IBI Health and Productivity Benchmarking

Transcription

1 IBI Health and Productivity Benchmarking Integrated Benefits Institute 595 Market St., Suite 810 San Francisco, CA (415) Short-Term Disability Program Calendar-Year Data: 2014 Based exclusively on claims active during the calendar year Report Contents Section I. Results Section II. Results by plan type Section III. Condition-specific results Glossary. Terminology and metric calculation PAGE 1

2 STD Report, Section I Results How well is the program working? HOW OFTEN IS THE PROGRAM USED BY + GROUP GROUP 10TH 25TH 75TH 90TH NUMBER OF NUMBER OF ALL GROUP EMPLOYEES? AVERAGE MEDIAN EMPLOYERS CLAIMS MEDIAN New claims per 100 covered lives , New claims per 100 covered lives, excluding pregnancy , Active claims per 100 covered lives , New claims as percentage of active claims 83.6% 90.1% 45.0% 82.8% 100.0% 100.0% 46 4, % Pregnancy claims as a percentage of new claims 3.5% 0.3% 0% 0% 3.2% 14.6% 44 3, % GROUP AVERAGE GROUP MEDIAN 10TH 25TH 75TH 90TH NUMBER OF EMPLOYERS NUMBER OF CLAIMS ALL GROUP MEDIAN HOW SEVERE ARE THE CASES? Calendar year payments per active claim $4,196 $2,525 $474 $1,033 $5,500 $10, ,083 $2,210 Calendar year payments per covered life $302 $196 $20 $93 $549 $ ,337 $121 Payments per closed claim $4,835 $2,858 $501 $1,117 $6,233 $12, ,773 $2, The median for all employers, all SIC codes in the IBI database Note: metrics with few employers are less reliable and more variable PAGE 2

3 STD Report, Section I Results HOW MUCH LOST WORK TIME DOES THE + GROUP GROUP 10TH 25TH 75TH 90TH NUMBER OF NUMBER OF ALL GROUP PROGRAM GENERATE? AVERAGE MEDIAN EMPLOYERS CLAIMS MEDIAN Calendar year lost workdays per 100 covered lives , Calendar year lost workdays per active claim , Lost calendar days per closed claim , Lost calendar days per closed claim, excluding pregnancy , Lost workdays per closed claim , Lost workdays per closed claim, excluding pregnancy , HOW SUCCESSFUL IS THE COMPANY AT RETURNING EMPLOYEES TO WORK? Claims reaching maximum benefit duration as a percentage of closed claims GROUP AVERAGE GROUP MEDIAN 10TH 25TH 75TH 90TH NUMBER OF EMPLOYERS NUMBER OF CLAIMS ALL GROUP MEDIAN 6.4% , Percentage of closed claims converted to LTD 6.9% , The median for all employers, all SIC codes in the IBI database Note: metrics with few employers are less reliable and more variable PAGE 3

4 STD Report, Section II Results by Plan Type PLAN CHARACTERISTICS Elimination Period Up to 1 day Up to 1 day Up to 1 day 1 week 1 week 1 week 2 weeks 2 weeks 2 weeks Duration of benefits 13 weeks 6 months 1 year 13 weeks 6 months 1 year 13 weeks 6 months 1 year PLAN TYPE COMPOSITION # of SIC employers with plan type % of SIC employers with plan type % of all employers with plan type % 2.4% 23.8% 69.0% 21.4% 9.5% 2.4% % 15.9% 1.4% 28.2% 44.8% 2.3% 15.8% 11.6% 0.4% The plan types in this report reflect the most common combinations of elimination period and maximum benefit duration observed among IBI benchmarking employers. They are not exhaustive of all observed or possible plan types. Employers may have more than one plan type. PAGE 4

5 STD Report, Section II Results by Plan Type How well is the program working? HOW OFTEN IS THE PROGRAM USED BY EMPLOYEES? New claims as percentage of active claims % % 90.4% % % 83.9% , Pregnancy claims as a percentage of new claims % 0.2% % 3.4% , PAGE 5

6 STD Report, Section II Results by Plan Type HOW SEVERE ARE THE CASES? Calendar year payments per active claim --- $2, $1,994 $2, $3, $2,640 $4, , Payments per closed claim --- $2, $2,057 $3, $4, $2,730 $5, , PAGE 6

7 STD Report, Section II Results by Plan Type HOW MUCH LOST WORK TIME DOES THE PROGRAM GENERATE? Calendar year lost workdays per active claim , Lost calendar days per closed claim , Lost calendar days per closed claim, excluding pregnancy , PAGE 7

8 STD Report, Section II Results by Plan Type Lost workdays per closed claim , Lost workdays per closed claim, excluding pregnancy , PAGE 8

9 STD Report, Section II Results by Plan Type HOW SUCCESSFUL IS THE COMPANY AT RETURNING EMPLOYEES TO WORK? Claims reaching maximum benefit duration as a percentage of closed claims % % 6.9% , Percentage of closed claims converted to LTD PAGE 9

10 STD Report, Section III Condition-Specific Results % OF CLOSED CLAIMS % OF PAYMENTS FOR CLOSED CLAIMS LOST CALENDAR DAYS PER CLOSED CLAIM CONDITION Count MEAN MEDIAN Infectious and Parasitic Diseases 0.9% 0.3% Neoplasms 4.5% 6.5% Endocrine, Nutritional and Metabolic Diseases, and Immunity Disorders 1.9% 0.8% Diseases of the Blood and Blood-Forming Organs 0.1% 0.1% Mental Disorders 5.8% 7.0% Diseases of the Nervous System and Sense Organs 5.4% 5.5% Diseases of the Circulatory System 8.4% 7.0% Diseases of the Respiratory System 4.6% 3.1% Diseases of the Digestive System 11.3% 6.5% Diseases of the Genitourinary System 3.9% 2.3% Complications of Pregnancy, Childbirth, and the Puerperium 2.3% 2.3% Diseases of the Skin and Subcutaneous Tissue 2.7% 1.4% Diseases of the Musculoskeletal System And Connective Tissue 25.7% 35.3% Congenital Anomalies 0.3% 0.3% Certain Conditions Originating in the Perinatal Period Symptoms, SIgns and Ill-Defined Conditions 3.9% 3.5% Injury and Poisoning 18.2% 18.0% PAGE 10

11 STD Report, Glossary Term Definition EMPLOYER DEMOGRAPHICS Covered lives Number of empolyees covered by an employer's STD program. TIMING OF CLAIM Active claims Closed claims Open claims New claims Claims reaching maximum benefit duration Claims that were newly opened, were closed, or had any payments or lost workdays during the calendar year. Claims that closed prior to the calendar year, or which remained opened but had no payment or lost time activity during the calendar year are excluded. Claims with a closing date that occurred during the calendar year. Claims that had no closing date by the end of the calendar year. Claims with a start date during the calendar year. Claims in which lost workdays met or exceeded its plan type's maximum benefits duration. CLAIM TYPE Pregnancy claim Claims for any pregnancy-related disability. Note: pregnancy need not end in childbirth to be included. PAYMENTS Payments Dollar value of claim payments. PAGE 11

12 STD Report, Glossary Term Definition LOST TIME Calendar days Workdays Calendar year lost workdays Elapsed days on a 365-day year basis. Observed lost workdays (not including elimination period). Lost workdays (not including elimination period) claimed during the calendar year. PLAN TYPE Elimination period Maximum benefits duration The period of time after disability before STD benefits become payable. The amount of time a disabled employee is eligible to continue receiving STD benefits. PAGE 12

13 STD Report, Glossary Metric Numerator Denominator HOW OFTEN IS THE PROGRAM USED BY EMPLOYEES? New claims per 100 covered lives Number of new claims multiplied by 100 Average number of covered lives New claims per 100 covered lives, excluding pregnancy Number of new claims, excluding pregnancy, multiplied by 100 Average number of covered lives Active claims per 100 covered lives Number of active claims multiplied by 100 Average number of covered lives New claims as percentage of active claims Number of new claims Number of active claims Pregnancy claims as a percentage of new claims Number of new pregnancy claims Number of new claims HOW SEVERE ARE THE CASES? Calendar year payments per active claim Calendar year payments for active claims Number of active claims Calendar year payments per covered life Calendar year payments for active claims Average number of covered lives Payments per closed claim Payments for closed claims Number of closed claims PAGE 13

14 STD Report, Glossary Metric Numerator Denominator HOW MUCH LOST WORK TIME DOES THE PROGRAM GENERATE? Calendar year lost workdays per 100 covered lives Calendar year lost workdays per active claim Calendar year lost workdays (not including elimination period), multiplied by 100 Number of lost workdays (not including elimination period) for active claims Average number of covered lives Number of active claims Lost calendar days per closed claim Number of lost calendar days for closed claims Number of closed claims Lost calendar days per closed claim, excluding pregnancy Lost workdays per closed claim Lost workdays per closed claim, excluding pregnancy Number of lost calendar days for closed claims Number of lost workdays (not including elimination period) for closed claims Number of lost workdays (not including elimination period) for closed claims Number of closed claims, excluding pregnancy Number of closed claims Number of closed claims, excluding pregnancy HOW SUCCESSFUL IS THE COMPANY AT RETURNING EMPLOYEES TO WORK? Claims reaching maximum benefit duration as a percentage of closed claims Number of closed claims reaching maximum benefit duration Number of closed claims Percentage of closed claims converted to LTD Number of closed claims converted to LTD Number of closed claims PAGE 14