A significant number of respondents do currently provide vaccine coverage: 20% cover human papillomavirus(HPV) vaccines, 37% travel vaccines, and 42% childhooddisease vaccines. In most cases, they are doing so in the same manner as they cover other drugs—without requiring higher co-insurance, for example.
Some employers, of course, may be waiting to see whether these vaccines will be covered by public funding. Ten percent of respondents expected to add coverage for the HPV vaccine over the next few years if it wasn’t publicly funded, though only 4% stated they would do so for childhood-disease and travel vaccines. These numbers may indicate a greater willingness on the part of Canadian organizations to cover the cost of the increasing number of vaccines that are being developed for the treatment of cancer.
Some respondents(9%)indicated they were unwilling to make a decision to provide coverage for these vaccines before the government did, lest that discourage public funding.
NEXT STEPS
Plan sponsors can protect their plans and/or their employees in the following ways:
Review policy. The first action item for Canadian employers is to examine their vaccine coverage policy. The policy should reflect the organization’s overall philosophy toward individual employee benefits and reinforce business objectives for organizational health. If it has been some time since you’ve reviewed your vaccine policy, your company may have broadened its employee healthcare perspective from one that focuses on treatment to one that also includes prevention and wellness. A vaccine policy can be an important element of a program designed to keep employees healthy.
Address the issue. Stepping back and looking at the big picture will help organizations determine whether they should be covering new vaccines, regardless of what other employers are doing. Having a clear, well-defined approach will help explain their decision to employees if they determine that covering certain vaccines is not appropriate—or their rationale for deferring the decision until later.
Consider coverage options. If the decision is made to cover the cost of these vaccines, organizations may want to consider whether that coverage should be the same as that for other drugs under the benefits plan. For some, making a distinction will be a dollars-and-cents necessity. Higher co-insurance or other cost-sharing methods may be the only way they can afford to provide comprehensive vaccine coverage.
Communicate your decision. Regardless of what the organization decides, it’s a good idea to let employees know what is—and isn’t—covered under the vaccine policy and why. This is an opportunity to provide information to your workforce about these diseases and how to prevent them, as well as to encourage workers to lobby for publicly funded coverage. The proliferation of new vaccines on the market is, of course, a major boost from a health perspective. However, for some employers, these breakthroughs should also serve as a reminder to revisit what appears to be an overlooked aspect of their employee benefit programs.
John Tompkins is a principal and senior benefits consultant for Hewitt Associates in Toronto. john.tompkins@hewitt.com
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