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TRANSCRIPT
The Treasury Isle of Man Government
Deploying Benefits – A Process Review
10 September 2014
Final Report
The Treasury Isle of Man Government
Deploying Benefits – A Process Review
2
Table of Contents
1. Introduction 3
1.1. Organisational Structure 4
1.2. Cost of Administration 8
2. Key Process Review 10
2.1. Approach and Assumptions 10
2.2. Conclusions 18
3. Recommendations 24
4. Appendices 25
4.1. Appendix 1 - Breakdown of Administration Costs 26
4.2. Appendix 2 – Scenarios Mapped 36
4.3. Appendix 3 – Process Maps 55
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Deploying Benefits – A Process Review
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1. Introduction This report sets out an overview of the current structure and key processes used to deploy the Social Security System, used on the IOM. The main purpose of this work is to ensure:
The recommendations made within the main report that change process can actually be employed
Improvements are identified that increase the resilience of the system, reduce costs and improve quality
We set out an overview of the current structure and costs, then we detail the key processes.
For each process / scenario, the process has been mapped the approach used was a combination of interviewing staff, and observation of live claims.
We have produced a high level analysis of any areas of waste / inefficiency, together with views on the customer experience (their positive and negative perspectives), how staff are deployed and some suggestions to simplify steps in the processes.
The final section of the report looks at common themes and issues, and makes the following recommendations for improvements and efficiencies:
Introduce online self-service systems
Introduce electronic payment cards for citizens in receipt of benefits to remove duplication and to support the collection of data required
With the upcoming replacement of ICT systems within the Department, serious thought needs to be given to a root and branch review of how the systems operate and interact (rather than a straight replacement or just incremental improvement to systems)
Investigate and introduce systems that carry out all calculations and approvals required from online approach (this will only be possible if some form of simplification of the benefits system is undertaken). The technology exists to take human interaction out of the entire system if required
Introduce cross training of benefits processes, eligibility and calculations. Merge teams to increase resilience and deliver the economy of scale, reducing resource costs (this will need an IT solution to deliver savings)
Increase the approach of the integration of benefit and tax systems, particularly 2changed to allow the sharing of information
Design reporting required and ensure any new system will allow the reporting needs to save duplicate systems
Introduce BAC’s for as many payments as possible, reducing the cost of producing cheques and vouchers
Produce process and procedure notes for all processes to enable cross skilling
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Deploying Benefits – A Process Review
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Consider the proposal of moving to a ‘New Manx Benefit’ before designing the system.
1.1. Organisational Structure
The Department is responsible for deploying benefits, it is structured around four main functions:
1. Policy
2. Pensions & Income Support
3. General Benefits
4. Investigations and Audit.
Detail of the organisational structure are set out in Figures 1, 2, 3 and 4 below. The Pensions and Income Department is further split into five areas:
Three pension teams
One working age income support team
One income support team – pensioners.
The General Benefits Team is split into five main teams and organised around four main functions:
One Incapacity Benefit team
One Child Benefit team
One Disability Benefit team
Two Job Seeker teams.
The Trea
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Figure 1
Figure 2
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asury Isle of
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The Trea
Deployin
Figure 3
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asury Isle of
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ssessing Officer
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The Trea
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Figure 4
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Deploying Benefits – A Process Review
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The team is made up of 63.3 fulltime employees (FTEs); 26.6 FTEs within the Pensions and Income Support team, 24.7 FTEs within the General Benefits team.
The grade mix by team is shown in Table 1 below:
Table 1 – Grade mix
Grade Policy Pensions & Income support
General Benefits
Investigations and Audit
SEO 1 1 1
HEO 1 1 1 1
EO 1 5 6 4
AO 1 18 18
AO LTA 1 2
AA 2
1.2. Cost of Administration
The total cost of social security administration for the 12 months ending 21st March 2012 was £3,727,644. A summary of costs are set out in Table 2 and a complete breakdown is shown in Appendix 1
Table 2 – Cost of Administration
2011/2012 Actuals
Pay Spend Non Pay
Spend Total
Policy / Legislation Section 264,841 1,051,559 1,316,400
Regional offices 280 7,891 8,171
ICT / BPS 4,696 283,825 288,521
Markwell House - 204,641 204,641
Inspectors / Contributions Team 513,917 5,533 519,450
Pensions / Income support Team 704,844 3,385 708,229
General Benefits Team 623,560 58,672 682,232
Total 2,112,138 1,615,506 3,727,644
Note – Regional offices salaries are accounted for in the functional teams.
Pay spend accounts for 56% of the total cost. Key costs within non pay spend include:
Professional fees: £132,578
Communications, post, general: £193,240
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Deploying Benefits – A Process Review
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Commissions payable to the post office: £493,000
Contracted out computing support: £202,333
Rent, rates and energy: £182,845.
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Deploying Benefits – A Process Review
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2. Key Process Review In the following section we set out our findings from a process review carried out on the following benefits:
Maternity & Paternity
Disability Living Allowance
Incapacity Benefit
Income Support
Jobseeker’s Allowance
Employed Persons Allowance
Child Benefit
Pensions.
We have included a process map and set out in detail the scenarios mapped, which are shown in Appendix 2.
2.1. Approach and Assumptions
A range of times for each stage of processing were ascertained through interviews with key staff. The range shows a minimum and maximum estimated processing time - the cumulative figure of each stage within a process.
The timings given refer to the initial set-up of a claim, a first payment of benefit and one change of circumstance. Benefits that are paid regularly will have a time burden, but this will be minimal assuming that details of the claim (or the claimant) have not changed.
For costs, an hourly rate (and hence a rate £ per minute) has been determined.
Days Hours PA
Available Time (255 days per annum 7.4 hours per day) per staff member
255 1,887
£ per Minute FTE Total Hours Pay PH OH /Ph Cost Ph Cost PM
Average for all teams 63.3 119,447 £17.68 £13.52 £31.21 £0.52
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2.1.1. Maternity / Paternity Allowance
The purpose of this process is to deliver, assess, qualify and pay a benefit to those expecting a child and is payable to all mothers for up to 39 weeks, plus a paternity allowance to fathers of up to two weeks. Those on benefits also receive a payment for maternity.
Time 20 - 75 minutes
Cost £10.40 - £39.00
Issues / waste
For Paternity Leave, no checks with employer for absence from work or whether any occupational scheme
Forms are manual, so any errors / omissions require the form to be mailed back to claimant
Administration of claims is split across two teams (and physically across two floors)
Being dependent on post can delay the process Paper based system Manual calculations Duties split across two teams split over two floors -
dedicated roles in each, so some resilience issues.
Customer's perspective
Good information provided – personally Department approachable Manual forms, no online system, at odds with modern
services.
2.1.2. Disability Living Allowance
This process covers three benefits:
Disability Living Allowance (DLA) payable for children and adults under 65
Attendance Allowance payable for over 65s
Carer's Allowance payable to someone who cares for someone on Attendance Allowance or DLA.
These are the lengthiest benefits processes since they involve a number of quite complex assessments and the use of third parties for the assessment. A claim can take up to eight weeks to process, even though administration staff time for a claim will be less than four hours.
Team Structure
There are potential resilience issues since the team only consists of two administrative officers and a team leader. Absences can lead to backlogs of claims. Procedure notes are not in place, but are being drawn up. There are similarities in the process to the award of Incapacity Benefit.
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Time 65 - 225 minutes
Cost £33.80 - £117.00
Issues / waste
Payments are made by cheque or vouchers (redeemable at a Post Office). There are often issues with lost cheques or vouchers, with associated costs of re-issue
There are also delays in assessing claims, since there is a reliance on medical evidence / assessments from third parties
The components of DLA are applicable in different cases, with differing rates, so this part of the process is complex
Cheques and vouchers not as cost-effective / flexible as direct bank credit payment
Manual forms can cause delay if errors or omissions Forms written in a style that prompts claimants to state
factors to maximise / increase rate of benefit Manual calculations - potential for error Physical files and paperwork - potential for loss,
documents being misplaced Process is extremely complex due to differences in
medical ailments and methods of assessment, as well as multiple benefits rates.
Customer's perspective
Manual forms and need for putting in personal details every time a form is completed. Lots of duplication
Process can take a long time to complete Paper form that at times needs support to complete No online or BACs provision.
2.1.3. Incapacity Benefit
There is no Statutory Sick Pay on the Island, so Incapacity Benefit is paid for short-term sickness (self-certification for first seven days) as well as longer-term incapacity. The onus is on the claimant to keep providing medical certificates to continue to be in receipt of benefit.
The workload is split across the General Benefits team and the Incapacity Benefits team.
Team Structure
There is a resilience issue regarding verification of UK NICs, since there is only one role with access to the system there are delays when this member of staff is absent.
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Time 45 - 120 minutes
Cost £22.95 - £61.20
Issues / waste
Parallel spreadsheets are maintained to provide statistical information for Treasury (even though this information has never been requested and they are now part of the Treasury Department)
Payment is still by made by cheque - and since they are "Do Not Redirect” there are sometimes issues with change of address. Lost cheques have to be reissued, with the additional cost of administration. Some cheques are produced in advance of receipt of medical evidence and held until the notes arrive
The payment cards held for claimants are physical documents and manually completed. There is a risk of cards being lost or misplaced or some errors in completion
Calculations are manual Manual forms, so delays in processing (through mail) and
need to complete all details every time Cheques can be wasted if produced before medical note
received; cheque payment not cost-effective Some delays when waiting on third parties (GPs, hospitals,
etc.) Manual forms and payment cards - loss of data Manual calculations - errors Risk of overpayment.
Customer's perspective
Manual forms, so need to complete details every time - duplication
Onus on claimant to provide medical notes to claim payment Onus on claimant to notify DSC when incapacity ends Onus is on employees claiming, rather than employers (as
with SSP) - this can be more time consuming for staff The level of customer service delivered by the team is very high, with a strong knowledge of claimants, their histories and the benefits process and eligibility. This means that claimants' queries are dealt with effectively.
2.1.4. Income Support
This allowance is a benefit to ensure that citizens are in receipt of income to cover the cost of living - whether that income is made up of earnings, Incapacity Benefit or other benefits. This makes it complex and tied up with any changes to other benefits or a citizen's earnings. The workload of the team is approximately 50% new claims and 50% revisions to existing claims.
There is scanning of documents and evidence into a Document Management System (DMS) that is interrogative. However, the scanning process is relatively lengthy as documents are scanned in one at a time, rather than batch-processing.
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Evidence is primarily taken at face value - there is not much in the way of verification.
A big positive is that Benefit Payment System (BPS) has a calculation module for Income Support, although there are some manual calculations that still need carrying out.
Payments are still made by cheque - but this is, in part, because the cheque itself acts as a declaration. There is also an issue where, when a claimant moves from Incapacity Benefit to Income Support, there can be a gap in claimants receiving benefits. Processes are often gone through, even though the outcome is known.
If there are overpayments debt balances are taken across all benefits - and referred to a specific role for all debts (this could be a resilience issue).
Time 56 - 130 minutes
Cost £28.56 - £66.30
Issues / waste
Main calculations are within a module on the Benefits Payment System but some manual calculations are required
Parallel spreadsheets are maintained as well as the BPS in order to provide statistics - BPS cannot export this data / report
Manual forms are posted out and there can be delays if posted back to claimant if there are errors / omissions. A paper based system which relies on the postal system
There are still issues with lost cheques, change of address and costs of reissue
Paper based systems carry the risk of loss of files / data and the potential for error
Review periods are quite lengthy and there is a risk of overpayment
The basis of this benefit is to ensure that a claimant's cost-of-living is met through benefits - as a result it is a complex process that will change whenever other benefits or circumstances change.
Customer's perspective
Manual forms, so need to complete details every time – duplication
Need to keep on top of informing DSC of changes in costs, circumstances, etc.
Seen as complicated but receive good reactive support from the team.
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2.1.5. Job-Seekers Allowance (JSA)
This is a fortnightly payment to those in receipt of this benefit and is a complex system, since there can be Incapacity Benefit claims and changes to applicable costs as well as a myriad of other factors.
This process has been through a re-vamp recently to streamline stages and improve efficiency. A lot of claimant interaction takes place at the dedicated counter at Markwell House, which means that errors on forms are reduced (or dealt with more quickly).
Time 55 - 115 minutes
Cost £28.05 - £58.65
Issues / waste
Manual claim forms (for start of a claim) Delays in processing if employer does not respond promptly Costs of mail correspondence Cheques can be lost, returned or need amending Payments are made by cheque (paid fortnightly in arrears).
There can be issues with changes of address, as well as lost cheques that need to be reissued
Manual documentation - risk of data loss Manual calculations - arithmetic errors, transcription errors Relatively complex system which requires numerous checks
and gateways.
Customer's perspective
Manual forms to complete (although majority filled in with help at JSA counter)
Jobseeker's agreement allows a more focused approach Payment by cheque rather than direct bank credit.
2.1.6. Employed Person’s Allowance (EPA)
If a person is in employment and working over 16 hours a week (or a couple working 30 hours per week) they may be eligible to EPA if they fulfil certain criteria. Claimants will move between EPA and Income Support and, as a result, will be aware of the process and criteria.
Team Structure
Claimants tend to move between Income Support and EPA, which means that there is a lot of interaction between the two teams. As with the other teams, there are only three members in the team and therefore potential resilience issues.
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Time 35 - 110 minutes
Cost £17.85 - £56.10
Issues / waste
The calculation of EPA, where payment is dependent on the level of income for a claimant adds complexity due to the proof required and lack of integrated systems. In turn this adds cost
There is scope for error, although the calculations are checked once done
When claims come in, and are entered on the BPS, a parallel spreadsheet is maintained for statistics (requested through Treasury)
Scanning is not batch-processing Payment by cheque is still continuing and has issues of lost
cheques or returned cheques (they are "do not redirect") and the associated cost of administration / re-issue
Manual calculations (plus checking) Delays in form completion (mailed back if errors / omissions) Claimants moving between EPA and Income Support have to
fill in manual forms each time, leading to duplication Staff physically check for claim forms every hour (down one
floor) Costs of mail correspondence.
Customer's perspective
Manual forms, so need to complete details every time Claimants need to keep track of their cost of living and notify
the Department of any changes There is an issue for renewals of claims - there has to be
submission at least two weeks before an EPA claim expires. If this window is missed, the claimant must submit a new claim and start the process over again.
2.1.7. Child Benefit
Benefits are paid to the main carers of children and there are standard rates. The benefit is now means-tested on the basis of the income of both parents. Benefits are paid until the child finishes full-time education or the family leaves the Island (switch to UK benefit).
Team Structure
The core team is made up of three staff, but this has been increased by a further two due to the introduction of means-testing. The two additional staff have been employed on three year fixed term contracts.
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Time 40-90 minutes
Cost £20.40 - £45.90
Issues / waste
Manual forms with no retention of details Delays in processing if errors / omissions in forms (some by
mail, some over phone) Checking of manual calculations Lots of manual intervention Not linked to the Tax system which would improve the
means-testing element.
Customer's perspective
Manual forms, so need to complete details every time Good reactive service from the team Wording on claim forms can be too vague - means that not
accurately completed No real consideration for those who have English as a second
language or have any language problems Leads to a high volume of phone calls and queries.
2.1.8. Pensions
In addition to a basic pension, there are the State Second Pension (S2P), SERPS, and, in some cases, a Supplementary IOM Pension. The process starts when citizens are approaching SPA. The pensions process is by far the most complex undertaken by the Department.
Due to delays in data being available on the Treasury NI mainframe system, data from the latest employment year has to be obtained through forms sent to employers.
The process cuts across two teams - processing and calculations.
A manual file is created for each claim - containing all details and evidence.
There will be split liabilities for claimants where there have been NI contributions in the UK and the IOM. Tax inspectors could be better trained to tighten up on what is due from the UK and to reduce lags.
There are a small proportion of Post Office vouchers still sent out, predominantly to older claimants, this is expected to tail off so that all payment is by direct credit.
Calculations are all manual except for a spreadsheet which calculates the additional pension payments. There are two knowledge-intensive posts and, whilst there are procedure notes and some junior team members are being trained up, there is a definite resilience issue.
Communications are through letter and, with issues as complex as pensions, it can be hard to explain what claimants are entitled to. One particular example is the letter to notify of the increase in pension payments for over 75s. This uses complex language and jargon that the average 75 year old would struggle to understand.
The other issue noted is that the onus of the pensions team is to ensure that every claimant gets the maximum pension that they are eligible for - including an option to
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make one-off payments of NIC to ensure they get their Pension Supplement entitlement.
Time 55 - 155 minutes
Cost £28.05 - £79.05
Issues / waste
Some delays and issues if split liability between the UK and the IOM from NICs
Letters not user-friendly (especially for older citizens) Calculations are very complex Obtaining / exporting information from Tax / NI systems is
not possible so, in some cases, count the number of contributory years from the system screen
Costs of mail correspondence Resilience issues due to a number of knowledge-intensive
posts Many calculations (except payment calculation) are done
manually with reference to charts / tables - risk of error Issue above re: system export carries risk of error / omissions Basic pension is supplemented by S2P, liability from
contracted out period, Pension Supplement (IOM Supplement) Calculations are lengthy and complex with multiple
components Due to complexity teams needs to be relatively large.
Customer's perspective
Pension information sent out to claimants, onus is not on the claimant to start a claim
Pension calculations are very complex and hard to fully understand
Pensions team will work to ensure pension is maximised to customer's benefit.
2.2. Conclusions
The IOM benefit system is a complicated and confusing mishmash of historic benefits, modern improvements, UK imported systems and IOM additions (which we have tried to show in Figure 5). That said, the departmental team is a group of hard working and committed individuals who, when focusing on evaluating and delivering payments, deliver well with the tools they have.
The Benefits team, in the main, have an excellent and close knowledge of their clients, there is a superb customer service ethos from the Department and good knowledge of the systems, as well as a very personable approach (at the counter and over the telephone).
Response times for calls are very good, except for the team which are also dealing with physical visitors at the counter.
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The BPS database is used to check on what other benefits the claimants are receiving and there is a ‘notes log’ process which works well, highlighting whenever new activity takes place.
Communication between teams is very good and almost constant where a claimant's circumstances change and one benefit is swapped for (or added to) another.
There is scanning of documentary evidence for claims and the DMS is interrogative and works well. However, the scanning process is limited to one document at a time rather than batch-scanning. This could be improved with a more sophisticated scanner. The use of Optical Character Recognition (OCR) for forms and submissions could also be utilised to improve efficiency.
T
D
The Treasury Isle
Deploying Benefit
Figure 5
e of Man Governm
ts – A Process Re
– Complexity of t
ment
eview
the benefits syste
em
20
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The issues found within the current system can be categorised under a number of common areas:
Use of technology
Resilience
Data sharing
Over-use of post.
2.2.1. Use of Technology
The use of paper based forms creates increased workload, creating duplication of data input by the customer and the Department and increasing the number of resources required and consequently the cost, for example:
Cost of printing forms / cost of amendments etc.
The need for re-entry of data into systems
Delays and costs from having to mail forms back for any errors / omissions
From a customer perspective, the need to enter common details each and every time a claim form is filled out is additional work.
There is a lack of self-service in the system, which is enabled by online technology. If self-service was employed errors and costs could be reduced.
Online and self-service systems are readily used in other public sector organisations, including the UK Government.
The benefits of this are:
Forms do not have to be sent out - just downloaded from a website and completed by the claimant. Some forms can be fully completed online
For those without online access, facilitated access through staff can be arranged (by physical visit or by phone)
Evidence could be scanned and submitted by claimants and online evidence could be used
Data can be "stripped" from forms to automatically update systems without the need for re-keying information, making productivity savings - this could be through OCR or fully integrated online forms.
Many local authorities in the UK are in the process of implementing web-based software that enables citizens to input commonly used details (personal details, address, etc.) and amend them if needed. These details can then feed into, and update, all relevant systems.
Many calculations of benefit payments and the application of rates are manual - staff calculating figures using calculators and rate charts. This is a high-risk approach, with the potential for arithmetical errors, transcription errors and mis-keying errors. There are checks in place, but if calculations were done using software systems, or even just an MS Excel spreadsheet, then the productivity and staff-time savings would be
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significant, as well as reducing the risk of error. If the system could be simplified a whole technology approach could be employed that would not require human intervention to carry out calculations.
The continuation of these manual steps in claim processing also highlights the high risk of resilience within the teams, since they require a detailed level of knowledge (discussed further below).
It is realised that not everyone has, or will, embrace technology as a form of communication but the ‘hard to help’ could be supported by sitting with an officer to complete the information online.
2.2.2. Resilience
With the Department split into many small teams, with only three or four members per team, the issue of resilience is a major concern. There are some procedure notes in some teams, but the majority of the knowledge is in people's heads. During the time of the mapping exercise, several instances were noted where one key individual was absent and so there were delays in processing claims.
Bigger teams, covering a number of benefits, would reduce this resilience issue and allow better knowledge management. If this was coupled with the introduction of more ICT-automated steps knowledge-intensive posts would be less of an issue. It is to be noted that, although the detail of the calculation is different, the actual process delivered by every team is similar:
This approach would require a multi-disciplinary team approach supported by cross skill working.
2.2.3. Data Sharing / Multiple Updates
Whilst the BPS does only require one change of data to cover all benefits (e.g. change of address), in some cases the links across benefits are more "stilted" for the majority of issues.
Another issue is that separate spreadsheets are maintained to capture details that may be used for national statistics. This is because the BPS does not appear to be able to provide reports of the data needed for the statistics. This is an additional workload for staff that is not always used or required.
Only certain staff have access to the Tax and NI systems to check contributions and identity etc. This system is an older mainframe system and no data is exported from the system, only information taken by staff from display screens. To have the most efficient system there needs to be more sharing and integration of the system.
Gather DataAssess Eligibility
Accept/ Decline
InformMake
Payment
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2.2.4. Over-Use of the Postal Service
The current paper based system relies heavily on the postal system, which is costly (£493,000 in commission charges alone) this is further compacted by the use of cheques / vouchers as a system for payment. The commission charges do not take into account the cost of handling paper, such as printing and putting the item in the post.
By moving to online technology costs could be reduced significantly in both people and resources, i.e. paper, printing, envelopes, cost of labour. This approach would also speed up the process, particularly in reducing errors, by locking fields that don’t allow you to input the incorrect information.
2.2.5. Reducing Complexity
As stated previously, the system is complex and the team works hard with the tools they have to deliver a quality service. Technology, adjusting structures, reducing paper and improving system communication will improve what the Department correctly delivers and reduce costs. But the biggest saving in costs can only come from reducing the complexity of the benefits system.
By introducing the recommendations in this report the expectation would be that postal costs could be reduced by 75% and that staff costs could be reduced by up to 25%. This could deliver a saving of £830,000 p.a., which would need to be offset against the investment in technology and training that would be required.
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3. Recommendations
1 Introduce online self-service systems.
2 Introduce electronic payment cards for citizens in receipt of benefits to remove duplication and to support the collection of data required.
3 With the upcoming replacement of ICT systems within the Department, serious thought needs to be given to a root and branch review of how the systems operate and interact (rather than a straight replacement or just incremental improvement to systems).
4 Investigate and introduce systems that carry out all calculations and approvals required from online approach (this will only be possible if some form of simplification of the benefits system is undertaken). The technology exists to take human interaction out of the entire system if required.
5 Introduce cross training of benefits processes, eligibility and calculations. Merge teams to increase resilience and deliver the economy of scale, reducing resource costs (this will need an IT solution to deliver savings).
6 Increase the approach of the integration of benefit and tax systems, particularly important if means-testing is to be increased. This will require legislation to be changed to allow the sharing of information.
7 Design reporting required and ensure any new system will allow the reporting needs to save duplicate systems.
8 Introduce BACs for as many payments as possible, reducing the cost of producing cheques and vouchers.
9 Produce process and procedure notes for all processes to enable cross skilling.
10 Consider the proposal of moving to a ‘New Manx Benefit’ before designing the system.
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4. Appendices
Appendix 1 – Breakdown of Administration Costs
Appendix 2 – Scenarios Mapped
Appendix 3 – Process Maps
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4.1. Appendix 1 - Breakdown of Administration Costs
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4.2. Appendix 2 – Scenarios Mapped
The following sets out additional details to the scenarios mapped.
Maternity / Paternity Allowance
Paternity
Scenario A citizen entering the system via Paternity
Initial contact Through District Office
Mode / channel of contact
Phone call, email request or physical visit (no online provision)
Claim forms Physical form PA1 sent out to claimant for completion (by post or physical issue)
Evidence required
Proof of earnings during test period Details of employer Must request specific dates for paternity leave to be taken (1 or
2 weeks)
Verification
Test period calculated, based on baby's due date Have to have worked for 26 weeks during the test period Self-employed workers cannot claim Civil Service workers have a different process - paid leave
Claim submission
Forms posted to the Maternity / Paternity Administrator within the General Benefits section, Markwell House
Details of claim input onto Benefits Payment System Establish whether any previous claims (no limit on number of
claims that can be submitted)
Approval
Form sent to IB Team to check that NI / Tax has been paid for period worked (verify employment)
Check on time period (window for paternity leave is limited) Cross check / data matching for claim against a maternity claim
or a child benefit claim
Contact with citizen
No award letter Benefit paid in form of cheque sent to claimant (2 to 3 days
later) No letter out to employer to establish whether claimant is being
paid by employer during paternity leave period (so claimant could be paid Paternity Allowance and paid by employer)
Change in circumstances (address, off-island, etc.)
Limited to 1 or 2 weeks' payment Unlikely to be a change in the course of the process.
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Maternity
Scenario A citizen entering the system via Maternity
Initial contact Through District Office
Mode / channel of contact
Phone call, email request or physical visit (no online provision)
Claim forms Physical form MA1 sent out to claimant for completion (by post or physical issue)
Evidence required
Proof of earnings during test period (3 highest months or 13 highest weeks, depending on pay frequency)
Details of all employers MAT1 - Maternity Certificate issued by GP / Midwife (states due
date)
Claim submission
Forms posted / handed to Maternity / Paternity Administrator - General Benefits Section, Markwell House
Time claimant stops work can be submitted at any time during the process
Verification
66 week test period calculated based on baby's due date (tables to calculate test period sent out with form)
Have to have worked for 26 weeks during the test period Self-employed workers can claim if Class 2 NI contributions have
been paid Civil Service workers have a different process - paid leave Letter MAT2 sent to employers to complete and verify pay and
dates of employment (form is sent out on same day as MAT1 received by General Benefits section)
Claim file placed in "Waiting file" on first floor Details of claim input onto Benefits Payment System Processed to establish whether other benefits are being paid and
which will be replaced by Maternity Benefit Establish whether any previous claims (no limit on number of
claims that can be submitted)
Approval Form sent to Income team to check that NI / Tax has been paid
for period worked Check on time period (window for Maternity leave is limited)
Contact with citizen
Award letter sent out to claimant OR Disallowance letter sent out to claimant (if not worked enough in
test period, or window for claim exceeded) Benefit paid fortnightly in arrears (by direct deposit through
Benefits Payments System) Set Maternity Allowance of £179.85 per week
Change in circumstance (address, off-island, etc.)
Limited to 39 weeks' payment maximum.
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Disability Living Allowance Processes
Attendance Allowance is for over 65s
DLA is for children and adults under 65
Carer's Allowance is payable to someone who cares for someone on Attendance Allowance or DLA.
Informed via email - referrals from doctors, hospital, social work teams or relatives of the claimant. Can also be hospice (in terms of terminally ill cases) or claimant themselves in some cases. Can also be by phone or physical visit (including regional offices).
Physical form sent out, with 3 parts. Part II is not compulsory but just for additional information, so no need to go back to claimant if this part is not completed. When the forms are requested the date of request is put on the form - this is the date the claim will be paid from. There is a 6 week period for the form to be submitted, otherwise it's discarded.
Different forms for different categories (Child, Adult, AA, DS1500 for terminally ill) DS1500 can only be paid from the date the completed form is received.
Part I of the form covers:
Personal details
Condition itself
Contact details (medical)
Signature.
Part II covers how the condition affects the claimant's life and capability, regarding bodily functions, etc.
Once the form is submitted it is checked for completeness and passed on to the Adjudication Officer (Team Leader). They make a decision:
Further information required (mainly from 3rd parties - doctors, schools, hospital etc.)
OR
Award (based on the information received).
Information received up to point where decision made - award or disallowed. If disallowed, then can be resubmitted for a second opinion (and hence adjudication) and then there is an appeal process.
Fixed rates are:
DLA - care component and a mobility component (can have one or other or both)
Mobility:
Low rate - require supervision / assistance with walking (£20.20)
High rate - unable to walk at all (£54.10)
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Care:
Lower level - basic help on frequent basis (assistance) (£20.10)
Middle level - assistance all the time during the day (£50.70)
High level - 24 hr attention / care (£75.65)
Applies to all, whether living independently or in care (helps to cover costs).
Select which ones apply (menu style) - fixed rates not means-tested.
AA - no mobility component and just 2 care rates:
Middle level - assistance all the time during the day (£50.70)
High level - 24 hr attention / care (£75.65).
If on DLA prior to being 65, then benefit remains as per DLA rather than AA. Care component remains the same - but cannot get mobility premium.
Verification - fair degree of 3rd party involvement.
Award letter sent out (or disallowed letter). Claim paid from date requested.
Payments are 4 weekly by BACs or paid by voucher (4 tear-off, weekly vouchers to be validated and cashed at a nominated Post Office). No emergency payments are made (unless DHSS shown to be at fault).
Onus is on the client to notify any change of circumstances. Address is not an issue, but there is an issue if they move too far from their nominated Post Office.
If clients go into a Government-run care home then payments are made directly to their finance section. Private care homes can also be paid directly if requested.
For hospital stays clients are permitted to stay up to 28 days before benefit stops (for an adult) or 84 days (for under 16s). All components are stopped, unless there is a lease for Motability vehicles.
Respite care works two ways - payment of benefits stop when client enters respite care (each 24hr period) and benefits will start if a client comes out from residential care (each 24hr period).
Payment cards are generated in these cases to record the dates and instances.
All claimant’s files are scanned in via ScanFile software Document Management System (DMS). Often there is too much information about one claimant to store on just one file, so there are numerous files per claimant. The DMS is interrogative. Paper copies are held for 3 months only and then destroyed.
There is no mobility component for children under 3 for DLA - review at age 3 (higher rate only) and again at age 5. More generally, DLA reviews take place every 3 years as children grow up.
The period for reviews depends on the condition (e.g. broken legs affecting mobility would be reviewed after 12 months).
AA is more or less indefinite.
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Onus is on the client to notify about any improvement or deterioration in condition. Claimant (or their representative) OR the DHSS can ask for a review.
Checking of Claims / Calculations - all payments are checked and authorised by the Team Leader (and some amendments)
Carer’s Allowance
Need to be caring for someone with Attendance Allowance or the more major DLA categories. Need to be caring 35 hw or more and earnings need to be less than £100 per week (less deductions) and NOT in receipt of any other benefit.
Issues
Definition of "care" is too vague. There are circumstances where a client can be in receipt of AA and CA. In relationships there are "start / stop" issues for Carer's Allowance.
Free vehicle tax if in receipt of higher level mobility - could [SHOULD?] be a subsidy rather than total payment. No limit on the number of vehicles that are eligible per household.
Quite a high amount of money spent on lost cheques / vouchers (cancellation and re-issue costs)... could be better to have pre-paid cards and have clients pay for any replacements for lost cards.
Other issue is transfer of files (and benefits) from the UK to the IOM. Clients have an assumption that benefits hold fast and will not need to be re-assessed once in the IOM. They need a new claim and need to re-submit their details.
The way the form is written (especially Part II) prompts claimants to put in reasons and effects of their condition (e.g. difficulties in bed, etc.).
Some benefits are passported for claimants:
NHS charges reduced
AA and DLA are non-taxable benefits - given an additional tax allowance (c.£2,600 pa)
Free bus pass for higher rate mobility
Blue Badge
Free road tax
Claim / eligibility for Motability.
Length of the process (including assessment) is an average of 8 weeks (dependent on staff availability, workloads, reviews and the time of year - especially delays from schools as a result of holidays).
Resilience - only 2 members & Team Leader. If one off on leave / sick workloads can be more than 1 person can cope with - some backlog. Procedure notes are being planned (in conjunction with other teams).
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Incapacity Benefit
Scenario A citizen with a family entering the system on short-term incapacity moving on to long-term incapacity
Time (mins)
Initial contact Contact IB team to request a claim form, often discuss eligibility - fact that it is contributory (through NI)
Mode / channel of contact
Majority by phone, some visits to counter
Claim forms IB1 form is sent out to claimant by post
Evidence required
Self-certification for 3 to 7 days Doctor's medical certificate Residency not an issue (scheme is based on
contributions) Details of pensions received are required
Claim submission
Claims can be retrospective for up to 3 months Can occasionally be paid beyond this if there is evidence
of sick notes being held onto by employer Claim submitted to IB team by post, together with
evidence
Checking forms
When a claim starts the form is checked by GB team, then transcribed [YES, TRANSCRIBED] onto a Payments card
Payment cards are colour-coded (Pink are female, White male, Yellow Class 2 NI and Green are any UK NI contributions) - this allows for categorisation for reporting of statistics
All medical certifications are listed, with associated payments to be made
Certifications are typed into BPS and scanned (originals retained for 3 months, then destroyed)
Helps keep track of days and triggers for short-term to long-term
Payment cards are filed alphabetically by surname Subsequent medical certifications are sent directly to the
IB team (either posted or handed in at office counters) Certificates seen at area offices, then details /
verification emailed to IB team (to ensure cheque deadlines met)
Verification Checks on NI eligibility If UK NI checks required, dedicated officer for this
(limited access to system) [RESILIENCE ISSUE]
Calculations
Set rates for IB, change / increase each April Some manual calculations required if period crosses
change in rates Manual adjustments calculated for pensions that are
above £85 per week (reduction of 50% of excess)
5-20
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Scenario A citizen with a family entering the system on short-term incapacity moving on to long-term incapacity
Time (mins)
Systems / data input
Benefit payment added to claimant file on BPS
Third party involvement
Communication with Income Support team Some interaction with GPs / doctors (e.g. if writing on
certificates is unclear / illegible)
Approval IB Team Leader authorising each entry on a payment
card (i.e. each new certification) Also checks calculations and payment cards
Award of benefit Decided by Team Leader - letter sent out to claimant
Payment of benefit
For short-term incapacity, payment is by cheque (sent to claimant's address)
Long-term incapacity is direct credit for longer periods
Change in circumstances (address, off-island, etc)
Onus on claimant to notify change of address Cheques are "DNR" - do not redirect, so are returned to
DHSS Claimants are obligated to inform of any change in
circumstance and this includes leaving the Island or returning to work
Review periods
If condition is longer-term there are some reviews, but mainly the assessment by medical professionals and issue of medical certificates is taken as the review process
Checks on expiry / eligibility
If no further medical certificates received, payments will cease
Claimants required to state expected return to work, if known
Benefit cheques often produced in advance, but held until certification is received
Cessation of benefits
Once medical certificates stop
Links to Passported Benefits
NHS charges are waived for those in receipt of benefit - this is administered by NHS
Can cover costs of travel to UK mainland for NHS treatment; dental charges; prescriptions
Issues / areas for improvement
Treasury require completion of spreadsheets when certain requests for checks on claimants come through.
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Income Support
Scenario A single parent with one or more children under 16 (working but low earnings) - Income Support
Time (mins)
Initial contact
Enquiries to DHSS about eligibility for Income Support Many claimants are aware of the process (move
between Income Support and EPA) Workload is approximately 50:50 between new claims
and maintaining claims
5-15
Mode / channel of contact
Telephone contact, small proportion through physical visit to office counters
Claim forms A2 (physical form) posted out / given to claimant No time limit on form submission
2-5
Evidence required
Payslips from last 2 months (or 5 weeks if weekly) Last 3 months' bank statements for all accounts held Mortgage / rent details Ownership of property or land (A90 form issued if
needed) If living together a CP1LT form needs to be
completed Form for child care (normally established if there are
children when discussing eligibility over the phone)
Claim submission
Form posted back to IS team (or delivered at the counter)
Some evidence can be accepted via email Process almost all paper based
5-10
Checking forms
Claimant name searched on BPS - if existing, retrieve file from archive to become a "live" file again
Forms are checked for completeness and accuracy Checked to ensure all evidence has been submitted If form incomplete, pre-printed letter is sent to
claimant requesting amendments / additional information
[CAN DELAY THE PROCESSING OF CLAIMS] If information not provided within 28 days, claim is
withdrawn and claimant must start again Live manual file created for any new claims Claimant added to new claims spreadsheet if
applicable
10-20
Verification
Evidence taken primarily on face value as being valid Residency verified through NI contributions and
receipt of other benefits OR past claims for EPA If a claim relating to sickness, Incapacity Benefit
spreadsheet is checked to see if claimant is in receipt of IB
Benefits disclosed can be checked with other DHSS
10-20
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Scenario A single parent with one or more children under 16 (working but low earnings) - Income Support
Time (mins)
teams
Calculations
Assessment module is part of the Benefits Payment System
Details of claim entered, including other benefits and expenses to be applied to the claim
Manual calculations for weekly amount for housing costs (e.g. monthly rental is multiplied by 12 and divided by 52)
Amount calculated by module as a single weekly amount net of benefits etc.
Workflow process within the module automatically notifies Team Leader for authorisation and checking
5-15
Systems / data input Claim details entered onto the Benefits Payment
System Payments scheduled on cheque run
2-5
Third party involvement
Other DHSS benefits teams (Incap. Ben, Gen Ben, Child Benefit, etc.)
Doctors / GPs (only as last resort) Banks / Building Societies Landlords etc. - direct payment of housing element of
IS Everything impacts as the benefit is means-tested
Approval Approval for award or disallowed by EPA Team Leader 2-5
Award of benefit
Award letter (pre-printed from BPS) is sent out OR Disallowance letter sent out For retrospective claims, a separate form is completed
by the claimant and this is passed to the adjudicating officer (Team Leader) for decision
2-5
Payment of benefit
Payment is fortnightly by cheque - no BACs For Lone Parents, the cheque receipt / collection /
cashing acts as a declaration by the claimant of their eligibility (assists counter-fraud measures)
In sickness cases, the sick notes act as that declaration
[COULD LOOK AT CHANNEL SHIFT AWAY FROM CHEQUES]
Cheques are printed and then posted to claimant
2-5
Contact with citizen Physical letter sent out to claimant
Change in circumstances (address, off-island, etc.)
Onus is on the claimant to submit their medical certificates if the claim continues
If no sick notes received, benefits cheque will be held Claim can be terminated if notes are not provided
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Scenario A single parent with one or more children under 16 (working but low earnings) - Income Support
Time (mins)
Change in address will not affect IS within period If address changed and paid by cheque, cheque will
be returned to DHSS (DNR) Since IS is means-tested, changes in circumstances
could affect costs or income, so onus is on claimant to notify DHSS when things change
Since IS is often paid in advance, there can be cases of overpayment (e.g. if costs of claim have reduced)
This debt is applied as a reduction to benefits paid (to avoid debt collection / management)
Any overpayment (or any debt) follows the claimant around (and so will be deducted from any form of benefits paid).
Job Seekers Allowance
Initial contact by phone or physical visit.
Form (JSA14) sent out to claimants (with a 2 weeks target) - initial claim form. Claim is dated from the date of submission. An additional form can be completed for any backdated claim. (Adjudication officer will allow or not).
For existing claimants, they will already have a claim file. Assess whether or not a claimant has the applied days (3 waiting days).
Establish whether they are a resident of the IOM or not - look on BPS using NINO as a reference. If so, qualify for contributory JSA - manual completion of JSA14. Form will ask about relationships / dependants and living arrangements.
Income-based JSA is the remainder of the applicable amount. Have a card to sign - JSA2. Sign on fortnightly. Job-seekers have an activity log to be handed in every fortnight. Claimants are asked of any change in circumstances. A Jobseeker's Agreement is developed and agreed to focus where the claimant should apply and look for work. This can relate to permitted work (e.g. trades where a claimant could have been working for a long time). Normally two jobs applied for each week.
New claims are kept at base of ground floor filing cupboard.
When entering claim on the system (BPS), the NINO reference will also show benefits. Linking claim (therefore no waiting) can often be linked to Incapacity Benefit or Income Support.
A letter goes out to the employer (template letter) to verify the reasons for leaving work.
Genuine reasons for unemployment - unsuitability / capability for a role or redundancy.
Vs
Walk out from a job - judged whether reasonable or not.
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Get client side of the story too.
Can pay a person before... personal only.
Can backdate claims.
Could be sanctions and an overpayment would be chased.
Claimants are encouraged to fill the form out at the counter area.
For payment amount of the claim, a chart of rates is consulted and amount calculated manually. Look at savings (£13,000 disregard). Payments are paid fortnightly in arrears - there is an option to apply for a "start-up" payment, dependent on when the last paid employment or benefits was made (doesn't take housing into account).
When claimants sign on their cheque is printed and sent out the next day.
Decisions that are made over sanctions:
Completeness of activity log
Filling in / drawing up of Jobseeker Agreement.
Decisions depend on provision of evidence. Stops can take place - an outright stop (can be disputed). Can disallow 1 week of 2.
Normal payment runs are on a Tuesday - will make a run if received by the Thursday before.
Payments are checked and validated by the Adjudication Officer (Team Leader) - sample checks rather than all of them.
All done by cheque and posted out - any outstanding debt is deducted from the payment. Details of correspondence / contact is put into an event log as part of the claim file. Alert / workflow to Adjudication Officer (2 of these on the team). Put claims onto the systems - NI contributions and jobseekers database. JSDB - key dates for agreement, claim, signing on, plus personal dates / data.
When a claimant finds work the Adjudication Officer is notified and they enter the details onto JSDB.
If a claimant claims for the receipt of Incapacity Benefit, then this is possible, subject to some qualifications. Can have up to 14 days' sickness (in one block or in instances). Any more than this and their claim stops and becomes an Income Support claim.
Award letter refers to the passported benefits:
Loans (if sign on for 4 weeks in a row, can get max £750 for rent deposits, white goods, etc. - only 1 per 2 years - can be challenged and validated)
Funeral costs
NHS prescription charges
Dental / eye charges
Free school meals.
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If working less than 16 hours per week, this can vary and needs to be reassessed.
Change of circumstances to be notified by claimants. Change of address can be an issue, especially if there are direct payments to landlords.
In the cases of overpayments, advising of affordability can be an issue. Departs from one plan to another. Have to sign up to a loan agreement.
There are also forms to complete if the claimant goes off-island - allowable if for a job interview, and can be granted for funerals / attending sick relatives, but this is limited.
Employed Persons Allowance
Scenario A single parent with one or more children under 16 (working but low earnings) - EPA
Time (mins)
Initial contact Enquiries to DSC about eligibility for EPA Many claimants are aware of the process (move
between Income Support and EPA)
5-15
Mode / channel of contact
Telephone contact, small proportion through physical visit to office counters
Claim forms
EPA1 (physical form) posted out / given to claimant
No time limit on form submission, but for payments to start onus on claimant as run from the next Tuesday after EPA award
2-5
Evidence required
Payslips from last 2 months (or 5 weeks if weekly)
If new starter, letter from employer regarding hours worked, pay rates, start date
Last 3 months' bank statements for all accounts held
Mortgage / rent details - claimant has to request Bank / Building Society to complete part 20 of the EPA1
Ownership of property or land (A90 form issued if needed)
If living together, a CPLT form needs to be completed
Form for child care (normally established if there are children when discussing eligibility over the phone)
Claim submission
Form posted back to EPA team (or delivered at the counter)
Some evidence can be accepted via email Process almost all paper based EPA team receive forms at 10:00am then go
down to General Benefits team (one floor) to check for new forms (every hour)
Live manual file created for the claim
5-10
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Scenario A single parent with one or more children under 16 (working but low earnings) - EPA
Time (mins)
Checking forms
Forms are checked for completeness and accuracy
Checked to ensure all evidence has been submitted
If form incomplete, pre-printed letter is sent to claimant requesting amendments / additional information
[CAN DELAY THE PROCESSING OF CLAIMS] If information not provided within 28 days,
claim is withdrawn and claimant must start again
10-20
Verification
Evidence taken primarily on face value as being valid
Residency verified through NI contributions and receipt of other benefits OR past claims for EPA
Form EPA 17 - request for work permit, if required
Bank / mortgage have to put official stamp on back of form
Benefits disclosed can be checked with other DHSS teams
Checks made on hours worked Cross checking with Child Benefit team
10-20
Calculations
Manual paper form [NOT EVEN AN EXCEL SPREADSHEET]
Kept on the live file Costs and other benefits applied to calculate
whether applicable amount has been exceeded EPA payment calculated as a single weekly
amount Calculation checked by EPA Team Leader
5-15
Systems / data input
Single weekly payment (from calculation sheet) entered onto the Benefits Payment System
Period for payment also entered Claim entered onto New Claims spreadsheet
2-5
Third party involvement
Treasury (for NI) Other DHSS benefits teams Banks / Building Societies Landlords etc.
Approval Approval for award or disallowed by EPA Team Leader
2-5
Award of benefit
Award letter sent out OR Disallowance letter sent out Letter states start and end dates for EPA
2-5
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Scenario A single parent with one or more children under 16 (working but low earnings) - EPA
Time (mins)
payments EPA periods can be 4 to 26 weeks, dependent
on circumstances
Payment of benefit
Payment is fortnightly by BACs or weekly by cheque
[COULD LOOK AT CHANNEL SHIFT AWAY FROM CHEQUES]
Cheques are printed and then posted to claimant
2-5
Contact with Citizen Physical letter sent out to claimant
Change in Circumstances (address, off-island, etc)
Change in address will not affect EPA within period
Change of job will not affect EPA within period Change in household composition WILL change
EPA - onus on claimant to inform DHSS Same for changes in hours worked If address changed and paid by cheque, cheque
will be returned to DHSS
Review periods
Reclaim form (EPA7) needs to be completed and submitted 2 weeks before EPA period ends [MANUAL FORM - CLAIMANT NEEDS TO RE-ENTER ALL PERSONAL DETAILS]
High volume of calls received about when EPA is due to stop for a claimant
Checks on expiry / eligibility
When EPA period ends, claims are taken off the live claims spreadsheet
Physical files removed from "live" filing cupboard
Cessation of benefits
EPA claim ends - if no EPA7 form received, any claim will be treated as a new claim
There is an option to backdate claims - these will go to an Adjudication Officer (there is also an appeal process)
Links to Passported Benefits
No passported benefits
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Child Benefit
Scenario A couple with their first child (Child Benefit) Time (mins)
Initial contact
Awareness of CHB through Hospital ("Bounty") Pack - although this a reference for UK CHB
Can be aware through word of mouth and knowledge of welfare system
Not available through registering a birth
Mode / channel of contact
Phone / email / counter visit 2 -5
Claim forms
Claim form (CH2) sent out by post Also currently going through a "reclaim" phase
now that means-testing has been brought in (7/4/14)
2-5
Evidence required
Declaration of residency for past 27 weeks Birth certificate (original) Joint declaration by partners for income
assessment Passport for claimant if need proof of identity Declaration of whether CHB received before
Claim submission
Posted to Treasury or physically delivered to counter
If physical visit, birth certificate photocopied and original returned to claimant
2-5
Checking forms
Claim booked in on Excel spreadsheet Form checked for missed / incomplete sections
and missing evidence Passed up to CHB team, annotated for
processing Form returned for major omissions or need for
more information (by post) Some minor amendments carried out by CHB
team and annotated Corrected forms have to be returned (post /
delivered) within 28 days otherwise claim disregarded and claimant has to re-apply
2-5
Verification
If coming from UK, contact (by email) to check CHB from UK DWP stopped (or exclusions applied)
NINO entered onto BPS to check if previous claimant (both partners)
10-20
Calculations Determine start date for CHB (from date of birth) 2-5
Systems / data input
On BPS, look up main claimant's record and add child record
System automatically creates QQ number for child on NI system (lasts until NINO allocated
2-5
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Scenario A couple with their first child (Child Benefit) Time (mins)
when 16) BPS links to NI & Tax system so when both
partner details entered on to the claim record on BPS, eligibility and amount of CHB awarded is calculated by BPS
Entry created on claimant event Log on BPS Copy of birth certificate annotated with claim
reference (in pencil) Claim manually entered onto physical RO
(Registry Office) form - for award Forms collated (with evidence) and passed to
Team Leader for authorisation and checking NI system is updated with details of claim start
date and the claim reference
Third party involvement
UK CHB team, DWP, Washington Benefit Debt Control - if any overpayment of CHB
Approval
Team Leader checks the claim and evidence Claim authorised Claim scanned into ScanFile system Booking in spreadsheet is highlighted to
complete entry
5-10
Award of benefit
Award letter (and at the moment, a reclaim letter) generated, populated with data from BPS by team member and sent to the claimant by post
Original documents returned to claimant, if not done so already
If disallowed, a template letter (with reason) is generated by CHB team and sent out / authorised by Team Leader
No copy of the award letter is retained
2-5
Payment of benefit
Direct payment (BACs) in 4 weekly arrears OR Orders to redeem at nominated Post Office Have tried to reduce order use (not completely
successful) Often a one-off payment when claim started -
can be retrospective up to 3 months (prior to Apr 2014 changes - currently only back to 7/4/14)
Weeks for retrospective benefit to be paid is entered by team member and amount to be paid is calculated by BPS
Lost / destroyed / not received orders require a BP10IV form before replaced
In rare emergency cases, cheques are issued
Overpayment Overpayments can arise due to claimant leaving the IOM, child leaving full-time education (and
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Scenario A couple with their first child (Child Benefit) Time (mins)
the recent reclaim process) Overpayments are calculated by the CHB team
(letter generated and populated) Passed to Team Leader for authorisation and
sending out Details passed to benefits overpayment role
(Benefit Debt Control) Deductions from benefit paid rather than
pursuance of debt
Change in circumstances (address, off-island, etc.)
Change of address form (specific one for CHB) issued when notified by the claimant
Generic change of circumstances form (BP9) sent out if household composition changes
Generic form for change of account for benefits to be paid into
If people move in together, a specific form is sent out to the claimant
When returned, data is entered on to BPS, will feed through to other benefits as necessary (e.g. change of address)
If a claimant leaves the IOM, onus is on them to notify CHB - UK will sometimes request details and a "nil date" for IOM CHB
5-10
Review periods
Cessation built into system for child reaching upper age limit
No other reviews - reclaim process has highlighted several cases of over-payments, as well as highlighting eligibility to some claimants who were not aware they were not receiving CHB
Checks on expiry / eligibility
CH297 letter generated when child approaches upper age limit unless in full-time education
2-5
Cessation of benefits When children reach age that CHB no longer applies
Finishing full-time education or over 16 When claimant leaves the IOM
Links to Passported Benefits
No passported benefits from UK Contact between DWP and the Treasury for
claimants leaving the IOM or coming to the IOM
Procedure notes Notes in place (written in April 2010) Need updating for new changes to bring in
means-testing and some other changes.
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Pensions
When approaching pension age, an RP1 claim form is sent out to the last current address on the Tax Mainframe system. Legally, cannot accept a claim form more than 4 months before reaching pensionable age.
Evidence required is a birth certificate (if male) or birth certificate, marriage certificate and divorce evidence (if female). Widows should already have records.
When received, claims are noted in the claims book (manual). RP1 forms are checked that they are complete and all evidence provided. Extra care is required with female claims since pensionable age is changing.
Manual tables are used to assess claims.
If wife has already retired and receiving a 60% pension, they are invited to increase this (mix of their and their husband's NI contributions when their husband reaches 65). Employment forms sent out until 2013-14 data is put on the mainframe (annual occurrence).
Any queries / omissions / errors used to be sent out by post, but are now done over the telephone for minor amendments / queries (still needs to be posted back if no signature or similar). Account for payment has to be the same as any for benefits.
A physical file is created with manual work sheets (initialled and countersigned when completed) for basic calculations on entitlement. The file is then passed to the calculation team for more detailed calculations (covering split liabilities, NI contributions, eligibility for pension supplement, graduated benefits, entitlement under SERPS and Second State Pension, etc.)
The files are returned with weekly rates to be paid for each component of the pension. These details are entered onto BPS. Award letters are drafted (from templates) - these will be date stamped and sent out at the appropriate time (in relation to a claimant reaching pensionable age). "Regret" letters are also sent out if claimants do not qualify for the Pension Supplement. Team Leaders approve claims and send out the award letters.
The Pension Supplement (the "IOM" Supplement) has a very political rationale. It was first implemented in the early 1970s as a £5 per week supplement. It was increased twice subsequently and linked to pension increases. It has now been set at £53.75 per week (now 47.52% of basic pension). Any changes to the Supplement would require legislation from the House of Keys and is unlikely to be considered until after the election in September 2016.
Split liability - if a person works x years in the UK and y years in the IOM, there needs to be a split of liability (for both basic and additional) between the two NI pots. [ISSUE - BETTER TRAINING OF TAX INSPECTORS COULD TIGHTEN UP ON WHAT'S DUE FROM THE UK AND REDUCE LAGS].
Payment of pension is by BACs predominantly (c90%) with the remainder paid by PO vouchers to be redeemed.
Any change in circumstances can be notified through a BP9 form (as for benefits).
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For those that leave the IOM to the UK, pension is transferred to the UK after 6 months (Supplement stops from date of leaving). For Northern Ireland, this is just 8 weeks. For those coming to reside in the IOM, pension transfers after 6 months.
Bereavement
Automatic inheritance of graduated benefits / guaranteed minimum pension. If claimant is female, need to see death certificate - then work out pension payable. If she has her own insurance, a claim form RP1 is issued.
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4.3. Appendix 3 – Process Maps
3.1 - Maternity / Paternity allowance process
3.2 - Disability Living Allowance
3.3 - Incapacity Benefit
3.4 - Income Support
3.5 - Job Seekers Allowance
3.6 - Employed Persons Allowance
3.7 - Child Benefit
3.8 - Pensions
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Maternity / Paternity allowance process
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Disability Living Allowance
Incapacity Benefit
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Income Support
Jobseeker’s Allowance
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Employed Person’s Allowance
Child Benefit
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Pensions
Any actuarial analysis contained in this report has been prepared for the purpose of the review of the Isle of Man social security arrangements, as set out under the terms of Mercer’s Engagement Letter dated 7 November 2013. Unless Mercer expressly agrees otherwise, by written agreement with the relevant party, Mercer does not accept any liability or responsibility to any party other than Ci65 Ltd in respect of this analysis. The only party to who they owe a duty of care in relation to this analysis is Ci65 Ltd.
Mercer retains all copyright and other intellectual property rights in the analysis.
This analysis relies on the accuracy of the data and information provided by the Isle of Man Treasury and supplementary information provided by the Government Actuary's Department ("GAD") in relation to their report dated 4 March 2014. Mercer does not accept responsibility for advice based on wrong or incomplete data or information provided.
It is anticipated that the results of this analysis will be shared with The Treasury Isle of Man Government as well as Ci65 partners (this project only) for information purposes in connection with possible changes to contributions or benefits payable (although please note this remains subject to the disclaimer set out in the first paragraph above in relation to whom we owe a duty of care). Further actuarial advice not covered by this analysis may be required to confirm the likely impact on the finances of the National Insurance fund. It may also be appropriate to take into account non-actuarial matters, such as legal, administrative and policy issues, which this analysis does not cover
The analysis has been based on base assumptions and modelling approach adopted by GAD in their paper titled “Report by the UK Government Actuary on the operation of the Social Security Acts in the Isle of Man for the period 1 April 2007 to 31 March 2012” dated 4 March 2014 and subsequent clarifications of approach provided by GAD in Tracey Cutler's emails of 18 June 2014, 19 June 2014 and 20 June 2014, and any subsequent assumptions advised by Ci65 for modelling purposes. We have not been asked to provide any advice in relation to the suitability of these assumptions and do not accept any liability should the underlying model assumptions prove to be unsuitable for the purpose intended.”
This report is prepared solely for the use of Senior Management of The Treasury Isle of Man Government. This report should not be quoted or referred to in whole or in part without prior written consent. No responsibility to any third party is accepted as the report has not been prepared, and is not intended for, any other purpose.
Whilst every care has been taken to ensure that the information provided in this report is as accurate as possible, based on the information provided and documentation reviewed, no complete guarantee or warranty can be given with regard to the advice and information contained herein.
For this reason, we do not consider it appropriate for the report to be made available, in part or in full, to third parties without our written prior consent. Nor do we accept responsibility for any reliance that third parties may place upon the report. Insofar as this report refers to matters of law, it should not be taken as expressing any formal opinion whatsoever.