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2009-27141 ResoRESOLUTION NO. 2009-27141 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE CITY TO ENTER INTO AN AGREEMENT WITH UNUM, FOR THE ADMINISTRATION OF THE CITY'S FAMILY AND MEDICAL LEAVE PROGRAM, COMMENCING ON JANUARY 1, 2010, AND ENDING ON DECEMBER 31, 2013, FOR A NOT TO EXCEED FEE OF $38,000 FOR THE FIRST AND SECOND YEARS; A LONG-TERM DISABILITY POLICY FOR THE PARTICIPANTS IN THE CITY'S 401(a) DEFINED CONTRIBUTION PENSION PLAN, FOR A NOT TO EXCEED FEE OF $9,950 FOR THE FIRST AND SECOND YEARS; AND SHORT-TERM DISABILITY AND LONG-TERM DISABILITY POLICIES, FULLY FUNDED BY EMPLOYEE CONTRIBTUTIONS, FOR A THREE YEAR PERIOD, ALL PURSUANT TO THE REQUEST FOR PROPOSALS ISSUED BY GALLAGHER BENEFITS SERVICES, THE CITY'S CONSULTANT OF RECORD. WHEREAS, as required by the U.S. Department of Labor, the City's Family Medical Leave (FML) policy provides employees the opportunity for up to twenty-six (26) weeks of unpaid leave for the care of a family member; and WHEREAS, the City's policy is administered by members of the Human Resources Compensation Division and Department Payroll Coordinators; and WHEREAS, certification of the employee's application for the medical necessity for the FML is provided through the City's agreement with Mount Sinai; and WHEREAS, while the Administration has done well in the administration of FML, the Administration is aware of the complexities of the U. S. Department of Labor's rulings; and WHEREAS, Unum can provide expert management of the City's FML policy; including medical certification and day to day management of FML; and WHEREAS, the City provides along-term disability plan for the fifty (50) current participants in the City's Defined Contribution Retirement Plan (401(a)); and WHEREAS, the Defined Contribution Retirement Plan (401(a)) includes a long- term disability benefit with the annual premium cost paid by the City, to mirror the long- term disability benefit provided by the Miami Beach Employees' Retirement Plan; and WHEREAS, the annual premium cost to the City to continue this coverage under the proposed Unum long-term is equal to the City's current annual cost; and WHEREAS, the opportunity to purchase short and long term disability offers employees the opportunity to purchase some salary protection should they be unable to work for an extended period of time; and WHEREAS, the short-term and long-term disability benefit would be a voluntary benefit made available to the employees, and would be paid fully by the employees; and WHEREAS, based on the responses to the RFP, the short-term and long-term disability plans proposed by Unum provide employees with the best value; and APPROVED AS TO FORM & LANGUAGE WHEREAS, after evaluating the respondents, Gallagher recommends the administration of the City's FML policy, the long-term disability policy for the City's 401(a) participants, and employee funded short-term and long-term disability plans be awarded to Unum, based on the value of the benefit provided and the cost; and WHEREAS, the City Manager has reviewed the recommendations of Gallagher and recommends accepting the recommendation, awarding the administration of the City's Family Medical Leave policy; long-term disability policy for participants in the Defined Contribution Retirement Plan (401(a); and an agreement for a voluntary short and long term disability plan to Unum. NOW, THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission hereby authorize the City to enter into an agreement with Unum, for the administration of the City's Family and Medical Leave program, commencing on January 1, 2010, and ending on December 31, 2013, for a not to exceed fee of $38,000 for the first and second years; along-term disability policy for the participants in the City's 401(a) Defined Contribution Pension Plan, for a not to exceed fee of $9,950 for the first and second years; and short-term disability and long-term disability policies, fully funded by employee contributions, for a three year period, all pursuant to the Request for Proposals issued by Gallagher Benefits Services, the City's consultant of record. PASSED and ADOPTED this 15th day of July , 2009. MA Mattie Herrera Bower TTEST: ~ ati C~ CITY CLERK Robert Parcher T:\AGENDA\2009Wu1y 15\Regular\Disability and FML t~ FO ELUTION rr 7 14 Qq ,- Resolution.d '" ity ttorne Date COMMISSION ITEM SUMMARY Condensed Title: A Resolution of the City to enter into an agreement with Unum for the administration of the City's Family and Medical Leave (FML) program, along-Term Disability policy for Defined Contribution Retirement Plan (401(a)) participants and a Short-Term Disability and Long-Term Disability policy fully-funded by the employee. Intended outcome 5u • Attract and maintain a quality workforce. • Ensure ex enditure trends are sustainable over the Ion term. Supporting Data (Surveys, Environmental Scan, etc.): I. 2007 Internal Support Functions Survey • Overall satisfaction of benefits administration was rated 75.6% as excellent or good combined II. 2008 Environmental Scan • Motivated and Skilled Workforce turnover rates = 13.86% for 2007 vs. 10.7% for 2006 Issue: Should the City contract with Unum for the administration of the City's Family Medical Leave (FML) program and a new voluntary short-term and long-term disability insurance program? item summarvircecommenaation: At the direction of the City's Administration, Gallagher Benefits Services issued RFP No. 10-2589 requesting proposals for a new voluntary short and long term disability benefit fully-funded by employee contribution. Offering employees the opportunity to purchase short and long term disability provides employees some salary protection should they be unable to work for an extended period of time. As a result of the City's voluntary short-term and long- termdisability RFP process, the Administration was made aware of the availability of expert management services of the Family Medical Leave (FML) Act which would follow consistent interpretations of the U.S. Federal Government regulations. Following their review of the RFP responses, Gallagher Benefits Services recommends the employee funded voluntary short-tern and long-term disability program and the administration of the City's Family and Medical Leave policy be administered by Unum. Adviso Board Recommendation: N/A Financial Information: ___ Source of Amount Account Funds: 1 $38,000 (not to exceed) 560-1793-000322 Administrative Fees for Active Employees for the administration of Family Medical Leave 2 $9,950 (not to exceed) 601.7000.229327 Premium for long-term disability coverage for the participants of the Defined Contribution Retirement Plan 401 a OBPI Total $47,950 (not to exceed) Financial Impact Summary: The City would not incur a cost impact offering a voluntary short-term and long-term disabilty benefit to its employees since these benefits are voluntary with the full cost of the plan paid by the employee through payroll contributions. For those fifty (50) remaining employees in the Defined Contribution Retirement Plan (401(a)), the City will need to continue the long-term disability. The annual proposed premium cost to the City $9,950, equal to the plan's current annual cost. This change in long-term disability plan vendors is cost neutral to the City. The City's FML policy is administered and processed by staff in Human Resources Department and the Payroll Coordinators in each department. Medical certification of the application is provided through the City's agreement with Mount Sinai Medical Center. For each application reviewed by Mount Sinai Medical Center, the City is charged fifteen dollars ($15). In the 2008 calendar year, Mount Sinai Medical Center reviewed seventy-eight (78) FML applications, for a total cost of $1,170. While the Administration is aware this is a much lower cost than the project annual administrative fee of $38,000, by contracting this service out, the need for staff to process the employee application is eliminated, therefore resulting in created efficiencies in the Human Resources Department as well as departments throughout the City. \.rll VI@fR 5 ViTIG@ Le ISlailve 1 raCKln Sue Radig, Human Resources Administrator I Sian-Offs: , DepartmenfDirector Assistant City Manager City Manager Ramiro Inguanzo, Human Resources Director ~~ l Y t ~ ~ ~~~ AGE#+IDfI iTEM -O DATE 7'~ S m MIAMIBEACH City of Miami Beath, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachA.gov COMMISSION MEMORANDUM TO: Mayor Matti Herrera Bower and Members of the City Co mission FROM: Jorge M. Gonzalez, City Manager DATE: July 15, 2009 SUBJECT: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE CITY TO ENTER INTO AN AGREEMENT WITH UNUM, FOR THE ADMINISTRATION OF THE CITY'S FAMILY AND MEDICAL LEAVE PROGRAM WITH A NOT TO EXCEED FEE OF $38,000 FOR THE FIRST AND SECOND YEARS, ALONG-TERM DISABILITY POLICY FOR THE PARTICIPANTS IN THE CITY'S 401(a) DEFINED CONTRIBUTION PENSION PLAN WITH A NOT TO EXCEED FEE OF $9,950 FOR THE FIRST AND SECOND YEARS, AND SHORT-TERM DISABILITY AND LONG-TERM DISABILITY POLICIES FULLY FUNDED BY EMPLOYEE CONTRIBTUTIONS, FOR A THREE YEAR PERIOD, PURSUANT TO THE REQUEST FOR PROPOSALS ISSUED BY GALLAGHER BENEFITS SERVICES, THE CITY'S CONSULTANT OF RECORD. ADMINISTRATION RECOMMENDATION Adopt the Resolution. ANALYSIS The City currently provides employees the opportunity to elect coverage to protect their heath and life, however, no coverage option is made available to employees to protect their income should they become unable to work due to an illness or injury. In order to provide employees with the opportunity to purchase voluntary disability coverage, the Administration worked with Gallagher Benefits Services (Gallagher), the City's consultant of record, to issue a Request for Proposals (RFP) for a voluntary group short-term and long-term disability plan funded fully by employee contributions, with no contribution being made toward the coverage by the City. Employees are not provided the opportunity to purchase short-term and long-term disability coverage. The Administration requested Gallagher Benefits Services (Gallagher) issue an RFP for voluntary short-term and long-term disability plans fully funded by the employees. Currently, employees who are not vested in the Miami Beach Employees' Retirement Plan are not provided salary protection should they be unable to work. For an employee to receive a disability benefit from the Miami Beach Employees' Retirement Plan, the employee must be fully vested in the plan. With the plan's current five (5) year vesting provision, a number of City employees would not be eligible for a disability benefit from the pension plan. In addition, the disability benefit provided by Social Security is not available to an individual who has not contributed to Social Security in the twenty four (24) months prior to the date of their disability. As City employees do not contribute to Social Security, an individual who has July 15, 2009 City Commission Meeting Selection of a Voluntary Group Disability Policy and a Family Medial Leave Administrator Page 2 of 5 been employed by the City for a period of twenty-four (24) months or more may not be eligible for any Social Security disability benefits. Offering employees the opportunity to purchase voluntary short-term and long-term disability coverage provides a protection should they be unable to work for an extended period of time due to an illness or accidental injury not related to their employment. Short-term disabilty provides an employee a percentage of their earnings for a maximum period of twenty-six (26) weeks due to a non-work related illness or injury. The cost of the coverage is based on the employee's earnings prior to their disability and the percentage of coverage purchased. While collecting short-term disability benefits the employee's medical condition is monitored by the plan to encourage an expedited return to work. Long-term disability provides the employee a percentage of their earnings after their first twenty-six (26) weeks of disability due to a non-work related illness or injury. Coverage under the plan is provided until the employee is able to return to work, is approved by Social Security for Disability Benefits (if eligible) or dies. In addition, the long-term disability plan provides training and job placement opportunities should the individual be unable to perform the duties of the job held prior to their illness or injury. The cost of the coverage is based on the employee's earnings and the percentage of coverage purchased. In response to the RFP, the following four (4) vendors responded with bids to provide a group voluntary short-term and long-term disability plan to the employees of the City: • Lincoln Financial • The Hartford • The Standard • Unum The response from The Standard did not include premium costs and was not considered. The following is a summary of the premium rates and rate guarantees of the three (3) proposals: Plan Administrator Short-Term Disability Rate er $100 Short-Term Disability Rate Guarantee Long-Term Disability Rate er $100 Long-Term Disability Rate Guarantee Lincoln Financial $.29 One 1 ear $.36 One 1 ear The Hartford $.57 One 1 ear $.36 One 1 ear Unum $.33 Two 2 ear $.50 One 1 ear After thoroughly evaluating the respondents, Gallagher Benefit Services determined the plans provide by Unum (Attachment A) provided the best benefit value at a cost affordable to the employees and recommends the City award an agreement for a voluntary short and long term disability plan, fully funded by employee contributions, to Unum based on the following supporting factors: • Unum provided the best continuity of coverage with a seamless transition of benefits from short-term disability to long-term disability • Same definition of disability under both the short-term disability program and long- term disability program July 15, 2009 City Commission Meeting Selection of a Voluntary Group Qisability Policy and a Family Medial Leave Administrator Page 3 of 5 • Transitioning to a long-term does not require additional certifications from the participants treating physicians as the participants treatment information is communicated between plans as necessary • Family Medical Leave (FML) administration provided for any employee approved for short-term disability at no cost In addition to a voluntary long-term disability offering, the City requested proposals for a long-term disability plan for the fifty (50) current participants in the City's Defined Contribution Retirement Plan (401(a)). These employees were hired prior to the March 18, 2006 change in the City's pension benefits terminating the defined contribution plan (401(a)) and elected to continue their pension benefit through the plan. Included in the Defined Contribution Retirement Plan (401(a)) is a long-term disability benefit with the annual premium cost paid by the City. This long-term disability benefit is provided to these plan participants to mirror the long-term disability benefit provided by the Miami Beach Employees' Retirement Plan. The annual premium cost to the City to continue this coverage under the proposed Unum long-term disabilty plan is $9,894, equal to the current annual City's current cost. This City provided long-term disability coverage ends when the plan participant terminates or retires. This change in plan vendors is cost neutral to the City. Included with their response for the short-term and long-term disability plan, Unum provided information regarding availability of their management services for the City's Family Medical Leave (FML) Act for all employees. As required by the U.S. Federal Government, Department of Labor the City's Family Medical Leave (FML) policy provides employees the opportunity for up to twelve (12) weeks of unpaid leave for their own care or the care of a family member due to a medical need. The leave can be taken all at once, or intermittently. In addition, the City has enhanced the FML policy to include an additional twelve (12) week period of FML, if deemed medically necessary. Additionally, recent enhancements made to the Family Medical Leave Act provides leaves for employees who have family members in the military called to active duty or to care for a covered service member recovering from a serious injury or illness incurred in the line of duty. Unum has indicated their ability to provide management of the City's FML policy. This management would include medical certification and day-to-day administration of the City's current FML policy, providing protections from misinterpretation of the FML Act and its current and future changes, and convenience to the employee with one (1) point of contact for all their FML application, questions, and certifications. In addition, Unum representatives maintain constant contact with the individual's treating physician to guarantee the employee is returned to work as quickly as possible. The Administration believes expert management of the FML policy to be valuable service to the City and its employees. Unum would be able to provide the employee a one (1) point of contact for the administration of the policy, constant contact with the treating physician to guarantee the employee compliance and expedited return to work and compliance with atl federally mandated changes in the program. Management of FML by Unum would create a cost impact to the City. However, the Administration believes the management provided by Unum could create overall cost savings due to close adherence to the FML regulations and the close medical monitoring and the employee's expedited return to work. Unum has also provided the City with a copy of their projected return on investment for their proposed administration of the City's FML Policy (Attachment B). July 15, 2009 City Commission Meeting Selection of a Voluntary Group Disability Policy and a Family Medial Leave Administrator Page 4 of 5 While the City has done well in the administration of FML in the past, the Administration is aware of the complexities of the FML rulings and the recent additions to eligible leave types have brought to the policy. While these changes in the policy provide job protections to the employee and grant them more unpaid leave, the City is left vulnerable to their own individual interpretation of the act itself. The Administration feels the day-to-day management of the policy exposes the City to penalties and fines related to errors in the interpretation of the FML regulations. Should the City make the decision to have Unum manage its FML policy, FML management would be coordinated with the management of the short-term disability plan, providing the employee one (1) point of contact for both their FML applications and short-term disability benefit. FINANCIAL IMPACT The City would not incur a cost impact offering a voluntary short-term and long-term disabilty benefit to its employees. Both the short-term and long-term disability benefits are voluntary with the full cost of the plan paid by the employee through payroll contributions. For those fifty (50) remaining employees in the Defined Contribution Retirement Plan (401(a)), the City will need to continue the long-term disability coverage included in this pension benefit. The annual premium cost to the City to continue this coverage under the proposed Unum long-term disabilty plan is $9,894, equal to the plan's current annual cost. This change in long-term disability plan vendors is cost neutral to the City. Currently the City's FML policy is administered by staff in Human Resources Department and the Payroll Coordinators in each department. Medical certification of the application (when required) is provided through the City's agreement with Mount Sinai Medical Center. For each application reviewed by Mount Sinai Medical Center the City is charged fifteen dollars ($15). In the 2008 calendaryear, Mount Sinai Medical Center reviewed seventy-eight (78) of the City's one hundred forty-six (146) FML applications, for a total cost of $1,170. The per employee per month charge by Unum is $1.45 based on the number of current employees the annual cost would be approximately, but not to exceed, $38,000. While the Administration is aware this is a much lower cost than the project annual administrative fee of $38,000, it is believed that the expert management of this federally mandated leave may result in the employee's expedited return to work and reduced exposure to potential fines and penalties from the U.S. Federal Government. FML processing time is dependent on the application being complete with the correct medical contact information and the cooperation of both the individual's treating physician and the employee. By contracting this service out, it eliminates the need for staff to process the employee application, therefore resulting in created efficiencies in the Human Resources Department as well as departments throughout the City. With this in mind, a vacant position in Human Resources Department is being proposed to be eliminated in Fiscal Year 2009/10 as the work related to the processing of FML requests, which has been done by various HR staff, will be consolidated and reorganized. The elimination of this vacant position will result in a cost savings greater than the amount paid for the management of FML by Unum. July 15, 2009 City Commission Meeting Selection of a Voluntary Group Disability Poiicy and a Family Medial Leave Administrator Page 5 of 5 CONCLUSION The City Manager has reviewed the recommendations of Gallagher Benefits Services and recommends accepting their recommendation, awarding the administration of the City's FML policy for a three year period with a not to exceed fee of $38,000 annually for the first and second years, along-term disability policy for the participants in the City's Defined Contribution Pension (401(a)) Plan with a not to exceed fee of $9,950 for the first and second years, for a three year period, and an agreement for a voluntary short and long term disabilty plan for the employees of the City of Miami Beach, fully funded by employee contributions, for a three year period. T:\AGENDA\2009\July 15\Regular\Disability and FML Memo.doc Attachment A Gallagher Benefits Services Letter of Recommendation e~ Gallagher Benefit Services, Inc. June 30, 2009 Ramiro Inguanzo, Human Resources Director City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 Re: Employee Benefits Recommendations Dear Mr. Inguanzo, A Subsidiary of Arthur J. Gallagher ~ Co. At the City of Miami Beach's request, we released Request for Proposals (RFP's) for all City employee benefits including Medical, Dental, Life, Accidental Death and Dismemberment, Voluntary and Dependent Life, Statutory Accidental Death and Dismemberment, Employee Assistance Program, Vision, Short and Long Term Disability. A vendor list has been provided illustrating what carriers were supplied the RFP's and those that responded by product (See exhibit A). Recommendations will be discussed briefly below. Medical proposals were requested for claims administration and network access. We requested both duplication of existing benefits and alternate benefit schedules. Responses were received from the incumbent carrier Humana, AvMed, Cigna Healthcare, Aetna United and Blue Cross & Blue Shield of Florida. We recommend renewal with Humana based on the following: 1) Humana offered the lowest administrative fee's to the City including a reduction of current costs 2) Retaining Humana will cause no disruption to member provider relations 3) Physician and hospital reimbursement analysis revealed Humana's strong South Florida discounts Life and Accidental Death and Dismemberment Request for Proposal resulted in thirteen responses including the incumbent carrier, Standard. Short listing and continued negotiations results in the recommendation of Hartford Life for the Basic Life and AD&D, Dependent Life, Retiree Life and Voluntary Life. Reasons are as follows: 1) Lowest Basic Life, AD&D and Retiree cost to City and employees 2) Thirty six month rate guarantee Statutory Accidental Death and Dismemberment Benefit Request for Proposal resulted in two responses, the incumbent Hartford Life and Ace USA. We recommend renewal with Hartford. 1) Hartford offered lowest cost including a 25% reduction in current annual premium 2) No change to current benefits 3) Three year rate guarantee One Boca Place 2255 Glades Road, Suite 400 E Boca Raton, FL 33431 561.995.6706 Fax 561.995.6708 www.ajg.com i~ ~. p Currently Dental coverage (Indemnity/PPO and DMO) are purchased by the City on a fully insured basis for the DMO and self insured for the Indemnity and PPO. In addition to the incumbent response from Comp Benefits, eight addition proposals were received. We recommend awarding MetLife the fully insured DMO plan and self funding the Indemnity/PPO dental coverage. Factors supporting this recommendation are as follows: DMO 1) MetLife offered lowest DMO cost (16% reduction annually) while improving benefits to members 2) Large network of general dentists, Periodontists, Endodontic and Orthodontists. 3) Two year rate guarantee. Indemnity/PPO 1) Lowest annual administrative fee's 2) Improved benefits to participating members 3) Thirty six month rate guarantee The Employee Assistance Program is currently provided by Ceridian. Six additional proposals were received and reviewed for cost, benefits provided and Medical Plan integration opportunities resulting from the recent Federal Benefits Law changes impacting Mental Health Parity. Humana is the recommended vendor for the following reasons: 1) Improved benefits via increased face to face visits 2) Low cost relative to benefits provided 3) Medical plan savings opportunity as a result of common vendor coordination The Vision benefits Request for Proposal resulted in eight responses. Similar to the Dental benefits, both fully insured and self insured proposals were received. We are again recommending this benefit be self funded based on the low claims risk and trend predictability. EyeMed is the recommended vendor based upon: 1) Lowest administrative services fee 2) Comprehensive exam and hardware benefits 3) Large tri-county provider network Short and Long Term Disability Benefits RFP's responses were evaluated by vendors offering both coverage's. For continuity of coverage and a seamless transition from short term to long term disability, the objective is to provide continuity of coverage and a seamless transition from short to long term disability with no disruption due to differences in disability definition, medical evaluation and benefits offered. Unum is the recommended carrier. 1) Minimal participation requirement and no termination feature 2) Low overall cost 3) Family Medical Leave Act administration for all employees 4) Twenty four month rate guarantee for Long Term Disability and FMLA Administration a ~~ 6~~' We appreciate the opportunity to work with the City and staff and would be happy to answer any questions you may have. Sincerely, Richard G. Schell Area Vice Preside Attachment B Unum's FML Return on Investment Illustration City of Miami Beach -FMLA Return on Investment (ROI) Illustration Illustrated ROI / FMLA with Unum Background Industry: Government Avg Salary: $62,000 Employees: 1,813 PEPM $1.45 illustration Leave rate (industry avg*) : 10% Avg Duration (industry avg*) : 23 days Estimated incidence 182 -1o°i° incidence rate Estimated FMLA acceptance rate 85% -Unum book is so°i° Impacted claims (denied) 28 - 15% of 182 Average leave duration 17 days - 23 calendar days (17 work) Est LW D's 476 - 28 leaves x 17 Estimate FTE's 1.83 x avg sal = Estimated full time equivalent savings $113,508 FMLA Administrative Costs $31,546 @ 1.45 pepm Cost~,~Benefit_(ROI) -~~~._:~ ~ ter . `' . = ,~3.~= ~7~~ ~:~~~~' ~. ,~..T ~~ ,,,s~~, . Sentinel effect ** Initial annual incidence 155 85 % of 182 Trended annual incidence after 6 months 140 90% of 155 Annualized savings / FTE's 0.98 15 leaves x 17 Iwd's / 260 Annual savings @avg salary $60,808 Additional Cost :Benefit 0.9 : 1 ... h,i~ w ., , . ,. Projected.cost :-bettiefit +~sentinel ~-:~ f.~ , °~ ~ * 5 5 ::r1r, ~ 1 _ ,, Additional Considerations Inhouse FML admin costs /per SHRM Employment law resources *** Wrongful termination lawsuit /legal expense Total add'I cost avoidance Total Savings (Reduced Costs) Total Projected,ROI $18,130 1 fte / 5000 ee's to administer $4,351 $2.40 per ee 10 000 avg cost = $150k/15 years $32,481 $206,797 6.6':,1 - - #.._ <.~, ~~,~~:' * Leave rate and duration based on Unum research on block of business and EPF Survey averages *' Sentinel effect represents the decrease in submitted leave requests 6-9 months after program implementation based on Unum historical book of business. *** Cost of Legal resources are based on Unum internal research studies