Wednesday, March 29, 2017

Could Property Casualty Insurers Be the EAP Profession's Ship Coming In?

Certainly, you know that the Property Casualty (P-C) insurance is a world away from Health Insurance and their managed behavioral care partners, correct?

P-C insurers are folks like Lloyds of London, AIG, and Hartford who worry about a fire burning the building down where your EAP office is located. They also worry about things like lawsuits for wrong termination, automobile and truck wrecks, lawsuit payouts for sexual harassment, and workers' compensation payouts when employees prove they have been cheated. Lawsuits for trips and falls, employment practices liability, and theft of tools--yep, they insure against these types of losses too--almost anything other than employee behavioral health.

And workplace violence, when it happens, someone getting shot, and families suing over their grieved relatives...who pays? It's not United Healthcare. It's these big boys with P-C.

Now stick with me on this post.While managed behavioral health care wants one thing from an EAP--assessment and avoidance of access to the employee's insurance afforded by the behavioral health plan if possible, (thanks to an EAP's assessment and short term counseling skills within the core technology), a property casualty insurance company would want everything it could possibly wring out of your EAP in order to target as many behavioral risk exposures as possible in an effort to prevent insurable and compensable losses. (Please read that again and consider the implications.)

Human behavior in the workplace contributes to many liabilities and exposures, and all of these risks are born by insurance premiums. They also come with high deductibles--like $25-$50,000 for a lawsuit associated with sexual harassment.

Back injury and lengthy periods of time out of work, the P-C pays. Sexual harassment by a supervisor? Yes, the P-C pays.

And the $1 million out of court settlement instead of the risk of $5 million in a jury trial? Yes, again, the P-C forks over the cash.

Now imagine a well integrated EAP able to educate supervisors, detect emerging risks, and go anywhere within an organization necessary to engage and discover, educate, and train, assess and consult, and all with the purpose of reducing losses. How much might this sort of "human factors exposures prevention" be worth?

My guess is a lot, because the stakes are enormous. This is could also be a renaissance for EAPs. Am I wrong?

It's time to engage this tremendously financially liquid world of P-C. There are thousands of brokers nationwide. They know nothing about EAPs (other than the # on the back of their own insurance card in the event of an alcohol or psychiatric issue.)

There is a potentially wide-open avenue for EAPs to grow and flourish in ways that have not been seen for quite awhile, I think.

Write me at if you think I am off base about this. I wouldn't have written this much except for one thing. In 1993, I went to one of the most competitive EAP markets in the U.S. (Denver) and I engaged with a property casualty insurance broker there. I trained insurance agents all about EAPs in about three hours so they could offer these tools to customers. A week later, I returned and picked up three checks from three different companies averaging 100 employees each who had never had a comprehensive EAP. No lie.

I then flew to Baltimore, MD to the corporate headquarters of NSF&G Insurance, and within their boardroom made a presentation to talk them into beginning an EAP division and hiring real core tech pros. They listened, but their staff turned over, and I was full time employed at Arlington Hospital, and couldn't do it all myself at the time.. But this opportunity still lingers.

Mark Attridge's (hats off to him) awesome article in the Jan 2017 Journal of Employee Assistance discusses the obvious difference between a free EAP and a for-fee EAP, and the 400% improved utilization that one could expect from the latter. Mark shy's away from calling these managed-care driven programs. This is a disappointment and the elephant in the living room. But his research is solid content for EAPs seeking a new home in the risk world--one where they will be full appreciated. See my 2002 article on this topic here that discusses these issues more directly EAPs Help Limit Behavioral Exposures from the NATIONAL UNDERWRITER INSURANCE MAGAZINE

Monday, March 13, 2017

Increase EAP Utilization Hack #18: Ask Satisfied EAP Clients to Refer Others On Their Way Out the Door

This is the simplest and easiest way to increase EAP utilization--ask satisfied clients to refer coworkers or peers to the EAP as they leave your office. And for the booster tip: Tell your satisfied client to tell other employees that the EAP is confidential--really confidential to the fullest extent of the law. Short tip, but marketing confidentiality works better coming from a client who happens to disclose their EAP participation than it does from an EAP Poster. And, of course, this boosts EAP utilization rates.

Increase EAP Utilization Hack #14: Conduct Refresher Training for Supervisors in Using the EAP Properly

Let's continue with EAP Utilization Hack #17 (I accidentally skipped a number.) We are counting down ot #1. We're talking EAP refresher training. This is critical for EAPs, but few formally do it. It's guaranteed to boost utilization, both of self-referred employees and supervisor-referred employees. Refresher training is follow-up training that allows supervisors to examine their experiences in using the EAP over a defined period of time.

The goal of refresher training is to learn how to use the EAP effectively, manage difficult employees with greater ease, and clear up questions, misconceptions, or roadblocks common among supervisors that typically interfere with, or inhibit use of the program. Refresher training reduces risk to the organization because it increases the likelihood of employees with serious troubles getting referred.

Print brochure for "EAP Refresher Training" product.

For example, a supervisor meets with an employee and formally refers him or her to the EAP, but fails to phone the EAP first, send documentation, or request that a release be signed. The supervisor than hears nothing back, phones the EAP, can't get information because no release exists, experiences frustration concluding that the program is not very helpful.

When conducting refresher training, include lots of discussion around hypothetical referral scenarios, and education about common issues that interfere with referral:

Ideas for EAP Refresher Training! Put together your own program using these concepts below or consider use of materials.

1) Discuss the need to refer early and why. Discuss the ramifications and risk associated with delay
2) Discuss importance of communicating with the EAP before, during, and after the referral--not about the nature of the employees programs, but the the mechanics of communication, both when, why, and how all with the goal of helping the employee and salvaging valuable workers.
3) Explain the parameters and dynamics of the signed release
4) Clarify what is meant by mandatory referral, formal referral, informal referrals, last chance agreements, and firm choice agreements. Many supervisors confuse these terms and they all have different meanings and implications in the management of troubled employees.
5) Talk about reducing emotional involvement, unbridled anger, and power struggles with employees.
6) Talk about how to maintain control of the communication and verification process with the EAP.
7) Discuss manipulation to avoid referral and later employee failure to follow-up with EAP recommendations
8) See the products associated with refresher training at this link.

EAP Utilization Hack #15: Do Outreach with Post-Heart Attack Employees and Help Them Fight Depression to Prevent Premature Death

You have probably heard me encourage EAPs to look under every nook and cranny for real opportunities to identify unaddressed behavioral risk in organizations. New ways of applying the core technology can be spotted during the year if you pay attention and listen with the "3rd ear" while engaging with supervisors, counseling employee-clients, and participating in various work organization projects. Also, subscribe to a couple workplace wellness news feeds. Personally, I like -- it hits a lot of workplace related news that EAPs should pay attention to.

Today, I was scanning press releases on wellness, and spotted new research from Intermountain Medical Center in Colorado. Research conducted by this group shows that if you have a heart attack, your chances of dying over the next 10 years are higher if you suffer from depression after the heart attack, but rehabilitation can reduce this risk.

Can you guess what the opportunity might be for applying the core technology of EAPs to risk in this situation? The opportunity is encouraging employees and their family members to meet with the EAP after they leave the hospital following a heart attack. In your office, explain support services and screen for depression, encourage rehabilitation, follow up, and also refer them as needed to psychiatric help (med management) for clinical depression.

This is ripe territory for EAPs to make a difference, and the cost-benefit of this outreach can't be under-estimated in my view. So, I am declaring this an EAP Utilization Hack #15. (See prior posts for other EAP Utilization Hacks.)

In summary, the Intermountain Medical Center Heart research team (link shown below) compiled information from 7,550 patients who completed at least two depression questionnaires over the course of one to two years. These are patients who had heart attacks.

Patients were categorized based on the results of their survey as never depressed, no longer depressed, remained depressed, or became depressed. Following each patient’s completion of the last questionnaire, patients were followed to see if they had any major cardiovascular problems such as a stroke, heart failure, heart attack or death.

At the conclusion of the study, 4.6 percent of patients who were no longer depressed had a similar occurrence of major cardiovascular complications as those who had no depression at all (4.8 percent).

Those who remained depressed, however, and those who became depressed throughout the study, had increased occurrences of major cardiovascular problems — their rates were 6 and 6.4 percent, respectively. Treatment for depression resulted in a decreased risk of cardiovascular risk that was similar to someone who didn’t have depression.

So EAPs, the strategy is to talk more about depression, how's its treated, and educate people about this brain disease. Encourage self-referral, and follow up during the year. I suggest you read these heart-related research studies on depression and its impact on cardiovascular health. See if this avenue of EAP utilization improvement doesn't make your EAP one that has greater value, and hopefully one that is less easily contracted out to managed care. You may also save a few lives along the way.

Helping Employees Overcome Emotionally Challenging Workplace Incidents that Distract from Productivity and Contribute to a Deteriorated Workplace Climate

There is one topic that you should seek to include in your EAP newsletter to employees. These topics tackle "emotionally challenging workplace incidents and events.” For the most part, these are intra-psychic stress issues, but articles or content offered to help employees tackle them will be the most appreciated because they help relieve emotional distress and add resilience.

An example would be how to respond to a very disappointing performance review an employee did not anticipate. Another would be criticism from the boss that blind-sides an employee. A nasty interaction with a coworker in the staff kitchen can ruin the whole day, and others include difficulty accepting feedback from peers, struggling with triggers and angry feelings when ignored, and being ostracized, bullied, or passively "aggressed" against. Much of this is about incivility, but the scope of these events is much broader. They represent interactions with coworkers, for example, where their might be purposely withheld compliments about one's new dress. The silent treatment is another one. These actions and similar common emotional stress experiences in the workplace take a toll on productivity. Your EAP newsletter can masterfully target them.

Employees look for articles like these. They will anxiously await articles that help them conquer stressful undesirable emotional states. They are a life-ring that you throw to workers to help them find resiliency in the EAP's outreach. Consider the content of a recent article below, and you will get a very good feel for what I am referring to.

Although eagerly welcoming constructive feedback, employees who accomplish a lot on the job know their successes will sometimes rub others the wrong way. Not everyone will be quick to praise one's triumphs when they are cast into the limelight by supervisors or others who recognize your achievements. Sound familiar? Sometimes these achievements are met with criticism for whatever reason. Do you know how to cope with such experiences? Learning to detach from unhelpful criticism is a skill to help you stay motivated, adapt to change, and think more creatively about your job. Try these “inoculations” to beef up your immunity: 1) Remember that those who criticize don’t know the real you. 2) See negative criticism as possible validation that you are “on the right track.” 3) Accept criticism of your success as normal and part of life’s challenges. 4) Search for the truth in the criticism, if any. Something about it may be helpful despite the style of its delivery. 5) Let criticism inspire you to work with even more vigor toward accomplishing your dreams, rather than forcing you into retreat.

There are many issues employees face that create emotional distress. Targeting them with workshops, articles, handouts, and especially with your EAP newsletter will help employees in ways that they will appreciate most.
(Get copies of the last 2-3 issues of Frontline Employee or Work Life Excel by visit or for Work Life Excel, email me at I will send you Jan, Feb, and Mar.