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These executive summaries were compiled from EMPLOYEE BENEFITS INFOSOURCE database, a source for information on employee benefits and human resources.
Time to Move Past Initiatives Around Health Awareness, Education.
Dobson, Sarah; Canadian HR Reporter; v25 no4 p 2 Feb 27, 2012; journal article
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While wellness programs are being widely adopted, Aon Hewitt finds most do not focus on trimming risk and costs. Health awareness and education initiatives are easy and inexpensive to implement. Employee assistance programs, newsletters, lunch sessions and health spending accounts were the most common initiatives among 120 employers polled. But nearly one in three of those polled did not know what health problems are driving their medical costs. Such analysis is critical, together with benchmarking costs against peer companies. Canadian companies that analyze costs focus on disability, drugs and absence from work, factors they can measure directly, and 39 percent provide online health risk assessments. Key factors affecting productivity and benefit costs which are often overlooked are job satisfaction, work autonomy and perceived stress.
[0161855]
Can Your Benefits Plan Touch Its Toes?
McFadden, Kevin; Benefits and Pensions Monitor; v22 no3 p 42 Feb 2012; journal article
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Flexibility has advantages, including in employee benefits offerings. Flexible benefit plans include modular arrangements, cafeteria-type plans and the increasingly popular healthcare spending accounts (HCSAs). HCSAs are set amounts of money provided to employees by the employer to cover medical and dental expenses. An HCSA can exist in addition to traditional coverage or replace insurance. Eligible expenses are fully reimbursable up to the amount in the account. For employers, costs are fully controlled, while employees enjoy flexible use, even for deductibles and coinsurance, expenses which are not normally reimbursed.
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Cancer Care in Canada: Opportunities and Challenges.
Balch, Denise; Benefits and Pensions Monitor; v22 no3 p 44 Feb 2012; journal article
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In 2007 cancer was the most common cause of death for Canadians, striking four of every ten. A positive sign is the development of innovative treatments including oral therapies, those administered in a doctor's office and those taken at home. However, most insurers decline infusion therapy if not in a hospital, and alternative administration methods have complicated payment arrangements, often leaving employer drug plans or the patient's family to pick up the cost. The Cancer Advocacy Coalition of Canada documented that a significant number of provinces paid little or nothing for take home cancer drugs in 2007. It is time for plan sponsors, advocacy groups and provincial health ministries to tackle the challenge of reimbursement for cancer therapy and stop cost shifting to the private sector and uninsured.
[0161831]
Decision Time.
Bauer, Gabrielle; Benefits Canada; v36 no2 pp 26-28, 30-31 Feb 2012; journal article
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A December 2011 Drug Plan Management Forum brought together insurers, employers, pharmacists, physicians and pharmaceutical industry representatives to discuss how to make drug plans more efficient. Attendees heard Mercer survey findings that over 70 percent of employers pay at least 80 percent of drug costs, including over-the-counter drugs and rarely with out-of-pocket caps or cost pooling. Plan design changes involving tiering, copayments, dispensing fee caps, generics and biologic drugs were offered as effective strategies for cost management. Lifetime specialty drug therapy for chronic diseases may be unsustainable for plan sponsors without design changes and consumer education. Key lessons include prioritizing drugs based on outcomes, educating plan members about therapeutic effectiveness and cost sharing needs, requiring prior authorization and exploring cost pooling options for underwriting biologic drugs.
[0161735]
Get Well Sooner.
Doyle, Leigh; Benefits Canada; v36 no2 pp 11, 13 Feb 2012; journal article
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The Vancouver Coastal Health Authority faced a critical staffing shortage in 2008 with insufficient applicants, high numbers of workers on disability and soaring long-term disability premiums. A British Columbia government audit led to an overhaul in disability management. Phase 1 focused on early intervention, speeding the time until first contact before a worker started disability. Within three years, this resulted in a saving of $2.5 million from productivity, absenteeism and long-term disability costs. Phase 2 focused on getting those on disability or on the edge to get back to whatever work they could do, without requiring them to be fully healthy. Critical components in the process included securing management support, having sufficient resources to handle the outreach and working with all stakeholders, including managers, unions, union members and nonmembers.
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Positioning ASO and Split Benefits Plans.
Carter, Bob; Benefits and Pensions Monitor; v22 no3 pp 22-23 Feb 2012; journal article
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Administrative Service Contracts (ASOs) can present opportunities through a customized approach. Best used for health, drug and dental components, a split plan approach pulls together best-in-class suppliers and offers flexibility, price transparency and competitive pricing. Plan sponsors have better prospects at renewal time than working with a single carrier. The additional time and cost requirements for an administrator working with two suppliers is minimal. For a variety of advantages, the ASO model and split service arrangement is worth considering.
[0161837]
Picture of Health.
Crawford, Neil; Benefits Canada; v36 no1 p 45 Jan 2012; journal article
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An Aon Hewitt study of the best employers in Canada highlights organizations with high, medium or low employee engagement levels and correlates engagement with health measures. The study found 56 percent of high-engagement organizations report better physical health, compared with 47 percent and 41 percent at medium- and low-engagement organizations, respectively. Job stress levels, days off taken for fatigue, long-term disability claims and workers compensation costs were also lower for high-engagement organizations, with corresponding cost savings. These organizations promoted a healthy workforce through onsite health activities, subsidies for fitness needs, personal health consultation and healthy cafeteria food choices. Managers who are aware of team members' health and wellbeing may be the most important factor.
[0161613]
The Joy of Coaching.
Wright, Brenda; Quint, Saul; Gordon, Neil; Benefits Canada; v36 no1 pp 28-30 Jan 2012; journal article
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Health coaching is designed to help people make and stick with behavioral and cognitive changes toward healthier lifestyles. It is individualized but increasingly delivered by coaches in call centers, as effective but much less costly than face-to-face meetings. Health coaches provide specialized expertise and insight and hold their clients accountable for progress. The coaching relationship provides for convenient, efficient and affordable services that work for the employee client and for the sponsoring employers. Getting high participation rates and engagement levels and overcoming individuals' ambivalence about change are common obstacles. Research from the U.S., Canada and other countries has demonstrated every dollar invested in wellness programs leads to $3.27 lower medical costs, $2.73 lower absenteeism costs, $4.42 saved on presenteeism costs and a 35.7 percent improvement in drug therapy compliance.
[0161625]
Shedding Weight of Workplace Health Risks.
Brown, Sue; Canadian HR Reporter; v24 no22 pp 15, 18 Dec 19, 2011; journal article
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Statistics Canada reports that 62 percent of Canadian workers are overweight or obese, making employee health a serious risk management issue for employers. These workers are disproportionately likely to be absent, generate disability and medical costs and be less engaged and productive at work. Employers can offer a variety of programs and tools to help employees manage their weight in a healthy way, including group and personal challenges which can boost morale and team spirit. Employee assistance programs and plan vendors may provide educational sessions and personal coaching. Technology can help through online progress tracking systems and simple pedometers, and workplace meetings can provide support. The Canada Standards Association and Bureau de Normalisation du Quebec established the Healthy Enterprise standard to focus on promoting employee health in the workplace.
[0161504]
New Build.
Smith, Rebecca; Benefits Canada; v35 no12 pp 53-54 Dec 2011; journal article
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Canadian workers lost 9.1 days for personal reasons in 2010, up from 8.0 days in 2000, with a similar increase in disability absences and soaring costs. This is despite the proliferation of wellness initiatives, causing employers to consider other workforce management strategies stressing prevention and intervention. Dealing with wellness and disability involves a solid foundation targeting the most significant health cost drivers, followed by prevention, accommodation and mitigation, and recovery support. The final component is integrated support involving health risk assessments, employee and family assistance programs, attendance management and targeted health benefits. Stronger case management and more effective use of metrics are essential for demonstrating and sustaining success.
[0161509]
The Complexities of Cancer.
Polk, Gordon; Ma, Johnny; Benefits and Pensions Monitor; v21 no8 pp 72-73, 75 Dec 2011; journal article
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The Canadian Cancer Society highlighted in 2009 the patchwork of coverage for cancer drugs, often leading to financial hardship for patients, and the situation was no better in 2011. Provinces vary widely in how much they cover cancer drugs, from 80 percent in British Columbia to under ten percent in Prince Edward Island. Since mid-2011, the Pan-Canadian Oncology Drug Review has been evaluating clinical and cost effectiveness of new drugs to make recommendations for consistent funding decisions. Employers can avoid unnecessary payments by rejecting claims coverable by government programs. Self-insured employers must be clear on their level of financial exposure for drug claims and consider provisions for alternate treatments, step therapy and prior authorization. Decision making must balance the health of cancer patients and the financial sustainability of the plan.
[0161543]
Absences, Resignations on the Rise.
Dobson, Sarah; Canadian HR Reporter; v24 no20 pp 1, 20 Nov 21, 2011; journal article
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Canada's employment numbers may be growing, but employee absenteeism and resignation rates are also on the rise and likely to get worse. The costs to employers are high, with 20 percent more missed days equating to an annual cost per employee rising from $1,500 in 2009 to $1,800 in 2010, about $1 million for a workforce of 500. Yet few employers are aware of the costs or have a strategy or policy for dealing with absenteeism, largely caused by personal and family stress, pressure to produce and the economy. Absences lead to higher health costs and often to resignations. The median cost for resignations for a 500-worker force rise from $1.2 million in 2009 to $1.9 million in 2010. The figures from the Human Resources Management Associations of British Columbia and Manitoba and the Human Resources Professionals Association highlight the need for strategic focus on retention and engagement.
[0161368]
Genetic Testing Will Only Continue to Grow.
Halls, John; Canadian HR Reporter; v24 no19 pp 22, 26 Nov 7, 2011; journal article
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Genetic testing is used to find genetic changes associated with inherited disorders. As testing becomes available for more and more common conditions, their private market use will expand. Genetic testing is relatively new in 2011 and it is unclear how much it is covered by public health care. The costs and effectiveness of the testing are uncertain, as is whether existing contract language is sufficiently clear on genetic testing.
[0161311]
Take Control.
MacFarlane, Leanne; Benefits Canada; v35 no11 pp 45-46, 48 Nov 2011; journal article
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According to the 2010 Annual Employer Insights Survey, more organizations are using active plan management. Active plan management begins with a design that covers the right elements, including formularies and pharmacy care services. Then employers must incentivize good behavior through value-based plan design, promotion of generic drugs, tiered drug plans and provider networks and pay-direct drug cards. Finally, the plan must be monitored and funded responsibly.
[0161372]
Battle Plan.
Smith, Brooke; Benefits Canada; v35 no10 pp 33-34 Oct 2011; journal article
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Construction materials supplier Lafarge North America was losing the battle against rising health care and drug costs. Employees failed to get basic annual physical exams and screenings and communications sent home produced little engagement or behavior change. Canadian operations saw an opportunity to adopt U.S. wellness efforts to stem disability costs. The company instituted a five-part strategy starting with a focus on healthy food, incorporating a colorful marketing approach and revamping foods available at the workplace. Other areas address physical activity, lifestyle including tobacco cessation and stress management, health screenings and counseling and measurement of the program's results. Birthday postcard reminders about screenings have already saved one person's life through early discovery of colon cancer.
[0161149]
Saving on Prescription Insurance Like a Fortune 500 Company.
Sakkejha, Yafa; Benefits and Pensions Monitor; v21 no7 pp 64-65 Oct 2011; journal article
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Ontario laws passed in 2010 could lead to higher drug costs unless steps are taken. Fortune 500 companies have a number of strategies that smaller employers can use to reduce drug costs. Identifying which pharmacies have the best rates, educating employees on the difference and incentivizing the use of preferred pharmacies are effective strategies. Another is using therapeutic alternatives, which are drug alternatives that have similar effects to patented drugs but have available generic versions. Small employers can gain negotiating power with national pharmacies by joining a buying group.
[0161286]
No Blank Cheques.
Stevenson, Helen; Benefits Canada; v35 no7 p 55 Jul-Aug 2011; journal article
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A blank check mentality has led to extreme growth in prescription drug spending. Plan sponsors can bring these costs down with a number of strategies. Requiring all drugs on the formulary to be evaluated based on clinical and cost effectiveness avoids the blank check mentality, as does mandating use of the lowest cost available product. Sponsors can build buying power by banding together. Pay direct plans save money over reimbursement plans because pharmacies can charge more when claims do not go directly to insurers. Promotion of consumerism breaks employees out of the blank check mentality and gets them to participate in lowering costs.
[0160798]
On the Radar.
Cimino, Sal; Benefits Canada; v35 no7 pp 18-19 Jul-Aug 2011; journal article
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U.S. think tank EvaluatePharma suggests that biologic drugs will make up six of the top ten drugs by 2014. Unlike other drugs, which are manufactured using easily replicated chemical synthesis, biologics are derived from living cells via complex, unique processes. According to Green Shield Canada, biologics made up 8.3 percent of total drug spending in 2005-2006 and 11.3 percent in 2009-2010. Total spending on biologics rose an average of 12.1 percent annually from 2005 to 2010. The most expensive five percent of drug plan claimants drove 40 percent of plan costs, with almost half of those costs coming from biologics, and 35- to 44-year-olds saw the highest annual cost growth thanks to biologic use.
[0160770]
Getting Employees to Butt Out for Good.
Dick, Erin; Canadian HR Reporter; v24 no12 pp 9, 11 Jun 20, 2011; journal article
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Despite restrictions on workplace smoking and smoking in general, the long-term health and cost issues of smoking remain relevant. Best practices for lowering employee smoking rates include conducting an assessment of the employee population, creating a personalized cessation program, following up on the results of the program, offering other wellness benefits and integrating the cessation plan with the overall employee benefits plan. As employee health costs rise, preventive measures like smoking cessation are increasingly important for managing a company's direct and indirect costs associated with employee tobacco use.
[0160559]
2011 Onwards: So What's the Plan?
Johannson, Joan; Benefits and Pensions Monitor; v21 no4 pp 42-43 Jun 2011; journal article
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The first decade of the 21st century was marked by a technology stock meltdown, development of guidelines for Capital Accumulation Plans (CAPs) and introduction of default investment options. Since the global economic downturn of 2008, balancing the budget has become a high priority, seen in health benefit cost sharing and investment asset-based fees. Plan sponsors are realizing they can lower administrative costs by moving older members out of group savings plans and encouraging a transition to personal pension plans, annuities or tax-free savings accounts. The Pooled Retirement Pension Plan, proposed by the Harper Government in late 2010, offers another potential arrangement serving small businesses, the self-employed and those who otherwise do not have access to a group plan.
[0160630]
Effective Absence Management Equals Comprehensive Risk Management.
Benefits and Pensions Monitor; v21 no4 p 28 Jun 2011; journal article
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The effects of employee absence extend beyond expenses related to sick or disability leave, amounting to significant potential costs. Managing absence is an aspect of risk management and starts with understanding its root causes, responding to impacts and preventing recurrence. Absence may rise not only from health issues but from the work environment, personal relationships and home and family issues. Supervisors must be alert to early signs leading to absence, the point of impairment, and ideally step in with support and accommodation to circumvent the absence. Providing coaching in a preemptive way or following inevitable time off can reduce the disruption and help the employee return to work. Reviewing claims data will help with identifying risks and spotting opportunities to intervene in preventable absences.
[0160619]
How Drug Plan Formulary Decisions Are Made.
Balch, Denise; Benefits and Pensions Monitor; v21 no4 pp 30, 32, 34-41 Jun 2011; journal article
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Prescription drugs formularies are an effective way to manage drug plan costs, yet Mercer found only five percent of plans use a restrictive formulary. Corporate plan formularies may be closed to new medications, managed to restrict access to certain medications, customized based on select criteria and coordinated with provincial formularies. All formulary details must be clearly and proactively communicated to employees, physicians and pharmacists. Restrictive formularies certainly save costs but often at the expense of patient health, with detrimental results apparent in productivity, absenteeism and presenteeism. It is crucial to balance tight control over access to medications with the long-term effects for the patient and workplace. A directory of benefit and pension consultants, included, indicates those offering health care consulting services.
[0160631]
Specialty Drugs, Biologics Have Side Effects for Employers: Soaring Costs.
Dobson, Sarah; Canadian HR Reporter; v24 no10 pp 1, 8 May 23, 2011; journal article
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According to experts the increased use of high-cost recurring and specialty drugs will lead to dramatic cost increases for employers in Canada. Manufacturers are targeting rare conditions and introducing more oral drugs that keep patients out of the public health system, and insurers are likely to respond by eliminating drug pooling. Employers will then either impose annual maximums, remove high-cost drugs from their formularies or eliminate drug coverage despite the likelihood that productivity will decrease and disability claims will increase. In the U.S., insurers see costs going down in other areas as drug costs increase. Since Canadian employers do not pay for hospital care, they need to look at the reductions in absenteeism and disability claims to see the return on investment from high-cost drugs.
[0160367]
Does Your Benefit Plan Address the Obesity Epidemic?
Sharma, Arya M.; Benefits and Pensions Monitor; v21 no3 pp 40-42 May 2011; journal article
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At the root of hypertension, diabetes and sleep apnea--conditions typically covered by health plans--is obesity. Eight percent of Canadians are severely or morbidly obese, vulnerable to costly complications and secondary illness. For those individuals, diet and exercise are rarely effective, but medically assisted procedures, including gastric bypass and laparoscopic adjustable gastric banding are. Providing oral medications and fitness programs may amount to discrimination against the severely obese. The cost of covering medical procedures typically is recouped in a short time through reduced need for medication, absence and disability leave, and increased productivity.
[0160348]
Finding Sweet Spot in Benefits Co-ordination.
Bossi, Michele; Canadian HR Reporter; v24 no8 pp 15, 20 Apr 25, 2011; journal article
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Dual career parents often each have medical and/or dental benefits available, and choosing which plan to submit claims under can be confusing. The Canadian Life and Health Insurance Association offers guidelines. A plan is the first payer for employees and second for dependents who have coverage through their own employer. For children, the primary payer is the plan with the parent member whose birthdate comes earlier in the year. For students, school or part-time job plans are the primary payers. Couples should analyze benefits and premiums under plan options and may choose to go with one plan, opting out of the other. Offering an opt-out benefit in exchange for some credit reduces an employer's insurance costs.
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