Communication breakdown between health benefit plan sponsors, providers: Survey

Only 36 per cent of sponsors regularly receive analysis of claims data

Workplace health benefit plan sponsors are ill-equipped to develop strategic health benefit plans to respond to the future needs of employees, according to the 2014 edition of The Sanofi Canada Healthcare Survey.

There appears to be a few problems in the communications between health benefit plan sponsors and providers. For one, only one-third (36 per cent) of sponsors said they regularly receive an analysis of claims data from their plan providers (insurance company or advisor) to better understand the use of their plan. A further 20 per cent reported receiving this type of information occasionally.

The second issue is that, of those who do receive this type of data, just 49 per cent use it to develop targeted improvements to their plans, found the survey of 1,502 primary holders of group health benefit plans.

"The health care of Canadians in general would benefit from further partnership, information-sharing and data analysis," said Jon Fairest, president and CEO of Sanofi Canada. "The same applies to employers and health-care benefit providers. By regrouping and setting goals to optimize health and productivity, plan sponsors will reap the returns of reduced absenteeism, improved productivity and an engaged workforce that helps drive organizational success."

Just four in 10 (40 per cent) plan sponsors said they formally track the absenteeism rate in their workplace, and only 17 per cent work formally with their insurance company or benefits advisor to analyze absenteeism or disability claims. Seventy per cent indicated they didn't know what their absenteeism rate was for last year, found Sanofi.

Eight in 10 (79 per cent) of the plan sponsors felt their plan carrier or benefits advisor should be playing a larger role in helping with their organization's wellness initiatives. When employers were asked who should be helping with overall health, wellness and prevention of disease programs for the workplace, 74 per cent said insurers or plan providers, 64 per cent looked to health-care professionals and 52 per cent to government.

"For employers, it's difficult to move past the typical initial conversations around health benefit plan cost-containment," said Fairest. "But, unfortunately, those objectives do not address employee wellness needs. A strategic approach that integrates health and wellness programs into business strategies, and one that is guided by employee data and needs, makes sense not only from an employee engagement point of view, but also as a competitive advantage."

While 78 per cent of respondents said the health benefit plan is an important factor when choosing a job (76 per cent among gen X and gen Y, 80 per cent among boomers), only 52 per cent of plan sponsors indicated that keeping employees healthy and productive is a main purpose of offering their health benefit plan.

"It is important that health-care plan sponsors and plan providers design health-care benefit plans that respond to the needs of their employee populations," said David Willows, vice-president of strategic market solutions at Greenshields Canada. "The goal of the plan should be to keep employees well, so that those involved (sponsor, provider and employee) do not find themselves with greater health costs and lost productivity."

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