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Employee Benefits Questionnaire 员工福利调查问卷员工福利调查问卷 Programs by which employees receive noncash compensation to ensure that the organization attracts retains and motivates employees to accomplish organization objectives 这是一种以非现金的薪酬方式存在的程序 提供给员工以确保阻止吸引 保留 和激励员工完成组织目标 1 Does the organization have a clear policy regarding employee benefits 组织有关于员工福利的一个明确政策吗 2 Is there one position within the organization accountable for fairly and consistently implementing employee benefit programs and ensuring compliance with governmental regulations such as ERISA COBRA EEO and the Family and Medical Leave Act 组织内部是否有岗位负责公平一致地执行员工福利计划 来确保和政府的规 范条例是保持一致的 例如 ERISA 雇员退休收入保障法案 COBRA 统 一综合预算汇编法案 EEO 平等就业机会 和家庭与医疗休假法 3 Is the organization current on competitive employee benefit practices such as childcare flextime job sharing vacation sick time time off provisions and health plan alternatives 该组织目前是否有在竞争员工福利方面下功夫呢 例如 儿童保育 弹性工 作制 工作分享 假期 病假 休假和健康计划这些方面的选择 HEALTH CARE COST CONTAINMENT 健康保健成本控制健康保健成本控制 4 Is there a process in place to contain medical costs while offering quality health care to employees 是否建立有一个控制医疗成本的程序 同时也向员工提供了高质量的医疗服 务 5 Do you periodically gauge employee satisfaction with the benefit plan in terms of customer service timeliness claim management and accuracy 是否有定期检测员工在客户服务 及时性 诉讼管理和准确性这些方面对福 利计划的满意度 6 If employee dissatisfaction is high or costs are out of control or noncompetitive do you put your benefit plans out to bid How often does this occur 若员工的不满意度很高或成本失控或不具备竞争性 你会把你的福利计划进行 招标吗 多久会发生一次 7 Does your medical cost containment review cover the following A Have you analyzed both of the following alternative health care programs for their cost containment processes including services offered accessibility quality of care and cost 你的医疗成本控制会评估下列方面嘛 A 你是否会分析下列可选择性的医保计划的成本控制过程 包括可提供的服务 保健方面的可获得性 高质量的医保和成 本 HEALTH MAINTENANCE ORGANIZATONS HMOS 健康维持组织 健康维持组织 HMOS What are enrollment numbers for the past three years Rapid enrollment rates may result in poorer service 过去三年的招生人数是多少 招生人数的飞快增长可能会导致服务越来越差 Is the HMO accredited by the National Committee for Quality Assurance NCQA HMO 是否有得到 NCQA 全国质量保证委员会 的许可 Were any conditions attached to the accreditation 对这个许可是否有附带其他的一些附加条件 What is the public perception of the HMO has it received bad press 公众对 HMO 有什么看法 是否有收到过坏消息 Have organizations similar to yours fared well under this HMO Ask for a list of clients and call some of them 和你们类似的组织在 HMO 方面出色吗 需要一份客户清单 并打电话询 问其中一些人来核查 What are the exclusions or limitations on procedures such as transplants rehabilitative procedures and mental and nervous disorders 程序中有哪些例外或限制 譬如移植 精神和神经疾病上的恢复 PREFERRED PROVIDED ORGANIZATIONS PPOS 优先选择提供者组织 优先选择提供者组织 PPOS In addition to all the questions for HMOs above what is the ratio of network vs non network charges 除了上述关于 HMO 的所有问题之外 网络和非网络收费的比率是多少 Do employees accept the network doctors 员工是否能接受网络医生呢 B Has HR reviewed the following administrative controls 人力资源人员是否有评估下列管理方面的控制 In house company data on premiums paid and claims processed 在公司内部是否有保险支付和索赔处理的数据 Retention provisions of carriers such as rebates or favorable rate consideration for retention of company funds 运营商保留条文 例如考虑回扣或优惠率来保留公司的资金 More favorable stop loss arrangements with a carrier 与运营商更有利的止损条款 Encouraging employees to report errors in medical bills 激励员工举报医疗账单中的错误 Health care spending accounts and changing rules 医疗保健支出账户和变化规律 Nonduplication of benefits instead of traditional coordination of benefits 非重复福利取代传统协调福利 Initiating a probationary period before health coverage begins 在健康保健开始进行前 先进行一个试用期 C Has HR reviewed basic cost management programs including the following 人力资源是否有评估管理计划的基本成本 包括如下 Increasing deductibles coinsurance responsibility or copayment amounts 增加免赔额 共同保险责任或共同负担费用的数额 Requiring second opinions for surgery 在外科手术方面要求第二建议 Instituting pre admission testing and certification 实行入院前的测试盒检查 Concurrent hospital stay reviews 同时住院观察 Closely managing chronic or costly illnesses 严密关注慢性的或昂贵的疾病 Patient auditing of hospital bills 对病人医院账单的审查 Requiring employee plan usage data from health care carriers administrators 要求员工从健康保健 管理员中计划使用的数据 D Has HR reviewed employee health promotion and education programs 人力资源是否有评审过员工的健康宣传和教育计划 D Has HR communicated with health care providers to review customized plan options and cost containment measures 人力资源是否有和健康保健提供者沟通过 来评估定制计划选 择和成本控制措施 8 Are the costs of employee benefits regularly calculated and compared to national industry and local data 员工福利的成本是否有定期地进行计算 且和国内 同行以及当地数据做比 较 9 Are vacation and sick leave accruals analyzed for purpose as well as cost consideration 是否有对假期和病假的权责发生制做原因分析和成本考量 10 Are there programs to control absentee costs 这些计划有对缺勤成本做控制吗 11 Are there programs to curb sick leave abuse 这些计划是否有遏制病假的滥用 12 Are unemployment compensation costs analyzed for cost savings 是否有从节省的角度对失业补偿费用做分析 13 Are pension plans reviewed and employees counseled on win win pension options that will save the organization money 是否有审查养老计划 是否有向员工提供过双赢养老计划选择的咨询 这些 都是可以帮组织节省费用的 14 Does your organization offer retirement counseling to employees 你们组织是否有向员工提供过退休方面的咨询服务 15 Are there benefits to extending the retirement age 对延长退休年龄的员工是否有其他福利 16 Should changes in long term disability payments be considered 是否有考虑过改变长期伤残抚恤金 17 Does your organization regularly communicate the benefits it provides as well as emphasize the company s contribution to employee benefits 你们组织是否有定期沟通其提供的福利 同样也强调公司对员工福利所做的 贡献 18 Does your organization have the capacity to provide necessary employee benefits and address cost containment issues that affect profitability 你们组织是否有能力来提供必要的员工福利 且阐述能影响盈利能力的成本 控制问题 19 On a scale of one to seven seven being the highest and four being adequate how do you think the Human Resources department would rate the effectiveness of employee benefits programs 在等级一至七中 七是最高等级 四就是能胜任的级别 针对人力资源部 门将评估员工福利计划的效力 你如何看待 20 On the same one to seven scale how do you think internal clients department heads and employees would rate the effectiveness of the employee benefits programs 在同样的一至七等级中 针对内部客户 部门领导和员工 将评估员工福利 计划的效力 你又如何看待 Explanation of Employee Benefits Questionnaire 员工福利问卷调查的解释 Employee benefits are necessary to attract and retain quality employees Few organizations however are able to find new ways to contain costs and use benefits as an incentive to improve employee productivity 员工福利对于吸引和留住合格员工是十分必要的 少数组织能找到新方法来控 制成本 且使用福利作为一种激励策略 来提高员工的生产力 Health care cost containment is covered in questions four to seven Aggressive negotiations with carriers a closer look at administrative controls and cost benefit analyses must be routinely carried out if an organization wants to convert high costs into increased profits An annual review of benefit plan vendors should be conducted especially for health care services which consume a large portion of expenses The remarketing of a benefit program however should take place no more frequently than every three to five years unless there are serious concerns about rates service or accessibility More frequent remarketing of a benefit plan damages the credibility of the employer in terms of seeming disinterested in a long term relationship In an insured arrangement the vendor will be left holding the bag on runout claims 问题 4 到 7 阐述了健康保健成本控制 如果一个组织想将高成本转化到提高利 润上 那就必须经常性地和运营商进行积极谈判 必须紧密关注行政控制和成 本效益分析 应该去执行一个有利于供应商的年度审查计划 特别是对于占据 了大部分经费的健康保健服务 一个福利计划的再交易不能发生地太过频繁 不能超过每隔三到五年 除非和汇率 服务或获得物有密切的关系 一个福利 计划 在表面上看起来公平的一个长期合作关系中 过于频繁的再交易会毁坏 雇主的信誉 在一个保险安排中 卖家就能避免再三索赔 Pay particular attention to cost management programs under question seven Spending more time on these details will result in better claims management Question 7C should answer the following questions 要特别注意到问题 7 下的成本管理计划 花费更多时间来关注这些细节会让 你有更好的投诉管理能力 问题 7 需要回答下列问题 1 How were charges distributed between employees the employer and other payers 在员工 顾主和其他付款方之间 经费是如何分配的 2 What types of services were used hospital inpatient outpatient emergency room physician s services inpatient outpatient lab x ray durable medical equipment supplies surgical center etc Any category labeled other on a report should account for no more than 5 of the total or require a detailed explanation 是使用的哪种服务 医院 住房部 外诊部 急诊室 身体上的服务 住 房部 外诊部 实验室 透视室 耐用的医疗设备 供应商 外科手术中 心等 任何一项若在报告上贴着 其他 的标签 应不要占据超过 5 的比 率 或者另外做详细解释 3 What types of illnesses did employees experience There should be at least 15 major diagnosis categories used on the report 员工能有哪些疾病史 在报告上至少要有 15 种大的诊断种类 4 What are employees demographics 什么是员工的人口统计学 You are entitled to this information By monitoring how the healthcare plan is used it is possible to decrease claim costs Some negotiation with the carrier administrator may be necessary to obtain reports in a meaningful format 你有权利掌握这些信息 通过监督来查看健康保健计划是如何被使用的 这样 就能减少诉讼成本 一些和运营商 管理者的谈判可能对于以一个特别的方式来 接受报告是很有必要的 Because health care accounts for the largest portion of most benefit packages you should strive to raise your performance standards as an employer by applying your business strategies to health care management According to David W Kempken Executive Director of Benefits for Chrysler Corporation you should re examine your standards for plan design administration communication and provider relationships with the goal of best practices Nonhealth related employee benefits such as vacation time sick leave pension formulas retirement incentives holidays and unemployment compensation tend to remain untouched There is literature which addresses these issues They could save your organization quite a bit of money 由于健康保健占据了福利中的很大一部分 作为雇主 你应该通过把你的商务 策略应用到健康保健管理中 为提高你的业绩标准而奋斗 根据 Chrysler 公司 在
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