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Disability Insurance Observer: Behavioral Risk

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Employers might be in a better position to add behavioral health to disability and absence management programs if they knew what was going to happen with the Patient Protection and Affordable Care Act (PPACA).

Analysts at the Disability Management Employer Coalition (DMEC), San Diego, talk about the effects of PPACA jitters on behavioral disability risk management programs in a summary of results from a behavioral risk survey.

The analysts conducted the survey by using the Internet to send questionnaires to 1,063 members of DMEC and four other benefits groups.

PPACA, of course, is at the Supreme Court. If the law survives the current court challenges, as a whole or in part, it could face more challenges during the fall general elections and in the courts.

Members of DMEC love the idea of taking steps to keep depression, alcoholism and other behavioral health problems from leading to absence and disability themselves, causing or aggravating disabling acute care health problems, or interfering with efforts to recover from acute care problems.

Behavioral health problems are the fifth leading cause of short-term disability and the third leading cause of long-term disability for U.S. employers, the DMEC analysts say in their report.

“Stress continues to be the name of the game in 2012,” the analysts say. “The economy is just beginning to improve, albeit slowly; therefore, employees’ concerns over job safety and financial security are only just starting to diminish.”

One participant reported seeing “an increased amount of stress among our employees…a leaner workforce combined with complex social factors.”

But uncertainty about the effects of PPACA may be adding to the list of factors keeping companies from expanding behavioral risk management efforts, the DMEC analysts say.

The federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) already requires employers that offer behavioral health benefits to use similar rules for the behavioral health benefits and general health benefits. But MHPAEA does not say anything about whether employers have to offer behavioral health benefits in the first place.

If PPACA survives, it likely will require the employers that still offer group health benefits to provide behavioral health benefits that are comparable to general health benefits, the DMEC analysts say.

But benefits specialists have no idea whether PPACA will survive, in what form it will survive if it survives, or what PPACA or remnants of PPACA will do to benefits costs.

About 78% of the participants said their companies provide behavioral health coverage through a “carve-in”attached to the general health plan.

Employers “may be reluctant to add/develop programs such as behavioral health if they’re going to have to ‘carve it back out’ in a couple of years,” the analysts write.

I think analysts raise a question worth thinking about: Does fighting what we think are bad rules to the point that we have no idea what the rules will be really help matters? Maybe we’d better off deciding to make decisions about health and benefits policy by tossing a coin and simply accepting whatever the coin says rather than continuing with the current state of gridlock-induced paralysis.

If the coin decided things the wrong way, from your point of view: At least then maybe the results would be so horrible that everyone would recognize we were going on the right path. As it is now, we never seem to put anybody’s approach to a solid experimental test, so we never get clear, experimental evidence suggesting whether either the Blue or Red approach is right or wrong. We just get a bunch of unproductive bickering. Instead of ending up with reasonable purple compromises, we end up with purple, angry faces.

So, in other words: Obama is lovely, and Romney is lovely, but my favorite candidate is the Susan B. Anthony dollar coin.


The Wellesley, Mass., arm of Sun Life Financial Inc. (NYSE:TSX) says it sees strong interest in voluntary, employee-paid short-term and long-term group disability insurance programs. Employers need to save on benefits, but employees still need to protect their income, the company says.

Employees may welcome the ability to adjust the amount of coverage, the elimination period and duration benefit options to suit their budgets and coverage needs, the company says.