In an effort to help workers achieve certain financial wellness goals, the Internal Revenue Service recently issued a ruling allowing one company to make contributions to 401(k) accounts on behalf of those who pay off a certain percentage of student debt.

The IRS private letter ruling, issued last summer, was a response to an unnamed company’s request to amend its plan so workers who voluntarily agree to put at least 2 percent of pay toward a student loan would be eligible to receive an employer contribution equal to 5 percent of pay to their 401(k) plan.

The company — reportedly pharmaceutical giant Abbott Laboratories — asked for the IRS ruling last year because it was concerned it was violating a rule that bans employers from setting certain conditions before employees can become eligible for other benefits. Because the employer 401(k) contribution is triggered by the employee first opting to make the student loan payment, the IRS said the company was not violating the rule.

Experts applaud the ruling because it’s another strategy in the financial wellness initiative many companies are adopting to help workers take care of money issues today while preparing for the needs of tomorrow. For employers, this program may save money because it would eliminate the need for a separate student loan program as well as any contributions the company might make to it. While the ruling is specific to one company’s situation, many believe it will pave the way for other organizations to follow.

student loan 401k

“There is some cost, but it is minor relative to a separate student loan program,” said Robyn Credico, defined-contribution consulting leader at Willis Towers Watson. “Clients are looking for financial wellness solutions like this and it won’t be a huge burden, cost-wise. It’s a great recruiting tool, too.”

While most agreed the ruling opens the door for organizations to help employees pay off debt today and save for retirement, there are a few glitches.

First, it creates a false sense of security, said John Lowell, partner at October Three Consulting. Most industry experts recommend saving between 10 percent to 15 percent of pay annually to retire on time, and 5 percent is well below that mark. In addition, a 2 percent reduction in a loan might not even be enough to cover interest payments.

“There are a lot of hidden pitfalls,” Lowell said, adding that he supports the initiative. “I think companies need to think this through.”

Also read: Tuition Reimbursement Appears to Be Paying Off

In addition, it might be hard for the company to track whether the employee is really paying down the student loan, Lowell added.

Also read: How Student Loans Influence the Talent Economy

Overall, Credico and Lowell agreed that the program is a good start. Employers interested in using it would need to amend their plan and check with plan attorneys to make sure the program follows the same structure as in the private letter ruling.


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regionality of employee benefitsYou’ve heard the old real estate adage: Property values are all about location, location, location. Likewise, the regionality of employee benefits comes into play when it comes to health care access and value. What works for an employer and its employees in New Jersey may not work in Mississippi.

Although large, familiar carriers, such as Blue Cross Blue Shield, UnitedHealthcare, Cigna and Aetna have a presence in most areas across the country, the networks these large carriers have built may not adequately service a workforce in smaller cities or rural regions. For example, employees who live in Manhattan have many choices of in-network oncologists, while employees who live in a small community in Nebraska may be limited to just a few cancer specialists in a nearby city.

The increase in mobile workforces means fully insured employers need to pay attention to where their employees live. Understanding those differences from location to location — the regionality of employee benefits — can help you ensure that all employees across your company have equivalent benefits.

Here are four ways to ensure your employees are getting the best benefits no matter where they work and live.

  1. Analyze your network.

Before signing a contract with a large insurer, analyze the carrier networks in each location in which your employees live. Your network should include enough hospitals, physicians and specialists in each zip code where your employees reside. Your carrier and employee benefits broker can help you determine if there are enough providers for your workforce and confirm the quality of the network and individual providers.

Also read: Addressing Behavioral Health in the Workplace

If the network isn’t adequate, you may have to turn to a smaller, regional carrier with a larger network in a specific area. You may have to work with both carriers to ensure all employee benefit plans are generally equivalent from location to location.

  1. Get to know state-mandated policies.

Each state has mandates that dictate coverages, benefits and time periods for certain health conditions. By one count there are more than 1,900 statutes across the 50 states. The state your benefit plan is underwritten in will determine which mandates apply. For example, if your benefits plan is underwritten in New York, all New York laws will apply to your employees regardless of where they live.

For example, one state may require diabetes test strips are supplied 90 days at a time, while another mandates 30-day supplies. The regionality of employee benefits comes into play here: If you underwrite your plan in a state that offers 90-day supplies, it applies to everyone covered, regardless of where they live. The same goes for drug formularies, mental health coverage, prescription limits and in vitro fertilization coverage, and others.

The nuances in laws from state to state warrant additional employee education and communications. HR managers should know which laws apply and ensure employees understand what is and is not covered to avoid confusion at the doctor’s office or the pharmacy. It’s worth your while, and that of your workforce, to build communications campaigns into your ongoing employee education plan.

  1. Underwrite where you get the best rate.

Make sure your plan is underwritten in the state with the best rates. A large carrier network may extend from the Northeast to the deep South; rates may vary from New York to Tennessee. Compare the rates to make sure you’re paying the lowest rate for your employees’ health care coverage.

  1. Educate your workforce on decision tools.

After you’ve worked with a carrier to set your network, don’t overlook educating employees on how to access the best care. Most carriers offer web and mobile app tools to help employees find the best provider or hospital location for their health care needs — whether it’s a specialist, an MRI location or a hospital to perform a knee replacement. These tools often include a “report card” with service listings, outcomes, complications and even the price. Regardless of whether your employees are in a rural or urban environment, the best provider isn’t always the closest or the most expensive. Comparing provider report cards can help your employees get the best in-network care.

Here’s the bottom line on the regionality of employee benefits: All health and welfare benefit plans are not created equal. Bear this in mind if your company is growing and you’re hiring employees in different locations. All employees deserve the equivalent value in their benefits program, regardless of location. Creating the same experience across your workforce will help elevate your organization to an employer of choice.

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Mental illness has been a long-avoided topic in the workplace. But as rates of suicide, substance abuse, anxiety and depression increase, more employers are making these issues a top priority.

In fact, 57 percent of employers plan to increase their focus on mental and behavioral health to a great or “very great extent” over the next three years, according to a recent survey by Willis Towers Watson. Those surveyed rank mental illness alongside metabolic syndrome, diabetes and musculoskeletal disorders as top areas of concern. These are chronic conditions that require ongoing treatment, which drive up costs and contribute to lost productivity.

These factors have led more employers to examine the financial impact of mental illness on the workplace, said Darcy Gruttadaro, director, Center for Workplace Mental Health at the American Psychiatric Association Foundation.

“Recent studies on the cost of depression in the workplace have caught the attention of employers, especially those that address comorbidity,” she said. “When a patient has chronic conditions like asthma, diabetes or cancer, the cost to treat those conditions is two to three times higher when the patient suffers from depression.”

Depression costs the U.S. economy an estimated $210 billion annually, up 21 percent from 2005, according to a study published in the Journal of Clinical Psychiatry in 2015. About half of those costs are attributed to workplace absenteeism and reduced productivity and the other half are due to medical costs, the study showed.

Also read: The Roads Not Taken: Quality and Access in Mental Health Care

Also read: Why Mental Health is a Top Talent Issue

employers mental health
57 percent of employers plan to increase their focus on mental and behavioral health over the next three years.

However, employers must do a better job of ensuring access to mental health providers and services, according to a recent report by the National Alliance of Healthcare Purchasers Coalition, a nonprofit network of business coalitions. The report recommends improving how depression is managed in primary care settings and promoting telehealth as a way to improve access, among other measures.

“If you have primary care offices addressing mental health issues with no special training, then it’s not clear that people getting the care that they need,” said Gruttadaro. “There’s a real push for collaborative care modes with well-trained professionals to monitor patient care. Employers can leverage their purchasing power to ask plans for the right data and ask the right questions.”

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When George Schwartz’s late wife was diagnosed with advanced lung cancer in 2002, he faced the task of managing her care while working as a financial advisor in a small brokerage firm.

He accompanied her to appointments, researched treatment options, coordinated her care and struggled to manage the fears that came with the dire diagnosis.

The experience was both physically and emotionally draining. It wasn’t until the couple turned to palliative medicine, a fairly new subspecialty recognized by the American Board of Medical Specialties in 2007 that helps patients manage serious illnesses, that the load became bearable, he recalled.

employers palliative care
Allison Silvers


“It provided us relief from anxiety, starting with a clear explanation of the course of the disease, what end of life would be like and how a palliative care doctor would deal with her deteriorating health,” said Schwartz, 66, whose firm, Gilbert, Doniger & Co., is based in New York. “I had a lot of interaction with the health care system and I hadn’t heard of it. My wife found out about it in a magazine article.”Palliative medicine, which is practiced by specially trained doctors, nurses and other health care professionals, provides care for patients with life-limiting conditions such as cancer, advanced heart disease, dementia, and kidney failure, among others. The goal of palliative care is to improve quality of life through pain management, stress relief, treatment for fatigue and depression, and by offering support for caregivers.

It is also associated with lower health care costs and better outcomes for patients and their caregivers, who are vulnerable to stress and illness, according to Lea Tessitore, a researcher with Catalyst for Payment Reform, a nonprofit organization that works on behalf of large employers.

“Cost savings can come in a variety of ways,” she said. “If you lead with a focus on quality of life then cost reductions will follow. For example, having a conversation around the goals of care with a provider can help to avoid aggressive and potentially harmful treatment that isn’t necessary.”

In September, CPR and the Center to Advance Palliative Care released a guide to help employers develop a palliative care strategy and educate them on what it is and how it can help patients and caregivers. Tessitore said that it could also help employers approach a topic that can be difficult to talk about.employers palliative care

“Many people think that palliative care is synonymous with hospice care and that creates a barrier to having these conversations,” she said. “They think that this is the type of care I get when I’m ready to give up. But palliative care is a high-value way to make an impact on the lives of employees with serious illness and their caregivers. It can improve the quality of life and it can reduce costs.”

Also read: Organ Transplant Innovations Can Save Health Care Dollars

It is associated with shorter hospital stays and lower health care costs due to a decreased need for 911 calls, emergency room visits, hospitalizations and the elimination of costly and ineffective treatments. In fact, patients with serious illnesses who received palliative care saved an average of $3,237 over the course of a hospital stay compared to patients who did not receive it, according to a study published in JAMA Internal Medicine in 2018.

employers palliative care
Lea Tessitore

These costs savings are catching the eye of employers, who recognize that while just a small fraction of employees have serious illnesses, most of their health care dollars are going toward their treatment, according to Allison Silvers, vice president of payment and policy at the Center to Advance Palliative Care.

“About 2 percent of the commercial population is facing a serious illness and the care they get is often unnecessary. … That percentage sounds tiny but it’s where employers are spending most of their money.”

One employer who recognized the costly gaps in care for seriously ill patients is Dow Chemical, which worked with insurance giant Aetna to launch a hospice program in 2004 that allows patients to pursue treatment through palliative care. Typically, insurers will not cover hospice care if the patient continues to seek “curative treatment,” said Silvers. This forces patients to choose between palliative care and hospice, which focuses on the needs of the terminally ill. Dow is featured in the CPR toolkit.

She hopes that more employers will see the potential of palliative care to improve the lives of employees with serious illnesses.

“We really want purchasers to demand from their health plans that they make palliative care available to participants,” she said. “We’re hoping to drive demand. It’s not a hard thing for health plans to do, but they don’t have much impetus. Employers need to demand this.” 

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Health care is costly. That’s nothing new.

Consider this: The average annual cost of health care has increased from $146 per person in 1960 to more than $10,000 per person in 2016, and care costs are expected to increase by six percent in 2019. So, while offering high-quality health care is a great way to take care of your employees, it’s becoming increasingly difficult to juggle the cost of their care with your company’s bottom line.

An option that’s become more available in recent years is the value-based health plan. In value-based health plans, payors share data and analysis to help providers improve their patient care outcomes. Through enhanced reporting and collaboration, doctors can identify areas to gain efficiencies, reduce unnecessary care, and most importantly, improve patient satisfaction and health.

Then, providers earn additional reimbursement based on their performance on cost, quality and outcomes measures. In value-based payment arrangements, health plans pay doctors more for improved patient outcomes and higher quality, and the total cost of care is better controlled.

Many companies are moving away from traditional fee-for-service agreements and toward these value-based payment arrangements. According to an analysis, the number of available alternative payment plans grew from 67 in 2011 to 823 in 2017.

Value-based payment arrangements get to the heart of the major drivers of health costs — hospital stays, ER visits, over treatment and chronic conditions like diabetes. So, when patients get the care they need at the right time, in the right setting, they have fewer complications, and require fewer hospital stays, ER visits and readmissions. These improvements help reduce costs paid by employers and insured members.

Value-Based Care
The average annual cost of health care has increased from $146 per person in 1960 to more than $10,000 per person in 2016

Nationally, the Michigan Blue Cross plan shares data and analysis with other Blue plans across the United States, so they can not only measure performance on a national scale, but use the data to create tailored, value-based health plans for companies with employees in multiple states.

For example, value-based Blue plans nationally have shown a 10 percent decline in ER visits, 2 percent decline in hospital stays, and an increase in prevention and chronic care management.

When it’s time for companies to decide on health plans for their employees, they should first ask their health plan some important questions.

  1. Are value-based plans available where you have employees? Does your plan have enough value-based providers and programs to benefit your team? Make sure to check the geographic distribution and depth of services available, so your employees can realistically use the services of these value-based providers.
  2. How long has your plan’s value-based program been in place? Find out if the program is mature, and whether they have a measurable trend in value. Programs that are older or more established typically have data that demonstrates the results they’ve been able to achieve.
  3. Do the health plan and its providers collaborate? This will show whether they understand the local dynamics, and whether the plan supports the providers in achieving improved performance.
  4. How extensive is the plan’s member base and value-based network? The larger the plan, the greater its ability to share meaningful data and influence care delivery practices.
  5. Does the plan offer flexible options? A one-size-fits-all approach to value-based networks doesn’t necessarily fit the unique needs of your employee base. Take some time to ask your plan how it measures provider performance and how it rewards members for choosing high-performing providers.

Value-based payment arrangements and value-based network design are two trends that have been demonstrating results for companies. Health care is costly. But now, there are strategies that help companies manage health costs while improving health care for employees.

Also read: Performing a Check-up on Value-based Health Care

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This past year we’ve reported on many aspects surrounding employee benefits, from the shifting retirement landscape to workplace stress and beyond. As we approach 2019, several employee-benefits experts shared with Workforce what trends they’re expecting next year.

Encouraging employees to map out their individual work-life balance strategy: 

Employees should make a point to consciously create a harmonious balance between their work and non-work lives, according to Rick Hughes, head of service at the University of Aberdeen’s Counselling Service and a co-author of the book “The Wellbeing Workout,” along with Andrew Kinder and Cary L. Cooper. Their work life can have a positive influence on their non-work life and vice versa.

“For example, a walk or fresh-air break at lunchtime can boost energy and generate a feel-good factor to aid afternoon productivity,” he said. “Or managing problems before leaving work may help to prevent thinking about the issues at home. It’s about getting things into perspective.”

Becoming more holistic in your wellness approach: 

One trend that is emerging now is the need to incorporate all dimensions of health into well-being programs, according to Joyce Young, managing director for the High Health Network. Research has found that to achieve the highest level of total well-being, one must focus on physical, mental and emotional wellness as well and one’s purpose in life.

In practice, this means that just focusing on an illness isn’t enough. For example, depression screening has value is some ways, but, ultimately, it’s just a disease search, Young said. It’s not a holistic approach.

“We need to provide the techniques and methods for the everyday person who’s not seeking treatment to be able to build their capacity and strength in the mental, emotional and purpose in life directions,” Young said.

Cecile Alper-Leroux, vice president of human capital management innovation at Ultimate Software, agreed that this is a major trend for HR leaders to be aware of and gave some practical suggestions on how to pursue it.

Employers should design work with overall employee well-being in mind, she said. They can also offer transformative technologies to help monitor and interact with employees to support and reinforce positive behavior.

Also read: Is Wellness Just an Employee Perk? 

Creating a workplace where people feel like their total well-being is supported is no easy task, she said. But it will “increasingly set apart the workplaces where employees will want to stay and be their most productive selves, and those that will struggle to retain the best talent.”

Reconsidering your conceptual understanding of health:

According to early trends in a survey she’s involved with, Joyce Young said, 90 percent of people find that the messaging of health frames it as a problem, not a resource. That is, when people see health-related communications, most of it is about getting treatment for an existing problem rather than general self-care.

“It’s not a surprise, but if the mindset is that way, then we don’t have as much motivation to cultivate [health as a] resource because we’re thinking more, we need to get this treatment or solve this problem,” she said.

Alternatively, if people thought of health as a resource, they could benefit in several ways. One, the health care system will deliver more for them. Also, the risks of the kinds of health problems by which people are preoccupied will decrease.

“We must bring our conceptual understanding into the 21st century,” Young said. “If we think differently, that will help us act differently as well.”

Considering onsite health care: 

This year saw a few Silicon Valley powerhouses like Apple and Tesla develop their own worksite health centers, and these weren’t the only organizations bringing health care onsite, said Michael Huang, national medical director of Marathon Health. In 2018, one third of organizations with 5,000 or more employees provided a general medical clinic at or near the worksite, up from 24 percent in 2012, according to Mercer’s “2018 Worksite Medical Clinics Survey.

The onsite health care model has proven results, with employers who measured their ROI last year reporting “returns of 1.5 times or higher,” Huang said. He expects momentum to continue in this area in 2019, with companies of all industries and sizes working with providers to create customized plans and programs that fit their budgets and the unique needs of their employee populations.

“By inserting the health system into the existing workplace, physicians are better able to forge lasting relationships with patients through face-to-face, personalized interactions,” he said. “This individualized care encourages regular visits to the health center, allowing employers to better track health trends, and improvement on those trends, by an employee population.”

Mental health is one area in which onsite care can be particularly beneficial, he said, as employers can utilize onsite care to give employees direct access to resources like counseling and therapy from licensed counselors, addressing barriers to mental health care like long waits for appointments and poor quality of care.

In addition to streamlining access to quality behavioral health care, “bringing these resources onsite signals that employees’ needs are understood and supported, reducing the mental health stigma in the workplace,” Huang said.

Providing cancer support services as an employee benefit:

The number of cancer patients and survivors will reach almost 18 million in the next decade, according to the CDC. And according to a recent survey that nonprofit Cancer and Careers commissioned The Harris Poll to conduct, 79 percent of the respondents said that patients/survivors that receive support from their employer are more likely to thrive in the workplace.

The poll — which surveyed 882 cancer patients/survivors who were either employed or unemployed but looking for work — also found that 53 percent of respondents feel that resources or support programs are needed to address cancer survivors’ workplace concerns, and 64 percent believe that working through their cancer treatment helped them cope.

Penn Mutual Life Insurance is one example of an organization seeking to expand its cancer care services. It began offering services this October through Cancer Guardian’s Comprehensive Cancer Support Program, which includes advanced DNA testing, dedicated cancer support specialists and digital medical records management.

Penn Mutual President and Chief Operating Officer David O’Malley said that a year before the launch of this program, the company began talks with Wamberg Genomic Advisors to learn about the changing genomics landscape and from there spent the next year deciding how to best leverage the cancer benefit.

What the company ended up deciding was offering the benefit to its 1,000-plus associates as a supplemental, employer-paid benefit, available to associates regardless of if they’re on Penn Mutual’s health plan. Also, the company does not track utilization. “Privacy is important to us,” O’Malley said, adding that the company didn’t want employees to feel as if their medical privacy was being infringed.

“We saw this as the opportunity to have a leading benefit,” he said. While benefits surveys have data on cancer insurance at organizations — the Society for Human Resource Management, for example, found that 33 percent of organizations offered cancer insurance in 2018, up from 28 percent in 2017 — the percentage of organizations offering comprehensive cancer support benefits is not as readily available.

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As the year winds down, here’s a look back at some of SHRM Online’s most-read articles about employee benefits this year, describing developments and trends that will have continuing impact in 2019.

Earlier this week, the Cleveland Clinic committed to raising the minimum wage for its employees to $15 an hour by January 2020.

According to its CEO, Dr. Tom Mihaljevic, its all about making sure employees feel respected and valued … and attracting and retaining the best employees.

As the largest employer in Northeast Ohio and the second largest employer in the state of Ohio, Cleveland Clinic has a responsibility to lead the way and help shape the future of health care and the health care workforce.…

Every caregiver’s role is important. Increasing our minimum wage demonstrates our commitment to our employees and their families, as well as the community and our patients. It is a reflection of who we want to be as an organization.…

Ultimately, we want to continue attracting the best and brightest caregivers in all roles. We want to remain an employer of choice and give back to the caregivers who do so much for the patients we serve at Cleveland Clinic. Our goal at Cleveland Clinic is to be the best place for health care and the best place to work in health care. To reach that goal, we will continue to align caregiver pay with other top employers in the markets where Cleveland Clinic operates … .

The clinic joins other large employers — Amazon, Walmart, Target, Disney Parks, McDonald’s — in adopting a $15 minimum wage.

Which is great for them and their employees, but why should this matter to you and your business?

Because by raising their minimum wage, you will have to do the same. Or you will if you want to attract and retain quality employees. These employers have moved the needle on the issue of the minimum wage. To compete in the job market against those offering a $15 minimum wage, other companies will have to match, or risk losing quality employees to higher paying employers. Thus, over time, the $15 minimum wage will organically spread.

This is not to say that this increased minimum wage is not without problems of its own. For example, if you raise your minimum wage to $15 an hour, what happens to all of those employees already earning $15 an hour? To the employee, hired 10 years ago at $8 an hour, who worked his butt off for the past decade, and, through a series of promotion and raises, earned his way up to $15 an hour? Will you provide a proportional raise to keep pace? And, if not, a $15 minimum wage will convert those millions of workers into minimum-wage employees. And, for better or for worse, there is a certain stigma with being classified as minimum wage — especially if you’ve worked hard for years not to be minimum wage.

These are not easy issues with easy solutions. However, the $15 minimum wage train has most definitely left the station, and there is no going back. The question is not if you will adopt it, but when, and how.

The post Why the Cleveland Clinic’s $15 Minimum Wage Matters to You appeared first on Workforce.

A: An employer must have one of these to avoid running afoul of discrimination laws when an employee is out on a medical leave of absence.

Q: What is an open-ended leave of absence policy?

Two employers recently learned this lesson the hard way, care of the Equal Employment Opportunity Commission.

  • Family HealthCare Network will pay $1.75 million to resolve disability and pregnancy discrimination claims stemming from its use of “rigid leave policies and practices to deny reasonable accommodations to its disabled and/or pregnant employees, refusing to accommodate them with additional leave and firing them when they were unable to return to work at the end of their leave.”
  • The Cato Corporation will pay $3.5 million, also to resolve claims that it “denied reasonable accommodations to certain pregnant employees or those with disabilities, made certain employees take unpaid leaves of  absence, and/or terminated them because of their disabilities.”

Says Melissa Barrios, director of EEOC’s Fresno, California, Local Office, “The EEOC continues to see cases in which employers have a rigid leave policy that discriminates against individuals with disabilities or pregnant employees.”

These issues very much remain on the EEOC’s radar. Unless you want to risk being on the receiving end of an expensive enforcement lawsuit, take these lessons to heart and ensure that your leave of absence policies, both in writing and in practice, permit for extended unpaid leaves as reasonable accommodations for disabled and pregnant employees.

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I’m looking forward to the holiday break after spending this month working on a 5,000-word article and finishing up my final assignments of 2018.

The end of the month for me will mean tons of family time with my parents, sisters and a very cute pit bull. I’m excited for simple pleasures like watching episodes of “Jeopardy!” by the fireplace, sipping coffee with my sisters and playing fetch with the puppy in my parents’ backyard.

I’ve also been thinking about the HR/business topics that have really stuck with me this past year. Looking toward 2019, I’ll be interested to see what changes happen in these environments.

The #MeToo Movement Moving Forward

A lot of us have been thinking a lot about sexual harassment this past year. It’s been hard not to. And for as much more work there is to do, it’s frustrating when people suggest that #MeToo has gone too far in “ruining” men’s lives or that men can’t even feel comfortable talking to/mentoring/hiring a woman anymore.

There’s one Quartz story I haven’t been able to shake these past few months about headhunters having trouble recruiting people in the era of #MeToo. An excerpt:

” … But in the last year, search firms also have had to consider host of other qualities about prospective candidates. Are they abusive to employees? Do they have a problem keeping their hands to themselves? Are they likely to engage in inappropriate behavior? Are they jerks? … ”

The fact that apparently headhunters did not have to consider if a candidate has been abusive or inappropriate to employees, while not surprising, is disgusting. There’s no reason that type of behavior shouldn’t be considered. In this environment, this is a great time to finally hold people accountable for their abusive/harassing actions instead of letting them hop from job to job to repeat the same patterns.

Hearing things like this makes me wonder about how many serial harassers can constantly get away with doing the same actions at different companies under the guise of getting a second chance.

I wonder what direction the #MeToo movement will go in next year. I hope it doesn’t lose steam when there’s still so much more that needs to change.

One thing I think to look out for is how much companies are actually trying to change versus just trying to do something that makes them look good. On the surface, certain developments may seem like wins, but it’s still necessary to dig deeper in the surface.

For example, Wired published an article in November about the limitations of revised sexual harassment policies. The gist of this story is that changes arrive too late for many women, as companies like Google, YouTube and Uber continue to try to force arbitration on ongoing claims that missed the cutoff for the new policy. Statistic: Forced arbitration is so common now that about half of all U.S. workers in the private sector (who don’t belong to unions) have waived their right to go to trial.

My major takeaway was that while progress is good, there’s a lot to be done here. Let’s not take every little win as the ultimate win or as a reason to stop caring about this topic. If we look deeper in ways companies are trying to improve, there could be limitations.

We should be able to give organizations a pat on the back for going in the right direction while also feeling free to give constructive criticism where there’s still work to be done. That’s not being ungrateful; that’s being logical.

Other 2018 articles on this topic:

Health Data and Data Privacy

Sometimes it seems like companies are giving fitness trackers away like candy. But what’s the actual cost of these supposedly free devices?

One annoyance I have in the employer health-care space is about the lack of transparency in certain areas, resulting in employees not getting all the necessary facts they need to make an informed decision. For example, life insurance companies can deny coverage based off an applicant’s genetic test results. Do employees know that when they take advantage of an employer’s genetic testing benefit?

Add this new one to the list, also relating to life insurance: John Hancock announced in September that it “will stop underwriting traditional life insurance and instead sell only interactive policies that track fitness and health data through wearable devices and smartphones.”

Excerpt from the Vox article: “The insurance companies can use this data to potentially weed out bad health-risk customers. A John Hancock representative told CNN it may use the data to try to sell customers other products like retirement plans. And it already charges less for people who are healthier. While the insurance market is heavily regulated, we’ve already seen what can happen when insurance premiums are left up to the whims of a free market … .”

None of this is to single out John Hancock, but it’s an example of one company’s practices.

A different article this year pointed out just how common fitness trackers have become for employers. Compared to 2 million workers in 2016, 6 million workers worldwide will receive fitness trackers through their employer by the end of 2018, reported NPR in November. Also, annual financial incentives for participating in voluntary wellness programs that may mean having to wear one of these trackers range from $100 to more than $2,000, depending on the company. That’s a lot of money for employees to give up by not participating.

An excerpt from the NPR article provides some insight into the potential meaning of too-large incentives:

[Andrew Boyd, an assistant professor of biometrics and health information at the University of Illinois at Chicago and the associate chief health information officer for innovation and research at the University of Illinois Hospital] is cautious but confident that some of the ongoing studies will show positive benefits for patient health. But he urges taking care before trading data for dollars. It’s important to know the type of information your tracker is revealing about your health, he says, and to know exactly how it will be used. Your incentives could offer a clue.

“If [your insurance company is] offering you two or three times the amount of money that every other insurance company’s offering you, there’s something else they value in the data that they’re giving you that cash for,” he says.

For instance, he says, if Congress ever repeals the Affordable Care Act, insurers could use the fitness data they’re collecting today to deny you coverage based on a medical condition that your tracker detects.

What do you think? What topics are you following closely now, and what are you curious to follow next year?

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