HRM textbook

CHAPTER 13 BENEFITS AND SERVICES 433
by instituting effective safety and health programs and complying with government
safety standards. Furthermore, although many workers compensation claims are
legitimate, some are not. Supervisors should therefore watch for typical fraudulent
claim red flags. These include vague accident details, minor accidents resulting
in major injuries, lack of witnesses, injuries occurring late Friday or very early
Monday, and late reporting. 39
Other workers comp cost-control techniques include monitoring health care
providers for compliance with their fee schedules and auditing medical bills. 40 Case
management is a popular cost-control option. It is the treatment of injured workers
on a case-by-case basis by an assigned manager, usually a registered nurse, who coordinates
with the physician and health plan to determine which care settings are the most
effective for quality care and cost. 41
Moving aggressively to support the injured employee and to get him or her back
to work quickly is important. The involvement of an attorney and the duration of the
claim both influence the workers claim cost. 42 Many firms have rehabilitation
programs. These include physical therapy, and nursing assistance to help reintegrate
claim recipients into the workforce.
Hospitalization, Health, and Disability Insurance
Health insurance looms large in many people s choice of employer, because it is so
expensive. Hospitalization, health, and disability insurance helps protect employees
against hospitalization costs and the loss of income arising from off-the-job accidents
or illness. Many employers purchase insurance from life insurance companies, casualty
insurance companies, or Blue Cross (for hospital expenses) and Blue Shield (for physician
expenses) organizations. Others contract with health maintenance organizations
or preferred provider organizations. The employer and employee usually both
contribute to the plan. Table 13-3 illustrates the prevalence of health-related benefits.
COVERAGE Most employer health plans provide at least basic hospitalization and
surgical and medical insurance for all eligible employees at group rates. Insurance is
TABLE 13-3 Percentage of Employers Offering Some Popular Health
Benefits Change Over Time
Yes (%) 2005 Yes (%) 2011
Prescription drug program coverage 97 96
Dental insurance 95 94
Mail order prescription program 90 91
PPO (preferred provider organization) 87 84
Chiropractic coverage 56 83
Mental health insurance 72 82
Vision insurance 80 76
Employee assistance program 73 75
Medical/Flexible spending account 80 73
HMO (health maintenance organization) 53 33
Source: Adapted from 2011 SHRM Employee Benefits Survey Report, p. 2. www.shrm.org/Research/SurveyFindings/
Articles/Documents/Emp_Benefits_Tables.pdf, accessed, June 1, 2011. Reprinted with permission from the Society
for Human Resource Management. All rights reserved.
supplemental unemployment benefits
Provide for a guaranteed annual income
in certain industries where employers must
shut down to change machinery or due
to reduced work. These benefits are paid
by the company and supplement
unemployment benefits.
workers compensation
Provides income and medical benefits
to work-related accident victims or their
dependents regardless of fault.