As technology advances and plan members’ needs become more diverse, the relationship between benefits plan sponsors and providers is adapting to fit these changes.
Sarah Beech, chief executive officer of benefits and consulting at Arthur J. Gallagher & Co., believes the trend of employees wanting more from their employers is the starting point for this evolving relationship. “They want detailed information about wellness and mental health and what’s covered for them and they look to their employers to provide that information. So the natural evolution is, employers are looking for the insurance companies to provide the required information because any single employer can’t find all of the most current solutions.”
The relationship between employers and providers is rapidly changing, agrees JP Girard, executive vice-president and head of health insurance at Green Shield Canada, noting the provider’s role is evolving to become the bridge assisting employees so they can stay healthy and productive. “Employers want solutions that address the unique needs of their workforce, including the rising need for mental-health support and digital tools. Providers that fail to adapt to these changing demands risk falling behind.”
In terms of distribution and the provision of more complex services, the changes started a few years ago, notes Jean-Guy Gauthier, expert in risk and benefits management at CQFD Actuariat. “It used to be just telemedicine that we were talking about, but now it’s more about wellness and administration services. Because of this shift, I think there’s an opportunity for more innovation in the market.”
In the last five years, Gauthier has also seen much larger, more sophisticated brokerage houses emerge. “Some years ago, consultants dealt with large employers and brokers dealt with smaller employers. Now, some of those brokers work with larger employers. They may have a different spin on a service or more innovative solutions. And if you look at that from the perspective of insurers, it’s a more complex world in which to sell their services.”
For Eric Trudel, executive vice-president and lead of group insurance at Beneva Inc., the aspect of the relationship that’s changed the most is personalization.
“I think the relationship for the first [part] of my career was more like a distinct customer/client relationship. Now I think it’s more like a true business partnership, especially with the larger clients. We work together with the plan sponsor as well as the advisor.”
Monica Warnell, manager of human resources and total rewards at Bruce Power Ltd., says the organization requires partnership relationships with its providers because “we’re not as much purchasing a product as we are coverage with a service and that service support evolves as our environment changes.
“I think of the complexity of our health landscape and how that’s everchanging with new drugs, devices, new regulatory changes [from] provincial governments. So really working . . . to be that expert, to bring evidence and clarity to plan sponsors is something that’s probably evolved in the last while.”
Both Warnell and Beech agree this evolution has led to providers becoming a one-stop shop and a hub of services beyond the traditional benefits lines. They provide access to multiple resources and vendors, says Warnell, so plan sponsors now have streamlined access to virtual pharmacy, physiotherapy and mental-health support. These services can be added to existing coverage so it provides a seamless experience for plan members.
“The ability to have this hub of new resources is incredible for developing relationships with new organizations and [plan sponsors are] able to add support through different wellness and preventative health platforms. These things make the process much more efficient for plan sponsors. We don’t have to set up a new relationship or contract with a new organization, we can offer them through these existing relationships.”
Marie-Chantal Côté, senior vice-president of group benefits at Sun Life Financial Inc., also recognizes that personalized health solutions have become more of a priority. “By offering inclusive solutions that support plan members’ unique needs and experiences, [insurers] can make a meaningful difference in employees’ lives. This includes offering things like gender affirmation coverage and family-building benefits.”
Gallagher’s latest annual benchmark survey found benefits plan sponsors are also looking for further evolution in technology and ease of use for plan members, says Beech, adding drug plan management and well-being initiatives are also priorities.
“It’s not just about the coverage anymore. There’s this paradigm shift that we talk to our [plan sponsor] clients about — benefits have traditionally helped you once you’re sick and the shift we’re talking about in the industry is how to become more proactive and preventative so people don’t actually need to use the plan when they’re sick.”
Indeed, another change in the relationship between plan sponsors and providers is a focus on prevention.
“Using the data we provide to plan sponsors to compare, we work with them to target their health services internally and what they can do to make sure their prevention, rehab and communications strategies will fit the issue and what’s needed to improve,” says Trudel. “That’s what has changed the most.”
Girard agrees, noting employers now expect their providers to offer cutting-edge insights on disease management and preventative care. “To stay ahead of the curve, providers need to develop innovative solutions that prioritize the health and wellness of their [plan sponsor] clients’ employees. This new era of employer-insurer partnership presents a unique opportunity for forward-thinking providers to establish themselves as leaders in the industry.”
From a product point of view, technology is the biggest change, says Trudel, noting it’s more about the efficient service and adding more self-serve tools. “The support from technology also goes a long way towards preventative care because before, people might not have known what [the best course of treatment was] and they would pay after the fact. Now it’s more about reducing claims by providing targeted support before it turns into a claim. That’s ultimately what plan sponsors want because they want employees to remain at work and not suffer that loss of productivity.”
To meet the evolving needs of plan sponsors and their members, Girard agrees providers need to keep pace with the changing times and technological advancements. “In the digital world, the old analog ways are no longer enough. Employees expect convenient access to their health information, easy navigation and problem-solving solutions to help them take charge of their health. In addition to employers wanting plans that are easy to manage and tailored to their employees’ unique needs, they want providers to offer in-sights on preventative care through [advancements in the technology and health-care industries].”
In addition to being an efficient way to deliver compensation to employees, Gauthier believes benefits are a way for employers to reinforce their workplace cultures.
“If, as a culture, you’re [promoting] diversity, then you’ll try to make sure you’re at the leading edge of what’s done in terms of catering to the various needs of every employee. It’s really about employers trying to have more loyalty from employees in order to build a long-term relationship with them. That really can make a difference. When an employer creates an inclusive culture and employees are enthusiastic about it, that’s a success story.”
With labour shortages prompting employers to be more competitive, Gauthier says the short-term impact is offering more pay alongside a multitude of inclusive benefits to help attract and retain talent.
Indeed, Trudel says the majority of plan sponsors are making diversity, equity and inclusion a priority internally — and they want their providers to work with them to ensure their benefits reflect these strategies. “For example, Beneva launched its gender affirmation coverage last year by working with one of its largest employers, as they requested this benefit to align with their DEI practices. We developed the product, launched it for them first and then offered it to the market. Today, we work more with plan sponsors to meet their needs, as opposed to before when it was mostly the insurer that had a product development team and those people decided what benefits to release to the market.”
Until recently, benefits plans have largely been left out of the DEI conversation, says Côté. In a February 2022 survey on integrating DEI into group benefits plans, Sun Life found only 17 per cent of respondents from diverse communities ‘strongly agreed’ their workplace plan addressed their unique needs as members of diverse communities.
“There is no one-size-fits all approach when it comes to employee health,” she says. “This is why insurers work closely with employers to offer health solutions that meet and reflect employees’ evolving and diverse needs. This can include new programs, digital tools and resources.”
For a country that prides itself on universal health care, the Canadian system leaves many families with little to no care, says Girard. “We need to prioritize the patient and build a health-care system that works for everyone. This includes focusing on the needs of those living in rural, remote and Indigenous communities, who often face additional barriers to accessing care.”
He urges all providers to create new solutions to remove these barriers and for public and private systems to collaborate to bridge the gap and ensure every Canadian can receive the care they need regardless of background or income.
“Society is constantly evolving in terms of DEI, so the industry also has to [adapt along with it],” says Beech. “This involves training on how to respectfully interact with members, how to track an individual and understand how an individual identifies themselves. It’s about being mindful and inclusive across the board, so that sort of change in the administrative process needs to be recognized.”
Sadie Janes is an associate editor at Benefits Canada.