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March 2008

Mar 01
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SAFETY TIPS FOR THE NIGHT SHIFT

By Risk Management Bulletin

One out of five workers in developed nations doesn’t enjoy the luxury of sleeping at night. Policing, medical care, and specialized industrial and service jobs go on 24 hours a day — which means that somebody has to be out there on the graveyard shift to keep society running.

Workplace experts have studied the effects of this topsy-turvy existence on the lives and health of shift workers.

“People who work other than the standard daytime shifts face a host of challenges,” notes safety writer Barbara Manning Grimm, “including physical and mental fatigue, digestive problems, stress, and a feeling of isolation from family, friends, and the community. There’s also evidence that shift workers are at greater risk of accidents.”

There might be another, more sinister risk: Some studies show that night work raises the occurrence of some cancers, as the production of melatonin, a hormone created during sleep which suppresses tumors, is itself suppressed by staying awake. (However this is a controversial finding because other studies haven’t shown any effect between melatonin production and cancer rates).

To help employers deal with the safety issues involved in shift work, we’d recommend these guidelines:

  • Explain what shift work entails. Before they take a job on the night shift, workers should have time to consider how it will change their lives. Give them a chance to think things over before agreeing to this.
  • Request volunteers. Some workers would rather work nights. Maybe it lets them be home when a spouse is working so that children have 24-hour child care, or maybe they just want their days free for other pursuits. In any case, volunteers will have a more positive attitude toward the job than those simply assigned to it.
  • Pay a differential. A few extra dollars in the paycheck can provide a powerful incentive.
  • Light the work area brightly. Although it won’t replace sunlight, several studies suggest that bright light increases alertness. This is especially important between 3:00 a.m. and 6:00 a.m., when accident rates are highest.
  • Get physical. Offer an exercise break. A fast-moving game of Ping-Pong or even a brisk walk might ward off sleepiness until the shift is over.
  • Schedule naptime. Allow workers to close their eyes for about 15 minutes, mid-shift. Any longer, though, and your crew can drop into a deep sleep rhythm that will make them less alert when you wake them.
  • Allow time off for family functions. Night workers do have a daytime life, and letting them enjoy it will pay big dividends in morale, which usually translates to gains in productivity.
Mar 01
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HELP YOUR WORKERS KEEP THEMSELVES SAFE

By Risk Management Bulletin

Most on-the-job accidents occur in “safe” workplaces. Why? Employee error. What can you do about it? Invest in a comprehensive employee safety motivation program that will reduce injuries in your workplace — increase productivity — and save you money. Some workplace injuries are due to lack of appropriate safety equipment or unsafe processes and procedures — problems that workplace safety laws can help correct. However, the most pervasive cause of these injuries is employee error (taking unneeded chances without thinking about them). For example, a worker might suffer a back injury despite having been trained in back safety, having a safety belt available, and knowing that there’s a risk.

Your employees might fail to minimize their workplace risks for a number of reasons, either related to or independent of the job. Job-related excuses for a back injury might include:

  • “I’ve picked up bigger boxes than this before without hurting myself.”
  • “Back belts are for sissies.”
  • “I’m too busy to stop and get a belt.”

In these cases, the employee at least thought about possible danger in lifting and alternatives. Some non-job-related reasons for ignoring safety procedures might be:

  • “I’m mad at my spouse. My kids are a pain.”
  • “How am I going to get my car fixed? Where will the money come from?”
  • “What should I wear tonight? Do the Joneses like asparagus?”
  • “I sure need a cigarette. When’s my break?”

The solution to this cavalier attitude toward safety is to develop an employee motivation program. The first step in an effective safety motivation program is marketing. You must instill the value of safety, communicate a commitment to safety, and motivate supervisors and employees to think and act safely. Rather than emphasizing management and control of responses to injury or illness, work toward preventing them and promoting safety. These efforts could pay big dividends — and lower your insurance premium.

Support the motivation program by committing to needed costs, promotions, and the total employee-motivation effort. Although employee motivation programs have been shown to provide a terrific savings-to-cost ratio, they do involve costs. If you save $25,000 on Workers Compensation, you won’t automatically get some of this money to spend on safety. However, the rate of return on an effective safety program can be $4 to $10 for every dollar invested.

Promote and maintain safety awareness by setting goals, rewarding success, and acknowledging failures. The employee motivation job isn’t complete till the paperwork is finished. Training must include program evaluation and trainee feedback for both supervisors and employees. Base your motivation program on awards, contests, premiums, and so forth. It’s essential to publicize such rewards as lottery tickets, selected gifts, savings bonds, and cash. However, no rewards will work without the basic structure of a workplace safety program.

Mar 01
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HOW INSURERS DETERMINE SMALL GROUP HEALTH INSURANCE RENEWAL RATES

By Employment Resources

Have you ever wondered how insurers determine small group (2-50 employees) renewal rates? Be assured that it’s not an arbitrary process. Yes, there is a method to this madness! Although there are various formulas used, generally insurers use the following factors to calculate your renewal rates:

General Health Care “Trend”
This is a baseline factor applied to all Group Health insurance renewals. Basically, “trend” refers to the change in cost of health care products and services, and how consumers utilize these products and services. New facilities, technologies, and procedures encourage more people to receive advanced services. The costs of these goods and services are expensive and increasing rapidly.

This component also includes “prescription drug trend.” More drugs are being introduced into the market and aggressively marketed. The costs of advertising and research/development of these drugs are significant. These rising costs, in combination with increasing utilization, all contribute to this baseline factor.

Keep in mind this “trend” also has much to do with your group’s geographic location. Just as home prices differ upon location, so do health care costs. Premiums in certain areas might reflect the higher cost of more people using state-of-the-art, yet expensive, treatments and services.

Group-Specific Medical/Health Factor
When permitted by state regulations, a carrier may adjust renewal rates based on the overall health of the people covered under your health plan. Your premiums may be adjusted to cover expected future claims costs. Depending on your state, certain rate caps might exist which limit the amount an insurer can raise premiums based on your group’s health status alone.

Most carriers use a “prospective” system, meaning that they look at medical conditions and diagnoses, which may affect the group’s claims experience in the coming year. Claims from the past year, which are resolved or if the risk is no longer present, are not taken into account using a prospective rating system.

Your renewal adjustment can also be positively impacted by good claims experience.

Group-Specific Characteristic/Demographic Profile
This component includes:

  1. Age bracket changes (An employee or spouse turns 40, for example, moving them from the 35-39 bracket to the 40-44 bracket.)
  2. Gender and coverage composition changes (The percentage of females and males changes or the mix of single and family contracts changes.)
  3. Changes in the group’s location (Claims costs are geographically-based, so the rates may change if the company moves to a new locale.)

Group-Specific Administrative Expenses
This factor includes the fixed costs needed to administer the plan. The larger the group, the lower the expense load. For example, a two-person group would have a larger expense load, as a percentage of premiums, than a 25-person group.

So, what can you do to influence the costs? Ideas include adjusting your plan design and/or premium contribution to support more efficient utilization, encouraging employees to become smarter health care consumers through communication efforts, and promoting prevention and wellness programs. It’s a start at least.

Mar 01
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LEARN HOW TO REDUCE MEDICAL CLAIMS PROBLEMS

By Employment Resources

Is your benefit department routinely tied up responding to complaints about medical claims for your company’s health plan members?

Medical claims problems are frequently the result of poor information and/or poor communication. Try some of the following methods to reduce the confusion, relieve the burden on your staff and improve the satisfaction of your plan members.

Remember, any time your staff works with personal health information, special care must be taken to assure that the information is treated confidentially and in compliance with all applicable HIPAA privacy rules.

Hold orientation sessions about health care benefits for members
It’s human nature to pay less attention to information that is not immediately useful. Consequently, many people who receive new benefit information do not absorb important changes if those changes do not appear to affect them at that time. Consequently, when the need unexpectedly arises, your plan member may not remember, for example, that she must place a call to her primary care physician within 24 hours of an emergency department visit.

One way to work around the “relevance/absorption” issue is to make effective use of scenarios during orientation sessions. The group leader should provide fictional examples of situations that illustrate new benefit rules. These examples will cause most people to apply the information to potential situations in their own lives and imprint the correct procedures or generate questions that will clarify information.

Hold orientation sessions about health care benefits for health care providers
This technique will not be practical in large city settings but can be very useful in smaller communities. If your company is introducing a new health plan into the community, everyone will need to incorporate new rules into their work. Invite the office staff of a local physician, hospital admitting and billing staff and others as appropriate to an orientation session with the insurer.

These staff members juggle many sets of health plan rules each day and, expectedly, cannot always keep information straight. They will be much more likely to integrate your new plan rules into their office practice if you have provided an opportunity for them to receive a full briefing and ask questions.

Select health plans that offer interactive Web sites
Medical claim problems often occur because the physician office or hospital admitting department has no way to verify eligibility or ascertain the specific rules related to your company’s plan. Health plans with interactive websites allow providers to go online and check eligibility, determine special rules, note any changes to the policy benefits, etc. This connectivity solves many of the potential medical claim problems.

Establish a regular meeting with the insurer to review medical claim issues
HR staff should keep a log of all medical claim complaints and status. Persistent problems should be turned over to the insurer with direction to resolve. In general, this technique keeps your HR staff as an intermediary so they are aware of problems but provides for the appropriate transfer of those problems to the insurer in a forum that requires follow up and reporting back results.

Data collected during this process, e.g., number of complaints, time to resolution, etc, can be useful evaluative tools. If your communication with the insurer is facilitated by a third party insurance broker, be sure that you have an agreement with the broker that all health information will be handled in compliance with HIPAA privacy rules.

HR as Advocate
Your staff will always play a middleman role for plan members because they are your members’ advocates to the health insurer. However, using these techniques should reduce the referee burden on your benefits group.

Mar 01
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OFFERING CONTINUED HEALTH PLAN COVERAGE TO DEPARTING EMPLOYEES WITH COBRA PORTABILITY PROVISION

By Employment Resources

An important federal law imposes certain obligations on many employers to continue providing health care coverage to an employee and dependents, if applicable, in the event of a change of employment or job status.

This law is often referred to as “COBRA” – The Consolidated Omnibus Budget Reconciliation Act of 1985. According to COBRA, if an employer provides health care benefits to an employee and there is a change in that employee’s job status, the employer must afford the ability to continue coverage under their employer’s group health plan, at the employee’s expense. The COBRA continuation requirements apply to all of the “core benefits” provided under any group health plan that furnishes medical benefits to employees and their dependents, regardless of whether the plan is insured or self-funded. COBRA does not apply to employers who have less than 20 employees.

COBRA was designed to address concerns about Health insurance portability during periods of unemployment and labor force withdrawal and in situations in which a worker leaves, or would like to leave a job. Under the rules, employers have important obligations to both apprise the covered employees and other qualified beneficiaries of their rights and to continue to supply the Health insurance coverage upon payment of the appropriate premium amount. The continued coverage must, in most cases, be supplied after the occurrence of a “qualifying event.” The premium charged by the employer can be no more than the employer’s actual cost, plus 2%.

An employee and his beneficiaries are eligible to elect COBRA only if they were covered by the employer’s health care plan immediately prior to a “qualifying event.” A “qualifying event” could be any of the following:

  • Termination of employment
  • Reduction in work hours
  • Employee’s death
  • Employee’s divorce
  • Loss of dependent status
  • Medicare entitlement
  • An employer’s filing of a bankruptcy proceeding (retirees and certain dependents only).

The most common qualifying event is the termination of employment. An employer is obligated to provide an employee with COBRA benefits in case of both voluntary and involuntary termination as well as reduction in work hours. Individuals who were covered by an employer’s group health plan are eligible to elect COBRA upon the occurrence of a qualifying event, no matter how long or short a time they were in the employer’s group health plan.

The time period for which continuation coverage must be offered by the employer varies. In the case of termination of employment or reduction of work hours, the employer is obligated to provide COBRA coverage for 18 months after the qualifying event. In case of the other qualifying events listed above, the coverage has to be provided for 36 months.

To fulfill COBRA obligations, it is the employer’s responsibility to notify the plan administrator (of the group health plan) of a qualifying event within 30 days of the actual event or by the date that the employee will lose their coverage, whichever is later. The employer should then see to it that the plan administrator notifies the beneficiary and his/her dependents, within the next 14 days, of their rights to continued coverage under COBRA. If the employer does not have access to COBRA administration services, the employer must ensure that the employee is provided with written notice of their rights within 44 days from the date of the event. Qualified beneficiaries are given a certain period of time (the “election period”) to elect continued coverage. This period lasts for at least 60 days, and may begin on different dates, depending on when coverage would otherwise be lost and when notices are given.

COBRA coverage is considered advantageous to most workers, as it allows them to continue coverage even after leaving or losing a job. Though they can be required to pay the entire entire premium, they can generally realize significant savings compared with the cost of purchasing equivalent insurance from the private insurance market. This is especially true for older workers, particularly those suffering from pre-existing conditions.

Mar 01
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KNOW THE CAUSES OF MUSCULOSKELETAL INJURIES

By Workplace Safety

Musculoskeletal injuries and disorders are among the most common ailments in today’s workplace. According to the Bureau of Labor Statistics in 2002 they accounted for 487,900, or 34%, of the injuries and illnesses that resulted in days away from work. In addition to back injuries, musculosketal disorders like Repetitive Strain Injuries such as Carpel Tunnel Syndrome are now rampant in the computerized office.

The remarkable thing about these disorders is that we now know what causes many of them and how to prevent them. The risk factors for work-related musculoskeletal disorders are work postures and movements, repetitiveness and pace of work, force of movements, vibration, and cold temperatures.

Work postures and movements can cause discomfort and fatigue if maintained for long periods of time. Activities like standing for long periods of time can cause sore feet, general muscular fatigue, and low back pain. If you have to stand or sit for extended periods at your job, make sure that you do some warm up exercises before you begin, and actively change positions throughout the day.

Repetitive movements are hazardous because we use the same joints and muscle groups over a long period of time. Using computer keyboards for long periods of time can cause serious damage to arm and finger muscles and tendons. If you perform repetitive tasks in your job, try finding ways to vary the routine. Take short breaks or timeouts. Make sure you have the proper equipment and ergonomically correct furniture.

Force of movements refers to the amount of effort our bodies must use to lift objects. The weight of objects and manner in which we lift things can cause low back strain, even ruptured discs and hernias. If you lift heavy objects, learn how to bend, stoop and lift correctly. Even if you only lift one heavy box a year, learn how to do it safely.

Vibration might encourage musculoskeletal disorders because they affect muscles, tendons, joints and nerves. Think of the ultimate vibrating job, a jackhammer operator, and you get the picture of what damage vibrations may cause. If your job entails operating vibrating equipment, you should wear a set of insulated headphones. Make sure that you have the right gloves and shoes, as well. Also, make sure you know the acceptable operating time for your equipment, and never exceed that limit.

Cold temperatures or handling cold objects can cause numbing which may make us misjudge the amount of force we need to apply, and may cause our bodies to become less flexible. When that happens our positions and movements become awkward and stiff which can lead to more problems. If you work in a cold place, make sure that you dress appropriately and warmly. Wear proper gloves and clothing that allows for flexibility.

You can avoid the pain and crippling effects of musculoskeletal injuries and disorders in the workplace. Be informed. Be prepared. Be safe.

Mar 01
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INFORMATION IS CRITICAL IN FIRST AID FOR CHEMICAL EXPOSURES

By Workplace Safety

Long before there is an accident involving exposure to harmful chemicals there should be a plan to deal with them. First, create a list of all chemicals in use in the workplace, their properties, and what to do in the case of an accident or exposure. Then make sure to have the necessary equipment and trained personnel to provide first aid treatment.

Accidents involving exposure to chemicals in the workplace are most likely to involve burns or eye injuries, although there have also been incidents where chemicals have been inhaled or ingested. If chemicals are inhaled and the person is unconscious, he should be resuscitated and immediately transported to a hospital.

In a case of chemical ingestion, it is a common misconception that antidotes of water, milk, charcoal, and other combinations can neutralize the ingested chemical. The correct procedure to dilute most chemical ingestions is to provide a small amount of water – about 8-10 oz. Any other procedure including inducing vomiting may cause more harm than good.

Being burned with chemicals is probably the most common accident involving chemicals in the workplace. It usually occurs when proper handling procedures are not followed, or when someone cuts corners. In some cases, even “empty” containers can cause problems and sometimes the person is not even aware that they have been burned until much later.

Normal first aid treatment for chemical burns is to flush the affected body part immediately and thoroughly using a large supply of clean fluid under low pressure for at least 15 minutes. However, this can be reduced or expanded depending on the severity and strength of the chemical. If irritation persists, repeat the flushing procedure. Follow- up medical analysis and treatment is always recommended.

In a case of eye contact with chemicals, the cause is usually improper handling of materials or not wearing protective eye gear like masks, goggles, or glasses. More often than not the contact is a splash or spill that makes contact with the eye.

The appropriate first aid response is to immediately rinse the eye with water at an eyewash station. Eyewash stations are required under health and safety legislation wherever chemicals are used. Rinse the eye(s) for at least a minute, and if still irritated rinse again. If problems persist, report the accident and proceed to the nurse’s station or the emergency room at the nearest hospital.

Caution is crucial when dealing with chemicals in the workplace. So is information. Know what you’re dealing with and how to treat accidents immediately. Your sight or your life just might depend on it.

Mar 01
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CREATE AN UPDATED EMERGENCY PLAN FOR YOUR COMPANY

By Workplace Safety

Part of an effective health and safety plan should be a well-defined plan to deal with major emergencies. Would people know what to do in the case of an explosion at your workplace? Who would be in charge? Who would phone the fire department, the police, and the hospital? Is there an evacuation plan? What happens if the power goes out?

An emergency plan would answer all of those questions, hopefully long before the real emergency. It is much better to be prepared than to be surprised. For employees, it is better to know in advance what your responsibilities are in an emergency situation than to find out when disaster strikes.

A good emergency plan begins with a vulnerability assessment. This assessment shows the organization where potential risks are, helps identify what can be done to prevent such a situation, and outlines the immediate steps to be taken if the risk becomes a reality.

If an emergency does occur, then a set of procedures must be followed that will protect individuals and property. In the case of a fire the procedures might include:

  1. Declare that there is an emergency
  2. Sound the alarm
  3. Evacuate the danger zone
  4. Call for help
  5. Initiate rescue operations
  6. Attend to casualties
  7. Fight the fire, if absolutely necessary

To accomplish all of these steps there must be an emergency plan outlining individual authority and responsibility, all needed supplies and equipment, and a storage map that shows where they are located. Needed supplies might include everything from flashlights to back up generators, bandages to respirators. But most importantly, each employee must be trained and well informed of the emergency plan, as well as any role they are expected to play. However an emergency plan is designed, it must contain the following elements:

  • An evacuation plan that all staff is familiar with and an easy to follow route that must always be clear of obstacles.
  • Safe locations for employees to gather outside the emergency zone so that everyone can be accounted for.
  • An ability to treat any injuries, search for the missing, and simultaneously contain the emergency.
  • An alternate source of medical assistance when the normal facilities may be affected by the emergency.

If you don’t have an emergency plan at your workplace, it’s wise to devise one. If you do have a plan, find out what your role might be in the case of an emergency. At a minimum, know the plan and route so that you can evacuate, help others to do so, and prevent confusion at the last minute.

Mar 01
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SEVEN KEY PRACTICES TO SIGNIFICANTLY LOWER ON-THE-JOB INJURY FREQUENCY RATES

By Construction Insurance Bulletin

The best way to prevent fleet crashes and in the process lower injury frequency rates is to hire drivers based on their ability and past performance. This discovery comes from Liberty Mutual Group, which recently released the results of its annual trucker survey.

As part of the study, the company identified practices in seven key areas that contributed to lower injury frequency rates:

1. Management Programs

  • Most companies that measure injury frequency rates have lower frequency rates.
  • Those companies that conduct driver surveys had frequency rates 18% lower than those that didn’t conduct surveys.
  • Although most companies conduct injury investigations, those that use written injury investigation forms, ask for prevention recommendations, calculate injury rates, set injury rate goals and track injury rates by customer had a 13% lower injury frequency rate.

2. Expectations

Four out of five companies have a written seat belt policy and close to 50% have both a written seat belt policy and enforcement activities. Those with both the policy and enforcement had a crash injury frequency rate that was 33% lower than those that didn’t use both.

3. Selection

  • Four out of five companies use a hiring checklist to document each step of the hiring process. Those using a hiring checklist had 30% lower injury frequency rates.
  • Four out of five companies have job descriptions that include essential job functions. Companies including essential job functions in the job descriptions had an 11% lower injury frequency rate.
  • Four out of five companies designate a medical provider. Those using designated medical providers had slightly lower injury frequency rates.

4. Monitoring Performance

  • Companies that provide technology for driver managers so they can verify available hours of service for drivers had a 37% lower crash injury frequency rate.
  • One out of four companies has GPS and uses it to monitor speed. These companies had a 15% lower crash injury frequency rate.
  • Two out of three companies conduct road observations. This practice results in a slightly lower injury frequency rate.

5. Transitional Work Programs

One out of four companies had someone responsible for tracking employees out of work and had written transitional work job descriptions. The group using both had a 7% lower injury frequency rate.

6. Injury Prevention

Most companies offer some form of injury prevention activities. Those that use an injury prevention manual provide regular training and have observations for enforcement had an injury frequency rate that was one-third of those that do not.

7. Training

Three out of four companies use written agendas for training. While written agendas are important, the survey found that injury frequency rates went down as the training group size became smaller. Those with written agendas and one-on-one training had a 30% lower injury frequency rate.

Mar 01
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ENCOURAGE ON-THE-JOB SAFETY WITH EMPLOYEE INCENTIVE PROGRAMS

By Construction Insurance Bulletin

Employees know the risk of serious injury, or death, that can result from not following their employer’s safety regulations. However, knowing these consequences doesn’t always provide enough motivation to all employees to use approved safety procedures. To add an extra incentive, many companies have developed reward programs that give prizes to employees who follow safety rules.

These types of incentive programs work best if they have simple, well-defined rules. Well-designed programs allow employees to accrue points over time, so that they can save up for the prize they really want. However, to prevent employees from losing interest, the program should offer rewards every 30 days, or let employees “cash in” accrued points whenever they want.

The program should offer a variety of prizes. Employers can partner with a company that manufactures incentive prizes and choose the prizes they want to offer from catalogs this company would provide. When deciding on prizes, include a selection of items that can be acquired with a small number of points and those that require a larger amount. This variety will help to maintain employee interest in the program over time.

Though cash might seem to be a good incentive on the surface, it usually is not for this type of program. When employees receive cash for their accrued points, they generally use it for a functional purpose like bill paying. In order for an incentive program to be successful, the prizes should have a recreational purpose, like a t-shirt or picnic basket. However, gift cards usually work well in incentive programs, because employees can redeem them for items that they really want.

Base program reward points on the actions of individual workers, not on the actions of a department or line as a whole. If the incentives are team-based, employees might be pressured by their fellow workers not to report something that management should hear about, in order to avoid the possibility that the group would lose the incentive.

Once you start a safety incentive program, continuity is important, and the program should be terminated only for a really good reason. If an employer terminates the program because it becomes too expensive to administer, it runs the risk of employees’ low morale from this decision, and also sending the message that the employer isn’t placing a high value on safety. Sometimes employers cut incentive programs because the results are not what they expected. Remember, not every employee will choose to participate. Some will feel that the incentive program is silly or demeaning. However, those that participate will give their full support, and the safety of your workplace will increase as a result.

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