Key Conversations in Benefits 2024

Key Conversations in Benefits 2024

Once again, this year, we have compiled the top conversations in benefits, from our perspective as benefits advisors. These are the topics we heard about the most in the news, from our supplier partners, and that members of our Client Community inquired about most often.

Each year, our Key Conversations in Benefits article proves to be very popular! This year, we will cover:

1. Inflation and Rising Claim Costs
2. Health & Wellness Spending Accounts
3. Women’s Health
4. Changes to Government Coverage
5. Pharmacogenetics
6. Mental Health Supports
7. Financial Literacy

Inflation is Still Impacting Benefit Costs

While we saw interest rates decrease in 2024 multiple times, and inflation supposedly contained, benefits program renewals in 2024 still felt the impacts of increased claims due to rising costs.

The plan renewals in 2024 saw pricing based on claims experience partially from 2024, 2023, 2022, and in some cases 2021. In analyzing experience data, we saw rising costs for claims across practitioners (physiotherapy, massage, chiropractic, equipment and most notably dental claims due to fee guide increases).  Compounding this, we saw the Reasonable & Customary limits (the maximum amount reimbursed per visit) increased by insurance providers, a measure intended to cover more of the true cost of the claim. The impact of this is higher claims in dollars for a group, even if the number of visits remained the same.

The result of increased claims is often increased premiums, although, of course, this depends on the break-even mark for the insurer.

The good news? We are seeing a tapering off – at least within our block of business- of rising costs. We are hopeful that 2025 plan renewals will see more typical adjustments.

Health & Wellness Spending Accounts

Inquiries about flexible Health & Wellness Spending Accounts were more frequent than ever in 2024! The popularity of these plans is not surprising, and many employees have come to see this as a typical inclusion under an employee benefits program.

A flex spending account is a great way to address generational differences, to offer ‘more’ to certain people, or even to provide customized coverage for a particular category of expenses. For those with just a couple of employees (or, incorporated individuals) a Health Spending Account is also a great option.

For Employers, the fact that the cost is predictable is one of the most desirable features of a Health Spending Account. Because you are pre-defining the allowable total annual spending per employee, you’re able to offer flexibility and choice, but at a maximum known cost for the business.

The good news for employers is that the implementation and administration of these plans are incredibly simple, and administrative costs have remained low.

We will be putting out a “Health & Wellness Spending Account 101” in 2025 to answer all your key questions, but in the meantime, please see our website for more information. 

Women’s Health at the Forefront of Conversation

This was a topic brought up not only by our clients (we had many inquiries about fertility coverage, for example) but also the subject matter at many industry seminars this year.

In particular, the Immix Group had the opportunity to attend an event where we heard directly from those involved in the “HER” study or the “Health and Economics Research on Midlife Women in British Columbia.” The HER-BC Report – Women’s Health Research Institute

The statistics this study revealed are actually quite shocking, revealing the impacts on health and well-being for mid-life women in perimenopause and menopause. In particular, the economic impacts that were highlighted were very eye-opening to many in the room; women turning down promotions, stepping down to a lower position or leaving the workforce altogether.

The takeaways from our perspective in the benefits world? We can play a role in ensuring benefit programs offer effective support for women, in particular, mid-life women. Solutions were highlighted, including the fact that Cognitive Behavioural Therapy has been found to be a leading treatment for women experiencing the symptoms of perimenopause and menopause. Things such as CBT, hormone replacement therapy and even flexibility when it comes to the work environment, hours and required dress while on the job all play a role.

Adjacent to this are conversations surrounding fertility coverage and hormone replacement therapy, which we will detail below.

Shifting Costs back to the Government

From our perspective, potentially the most impactful conversation of 2024 was the announcement of funding from the federal government to cover diabetes medications and prescription birth control through provincial medical plans. As BC already made the move to cover birth control back in 2023, in BC these funds will be used for hormone replacement therapy medications. Additionally, BC will cover one round of In-Vitro Fertilization (IVP).

B.C. pharmacare deal will cover diabetes meds, hormone therapy | CBC News

Publicly Funded IVF Program – Province of British Columbia

This could be significant for employers; depending on your demographics and drug spending, the result could be a notable reduction in the cost of drug claims running through the Employer’s benefit program. 

We are uncertain at this point as to the drugs that will be covered; as with the April 2023 implementation of government coverage for birth control, we expect the listing of covered medications to be robust, but not 100%.

Lastly, as we’re on the topic of government coverage, the Canadian Dental Care Plan (CDCP) is now in its second year. The program received a lot of media attention due to the initial small percentage of dental offices who signed up to participate in this plan, citing concerns relating to their ability to be reimbursed quickly and fairly. With some changes- notably, to allow for direct billing to the provider SunLife- participation reached over 75% late in 2024.

Is Personalized Medicine the Future of Medicine?

It’s been many years now since pharmacogenetics first came up in employee benefits conversations. If you’re unfamiliar with the term, in short, pharmacogenetics refers to how our genes affect the way our bodies respond to medications.

According to a popular provider, Pillcheck, this “provides insights about each patient’s predicted response to various medications, enabling you to narrow the potential treatments to those most likely to be safe, tolerable, and effective for the individual.”

Personalized medicine simply means choosing or avoiding certain medications, based on your own genetic profile, with the goal of finding those that will provide you with the desired effect. What does this mean and why are benefits providers interested in this? 

We know that people often need to try multiple medications before landing on one that works well for them; this is especially true for certain drug categories, for example, medications used to treat mental health conditions. In getting straight to the drug that is most likely to work the best, there is less waste of; time, money and medications, and most importantly, improved health outcomes.

For insurance providers and in turn, employers who ultimately bear the cost of claims, covering the cost of this testing makes financial sense.

Manulife Financial has an excellent overview online, where they state: “Over the past 2 years, we ran a Personalized Medicine pilot program. After getting their results, 44% of people in the program changed their medication or dosage. These changes led to better health outcomes.”

Coverage under a benefits program is available but not common yet. Please note in most instances pharmacogenetic testing could be claimed via a Health Spending Account.

Mental Health Support Remains at the Forefront

Offering appropriate support for mental wellbeing continues to be a huge conversation – in fact, it’s woven through most other areas whether it’s drug costs/ pharmacogenetics, women’s health, financial literacy, benefits plan design, or disability claims.

We continue to see claims for mental health practitioners increase. For example, within our Pacific Blue Cross block of business, we have seen the percentage of total paramedical practitioner claims under the “Psychology/ Clinical Counsellors” benefit increase as follows:

• 2016: 5.86%
• 2018: 5.7%
• 2020: 9.29%
• 2022: 9.5%
• 2024: 11.5%

What we thought of as a ‘Covid phenomenon’ is now the routine inclusion of these practitioners in the top-five. We are encouraged to see providers expand their listing of covered practitioners in order to increase access for members, both from an availability standpoint and financially speaking.

Additionally, many benefits plan sponsors are carving out practitioner coverage in this area, offering more dollars towards mental health practitioners, acknowledging that this area not only costs more per-visit, but usually requires ongoing care, in contrast to other practitioners which may be used on a more acute basis.

We have written about how to develop a comprehensive mental health support program that utilizes an Employee & Family Assistance Program, insured coverage and flexible spending coverage, and additionally, an employer-sponsored group savings plan.

Financial Literacy, Financial Resilience and the Employer’s Role

As mentioned above, mental well-being is woven through many areas of the benefits world. Why is this? Quite simply, Employees continue to report “finances” as their number one source of stress. Explore our many articles on this topic; as we write, Employers can play a pivotal role in assisting employees in this area.

Each November, we highlight the Government of Canada’s theme for Financial Literacy Month. Fittingly, this year it was “Money on your Mind; Talk about It” acknowledging the stress, shame and embarrassment that can come with financial difficulties. Talking money builds financial confidence and leads to better outcomes; their stated goals are to “strengthen financial literacy and build financial resilience.”

This is a frequent topic of conversation for us, with Employers seeking to implement or expand Group Savings Plans, organize education sessions, and take advantage of our partnership with our sister company, Ciccone McKay Financial Group in order to provide employees with one-on-one financial planning assistance.  

Related to this, Employers reached out more than ever in 2024 to inquire about cost-sharing of employee benefits premiums. We continue to assist with making fair and logical changes that address the taxation of benefits while falling within the 50% rule followed by insurers.

That’s a Wrap for 2024!

It’s clear 2024 has brought several important shifts in the employee benefits landscape, driven by rising costs, evolving wellness needs, and growing demands for flexibility. From the ongoing impact of inflation on claims to the increasing focus on mental health support, financial literacy, and personalized medicine, benefits programs are becoming more personalized and comprehensive.

With that being said, we’re eager to see which trends will continue to shape the benefits landscape and what new developments 2025 has in store for us. In particular, we will be keeping an eye on drugs coming off patent, and the expected impact of the government taking on new medications, most notably, for diabetes.

Be sure to keep up with our monthly articles to stay updated throughout the year on the latest trends, insights, and conversations for all things employee benefits.

If you’d like to review your employee benefits program and ensure it’s in line with the latest trends and offerings, reach out today to us at info@immixgroup.ca or (604) 688-5559, as always – we love to hear from you!