Global Employee Assistance Programs: Purchasing Materials

January 09, 2020

As companies become increasingly global, employers are searching for ways to improve the health and productivity of their employees around the world by implementing employee assistance programs (EAPs) globally.

Full Series icon_right_chevron_dark

Through a variety of interviews conducted with global employee assistance program (EAP) vendors, employers and experts, Global Institute staff developed a list of “lessons learned” for employers who are considering purchasing a global EAP, as well as sample request for proposal (RFP) questions. Employers should review these documents when they are launching an RFP, discussing the possibilities of implementing an EAP with their local HR staff, or having renewal conversations with their current vendors.

Know where you currently have EAPs and what they involve

Many companies that have a decentralized structure may not have had a consistent way of reporting the available benefits in each of their locations. If this describes your organization, survey your country staff to determine where EAPs already exist. Use this opportunity to ask about location-specific drivers of employee absences and their health concerns to find out what interventions will be most helpful in filling existing needs and gaps.

Determine what you want and need

Have a clear vision of what services and/or capabilities are most important to you before you begin the RFP process. What is your priority? Is it consistency and equity across your various locations? Or is it an in-country phone answering capability or a toll-free number in all locations? Or a thorough and complete Web platform or app that is available in most or all of your locations? Or is it well-being and work/life offerings?

While technology, evaluation methods and well-being/wellness seem to be focus areas for almost all global EAP vendors today, some have put more emphasis on one or two of those versus the other. It may be helpful to develop both minimum standards (e.g., what each EAP vendor, whether global, regional or local must be able to provide in order to serve your employees) and ideal standards (what you would prefer that they be able to provide, but are negotiable). You may then want to conduct a gap analysis to see how EAPs that currently exist in your locations compare to these standards and how your potential vendors compare in order to aid in decision-making for future programs.

Decide if you want to use a local, regional or global approach

Many employers, particularly those who do not have a dedicated EAP staff member in their organization, choose to have one global provider of EAP services in order to ease the burden of administration and oversight of multiple vendors. As one Global Institute member said, “Having one vendor allows us to better track and manage our finances and global initiatives in a central area. It’s just easier.” A global vendor also allows for an “apples to apples” comparison across countries. Another member said, “we went with a single provider to have reports that were consistent and could be easily summarized and provided to the senior leadership team.”

Other employers insist that a single vendor cannot truly serve all of their global locations and use regional or local providers instead. One Global Institute member said, “We intentionally look for smaller, local companies because they know the culture and language and engage with the business unit better.” Employers who do not prescribe to the global vendor approach may be concerned about higher price markup and less direct line of sight due to the number of middlemen involved.

Ultimately, each employer must decide which approach works best for their corporate and in-country staff based on their available financial and staffing resources, existing EAP vendor relationships and desire for global standards and services.

If Global, consider whether you want to contact with U.S. or global based vendor

Several U.S.-based vendors contract out to global vendors to provide EAP services around the world. Some employers prefer this approach because they like the familiarity of working with a U.S.-based organization that also may provide their health benefits.

Other employers prefer to do away with up and said, “When you’re looking at why you should go with a U.S. carrier or a U.S. provider that then contracts with a global provider, the two things you’re really looking at are contracting and account management.

If you’re contracting directly with a global EAP provider then you’re closer to source of service delivery. You’re closer to the account manager and the contact is direct. If you decide to go through a U.S. EAP provider or an insurance carrier, then it’s another layer, but the reason you might want to do that is you might want one point of contact for account management. You may want to call up the person in the U.S. to say, ‘What’s happening in India?’ and trust that they will find out and get back to you. If you want a single point of contact in North America, that’s definitely a benefit. And then contracting would be an obvious one. If a large amount of your employees are in the States and you have disparate populations globally, you can get cost-efficiencies because the U.S. carrier or U.S. provider will give you one blended rate.”

Involve local staff from the beginning

Involving local staff in the selection of your EAP vendor can increase buy-in by providing them with a sense of ownership. Determine based on your company structure in which phases they are involved. Having a local EAP champion does wonders for promoting and keeping it marketed locally. That person is usually in-country HR. Also, they will be needed to help navigate the labor/ employee relations requirements to implement. Additionally, some employers who have successfully implemented global employee assistance programs have established EAP committees, consisting of a medical professional, an operations or HR leader, and one or two employee representatives in each location. These committees are involved from the selection phase to the implementation phase. Having support from in country leaders can help mitigate some of the skepticism that may surround an EAP in many locations and can therefore increase utilization.

When there are multiple stakeholders involved in the selection phase, however, it’s important to have an objective process that incorporates metrics and measurement so that each person understands how the particular vendor was chosen. It is important that corporate staff also establishes a culture where every person is heard, but once a particular vendor is chosen, it is the responsibility of all staff members to support the decision that was made.

Local staff members are also experts in their own country and can help you to determine what services are needed in their location. As one vendor said, “it [EAP] requires a consultative joint learning process with the local national leadership team around their issues, what is available to help support those issues, and how you can help them become aware of those issues they may not be seeing in order to begin designing a program. After you have the leadership team convinced and have a design that you’ve raised up together with mutual learning and education, you have to ask yourself, how do we begin to get it to a level of acceptance on the shop floor?”

Understand your pricing options

Understand your pricing options. Understanding the pricing structure options by vendor and what is most economical given the employee footprint. Also, weigh efficiencies costs related to having different EAP models; for example, not having to manage or renew several local providers may be worth some added cost.

According to one vendor, “If your company has 1,000 employees in Asia, and 900 of them are in India and 100 are in Hong Kong, it might be rate x. But if the same 1,000 employees are split with 900 in Hong Kong and 100 in India, that rate might triple or double and it’s still Asia. The rate can vary even by the language provided in the same country. There’s a bit of a bell curve to rates but it’s reversed. The lowest prices are in locations where EAP is well-established, the U.S. or U.K. for example. EAPs are most expensive in countries that view themselves as more specialized or the services are harder to provide. Japan is a great example. But then, ironically, the other places that are really expensive are Tanzania or the Ivory Coast or places like those, where the provider knows you have no choice but to use them.”

In order to give you an accurate quote, vendors will need headcounts of the populations you are interested in covering in each of your locations. If possible, include this information in your RFP.

Ensure Services are delivered in a culturally sensitive manner

Make sure services are tailored to the needs of your employee population. Even if you choose to have global administration of your EAP, service delivery needs to be done at a local level if you want the program to meet your company’s needs. This means that all services need to be culturally adapted, tailored and tested to fit the demands of the particular employee population in each location. It is important that the vendor you choose understands that you cannot take a template with a specific set of processes, procedures and messages and apply it across all countries and expect it to work. All tools and communication materials should be locally tested and adjusted as necessary in order for them to be successful. If you instead choose to have local or regional vendors, you may want to develop global minimum standards in order to have some sense of continuity and equity across locations (e.g., minimum number of sessions, focus on management consultation, specific trainings available, etc.).

Meet the vendors you are considering in person

Visiting vendors on-site allows you to get a more complete perspective on what they can offer your employees. If you are able to conduct an on-site visit, use that time to evaluate the quality of the staff and their level of cultural awareness, talk to their local customer base, view their available materials and their filing practices, and travel to the locations of their community affiliates to see if they are located near where your employees live. Making the local office or plant-site visit part of the evaluation and selection process gives the local staff some sense of ownership over the program, which may assist in increasing buy-in and utilization. You may also want to evaluate their local providers’ ability to work effectively and respectfully with all aspects of the population without prejudice. For example, are they respectful of a particular religious holiday or practice?

Decide if you are going to pay for an EAP

Will you require the local divisions to pay for the program? There are positives and negatives to both approaches. Paying for the EAP at a corporate level allows corporate staff to have more control over what is required and available in each country; however, this also means that local divisions may feel that they have very little “skin in the game” and may not be invested in the success of the program. On the other hand, many employers who have asked the local country or division to pay for the program have had difficulties in getting them to do so unless it’s required, which may then result to local staff feeling that it’s another corporate-required policy. However, this approach may also result in local staff having a sense of more ownership over the program since they are financing it.

Be clear on billing and payment structure

One Global Institute member pointed out the importance of understanding the vendors’ way of billing or invoicing for their services, particularly when the individual countries are paying the costs themselves. “I know that’s a tricky part and there are some interesting tax rules in some countries that make it maybe not as straightforward as one would like, but I think it’s a key question,” the member said. “That was something I had to go through on my own so it didn’t sound like it was discussed all that much prior to it. There needed to be an understanding on how we could make sure it wasn’t one invoice that I was going to have to charge back. We needed to set it up so that we’d get the global price but have the invoices in local dollars to the local countries, with the exception of those countries where that is a prohibitive concept from a tax perspective.”

Make sure RFP reflect local needs

Make sure the vendor you choose is aware of relevant country-specific legislation. As one employer said, “we just found out very quickly that there were going to be, and necessarily were, differences at a market level that we really needed to tease out.”

Another employer said, “When I go back to the very first time we did it [an RFP], I would have wanted to talk to them more at the very front-end about country-specific legal competence. Do they know the labor laws and the privacy laws in China versus the Middle East versus Europe?”

And another employer said, “Don’t tell me you’re in 140 countries. Tell me you’re in 40 countries doing full blown EAP and in others you’re doing telephonic support. We need to understand what you’re really doing.”

It is unlikely that you will want to have a separate RFP for each country if you are administering the selection process centrally, but you should have country-specific sections to help you determine a vendor’s cultural awareness and its capabilities in at least your most important locations, both by country and by city. As part of this, make sure you have a listing of the number of providers your vendor has in each location and the providers’ availability. For example, does the vendor only have one provider in Istanbul who has a wait list that is three months long? If so, this is probably not going to be sufficient for your population there.

Know who the providers are

Know where they’re located, what their specialties are and how they are credentialed. Ask vendors about their requirements for providers, whether they’re affiliates or employees of the company, and how they are chosen. Some employers require that the intake staff answering the phones have a mental health background as well as those engaging in telephonic or face-to-face counseling. Since the providers will be the ones actually interacting with your employees, they can make a huge difference in whether your employees stay engaged in services and show improvement. Another way to gauge employee satisfaction with providers is to ask the average number of sessions attended by employees to see if they are returning after the first session.

Include relevant performance guarantees in your contracts

asked what they would do differently next time in terms of selecting a vendor, one employer said, “Definitely stronger performance guarantees… really keeping those vendors accountable for what they’re providing us.” Employers should ensure that they’re receiving regular reports on utilization as well as having quarterly reviews with account managers to compare performance. Vendors should also be held accountable for supporting EAP promotion to increase utilization and include some “extra services” that do so (i.e. lunch and learns, etc.) at no additional cost.

However, it’s important to make sure the performance guarantees you choose are relevant to your location and align with your goals. As one EAP vendor said, “We see a lot of performance guarantees that are around metrics that at the end of the day either a) can’t be done outside the U.S. or b) regardless of whether they’re met have no bearing on the outcome. What would be the benefit? Frequently the performance guarantees aren’t tied to whether we made any kind of impact.”

Don’t use your U.S. RFP

A common concern among global vendors is the fact that some employers structure their global RFP just like their U.S. one. One vendor said, “If you were to take the standard EAP and work/life RFP that exists in this country, so much of it is about your network, your call center, and how you deal with claims. It really needs to be more country-specific.”

Another vendor said, “Large employers have a tendency for an EAP RFP to be generated out of a procurement department and they don’t necessarily know what they’re asking for, so they use the same RFP that they use for their vendors in North America. Then they score it based on the same criteria -- how many seconds to answer, how many dropped calls, do you have child care resources and referral services?” It is, however, a fact of life for many companies that procurement will be involved. Global employers should engage with their procurement partner and align expectations about how the RFP may need to be structured differently to meet global needs.

Sample RFP Questions

Business Group staff members have developed a list of potential questions that employers may want to include in their existing or new global EAP RFPs. Employers should examine each question to ensure its relevance to their particular needs before including it in all of their requests.

Business Overview and Experience

How many years of experience do you have in providing global EAP services?
Can you provide us with customer references in countries where we have company locations?
How many global clients are you currently serving and in which countries?
What is your customer retention rate and what is the percentage of global clients that have renewed at least twice?
What is the average utilization rate for your book of business?
Please describe the ownership structure and organization of your company.

Cultural Sensitivity and Literacy

Please describe the laws and regulations that affect your EAP offerings in the countries in which we have operations (e.g., where are you most limited? Where do you need to take very different approaches)?
Can you give specific examples of regional/country/cultural differences in service delivery that are applicable in our top 5 or 10 locations?
Please walk me through exactly what would happen from the time a potential client called the EAP in our top 2 or 3 locations to the time they finished receiving services. Who would answer the phone and in what language? What type of mental health treatment would they receive (if applicable)? How would their progress be monitored?
What types of cross-cultural training can you provide for both local hires and expatriates in order to help them work together successfully?
Please give a few recent examples of how employers have tailored your EAP to meet their specific needs.
What emerging issues do you see in global EAPs that we should be aware of?
What are you doing to address barriers such as access and stigma in particular countries?

Services Offered

How many face-to-face sessions are included?
What services do you offer for critical incidents and crises (e.g., natural disaster, employee death, workplace accident, etc.)? Are there additional costs for these services? Who provides the services and where are they located?
Please explain your call center/intake structure and why you have chosen that model. Is it 24/7 live answer? Are calls answered in a regional call center or locally in each country? Is there a toll-free number available in all of our locations?
Would you be willing to sell us critical incident services around the world if needed, regardless of whether that country has an EAP program?
How do you provide training, outreach and consultation to HR, managers and supervisors?
Please outline your wellness/well-being capabilities globally. Specifically outline which services are available in our top 2-3 locations and how exactly those services are provided.
How do you provide services for expatriates and their families (e.g., preparation for trip, while on assignment, and preparation for returning home)? Are these proactive or reactive services?
How do you integrate/coordinate the services you provide with other key organizational functions, like health promotion, disability/return to work, health/welfare benefits planning and administration, wellbeing programs, occupational health, etc?
Do you have services for caregiving or end-of-life care? Stress? Suicide and suicide prevention? In which countries are these services available and how are they provided?
In which of our countries do you not offer face-to-face capabilities? How will you meet employee needs in those locations? Please explain your system for referring employees to community providers once EAP services are exhausted. What do you do in countries where there are no appropriate community providers or where they are prohibitively expensive?

Networking and Staffing Capabilities

What are your minimum requirements for both counselors and for intake staff? If this varies by country, please detail those differences.
How many affiliate providers do you have in each of our locations (by city and country if possible)?
In which countries do you have your own staff versus in which countries do you have affiliates/ subcontractors?
What is your training process for new and existing employees and affiliates? How do you ensure global consistency in your training for network affiliates?
Do you have continuing education requirements for your employees and affiliates? If so, what does this involve?
Please provide a listing of your global affiliates.

Administration

Please outline your account management structure. Will we have a dedicated account manager? Are there regional, global and market-level account managers?
What are the language capabilities of the account managers that you have identified for our company?
How many times per year are we able to meet with the account manager(s) in person and/or by phone?
What is the percentage of cases globally that are reviewed for quality control? What does this review entail? What is your process for correcting deficiencies?
How will you protect the privacy of our employees, particularly if/when you are subcontracting with a local vendor?
What data privacy and transfer issues/laws are relevant in our company locations?

Promotion, Communication and Technology

Please provide an example of communications you’ve created to assist a client with communicating the value of EAP in a specific location.
What is included in the basic package of communications when a client contracts with your organization? Do you provide us with rollout webinars, brochures, posters, employee welcome letters, etc? What “add-ons” are available for an additional fee?
How will you tailor your communication strategies for the employees we have in different divisions or occupations, even within the same country and culture?
How will you promote our services to reach maximum utilization? What will you need from us versus what are you able to do? What exactly will promotion look like and how often will it happen?
In what languages is your Web portal available? Do you have acculturated online materials? If so, where?
Please outline your global technological capabilities outside of your website (apps, instant messaging/ chat, video counseling, AI, etc.). How do you use these to help people access services in a confidential manner when and where they need to?
Will you help us communicate the value of EAP to “sell” it to our various locations? Please describe.

Reporting

How do you evaluate the effect of EAP on organizational performance (productivity, disability, engagement, absenteeism, retention, etc.)? Can you quantify this?
How can we benchmark the success of our program versus other companies in your book of business?
How often will market-level, regional and global reports be available and in what timeframe? For example, how soon after a quarter closes will we receive a quarterly report?
Can you provide examples of market-level, regional and global reports?
Is there any additional cost for other reports we may need?
How do you count utilization and what types of utilization statistics do you include in your typical reports?
What is your policy about third-party external auditors reviewing the business or clinical practices of your EAP? Identify any external audits that have been conducted on your EAP. What was the outcome of these audits?1