Answer from Marie-Chantal Coté, Senior Vice President, Group Benefits, Sun Life

Did you know that 93% of employees said their gradual return to work was helpful? ^[1] Returning to work after a disability leave can be a challenging time for employees. Although returns are good news, it can also be stressful to reintegrate into the workplace. Employers play a key role in helping manage the return-to-work process. To help with this, employers can introduce some best practices. An effective transition plan can ensure employees have all the tools and resources to make their return smooth. Setting up return-to-work best practices can help employees better manage stress and maintain their work productivity. By assisting employees in their journey back to work, employers can help to lower the risk of relapse and improve their productivity in the workplace. Care may be different for every employee and understanding what employees need helps in building a productive workforce. With the right support, employers can increase the success of employee returns. This means employees who feel happier, healthier and more engaged at work.

[1] Healthy Returns, Supporting employees who have returned to work after a disability leave, a joint research report with Ipsos, Sun Life, 2024

Answer from Kellee Irwin, Vice-President at Orion Travel Insurance, A CAA Company

For most families, vacation time is the highlight of the year - a chance to escape the hustle of everyday life, relax, and make unforgettable memories. However, what happens when those precious moments turn into unforeseen medical emergencies?

Recently, a family vacation took an unexpected turn when their youngest member fell ill and required immediate surgery while aboard a cruise. The medical expenses, which included repatriation and treatment costs, exceeded $54,000 CAD. Fortunately, their travel insurance afforded them extensive coverage, providing crucial financial support when it was most needed.

Unfortunately, that’s not always the case.

A recent Orion survey of travelers under age 65, highlights a 19% increase of respondents who rely on their employee benefits or credit cards for travel insurance (compared to 2017). However, many are unaware of the hidden exclusions and lifetime limits that can leave them vulnerable during times of need. This provides an opportunity for employers. Including comprehensive travel insurance coverage as part of your employee benefits package not only provides employees with peace of mind and shields them from unforeseen financial burdens but also fosters a sense of security and support when they need it the most.

In critical moments, the value of reliable travel insurance cannot be understated. Comprehensive travel insurance coverage in the employee benefits package is an invaluable asset for both employees and employers. Empower your employees with the assurance of comprehensive coverage, and ensure their well-being is safeguarded at all times.

Orion Travel Insurance is expanding into the employee benefits market to protect Canadian employees with the same dedication to safety they have come to know from CAA. As an organization that consistently demonstrates its expertise, reliability, and outstanding level of care, it’s possible for travel insurance to strengthen trust between employers and employees, which is the best competitive edge employers can provide to the employee experience.

Answer from Marie-Chantal Coté, Senior Vice President, Group Benefits, Sun Life

There's so much employers can do. When it comes to women's health, including menopause, there's often the barrier of stigma. This stigma can make it challenging for employees to discuss topics such as menopause, and also seek the care they need. Did you know that 67% of women wouldn’t feel comfortable speaking to their supervisor about their symptoms? ^[1] This is where employers can step in to show their allyship.

Employers can start building in the listen, learn and act framework into their workplace health strategy. This is a great starting point to help break down barriers. Listening helps in understanding the pain points in how women's health issues like menopause affect day-to-day living. By recognizing roadblocks, employers can work with their group benefits provider to learn about benefit plan solutions. Finally, employers can act by including effective solutions and sharing resources to encourage further learning.

Solutions include revisiting benefit plan design, providing communities for networking, flexible work arrangements, education sessions and improving the office environment. The report Menopause and Work in Canada and the Menopause Inclusive Playbook, from the Menopause Foundation of Canada, are great resources. They can help employers understand the challenges women may face and how employers can take action to build a more menopause-inclusive workplace.

[1] Menopause and Work in Canada, Menopause Foundation of Canada, 2023

Answer from Corissa Androich, Senior Program Manager and Genetic Counsellor at TELUS Health Care Centres.

According to the 2023 Benefits Canada Healthcare Survey, 39% of employers are interested in adding genetic testing for disease risk to their benefit plan. ^[1] Genetics holds great potential to help employees on their health journeys, particularly in identifying personalized risks for conditions such as diabetes, cancer and heart disease, among others, which may lead to changes in screening, treatment and lifestyle.

For example, consider a scenario where someone has been found to have a result on their genetic testing associated with a high risk of breast cancer. They can work with their healthcare team to take steps to reduce breast cancer risk, which may include:

• Increased screening measures
• Consideration of medication to help reduce their risk of developing breast cancer
• Measures such as surgery to lower risk further
• Lifestyle changes to complement medical management, such as a healthy diet and regular exercise
• Personalized treatments based on their genetic information if they do develop cancer

Employers incur estimated indirect costs as high as $23,987 per employee diagnosed with cancer every year.^[2] For diabetes, the rising cost of drugs and devices led to this condition ranking first in drug categories by eligible amount in 2023.^[3]

Given these trends, genetics holds promise for insights today that can lead to a healthier workforce tomorrow. Learn more about TELUS Health’s Genetics Program.

[1] Benefits Canada Healthcare Survey, 2023.

[2] The Indirect Cost Burden of Cancer Care in Canada: A Systematic Literature Review. Applied Health Economic Health Policy. (2020). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060233/

[3] 2023 Drug Data Trends & National Benchmarks report, TELUS Health.

Answer from Véronique Tremblay, Data Scientist Responsible AI Expert at Beneva.

A new business risk, the unsupervised use of artificial intelligence (AI) can compromise the personal data of our clients, members and partners. And did you know that AI may discriminate against certain groups based on algorithmic bias?

These are important reasons for Beneva to focus on the responsible use of AI.

To address the risks, our Artificial Intelligence and Advanced Analytics team has developed a framework based on the Montreal Declaration on Responsible AI. The team takes equity, diversity and inclusion into consideration in its artificial intelligence processes and is developing tools to avoid inequities in its algorithms.

Plus, it’s important for us that all data scientists using AI at Beneva have access to a code of conduct to govern their work.

We are also educating our employees about the use of generative AI models, such as ChatGPT. One challenge: prevent the sharing of confidential information through the platform. A directive on generative AI use is in the works.

In our organization, AI allows us to be more efficient, particularly when it comes to detecting group insurance fraud and quickly processing claims. So it’s essential for us to keep this technology as a tool in the hands of responsible human beings.

This sector is evolving at hyper speed. All of our best practices help to better protect our clients, members and partners as we want - and have - to do!

Answer from Kellee Irwin, Vice-President at Orion Travel Insurance, A CAA Company

Since pandemic restrictions have lifted, we have seen a surge in Canadians travelling. Part of this is due to pent up demand but it also because the way people live, work and travel has changed.

• Due to impacts of COVID-19, people are more likely to spend money on experiences, like travel.
• New work models like remote and hybrid are here to stay, allowing many workers with the freedom to travel more.
• Employees are looking for greater work-life balance, and they are using their personal time off to travel and/or blend work and leisure travel.

However, travel has also become more complicated and expensive. Between flight delays, airport disruptions, and rising medical costs in countries like the US and Mexico, Canadians are also much more aware of the importance of having a comprehensive travel insurance plan that will have their back when they are at their most vulnerable.

This is why travel insurance now needs to play a much bigger role in a benefits package. From the Orion Travel Insurance perspective, providing a “traveller-centric” travel insurance policy within a benefits package can help build trust between employer and employee as it demonstrates that travel is valuable for their well-being. And when employees feel valued, assured, and protected, it can translate to reduced impact from disruptions and a competitive advantage for employers because employees are healthier, happier, and safer. That’s what we, at Orion, like to call a “win-win”.

Orion Travel Insurance is expanding into the employee benefits market to protect Canadian employees with the same dedication to safety they have come to know from CAA. As an organization that consistently demonstrates its expertise, reliability, and outstanding level of care, it’s possible for travel insurance to strengthen trust between employers and employees, which is the best competitive edge employers can provide to the employee experience.

How can a focused approach to disability management help companies better support employees with a return to health and work?

Answer from Olivier Pagé, Director, Group Disability Management Operations at Medavie Blue Cross

In Canada, one in five individuals experiences mental health issues each year,^[i]  becoming the primary cause of approximately 30 per cent of short- and long-term disability claims, and representing 70 per cent of total disability costs.^[ii] The economic impact stands at $51 billion annually, covering health expenses, reduced productivity, and diminished quality of life.^[iii]

As the incidence of mental health-related disability claims grows, employers face multiple direct and indirect impacts. To address this reality, fostering a workplace culture that promotes open conversations on mental health and overall well-being is crucial.

Early intervention and prevention play key roles in reducing the frequency and severity of illnesses, potentially preventing employee absences. Data from Medavie Blue Cross reveals that prioritizing proactive case management and early intervention can reduce mental health claims transitioning from short-term to long-term disability by up to 20 per cent. By integrating various types of diagnostics, we could see up to a 33 per cent reduction in transition to long-term disability.

For employees requiring time off, a focused approach to disability management can support a successful return to health and work, consisting of:

• Integrating evidence-based mental health support within health plans, pharmacy benefits, and disability coverage.
• Providing timely access to proactive support, including a range of health care professionals, to help reduce wait times.
• Offering responsive, flexible and inclusive solutions tailored to the employer working population.
• Being open to accommodation and enabling personalized return-to-work plans for a smoother reintegration into the workforce.

[i] CAMH. Mental illness and addiction: facts and statistics. Retrieved October 26, 2023 from https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics

[ii] Mental Health Commission of Canada. Workplace Mental Health. Retrieved October 26, 2023 from https://mentalhealthcommission.ca/what-we-do/workplace/

[iii] CAMH. The crisis is real. Retrieved October 23, 2023 from https://www.camh.ca/en/driving-change/the-crisis-is-real#:~:text=All%20in%2C%20the%20economic%20burden,health%2Drelated%20quality%20of%20life.

Answer from Daniel Dufour, National Senior Advisor, Best Practices, Special Projects, and Health Continuum Support at Beneva

Whether the disability is psychological or physical in nature, your organization must stay in contact with employees, barring exceptional situations like strained relationships. The manager’s role is to help them get better and foster a positive return to work. After all, a person on disability leave is still an employee. So, maintaining contact starting on day 1 of their leave is part of the best practices. The purpose of this is to build trust and rapport.

Avoiding long periods of silence is a good practice because you’ll both be working together again eventually. Helping the person get past their shame, guilt or fear of judgement will reduce their return-to-work anxiety.

This approach requires adequate preparation, which is why Beneva provides specialized tools and training to its clients. Moreover, asking open questions ensures that the person is referred to the right services. This will help prepare a sustainable return to work.

It’s also best to avoid asking the person how they are doing. Although the intention is good, it could force the person to talk about their medical condition, which is not the point. You’re there to provide support—you’re a manager, you’re not a therapist.

Finally, preparation is key for a successful return to work. Understanding the policies and services offered by the company or the group insurance plan will allow you to accompany your employee throughout this difficult period.

Answer from Laëtitia Kapps, Director – Governance, Performance, and Human Capital Development at Beneva

First and foremost, Beneva gets all its teams involved. In fact, the company recently organized an unprecedented event called The Great Consultation.

What is The Great Consultation?

It’s the consultation of all 5,400 of the company’s employees, through workshops held from June to August 2023. A total of 500 spokespersons from each workshop then gathered at a special large-scale corporate activity to discuss their findings. It’s the results of these findings that will help fuel the company's strategic planning.

Beneva is driven to do this because of its mutualist and caring values, the same core values that it wants to make visible to all. The ultimate goal of such an activity is to empower employees, give meaning to their work and motivate them to be part of something bigger than themselves.

This co-construction with employees is also a testament to the company's strong social dialogue and inclusive approach. It allows Beneva not only to better connect with its clients and partners, but provide them with personalized, caring service.

Finally, an event like The Great Consultation sets up the ideal conditions for employees to understand the issues that the company is facing. It opens lines of communication. It instills a climate of trust. It encourages employees to work together to find solutions. With engaged employees, we can build the future.

Answer from Kellee Irwin, Vice-President at Orion Travel Insurance, A CAA Company

The pandemic has increased Canadians’ awareness of the importance of having a comprehensive travel insurance plan that will have their back when they need it. Employees are asking for better protection, providing employers with the opportunity to evaluate if their current employee travel insurance program is offering the best protection.

Here are some questions to consider:

• Are you offering your employees comprehensive coverage when they travel? Review the coverage amounts and exclusions that could cause the employee to be out-of-pocket. If only providing emergency medical travel insurance, consider adding trip cancellation and interruption insurance.
• Does the product offer direct billing with international medical facilities, in the event they must seek medical treatment while they are away?
• Would the employee understand their travel protection? Transparency and simplicity are key to ensuring employees feel assured and confident.
• Do you have confidence that your travel insurance provider will take care of your employees in their time of need abroad?

With more and more employees prioritizing travel post-pandemic, travel insurance needs to play a much bigger role than as an add-on to a benefits package. Travel insurance is now truly becoming a key enabler in building and sustaining the new employee experience.

Orion Travel Insurance has ventured into employee benefits to protect Canadian employees with the same dedication to safety they have come to know from CAA. As an organization that consistently demonstrates its expertise, reliability, and outstanding level of care, it’s possible for travel insurance to strengthen trust between employers and employees, which is the best competitive edge employers can provide to the employee experience.

Answer from Alexandra Sonnenwirth, Director of Client delivery at Club Vita

Canadian excess deaths (based on pre-pandemic expectations) have increased considerably since the beginning of 2022. While they were at 5.7% in 2020, 7.5% in 2021, excess deaths reached 13.5% in 2022[1]; a far larger number than in the US (≈10% in 2022) and in England (≈6% in 2022). While the number of COVID deaths increased, so did the number of non-COVID related deaths. See chart here.

The last major wave of the COVID-19 pandemic was the Omicron wave that occurred in January-February 2022. Since then, excess deaths remained persistently high (after a brief dip in February-March). There are also some significant regional variations in excess death levels, with western Canada (BC, AB, SK) experiencing the highest levels of excess deaths (16-20% more deaths than expected). While COVID-19 is still an important driver, cause of death data suggests that other factors are contributing to excess mortality in Canada.

How much DB plans reflect these elevated levels of mortality in their future assumptions will depend on how long they are expected to continue, and whether these population level experiences are reflected in the DB pension population.

What do you think? How will you allow for this emerging picture when modeling future mortality?

For more longevity insights, visit our website.

Answer from Sandra Demers, Pharmacist Director – Pharmaceutical Expertise and High Cost Drug Management, Beneva

The patient always come first and is at the core of our decision-making. This is why we’ve assembled a team of experts to ensure prescription drugs are used appropriately and their costs are better managed. As mentioned by the Canadian Drug Agency Transition Office, “appropriate use refers to patients receiving medications appropriate to their clinical needs, in doses that meet their individual requirements, for an adequate period of time, in order to provide the greatest possible benefit, and at the lowest cost to them, their community, the health system and the broader environment.”

Sound management of drug costs includes various initiatives such as:

• A robust and efficient preauthorization program
• Optimal coordination of benefits with existing government programs
• Step therapy
• The use of biosimilars
• Product Listing Agreement

It is also important to act at various times throughout the care continuum to make a real impact with our insureds who need specific types of support.

We propose two options for plan sponsors:

• Our Preferred Pharmacy Network (except in Quebec and Alberta) ensures the sustainability of the plan by reducing the cost for preauthorized drugs, and offers support and assistance by pharmacists to major claimants to ensure an adequate framework
• Through our Support for Speciality Medications Program, our team of nurses can provide assistance to plan members who submit claims for high cost drugs.

We’re also focusing on prevention and offering services that increase access to care, such as telemedicine and an Employee Assistance Program (EAP).

Lastly, it’s important to note that major claimants are people who have specific health issues. Kindness, a pleasant customer experience and tailor-made tools (e.g. a tool that compares drug prices across pharmacies) simplifies their journey toward better health.

 *The Canadian Drug Agency Transition Office. Interim Report Addressing Appropriate Use of Prescription Medicines in Canada. An Interim Report from The Appropriate Use Advisory Committee. Health Canada 2023.

What kind of impact has biosimilar switching policies had on group insurance plans, and what can we expect in the future?

Answer from Martin Bélanger, Managing Director, Payor Solutions, TELUS Health

Thanks to data from plan sponsors detailing the claim activities of insured Canadians in 2022, the newest annual TELUS Health Drug Data Trends and National Benchmarks Report has provided excellent insights into the growing impact of biosimilar switching policies on cost trends. At first glance, we note that the savings realized by switching to less expensive biosimilars have been mostly offset by growth in higher-cost, second- and third-line therapies for diabetes. The result has been moderate overall increases in spending by private drug plans over the last three years, but with renewed potential for savings in 2023 and 2024.

The proportion of biosimilars in the biologics category give us important hints of what is to come. B.C. was the first province to launch a switching policy in 2019, and as of December 2022, biosimilars accounted for 64.7 per cent of claims for all biologics in the province. Similarly dramatic results occurred in Quebec, where the share grew to 38 per cent by the end of April 2022. By the end of that year, in lockstep with B.C., their share reached 64.8 per cent.

These policies have had a ripple effect on private drug plans, where sponsors have followed the lead of public payors in biosimilar switching. It should also be noted that other strategies exist which drive savings for plan sponsors but do not show up when looking at biosimilar uptake, such as Product Listing Agreements. Nationally, provincial switching policies have translated to significant growth of biosimilars’ share of claims in the biologics category from just 4.2 per cent in January 2019 to 32.0 per cent in December 2022. This will likely accelerate in 2023 and 2024, as remaining provinces and territories complete their transition periods.

With more than 20 years of experience, Martin Bélanger, Managing Director, Payor Solutions at TELUS Health, is an executive in the workplace benefits space supporting digital health & insurance management sectors. He is focused on leveraging technology for private and public sector payors. For more details and other key findings from the 2023 TELUS Health Drug Trends Report, visit www.telushealth.com/drugtrends2023.

Does our National and Provincial healthcare coverage do enough to solve for the infertility crisis in Canada? 

Answer from Sonia Singh, VP of Sales in Canada for Progyny.

1 in 6 couples in Canada today are struggling with infertility. Despite being a country with excellent healthcare, infertility continues to be on the rise, doubling since the 80s and becoming more prevalent than diabetes, asthma, or depression.

In fact, studies show the personal and physical nature of infertility creates ripple effects that compound negatively on a person’s overall wellbeing; 1% of women and 15.3% of men dealing with infertility meet the criteria for a Major Depressive Disorder, and 70% go into debt, adding undue stress to an already difficult journey. With such dire need to support fellow Canadians struggling with infertility, you would think National and Provincial Healthcare would provide the necessary benefit.

But the truth is, fertility is not covered under National Healthcare, and only 6 provinces in Canada offer support. Even when support is covered, it’s limited, with long waitlists and complex restrictions that make it challenging to qualify, perpetuating inequities that already exist among marginalized communities like LGBTQ+, BIPOC, and single parents by choice.

Data shows access to financial, mental, and physical support are the buildings blocks of effective fertility benefits. When provided this access, families experience 25% fewer miscarriages, and 27% higher successful delivery rate, meaning healthier pregnancies, healthier babies, and reduced financial burden for employees and employers.

Companies who want to be an organization of change in Canada and embody the diverse culture that attracts the best talent have a real opportunity to consider providing differentiated support to the fertility community through a comprehensive fertility solution.

Sonia Singh is VP of Sales in Canada for Progyny, the first and only comprehensive fertility solution to be available in Canada and is proven to consistently deliver superior outcomes that change lives and cost savings that protect budgets. For questions or more information, reach out to Sonia at Sonia.singh@progyny.com or visit go.progyny.com/canada

How did Beneva ensure the success of its biosimilar transition policy?

Answer from Christian Yared, Pharmacist, D- Pharmaceutical expertise and high-cost drug management at Beneva.

While innovation through biologic drugs has changed modern medicine, it has also led to rising drug costs. To remain sustainable, drug plans have adopted cost-control measures, such as prior authorization programs.

The arrival of biosimilars - highly similar versions of reference biologics that cost less - on the Canadian market was expected to lead to significant savings on drug plans. Unfortunately, there were obstacles to their adoption which greatly slowed down their uptake.

Since we put people first at Beneva, as soon as major provinces announced their biosimilar transition initiatives, we moved in the same direction.

First, we decided to adopt a pan-Canadian vision for our policy, to simplify our offering while ensuring optimal coordination with available public drug plans.

Next, to maximize customer experience, communication became the focal point of our efforts. This meant being transparent with our clients and partners, and providing educational material such as webinars and online FAQs.

Finally, we believe that ensuring a good patient experience by supporting them through this change also led to its success. To that end, a transition period that provided those impacted with sufficient time to adapt, coupled with online help and transparent exemption criteria, plus the involvement of our internal drug management team, made the transition process a satisfying experience.

We therefore proudly look back on this achievement and look forward to the positive impact it will have in keeping our drug plans sustainable while this policy is set to evolve with the expansion of the biosimilar market.

Where are potential strategic opportunities in emerging markets debt?

Answer from Marco Ruijer, CFA, Portfolio Manager, Emerging Markets Debt Team, William Blair Investment Management

Emerging markets debt (EMD) investors face headwinds in the last quarter of 2022, thanks to monetary tightening, geopolitical tensions, energy crises, and economic weakness in China. However, despite the uncertainty, we have a constructive medium-term view.

EMD fundamentals remain supportive despite less favorable fiscal and debt dynamics being driven by softer economic conditions, and in our opinion, emerging markets debt valuations remain compelling on both an absolute and relative basis, with spreads remaining wider than their historical levels.

Our EMD team continues to favor high-yield issuers over high-grade issuers, and remains strategically overweight in higher-yielding, frontier markets, where we believe the risk premia continue to overcompensate investors for credit risk and volatility.

However, we still see scope for fundamental differentiation among countries. Our EMD team prefers commodity-exporting countries, especially in the energy space, but remains cautious about countries with strong trade and financial links to Russia, as well as countries with strong dependence on food and energy imports.

We also continue to see opportunities in select distressed debt positions, where we believe bond prices do not reflect realistic assumptions for default risk and recovery values.

Lastly, our EMD team continues to prefer countries with easier access to financing, especially those that have strong relationships with multilateral and bilateral lenders.

How does Beneva set itself apart through its caring approach?

Answer from Martin Robert, Executive Vice-President and Leader for Talent, Culture and Communication at Beneva.

At Beneva, we opted to put people first. We want insurance to focus on people, make it more accessible and simple, and make it about what matters to them most. We’re obviously pursuing business objectives, but we want to do it for the benefit of a world where diversity, differences and the well-being of society are also taken into account.

For years now, people's psychological health and well-being have been a priority for us. The pandemic and the uncertainty it brought caused us to focus more on our health. It turns out that nearly one third of Canadians say they experienced a high level of anxiety, which is four times greater than before the pandemic began.¹

That was enough for us to decide what our philanthropic approach would focus on. We decided to tackle the growing challenge of anxiety.

We wanted to do this one concrete step at a time, by taking action across many fronts: raising awareness among people and companies, supporting research in the field but also, the research organizations themselves.

We hope this will result in better access to specialists and concrete tools for our society, customers and employees. We also ensure that this is reflected in our corporate insurance and health offers.

That’s why we developed partnerships with York University and Anxiety Canada. Research and accessibility to resources and reliable anxiety prevention and management programs will have a tangible impact on the well-being of the community.

Beneva’s goal is to demystify anxiety and thereby provide a world of caring benefits to its people.

¹ 1. Dozois, D. J. A., & Mental Health Research Canada. (2021). Anxiety and depression in Canada during the COVID-19 pandemic: A national survey. Canadian Psychology/Psychologie canadienne, 62(1), 136-142.

With burnout on the rise, how can employers best support employee wellbeing in 2023?

Answer from Daniel Martz, VP & President, Virtual Care, TELUS Health 

As we head into 2023, employees will continue to be impacted by the effects of the global pandemic and ongoing changes to hybrid, remote and onsite working arrangements. Employers cannot stand by idly and wait for this to pass but rather, they can play a more active role in supporting staff health and wellness.

A TELUS Health study conducted with the Conference Board of Canada identified an 83% gap between the extended health and wellbeing benefits Canadian employees have and what they want from their employer. Another recent survey also found that 77% of Canadians would consider changing jobs for better wellbeing support. This means there is a significant opportunity for organizations to improve on the benefits they currently provide. What can fill this gap?

Proactive health supports, in the form of wellbeing benefits, promote regular, ongoing engagement as this type of benefit is designed to nudge and support daily behaviours. By empowering employees with the tools to embrace new habits, employers have the potential to help improve health outcomes while demonstrating compassion by supporting employees in their day-to-day lives.

The time for transformation in employee benefits is urgent. Employees have faced increasing challenges over the past several years, both professionally and personally, and these have shaped the trends dominating HR conversations: burnout, the “Great Resignation” and “quiet quitting.” Developing a wellbeing strategy and providing tools that promote proactive wellness puts the power in employee’s hands to help them see improved health outcomes and better navigate these uncertain times.

¹ Séverine Degallaix, 77% of employees are ready to leave to improve their well-being”, Jobs.ca, February 12, 2020, https://www.jobs.ca/77-employees-ready-leave-improve-well/

How can plan sponsors contribute to a health culture?

Answer from Sunil Hirjee, Vice President Group Sales & Partner Experience, Beneva

As a result of the recent pandemic, organizations are much more aware of the role and opportunity they have to impact their health culture. Employers were uniquely exposed to gaps and saw that there are many different aspects to health –social, physical, financial, or mental. The focus shifted from just a benefits plan to what working conditions and support programs are in place. Measuring the effectiveness of their total health offering, employers are increasingly surveying and seeking feedback from their employees.

While all these pieces are coming together to help bring about a health culture, an important shift for employers to take is that of creating clear awareness of available services by effectively communicating throughout the organization. Not just a top-down approach, an impactful way to address health gaps at any level is to adequately train and equip front-line managers with the knowledge of, and access to the right tools needed depending on the situation. No longer about gaps in performance, an engrained health culture helps managers identify red flags and help employees keep their good health and improve their wellbeing to flourish.

So what can you, as an employer do?
Focus on how you communicate – with simplicity and a human touch
Focus on the way you communicate – by making information available and accessible when employees need it (creating a Health Hub)

By taking concrete steps, employers can ensure the concept of health and wellness are embedded in the organization’s values, at all levels.

What defines William Blair’s approach to value strategies?

Answer from Matthew Fleming, CFA, Co-Portfolio Manager, U.S. Value Equity Team, William Blair Investment Management

William Blair’s value equity team has worked together for years—even prior to joining William Blair. And one of the hallmarks of our approach is that it’s bottom-up, meaning it’s led by investment analysts. Our analysts are encouraged to challenge portfolio managers and each other. Everything is up for debate. There are no sacred cows; anything that’s in the portfolio, however long we’ve owned it, is open for discussion. We really pride ourselves on being willing to discuss anything and everything as a team.

I would also describe our process as the combination of value and quality. We’re looking for very high-quality companies that are trading at what we believe is a discount to their intrinsic value. This could be caused by several different situations—overlooking companies; misunderstood companies that are going through a transformation the market is not appreciating; or any area of potential or unrecognized value.

We think of this as finding the four-leaf clover in a field of three-leaf clovers.

To determine the quality of a business, we look for companies with differentiated products or services, very strong margins and return profiles, and very importantly, high free-cash-flow generation and low balance-sheet leverage.

Additionally, we look for empirical evidence that a company is a market leader; that companies are run by management teams that are aligned with shareholders; and evidence of superior capital allocation, both within the business and in shareholder capital—things like buy-backs and dividends.

It’s a very qualitative assessment of the business being supported by quantitative evidence.

For the diabetes category, what are the major trends in claims activity?

Answer from Shawn O’Brien, Principal, Health Benefits Management, TELUS Health 

Diabetes appears poised to overtake rheumatoid arthritis as the top category by eligible amount. This is significant since rheumatoid arthritis  has long held the number-one position, mainly due to the costs of biologic immunomodulator drugs to treat the  disease.

Claims activity for the past five years shows that diabetes drugs have steadily grown their share of the eligible amount, from 9.2% in 2017 to 12.0% in 2021. Their share of claims has climbed as well, from 6.6% in 2017 to 7.7% in 2021. This is largely due to the growing use of second-line therapies for type 2 diabetes and next-generation blood glucose monitors.

Meanwhile, inflammatory disease’s share of the eligible amount has changed little in five years, from 12.0% in 2017 to 12.6% in 2021. The gap between inflammatory disease and diabetes is now less than one percentage point. Public-plan biosimilar switching policies are expected to slowly bring down that share, further paving the way for diabetes to ascend to the number-one category.

In B.C., where we have data measuring the impact of the province’s biosimilar switching policy, private drug plans saw their share of lower-cost biosimilars soar from 7% of the eligible amount for biologics in January 2019 to 65 per cent by the end of 2021.

This information and much more is captured in the TELUS Health’s 2022 Drug Data Trends & National Benchmarks report, which considers major trends in private drug plan costs, utilization and plan management.

Download the full report from the TELUS Health Benefits Hub.

How Can You Make Your Benefits Administration System Work for All Genders?

Answer from Tewfik Madani, VP Sales & Client Management, SEB Administrative Services Inc.

Diversity, equity, and inclusion are complex and evolving matters that have been hot topics of discussion for companies for quite some time.  Although everyone in the organization has a part to play, often it’s HR that is leading the DEI strategy, training employees to learn and unlearn, and driving change throughout the organization.

SEB’s clients are HR leaders from Canada’s top companies, and they are driving change in diversity, equity and inclusivity when it comes to the employee benefits experience.  Every organization has different needs, but the desire to create an environment and experiences where all employees feel that they belong is important to many organizations.

One area of focus is the practice of collecting gender demographic data which has traditionally been required for pricing benefits or insurance.  HR leaders are working with their carriers to determine a more inclusive approach, one that is the right fit and is financially sustainable for their organization. Some organizations are implementing group insurance benefits with one “unique rate” that does not require employees to specify their gender. Others allow the employee to select “X” for gender and deploy a new rate table for gender “X”.

One-size does not fit all when solutioning this complex and ever-evolving matter. Once an approach is decided, it’s important to have a flexible benefits administration provider whose system is agile and can be configured to support these plan design changes or any solution updates, especially if there is a carrier change down the road and that carrier has a different approach.

At SEB, we understand that the employee experience will continue to evolve and drive change in benefits plans.  We built our core business around the fact that employers need flexibility, automation, and an enhanced user experience. Find out more about our solutions at www.seb-admin.com

Is the long run of growth over value over?

Answer from Ken McAtamney, Partner, Head of the Global Equity Team, William Blair Investment Management

Thus far in 2022, we’ve seen one of the most significant style rotations of the past few decades, which leads us to a discussion of equity valuations.

The general relationship between rates and valuations holds. We expect gradual monetary tightening and removal of excess liquidity—leading to further multiple contraction as rates go higher.

This has direct implications for the performance of growth equities relative to value equites, and we’ve seen this play out in 2022. Valuation as a factor has been, by far, the strongest driver of performance year-to-date.

We don’t think this means the long run of quality growth over value is over. Many of the drivers of growth’s outperformance are still in place: positive but lower economic growth, low (albeit rising) interest rates, and a competitive landscape in the real economy (which acknowledges the structural advantages of some areas of the economy as well as differentiated, innovative business models.)

But as the saying goes, the more things change, the more they remain the same. We believe the innovation and disruption cycle remains solid. The dynamic shifting of corporate winners and losers is a constant, and again, may have accelerated. Importantly, durability (or improvements in corporate competitive advantage) will likely remain underappreciated.

We’re currently in a tight labour market, and research shows that employees are looking for employers who support their total well-being. What health strategies can help small and medium-sized businesses attract and retain employees?

Answer from Michael Bradie, Vice President, Market Development, Group Benefits, Sun Life

The issue in a tight labour market is that larger businesses have the profile and resources to attract talent. In fact, that’s true in almost any business cycle. Even pre-pandemic, almost 40% of small and medium-sized Canadian businesses said they were struggling to find new workers. This figure rises to 60% for businesses requiring highly skilled workers.¹

Post-pandemic, it hasn’t gotten any easier. So, how can these businesses implement solutions to give employees what they need?

One place to start is health supports – because the pandemic has brought health care to the forefront. Many industry studies have affirmed the high value employees place on a group benefits plan. It can be a powerful tool for attracting and retaining employees. And even the most foundational of plans offer important protections that employees need and value.

For example, every plan we offer to small businesses includes Lumino Health Virtual Care. This lets employees connect with and receive care from health professionals 24/7 for their physical and mental health needs.

We also provide many free resources that support prevention and early intervention to keep employees healthy and at work. These include new tools like our Mental Health Strategy Toolkit and Musculoskeletal Toolkit. These can help employers in a variety of industries support employee health and avoid worsening conditions and time off work.

We’re all feeling the effects of the pandemic and need to take care of our mental health. We’ve recently added low-cost mental health prevention support to our virtual care offering. It provides unlimited counselling sessions for employees with emerging mental health issues. And our free manager mental health training video series can help people managers better support the mental health of their direct reports. They teach managers to recognize mental health issues, communicate effectively with their teams, and address stigma around mental health.

While smaller businesses are the engine of our economy, many don’t have the dedicated internal resources of larger employers. For this reason, these free and lower-cost resources can be a critical support. And in terms of overall affordability, plans can always be tailored to the budget needs of the business. No matter the size of the business, there are options to help support the well-being of its team. Sun Life is committed to being your partner in health. We want to provide benefits plans and resources that help employers support the total well-being of their employees and be an employer of choice. Visit our website to learn more.

¹ 2018 Indeed/Censuswide survey

The World Health Organization has identified myopia as a significant public health concern. What is myopia and should plan sponsors be concerned?

Answer from Deborah Jones, Clinical Professor, School of Optometry and Vision Science, University of Waterloo, Ontario

May 23rd to 27th is Myopia Awareness Week. Myopia (nearsightedness) occurs when light entering the eye is not focused properly on the retina, typically because the eyeball is too long. Myopia affects nearly 30% of Canadians. Uncorrected myopia results in blurred vision at distance with close objects being clear.

Myopia typically starts in childhood and continues to increase in severity until the age of 20. There are options available to slow down myopia (spectacles, contact lenses and eye drops). Early intervention results in better uncorrected vision and reduces the risk of sight threatening conditions such as glaucoma, retinal detachment, and retinal degeneration.

Optometrists are concerned about rising rates of myopia. Without effective intervention, myopia is expected to affect 50% of the global population by 2050; up from 28% in 2010. Myopia is occurring at earlier ages and those under 20 are most at risk for high myopia which can lead to sight threatening eye diseases. Myopia needs to be diagnosed and managed early.

While some risk factors like family history cannot be avoided, lifestyle changes, early detection and management can significantly improve outcomes. Plan sponsors can help by educating employees, particularly those with children, on the value of regular comprehensive examinations and early management of myopia. They can also promote the benefits of increased time spent outdoors and reducing screen time, engaging in healthy and fun lifestyle activities the whole family can enjoy.

To find out more about how to design a balanced vision care plan or to book a meeting, contact the Canadian Association of Optometrists at info@opto.ca. You can also find more information on modernizing vision care at https://dontlosesight.ca.

How does impact investing seek to support Sustainable Development Goals?

Answer from Monika Freyman, Vice-President, Sustainable Investing, Addenda Capital

Impact investing is an approach that features the intent to achieve positive, measurable social and/or environmental impacts alongside a financial return. Such is the definition championed by the Global Impact Investing Network, the key industry group helping develop standards and methods. Many impact strategies focus on the United Nations’ Sustainable Development Goals (SDG). However, the financing gap to meet these needs in developing countries has increased dramatically as a result of COVID-19, jumping from US$2.5 trillion annually to an estimated US$4.2 trillion, according to the OECD. The pandemic has made it even more critical for private capital to allocate to these goals.

Financial returns and goals vary depending on how an impact strategy is developed. For some strategies, expected returns may be lower than the benchmark. For others, including Addenda Capital, the approach aims to provide returns that are comparable to those in the market.

Impact investing is different than environmental, social and governance (ESG) integration which does not tend to have the intent to track positive measurable impacts. Rather, ESG integration looks to consider a broad list of E, S and G factors to improve risk/return outcomes and often features active engagement with companies on these issues to drive positive change.

In other words, impact investing is more intentional, with associated key performance indicators (KPI) reporting.

Originally, impact investing began to grow through private equity and venture capital asset classes focused on themes such as micro-lending, financial inclusion and numerous other areas inspired by the massive gaps in meeting the UN’s Sustainable Development Goals. It has since more actively been applied to a greater number of asset classes including fixed income and public equities.

At Addenda Capital, broad themes in which we invest to make an impact are climate change, health and wellness, education, and community development. The firm has also included Indigenous economic opportunities in its focus areas. The quest to effect change is what led Addenda Capital to also create its Impact Fixed Income Fund, whose goal is to address modern-day challenges while seeking to meet the needs of clients.

To learn more about our sustainable investing solutions, visit our website.

It’s Mental Health Awareness Week. How can employers help support the mental health of their globally-mobile employees?

Answer from Nancy Brown, Director, Voyageur Global Benefits

For globally-mobile employees, Mental Health Awareness Week is especially relevant – it amplifies the need for employee benefits plans to help support their evolving state of mental health. The impact of COVID-19 on working conditions has entirely transformed the way we understand the psychological and emotional well-being of this unique employee population.

According to MetLife’s most recent Trends Study, 71% of globally-mobile employees feel their employers have a responsibility for their mental health.¹ This highlights the importance of providing a benefits package that supports their mental health on top of their physical health and safety.

As their need for mental health support rises, globally-mobile employees are turning to their employers for a more comprehensive offering. Here’s a list of five services employers should look for when building a benefits plan:

Health and wellness toolkits — Provides everything employers need to promote, launch and distribute robust health and wellness campaigns among their global workforce.

International Employee Assistance Program (IEAP) — Telephonic or face-to-face counselling by counsellors who have been a part of the global workforce themselves can help globally-mobile employees navigate through the challenges of living and working abroad.

Telemedicine – Accessing a doctor remotely adds safety and convenience by eliminating the complexity of seeking in-person medical assistance while abroad.

Online wellness tools — Educational information, self-help tools and articles that help globally-mobile employees manage their health.

Grief Counselling² — Professional counsellors help globally-mobile employees and their families navigate major life changes or cope with loss.

Voyageur Global Benefits offers these services – and more.

¹MetLife’s 19^th Annual Employee Benefit Trends Study, 2021.

²Grief Counselling Services are provided by a vendor not affiliated with Voyageur Global Benefits (VGB), and the services provided are separate and apart from the insurance provided by VGB. The vendor’s network of Counsellors have master’s or doctoral degrees and are licensed professionals. The Grief Counselling program does not provide support for issues such as: domestic issues, parenting issues, or marital/relationship issues (other than a finalized divorce). For such issues, members should inquire with their human resources department about available company resources. Events that may result in a loss are not covered under this program unless and until such loss has occurred. This program is available to Employees and their family members, as well as to beneficiaries at the time of a death claim. Family members are defined as an Employee’s lawful spouse, domestic partner, natural child, adopted child, and stepchild. Services are not available in all jurisdictions and are subject to regulatory approval.

Voyageur Global Benefits is a Canadian group insurance benefit program that is governed by the laws of Canada and that is underwritten by The Empire Life Insurance Company, an insurance company domiciled at 259 King Street East, Kingston, ON K7L 3A8. Empire Life is the Canadian insurance company that provides the benefits under the insurance policies it issues. Voyageur Global Benefits is administered by Delaware American Life Insurance Company (MetLife Worldwide Benefits), a MetLife, Inc. affiliate domiciled at 600 North King Street, Wilmington, DE 19801, U.S.A., and MetLife Worldwide Benefits has agreed to provide administration services to Empire Life with regard to Voyageur Global Benefits. 

L0422021531[exp0623][CAN] © 2022 MetLife Services and Solutions, LLC.

What does net zero investing involve?

Answer from Roger Beauchemin, President and CEO,  Addenda Capital

Net zero investing is about listening to the science, which has never been clearer. When an investment firm commits to net zero investing, it means that its approach aligns with the goal of a net zero emissions society by 2050 as countries seek to limit warming to 1.5 degrees Celsius.

There are a few ways to align portfolio assets with net zero ambitions. One way is to select companies that are taking specific steps to actually reduce their emissions in accordance with science-based targets. For an investment firm, this also involves engaging with these companies as they work to achieve their reductions goals. Another way could include divesting from certain sectors to various degrees, while another may feature a blend of different strategies.

Addenda Capital is one of the Canadian firms that joined the Net Zero Asset Managers (NZAM) initiative, committing to work with clients on decarbonization goals. We have also launched two climate transition equity funds. The strategy, which revolves around the selection of companies that have adopted clear reductions targets, includes gradually reducing the portfolios’ carbon footprint to lower levels relative to their benchmarks, strengthening selection criteria over time and practicing stewardship.

We need to use the portfolio as a fulcrum to decarbonize the real economy. In addition to supporting the economy, it is helpful to our clients’ portfolios because it allows us to calibrate risk. As investment managers, we are the stewards of our clients’ assets and our goal is to generate compelling financial returns and help them achieve their objectives.

To learn more about sustainable investing solutions, visit our website.