Over the last decade, the group benefits space has been all about digitizing documents and data, embracing a mobile-first mindset and urging plan sponsors and members to ditch paper and go online for a more customized experience.

The next decade will build on all of that, pushing group benefits plans into the era of hyper-personalization, thanks to new technologies like big data, predictive analytics and artificial intelligence. In addition to providing a customized experience based on data-driven personas, providers are striving to tailor hyper-relevant experiences for individual users and their evolving contexts.

Read: Creating a thriving workplace with data, personalized employee benefits

As an example, Ryan Weiss, vice-president of product and experience for group customer at Canada Life Assurance Co., refers to plan sponsors that offer out-of-country coverage, noting employees often don’t remember or realize they have it. “So if they’ve been at an airport more than 30 minutes, and/or are at a kiosk buying travel coverage, we send a one-time message to their phone that might read something like, ‘Hi, it seems you’re going on a trip. Just so you know, your employer provides out-of-country coverage. Let’s hope you don’t need it, but if you do, you can use your digital benefits card (it’s right here). Click here if you want to know more. Hope you have a great trip.’”

This level of personalization wasn’t available 10 years ago, but big data and AI are changing that. “Now we’re looking through claims data and trying to identify people most likely to take advantage of a certain service,” says Weiss.

Also, where a plan member might be trying different mental-health medications and bouncing between them, or not administering the drug correctly, Canada Life would prompt them to join its second medical opinion program to help them onto the right treatment path.

Read: Great-West Life, London Life, Canada Life to combine into one company

Over the past year, the provider has been running a pilot program with its own employees and a couple of large plan sponsors. “We’ve seen really good cost avoidance and cost saving, which goes to show, if you target the right people and bring resources to the highest use cases, you can get powerful [returns on investment],” says Weiss.

New frontiers in digital health

For David Willows, executive vice-president of digital innovation and brand experience at Green Shield Canada, the most fascinating trend right now is digital health. “With a [public] health-care system stretched to its limits, the possibility of getting evidence-based care from new avenues is quite exciting,” he says.

However, Willows notes the uptake so far has been surprisingly slow. While people have started turning to physicians online or through Skype, and are using telemedicine for a cough or if a child comes down with an ear infection, he says, “when we use mobile apps or chatbots for complex disease states, such as diabetes or chronic pain, and use targeted methods to reach the people we know have those conditions, we see low rates of engagement.”

Virtual health care
by the numbers

Just 9% of employer respondents were offering virtual health care in 2018, though 67% of employee respondents said they’d use the benefit if it was available. Indeed, 71% of Canadian workers said they’d be willing to trade their current benefits for improved access to health-care professionals.

Source: Medisys Health Group Inc., 2018

Some 60% of employers said they expect their employees will be customizing which benefits and options to purchase using their employer-provided benefits dollars by 2020, up from 43% in 2019. It also found 31% of respondents said they’re willing to launch technology pilots to support health and well-being programs. And nearly 80% said they’ll offer access to online wellness platforms or apps by 2020.

Source: Willis Towers Watson, 2019

Nearly three-quarters (74%) of plan sponsors said they’re interested in having their benefits provider send targeted health information to plan members. Meanwhile, 65% of plan members said they’d consent to receive health-related information based on their personal use of benefits.

Source: 2019 Sanofi Canada health-care survey

Willows attributes this laggard response to a lack of trust and awareness, but he hopes investments in digital health will eventually pay off, making people more proactively healthy and reducing costs to the health-care system over time.

In 2019, CAA Club Group made virtual health care available to all employees through its benefits plan.

Read: CAA Club Group adding virtual care to benefits plan

One immediate advantage of the new program is staff taking less time off for medical appointments, says Mary Duncan, the company’s chief human resources officer. “Employees also tell us they appreciate this program as it reduces their stress in many ways; for example, not having to take time off and be exposed to the risks associated with visits to clinics. Those are two wins that came through for both plan sponsors and members.”

In addition, 45 per cent of CAA Club Group’s employees have registered for the benefit since it was introduced. As of Jan. 30, 2020, more than 200 employees had used it. And so far, the return on investment, assuming one day off to see a doctor is saved in absenteeism, is a minimum of $44,000, says Duncan.

Total rewards makeover

Dawn Noordam, senior director of health and benefits consulting at Willis Towers Watson, believes the coming decade will see a modernization of total rewards, harnessed by an analytics engine. “Benefits will become much more dynamic, agile, flexible, relevant and responsive to individual needs, priorities and circumstances. Employees will be able to allocate their benefits money where they deem fit.”

Noordam likens the trend to a retail shopping experience, with the benefits marketplace designed to cater to what employees need and what they want. Employers will pay for the basics, such as health benefits and insurance, while the additional shopping dollars will help employees personalize their package. The categories for personalization will include: health (health care, drug coverage, dental, vision, health-care spending account); money (pension plans, other savings programs); protection (life insurance, critical illness, disability, accidental death and dismemberment); and lifestyle (extra vacation time, wellness, education, skills training, pet insurance, identity theft insurance and more).

Read: Willis Towers Watson introduces online shopping for employee benefits

According to a 2019 survey by Willis Towers Watson, 60 per cent of plan sponsors were offering flexible benefits plans, with that number expected to rise to 78 per cent in 2020. Almost two-thirds (60 per cent) of respondents said they expect their employees will be customizing their benefits and purchase options using their employer-provided benefits dollars by 2020.

Choice and transparency are also improving employee well-being and engagement, which helps curb costs for plan sponsors, says Noordam. “Employees spend their own money differently than they spend someone else’s so, even though the employer is contributing the . . . dollars, the onus is on employees to [choose the] products and services that mean the most to them.”

Fraud has a new enemy — big data

Benefits providers are also continuing to look for ways to help plan sponsors manage the rising costs of their plans. This includes helping employees become active consumers of their benefits plan or managing benefits fraud, says Dave Jones, Sun Life’s senior vice-president of group benefits.

Indeed, the industry agrees benefits fraud is one area where big data and AI are playing a crucial and exciting role. Sun Life is using AI to look at large datasets in near real time to draw connections between claiming patterns at a plan sponsor, member and provider level, he says. As a result, the insurer has saved employers more than $100 million in the past five years and delisted more than 2,000 fraudulent service providers.

As an employer, Manulife’s benefits claims also go through an advanced analytics tool that leverages historical and just-in-time data to flag areas of concern and check fraud, says Donna Carbell, the insurer’s head of group benefits.

Read: Head to head: Who’s responsible for detecting benefits fraud?

Of course, with big data comes big responsibility. As consumer concern — and even outrage — over data privacy grows, brands that give their customers the ability to choose what data is being collected and used will have a competitive edge.

“It’s important to remember our customers own the data, and they give us access to leverage their information to build better products and experiences for them,” says Aly Dhalla, chief executive officer and co-founder of Toronto-based fintech company Finaeo Inc. “The first and foremost piece is to be very transparent with them on what data access we require and, more importantly, why we require it.”

He suggests that providers spell it out clearly, for example: “‘This is what we collect from you, this is why we collect it and this is the value we’re going to create for you.’ And then give them the option to opt out, while explaining clearly what they will forgo if they do so.”

Companies have a corporate responsibility to establish a data philosophy and clearly articulate their stance, says Dhalla, and then allow that to surface very visually for the rest of the industry to absorb and assimilate.

However, the promising part is that, as technologies and businesses evolve, so do consumers. They’re no longer surprised by companies’ interest in their lives. According to global research and advisory firm Gartner, nearly one-third of consumers expect the companies with which they engage to know more about them. And two-thirds are willing to share personal information.

Read: Do benefits plan members want more personalized health info?

The 2019 Sanofi Canada health-care survey asked plan members if they’d like to share their personal data to make their benefits plan richer or more customized. Two-thirds (65 per cent) of respondents said they’d consent to receive health-related information based on their personal use of benefits.

But there’s a catch — they’ll only do so in exchange for some perceived value. If that value exchange, or the trust upon which it’s based, is broken, plan members will walk. The possibility of that trust being broken keeps Jones up at night. But eventually, he says, if you bring everything back to what’s in employees’ best interests, it’s a fairly easy field to navigate. 

Kanupriya Vashist Handa is a Milton, Ont.-based freelance writer.

Download a PDF of the 2020 Group Benefits Providers Report.