Employees who are a part of the A Plus Benefits health plan often have questions about finding doctors that are in network. It is important to go to in network doctors in order to receive the best coverage from your medical or dental plan.

There are two different networks for the medical plan. You can find the name of your health network on the medical plan cards sent to you in the mail or by asking the benefits department at A Plus Benefits.

First Health (used in Idaho)
To find doctors on the First Health network go to www.firsthealth.com.
Click on Consumer of the left side of the screen.
Then click on Electronic Directory on the left side of the screen.
On the next screen under Provider Types, click on Physicians/Clinics.
Choose a specialty (such as family practice, dermatology, etc.) or select Any Specialty from the drop down list on the left side of the screen.
On right side of the screen enter your zip code and the amount of miles away from that zip code you would like to search.
Click on the Search button.
Information on doctors in the area should show up on the next screen. For more information about each doctor, click on their name.

Beech Street (used in Utah)
To find doctors on the Beech Street network go to www.beechstreet.com.
Click on Patients in the blue bar in the center of the screen.
On the right side of the screen in a small green box click Search for a doctor or hospital near you.
Enter in your city and state or zip code.
Scroll down and choose a specialty from the drop down list (such as family practice, dermatology, etc.) or select All.
Click on the Search button.
Information on doctors in the area should show up on the next screen. For more information about each doctor, click on their name.

The dental network is the same for all employees.

Dental Select
To find dentists on the Dental Select network go to www.dentalselect.com.
Click on Members in the right side of the screen.
On the right side of the screen in the Providers box click on the orange Go button.
Choose your state and your plan (Silver, Gold or Platinum) from the drop down lists.
Choose your city from the drop down list or enter your zip code.
Choose a specialty or select all from the specialty drop down list.
Enter other information if you wish and then click on the Search button.
Information on dentists in the area should show up on the next screen.

These electronic directories are updated as often as possible, but some changes may not be in the system immediately. Please remember to ask your doctor if they accept your network before making an appointment.

If you have questions about doctor networks please contact the benefits department at A Plus Benefits.

Samantha Bushard is an HR Employee for the Idaho office of A Plus Benefits, Inc.

I have promised to keep A Plus Benefits clients informed of developments concerning Department of Homeland Security rule changes involving Social Security Mis-Match letters. Below is a short article issued by BNA in their November 20th Bulletin to Management.

After the article concerning mis-match letters you’ll find an interesting article involving FMLA that appeared also appeared in the November 20th Bulletin to Management.

SSA Announces That It Will Not Issue Employer No-Match Letters This Year

The Social Security Administration will not be sending out no-match letters to employers this year because of the lawsuit challenging the Homeland Security Department’s worksite enforcement regulations, an SSA spokesman told BNA Nov. 13.

The decision not to send out the letters based on 2006 tax year data means SSA is not likely to send out any letters until at least spring of 2008, SSA spokesman Mark Hinkle said.

A federal judge in California granted a preliminary injunction Oct. 10 barring SSA from sending out the no-match letters because for the first time the letters were to include language threatening possible immigration law criminal and civil liability for employers that failed to respond.

“Because of the lawsuit, we needed to revise letters and it became apparent it was getting too late in the year to send them out,” Hinkle explained Nov. 13, adding that employers and SSA were already gearing up to focus on wage reporting for 2007.

The lawsuit was triggered by the Bush administration’s Aug. 10 announcement that SSA would be altering how it sends out no-match letters. According to the new rule, SSA would include language in the letter explaining that there was possible liability under immigration laws. In addition, SSA planned to include a general letter from DHS explaining the liability as well as describing a “safe harbor provision” meant to protect employers that attempted to comply with the letter.

Although DHS was not going to have access to the names of employers sent the no-match letters, the new rule would treat the receipt of the letter as evidence that the employer had “constructive knowledge” that an immigration violation was taking place.

The final rule was challenged in the U.S. District Court for the Northern District of California by a coalition of immigrant rights, organized labor, and civil liberties groups led by the AFL-CIO, the American Civil Liberties Union, and the National Immigration Law Center. The U.S. Chamber of Commerce and other business groups later joined the litigation.

One of the trickier aspects of the Family and Medical Leave Act is that employers may have to offer employees leave even if it is not specifically requested. If it is clear that an employee has a serious medical condition, that in itself may constitute notice to the employer.

Employee’s Behavior Goes to Dogs After Encounter With Stray

“You can’t fire me,” screamed employee Constance Caniscus. “I was seriously ill and sent you medical statements to prove it.”

“I’m sorry, but your behavior was so outlandish we didn’t want you in our employment,” replied HR Director Florence Bagley.

Did behavior constitute notice?

Facts: The employee was a receptionist and a clerical assistant in the company’s purchasing department for eight years and had a clean disciplinary record prior to an incident on Feb. 9, 2004, when a stray dog climbed through a window of the warehouse where she worked and approached her desk.

The employee said she immediately felt a headache, a rush of blood to her head, and a tightening of her neck and back. Her supervisor observed that the employee was agitated and was spraying a deodorizer, yelling, and cursing. Two hours later, the employee told the accounting manager that she was ill and needed to go home.

The following morning, the employee called in sick and went to the hospital for an unrelated medical test. On Feb. 11, the employee went to the office of the company’s president and screamed and cursed for eight to 10 minutes about the dog incident. The employee then left work.

Later that day, the employee filed a complaint with the Occupational Safety and Health Administration regarding the stray dog. She then went to a hospital emergency room, complaining of a headache, insomnia, anxiety, and loss of appetite for three days following what she described as an “emotionally stressful incident at work.” She was diagnosed with “anxiety and stress” and prescribed a medium dose of Ativan. The employee called in sick on Feb. 12 and met with a union representative to discuss the dog incident. She then called in sick on Friday, Feb. 13, and Monday, Feb. 16.

When she went to work on Feb. 17, she discovered that her supervisor had moved the contents of her desk to another room. The employee became agitated and called the police, saying she was being harassed. She placed a report about her emergency room visit on the accounting manager’s desk and left work at about 10 a.m., telling her supervisor that she was not feeling well.

That day, the company president authorized changing the office locks and sent the employee a letter stating that she had used up her paid leave and would be fired for unexcused absences if she did not submit a medical certification by Feb. 24.
The employee called in sick on Feb. 18 and visited her regular doctor, who prescribed a sleep aid and scheduled a follow-up visit for Feb. 20. The employee did not work the next two days. On Feb. 20 she gave her union representatives documentation about her emergency room visit. She again visited her doctor, who wrote a note excusing her absences from Feb. 9 through Feb. 20.

The employee came to work on Feb. 24 and discovered that the locks had been changed. The president refused to accept the doctor’s note as FMLA certification and gave the employee a box containing her personal belongings. In a March 9 letter, the company told the employee she was terminated effective Feb. 25.

She sued under the FMLA, but the U.S. District Court for the Northern District of Illinois dismissed the case. She appealed.

Award: The former receptionist may proceed with her claim under the Family and Medical Leave Act, the U.S. Court of Appeals for the Seventh Circuit ruled Oct. 16 in a 2-1 decision ( Stevenson v. Hyre Elec. Co., 7th Cir., No. 06-3501, 10/16/07).

Discussion: The appeals court found that the employee raised genuine issues of material fact as to whether her unusual behavior on several days—including yelling and swearing at her superiors and calling the police—gave the employer constructive notice of her need for FMLA leave for a serious health condition.

“[A] trier of fact could find that her behavior was so bizarre that it amounted to constructive notice of the need for leave,” the court said.

Pointers: When requesting FMLA leave an employee is not required to say, “I’m taking FMLA leave,” or even to mention the FMLA by name. The employee only has to give the employer sufficient information to put it on notice that the leave is qualified under the FMLA. Thus, given these flexible notice requirements, if all other FMLA conditions are met, it is likely that even with improper notice, the leave is nevertheless counted under the federal statute.

In such cases, the employer still has the right to require verification of the reason for the leave, but the employer cannot contact anyone but the employee for that verification, such as the doctor or family members, unless the employee grants permission.

Further Discussion: It is important for all A Plus Benefits clients to remember that the Department of Labor has interpreted the FMLA in such a way as to make all employees associated with a Professional Employer Organization eligible for FMLA whether or not the individual client organization would be required to comply on it’s own merits. Your assigned HR Advisor can address any concerns with FMLA.

Randall Barker is the VP of Human Resources for A Plus Benefits, Inc.

Read Randall’s previous HR update.

I’ve recently read several articles written about health coverage. Some have criticized the health carriers, many have extolled the virtue of the Canadian system, and others have provided helpful information for consumers of health plans. However, most articles miss or purposely omit the role of the consumer. Yes, that’s you.

I think it’s time for all of us, the users of health plans, to take a much more participative approach. If we would more responsibly use our coverage everyone would spend less. So how can you help? To start, read your plan booklet before going to the doctor, know which doctors are in network and what procedures are and are not considered pre-existing. If offered a group plan through your employer remember that how you utilize the plan affects the entire group. Take a few extra second to ask about generic prescription drugs and see if paying for the entire drug would be cheaper than the co-pay. There are several things you can to do influence the cost of health care. By taking some personal responsibility for the current health care challenges you can make a difference. In the process, you’ll probably notice that your wallet’s a little fatter.

Jake Lunt is the General Manager of Idaho operations for A Plus Benefits, Inc.

I continue to hear people mention how difficult it is to find employees in the current hiring environment. This seems particularly true when business owners feel they need compete with larger organizations like HP, Simplot, or Micron.

I was visiting with a friend this morning and we were talking about working with the big guys and he mentioned several things that caused me to think about the benefits associated with working for one of the little guys. Seriously, how many big company jobs allow an employee to work on two, three or more very different tasks on any given afternoon? How many big company opportunities include constant change and significant job flexibility? When I was working for Intel two years ago I spent my entire day boxed in a cubicle working on a very specific job. I had little interaction with co-workers unless it was over the phone and even less task flexibility. I was there to do a very finite job day in and day out.

It was this experience that convinced me that regardless of the health plans, stock options, and a good salary I wanted something different. Among other things, I wanted change, I wanted more responsibility and I wanted to feel like my contribution meant something. Fortunately I found that opportunity and by working for small businesses, so have many others. Small business owners can attract key talent by highlighting their flexibility when working with employees versus their much larger counterparts. Focus on the benefits of working in a smaller, more adaptable company and you’ll be in good shape.

Jake Lunt is the General Manager of Idaho operations for A Plus Benefits, Inc.

Suit Seeks to Stop ‘No-Match’ Rule
A group of labor, civil liberties, and immigrant rights organizations filed a federal lawsuit Aug. 29 to stop implementation of the Homeland Security Department’s “no-match” regulation, saying the rule oversteps the boundaries created by Congress for worksite immigration enforcement. The lawsuit—filed by the AFL-CIO, the National Immigration Law Center, and the American Civil Liberties Union—says that DHS and the Social Security Administration lack the authority to use tax data to enforce immigration laws; therefore, holding employers liable for immigration law violations because they received a “no-match letter” is beyond the power of the agencies (AFL-CIO v. Chertoff, N.D. Cal., docket number unavailable, 8/29/07).

The Judge in this case has placed a hold on the plan to send out the new letters until at least October 1, 2007. The judge has called this a cooling off period needed to examine the issue entirely. At this time the plan to send out the new letters has not been cancelled, the plan is at this time delayed.

At the time Sec. Chertoff announced the new rules he was asked about the new rules being legal. In responding to the question Sec. Chertoff said that DHS has thoroughly examined the legality to the changes and was sure that the new rules would stand up to scrutiny.

We continue to believe that the best practice for every employer is to make an effort to verify that the information provided by new employees is verified as accurate and confirming of the new employee’s eligibility to legally work in the U.S.

We will continue to provide updates on this subject.

Following is a case that was presented in the August 22, 2006 BNA Bulletin to Management:

Circuit Court Says PIP (Performance Improvement Plan) Alone Is Not Adverse Act
A sales manager failed to establish her discrimination claims because the potentially discriminatory employment actions she identified were untimely, and her discharge was unconnected to those actions, the U.S. Court of Appeals for the Tenth Circuit held Aug. 8 (Haynes v. Level 3 Commc’ns LLC, 10th Cir., No. 04-1307, 8/8/06).

The court affirmed a lower court’s ruling in favor of Level 3 Communications on claims brought by Linda Haynes, but said, “We disagree with the district court’s interpretation of our precedent and expressly join our sister circuits in holding a PIP, standing alone, is not an adverse employment action.” The court added, “A written warning may be an adverse employment action only if it effects a significant change in the plaintiff’s employment status,” and Haynes presented no evidence that her performance improvement plan had such effects.

Claimed Supervisor Favored Males
Haynes was a “carrier sales manager” in Level 3’s San Francisco office. Paul Larson was her supervisor. Haynes alleged that, shortly after he became the carrier products unit supervisor, Larson began to recruit 31-year-old Shane Quivey from the Internet products unit. After Quivey arrived, Larson treated him with a marked preference compared to his female subordinates, Haynes claimed.

According to Haynes, Larson also gradually took customer accounts away from employee Mary Vargo and gave them to Quivey. When Vargo was unable to meet her sales quota and complained, Larson gave her a poor performance evaluation and placed her on a performance improvement plan. Vargo resigned. Haynes alleged that Larson then began giving her accounts to Quivey.

Haynes’s health began to decline, and Larson demanded she come to work against her doctor’s advice. She alleged he began to criticize her to customers and management. Haynes said she was unable to meet her sales quota, was informally counseled regarding her performance, and also was placed on a performance improvement plan.

She was on medical disability leave June 18, 2001, when she was let go in a reduction in force. Larson and his supervisor also were terminated in the RIF. Scott Roberts, senior vice president of sales and marketing, made the RIF decisions. One of the criteria he used was whether an employee was on a performance improvement plan.

Haynes filed a charge with the Equal Employment Opportunity Commission on Oct. 11, 2001, and later sued in federal court, asserting discrimination and retaliation claims under Title VII of the 1964 Civil Rights Act, the Americans with Disabilities Act, and the Age Discrimination in Employment Act. The trial court dismissed her claims, and she appealed.

Proof on Timely Acts Lacking
The Tenth Circuit noted that Haynes’s discharge while she was out on disability leave was the only adverse action that occurred within 300 days of when she filed a charge with EEOC and it was based on the neutral fact that she was on a performance improvement plan and all employees on a such plans were included in the RIF. Moreover, she could not use other time-barred acts of alleged bias, such as her allegations that customer accounts were removed from her portfolio and assigned to a male co-worker, to prove that her discharge was discriminatory, it held.

The court said Haynes “does not claim that a PIP was outside standard operating procedure to address a failure to meet her sales quota. Neither has she alleged that Level 3 did not evenhandedly include all employees currently on a PIP in the RIF. Finally, Haynes presented no evidence that any other employees on a PIP were spared in the RIF. As a result, she fails to demonstrate any timely inference of discrimination in her inclusion in the RIF.”

As the case above points out Level 3 was able to avoid being guilty of discrimination because of their advance plan to treat all employees currently on PIPs (at the time of the RIF) on a equal basis.

We cannot emphasize enough the importance of equal treatment. Even though the above case does not deal with everyday policy issues employers must decide who to cope with employees who violate policy and treat all violators equally. Employees must understand that an employer’s policy guide is a document that must be seriously considered. When policies are violated an employer must have the will to deal with violators in a firm, fair, and even manner. This type of behavior on the part of employers provides incredible protection when an employee claims to have been treated in an unfair and uneven manner when a policy has been violated.

It is true, sitting down with an employee to discuss policy violations or other concerns can be unsettling. However, ultimately it is completely fair when each and every employee understands the expectations of their employer and is informed when he or she has fallen short. Generally, employees who are apprised of their short comings will make efforts to overcome the noted deficiencies and go on to be valuable contributor to the business.

We appreciate the time our valued clients take to read our weekly updates. We appreciate your business and acknowledge your part in our success.

Randall Barker is the VP of Human Resources for A Plus Benefits, Inc.