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Preventive Care Concept: Wellness Coaching |
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The wellness coaching concept is built upon the following principle: in Workers' Compensation, the employer is able to control and prevent claims to an extent because he can install safety measures in the workplace to reduce workplace accidents. However, on the health insurance side, the employer has little ability to control or prevent individuals from becoming high-risk claimants.
Health insurance claims are more illness-oriented, and accidents take place away from the workplace. Also, spouses are a contributing factor under health insurance plans, and yet the employer cannot see spouses and know which ones are ill, until it is too late. In other words, on the health insurance side, the employer REACTS to large claims, instead of working to prevent large claims. |
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Wellness coaching strives to prevent large claims on the health insurance side. It is basically a two-phase program. The first phase of the program is a Health Risk Assessment done at a health fair on the employer's site. It may involve a general set of questions, but more importantly, it should include a blood draw and analysis, blood pressure check, and weigh-in.
The results are analyzed and the high risk individuals in the group are identified under three broad categories of illness: cardiovascular, diabetic, and pulmonary/respiratory illnesses. |
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Generally, high-risk individuals will not compose more than 3% to 5% of a group. Yet it is this group that can drive 60% or more of possible future claims. |
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The second phase is to notify those people who are high-risk that they may have a problem, and that they should seek medical help. Some high-risk individuals will indicate that they are already working closely with physicians and that they may have already filed large claims in the recent past. However, there are usually some newly identified high-risk people who may not have previously known they were at high risk of a serious illness. For instance, it has been our experience that some people do not see a physician on a regular basis.
In the second phase, the employer offers to provide a "wellness coach," a professionally-credentialed individual who makes contact with the high-risk employee or spouse either through live web video or over the phone as part of the second phase. The coach encourages and guides the high-risk individual to take action , whether it is to see their doctor or change their diet/ lifestyle. This phase is usually done on a weekly or bi-weekly basis for the first 3 months, then gradually is scaled back to once a month sessions. After the first year, the employer may drop the payments for the participant, but leave it up to the participant if they want to pay for more coaching sessions themselves.
Usually after one year, new lifestyle habits are firmly in place, and most people do not fall back to their old habits that got them in trouble in the first place. The greatest results are obtained within the first 3 to 6 months. For instance, a person identified as very overweight and with high blood pressure may show results of losing, say 20 pounds, and lowering their blood pressure to normal in the first 6 months. This would be a positive outcome, and is reported back to the employer as such in aggregate statistics as an individual who is no longer a high risk to the medical plan.
The unknown high-risk individuals are the ones the program seek s with the wellness coaching concept, sometimes known as "walking time bombs." Note that wellness coaching generates savings results of $6 for every $1 invested in many cases for employers with more than 100 employees; smaller employers results may not be so evident. |
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Contact Joe Carlton, Employee Benefits, Ph 630-773-0241, ext. 231 for information. |
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Failure to Plan is Planning for Failure |
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According to a UN report at least 2.5 billion people (more than one-third) of the world's population) have been touched by natural catastrophes over the last 10 years - an increase of 60 percent although Asian countries account for over 50 percent of the affected people, including 90 percent of the injured or homeless, the USA is not immune to risks both man-made and natural. The recent train derailment and chlorine poisoning in South Carolina; the 9/11 attacks; the flooding in Los Angeles, CA that disrupted train (supply) lines; severe winter storms; workplace violence; and hurricanes along the East Coast are just a few of the many types of risks every US business and person faces today. If a loss occurs, how quickly can your company provide proofs of your exact claim loss? If a disaster strikes, or even severe weather, will your employees know what to do?
Insurance alone is not sufficient for proper business risk management. Two other critical or strategic areas that may not receive the proper attention they deserve are: (1) a frequently updated documentation (archive) of all business related inventory, office equipment, important documents, and so forth; and (2) an Emergency Action Plan. In fact, for businesses that have over 10 employees, OSHA requires employers to create a written Plan and communicate it to all their employees.
A great way to create a corporate archive is digitally. Once completed, make multiple copies of the digital archive, ideally keeping one set of copies offsite in a secure, limited-access location. Though your business will never have full control over all it's risks, it does have full control over the creation and maintenance of a digital archive.
The other strategic risk management step that businesses need to take is to develop and communicate an Emergency Action Plan (EAP).
Furthermore, for employers with more than 10 employees, the EAP must be a written plan and communicated to all employees. Per 29 CFR 1910.38(c) [US Code of Federal Regs], the minimum elements of an EAP must include: |
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(1) |
Procedures for reporting a fire or other emergency; |
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(2) |
Procedures for an emergency evacuation, including type of evacuation and exit route assignments; |
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(3) |
Procedures to be followed by employees who remain to operate critical plant operations before they evacuate; |
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(4) |
Procedures to account for all employees after evacuation; |
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(5) |
Procedures to be followed by employees performing rescue or medical duties; and |
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(6) |
The name or job title of every employee who may be contacted by employees who need more information about the plan or an explanation of their duties under the plan. |
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For more information, including a guided "walk-through" to create an EAP, please check out: http://www.osha.gov/SLTC/etools/evacuation/eap.html.
Also, check out this OSHA guide: How to Plan for Workplace Emergencies and Evacuations.
http://www.osha.gov/Publications/osha3088.pdf . This 21 page guide will take you through the main areas that need to be considered for a proper EAP.
Another great website for both businesses and individuals or families is: www.ready.gov .
The information on this website includes business continuity management concepts and planning.
Finally, because the above risks and responses also apply to all of us and our families, I recommend this website: http://www.knowyourstuff.org/.
No matter how it is defined or valued, risk is inseparable from our lives, our families, and our business or work activities. However, we can always take action to avoid or reduce the risk of adverse occurrences and subsequent losses. |
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Does your company sometimes send domestic employees (US Citizens) to other countries for short periods of time for sales opportunities, conferences, or training? If so, you may be unaware of the uncertain atmosphere that exists for employees who become caught in an emergency medical situation. Doctors and hospitals may seem to be unfamiliar, and language barriers exist in many overseas locations.
Fortunately, there is special insurance and overseas translation and guidance for such infrequent traveling employees. An established 24/7 international program from either Cigna International or Aetna Global Benefits could be the solution for your employees.
If this sounds like your situation, then short-term medical, including recommended quality physicians are available, and insurance is available to cover medical claims. Such a plan offers peace of mind to your employees who travel abroad. |
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For more information, contact
Mr. Joe Carlton at Cosmos-Chicago., ph. (630) 773-0241. |
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OSHA Reminds employer to Post Injury/Illness Summaries Beginning February 1 |
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WASHINGTON -- Beginning February 1, employers must post a summary of the total number of job-related injuries and illnesses that occurred last year, the Occupational Safety and Health Administration (OSHA) announced today. Employers are only required to post the Summary (OSHA Form 300A) -- not the OSHA 300 Log -- from Feb.1 to Apr. 30, 2005.
The summary must list the total numbers of job-related injuries and illnesses that occurred in 2004 and were logged on the OSHA 300 form. Employment information about annual average number of employees and total hours worked during the calendar year is also required to assists in calculating incidence rates.
The form is to be displayed in a common area wherever notices to employees are usually posted. Employers must make a copy of the summary available to employees who move from worksite to worksite, and employees who do not report to any fixed establishment on a regular basis.
Copies of the OSHA Forms 300, 300A and 301 are available on the OSHA Recordkeeping Webpage in either Adobe PDF or Microsoft Excel Spreadsheet format. |
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http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=
NEWS_RELEASES&p_id=11189 |
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Cosmos Services (America), Inc. specializes in insurance cover for internationally owned companies, especially Asian-owned, that operate with facilities in the United States. Our international resources make available more options for business clients when comparing insurance programs. Cosmos offers a full complement of Property & Casualty as well as Employee Benefit programs, tailored to your company's particular needs. With US offices strategically located in New York, Chicago, and Los Angeles, Cosmos Services are available to nearly every company in the US. |
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| New York City Office |
Phone |
(866)926-7667 |
| Chicago Office |
Phone |
(630)773-0241 |
| Los Angeles Office |
Phone |
(213)239-0480 |
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