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The world of employee benefits and policies has changed literally overnight. Human resource and benefit plan managers are navigating a new normal with operational, policy and plan changes to consider. PayneWest has developed this checklist to help you anticipate these changes for your self-funded plan.


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  • Consider how you will design new return-to-work policies as well as any operational changes necessary. Will you take temperatures and ask your employees if they are experiencing any flu-like symptoms? Have you sourced hand sanitizer, wipes, cleaning products, etc.? Will you allow clients and guests into your offices? And if so, how will they know where to stand when meeting a receptionist? Will you limit the areas they can visit within your office? Are you planning for new cleaning or occupancy procedures for common spaces like kitchens, restrooms, etc.?
  • Consider adjusting your HR policies to allow more employees to work from home. As states lift their shelter-in-place orders,  some of your employees will naturally inquire about continuing to work from home. If you’re hesitant to make changes to your old telecommuting policies, think about this fact: employees generally come to work sick because they’re concerned about using their PTO. Exploring how you can keep your workforce from coming into the office reduces the risk of community spread.
  • Understand about how your employees will respond going back to the office under the new normal. They’ll likely return to work with  a higher level of anxiety than when they left. Not only will they carry reasonable concerns with them, but there will be added stress as they return to a formal work environment with in-person, colleague interaction. Even wearing business attire and commuting in the morning will be a big adjustment for many. Are your managers prepared to respond appropriately?
  • Encourage those on your plan to use telemedicine for chronic conditions including physical therapy and post-operative care to ensure they’re getting the help they  need.  The Families First Coronavirus Response Act requires that plans provide telemedicine to improve access to health care at a time they may not be able to or do not want to visit doctors’ offices in person.
  • Enhance compliance and preventive care to reduce general risk. Make sure you’re covering what people need to reduce claims later and improve employees’ overall wellness (such as with diabetes care). Consider offering items like thermometers at a reduced cost so your employees can check their own temperatures before coming to work.
  • Consider modifying benefits eligibility for those you’ve furloughed to allow them  to  stay on your plan. Some reinsurance markets and TPAs are allowing employers to leave furloughed employees on their plan because  of COVID-19 and to ultimately keep claims lower due to adverse selection. This also could potentially help your plan when remarketed.
  • Promote your company’s Employee Assistance Program (EAP) and behavioral health telemedicine to better serve your employees who may be struggling behind the scenes.
  • Review and forecast how your plan’s claims may change as your employees begin to seek elective surgeries with help from your broker. Some plans are  already  seeing  an  increase  in prescription claims related to anxiety and depression medications. Unfortunately, during this time of staying at home, your employees may experience greater instances of mental health issues, domestic abuse and drug and alcohol addictions. Experts are predicting an uptick in these procedures in the third and fourth quarters of 2020 as well as into 2021. Make sure your plan saves some of this year’s savings to cover those additional costs. Your consultant can review your self-funded plan’s financials as there will be changes in spend, lag and incurred-but-not-reported (IBNR) costs because of COVID-19.
  • Explore  your  company’s  severe  claim  risk  if an employee were to contract COVID-19. Your current broker should be able to  send you reporting that drills down to demographic data to aggregate your relative risk score. Additionally, they can use predictive modeling for COVID-19 as well as for elective procedures.
  • Work with your employees to understand if they forfeited any elective surgeries during quarantine that may become a workers’ compensation issue. For instance, a delayed hip replacement surgery could make traversing stairs difficult and even dangerous.

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