Community Living Algoma targets disability with proactive case management
Tony Fasulo, chief executive officer (l) and Chris Sanderson, vice-president of operations (r) Maximus Rose Living Benefits
In search of a better way to manage disability claims, the organization partnered with sister companies Maximus Rose Living Benefits and Acclaim Ability Management Inc. in October 2021 to streamline its benefits program and implement a proactive, personalized, self-insured STD program. The switch to a self-insured model with Acclaim meant leaving behind an insured STD policy with the current insurance company. But the push to improve disability management aligned with CLA’s day-to-day mission of helping people with disability or autism achieve independence to live their lives to the fullest.
CLA chose Maximus Rose and Acclaim for its own disability component because both these organizations had experience working with similar companies that were facing similar pandemic pressures, including long-term care facilities. Maximus Rose and Acclaim also had a proven record of reducing disability associated costs—and the partnerships paid off.
Within 12 months, Maximus Rose and Acclaim were able to reduce CLA’s STD costs to $96,136 (under the self-insured model) from $210,422 (under the fully insured model). Before the new teams stepped in, CLA experienced 14 LTD claims rolled over from STD within a six-month period. In comparison, there were zero LTD claims during the first year under the new model, meaning Maximus Rose and Acclaim stopped the rollover to LTD from STD. The self-insured model also reduced or shortened average days lost and stabilized LTD premiums, which were becoming unsustainable due to the frequent STD to LTD rollover.
“Our field is very stressful, both physically and mentally. But moving to Maximus Rose has been incredible—it’s been easy, and anytime I had any worries or wasn’t sure of the process, there was always someone there,” says Judy Duffy, recently retired, who moved into the human resources manager role at Algoma Community Living shortly after Maximus Rose was engaged.
Duffy especially liked that a single claims manager was assigned to her organization, meaning she always knew who was picking up the phone, didn’t have to repeat a story several times and could let employees know in advance who would be reaching out to them when they started disability leave.
The contrast to the old carrier—that Duffy continued to work with on existing LTD cases—was stark. “I never knew who I was going to connect with when I needed information. But with Maximus Rose, there were no complaints and employees knew exactly who they were going to be communicating with.”
In addition, it was easy to keep tabs on the program thanks to Acclaim’s proprietary Acctrak digital network system that allows plan administrators to see live updates and the status of STD claims. “This robust technology means less back-and-forth with documents, makes administration more efficient and, when safe, speeds up return to work.” Explains Tony Fasulo, chief executive officer of Maximus Rose Living Benefits.
“The experience was really good. I had no HR background whatsoever, but Maximus Rose made it easy to get to know the system and the lingo—and they were always there to support me,” Duffy says.
The mix of formal quarterly meetings and informal touch points were very helpful, she added. And since Acclaim and Maximus Rose are sister companies, they were able to share integrated data across benefits and disability.
From Maximus Rose’s perspective, vice-president of operations Chris Sanderson says CLA’s cost savings was possible because the organization was open to trying a different self-insurance model, as well as working with a third-party disability company rather than an insurance company.
“If an organization feels they’re not getting service from insurance companies, if they’re having a lot of employees roll over from short-term to long-term disability or if there’s broken communication between the case managers managing their disability files—we excel at streamlining all of that,” Sanderson says. “Then, essentially, you’re getting these employees back to work quicker, sooner and faster, so they can produce for their companies with fewer headaches for human resources.”
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