Employee Assistance Programs (EAP): A Deep Dive

In this iPMI Global Insights article, global healthcare and insurance veteran Brian Piper, explores the benefits of employee assistance programs.

Setting up a business is risky, and entrepreneurs face immense challenges.  Imagine starting a U.S. corporation as an expat, in the Czech Republic, then creating a branch office and subsidiary operations in a foreign country. 

It has been an interesting time with many challenges along the way.

As a management consultant for over 30 years, I’ve worked in Cost Containment, Cross Border Healthcare, IPMI, Insurtech, and now EAP, over the various phases of my career and gained significant experience in the global arena. 

As an American expat since 1992, in 2006 I returned to the USA as a trailing spouse. My direct experience may be worthwhile in sharing my know-how with IPMI Global readers. 

One element of IPMI and Employee Benefits that may be overlooked and undervalued is Employee Assistance Programs (EAP) or within IPMI - Expat Assistance Programs. 

For those of you that are not familiar with the concept here is a description. 

Defining the benefits of an Employee Assistance Program (EAP) involves looking at how it serves employees and employers. Here’s a breakdown of its advantages:

Benefits for Employees

Mental Health Support: EAPs provide access to counselling and mental health resources, helping employees manage stress, anxiety, and depression.

Work-Life Balance: These programs help with personal issues, such as family problems, financial concerns, and legal matters, enabling employees to maintain a better work-life balance.

Confidentiality: EAP services are typically confidential, allowing employees to seek help without fear of stigma or repercussions at work.

Improved Job Performance: By addressing personal and psychological issues, employees can enhance their focus and productivity, leading to better job performance.

Preventative Care: EAPs often provide preventive resources and workshops, promoting overall well-being and resilience among employees.

Benefits for Employers

Increased Productivity: Healthy employees are more productive. EAPs help reduce absenteeism and presenteeism by addressing issues that affect work performance.

Reduced Healthcare Costs: By promoting mental health and well-being, EAPs can help lower healthcare expenses associated with stress-related illnesses.

Enhanced Employee Retention: Offering EAPs can improve job satisfaction and loyalty, which helps reduce turnover rates.

Positive Workplace Culture: EAPs contribute to a supportive work environment, showing employees that their well-being is valued.

Compliance and Risk Management: EAPs can assist in managing workplace issues like harassment or conflict, helping employers navigate legal and compliance challenges.

Key Themes

Employee Assistance Programs serve as a valuable resource for both employees and employers. They promote mental health, enhance workplace productivity, and foster a supportive company culture, leading to a healthier, more engaged workforce.

My introduction to EAP was by an Expat Healthcare Insurance Provider, a pioneer in utilizing EAP and embedding it in all our plans. As a boutique provider, this was to help insureds cope with the challenges of being an expatriate. However, domestic employees face the same challenges.

This brings up a few areas for consideration to embellish upon.

For Mobility experts - sending expats abroad is more challenging, involved, and expensive than a typical staff in the home country. Expats face challenges that others do not incur at home, Cultural Adjustment, Language Barriers: Isolation and Loneliness, Workplace Integration, Legal and Bureaucratic Hurdles, Healthcare Access: Financial Management, Homesickness, Education for Children, and Repatriation.

Moreover, given only 3.6 % of the global population are expatriates, HR professionals likely haven’t been on an expat assignment or lived abroad. Therefore, they may underestimate the actual challenges an expat may face, whether it's a short or long-term assignment. 

Logically, expats have certain perks not afforded to them in the home office - paid accommodation, school, travel, and repatriation costs, plus other incentives. With all the benefits the expat should be thrilled to relocate abroad. Typically, working expatriates are normally engaged and productive when they are sent abroad. 

However, what about the trailing spouse and family, they do not have the same conditions at home with a support group such as their family and friends. Often, they cannot find the same level of work or engagements (hobbies, sports, social life) they had back at home. 

If not addressed these factors can lead to a failed assignment, which is costly and creates issues that could be avoided if the proper measures are taken to educate the expats and their families on what to expect before going on an assignment. 

This is a benefit of an EAP.  From personal experience, the EAP provider was training our team on the scope of services they offered. They had a diagram outlining the ebb and flow, regarding what to expect on an expat assignment, and what to expect when you repatriate.

My wife and I looked at one another and agreed - our assignment would have been much better if we had known “This is normal”.  

There are a few other points I would like to highlight:

Embedded vs Standalone: 

Some IPMI plans have EAP embedded in their plans. 

1. Does the insured know about the full service and the range of issues it covers? 
2. Have they tried it? 
3. Do they find it useful?

Onboarding is vital to communicate the value and function of EAP.  

When members use Standalone, they might initially feel they are paying for a service and want to test it. However, once they experience the benefits, employees are likely to stay loyal.

Case Study: A team working for a foreign bank in EAP had a colleague die unexpectedly. They were overwhelmed with grief.  The EAP offered bereavement counselling to help them get through the acute grieving stage.  EAP is not limited to expatriates, it’s universal, assisting employees to cope with day-to-day issues and challenges.   

From an IPMI perspective, I recommend embedded EAP to groups and individuals with strong onboarding and training on the benefits available. If EAP is standalone, include strong support and onboarding with the EAP provider. This can be as simple as a webinar introducing the member through the benefits and scope of services offered. 

As an employer - when comparing jobs - all things being equal - pay, and typical benefits, the employer offering an EAP is likely to come out on top. Think of the banking group, it was tremendously helpful to them. If they did not have an EAP how would this have impacted them?  

Offering an EAP illustrates to employees a sense of caring for their well-being. It’s likely to improve employees' motivation, reduce absenteeism, and a more well-rounded work/life balance.    

ROI - Return on Investment.

At a recent webinar on health and wellness benefits a large UK insurer shared one of their biggest obstacles in convincing the C-Suite executives the Return on Investment of wellness programs in general. 

My first question to any executive is what is your most valuable resource? The likely response is people. So, the next question is what measurable steps are you taking to secure their wellbeing and productivity? 

Employee Assistance Program – your return-on-investment ROI Calculator

• Full-time employees (FT) 
• Sickness absence percentage
• Average salary per day
• Average absence length in workdays
• = Your return on investment

EAP - Consolidation within the industry  

The EAP provider I initially worked with, merged with a lesser-known brand. Following, they were acquired, becoming a division of a large Canadian firm. Other EAP providers are part of large multinational corporations. 

From experience, mergers and acquisitions often look good on paper, and execution is key. As firms get larger, they can lose touch with their core base - clients, over operational efficiencies and profit margins.  As an American, I’ve observed several acquisitions in the IPMI field by U.S. companies. 

The American mentality seems to be - no matter how profitable or well-run the company “…we will fix it…”

My former employer and a competitor in Canada were separately acquired by a European insurer and assistance provider. They were allowed to operate independently during the integration, which created valuable synergy. Another independent competitor was acquired by a US healthcare giant, leaving the local team feeling overwhelmed and frustrated by the bureaucracy and corporate oversight that followed. 

In summary, instead of pausing to understand operations and identify improvements, the standard approach - to impose a top-down corporate mold on the acquisition.

Having lived in Europe for over half my life, I greatly value the diverse European mentality, culture, languages, and distinct approach to services, it’s more personalized. 

Unless your company is a major North American or UK-based multinational corporation, a European EAP provider will likely have a better understanding of employee challenges and greater cultural knowledge, expertise, and language skills. Again, this depends on the location of the employer and where the employees are based. For employers, a consideration may be splitting the EAP services to the headquarters and a separate EAP provider where the operations are based elsewhere.   

Case in point, I was training in Florida, with a German colleague who had lived in South America.  An insured called in very anxiously as his Brazilian wife was taken to the hospital and he was calling about coverage and benefits, we had access to the policy and coverage. 

Ascertaining the situation, my colleague asked politely, "Do you speak Portuguese?" 

His voice lowered; he was calm and more collected. He explained the issue with great relief. The simple point is the ability to seek help in your native language can make a huge difference especially when discussing more delicate matters.  

Market Opportunities 

In North America, the UK, and Ireland EAP is more well-known than in other parts of the world.

Within Europe, GCC, Africa, and globally, there is an emerging awareness of offering employee benefits that are meaningful and valued by employees and their families.  

Talent recruitment and retention is a challenge for companies.  Finding the right blend of knowledge, skills, and experience is difficult. Retaining talent is equally as important.  Some employees may leave for various reasons but if an employer has a solid scope of benefits differentiating themselves from other employers they stand to gain in the long run. 

Employee Benefits are the “special sauce” that can make a difference to employees EAP is a unique flavour that supports the overall contentment of the workforce.

Employees who leave for better pay often lack an understanding of the balance between their contributions and the employer's interests. In contrast, those who recognize that their employer values them and provides a stable foundation tend to work more calmly, the result - improved productivity and outcomes. 

This aligns with Maslow's Hierarchy of Needs.

White label

EAP services are typically targeted at larger employers 1,000 plus employees, which reduces the cost per employee dramatically. EAP services may not be affordable for smaller companies.  

For insurance Brokers and International Broker Networks, but also Associations and Chambers of Commerce creating a White Label can draw in members who benefit from larger group discounts. In the USA joining a Chamber of Commerce, the cost of membership vs the savings on group healthcare insurance is exponential. Rather than paying individual rates, via the Chamber members can access group rates. 

The same applies to organizations that can offer an umbrella benefit for members that when scaled lowers the cost and provides access to benefits typically only offered by larger companies 1,000 employees and more. For insurance brokers, the same applies if they can set up and run an affinity plan ABC Broker EAP powered by EAP Provider, where all their clients from SMEs to large groups can access benefits as a group scheme. 

Emerging Markets

Here in the Czech Republic, one-tenth of the population are foreigners. Attending an expat seminar sponsored by the Expat Center Prague. A young man Mikoláš Voborský spoke on behalf of a non-profit organization Nevyhasni, on the topic of Burnout. He shared a statistic 25% of Czech employees are experiencing burnout. When I asked how HR professionals deal with this issue, he explained they do not want to “Open Pandora's Box”. 

If one in four of your employees is experiencing burnout, Pandora’s Box is open.  HR staff may not know about EAP, how it can help, and the value it can bring to their employees.  Independent, confidential, trained counsellors can be highly effective in directly accessing and assisting employees with their personal and professional issues.  

This is not the job of the HR department to offer direct support to employees but if they have a resource EAP available, they should use it. 

In summary, HR professionals should evaluate EAP offerings and engage in discussions about employee well-being. Intermediaries and international networks, Employee Benefits advisors should take a consultative approach, educate, share know-how, and add value to their clients.  

Bottom line - Studies show that organizations using EAPs experience increased productivity. Meanwhile, highly engaged teams provide up to 21% more profitability.

EAP is an employee service that benefits both the employer and the employee. It is both tangible and measurable, a benefit that underpins the well-being of employees and their extended families. EAPs help employees manage stress and mental health challenges, allowing them to focus more effectively on their work. 

Article Summary

David Trott, who runs Somerset Counselling, a private counselling practice, in the UK, and works with EAP providers concludes, “This article provides a comprehensive overview of the benefits and considerations surrounding Employee Assistance Programs. It argues that EAPs are a valuable investment for organizations looking to improve employee well-being, productivity, and retention, particularly in an increasingly globalized and demanding work environment. The author emphasizes the need for culturally sensitive and personalized approaches and highlights the importance of effective communication and onboarding to maximize the impact of EAP services.”

About the Author

Brian S. Piper, MBA is the President of IBDA INC. – specializing in international trade and business development.  2024 marked the 30th year in business for IBDA INC. Brian’s expatriate journey started in Czechoslovakia in 1992, as a volunteer. 

In October last year, teaming up with Oldorff Consulting we started working with CCS a strategic provider of EAP services, a pioneer in Europe since 1988. Our mission – developing the CCS brand with an emphasis on raising awareness and offering CCS's expertise and solutions. We are partnering with brokers, insurers, assistance companies, EB specialists, and directly with clients.

To contact Brian, reach him on LinkedIn: Brian S. Piper  

Learn more about CCS, visit: www.ccsint.com