Absence isn’t just an HR issue anymore — it’s a business issue

In this episode of The Pulse in 15, Mary Delaney sits down with Teri Weber to talk about the growing complexity of absence management—and why so many employers are feeling the impact across their organizations. 

From FMLA and ADA to evolving state leave laws, rising mental health–related absences, and hybrid work challenges, absence is hitting organizations from every direction. What used to be a compliance exercise is now directly impacting productivity, cost, manager effectiveness, and employee trust. 

In this quick 15-minute conversation, Teri focuses on what matters most right now:

• Where employers are most at risk
• What’s changed in the absence landscape
• Practical steps leaders should be thinking about this year

If you’re navigating absence across your workforce, this is a conversation worth 15 minutes of your time.

Transcript

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Welcome to The Pulse in 15, a series for busy professionals who want to stay on top of what's shaping employee benefits. This 15-minute version of our podcast series delivers what The Pulse is

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insights from leading experts across health, pharmacy, and research institutions, with the clarity and straight answers you need in a fast-moving space. I'm Mary Delaney, Managing Partner of Vital Incite an Alera Group Company. If you're an employer today, absence is probably hitting you in every direction. Employees are asking for more flexibility. Managers are nervous about saying wrong things. HR teams are juggling FMLA, ADA, state-level laws, short-term disability, mental health-related absences, and trying to keep operations running at the same time. For many organizations, absence management started as a compliance issue. But increasingly, it's becoming a business issue, affecting productivity, staffing, costs, manager effectiveness, and employee trust. And the reality is, even well-intentioned employers are getting tripped up - not because they don't care, but because the rules are complex and the landscape keeps changing. That's why I'm excited for today's conversation. Today, I'm joined by Teri Weber, an expert in absence management and a trusted member of our Alera Group team. Teri works with employers every day who are trying to do the right thing, support employees, stay compliant and operate efficiently, all at the same time. In the next 15 minutes, we're going to focus on what matters most right now, where employers are most at risk, what's changed in the absence landscape, and what practical steps leaders should be thinking about this year. This isn't about theory or perfect policies. It's about real-world guidance that you can actually use. So with that, Teri, thank you for joining us today. Thank you for having me. So as we get started, this is an area I know nothing about, so help educate me. Can we start today with what are the most common hidden absence management risks that you see right now? Sure, that's a great place to start. I think if you're someone who's a boots-on-the-ground professional, there's not a lot that's hidden to you. But for those that are maybe newer to absence, or sometimes leaders that just aren't dealing with this every single day, I would say the things we talk about a lot that bubble up as concerns, number one being stacking and overlapping of all these different absences, which of course, not only, as you said in your intro, talks about compliance, but also just the administrative complexity. I'd say the second thing that's hidden to a lot of leaders is how we drift from policies to actual practice. And so sometimes what's written on paper isn't actually what happens, which creates a significant risk to the enterprise. Way beyond absence. Think about your medical plan, your stop-loss carriers - all of those things link when policies aren't really adhered to. And then probably the third one that we talk a lot about is managers. You talked about it in your intro as well. Those well-intentioned managers who are likely not enforcing the policies or doing things consistently - even just them saying the wrong thing with good intention creates a significant risk. Employees are really counting on their manager to know the right answer, and they're gonna depend on it, which creates an enterprise risk for everyone. Sounds very complicated, and kind of dangerous when I think about all the ways this can have an impact. So, we see in our mutual data that mental health has become one of the leading drivers of absence, disability claims and intermittent leave. How should employers adjust their absence approach as mental health becomes a primary driver for leave? I think this might be one of the hardest things to really address, because we talk a lot about mental health in our health and welfare practices. But when I think about it on the health side, we talk about mental health parity, we talk about the NQTLs, which are our nonqualified-- or nonquantified treatment limitations. You know, I think what's hard with absence is, if we dig in, we have a model that works reasonably well for physical impairment and the traditional recovery that comes along with it. And then we're always trying to spot the abuse or the misuse. But a lot of times folks with mental health conditions, they require something different. And I certainly don't want to oversimplify a fix. This is a really complicated fix. But to pivot, really takes away from what we've been doing in the absence space because a lot of times folks with mental health absences, their utilization looks like abuse or misuse. And I'm not trying to suggest that it is, but they follow certain patterns and it might trigger certain impressions or behaviors like, you know, unscheduled time off, or the need to use PTO, call-outs, late arrivals, taking off a pattern of Mondays and Fridays. Lack of being present when they're there. And so in our head as practitioners, I think we have started to normalize that that might be misuse or abuse. But a lot of times it can be a symptom of what these employees are dealing with. You know, the stress of coming back to work on a Monday might just be too much for them to really handle. So that's kind of a backdrop, I guess, to your question about what can we do and how can we address, you know, I always think about that intake process with absence. How can we make that front door, if you will, as accommodating as possible? So, you know, what are we giving for resources when someone calls and asks for time off? Is the right person answering the phone? Is the call set up for success? Are we telling them about programs that might help them? That's probably, you know, one of the main ways we can start the process. I also think the managers are a linchpin here with behavioral health, because if we can train them, not to say too much, but to just notice a pattern, to say things in a way that just invite not detailed information, but just invite some acceptance. Even before someone's out, are you noticing performance dips? Things that might be an indication. And then probably the other thing that is something we talk about a lot is try to be holistic. You can't solve for a behavioral health issue in absence if you're not solving for it in your health plan, if you're not solving for it in your workplace culture. And then I guess, you know, the other thing I didn't mention, but I think I probably should is return to work. You know, return to work for folks with behavioral health and mental health concerns, it's gotta look a little different. Maybe it's more graduated. Maybe it's temporary modifications. You know, we often think about return to work as like a cliff, you know, they're out and now they're back. But I think for those with behavioral health, it might be more of a process. I actually had an employee - I won't take too long; I know we only have 15 minutes - but I had an employee that was struggling and I didn't really know why. I was early in career and she just kept being late. But she had been such a top performer. And I finally just said to her one day, what's going on? Why aren't you able to get to work? Is there something happening? I went to problems at home or a domestic situation, and she did end up opening up to me. She certainly didn't have to, but she said, I'm on a medication and I just can't get up in the morning and I don't know what to do. And I was like, okay, we can solve for this. You don't have to be here at a certain time. We can work around it. This job can be flexible. But without telling me that she was dealing with some behavioral health issues, we were able to kind of shed some light on how we could make the job work for her. I love that, because I think the fear is always you're afraid to ask, because maybe you shouldn't ask or you shouldn't know too much, but you were honest and open, and it was their option to give you that information. Is that correct? Is that why that makes it safe? Yeah. And I think also I wasn't saying, you know, do you have a medical issue? I was just saying what's impeding you from getting to work? You know, is it… And so, it could-- she could have said, well, my car's broken down, or she could have said, I don't have childcare. You know, there were a million paths that she could have taken, but she just said, I'm on a medication and I'm just not able to wake up and I don't really know what to do about it. And so from there, we were really able to set a plan. I was like, okay, I don't have to be married to an 8 a.m. start. Now, certainly there's some jobs where you might have to be married to an 8 a.m. start, and the path might be different. But for me, in the job that we were in and the role she had, I was like, great, let's work around this. We can figure out a different path. So I think just being open to the conversation and knowing that every person is gonna be different certainly helps, especially related to behavioral health. Yeah, that's an excellent, excellent conversation to have. And I appreciate that you had the trust so that they could actually tell you the truth. So that's a big deal. So tell me one of the things I hear about all the time is all the difference in the state laws and why that's causing so much chaos. Can you speak to that a little bit? Yeah, there's so many different categories related to state leaves. I think it's really easy to underestimate how complicated it gets, and also how difficult it can be to return people to work on state-specific leaves. A lot of times our brain goes to STD where we have a short-term disability, where we have a lot more control. We can design our policy, we can create a framework. And we've all accepted that the FMLA, the Family Medical Leave Act, which we've had for quite a long time, know, 1993, I believe, we've all become accustomed to how that is a little bit more tolerant, and a little harder to control, but it's also in most cases unpaid. These state leave laws take a lot of the flexibility and challenges that we have managing FMLA, and they overlay that mostly on paid leaves. And so it's really, really a challenge. You know, to anyone who's in the absence space - my fellow absence geeks out there - you know how we're dealing with concurrency, and stacking, and top-up payments, and all of those challenges. But I think sometimes the state plans where we even have more difficulty is anything financial. So benefit contributions, coordination with payroll, and actually coordinating with the state, because the states aren't out there trying to make their plans necessarily the best it can be. So even though they might have a system, or they might have a portal, it can be really difficult to coordinate with the states. And, you know, sometimes it even requires additional headcount, depending on where employers are, to manage those state plans. And the other thing I would comment on is a lot of times larger employers might be able to take these state plans and self-administer them, self-insure them, create private plans. That's some terminology that we use in the industry. And sometimes that can be best practice and a better employee experience, but it's certainly not easy, either. It's certainly not like, oh, let me do a private plan and it's effortless. I don't think we're really gonna get past the complexity with these state plans. I don't see a national plan coming anytime soon. And even if they did, that would just probably be one more thing for us to comply with. So I would just say, do the best you can. Really try to think about these programs. You can't always be 100% consistent, but where possible, you really want all employees to have a similar feel, regardless of what state they're in. Amazing. So complex. So this is so complex. At what point should leadership view absence management as a strategic issue, not just an HR task? I mean, I'm biased, but I would say yesterday. You know, if you're a small workforce and absence doesn't feel like a burden, then maybe it isn't. But I bet you most folks listening to us are really feeling the pain. I'm doing a course for the International Foundation of Employee Benefit Plans related to absence. And one of the things we're talking about is how much indirect cost there is. Some estimates are that it's at least one time, if not two times, the direct cost impact. And so we focus on the direct cost. We focus on how much does short-term disability cost, or these state plans cost, or even benefit continuation. But there's a lot of indirect costs that are really difficult to quantify, but critically important. And I think mature organizations really realize that absence has got to be part of their overall workforce strategy. Ideally, having an end-to-end owner definitely helps, but we need people in, you know, we used to joke when I worked, you know, in healthcare and in customer service, like, derrières in seats, right? We need people making things happen for our organizations. And whether you're virtual or whether you're in person, we still need that human capital. So I think the time to, if you already aren't thinking about absence in that way, the time is definitely now. Let's pause to thank our sponsor. This podcast is brought to you by Alera Group. Vital Incite is part of Alera Group, an independent financial services firm offering comprehensive property and casualty insurance, employee benefits, wealth services, and retirement plan solutions to clients nationwide. Working collaboratively across specialties and across the country, Alera Group's team of more than 4,600 colleagues offer unique solutions, personalized services and proactive insights to help ensure each client's business and personal success. For more information, visit alleragroup.com and follow us on LinkedIn. All right, you brought the remote and hybrid. You kind of mentioned that, which also led me to one other thing I want you to speak on before we have to close. The complexity of the workforce has really changed. When you think about the return-to-work strategies and, kind of what are the tips for employers that are trying to figure out how to make this all work now? Yeah, that's a great question. I actually think that employers should challenge themselves to be agnostic to work location when they're designing their initial return-to-work strategy. I mean, it has to be a piece of the puzzle. So that doesn't mean that you're not factoring in work location at all. But it shouldn't be the primary driver. You know, the return-to-work framework should be structured but flexible. So, you know, instead of a fork in the road where it's like someone's returning or not returning, it's almost like a rotary. I live, you know, in New England, we have a lot of rotaries here. It's almost like a rotary. You kind of stay on the path until you find an exit that works for you. So, you know, think about return to work as first and foremost, job requirements and functional capacity. That's where you have to start. Then think about what's the volume of work? Can I do a reduced schedule? Can I modify my duties? Then think about where could the work happen? You know, if you're hearing people in your organization say things like, oh, they're not ready for full duty, so let's keep them remote. I think that's probably something we need to nip in the bud because it's too simplistic to just have people stay home. You know, staying home can be a wonderful thing, but it can also hinder recovery. It can mean more anxiety, isolation, disengagement, lack of structure. Not to mention they might not push themselves toward physical recovery if they don't have to. And then the flip side, of course, is employees who might be capable of doing the actual job, but maybe they just can't drive. Then remote work seems like a perfect solution. So the sight of someone's work is definitely a piece of the puzzle, but I’d say the best return-to-work programs have more, I guess I'd call it structured flexibility, but not really case-by-case implementation. Teri, you just ooze of knowledge in absence management, but also I can see the connection with employee benefits and health and wellness. So thank you so much for sharing so much critical information in such a short conversation. This is really much more complicated and a bigger issue than I even realized, and I hope this conversation allows employers to recognize that too. So thank you very much. Thank you so much. And to our audience, I hope today's conversation has given you a clear real-world perspective on how absence benefits strategies can drive better outcomes for both people and organizations. The Pulse is brought to you by Alera Group. Alera Group is an independent financial services firm offering comprehensive property and casualty insurance, employee benefits, wealth services, and retirement plan solutions to clients nationwide. For more information, visit aleragroup.com and follow us on LinkedIn. I'm Mary Delaney. Thanks for listening.