Topic7.2 b_benefit and service

1. Welcome toHUMAN RESOURCES
MANAGEMENT
Benefit and Service
Dyah Pramanik, MM
[ ]
Copyright © 2011 Pearson Education, Inc.
publishing as Prentice Hall

2. 8–2
CHAPTER 7.2b
INSURANCE BENEFITS:

3. 8–3
LEARNING OUTCOMES
1. Describe each of the main
insurance benefits

4. Insurance Benefits
Workers’ Compensation.
Controlling workers’ compensationcosts
1. Death or disability:a cash benefit based on earnings per
week of employment.
2. Specificloss injuries:statutory list of losses.
3. Injured workers are protected by ADA provisions.
1. Screen out accident-prone workers.
2. Make the workplace safer.
3. Thoroughlyinvestigate accident claims.
4. Use case management to return injured employees to work as
soon as possible.
Provides income and medical benefits to work-related accident victims
or their dependents, regardless of fault

5. Insurance Benefits
Hospitalization, Health, and DisabilityInsurance
Provide for loss of incomeprotection and group-rate coverage
of basic and major medical expenses for off-the-job accidents
and illnesses
1. Accidental death and
dismemberment
2. Disability insurance
3. Mental health benefits

6. TABLE 13–3 Percentage of Employers Offering Popular Health Benefits—
Change Over Time
Yes (%) 2005 Yes (%) 2009
Prescriptiondrug program coverage 97 96
Dental insurance 95 96
Mail order prescription program 90 91
PPO (preferred provider organization) 87 81
Chiropractic coverage 56 80
Mental health insurance 72 80
Vision insurance 80 76
Employeeassistanceprogram 73 75
Medical spending account 80 71
Life insurance for dependents 67 58
HMO (health maintenance organization) 53 35

7. Insurance Benefits
Health Maintenance Organization (HMO)
A medical organization consisting of specialists
operating out of a health care center.
1. Provides routine medical services to employees who
pay a nominal fee.
2. Receives a fixed annual contract fee per employee
from the employer (or employer and employee),
regardless of whether it provides that person with
service.

8. Insurance Benefits
Preferred Provider Organizations (PPOs)
Groups of health care providers that contract to provide
services at reduced fees
1. Employees can select from a list of preferred individual
health providers.
2. Providers agree to discount services and to submit to
utilization controls.
3. Employees using non-PPO-listed providers may pay
all costs or only costs above the reduced fee structure for
services.

9. Laws Influencing Health Care Benefits
Preferred Provider Organizations (PPOs)
Health Services and Insurance
1. COBRA notification and insurance continuance requirements
2. Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Retirement and Pension Plan
1. EmployeeRetirement Income Security Act of 1974 (ERISA)
Mental Health Benefits
1. Mental Health Parity Act of 1996
Family Leave
1. Pregnancy Discrimination Act
2. Family Medical Leave Act
3. The Newborn Mother’s Protection Act of 1996

10. FIGURE 13–5
COBRA Record-Keeping
Compliance Checklist

11. Premium
s and
co-pays
Communi
cation
and
empower
ment
Wellness
programs
Health
savings
accounts
Claim
audits
Trends in
Health Care
Cost
Controls
Cost-
Control
Trends

12. Mandatory
online plan
enrollment
Defined
contributio
n health
care plans
Outsource
d health
care plan
administrati
on
Reduced
retiree
health care
coverage
Benefits
purchasing
alliances
Other Cost-
Control
Options
Controlling
Health
Care Costs

13. Other Benefits Issues
Long-Term Care
1. Insurance for older workers is a growing issue.
Life Insurance
1. Types
• Group life insurance
• Accidental death and
dismemberment
2. Personnel policyconsiderations
• Benefits-paidschedule
• Supplemental benefits
• Financing (employee
contribution)
1. Benefits for Part-Time and
Contingent Workers
• Leave and health benefits
available to part-time workers.
• Benefits for long-term
independent contractors.

14. Copyright © 2011 Pearson
Education,Inc. publishing as
Prentice Hall
13–14
K E Y T E R M S
• benefits
• supplemental pay benefits
• unemployment insurance
• sick leave
• severancepay
• supplemental unemployment benefits
• workers’ compensation
• health maintenanceorganization
(HMO)
• preferred provider organizations(PPOs)
• group life insurance
• Social Security
• pension plans
• defined benefit pension plan
• defined contribution pension plan
• portability
• 401(k) plan
• savingsand thrift plan
• deferred profit-sharing plan
• employee stock ownership plan (ESOP)
• cash balance plans
• Employee Retirement Income Security Act
(ERISA)
• Pension Benefits GuaranteeCorporation
(PBGC)
• early retirement window
• employee assistance program (EAP)
• family-friendly (or work–life) benefits
• flexible benefits plan/cafeteria benefits
plan
• flextime
• compressed workweek
• workplace flexibility
• job sharing
• work sharing

15. 8–15
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Copyright © 2011 Pearson Education, Inc.
publishing as Prentice Hall