EAP Integration Project

I’m at it again. I’ve been working on this for a few years and it’s now time to pilot the program. I’ve posted a call to action on LinkedIn with the hope that an insurer and/or TPA will take the idea and run with it.  Fingers Crossed that we’re more successful than the Trillium Project.

Sun Life did something very cool back in the fall of 2017. They introduced us to Ella, an interactive digital coach to help our clients navigate and maximize their benefits. Originally it was launched to help people use up their HSA funds before they were due to expire (would we consider this with vision, dental or paramedicals?). It was also tasked to sell products like individual health coverage to dependents as they left school or lost their parents coverage due to age. Other companies followed with similar programs in both benefits and pensions. I envisioned a whole world ahead of areas where it could assist plan members, not just to sell, but to engage them when specific health events occurred. Alas, none of that has come to pass. It’s time to change that.

We know that less than one third of people prescribed anti-depressants or anxiety medication ever speak to someone other than a family doctor. They never engage in any form of therapy that may help provide them with needed coping mechanisms. We also know that there are a wide variety of events that can trigger situational depression that could benefit from timely intervention. Imagine how we could minimize the duration of, or improve the outcomes, if treatment were introduced earlier. Waiting until a situation worsens until someone is left with no option but to ask for help, or to the point of losing time from work, is too late.

Here’s the idea I’d like to share. Think of this as “open source” information. Anyone can make use of this idea to better our industry, improve their offerings, and help our clients when they need it most. Let’s use the transactional side of medical claims to trigger EAP usage at the time it’s needed most. COVID has taught us the importance of these programs, but we still rely on the person affected to remember they have the benefit, then reach out to take advantage of it. Employers promoting EAP is good, but embedding it into plans so that the employee is reminded at the time it matters most?

Here’s how I see it working…

Anytime an employee faces a major life event that might indicate the need for mental health supports, an reminder of the EAP program would be sent to them. This could be in the form of an e-mail, text, pop-ups on the plan member site or, ideally a combination of all of these. The reminder of the EAP service, or other mental health supports provided by the plans paramedical coverage (psychologists etc) would be generic so as not to identify the problem (so no privacy issue) and would be sent immediately following the triggering event.

These triggering events would include…

A life claim, dependent life claim, or triggering of survivor benefits. These indicate a huge loss to the employee, spouse or other family members and a potential need.

An AD&D or LTD claim being submitted. Whether a loss of limb, vision or an inability to work due to a medical condition or accident, all are often accompanied by depression and are a natural fit for EAP programs,

Any prescription for anti-anxiety or anti-depressant drug being filled for the employee or dependant. This is just self explanatory and provides a reminder of the assistance available before even the first pill is taken.

A prescription for any cancer, transplant/anti-rejection, opioid pain relief or other related drug. These are all situations where supports are well warranted and DIN’s related to these and other treatments could readily be identified.

Any hospital stay over 5 days, any convalescent or rehab hospital stay. Regardless of the reason, these events often are a time of need for either the patient or their family.

Any claim for medical equipment such as hospital beds, wheelchairs, artificial limbs, permanent braces, or other devices indicating a longer lasting , life changing event.

The list is actually longer than listed above and can be fine tuned to “tag” more drugs, treatments or equipment claims, but most things fit in those categories.

They are all events that indicate the employee or dependent is going through a traumatic event, where there is an increased risk of depression or anxiety, and an opportunity to provide mental supports. The goal is to drive EAP usage, by placing it front and centre to the person at the time they need it most.

Sure there are challenges. The biggest naysayers will point out that EAP usage will climb and with it the corresponding costs to employers. I agree that will happen, but think having a program that is being used to support employees is a whole lot easier to justify, than one being paid for that is never used. Others may say a reminder at just the right time may not be enough for the employee to initiate action, and that’s true, but much better than anything we have today. As we tweak the system, the messaging and the triggers, I think it will only help improve outcomes. From there we will likely see (though tough to track) a reduction in presenteeism, absenteeism, disability etc. The investment is small, the technology is available and if COVID has taught us one thing, there has never been a greater need.

Here’s what I am asking of you.

If you like the idea, reach out to your advisor, insurer, TPA’s and EAP provider and share this idea. We have nothing to lose and everything to gain. Isn’t it time we tried using this new technology to help, rather than just sell?

This project is an initiative of Dave Patriarche, the founder of CGIB. CGIB is an association dedicated to advisor education and not an advocacy group. The results posted here are for general public reference only and should not be construed as a CGIB initiative, or that it has been supported by CGIB members in any way.