Canadian Treasurer

June 3 , 2015

Employers with health benefit plans question the value of their plans

Toronto, ON--Organizations that offer health benefits to their employees are looking for more information and analysis regarding their plans, says the 2015 edition of  t he ‘Sanofi Canada Healthcare Survey’. Seventy-two per cent desire better reporting/evaluation of the ROI of their health and wellness program; 76 per cent want a better understanding of how their benefit plan affects health outcomes, productivity and absenteeism; 62 per cent want a better understanding of their claims data; and 68 per cent want a better understanding of connections between claims and utilization of programs. 

"It's encouraging that plan sponsors are looking for more information in these areas. It tells us there could be an appetite to do more, which we really haven't seen before," says   Marilee Mark, vice-president, market development, at Sun Life Financial and a member of the advisory board for   the survey.

"Through   the Sanofi Canada Healthcare Survey, we are happy to help the industry make important connections between health benefits, wellness and chronic disease management," says   Jon Fairest, president & CEO, Sanofi Canada. "It is necessary to make these links so they can offer effective and sustainable programs. The benefits of good health go beyond reducing costs. We know that healthy, happy individuals are more satisfied in their personal lives and more productive in the workplace. It just makes good business sense."

The Link with Chronic Disease

The survey reveals that plan sponsors and plan members are not making the link regarding their plans and the prevalence of chronic disease in the workplace. While plan sponsors estimate that about one-quarter (26 per cent on average) of their workforce has a chronic condition, more than half (56 per cent) of plan members indicate they have such a condition. Such a gap between perception and reality raises questions about the ability of traditional plan designs to support best health outcomes – as well as a meaningful return on investment for employers. "Employers underestimate the prevalence of chronic disease in their workplaces and they underestimate the positive impact they can have on employee health," states   David Willows, advisory board member and vice-president, strategic market solutions, at Green Shield Canada.

"Right now there is clearly a disconnect between traditional plans and what will be required in the workplace due to chronic disease. Plan designs require more strategy along the lines of health and productivity," adds board member Nathalie Laporte, vice-president of product development and marketing, group and business insurance, at Desjardins.


On the wellness front, 45 per cent of employers report offering programs or support for health and fitness (such as weight-loss programs, fitness challenges), a finding that has not changed much since first explored in 2012. Among employees who say they have access to such programs, 34 per cent say they definitely (11 per cent) or somewhat regularly (23 per cent) participate – unfortunately, participation is even lower among employees who describe themselves as being in poor or very poor health (30 per cent), and 39 per cent do not participate at all. Clearly wellness offerings, as with health benefits, need to be considered in a new light in order to encourage use by those who need it most.

Making the connection

Most plan sponsors regard benefit plans as a form of compensation or reward (39 per cent), or as a cost of doing business to be competitive (26 per cent). Almost a third (31 per cent), meanwhile, indicate they make the connection between healthy employees and healthy businesses – which is the right approach, says the advisory board. "Managing health becomes as important as managing turnover, competitive compensation, etc.," says   Serafina Morgia, senior consultant at Towers Watson. "We can reshape how to use benefits dollars more effectively – for example, so that dollars can be put toward health risk screenings."

Such non-traditional benefits as screenings or one-on-one wellness coaching are also good for business because "they reduce the risk of much higher benefit costs down the road through the early detection of chronic diseases and risk factors," adds Dr.   Alain Sotto, occupational medical consultant at Toronto Transit Commission (TTC) and director of Medcan Wellness Clinic.

Paramedical services

The survey shows that almost half  (47 per cent) of plan members submitted at least one claim for paramedical services in the past year, and those that did submitted a total of 7.3 claims on average – a frequency second only to prescription medications (9.5). While paramedical services can help make the connection between health productivity for those suffering from injury or chronic pain, their level of use may suggest the need for eligibility based on clinical criteria rather than self-perceived needs. "When you consider the disability issues in some workplaces and the issues around specialty pharmaceuticals, which can be life-changing for plan members, the cost and use of some paramedicals just don't seem to make sense," says   Paula Allen, vice-president of research and integrative solutions at Morneau Shepell.

Collaboration and information sharing between insurance carriers, benefits advisors, and other stakeholders are vital to such an evolution in health benefits and wellness offerings. "We can see a desired shift toward supporting employees more on health and wellness, but until the components are better defined it's hard to move beyond the focus of traditional plan design. We need to identify the obstacles before we can overcome them, and what feeds into this is deeper data analytics," notes   Ben Harrison, director of group strategic relationships at Great-West Life.

*  Plan sponsors = employers

Other findings:

  • Three-quarters (77 per cent) of plan members say they would not move to a job that did not include health benefits.

  • Drug (94 per cent), dental (basic 92 per cent; major 83 per cent) and vision care (89 per cent) remain the most valued components of health benefit plans according to plan members.

  • When offered a list of seven possible new health benefits, plan members were most likely to select onsite health risk screenings (45 per cent), followed by onsite immunizations for infectious diseases (40 per cent).

  • 85 per cent of plan members say they have one or more health or fitness goals – and one in five (21 per cent) reports that their workplace is a barrier to reaching those goals.

  • Less than half (47 per cent) of plan members indicate they will definitely or most likely purchase private health benefits when they retire.





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