Genetic testing is gradually growing in popularity as some employers adopt a more preventative benefits and wellness strategy.
In its annual employee benefits report, the U.S.-based Society of Human Resources Management found 18 per cent of organizations offered genetic testing in 2018, up six per cent from 2016. It also found plan members are increasingly interested in learning about their predisposition to certain illnesses. But the new offering may present challenges for plan sponsors and insurers alike.
In another recent report, on new and emerging risks to the insurance industry, the Swiss Re Group said it expects the increasing use of genetic testing to have a high impact on life and health insurance providers in the next few years.
Most countries don’t allow for the use of genetic information for life insurance underwriting, according to the report, which noted this could lead to more people who know they have a heightened risk of disease applying for life insurance coverage at lower rates, creating an environment of adverse selection. “Customers in the know may also fear being denied life cover[age] due to some genetic conditions, leading the insured to withhold such information from the insurer,” stated the report.
A new wave of predictive tests based on polygenic risk scores by companies like 23andMe and YouSurance could further “widen the information gap between insurer and insured,” it said, noting this asymmetry will affect insurers’ ability to offer reasonably priced coverage and may “challenge the way in which insurance risk is considered and managed.” As well, genetic testing methods that are both more accurate and widely used could change the way insurers pool risk to differentiate individual risk.
However, if insurers were able to access information from genetic tests, plan member engagement could improve, with members able to access products that handle specific diagnoses and services directly aligned to their own health goals, said the report.
Kevin Dorse, assistant vice-president of strategic communications and public affairs for the Canadian Life and Health Insurance Association, said it’s too early to determine the effect genetic testing. “While this discussion is occurring among benefits sponsors and providers in the U.S., we are not familiar with instances where genetic tests are being offered as a stand-alone workplace benefit in Canada,” he wrote in an email to Benefits Canada. “It is difficult to speculate on the challenges it may present for insurers as genetic testing is still an evolving field, as is the practice of genetic tests being offered as insured benefits.”
Suzi Beckett, chief operating officer of Northern Star Benefit Consultants, says her firm has seen a growing interest in genetic testing from companies that take a proactive approach to health care. These companies tend to be the ones where employees primarily use preventative benefits, such as chiropractic services, physiotherapy and massage therapy, she notes, as well as those that provide wellness offerings and may have a higher number of younger employees, she says.
“Where it seems to be relevant or of interest is to companies that tend to advocate, and whose employees tend to follow, a more preventative health-care approach,” she says, adding companies with higher use of reactionary, treatment-based benefits, such as drug coverage, aren’t as likely to be interested.
“Even though they might benefit from genetic testing, there seems to be some reluctance in adopting that more proactive approach.”
Employers interested in genetic testing may see the long-term benefit of providing employees with the ability to prevent against diseases to which they have a genetic predisposition with healthy lifestyle choices, potentially reducing health benefits plan spending over time. As well, a subset of genetic testing, pharmacogenetics, can match employees with the drugs they need for chronic diseases or mental-health issues more quickly than a trial-and-error approach, reducing their drug spend.
“Genetic testing enters into that realm of an opportunity for employers to have a competitive benefits program and that is allowing them to stand out in terms of really advocating for their employees,” says Beckett.
However, she notes, offering genetic testing could become a double-edged sword for employers if their employees learn more than they’d bargained for.
“They might understand they have a proactive or millennial culture that tends to be about health and wellness, but . . . you might end up with, everybody jumps on the bandwagon,” says Beckett. “And really, is that information going to be positive or negative? Will it create a culture where everybody is really concerned and worried? Perhaps it’s giving them information they’re not able to deal with. I think that’s an extreme situation, but one that employers really need to think about.”
In those cases, employers may consider providing additional programs to help employees handle the information they receive from genetic testing.
“Do employers really want to enter into the space of being medical advocates?” asks Beckett. “I think there’s some danger to it, in terms of getting ahead of themselves rather than promoting an overall perspective of health and wellness.”