Create A Critical Illness Employee Assistance Checklist

Helping an ill employee understand and use their health insurance benefits is a daily occurrence in every HR benefits office. But from time to time benefit pros must assist an employee who is experiencing a life threatening illness. And while some benefits pros may be tempted to treat these employees like all others needing their assistance, top benefit pros know that critically ill employees need more than advice about the mechanics of their health plan. They need a benefits advocate and amateur therapist.

A Benefits Advocate for Critically Ill Employees

Critically ill employees have more than a major illness to conquer. They may not be able to work full-time or at all. If unable to earn income, they may need assistance paying their bills. They may not have family members or friends capable of assisting them with transportation needs, food preparation and other daily life activities.

In addition to sharing the status of their health with their benefits representative, these employees often share their personal situation. This puts benefit professionals in a unique position to use all of their expertise and resources to help these employees and their families. And because these situations will arise more than once in the career of the average benefit pro, a critically ill employee assistance checklist is a must.

Checklist (not exhaustive and in no particular order):
  • Provide health insurance claim assistance (Inform insurance rep of the situation and work with them exclusively on all claims' issues)
  • Activate paid and unpaid leave programs
  • Assist with the completion of short- and long-term disability applications
  • Help apply for Social Security disability insurance
  • Investigate state assistance programs that help pay for health care, mortgage, and utilities
  • Investigate public assistance programs that provide transportation and food delivery services
  • Activate Employee Assistance Program (EAP) benefits for employee and their dependents
  • Provide pension plan benefit projections or account balance information
  • Verify life insurance benefits
  • Ensure completion of life insurance and retirement plan beneficiary forms
  • Offer to meet with a spouse or significant other to answer any questions or provide general information about benefits or local resources
An Amateur Therapist For Critically Ill Employees

Critically ill employees experience many emotions. These emotions are similar to the stages of grief of losing a loved one. When learning of their illness, they may experience feelings of fear, denial, anger, depression and later acceptance. It is a near certainty that their interactions with benefits pros will involve all of these emotions. Benefit pros can expect critically ill employees to yell at them about denied health insurance claims. They should also expect critically ill employees to share deeply personal information with them or express feelings of fear and loneliness. They should also learn to listen but refrain from providing personal or financial advice.


Critically ill employees need special assistance from HR benefit pros. In addition to assistance understanding their health plan, they need help identifying local social services and to listen to their fears and concerns. Benefit pros should create a checklist to ensure they meet the needs of these special employees.
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