When it comes to benefits plan management, each case is individual, said Diana Godfrey, senior vice-president of human resources and corporate at Fidelity Canada, during a session at Benefits Canada’s 2020 Employers Cancer Care Summit on Mar. 3.
“If employers think they have a program or policy that covers every situation, they may be mistaken.”
It’s important to have a benefits plan with the underpinnings or direction that treats all employees in the same way, she noted, but employers have to understand the circumstances a person might be dealing with in a different way. At Fidelity Canada, one of the guiding principles is to handle everything with compassion, which makes it a bit easier to have conversations with managers about benefits plan coverage.
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The organization’s benefits plan is unusual in the sense that it’s traditional, said Godfrey, noting Fidelity Canada is considering moving to a flexible program. “We’re using a consultant to help us look at this. We know that we need to make some changes, but we’re not entirely sure how. We’re the sort of organization that takes slow and careful steps.”
Currently, the company offers a health-care spending account and also spends a lot of time poring over the data from its employee assistance program provider, as well as its benefits plan. Fidelity Canada has a relatively young population, she added, which makes a difference in terms of what costs look like.
Godfrey said there are two ways that cancer impacts the organization’s workforce, including employees with cancer and employees whose family members have cancer. “These family members may be here or abroad and I think this is an opportunity for employers to set themselves apart, create flexibility and have conversations.”
Like most employers, Fidelity Canada relies heavily on its independent third-party adjudicator for benefits plan management conversations. However, it also provides a service for its employees and their family members that enables them to seek a second opinion for any diagnosis or treatment. “This allows [employees and their dependants] the ability to talk to someone else, which makes them feel supported in a different way.”
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The organization also leans on its EAP and encourages employees and their family members to use the program throughout their illness. As a result, it’s seen an uptake in its third-party service and EAP, which can cause a sticky situation, noted Godfrey. “We encourage people to call, but then our usage increases and we end up with a big bill. Now, I budget for higher costs because the reality is, everyone’s more productive if they’re getting help somewhere else.”
In addition, the company approaches cancer drugs with trepidation, as it understands there could be significant impacts on the benefits plan, she said, noting Fidelity Canada has reasonable guardrails, but no gaps on cancer treatments if they’re required. “When we put limitations on our programs — and we do have some — we’ve put the limitations on things that aren’t life-sustaining. We try and implement more preventative measures and ensure there’s life-sustaining programs.”
When looking at drug plan usage, it’s important for an employer to understand the situation, said Godfrey, highlighting that chemotherapy drugs aren’t solely prescribed for cancer patients, there are other autoimmune disorders that require these drugs.
She also noted that Fidelity Canada’s drug formulary is more robust than the provincial formulary, though she acknowledged not all employers can afford to follow suit. However, because of the company’s flexibility, very little benefits plan abuse is taking place. “Employees understand the value of what they have. As we explore the idea of having a flex program, however, we don’t want to lose what we have in our current plan.”
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Currently, the company hasn’t been faced with covering diagnostic tests for cancer, but the benefit of having open conversations with employees is the opportunity to listen to them, said Godfrey. “If we find ourselves in a position where [plan members] can’t get those diagnostic cancer tests, then perhaps we would explore it. We need to think about this because it ultimately could be less expensive for us in the long term. We’re not putting it in the program automatically, but again, we’re having open dialogue with our employees.”
Annually, Fidelity Canada asks its employee resource groups to make suggestions about where they’d like charitable money donated — and cancer comes up every single time. “I don’t think there’s a person who’s not touched by cancer in some way, whether it’s themselves, a direct family member, friend or someone they work with,” she said. “What we’ve learned through this is that our programs need to incorporate the community and things that touch our employees. It all comes back to compassion.”
Read more coverage from the 2020 Employers Cancer Care Summit.