SHRM: Health, Wellness and Leave Benefits Help Employees with Coronavirus
Benefit specialists advise employers to:
- Follow guidelines posted by the Centers for Disease Control and Prevention (CDC).
- Encourage workers to use telehealth services, if available, unless their symptoms are severe.
- Use wellness programs to instruct workers about hygiene and disease prevention.
- Tell employees to stay home if they have a fever and cough and to seek care for severe respiratory distress.
If employees need to be off work for a long time, try to be lenient about the use of leave under the Family and Medical Leave Act (FMLA).
These recommendations are discussed in more detail below.
No Doctor’s Note Required
The CDC recommends that people who are experiencing respiratory illness stay home until they are free of fever and other symptoms, such as frequent and severe coughing, for at least 24 hours without the use of medicines (e.g., aspirin and cough suppressants).
“Do not require a health care provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as health care provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way,” the CDC advised.
“We’re following the CDC guidelines,” said Jennifer Ho, vice president of human resources at Ascentis, a human capital management software firm based in Minneapolis. “We’re telling employees if they are experiencing symptoms, to work from home if they’re able, or to take time off—and to return to work only when they’re symptom free.”
“Employees need to check their symptoms—fever, cough, shortness of breath—against those of COVID-19 and consider if they have been in an affected area or exposed to someone who is infected,” said Bobbi Kloss, director of human capital management services at Benefit Advisors Network (BAN), a consortium of independent benefit advisory and consulting firms. “Illness could occur from 2 to 14 days after exposure.”
Employers, however, “should be cautious about providing medical advice to sick employees,” advised Danielle Capilla, director of compliance and employee benefits at Alera Group, an employee benefits and financial services firm. “Guiding employees to speak with their physician, their local health department, and to use telemedicine as appropriate is the best course of action.”
Be Lenient with Sick Leave
The CDC advises employers to “ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.”
Employers can require employees who exhibit coronavirus symptoms to stay home until they are symptom free, said Mark Neuberger, a litigation attorney in the Miami office of law firm Foley & Lardner LLP. The same is true if an employee is returning from a country designated by the CDC and the World Health Organization (WHO) as having high risk for COVID-19 transmission, or has been exposed to someone ill with the virus. Employers can require that these workers wait the maximum incubation period of the virus—thought to be approximately 14 days—before returning to the workplace.
Be cautious, though, and think about modifying your attendance policies. Requiring these quarantines could encourage hourly workers who have no remaining paid sick days or other paid time off (PTO) not to reveal that they may pose a risk to others.
“If employers force someone to stay home for two weeks without pay or make them use precious PTO, they may push people to hide where they have been or what symptoms they are experiencing, which will defeat planning to ensure that management is taking all reasonable steps to prevent the illness from spreading through the workplace,” Neuberger said.
While recognizing there is a possibility for abuse by employees who would like to stay home for two weeks, Ho noted that “it really is up to employers to have best practices and training for managers on how to handle situations like this.” Managers, she advised, “should work with their HR teams, who are familiar with signs that they need to dive in a little deeper” to ensure that leave isn’t being abused.
“Employees who come to work with a contagious disease will spread that disease,” Kloss said. “Consider providing paid leave for those employees who have no paid leave available and who are confirmed with COVID-19. In the long run it may save more dollars than it costs.”
Last year, 73 percent of private industry workers in the U.S. had paid sick leave benefits available from their employers, the U.S. Bureau of Labor Statistics reported.
There’s another sick leave complication employers may face: If public health officials order employees or their family members quarantined for up to two weeks because they have been exposed to someone with COVID-19 or visited a high-risk area, those being quarantined—if they show no symptoms—may not be covered by their employer’s sick or disability leave policy.
For quarantined employees who can’t telework or otherwise perform their jobs remotely, employers should consider their response and may choose to extend paid leave benefits to cover this situation.
The nation’s private largest employer, Walmart, announced on March 10 that it will provide up to two weeks’ pay for workers who are quarantined or if one of its locations falls under a mandatory quarantine. If a Walmart worker is diagnosed with coronavirus, the company will offer two weeks’ pay and additional pay replacement for up to 26 weeks.
Darden Restaurants, parent company for Olive Garden, also announced it will begin offering its 170,000 workers paid sick leave amid coronavirus concerns. The company was already developing the policy but it’s rolling it out sooner following a report that workers were coming in sick because they couldn’t afford to take time off.
Encourage Workers to Use Telehealth
The CDC encourages employees to use telehealth services, rather than visiting a doctor’s office or clinic, to limit the spread of the virus.
“It is important for employers to keep employees advised as to the benefits that they have available that can assist them with making health decisions,” Kloss said. “Telehealth programs can assist by providing clarity to the situation and aid the employee with determining their next steps.”
“If telehealth is an option for your employees, advise them to make use of it,” said Kim Buckey, vice president of client services at DirectPath, a benefits education, enrollment and health care transparency firm based in Burlington, Mass. “The doctor will be able to assess whether the employee needs to come in for testing or can be treated at home. This minimizes the risk of infecting others in the office waiting room or getting infected themselves” if it turns out that they have a cold or the flu.
For employees without a telehealth plan, “the best course of action is to call their health provider if they have one, their local urgent care clinic, or—in a pinch— the local ER and describe their symptoms. Tests are limited at this point and will be reserved for those who are severely ill, recently traveled to affected countries or have interacted with those who have,” Buckey pointed out.
Noted Kathleen Ann O’Driscoll, vice president of the nonprofit Business Group on Health, an employers’ education and advocacy group in Washington, D.C., “Telehealth has been a growing focus for employers and has a prime role to play in health care overall. The coronavirus has highlighted its benefits.”
Mary Kay O’Neill, a partner at HR consultancy Mercer, called telehealth “an important first step to managing the virus,” but advised “it’s important to ensure your vendor doesn’t over-promise and under-deliver and to make sure they have the proper protocol for handling a virus like this.” However, “If you are confident in the vendor/carrier system, there will never be a better time to communicate its availability to your employees.”
Don’t overlook telehealth for treating emotional health issues, she advised, “especially if people are quarantined for weeks on end. Epidemics like this can increase anxiety and depression among people, resulting in a greater need for these services.”
Deploy Wellness Programs
Show employees how to use good hygiene and take responsible precautions through lunch ‘n learn sessions, posters, e-mail campaigns and other channels. “This is back to basics—take care of yourself by getting enough sleep, exercise and eating healthy,” Buckey said. Advise employees to wash their hands vigorously throughout the day, for at least 20 seconds using warm water and soap, to use hand sanitizers and disinfect hard surfaces, and—especially—to stay home if they are sick.
This is good advice regardless of COVID-19, Neuberger pointed out. “As statistics demonstrate, seasonal flu poses a far greater and more immediate threat to your employees’ health than does the coronavirus.”
Jeff Levin-Scherz, M.D., Boston-based co-leader of the health management practice at consultancy Willis Towers Watson, said wellness education should emphasize changing the way we great one another. “Don’t shake people’s hands, it’s just silly,” he noted. “Encourage people to use a fist bump” or wave hello, instead.
As part of your wellness initiatives, “make sure that employees understand the resources available to them,” Levin-Scherz said. These could include an employee assistance program for those experiencing severe stress or mental health issues triggered by virus fears.
O’Driscoll noted that onsite clinics, for those employers that provide them, are also a great resource for educating employees. “For employees who may start to feel unwell while at the office, they have ready access to a medical professional for guidance.”
Temperature Checks Not Advised
Levin-Scherz does not recommend that employers scan workers for increased body temperature. “While a handful of employers are doing thermal scanning to estimate employees’ temperature, there are many false negatives and false positives. Employees could have a fever for some other reason,” he explained.
Checking employees’ temperatures could also run afoul of U.S. and EU law.
When to Use FMLA
For long-term absence, most employees dealing with their own or a family member’s serious illness can take up to 12 weeks of unpaid leave under the federal Family Medical Leave Act.
“If it turns out to be coronavirus, the employee will likely be out for two weeks or more, so short-term disability and FMLA may come into play,” Buckey said.
“An eligible employee of a covered employer could request FMLA leave in order to recuperate from coronavirus or care for a sick family member if the illness was a ‘serious health condition,’ which would be dependent on a variety of factors,” Capilla noted.
Ho advised employers to “follow whatever FMLA guidelines you typically use, working with your employment attorneys.”
While generally a doctor’s certification is needed for FMLA leave, “if an employer understands the employee has a serious health condition within the meaning of the FMLA, the employer is free to waive the requirement to provide documentation,” said Neuberger. “That can be a management decision.”
At the same time, he noted, employers may have legitimate concerns about people who try to “milk the system and take 12 weeks off, claiming they have something they don’t,” he said. “It’s a balancing act. But under these circumstances, being flexible is the better way to go.”
Attorney Carrie B. Cherveny, senior vice president for strategic client solutions and compliance at Hub International, a global insurance brokerage, and Mingee Kim, senior vice president and certified leave management specialist at the firm, shared a cautious view.
“An employer facing the possibility of an employee or family member being diagnosed with the coronavirus may be inclined to bypass the regular and ordinary FMLA steps,” they wrote recently. “The FMLA rules regarding notices and documentation have not been lifted. Therefore, employers must continue to follow their regular and ordinary FMLA process including the notice of eligibility and rights and responsibilities, certifications, designation notice, and most important, the fitness for duty.”
Caution vs. Panic
“There are going to be employee responses across the spectrum, from lack of concern to fearful and overly cautious,” Kloss said.
At some workplaces, Neuberger observed, “employees are afraid to touch shipments from China.” Management, he said, “has to deal with irrational fears in a rational way, by providing good information and staying on top of rapidly changing advice posted by the CDC and WHO, and assigning someone to monitor those websites every day,” he advised.
“It’s important to be cautious, to be up to date and to stay informed,” Ho said. “It’s equally important to deploy common sense,” and to encourage employees to do the same.
Employers should “continually inform employees about what’s included in their benefit plans in case they were to get sick,” said Nancy Reardon, chief strategy and product officer at Maestro Health, an employee-benefits services firm. “One contributing factor to employees’ fear is that they wouldn’t know what to do if they became infected or how much it would cost to begin treatment. It shouldn’t take something like coronavirus for companies to proactively communicate and engage their employees’ in their overall health and benefits.”
Educate employees year-round to make sure they understand which care options are covered in their benefits plan, “not just during times of crisis,” Reardon advised. To prevent frustration and fear, employees should know where to go to get the best care at a fair price; what primary care doctors exist in their network; when they should use a retail clinic or urgent care center; what services their benefits cover; and how to use telehealth and counseling options.
“By offering a variety of health care options and pointing workers in the right direction, employers can help their employees feel prepared, rather than panicked,” she noted.
A final thought: Some employees, including recent hires or part-time workers, may not be covered by health benefits. “Employer notifications should be responsive to this group as well,” Kloss said. “Employers should communicate with their local health departments to assist them with a responsiveness plan.”
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(Stephen Miller, CEBS, Online Manager/Editor, Compensation & Benefits, SHRM Online.)