Employee assistance programmes (EAPs) are a great way for employers to support staff, particularly during an economic downturn. They provide independent and anonymous telephone, online and face-to-face counselling for employees with psychological issues or debt and financial problems, as well as those requiring child, eldercare and legal information and guidance.
Debt and financial difficulties are the most frequent subject raised in the current economic climate, according to the Employee Assistance Professionals Association (EAPA). Callers are typically referred to independent support networks or to the existing benefits and services their employer provides.
Product development has resulted in EAPs offering wider measures to support employers’ health and wellbeing strategies. For example, some providers offer training programmes, trauma management and mediation.
The good news for cashstrapped employers is that the price of EAPs continues to fall. A telephone-only service can cost as little as £2 per employee per year, while a more extensive service, including face-to-face counselling, costs between £7 and £9 per year per employee for organisations with 1,000 staff. This compares with £20 to £25 per employee per year three or four years ago. The decline in cost has allowed smaller employers to access similar deals as larger organisations.
Competition between EAP providers has helped to drive down programme prices, with several organisations having been swallowed up by larger firms, such as Capita’s acquisition of FirstAssist in September 2010. Price wars have also been prevalent, with a number of providers offering free EAPs as an add-on to products such as group income protection (GIP), although such EAPs typically offer basic services rather than a comprehensive programme.
Integration trend
A growing trend is to integrate EAPs with other areas of healthcare. For example, some providers are looking at ways of making benefits such as private medical insurance (PMI) and occupational health more integrated with EAPs to help minimise claims and therefore employers’ costs.
In terms of product development, EAP providers have become increasingly focused on prevention. For example, it is now common for employers to run an EAP alongside a smoking cessation programme, or a diet or fitness plan because it can help to promote behavioural change.
Broadening EAP services encourages more employees to use them, which, in turn, helps to reduces the stigma around asking for support.
Providers are also developing EAPs to engage staff better, with many believing that technology is the best medium through which to do this. EAP websites are common and can give staff access to information to help prevent their problems escalating. Some providers also use web chats, social media and text messaging to reach staff, while others are developing secure websites through which staff can exchange live messages with a counsellor.
An advantage of this approach is that employees and counsellors have access to a stream of information that can be reviewed and reflected upon.
Meanwhile, multinational employers are seeking global solutions to enable them to streamline their EAP offering. The Employee Benefits/Cigna UK HB healthcare research 2012 showed that 43% of respondents offer an EAP to some, or all, expatriates.
But whatever an employer’s approach, communication of their EAP is key to ensure their staff get maximum value. Promotional activity could include information uploaded to their intranet site, or on wallet cards, posters and in employee newsletters, as well as reminding staff about the service if they are off sick.
Communication between employers and EAP providers is equally important, particularly in light of the extent to which providers’ services differ.
Telephone services
For example, some providers’ telephone services will simply refer employees to other counselling services, while others’ telephone service will conduct a full assessment of an individual over six counselling sessions.
There are a number of questions employers should ask EAP providers during a due-diligence exercise to ensure their product is the right fit for their organisation, according to the EAPA.
These include: What is the structure of your organisation? What is your registered name? How many staff do you employ? What is your annual turnover? How many counsellors do you employ on a full-time or part-time basis? Are any of your senior management qualified psychologists or counsellors? How many complaints a year do you receive about your service?
Employers should also assess providers’ access points, be these phone, internet or face-to-face, and workplace assistance, particularly for expatriate staff working across the globe.
Other factors to be established include: what support do providers offer to employers’ management to help improve their employees’ performance, and how is the outcome in face-to-face interventions measured?
Management information about employees and organisational interventions are typical features of comprehensive EAPs, as is usage reporting.
Finally, employers should ask each prospective provider for examples of printed communication to get a sense of its service offering and its suitability for their workforce.
THE FACTS
What is an employee assistance programme?
It is a service designed to provide confidential information, support and counselling to staff with personal and work-related concerns. Support is available 24 hours a day, seven days a week by telephone, but increasingly EAP providers are offering their services online, and some face-to-face. Comprehensive EAPs provide up to six or eight face-to-face sessions. Calls are confidential, but many EAPs give employers management information to help them tailor wellbeing campaigns, and enable them to identify and tackle potential workplace issues.
What are the origins of EAPs?
EAPs first appeared in the US in the 1950s to help staff deal with alcoholism. They were introduced in the UK in the early 1980s.
Where can employers get more information and advice?
The Employee Assistance Professionals Association (EAPA).
What are the costs involved?
Price depends on the type of service and the number of staff covered. A telephone-only service might cost between £2 and £3 per employee per year, while a full service for an employer with 1,000 staff would cost £7 to £9 per employee per year. Larger employers may be able to negotiate a volume based discount, which could see an employer with 50,000 staff paying £5 to £8 per employee per year for a full service.
IN PRACTICE
What are the legal implications?
EAPs can be important to an employer’s strategy to safeguard employees’ mental health and wellbeing. A Court of Appeal ruling in 2002 (Sutherland v Hatton) found an EAP could protect an employer from being sued for stress by an employee. But the position was clarified in 2007 when judges said an employer had to take more steps to protect employees than simply implementing an EAP.
What are the tax issues?
EAPs are a business expense rather than a benefit in kind, if they comply with HM Revenue and Customs’ exemption for welfare counselling. This means EAPs cannot include advice on: finance, other than debt; tax; leisure and recreation; and legal issues. Couples and family counselling is allowed, but EAPs cannot be made directly available to dependants.
What is the annual spend?
No EAP market share data is available because providers are reluctant to disclose sales details, but the EAPA estimates the annual spend on EAPs in 2012 was close to £70 million.
Which providers have the biggest market share?
With no recent sales data, it is difficult to say. But, based on the size of their operations and some of their contracts, the largest include Axa Icas International, Bupa, PPC Worldwide and Workplace Options. Others include Ceridian, CIC, ComPsych, FirstAssist, PMI Health Group, Right Corecare and Validium.
Which have increased their market share the most?
It is impossible to say because of a lack of data.
STATISTICS
94% of respondents offer counselling/an EAP as part of a strategy to combat workplace stress.
Source: Employee Benefits/Cigna UK HB Healthcare research 2012, published in June 2012
69% of respondents cite EAPs or other stress counselling as the most popular way of tackling sickness absence.
Source: Employee Benefits/Cigna UK HB Healthcare research 2012, published in June 2012
21% (one in five) employers believe that stress/mental health issues are the number one health risk to their organisation.
Source: Employee Benefits/Cigna UK HB Healthcare research 2012, published in June 2012
31% of employers say managing stress and mental ill health is a top priority for 2013
Source: Group risk employer research (500 employers), published in November 2012
78% of respondents offer an EAP as their top core health benefit.
Source: Employee Benefits/Cigna UK HB Healthcare research 2012, published in June 2012
