Advice to Pay
The Fundamentals
Who is it for?
Employers who have an internal sick leave policy looking for a confidential way to support employees through early intervention prior to the Long Term Disability start date. A safe and timely return to work is in the best interest of the employee and the organization.
How is the program structured?
Plan design can mirror a traditional Short Term Disability (STD) program, and sick leave is paid based on the employer’s internal sick leave policy.
How does it work?
Claims are submitted and assessed through Wawanesa’s Advice to Pay, which uses the same early intervention and management approach as traditional Short-Term disability claims. Claims are submitted using customized claims forms and submission protocols. Once our Case Manager has reviewed the file, a support or decline decision based on the program parameters is communicated back to the employer and employee. Depending on the assessment decision, the employer can decide to begin paying the employee or lean on the case management decision to support a “no pay” decision.
What are the benefits of Advice to Pay?
Because the employer is simply relying on a flat rate assessment service combined with a sick leave salary continuance program, there are no insurance costs or additional administrative service fees. The program structure is generally considered the most cost-effective way to provide support to employees through early intervention. Provided the benefit the employer is providing through their salary continuance program meets EI guidelines, the employer may still qualify for the EI premium reduction program, further enhancing value and cost savings. Additionally, by using Advice to Pay to produce a support/decline decision, the employer separates decisions made from their own internal staff, which helps to reduce or eliminate the legal risk associated with making the decisions internally.
Utilizing Wawanesa’s Advice to Pay to render decisions on absence due to medical reasons, combined with an EI compliant self-insured salary continuance program can provide employers with a robust and sustainable early intervention program to employees at a low-cost.
Other Highlights:
- Case Managers will manage and advise on cases identified as extending beyond the sick leave period to ensure a seamless transition to LTD.
- This model offers proactive handling at the forefront resulting in program cost efficiencies.
- Addresses non-medical factors that may be impacting a return to work.
- Return to work/rehabilitation assessment included. If additional supports are desired to promote early return to work/ recovery, this would be referred to the employer to approve extra costs.
- Independent Medical Consultant review included where necessary.
- Recognition of the employee’s diminished capability and not compromising the employee’s recovery or safety.
- Ensure the general workplace safety is not compromised.
To learn more, please contact your Regional Group Manager or National Manager.