2024 Vancouver Benefits Summit: A look at post-pandemic paramedical, drug claims

Read: Employers seeing paramedical claims return to pre-pandemic levels

While the findings track with outside research on increased rates of post-pandemic depression and anxiety, this growth is largely coming from people who have never had a mental-health claim in the past as well as younger employees. Another key driver was the increased use of alternative provider types, such as psychotherapists, clinical counsellors and social workers. Notably, claims by women have grown more sharply than men’s.

Since mental-health practitioners are roughly twice as expensive as other paramedical practitioners, the growth in claims has had a “big impact on costs,” said Leclerc.

“From a plan design perspective, it means that we are paying more . . . but there’s a potential silver lining, because when people are reaching out for those services, they’re learning coping skills, they’re developing resilience and so we know that this is going to help them at the end of the day.”

The claims trends also show up in disability data, where there has been a sustained increase in plan members younger than age 45 taking leave for mental-health reasons.

Read: A closer look at how chronic conditions are impacting benefits plans

Looking at claims for other paramedical practitioners, most haven’t recovered the claims volume they saw pre-pandemic, with chiropractic and physiotherapist claims taking the biggest hits. While long-term disability claims for musculoskeletal issues have also decreased, she said new data indicates those claims are starting to creep back up.

Drug claims have increased modestly since the onset of the pandemic, with a notable exception among plan members aged 60 and older. The claims volume for that cohort, which makes up 19 per cent of Sun Life’s block of business and 41 per cent of drug claims, hasn’t returned to baseline. “It may be a sign they’re not necessarily maintaining their treatment plan from a chronic disease perspective,” she said. 

In contrast, drug claims by plan members younger than age 60 has increased, with the largest increase for antidepressants, followed by medications for diabetes, cardiovascular conditions and asthma.

Read: 34% of U.S. employers covering GLP-1s for both diabetes, weight loss: survey

Antidepressant claims jumped more significantly than mental-health paramedical spend, noted Leclerc. “Many of our claimants who are taking mental-health medication are not reaching out for therapy . . . and we know from research that having both therapy and drug treatment is really what brings us to the best health outcome.”

She also drew attention to diabetes claims, noting plan members who claim for diabetes alone “are actually a minority,” with the majority having at least one comorbidity, including a cardiovascular or mental-health condition or both. 

“Chronic disease is also about mental health. When we’re looking at our health promotion programs and designing our benefits, we want to make sure . . . we look at it in a more holistic perspective.”

Read more coverage of the 2024 Vancouver Benefits Summit.