Challenges in Managing Claims in a Diverse Workforce

At the 2015 National Council of Self-Insurers Annual Conference, a panel discussed the challenges of managing claims in a diverse workforce. The panels were:

• Michele Adams – Walt Disney World Resorts
• Loyd Hudson – American Electric Power
• Max Koonce – Walmart

Disney has a diverse workforce. In fact, employees at Disney World speak three primary languages: English, Spanish and Haitian-Creole. All company meetings and communications are presented in these three languages. Approximately 45% of Disney’s new hires are minorities, and 59% are female. All 36,000 new cast members receive safety training every year and injury prevention is a high priority. Cast members include college students, retirees, full-time and part-time hourly and salaried employees. Much of this workforce is unionized. Over 12% of Disney’s employees are considered “high risk” for chronic disease. This is a reflection of the risk factors present in society. This is a complicating factor that must be considered in claims handing. From the claims-handling side, translators are available to ensure all communication is clearly communicated. Disney is self-insured and self-administered. They have a strong transitional duty program with the goal of getting everyone back to work in some capacity as soon as possible. Disney has an early intervention strategy to identify employees who have risk factors that may impact the claim and steps are taken to mitigate those factors. Because so many Disney employees are retirees, Medicare Secondary Payer Compliance is an issue they deal with frequently.

American-Electric Power has a workforce that is 83% male. They operate coal mines, a railroad, barges, along with all the other jobs associated with the utility industry. They have an aging workforce with mostly long-term employees, and this is their big focus from a diversity point of view. Their data shows that for every year older an employee is, the claim will cost at least $50 more. They have found that the closer a worker gets to retirement age, the more challenging it is to get that person back to work following an injury.

Walmart has over 2.2 million associates across 11,000 stores in 27 countries. Approximately 60% of their locations are outside the United States. They have a diverse mix of risk and insurance programs across all these different locations and countries. Integrating the international aquisitions into their risk management program has been particularly challenging. They have 1.3 million associates in the U.S. where their three largest states are Florida, Texas and California. In the U.S., 57% of their associates are women and 39% are minorities. Overcoming language barriers is a challenge for claims handling and they use translators when needed. They have noticed a difference between cultures when it comes to how employees respond to the medical treatment process. Some cultures are very hesitant to go to a physician. Walmart also has a robust return-to-work program and works with both employees and stores to ensure injured employees return to work as quickly as possible. They have also found that different religious beliefs and the person’s status within the household will impact their claim outcomes. Walmart utilizes a lot of analytics around psycho-social issues so that they can take steps to help mitigate the impact that these factors can have on the claim. There is a significant generational difference in how their workers want to receive information based on age. Younger workers prefer texts versus e-mail or regular mail. It is important for their claims staff to find ways to relate to the injured workers to improve the communication and reduce misunderstandings.