ARPA: What Employers Need to Know
On March 10, 2021 Congress passed the American Rescue Plan Act (ARPA) of 2021, which was signed
into law on March 11th. The ARPA attempts to address and help mitigate some of the far-reaching financial impacts of the COVID-19 pandemic. In addition to those provisions, the ARPA contains provisions that are of special interest to employers and employees.
The ARPA Nitty Gritty
- COBRA Subsidy - A 100% premium subsidy is provided, funded through employer tax credits.
- FFCRA Leave - Employer tax credits have been extended through September 30, 2021.
- FFCRA Leave - Inclusion of testing and immunization as qualifying reasons for FFCRA leave.
- FFCRA Tax Credits - Definition of employee earnings eligible have been expanded.
- Unemployment - The $300 weekly increase has been extended and expanded.
- ACA - Exchange insurance subsidies are increased.
- DCAP - Contribution limits have been increased.
- Employee Retention Tax Credit - Extended and expanded eligibility for some businesses.
Let's Break It Down
COBRA Subsidy
What is it?
COBRA (Consolidated Omnibus Budget Reconciliation Act of 1986) allows employees who would lose employer-sponsored health insurance because of job loss (or reduction in working hours) to continue that insurance for 18 months. However, the employer can require the employee that elects COBRA coverage to pay the entire cost of the premium oftentimes creating a necessary, but an unexpected financial burden for the employee.
ARPA Provisions
- 100% subsidy of COBRA premiums from April 1, 2021, through September 30, 2021, for employees and their family members who lost health insurance due to involuntary termination or reduction in hours of their employment
- Allows employees who declined COBRA coverage, or elected it and dropped it, to elect subsidized COBRA
- Does not apply to employees who voluntarily terminated their employment or who qualify for another group health plan
Who Pays For It?
The subsidy is funded through the federal government through a refundable payroll tax credit.
Action Steps
- New employee notice requirements for plan administrators will be issued by the US Department of Labor
- Employees may elect subsidized COBRA starting April 1, 2021, through 60 days after receiving notice of the benefit
FFCRA Leave
What is it?
FFCRA (Families First Coronavirus Response Act) was passed in March 2020 and provided a tax credit for employers to fund two types of paid employee leave required by the law. These leave requirements expired in December 2020, but for employers that chose to continue providing FFCRA leave voluntarily, the tax credit was extended through March 2021.
ARPA Provisions
- Extends tax credit through September 30, 2021
- Adds a provision to include employee time off related to COVID-19 testing and immunization
- Increases the amount of wages eligible for the family leave credit from $10,000 to $12,000 per employee
- Provides an additional 10 days of voluntary emergency paid sick leave for employees beginning April 1, 2021
Unemployment
What is it?
Due to the COVID-19 pandemic, unemployment provisions were expanded under the previous administration to include three new federal unemployment programs. These programs were scheduled to end no later than April 2021.
- Pandemic Unemployment Assistance (PUA): Provided weekly benefits to independent contractors, self-employed individuals, and other workers that typically would not be eligible for unemployment benefits
- Pandemic Emergency Unemployment Compensation (PEUC): Provides weekly benefits to individuals who have exhausted their eligibility for all other unemployment benefits
- Federal Pandemic Unemployment Compensation: Provides an additional $300 weekly payment to individuals already receiving PUA, PEUC, or regular unemployment benefits
ARPA Provisions
- Previously established provisions that were set to expire have been extended through September 6, 2021
- Changes how unemployment benefits are taxed, exempting the first $10,200 from federal income tax for each spouse in households with under $150,000 in adjusted gross income.
ACA
What is it?
The ACA (Affordable Care Act) established health insurance exchanges for the purchase of individual health insurance coverage, as well as premium tax credits. These tax credits are not available to individuals with income at or above 400% of the federal poverty level.
ARPA Provisions
- Temporarily eliminates the income cap on subsidies for a period of two years
- Limits the total amount a household is required to pay for health coverage through the Exchanges to 8.5% of household income
- Increases federal subsidy amounts available for lower-income individuals, in some cases eliminating premium costs entirely
- Increases federal funding intended to encourage states to expand Medicaid programs (if they previously had not done so)
- All provisions are temporary and will expire in two years
DCAP
What is it?
A DCAP (Dependent Care Assistance Plan), also sometimes referred to as a dependent care flexible spending account (FSA), is an employee benefit plan that helps employees pay for the care of a qualifying dependent, such as a child or elder, as defined by Internal Revenue Service (IRS) regulations.
ARPA Provisions
- Increases annual contribution limit from $5,000 to $10,500 ($2,500 to $5,250 for married filing separately) for tax years beginning after December 31, 2020 and before January 1, 2022
- Employers meeting requirements can retroactively amend plans to incorporate the increase
Action Steps
- Employers with DCAPs can retroactively amend plans, if
- The amendment is adopted by the last day of the plan year in which it is effective; and
- The plan operates consistently with the terms of the amendment until it is adopted.
- It is recommended that you speak with your benefits advisor to ensure plans meet the requirements and stay in compliance
Employee Retention Tax Credit
What is it?
The Employee Retention Tax Credit was originally enacted with the CARES (Coronavirus Aid, Relief and Economic Security) Act. The credit was tended to encourage employers to retain employees on their payroll who were unable to work due to COVID-19 related reasons. This credit was set to expire in June of 2021.
ARPA Provisions
- Extends the credit through the end of 2021
- Expands eligibility to some small startups that began operating after February 15, 2020. Qualifying businesses will be eligible for a maximum credit of up to $50,000 per quarter even if they do not experience an eligible decline in gross receipts or a full or partial suspension
- Creates a new provision for 'severely financially distressed' employers which beginning in the third quarter of 2021 allows employers of any size to count all wages toward the $10,000 cap.
New direct primary care rules are a tough pill for HSAs
For many Americans, direct primary care has taken control of medical costs, which has cut through many frustrating options and has created a peach of mind when it comes to both health and its costs. Read this blog post to learn more
As an employee benefits attorney and compliance consultant, last summer’s executive order on “improving price and quality transparency in American healthcare to put patients first” piqued my interest. In particular, I honed on in section 6(b), aimed at treating expenses related to direct primary care arrangements as eligible medical expenses.
As someone dealing with a complicated medical history, digging into the order and digesting the resultant proposed IRS rule was more than my job – it was and is part of my life.
Several years ago, I decided to give direct primary care a try. For about $100 a month, I gained direct access to and the undivided attention of a physician who knows me and my unique medical needs. I pay a flat, upfront fee and my doctor coordinates and manages my treatment, which isn’t always smooth sailing for someone dealing with a complex connective tissue disorder. My primary care physician serves as the coach and quarterback of my medical care, directing tests, meds, and visits to various specialists like rheumatologists or neurologists. If I have a common cold or infection, she’s readily available to prescribe treatment and set my mind at ease.
Since arriving on the scene in the 2000s, direct primary care has grown in popularity and availability. In the age of skyrocketing monthly premiums and a multitude of confusing options, more Americans are flocking to direct primary care to supplement their existing coverage. Some employers are even looking at it to drive down costs.
Now, direct primary care only covers, well, primary care, so I’ve paired it with a high-deductible healthcare plan and a health savings account to pay for my many additional medical expenses. I’m not alone: more than 21 million Americans are following the same path.
However, rather than making direct primary care more accessible, the proposed regulations actually make it virtually impossible for all of us with HSAs. Remember, by law, to qualify for an HSA, individuals must be covered by a high deductible health insurance plan. The rationale for this is consumers with more on the line are more responsible in controlling their health care costs and thus rewarded with the tax-advantaged benefits of an HSA.
Here’s the problem: the proposed regulations define direct primary care as a form of insurance – one that is not a high-deductible health plan and would therefore disqualify me from having access to an HSA.
Regulators point out that direct primary care arrangements provide various services like checkups, vaccinations, urgent care, lab tests, and diagnostics before the high deductible has been satisfied. According to the preamble to the proposed regulations, “an individual generally is not eligible to contribute to an HSA if that individual is covered by a direct primary care arrangement.”
Keep in mind, 32 states consider direct primary care a medical service rather than a health plan and exempt it from insurance regulation. Even the Department of Health and Human Services shares that view, noting in a March 12, 2012, final exchange rule that “direct primary care medical homes are not insurance.” In addition, the proposed rule itself includes some contradictory language and implications when it comes to defining direct primary care relating to other factors.
By its very nature, direct primary care is a contract between patient and physician without billing a third party. In cutting out the insurance companies, it seems obvious that direct primary care is not a competing insurance plan, but instead, a valuable service that can accompany existing coverage.
Furthermore, there is no clear justification for painting direct primary care as disqualifying medical insurance for those with HSAs. The IRS has more than enough flexibility and discretion to determine that direct primary care does not count as insurance. Regulators could do so while still treating direct primary care as a tax-deductible medical expense, which seems to be the intention of the proposed rule in the first place.
For millions of Americans, direct primary care has been a godsend in taking control of medical care, cutting through frustrating options, and gaining peace of mind when it comes to both health and healthcare costs. In short, direct primary care is everything primary care should be and was supposed to be. It’s an option that individuals should be permitted to access to complement (not compete with) high deductible health insurance plans and HSAs.
Although the comment period for the proposed regulations is now over, I am hopeful with a few tweaks and small changes they can better align with the stated purpose of the executive order, empowering patients to choose the healthcare that is best for them. If not, the new rules would likely be a hard pill to swallow for the entire direct primary care community.
SOURCE: Berman, J. (26 August 2020) "New direct primary care rules are a tough pill for HSAs" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/new-direct-primary-care-rules-are-a-tough-pill-for-hsas
5 ways to prepare for open enrollment during COVID-19
As open enrollment draws near, it's time to critically prepare for it especially during the crazy time that the coronavirus pandemic has brought to many families. Read this blog post to learn more.
The COVID-19 pandemic has focused consumer attention on health care, germs and the impact a single illness can have on their lives, livelihoods and loved ones. With the fall open enrollment season just months away, you have the opportunity to think more critically about the specific plans you choose for yourself and your family, as well as any voluntary benefits that may be available to you, including childcare, elder care and critical illness. In a world where it feels like health is out of the individual’s control, we all want, at the very least, to feel control over our coverage.
As we know all too well, there’s a lot to consider when it comes to choosing and using health care benefits. The most important piece of becoming an informed health care consumer is ensuring you have access to — and understand — the benefits information you need to make smart health care choices. Here are five tips to keep in mind as you prepare for and participate in open enrollment.
1. Prepare for COVID-19 aftermath
As if dealing with the threat of the virus (or actually contracting it) wasn’t enough, consumers must consider the unexpected consequences. Quarantines, stay-at-home orders and business shutdowns have resulted in missed preventive care visits — including annual immunizations. For instance, many children will have missed their preschool vaccinations, which could result in an uptick in measles, mumps and rubella. If school is conducted virtually, the risk of catching one of these highly contagious diseases is somewhat reduced, though consumers should still proceed with caution as states reopen. In fact, with continued waves of COVID-19 expected well into the school season, you and your children may have to wait even longer to get vaccinations due to pent up demand and possible shortages.
Don’t forget that preventive care is covered by most plans at 100% in-network regardless of where that care is received. Schedule your appointments as soon as possible (and permissible in their area), and research other venues for receiving care, such as pharmacies, retail clinics and urgent care facilities. Most are equipped to provide standard vaccinations and/or routine physicals.
Unfortunately, there are also the long-term implications of COVID-19 to consider. Research suggests that there are serious health impacts that emerge in survivors of COVID-19, such as the onset of diabetes and liver, heart and lung problems. And many who were able to ride out the virus at home are finding it’s taking months, not weeks, to fully recover. As a result, you should prepare for the possibility that you, or a loved one, may be ill and possibly out of work for an extended period of time. Be sure to evaluate all of the plans and programs your employer offers to ensure your family has the financial protections you need. For some, a richer health plan with a lower deductible, voluntary plans such as critical illness or hospital indemnity insurance, and buy-up life and disability insurance may be worth investigating for the first time.
2. Re-evaluate postponed elective procedures
Many employees or their family members have postponed or skipped elective procedures — either from fear of exposure to COVID-19 at hospitals and outpatient facilities, or because their hospitals and providers cancelled such procedures to conserve resources to treat COVID-19 patients. As a result, an estimated 28.4 million elective surgeries worldwide could be canceled or postponed in 2020 due to the virus.
As hospitals reopen, it may be difficult to schedule a procedure due to scheduling requirements and pent up demand. A second opinion may be in order if your condition stabilized, improved or worsened during the delay; there may be other treatment options available.
A delay in scheduling also provides an opportunity to “shop around” for a facility that will provide needed care at an appropriate price — especially if you are choosing to go out-of-network or have a plan without a network. Researching cost is the best way to find the most affordable providers and facilities with the best quality, based on your specific needs.
Many medical plans offer second opinion and transparency services, and there are independent organizations who provide “white glove,” personalized support in these areas. Read over your enrollment materials carefully, or check your plan’s summary plan description, to see what your employer offers. If nothing is available, ask your employer to look into it, and don’t hesitate to do some research on your own. Doing so can often result in substantial cost savings, without compromising on quality of care.
3. Confirm your caregivers
Because so few elective procedures were performed during the initial phases of the pandemic, many hospitals sustained huge financial losses. As a result, many small hospitals are closing, and large hospitals are using this opportunity to purchase smaller, independent medical practices that became more financially vulnerable during the pandemic. Further, many physicians have opted to retire or close their practices in light of the drastic reductions to their income during local shutdowns.
Be sure to check up on your preferred health care providers — especially those you might not see regularly — to confirm they are still in business and still in network (if applicable). If you live in a rural area, you may have to travel farther to reach in-network facilities. If you’re currently covered by an HMO or EPO, you may want to evaluate whether that option still makes sense, if your preferred in-network providers are no longer available.
4. Look at ALL the options
Voluntary coverages — such as critical illness, hospital indemnity, buy-up disability, and supplemental life insurance — may help ease your concerns about how you will protect your and your family’s finances if you become ill. Pandemic aside, these benefits can provide a substantial safety net at a relatively low cost. Investigate your employer’s offerings — many employers are offering virtual benefit fairs where vendors can provide more information about these benefits while remaining safe from large social gatherings.
When was the last time you changed your medical plan? If you’ve been keeping the same coverage for years, it might be time to look at what else is available. Your employer may have introduced new plans, or you may find that a different plan makes more sense financially based on how often you need health care. Don’t forget — the cheapest plan isn’t always the one with the lowest premiums.
5. Uncover every resource available
Besides your health coverage (medical, dental and vision), many employers offer other plans and programs to support your health. While you’re already focused on benefits, take the time to learn about what else is available to you. These offerings may range from the previously mentioned advocacy and transparency services and voluntary benefits, to personalized, one-on-one enrollment support, to telemedicine services and an Employee Assistance Program (EAP). Also, many employers made temporary or permanent plan changes to address COVID-19 regulations and concerns. Be sure to familiarize yourself with these changes — and when they might expire.
You may also want to consider setting aside funds in a health savings account or health care flexible spending account (if available). If your employer offers a wellness program, this might be an opportunity to start adopting better health habits to ensure you’re better equipped physically and mentally to deal with whatever lies ahead.
While open enrollment may seem daunting, devoting an hour or two to reviewing your plan options, the programs available to support you and your family physically, mentally and financially, and how to get the most from the coverages you do elect, can go a long way towards providing peace of mind as we face the unknowns of 2021.
SOURCE: Buckey, K. (17 August 2020) "5 ways to prepare for open enrollment during COVID-19" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/list/5-ways-to-prepare-for-open-enrollment-during-covid-19
Overview of COVID-19 Law and Guidance for Health and Welfare Plans
The business operations of many small and large companies have been significantly affected due to the coronavirus pandemic. During this time, health and benefit plans are also being affected. Read this blog post to learn more.
The COVID-19 pandemic has significantly affected the business operations of small and large employers alike. To mitigate the harm from the pandemic to employers, the government has enacted major legislation and issued numerous guidance in the past few months pertaining to COVID-19, including rules that address various aspects of employee benefits.
This article provides an overview of significant COVID-19 legislation and guidance related to employer-sponsored health and welfare benefit plans that has been enacted or issued to date.
Some of these changes are mandatory for group health plans. Other are optional. Employers should carefully review these rules to determine any compliance obligations as well as any opportunities to benefit their businesses and respective employees.
Mandated Coverage of COVID-19 Testing (Mandatory)
Effective March 18, 2020 and until the end of the national emergency period for COVID-19, the Families First Coronavirus Response Act (FFCRA) requires group health plans to cover:
- COVID-19 diagnostic testing.
- Certain items and services that result in an order for, or administration of, the testing.
Plans must provide this coverage without imposing any requirements for cost-sharing, prior authorization, or medical management.
CARES ACT
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which was signed into law on March 27, 2020, amended the FFCRA's coverage mandate to:
- Expand the scope of COVID-19 diagnostic tests that must be covered.
- Include rules regarding the rate at which a plan must reimburse a health care provider for the mandated services.
- Require coverage of preventive services and vaccines for COVID-19 as of 15 days after such a service or vaccine is given an "A" or "B" rating in a recommendation by the U.S. Centers for Disease Control and Prevention (CDC) or U.S. Preventive Services Task Force.
ADDITIONAL GUIDANCE
On April 11, 2020, the FFCRA and CARES Act FAQs provided additional information about this COVID-19 mandate. Items included details on required coverage of COVID-19 antibody tests, rules regarding required disclosures of the new coverage to plan participants, and which items and services related to COVID-19 testing must be covered by a plan.
Continuation of Health Benefits During Certain Leaves of Absence (Mandatory)
The FFCRA also requires (with some exceptions) employers with fewer than 500 employees to provide certain paid sick leave and family and medical leave related to certain COVID-19 reasons, as follows:
- Paid sick leave. An applicable employer must provide two weeks of emergency paid sick leave (EPSL) to an employee who is unable to work (or telework) due to certain reasons related to COVID-19. Reasons include quarantining of an employee (due to a Federal, state or local order or advice from a health care provider) experiencing COVID-19 symptoms, caring for an individual who is quarantined, and caring for a child under age 18 whose school or child care provider is closed.
- Family and medical leave. The employer must also provide up to twelve weeks of expanded Family Medical and Leave Act (FMLA) leave (ten of which is paid) for an employee who has been employed for at least 30 days and who is unable to work (or telework) due to a bona fide need for leave to care for a child whose school or child care provider is closed or unavailable for reasons related to COVID-19.
During FMLA leave, an employer is required to allow the employee to continue his or her group health coverage at the same premium rate as that of active employees. The DOL has also issued FAQs stating that employers must continue employees' coverage during EPSL, as well. Note, there are also implications for retirement plans under the FFCRA and CARES Act. Although those retirement plan rules are not discussed in this article, some of the CARES Act rules are conceptually similar for retirement plans (e.g., 401(k) plans may allow participants to take "Coronavirus-related" 401(k) plan distributions due to certain COVID-19 reasons).
High-Deductible Health Plans and Health Savings Accounts (Optional)
IRS GUIDANCE
IRS Notice 2020-15 (March 11, 2020), which was issued prior to passage of the FFCRA and CARES Act, provided that a high-deductible health plan (HDHP) will not lose its HDHP status if it covers COVID-19 testing and treatment before the statutory minimum HDHP deductible is met. Therefore, the plan can cover those COVID-19 related services without causing participants to be ineligible to contribute to a health savings account (HSA). IRS Notice 2020-29 (May 12, 2020) clarified that the provisions in Notice 2020-15 apply to an HDHP's reimbursement of expenses incurred on and after January 1, 2020.
CARES ACT
The CARES Act amended the HSA rules to provide that, for plan years before December 31, 2021, an HDHP does not lose its HSA-eligible status if it covers telehealth and other remote healthcare services before the HDHP deductible is met. This CARES Act provision is broader than the IRS Notices, as it provides that an HDHP can cover telehealth services regardless of whether the services are related to COVID-19. The CARES Act also allows participants to use their HSAs, health flexible spending accounts (FSAs), and health reimbursement arrangements (HRAs) to pay for certain over-the-counter drugs without a prescription as well as certain menstrual care products.
Extended Form 5500 Filing Deadline for Certain Plans (Optional)
IRS Notice 2020-23 (April 9, 2020) extended certain deadlines for a plan to file the required annual Form 5500. Under Notice 2020-23, the Form 5500 deadline was extended to July 15, 2020 for any plan whose plan year ended in September, October, or November 2019 (or any plan that was given a filing extension between April 1 and July 15, 2020). Ordinarily, a plan must file its Form 5500 (absent an extension) by the last day of the seventh month following the end of the plan year.
Relief for Certain Disclosures Required by ERISA (Optional)
EBSA Disaster Relief Notice 2020-01, which was issued by the DOL on April 28, 2020, extended the deadlines for plans to provide certain notices and disclosures under Title I of the Employee Retirement Income Security Act of 1974 (ERISA). Under Notice 2020-01, a plan will not be treated as violating ERISA if it fails to timely furnish a notice, disclosure, or document required by Title I of ERISA between March 1, 2020 and 60 days after the announced end of the national emergency declaration for COVID-19. The plan fiduciary, however, must act in good faith to furnish the notice, disclosure, or document as soon as administratively practicable. For this purpose, a plan fiduciary can meet the "good faith" standard by furnishing a document electronically if it reasonably believes that the recipient has access to electronic communication.
Extensions of Certain Plan Deadlines (Mandatory)
A joint notice issued by the DOL and IRS (published May 4, 2020) required group health plans to extend certain timeframes for participants during the "outbreak period" (defined as the period from March 1, 2020 until 60 days after the announced end of the national emergency for COVID-19). Those plans are required to disregard the outbreak period for purposes of determining the following periods and dates:
- The 30-day/60-day special enrollment period under the Health Insurance Portability and Accountability Act (HIPAA).
- The 60-day deadline for a qualified beneficiary to elect continuation coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).
- The deadlines for a COBRA qualified beneficiary to pay his or her required COBRA premiums.
- The deadline for an individual to notify the plan of COBRA certain qualifying events (e.g., divorce).
- The deadlines for a participant to file benefit claims, appeals, and external review requests with the plan (or to perfect an external review request).
Because of this joint notice, a group health plan must essentially "pause" the above deadlines during the outbreak period. For example, if an individual experienced a COBRA qualifying event on March 1, 2020, the individual would have until 60 days after the end of the outbreak period (rather than 60 days after March 1) to elect COBRA coverage. This is because the joint notice requires a group health plan to pause the 60-day timeframe for COBRA elections during the outbreak period. Also, because the joint notice was issued on May 4 and is retroactive to March 1, plans may be required to re-process previous claim denials that were based on a participant's failure to meet one of the above deadlines between March 1 and May 4.
Cafeteria Plans and Flexible Spending Accounts (Optional)
2020 MIDYEAR ELECTION CHANGES
IRS Notice 2020-29 (May 12, 2020) relaxed the rules regarding cafeteria plan pre-tax elections in light of the COVID-19 pandemic. Under Notice 2020-20, employers may (but are not required to) amend their cafeteria plans to allow participants to make the following mid-year, pre-tax election changes in 2020:
- An election to enroll in the health plan by an eligible employee who previously declined coverage (e.g., someone who waived coverage during open enrollment).
- An election to change plan options (e.g., from an HMO to a PPO) or add dependents.
- An election to drop coverage by a participant.
- An election to enroll in or drop health FSA or dependent care FSA coverage or to increase or decrease health FSA or dependent care FSA contributions.
An employer that wishes to adopt any of all of the above cafeteria plan changes must disclose the changes to employees and amend its cafeteria plan by no later than Dec. 31, 2020 (i.e., an amendment is not required in advance of making the changes).
EXTENDED GRACE PERIOD TO INCUR FSA CLAIMS AND INCREASE OF MAXIMUM HEALTH FSA CARRYOVER AMOUNT
Notice 2020-29 also permits employers to amend their health and dependent care FSAs to allow employees to incur eligible claims through the end of the 2020 calendar year for any FSA plan year (or for any FSA grace period that ends in 2020). For example, if a health FSA has a grace period until March 15, 2020 for a participant to incur eligible claims for the 2019 plan year, the FSA can allow participants to incur expenses through 2020 and use their 2019 elections to pay for those expenses.
This change does not apply to FSAs with a carryover provision. IRS Notice 2020-33 (May 14, 2020), however, provides for a permanent FSA carryover increase based upon annual indexing. For the 2020 plan year, employers may amend a cafeteria plan with carryover provision to allow participants to carry over up to $550 in unused health account balances in the 2021 plan year. An employer that adopts the extended FSA grace periods or the increased carryover limit must amend its cafeteria plan or FSA (as applicable) by no later than December 31, 2021.
Tax-Free Payment of Employees' Student Loans (Optional)
The CARES Act amended Section 127 of the Internal Revenue Code (education assistance programs) to permit employers to pay up to $5,250 of an employee's student loans on a tax-free basis. This provision applies from the date of enactment of the CARES Act (March 27, 2020) through the end of 2020. The payment must be for either the principal or interest of a qualifying education loan incurred by the employee, and the employer can make payment either directly to the lender or as a reimbursement to the employee.
Takeaways for Employers
As employers grapple with the impact of the COVID-19 pandemic and return to normal business operations, it is important for them to be aware of their compliance obligations under the FFCRA, CARES Act and other guidance issued by governmental agencies. Employers should also carefully review the guidance and legislation for potential avenues of benefit for their business and employees.
Additional guidance for both mandatory and optional items is likely forthcoming as well, and COVID-19 continues to have a major impact on both companies and individuals as new infections spike in numerous states. Accordingly, employers would be well-advised to keep a close eye out for new legislation and guidance in the coming months and periodically evaluate their benefits programs for compliance and competitive considerations.
SOURCE Tyler Hall, A.; Schillinger, E. (16 July 2020) "Overview of COVID-19 Law and Guidance for Health and Welfare Plans" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/overview-of-covid-19-legislation-and-guidance-for-benefits-plans.aspx
How Hospitals Can Meet the Needs of Non-Covid Patients During the Pandemic
As there has been many waves of coronavirus cases for many months, health care has seemed to only point to helping those who have been impacted by the virus. Although there are still many cases that test positive for the virus, there has been a dramatic decline in other non-COVID related health issues. Read this blog post to learn more.
During the initial wave of the Covid-19 pandemic, hospitals worldwide diverted resources from routine inpatient critical care and outpatient clinics to meet the surge in demand. Because of the resulting resource constraints and fear of infection, clinicians and non-Covid patients deferred “non-urgent” visits, evaluations, diagnostics, surgeries and therapeutics. Indeed, early in the pandemic physicians and leading public health officials noted a dramatic decline in non-Covid-related health emergencies, including upwards of a 60% decrease in patients with acute myocardial infarctions and strokes.
Drawing on key principles from operations management and applying a health-systems perspective, we propose four strategies to facilitate care of non-Covid patients even as hospitals are stretched to absorb waves of patients with Covid-19.
1. Innovate outpatient management to reduce demand at downstream bottlenecks.
To reduce future bottlenecks in emergency departments (EDs) and hospitals, outpatient clinicians should expand their proactive management of patients at high risk of needing acute or inpatient services, such as those with poorly managed hypertension or diabetes, and triage patients with acute needs to EDs now in order to reduce more serious complications later. This will help reduce potential future spikes in demand on EDs and inpatient beds from non-Covid patients.
While most clinicians have rapidly adopted some form of telemedicine, they will need to increase their digital engagement with high-risk patients in a more targeted fashion. Clinicians should evaluate their patient panels to identify high-risk individuals and initiate telemedicine visits, rather than relying on patients to initiate contact, similar to the process for proactive disease management used by several community health care organizations.
Although high-risk patients will vary by specialty, targeted populations may include patients recently discharged from the hospital and those at high risk for hospitalization, including those with uncontrolled heart failure or active malignancy. To facilitate remote patient monitoring of high-risk patients, clinicians may opt to send telehealth kits tailored to patients’ medical and technological needs. These kits may include connected health devices such as blood pressure monitors, pulse oximeters, and heart rate monitors, and even mobile technology devices such as tablets or smart phones. To most effectively leverage telemedicine during the pandemic, clinicians must also promote multidisciplinary virtual collaboration across primary care clinicians, specialists, social workers, home health clinicians, administrative support, and patients and their caregivers.
2. Combine essential non-Covid inpatient services across hospitals.
To balance demand across hospitals, public health officials should apply a version of the logistics strategy known as “location pooling,” combining demands from multiple locations. Rather than each hospital in a region redundantly providing the full suite of essential inpatient non-Covid clinical services, each of these services should be concentrated at one location. For example, each region should have a single designated cancer center, transplant center, stroke center, and trauma center. Implementing this strategy is fraught with challenges as hospitals are currently organized independently and compete with one another for patients and revenue. Nevertheless, during the initial Covid-19 wave, several hospitals in Boston collaborated to share data on the availability of hospital beds to efficiently route patients based on their clinical need and the available capacity. And centralization of acute stroke care, in which patients are taken to central specialty hospitals rather than the nearest hospital, demonstrates both the feasibility and potential improved outcomes of utilizing this approach in several countries including the United States, Canada, the Netherlands, Denmark, and Australia.
Crises require all possible realizations of economies of scale. Location pooling mitigates variability in service-specific demand faced by each hospital. As demand falls for specific non-Covid services at an individual hospital (e.g., for acute stroke care), hospital administrators can close those services and repurpose the specialty capacity to care of Covid-19 patients with underlying conditions, as discussed below. If all hospitals implement this strategy, not all non-Covid services will be available at every hospital. However, location pooling draws demand from across hospitals, ensuring that as a given hospital loses some patients it gains others, allowing it to maintain sufficient census to remain fiscally viable.
Centrally coordinated regional organization, similar to mass casualty planning, is critical to ensure that each essential service remains fully operational for routine emergencies, while adapting to dynamic changes in the region’s hospital capacity. The number of hospitals to include in location pooling should be determined by weighing the tradeoff of efficiency gains from pooling across more locations versus inefficiencies from increased travel time incurred by patients and emergency medical services.
3. Group hospitalized Covid-19 patients by their underlying clinical conditions.
At the same time that hospitals should be location-pooling specialty services for non-Covid patients, to the extent possible they should place their Covid-19 patients who have serious underlying health issues (e.g., cardiac conditions) with other Covid-19 patients with the same condition. In each of these “cohorted wards,” redeployed clinical staff from the relevant specialty service, such as cardiology, can provide essential specialty care alongside clinicians addressing patients’ Covid-specific care needs.
While such cohorting limits efficiency gains from pooling all Covid-19 patients in one ward, it maintains specialty care for patients who still need it while reducing the additional inpatient capacity strain resulting from patients being dispersed across the hospital. Indeed, prior research demonstrates that displacing patients from cohorted specialty units is associated with prolonged hospital length of stay and more frequent readmissions.
4. Discharge patients into post-acute care based on Covid-19 status.
Nursing home, rehabilitation hospital, and long-term acute care facility leadership should collaborate to establish separate regional, specialized, post-acute care facilities for Covid-19 and non-Covid patients. Sending patients to specialized post-acute care facilities based on their Covid-19 status will facilitate discharge planning, improving patient flow out of the hospital for Covid-19 and non-Covid patients alike. This will relieve strain at ED and hospital bottlenecks while maintaining care quality. Furthermore, having dedicated post-acute care facilities for Covid-19 patients will preserve post-acute care capacity for those recovering from non-Covid illnesses, while lowering their risk of becoming infected.
Challenges to this model include ensuring timely access to Covid-19 testing and rapid test results to guide appropriate patient routing. To prevent discharge delays due to testing constraints, hospitals need to implement rapid tests more widely, and post-acute care facilities should designate quarantine areas for patients to receive care while awaiting results.
* * *
These strategies will undoubtedly be challenging to implement. But now is the time to rethink health care delivery and adopt operations management strategies with demonstrated success that are most promising. This will allow us to be better prepared for future waves of the Covid-19 pandemic.
SOURCE; Song, H.; Ezaz, G.; Greysen, S. Ryan.; Halpern, S.; Kohn, R. (14 July 2020) "How Hospitals Can Meet the Needs of Non-Covid Patients During the Pandemic" (Web Blog Post). Retrieved from https://hbr.org/2020/07/how-hospitals-can-meet-the-needs-of-non-covid-patients-during-the-pandemic
Trump Signs Coronavirus Relief Bill with Paid-Leave Mandate
As the COVID-19 pandemic cases increase, employees are stuck choosing between staying home to avoid spreading the illness and working for a paycheck to pay their household bills. Due to the effect that the spread of coronavirus has created, the U.S. Senate has approved the Families First Coronavirus Response Act. Continue reading this blog post from SHRM to learn more.
The U.S. Senate approved the Families First Coronavirus Response Act in a 90-8 vote on March 18, and President Donald Trump signed it into law a few hours later. The bill will provide free screening, paid leave and enhanced unemployment insurance benefits for people affected by COVID-19, the respiratory disease caused by the coronavirus.
The U.S. House of Representatives passed the bill late on March 13. After several days of negotiation, House Speaker Rep. Nancy Pelosi, D-Calif., announced that negotiators had reached a deal with the White House to pass the bill. "We cannot slow the coronavirus outbreak when workers are stuck with the terrible choice between staying home to avoid spreading illness and the paycheck their family can't afford to lose," Pelosi said.
Republican senators were concerned that the bill might hurt small businesses, and Sen. Mitch McConnell, R-Ky., said lawmakers are working on another bill that would include relief for small businesses. McConnell said he would not adjourn the Senate until the third COVID-19 economic stimulus package is passed, CNN reported.
Trump declared a national emergency March 13, which frees up billions of dollars to fund public health and removes restrictions on hospitals to treat more patients. The Families First Coronavirus Response Act (H.R. 6201) will provide:
- Free coronavirus testing.
- Paid emergency leave.
- Enhanced unemployment insurance.
- Additional funding for nutritional programs.
- Protections for health care workers and employees responsible for cleaning at-risk places.
- Additional federal funds for Medicaid.
We've rounded up articles and resources from SHRM Online and other trusted media outlets on the news.
Paid Family Leave
As originally drafted, H.R. 6201 would have temporarily provided workers with two-thirds of their wages for up to 12 weeks of qualifying family and medical leave for a broad range of COVID-19-related reasons. The revised version of the bill will only provide such leave when employees can't work because their minor child's school or child care service is closed due to a public health emergency. Workers who have been on the payroll for at least 30 calendar days will be eligible for paid family leave benefits, which will be capped at $200 a day (or $10,000 total) and expire at the end of the year.
(Littler)
Paid Sick Leave
Under the bill, many employers will have to provide 80 hours of paid-sick-leave benefits for several reasons, including if the employee has been ordered by the government to quarantine or isolate or has been advised by a health care provider to self-quarantine because of COVID-19. Employees could also use paid sick leave when they have symptoms of COVID-19 and are seeking a medical diagnosis, if they are caring for someone who is in quarantine or isolation, or their child's school or child care service is closed because of the public health emergency. Paid-sick-leave benefits will be immediately available when the law takes effect and capped at $511 a day for a worker's own care and $200 a day when the employee is caring for someone else. This benefit will also expire at the end of 2020.
(CNN)
Large and Small Business Exceptions
Private businesses with at least 500 employees are not covered by the bill. "I don't support U.S. taxpayer money subsidizing corporations to provide benefits to workers that they should already be providing," Pelosi said on Twitter. Treasury Secretary Steven Mnuchin also said that "big companies can afford these things."
Covered employers that are required to offer emergency FMLA or paid sick leave will be eligible for refundable tax credits. Employers with fewer than 50 workers can apply for an exemption from providing paid family and medical leave and paid sick leave if it "would jeopardize the viability of the business." Gig-workers and other self-employed workers will be eligible for a tax credit to cover the benefits.
Lawmakers Previously Approved $8.3 Billion Emergency Bill
Another emergency spending package to fight coronavirus rapidly worked its way through Congress, and President Donald Trump signed it into law March 6. The measure will provide funds to develop a vaccine, provide protective and laboratory equipment to workers who need it, and aid locations hit with the virus.
Coronavirus Prompts Employers to Review Sick Leave Policies
Do employees have the right to take time off if they are concerned about contracting coronavirus? Can employers send sick workers home? Should employees be paid for missed work time? HR and other business leaders are likely considering these questions and more as COVID-19 makes its way through the United States. "We believe employers would be wise to review their paid-time-off practices immediately," said Francis Alvarez, an attorney with Jackson Lewis in White Plains, N.Y. "Employers are likely to face unique circumstances that were not anticipated when they prepared their attendance and leave policies."
Visit SHRM's resource page on coronavirus and COVID-19.
SOURCE: Nagele-Piazza, L. (18 March 2020) "Trump Signs Coronavirus Relief Bill with Paid-Leave Mandate" (Web Blog Post). Retrieved from https://www.shrm.org/ResourcesAndTools/legal-and-compliance/employment-law/Pages/Senate-to-Vote-Soon-on-Coronavirus-Paid-Leave-Mandate.aspx
Starbucks Unveils Mental Health Initiatives for Employees
Did you know: One in Five United States adults experiences mental illness. According to the World Health Organization, work is good for mental health but a negative environment can lead to physical and mental health issues. Starbucks has announced that they have launched an app for its employees to improve their mental health along with their anxiety and stress. Read this blog post to learn more about how Starbucks is creating mental health benefits for their employees.
Starbucks has launched an app to help its employees improve their mental health and deal with anxiety and stress.
The global coffee company also announced it will be retooling its employee assistance program based on feedback from employees and mental health experts. It plans to offer training to its U.S. and Canada store managers on how to support workers who experience a mental health issue, substance-abuse problem or other crisis.
Every year, one in five U.S. adults experience mental illness and one in 25 experience serious mental illness, according to the National Alliance on Mental Health. And more people are killing themselves in the workplace, according to the Washington Post. The number of such suicides increased 11 percent between 2017 and 2018. Employers, the Post reported, "are struggling with how to respond."
Business Insider reported that some Starbucks employees it interviewed about the initiatives said much of their stress comes from the company cutting back on hours and relying on employees to work longer shifts with fewer people and no pay increase.
The World Health Organization points out that while work is good for mental health, a negative environment can lead to physical and mental health problems. Harassment and bullying at work, for example, can have "a substantial adverse impact on mental health," it said. There are things employers can do, though, to promote mental health in the workplace; such actions may also promote productivity.
SHRM Online has collected the following articles on this topic from its archives and other sources.
Starbucks Announcements Its Commitment to Supporting Employees' Mental Health
The company released a statement Jan. 6 about additions to its employee benefits and resources that support mental wellness.
"Our work ahead will continue to be rooted in listening, learning and taking bold actions," it said. In the past, that has included tackling topics such as loneliness, vulnerability "and the power of small acts and conversation to strengthen human connection."
(Starbucks)
Mental Illness and the Workplace
Companies are ramping up their efforts to navigate the mental health epidemic. Suicide rates nationally are climbing, workers' stress and depression levels are rising, and addiction—especially to opioids—continues to bedevil employers. Such conditions are driving up health care costs at double the rate of illnesses overall, according to Aetna Behavioral Health.
Starting workplace conversations about behavioral health is challenging because such conditions often are seen as a personal failing rather than a medical condition.
(SHRM Online)
Research: People Want Their Employers to Talk About Mental Health
Mental health is becoming the next frontier of diversity and inclusion, and employees want their companies to address it. Despite the fact that more than 200 million workdays are lost due to mental health conditions each year—$16.8 billion in employee productivity—mental health remains a taboo subject.
(Harvard Business Review)
Viewpoint: Addressing Mental Health in the Workplace
Companies are reassessing their behavioral health needs and are looking to their health care partners for creative, integrated and holistic solutions. Many are turning to employee assistance programs for help.
(Benefits Pro)
4 Things to Know About Mental Health at Work
Kelly Greenwood graduated summa cum laude from Duke University with degrees in psychology and Spanish. She holds a master's degree in business from Northwestern University's Kellogg School of Management, contributes to Forbes magazine and is editor-at-large for Mental Health at Work, a blog on Thrive Global.
She also is someone who has managed generalized anxiety disorder since she was a young girl. It twice led to debilitating depression. She shared four things she wishes she had known earlier in her life about mental health.
(SHRM Online)
Employers Urged to Find New Ways to Address Workers' Mental Health
An estimated 8 in 10 workers with a mental health condition don't get treatment because of the shame and stigma associated with it, according to the National Alliance on Mental Illness. As a result, the pressure is growing on employers to adopt better strategies for dealing with mental health.
(Kaiser Health News)
Mental Health
Depression, bipolar disorder, anxiety disorders and other mental health impairments can rise to the level of disabilities under the Americans with Disabilities Act that requires employers to make accommodations for workers with such conditions.
This resource center can help employers understand their obligations and address their workers' mental health.
(SHRM Resource Spotlight)
SOURCE: Gurchiek, k. (14 January 2020) "Starbucks Unveils Mental Health Initiatives for Employees" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/starbucks-unveils-mental-health-initiatives-for-employees.aspx
New drug plan would curb exorbitant pharmaceutical costs
California Governor, Gavin Newsom has proposed a pharmaceutical plan to cut costs of pharmaceutical prescriptions. It was suggested that using low prices obtained by the state, could help other buyers. Read this blog to learn about how California Governor is purposing an attempt to lower costs for California residents.
California’s governor unveiled plans to establish a state-run generic-drug wholesaler, as part of a series of measures that together would constitute one of the furthest-reaching attempts to curb pharmaceutical costs in the U.S.
Gov. Gavin Newsom on Thursday also proposed creating a single market that would allow drug buyers to pool their bargaining power to drive down costs. And Newsom suggested using low prices obtained by the state’s Medicaid program to aid other buyers, among other steps.
The most populous U.S. state, California has a history of using its economic muscle to try to influence national policy on everything from auto emissions to health care. The drug-pricing proposals, which in some cases appear to require new law, are likely to be opposed by a pharmaceutical industry that has formidable economic and legal wherewithal of its own.
“These nation-leading reforms seek to put consumers back in the driver seat and lower health care costs for every Californian,” Newsom, a Democrat, said in a statement.
The plans, released as part of the state’s proposed 2020-2021 budget, are almost certain to face substantial practical, political and legal hurdles. For example, the proposal to create a state-run drug label would rely on drug companies to supply inventory on a contract basis.
Companies could balk at that notion if it stands to further compress their margins. Major generic manufacturers, including Mylan NV and Teva Pharmaceutical Industries, have struggled to turn a profit on some widely used medications. For higher-cost generic drugs, there can be few competing manufacturers with the licenses to produce the pills for the U.S. market.
Creating a single buying pool could run into difficulties, as well. Newsom’s proposal says state programs, health insurers and private employers would band together as a sole buyer, and that drugmakers would have to offer their products at one price to the entire market.
But that could limit patient access to medications if pricing disputes lead drug companies to withhold their products. In Europe, negotiations between drugmakers and government health programs have resulted in some expensive drugs not being available, one of the trade-offs for the continent’s typically lower costs. It’s unclear if California could successfully hold together a large pool of independent buyers in the face of pressure from patients unable to access treatments.
SOURCE: Bloomberg News (09 January 2020) "New drug plan would curb exorbitant pharmaceutical costs" (Web Blog Post). Retrieved from benefitnews.com/articles/new-c-a-drug-plan-would-curb-exorbitant-pharmaceutical-costs
Improving your employee experience during open enrollment
Is your company open enrollment hosted on an online platform? Employers often struggle with employee participation during the open enrollment season. Hosting enrollments online is one way to increase employee participation this year. Read on for more tips to help ease this open enrollment season.d
For HR professionals, open enrollment is one of the most stressful and demanding times of the year. Many employers struggle with employee participation and expensive, time-consuming roll-outs. They also have to provide resources to help employees make the right plan selections for themselves and their families. As we head into another open enrollment season, consider these tips to ease the process.
Switch your open enrollments to online platforms.
If you’re still relying on paper enrollment forms, you are likely spending more money and time than you need to in pursuit of your manual work process and its many inconsistencies. Online platforms provide optimum efficiency, accuracy and convenience for your workforce, offering employee self-service options that encourage employees to take initiative in selecting the best plan for their situation. Not only will members of your workforce benefit from the convenience of being able to explore their options on their own time, but you’ll be able to offer them multi-lingual enrollment materials and have more time to assist them than ever before.
Prioritize and diversify communication.
One of the top ways to ensure a smooth open enrollment period is to use multiple communication channels, including frequent reminders regarding open enrollment deadlines. Without consistent outreach on the part of your HR officers and general managers, you will likely find yourself hunting people down to meet your enrollment and extension deadlines. Using an online self-service portal as well as traditional in-person meetings allow you to remind your employees of critical dates and changes as enrollment closes in.
The robust benefits administration system you choose should offer enrollment tracking and reporting features so you can see at a glance who still needs to begin open enrollment, who has left enrollment documents incomplete, who has made changes to their benefits (such as adding a dependent) and more. You can arrange for the system to send automatic reminders to signal the employee that further actions are needed. Providing multiple reminders will improve participation and the completion of on-time enrollments.
Help employees choose the best health plan for their situation.
In order to have the most successful open enrollment period possible, educating your employees on the different plan options available will go a long towards ensuring employee satisfaction. Studies have shown that most employees don’t have the necessary understanding of terms like “deductible” and “coinsurance,” let alone the tools to know which plan is best for their individual needs. Incorporating at-a-glance comparison tools and charts into your online or print enrollment materials can help employees make the most informed decision possible. It can also be helpful to provide educational materials like videos and simplified plan charts or cost calculators.
Keep Up with Benefit Trends and Voluntary Offerings.
Given the current labor shortage and competitive talent market, you’ll want to make sure your company is up to speed on which new benefits your competitors are looking to add, as well as which ones are appealing to specific roles, locations or generations within potential candidates from your hiring pool.
Voluntary benefits, for example, are playing an increasingly important role in employee benefits portfolios and they don’t cost you anything. Some of the most popular voluntary benefits right now include identity theft protection, pet insurance, long term care insurance and critical illness protection. If you aren’t currently offering these types of additional benefits, they could be a cost-effective way to boost employee morale, increase participation in enrollment and attract more workers to your business.
SOURCE: Smith, M. (2 December 2019) "Improving your employee experience during open enrollment" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/improving-your-employee-experience-during-open-enrollment
4 Things to Know About Mental Health at Work
Did you know: 80 percent of workers will not seek help for mental health issues because of the associated shame and stigma. Read this blog post from SHRM for four things employees and employers should know about mental health in the workplace.
Kelly Greenwood graduated summa cum laude from Duke University with degrees in psychology and Spanish. She holds a master's degree in business from Northwestern University's Kellogg School of Management, contributes to Forbes magazine and is editor-at-large for Mental Health at Work, a blog on Thrive Global.
She also is someone who has managed generalized anxiety disorder since she was a young girl. It twice led to debilitating depression. During a Smart Stage presentation at the recent Society for Human Resource Management Inclusion 2019 event in New Orleans, she discussed how someone can be a high-performing individual and still contend with mental health issues.
Greenwood had to take a leave of absence after experiencing a perfect storm at work—a new job in an understaffed, dysfunctional environment; an inflexible schedule that caused her to miss therapy sessions; and a change in her medication. When it became clear her performance had deteriorated, she was forced to disclose her condition to her manager.
She took a three-month leave, but that only fueled her anxiety. Still in her 30s, she worried about whether she would be able to return to work and feared her career was over. It wasn't. She went on to join the executive team of a nonprofit and in 2017 founded Mind Share Partners, a San Francisco-based nonprofit that offers corporate training and advising on mental health.
Greenwood shared the following four things she wishes she had known earlier in her life about mental health:
- Mental health is a spectrum. "Hardly anybody is 100 percent mentally healthy" all the time, she said. "We all go back and forth on this spectrum throughout the rest of our lives." The grief a person experiences over the loss of a loved one, for example, affects that person's mental health. "You can be successful and have a mental health condition," Greenwood said, noting that a study Mind Share Partner conducted with Harvard Business Review (HBR) found that mental health symptoms are equally prevalent across seniority levels within companies, all the way up to the C-suite.
- You cannot tell a person's mental condition by his or her behavior. "It's never your job," she told managers and other workplace leaders, "to diagnose or gather [information] or assume what's going on. Our goal at work is not to be clinicians, but to create a supportive environment."
- Mental health conditions and symptoms, including suicidal thoughts, are common. Greenwood said the Mind Share Partners/HBR study found that 60 percent of 1,500 people surveyed online in March and April said they had a mental health symptom: feeling anxious, sad or numb or experiencing a loss of interest or pleasure in most activities for at least two weeks. National Institutes of Health research suggests that up to 80 percent of people will manage a diagnosable mental health condition in their lifetime. "They may not know it," Greenwood said. "It may be a moment in time because of a job loss or grief over a death. That means mental health affects every conference call, every team meeting. It is the next frontier of diversity and inclusion."
- Workplace culture can reinforce the stigma around mental health issues. And so, 80 percent of workers will not seek help because of the associated shame and stigma. If they do, they cite a different reason, such as a headache or upset stomach, rather than admit they are taking time off because of stress. That is leading to what Greenwood calls a "huge retention issue," with 50 percent of Millennials and 75 percent of Generation Z saying they left a job—voluntarily and involuntarily—because of a mental health challenge. She advised leaders to have "courageous conversations" with those they work with. Even simply engaging in a discussion about having to deal with a child's tantrum can be powerful.
"There is so much research," she said, "about the power of vulnerability in leadership."
SOURCE: Gurchiek, K. (12 November 2019) "4 Things to Know About Mental Health at Work" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/4-things-to-know-about-mental-health-at-work.aspx