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Employer Assistance & Resource Network on Disability Inclusion (EARN): A service of The Viscardi Center.
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Company Name:
Aetna Inc.
Type of Industry:
Health Insurance
Number of Employees:

Work Break Flexibility As An Accommodation


This case study focuses on Aetna's 'work break flexibility' policy which is the most common accommodation Aetna implements to assist employees with disabilities meet job performance standards. This strategy was developed to retain employees working as telephonic Customer Service Representatives which requires the ability to meet a key performance measure, adherence to the established workday schedule. Tools provided to make this policy successful include a HR Call Center, a standard request form, a Workplace Accommodation Unit, and an interactive process to customize a schedule for the individual employee's need.

Case Study

At Aetna, every employee lives by a core set of values that put the people who use our services at the center of everything we do. For the thousands of employees who deliver telephonic Customer Service to members and providers, our values mean that we strive to address peoples' questions and concerns quickly and efficiently. To that end, Aetna customer service representatives must meet performance metrics around the quality and efficiency of their work.

Skilled training and technological innovation help employees meet expectations. However, some employees may have disabilities that could affect their ability to meet certain job performance standards. Aetna has implemented a variety of accommodations for employees with disabilities arising from a range of different medical conditions. One of the most common accommodations is work break flexibility, which is a simple, low-to-no-cost example of how to help and retain employees affected at work by a disability.

Performance standards for telephonic Customer Service Representatives include measures of both quality and quantity of work. Aetna's ability to answer calls quickly is critical, and staffing levels and workload balancing are based on the cumulative schedules of everyone in the department. As a result, a key performance measure for these employees is adherence to the workday schedule. In an eight-hour day this typically includes two 15-minute paid work breaks and a 30-minute lunch. In addition, there is an allowance for a limited amount of unscheduled time away from job duties. Taking longer breaks or lunch, or exceeding the extra allowance will count against an employee's schedule adherence.

So what chronic condition or disability could cause symptoms that result in not meeting schedule adherence? In general these are invisible disabilities that managers will be unaware of unless the employee requests an accommodation. For example, cardiovascular conditions such as hypertension often require medications that increase urinary voiding. Employees with diabetes, especially when newly diagnosed or not well-controlled, may require additional time for glucose testing or bathroom breaks. Gastrointestinal and genito-urinary conditions such as chronic interstitial cystitis or inflammatory bowel syndromes can increase the need for bathroom breaks. Finally, pregnancy, though not generally considered a disability, can create a need for flexibility with standard work break schedules. These are just a few examples and, under the 2008 Americans with Disabilities Amendments Act the range of covered conditions and disabilities are even more inclusive than under the original Americans with Disabilities Act (ADA).

Aetna's culture of diversity and ease of access support the accommodation process. When an employee reports to the supervisor that his or her performance challenge could have a medical reason, that front line supervisor refers the employee to a subject matter expert in Human Resources (HR). Aetna has a centralized HR Call Center with 1-800 phone number access. Call Center staff guide employees with accommodation inquiries to the ADA accommodations policy, instructions and request forms, and to consultants who can answer any questions they may have. Once the Workplace Accommodation Unit receives the Request Form completed by the employee and his/her health care provider, they engage the employee and management in the interactive process, keeping the supporting clinical information confidential. This process determines whether there is a reasonable accommodation that will enable the employee to perform the essential functions of his/her job.

What does work break flexibility mean? In most situations this flexibility simply means changing the two 15-minute paid work breaks to three 10-minute or six 5-minute breaks. In other situations, management may approve additional unpaid, unscheduled breaks of 20 minutes or more that would be made up during the same work week. If the employee is not EML eligible, Aetna can provide a limited amount of protected absence time as an accommodation. Each employee's case is unique, so the interactive process results in a schedule customized to each employee's need. In addition, it must be compliant with relevant federal and state laws.

In the first quarter of 2011, 25% of Aetna's ADA workplace accommodation requests related to work breaks and schedules. Only one week after implementation of a flexible break schedule, one employee reported that his performance improved 15-20%. This type of accommodation costs only the time it takes to arrange it, and is yet one more example of a workplace accommodation that costs less than $500. It is a win-win for employees and corporation alike.

Aetna's user-friendly accommodation process demonstrates its commitment to a diverse employee base and helps retain talented employees. In addition, Aetna's ability to accommodate a wide range of disabilities expands the pool of potential talent that can be recruited from outside the company.