and manage it as the new reality, or we risk accomplishing the very opposite of what we had in mind when we brought in paramedical benefits in the first place.
Okay, that may surprise you. Let me tell you why I’m thinking this way.
Essentially, employers offer paramedical benefits to employees for a number of very different reasons. I think if we break it down and look at those reasons individually, we can get a much better understanding of what we’re trying to accomplish – and how to accomplish it successfully.
1) The core purpose of offering paramedical benefits is to support the health and wellness of employees and their families, by providing treatment for conditions, or encouraging lifestyle changes that result in better health outcomes. This is pretty obvious, and it may be the only thing you read on the benefits brochure, but let’s not think for a moment that it’s the whole story.
2) A second purpose is to provide support – and to be seen to be providing support — for employees struggling with health issues. There are any number of wellness issues, some black-and-white, some every shade of grey in between, for which employees seek help from paramedical providers when mainstream medicine isn’t helping them. Maybe the condition is well defined and maybe it isn’t. Maybe the treatment objectively helps and maybe it doesn’t. But the point is that you, as employer and benefits provider, are providing support to that employee to work through a rough patch.
3) And, third, let’s not forget the fact that a big part of the reason you offer paramedical benefits in the first place is that you want to have a Cadillac benefits plan to attract and retain employees, and as part of your efforts to do everything possible to build “the well workplace.”
I think all three of these reasons carry almost equal weight. But it is not always communicated within the organization, and this is where a lot of the discomfort with paramedicals comes into play. Basically, the benefits administrator, looking at the numbers at the end of the year, says, “I don’t think that maxing out this service and then maxing out this other service are really helping that employee’s bad back at all.” And the CEO, if anyone asked him or her, replies, “Yeah, well it would be nice if it did help his back, and maybe it will, but we’re also doing this to show that we care, that we’re doing everything possible to support all our employees, and that we really mean it when we say we have the best benefits plan in the industry.”
It’s tricky and hard to navigate. On the one hand, if we push back too hard on iffy claims or practices, we risk creating dissatisfaction among employees; on the other hand, if allow any kind of abuse of the system, the word spreads though the workplace in no time at all, and the result is even more dissatisfaction. Ironic, when you realize that half the reason we’re doing this is to build employee satisfaction in the first place.
So what should we do? When I said, “get comfortable with it and manage the new reality,” I was basically talking old-time religion:
- Start by making sure that everyone understands where paramedicals fit into the overall scheme of your workplace culture.
- Keep yourself up to date on what’s happening in the world of paramedical benefits and make sure that your rules and procedures stay in line with a rapidly changing world of what’s being offered by providers and what employees may expect to have covered.
- Communicate very clearly to all employees what is covered, what is not covered, what the rules are, what the limits are, and what the process is for approving claims.
- Play by the rules and apply the rules consistently.
So, yes, if you build a paramedical benefits plan, they will come. And you should be ready to manage it in line not only with benefits best practices, but also with your organization’s overall goals. (And if Shoeless Joe Jackson comes out of the cornfield and hands you a claim for orthotic footwear… aw, heck, I’d say give it to him.)
***
If there is a topic that you would like me to write about, please email me at bill@penmore.com.
Copyright Notice
© Penmore Callery Group 2020. All rights reserved. All of the content herein is the sole property of the Penmore Callery Group, and may not be reproduced, transmitted, or stored in a retrieval system – in whole or in part – without the written permission of the Penmore Callery Group. Links to the originating article at www.callerygroup.com are permitted.
The Buzz Bits
Disability Act Deadlines Coming Up
Path becoming clearer for defined-contribution benefits
Penmore Businesshealth: Opioid use, a hidden workplace tragedy
Tools available to help employers address employees’ sleep concerns
54% of Canadian employers planning to invest in digital health
What’s driving higher drug costs in Canada’s benefits plans?