Self-risk bearer for the Sickness Benefits Act and WGA

More control, fewer costs as a self-risk bearer for the Sickness Benefits Act and WGA

As an employer, you have two opportunities every year to largely take over the role of UWV in the event of absenteeism or incapacity for work of your employees. You then become your own risk bearer (ERD). We spoke to Victoria Baranova, ERD specialist at ArboNed, about the idea behind self-risk bearing and the obligations that come with it. As an employer, you are responsible for up to 12 years for permanent and (since January 1, 2017 also) temporary employees who leave work sick. You must ensure their benefits and take action to help them get back to work. The sick employee is covered by the Sickness Benefits Act for the first two years. If he cannot return to work after 104 weeks, but there is a chance that he will be able to work (partially) again in the future, your (ex-)employee is entitled to a WGA benefit (Resumption of Work for the Partially Disabled) for a maximum of 10 years. ). Take control in your own hands Employers can take out public insurance against employee disability through the benefits agency UWV. The composition of your premium then depends on the size of your company. If you are dealing with a long-term illness, UWV will arrange the benefit, reintegration and administrative processing. You are essentially taking your hands off your employee; you cannot influence his reintegration, even after the first two years. For a few years now you have also been able to choose to take control and become a self-risk bearer (ERD) for WGA and/or Sickness Benefits Act. You will then largely take over the role of UWV. Complex laws and regulations “For many employers, ERD is an interesting option,” explains Victoria Baranova. “They will then only be charged the costs that are actually incurred in the event of long-term absenteeism. In certain sectors, where large employers and employment agencies give many temporary contracts to employees, the UWV premiums are relatively high and it is financially attractive to have matters in your own hands. Many employers also like to keep control over what happens to their (former) employee who has left work sick.” Because the costs of incapacity for work quickly increase and the legislation and regulations surrounding implementation are extremely complex, employers can place the financial risk and implementation with a private insurer, supported by ERD specialists from an occupational health and safety service. Get advice first According to Victoria, self-risk bearing has advantages, if you approach it properly as an employer. “ERD can provide significant savings, but it is certainly not something to take lightly. It is really a profession in itself to manage the entire process of self-risk bearing, and it is not the best option for every company. I always tell companies that they should first seek proper advice from a financial advisor. An incapacitated employee will cost you around €1.000,000 in benefits alone over the entire 12-year period. On top of that there are the costs for reintegration and possible continued payment of wages. To properly assess and cover that risk, it is definitely advisable to seek the assistance of specialists.” ERD specialists provide tailor-made solutions As an occupational health and safety service, ArboNed offers support to self-risk bearers with a dedicated team of ERD specialists. Together with you and your (ex)employee, they determine the best route to quick and responsible reintegration, both during the Sickness Benefits Act and during the WGA period. “In the first two years, we can completely take over the implementation of the ERD for the Sickness Benefits Act or only fulfill an advisory role. That is always tailor-made. At two moments we determine how likely it is that someone will end up in the WGA. This estimate of the WGA influx appears to be quite reliable: in recent years we have made a correct estimate of the cases in 84%. If the risk of inflow is high, we can help the employer to take action in time.” Such an action could, for example, consist of offering a retraining program to the (former) employee under the Sickness Benefits Act, so that he can eventually work (elsewhere) again. “Insurers are often prepared to make an investment for this, because we as experts can clearly argue the usefulness of such an intervention,” says Victoria. “They would rather reimburse retraining of 3,000 euros now if they can prevent someone from ending up in the WGA for a hundred thousand euros or more.” From a broader perspective Many employers indicate that - in addition to the practical support and explanation of complex legislation and regulations - they benefit greatly from experts looking at an absenteeism case from a helicopter view. “Employers themselves are often too close to such a file and are so emotionally involved that they lose the big picture and overlook practical matters,” Victoria explains. “We continue to look at the broader perspective. Is this now the fourth employee who ends up under the Sickness Benefits Act with back problems? Then we must not only focus on this case, but also initiate preventive measures in the company.” Because the self-risk bearer may have to deal with a variety of cases, a large number of specialized partners is an advantage. Victoria: “Last year we received a file from an employee with acquired brain injury (NAH). The employer had given up all reintegration attempts and the employee would join the WGA. I then put this man in touch with one of our partners, who specializes in NAH. We discovered that his limitations were so far-reaching and lasting that he was early eligible for an IVA, i.e. a benefit for the completely disabled. It was good for the employee to have immediate clarity. This saved him from dozens of reassessments and endless job applications. For the employer and his insurer, this meant complete savings on the WGA portfolio. All thanks to a fairly simple intervention.” 12-year proposition from ArboNed ArboNed supports self-risk bearers during the total period of 12 years, with the aim of limiting the damage to everyone involved as much as possible. According to Victoria, this support goes beyond the case management offered by private insurers. “We continuously monitor the progress of the recovery, ensure that the employer complies with legal obligations, implement reintegration activities and, together with our partner SV Pay, take care of the complex benefits administration. Thanks to our WGA Risk Scan, we can estimate the WGA influx and take early action. And if the (ex)employee does enter the WGA, our ERD team will also carry out all aspects of the WGA guidance, from continuing the reintegration activities, starting objection and appeal procedures to applications and assessments. of a reassessment and the implementation of enforcement measures. Everything with one important goal in mind: helping self-risk bearers to limit absenteeism costs and increase the sustainable employability of employees.” Do you want to know more? To become a self-risk bearer or not? Please contact HBR Insurance Industry and receive extensive advice. For years, an FHI cover has been in place for WGA ERD insurance at competitive premiums. For questions about ArboNed's services, please contact our Sales Support department on 030 299 62 77 or salessupport@arboned.nl, or look at arboned.nl/erd.