Unfortunately, the dying process is complicated not just on a spiritual and emotional level, but also on a practical one. It can be surrounded with red tape, petty details and convoluted problems. Too much time spent dealing with this side drains the time people have to ready themselves. Lynn Franzoi, senior vice president of benefits for Fox Inc. in Los Angeles, appreciates the time a good death can take. Through Franzoi’s understanding, stamina and persistence, Fox offers the support its terminally ill and disabled employees need so they can focus on what they need to focus on. HR professionals spend a lot of time these days helping employees live their lives better. The people at Fox realize that dying is a part of living. Through the company’s special policies, much of them low-cost, Fox truly exemplifies a holistic work/life attitude. Says Franzoi’s friend Nancy Breuer, a fellow AIDS educator for the entertainment industry, "The kinds of benefits Lynn has put in place represent an ingenious blend of helping the company’s bottom line while providing resources to employees that are excellent, making their lives easier and much more pleasant. I think, because of her attitude, which is so pro-employee, it would be easy to get the idea that this is a very compassionate woman who’s costing her company untold money. Not true—remember she works for [business magnate] Rupert Murdoch."
The dollars and cents of living and dying.
It was the AIDS crisis that prompted Franzoi’s proactive stance toward terminally ill employees in the late ’80s. An activist on AIDS issues in the Hollywood community, Franzoi had seen the disease cut a swath through the entertainment industry. She had actually met a man through Hollywood Supports, an AIDS education program, whose partner had worked for Fox and quit after developing AIDS—walking away from his salary continuation, disability benefits and medical coverage during disability. He and his partner spent their life savings caring for him until he died. "I wanted to make people aware that this company was really friendly toward people who had a serious illness, whether it was a brain tumor or heart disease or cancer or AIDS," she says. "The people who had brain tumors or had cancer were using our benefits. But people who had AIDS were walking away because of the stigma."
They were walking away from lucrative benefits. First there’s the salary continuation. If an employee has been with the company for at least a year and contracts a serious illness, Fox continues the employee’s full salary for a period of up to 26 weeks. The company offers this once in any 18-month period. If an employee has less than a year of service with the company, he or she receives full salary for 13 weeks and half salary for 13 weeks. The employee must pay only $10 a week for medical coverage.
At the end of the 26 weeks, if an employee can’t return to work, he or she is terminated from actual employment. But Fox continues medical coverage for the employee and covered dependents from the time the employee is disabled and up to five years if the worker remains disabled. The cost to the employee is $10 a week for single coverage or $20 for family coverage. The company’s life insurance plan is also generous. For that first five years an employee is disabled, he or she receives life insurance of two times base salary, up to a half-million dollars. At the end of five years, if the employee remains disabled, Fox drops the insurance to equal the person’s base salary, but continues it for life.
Today, employees also can take advantage of a living death-benefit option that allows them to receive 50 percent of their life insurance paid to them upfront, up to a maximum of $50,000 for any reason, if they have a doctor’s statement saying their life expectancy is less than a year. This way, instead of employees selling their life insurance to viaticum companies for 30 cents or 40 cents on the dollar, they can get 50 cents on the dollar upfront, with the balance going to their named beneficiaries. By splitting the life insurance from the living death-benefit between two life insurance carriers, Franzoi also has been able to offer employees 50 percent up to $100,000 on a separate living death-benefit.
At the beginning of June this year, Franzoi raised the lifetime maximum for the medical plan to $3 million. "We haven’t had anyone hit the million-dollar mark yet," she says. "But we decided we’d rather address it before it happens than have someone come up against the lifetime maximum and then react."
Any of the 7,800 employees who aren’t union (that group, making up about 20 percent of the workforce, has its own plan) can take advantage of Fox’s rich benefits plan. Franzoi says her superiors, such as Senior Vice President of Employee Relations Dean Ferris, have been receptive to benefits issues. "We look at it from both the HR side and the financial side," she says. "If a company has good benefits in place, and it has benefits designed to help people when they really need them, it enables the company to keep employees at work longer being more productive. And that’s a soft-dollar cost you just can’t measure."
So eager has Franzoi been to reach all employees who need these benefits, she has become almost a single-handed crusader to determine no employees walk away from Fox without their full and best use of Fox’s benefits package.
Taking the time to make the connection.
Surprisingly, for a media company, Fox doesn’t have much of a communications budget. With 22 different TV stations across the country currently, it has become difficult for Franzoi to continue employee meetings to explain the benefits. Still, Franzoi, an energetic, 12-hour-workday type who swings agilely from elaborating on the grieving process to rattling off hard numbers like a seasoned auctioneer, ensures no employees slip through the cracks. She makes it part of her work schedule to contact people directly, encouraging them to meet with her to go over their options. One man who’d been putting her off for weeks finally called her on the Fourth of July, announcing he was ready to go over his options. She left a picnic to meet him.
The man, like all Fox employees, had many options to consider. If an employee qualifies for Social Security disability benefits, for instance, Fox will continue pension accrual for the person as if he or she were continuing to work at the company at the same salary upon leaving. The employee then could draw disability benefits while continuing to accrue a pension until retiring anywhere between 55 and 65.
This scenario won’t work for everyone though. If a person chooses not to retire, but dies before the pension benefit starts, the beneficiary would receive only 50 percent. In that case, if the person thinks he or she won’t live to the date the pension kicks in, the employee may want to retire and elect to join a 100 percent survivor annuity. Franzoi will diagram for the family what happens to life insurance, disability insurance and pension benefits under every available scenario. "It’s kind of hard to just give people the numbers. But I think it’s better to do that than have them make decisions not knowing."
Franzoi says she sometimes bears the brunt of an employee’s anger when making her cold calls. On occasions, she has been able to bring the employee around. For instance, upon encountering one hostile man living with AIDS, a man resentful she even contacted him, Franzoi was able to turn the conversation toward her volunteer work with AIDS, which finally convinced the employee she might understand his situation. "He came in and met with me and had all the numbers laid out in front of him. He made a very different choice than what he initially thought he was going to make," she remembers.
Jane Henderson, a San Francisco-based organizational development and learning consultant who helps companies deal with death in the workplace, says that guiding employees through the intricate benefits details can be as important as having the benefits in the first place. "I think it’s an absolutely wonderful service," she says. "It takes the petty stuff off their plates so they can focus on the important things, and it takes it off the family members’ too. The last thing a spouse is going to want to do is [work through bureaucracies] while her husband is dying."
Franzoi’s outreach doesn’t stop with employees on the brink of leaving Fox, however. When employees with terminal illnesses exit the company, Franzoi logs their names into her computer’s daily planner, with a reminder every two weeks to call. She’ll chat with employees, ask them if they need anything, basically remind them that someone at Fox is thinking about them. She continued her calls to one man for almost three years, working with his family to ensure Social Security and Medicare kicked in at the right times. "It takes three minutes to make that phone call," she says. "And it makes people feel good. I must admit, I probably benefit more from it than they do."
The little extras that go a long way.
Other services also help raise the quality of life—and treatment—for employees. In addition to the regular employee-assistance plan, Fox offers an AIDS EAP available to all employees, their spouses and anyone living in their households. People may call with any questions on HIV or AIDS; they also may receive handouts on HIV/AIDS and information on where to go for testing. If an employee or a dependent covered under the Fox medical indemnity plan or one of the company’s optional HMOs is HIV-positive, that person has access to a nurse-staffed hot line, nutritional counseling, psychiatric counseling one-on-one or in support groups, and medication case management—all for free. These services can prove invaluable. For instance, nutritional advice includes such esoteric tips as telling HIV-positive people to avoid eating cookie dough, which has raw eggs in it, dangerous to people with impaired immune systems. And medication case management offers 24-hour access to an HIV case manager who works with the patient, the patient’s doctor, family and significant others to prepare a plan of action. If crisis intervention is needed, these case managers coordinate hospitalizations, handle discharge planning and arrange for transition back home or to a hospice. The AIDS EAP professionals even arrange home health-care services and negotiate lower costs for different medications.
Such practical offerings allow many kindnesses. For instance, recently Franzoi was working with a former employee in the last stages of AIDS. He didn’t want to die in a hospital, but although his partner could be home with him, he couldn’t care for him. Through the AIDS EAP, Fox was able to place a 24-hour nurse at the home for the man’s final two weeks. The cost ended up being less than keeping the man in a hospital. "He died in the setting he wanted to be in," Franzoi says. "It worked out the best for everybody. He got the best treatment in the best setting, and it was also the best answer for the plan."
Another man was on home-infusion therapy for AIDS, taking seven units a week at the prescribed home-infusion company’s cost of $1,200 a unit. The AIDS EAP representative was able to negotiate the price down to $384 a unit, a great savings both to Fox and the individual, who had to pay 20 percent until he hit his out-of-pocket maximum. Even after that, the lower price meant fewer dollars contributing toward his lifetime maximum.
Employees who may benefit from experimental treatments also find a champion in HR. Franzoi has linked Fox to a utilization review program, in which physicians at medical giants such as Johns Hopkins and UCLA—or an institution specializing in research on a particular disease—will review individual cases to ascertain whether these employees might benefit from certain treatment programs. Some employees with multiple sclerosis have undergone treatments, thanks to the plan, that are considered experimental although they’re close to approval by the FDA. Other employees with AIDS suffering from CMV, an infection that causes blindness, received plan-covered eye implants for treatment before they were FDA-approved.
"We can always say we’re proactive, we’re trying," Franzoi says. "We’re looking out for the best interests of the employee, but we’re also being fiscally responsible. And both those issues matter. It means we’re providing employees with what managed care in its ideal terms would be."
What your company can do for terminally ill employees.
As people continue the trend of paying more respect to the dying process, they’re likely to start considering policies and programs for the terminally ill as part of a good benefits package. It won’t likely happen in the next year or two, but in the next decade, such benefits may be part of a company’s competitive advantage, says Michael J. Powers, senior consultant at William M. Mercer in Los Angeles. It’s all part of an awareness evolution, he says.
"Employers in the past several years, because of AIDS and other illnesses, have been faced with having to deal with long-term illnesses in the workplace, particularly with a younger workforce than was traditional," he says. "Employers are examining all their HR policies to [see] how to accommodate people with terminal illnesses so they can continue to work, and how to accommodate them once they need to leave the workplace. ¼ As a result, programs and accommodations have been made that probably wouldn’t have been thought about before. Fox clearly has been very progressive in its thinking. It’s looking forward."
That progressiveness, Franzoi admits, doesn’t all come cheap. Although the company doesn’t track how many people use different types of benefits, she knows the salary continuation is, by its very nature, expensive. Some of that expense comes, Franzoi suspects, from abuses of the system. Employees who aren’t really disabled may be taking advantage of Fox’s generosity through doctors’ notes. It’s a difficult situation to police; the most the company can do is send an employee with a dubious prognosis to an independent doctor. "But the salary continuation, when it works for the right people, which it usually does, is invaluable," Franzoi says.
The medical indemnity plan’s per capita cost is also fairly high. Through hospital networks, negotiating fees and other cost-saving initiatives, HR has been able to keep these costs fairly level over the past few years. At the end of March 1997, per capita cost was approximately $4,700 per employee. That figure is actually lower than 1996, when it was $5,500 per employee due to several AIDS cases, premature triplets, several bad car accidents and two bone marrow transplants. It’s also lower, however, than the ’94 and ’95 figures of approximately $4,800. The company’s HMO plans run closer to approximately $2,900 per capita.
Other benefits are inexpensive or free. Franzoi negotiated the living death-benefit option with insurance carriers at no additional cost to Fox, and says that any company, no matter the size, should have no trouble following suit.
The AIDS EAP also has proven fiscally sound, with its negotiating function actually reducing Franzoi’s medical plan costs. Henderson lauds companies that establish EAPs. They’re often key to employees’ dealing with the grief process. "Companies are discovering people do have emotions in the workplace and they can be dealt with in a constructive way, which restores employees to productivity more quickly than pretending nothing’s wrong," she says. Finally, some of the most important aspects of Fox’s programs are the simplest. "Following up with employees, keeping in touch with them while they’re on leave and helping them make the decisions that are right for them, you don’t need money or approval from upper management to do that," says Franzoi. "You just need to take the time to be involved enough to do it."
HR professionals spend a great deal of energy helping employees live their lives, but they also must remember that dying is a part of living. Franzoi and her HR peers at Fox remember, and their gift of reassurance, guidance and consideration for employees and their families is perhaps the best benefit an employer could offer.
Workforce, September 1997, Vol. 76, No. 9, pp. 59- 65.