Canadian benefits plan sponsors are increasingly seeking to balance providing competitive benefits against plan sustainability issues, said expert panellists during the launch event for the 2024 Benefits Canada Healthcare Survey last week.
Andrea Belvedere (pictured right), assistant vice-president of health benefits and solutions at Sun Life, said plan sponsors are starting to ask more questions about benefits utilization data, measuring the impact of newly introduced benefits and relevant offerings for diverse populations to ensure their plans are sustainable while also meeting a wide range of needs.
“Certainly we’re having more conversations around, ‘What’s the value of this component of my plan?’ . . . and ‘How can I see outcomes that my members can benefit from that ultimately support me as an employer?’”
Read: Employers, insurers have role in managing benefits plan sustainability
That squares with findings in the report: 75 per cent of plan sponsors said they consider their health benefits plan highly important to their organization, but four in five are experiencing some level of challenge providing their plan. While cost management, inflation impacts and increased benefits utilization were plan sponsors’ top three challenges, they were still more likely to add coverage than reduce or remove it. Plan sponsors were most likely to add or increase mental-health benefits.
Two in five plan sponsors believed their plan utilization has increased year-over-year, while half said it stayed the same. Sun Life has also seen utilization increase for a number of reasons, said Belvedere, including higher drug costs, greater demand for mental-health services and rising rates of chronic disease.
Ayla Azad (pictured left), chief executive officer of the Canadian Chiropractic Association, noted that, while the majority of plan members rated their benefits plan highly, they may not be using it as a preventative health-care tool. The survey found the majority of plan members view their benefits plan as something to be used only when they need care for themselves or a family member.
Typically, patients come to Azad once a minor health issue has progressed to a major one. While she noted the coronavirus pandemic has prompted many people to engage more seriously with their health, she suggested plan sponsors emphasize the value of prevention and seeking care early.
Read: Fidelity Canada touts preventative, life-sustaining benefits plans
Doing so could also reduce stigma around physical and mental-health issues in the workplace, she said. “I have patients who say they will not tell their employer how they’re feeling because they’re afraid of a reprimand. . . . Making it a safe environment for people to have the conversations is the first step and then offering them supports.”
Encouraging preventative care could also help address another issue that emerged from the survey, noted Azad. When plan members were asked what they do when their coverage runs out, 27 per cent said they’d stop treatment until their coverage resets, 23 per cent would pay the full cost themselves but reduce the number of treatments and 10 per cent would jump to a new service.
For plan members whose health issue is more severe, stopping coverage or profession-hopping could harm their recovery, she said, noting early treatment of a more minor issue could ensure it doesn’t snowball and lessens the possibility of plan members running out of coverage. She also suggested health-care spending accounts could assist with this issue.
Download the full 2024 Benefits Canada Healthcare Survey report here.
Tune in for the rest of the coverage of this year’s event throughout the week.