Mendocino County Employees Retirement Association

Transcription

1 Mendocino County Employees Retirement Association James Wilbanks, Ph.D. Retirement Administrator Considering External Partnerships in the Retirement Disability Application Process

2 Outline What to Worry About Understanding Your Process Considering External Partnerships Other Factors for Consideration Closing Thoughts 1

3 What to Worry About The most important thing is fulfilling your fiduciary duty and mitigating risk. The key to doing these when it comes to disability retirement applications is to create a clear and reasonable process, then consistently follow that process. Doing this will do more to ensure your plan fulfills the fiduciary duties to act in the sole interest of the plan and to consistently follow plan documents than anything else. 2

4 Understanding Your Process It is critically important to clearly understand and define your process prior to considering external partnership Once you have done this you can consider the following types of questions: Which parts of our current process could benefit from an external partnership? Which parts of our current process are immutable? Where can we improve our current processes and implement best practices? 3

5 Understanding Your Process MCERA Employs a Two Stage Disability Process Administrative Review Appeal Hearings Focus on Administrative Review. 4

6 Understanding Your Process MCERA Administrative Review Process: Application Filed by Client. Includes medical evidence to support application. Association gathers any additional materials needed. Workers Comp records, Information from Employer, etc. Client Sent to Independent Medical Evaluator (IME) Specialist, chosen by Association. Legal Review of IME report to ensure adequacy; Request additional input from IME if needed. IME reports sent to Medical Advisor. 5

7 Understanding Your Process MCERA Administrative Review Process: Medical Advisor reviews application and IME reports, then submits recommendation. Legal Review of Medical Advisor Recommendation to ensure adequacy; Request additional input from Medical Advisor if needed. Board considers application after reviewing documents supplied by Client, IME and Medical Advisor recommendation. 6

8 Understanding Your Process MCERA Administrative Review Process: Board decides case at the administrative level: Determination of Disability Determination of Service Connection Determination of need for subsequent medical evaluations Determination of effective date of disability retirement MCERA Disability Appeal Hearings Process: Legal process initiated if Client appeals a determination from the Administrative Review 7

9 Understanding Your Process MCERA Administrative Review Process Summary: Application Filed by Client Client Sent to Independent Medical Evaluator (IME) Medical Advisor makes recommendation to Board. Board decides case at the administrative level 8

10 Considering External Partnerships We identified the use of IMEs as an opportunity to improve our current process. Previously we always sent applicants to an IME because we lack clinical expertise to determine if an IME is needed (CONSISTENCY). The only way to access such clinical expertise was through an external partnership. 9

11 Considering External Partnerships Additionally, we identified the administrative handling of disability retirement applications as an opportunity to improve our process and be more efficient. We handle relatively few applications annually but these require approximately 0.25 FTE to handle these administratively. 10

12 Considering External Partnerships Our external partner streamlines this for us. They handle most of the administrative work around disability application: Coordinating with Applicant, Gathering additional information from applicant, Scheduling IME, et cetera. Use of portal streamlines information flows. 11

13 Other Factors to Consider Disability Process: Core Mission or not? Process Delays Age & Maturity of Process and System Staff Expertise Economies of Scale Cost advantages of External Partnership Contract Management 12

14 Closing Thoughts Whether, how much, and when to utilize an external partnership in the disability retirement application process are questions that do not have a one-size fits all answer. Engaging in the discussion regarding whether to use an external partnership affords the opportunity to review processes and make improvements to better serve our clients. 13