| 1 | 17/11/2017 || 1 | 17/11/2017 |

Return-to-work program in Income Care

Pia Cox Medical Insurance Summit 2017, Zurich

Socio-economic trends

4 | 17/11/2017

Current socio-economic trends

a rapidly aging population(INAMI/RIZIV research)

5 | 17/11/2017

an

increasing

ly aging

active

population(INAMI/RIZIV

research)

<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ >50ans

31/12

2004 0,7% 8,9% 14,0% 14,6% 14,7% 14,2% 12,3% 10,1% 7,7% 2,7% 0,2% 20,7%

2005 0,7% 8,6% 14,0% 14,1% 14,4% 14,3% 12,5% 10,4% 8,0% 2,9% 0,2% 21,4%

2006 0,6% 8,4% 14,0% 13,6% 14,2% 14,3% 12,7% 10,6% 8,1% 3,3% 0,2% 22,1%

2007 0,7% 8,4% 13,9% 13,4% 13,9% 14,2% 12,8% 10,8% 8,2% 3,6% 0,1% 22,7%

2008 0,6% 8,3% 13,8% 13,3% 13,7% 13,9% 13,0% 11,1% 8,3% 3,7% 0,1% 23,3%

2009 0,6% 8,1% 13,6% 13,3% 13,4% 13,6% 13,3% 11,3% 8,5% 4,1% 0,2% 24,1%

2010 0,5% 7,8% 13,4% 13,4% 13,1% 13,5% 13,4% 11,6% 8,7% 4,3% 0,2% 24,8%

2011 0,5% 7,7% 13,2% 13,5% 12,8% 13,4% 13,5% 11,8% 9,0% 4,4% 0,2% 25,4%

2012 0,4% 7,5% 13,1% 13,6% 12,7% 13,3% 13,5% 12,1% 9,4% 4,5% 0,2% 26,1%

2013 0,3% 7,2% 13,0% 13,5% 12,6% 13,2% 13,3% 12,4% 9,7% 4,6% 0,2% 26,9%

downtrend uptrend

Current socio-economic trends

6 | 17/11/2017

People will have to continue

working for longer

Current socio-economic trends

L’echo

De

Standaard

It’s official: we’ll all have to continue working for longer

State pension age officially pushed to 67

7 | 17/11/2017

Higher risk

of extended

sick leave

among older

employees(Securex research)

Current socio-economic trends

| 9 | 17/11/2017 |

The number of

long-term sick

leave cases

has continued

to skyrocket(INAMI/RIZIV research)

De Standaard graph (source: INAMI/RIZIV )

Current socio-economic trends

| 10 | 17/11/2017 |

Een “niet-klassiek” traject Hoe kunnen we dan sneller schakelen?

De Standaard graph (source: Securex Whitepaper April 2017 & INAMI/RIZIV annual report 2015

Every day, 7 out of 100 employees are off sick fromwork

| 11 | 17/11/2017 |

Een “niet-klassiek” traject Hoe kunnen we dan sneller schakelen?

Source: Securex Whitepaper April 2017 & INAMI/RIZIV annual report 2015

Highestincrease: 30 to 40 year olds

13 | 17/11/2017

Mental

disorders

account for

35% of all

cases, and

this is a

growing trend (INAMI/RIZIV research)

Current socio-economic trends

14 | 17/11/2017

In the short

term:

more government

involvement and

control for

employees as

well as

employers

Current socio-economic trends

Mandatory return-

to-work programme

for long-term

incapacity benefit

recipients?

Better and more intensive return-to-

work guidance for incapacity benefit

recipents that are still able to workPress release issued by Maggie De Block

Companies inspected for burnout prevention

De Tijd-Trends

The auditing department behind the Well-Being at Work

initiative will check whether employers have put

sufficient measures in place to protect their staff

from burnout syndrome

| 15 | 17/11/2017 |

AG Insurance

statistics

show the

same rising

trend in

mental

disorders

Source: AG Insurance statistics

| 16 | 17/11/2017 |

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Play a

new role,

create a

new future

• Continue to provide a safety net

• …that reflects our social responsibility• stress-related conditions = treatable (within the year)

• the longer the sick leave, the higher the psychological barrier to

return to work

• early intervention is critical for treatment and a quick(er) return

• … and is in the best interests of the employee

and the employer• 80% of employees on sick leave (> 6 weeks) request assistance

• much of the responsibility to get employees fit for active duty again

now lies with the employer (Royal Decree on return-to-work

assistance)

Source: Securex

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• Unlimited coverage for

– physiological diseases (e.g. cancer)

– major mental disorders (e.g.

schizophrenia, psychotic disorders, etc.)

• 2 years of coverage for treatable mental

disorders and stress-related conditions

with proactive return-to-work

assistance

Revamped

Income Care

2017

Income Care 2017:

What’s new?

20 | 17/11/2017

Retirement age

increased to 67 Adjusted coverage for

mental disorders

Coverage during

career breaks

included as

standard

Proactive return-to-

work assistance for all

stress-related

conditions, free of

charge, even during the

qualifying period

Quicker access to

treatment, claims

to be reported

within 30 days

What’s new?

21 | 17/11/2017

o Unlimited coverage for:

o bipolar disorder

o psychotic disorder

o dissociative disorder

o obsessive-compulsive disorder

o schizophrenia

o anorexia nervosa

o bulimia nervosa

o In cases whether occupational incapacity leave has been taken

for depression or another mental disorder (incl. burnout, CFS

and fibromyalgia), coverage will be capped at a maximum of two

years, whether consecutive or intermittent.

o This two-year limit will be extended to include inpatient stays in a

psychiatric hospital (if start date prior to expiration of two-year

period)

Adjusted coverage for mental disorders

22 | 17/11/2017

Return to work Mental disorders Other conditions

During the 1st year 36% 55%

During the 2nd year 24% 35%

<<

Beyond 2 years: 71% return to work

Beyond 2 years: 51% return to work

Total number of ongoing claims per year of occurrence(excluding mental disorders )

Total number of ongoing claims per year of occurrence(mental disorders)

Without

assistance,

it takes

more time for

the employee

to return to

work

Proactive return-to-work assistance: why?

23 | 17/11/2017

• Risk of death 63% higher among the

unemployed vs the employed

• Back pain resolves itself and heals

faster when returning to work (within

2 weeks)

• Likelihood of returning to work

– 50% if sick leave lasts 3-6 months

– 10% if sick leave lasts 1 year or

more

Long-term

sick leave

is bad

for

employee

health

Source: KU Leuven article: Lode Godderis: Is a quick return to work good for employee health? (17/07/2015)Lode Godderis, Professor of Occupational Medicine & Director of Research at IDEWE

Why provide return-to-work assistance?

24 | 17/11/2017

• Risk of death 63% higher among the

unemployed vs the employed

• Back pain resolves itself and heals

faster when returning to work (within

2 weeks)

• Likelihood of returning to work

– 50% if sick leave lasts 3-6 months

– 10% if sick leave lasts 1 year or

more

Why provide return-to-work assistance?

Source: KU Leuven article: Lode Godderis: Is a quick return to work good for employee health? (17/07/2015)Lode Godderis, Professor of Occupational Medicine & Director of Research at IDEWE

Long-term

sick leave

is bad

for

employee

health

Working is good for employee

health• Structure

• Social contact

• Involvement in society

• Status and identity

• Self-actualisationWIN for the

employee

WIN for the

company

25 | 17/11/2017

2017

Actio

n

Plan

• Recognition of burnout as a work-

related illness in the pipeline

• 2 new laws on return-to-work

(Ministry of Public Health and

Ministry of Employment) effective

1/12/2016

– To provide a return-to-work assistance

program

– by an occupational health physician ,

requested by:

• employee

• Social Security advisory physician (after 2

months)

• employer (after 4 months)

26 | 17/11/2017

Complement to statutory requirements

OI +1M OI +2M OI +3M OI + 4M OI +6M OI +8M

Legi

slat

ion

AG

Insu

ran

ce

DI claim

reported +

questionnaire

sent by

Sickness Fund

DI claim reportedStart of return-to-

work assistance

program

Average end of

return-to-work

assistance program

OI +9/18MOI

Occupational

health

physician

issues

decision

Mutual

agreement

between

employer

and employee

Start of

return-to-work

assistance

plan

Sickness Fund

physician checks

eligibility of

employee for

assistance (max

2M after claim

reported)

Process may be

initiated by

employer

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Return-to-work

assistance via

AG Insurance?

1. since 1 January 2017

2. for employees on sick leave

(> 30d)

3. for stress-related conditions

4. delivered by external care

providers

5. independently of the waiting

period

| 29 | 17/11/2017 |

How does this

affect statutory

obligations of the

employer? 1. Does not replace obligations

2. Proactive and curative

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What are the

benefits for the

employer? 1. Off-the-shelf approach

delivered by accredited

experts

2. Helps to minimise indirect

costs

3. Consistent with social and

human values of the

company

| 31 | 17/11/2017 |

How does it

work?

1. Employer pre-selects return-to-

work assistance partner

2. Employee on sickleave for

stress-related illness• Claim reported

• AG Insurance offers to start

assistance program

• Employee goes through program

• Different outcomes possible

3. Feedback

| 32 | 17/11/2017 |

What are the

different steps in

the program ?

with respect for the employee’s privacy

1. Recover and stabilize2. Reactivate3. Reintegrate4. Consolidate (avoid relapse)

| 33 | 17/11/2017 |

How long does

an assistance

program take?

1. Objective: to get the employee back

into the workplace

2. On average, 4 to 6 months, depending

on pathology and severity

3. Soft landing

1. Always by mutual agreement

2. Program continues after employee

has returned to work (relapse

prevention)

3. Additional sessions can be

arranged (upon own initiative)

| 34 | 17/11/2017 |

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