Notes from April 15, 2009 workshop on benefits

April 15, 2009 workshop “Benefits and Resources at Harvard for families of children with special needs” sponsored by the Office of Work / Life and the Benefits Services Group was attended by close to twenty people (19 signed up but not everyone came).

The presenters were:

Christina Fluet, Executive Director of the Massachusetts Consortium for Children with Special Health Care Needs and former Project Director at the Center for Child and Adolescent Health Policy at the Massachusetts General Hospital;

Timothy Carey, Benefits Analyst in the Office of Human Resources at Harvard University; and

Natalie Beaumont-Smith, Work/Life Analyst in the Office of Work Life Resources at Harvard University

The handouts included:

PowerPoint presentation

(added April 25, 2009:
Several links included in the handout at the April 15, 2009 workshop are not working since the new Harvard employees’ intranet Harvie was launched. Most of the new links are fairly easy to find, or mentioned later in this post, but the section about Flexible Work Arrangements was moved from section titled “Working at Harvard” to “Work/Life Balance.”
Take your time to review the “Guide to flex work” in the main part of the page, especially the “Practical Resources for Requestors and Managers,” but also remember about the “Flexible work FAQ” and “Forms and Related Documents” including a “Sample flex work proposal” posted in the (green) right hand margin. Note — you need a Harvard ID to log into Harvie)

Special Needs Services in the Cambridge Area handout prepared by the Harvard Employee Assistance Program and the Office of Work / Life Resources

Frequently Asked Questions about the University-Wide Child Care Scholarships (this document used to be on the “old” Harvie, but it has not been included in the new version, look at the new “Scholarships and Affording Child Care” page which includes some of the same information that was included in the FAQ document; you need a Harvard ID to log into Harvie to view this page)

Harvard’s Back-Up Care Quick Reference Sheet (link to Harvie – you need a Harvard ID to log in)

Parents in a Pinch! Frequently Asked Questions (again, this document is not on the “new” Harvie, but there is a page with information about Parents in a Pinch)

Employee Benefits Study

Christina Fluet spoke about the Employee Benefits Study conducted at the Mass General Hospital for Children and the results of the study (see the PowerPoint presentation for more information).

More information about the project can be found in:

Fluet et al, Three Workplace Models for Employees Caring for Children with Special Needs, Journal of Workplace Behavioral Health (2008), 23(3), 245-262

Perrin et al Benefits for Employees with Children with Special Needs: Findings from the Collaborative Employee Benefits Study, Health Affairs, (2007), Vol. 26, No. 4: 1096–1103

Perrin et al, Benefits for Employees with Children with ADHD: Findings from the Collaborative Employee Benefits Study, Journal of Developmental and Behavioral Pediatrics (2005), Vol. 26, No 1: 3-8

(The first two articles can be accessed online through HOLLIS, through EBSCO. If anyone would like more detailed instructions on how to access these journals, please let me know. The third journal is not available online.)

Harvard Benefits

While the rest of the workshop provided a refresher on existing benefits, the presenters also pointed out information and benefits that some employees may not have been aware of. For instance:

Employee Assistance Program

One of the things I was not aware of was that employees can contact the Harvard’s Employee Assistance Program (EAP) to ask for help in specialized searches for available child care and other resources for children with disabilities (residential treatment, day and boarding schools, special needs advocates, educational consultants, and local chapters of resources like The Autism Society of America, CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder), etc.)

The EAP can also provide support in acute situations such as dealing with the news of a diagnosis, or free consultation related to a child’s legal rights.

To contact the Harvard’s Employee Assistance Program (the Wellness Corporation) you can call 1-877-327-4278 (crisis support is open 24 hours a day, 7 days a week). They also have a web site.

$350 Just in Time Care Subsidy

Another parent did not realize that the $350 “just in time care” subsidy for child or elder care can be used for Harvard’s school’s out camps or even when the back up care was provided by a relative or a friend (provided they were paid for that and are willing to list their Social Security number on the application form).

The program runs on a fiscal year basis. For care for this fiscal year (July 1, 2008 through June 30, 2009) the invoices will have to be submitted by August 31, 2009.

While $350 may not seem like much, every bit helps and I have used it to offset the cost of summer camps, but it can also be used for care during school breaks (February and April), snow days, or even paid after or before school care – anything beyond “regular care arrangements.” If your mother or neighbor watches your child after school and you paid her for that, you can apply for the $350 reimbursement.

For more information about the Just in Time Care, see http://harvie.harvard.edu/docroot/standalone/Work_Life_Balance/Caring_for_Children/Finding_Child_Care/justintime.shtml (you need a Harvard ID to log in).

Non-HUCTW Child Care Scholarships

Another thing parents may not have known is that child care scholarships could be used for care that has a therapeutic benefit – so while hippotherapy (therapeutic horseback riding) may not be thought of as “child care” – because it has a therapeutic benefit for some children (for instance those on the autism spectrum), a parent may apply for reimbursement for that as part of the childcare scholarship program.

Also, child care scholarship requirement that a spouse/partner work a minimum of 15 hours per week may be relaxed if the spouse is caring for a disabled child.

And finally, the rule that child care scholarship reimburses child care costs only for children under 13 years old may also be relaxed if an older child is disabled and needs care until a parent comes home from work.

Situations like that are considered special circumstances and are reviewed on a case by case basis. With any questions, do not be afraid to contact the Office of Work / Life Resources, (671) 495-4100 or worklife@harvard.edu. They will be happy to answer your questions.

For more information about Child Care Scholarships, see the PowerPoint presentation Child Care Scholarship at Harvard (link to Harvie – you need a Harvard ID to log in). The Administrative and Professional Staff child care scholarship is on a fiscal year basis. The deadline for application is some time in August.

HUCTW scholarships

The workshop did not discuss specifically the HUCTW scholarships, including the Childcare Fund, Educational Fund, and the Academic Enrichment Fund, but HUCTW reps I talked to told me that the Academic Enrichment Fund may be used to offset the cost of social skills programs, or that the Educational Fund could be used to offset the cost of attending “advocacy skills for parents” workshop.

For more information on the HUCTW funds, see: http://www.huctw.org/ (the information is on the right hand side). Application deadlines and rules are different for each fund.

The page about the Academic Enrichment Fund includes a note “The currently negotiated fund covers only academically-related costs. If you have enrichment costs that are not covered by these fellowship criteria (such as music, art, and athletic programs), please let us know about them! This information will provide valuable data to support the enhancement of the Academic Enrichment Fellowship in future negotiations. E-mail us (huctw.childcare@huctw.org) with info on the type and amount of your other expenses.”

I would suggest to parents of children with disabilities (including learning disabilities) who are HUCTW members to contact the union and let them know what you’d like to see the Academic Enrichment Fund cover. (For instance, I think it would be very useful if the Academic Enrichment Fund could be used to offset the cost of hiring an educational advocate to come to IEP meetings to help negotiate appropriate academic placement and services for a child, or the cost of Independent Evaluations (including neuropsychological assessments), which are not covered by health insurance, but which also can be crucial to help get appropriate services at school. But that’s not possible right now.)

Health Insurance

During the workshop there was some discussion about health insurance and what Harvard offered health insurance plans cover, what are lifetime maximums on certain services, etc.

Tim Carey, the Benefits Analyst from the Harvard Benefits Services Group reminded everyone that anyone with specific questions about their health insurance coverage should not hesitate to contact the Benefits Services Group to set up one-on-one appointments to talk about specific issues. (617-496-4001, benefits@harvard.edu, Holyoke Center, 6th floor, room 664, 8:30-5:00)

(added April 25, 2009:

Christina Fluet also mentioned the Catalyst Center – “a national center dedicated to improving health care insurance and financing for children and youth with special health care needs.”)

In addition, Christina Fluet mentioned Medicaid and supplemental Mass Health, which in some cases can apparently serve as a supplemental insurance. I do remember hearing at a workshop once that parents of children with autism or ADHD could apply for state health insurance, but I do not remember the specifics.

(added April 25, 2009:

The Catalyst Center has a brief, four-page publication that might be about that – “Medicaid Buy-In Programs: Reducing Under-Insurance for Children and Youth with Special Health Care Needs“)

If anyone has more information about Medicaid and supplemental Mass Health, please post it in the comments, or let me know if you could (want to) write a post just about that.

By the way, NE Serve published two very interesting publications on the topic of insurance coverage:

Making the Case for Coverage: Tips for Helping Children and Families Get the Benefits They Need from Their Health Plans” was published in 2007 by New England SERVE and the Massachusetts Consortium for Children with Special Health Care Needs. (I think I’m going to give a copy of this publication to my children’s pediatrician.)

Paying the Bills: Tips for Families on Financing Health Care for Children with Special Needs”  which includes some useful tips as well, was published in 1999 (second edition).

Flexible Spending Accounts

During a discussion about the Flexible Spending Accounts a question came up whether the cost of hiring a nurse caring for a disabled child should be submitted to Flexible Spending Accounts for reimbursement as a Medical Care or Dependent Care (or can it be both).

Harvard’s FSA is managed by Crosby Benefit Systems, Inc. and if I understood the discussion correctly, they only accepted reimbursement under one plan, not both.

Co-Pay Reimbursement Program

It also seemed not all parents knew about the copay reimbursement program at Harvard and how it worked.

The program covers copayments for in-network office visits (including mental health care visits) and prescription drug copayments once certain threshold is reached (depending on employee’s income).

For instance, an employee who earns less than $70,000 a year and has a family health insurance coverage through Harvard can get reimbursement for in-network office visit copays that exceed $330 a year and reimbursement for prescription drug expenses that exceed $1,000 a year.

Employees who earn between $70,000 and $95,000 can get reimbursement for copays for office visits that exceed $660 per year and reimbursement for prescription drug expenses that exceed $2,000 per year.

The program is not available to employees earning more than $95,000 per year, regardless of the expenses incurred.

So basically, if you make less than $95,000 this benefit is very helpful if, for instance, your child sees a mental health provider every week, because at $15 per copay, that might add up pretty fast. You can use FSA for the first $330 (or $660) of co-pays (depending on your income), although you don’t have to.

If you do use FSA, the important thing to remember is to keep a copy of the copay stubs and make a copy of the completed FSA reimbursement claim form! Once you have reached the threshold, you can apply to have the rest of the copays reimubursed.

When you submit the Copay Reimbursement Claim Form you need to prove that you had already spent $330 (or $660) – that’s why you need a copy of the FSA Medical Expenses reimbursement form and receipts you had already submitted to the FSA.

Keep the copay reimbursement program in mind when you elect the deduction for the Medical Expenses FSA at the end of the year! Because most of our family’s medical expenses are co-pays, when I figure out the annual contribution amount for the Medical FSA I usually elect just the threshold amount plus whatever I think I might spend during the year for over the counter and prescription medication, eye glasses, and contact lenses.

You also need to remember that the program covers only copays for in-network office visits and prescription drugs, although someone mentioned that it also covered co-pays for Early Intervention visits. (Whoever said that – could you please clarify – I thought EI visits are free, at least they are in my area; or did you mean the co-pay for the annual fee?)

With questions about the copay plan or for more information, contact the Harvard Benefits Services Group.

Overall, both Tim Carey and Natalie Beaumont-Smith emphasized that they would be happy to answer any questions an employee may have about their specific situation and coverage.

To contact the Office of Work / Life Resources, call 671-495-4100, e-mail worklife@harvard.edu, or visit the Holyoke Center, 6th floor.

To contact the Benefits Services Group call 617-496-4001, e-mail benefits@harvard.edu, or visit Holyoke Center, 6th floor, room 664.

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