{"id":1569,"date":"2024-12-27T16:26:48","date_gmt":"2024-12-28T00:26:48","guid":{"rendered":"https:\/\/immixgroup.ca\/blog\/?p=1569"},"modified":"2024-12-27T16:44:03","modified_gmt":"2024-12-28T00:44:03","slug":"key-conversations-in-benefits-2024","status":"publish","type":"post","link":"https:\/\/immixgroup.ca\/blog\/2024\/12\/27\/key-conversations-in-benefits-2024\/","title":{"rendered":"Key Conversations in Benefits 2024"},"content":{"rendered":"\t\t
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Key Conversations in Benefits 2024<\/strong><\/h2>

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.<\/p>

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

  1. Inflation and Rising Claim Costs<\/li>
  2. Health & Wellness Spending Accounts<\/li>
  3. Women\u2019s Health<\/li>
  4. Changes to Government Coverage<\/li>
  5. Pharmacogenetics<\/li>
  6. Mental Health Supports<\/li>
  7. Financial Literacy<\/li><\/ol>
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    Inflation is Still Impacting Benefit Costs<\/h3>

    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.<\/p>

    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). \u00a0Compounding 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.<\/p>

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

    The good news? We are seeing a tapering off \u2013 at least within our block of business- of rising costs. We are hopeful that 2025 plan renewals will see more typical adjustments.<\/p>

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    Health & Wellness Spending Accounts<\/h3>

    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.<\/p>

    A flex spending account is a great way to address generational differences, to offer \u2018more\u2019 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.<\/p>

    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\u2019re able to offer flexibility and choice, but at a maximum known cost for the business.<\/p>

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

    We will be putting out a \u201cHealth & Wellness Spending Account 101\u201d in 2025 to answer all your key questions, but in the meantime, please see our website<\/a> for more information.\u00a0<\/p>

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    Women\u2019s Health at the Forefront of Conversation<\/h3>

    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.<\/p>

    In particular, the Immix Group had the opportunity to attend an event where we heard directly from those involved in the \u201cHER\u201d study or the \u201cHealth and Economics Research on Midlife Women in British Columbia.\u201d The HER-BC Report \u2013 Women’s Health Research Institute<\/a><\/p>

    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.<\/p>

    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.<\/p>

    Adjacent to this are conversations surrounding fertility coverage and hormone replacement therapy, which we will detail below.<\/p>

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    Shifting Costs back to the Government<\/h3>

    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).<\/p>

    B.C. pharmacare deal will cover diabetes meds, hormone therapy | CBC News<\/a><\/p>

    Publicly Funded IVF Program – Province of British Columbia<\/a><\/p>

    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\u2019s benefit program.\u00a0<\/p>

    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%.<\/p>

    Lastly, as we\u2019re 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.<\/p>

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    Is Personalized Medicine the Future of Medicine?<\/h3>

    It\u2019s been many years now since pharmacogenetics first came up in employee benefits conversations. If you\u2019re unfamiliar with the term, in short, pharmacogenetics refers to how our genes affect the way our bodies respond to medications.<\/p>

    According to a popular provider, Pillcheck<\/a>, this \u201cprovides insights about each patient\u2019s 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.\u201d<\/p>

    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?\u00a0<\/p>

    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.<\/p>

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

    Manulife Financial has an excellent overview online<\/a>, where they state: \u201cOver 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.\u00a0These changes led to better health outcomes.\u201d<\/p>

    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.<\/p>

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    Mental Health Support Remains at the Forefront<\/h3>

    Offering appropriate support for mental wellbeing continues to be a huge conversation \u2013 in fact, it\u2019s woven through most other areas whether it\u2019s drug costs\/ pharmacogenetics, women\u2019s health, financial literacy<\/a>, benefits plan design, or disability claims<\/a>.<\/p>

    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 \u201cPsychology\/ Clinical Counsellors\u201d benefit increase as follows:<\/p>