Just a quarter of plan sponsors review claims data regularly: Sanofi

Just 24 per cent of plan sponsors said they regularly receive claims analyses to help identify disease states in their workplaces, according to the 2019 Sanofi Canada health-care survey.

This number rose to 31 per cent for employers with 500 or more employees and dropped to 13 per cent among small employers. It also found 22 per cent of plan sponsors receive claims analyses on occasion, followed by when requested (20 per cent) and by collecting carrier system data (five per cent). Among the 30 per cent that don’t receive this data, 47 per cent said they would have preferred to.

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“Some plan sponsors still use the terms data and analysis interchangeably. Carriers and advisors can do a better job to educate plan sponsors about the ‘so what’ in their claims data,” said Adrian Ebrahimi, account executive, corporate accounts at SSQ Insurance and a survey advisory board member. “The value is in the analysis, and plan sponsors should come to expect that.”

Only 26 per cent of plan sponsors said they regularly receive reports that help them make drug claim connections. Among those that didn’t have access to this data, 53 per cent said they’d like to.

The survey also found plan sponsors that receive data claims analyses are more likely to have a positive attitude about their health benefits plans and actively support employee health and well-being. Among employers that would like to receive this reporting, 64 per cent said they didn’t because their benefits advisor or carrier didn’t offer it. About a third (29 per cent) said there’s a lack of internal resources to help advisors or carriers pull this information together.“We are seeing a trend in [requests for proposals], where more and more information is being requested of insurers,” said Marc Bertossini, marketing director of group insurance at Desjardins Insurance and an advisory board member. “But what we are being asked to provide is not always giving policyholders what they need to create optimal benefits plans. Our role as a provider is to help policyholders identify priorities and create the best plan for them.”

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While 80 per cent of plans sponsors said they’d prefer to better understand absenteeism, less than half (43 per cent) reported tracking it formally and 39 per cent reported doing so informally.

In addition, 27 per cent of plan sponsors said they receive analyses and data regularly to understand long-term disability benefit use, while 22 per cent reported they receive it on occasion, followed by upon request (20 per cent) or by collecting data from the carrier’s system (four per cent). Among the 26 per cent of plan sponsors that don’t receive any of this data, 43 per cent said they’d like to.

Use of long-term disability benefits is a concern for more than half (54 per cent) of plan sponsors, with higher levels of concern expressed by larger, unionized employers and those in Quebec.

Almost half (49 per cent) of plan sponsors have a formal return-to-work process in place. This ranges from 69 per cent among employers with 500 or more employees to 24 per cent among employers with fewer than 50 employees. Among those without a formal process, 24 per cent said they’d like to have one.

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