5 Changes to the Procedures for Processing Disability Claims at the Department of Labor

On April 1, 2018, the U.S. Department of Labor (DOL) implemented new procedures for processing disability claims.  This change impacts employer-sponsored plans, which deal with disability claims.  The Society of Human Resource Management recommends amending plans as needed, with the significant change in procedure processing.  The final rule was published in the Federal Register in December of 2016 and initial implementation was scheduled for January 1, 2018.  In November 2017, the DOL delayed the rollout of the new procedure until April 1, 2018.

Federal Register: Claims Procedure for Plans Providing Disability Benefits

90 Day Delay Information

The 5 changes for disability claims:

  1. “Requires that the reason for a denied claim be provided as soon as possible and sufficiently in advance of the date that the plan’s decision on appeal is due, to give the claimant a reasonable opportunity to respond.
  2. Ensures that disability claimants receive a clear explanation for why their claim was denied, as well as information on their rights to appeal a denial and to review and respond during the course of an appeal to any new or additional evidence the plan relied on in connection with the claim.
  3. Requires that a claims adjudicator cannot be hired, promoted, terminated or compensated based on the likelihood of denying claims.”[i]
  4. The new procedures can impact disability claims under the employee benefit plan, which is covered by the Employee Retirement Income Security Act (ERISA). In some circumstances, this can impact retirement plans, as well as medical coverage and other perks.  “Nonqualified deferred compensation or supplemental retirement plans…may have different benefit terms or entitlements based on disability.”[ii]
  5. “If employers have fully insured plans, they should monitor their insurance providers to ensure that the new procedures are being followed, Mindy said. For the most part, insurers have started implementing these procedures,” and they have reason to do so, since the courts can hold them liable as plan fiduciaries for a fully insured plan, he noted.  For self-funded plans, typically managed by a third-party administrator (TPA), there’s obviously more for plan sponsors to look at” because the employer bears greater liability for noncompliance.”[iii]

The reporting and disclosure guide for employee benefit plans outlines the required steps plan sponsors and organizations need to take when communicating changes to the summary plan description or summary of material modifications.  The modifications should outline the claims procedures and distribution should take place 120 days after the end of the plan year in which the change is made or as outlined in the reporting disclosure guide.  As discussed in previous articles, we continue to see significant changes in laws and compliance requirements.  Ensure your organization is working with your plan sponsors to communicate the required information.

Reporting and Disclosure Guide for Employee Benefit Plans

 

– Matthew Burr, HR Consultant

 

 

 

[i] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/new-disability-claims-procedures-take-effect.aspx

[ii] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/new-disability-claims-procedures-take-effect.aspx

[iii] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/new-disability-claims-procedures-take-effect.aspx

 

5 Definitions for Alternative Dispute Resolution

Alternative dispute resolution (ADR), is an umbrella term used for methods to resolve disputes internal to the organization and outside the court system.  Many organizations use one or all of the ADR techniques, with the techniques continuing to grow in popularity.  Union and nonunion organizations use ADR techniques to resolve disputes, large and small.  Dispute resolution is a necessity for any organization, resolution can impact organizational culture, engagement and turnover rates.  The techniques defined below can be used to resolve disputes outside of the workforce as well, we have mediation services in our communities that assist families, neighbors, etc. resolve disputes through proactive channels of communication.

The 5 Definitions of Alternative Dispute Resolution:

  1. “Arbitration: an ad judicatory process in which a neutral third party imposes a final, binding decision to resolve a dispute.
  2. Mediation: an informal process in which a neutral third party assists opposing parties to reach a voluntary, negotiated, non-binding resolution of a dispute; may be conducted internally or externally.
  3. Ombudsman: a neutral third party who is designated to confidentially investigate and propose settlement of complaints brought by employees; may be an insider or outsider.
  4. Open-door policy: a process in which employees are encouraged to discuss problems with their immediate supervisors or others in the chain of command.
  5. Peer review an internal process in which a panel of employees works together to resolve employment complaints.”[i]

Arbitrators, mediators and ombudsman are trained in dispute resolution techniques.  They know how to fact-find, draft agreements and issues decisions.  An open-door policy is an easy way to resolve disputes.  We listen to the issue (not listen to respond) and address any concerns.  Peer review is another process that can be implemented, this also needs to be managed proactively to ensure it’s legal.   All of the ADR techniques work, the effectiveness will vary by organization.  Select a process that works for your organization and be consistent with dispute resolution.

New York State Paid Family Leave Update:

Recent changes to NYS PFL confirmed that employers do not need to cap the weekly employee payroll deduction for PFL at .126% of the NYS Average Weekly Wage ($1.65 per week in 2018).  Employers can deduct .126% of an employee’s weekly wage until the employee hits the annual cap of $85.56, which is .126% of the annualized weekly wage.  This is a significant change, which better positions employers to collect the full PFL premium from each employee.

Work with your payroll companies and NYS PFL providers to ensure the calculations are accurate and deducted under current legislation.  If you are confused, seek guidance.  Like many laws, we continue to see changes to NYS Paid Family Leave. 

 

– Matthew Burr, HR Consultant

[i] American Arbitration Association, U.S. EEOC & SHRM Magazine

5 Elements of Due Process

As organizational leaders, we have the complex task of managing the workforce, coaching and counseling, disciplining, and at times, discharging employees.  Conflict resolution is never easy, but necessary, for the workforce, employee morale and the organization.  Avoiding difficult discussions or not addressing employee relations issues, can and will impact the organization.  We need to be consistent and fair for all employees, while providing a due process for discipline to potential discharge.

Below are 5 elements of due process:

  1. Expectations and Consequences: Communicating expectations, consequences and performance standards to the employee or workforce is the first step in the process.  The write-up should document a performance problem, consequences of not meeting expectations and all metrics associated with the performance problem.  Follow-up dates and action items are great to include in the first step.
  2. Consistency: We need to treat all workers with consistent and fair rules.  If we discipline one employee for a performance issue, all employees with the same issue should be disciplined.  Inconsistent practices can lead to legal issues, employee moral issues, turnover and internal conflict.
  3. The Discipline Must be Appropriate for the Offense: Review the “big picture” prior to making a decision on discipline and probable cause for termination.
  4. Employee Response: The employee should be given the opportunity to respond during any investigation or administration of discipline.
  5. Time to Improve Performance: If your organization is using progressive discipline, we do need to allow the employee time to improve performance.  However, certain situations will dictate decisions regarding performance improvement plans and immediate termination.  These situations need to be consistent and fair, throughout the organization.

Coaching and counseling, disciplining or terminating an employee is never an easy decision, but one that is necessary for the organization and rest of the workforce to grow and succeed.  The definition of due process is an area we should design our policies and procedures around.  Remember, as the employer, you have the right to change the policies.  We need to ensure we communicate the changes to the workforce.  Also, keep in mind Employment-At-Will doctrine, laws and regulations.  This can vary, state to state and union versus non-union employers.  Seek guidance if you need assistance on coaching, counseling, disciplining or terminating an employee.  How we communicate the action/decision can have an impact.

New York State Paid Family Leave Communication Letter

In late July, I wrote a brief article regarding “6 Need to Knows About the New York State Paid Family Leave (NYSPF) Legislation” and will more than likely write a few more articles about the legislation as we approach deadlines and implementation in 2018.  We are still patiently waiting for final rules and regulations to be issued from the New York State Workers’ Compensation Board, which continue to be communicated slowly.  Continue to monitor for any changes that can and will impact your organization.  As we approach 2018, we should begin communicating with employees about NYSPFL and the upcoming payroll deductions (if you haven’t started the deductions yet).

Below is a draft communication letter to consider when communicating NYSPFL information throughout the organization, which can also be used as a memo for a bulletin board or intranet/email message:

“Effective January 1, 2018, employees could be eligible for Paid Family Leave, as permitted under the New York Paid Family Leave Benefits Laws and Regulations.  After this date, eligible part-time and full-time employees may take Paid Family Leave under certain conditions, including: (1) to care for a family member with a serious health condition, (2) to bond with a child after birth or placement for adoption or foster care within the first 12 months after the birth or placement, or (3) because of any qualifying exigency arising from the fact that an employee’s spouse, domestic partner, child or parent is on active duty (or has been notified of an impending call or order to active duty) in the armed forces of the United States.

Paid Family Leave will phase in over 4 years with a gradually increasing benefit amount and duration, as shown below:

The cost of Paid Family Leave benefits is paid for by the employee via payroll deductions.  The Company will be deducting a percentage of your average weekly wages (determined by New York State) to fund Paid Family Leave benefits.  The deduction rate, which is set by New York State and is the same for everyone, is 0.126% of each employee’s weekly wage with a weekly wage cap of $1,305.92.  The maximum contribution is currently $1.65 each week.  For example, if the employee’s weekly wage amounts to $1,000.00, the maximum payroll deduction for Paid Family Leave would be $1.26 for that week.  For employees who make more than the state’s average weekly wage of $1,305.92, the Paid Family Leave deduction will be capped at $1.65 per week (0.126% of $1,305.92).  We will be designing and communicating a more detailed Paid Family Leave policy in the future to be effective in 2018.  If you have any questions please contact ____.”

Other considerations for NYSPFL Communication Letter and/or Policy:

  • Dates for deductions and payroll processing
  • Concurrent use with Family Medical Leave (remember FMLA varies in coverage)
  • Concurrent use of vacation and/or other paid time off
  • Eligibility, job protection and benefits protection regulations
  • Provider information, certification forms and submission processes
  • Approval and denial information

Additional organizational considerations for NYSPFL:

  • FMLA policy updates
  • Handbook updates
  • Labor and employment law posters/legal communication

The letter is designed for proactive communications.  As laws and regulations evolve, the letter/communication tools will also change.  Organizations should consider developing a frequently asked questions list, to assist employees in better understanding NYSPFL laws.  

 

– Matthew Burr, HR Consultant

8 Thoughts on Selecting an HRIS or Payroll Management System

Recently, I conducted a webinar on HRIS and Payroll Management Systems.  As leaders, we need to have a clear understanding of organizational needs for these systems.  Is the organization prepared to implement a new system or upgrade to a different system?  Are either of the systems necessary for the success of the organization?  Will it make the organization more efficient?  Are we prepared to pay for the new system?  Can we internally manage the new system?  There are many questions to consider prior to purchasing a system or buying software.

Below are 8 thoughts on selecting an HRIS or Payroll management system:

  1. Organizational assessment: Do you have the resources inhouse to select a system or should an external consultant (neutral) guide the organization through the process?
  2. Organizational needs: How would a new system work within the strategic plan of the organization?  Who is responsible for processing payroll?  Which reports do we need?  Turnover, terminations, new hires, Affirmative Action and other compliance reports.  Do we want an employee-self service module?  What about cellphone aps?  Will employees enroll in benefits on the new system?  Is it just for payroll processing?  What about all these modules?
  3. Project planning: What is the budget for the new system?  Do we have IT support to manage the new system?  Do we have server space for the new system?  Do we have the time to invest in project planning and project implementation?  As we approach the fall months, open enrollment, holidays and performance reviews will take priority.  Time is important for the success of a major implementation.
  4. Evaluating available systems: Develop a spreadsheet that ranks and rates the available system, based on the needs assessment.  What does the organization need and how will we measure available systems?
  5. Project team: “Critical stakeholders may differ from organization to organization, but the considerations and evaluation committee should at least include members from the following departments: IT, payroll/finance/accounting, HR, compensation, performance management, training, recruiting, operations.”[i] Operations is a major stakeholder in the selection process.  Supervisors, managers and employees will be inputting and approving timesheets.  They need to be included in the selection process.  Slow and inefficient systems take away from operations.
  6. Requesting the proposals: Utilize the RFP process within your organization and seek four to seven bids from vendors.  Include information about the organization, project specifications (organizational needs), high-level budget information and project schedule/implementation dates.  Ensure you leave enough time to evaluate systems, 3-6-month commitments on current pricing schedule.
  7. Trial the systems: The project team should meet with three to four potential vendors.   A demonstration of the systems should be included in the evaluation.  Utilize the evaluation spreadsheet that was developed and be prepared to ask questions.  The entire team should be present during the demonstrations and evaluation discussions.
  8. Make your choice: Upon selecting one or two final systems, a request should be made to each vendor for references and potential onsite visits.  The vendors should provide current or past clients.  If they avoid providing references, this might a red flag during the selection process.

Once the finalist has been selected, the organization should negotiate a service contract.  Other negotiation considerations; training, IT support, cloud support, compliance updates, software updates, warranties, self-service, cellphone aps and modules.  Does the organization need a system with all the bells and whistles?  Ensure that you are not upsold on modules and system add-ons you do not need or will not use.  Hold the vendor accountable to the agreed upon service contract.  If you are unclear on the process seek guidance and welcome advice.

 

– Matthew Burr, HR Consultant

Burr Consulting, LLC

 

[i] https://www.shrm.org/resourcesandtools/tools-and-samples/how-to-guides/pages/howtoselectanhrissystem.aspx

5 Considerations for Effective Workplace Investigations

We recently completed a successful training on effective and legal workplace investigations.  During the recording of our next podcast for Upstate HR, we also discussed workplace investigations and the importance of proactive investigatory processes.  Throughout my career, many of my experiences have provided valuable insight into the importance of effective and efficient workplace investigations.  As leaders, we need to take complaints and investigations seriously, as these issues can escalate into additional problems in the workplace, on social media,  and create stress outside of work.

Below are 5 considerations for effective workplace investigations:

  1. Don’t ignore the issue/complaint. If any employee approaches the organization with a complaint or allegation, we need to take this seriously.  Ignoring or hoping the issue goes away or resolves itself is not the right approach; we need to address the underlying issues.  Ask questions and ensure you understand the details of the issues/allegations.
  2. Never assume: Remember, there are two-sides to every story.  Do not assume that one party is guilty, because we only hear one-side of the story.  In most cases, fact-finding means understanding the entire allegation/situation before making a decision.
  3. Prepare, Prepare, Prepare: Preparing for the investigation interviews and fact-finding is challenging.  What questions do we ask?  What information do we need?  Who should we talk too?  The answer to this is that it depends on the situation.  Creating a template or checklist to ensure consistency and accuracy will help in working through the process efficiently and proactively.  Ask leading questions that force individuals to answer questions with more information, versus “yes” or “no” answers.  The more prepared you are, the more efficient the process will become.  Investigations are not easy and questions that are asked will not always be enjoyable for people to answer.  I have asked many of these questions throughout my career.  Be prepared, and know laws, policies, procedures, contract language, etc. that may be involved or impacted by the investigation.
  4. Neutrality: This consideration defaults back to consideration #2.  Remain neutral throughout the investigation and recommendation process.  This takes practice and is not easy in small organizations.  If you as a leader feel that neutrality is not practical internally, it is not always a bad idea to bring in a third-party to conduct the investigation and draft a finding of facts.  Using a third party all but ensures neutrality throughout the process.
  5. Closure/Conclusion/Recommendation: Throughout my career, I have seen this final step as the biggest hurdle for many organizations.  The investigation is conducted, information is gathered and then nothing happens.  Regardless of the outcome or recommended outcomes, the investigation needs to be closed.  I’m not suggesting revealing confidential information, but we do need to close the loop of communication with the parties involved.  Without proactive communication, we could see increased employee relations issues, decreased employee morale, and potential retaliation issues.  This is one of the most important pieces of the investigation process.

We closed out the podcast yesterday on a positive note.  Not all workplace investigations are negative or lead to discipline.  Workplace investigations are great for process improvement, addressing safety concerns, Six Sigma change, employee engagement, and efficiency.  Regardless, we need to take the investigation process seriously and manage it proactively, by reinforcing rules and policies throughout.  If you are unclear on how to investigate, ask for assistance or hire a third-party neutral to manage the process for the organization.

– Matthew Burr, HR Consultant

 

Below are the for upcoming training’s I will be conducting at Elmira College, Corning Community College (CCC), 247 Compliance and Compliance Online (July & August):

Elmira College: SHRM Certification Exam Prep Course- September through November

Upcoming Corning Community College Training’s

247 Compliance: Performance of Dashboard Using KPIs and Designing

 

Below is a link to our new Podcast Upstate HR:

Recruitment in the Modern Age

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