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The Treasury Isle of Man Government

Deploying Benefits – A Process Review

10 September 2014

Final Report



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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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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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.

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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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Commissions payable to the post office: £493,000

Contracted out computing support: £202,333

Rent, rates and energy: £182,845.



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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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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.


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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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.


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).


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.


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).


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.


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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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.


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.


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.


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.


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

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The Treasury Isle

Deploying Benefit

Figure 5

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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


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)


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


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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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


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


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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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


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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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


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


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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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


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)


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


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


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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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


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



52


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 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


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


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



57

Disability Living Allowance

Incapacity Benefit



58

Income Support

Jobseeker’s Allowance



59

Employed Person’s Allowance

Child Benefit



60

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.

1.3 deploying benefits - a process review€¦ · deploying benefits – a process review 11 2.1.1....

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