Today’s consumer culture includes shopping online, booking vacations on smartphones and receiving recommendations for the next must-watch movie or television show based on most recent views. So it’s no surprise employees are starting to expect the same level of technology in their benefits plans and communications.
“Today’s technologies — as well as consumer expectations — have set a new bar for just-in-time information using mobile apps, on-demand videos, online chats and virtual assistants,” noted the 2018 Sanofi Canada health-care survey.
Plan sponsors, insurers and third-party administrators are all trying to provide plan members with a consumer-grade experience by throwing out the fusty old benefits booklet in favour of short, simple communications; sending employees information at the exact moment they need it and using claims data to help nudge them to healthier choices.
“When we talk about the Amazon or Netflix experience, [they] have done a phenomenal job making it easier for consumers to get what they want or what they need,” says Simone Reitzes, vice-president of global pension and benefits at Scotiabank. “If we can make it that easy for our employees to get what they want and what they need and engage with the plan, they’re going to have better outcomes and ultimately be healthier, happier and more engaged employees.”
Meeting members where they’re at
With that goal in mind, the bank developed an online navigator to help employees find the mental-health solution that was right for them. “We have a lot of resources for employees through different partnerships in the mental-health space,” says Reitzes. “But as an employee, if I’m having a challenge or am looking for help, I don’t want to read a list of vendors and what each one does, I just want help for my issue today.”
Instead of showing employees the list of mental-health services they can access, the navigator presents them with four options ranging from “I’m curious about mental health” to “I need to talk to somebody.” Each of those four links takes them to a different resource centre. “[Employees] are telling us, . . . ‘This is what I’m experiencing. This is where I’m at,’” she says. “We find employees are much more likely to click on these links that are in plain English.”
The option for plan members to learn more about mental health generally fits well with the bank’s preventative strategy, she adds. “We don’t want people only coming to look for help when they’re going through an acute issue; often we can get employees support much earlier in the process that can avoid a situation becoming that severe.”
Manulife Financial Corp. is using technology to proactively address certain diagnoses associated with a higher likelihood of taking disability leave, including mental-health issues and diabetes, where lifestyle changes can improve plan member outcomes. The insurer’s early intervention program uses data analytics and engagement tools to connect at-risk plan members with preventative-style services covered under their benefits plan, such as health coaching or its Vitality well-being app.
“It’s something as simple as giving them information on their app when they’re putting a claim in — ‘We can see this is your first claim for diabetes medication. Did you know you have this program available for you?’” says Donna Carbell, head of group benefits for Canada.
“Or it could be a reach out from a care model, which is what we’ve [done] with our pharmacogenetics [pilot project]; we’ve reached out and said, ‘We can see that you’re trying different medications to address a mental-health issue. Why don’t you try this program and see if that might help? . . . It really would be very much personalized and individual and that to me is such an exciting part of what we’ve been able to do.”
Pointing members in the right direction
Similarly, Sun Life Canada’s artificial intelligence assistant Ella asks questions to plan members while they’re using the insurer’s app or online portal, then leverages their claims data and chat history to make relevant suggestions.
“We can help plan members understand their plan [and] . . . the solutions within their plan and making that very personalized,” says Marie-Chantal Côté, the insurer’s vice-president of market development for group benefits. “We understand Canadians want access to health information and benefits information through a variety of channels that are most convenient to them. . . . That information needs to surface in a way that is optimal for plan members.”
Ella can also determine what nudges are pressing enough to send an email to a plan member, such as when they forget to finish an application for a new medical device, and which ones can wait until they log back into the app, such as information on nearby pharmacies with the lowest dispensing fees.
While the assistant connects with plan members about benefits and retirement topics, it also shares external information outside of an employer’s offerings, such as the coronavirus pandemic, says Côté. “In the first six months of the pandemic, Ella had more than two million engagements focused on [that]. This would be a very particular point in time where people would have unique needs and things they want to learn about.”
Sun Life has also noticed plan members are increasingly using Ella to find information on market fluctuations, as well as debt counselling, virtual care and mental-health services.
Dump the benefits booklet
Ryan Weiss, vice-president of product and experience for group customer at Canada Life, says it’s important to remember that nudge-style programs by insurers are just directing members to benefits or services that have long been a part of their plans.
“Those programs existed for many years, but it was up to members to be aware of them. They had to read their benefits booklet start to finish. That’s a very crude way to get people to know about [these programs]. The better way to do it is, we’ve got technology and right when that person needs that, right at that point of their life, we send them the right message to let them know [what solutions are available] and we’re connecting them to that in a very simple, easy, digital way.”
On the employer side, Scotiabank has largely done away with paper communications, revamping its communications strategy leading up to its 2020 benefits enrolment period. It developed a new campaign that emphasized easily recognizable branding, including plenty of images and simple text instead of long, text-heavy emails, says Reitzes.
When the bank sent its enrolment introduction email and intranet posting, both included a brief description and links to either learn more on a detailed information page or watch a short animated video. The campaign netted exponential growth in employee engagement, with almost 75,000 views on benefits materials during the first half of 2020, compared to just under 3,000 in 2019.
“We got really great interaction with all of the different methods of communications,” she says. “It really reminds us we have such a large and diverse work-force [and] that giving employees flexibility in how they want to learn and receive information is really powerful.”
In terms of targeted communications, insurers have typically been limited by privacy legislation and their own existing authorizations in contracts, says Lizann Reitmeier, health practice leader at Buck. “We tend to look at things in isolation; we don’t look at health claims and go, ‘Wow, it looks like that person’s using seven different drugs, that’s a disability claim waiting to happen.’”
Canada Life recently revamped its contracts with plan sponsors, which included wording that allows it to have “broader, more direct conversations with members,” says Weiss. Plan members must opt in to receive nudges through the app.
The 2020 Sanofi Canada health-care survey found 62 per cent of plan members would consent to receiving targeted health-related information from their benefits provider based on their personal benefits use. These respondents were most interested in recommendations from local health-care professionals (45 per cent), information about their medications (44 per cent), help to manage their health conditions (44 per cent) and tips on learning how to stay healthy (43 per cent).
“Members are expecting consumer-grade experiences; they’re hungry for it,” says Weiss. “If we want to improve health outcomes and keep costs contained, that relies on consumer-grade technology and communications coming to the benefits world.”
Sun Life’s plan members don’t have to opt in to speak with Ella, since she’s part of the authorization they agree to when signing up to the app or online portal. But Côté notes the company is, by nature, accessing historical plan member data in order to personalize Ella’s conversations with them and to improve the usefulness of her suggestions. “We’re very conscious of the security of that data and how we leverage the data.”
While Amazon and Netflix have been lauded as examples of successful engagement with users, tools that take that kind of approach to recommending or letting employees “shop” for benefits during the enrolment process aren’t particularly well used in Canada, says Melanie Jeannotte, Arthur J. Gallagher Canada’s national president of its benefits and human resources consulting practice.
The reason is the nature of the benefits plans provided by Canadian employers. In the U.S., employees have to re-enroll in their benefits every year and employers are more likely to offer a flexible plan, but many Canadian employees tend to enroll once in one-size-fits-all plans. According to data from Gallagher, only about 10 or 11 per cent of Canadian employers have a flexible plan.
“I think there’s a desire for that, [but] our experience is [there’s] not yet that degree of sophistication,” she says. “Most employers have their employees enroll upon hire and they don’t enroll again, so it’s not as easy to engage because we’re not forcing them into the process once a year unless you’re in a flex plan — but there’s not that many.”
Dawn Noordam, Willis Towers Watson’s senior director of health and benefits consulting and the lead of its Benefits Marketplace Canada, says these shopping models provide employees with the tools to better understand the offerings in their benefits plan and make their decisions with more confidence.
The consulting firm’s platform allows plan sponsors to provide members with a set dollar amount they can spend on benefits and other perks, such as additional dollars toward retirement savings or purchasing extra vacation days. The platform also takes into consideration employees’ age, marital status and life stage to recommend benefits they’re more likely to be interested in — for example, promoting a health-care spending account or increased vision benefits to a young, single employee who doesn’t care as much about full health benefits or extra spending on dental to a plan member with multiple dependants.
These shopping-style offerings help employees grasp the true value of the benefits provided by their employer and put their needs front and centre, says Noordam. “It’s really increasing the perceived value of the benefits and employees’ level of engagement with their benefits plan.”
Kelsey Rolfe is a former associate editor at Benefits Canada.