It is essential that social security institutions engaged in the promotion, advocacy and support of effective return-to-work programmes include a broad range of institutional and individual stakeholders in this process.

Internal and external business units and professionals play important roles in the return-to-work process to support and facilitate the return to work.

Key professionals include the human resources manager, employee representatives, medical and other care and rehabilitation professionals, and other collaborators in the return-to-work field.

The return-to-work field is complex and involves many stakeholders, including the social security institution, other government agencies, employers, trade union organizations, health-care professionals, service providers and people whose jobs are in jeopardy as a result of an injury, illness, or acute, long-term or chronic health condition.

The institution adopts a formal methodological approach to service quality starting with a clear statement on the importance of service quality and how it intends to deliver and measure it.

The social security institution must have a legal and financial mandate for its role as a workplace health promoter. The mandate defines the institution’s scope of action and allows individualized services as well as community-based workplace health promotion activities. The mandate establishes a statutory right to health promotion services for insured persons. It may also state that a specified amount of the social health insurance budget may be used for (workplace) health promotion.

The social security institution supports a workplace review to identify existing structures and activities which support workplace health promotion and develop a health profile of the target population.

The institution encourages and enables good communication practice in workplace health promotion.

Assumptions used for a valuation of a social security scheme are sufficient to value the scheme in accordance with its financing objectives and consistent with the overall socio-economic environment of the country. The development of assumptions combines the analysis of historical trends with a forward-looking approach. Social security institutions assign major responsibilities to an actuary in the assumption-setting process.

Where it is the responsibility of the actuary, he or she uses appropriate methodology and assumptions to determine the conversion factors of lump sums to income. Unless these factors are set so as to meet specific policy objectives, they are determined as cost-neutral. If the factors are not cost-neutral, the actuary discloses this fully and determines and reports on the implications on adequacy and sustainability of the scheme.

The social security institution sets out appropriate processes and structures to measure risk.

The measurement of risk consists of assessing the frequency and severity of the risks identified as well as the likely distribution of outcomes. The frequency of a risk is the probability the event will occur; the severity is the financial implication; while the distribution refers to how widely outcomes are likely to vary from the mean expected event.

The current legal and effective coverage situation are analysed both in the light of current legislation and scheme administration, as well as within the global context of employment trends and population changes which may trigger changes in both legal and effective coverage.

The institution develops a long-term social security coverage extension plan subject to the guidance and support of the relevant authority. The inclusion of relevant stakeholders in the development of the plan helps to identify issues early but also helps in securing external support in the implementation phase.

The institution combines administrative solutions with supporting policy measures to foster compliance with minimal intervention required.

To increase the efficiency and effectiveness of its communication activities, the institution identifies the major groups and sub-groups of its stakeholders.

The communication unit establishes service level agreements with relevant internal units for the provision of communication services.

The ISSA defines governance as the manner in which the vested authority uses its powers to achieve the institution’s objectives, including its powers to design, implement and innovate the organization’s policies, rules, systems and processes, and to engage and involve its stakeholders.

The institution improves its processes of audit and fraud control by using advanced ICT tools and any other available and consistent resource.

Relevant tools include data mining, business rules, multidimensional data analysis and external data (e.g. satellite photography and geographic information systems).

Most mandatory social security programmes are created by legislation, decree or some official act of government, to define the mandate of the institution that is responsible for the implementation of the programme. The mandate often draws a distinction between the “board” and “management”, with the board as the governing and policy-making body of the institution and the management as the body that administers the programme and implements the resolutions of the board.

Open dissemination of key information about the social security institution does not necessarily imply transparency. To be transparent, such information, which is a basic right for stakeholders, members and beneficiaries of the social security scheme, should be timely, reliable, relevant, accurate and objectively verifiable.

Legislation, policy or decree defines the powers and responsibilities of the management. The powers and responsibilities of the management are clearly delineated from those of the board. There are no areas of ambiguity, dilemma or conflict of interest.

Members are regularly and promptly informed about the benefits due to them under the social security programme.

The strategic plan is cascaded to all units of the institution. Implementation is regularly monitored and assessed. The strategic plan is revisited, evaluated and fine-tuned, if necessary. Management aligns the performance trinity of strategy and vision, leadership and management, and institutional culture and values in implementing the strategic plan.

For institutions that have investment reserve funds, standards and benchmarks are established for the returns on fund investments to support the financial sustainability of the programme.

The board and management protect the institution from all forms of corruption and fraud in the payment of programme benefits.

The management ensures the integrity of existing ICT infrastructure and averts any threat of system failure. The overall goal is to ensure the high availability of the social security services.