美国人力资源管理—福利管理-教学课件8.ppt

Chapter8 Government MandatedSocialSecurityandWorkers CompensationPrograms McGraw Hill Irwin Copyright 2011TheMcGraw HillCompanies Inc Allrightsreserved NoelleBaker ContributingEditor LEARNINGOBJECTIVES BasicSocialSecurityprogramsaffectingemployment OASDI Medicare andunemploymentinsuranceAdministrationandfundingofSocialSecurityprogramsStructureofSocialSecurityprogrambenefitsReasoningbehindworkers compensationinsuranceTypesofworkers compensationclaims NoelleBaker ContributingEditor SOCIALSECURITYPROGRAMS Old Age Survivor andDisabilityInsurance OASDI MedicareUnemploymentInsuranceSupplementalSecurityIncomeBenefits TwofederalagenciesoverseeSocialSecurityprograms TheSocialSecurityAdministrationandtheCentersforMedicareandMedicaidServices Programsweredesignedtofurtherthe commongood ensuringprogressivewagesandbenefitsthatallowemployeestoparticipatefullyinaconsumer basedeconomy NoelleBaker ContributingEditor SocialSecurityProgramEligibilitySeeExhibit8 1 OASDI Medicare ExemptfromOASDIONLY Civilianemployeesofthefederalgovernmenthowevermustparticipateif18oroverandworkforparent sbusiness InterestingFacts SocialSecurityisthemajorsourceofincomeformostelderlySocialSecurityprovidesmorethanjust retirement In2008morethan50millionAmericansreceivedmorethan 53billioninSocialSecuritybenefits TheagingworkforceisplacingastrainontheSocialSecuritybecausetherewillbemoreretiredindividualsreceivingbenefitsthanemployedindividualscontributingtotheprogram In2032 therewillbejust2 1workersperbeneficiarycomparedto3 3workersperbeneficiaryin2007 NoelleBaker ContributingEditor UNEMPLOYMENTINSURANCE Thecurrenteconomicrecessionhaspushedtheunemploymentrateatthetimeofthiswritingtoalmost10 thehighestratein28years Asaninitialreaction CongresspassedtheEmergencyUnemploymentInsuranceProgram EUC inJune2008tosupplementunemploymentbenefits Additionally in2009significanttemporaryenhancementsweremadeundertheAmericanRecoveryandReinvestmentActof2009 ARRA whichprovided13additionalweeksofbenefitsaswellasa 25weeklyincreaseinbenefitamount TheActissettoexpireonDecember31 2009 howeverCongressmay onceagain voteforabenefitextension NoelleBaker ContributingEditor UnemploymentInsuranceAdministration FederalLevel TheEmploymentandAdministrationintheU S Dept ofLaboroverseesunemploymentinsuranceprograms Bothfederalandstatepayrolltaxesarecollectedtofundbenefitcosts howeverthefederalportionisusedtoactuallyadministerthebenefit StateLevel Thestate sshareofbenefitcostsmaybeusedforactualemployeebenefitsonly Stateemploymentsecurityagencies officesoverseetheadministrationoftheprogram Statesalsomaintainrecords collecttaxes processclaims anddistributebenefits NoelleBaker ContributingEditor QualifyingForOASDIBenefits TheSocialSecuritySystemusesasystemofcreditstodeterminewhethereligibleindividualsqualifyforOASDIandMedicarebenefits Employeesaccumulate credits basedontheirpaymentofSocialSecuritytaxes Employeesearnonesocialsecurity credit foreach 1090ofearnings subjecttoamaximumoffourcreditspercalendaryear Employeestypicallymusthave40 creditstobeeligibleforretirementbenefits Thenumberofcreditsrequiredtoqualifyforbenefitsdependsonaperson sageandtheparticularSocialSecuritybenefit NoelleBaker ContributingEditor DETERMININGOASDIBENEFITS AverageIndexedMonthlyEarnings AIME SetsPrimaryInsuranceAmount PIA CostofLivingAdjustments COLAs GuardsAgainstInflationBasedonConsumerPriceIndex CPI fromDepartmentofLabor AverageIndexedMonthlyEarnings AIME representaperson searningspriortoage62 disability ordeathadjustedforfluctuationsinincomeandaveragechangesintheeconomyoverthesameperiod AIMEisusedtoensurethatparticipantsbenefitsareproportionallythesame AdjustmentstobasicratesaremadebasedontheConsumerPriceIndexwhichtracksthechangesinthecostsofgoodsandservicesintheU S EffectiveJanuary2009 theannualincreaseinSocialSecuritybenefitswas5 8percent NoelleBaker ContributingEditor OldAgeBenefits Earlyretirementat62 howeverbenefitsarereducedtoaccountforalongerbenefitperiod RetirementAgeisgraduallyincreasingfrom65yearsandwillreach67yearsin2022 Theretirementprogramincludesincentivesforindividualstodelaytheirretirementuntilreachingfullretirementage Individualsmayreceiveretirementcreditsuntilage70subjecttoamaximumpercentageincrease NoelleBaker ContributingEditor OASDIBENEFITSFORFAMILYMEMBERS Wifeorhusbandage62andolderWifeorhusbandunder62 ifsheorheistakingcareofchildrenunder16orisdisabledFormerhusbandorwifeage62andolderChildrenuptoage18 ages18 19iffulltimestudentsthrough12thgradeordisabledchildrenofanyageTheOASDIprogramincludesanoffsetprogramtoreducethedollaramountforadualincomefamilysothattheworkingspousedoesnotreceivetwoSocialSecurityretirementpayments NoelleBaker ContributingEditor DISABILITYBENEFITSELIGIBILITY MentalorPhysicalImpairmentLasting12MonthsMustHave40Credits 20CreditsinLast40Quarters6MonthWaitingPeriodBlindedWorkersNeedonly40CreditsWorkersAge23 6Creditsin3YearsWorkers24 31 WorkHalfofPeriod NoelleBaker ContributingEditor MEDICARE PartA HospitalizationInsurancePartB SupplementalHealthInsuranceMedigap SupplementsPartsA BMedicareAdvantage PartCMedicarePrescriptionDrugBenefit PartD NoelleBaker ContributingEditor MEDICAREPARTACOVERAGE Inpatienthospitalcareinasemiprivateroom meals generalnursing andotherhospitalsuppliesandservicesHomehealthservicesHospicecareSkillednursingfacilitycare NoelleBaker ContributingEditor MEDICAREPARTBCOVERAGE VoluntaryMedicalInsurance 80 ofServices Supplies 100DeductibleDiagnosis Therapy SurgeryConsultationMedicalServices SuppliesMedication notSelf AdministeredOutpatientHospitalServices Structure Voluntarysupplementalinsuranceisstructuredsimilarlytoindemnitymedicalinsurance Afterthedeductibleismet expensesarepaidat80 NoelleBaker ContributingEditor MEDIGAPCOVERAGE SupplementsPartsA BOfferedbyPrivateInsurers10ChoicesinLevelofProtectionMedicareSelectOffersProtectionwithLowerPremiums LessChoiceAvailablein47States NoelleBaker ContributingEditor MEDICAREADVANTAGE PARTC Establishedin1997ProtectionfromPrivatePlansFee for ServicesManagedCareMedicalSavingsAccountsNovemberEnrollmentPeriodExtendedBenefitsin2006 NoelleBaker ContributingEditor MEDICAREPRESCRIPTIONDRUGBENEFIT Covers75 ofprescriptiondrugcostsafteracalendaryeardeductibleof 295upto 2700 Afterthat expendituresupto 4350arenotcoveredbyMedicare Thisiscalledthe donuthole Medicarecovers95 ofprescriptionsforeachdollarspentinexcessof 4350spentduringthecalendaryear NoelleBaker ContributingEditor MEDICAREASPRIMARYPAYER IndividualwithMedicarecoveragemayalsohaveanotherindividualoremployer sponsoredhealthinsuranceplan Medicareistheprimaryifthesecondaryis aretireehealthinsuranceprogram anemployer sponsoredhealthinsuranceplanwithlessthan20employees orCOBRA Othermorespecificrulesapplytoemployerorunion basedhealthinsurancebenefits No faultinsurance liabilityinsurance andblacklungbenefitsarealwaysprimary NoelleBaker ContributingEditor FINANCINGOASDI MEDICAREPROGRAMS FICARequiresEqualEmployerwithoutchangesinthetaxstructurethefundwouldbedepletedin2040 NoelleBaker ContributingEditor UNEMPLOYMENTDISQUALIFYINGEVENTS RefusalofSuitableWorkMisconductParticipationinaLaborDisputeRegularBreaksDuringSchoolDeliberateMisrepresentationtoReceiveBenefits NoelleBaker ContributingEditor UnemploymentInsurance EligibilityCriteriaMustbeinvoluntaryseparationMinimumwageearningsmetAwaitingperiodinmoststatesAcapacitytoworkWorkerisactivelyseekingworkUnemploymentInsuranceprovidesaweeklybenefittothosewhoareunemployedthroughnofaultoftheirown NoelleBaker ContributingEditor UNEMPLOYMENTBENEFITAMOUNTS VariesbyState NoFederalRulesMaximumof26Weeks 13weekextensionmaybegranted Duetorecenteconomicrecession 21additionalweeksmaybeaddedtothepermanentprogram FundedbyFUTAtax currentlyemployerspay6 2 offirst 7 000earnedbyeachemployee theminimumtaxablewagesetbyFUTA Howeverstateshaveestablishedtheirowntaxablewagebasethatrangesfrom 7 000to 35 700 Anemployer sactualtaxburdenvariesaccordingtotheirexperiencerating NoelleBaker ContributingEditor WORKERS COMPENSATIONOBJECTIVES Toprovidesure prompt andreasonableincomeandmedicalbenefitstowork accidentvictims orincomebenefitstotheirdependents regardlessoffault Toprovideasingleremedyandreducecourtdelays costs andworkloadsarisingoutofpersonalinjurylitigation Torelievepublicandprivatecharitiesoffinancialdrains Toeliminatepaymentoffeestolawyersandwitnessesaswellastime consumingtrialsandappeals Toencouragemaximumemployerinterestinsafetyandrehabilitationthroughappropriateexperience ratingmechanisms Topromotefrankstudyofcausesofaccidents ratherthanconcealmentoffault reducingpreventableaccidentsandhumansuffering NoelleBaker ContributingEditor ThereisaDifference Workers compensationdiffersfromSocialSecuritydisabilityinsuranceandMedicare Itpaysformedicalcareforwork relatedinjuriesbeginningthedate timeofincident Itpaystemporarydisabilitybenefitsandmaypaypermanentpartialorpermanenttotaldisabilitypayments Itmaypayforrehabilitationandtraining SocialSecuritypaysdisabilitybenefitsbutonlywhenthedisabilityprecludeswork Itmayalsopayforrehabilitation SocialSecurityalsopayssurvivorbenefitsandtypicallybegins5monthsfromdateofincident NoelleBaker ContributingEditor WORKERS COMPENSATIONCOSTS InDecember2008 employersgenerallypaid 0 46percivilianemployeeforeachhourworkedtoprovideworkers compensationprotectionThehourlyamountwassubstantiallyhigherforworkersingoods producingindustriesat 0 84 andsubstantiallylowerforemployeesinservice providingindustriesat 0 36Althoughtheseamountsrepresentnomorethan3percentofthetotalcompensationcosts thatis thetotalcostofwages salary andallemployer sponsoredbenefits theannualcostsforemployeesingoods producingindustriesisquitehighThereiswidevariationinthecostofworkers compensationfromstatetostate NoelleBaker ContributingEditor Claims Benefits andIncome Claims InjuryatworkOccupationaldiseaseDeathclaimBenefitUnlimitedMedicalcareDisabilityincomeDeathbenefitRehabilitationservices TypesofDisabilities Income TemporarytotaldisabilitiesTemporarypartialdisabilitiesPermanentdisabilitiesPermanentpartialdisabilities scheduledinjuries nonscheduledinjuriesStatesdeterminebenefitamounts durationbaseduponeithertheimpairmentorwage lossapproach NoelleBaker ContributingEditor TortsDualCapacityisalegaldoctrinethatappliestotherelationshipbetweentheemployerandtheemployee Anemployer sactiondoesnotprotectitfromcommonlawactivitygeneratedbytheemployee Employershavefourtypicalresponsestoemployeetortes Pre existingconditionEmployeenegligenceEmployeeconductSafetyviolationsbytheemployee AnEmployer sIntentionalActsMostcourtsholdintentionalactstoharmemployeesasthenecessarybasisforemployee initiatedtortes Anemployeemayinitiateoneoftwotypesoflawsuits de