Robert Mendonsa

Monday, 24 May 2004 20:00

A quiet crisis

Employers are feeling the pressures of an increasingly competitive global market, rising expenses and a other factors contributing to shrinking bottom lines.

As employers attempt to attract a highly skilled work force and retain talented employees, it is essential they offer a well-rounded benefits package. Long-term care insurance plans are increasingly becoming part of the employer-sponsored benefit landscape.

Long-term care is required when an individual needs regular assistance with day-to-day functions such as bathing, eating or dressing, or supervision due to an illness, injury or cognitive impairment. Illness and injury could be due to aging, but could also strike a younger person due to a chronic progressive disease such as multiple sclerosis or Parkinson's.

With a long-term care insurance plan, consumers choose where their care is received, whether at home, in an assisted living facility, adult day care center, nursing home or hospice.


Business case for long-term care insurance

In most cases, medical insurance does not reimburse consumers for long-term care. As a result, people spend their own money to get needed care for themselves or for a loved one.

In the majority of instances, family members and close friends act as informal caregivers. According to Kiplinger's, 25 percent of American employees are providing some kind of care for an elderly relative, and half of these caregivers also work full time.

Employees who are balancing work and caregiving are less productive due to the emotional and financial stresses of providing long-term care. For employers, it's a big problem that's getting bigger.

The National Council on Aging estimates that 20 million to 25 million U.S. citizens are providing informal care, accounting for 80 percent of the care to the chronically ill. And according to Gary Applebaum, M.D., author of "Eldercare: Corporate America's Silent Crisis," employees' caregiving responsibilities lead to lost productivity, which costs U.S. companies more than $11 billion a year.


A piece of the puzzle

While the looming long-term care crisis is complex, employers do have options for helping employees be better prepared for their own (or a family member's) long-term care needs.

An employer can offer a group long-term care insurance plan on either an employer- or employee-paid basis. In most cases, a group long-term care plan is a hassle-free way to demonstrate your company's commitment to the well-being of its employees.

Employers interested in offering a group long-term care insurance plan should look for a few key features when choosing a plan.


1. Ask about case management services and whether there is a dedicated staff of case managers who can help people manage the wide range of changing emotional, financial and medical issues associated with long-term care.


2. Look for a plan that offers an information and referral service that helps people find care resources for a loved one. Not only is this more convenient for the employee, it also cuts down on lost productivity, since employees will often try to squeeze this critical research into their work day.


3. Make sure the long-term care insurance provider offers useful educational tools and opportunities to explain the types of resources available to employees and details of how the plans work.


Benefiting your bottom line

As the American population ages and the informal caregiving responsibilities of employees continue, industry experts believe that costs to employers will skyrocket. Lost productivity and increased absenteeism are just two of the inevitable results of this trend.

Employers who have the foresight to begin educating their employees about adding long-term care insurance to their personal financial plans are taking two important steps -- helping employees be better prepared for the future and building protection for their own bottom line down the road. Robert Mendonsa ( is general manager for Aetna's North Central Region, covering 16 states. He has responsibility for the customer segment representing all employers with 300 to 3,000 employees. He is a past president of the Board of the Illinois Association of Health Plans and a member of Chicago's Economic Club. He also serves as president of the board of yrustees of CommunityHealth, a free clinic staffed with volunteers, which provides more than 10,000 free patient visits each year to Chicago's uninsured. Reach him at (312) 928-3035.

Thursday, 20 November 2003 06:27

Data track

Technology is changing our lives in dramatic and positive ways. It is the engine that allows health care companies to improve the quality and efficiency of our current health care system.

Business leaders, grappling with trying to provide a comprehensive health care benefit for employees while facing increasing medical costs are looking for innovative solutions.

Forward-thinking health care benefits companies are helping employers get the most value out of their benefits plan by pioneering technologies that control costs, engage employees in understanding and appreciating their benefits, and ease administration.

Using data to improve health

One of the best ways to leverage technology is to translate the massive databases of medical and pharmacy data into meaningful information and easy-to-use reports. Carriers can provide company managers with customized employer reports showing their significant health care expenditures and what is driving those costs.

The medical experiences of only a few employees can greatly distort the employer's overall claim experience. By looking more closely at where costs are highest and pinpointing which conditions are driving those costs, employers can provide targeted health care interventions for employees to offset more serious health care conditions that may occur if left untreated.

For example, experts agree that most youths with asthma can avoid serious complications or hospitalizations by following certain guidelines and taking medications prescribed. An employer that knows asthma-related claims are a key driver of medical expenses may add a disease management program that focuses on just that disease. This program may include targeted communications such as home mailings or reminders for check-ups.

Interactive employee engagement

Technology is alleviating time-consuming benefits administration for many companies. Through Internet-based solutions aimed at employees, many companies have simplified processes in a variety of ways, saving them valuable time and money.

New online features to help employees enroll and make benefits changes are easing the administrative burden from company human resources personnel. Easy access to personalized benefits Web sites and easy-to-use Web tools are revolutionizing the way employees interact with their personal health information.

E-connectivity options are empowering employees to manage their health benefits, enroll online in health and wellness programs, and provide access to credible sources of health information.

Carriers also are using sophisticated telephone self-service systems that provide employees with a wealth of personalized information. This system helps provide immediate assistance to callers with simple transactions, such as checking a claims status, and routes them to a customer service professional for more complex issues.

Easy administration

Increasingly, companies looking to simplify benefits administration are using Internet-based tools. Online eligibility and enrollment reduces errors and eliminates cumbersome paperwork that can complicate billing and payment transactions.

According to industry research, using Web-based benefits enrollment systems can save 60 percent to 80 percent of the cost associated with manual processing and benefits administration.

Companies can also feel confident about transferring their eligibility and enrollment files through safe and reliable electronic systems. With the speed of the Internet and advanced software programs, data is transferred immediately and includes security features to ensure the privacy of benefits information.

Technology is playing a key role in giving companies the tools and support they need to manage their benefits plans. New technologies using health benefits databases and Web capabilities are helping employers of all sizes to deliver a quality employee benefits package that keeps employees healthy and productive while making it more cost-effective and easy to administer.

Robert Mendonsa is general manager for Aetna's North Central Region, covering 16 states. He has responsibility for the customer segment representing employers with 300 to 3,000 employees. He is a past president of the board of the Illinois Association of Health Plans and is a member of Chicago's Economic Club. He also serves as president of the board of trustees of CommunityHealth, a free clinic staffed with volunteers, which provides more than 10,000 free patient visits each year to Chicago's uninsured. Reach him at (312) 928-3035 or (