Driving the Absence Management Industry with Technology

As Chief Solutions Officer of Reliance Matrix, a member of Tokio Marine Group since 2012, Gordon Smith holds a unique title in a nontraditional organization that has been shaped, in large part, by phenomena taking place outside the insurance industry.

“The enemy is out there,” he emphasizes, but with a smile. He’s smiling because, like many success stories, this one begins with meeting a need. Or two.   

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Matrix Absence Management, Inc., was formed as a workers’ compensation claim administrator in the northern California town of San Jose in 1987. It was a nice local business at a very opportune point in history: The tech boom would quickly change the landscape of Silicon Valley and the world. And the landmark Family and Medical Leave Act (FMLA) legislation, signed into law by President Bill Clinton, would alter the US employment landscape forever. In short, the FMLA required employers with more than 50 employees to award leave from work – and job protection while away – for a variety of personal and family illnesses and conditions. 

In 1997 Matrix used its high-tech pedigree and the new law to launch the first formal, outsourced FMLA program. The value proposition was still unclear to most: Employers, brokers and consultants were largely at a loss to understand the full ramifications of the law, let alone implement programs to stay compliant. One important client, Reliance Standard Life Insurance Company in Philadelphia, saw the value, however. They saw enough value to justify parent company Delphi Financial Group’s purchase of Matrix, paving the way for an integration journey that culminated in 2023 with the rebranded entity, Reliance Matrix. 

And before year-end, Reliance Matrix would be named America’s number one Absence Management service provider among 30-plus competitors, according to number of employees supported, in a biennial industry survey conducted by Spring Consulting Group. 

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Gordon Smith began his journey at home in Ireland, where he attained a Higher National Diploma in Electronic Engineering from the University of Ulster and his British Computer Society qualification in Computing. From a 15-year IT career in Europe and the US, he joined Matrix in 2003 as Vice President and Chief Information Officer. An insurance third party administrator (TPA) is arguably one of the least interesting places to find oneself, but Gordon – an outsider himself – saw the future not through a competitive lens but rather a wider one. Facebook’s debut was still a year away, but the seeds of innovation were already breaking ground in Silicon Valley.

“The tech firms around us, our clients, were poised for explosive growth,” he recalls. “And there was this new, complicated wrinkle to administering employee absence. The culture of these early technology brands focused, by necessity, on scalability and an interactive customer experience. And because they sought to drive society forward through technology, they took the same approach as employers.”

As employers increasingly sought outside help complying with the dense FMLA requirements, Matrix innovated now common features like secure online claim intake and one of the industry’s first mobile apps. The common and persistent thread was the focus on the individual – an approach vastly different from virtually all Matrix competitors, including those many times its size. 

“Technology adoption worldwide has changed user expectations so that all of our services are compared against the best of the best, regardless of the industry,” Smith said in 2018, the year he formed Matrix’s Solutions Group and assumed the Chief Solutions Officer role. “Everything that happens outside the bubble affects what’s inside the bubble.”

The distinction of a Solutions Group as opposed to an IT organization is far from semantics. 

“We have to provide the best user experience in all our interactions and client touch points,” he said. “That means leading the market not simply in technology, but in holistic, unending advocacy for our customers and their employees. That is the formula for lasting success.”

From innovator to disruptor

It’s generally accepted that TPA culture and insurance carrier culture are divergent. As the party that assumes the risk, insurance carriers are typically process oriented, and stick with the certainties of policy language. In contrast, TPAs succeed by delivering on the promise of superior service, and – particularly in Matrix’s case – evolving the customer experience through technology. 

“Entrepreneurial spirit is in our DNA,” Smith says. “Our customers don’t want to learn our business, they have their own business to staff and run. It’s up to us to understand the impact of employee absence in their specific use case, and solve for that.”

That thinking led to development of Absence Radar®, an interactive platform that delivers real time employee status across 12 consecutive months, looking forward and backwards, in an easy-to-consume calendar format. As intuitive as it sounds, nothing like it existed in the market and Absence Radar earned Reliance Matrix its first US patent in 2021. 

“Conventional wisdom is, ‘become part of the HR team, make their jobs easier,’” Smith said. “But you change the game when you put actionable information in the hands of managers and line supervisors. They are the ones who have to staff by the day, by the week. They have to be agile and maintain productivity and morale. That’s a whole layer of service that didn’t exist in the TPA space.”

The proliferation of state disability and paid leave plans has made it even more impactful for supervisors to know who is out, and why, and when they are destined to return to work full time. That is innovation. But consider the impact to employees: A single maternity leave could qualify for company-sponsored short term disability, state-mandated paid family and medical leave, and any number of elective supplemental health coverages like hospital indemnity insurance. These benefits and entitlements are siloed by nature, and differ by jurisdiction, employer and other factors. Not surprisingly, it’s not unusual for benefits, particularly voluntary ones, to be overlooked.

“Imagine how you’d feel if you realized after the fact that you were paying for a coverage that you simply forgot to use,” he said. “And that’s not uncommon in the market. It’s somewhere between an industry shortcoming and a dirty secret no one talks about.”

Which is why Reliance Matrix integrates all benefits and entitlements behind the scenes, ensuring that covered employees and their family members who call or log on to begin a claim are automatically filed for everything to which they are entitled, whether based on corporate, legislative or paid benefit time.  

“That quantum shift moves from innovation to disruption,” Smith notes. “We’re taking a fundamental market truth and throwing it out the window in service of doing the right thing.”

Competitors watch the landscape and move to close gaps when they appear, to the extent they can. So it’s important to continue the drive forward. The next best practice, implemented across some of Reliance Matrix’s most progressive employer clients, is medical integration. In these instances the employer, typically a self-insured medical plan sponsor, allows secure access to medical claim data to ensure all allowable benefits are identified and paid to the employee. Reliance Matrix uses proprietary AI to scrub the data for likely benefit and leave triggers, delivering the highest value to the employee and client.

“This is something start-ups do very well,” he says. “They don’t look at how to do something better. They ask, ‘Why are we doing that?’ If you’re not constantly challenging the status quo, if you’re not listening more than you’re talking, you can’t legitimately disrupt anything.” 

Over the horizon

In 2023 Reliance Matrix earned its second US patent for Absence Blueprint®, an interactive tool designed to help employees plan for time away from work. In true form, nothing like it exists in the market today.

“Up until now, we have focused – like the industry – on the actual leave. The why, and the how,” says Smith. “But if you talk to employees, and the HR business partners on the front lines, you quickly understand there’s a huge opportunity in understanding what benefit time, salary replacement and job protection exist before the actual leave. Each individual, each leave, is unique.”

“It’s a huge stressor for the employee and an equally big burden for the HR partner trying to answer these important questions.”

So Absence Blueprint takes the federal and statutory leave regulations specific to each employee and employer, folds in that employer’s policies and benefits programs, and voila – delivers an at-a-glance view of what to expect when, for example, you’re expecting. 

“Blueprint also allows the employee to manipulate different parameters to see different possibilities, to maximize their time away or compensation, for example,” he said. “And the output lets employees share plans in real time with spouses, managers and caregivers so everyone is on the same page.”

More patented technology is in the future for Reliance Matrix. In addition to safeguarding proprietary intellectual property, it’s very much a business strategy.

“At its core, I think pursuing and winning a patent demonstrates to our customers and prospects the fact that we think about their business, their challenges, in a unique way,” Smith said. “It’s a badge of legitimacy, and positions us as thought leaders. Given the opportunity, who wouldn’t want to do business with an industry leader?”

Additionally, he said, building a portfolio of patented solutions ultimately builds value for the company and for Tokio Marine globally. “Tokio Marine is distinguished in its ability to aggregate and leverage world class resources in dozens of specialty markets around the globe. Patented solutions are just one more layer to that advantage, that piece of our organizational DNA.” 

Of course, a highlight – or perhaps consequence – of being a market disruptor is the inevitability of “the next thing.” Gordon Smith sees nothing but opportunity.

“I think there is a lot of concern in the market today about AI, and what it can and cannot be trusted to do,” he said. “I think that’s a necessary phase of its life cycle, and that a time will come, pretty quickly, when AI is baked into most business processes, improving service and empowering customers.”

“I think what most people fear is a point in time when human contact is removed from our lives as an option, in favor of technology that’s ultimately quicker, cheaper and in a lot of ways, better. I can say with confidence that will never happen at Reliance Matrix,” he said. “We know the heart of what we do is service, helping people when they need help. And as comprehensive as technology gets, there always has to be a compassionate, knowledgeable human being on deck to answer questions and reassure someone who needs it. Those are table stakes, and they are never going away.”

Elaborating on that thought, he muses, “It’s ironic. Technology isn’t our success driver in the way that most people think. It’s how we see and embrace our customers’ challenges. Fact: Today, and for the foreseeable future, talent is the single most valuable asset in any company. Smart employers use benefits as weapons in the war for talent, ways to attract and retain the best of the best.”

“And we build some pretty effective weapons.”