Fluor Canada shares journey of move to managed drug formulary

Alongside Fluor Canada’s recent move to a flexible benefits plan, it also introduced a managed drug formulary, which includes generic substitution, prior authorization, lifetime maximums and an annual out-of-pocket maximum.

While the organization was hesitant to make the change, it knew it was necessary to help control drug costs, said Michelle Ginter, senior human resources manager at Fluor Canada, during Benefits Canada’s 2019 Calgary Drug Trends Summit on Oct. 24.

The engineering, procurement and construction company has a diverse workforce, with about 60,000 global and 2,000 Canadian employees, as well as four different business lines: energy and chemicals, mining and minerals, power and infrastructure. In Canada, employees are coast-to-coast and many aren’t based in an office environment.

Read: Important questions to consider before making changes to a benefits plan

As a result, one of Fluor Canada’s biggest challenges was educating plan members about the changes, said Ginter. “They could be up at a construction site or on scaffolding all day long with no access to a computer. How do you actually engage those employees, so they truly understand their benefits?”

The company created an app to help plan members understand their coverage. Once they receive a prescription, employees can search for the drug in the app to learn about co-insurance levels. It also provides different alternatives, with coverage on a higher or lower tier. This brings the conversation about an employee’s health right into their doctor’s office, said Ginter, adding the app allows them to engage in that conversation, determine alternatives and discuss the risks.

Currently, Fluor Canada’s sick day program isn’t linked directly to the benefits plan. So absenteeism — and making connections between absenteeism and drugs, specifically — is another area where the company struggles, she said. “Our next aspect is to look deeper into the linkage of productivity to our employment and our drug spend there.”

Read: How to use data to address workplace absence

Drugs are just a sliver of the entire health spectrum, noted Ginter, which is why Flour Canada created its People Charter, a group that looks out for employees’ mental, physical, financial and social wellness. Since it implemented the charter, the company’s incidences of disability have dropped by about 75 per cent, specifically around mental health, she added.

In terms of medical cannabis, employees can currently choose to direct their flex dollars towards coverage. “We ask our insurer to really monitor those,” said Ginter. “About every six months I ask how many claims have gone through. Is this something that’s in the interest of my employee population? Quite honestly, it’s been very low. Both for the claimants and for the amount that are going through, for now, we don’t see it as something that necessarily needs to be covered altogether.”

During the session, Ginter also noted that mental health has been a big area of discussion for Fluor Canada. It’s an especially open topic of conversation as new graduates enter the workforce. “They just want to talk about it. It’s really changing the culture within our organization, to be OK to talk about mental health.”

Read: How to use benefits to support diversity and inclusion

Ginter also spoke about Fluor Canada’s diversity and inclusion department, she said, noting the company tries to integrate this into everything it does. Since diversity and inclusion can be linked to mental health, the organization recently increased the medical practitioners covered by the benefits plan, as well as the maximums for coverage.

“We’ve also looked very closely into adding gender affirmation coverage on our plan, to just make sure that we are covering all the bases,” she said. “We haven’t yet gone down that road, but it’s very much something that’s on our radar.”

Read more coverage of the 2019 Calgary Drug Trends Summit.