Bert Alicea | BenefitsPRO

Domestic violence may frequently occur behind closed doors, but the repercussions of abuse have the potential to spill over into the workplace. October is Domestic Violence Awareness Month, an opportunity to raise awareness of this important and difficult topic. For organizations who may employ either victims or perpetrators, domestic violence can impact the individuals involved as well as those around them, leading to a ripple effect of lost productivity, legal concerns, and other costs, not to mention the risk of an incident occurring at work.

Unfortunately, no business is immune to the issue of domestic violence. According to the most recent National Intimate Partner and Sexual Violence Survey, approximately a third of women and a quarter of men report being the victim of violence by a partner at some point in their lives. This means the likelihood of an employee being either a victim or perpetrator is higher than many may realize.

It is important to note that domestic violence is not limited to physical abuse. It can include any range of assaultive and coercive behaviors used by an individual to hurt, dominate or control and intimate a partner or family member, such as stalking, emotional or verbal abuse, financial control and more.

While this is a difficult subject matter to tackle within the workplace, taking a proactive approach to domestic violence can help organizations simultaneously protect their employees while minimizing their risk. Brokers and business leaders can work together to create an action plan and implement prevention and intervention strategies to address domestic violence within their workforce.

The impact on the workplace

Domestic violence impacts people of all ages, races and backgrounds, including employed adults. Although domestic violence is not always physical, tragically, 78 percent of women killed in the workplace between 2003 and 2008 were murdered by their abuser. While alarming, the effects on the workplace begin much sooner, and everyone pays the toll.

Consider that each year, domestic violence victims miss about eight million days of work, the equivalent of 32,000 full-time jobs. Because of this and other factors, the Centers for Disease Control and Prevention estimates that businesses lose $729 million each year in lost productivity related to domestic violence. Employee turnover is also a contributing factor; up to 60 percent of employees experiencing domestic violence reported losing their job as a result, either because they were fired or had to quit.

In addition to indirect costs, health care costs related to domestic violence can also add up for organizations. Domestic violence victims frequently require medical attention and support as a result of abuse, leading to combined medical and mental healthcare costs of more than $4 billion a year.

The effects of domestic violence are not limited to victims; a survey conducted by the Corporate Alliance to End Partner Violence found that at least 44 percent of those who worked with a victim of domestic violence reported feeling personally impacted, including concern for their own safety. This can also have a devastating effect on workplace morale.

Recognizing instances of domestic violence

In order to effectively support employees experiencing domestic violence, it is critical to understand some of the common signs that may indicate a problem:

  • Unexplained bruises
  • Unusually quiet/withdrawn
  • Frequent absences
  • Lack of concentration
  • Wearing concealing clothing, even in warm weather
  • Depression and/or anxiety
  • Change in performance attitude
  • Frequent breaks or appointments with friends/family
  • Receipt of harassing phone calls

If an employee demonstrates any of these red flags, intervening in a sensitive and private manner can make a difference and encourage them to seek help before the problem escalates. In order to be most effective, it is beneficial for managers and other employees to be prepared to handle this important yet personal matter. Yet surprisingly, 65 percent of respondents to a survey from the Society for Human Resource Management reported that their organization does not have a policy or program in place to prevent or address domestic violence.

It is important for organizations to realize that domestic violence does not solely happen outside working hours – a survey from the National Safe Workplace Institute found that 94 percent of corporate security directors reported domestic violence as a high security issue at their organization. Keep in mind the workplace is somewhere perpetrators know they can locate their victim. This increases risk and liability for businesses, which can also lead to additional costs, especially without a plan in place to address this issue.

A proactive approach

Many organizations may be hesitant to get involved in instances of domestic abuse or violence. Yet organizations and their partners have the potential to make a big difference by stepping in early and supporting employees, making it critical to have a comprehensive prevention and response plan ready.

  1. Assess current plans (or lack thereof). The first step is to analyze past incidents, assess the potential for issues and determine current preparedness. Taking the time to review this information will help create a plan that meets the organization’s unique needs.
  2. Develop comprehensive policy. Based on the results of the assessment, this should include internal reporting procedures, support mechanisms for victims, including enhanced security measures, and disciplinary procedures for perpetrators.
  3. Implement company-wide training. In order for the policy to be effective, it is important to raise awareness of the issue and educate both managers and employees on how to identify potential situations, follow reporting procedures and respond appropriately. This may also include what to do if an incident happens at work.

Ensure employees are in the know – Get the message out to the workforce through a variety of channels, including newsletters, posters in break rooms or restrooms, the intranet and more. This can include information about the company’s program as well as how to access available resources, such as the Employee Assistance Program (EAP), community organizations or even local law enforcement.

Benefits professionals play an important role in this process by helping organizations proactively implement the right programs to help should the need arise. Waiting until something happens might be too late. By raising awareness of this important issue and connecting businesses with EAPs and other resources, brokers, consultants and others can ensure employers are prepared to address issues related to domestic violence should they arise, reducing liability while ensuring the safety of the workforce.

Norbert “Bert” Alicea, MA, CEAP, is executive vice president of EAP+Work/Life Services at Health Advocate. Alicea is a licensed psychologist and premier trainer with over 29 years of experience in the EAP field. He has a specialization with executive coaching and management consultations in assisting with difficult workplace situations and also conducts corporate training locally and on a national level.

Keep health care costs in check

By Melissa Erickson | Healthy Living

The average American spends more than $10,000 a year on personal health care, according to the most recent estimates from the Centers for Medicare & Medicaid Services, but there are ways to keep health care expenses down.

Be healthy

While staying healthy is the most straightforward way to minimize health care expenses, that’s easier said than done. Chronic health problems cost Americans big bucks, and many of them are the result of poor health choices, said Angela Snyder, director of health policy and financing at the Georgia Health Policy Center and associate professor at Georgia State University.

Diet and nutrition matter in the prevention of chronic diseases so follow these tips: Eat healthfully and get moderate exercise, regular checkups and adequate sleep. Doing those simple things can go a long way to minimize long-term health expenditures, Snyder said.

Be a smart shopper

“Shopping around for the lowest cost is an important part of being a health care consumer,” said Dr. Raffi Terzian, senior medical director at HealthAdvocate Solutions, which works with companies and organizations to communicate insurance benefits to employees. To avoid surprise bills, find out how much procedures will cost before having them done, Terzian said.

Price-shopping can pay off big when it comes to medications. Request generics, which are required to have the same active ingredients and must work the same as their brand-name counterparts to obtain FDA approval.

“Other ways to defray costs include taking advantage of drugstore discounts and manufacturers’ coupons,” Terzian said.

Stay in-network

While how much you pay depends on your health plan, it’s always better to stay within your health insurance network. It’s also in your best interest to know what your plan covers, Terzian said.

“Certain fixed amounts are set, but out-of-pocket costs may be independent. Find out how much (a procedure or test) will cost, and have a conversation with your provider,” Terzian said.

The best time to ask for a discount on a noncovered procedure is before service is rendered.

“You have a better opportunity to negotiate on the front end,” Terzian said.

Be proactive

If your health plan offers preventative services, be sure to use them, Terzian said. For example, the Affordable Care Act requires that most health plans cover blood pressure, colorectal cancer and cholesterol screenings and flu and tetanus shots for free. If you’re taking advantage of these screenings, it’s more likely a physician will notice a serious condition earlier, which may help reduce health care costs long-term.

Use a health spending account

Health spending accounts allow a person to put money aside for future health care costs, Terzian said.

“You need to anticipate what expenses will be ahead of time and put money aside to cover them. It’s good for a whole host of medical, dental and vision expenses,” Terzian said.

For people with high-deductible health plans, a health savings account is a great way to save for medical expenses and reduce taxable income, but a user must qualify for the program, Terzian said. The government sets the limits for annual contributions, and for 2018 the limit is $3,450 for singles and $6,900 for families.

Read your bill

Mistakes happen. Protect yourself from overpaying by checking your bill. If you see something you don’t understand or think there’s an error, contact your provider and ask about the charge.

Episode 18: Managing Employee Stress

Whether stemming from work issues or their personal lives, most employees will experience stress at some point in time, and the impact can be detrimental to the organization. In this episode of Health Advocate’s Ask the Expert series, Matt Verdecchia, a senior trainer with Health Advocate’s EAP+Work/Life program, shares how employers can take steps to more effectively understand and manage employee stress at work.

Combating the Effects of Employee Stress

By Norbert “Bert” Alicea, MA, CEAP, Executive Vice President of EAP+Work/Life Services, Health Advocate

Employee stress, dubbed the “nation’s fastest growing occupational disease,” has become a major problem for organizations of all sizes.

According to a survey from the American Psychological Association, nearly one third of American workers reported feeling stressed or tense on a regular basis while at work. The causes of stress are widespread and include a lack of work/life balance from juggling household and family responsibilities; everyday challenges from student debt to retirement concerns to information overload; and workplace stressors such as feeling undervalued, under-compensated and overworked.

Whatever the cause, stressed workers tend to be fatigued, prone to mistakes and injuries, and are more likely to be absent. Most significantly, they incur healthcare costs two times the average of other employees. In total, the consequences of stress-related illnesses, from depression to heart disease, costs businesses an estimated $200 to $300 billion a year in lost productivity.

However, with a proactive dual strategy of organizational change and individual stress management, businesses can take steps to promote healthier, more productive employees while reducing healthcare costs.

The True Toll of Stress

The American Institute of Stress estimates that one million employees miss work each day because of stress. But even when employees come to work, emotional distress can reduce a worker’s capacity to perform by up to 50 percent.

If the stress is not addressed, a variety of potential issues may result including absenteeism, job resignations, and an increased risk of developing chronic and costly diseases such as heart disease, diabetes, certain cancers and/or mental health problems like anxiety and depression.

Furthermore, as a means to cope with stress, many employees turn to the risky use of alcohol, prescription pain medications and other substances. Left untreated, substance abuse can cost an employer upwards of $13,000 per employee per year, according to a recent National Institutes of Health study.

How Employers Can Be Proactive

The first step is to evaluate the scope of stress in the organization by looking at absenteeism, illness and turnover rates as well as performance problems. Employee surveys, Health Risk Assessments and internal committees can pinpoint specific stressors and identify if they are company-wide or concentrated in a particular department. It’s also crucial to work directly with employees, including through exit interviews, to get their input about strategies that could help reduce stress.

While some changes to the corporate culture may need to be instituted, such as flexible work hours, workload redistribution, and better employee recognition, the following are some key ways to address and reduce employee stress:

  • Provide access to an Employee Assistance Program (EAP). EAPs, which often include in-person and/or telephonic counseling benefits, help assess and provide support for personal/emotional issues that affect performance and productivity as well as those that create stress. Issues may range from substance abuse to family problems and financial issues. EAPs that help address substance abuse issues, for example, can reduce workers’ compensation claims, employer healthcare costs, and absenteeism. These programs can also help employees with related work/life issues that may impact their stress levels, such as locating resources for eldercare support for those who may be caring for older loved ones.
  • Incorporate health advocacy into employee benefits. Offering an expert who can personally address healthcare issues, such as helping to resolve medical bills and interacting with insurance companies and providers, can help employees reduce worry and stay focused on their job.
  • Offer an accessible, well-rounded wellness program. A multichannel program that addresses the overall well-being of employees–including physical, emotional and financial health–through web-based workshops alongside traditional coaching components can help reduce stress while increasing productivity.

As an integral part of these efforts, engagement strategies can include built-in incentives to reward enrollment and sustained involvement as well as for making healthy lifestyle changes. Additionally, providing consistent employee communications can help drive them to take action.

Don’t wait to take action. Contact us.

Beyond lowering healthcare costs, a continued commitment to reducing stress and providing support to improve the well-being of all workers, no matter what they are going though, produces many benefits. Workers who are less stressed, for example, are more resilient and inclined to stay with their companies.

Learn how Health Advocate can help you create a customized, comprehensive program to promote total well-being, leading to a stronger, healthier, and more productive and satisfied workforce and reduced healthcare costs.


Next Story >> Clinical Corner: Depression in the Workplace: Reversing the Toll on Productivity, Health and the Bottom Line 

By Jocelyn Sivalingam, M.D., Medical Director, Health Advocate

Depression is an extraordinarily common, costly, disabling, and recurrent condition that touches every workplace. Those suffering from depression often experience alcohol and substance misuse, and the disease also frequently complicates common chronic conditions such as arthritis, diabetes, heart disease and chronic lung diseases. Depression, in fact, is one of the top disabling conditions worldwide.

Although depression is a widespread, devastating problem, studies show that only a little over a third of those affected receive treatment.

According to the National Institutes of Mental Health estimates, in 2016, 6.7 percent (or 16.2 million) of adults in the U.S. suffered a major depressive episode. More women than men suffered an episode (8.5 vs. 4.8 percent) and overall, about two thirds of those affected suffered major impairment. Yet only 37 percent of those affected were actually treated for depression. When treatment occurred, about 44 percent received treatment that included care and medication from a health professional.

The True Costs of Depression

The consequences of untreated depression and its associated conditions include absenteeism, presenteeism and lost workplace productivity, with significant financial impact. In one 2015 report, the estimated overall economic burden of depressive conditions in the U.S. increased to more than $210 billion between 2005 and 2010. Half of the costs were attributed to absenteeism and presenteeism, while nearly another half were direct costs. Notably, five percent of the costs were directly related to suicide.

In addition to the more obvious economic burden on employers, people suffering from depression are often unable to care for other medical conditions they may have. This can result in more complications and higher healthcare costs. It’s estimated that for every dollar spent on depression treatment, another $2.57 was spent on a co-occurring condition and another $2.13 went to workplace costs such as absenteeism and presenteeism related to the condition.

Employers Play a Key Role in Removing Stigma

A major barrier for people to get the treatment they need is the stigma surrounding mental health issues. However, employers can improve the health both of the workforce and their bottom line through recognition of the importance and costs of depression and associated mental health conditions.

Eliminating the mental health stigma so that seeking help for depression has the same importance as getting help for high blood pressure may not yet be a norm in most sectors, but would go far toward removing barriers to seeking needed care. Education on mental health issues and a workplace culture where total (mental and physical) well-being is a priority, is openly discussed, and seeking help is actively encouraged can help normalize treatment and care.

Connecting and engaging employees with behavioral health care in a timely manner—and that this care is confidential and easily accessible—is also crucial.

Finally, it’s important that employers have a full understanding of how benefit design around both pharmacy and behavioral health care affects employee utilization of benefits for mental health. All these factors help ensure that workers get the help they need for depression and other mental health issues when they need it most.

Contact Us for Help

Health Advocate offers access to Licensed Professional Counselors, easily reachable by phone or email, for confidential, short-term help for depression and other mental health issues. We also offer clinical coaching and advocacy to help employees understand mental health benefits, locate providers and treatment options, and for coordinating care between health insurance companies and providers. Our robust communications educate employees about mental health symptoms and offer self-care steps to better cope with depression, anxiety and other issues. Find out how we can help you put the right program in place to help support the total well-being of your employees.




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