There has been a gradual decrease in the level of satisfaction among employees when it comes to their company benefit packages, according to the latest Sanofi Canada Healthcare Survey.
But many employees would consent to their personal data being accessed by insurance carriers if it meant they would receive better coverage, according to the survey of 1,500 plan holders and 461 benefit plan sponsors.
Fifty-three per cent of employees feel their health benefit plans meet their needs extremely or very well, down from 63 per cent in 2006 and 73 per cent in 1999.
“As we’ve seen more costs for services go up, then the percentage of the co-insurance (the amount you need to pay out of pocket) also goes up, so it may feel like your benefit dollars aren’t going as far they once might have,” said Marilee Mark, vice-president of product development and integrated health solutions, group benefits, at Sun Life Financial in Toronto.
The reaction could be partly explained by results that show 60 per cent of employees feel they have an obligation to help control the costs of their health benefit plan — down from 76 per cent in 2008 and 73 per cent in 2005.
At the same time, 68 per cent feel their employer is more concerned about limiting costs than ensuring the best health benefits are available — up from 51 per cent in 2000.
Plan sponsors should better educate employees about the benefits offered, said Art Babcock, senior vice-president at Aon Hewitt in Calgary.
“Employees like the fact that it pays some costs but they tend to get more upset when something is denied or not paid fully and that tends to taint their view of benefit plans,” he said.
“(Employers) don’t tend to explain, ‘We’ve been able to pay $3 million of drug claims and we’ve assisted people to continue their income stream when they’ve become disabled and we’ve helped beneficiaries when people have passed away.’”
There was a big boost in the number of people surveyed who said they would give consent to their insurance carriers using personal claims data to provide targeted benefits. Last year, 58 per cent said this would be an idea they would accept, compared to 70 per cent this year.
“That’s something that has really changed over the years, the willingness of people to share that kind of information, because if they see that they can get the benefit by showing that kind of information, they are willing to share that information,” said Nathalie Laporte, vice-president of product development, marketing and strategy at Desjardins Assurances in Montreal. “They will get more targeted solutions and they will benefit from it.”
Human resources should be mobilized to use claims data for plan management, said Babcock.
“HR departments can build on that when they are thinking about their wellness initiatives and see how they can support that. We’ve had a look at our claims and we can’t individualize it like the insurance companies could do, but (for example) we see there is a lot of diabetic claims in our drug spend, so maybe we’ll promote education and information that would support people with diabetes.”
To best accomplish this, there has to be a trust established between employee and employer.
“There’s disconnect because the employee is going, ‘But my particulars are my particulars and I’m nervous about sharing that information because in the past, it’s been used against me,” said Smith. “Can you use the data from the underwriter — whether it’s insured or de-insured — in a confidential way that doesn’t identify individuals but allows you to be able to respond to those individual needs?”
Confidentiality must be maintained to enable that trust to flourish, said Mark.
“They have to feel that their privacy is protected, because we don’t want somebody avoiding getting a diagnosis or treatment because they’re concerned it might impact their employability or their eligibility for benefits.”
The confidence of employees allowing this is “growing because they know they have an option to opt out,” she said. “We’re all getting more used to when to give permission and not give permission — regardless of the generation.”
Chronic knowledge gap
When it comes to chronic conditions, there’s a disconnect between employees and employers, according to the survey. More than half (57 per cent) of workers said they suffer from a least one chronic condition (such as high blood pressure or depression). This number jumped to 72 per cent among those aged 55 to 64.
Employers, on the other hand, estimate 32 per cent of employees have a chronic condition.
“We’ve seen a historical gap in what the employers think chronic illness looks like and what the employees are reporting,” said Laporte. “That’s not something that you will necessarily talk about with your employer.”
Employers could probably do a better job in understanding the state of health of their workforce, said Babcock, “and that comes through sitting down with the right reports, the right advisors, to have a look at those; what are those reports telling you, what are those claims telling you?”
But having a condition doesn’t always mean a person is using drugs through the benefit plans to treat that condition. For example, some people succeed in managing high blood pressure through diet changes and “the employer might not even be aware of this,” said Mark. “Even if somebody has a chronic condition, it may not mean that they are currently being treated or using a benefit for that.”
If employers use claims data to manage plans, it might help them deliver more targeted offerings, she said.
“If we knew that you — through your claiming pattern — have or may likely have certain chronic conditions, we can offer up to you options of additional services, resources and you can choose if you want to take advantage of them or not, and a lot of that can be delivered digitally,” said Mark, and as long as it maintains the person’s privacy and it’s optional, employees will embrace it.
Flexibility key driver
Health-spending accounts (HSAs) seem to be popular, according to Sanofi. Plan members with HSAs are more likely to describe the quality of their benefit plan as excellent or very good (55 per cent) compared to those without such accounts (45 per cent)
“The one-size-fits-all really culturally doesn’t fit anymore; it’s not the way people’s brains are interpreting value,” said Darcy Smith, president of Benefit Consultants Inc. (BCI) in Calgary. “Flexibility doesn’t necessarily have to present itself in the form of a flex benefit program, as much as flexibility is about trying to meet the need of the individual or giving them the capacity to customize.”
Flexibility is getting more attention now because there are more generations in the workplace, and a simple, traditional model doesn’t meet everyone’s requirements, said Babcock.
“Employers and employees are saying, ‘Well, you know, it’s nice to have it but I think I’d like to be able to focus a bit more on the needs of my family and myself, and the plan that we have in place just doesn’t seem to give me what I need.’”
But HSAs may be too complex for some companies to consider.
“Smaller employers may say, ‘I don’t have the internal HR support to manage a plan or make decisions around a plan,’ so they tend to go for something that’s a little more simple,” said Mark. “We know we need to bring in more choice, for small plans as well as large plans.”
Plan sponsors are a bit concerned about the administration that comes along with the advent of a flex plan and the communication that’s required, said Babcock.
“The education of employees, you have to ramp that up a little bit to get employees understanding how the flex plan works.”
But things are changing, he said. “Flex plans have come a long way in terms of the ease of administration: There are programs that are very user-friendly and they give employees the ability to model their choices and see what the outcomes would be with respect to contributions requirements.”
Wellness levels plateau
While wellness programs have consistently shown positive results, such as boosting employee loyalty and employee health, the percentage of employees who say their corporate culture encourages health and wellness has dropped to 53 per cent, after reaching 62 per cent in 2012, found the Sanofi survey.
And 64 per cent of employers feel their corporate culture encourages wellness, down from 90 per cent in 2012.
The economy is to blame for some of this — especially in Alberta — said Darcy Smith, president of Benefit Consultants Inc. (BCI) in Calgary.
“When there is lots of buoyancy in the economy, there are dollars to spend and employers are a little more comfortable putting money into programs that they don’t necessarily see an immediate return on,” he said.
“It’s always been a little bit precarious on wellness initiatives because from the employer’s perspective, they want to have some way of gauging ROI and with a number of those initiatives, it’s a little harder to give actual hard data that can validate what that return on investment is.”
But promoting wellness must be a long-term investment to be successful, said Art Babcock, senior vice-president of Aon Hewitt in Calgary.
“You can’t make employees healthy in a year, or two or three; you have to develop a wellness culture over a number of years and put some effort into it before it starts to pay off.”
Conversations should take place before implementing a plan so employees’ needs are best met, said Marilee Mark, vice-president of product development and integrated health solutions, group benefits, at Sun Life Financial in Toronto.
“You can say, ‘Let’s just do a general wellness program,’ but if you really took a look at both what employees say they want, and where your expenses are going in your plan, if you could find out what are the drivers both as satisfaction, and the drivers of claims, then you could target a program.”
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